AH2 FINAL EXAM LATEST ACTUAL
EXAM AND PRACTICE EXAM 2024-2025
QUESTIONS AND DETAILED CORRECT
ANSWERS WITH RATIONALES |
GUARANTEED A+ GRADE
A patient with a history of peptic ulcer disease is
hospitalized with symptoms of a perforation. During the
initial assessment, the nurse would expect the patient to
report
a) vomiting of bright-red blood
b) projectile vomiting of undigested food
c) sudden, severe upper abdominal pain and shoulder
pain
d) hyperactive stomach sounds and upper abdominal
swelling Correct Answer Answer: C
Rationale: Perforation of an ulcer causes sudden, severe
abdominal pain that is often referred to the shoulder,
accompanied by a rigid, birdlike abdomen and other signs
of peritonitis. Vomiting of blood indicates hemorrhage of
an ulcer, and gastric outlet obstruction is characterized by
projectile vomiting of undigested food, hyperactive
stomach sounds, and upper abdominal swelling.
When caring for a patient with an acute exacerbation of a
peptic ulcer, the nurse finds the patient doubled up in bed
,with shallow, grunting respirations. The initial appropriate
action by the nurse is to
a) notify the health care provider
b) irrigate the patient's NG tube
c) place the patient in high Fowler's position
d) assess the patient's abdomen and vital signs Correct
Answer Answer: D
Rationale: Abdominal pain that causes the knees to be
drawn up and shallow, grunting respirations in a patient
with peptic ulcer disease are characteristic of perforation,
and the nurse should assess the patient's vital signs and
abdomen before notifying the health care provider.
Irrigation of the NG tube should not be performed because
the additional fluid may be spilled into the peritoneal
cavity, and the patient should be placed in a position of
comfort, usually on the side with the head slightly
elevated.
The nurse determines that further dietary teaching is
indicated when a patient with dumping syndrome says,
a) "I should eat bread with every meal."
b) "I should avoid drinking fluids with my meals."
c) "I should eat smaller meals about six times a day."
d) "I need to lie down for 30 to 60 minutes after my meals."
Correct Answer Answer: A
Rationale: Dietary control of dumping syndrome includes
small, frequent meals with low carbohydrate content and
,elimination of fluids with meals. The patient should also lie
down for 30 to 60 minutes after meals. These measures
help delay stomach emptying, preventing the rapid
movement of a high-carbohydrate food bolus into the
small intestine.
A patient is admitted to the emergency department with
acute abdominal pain. The nursing intervention that should
be implemented first is
a) measurement of vital signs
b) administration of prescribed analgesics
c) assessment of the onset, location, intensity, duration,
and character of the pain
d) physical assessment of the abdomen for distention,
assess, abnormal pulsations, bowel sounds, and
pigmentation changes Correct Answer Answer: A
Rationale: The patient with an acute abdomen may have
significant fluid or blood loss into the abdomen, and
evaluation of blood pressure (BP) and heart rate (HR)
should be the first intervention, followed by assessment of
the abdomen and the nature of the pain. Analgesics
should be used cautiously until a diagnosis can be
determined so that symptoms are not masked.
Identify whether the following statements are true (T) or
false (F). If a statement is false, correct the statement to
make it true.
, ___a) The nurse recognizes that surgery is indicated for
the patient with abdominal trauma when positive findings
are obtained with peritoneal lavage.
___b) The major complication of appendicitis is colitis.
___c) The site of pain localization in appendicitis is known
as Grey Turner's sign.
___d) Regardless of the cause of peritonitis, the nurse
would anticipate that treatment of the patient would
include IV fluid replacement.
___e) The nurse advises the patient with gastroenteritis to
start increasing fluid intake as soon as vomiting subsides.
Correct Answer Answers:
a: T
b: F, perforation with peritonitis
c: F, McBurney's point
d: T
e: T
A patient with ulcerative colitis has a total colectomy with
formation of a terminal ileum stoma. An important nursing
intervention for this patient postoperatively is to
a) measure the ileostomy output to determine the status of
the patient's fluid balance.
b) change the ileostomy appliance every 3 - 4 hours to
prevent leakage of drainage onto the skin.
c) emphasize that the ostomy is temporary and the ileum
will be reconnected when the large bowel heals.
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