You're performing an abdominal assessment on Brent who is 52 y.o.

In which order do
you proceed?
A. Observation, auscultation, percussion, palpation
B. Percussion, palpation, auscultation, observation
C. Palpation, percussion, observation, auscultation
B. Percussion, palpation, auscultation, observation

While palpating a female client's right upper quadrant (RUQ), the nurse would expect to
find which of the following structures?
A.Sigmoid colon
B.Appendix
C. Spleen
D. Liver

A female client being seen in a physician's office has just been scheduled for a barium
swallow the next day. The nurse writes down which instruction for the client to follow
before the test?
A. Fast for 8 hours before the test
B. Eat a regular supper and breakfast
C. Continue to take all oral medications as scheduled
D. Monitor own bowel movement pattern for constipation

Which diagnostic test would be used first to evaluate a client with upper GI bleeding?
A. Endoscopy
B. Upper GI series
C. Hemoglobin (Hb) levels and hematocrit (HCT)
D. Arteriography

A patient complains about an inflamed salivary gland below his right ear. The nurse
documents probable inflammation of
which gland/s?
A. Buccal
B. Parotid
C. Sublingual

Parotitis caused by bacteria is treated with which of the following drug classifications?
B. Corticosteroids
C. Antipyretics
D. Antibiotics

Which of the following are the possible causes of sialadenitis? Select all that apply.
A. Dehydration
B. Stress
D. Improper oral hygiene
A patient asks, "Is surgery always the treatment of choice for inflamed salivary glands?"
Your best response would be:
A. Yes, surgery is always the answer.
B. Surgery is only recommended for children.
C. Elderly is not a candidate for parotidectomy.
D. The procedure is advised for chronic sialadenitis and
uncontrolled pain.

Which of the following conditions described as presence of calculi in the salivary glands?
A. Parotitis
B. Sialolithiasis
C. Sialadenitis
D. Mumps

Which of the following medical management is recommended for salivary calculus?

A. Lithotripsy
B. Antibiotic therapy
C. Nephrectomy
D. Endoscopy

A certain patient will undergo a barium swallow, as a nurse, she is knowledgeable that
the other name of the diagnostic procedure is:
A. upper gastrointestinal fibersocopy
B. barium swallow
C. liver biopsy
D. barium enema

A certain organ that belong to the vital accessory which is considered to be the largest
organ that can be found in the gastrointestinal system that metabolizes that fats,
carbohydrates and even foods as well as the fluids.
A. gallbladder
B. none of the choices
C. liver
D. pancreas

Dr. Sol, the attending physician of Ms. Pamela ordered her to undergo a CT-scan, and the
result revealed that she has a fluid in her abdomen. Dr. Sol, decided to perform the
paracentesis to her. As a nurse, all of the following are not true about paracentesis
except one:
A. it is a procedure that involves the removal of fluid into the
stomach
B. it is a procedure that involves the introduction of barium sulfate into the patient.
C. it is a procedure wherein it involves the removal of fluid within the lungs.
D. none of the choices.

how many hours that the patient will be on NPO who will undergo uppergastrointestinal
fiberoscopy. Her answer is correct if her answer in the exam is:
A. none of the above
B. ideally the patient should not eat for about 10-12 hours before the procedure.
C. the patient should be at NPO for about 48 hours
D. the patient should be at NPO for at least 6-10 hours
Which of the following is the priority for the patient who will undergo upper
gastrointestinal fiberoscopy?
A. provide rest
B. prevent injury
C. maintain patent airway
D. minimize pain

In the gastrointestinal system, it is said that it has two process such as digestion and
elimination. As a nurse, you are aware that the process of elimination is done of what
kind of process?
A. elimination with regards to the gastrointestinal system is done through sweating
B. elimination with regards to the gastrointestinal system is done
through defecation
C. elimination with regards to the gastrointestinal system is done through urination.
D. all of the choices.

In the dengue ward of the hospital, majority of the patient will undergo stool
examination. In conducting a stool examination, as much as possible it should be NCCF.
What does abbreviation NCCF means?
A. no colored chocolate food
B. now chocolate colored food
C. no chocolate colored food
D. letter a and b only

On that day of examination, she encounter a question that talks about a certain
diagnostic procedure which is upper gastrointestinal firberoscopy. All of the following are
not correct description about that kind of diagnostic procedure except one:
A. the patient will be sedated wherein an endoscope is inserted
from the mouth down into the esophagus.
B. it has other name which is barium enema
C. an endoscopy will be directly inserted into the abdomen of the patient.

While having a tour in the laboratory that is intended for the gastrointestinal system, she
saw another patient who is a candidate for a lower gastrointestinal tract study. Ms.
Pamela is knowledgeable that the kind of procedure is:
C. barium enema is the other name of lower gastrointestinal tract study.

Which of the following statement is correct that refers to the gastrointestinal system?
A. it talks the process of digestions.
B. the process of elimination with regards to the process of gastrointestinal system is
done through excretion of sweats.
C. it involves the process of elimination through defecation as well as urination.
D. none of the choices

After the procedure of barium swallow, what medication that you are going to anticipate
that the physician will prescribes?
A. anti-diuretics will be given to the patient.
B. all of the choices
C. the physician will ordered anti-hypertensive medication.
D. laxatives will be given to the patient who undergo barium
swallow.

It is one of the segment of the large intestine that is located at the top of the small
intestine that passes horizontally across the abdomen and below the liver, stomach and
spleen
A. descending colon
B. rectum
C. ascending colon
D. transverse colon

Dr. Marky instructed Ms. Pamela to give nursing instruction to the patient before he/she
will undergo a barium swallow. She is correct if her appropriate instruction to the patient
before the diagnostic procedure is
A. instruct the patient to have a high fat diet
B. obtained informed consent to the patient
C. assess the vital sign of the patient
D. remind the patient that he/she will undergo a cleansing enema

Acute gastritis is often caused by:

A. Ingestion of strong acids
B. Irritating foods
C. Overuse of Aspirin
D. All of the above

Which of the following definitions best describes gastritis?

A. Erosion of the gastric mucosa
B. Inflammation of a diverticulum
C. Inflammation of the gastric mucosa
D. Reflux of stomach acid into the esophagus

Which of the following substances is most likely to cause gastritis?

A. Milk
B. Bicarbonate of soda, or baking soda
C. Enteric coated aspirin
D. Nonsteriodal anti-imflammatory drugs

The nurse is caring for a client with chronic gastritis. The nurse monitors the client,
knowing that this client is at risk for which of the following vitamin deficiencies?
A.Vitamin A
B. Vitamin B12
C. Vitamin C
D. Vitamin E

The nurse is reviewing the medication record of a client with gastritis. Which medication,
if noted on the client's record, would the nurse question?
A. Amoxicillin (Amoxil)
B. Indomethacin (Indocin)
C. Lansoprazole (Prevacid)
D. Clarithromycin (Biazin)

Which of the following treatments should be included in the immediate management of

acute gastritis?
A. Reducing work stress
B. Completing gastric resection
C. Treating the underlying cause
D. Administering enteral tube feedings

Which of the following risk factors can lead to chronic gastritis?

A. Young age
B. Antibiotic usage
C. Gallbladder disease
D. Helicobacter pylori infection

Which of the following factors associates chronic gastritis with pernicious anemia?
A. Chronic blood loss
B. Inability to absorb vitamin B12
C. Overproduction of stomach acid
D. Overproduction of vitamin B12

Which of the following measures helps relieve pain to a client with gastritis?
A. Avoid foods and beverages that may be irritating to the gastric
mucosa.
B. Monitor fluid intake and output daily to detect early signs of dehydration.

A patient with gastritis is nauseated and vomited 10 times at home, which of the
following nursing diagnoses is appropriate for this patient? Select all that apply.
A. Acute pain related to irritated stomach mucosa
B. Anxiety related to treatment
C. Imbalanced nutrition, less than body requirements related to inadequate intake of
nutrients
D. Risk for imbalanced fluid volume related to insufficient fluid
intake and excessive fluid loss

Michael, a 42 y.o. man is admitted to the med-surg floor with a diagnosis of acute
pancreatitis. His BP is 136/76, pulse 96, Resps 22 and temp 101. His past history includes
hyperlipidemia and alcohol abuse. The doctor prescribes an NG tube. Before inserting the
tube, you explain the purpose to patient. Which of the following is a most accurate
explanation?
A. "It empties the stomach of fluids and gas."
B. "It prevents spasms at the sphincter of Oddi."
C. "It prevents air from forming in the small intestine and large intestine."
D. "It removes bile from the gallbladder."

Jason, a 22 y.o. accident victim, requires an NG tube for feeding. What should you
immediately do after inserting an NG tube for liquid enteral feedings?
A. Aspirate for gastric secretions with a syringe.
B. Begin feeding slowly to prevent cramping.
C. Get an X-ray of the tip of the tube within 24 hours.
D. Clamp off the tube until the feedings begin.

Stephanie, a 28 y.o. accident victim, requires TPN. The rationale for TPN is to provide:
A. Necessary fluids and electrolytes to the body.
B. Complete nutrition by the I.V. route.
C. Tube feedings for nutritional supplementation.
D. Dietary supplementation with liquid protein given between meals.

Your patient has a GI tract that is functioning, but has the inability to swallow foods.
Which is the preferred method of feeding for your patient?
A. TPN
B. PPN
C. NG feeding
D. Oral liquid supplements

An intubated patient is receiving continuous enteral feedings through a Salem sump tube
at a rate of 60ml/hr. Gastric residuals have been 30-40ml when monitored Q4H. You
check the gastric residual and aspirate 220ml. What is your first response to this finding?
A. Notify the doctor immediately.
B. Stop the feeding, and clamp the NG tube.
Situation: Mrs. Dela Cruz was admitted in the Medical Floor due to pyrosis, dyspepsia and
difficulty of swallowing. Based from the symptoms presented, Nurse Melinda might
suspect:
A. Esophagitis
B. Hiatal hernia
C. GERD
D. Gastric Ulcer

Situation: Mrs. Dela Cruz was admitted in the Medical Floor due to pyrosis, dyspepsia and
difficulty of swallowing. What diagnostic test would confirm the type of problem Mrs.
Cruz have?
A. barium enema
B. barium swallow
C. colonoscopy
D. lower GI series

Situation: Mrs. Dela Cruz was admitted in the Medical Floor due to pyrosis, dyspepsia and
difficulty of swallowing. Mrs. Dela Cruz complained of pain and difficulty in swallowing.
The terms are referred as:
A. Odynophagia
B. Dysphagia
C. Pyrosis
D. Dyspepsia

Situation: Mrs. Dela Cruz was admitted in the Medical Floor due to pyrosis, dyspepsia and
difficulty of swallowing To avoid acid reflux, Nurse Melinda should advice Mrs. Dela Cruz
to avoid which type of diet?
A. cola, coffee and tea
B. high fat, carbonated and caffeinated beverages
C. beer and green tea
D. All of the above

Situation: Nurse Marishka is the staff nurse assigned at the Emergency Department.
During her shift, a patient was rushed in the ED complaining of severe heartburn,
vomiting and pain that radiates to the flank. The doctor suspects gastric ulcer. What
other symptoms will validate the diagnosis of gastric ulcer?
A. right epigastric pain
B. pain occurs when stomach is empty
C. pain occurs immediately after meal
D. pain not relieved by vomiting

What diagnostic test would yield good visualization of the ulcer crater?
A. Endoscopy
B. Gastroscopy
C. Barium Swallow
D. Histology

Peptic ulcer disease particularly gastric ulcer is thought to be cause by which of the
following microorgamisms?
A. E. coli
B. H. pylori
C. S. aureus
D. K. pnuemoniae

What Diagnostic test will confirm Achalasia?

A. Barium Swallow
B. X- ray Studies
C. Manometry
D. Barium Enema

For Sliding Hiatal Hernia, all are clinical manifestations except:

A. Heartburn
B. Halitosis
C. Regurgitation
D. Dysphagia

For Jayvin who is taking antacids, which instruction would be included in the teaching
plan?
A. "Avoid taking other medications within 2 hours of this one."
B. "Weigh yourself daily when taking this medication."
C. "Continue taking antacids even when pain subsides."
D. "Take the antacids with 8 oz of water."

The other name of the haital hernia is:

A. diaphragmatic hernia
B. pancreatitis
C. inguinal hernia
D. gastritis
One of the group asks Dr. Jessie about the condition of GERD, He is in-correct if his
explanation to him/her is:
A. it is caused by a helicobacter pylori
B. it is the backflow of the gastric contents into the esophagus until
it will be vomit from the patient.
C. it herniates the diaphragm, into the thorax cavity.

The patient with hiatal hernia always complain of being fullness in his/her stomach in
fact the patient's weight does not reach in accordance to his/her respective age as well
as his/her height. As a nurse, the priority nursing diagnosis of the patient based on the
assessment is:
A. imbalance nutrition less than body requirements

The nurse is providing discharge instructions to a male client following gastrectomy and
instructs the client to take which measure to assist in preventing dumping syndrome?
A. Sit in a high-Fowler's position during meals
B. Eat high carbohydrate foods
C. Limit the fluid taken with meal
D. Ambulate following a meal

The nurse is caring for a female client following a Billroth II procedure. Which
postoperative order should the nurse question and verify?
A. Leg exercises
B. Irrigating the nasogastric tube
C. Coughing and deep-breathing exercises
D. Early ambulation
B. Irrigating the nasogastric tube

In order to promote the nutritional status of the patient, Ms. Pamela should encourages
the feeding pattern of the patient. She is correct if she encourage to the patient that the
feeding should be:
A. full feeding
B. none of the choices
C. small but frequent feeding pattern
D. small feeding

what does abbreviation GERD means?

A. gastroesophajeal reflux disease
B. gastroesophageal reflux disease
C. gastroesophageal reflux disorder
D. gastroesophageal reflex disease

The nurse is performing an abdominal assessment and inspects the skin of the abdomen.
The nurse performs which assessment technique next?
A. Listens to bowel sounds in all four quadrants
B. Palpates the liver at the right rib margin
C. Palpates the abdomen for size
D. Percusses the right lower abdominal quadrant
The nurse is monitoring a female client for the early signs and symptoms of dumping
syndrome. Which of the following indicate this occurrence?
A. Abdominal cramping and pain
B. Bradycardia and indigestion
C. Sweating and pallor
D. Double vision and chest pain

When teaching an elderly client how to prevent constipation, which of the following
instructions should the nurse include?
A. "Drink 6 glasses of fluid each day."
B. "Avoid grain products and nuts."
C. "Add at least 4 grams of bran to your cereal each morning."
D. "Be sure to get regular exercise."

The nurse would monitor for which of the following adverse reactions to aluminum-
containing antacids such as aluminum hydroxide (Amphojel)?
A. Diarrhea
B. Constipation
C. GI upset
D. Fluid retention

Nursing suggestions to help a person break the constipation habit include all of the
following except:
A. A low-residue, bland diet.
B. A fluid intake of at least 2 L/day.
C. Establishing a regular schedule of exercise.
D. Establishing a regular time for daily elimination.

All of the following are considered complications of constipation except:

A. Hemorrhoids
B. Fecal impaction
C. Hypokalemia
D. Hypertension

In a client with diarrhea, which outcome indicates that fluid resuscitation is successful?
A. The client passes formed stools at regular intervals
B. The client reports a decrease in stool frequency and liquidity
C. The client exhibits firm skin turgor
D. The client no longer experiences perianal burning.

The mechanism of action of diphenoxylate (Lotomil) is:

B. An increase in intestinal motility
C. A decrease in peristalsis in the intestinal wall
D. A decrease in the reabsorption of water in the bowel
Which of the following statements best describes fecal incontinence?
A. It is a common disorder that affects the large intestine characterized by cramping,
abdominal pain, bloating, gas, and diarrhea or constipation, or both.
B. It is the involuntary passage of stool from the rectum.
C. It is an infrequent bowel movements or difficult passage of stools that persists for
several weeks or longer.
D. It is condition with loose and watery stools during a bowel movement.

Which of the following measures helps control fecal incontinence?

A. Increase fiber in the diet during episodes of diarrhea.
B. Initiate a bowel-training program.
C. Encourage use of laxatives 3 times a day.
D. Use incontinence brief/adult diaper.

Which of the following best describes Malabsorption syndrome?

A. Are open sores that develop on the inside lining of your stomach and the upper
portion of your small intestine.
B. It is the inability of the digestive system to absorb one or more
of the major vitamins, minerals, and nutrients.
C. It is a digestive disorder that occurs when acidic stomach juices, or food and fluids
back up from the stomach into the
esophagus.
D. An inflammatory disease which can lead to abdominal pain, severe diarrhea, fatigue,
and weight loss.

A patient complains of abdominal pain and distention is suspected of having

malabsorption syndrome when he/she has:
A. A bulky, foul-smelling stools with steatorrhea
B. Episodes of constipation and diarrhea
C. Chronic constipation
D. Severe abdominal pain after eating

Which of the following diagnostic tests confirms malabsorption syndrome?

A. Complete blood count
B. Abdominal ultrasound
C. Panceatic function test
D. Endoscopy with biopsy

Which of the following recommended to a patient with malabsorption syndrome?

A. Encourage patient to eat pasta three times a day
B. Instruct patient to increase milk consumption.
C. The patient is advised to limit fluid intake.
D. Vitamin supplementation is prescribed.

A client with irritable bowel syndrome is being prepared for discharge. Which of the
following meal plans should the
nurse give the client?
A. Low fiber, low-fat
B. High fiber, low-fat
Katrina is diagnosed with lactose intolerance. To avoid complications with lack of calcium
in the diet, which food should be included in the diet?
A. Fruit
B. Whole grains
C. Milk and cheese products
D. Dark green, leafy vegetables

A patient with IBS asks, "How can I manage abdominal discomfort?" Your best response
would be:
A. "It is best managed by eating dry crackers."
B. "Some patients maintain an antidepressant drugs."
C. "You will be the one to choose what is best for you."
D. "Abdominal pain can be reduced by avoiding carbonated
beverages."

Care for the postoperative client after gastric resection should focus on which of the
following problems?
A. Body image
B. Nutritional needs
C. Skin care
D. Spiritual needs

A 30-year old client experiences weight loss, abdominal distention, crampy abdominal
pain, and intermittent diarrhea after birth of her 2nd child. Diagnostic tests reveal gluten-
induced enteropathy. Which foods must she eliminate from her diet permanently?
A. Milk and dairy products
B. Protein-containing foods
C. Cereal grains (except rice and corn)
D. Carbohydrates

Which of the following conditions cause/s malabsorption? Select all that apply.
A. Celiac disease
B. Lactose intolerance
C. Gastritis
D. Gastric resection
E. GERD

This is performed if carbohydrate malabsorption is suspected.

A. Stool exam
B. Pancreatic function test
C. Endoscopy with biopsy
D. Hydrogen breath test

It is described as foul-smelling stool with high fat content.

A. Melena
B. Hematoschezia
C. Steatorrhea
D. Diarrhea

Which of the following are considered as the risk factors of irritable bowel syndrome?
Select all that apply.
A. Smoking
B. Celiac disease
C. Spicy foods
D. Stress

Which of the following disorders characterized by spasm, distention, and accumulation of

mucus in the intestines
A. Constipation
B. Gastritis
C. Malabsorption syndrome
D. Irritable bowel syndrome

During assessment, the nurse is looking for positive indicators of appendicitis, which
include all of the following except:
A. vomiting
B. low-grade fever
C. Thrombocytopenia
On physical examination, the nurse should be looking for tenderness on palpation at
Mcburney's point, which is located in the:
A. Right lower quadrant
B. Right upper quadrant
C. Left lower quadrant
D. Left upper quadrant

Which of the following complications is thought to be the most common cause of

appendicitis?
A. A fecalith
B. Bowel kinking
C. Internal bowel occlusion
D. Abdominal bowel swelling

An enema is prescribed for a client with suspected appendicitis. Which of the following
actions should the nurse take?
A. Prepare 750 ml of irrigating solution warmed to 100*F.
B. Question the physician about the order.
A client with acute appendicitis develops fever, tachycardia, and hypotension. Based on
these assessment findings, thenurse suspects which of the following complications?
A. Peritonitis
B. Bowel ischemia
C. Intestinal obstruction
D. Deficient fluid volume

Eleanor, a 62 y.o. woman with diverticulosis is your patient. Which interventions would
you expect to include in her care?
C. High-fiber diet and administration of psyllium.
D. Administration of analgesics and antacids.
Which of the following types of diets is implicated in the development of diverticulosis?
A. Low-fiber diet
B. High-fiber diet
C. High-protein diet
D. Low-carbohydrate diet

Donald is a 61 y.o. man with diverticulitis. Diverticulitis is characterized by:

A. Periodic rectal hemorrhage.
B. Hypertension and tachycardia.
C. Vomiting and elevated temperature.
D. Crampy and lower left quadrant pain and low-grade fever.

Medical management of the client with diverticulitis should include which of the following
treatments?
A. Reduced fluid intake
B. Increased fiber in diet
C. Administration of antibiotics
Which of the following mechanisms can facilitate the development of diverticulosis into
diverticulitis?
A. Treating constipation with chronic laxative use, leading to dependence on laxatives
B. Chronic constipation causing an obstruction, reducing forward flow of intestinal
contents
C. Herniation of the intestinal mucosa, rupturing the wall of the intestine
D. Undigested food blocking the diverticulum, predisposing the
area to bacterial invasion.

A patient admitted with inflammatory bowel disease asks the nurse for help with menu
selections. What menu selection is most likely the best choice for this patient?
A) Spinach
B) Tofu
C) Multigrain bagel

A nurse is preparing to provide care for a patient whose exacerbation of ulcerative colitis
has required hospital ladmission. During an exacerbation of this health problem, the
nurse would anticipate that the patient's stools will have what characteristics
A) Watery with blood and mucus
B) Hard and black or tarry
C) Dry and streaked with blood
D) Loose with visible fatty streaks

Annabelle is being discharged with a colostomy, and you're teaching her about
colostomy care. Which statement correctly describes a healthy stoma?
A. "At first, the stoma may bleed slightly when touched."
B. "The stoma should appear dark and have a bluish hue."
C. "A burning sensation under the stoma faceplate is normal."
D. "The stoma should remain swollen away from the abdomen."

You're advising a 21 y.o. with a colostomy who reports problems with flatus. What food
should you recommend?
C. Broccoli
D. Yogurt
Claire, a 33 y.o. is on your floor with a possible bowel obstruction. Which intervention is
priority for her?
A. Obtain daily weights.
B. Measure abdominal girth.
C. Keep strict intake and output.
D. Encourage her to increase fluids.

A 52-year-old man was referred to the clinic due to increased abdominal girth. He is
diagnosed with ascites by the presence of a fluid thrill and shifting dullness on
percussion. After administering diuretic therapy, which nursing action would be most
effective in ensuring safe care?
A. Measuring serum potassium for hyperkalemia
B. Assessing the client for hypervolemia
C. Measuring the client's weight weekly
D. Documenting precise intake and output

Sharon has cirrhosis of the liver and develops ascites. What intervention is necessary to
decrease the excessive accumulation of serous fluid in her peritoneal cavity?
A. Restrict fluids
B. Encourage ambulation
C. Increase sodium in the diet

A client with cirrhosis begins to develop ascites. Spironolactone (Aldactone) is prescribed

to treat the ascites. The nurse should monitor the client closely for which of the following
drug-related side effects?
B. Hyperkalemia
C. Irregular pulse
D. Dysuria

For which of the following positions would be appropriate for a client with severe ascites?
A. Fowler's
B. Side-lying
C. Reverse Trendelenburg

You're caring for Jane, a 57 y.o. patient with liver cirrhosis who developed ascites and
requires paracentesis. Before her paracentesis, you instruct her to:
A. Empty her bladder.
B. Lie supine in bed.
C. Remain NPO for 4 hours.
D. Clean her bowels with an enema.

Nurse Farrah is providing care for Kristoff who has jaundice. Which statement indicates
that the nurse understands the rationale for instituting skin care measures for the client?
A. "Jaundice is associated with pressure ulcer formation."
B. "Jaundice impairs urea production, which produces pruritus."
C. "Jaundice produces pruritus due to impaired bile acid excretion."
D. "Jaundice leads to decreased tissue perfusion and subsequent breakdown."
Develop a teaching care plan for Angie who is about to undergo a liver biopsy. Which of
the following points do you include?
A. "You'll need to lie on your stomach during the test."
B. "You'll need to lie on your right side after the test."
C. "During the biopsy you'll be asked to exhale deeply and hold it."
D. "The biopsy is performed under general anesthesia.

Immediately after a liver biopsy, which of the following complications should the client
be closely monitored for?
A. Abdominal cramping
B. Hemorrhage
C. Nausea and vomiting
D. Potential infection

Which of the following tests confirms that the origin of the disorder is in the liver?
C. Gamma-glutamyl Transferase (GGT)
D. Serum Alkaline Phosphatase

Mr. Hasakusa is in end-stage liver failure. Which interventions should the nurse
implement when addressing hepatic encephalopathy? Select all that apply.
A. Assessing the client's neurologic status every 2 hours
B. Monitoring the client's hemoglobin and hematocrit levels
C. Evaluating the client's serum ammonia level
D. Monitoring the client's handwriting daily
E. Preparing to insert an esophageal tamponade tube
F. Making sure the client's fingernails are short

Nathaniel has severe pruritus due to having hepatitis B. What is the best intervention for
his comfort?
A. Use hot water to increase vasodilation.
B. Use cold water to decrease the itching
C. Give tepid baths.
D. Avoid lotions and creams.

The most important pathophysiologic factor contributing to the formation of esophageal

varices is
A. Portal hypertension
B. Increased central venous pressure
C. Decreased albumin formation by the liver
D. Decreased prothrombin formation

You're caring for Betty with liver cirrhosis. Which of the following assessment findings
leads you to suspect hepatic encephalopathy in her?
A. Chvostek's sign
B. Hepatojugular reflex
C. Trousseau's sign
D. Asterixis

Jordin is a client with jaundice who is experiencing pruritus. Which nursing intervention
would be included in the care plan for the client?
A. Keeping the client's fingernails short and smooth
B. Decreasing the client's dietary protein intake
C. Applying pressure when giving I.M. injections
D. Administering vitamin K subcutaneously

Which assessment finding indicates that lactulose is effective in decreasing the ammonia
level in the client with hepatic encephalopathy?
A. Evidence of watery diarrhea
B. Daily deterioration in the client's handwriting
C. Passage of two or three soft stools daily
D. Appearance of frothy, foul-smelling stools

A nurse is preparing to care for a female client with esophageal varices who just had a
Sengstaken-Blakemore tube inserted. The nurse gathers supplies, knowing that which of
the following items must be kept at the bedside at all times?
A. An irrigation set
B. Kelly clamp
C. An obturator
D. A pair of scissors

For a client in hepatic coma, which outcome would be the most appropriate?
A. The client is oriented to time, place, and person.
B. The client increases oral intake to 2,000 calories/day.
C. The client exhibits increased serum albumin level
D. The client exhibits no ecchymotic areas.

A patient with liver disease may experience which of the following manifestations?
A. Clavicular injury
B. Spider angiomas
C. Chronic hyperglycemia
D. Ascites
E. Jaundice

When planning home care for a client with hepatitis A, which preventive measure should
be emphasized to protect the client's family?
A. Keeping the client in complete isolation.
B. Using good sanitation with dishes and shared bathrooms.
C. Avoiding contact with blood-soiled clothing or dressing.
D. Forbidding the sharing of needles or syringes.

Which of the following will the nurse include in the care plan for a client hospitalized with
viral hepatitis?
A. Increase fluid intake to 3000 ml per day
B. Adequate bed rest
C. Bland diet
D. Administer antibiotics as ordered

You're discharging Nathaniel with hepatitis B. Which statement suggests understanding

by the patient?
A. "Now I can never get hepatitis again."
B. "I can safely give blood after 3 months."
C. "I'll never have a problem with my liver again, even if I drink alcohol."
D. "My family knows that if I get tired and start vomiting, I may be getting sick again."

A client is suspected of having hepatitis. Which diagnostic test result will assist in
confirming this diagnosis?
A. Elevated hemoglobin level
B. Elevated serum bilirubin level
C. Elevated blood urea nitrogen level
D. Decreased erythrocyte sedimentation rate

A female client who has just been diagnosed with hepatitis A asks, "How could I have
gotten this disease?" What is the nurse's best response?
A. "You may have eaten contaminated restaurant food."
B. "You could have gotten it by using I.V. drugs."
C. "You must have received an infected blood transfusion."
D. "You probably got it by engaging in unprotected sex."

A male client has just been diagnosed with hepatitis A. On assessment, the nurse
expects to note:
A. Severe abdominal pain radiating to the shoulder.
B. Anorexia, nausea, and vomiting.
C. Eructation and constipation.
D. Abdominal ascites.

For a client with hepatic cirrhosis who has altered clotting mechanisms, which
intervention would be most important?
A. Allowing complete independence of mobility
B. Applying pressure to injection sites
C. Administering antibiotics as prescribed
D. Increasing nutritional intake

A client with advanced cirrhosis has been diagnosed with hepatic encephalopathy. The
nurse expects to assess for:
A. Malaise
B. Stomatitis
C. Hand tremors
D. Weight loss

A client diagnosed with chronic cirrhosis who has ascites and pitting peripheral edema
also has hepatic encephalopathy. Which of the following nursing interventions are
appropriate to prevent skin breakdown? Select all that apply.
A. Range of motion every 4 hours
B. Turn and reposition every 2 hours
C. Abdominal and foot massages every 2 hours
D. Alternating air pressure mattress
E. Sit in chair for 30 minutes each shift
A patient with chronic alcohol abuse is admitted with liver failure. You closely monitor the
patient's blood pressure because of which change that is associated with the liver
failure?
A. Hypoalbuminemia
B. Increased capillary permeability
C. Abnormal peripheral vasodilation
D. Excess rennin release from the kidneys

Nurse Juvy is caring for a client with cirrhosis of the liver. To minimize the effects of the
disorder, the nurse teaches the client about foods that are high in thiamine. The nurse
determines that the client has the best understanding of the dietary measures to follow if
the client states an intention to increase the intake of:
A. Pork
B. Milk
C. Chicken
D. Broccoli

The nurse is caring for a male client with cirrhosis. Which assessment findings indicate
that the client has deficient vitamin K absorption caused by this hepatic disease?
A. Dyspnea and fatigue
B. Ascites and orthopnea
C. Purpura and petechiae
D. Gynecomastia and testicular atrophy

A patient with severe cirrhosis of the liver develops hepatorenal syndrome. Which of the
following nursing assessment data would support this?
A. Oliguria and azotemia
B. Metabolic alkalosis
C. Decreased urinary concentration
D. Weight gain of less than 1 lb. per week

Which of the following tests is the most accurate for diagnosing liver cancer?
A. Abdominal ultrasound
B. Abdominal flat plate X-ray
C. Cholangiogram
D. Computed tomography (CT) scan

Which of the following considerations has highest priority when preparing to administer a
medication to a client with liver cancer?
A. Frequency of the medication
B. Purpose of the medication
C. Necessity of the medication
D. Metabolism of the medication

Early manifestation of a patient with liver cancer includes:

A. Ascites
B. Hepatomegaly
C. Continuous dull abdominal pain at RUQ
D. Jaundice

Which of the following are considered as complications of liver transplant? Select all that
apply.
A. Hemorrhage
B. Hypertension
C. Infection
D. Hyperglycemia
E. Rejection

Which of the following interventions is appropriate after liver transplant?

A. Place patient in an environment free from bacteria, viruses, and
fungi as possible.
B. Antibiotic agents are used as long-term therapy to prevent rejection of the
transplanted liver.
C. Place patient in Trendelenburg position to facilitate pulmonary drainage.
D. Monitor cardiac output, oxygen saturation, urine output, heart rate, and blood
pressure every 8 hours to evaluate hemodynamic status and intravascular fluid volume.

When teaching a client about pancreatic function, the nurse understands that pancreatic
lipase performs which function?
A. Transports fatty acids into the brush border.
B. Breaks down fat into fatty acids and glycerol.
C. Triggers cholecystokinin to contract the gallbladder.
D. Breaks down protein into dipeptides and amino acids.

What laboratory finding is the primary diagnostic indicator for pancreatitis?

A. Elevated blood urea nitrogen (BUN)
B. Elevated serum lipase
C. Elevated aspartate aminotransferase (AST)
D. Increased lactate dehydrogenase (LD)

Pierre who is diagnosed with acute pancreatitis is under the care of Nurse Bryan. Which
intervention should the nurse include in the care plan for the client?
A. Administration of vasopressin and insertion of a balloon tamponade
B. Preparation for a paracentesis and administration of diuretics
C. Maintenance of nothing-by-mouth status and insertion of
nasogastric (NG) tube with low intermittent suction
D. Dietary plan of a low-fat diet and increased fluid intake to 2,000 ml/day

Britney, a 20 y.o. student is admitted with acute pancreatitis. Which laboratory findings
do you expect to be abnormal for this patient?
A. Serum creatinine and BUN
B. Alanine aminotransferase (ALT) and aspartate aminotransferase (AST)
C. Serum amylase and lipase
D. Cardiac enzymes

Michael, a 42 y.o. man is admitted to the med-surg floor with a diagnosis of acute
pancreatitis. His BP is 136/76, pulse 96, Resps 22 and temp 101. His past history includes
hyperlipidemia and alcohol abuse. The doctor prescribes an NG tube. Before inserting the
tube, you explain the purpose to patient. Which of the following is a most accurate
explanation?
A. "It empties the stomach of fluids and gas."
B. "It prevents spasms at the sphincter of Oddi."

Ralph has a history of alcohol abuse and has acute pancreatitis. Which lab value is most
likely to be elevated?
A. Calcium
B. Glucose
C. Magnesium
D. Potassium

For Rico who has chronic pancreatitis, which nursing intervention would be most helpful?
A. Allowing liberalized fluid intake.
B. Counseling to stop alcohol consumption.
C. Encouraging daily exercise.
D. Modifying dietary protein.

Leigh Ann is receiving pancrelipase (Viokase) for chronic pancreatitis. Which observation
best indicates the treatment is effective?
B. Her appetite improves.
C. She loses more than 10 lbs.
D. Stools are less fatty and decreased in frequency.

To inhibit pancreatic secretions, which pharmacologic agent would you anticipate

administering to a patient with chronic pancreatitis?
A. Nitroglycerin
B. Somatostatin
C. Pancrelipase

A clinical manifestation of chronic pancreatitis is epigastric pain. Your nursing

intervention to facilitate relief of pain would place the patient in a:
A. Knee-chest position

A client is taking NPH insulin daily every morning. The nurse instructs the client that the
most likely time for a hypoglycemic reaction to occur is:
A. 2-4 hours after administration
B. 6-14 hours after administration
C. 16-18 hours after administration
D. 18-24 hours after administration

A client with a diagnosis of diabetic ketoacidosis (DKA) is being treated in the ER. Which
finding would a nurse expect to note as confirming this diagnosis?
A. Elevated blood glucose level and a low plasma bicarbonate
B. Decreased urine output
C. Increased respirations and an increase in pH
D. Comatose state

A nurse is preparing a plan of care for a client with DM who has hyperglycemia. The
priority nursing diagnosis would be:
A. High risk for deficient fluid volume
B. Deficient knowledge: disease process and treatment
C. Imbalanced nutrition: less than body requirements
D. Disabled family coping: compromised.

A nurse is caring for a client admitted to the ER with DKA. In the acute phase the priority
nursing action is to prepare to:
A. Administer regular insulin intravenously
B. Administer 5% dextrose intravenously
C. Correct the acidosis
D. Apply an electrocardiogram monitor.

A nurse performs a physical assessment on a client with type 2 DM. Findings include a
fasting blood glucose of 120mg/dl, temperature of 101, pulse of 88, respirations of 22,
and a bp of 140/84. Which finding would be of most concern of the nurse?
A. Pulse
B. BP
C. Respiration
D. Temperature

A client with type 1 DM calls the nurse to report recurrent episodes of hypoglycemia with
exercise. Which statement by
the client indicated an inadequate understanding of the peak action of NPH insulin and
exercise?
A. "The best time for me to exercise is every afternoon."
B. "The best time for me to exercise is right after I eat."
C. "The best time for me to exercise is after breakfast."
D. "The best time for me to exercise is after my morning snack."

Glucose is an important molecule in a cell because this molecule is primarily used for:
A. Extraction of energy
B. Synthesis of protein
C. Building of genetic material
D. Formation of cell membranes

When a client is first admitted with hyperglycemic hyperosmolar nonketotic syndrome

(HHNS), the nurse's priority is to
provide:
A. Oxygen
B. Carbohydrates
C. Fluid replacement
D. Dietary instruction

The nurse is admitting a client with hypoglycemia. Identify the signs and symptoms the
nurse should expect. Select all that apply.
B. Palpitations
C. Diaphoresis
D. Slurred speech
When a client is in diabetic ketoacidosis, the insulin that would be administered is:
A. Human NPH insulin
B. Human regular insulin
C. Insulin lispro injection
D. Insulin glargine injection

A client diagnosed with type 1 diabetes receives insulin. He asks the nurse why he can't
just take pills instead. What is the best response by the nurse?
A."Have you talked to your doctor about taking pills instead?"
B. "I know it is tough, but you will get used to the shots soon."
C. "Insulin must be injected because it needs to work quickly."
D. "Insulin can't be in a pill because it is destroyed in stomach
acid."

A clinical instructor teaches a class for the public about diabetes mellitus. Which
individual does the nurse assess as being at the highest risk for developing diabetes?
A. The 42-year-old client who is 50 pounds overweight
B. The 50-year-old client who does not get any physical exercise
C. The 38-year-old client who smokes one pack of cigarettes per day
D. The 56-year-old client who drinks three glasses of wine each evening

A 50-year-old widower is admitted to the hospital with a diagnosis of diabetes mellitus

and complaints of rapid-onset weight loss, elevated blood glucose levels, and
polyphagia. The gerontology nurse should anticipate which of the following secondary
medical diagnoses?
A. Gestational diabetes mellitus
B. Impaired glucose tolerance
C. Pituitary tumor
D. Pancreatic tumor

Which of the following nursing interventions should be taken for a client who complains
of nausea and vomits one hour after taking his glyburide (DiaBeta)?
A. Monitor blood glucose, and assess for signs of hyperglycemia
B. Monitor blood glucose closely, and look for signs of
hypoglycemia
C. Give glyburide again
D. Give subcutaneous insulin and monitor blood glucose

Which of the following is accurate pertaining to physical exercise and type 2 diabetes
mellitus?
A. Strenuous exercise is beneficial when blood glucose is high.
B. Physical exercise can slow the progression of type 2 diabetes
mellitus.
C. Adjusting insulin regimen allows for safe participation in all forms of exercise.
D. Patients who take insulin and engage in strenuous physical exercise might experience
hyperglycemia.

Ben injects his insulin as prescribed, but then gets busy and forgets to eat. What will the
best assessment of the nurse reveal
A. The client will need to urinate.
B. The client will be very thirsty.
C. The client will complain of nausea.
D. The client will have moist clammy skin.

Rotating injection sites when administering insulin prevents which of the following
complications?
A. Insulin edema
B. Insulin lipodystrophy
C. Systemic allergic reactions
D. Insulin resistance

Joko has recently been diagnosed with type 1 Diabetes Mellitus and asks nurse Jessica
for help formulating a nutrition plan. Which of the following recommendations would the
nurse make to help the client increase calorie consumption to offset absorption
problems?
A. Eat small meals with two or three snacks throughout the day to keep blood glucose
levels steady
B. Eating small meals with two or three snacks may be more helpful
in maintaining blood glucose levels than three large meals.
C. Skip meals to help lose weight
D. Increase the consumption of simple carbohydrates
Gary has diabetes type 2. Nurse Martha has taught him about the illness and evaluates
learning has occurred when the client makes which statement?
A. "My cells have increased their receptors, but there is enough insulin."
B. "My cells cannot use the insulin my pancreas makes."
C. "My peripheral cells have increased sensitivity to insulin."
D. "My beta cells cannot produce enough insulin for my cells."

During a visit to the hospital, the student nurses are asked which of the following
persons would most likely be diagnosed with diabetes mellitus. They are correct if they
answered a 44-year-old:
A. Hispanic male.
B. Caucasian woman.
C. Asian woman.
D. African-American woman.

When reviewing the urinalysis report of a client with newly diagnosed diabetes mellitus,
the nurse would expect which urine characteristics to be abnormal? Select all that apply.
A. Specific gravity.
B. Odor.
C. pH.
D. Amount.

Clients with type 1 diabetes may require which of the following changes to their daily
routine during periods of infection?
A. More insulin
B. Less insulin
C. No changes
D. Oral antidiabetic agents
An older woman with diabetes mellitus visits the clinic concerning her condition. Which
of the following symptoms might an older woman with diabetes mellitus complain?
A. Weight loss
B. Anorexia
C. Pain intolerance
D. Perineal itching

A client with diabetes mellitus has an above-knee amputation because of severe

peripheral vascular disease, Two days following surgery, when preparing the client for
dinner, it is the nurse's primary responsibility to
A. Ensure that the client's residual limb is elevate
B. Check the client's serum glucose level
C. Place the client in a High-Fowler's position
D. Assist the client out of bed to the chair

Marlisa has been diagnosed with diabetes mellitus type 1. She asks Nurse Errol what this
means. What is the best response by the nurse? Select all that apply.
A. "It means your pancreas cannot secrete insuli
B. "Without insulin, you will develop ketoacidosis (DKA)."
C. "The endocrine function of your pancreas is to secrete insulin."
D. "The exocrine function of your pancreas is to secrete insulin.

Which of the following chronic complications is associated with diabetes

A. Retinopathy, neuropathy, and coronary artery disease
B. Fatigue, nausea, vomiting, muscle weakness, and cardiac arrhythmias
C. Leg ulcers, cerebral ischemic events, and pulmonary infarcts
D. Dizziness, dyspnea on exertion, and coronary artery disease

Serge who has diabetes mellitus is taking oral agents and is scheduled for a diagnostic
test that requires him to be NPO. What is the best plan of the nurse with regard to giving
the client his oral medications?
A. Administer the oral agents with a sip of water before the test
B. Notify the diagnostic department and request orders.
C. Administer the oral agents immediately after the test.
D. Notify the physician and request orders.

After suffering an acute MI, a client with a history of type 1 diabetes is prescribed
metoprolol (Lopressor) I.V. Which nursing interventions are associated with I.V.
administration of metoprolol? Select all that apply. *
A. Monitor glucose levels closely.
B. Monitor blood pressure closely.
C. Monitor for heart block and bradycardia.

Harry is a diabetic patient who is experiencing a reaction to alternating periods of

nocturnal hypoglycemia and hyperglycemia. The patient might be manifesting which of
the following?
A. Uncontrolled diabetes
B. Diabetes insipidus
C. Brittle diabetes
D. Somogyi phenomenon

A nurse went to a patient's room to do routine vital signs monitoring and found out that
the patient's bedtime snack was not eaten. This should alert the nurse to check and
assess for:
A. Signs of hypoglycemia earlier than expected
B. Elevated serum bicarbonate and decreased blood pH
C. Symptoms of hyperglycemia during the peak time of NPH insulin
D. Sugar in the urine

A male nurse is providing a bedtime snack for his patient. This is based on the
knowledge that intermediate-acting insulins are effective for an approximate duration of:
A. 24-28 hours
B. 6-8 hours
C. 14-18 hours
D. 10-14 hours

A client with diabetes mellitus states, "I cannot eat big meals; I prefer to snack
throughout the day." The nurse should carefully explain that:
A. Large meals can contribute to a weight problem
B. Small, frequent meals are better for digestion
C. Salt and sugar restriction is the main concern
D. Regulated food intake is basic to control

A client with diabetes mellitus visits a health care clinic. The client's diabetes previously
had been well controlled with glyburide (Diabeta), 5 mg PO daily, but recently, the
fasting blood glucose has been running 180-200 mg/dl. Which medication, if added to
the clients regimen, may have contributed to the hyperglycemia? *
A. phenelzine (Nardil)
B. prednisone (Deltasone)
C. allopurinol (Zyloprim)
D. atenolol (Tenormin)

The nurse knows that glucagon may be given in the treatment of hypoglycemia because
it:
A. Inhibits gluconeogenesis
B. Provides more storage of glucose
C. Increases blood glucose levels
D. Stimulates the release of insulin

Knowing that gluconeogenesis helps to maintain blood glucose levels, a nurse should
A. Protect the patient from sources of infection because of decreased cellular protein
deposits.
B. Do all of the above.
C. Evaluate the patient's sensitivity to low room temperatures because of decreased
adipose tissue insulation.
D. Document weight changes because of fatty acid mobilization.
A clinical feature that distinguishes a hypoglycemic reaction from a ketoacidosis reaction
is:
A. Blurred vision
B. Diaphoresis
C. Weakness
D. Nausea

An external insulin pump is prescribed for a client with DM. The client asks the nurse
about the functioning of the pump. The nurse bases the response on the information that
the pump:
A. Gives a small continuous dose of regular insulin subcutaneously,
and the client can self-administer a bolus with an additional dosage
from the pump before each meal.

Rotation sites for insulin injection should be separated from one another by 2.5 cm (1
inch) and should be used only every:
A. Every other day
B. Third day
C. 1-2 weeks
D. 2-4 weeks

Nurse Andy has finished teaching a client with diabetes mellitus how to administer
insulin. He evaluates the learning has occurred when the client makes which statement?
A. "I should check my blood sugar immediately prior to the administration."
B. "I should use the abdominal area only for insulin injections."
C. "I should only use a calibrated insulin syringe for the injections."
D. "I should provide direct pressure over the site following the injection."

A client with DM demonstrates acute anxiety when first admitted for the treatment of
hyperglycemia. The most appropriate intervention to decrease the client's anxiety would
be to:
A. Make sure the client knows all the correct medical terms to understand what is
happening
B. Ignore the signs and symptoms of anxiety so that they will soon disappear
C. Convey empathy, trust, and respect toward the client
D. Administer a sedative

The nurse is admitting a patient diagnosed with type 2 diabetes mellitus. The nurse
should expect the following symptoms during an assessment, except:
A. Dry mouth
B. Frequent bruising
C. Hypoglycemia
D. Ketonuria

A client with type 1 diabetes mellitus has a fingerstick glucose level of 258mg/dl at
bedtime. An order for sliding scale insulin exists. The nurse should *
A. Encourage the intake of fluids
B. Give the client 1/2 c. of orange juice
C. Call the physician
D. Administer the insulin as ordered

The nurse recognizes that additional teaching is necessary when the client who is
learning alternative site testing (AST) for glucose monitoring says:
A. "I have to make sure that my current glucose monitor can be used at an alternate
site."
B. "Alternate site testing is unsafe if I am experiencing a rapid change in glucose levels."
C. "I need to rub my forearm vigorously until warm before testing at this site."
D. "The fingertip is preferred for glucose monitoring if
hyperglycemia is suspected."

When caring for a male client with diabetes insipidus, nurse Juliet expects to administer:
A. Vasopressin (Pitressin Synthetic).
B. Furosemide (Lasix).
C. Regular insulin.
D. 10% dextrose

Nurse Louie is developing a teaching plan for a male client diagnosed with diabetes
insipidus. The nurse should include information about which hormone lacking in clients
with diabetes insipidus?
A. Antidiuretic hormone (ADH).
B. Thyroid-stimulating hormone (TSH).
C. Follicle-stimulating hormone (FSH).
D. Luteinizing hormone (LH).

Which outcome indicates that treatment of a male client with diabetes insipidus has
been effective?
A. Fluid intake is less than 2,500 ml/day.
B. Urine output measures more than 200 ml/hour.
C. Blood pressure is 90/50 mm Hg.
D. The heart rate is 126 beats/minute.

An incoherent female client with a history of hypothyroidism is brought to the emergency

department by the rescue squad. Physical and laboratory findings reveal hypothermia,
hypoventilation, respiratory acidosis, bradycardia, hypotension, and nonpitting edema of
the face and pretibial area. Knowing that these findings suggest severe hypothyroidism,
nurse Libby prepares to take emergency action to prevent the potential complication of:
A. Thyroid storm
B. Cretinism
C. Myxedema coma
D. Hashimoto's thyroiditis

Vasopressin is administered to the client with diabetes insipidus (DI) because it:
A. Decreases blood sugar.
B. Increases tubular reabsorption of water.
C. Increases release of insulin from the pancreas.
D. Decreases glucose production within the liver.
A male client is admitted for treatment of the syndrome of inappropriate antidiuretic
hormone (SIADH). Which nursing intervention is appropriate?
A. Infusing I.V. fluids rapidly as ordered.
B. Encouraging increased oral intake.
C. Restricting fluids.
D. Administering glucose-containing I.V. fluids as ordered.

What test should be ordered if hypothyroidism is suspected?

A. Liver function tests
B. Hemoglobin A1c
C. T4 and thyroid-stimulating hormone
D. 24-hour urine free cortisol measurement

Which of the following conditions is caused by excessive secretion of vasopressin?

A. Thyrotoxic crisis
B. Diabetes insipidus
C. Primary adrenocortical insufficiency
D. Syndrome of inappropriate antidiuretic hormone (SIADH)

A client represents with flushed skin, bulging eyes, and perspiration, and states that he
has been irritable and having palpitations. This client is presenting with symptoms of
which disorder?
C. Hyperthyroidism

The appropriate nursing diagnosis for a patient with SIADH is:

A. Fluid volume deficit related to excessive fluid loss
B. Fluid volume excess related to fluid retention
C. Risk for injury related to decreased blood pressure
D. Impaired skin integrity related to dehydration

A male client has recently undergone surgical removal of a pituitary tumor. Dr. Wong
prescribes corticotropin (Acthar), 20 units I.M. q.i.d. as a replacement therapy. What is
the mechanism of action of corticotropin?
C. It interacts with plasma membrane receptors to produce
enzymatic actions that affect protein, fat, and carbohydrate
metabolism.
A female client whose physical findings suggest a hyperpituitary condition undergoes an
extensive diagnostic workup. Test results reveal a pituitary tumor, which necessitates a
transsphenoidal hypophysectomy. The evening before the Surgery, nurse Jacob reviews
preoperative and postoperative instructions given to the client earlier. Which
postoperative instruction should the nurse emphasize?
A. "You must lie flat for 24 hours after surgery."
B. "You must avoid coughing, sneezing, and blowing your nose."
C. "You must restrict your fluid intake."
D. "You must report ringing in your ears immediately."

A somatotropin-secreting tumor of which of the following glands would lead to the

development of acromegaly, Cushing's syndrome, and hypopituitarism?
A. Adrenal gland
B. Hypothalamus
C. Pituitary gland
D. Thyroid gland

Surgical management for large, invasive pituitary tumors is a transphenoidal

hypophysectomy. The nurse would explain that the surgery will be performed through an
incision in the:
A. Nose
B. Back of the mouth
C. Sinus channel below the right eye
D. Upper gingival mucosa in the space between the upper gums
and lip

Initial treatment for a CSF leak after transsphenoidal hypophysectomy would most likely
involve:
A. Repacking the nose.
B. Returning the client to surgery.
C. Enforcing bed rest with the head of the bed elevated.
D. Administering high-dose corticosteroid therapy.

The patient who was admitted basing on the condition of the previous number will
undergo a certain laboratory procedure which is blood extraction to determine the level
of the vasopressin. It was found out that the level of the vasopressin is decreasing or
below the normal duration. As a nurse, Ms. Pauline is correct if she anticipates what kind
of endocrine disorder?
A. she anticipates that the condition of the patient addison's disease
B. based on the condition of the patient, it has a high probability of having a diabetes
mellitus.
C. the condition of the patient is possible to the condition of diabetes mellitus.
D. based on her learning, Ms. Pauline expects that the condition of
the patient is diabetes insipidus

The patient who has a maintenance medication of anti-diuretic was reportedly turned out
into SIADH based on the assessment of the attending physician. Ms. Pamela is correct if
the abbreviation of the SIADH is:
A. syndrome of inappropriate ante-diuretic hormone
B. syndrome of inappropriate diuretic hormone
C. syndrome of anti-diuretic hormone
D. syndrome of inappropriate anti-diuretic hormone

Ms. Pauline will anticipates that the attending physician will prescribed what medication
that is appropriate for SIADH patient? SELECT ALL THAT APPLY
B. the physician will give a diuretics for SIADH patient.

All of the following are not true description about SIADH except one. SELECT ALL THAT
APPLY
B. it is a condition wherein there is not enough production of the vasopressin
C. it is a condition in which there is an excess of vasopressin
D. it is a condition where in there is an excess secretion of anti-
diuretic hormone

A hormone that is produced from the anterior pituitary gland in which the hormone is
responsible for the skin color.
A. follicle stimulating hormone
B. oxytocin
C. anti-diuretic hormone
D. melanocytes stimulating hormone

A client was brought to the emergency room with complaints of slurring of speech,
vomiting, dry mucosa, and dry skin turgor. Lab tests showing serum sodium 125 mEq/L
and serum blood glucose of 350 mg/dL. Nurse Sophie will anticipate the physician to
initially order which of the following intravenous solutions?
A. 5% dextrose in water (D5W)
B. 0.45% normal saline solution
C. 10% dextrose in water (D10W)
D. 0.9% normal saline solution

A nurse has a four-patient assignment in the medical step-down unit. When planning
care for the clients, which client would have the following treatment goals: fluid
replacement, vasopressin replacement, and correction of underlying intracranial
pathology?
B. The client with diabetes mellitus.
C. The client with diabetes insipidus.
At the time Cherrie Ann found out that the symptoms of diabetes were caused by high
levels of blood glucose, she decided to break the habit of eating carbohydrates. With
this, the nurse would be aware that the client might develop which of the following
complications
A. Acidosis
B. Glycosuria
C. Atherosclerosis
D. Retinopathy

During the lecture, the clinical instructor tells the students that 50% to 60% of daily
calories should come from carbohydrates. What should the nurse say about the types of
carbohydrates that can be eaten?
A. Simple sugars should never be consumed by someone with diabetes.
B. Simple carbohydrates are absorbed more rapidly than complex carbohydrates.
C. Simple sugars cause a rapid spike in glucose levels and should be avoided.
D. Try to limit simple sugars to between 10% and 20% of daily
calories.

Which of these signs suggests that a male client with the syndrome of inappropriate
antidiuretic hormone (SIADH) secretion is experiencing complications?
A. Tetanic contractions
B. Neck vein distention
D. Polyuria
C. Weight loss
A client with a diagnosis of diabetic ketoacidosis (DKA) is being treated in the ER. Which
finding would a nurse expect to note as confirming this diagnosis?
A. Elevated blood glucose level and a low plasma bicarbonate
B. Increased respiration and an increase in pH
C. Decreased urine output
D. Comatose state

A female adult client with a history of chronic hyperparathyroidism admits to being

noncompliant. Based on initial assessment findings, the nurse formulates the nursing
diagnosis of Risk for injury. To complete the nursing diagnosis statement for this client,
which "related-to" phrase should the nurse add?
A. Related to bone demineralization resulting in pathologic
fractures
B. Related to exhaustion secondary to an accelerated metabolic rate
C. Related to edema and dry skin secondary to fluid infiltration into the interstitial spaces

A 67-year-old male client has been complaining of sleeping more, increased urination,
anorexia, weakness, irritability, depression, and bone pain that interferes with her going
outdoors. Based on these assessment findings, nurse Richard would suspect which of the
following disorders?
A. Diabetes mellitus
B. Diabetes insipidus
C. Hypoparathyroidism
D. Hyperparathyroidism

When instructing the female client diagnosed with hyperparathyroidism about diet, nurse
Gina should stress the importance of which of the following?
A. Restricting fluids
B. Restricting sodium
C. Forcing fluids
D. Restricting potassium

Which nursing diagnosis takes highest priority for a female client with hyperthyroidism?
A. Risk for imbalanced nutrition: More than body requirements related to thyroid
hormone excess
B. Risk for impaired skin integrity related to edema, skin fragility, and poor wound
healing
C. Body image disturbance related to weight gain and edema
D. Imbalanced nutrition: Less than body requirements related to
thyroid hormone excess

Which of the following laboratory results supports a diagnosis of primary

hyperparathyroidism?
A. High parathyroid hormone and high calcium levels
B. High magnesium and high thyroid hormone levels
C. Low parathyroid hormone and low potassium levels
D. Low thyroid-stimulating hormone and high phosphorous levels
Following a unilateral adrenalectomy, nurse Betty would assess for hyperkalemia shown
by which of the following?
A. Muscle weakness
B. Tremors
C. Diaphoresis
D. Constipation

A female client has a serum calcium level of 7.2 mg/dl. During the physical examination,
nurse Noah expects to assess:
A. Trousseau's sign.
B. Homans' sign.
C. Hegar's sign.
D. Goodell's sign.

Nurse Wayne is aware that a positive Chvostek's sign indicate?

A. Hypocalcemia
B. Hyponatremia
C. Hypokalemia
D. Hypermagnesemia

Hyperphosphatemia and hypocalcemia are indicative of which of the following disorders?

A. Grave's Disease
B. Hypothyroidism
C. Cushing's Syndrome
D. Hypoparathyroidism

Which of the following symptoms is the chief sign of hypoparathyroidism?

A. Chest pain
B. Exophthalmos
C. Shortness of breath
D. Tetany

Nurse Ronn is assessing a client with possible Cushing's syndrome. In a client with
Cushing's syndrome, the nurse would expect to find:
C. Deposits of adipose tissue in the trunk and dorsocervical area.
D. Weight gain in arms and legs.

In a 29-year-old female client who is being successfully treated for Cushing's syndrome,
nurse Lyzette would expect a decline in:
A. Serum glucose level.
B. Hair loss.
C. Bone mineralization.
D. Menstrual flow.

A female client with Cushing's syndrome is admitted to the medical-surgical unit. During
the admission assessment, nurse Tyzz notes that the client is agitated and irritable, has
poor memory, reports loss of appetite, and appears disheveled. These findings are
consistent with which problem?
A. Depression
B. Neuropathy
C. Hypoglycemia
D. Hyperthyroidism

Which of the following nursing diagnoses is appropriate for a client with Cushing's
syndrome?
A. Risk for infection
B. Deficient fluid volume
C. Acute pain with movement
D. Functional urinary incontinence

A client has thin extremities but an obese truncal area and a "buffalo hump" at the
shoulder area. The client also complains of weakness and disturbed sleep. Which of the
following disorders is the most likely diagnosis?
A. Addison's disease
B. Cushing's syndrome
C. Grave's disease
D. Hyperparathyroidism

Adrenal insufficiency develops secondary to inadequate secretion of which of the

following pituitary hormones?
A. Corticotropin
B. Antidiuretic hormone (ADH)
C. Follicle-stimulating hormone (FSH)
D. Thyroid-stimulating hormone (TSH)

Laboratory findings indicating decreased levels of glucose and sodium and increased
levels of potassium and white blood cells (WBC) would correlate with which diagnosis?
A. Addison's disease
B. Cushing's syndrome
C. Diabetes mellitus
D. Hypothyroidism

An appropriate nursing diagnosis for a client with Addison's disease would include which
of the following assessments?
A. Risk for injury
B. Excess fluid volume
C. Impaired gas exchange
D. Ineffective thermoregulation

Nursing care for a client with Addison's disease may include which of the following goals?
A. Limiting fluid intake to 100 mL/day.
B. Participating in relaxation techniques.
C. Ambulating in the hall five to six times per day
D. Knowing which high-sodium foods to avoid.

Which of the following outcomes are expected for a client being treated for Addison's
disease?
A. Avoiding alcohol to decrease abdominal girth.
B. Avoiding hot and uncomfortable environments.
C. Reporting absence of postural hypotension symptoms.
D. Selecting and eating foods high in protein, calcium, and vit D.

Which of the following forms of severe hyperthyroidism is life threatening and produces
high fever, extreme tachycardia, and altered mental status?
A. Hyperosmolar hyperglycemic nonketotic syndrome (HHNS
B. Thyroid storm
C. Hepatic coma
D. Myxedema coma

A female client with hypothyroidism (myxedema) is receiving levothyroxine (Synthroid),

25 mcg P.O. daily. Which finding should nurse Hans recognize as an adverse drug effect?
A. Dysuria
B. Leg cramps
C. Blurred vision
D. Tachycardia

What test should be ordered if hypothyroidism is suspected?

A. Liver function tests
B. Hemoglobin A1c
C. T4 and thyroid-stimulating hormone
D. 24-hour urine free cortisol measurement

Nurse Oliver should expect a client with hypothyroidism to report which health concerns?
]C. Puffiness of the face and hands
D. Increased appetite and weight loss

Nurse Ruth is assessing a client after a thyroidectomy. The assessment reveals muscle
twitching and tingling, along with numbness in the fingers, toes, and mouth area. The
nurse should suspect which complication?
A. Tetany
B. Thyroid storm
C. Hemorrhage
D. Laryngeal nerve damage

Which of the following treatments can be used for hyperthyroidism

A. Administration of oral thyroid hormones
B. Irradiation of the thyroid
Hyperphosphatemia and hypocalcemia are indicative of which of the following disorders?
A. Hypothyroidism
B. Hypoparathyroidism
C. Cushing's Syndrome
D. Grave's Disease

After undergoing a subtotal thyroidectomy, a female client develops hypothyroidism. Dr.

Smith prescribes levothyroxine (Levothroid), 25 mcg P.O. daily. For which condition is
levothyroxine the preferred agent?
A. Thyrotoxicosis
B. Euthyroidism
C. Primary hypothyroidism
D. Graves' disease

The patient undergoes a therapy for the calcium replacements into his/her body. The
patient is correct if his/her calcium replacement is:
A. calcium gluconate
B. levothyroxine sodium
C. vasopressin
D. estrogen

Prior to the surgical procedure that involves the removal of the thyroid gland of the
patient who has excess hormone of the thyroid hormone, which is appropriate for the
nurse as part of pre-operative intervention for the patient:
A. check the level of the thyroid hormone.
B. position the patient into a high-fowlers position.
C. perform a reverse isolation technique to prevent infection.
D. explain the procedure to the patient as well as to the relatives.

The patient decided to go to the hospital for the physical consultation. In the hospital,
the physician suggests that the patient needs to undergo the surgical removal of the
thyroid gland to prevent the complication of the hypo-function of the thyroid gland. As a
nurse, you knowledgeable that the medical terminology of the patient's surgery is:
A. hypophysectomy
B. thyroidectomy
C. parathyroidectomy
D. adrenalectomy

The patient who has an exophthalmos is in need to undergo a surgical removal of the
thyroid gland in order to prevent the complication. A life-threatening situation for the
patient who has excess production of the thyroid hormone is :
A. thyroid complication
B. thyroid storm crisis
C. crisis thyroid storm
D. thyroid storm

The nurse on duty prepares a nursing care plan to a patient who has a low level of
calcium. In her nursing diagnosis, which of the following that she needs to prioritize in
order for him/her to plan an action to the patient:
D. risk for bone fracture

Ms. Pauline is aware that appearance of an exophthalmos is:

A. protrusion of the tongue
B. protrusion of the stomach
C. none of the choices
D. protrusion of the eyeballs

What does abbreviation PTU means

A. propelthyuracil
B. propylthiouracil
C. propylthyuracil
D. propylthiuracil

There were two patient who were scheduled to a surgical removal of the thyroid gland.
But their disease condition has something to do with an excess production of the thyroid
hormone. Which of the following endocrine disease that fits to the description of the
disease process of the patient:
A. hypothyroidism
B. hypoparathyroidism
C. hyperparathyroidism
D. hyperthyroidsim

The nurse is assessing the motor function of an unconscious male client. The nurse
would plan to use which plan to use
which of the following to test the client's peripheral response to pain?
A. Sternal rub
B. Nail bed pressure
C. Pressure on the orbital rim
D. Squeezing of the sternocleidomastoid muscle

A client is at risk for increased ICP. Which of the following would be a priority for the
nurse to monitor?
A. Unequal pupil size
B. Decreasing systolic blood pressure
C. Tachycardia
D. Decreasing body temperature

Which of the following nursing interventions is appropriate for a client with an ICP of 20
mm Hg?
A. Give the client a warming blanket.
B. Administer low-dose barbiturate.
C. Encourage the client to hyperventilate.
D. Restrict fluids.

A client has signs of increased ICP. Which of the following is an early indicator of
deterioration in the client's condition?
A. Widening pulse pressure
B. Decrease in the pulse rate
C. Dilated, fixed pupil
D. Decrease in LOC

A client who is regaining consciousness after a craniotomy becomes restless and

attempts to pull out her IV line. Which nursing intervention protects the client without
increasing her ICP?
A. Place her in a jacket restraint.
B. Wrap her hands in soft "mitten" restraints.
C. Tuck her arms and hands under the draw sheet.
D. Apply a wrist restraint to each arm.
In planning the care for a client who has had a posterior fossa (infratentorial) craniotomy,
which of the following is contraindicated when positioning the client?
A. Keeping the client flat on one side or the other.
B. Elevating the head of the bed to 30 degrees.
C. Log rolling or turning as a unit when turning.
D. Keeping the head in neutral position.

A 23-year-old patient with a recent history of encephalitis is admitted to the medical unit
with new onset generalized tonicclonic seizures. Which nursing activities included in the
patient's care? Select all that apply.
A. Document the onset time, nature of seizure activity, and postictal behaviors
for all seizures.
B. Administer phenytoin (Dilantin) 200 mg PO daily.
C. Teach patient about the need for good oral hygiene.
D. Develop a discharge plan, including physician visits and referral to the
Epilepsy Foundation.

Shortly after admission to an acute care facility, a male client with a seizure disorder
develops status epilepticus. The physician orders diazepam (Valium) 10 mg I.V. stat. How
soon can the nurse administer the second dose of diazepam, if needed and prescribed?
A. In 30 to 45 seconds
B. In 10 to 15 minutes
C. In 30 to 45 minutes
D. In 1 to 2 hours

A male client is having tonic-clonic seizures. What should the nurse do first?
A. Elevate the head of the bed.
B. Restrain the client's arms and legs.
C. Place a tongue blade in the client's mouth.
D. Take measures to prevent injury.

The nurse is caring for the male client who begins to experience seizure activity while in
bed. Which of the following actions by the nurse would be contraindicated?
A. Loosening restrictive clothing.
B. Restraining the client's limbs.
C. Removing the pillow and raising padded side rails.
D. Positioning the client to side, if possible, with the head flexed forward.

The staff nurse forgot to assess the respiratory pattern of the patient who has an
increase intra-cranial pressure, it is already expected that the respiration of the patient
who has an increase intra-cranial pressure is:
A. the patient's respiration is less than to 12cpm.
B. none of the choices
C. the patient will complain of difficulty of breathing
D. there is an existence of a barrel chest upon the respiration of the patient

The patient who complains of being thirsty into the staff nurse, the staff nurses is aware
of the patient's condition which is increased intra-cranial pressure that is associated with
cerebral edema. As a nurse, which statement that will be likely to tell to the patient:
A. please talk to the physician if you can drink a lot of fluid or limit your fluid intake
B. it has no limit in drinking water
C. you need to limit the fluid intake.
D. You can drink a lot of fluid in order for the fluid to excrete as fast as it is.

The patient who has an increased intracranial pressure is associated with a cerebral
edema, as a nurse on that specific station is precisely correct that the appropriate
intervention to the patient is:
A. elevate the head of bed of the patient
B. high fiber diet is necessary to the patient.
C. increase fluid intake to the patient
D. administer diuretics to the patient

Which of the following signs and symptoms of increased ICP after head trauma would
appear first?
A. Restlessness and confusion
B. Bradycardia
C. Large amounts of very dilute urine
D. Widened pulse pressure

Which of the following values is considered normal for ICP?

A. 25 mm Hg
B. 35 to 45 mm Hg
C. 0 to 15 mm Hg
D. 120/80 mm Hg

After the episodes of the seizure, the patient is still unconscious, the paramedics is
correct if they perform the priority intervention to the staff nurse:
A. gather and collect the valuable things of the patient and kept in secret
B. assess if there is an airway obstruction to the patient.
C. assess the rise and fall of the chest of the patient
D. assess the vital signs of the patient

The paramedics who assess the staff nurses on the scenario asks the bystanders on their
intervention into the patient, and one of them respond to the paramedics that they put a
spoon into the mouth of the patient. Which of the following response that will be
appropriate from the paramedics into the bystanders.
A. thank you, at least you help the patient.
B. are you out of your mind, you can kill the patient.
C. did you assess the level of the consciousness before you put something into the
mouth of the staff nurse
D. did you assess the airway pattern or even the breathing pattern
of the patient

A client with subdural hematoma was given mannitol to decrease intracranial pressure
(ICP). Which of the following results would best show the mannitol was effective?
A. Systolic blood pressure remains at 150 mm Hg.
B. BUN and creatinine levels return to normal.
C. Pupils are 8 mm and nonreactive.
D. Urine output increases.

The nurse will anticipate that the patient will undergo limitation of the fluid intake. You
are knowledgeable that the volume of fluid that will be given in to the patient is:
A. the volume of fluid that will be given into the patient is 1200L/day
B. the volume of the fluid that the patient should consume is 1200mm/day
C. it is 1200ml/day of fluid will be given into the patient
D. it should be 1200ml/week of fluid that the patient will be consume

A patient has a history of seizure, but unfortunately the epsidoes of his/her seizure is
already continuous episodes. The medical diagnosis of the physician into the staff nurse
is:
A. the patient's condition is already a form of terminal brain cancer
B. there is already a status asthamicus basing on the situation of the patient.
C. none of the choices
D. there is already a status epilepticus on the situation of the
patient.

Regular oral hygiene is an essential intervention for the client who has had a stroke.
Which of the following nursing measures is inappropriate when providing oral hygiene?
A. Placing the client on the back with a small pillow under the head.
B. Keeping portable suctioning equipment at the bedside.
C. Opening the client's mouth with a padded tongue blade.
D. Cleaning the client's mouth and teeth with a toothbrush.

A 78-year-old client is admitted to the emergency department with numbness and

weakness of the left arm and slurred speech. Which nursing intervention is a priority?
A. Prepare to administer recombinant tissue plasminogen activator (rt-PA).
B. Discuss the precipitating factors that caused the symptoms.
C. Schedule for A STAT computer tomography (CT) scan of the head.
D. Notify the speech pathologist for an emergency consult.

A client arrives in the emergency department with an ischemic stroke and receives tissue
plasminogen activator (t-PA) administration. Which is the priority nursing assessment?
A. Current medications.
B. Complete physical and history.
C. Time of onset of current stroke.
D. Upcoming surgical procedures.

During the first 24 hours after thrombolytic therapy for ischemic stroke, the primary goal
is to control the client's:
A. Pulse
B. Respirations
C. Blood pressure
D. Temperature

What is a priority nursing assessment in the first 24 hours after admission of the client
with a thrombotic stroke?
A. Cholesterol level
B. Pupil size and pupillary response
C. Bowel sounds
D. Echocardiogram

Which assessment data would indicate to the nurse that the client would be at risk for a
hemorrhagic stroke?
A. A blood glucose level of 480 mg/dl.
B. A right-sided carotid bruit.
C. A blood pressure of 220/120 mmHg.
D. The presence of bronchogenic carcinoma.

A client admitted to the hospital with a subarachnoid hemorrhage has complaints of

severe headache, nuchal rigidity, and projectile vomiting. The nurse knows lumbar
puncture (LP) would be contraindicated in this client in which of the following
circumstances?
A. Vomiting continues
B. Intracranial pressure (ICP) is increased
C. The client needs mechanical ventilation
D. Blood is anticipated in the cerebrospinal fluid (CSF)

A client with a subdural hematoma becomes restless and confused, with dilation of the
ipsilateral pupil. The physician orders mannitol for which of the following reasons?
A. To reduce intraocular pressure
B. To prevent acute tubular necrosis
C. To promote osmotic diuresis to decrease ICP
D. To draw water into the vascular system to increase blood pressure

A female client who's paralyzed on the left side has been receiving physical therapy and
attending teaching sessions about safety. Which behavior indicates that the client
accurately understands safety measures related to paralysis?
A. The client leaves the side rails down.
B. The client uses a mirror to inspect the skin.
C. The client repositions only after being reminded to do so.
D. The client hangs the left arm over the side of the wheelchair.

During recovery from a cerebrovascular accident (CVA), a female client is given nothing
by mouth, to help prevent aspiration. To determine when the client is ready for a liquid
diet, the nurse assesses the client's swallowing ability once each shift. This assessment
evaluates:
C. Cranial nerves VI and VIII.
D. Cranial nerves IX and X.

Numbness or weakness of the face

A. Ischemic stroke
B. Hemorrhagic stroke
It is caused by thrombus or emboli that results to occlusion
A. Ischemic Stroke
B. Hemorrhagic Stroke

The most common side effect of Thrombolytic Therapy (Recombinant t-PA) is:
A. Bleeding
B. Nausea and vomiting

The inability to speak.

A. Aphasia
B. Apraxia
C. Agnosia
D. Dysarthria

The most common manifestation to a patient having hemorrhagic stroke is:

A. Severe headache
B. Vomiting
C. Change in level of consciousness
D. Seizure

It is caused by cerebral aneurysm

A. Hemorrhagic stroke
B. Ischemic stroke

The inability to recognize previously familiar objects perceived by one or more of the
senses.
A. Hemianopsia
B. Aphasia
C. Apraxia
D. Agnosia

The inability to perform a previously learned action

A. Agnosia
B. Apraxia
C. Dysarthria
D. Aphasia

When a stroke patient has difficulty in speaking, he/she has:

C. Agnosia
D. Dysarthria

It is primarily caused by intracranial or subarachnoid hemorrhage.

A. Hemorrhagic stroke
B. Ischemic stroke

A male client has an impairment of cranial nerve II. Specific to this impairment, the nurse
would plan to do which of the following to ensure client to ensure client safety?
A. Speak loudly to the client
B. Test the temperature of the shower water
C. Check the temperature of the food on the delivery tray.
D. Provide a clear path for ambulation without obstacles

An 18-year-old client is admitted with a closed head injury sustained in an MVA. His
intracranial pressure (ICP) shows an upward trend. Which intervention should the nurse
perform first?
A. Reposition the client to avoid neck flexion
B. Administer 1 g Mannitol IV as ordered

A client comes into the ER after hitting his head in an MVA. He's alert and oriented.
Which of the following nursing interventions should be done first?
A. Assess full ROM to determine extent of injuries
B. Call for an immediate chest x-ray
C. Immobilize the client's head and neck
D. Open the airway with the head-tilt-chin-lift maneuver

A 23-year-old client has been hit on the head with a baseball bat. The nurse notes clear
fluid draining from his ears and nose. Which of the following nursing interventions should
be done first?
A. Position the client flat in bed
B. Check the fluid for dextrose with a dipstick
C. Suction the nose to maintain airway patency
D. Insert nasal and ear packing with sterile gauze

An 18-year-old client was hit in the head with a baseball during practice. When
discharging him to the care of his mother, the nurse gives which of the following
instructions?
A. "Watch him for keyhole pupil the next 24 hours."
B. "Expect profuse vomiting for 24 hours after the injury."
C. "Wake him every hour and assess his orientation to person, time,
and place."
D. "Notify the physician immediately if he has a headache."

Lumbar puncture is performed on a child suspected of having bacterial meningitis. CSF is

obtained for analysis. A nurse reviews the results of the CSF analysis and determines
that which of the following results would verify the diagnosis?
B. Cloudy CSF, elevated protein, and decreased glucose

A nurse is planning care for a child with acute bacterial meningitis. Based on the mode of
transmission of this infection, which of the following would be included in the plan of
care?
A. No precautions are required as long as antibiotics have been started
B. Maintain enteric precautions
C. Maintain respiratory isolation precautions for at least 24 hours
after the initiation of antibiotics
D. Maintain neutropenic precautions

Which of the following assessment data indicated nuchal rigidity?

A. Positive Kernig's sign
B. Negative Brudzinski's sign
C. Positive homan's sign
D. Negative Kernig's sign

Which of the following are considered as the initial symptoms of HSV-1 encephalitis?
Select all that apply.
A. Confusion
B. Seizure
C. Headache
D. Behavioral changes
E. Fever
5. The nurse is assessing a 37-year-old client diagnosed with multiple sclerosis. Which of
the following symptoms would the nurse expect to find?
A. Vision changes
B. Absent deep tendon reflexes
C. Tremors at rest
D. Flaccid muscles

The nurse is teaching a female client with multiple sclerosis. When teaching the client
how to reduce fatigue, the nurse should tell the client to:
A. Take a hot bath.
B. Rest in an air-conditioned room.
C. Increase the dose of muscle relaxants.
D. Avoid naps during the day.

A physician diagnoses a client with myasthenia gravis, prescribing pyridostigmine

(Mestinon), 60 mg P.O. every 3 hours. Before administering this anticholinesterase agent,
the nurse reviews the client's history. Which preexisting condition would contraindicate
the use of pyridostigmine?
A. Ulcerative colitis
B. Blood dyscrasia
C. Intestinal obstruction
D. Spinal cord injury

A female client has experienced an episode of myasthenic crisis. The nurse would assess
whether the client has precipitating factors such as:
A. Getting too little exercise
B. Taking excess medication
C. Omitting doses of medication
A female client is admitted to the hospital with a diagnosis of Guillain-Barre syndrome.
The nurse inquires during the nursing admission interview if the client has a history of:
A. Seizures or trauma to the brain
B. Meningitis during the last five (5 years
C. Back injury or trauma to the spinal cord
D. Respiratory or gastrointestinal infection during the previous
month.

The nurse is teaching the female client with myasthenia gravis about the prevention of
myasthenic and cholinergic crises. The nurse tells the client that this is most effectively
done by:
A. Eating large, well-balanced meals
B. Doing muscle-strengthening exercises
C. Doing all chores early in the day while less fatigued
D. Taking medications on time to maintain therapeutic blood levels

It is a rare but serious autoimmune disorder in which the immune system attacks healthy
nerve cells in your peripheral nervous system
A. Multiple sclerosis
B. Encephalitis
C. Meningitis
D. Guillain-Barre Syndrome
E. Myasthenia Gravis

It produces ascending weakness

A. Multiple sclerosis
B. Encephalitis
C. Meningitis
D. Guillain-Barre Syndrome
E. Myasthenia Gravis

It is an inflammation (swelling) of the protective membranes covering the brain and

spinal cord
A. Multiple sclerosis
B. Encephalitis
C. Meningitis
D. Guillain-Barre Syndrome
E. Myasthenia Gravis

Destruction of myelin sheath

A. Multiple sclerosis
B. Encephalitis
C. Meningitis
D. Guillain-Barre Syndrome
E. Myasthenia Gravis

Antibodies attack acetylcholine receptor sites

A. Multiple sclerosis
B. Encephalitis
C. Meningitis
D. Guillain-Barre Syndrome
E. Myasthenia Gravis

It is a demyelinating disease in which the insulating covers of nerve cells in the brain and
spinal cord are damaged
A. Multiple sclerosis
B. Encephalitis
C. Meningitis
D. Guillain-Barre Syndrome
E. Myasthenia Gravis
It is a chronic autoimmune, neuromuscular disease that causes weakness in the skeletal
muscles that worsens after periods of activity and improves after periods of rest
A. Multiple sclerosis
B. Encephalitis
C. Meningitis
D. Guillain-Barre Syndrome
E. Myasthenia Gravis
E. Myasthenia Gravis

Positive Brudzinski' sign

A. Multiple sclerosis
B. Encephalitis
C. Meningitis
D. Guillain-Barre Syndrome
E. Myasthenia Gravis
Nuchal rigidity
A. Multiple sclerosis
B. Encephalitis
C. Meningitis
D. Guillain-Barre Syndrome
E. Myasthenia Gravis

It is an inflammation of the brain tissue

A. Multiple sclerosis
B. Encephalitis
C. Meningitis
D. Guillain-Barre Syndrome
E. Myasthenia Gravis

Tic douloureux is characterized by paroxysms of pain and burning sensations. It is a

disorder of which cranial nerve?
A. Third
B. Fifth
C. Seventh
D. Eighth

Which of the following drugs is used for trigeminal neuralgia?

A. Riluzole (Rilutek)
B. Levodopa (Larodopa)
C. Carbamazepine (Tegretol)
D. Ceftriaxone sodium (Rocephin)

A male client with Bell's Palsy asks the nurse what has caused this problem. The nurse's
response is based on an understanding that the cause is:
A. Unknown, but possibly includes ischemia, viral infection, or an
autoimmune problem
B. Unknown, but possibly includes long-term tissue malnutrition and cellular hypoxia
C. Primary genetic in origin, triggered by exposure to meningitis
D. Primarily genetic in origin, triggered by exposure to neurotoxins
The nurse has given the male client with Bell's palsy instructions on preserving muscle
tone in the face and preventing denervation. The nurse determines that the client needs
additional information if the client states that he or she will:
A. Exposure to cold and drafts
B. Massage the face with a gentle upward motion
C. Perform facial exercises
D. Wrinkle the forehead, blow out the cheeks, and whistle

The care team has deemed the occasional use of restraints necessary in the care of a
patient with Alzheimer's disease. What ethical violation is most often posed when using
restraints in a long-term care setting?
A. It limits the patient's personal safety.
B. It exacerbates the patient's disease process.
C. It threatens the patient's autonomy.
D. It is not normally legal
An 83-year-old woman was diagnosed with Alzheimer's disease 2 years ago and the
disease has progressed at an increasing pace in recent months. The patient has lost 16
pounds over the past 3 months, leading to a nursing diagnosis of Imbalanced Nutrition:
Less than Body Requirements. What intervention should the nurse include in this
patient's plan of care?
A. Offer the patient rewards for finishing all the food on her tray.
B. Offer the patient bland, low-salt foods to limit offensiveness.
C. Offer the patient only one food item at a time to promote
focused eating.
D. Arrange for insertion of a gastrostomy tube and initiate enteral feeding.

Which nursing diagnosis takes highest priority for a client with Parkinson's crisis?
A. Imbalanced nutrition: Less than body requirements
B. Ineffective airway clearance
C. Impaired urinary elimination
D. Risk for injury

When evaluating the extent of Parkinson's disease, a nurse observes for which of the
following conditions?
A. Bulging eyeballs
B. Diminished distal sensations
C. Increased dopamine levels
D. Muscle rigidity
D. Muscle rigidity

A female client with amyotrophic lateral sclerosis (ALS) tells the nurse, "Sometimes I feel
so frustrated. I can't do anything without help!" This comment best supports which
nursing diagnosis?
A. Anxiety
B. Powerlessness
C. Ineffective denial
D. Risk for disuse syndrome
Which of the following clinical manifestations suggest ALS?
A. Fatigue, progressive muscle weakness, cramps, fasciculations
(twitching), and incoordination
B. Tremor, rigidity, bradykinesia (abnormally slow movements), and postural instability

Parkinson's disease is associated with decreased levels of __________ resulting from

destruction of pigmented neuronal cells in the substantia nigra in the basal ganglia
region of the brain.
A. Dopamine
B. Serotonin
C. Acetylcholine
D. Epinephrine

Amyotrophic lateral sclerosis (ALS) is a disease of unknown cause in which there is a loss
of __________ neurons (nerve cells controlling muscles)
A. Motor
B. Sensory
C. Sensorimotor
D. Sensorineural

Bell's palsy (facial paralysis) is caused by unilateral inflammation of the seventh cranial
nerve, which results in weakness or paralysis of the __________ muscles on the affected
side.
A. Facial
B. Trigeminal
C. Vagal
D. Hypoglossal

The clinic nurse is preparing to test the visual acuity of a client using a Snellen chart.
Which of the following identifies the accurate procedure for this visual acuity test?
A. Both eyes are assessed together, followed by the assessment of the right and then the
left eye.
B. The right eye is tested followed by the left eye, and then both
eyes are tested.
C. The client is asked to stand at a distance of 40ft. from the chart and is asked to read
the largest line on the chart.

Tonometry is performed on the client with a suspected diagnosis of glaucoma. The nurse
analyzes the test results as documented in the client's chart and understands that
normal intraocular pressure is:
A. 2-7 mmHg
B. 10-21 mmHg
C. 22-30 mmHg
D. 31-35 mmHg

Which of the following refractive surgeries has high success rate?

A. Laser Vision Correction Photorefractive Keratectomy (PRK)
B. Laser-Assisted In Situ Keratomileusis (LASIK)
C. Phakic Intraocular Lenses
D. Conductive Keratoplasty
After an eye examination, a male client is diagnosed with open-angle glaucoma. The
physician prescribes Pilocarpine ophthalmic solution (Pilocar), 0.25% gtt i, OU q.i.D.
Based on this prescription, the nurse should teach the client or a family member to
administer the drug by:
A. Instilling one drop of pilocarpine 0.25% into both eyes daily.
B. Instilling one drop of pilocarpine 0.25% into both eyes four times
daily.
C. Instilling one drop of pilocarpine 0.25% into the right eye daily.
D. Instilling one drop of pilocarpine 0.25% into the left eye four times daily.

The client with glaucoma asks the nurse is complete vision will return. The most
appropriate response is:
A. "Although some vision as been lost and cannot be restored,
further loss may be prevented by adhering to the treatment
plan.

The nurse is developing a teaching plan for the client with glaucoma. Which of the
following instructions would the nurse
include in the plan of care?
A. Decrease fluid intake to control the intraocular pressure
B. Avoid overuse of the eyes
C. Decrease the amount of salt in the diet
D. Eye medications will need to be administered lifelong.

The client is being discharged from the ambulatory care unit following cataract removal.
The nurse provides instructions regarding home care. Which of the following, if stated by
the client, indicates an understanding of the instructions?
A. "I will take Aspirin if I have any discomfort."
B. "I will sleep on the side that I was operated on."
C. "I will wear my eye shield at night and my glasses during the
day."
D. "I will not lift anything if it weighs more that 10 pounds."

When obtaining the health history from a male client with retinal detachment, the nurse
expects the client to report:
A. Light flashes and floaters in front of the eye.
B. A recent driving accident while changing lanes.
C. Headaches, nausea, and redness of the eyes.
D. Frequent episodes of double vision.

After pneumatic retinopexy, the patient must be placed in:

A. Side-lying position
B. Prone position
C. Trendelenburg position
D. Recumbent position

The most common manifestation in dry eye syndrome is:

A. Excessive mucus secretions
B. Difficulty moving the lids
C. Burning sensation
D. Scratchy or foreign body sensation

It is the inflammation of the conjunctiva.

G. Conjunctivitis

Measures IOP by determining the pressure necessary to indent or flatten (applanate) a

small anterior area of the globe of the eye.
A. Tonometry
Enables the examiner to examine the eye with magnification of 10 to 40 times the real
image.
A. Direct Ophthalmoscopy
B. Indirect Ophthalmoscopy
C. Slit-Lamp Examination
D. Color Vision Testing

Refers to the separation of the retinal pigment epithelium (RPE) from the sensory layer.
D. Retinal Detachment
The most common cause of visual loss in people older than 60 years of age, central
vision is generally the most affected, with most patients retaining peripheral vision.
E. Age-related Macular Degeneration

It is a deficiency in the production of any of the aqueous, mucin, or lipid tear film
components
F. Dry Eye Syndrome
Vision is impaired because a shortened or elongated eyeball prevents light rays from
focusing sharply on the retina.
A. Refractive Errors
It is the opacity or cloudiness of the lens.
C. Cataract
Helps identify which parts of the patient's central and peripheral visual fields have useful
vision.
A. Tonometry
B. Perimetry
The optic nerve damage is related to the increased intraocular pressure (IOP) caused by
congestion of aqueous humor in the eye.
B. Glaucoma
considered as the standard normal vision
C. 20/20
Painless, blurry vision
B. Cataract
Sensation of a shade or curtain coming across the vision of one eye, cobwebs, bright
flashing lights, or the sudden onset of a great number of floaters.
D. Retinal Detachment

Normal IOP is:

A. 15 to 30 mmHg
B. 10 to 21 mmHg
Scratching or burning sensation, itching, and photophobia
A. Dry Eye Syndrome
B. Age-related Macular Degeneration
C. Conjunctivitis
"Halos" around lights
C. Glaucoma
Scratchy or foreign body sensation
D. Dry Eye Syndrome

It is the leading cause of blindness in the world.

B. Cataract
Composed of a series of progressively smaller rows of letters- used to test distance vision
D. Snellen Chart

Tiny, yellowish spots (drusen) beneath the retina

D. Age-related Macular Degeneration
The nurse is performing a voice test to assess hearing. Which of the following describes
the accurate procedure for performing this test?
A. Stand 4 feet away from the client to ensure that the client can hear at this distance.
B. Whisper a statement and ask the client to repeat it.
C. Whisper a statement with the examiners back facing the client
D. Whisper a statement while the client blocks both ears

During a hearing assessment, the nurse notes that the sound lateralizes to the clients
left ear with the Weber test. The nurse analyzes this result as:
A. A normal finding
B. A conductive hearing loss in the right ear
C. A sensorineural or conductive loss
D. The presence of nystagmus

The nurse is caring for a client that is hearing impaired. Which of the following
approaches will facilitate communication?
A. Speak frequently
B. Speak loudly
C. Speak directly into the impaired ear
D. Speak in a normal tone

The nurse has notes that the physician has a diagnosis of presbycusis on the client's
chart. The nurse plans care knowing the condition is:
A. A sensorineural hearing loss that occurs with aging
B. A conductive hearing loss that occurs with aging.
C. Tinnitus that occurs with aging
D. Nystagmus that occurs with aging

The most common fungus associated with external ear infection is:
C. Aspergillus
A nurse would question an order to irrigate the ear canal in which of the following
circumstances?
A. Ear pain
B. Hearing loss
C. Otitis externa
D. Perforated tympanic membrane

Postoperative nursing assessment for a patient who has had a mastoidectomy should
include observing for:
A. Facial paralysis
B. Olfactory paralysis
C. Optic paralysis
D. Oculomotor paralysis

A male client with a conductive hearing disorder caused by ankylosis of the stapes in the
oval window undergoes a stapedectomy to remove the stapes and replace the impaired
bone with a prosthesis. After the stapedectomy, the nurse should provide which client
instruction?
D. "Don't fly in an airplane, climb to high altitudes, make sudden
movements, or expose yourself to loud sounds for 30 days."
The nurse has conducted discharge teaching for a client who had a fenestration
procedure for the treatment of otosclerosis. Which of the following, if stated by the client,
would indicate that teaching was effective?
A. "I should drink liquids through a straw for the next 2-3 weeks."
B. "It's ok to take a shower and wash my hair."
C. "I will take stool softeners as prescribed by my doctor."
D. "I can resume my tennis lessons starting next week."

Which of the following medications relieves motion sickness symptoms?

A. Corticosteroids
B. Antihistamines
C. Diuretics
D. Antibiotics

A client with Meniere's disease is experiencing severe vertigo. Which instruction would
the nurse give to the client to assist in controlling the vertigo?
A. Increase fluid intake to 3000 ml a day
B. Avoid sudden head movements
C. Lie still and watch the television
D. Increase sodium in the diet

The nurse is reviewing the physician's orders for a client with Meniere's disease. Which
diet will most likely be prescribed?
A. Low-cholesterol diet
B. Low-sodium diet
C. Low-carbohydrate diet
D. Low-fat diet

Canalith repositioning is performed to patients with benign paroxysmal positional vertigo

to:
A. Relieve nausea and vomiting
B. Treat vertigo
C. Enhance disequilibrium
D. Suppress vestibular function

A client is diagnosed with a disorder involving the inner ear. Which of the following is the
most common client complaint associated with a disorder in this part of the ear?
A. Hearing loss
B. Pruritus
C. Tinnitus
D. Burning of the ear

A client who is complaining of tinnitus is describing a symptom that is:

A. Objective
B. Subjective
The single most important diagnostic instrument in detecting hearing loss
A. Audiometry
B. Tympanogram
C. Weber Test

This involves damage to the cochlea or vestibulocochlear nerve.

C. Weber Test
Used to distinguish between conductive and sensorineural hearing loss
D. Rinne Test
Measures middle ear muscle reflex to sound stimulation and compliance of the tympanic
membrane by
B. Tympanogram
Used to test lateralization of sound.
E. Sensorineural Hearing Loss

Tympanoplasty is surgically performed to:

A. Prevent recurrent infection
B. Accomplish all of the above
C. Reestablish middle ear function
D. Close a perforation

A myringotomy, the most common procedure for acute otitis media, is performed
primarily to:
A. Identify the infecting organism
B. Relieve tympanic membrane pressure
C. Drain purulent fluid
D. Accomplish all of the above

A client with osteoarthritis has a prescription for Celebrex (celecoxib). Which instruction
should be included in the discharge teaching?
A. Take the medication with milk.
B. Report chest pain.
Pathophysiologic changes seen with osteoarthritis include:
A. Joint cartilage degeneration.
B. The formation of bony spurs at the edges of the joint surfaces.
C. Narrowing of the joint space.
A client has been prescribed a diet that limits purine-rich foods. Which of the following
foods would the nurse teach him to avoid eating?
A. Bananas and dried fruits
B. Milk, ice cream, and yogurt
C. Wine, cheese, preserved fruits, meats, and vegetables
D. Anchovies, sardines, kidneys, sweetbreads, and lentils

A client with gout is encouraged to increase fluid intake. Which of the following
statements best explains why increased fluids are encouraged for gout?
A. Fluids decrease inflammation.
B. Fluids increase calcium absorption.
C. Fluids promote the excretion of uric acid.
D. Fluids provide a cushion for weakened bones

Alendronate (Fosamax) is given to a client with osteoporosis. The nurse advises the client
to?
A. Take the medication in the morning with meals.
B. Take the medication 2 hours before bedtime.
C. Take the medication with a glass of water after rising in the
morning.
D. Take the medication during lunch.

The nurse knows that a 60-year-old female client's susceptibility to osteoporosis is most
likely related to:
A. Lack of exercise
B. Hormonal disturbances
C. Lack of calcium
D. Genetic predisposition
The most common symptoms of osteomalacia are:
A. Bone fractures and kyphosis
B. Bone pain and tenderness
C. Muscle weakness and spasm
D. Softened and compressed vertebrae

Which of the following dietary management is recommended to patient with

osteomalacia associated with diet?
A. Adequate calcium and low protein intake
B. Adequate protein and moderate vitamin intake
C. Restrict calcium and vitamin D intake
D. Increase calcium and vitamin D intake

Which of the following medications used in Paget's disease which facilitates remodeling
of abnormal bone?
A. Plicamycin
B. Calcitonin
C. Dexamethasone
D. Atropine sulfate

Which of the following diagnostic tests confirms Paget's disease?

A. X-ray
A 20-year-old client developed osteomyelitis 2 weeks after a fishhook was removed from
his foot. Which of the following rationales best explain the expected long-term antibiotic
therapy needed?
A. Bone has poor circulation.
B. Tissue trauma requires antibiotics.
C. Feet are normally more difficult to treat.
D. Fishhook injuries are highly contaminated.

Management for a patient with sprain includes RICE? Which of the following is the correct
meaning of ICE?
A. Rise, Ice, Compression, and Elevation
B. Rest, Ice, Compression, and Elevation
C. Rinse, Immobilize, Cast, and Elevation
D. Rest, Immobilize, Compression, and Elevation

Which of the following is the primary treatment of septic arthritis?

A. Aspiration of joint fluid
B. Arhtrotomy
C. Antibiotics
D. Arthroscopy

A client who has an above-the-knee amputation is to use crutches until the prosthesis is
properly fitted. When teaching the client about using the crutches, the nurse instructs
the client to support her weight primarily on which of the following body areas?
A. Axillae
B. Elbows
C. Upper arms
D. Hands

Nursing interventions to treat a musculoskeletal injury may include cold or heat therapy.
Cold therapy decreases pain by which of the following actions?
A. Promotes analgesia and circulation
B. Numbs the nerves and dilates the vessels
C. Promotes circulation and reduces muscle spasms
D. Causes local vasoconstriction and prevents edema or muscle
spasm

It is a localized disorder of bone remodeling that typically begins with excessive bone
resorption followed by an increase in bone formation
A. Paget's disease
Literally means porous bone, is a disease in which the density and quality of bone are
reduce
B. Osteoporosis
It is also called as degenerative joint disease or "wear and tear" arthritis and the most
common form of arthritis
C. Osteoarthritis
It refers to a marked softening of your bones, most often caused by severe vitamin D
deficiency.
D. Osteomalacia
It is a kind of arthritis caused by a buildup of uric acid crystals in the joints
E. Gout

A client describes a foul odor from his cast. Which of the following responses or
interventions would be the most appropriate?
A. Assess further because this may be a sign of infection.
B. Teach him proper cast care, including hygiene measures.
C. This is normal, especially when a cast is in place for a few weeks.
D. Assess further because this may be a sign of neurovascular compromise.

To reduce the roughness of a cast, which of the following measures should be used?
A. Petal the edges.
B. Elevate the limb.
C. Break off the rough area.
D. Distribute pressure evenly.
A client is put in traction before surgery. Which of the following reasons for the traction is
correct?
A. Prevents skin breakdown
B. Aids in turning the client
C. Helps the client become active
D. Prevents trauma and overcomes muscle spasms
After a hip replacement, which of the following activity level is usually ordered?
A. Bed rest
B. No restrictions
C. No weight bearing
D. Limited weight bearing

Which of the following discharge instructions should be given to a client after surgery for
repair of a hip fracture?
A. "Don't flex the hip more than 30 degrees, don't cross your legs, get help putting on
your shoes."
B. "Don't flex the hip more than 60 degrees, don't cross your legs, get help putting on
your shoes."
C. "Don't flex the hip more than 90 degrees, don't cross your legs,
get help putting on your shoes."

Which of the following symptoms are considered signs of a fracture?

A. Tingling, coolness, loss of pulses
B. Loss of sensation, redness, coolness
C. Coolness, redness, new site of pain
D. Redness, warmth, pain at the site of injury

Which of the following serious complications can occur with long bone fractures?
B. Fat emboli
Which of the following symptoms is an early sign of compartment syndrome?
B. Paresthesia

Treatment of compartment syndrome includes which of the following measures?

C. Fasciotomy

Which of the following areas would be included in a neurovascular assessment?

A. Orientation, movement, pulses, warmth
B. Capillary refill, movement, pulses, warmth
C. Orientation, pupillary response, temperature, pulses
D. Respiratory pattern, orientation, pulses, temperature

The physician suggests a certain procedure to confirm if the patient has a certain of
arthritis that has the same signs and symptoms to the patient. What findings of the
diagnostic procedure that confirms that the patient has a certain kind of arthritis:
A. elevation of white blood cells.
B. elevation liver enzymes
C. elevation of the cholesterol level
D. elevation of the erythrocytes sedimentation rate

For a client diagnosed with Ewing's sarcoma, which test is most useful in determining the
extent of metastasis?
A. Bone scan
B. Computerized tomography (CT) scan
C. Positron emission tomography (PET
D. Magnetic resonance imaging (MRI)

The elderly patient who has an osteoporosis is instructed by the nutritionist to eat foods
that has a high level of calcium. As a nurse, you are aware that the foods that the high
level concentration of calcium is:
C. yogurt
D. cheese

In the medical mission, a medical technologist also found out that the majority of the
result of the laboratory among the elderly peoples has excess of the level of uric acid.
Upon reading the results, you anticipate that that elderly patient that has an excess of
the uric acid has a certain condition that is:
A. the patient's condition is osteoarthritis
B. the patient's condition is possible of osteoporosis
C. none of the choices
D. the patient's condition is gout arthritis.

What will be the least priority nursing intervention to a patient who has a joint pain that
has a tentative diagnosis of osteoarthritis
A. apply paraffin bath to the affected joint cavity to the patient.
B. ice compression is still applicable to the patient who has osteoarthritis.
C. provide rest to the patient and immobilize the affected joint cavity.
D. encourage the patient to engage in any kind of sports.

Osteomyelitis most commonly results from which of the following mechanisms?

A. Trauma
The physical therapist recommends the elderly patient to go back on the next morning
for their passive exercises. As a nurse, you are correct that the correct description of the
said exercise is
A. the physical therapist will encourage or even gives an instruction from the patient to
participate in any form of exercises.
B. the physical therapist will guide in every movement of the patient during the
exercises.
C. the physical therapist will conduct an exercises that involves forces or any
effort from the patient during the exercises.
D. the physical therapist will be the one to perform the exercises with the guidance of
the patient.

The finding of a physician to elderly patient who is complaining of joint pain is

rheumatoid arthritis. What best describes about the disease process of an elderly patient
basing on the choices below:
A. it is a degenerative and progressive diseases of the joint.
B. none of the choices
C. it is caused by an excessive accumulation of urate crystals of a certain joint cavity.
D. it is a chronic systemic inflammation of the joint cavity.
Mr. Miller has been diagnosed with bone cancer. You know this type of cancer is classified
as
C. sarcoma.

The nurse is correct if he/she anticipates that the medication will be given to the patient
for inflammation of the joint cavity aside from pain medication is:
B. Non-steroidal anti-inflammatory drugs

An elderly patient who complaint of joint pain and also has a presence of a bony growth
in the distal interphalangeal ends of the finger. Based on the situation of the patient, you
are correct that the patient is experiencing of what kind of disease condition:
D. osteoarthritis is the closest condition that the possibility that
the patient experience.

In the orthopedic ward, the elderly patient fell down. The staff nurses assist the patient
as fast as they can and the resident on duty prescribed to let the patient undergo into
the magnetic resonance imaging. The result of the diagnostic procedure reveals that the
patient has a bone fracture already. Which of the following best describes about fracture:
A. it happens mainly of lack of vitamin D.
B. it has something to do with break of the continuity of the bone.
C. it has something to do with systemic viral infection.
D. it involves the excessive accumulation of the urate crystals.

A bone fracture that has a splintering on one side of the bone:

B. greenstick bone fracture

The elderly patient will have a traction on the neck portion. Which of the traction that is
applicable on the neck portion:
B. cervical neck traction.

The fracture of the patient is classified into general fracture. Which of the following
fracture belongs to the general classification of the fracture:
A. complicate bone fracture
B. all of the choices
C. simple bone fracture
D. complete bone fracture

The staff nurse should be aware of the signs and symptoms of continuous pain on where
the cast is applied it is because of the possible condition which is
D. compartment sign and symptoms

A kind of a bone fracture that exist into the distal ends of the fibula:
A. dpott's fracture
Another traction that will apply to the elderly patient is buck skin traction. Which of the
following choices below that best describes about bucks skin traction:
A. it pulls down the neck portion of the patient.
B. it pulls down the lower extremities in an angle of 45 degrees using the weight
C. it pulls down the lower extremities with in a straight motion
using the weight.
D. it pulls down the pelvic, hips and even the lower extremities of the patient.
C. it pulls down the lower extremities with in a straight motion using the weight.