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NR 325 Exam 3 Study Questions with Answers Perfectly GRADED A+
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NR 325 Exam 3 Study Questions with Answers Perfectly GRADED A+
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NR 325 Exam 3 Study Questions with AnswersPerfectly GRADED A+
1.1. The nurse is performing an assessment of an 80-year-old patient.
Which information obtained by the nurse will be of most concern?
a. Decreased appetite
b. Difficulty chewing food
c. Unintentional weight loss
d. Complaints of indigestion: ANS: C
Unintentional weight loss is not a normal finding in older patients and
may indicate a problem such as cancer or depression. Poor appetite,
difficulty in chewing, and complaints of indigestion are common in older
patients. These will need to be addressed, but are not of as much
concern as the weight loss
2.2. To promote bowel evacuation in a patient with chronic complaints of
constipation, the nurse will suggest that the patient should attempt
defecation
a. in the mid-afternoon.
b. after eating breakfast.
c. right after getting up in the morning.
d. immediately before the first daily meal.: ANS: B
These reflexes are most active after the first daily meal. Arising in the
morning, the anticipation of eating, and physical exercise do not
stimulate these reflexes.
3.3. When a patient has a history of a total gastrectomy, the nurse will
monitor for clinical manifestations of
a. constipation.
b. dehydration.
c. elevated total cholesterol.
d. cobalamin (vitamin B12) deficiency.: ANS: D
The patient with a total gastrectomy does not secrete intrinsic factor,
which is needed for cobalamin (vitamin B12) absorption. Because the
stomach absorbs only small amounts of water and nutrients, the patient
is not at higher risk for dehydration, elevated cholesterol, or
constipation.
4.4. The nurse will monitor a patient who has an obstruction of the
common bile duct for
a. melena.
b. steatorrhea.
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,c. decreased serum cholesterol levels.
d. increased serum indirect bilirubin levels.: ANS: B
A common bile duct obstruction will reduce the absorption of fat in the
small intestine, leading to fatty stools. Gastrointestinal (GI) bleeding is
not caused by common bile duct obstruction. Serum cholesterol levels
are increased with biliary obstruction.
Direct bilirubin level is increased with biliary obstruction.
5.5. During change-of-shift report, the nurse receives the following
informa- tion about a patient who is scheduled for a colonoscopy. Which
information should be communicated to the health care provider before
sending the patient for the procedure?
a. The patient has a permanent pacemaker to prevent bradycardia.
b. The patient is worried about discomfort during the examination.
c. The patient has had an allergic reaction to shellfish and iodine in the past.
d. The patient refused to drink the ordered polyethylene glycol (GoLYTELY).:
-
ANS: D
If the patient has had inadequate bowel preparation, the colon cannot
be visual- ized and the procedure should be rescheduled. Because
contrast solution is not used during colonoscopy, the iodine allergy is
not pertinent. A pacemaker is a contraindication to magnetic resonance
imaging (MRI), but not to colonoscopy. The nurse should instruct the
patient about the sedation used during the examination to decrease the
patient's anxiety about discomfort.
6.6. When the nurse is obtaining a history from a patient who is admitted
with jaundice, which statement is most indicative of a need for patient
teaching?
a. "I used cough syrup several times a day last week."
b. "I take a baby aspirin every day to prevent strokes."
c. "I need to take an antacid for indigestion several times a week"
d. "I use acetaminophen (Tylenol) every 4 hours for chronic pain.": ANS: D
Chronic use of high doses of acetaminophen can be hepatotoxic and
may have caused the patient's jaundice. The other patient statements
require further assess- ment by the nurse, but do not indicate a need
for patient education.
7.7. To palpate the liver, the nurse
a. places one hand on the patient's back and presses upward and inward
with the other hand below the patient's right costal margin.
b. places one hand on top of the other and uses the upper fingers to
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,apply pressure and the bottom fingers to feel for the liver edge.
c. presses slowly and firmly over the right costal margin with one hand
and withdraws the fingers quickly after the liver edge is felt.
d. places one hand under the patient's lower ribs and presses the left lower
rib cage forward, palpating below the costal margin with the other hand.:
ANS: A
The liver is normally not palpable below the costal margin, the nurse
needs to push inward below the right costal margin while lifting the
patient's back slightly with the left hand. The other methods will not
allow palpation of the liver.
8.8. When the nurse is listening to a patient's abdomen, which finding
indi- cates a need for a focused abdominal assessment?
a. Loud gurgles
b. High-pitched gurgles
c. Absent bowel sounds
d. Frequent clicking sounds: ANS: C
Absent bowel sounds are abnormal and require further assessment by
the nurse. The other sounds may be heard normally.
9. 9. When caring for a patient following a needle biopsy of the liver at
the bedside, the nurse should
a. put pressure on the biopsy site using a sandbag.
b. elevate the head of the bed to facilitate breathing.
c. place the patient on the right side with the bed flat.
d. check the patient's postbiopsy coagulation studies.: ANS: C
After a biopsy, the patient lies on the right side with the bed flat to
splint the biopsy site. Coagulation studies are checked before the
biopsy. A sandbag does not exert adequate pressure to splint the site.
10.10. Which information obtained by the nurse when admitting a patient
who is scheduled for an ultrasound of the gallbladder indicates that the
ultrasound may need to be rescheduled?
a. The patient has a permanent gastrostomy tube.
b. The patient took a laxative the previous evening.
c. The patient ate a low-fat bagel an hour previously.
d. The patient had a high-fat meal the previous evening.: ANS: C
Food intake can cause the gallbladder to contract and result in a
suboptimal study. The patient should be NPO for 8 to 12 hours before
the test. A high-fat meal the previous evening, laxative use, or a
gastrostomy tube will not affect the results of the study.
11.11. When the nurse is assessing an alert and independent older patient
in the clinic for malnutrition risk, the most appropriate initial question is,
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, a. "How do you get to the grocery store to buy your food?"
b. "Do you have any difficulty in preparing or eating food?"
c. "Can you tell me the foods that you have eaten over the past 24 hours?"
d. "Are you taking any medications that alter your taste or tolerance
of foods?": ANS: C
This question is the most open-ended and will provide the best overall
information about the patient's daily intake and risk for poor nutrition.
The other questions may be asked, depending on the patient's
response to the first question.
12.12. Which information collected by the nurse when caring for a patient
who has just arrived in the recovery area after an upper endoscopy is
most important to communicate to the health care provider?
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