Practice Questions Exam 4 PDF

**A patient with GERD is experiencing severe pyrosis. Which lifestyle modification should the nurse suggest?** - A. Eat large meals before bedtime - B. Elevate the head of the bed - C. Drink caffeinated beverages - D. Lie down immediately after eating 2. **A nurse is caring for a patie...

**A patient with GERD is experiencing severe pyrosis. Which lifestyle modification should the nurse suggest?** - A. Eat large meals before bedtime - B. Elevate the head of the bed - C. Drink caffeinated beverages - D. Lie down immediately after eating 2. **A nurse is caring for a patient with a nasogastric tube receiving enteral nutrition. Which intervention is the highest priority to reduce the risk of aspiration?** - A. Checking the placement of the tube before each feeding - B. Administering feedings at room temperature - C. Monitoring the patient\'s weight daily - D. Flushing the tube with water before and after medications 3. **Which of the following is a common complication of intravenous therapy that requires immediate attention?** - A. Phlebitis - B. Infiltration - C. Fever - D. Tachycardia 4. **The nurse is assessing a patient with melena. What is the most likely source of the bleeding?** - A. Lower gastrointestinal tract - B. Stomach or upper GI tract - C. Small intestine - D. Rectum 5. **A patient with diarrhea is placed on the BRAT diet. Which food is appropriate for this diet?** - A. Broccoli - B. Applesauce - C. Cheese - D. Yogurt 6. **Which of the following is an important step in managing constipation?** - A. Decrease fluid intake - B. Increase dietary fiber - C. Limit physical activity - D. Administer diuretics 7. **A patient is diagnosed with GERD. Which of the following is an appropriate nursing intervention?** - A. Encourage the patient to eat spicy foods - B. Advise the patient to eat smaller, more frequent meals - C. Recommend lying down immediately after meals - D. Suggest the patient drink carbonated beverages 8. **In managing a patient with peptic ulcer disease, which medication is commonly prescribed?** - A. Antibiotics - B. Antidiarrheals - C. Antacids - D. Antihistamines 9. **A nurse is educating a patient on the prevention of urinary tract infections. Which of the following should be included?** - A. Drink plenty of fluids - B. Limit bathroom trips - C. Wear tight clothing - D. Avoid cranberry juice 10. **Which assessment finding would indicate dehydration in a patient with diarrhea?** - A. Elevated blood pressure - B. Increased urine output - C. Dry mucous membranes - D. Diluted urine 11. **What is the primary goal of administering an enema?** - A. Hydrate the patient - B. Stimulate bowel movements - C. Reduce fever - D. Provide pain relief 12. **Which symptom would suggest a complication in a patient receiving enteral nutrition?** - A. Steady weight gain - B. Regular bowel movements - C. Respiratory distress - D. Clear lung sounds 13. **What type of urine sample is required for urinalysis?** - A. 24-hour collection - B. Random sample - C. Clean-catch midstream - D. First-morning void 14. **Which electrolyte is primarily responsible for fluid balance in the body?** - A. Calcium - B. Potassium - C. Sodium - D. Magnesium 15. **Which of the following symptoms is associated with GERD?** - A. Lower abdominal pain - B. Dark, tarry stools - C. Heartburn - D. Bright red blood in stool 16. **A patient with a colostomy is being taught stoma care. Which statement indicates effective learning?** - A. \"I should change the appliance daily.\" - B. \"I\'ll clean the stoma with alcohol wipes.\" - C. \"I need to monitor the skin around the stoma for irritation.\" - D. \"It\'s normal for the stoma to bleed excessively.\" 17. **Which of the following foods should be avoided by a patient with diarrhea?** - A. White rice - B. Bananas - C. Applesauce - D. Dairy products 18. **What is the normal specific gravity range of urine?** - A. 1.000 - 1.005 - B. 1.005 - 1.030 - C. 1.030 - 1.050 - D. 1.050 - 1.080 19. **Which intervention should be included in the care plan for a patient with peptic ulcer disease?** - A. Encouraging a high-fat diet - B. Administering proton pump inhibitors - C. Advising regular use of NSAIDs - D. Recommending large meals 20. **A nurse is caring for a patient with a history of urinary tract infections. What is a common cause of UTI in females?** - A. Drinking too much water - B. Poor perineal hygiene - C. Frequent urination - D. Excessive exercise - A. Apples - B. Carrots - C. Chocolate - D. Whole grains 21. **Which fluid balance indicator is crucial to monitor in patients with diarrhea?** - A. Blood pressure - B. Skin turgor - C. Heart rate - D. Weight 22. **Which of the following conditions can lead to metabolic acidosis?** - A. Diabetic ketoacidosis - B. Chronic respiratory disease - C. Vomiting - D. Hyperventilation 23. **A nurse is educating a patient on increasing dietary fiber. Which food should be included?** - A. White bread - B. Broccoli - C. Ice cream - D. Chicken 24. **A patient with an ileostomy needs to be monitored for which common complication?** - A. Urinary retention - B. Dehydration - C. High blood pressure - D. Hyperglycemia 25. **What is a priority nursing intervention for a patient with urinary retention?** - A. Encourage fluids - B. Limit movement - C. Administer diuretics - D. Catheterize the patient 26. **Which symptom should be reported immediately in a patient receiving intravenous therapy?** - A. Localized redness - B. Slight discomfort - C. Coolness at the IV site - D. Fever and chills 27. **A nurse is assessing a patient with a jejunostomy tube. What is an important aspect of care?** - A. Administering feedings quickly - B. Keeping the head of the bed flat - C. Checking for tube placement and residuals - D. Flushing the tube with soda 28. **Which electrolyte imbalance is associated with muscle cramps and weakness?** - A. Hypernatremia - B. Hypercalcemia - C. Hypokalemia - D. Hypermagnesemia 30. **Which intervention is essential for preventing complications in a patient with a urinary catheter?** - A. Regularly changing the catheter - B. Encouraging the patient to walk frequently - C. Keeping the drainage bag below bladder level - D. Applying a heating pad to the catheter site 31. **A patient presents with symptoms of metabolic acidosis. Which lab result supports this diagnosis?** - A. pH 7.48 - B. HCO3 22 mEq/L - C. pH 7.30 - D. PaCO2 45 mm Hg 32. **In a patient with constipation, which dietary recommendation is appropriate?** - A. Increase intake of dairy products - B. Consume more high-fiber foods - C. Limit fluid intake - D. Eat more refined grains 33. **What is a common symptom of urinary tract infection in older adults?** - A. Fever - B. Hematuria - C. Confusion - D. Hypertension 34. **When assessing a patient with diarrhea, which electrolyte imbalance is a concern?** - A. Hypernatremia - B. Hyperkalemia - C. Hypokalemia - D. Hypercalcemia 35. **A patient receiving enteral nutrition via gastrostomy tube is at risk for which complication?** - A. Hypoglycemia - B. Aspiration pneumonia - C. Urinary retention - D. Joint pain 36. **Which lifestyle change can help manage GERD symptoms?** - A. Eating large meals before bedtime - B. Avoiding smoking and alcohol - C. Drinking carbonated beverages - D. Lying down after eating 37. **What is the best way to assess fluid balance in a patient?** - A. Measuring blood pressure - B. Monitoring daily weights - C. Checking capillary refill time - D. Observing skin turgor 38. **A patient with a history of peptic ulcer disease reports sudden, severe abdominal pain. What should the nurse suspect?** - A. Bowel obstruction - B. Perforation - C. Gastroenteritis - D. Appendicitis 39. **Which dietary advice is appropriate for a patient with constipation?** - A. Eat more processed foods - B. Drink more caffeine - C. Increase fluid intake - D. Reduce fiber intake 40. **A patient with GERD is advised to elevate the head of the bed. This recommendation helps to:** - A. Prevent regurgitation - B. Decrease heart rate - C. Increase appetite - D. Prevent dehydration 41. **Which condition can cause hematochezia?** - A. Upper gastrointestinal bleeding - B. Lower gastrointestinal bleeding - C. Peptic ulcer disease - D. GERD 42. **What is the normal pH range of urine?** - A. 1.005 to 1.030 - B. 6.5 to 7.5 - C. 4.5 to 8.0 - D. 2.5 to 5.0 43. **What complication should be monitored for in a patient with a nasogastric tube?** - A. Urinary tract infection - B. Hypertension - C. Aspiration - D. Hyperglycemia 44. **Which symptom is commonly associated with a urinary tract infection (UTI)?** - A. Polyphagia - B. Dysuria - C. Hyperglycemia - D. Hemoptysis 45. **A nurse is assessing a patient with melena. What does this finding suggest?** - A. Upper gastrointestinal bleeding - B. Lower gastrointestinal bleeding - C. Kidney infection - D. Urinary tract infection 46. **A patient reports frequent heartburn and is diagnosed with GERD. Which advice should the nurse give?** - A. Avoid lying down after meals - B. Drink plenty of carbonated beverages - C. Eat large, infrequent meals - D. Increase caffeine intake 47. **What is an important nursing intervention for a patient with diarrhea?** - A. Encouraging dairy products - B. Limiting fluid intake - C. Implementing the BRAT diet - D. Increasing fiber intake immediately 48. **A patient with chronic constipation is advised to increase their intake of which type of food?** - A. Dairy - B. Processed foods - C. Fiber-rich foods - D. Refined sugars 49. **A nurse is educating a patient with a new ileostomy. Which statement indicates understanding?** - A. \"I need to eat a high-fiber diet immediately.\" - B. \"I should limit my fluid intake.\" - C. \"I need to monitor for signs of dehydration.\" - D. \"I should avoid all exercise.\" 50. **Which finding in a urinalysis would indicate a potential urinary tract infection?** - A. High specific gravity - B. Presence of ketones - C. Presence of leukocytes and nitrates - D. Low pH 51. **A patient is experiencing pyrosis. Which condition is most likely causing this symptom?** - A. Diabetes mellitus - B. GERD - C. Chronic kidney disease - D. Peptic ulcer disease 52. **When administering a cleansing enema, what is the appropriate position for the patient?** - A. Supine - B. Prone - C. Left lateral with right knee flexed - D. Standing 53. **A nurse is educating a patient on fluid and electrolyte balance. Which symptom indicates hypernatremia?** - A. Muscle cramps - B. Thirst - C. Bradycardia - D. Hypotension 54. **In a patient with chronic constipation, which non-pharmacological intervention is recommended?** - A. Bed rest - B. Decreased fluid intake - C. Increased physical activity - D. Low-fiber diet 55. **Which type of feeding tube is appropriate for long-term enteral nutrition?** - A. Nasogastric tube - B. Orogastric tube - C. Gastrostomy tube - D. Nasointestinal tube 56. **A patient with diarrhea is at risk for which electrolyte imbalance?** - A. Hypercalcemia - B. Hyponatremia - C. Hyperkalemia - D. Hypokalemia 57. **Which of the following is a primary function of potassium in the body?** - A. Bone formation - B. Muscle function - C. Blood clotting - D. Oxygen transport 58. **A nurse is caring for a patient with a urinary catheter. Which practice helps prevent infection?** - A. Keeping the drainage bag above bladder level - B. Disconnecting the catheter from the drainage bag frequently - C. Maintaining a closed drainage system - D. Irrigating the catheter frequently 59. **What is the significance of dark, tarry stools (melena)?** - A. Upper gastrointestinal bleeding - B. Lower gastrointestinal bleeding - C. Small bowel obstruction - D. Intestinal infection 60. **Which condition is indicated by a high specific gravity of urine?** - A. Overhydration - B. Dehydration - C. Diabetes insipidus - D. Renal failure 61. **A patient with peptic ulcer disease is prescribed a proton pump inhibitor. The nurse knows this medication helps by:** - A. Neutralizing stomach acid - B. Coating the stomach lining - C. Reducing acid production - D. Increasing gastric motility 62. **Which practice helps prevent catheter-associated urinary tract infections (CAUTIs)?** - A. Keeping the catheter open for air circulation - B. Using sterile technique during insertion - C. Changing the catheter every day - D. Irrigating the catheter regularly 63. **A nurse is teaching a patient with constipation about dietary changes. Which food should be avoided?** - A. Whole grain bread - B. Fresh fruits - C. Processed cheese - D. Leafy vegetables 64. **Which of the following is a potential complication of an ostomy?** - A. Hypertension - B. Stoma infection - C. Hypoglycemia - D. Joint pain 65. **What is the first-line treatment for a patient with severe diarrhea?** - A. Administering antibiotics - B. Providing rehydration therapy - C. Giving opioid medications - D. Encouraging high-fiber diet 66. **Which symptom indicates a possible complication from intravenous therapy?** - A. Redness and warmth at the site - B. Clear lung sounds - C. Regular pulse rate - D. Normal blood pressure 67. **A patient with GERD is advised to avoid which type of food?** - A. High-fiber foods - B. Acidic foods - C. Lean proteins - D. Whole grains 68. **What is the primary function of calcium in the body?** - A. Energy production - B. Oxygen transport - C. Bone health and muscle function - D. Blood clotting 69. **Which electrolyte imbalance is associated with cardiac arrhythmias?** - A. Hypernatremia - B. Hypokalemia - C. Hypercalcemia - D. Hypomagnesemia 70. **A nurse is educating a patient with constipation. Which advice is most appropriate?** - A. Limit fluid intake to reduce bloating - B. Engage in regular physical exercise - C. Increase consumption of processed foods - D. Eat low-fiber foods - A. Apply alcohol-based products - B. Use mild soap and water - C. Increase adhesive use - D. Avoid cleaning the area frequently 71. **What is a common cause of constipation in older adults?** - A. High physical activity - B. Increased fiber intake - C. Decreased fluid intake - D. Low use of medications 72. **A patient with heartburn is advised to avoid which of the following to reduce symptoms?** - A. Drinking milk - B. Eating spicy foods - C. Chewing gum - D. Walking after meals 73. **Which laboratory value indicates dehydration in a patient with diarrhea?** - A. Low hematocrit - B. Low specific gravity - C. High specific gravity - D. High glucose 74. **A nurse is preparing to insert a nasogastric tube. What position should the patient be in?** - A. Supine - B. Semi-Fowler's - C. Prone - D. Trendelenburg 75. **Which assessment finding is consistent with metabolic alkalosis?** - A. pH 7.45 - B. pH 7.30 - C. pH 7.50 - D. pH 7.35 76. **Which dietary recommendation is appropriate for a patient with GERD?** - A. Eat large, infrequent meals - B. Avoid eating right before bedtime - C. Consume spicy foods - D. Drink carbonated beverages 77. **A nurse is caring for a patient with a stoma. What is an important aspect of care?** - A. Using strong adhesives - B. Monitoring for skin breakdown - C. Limiting fluid intake - D. Avoiding exercise 78. **Which intervention is crucial for managing constipation in a bedridden patient?** - A. Limiting fluid intake - B. Increasing dietary fiber - C. Encouraging bed rest - D. Avoiding fruits and vegetables 79. **What is the normal urine output for an adult?** - A. 10 mL/hour - B. 20 mL/hour - C. 30 mL/hour - D. 40 mL/hour 81. **Which intervention helps prevent urinary tract infections in patients with indwelling catheters?** - A. Changing the catheter frequently - B. Keeping the drainage bag above the bladder - C. Maintaining a closed drainage system - D. Using antiseptics on the catheter 82. **Which symptom indicates a possible electrolyte imbalance in a patient with diarrhea?** - A. Increased appetite - B. Muscle weakness - C. Hypertension - D. Decreased urine output 83. **A patient with melena should be evaluated for bleeding in which part of the gastrointestinal tract?** - A. Lower GI tract - B. Upper GI tract - C. Small intestine - D. Rectum 84. **What is the normal specific gravity range of urine?** - A. 1.000 - 1.005 - B. 1.005 - 1.030 - C. 1.030 - 1.050 - D. 1.050 - 1.080 85. **A patient is experiencing heartburn. Which lifestyle modification should the nurse suggest?** - A. Drinking more coffee - B. Eating smaller, more frequent meals - C. Lying down after meals - D. Consuming high-fat foods 86. **What is the priority nursing intervention for a patient with severe diarrhea?** - A. Encouraging a high-fiber diet - B. Providing oral rehydration therapy - C. Administering antibiotics - D. Limiting fluid intake 87. **Which dietary change is recommended for a patient with constipation?** - A. Increasing fiber intake - B. Avoiding fruits and vegetables - C. Limiting water intake - D. Consuming more processed foods 88. **What is an appropriate nursing intervention for a patient with a nasogastric tube to prevent aspiration?** (Select all that apply) - A. Lying the patient flat during feedings - B. Checking tube placement before feedings - C. Keeping the head of the bed elevated - D. Administering feedings slowly 89. **Which of the following are common symptoms of GERD?** (Select all that apply) - A. Heartburn - B. Regurgitation - C. Constipation - D. Chest pain - E. Diarrhea 90. **What are the typical signs of dehydration in a patient with diarrhea?** (Select all that apply) - A. Dry mucous membranes - B. Increased urine output - C. Hypotension - D. Tachycardia **Case-Based Scenario:** 91. **Case Scenario**: A 55-year-old male patient presents to the emergency department with severe abdominal pain, dark tarry stools, and a history of chronic NSAID use for arthritis. The patient is diagnosed with peptic ulcer disease. - **Question 1**: What initial assessments should the nurse prioritize for this patient? (Select all that apply) - A. Vital signs - B. ECG - C. Pain assessment - D. Medication history - **Question 2**: Which of the following interventions would be appropriate for managing this patient's condition? (Select all that apply) - A. Administering proton pump inhibitors - B. Providing high-fat meals - C. Encouraging fluid intake - D. Monitoring for signs of bleeding - **Question 3**: What patient education should be provided to prevent recurrence of peptic ulcer disease? (Select all that apply) - A. Avoiding NSAIDs - B. Eating smaller, more frequent meals - C. Drinking caffeinated beverages - D. Smoking cessation **Select All That Apply:** 92. **Which symptoms are indicative of a urinary tract infection?** (Select all that apply) - A. Fever - B. Polyuria - C. Dysuria - D. Hematuria 93. **What are the essential elements of ostomy care?** (Select all that apply) - A. Checking the stoma regularly for color and swelling - B. Using alcohol-based products to clean the stoma - C. Teaching the patient how to change the appliance - D. Encouraging the patient to drink adequate fluids 94. **Which foods should a patient with GERD avoid?** (Select all that apply) - A. Chocolate - B. Citrus fruits - C. Whole grain bread - D. Spicy foods **Answers**: A. Chocolate, B. Citrus fruits, D. Spicy foods **Multiple Choice:** 95. **A nurse is caring for a patient with severe diarrhea. What is the most immediate concern?** - A. Hyperglycemia - B. Dehydration - C. Hypothermia - D. Bradycardia **Answer**: B. Dehydration 96. **A patient with a history of constipation is admitted to the hospital. Which intervention is most likely to be effective?** - A. Administering diuretics - B. Increasing dietary fiber - C. Reducing fluid intake - D. Limiting physical activity **Answer**: B. Increasing dietary fiber 97. **What is the priority intervention for a patient with an intravenous catheter to prevent complications?** - A. Flushing the catheter with saline every 8 hours - B. Replacing the catheter every 24 hours - C. Keeping the catheter insertion site covered at all times - D. Assessing the catheter site for signs of infection **Answer**: D. Assessing the catheter site for signs of infection 98. **A patient with GERD is advised to elevate the head of their bed. This intervention helps by:** - A. Preventing regurgitation - B. Increasing appetite - C. Reducing nausea - D. Improving digestion 99. **Which electrolyte imbalance should a nurse monitor for in a patient with frequent vomiting?** - A. Hypercalcemia - B. Hyperkalemia - C. Hypokalemia - D. Hypernatremia **Answer**: C. Hypokalemia 100. **What is an important aspect of care for a patient with an ileostomy?** - A. Encouraging a low-fiber diet - B. Monitoring for dehydration - C. Keeping the stoma dry - D. Limiting fluid intake **Answer**: B. Monitoring for dehydration **Case-Based Scenario 1: GERD Management** **Case Scenario**: A 45-year-old female patient comes to the clinic with complaints of heartburn, especially after meals, and regurgitation at night. She has a history of obesity and smokes one pack of cigarettes per day. The patient is diagnosed with gastroesophageal reflux disease (GERD). - **Question 1**: What lifestyle modifications should the nurse recommend to the patient to manage GERD symptoms? (Select all that apply) - A. Quit smoking - B. Eat smaller, more frequent meals - C. Avoid lying down immediately after meals - D. Drink caffeinated beverages - **Question 2**: Which medications might be prescribed to manage this patient\'s GERD symptoms? (Select all that apply) - A. Antacids - B. Proton pump inhibitors (PPIs) - C. Antidiarrheals - D. H2 receptor blockers - **Question 3**: During a follow-up visit, the patient reports no significant improvement in symptoms despite lifestyle changes and medication. What further diagnostic tests might be considered? (Select all that apply) - A. Upper endoscopy - B. Colonoscopy - C. Esophageal pH monitoring - D. Barium swallow study **Case-Based Scenario 2: Peptic Ulcer Disease** **Case Scenario**: A 60-year-old male patient presents with severe epigastric pain that is relieved by eating but returns a few hours later. He has a history of using NSAIDs for chronic back pain. The patient is diagnosed with peptic ulcer disease. - **Question 1**: What initial assessments are critical for this patient? (Select all that apply) - A. Pain assessment - B. Dietary history - C. Medication history - D. Exercise routine - **Question 2**: Which treatment options should be included in the management plan for this patient? (Select all that apply) - A. Proton pump inhibitors (PPIs) - B. Continued use of NSAIDs - C. Antibiotics if H. pylori is present - D. Lifestyle modifications - **Question 3**: The patient asks about strategies to prevent recurrence of peptic ulcers. What should the nurse advise? (Select all that apply) - A. Avoid NSAIDs and aspirin - B. Eat smaller, more frequent meals - C. Reduce alcohol intake - D. Engage in high-stress activities **Case-Based Scenario 3: Constipation Management** **Case Scenario**: An 80-year-old female patient in a long-term care facility complains of infrequent bowel movements and straining during defecation. The patient has a history of reduced mobility and low fluid intake. She is diagnosed with constipation. - **Question 1**: What non-pharmacological interventions should the nurse implement first? (Select all that apply) - A. Encourage increased fluid intake - B. Increase dietary fiber intake - C. Promote regular physical activity - D. Administer stool softeners - **Question 2**: If lifestyle modifications are not effective, which medications may be considered for this patient? (Select all that apply) - A. Laxatives - B. Antidiarrheals - C. Proton pump inhibitors - D. Enemas - **Question 3**: What patient education should the nurse provide to prevent future episodes of constipation? (Select all that apply) - A. Drink at least 2-3 liters of water daily - B. Include more fruits, vegetables, and whole grains in the diet - C. Engage in regular physical activity, such as walking - D. Avoid all physical activity **Case-Based Scenario 4: Urinary Tract Infection** **Case Scenario**: A 25-year-old female presents with dysuria, urinary frequency, and lower abdominal pain. She has a history of recurrent UTIs. A urinalysis confirms the presence of a urinary tract infection. - **Question 1**: What initial treatments should be initiated for this patient? (Select all that apply) - A. Antibiotics - B. Increased fluid intake - C. Caffeine consumption - D. Proper hygiene practices - **Question 2**: The patient asks about measures to prevent future UTIs. What should the nurse recommend? (Select all that apply) - A. Urinate before and after sexual activity - B. Wear tight clothing - C. Wipe from front to back after using the toilet - D. Avoid prolonged use of catheters - **Question 3**: What are some potential complications of untreated UTIs that the nurse should explain to the patient? (Select all that apply) - A. Kidney infection (pyelonephritis) - B. Sepsis - C. Hypertension - D. Hematuria **Case-Based Scenario 5: Diarrhea Management** **Case Scenario**: A 35-year-old female patient presents with complaints of frequent loose stools, abdominal cramping, and dehydration. She reports a history of irritable bowel syndrome (IBS) and recent antibiotic use. - **Question 1**: What initial assessments should the nurse prioritize for this patient? (Select all that apply) - A. Vital signs - B. Stool sample analysis - C. Pain assessment - D. Dietary history - **Question 2**: Which interventions would be appropriate for managing this patient's symptoms? (Select all that apply) - A. Administering antidiarrheals as prescribed - B. Encouraging the BRAT diet (bananas, rice, applesauce, toast) - C. Increasing fluid intake - D. Administering antibiotics without a prescription - **Question 3**: The patient asks about strategies to prevent diarrhea in the future. What should the nurse advise? (Select all that apply) - A. Avoiding known food triggers - B. Eating high-fiber foods during flare-ups - C. Maintaining hydration - D. Using probiotics **Case-Based Scenario 6: Fluid and Electrolyte Balance** **Case Scenario**: A 65-year-old male patient is admitted with severe dehydration and electrolyte imbalance after experiencing prolonged diarrhea. His laboratory results show low potassium and sodium levels. - **Question 1**: What initial assessments are critical for this patient? (Select all that apply) - A. Monitoring vital signs - B. Assessing skin turgor - C. Reviewing electrolyte levels - D. Checking for signs of edema - **Question 2**: Which treatments should be initiated to correct the patient's electrolyte imbalance? (Select all that apply) - A. Administering IV fluids with electrolytes - B. Encouraging oral fluid intake - C. Giving potassium supplements - D. Restricting fluid intake - **Question 3**: What patient education should be provided regarding the management of dehydration and electrolyte imbalance? (Select all that apply) - A. The importance of drinking fluids regularly - B. Signs and symptoms of dehydration to watch for - C. Foods rich in electrolytes to include in the diet - D. Avoiding all physical activity **Case-Based Scenario 7: Enteral Nutrition** **Case Scenario**: A 50-year-old male patient with a history of stroke is receiving enteral nutrition via a gastrostomy tube. He is experiencing nausea and occasional vomiting after feedings. - **Question 1**: What initial assessments should the nurse prioritize for this patient? (Select all that apply) - A. Checking tube placement - B. Assessing for signs of infection - C. Reviewing feeding schedule - D. Evaluating for potential aspiration - **Question 2**: Which interventions would be appropriate to manage the patient's symptoms? (Select all that apply) - A. Adjusting the rate of feeding - B. Ensuring the head of the bed is elevated - C. Administering antiemetics as prescribed - D. Increasing the volume of each feeding - **Question 3**: The patient's family asks about the potential complications of enteral feeding. What should the nurse explain? (Select all that apply) - A. Aspiration pneumonia - B. Diarrhea - C. Tube displacement - D. Weight gain **Case-Based Scenario 8: Urinary Diversions** **Case Scenario**: A 70-year-old female patient has undergone a urostomy due to bladder cancer. She is anxious about managing her stoma and caring for the urostomy at home. - **Question 1**: What are the key points of education that the nurse should provide to the patient about stoma care? (Select all that apply) - A. How to clean the stoma - B. Signs of infection to watch for - C. How to change the urostomy appliance - D. Importance of avoiding fluid intake - **Question 2**: Which psychological aspects should the nurse address with the patient? (Select all that apply) - A. Coping strategies for body image changes - B. Emotional support and reassurance - C. Social support resources - D. Denial of the condition - **Question 3**: The patient is concerned about potential complications. What complications should the nurse discuss? (Select all that apply) - A. Stoma infection - B. Skin irritation around the stoma - C. Blockage of the urostomy - D. Increased urine output **Case-Based Scenario 9: Diagnostic Studies for GI Tract** **Case Scenario**: A 55-year-old male patient presents with unexplained weight loss, abdominal pain, and changes in bowel habits. The physician orders a colonoscopy to investigate. - **Question 1**: What pre-procedure education should the nurse provide to the patient? (Select all that apply) - A. Instructions on bowel preparation - B. Fasting requirements before the procedure - C. Possible sedation during the procedure - D. Avoiding all medications before the procedure - **Question 2**: What post-procedure care should the nurse provide after the colonoscopy? (Select all that apply) - A. Monitoring for signs of bleeding or perforation - B. Encouraging the patient to eat a heavy meal immediately - C. Assessing the patient's level of consciousness - D. Providing written discharge instructions - **Question 3**: The patient is anxious about the procedure. How can the nurse help alleviate the patient's anxiety? (Select all that apply) - A. Providing detailed information about the procedure - B. Offering reassurance and support - C. Encouraging the patient to ask questions - D. Dismissing the patient's concerns **Case-Based Scenario 10: IV Site Assessment** **Case Scenario**: A 70-year-old female patient with a history of chronic obstructive pulmonary disease (COPD) is admitted to the hospital for intravenous (IV) antibiotic therapy. On the second day of hospitalization, she reports pain and redness at the IV site. - **Question 1**: What initial assessments should the nurse conduct for this patient? (Select all that apply) - A. Inspect the IV site for signs of infiltration - B. Check the IV site for phlebitis - C. Palpate the site for warmth or coolness - D. Assess the patient\'s respiratory status - **Question 2**: What actions should the nurse take if the IV site is infiltrated? (Select all that apply) - A. Discontinue the IV line - B. Apply a warm compress to the site - C. Elevate the affected limb - D. Administer the medication subcutaneously - **Question 3**: The patient is anxious about receiving another IV. How can the nurse help alleviate her anxiety? (Select all that apply) - A. Explain the procedure step by step - B. Offer reassurance and support - C. Allow the patient to ask questions - D. Ignore the patient\'s concerns **Case-Based Scenario 11: Bowel Elimination** **Case Scenario**: A 40-year-old male patient with a history of irritable bowel syndrome (IBS) presents with alternating constipation and diarrhea, abdominal pain, and bloating. The patient is seeking guidance on managing his symptoms. - **Question 1**: What initial assessments should the nurse conduct for this patient? (Select all that apply) - A. Review the patient\'s dietary habits - B. Assess bowel movement patterns - C. Check for abdominal distension - D. Evaluate the patient\'s hydration status - **Question 2**: Which dietary recommendations should the nurse provide to help manage the patient\'s IBS symptoms? (Select all that apply) - A. Increase fiber intake gradually - B. Avoid trigger foods - C. Eat smaller, more frequent meals - D. Increase caffeine consumption - **Question 3**: The patient expresses frustration with managing his IBS. What supportive measures can the nurse suggest? (Select all that apply) - A. Encourage stress management techniques - B. Recommend keeping a symptom diary - C. Suggest joining a support group - D. Advise avoiding all physical activity **Case-Based Scenario 12: Urinary Retention** **Case Scenario**: An 82-year-old male patient with benign prostatic hyperplasia (BPH) presents to the emergency department with urinary retention, lower abdominal discomfort, and an inability to void. - **Question 1**: What initial assessments should the nurse conduct for this patient? (Select all that apply) - A. Assess for bladder distension - B. Check the patient\'s urine output history - C. Review the patient\'s medication list - D. Perform a prostate examination - **Answers**: A. Assess for bladder distension, B. Check the patient\'s urine output history, C. Review the patient\'s medication list - **Question 2**: Which interventions should the nurse initiate to relieve the patient\'s urinary retention? (Select all that apply) - A. Insert a urinary catheter as prescribed - B. Encourage fluid intake - C. Administer alpha-blockers as prescribed - D. Apply a warm compress to the lower abdomen - **Question 3**: What patient education should the nurse provide regarding the management of BPH and urinary retention? (Select all that apply) - A. Avoiding caffeine and alcohol - B. Performing regular pelvic floor exercises - C. Recognizing signs of urinary retention - D. Drinking large amounts of fluids before bedtime **Case-Based Scenario 13: Acid-Base Balance** **Case Scenario**: A 60-year-old female patient with chronic kidney disease (CKD) presents with fatigue, confusion, and shortness of breath. Her arterial blood gas (ABG) results indicate metabolic acidosis. - **Question 1**: What initial assessments should the nurse conduct for this patient? (Select all that apply) - A. Review the patient\'s ABG results - B. Assess respiratory status - C. Check for signs of dehydration - D. Evaluate the patient\'s diet - **Question 2**: Which interventions should the nurse initiate to address the patient's metabolic acidosis? (Select all that apply) - A. Administer sodium bicarbonate as prescribed - B. Encourage deep breathing exercises - C. Monitor electrolyte levels - D. Administer diuretics as prescribed - **Question 3**: What patient education should the nurse provide regarding the management of metabolic acidosis in CKD? (Select all that apply) - A. Dietary modifications to reduce acid load - B. Importance of medication adherence - C. Monitoring and reporting symptoms of acidosis - D. Reducing physical activity **Case-Based Scenario 14: Psychosocial Effects of Bowel Issues** **Case Scenario**: A 50-year-old female patient with a history of irritable bowel syndrome (IBS) reports experiencing anxiety and depression related to her bowel issues. She feels socially isolated and avoids outings due to fear of symptoms. - **Question 1**: What initial assessments should the nurse conduct for this patient? (Select all that apply) - A. Assess the patient's mental health status - B. Review the patient\'s bowel habits - C. Evaluate the patient\'s support system - D. Check for signs of malnutrition - **Question 2**: Which interventions should the nurse suggest to help the patient manage the psychosocial effects of her bowel issues? (Select all that apply) - A. Encourage the patient to join a support group - B. Refer the patient to a mental health professional - C. Provide education on IBS management - D. Advise the patient to avoid all social activities - **Question 3**: What patient education should the nurse provide to help the patient cope with her IBS symptoms in social settings? (Select all that apply) - A. Planning ahead for outings - B. Practicing relaxation techniques - C. Carrying necessary medications - D. Avoiding all social interactions **Case-Based Scenario 15: Urinalysis and Urinary Function (Continued)** **Case Scenario**: A 55-year-old male patient presents with fatigue, dark-colored urine, and a history of hypertension. A urinalysis shows hematuria and proteinuria. The patient is concerned about these findings. - **Question 2**: Which interventions should the nurse prioritize based on the urinalysis results? (Select all that apply) - A. Monitoring blood pressure closely - B. Assessing for signs of kidney function decline - C. Administering antihypertensive medication as prescribed - D. Restricting fluid intake completely - **Question 3**: What patient education should the nurse provide to address the patient\'s concerns about hematuria and proteinuria? (Select all that apply) - A. The importance of follow-up appointments and monitoring kidney function - B. Dietary modifications to support kidney health - C. Avoiding high-sodium foods - D. Ignoring any changes in urine color **Case-Based Scenario 16: Enemas** **Case Scenario**: A 65-year-old female patient with chronic constipation is admitted for a bowel prep prior to a colonoscopy. The physician orders a cleansing enema. - **Question 1**: What steps should the nurse take to prepare the patient for the enema? (Select all that apply) - A. Explain the procedure to the patient - B. Gather all necessary supplies - C. Ensure patient privacy and comfort - D. Administer the enema without any explanation - **Question 2**: During the administration of the enema, what observations should the nurse make? (Select all that apply) - A. Monitor the patient's tolerance to the procedure - B. Check for signs of discomfort or pain - C. Observe the return of the enema solution - D. Ignore the patient's responses - **Question 3**: What post-procedure care should the nurse provide after administering the enema? (Select all that apply) - A. Assist the patient to the bathroom as needed - B. Monitor for signs of bowel movement - C. Encourage the patient to lie down immediately - D. Document the procedure and patient's response **Case-Based Scenario 17: Diagnostic Studies for GI Tract (Advanced)** **Case Scenario**: A 60-year-old female patient is scheduled for an upper endoscopy to evaluate symptoms of persistent heartburn and difficulty swallowing. She is anxious about the procedure. - **Question 1**: What pre-procedure education should the nurse provide to the patient? (Select all that apply) - A. Fasting instructions prior to the procedure - B. Explanation of the sedation process - C. Possible sensations during the procedure - D. The importance of taking medications as usual before the procedure - **Question 2**: What are the key post-procedure observations the nurse should make after the endoscopy? (Select all that apply) - A. Assess for signs of bleeding - B. Monitor the patient's level of consciousness - C. Check for any difficulty swallowing post-procedure - D. Encourage the patient to eat a large meal immediately - **Question 3**: The patient is worried about complications from the endoscopy. How can the nurse address these concerns? (Select all that apply) - A. Provide information on signs and symptoms of complications - B. Offer reassurance about the safety of the procedure - C. Encourage the patient to ask questions - D. Downplay the patient's concerns **Case-Based Scenario 18: Fluid and Electrolyte Balance (Advanced)** **Case Scenario**: A 50-year-old male patient with a history of heart failure presents with shortness of breath, swelling in the legs, and weight gain. His laboratory results indicate low serum sodium (hyponatremia) and elevated serum potassium (hyperkalemia). - **Question 1**: What initial assessments should the nurse prioritize for this patient? (Select all that apply) - A. Monitoring vital signs - B. Assessing for edema - C. Reviewing electrolyte levels - D. Evaluating dietary intake - **Question 2**: Which interventions should the nurse initiate to address the patient's electrolyte imbalances? (Select all that apply) - A. Administering diuretics as prescribed - B. Restricting fluid intake - C. Providing a low-potassium diet - D. Encouraging high-sodium foods - **Question 3**: What patient education should the nurse provide regarding the management of fluid and electrolyte balance in heart failure? (Select all that apply) - A. Importance of daily weight monitoring - B. Recognizing signs of fluid overload - C. Adhering to a low-sodium diet - D. Increasing fluid intake significantly **Case-Based Scenario 19: Ostomy Care** **Case Scenario**: A 45-year-old female patient with a new colostomy is anxious about managing her stoma and changing the ostomy appliance at home. - **Question 1**: What key points of education should the nurse provide to the patient about colostomy care? (Select all that apply) - A. How to clean the stoma - B. Signs of infection to watch for - C. How to change the ostomy appliance - D. Importance of staying hydrated - **Question 2**: Which psychological aspects should the nurse address with the patient? (Select all that apply) - A. Coping strategies for body image changes - B. Emotional support and reassurance - C. Social support resources - D. Avoiding discussions about the stoma - **Question 3**: The patient is concerned about potential complications. What complications should the nurse discuss? (Select all that apply) - A. Stoma infection - B. Skin irritation around the stoma - C. Blockage of the ostomy - D. Increased bowel movements