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1. A nurse is assisting with the care of a client with a nasogastric tube(N/G) tube. The nurse understands that which of the following would be the most potentially hazardous, method for checking tube placement when caring for the client? A. Measuring the pH of the gastric aspirate. B. Submerging the N/G tube in water to check for bubbling. C. Aspirating the N/G tube with 50 mL syringe for gastric content. D. Instilling 10-20mL of air into the N/G tube while auscultating over the stomach. 2. A nurse employed in the physician’s office is asked to check a client who is at low risk for contracting tuberculosis(TB) for the results of the purified protein derivative (PPD) test implanted 72 hours previously. The nurse determines that the PPD indurations has a diameter of 11mm. What action should the nurse do first? A. Notify the physician B. Ask the client for permission to repeat the test. C. Document the normal finding in the client’s record. D. Tell the client to make an appointment with a pulmonologist. 3. A nurse is assisting with caring for a client with a central intravenous (IV) line who is receiving IV solutions. The client suddenly develops tachycardia, dyspnea and cyanosis are noted. The nurse suspects and air embolism. Which initial nursing action should the nurse take? A. Slow the IV rate. B. Provide emotional support for the client. C. Elevate the head of the bed and monitor the vital signs. D. Turn the client on the left side and lower the head of the bed. 4. A nurse is checking an intravenous(IV) site of a client and an infiltration is suspected. The nurse notes which of the following if an infiltration has occurred? a. Warmth at the site B. Redness at the site C. Coolness at the site D. Inflammation at the site, 5.A client arrives at the nursing unit after abdominal surgery. A nasogastric tube (N/G) is in place an physician has instructed that the NG tube be attached to intermittent suction. The nurse monitors client that an NG attached to suction is at risk for which acid-base disorder? a. Metabolic acidosis B. Metabolic alkalosis C. Respiratory acidosis D. Respiratory alkalosis 6. A nurse is monitoring the intravenous site (IV) of a client receiving an IV solution and suspects thrombophlebitis Which sign indicates that thrombophlebitis has occurred? a. Inflammation at the IV site B. Coolness around the IV site C. Edema and coolness at the IV site D. A hard or cord like feeling along the vein 7. A nurse is monitoring the intravenous site (IV) tells the nurse that the IV site is swollen. The nurse assessed the IV site and notes that it is also cool and pale and that the IV has stopped running . Which of the following has probably occurred? A. Phlebitis B. Infection C. Infiltration D. Thrombosis 8. A client is being treated for diabetlc ketoacidosis!(DKA). The nurse monitors for which of the following as the most serious electrolyte disturbances that can accompany the treatment of this disorder? A. Hypokalemia B. Hyponatremia C. Hypocalcemia D. Hypomagnesemia 9. The nurse reviews a child’s health care record and notes that the laboratory values indicate a Potassium level of 3.2/mEg/L. Which clinical manifestation does the nurse expect to note in this child? a.Nausea B. Muscle weakness C. Increased bowel sounds D. Elevated blood pressure 10. A nurse is monitoring a client with hypoparathyroidism for signs of hypocalcemia. The nurse wraps a blood pressure (BP) cuff around the client’s upper arm, inflate the cuff and monitors for spasms of the wrist and the hand. The nurse documents the findings, knowing that this test signals the presence of which of the following? a.Homan’s sign. B. Chvostek’s sign. C. Trousseau’s sign D. Positive Allen’s test 11. A client has parenteral nutrition that is infusing, per the physician’s order at 75 mL. per hour. The nurse prepares to care for the client and plans to do which of the following? a.Monitor the urine output hourly B. Monitor the vital signs every hour. C. Monitor for dependent edema every hour. D. Monitor for blood glucose level every 4 to 6 hots. 12. A nurse is reviewing the records of several hospitalized client to identify the clients who are candidates for receiving parenteral nutrition. Select all of the clients who would be candidates? A. A client with severe injury. B. A client with congestive heart failure. C. A client with severe anorexia nervosa. D. A client with malabsorption syndrome. E. A client with uncomplicated gastroenteritis. F. A client receiving chemotherapy who has severe vomiting and diarrhea. 13. A nurse is caring for a client who has nasogastric tube (NG) tube in place that has been connected to suction after abdominal surgery. Which observation by the nurse indicates that the tube is functioning properly? a.The suction gauge reads low intermittent suction. B. The client indicates that the pain is a 3 on a 1-10 scale. C. The distal end of the NG tube is pinned to the client’s gown. D. The client denies nausea and has 250 mL of fluid in the collection container. 14. A client with colostomy is complaining of gas building up in the colostomy bag. The nurse tells the client that which food item is least likely to aggravate the problem? a.Corn B. Beans C. Potatoes D. Cauliflower 15.A physician has inserted a nasoenteric tube for the treatment of intestinal obstruction. The nurse raises the head of the bed and tells the client to lie in which position to help the tube advances into the duodenum through the pyloric sphincter? a.On the left side. B. On the right side. C. Supine with the head of the bed flat. D. Supine with the head of the bed elevated at 30 degrees angle. 16. A nurse is assisting a physician who is performing abdominal paracentesis on a client. The nurse should assist with placing the client into which of the following positions for the procedure? a. Supine. B. Left lateral position. C. Right lateral position. D. Upright or high fowler’s position. 17. A nurse is monitoring a client after endoscopic retrograde cholangiopancreatography for complications of the procedure. Which of the following indicates a potential complication? a.Lethargy. B. Abdominal pain C. Lack of gag reflex D. Lack of cough reflex 18. A client with duodenal ulcer asks the nurse why an antibiotic has been prescribed? The nurse responds by the telling the client that this medication will do which of the following? a.Reduce the inflammation. B. Prevent secondary infections. C. Soothe the inflamed mucosal surface. D. Eliminate the bacteria that impairs mucosal function. 19. A client with pancreatitis is experiencing severe pain from the disorder. The nurse should avoid placing the client in which of the following positions? A. Recumbent B. Semi-fowler’s C. Side lying with legs flexed D. Upright and leaning forward 20. A client arrives at the nursing unit after abdominal surgery. A nasogastric tube is in place and physician has instructed that the NG tube be attached to intermittent suction. The nurse monitors client knowing that the client with an NG tube attached to suction is at risk for which acid-base disorder? a.Metabolic acidosis B. Metabolic alkalosis C. Respiratory acidosis D.Respiratory alkalosis 21. A nurse assigned to assist with caring for a client after a gastric resection is monitoring the drainage form a nasogastric tube(NG) tube. No drainage has been noted for the past 4 hours and client complains of severe nausea. Which of the following is the appropriate nursing action? a.Irrigate the tube B. Reposition the tube C. Medicate for nausea D. Notify the Registered Nurse 22. The husband of a client who has Sengstaken-Blakemore tube states “I thought having this tube down her nose the first time would convince my wife to quit drinking.” Based on this statement, the appropriate response by the nurse is which of the following? a.”I think you are a good person to stay with your wife.” B.”Alcoholism is a disease that affects the whole family.” C. “Have you discussed this subject at the whole group.” D.”You sound frustrated with dealing with your wife’s drinking problem.” 23. A nurse is providing dietary home-care instructions to client with pancreatitis. Which of the following foods should the nurse instruct the client to avoid? A. Chili B. Bagel C. Lentil soup D. Wtermelon 24. A nurse reinforces dietary instructions to a client with Cirrhosis and ascites and teaches the client to do which of the following? a. Decrease the intake. B. Restrict sodium intake. C. Decrease carbohydrate intake. D. Restrict calories to 1500 daily 25.A client with colostomy complains to the nurse of appliance odor. The nurse recommends that the client consumes which of the following deodorizing foods? A Eggs B. Yogurt C. Cucumbers D. Mushrooms 26. A nurse is reinforcing home-care instructions to a client with peptic ulcer disease regarding symptom management. The nurse tells the client to do which of the following? a.Limit the intake of water. B. Use of aspirin to relieve gastric pain. C.Eat large meals to absorb gastric acid. D. Eat slowly and chew the food thoroughly. 27. A client with possible renal disease is scheduled to undergo diagnostic testing by intravenous pyelogram (IVP). To ensure client safety, the nurse should be certain to collect data from this client about the history of which of the following? A. Allergy to shellfish or iodine. B. Family incidence of renal disease. C.Frequent and chronic antibiotic use. D. Long-term use of diuretic medications. 28. A client is diagnosed with pernicious anemia. The nurse understands that which of the following risk factors is associated with the development of this type of anemia? A. Gastric resection. B.Inadequate iron in the diet. C. Musculoskeletal disorders. D. Central Nervous system disorders. 29. A nurse is assigned to care for a client who has just returned to the nursing after an oral cholecystogram. At this point in time, the nurse should question which of the following physician’s order by the medical record? a.Monitor for nausea and vomiting. B. Monitor for the client hydration status. C. Maintain a clear liquid status for 72 hours. D. Monitor the client for abdominal discomfort. 30. A nurse who is assisting a physician with the insertion of a Miller-Abbot tube should do which of the following to ensure a safe environment and to decrease the client’s risk for aspiration? a.Place the client in high fowler’s position. B. Assist with inserting the tube with balloon inflated. C. Instruct the client to bear down if there is an urge to Rap D.Ask the client to cough when the tube reaches the nasopharynx 31. A nurse is reviewing the record of several hospitalized clients to identify candidates to receiving parenteral nutrition. Which clients would the nurse choose to be candidates for parenteral nutrition? Select all that apply. A. Client with severe burn injury. B. Client with severe anorexia nervosa.. C. Client scheduled for appendectomy D. Client with malabsorption syndrome. E. Client with Diabetes Mellitus who has an ulcer on the right ankle. F. Client receiving chemotherapy who has severe vomiting and diarrhea. 32. A nurse provides dietary instructions to a client who has a diagnosis of Celiac Disease (Celiac Sprue). The nurse recognizes that teaching has been effective when the client states: a.”I can eat whatever I want.” B. “I will eat rice cereal for breakfast.” C. “I will eat my barley soup for lunch.” D. “I will eat only wheat bread for a snack.” 33. A nurse assists in developing a discharge teaching plan for a client who had ostomy surgery. Which of the following instructions should be included in the teaching plan? Select all that apply. A. Avoid foods that cause excess gas. B. Limit fluid intake 1000 mL daily. C. Contact the physician if the stoma appears to bulge outward. D. Bathe and shower with the appliance in place. E. Wear a snug of clothing over the stoma to hold the appliance in place. F. Limit travel because drinking water and food preparation differ from those that the client is used to drinking and eating. 34. A client is scheduled for an endoscopic retrograde cholangiopancreatography(ERCP). The nurse plans to do which of the following in order to care for the client undergoing this procedure? a.Administer enemas the evening before and morning of the procedure. B. Keep the client NPO after the procedure and until he gag reflex returns. C. Keep the client on clear liquids for 24 hours before the procedure. D. Tell the client that the substances used in this test contains only traces of radioactivity. 35. The client is being discharge after subtotal gastrectomy. The nurse teaches the client to do which of the following to minimize the risk of dumping syndrome? a.Sit up for 12 hours after eating. B. Eat only two large meals a day. C. Avoid drinking liquids during a meal. D. Eat a highly concentrated carbohydrate foods. 36. The nurse is teaching a client with cholecystitis about foods that must be eliminated from the diet. The nurse tells the client that which food is acceptable to eat? A .Donuts B. Baked fish C. French fries D. Fried chicken. 37. The nurse is caring for a postoperative client who has a nasogastric tube(NG) tube connected to suction in place. Which observation by the nurse most reliably indicates that the tube is functioning properly? A .The suction gauge reads low intermittent suction. B. The distal end of the NG tube is pinned to the client’s gown. C. The client indicates that pain is 3 on a 1-10 scale. D. The client denies nausea and has 250 mL of fluid in the suction collection container. 38.The nurse is providing instructions to a client who will collect a stool specimen for occult blood. The nurse instructs the client to avoid which of the following for 3 days before the collection of the stool specimen? A . Milk products B. Hard cheese C. Turnips D. Cottage cheese 39. A client with diagnosis of cholelithiasis is experiencing severe pain. The nurse reviews the client’s medication record and plans to administer which anticipated prescribed opiod analgesic? A . Oxycodone B. Hydromorphone C. Meperidine hydrochloride D. Morphine sulfate 40. A nurse helps develop a plan of care for a client who is scheduled to return to the nursing unit after a liver biopsy. Post procedure, the nurse plans to position the client: A. On the left side B. On the right side C. Supine. D. Prone. 41. A nurse provides instructions to a client who is scheduled for an oral cholecystogram. The nurse tells the client to: A. Eat high fat meal on the evening before the procedure. B. Maintain a strict NPO on the day of the procedure. C. Avoid oral intake except for water on the day of the procedure. D. Eat a high-fat meal for breakfast on the day of the procedure. 42. A nurse is instructed to ambulate with a Foley catheter four times a day in the hall. The nurse understands that the safest way to accomplish this while maintaining the integrity of the catheter is to: A.Change the drainage bag to a leg collection bag. B. Tie the drainage bag to the client’s waist while ambulating. C.Use a walker to hang the drainage bag while ambulating. D. Tell the client to hold the drainage bag lower than the level of the bladder. 43. A nurse is assigned to assist with caring for a client after transurethral prostatectomy. The nurse avoids which of the following after this procedure? A .Reporting signs of confusion B. Monitoring hourly urine output. C. Removing the traction tape on the three-way catheter. D. Administering belladonna and opium(B&0) suppositories at room temperature as prescribed. 44. A nurse is assisting with caring for a client after suprapubic prostatectomy. The nurse monitors continuous bladder irrigation to detect which of the following signs of catheter blockage? A. Drainage that is pale pink. B. Drainage that is bright red. C. True urine output of 50mL per hour. D. Urine leakage around the three-way catheter at the meatus. 45. A nurse is told that the client has a history of heart failure who is undergoing peritoneal dialysis as developed crackles in the lower lung fields. The nurse interprets that his finding is most likely related to which of the following? a.Natural progression of the heart failure. B. Compliance with dietary sodium restriction. C. Intake greater than output in the dialysis record. D. Adherence to digoxin therapy schedule. 46. A client with Chronic renal failure did not receive any juice on the breakfast tray. The nurse obtains a cup of which of the following juices from the unit kitchen? a. Grape B. Prune C. Orange D. Grapefruit 47. Ofloxacin(Floxin) is prescribed. The nurse provides which information to the client about this education? a.Take the medication with food. B. Take the medication with antacid. C. Drink at least three glasses of milk each day. D. Drink at least 1500mL to 2000mL of fluid per day. 48. A nurse is working in a renal unit in a local hospital. The nurse interprets at which of the following clients in the unit is best suited for peritoneal dialysis as a treatment option? a.A client with severe congestive heart failure. B. A client with a history of ruptured diverticuli C. A client with a history of herniated disk. D. A client with a history of three previous abdominal surgeries. 49. A nurse is reinforcing teaching about the signs of peritonitis with a client who has begun peritoneal dialysis. The nurse instruct the client to report which finding to the physician? a.Heartburn B. Cloudy dialysate output. C. Increased abdominal pain. D. A temperature of 99 degrees Fahrenheit orally. 50. A client with Acute Renal Failure (ARF) has been treated with sodium polystyrene sulfonate by mouth. The nurse determines that this therapy is effective if which of the following values is noted on follow up laboratory testing? a.Calcium 9.8 mg/dL B. Sodium 142 mEq/L C. Potassium 4.9 mEq/L D. Phosphorus 3.9 mg/dL

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