Some examples from this set of practice questions
1.
A nurse is caring for a client who has a percutaneous endoscopic gastrostomy (PEG) tube and is receiving intermittent feedings. Prior to initiating the feeding, which of the following actions should the nurse take first?
Answer: A. Flush the tube with water. B. Place the client in semi-Fowler\'s position. C. Cleanse the skin around the tube site. D. Aspirate the tube for residual contents. - Ans-B. Place the client in semi-Fowler\'s position.
2.
A nurse is caring for a client who is scheduled to undergo an esophagogastroduodenoscopy (EGD). The nurse should identify that this procedure is used to do which of the following?
Answer: A. To visualize polyps in the colon B. To detect an ulceration in the stomach C. To identify an obstruction in the biliary tract D. To determine the presence of free air in the abdomen - Ans-A. A sigmoidoscopy or barium enema is used to visualize the lower gastrointestinal tract, where polyps are found. B. CORRECT: An EGD is used to visualize the esophagus, stomach, and duodenum with a lighted tube to detect a tumor, ulceration, or obstruction. C. Identifying an obstruction in the biliary tract is performed during endoscopic retrograde cholangiopancreatography (ERCP). D. The measurement of free air, which is a gas, is obtained using fluoroscopy or an x-ray, not an EGD.
3.
A nurse is teaching a client who has Barrett\'s esophagus and is scheduled to undergo an esophagogastroduodenoscopy (EGD). Which of the following statements should the nurse include in the teaching
Answer: A. \"This procedure is performed to measure the presence of acid in your esophagus.\" B. \"This procedure can determine how well the lower part of your esophagus works.\" C. \"This procedure is performed while you are under general anesthesia.\" D. \"This procedure can determine if you have colon cancer.\" - Ans-A. A pH probe study, which involves the insertion of a specially designed probe into the distal esophagus. is performed to monitor for the presence of acid in the normally alkaline esophagus. B. CORRECT: An EGD is useful in determining the function of the esophageal lining and the extent of inflammation, potential scarring, and strictures. C. An EGD is performed while the client receives moderate sedation. D. A colonoscopy is performed to detect colon cancer
4.
A nurse is caring for a client who is dehydrated and is receiving continuous tube feeding through a pump at 75 mL/hr. When the nurse assesses the client at 0800, which of the following findings requires intervention by the nurse?
Answer: A. A full pitcher of water is sitting on the clients bedside table within the clients reach. B. The disposable feeding bag from the previous day at 1000, and contains 200 mL of feeding. C. The client is lying on the right side with a visible dependent loop in the feeding tube. D. The head of the bed is elevated 20 degrees. - Ans-A. the nurse should monitor the clients intake and output and should observe the client for manifestations of dehydration, such as dry mucous membranes, thirst, and decreased urinary output. A pitcher of water at the clients bedside does not require intervention by the nurse. B. The clients feeding bag should be changed every 24 hrs. The 200 mL remaining in the bag is sufficient to last until the bag needs to be changed. Because the rate is 75 mL/hr, the nurse will need 150 mL to cover the 2 hr until the bag needs to be changed. The 50 mL left in the bag will ensure that the bag does not run dry, causing air to enter the clients stomach. C. This observation does not require intervention because the feeding is not by gravity, but by a pump. and is set at a constant rate. The clients side-lying position will not affect the pump\'s rate of flow unless the client is lying on the tubing. D. CORRECT: The head of the bed should be elevated at least 30. (Semi-Fowler\'s position) while the tube feeding is administered. This position uses gravity to help the feeding move down through the digestive system and lessens the possibility of regurgitation.
5.
A nurse is caring for a client who is receiving total parenteral nutrition (TPN) therapy and has just returned to the room following physical therapy. The nurse notes that the infusion pump for the client\'s TPN is turned off. After restarting the infusion pump, the nurse should monitor the client for which of the following findings?
Answer: A. Hypertension B. Excessive thirst C. Fever D. Diaphoresis - Ans-A. A client experiencing fluid volume overload will exhibit hypertension. B. A client experiencing hyperglycemia will exhibit excessive thirst. C. A client who has an infection will have an increased temperature. hypoglycemia due to the sudden withdrawal of the TPN solution. In addition to diaphoresis. other potential manifestations of hypoglycemia can include weakness, anxiety, confusion. and hunger.
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