T-Tube NCLEX Questions for Nursing Care
1. A patient had a cholecystectomy and has a t-tube in place. You’re helping the nursing student
understand how to care for the t-tube. The nursing student asks you where the t-tube is located in the body.
Your response is the:
A. Cystic duct
B. Hepatic duct
C. Bile duct
D. Pancreatic duct
2. The nurse helps the patient with a t-tube get up from the bed and sit in the bedside chair. Where will the
nurse make it priority to position the tubing and drainage bag of the t-tube?
A. Slightly elevated above the t-tube insertion site
B. At heart level
C. Midline with the t-tube insertion site
D. At or below the waist
3.
A.
B.
C.
D.
Which position is best for a patient with a t-tube?
Supine
Semi-Fowler’s
Right lateral recumbent
Left lateral recumbent
4. A patient is post-op day 4 from a t-tube placement. Which finding below requires you to notify the
physician?
A. Drainage from the t-tube is yellowish green.
B. Drainage from the t-tube within the past 24 hours is approximately 925 cc.
C. Blood tinged drainage from the t-tube has decreased.
D. Patient reports a decrease in nausea.
5. The physician orders a patient’s t-tube to be clamped 1 hour before and 1 hour after meals. You clamp
the t-tube as prescribed. While the tube is clamped which finding requires immediate nursing intervention?
A. The t-tube is not draining.
B. The t-tube tubing is below the patient’s waist.
C. The patient reports nausea and abdominal pain.
D. The patient’s stool is brown and formed.
6. You’re assessing a patient’s t-tube and note that it is not draining bile. The patient is reporting nausea.
The nurse will first?
A. Notify the physician
B. Assess if the tubing from the t-tube is kinked or clamped.
C. Flush the tubing.
D. Administer an antiemetic medication per physician order.
Cholecystits NCLEX Questions
1. The gallbladder is found on the
. It stores
A.
B.
C.
D.
side of the body and is located under the
.
right; pancreas; bilirubin
left; liver; bile
right; thymus’ bilirubin
right; liver; bile
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2. Which statements below are CORRECT regarding the role of bile? Select all that
apply:
A.
B.
C.
D.
Bile is created and stored in the gallbladder.
Bile aids in digestion of fat soluble vitamins, such as A, D, E, and K.
Bile is released from the gallbladder into the duodenum.
Bile contains bilirubin.
3. You’re providing a community in-service about gastrointestinal disorders. During your teaching about
cholecystitis, you discuss how cholelithiasis can lead to this condition. What are the risk factors for
cholelithiasis that you will include in your teaching to the participants? Select all that apply:
A. Being male
B. Underweight
C. Being female
D. Older age
E. Native American
F. Caucasian
G. Pregnant
H. Family History
I. Obesity
4. A patient is being transferred to your unit with acute cholecystitis. In report the transferring nurse tells
you that the patient has a positive Murphy’s Sign. You know that this means:
A. The patient stops breathing in when the examiner palpates under the ribs on the right upper side of the
abdomen at the midclavicular line.
B. The patient stops breathing out when the examiner palpates under the ribs on the right upper side of
the abdomen at the midclavicular line.
C. The patient verbalizes pain when the lower right quadrant is palpated.
D. The patient reports pain when pressure is applied to the right lower quadrant but then reports an
increase in pain intensity when the pressure is released.
5. Your patient is post-op day 3 from a cholecystectomy due to cholecystitis and has a T- Tube. Which
finding during your assessment of the T-Tube requires immediate nursing intervention?
A. The drainage from the T-Tube is yellowish/green in color.
B. There is approximately 750 cc of drainage within the past 24 hours.
C. The drainage bag and tubing is at the patient’s waist.
D. The patient is in the Semi-Fowler’s position.
6. The physician orders a patient’s T-Tube to be clamped 1 hour before and 1 hour after meals. You clamp
the T-Tube as prescribed. While the tube is clamped which finding requires you to notify the physician?
A. The T-Tube is not draining.
B. The T-Tube tubing is below the patient’s waist.
C. The patient reports nausea and abdominal pain.
D. The patient’s stool is brown and formed.
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7. Your recent admission has acute cholecystitis. The patient is awaiting a cholecystostomy. What signs
and symptoms are associated with this condition? Select all that apply:
A. Right lower quadrant pain with rebound tenderness
B. Negative Murphy’s Sign
C. Epigastric pain that radiates to the right scapula
D. Pain and fullness that increases after a greasy or spicy meal
E. Fever
F. Tachycardia
G. Nausea
8. A patient in the emergency room has signs and symptoms associated with cholecystitis. What testing
do you anticipate the physician will order to help diagnose cholecystitis? Select all that apply:
A. Lower GI series
B. Abdominal ultrasound
C. HIDA Scan (Hepatobiliary Iminodiacetic AciD scan)
D. Colonoscopy
9. You’re precepting a nursing student who is helping you provide T-Tube drain care.
You explain to the nursing student that the t-shaped part of the drain is located in what part of the biliary
tract?
A. Cystic duct
B. Common hepatic duct
C. Common bile duct
D. Pancreatic duct
10. Your patient is unable to have a cholecystectomy for the treatment of cholecystitis.
Therefore, a cholecystostomy tube is placed to help treat the condition. Which statement about a
cholecystostomy (C-Tube) is TRUE?
A. The C-Tube is placed in the cystic duct of the gallbladder and helps drain infected bile from the
gallbladder.
B. Gallstones regularly drain out of the C-Tube, therefore, the nurse should flush the tube regularly to
ensure patency.
C. The C-Tube is placed through the abdominal wall and directly into the gallbladder where it will drain
infected bile from the gallbladder.
D. The tubing and drainage bag of the C-Tube should always be level with the insertion site to ensure the
tube is draining properly.
11. A patient, who has recovered from cholecystitis, is being discharged home. What meal options below
are best for this patient?
A. Baked chicken with steamed carrots and rice
B. Broccoli and cheese casserole with gravy and mashed potatoes
C. Cheeseburger with fries
D. Fried chicken with a baked potato
12. Your patient is diagnosed with acute cholecystitis. The patient is extremely nauseous.
A nasogastric tube is inserted with GI decompression. The patient reports a pain rating of 9 on 1- 10 scale
and states the pain radiates to the shoulder blade. Select all the appropriate nursing interventions for the
patient:
A. Encourage the patient to consume clear liquids.
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B. Administered IV fluids per MD order.
C. Provide mouth care routinely.
D. Keep the patient NPO.
E. Administer analgesic as ordered.
F. Maintain low intermittent suction to NG tube.
As a nurse providing care to a patient with hepatitis, it is important to know the signs and symptoms
1.
The liver receives blood from two sources. The
rich in nutrients to the liver.
A.
hepatic artery
B.
hepatic portal vein
C.
mesenteric artery
D.
hepatic iliac vein
2.
is responsible for pumping blood
Which statements are INCORRECT regarding the anatomy and physiology of the liver?
Select all that apply:
A.
The liver has 3 lobes and 8 segments.
B.
The liver produces bile which is released into the small intestine to help digest fats.
C.
The liver turns urea, a by-product of protein breakdown, into ammonia.
D.
The liver plays an important role in the coagulation process.
3.
You’re providing an in-service on viral hepatitis to a group of healthcare workers. You are teaching
them about the types of viral hepatitis that can turn into chronic infections. Which types are known to cause
ACUTE infections ONLY? Select all that apply:
A.
Hepatitis A
B.
Hepatitis B
C.
Hepatitis C
D.
Hepatitis D
E.
Hepatitis E
4.
Which patients below are at risk for developing complications related to a chronic hepatitis
infection, such as cirrhosis, liver cancer, and liver failure? Select all that apply:
A.
A 55-year-old male with Hepatitis A.
B. An infant who contracted Hepatitis B at birth.
C.
A 32-year-old female with Hepatitis C who reports using IV drugs.
4
D.
E.
A 50-year-old male with alcoholism and Hepatitis D.
A 30-year-old who contracted Hepatitis E.
5.
A patient is diagnosed with Hepatitis A. The patient asks how a person can become infected with
this condition. You know the most common route of transmission is?
A.
Blood
B.
Percutaneous
C.
Mucosal
D.
Fecal-oral
The answer is D. Hepatitis A is most commonly transmitted via the fecal-oral route.
6.
apply:
A.
Which of the following is NOT a common source of transmission for Hepatitis A? Select all that
Water
B.
Food
C.
Semen
D.
Blood
7.
A 36-year-old patient’s lab work show anti-HAV and IgG present in the blood. As the nurse you
would interpret this blood work as?
A.
The patient has an active infection of Hepatitis A.
B.
The patient has recovered from a previous Hepatitis A infection and is now immune to it.
C.
The patient is in the preicetric phase of viral Hepatitis.
D.
The patient is in the icteric phase of viral Hepatitis.
8.
TRUE or FALSE: A patient with Hepatitis A is contagious about 2 weeks before signs and
symptoms appear and 1-3 weeks after the symptoms appear.
9.
A 25-year-old patient was exposed to the Hepatitis A virus at a local restaurant one week ago.
What education is important to provide to this patient?
A.
Inform the patient to notify the physician when signs and symptoms of viral Hepatitis start to appear.
B.
Reassure the patient the chance of acquiring the virus is very low.
C.
Inform the patient it is very important to obtain the Hepatitis A vaccine immediately to prevent
infection.
D.
Inform the patient to promptly go to the local health department to receive immune globulin.
5
10.
Select all the ways a person can become infected with Hepatitis B:
A.
Contaminated food/water
B.
During the birth process
C.
IV drug use
D.
Undercooked pork or wild game
E.
Hemodialysis
F.
Sexual intercourse
11.
A patient has completed the Hepatitis B vaccine series. What blood result below would demonstrate
the vaccine series was successful at providing immunity to Hepatitis B?
A.
Positive IgG
B.
Positive HBsAg
C.
Positive IgM
D.
Positive anti-HBs
12.
A patient has lab work drawn and it shows a positive HBsAg. What education will you provide to the
patient?
A.
Avoid sexual intercourse or intimacy such as kissing until blood work is negative.
B.
The patient is now recovered from a previous Hepatitis B infection and is now immune.
C.
The patient is not a candidate from antiviral or interferon medications.
D.
13.
A.
The patient is less likely to develop a chronic infection.
A patient with Hepatitis A asks you about the treatment options for this condition. Your response is?
Antiviral medications
B.
Interferon
C.
Supportive care
D.
Hepatitis A vaccine
14.
A patient was exposed to Hepatitis B recently. Postexposure precautions include vaccination and
administration of HBIg (Hepatitis B Immune globulin). HBIg needs to be given as soon as possible,
preferably
after exposure to be effective.
A.
2 weeks
B.
24 hours
C.
1 month
D.
7 days
6
15.
You’re providing education to a patient with an active Hepatitis B infection. What will you include in
their discharge instructions? Select all that apply:
A.
“Take acetaminophen as needed for pain.”
B.
“Eat large meals that are spread out through the day.”
C.
“Follow a diet low in fat and high in carbs.”
D.
“Do not share toothbrushes, razors, utensils, drinking cups, or any other type of personal hygiene
product.”
E.
“Perform aerobic exercises daily to maintain strength.”
16.
What is the MOST common transmission route of Hepatitis C?
A.
Blood transfusion
B.
Sharps injury
C.
Long-term dialysis
D.
IV drug use
17.
A patient is diagnosed with Hepatitis D. What statement is true about this type of viral Hepatitis?
Select all that apply:
A.
The patient will also have the Hepatitis B virus.
B.
C.
Hepatitis D is most common in Southern and Eastern Europe, Mediterranean, and Middle East.
Prevention of Hepatitis D includes handwashing and the Hepatitis D vaccine.
D.
Hepatitis D is most commonly transmitted via the fecal-oral route.
18.
Select all the signs and symptoms associated with Hepatitis?
A.
Arthralgia
B.
Bilirubin 1 mg/dL
C.
Ammonia 15 mcg/dL
D.
Dark urine
E.
Vision changes
F.
Yellowing of the sclera
G.
Fever
H.
Loss of appetite
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19.
A patient with Hepatitis has a bilirubin of 6 mg/dL. What findings would correlate with this lab result?
Select all that apply:
A.
None because this bilirubin level is normal
B.
Yellowing of the skin and sclera
C.
Clay-colored stools
D.
Bluish discoloration on the flanks of the abdomen
E.
Dark urine
F.
Mental status changes
20.
A patient with Hepatitis is extremely confused. The patient is diagnosed with Hepatic
Encephalopathy. What lab result would correlate with this mental status change?
A.
Ammonia 100 mcg/dL
B.
Bilirubin 7 mg/dL
C.
ALT 56 U/L
D.
AST 10 U/L
21.
The physician writes an order for the administration of Lactulose. What lab result indicates this
medication was successful?
A.
Bilirubin <1 mg/dL
B.
ALT 8 U/L
C.
Ammonia 16 mcg/dL
D.
AST 10 U/L
22.
How is Hepatitis E transmitted?
A.
Fecal-oral
B.
Percutaneous
C.
Mucosal
D.
Body fluids The answer is A.
23.
A.
Which patient below is at MOST risk for developing a complication related to a Hepatitis E infection?
A 45-year-old male with diabetes.
B.
A 26-year-old female in the 3rd trimester of pregnancy.
C.
A 12-year-old female with a ventricle septal defect.
D.
A 63-year-old male with cardiovascular disease.
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24.
What is the BEST preventive measure to take to help prevent ALL types of viral Hepatitis?
A.
Vaccination
B.
Proper disposal of needles
C.
Hand hygiene
D.
Blood and organ donation screening
25.
Select all the types of viral Hepatitis that have preventive vaccines available in the United States?
A. Hepatitis A
B.
Hepatitis B
C.
Hepatitis C
D.
Hepatitis D
E.
Hepatitis E
The answers are A and B. Currently there is only a vaccine for Hepatitis A and B in the U.S.
26.
A patient is prescribed Peginterferon alfa-2a. The nurse will prepare to administer this medication
what route?
A.
Oral
B.
Intramuscular
C.
Subcutaneous
D.
Intravenous
The answer is C. This medication is administered subq.
27.
A patient with viral Hepatitis states their flu-like symptoms have subsided. However, they now have
yellowing of the skin and sclera along with dark urine. Based on this finding, this is what phase of Hepatitis?
A.
Icteric
B.
Posticteric
C.
Preicteric
D.
Convalescent
28.
A.
During the posticteric phase of Hepatitis the nurse would expect to find? Select all that apply:
Increased ALT and AST levels along with an increased bilirubin level
B.
Decreased liver enzymes and bilirubin level
C.
Flu-like symptoms
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D.
Resolved jaundice and dark urine
Cirrhosis NCLEX Questions
1. Which condition is NOT a known cause of cirrhosis?
A. Obesity
B. Alcohol consumption
C. Blockage of the bile duct
D. Hepatitis C
E. All are known causes of Cirrhosis
The answer is E. All of these conditions can cause cirrhosis.
2. The liver receives it blood supply from two sources. One of these sources is called the
, which is a vessel network that delivers blood
oxygen.
A. hepatic artery, low, high
in nutrients but
in
B. hepatic portal vein, high, low
C. hepatic lobule, high, low
D. hepatic vein, low, high
3. A patient with late-stage cirrhosis develops portal hypertension. Which of the following options below
are complications that can develop from this condition? Select all that apply:
A. Increase albumin levels
B. Ascites
C. Splenomegaly
D. Fluid volume deficient
E. Esophageal varices
4. Your patient with cirrhosis has severe splenomegaly. As the nurse you will make it priority to monitor the
patient for signs and symptoms of? Select all that apply:
A. Thrombocytopenia
B. Vision changes
C. Increased PT/INR
D. Leukopenia
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5. A patient is admitted with hepatic encephalopathy secondary to cirrhosis. Which meal option selection
below should be avoided with this patient?
A. Beef tips and broccoli rabe
B. Pasta noodles and bread
C. Cucumber sandwich with a side of grapes
D. Fresh salad with chopped water chestnuts
6. During your morning assessment of a patient with cirrhosis, you note the patient is disoriented to person
and place. In addition while assessing the upper extremities, the patient’s hands demonstrate a flapping
motion. What lab result would explain these abnormal assessment findings?
A. Decreased magnesium level
B. Increased calcium level
C. Increased ammonia level
D. Increased creatinine level
7. You are receiving shift report on a patient with cirrhosis. The nurse tells you the patient’s bilirubin levels
are very high. Based on this, what assessment findings may you expect to find during your head-to-toe
assessment? Select all that apply:
A. Frothy light-colored urine
B. Dark brown urine
C. Yellowing of the sclera
D. Dark brown stool
E. Jaundice of the skin
F. Bluish mucous membranes
8. A 45 year old male has cirrhosis. The patient reports concern about the development of enlarged breast
tissue. You explain to the patient that this is happening because?
A. The liver cells are removing too much estrogen from the body which causes the testicles to produce
excessive amounts of estrogen, and this leads to gynecomastia.
B. The liver is producing too much estrogen due to the damage to the liver cells, which causes the level to
increase in the body, and this leads to gynecomastia.
C. The liver cells are failing to recycle estrogen into testosterone, which leads to gynecomastia.
D. The liver cells are failing to remove the hormone estrogen properly from the body, which causes the
level to increase in the body, and this leads to gynecomastia.
9. You’re providing an in-service to new nurse graduates about esophageal varices in patients with
cirrhosis. You ask the graduates to list activities that should be avoided by a patient with this condition.
Which activities listed are correct: Select all that apply
A. Excessive coughing
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B. Sleeping on the back
C. Drinking juice
D. Alcohol consumption
E. Straining during a bowel movement
F. Vomiting
10. While providing mouth care to a patient with late-stage cirrhosis, you note a pungent, sweet, musty
smell to the breath. This is known as:
A. Metallic Hepatico
B. Fetor Hepaticus
C. Hepaticoacidosis
D. Asterixis
11. The physician orders Lactulose 30 mL by mouth per day for a patient with cirrhosis. What findings
below demonstrates the medication is working effectively? Select all that apply:
A. Decrease albumin levels
B. Decrease in Fetor Hepaticus
C. Patient is stuporous.
D. Decreased ammonia blood level
E. Presence of asterixis
The answer is B and D. A patient with cirrhosis may experience a complication called hepatic
encephalopathy. This will cause the patient to become confused (they may enter into a coma)
GASTROINTESTINAL
12.
reside in the liver and help remove bacteria, debris, and old red blood cells.
A. Hepatocytes
B. Langerhan cells
C. Enterocytes
D. Kupffer cells
13. Which of the following is NOT a role of the liver?
A. Removing hormones from the body
B. Producing bile
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C. Absorbing water
D. Producing albumin
GASTROINTESTINAL
Pancreatitis NCLEX Questions
1. Inside the pancreas are special cells that secrete digestive enzymes and hormones. The cells that
secrete digestive enzymes are known as
cells.
A. Islet of Langerhans
B. Protease
C. Acinar
D. Amylase
2. From the pancreas and gallbladder, the common bile duct and pancreatic duct open into the
where digestive enzymes and bile flow through the duodenum via the major duodenal
papilla which is surrounded by a muscular valve that controls the release of digestive enzymes known as
the
.
A. ampulla of vater, sphincter of Oddi
B. papilla of vater, sphincter of Oddi
C. minor duodenal papilla, ampulla of vater
D. jejunum, sphincter of pylori
3. Select-ALL-that-apply: In the pancreas, the acinar cells release:
A. Amylase
B. Somatostatin
C. Lipase
D. Protease
4. You’re caring for a 45 year old patient who is admitted with suspected acute pancreatitis. The patient
reports having extreme mid-epigastric pain that radiates to the back. The patient states the pain started last
night after eating fast food. As the nurse, you know the two most common causes of acute pancreatitis are:
A. High cholesterol and alcohol abuse
B. History of diabetes and smoking
C. Pancreatic cancer and obesity
D. Gallstones and alcohol abuse
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5. Which patient below is at MOST risk for CHRONIC pancreatitis?
A. A 25 year old female with a family history of gallstones.
B. A 35 year old male who reports social drinking of alcohol.
C. A 15 year old female with cystic fibrosis.
D. A 66 year old female with stomach cancer.
6. Your patient with acute pancreatitis is scheduled for a test that will use a scope to assess the pancreas,
bile ducts, and gallbladder. The patient asks you, “What is the name of the test I’m going for later today?”
You tell the patient it is called:
A. MRCP
B. ERCP
GASTROINTESTINAL
C. CT scan of the abdomen
D. EGD
7. A patient is admitted to the ER with the following signs and symptoms: very painful mid- epigastric pain
felt in the back, elevated glucose, fever, and vomiting. During the head-to-toe assessment, you notice bluish
discoloration around the belly button. As the nurse, you know this is called?
A. Grey-Turner’s Sign
B. McBurney’s Sign
C. Homan’s Sign
D. Cullen’s Sign
8. While assisting a patient with chronic pancreatitis to the bathroom, you note the patient’s stool to be
oily/greasy in appearance. In your documentation you note this as:
A. Steatorrhea
B. Melena
C. Currant
D. Hematochezia
9. A patient with acute pancreatitis is reporting excessive thirst, excessive voiding, and blurred vision. As
the nurse, it is priority you?
A. Reassure the patient this is normal with pancreatitis
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GASTROINTESTINAL
B. Check the patient’s blood glucose
C. Assist the patient with drinking a simple sugar drink like orange juice
D. Provide a dark and calm environment
10. A patient who received treatment for pancreatitis is being discharged home. You’re providing diet
teaching to the patient. Which statement by the patient requires immediate re- education about the diet
restrictions?
A. “It will be hard but I will eat a diet low in fat and avoid greasy foods.”
B. “It is very important I limit my alcohol intake to no more than 2-3 glasses of wine a week.”
C. “I will concentrate on eating complex carbohydrates rather than refined carbohydrates.”
D. “I will purchase foods that are high in protein.”
11. The physician orders a patient with pancreatitis to take a pancreatic enzyme. What assessment finding
demonstrates the pancreatic enzymes are working properly?
A. Abdominal girth is decreased
B. Skin turgor is less than 2 seconds
C. Blood glucose is 250
D. Stools appear formed and solid
12. During a home health visit, you are assessing how a patient takes the prescribed pancreatic enzyme.
The patient is unable to swallow the capsule whole, so they open the capsule and mix the beads inside the
capsule with food/drink. Which food or drink is safe for the patient to mix the beads with?
A. Pudding
B. Ice cream
C. Milk
D. Applesauce
Celiac Disease NCLEX Questions
1. You’re educating a group of nursing students about the pathophysiology of Celiac Disease.
You ask the group to identify the specific protein that plays a role in the immune reaction experienced in
Celiac Disease. Which answer is correct?
A. Zein
B. Globulins
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C. Gliadins
D. Glutamate
2. A patient is suspected to be suffering from Celiac Disease. The physician orders an endoscopy. If the
patient has Celiac Disease, what finding will be discovered with the endoscopy?
A. Over exaggerated intestinal villi
B. Ulcerations in the small intestine, specifically the Jejunum
C. Flat intestinal villi
D. Cobble-stone appearance throughout the small intestine
3. Which of the following is not an anti-body blood test ordered by a physician to diagnose Celiac Disease?
A. Antinuclear antibody (ANA)
B. Tissue Transglutaminase Antibodies (tTG-IgA)
C. IgA Endomysial antibody (EMA)
D. IgA serum
4. A patient, who was recently diagnosed with Celiac Disease, has blister type bumps on the elbow and
knees. The patient reports it is extremely itchy. As the nurse, you know this is as known as:
A. Seborrheic Dermatitis
B. Psoriasis
C. Dyshidrotic Eczema
D. Dermatitis Herpetiformis
5. During an outpatient clinic visit, a female patient reports feeling abdominal bloating/pain, and diarrhea
when eating foods that contain wheat or rye. The patient states her mother was diagnosed with Celiac
Disease 5 years ago. What other symptoms will you assess the patient for that can be present in Celiac
Disease? SELECT-ALL-THAT-APPLY:
A. Unexplained Weight loss
B. Jelly-like stools
C. Mouth ulcers
D. Menstrual irregularities
E. Pain at McBurney’s Point
F. Ribbon-like stools
G. Inability to tolerate dairy products
H. Enamel changes
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6. Your patient was admitted 3 days ago for treatment of severe malnourishment secondary to Celiac
Disease. The patient is doing well and will be discharged tomorrow. When you arrive to the patient’s room,
the patient’s friends and family are visiting and have brought dinner for the patient. Which food item below
should the patient avoid consuming?
A. Pork barbeque sandwich
B. Steak and steamed broccoli
C. Braised chicken with carrots
D. Vegetables and rice
7. Gliadin is a wheat prolamin, which is a plant storage protein that is high in the amino acids
particularly and
.
A. lysine and proline
B. glutamine and cysteine
C. gliadin and gluten
D. proline and glutamine
8. You’re helping a mother, whose child was recently diagnosed with Celiac Disease, read food labels.
Which items below, if listed as the ingredients, should the mother avoid feeding her child?
A. Millet
B. Wheat
C. Malt
D. Corn
E. Buckwheat
F. Rye
GERD NCLEX Questions
1. A patient reports frequent heartburn twice a week for the past 4 months. What other symptoms reported
by the patient may indicate the patient has GERD? SELECT-ALL-THAT-APPLY:
A. Bitter taste in mouth
B. Dry cough
C. Melena
D. Difficulty swallowing
E. Smooth, red tongue
F. Murphy’s Sign
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2. Your patient, who is presenting with signs and symptoms of GERD, is scheduled to have a test that
assesses the function of the esophagus’ ability to squeeze food down into the stomach and the closer of
the lower esophageal sphincter. The patient asks you, “What is the name of the test I’m having later today?”
You tell the patient the name of the test is:
A. Lower Esophageal Gastrointestinal Series
B. Transesophageal echocardiogram
C. Esophageal manometry
D. Esophageal pH monitoring
3. After dinner time, during hourly rounding, a patient awakes to report they feel like “food is coming up” in
the back of their throat and that there is a bitter taste in their mouth. What nursing intervention will you
perform next?
A. Perform deep suctioning
B. Assist the patient into the Semi-Fowler’s position
C. Keep the patient NPO
D. Instruct the patient to avoid milk products
4. During a home health visit, you are helping a patient develop a list of foods they should avoid due to
GERD. Which items in the patient’s pantry should be avoided? SELECT-ALL-THAT- APPLY:
A. Hot and Spicy Pork Rinds
B. Peppermint patties
C. Green Beans
D. Tomato Soup
E. Chocolate Fondue
F. Almonds
G. Oranges
5. After providing education to a patient with GERD. You ask the patient to list 4 things they can do to
prevent or alleviate signs and symptoms of GERD. Which statement is INCORRECT?
A. “It is best to try to consume small meals throughout the day than eat 3 large ones.”
B. “I’m disappointed that I will have to limit my intake of peppermint and spearmint because I love eating
those types of hard candies.”
C. “It is important I avoid eating right before bedtime.”
D. “I will try to lie down after eating a meal to help decrease pressure on the lower esophageal sphincter
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
1. The liver receives blood from two sources. The _____________ is responsible for pumping
blood rich in nutrients to the liver.*
o
A. hepatic artery
o
B. hepatic portal vein
o
C. mesenteric artery
o
D. hepatic iliac vein
2. Which statements are INCORRECT regarding the anatomy and physiology of the liver? Select
all that apply:*
o
A. The liver has 3 lobes and 8 segments.
o
B. The liver produces bile which is released into the small intestine to help digest
fats.


o
C. The liver turns urea, a by-product of protein breakdown, into ammonia.
o
D. The liver plays an important role in the coagulation process.
3. You’re providing an in-service on viral hepatitis to a group of healthcare workers. You are
teaching them about the types of viral hepatitis that can turn into chronic infections. Which types
are known to cause ACUTE infections ONLY? Select all that apply:*
o
A. Hepatitis A
o
B. Hepatitis B
o
C. Hepatitis C
o
D. Hepatitis D
o
E. Hepatitis E
4. Which patients below are at risk for developing complications related to a chronic hepatitis
infection, such as cirrhosis, liver cancer, and liver failure? Select all that apply:*
o
A. A 55-year-old male with Hepatitis A.
o
B. An infant who contracted Hepatitis B at birth.
o
C. A 32-year-old female with Hepatitis C who reports using IV drugs.
o
D. A 50-year-old male with alcoholism and Hepatitis D.
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o



5. A patient is diagnosed with Hepatitis A. The patient asks how a person can become infected
with this condition. You know the most common route of transmission is?*
o
A. Blood
o
B. Percutaneous
o
C. Mucosal
o
D. Fecal-oral
6. Which of the following is NOT a common source of transmission for Hepatitis A? Select all that
apply:*
o
A. Water
o
B. Food
o
C. Semen
o
D. Blood
7. A 36-year-old patient’s lab work show anti-HAV and IgG present in the blood. As the nurse you
would interpret this blood work as?*
o
o


E. A 30-year-old who contracted Hepatitis E.
A. The patient has an active infection of Hepatitis A.
B. The patient has recovered from a previous Hepatitis A infection and is now
immune to it.
o
C. The patient is in the preicetric phase of viral Hepatitis.
o
D. The patient is in the icteric phase of viral Hepatitis.
8. TRUE or FALSE: A patient with Hepatitis A is contagious about 2 weeks before signs and
symptoms appear and 1-3 weeks after the symptoms appear.*
o
True
o
False
9. A 25-year-old patient was exposed to the Hepatitis A virus at a local restaurant one week ago.
What education is important to provide to this patient?*
o
o
o
A. Inform the patient to notify the physician when signs and symptoms of viral
Hepatitis start to appear.
B. Reassure the patient the chance of acquiring the virus is very low.
C. Inform the patient it is very important to obtain the Hepatitis A vaccine
immediately to prevent infection.
20
o



10. Select all the ways a person can become infected with Hepatitis B:*
o
A. Contaminated food/water
o
B. During the birth process
o
C. IV drug use
o
D. Undercooked pork or wild game
o
E. Hemodialysis
o
F. Sexual intercourse
11. A patient has completed the Hepatitis B vaccine series. What blood result below would
demonstrate the vaccine series was successful at providing immunity to Hepatitis B?*
o
A. Positive IgG
o
B. Positive HBsAg
o
C. Positive IgM
o
D. Positive anti-HBs
12. A patient has lab work drawn and it shows a positive HBsAg. What education will you provide
to the patient?*
o
o

D. Inform the patient to promptly go to the local health department to receive
immune globulin.
A. Avoid sexual intercourse or intimacy such as kissing until blood work is negative.
B. The patient is now recovered from a previous Hepatitis B infection and is now
immune.
o
C. The patient is not a candidate from antiviral or interferon medications.
o
D. The patient is less likely to develop a chronic infection.
13. A patient with Hepatitis A asks you about the treatment options for this condition. Your
response is?*
o
A. Antiviral medications
o
B. Interferon
o
C. Supportive care
o
D. Hepatitis A vaccine
21


14. A patient was exposed to Hepatitis B recently. Postexposure precautions include vaccination
and administration of HBIg (Hepatitis B Immune globulin). HBIg needs to be given as soon as
possible, preferably ___________ after exposure to be effective.*
o
A. 2 weeks
o
B. 24 hours
o
C. 1 month
o
D. 7 days
15. You’re providing education to a patient with an active Hepatitis B infection. What will you
include in their discharge instructions? Select all that apply:*
o
A. “Take acetaminophen as needed for pain.”
o
B. “Eat large meals that are spread out through the day.”
o
C. “Follow a diet low in fat and high in carbs.”
o
o


E. “Perform aerobic exercises daily to maintain strength.”
16. What is the MOST common transmission route of Hepatitis C?*
o
A. Blood transfusion
o
B. Sharps injury
o
C. Long-term dialysis
o
D. IV drug use
17. A patient is diagnosed with Hepatitis D. What statement is true about this type of viral
Hepatitis? Select all that apply:*
o
o

D. “Do not share toothbrushes, razors, utensils, drinking cups, or any other type of
personal hygiene product.”
A. The patient will also have the Hepatitis B virus.
B. Hepatitis D is most common in Southern and Eastern Europe, Mediterranean,
and Middle East.
o
C. Prevention of Hepatitis D includes handwashing and the Hepatitis D vaccine.
o
D. Hepatitis D is most commonly transmitted via the fecal-oral route.
18. Select all the signs and symptoms associated with Hepatitis?*
o
A. Arthralgia
o
B. Bilirubin 1 mg/dL
22




o
C. Ammonia 15 mcg/dL
o
D. Dark urine
o
E. Vision changes
o
F. Yellowing of the sclera
o
G. Fever
o
H. Loss of appetite
19. A patient with Hepatitis has a bilirubin of 6 mg/dL. What findings would correlate with this lab
result? Select all that apply:*
o
A. None because this bilirubin level is normal
o
B. Yellowing of the skin and sclera
o
C. Clay-colored stools
o
D. Bluish discoloration on the flanks of the abdomen
o
E. Dark urine
o
F. Mental status changes
20. A patient with Hepatitis is extremely confused. The patient is diagnosed with Hepatic
Encephalopathy. What lab result would correlate with this mental status change?*
o
A. Ammonia 100 mcg/dL
o
B. Bilirubin 7 mg/dL
o
C. ALT 56 U/L
o
D. AST 10 U/L
21. The physician writes an order for the administration of Lactulose. What lab result indicates
this medication was successful?*
o
A. Bilirubin <1 mg/dL
o
B. ALT 8 U/L
o
C. Ammonia 16 mcg/dL
o
D. AST 10 U/L
22. How is Hepatitis E transmitted?*
23




o
A. Fecal-oral
o
B. Percutaneous
o
C. Mucosal
o
D. Body fluids
23. Which patient below is at MOST risk for developing a complication related to a Hepatitis E
infection?*
o
A. A 45-year-old male with diabetes.
o
B. A 26-year-old female in the 3rd trimester of pregnancy.
o
C. A 12-year-old female with a ventricle septal defect.
o
D. A 63-year-old male with cardiovascular disease.
24. What is the BEST preventive measure to take to help prevent ALL types of viral Hepatitis?*
o
A. Vaccination
o
B. Proper disposal of needles
o
C. Hand hygiene
o
D. Blood and organ donation screening
25. Select all the types of viral Hepatitis that have preventive vaccines available in the United
States?*
o
A. Hepatitis A
o
B. Hepatitis B
o
C. Hepatitis C
o
D. Hepatitis D
o
E. Hepatitis E
26. A patient is prescribed Peginterferon alfa-2a. The nurse will prepare to administer this
medication what route?*
o
A. Oral
o
B. Intramuscular
o
C. Subcutaneous
24
o


D. Intravenous
27. A patient with viral Hepatitis states their flu-like symptoms have subsided. However, they now
have yellowing of the skin and sclera along with dark urine. Based on this finding, this is what
phase of Hepatitis?*
o
A. Icteric
o
B. Posticteric
o
C. Preicteric
o
D. Convalescent
28. During the posticteric phase of Hepatitis the nurse would expect to find? Select all that apply:*
o
A. Increased ALT and AST levels along with an increased bilirubin level
o
B. Decreased liver enzymes and bilirubin level
o
C. Flu-like symptoms
o
D. Resolved jaundice and dark urine
25