Exam 2 Practice
1. A client has been receiving total parenteral nutrition (TPN) for the last 5 days. Before discontinuing
the infusion, the infusion rate is slowed. What complication of TPN infusion should the nurse assess the
client for as the infusion is discontinued?
A. dehydration
B. essential fatty acid deficiency
C. rebound hypoglycemia
D. malnutrition
2. A client who has been vomiting for 2 days has a nasogastric tube inserted. The nurse notes that over
the past 10 hours, the tube has drained 2 L of fluid. The nurse should further assess the client for which
electrolyte imbalance?
A. hypermagnesemia
B. hypernatremia
C. hypokalemia
D. hypocalcemia
3. The client with a major burn injury receives total parenteral nutrition (TPN). What is the expected
outcome of TPN?
A. Correct water and electrolyte imbalances
B. Allow the gastrointestinal tract to rest
C. Provide supplemental vitamins and minerals
D. Ensure adequate caloric and protein intake
4. When measuring gastric residual volume in a client receiving continuous tube feeding through a
gastrostomy tube, the nurse attaches a large syringe to the tube and withdraws all fluid remaining in the
stomach. After noting the amount of fluid, what should the nurse do?
A. Discard the aspirated fluid down the toilet
B. Readminister the aspirated fluid through the feeding tube
C. Add the aspirated fluid to the bag of formula
D. Discard the aspirated fluid into a biohazard container
5. A nurse is caring for a client who has hypernatremia and requires IV fluid therapy due to his NPO
status. Which of the following solutions should the nurse prepare to infuse for this client?
A. Lactated Ringer's
B. Dextrose 5% in 0.9% sodium chloride
C. 0.45% sodium chloride
D. Dextrose 10% in water
6. A nurse is assessing an older adult client who is receiving IV therapy. The nurse should recognize that
which of the following findings indicates fluid volume excess? (Select all that apply.)
A. Bounding pulse
B. Pitting edema
C. Swelling at the IV site
D. Urine-specific gravity greater than 1.030
E. Crackles upon auscultation
7. A nurse is teaching a client who has acute kidney injury about dietary sources of potassium. Which of
the following statements by the client indicates a need for clarification?
A."I will enjoy eating cantaloupe for my morning snack."
B."I can easily add baked potatoes to my diet."
C. "Eating yogurt will be a new experience."
D. "Adding pecans will be a change I can readily make."
8. A nurse in a provider’s office is reviewing the laboratory results of a client who takes furosemide for
hypertension. The nurse notes that the client’s potassium level is 3.3 mEq/L. The nurse should monitor
the client for which of the following complications?
A. Cardiac dysrhythmias
B. Hypoglycemia
C. Seizures
D. Neurogenic shock
9. A nurse is providing preoperative teaching for a client who will undergo surgery. The nurse explains
that the client will wear antiembolism stockings during and after the procedure. When the client asks
what the stockings do, which of the following responses should the nurse make?
A. “They protect your legs and heels from skin breakdown.”
B. “They help keep you warm after your surgery.”
C. “They improve your circulation to keep blood from pooling in your legs.”
D. “They make it easier for you to do leg exercises after your surgery.”
10. A client refuses to look at or care for their colostomy. Which statement by the nurse would be most
appropriate?
A. It’s been 4 days since your surgery, and you’ll soon be discharged. You have to learn to care for your
colostomy before you leave the hospital.”
B. “I think we will need to teach your husband to care for your colostomy if you are not going to be able
to do it.”
C. “I understand how you are feeling. It is important for you to feel attractive, and you think having a
colostomy changes your attractiveness.”
D. “I can see that you are upset. Would you like to share your concerns with me?”
11. Which goal for the client’s care should take priority during the first days of hospitalization for an
exacerbation of ulcerative colitis?
A. promoting self-care and independence
B. managing diarrhea
C. maintaining adequate nutrition
D. promoting rest and comfort
12. A client has had an exacerbation of ulcerative colitis with cramping and diarrhea persisting longer
than 1 week. The nurse should assess the client for which complication?
A. heart failure
B. deep vein thrombosis
C. hypokalemia
D. hypocalcemia
13. A client who has ulcerative colitis has persistent diarrhea and has lost 12 lb (5.5 kg) since the
exacerbation of the disease. Which approach will be most effective in helping the client meet nutritional
needs?
A. continuous enteral feedings
B. following a high-calorie, high protein diet
C. total parenteral nutrition (TPN)
D. eating six small meals a day
14. A client with Crohn’s disease has concentrated urine; decreased urinary output; dry skin with
decreased turgor; hypotension; and weak, thready pulses. What should the nurse do first?
A. Encourage the client to drink at least 1,000 mL/day.
B. Provide parenteral rehydration therapy as prescribed.
C. Turn and reposition every 2 hours.
D. Monitor vital signs every shift.
15. Which is a priority focus of care for a client experiencing an exacerbation of Crohn’s disease?
A. encouraging regular ambulation
B. promoting bowel rest
C. maintaining current weight
D. decreasing episodes of rectal bleeding
16. Which instruction should the nurse include in the teaching plan for a client who is experiencing
gastroesophageal reflux disease?
A. Limit caffeine intake to two cups of coffee per day.
B. Do not lie down for 2 hours after eating.
C. Follow a low-protein diet.
D. Take medications with milk to decrease irritation.
17. A client who has been diagnosed with gastroesophageal reflux disease (GERD) has heartburn. To
decrease the heartburn, the nurse should instruct the client to eliminate which item from the diet?
A. lean beef
B. air-popped popcorn
C. hot chocolate
D. raw vegetables
18. The client with gastroesophageal reflux disease (GERD) has a chronic cough. The nurse should
further assess the client for which other possible problem?
A. development of laryngeal cancer
B. irritation of the esophagus
C. esophageal scar tissue formation
D. aspiration of gastric contents
19. The nurse is developing a care management plan with a client who has been diagnosed with
gastroesophageal reflux disease. What should the nurse instruct the client to do? Select all that apply.
A. Avoid a diet high in fatty foods.
B. Avoid beverages that contain caffeine.
C. Eat three meals a day, with the largest meal being at dinner in the evening.
D. Avoid all alcoholic beverages.
E. Lie down after consuming each meal for 30 minutes.
F. Use over-the-counter (OTC) antisecretory agents rather than prescriptions.
20. Which dietary measure would be useful in preventing esophageal reflux?
A. eating small, frequent meals
B. increasing fluid intake
C. avoiding air swallowing with meals
D. adding a bedtime snack to the dietary plan
21. A client has undergone a laparoscopic cholecystectomy. Which instruction should the nurse include
in the discharge teaching?
A. Empty the bile bag daily
B. Breathe deeply into a paper bag when nauseated.
C. Keep adhesive dressings in place for 6 weeks.
D. Report bile-colored drainage from any incision.
22. A client with acute cholecystitis has severe pain. Which prescription will be most effective in
relieving the pain?
A. infusing normal saline solution at 100 mL/h
B. administering morphine sulfate 10 mg IM every 3 to 4 hours
C. receiving nothing by mouth (NPO)
D. having a nasogastric tube connected to low intermittent suction
23. A client is admitted to the hospital with a diagnosis of cholecystitis. The client has severe abdominal
pain and nausea and has vomited 120 mL. Based on these data, which nursing action would have the
highest priority at this time?
A. Manage anxiety.
B. Restore fluid loss.
C. Manage the pain.
D. Replace nutritional loss.
24. A client’s stools are light gray in color. What additional information should the nurse obtain from the
client? Select all that apply.
A. intolerance to fatty foods
B. fever
C. jaundice
D. respiratory distress
E. pain at McBurney’s point
F. bleeding ulcer
25. A client who has been scheduled to have a choledocholithotomy expresses anxiety about having
surgery. Which nursing intervention would be the most appropriate to achieve the outcome of anxiety
reduction?
A. providing the client with information about what to expect postoperatively
B. telling the client not to be afraid
C. reassuring the client by saying that surgery is a common procedure
D. stressing the importance of following the health care provider’s (HCP’s) instructions after surgery
26. After a cholecystectomy, the client is to follow a low-fat diet. Which food would be most appropriate
to include in a low-fat diet?
A. cheese omelet with onions
B. peanut butter on wheat toast
C. ham salad sandwich made with mayonnaise
D. turkey sandwich with lettuce and tomato
27. A client undergoes a laparoscopic cholecystectomy. Which instructions should the nurse give the
client about a diet immediately after surgery?
A. “You can’t eat or drink anything for 24 hours.”
B. “You may resume your normal diet the day after your surgery.”
C. "Start with liquids and see how you feel.”
D. “You can progress from a liquid to a bland diet as tolerated.”
28. Which discharge instruction would be appropriate for a client who has had a laparoscopic
cholecystectomy and has sutures covered by a dressing?
A. Avoid showering for 1 week after surgery.
B. Return to work within 1 week.
C. Leave dressing in place until seeing the surgeon at the postoperative visit.
D. Use acetaminophen to control any fever.
Answer Key:
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C
C
D
B
C
A, B, E
D
A
C
D
B
C
C
B
B
B
C
D
A, B, D
A
D
B
C
A, B, C
A
D
D
C