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1. A patient diagnosed with ulcerative colitis is admitted to the medical unit. When assessing the
patient, which of these findings would be of the most concern?
A. Oral Temperature of 99.0 F (37.2 C) C. Bloody Diarrhea
B. Rebound Tenderness D. Borborygmi
2. The healthcare provider is preparing a patient for a total colectomy and the placement of an
ileostomy. The patient asks where the stoma will be located. The healthcare provider identifies which
of the following areas as the correct stoma site?
Right Lower Quadrant

3. During an acute exacerbation of inflammatory bowel disease, a patient is to receive total

parenteral nutrition (TPN) and lipids. Which of these interventions is the priority when caring for this
patient?
A. Monitor the patient’s blood glucose per protocol
B. Infuse the solution in a large peripheral vein
C. Change the administration set every 72 hours
D. Monitor urine specific gravity every shift
4. The healthcare provider is assessing a patient diagnosed with ulcerative colitis. The patient has
an altered level of consciousness, fever, and lower abdominal distension. Which of these additional
findings would confirm a diagnosis of toxic megacolon?
A. Leukocytosis C. Constipation
B. Bradycardia D. Splenomegaly
5. A patient diagnosed with inflammatory bowel disease experiences an obstruction in the small
bowel. When assessing the patient, which of the following will the healthcare provider anticipate?
A. Scaphoid abdomen C. Increased flatus
B. Passage of melena D. Hypovolemia
6. A patient is prescribed a tumor necrosis factor (TNF) blocking agent for the treatment of Crohn's
disease. Before beginning treatment, the healthcare provider will confirm the results of which of
these diagnostic tests?
A. Sigmoidoscopy C. Stool culture
B. Tuberculin skin test D. Erythrocyte sedimentation rate
7. A patient diagnosed with Crohn’s disease has a new colostomy. When assessing the patient’s
stoma, which of these will alert the healthcare provider that the stoma has retracted?
A. Narrowed and flattened C. Pinkish-red and moist
B. Concave and bowl-shaped D. Dry and reddish-purple
8. A patient diagnosed with ulcerative colitis is prescribed the aminosalicylate sulfasalazine. When
teaching the patient about this medication, which of the following statements is a priority for the
healthcare provider include?
A. “Avoid exposure to sunlight while taking this medication.”
B. “You may crush the enteric-coated tablet and mix it with applesauce.”
C. “Call our office immediately if your urine turns an orangish color.”
D. “Be sure to limit your intake of fluids during therapy.”
9. The healthcare provider is teaching a patient diagnosed with Crohn's disease who is recovering
from a bowel resection. Which of the following statements made by the patient indicates the teaching
has been effective?
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A. “Now that the bowel has been removed, the disease is cured.”
B. “Now I can discontinue taking my multivitamin supplements.”
C. “The disease might reappear in another part of the bowel.”
D. “I might develop ulcerative colitis because some of my bowel is missing.”
10. A patient has been admitted to the medical unit after several days of watery diarrhea related to
Crohn’s disease. The healthcare provider recognizes which of the following symptoms as most
concerning?
A. Palpitations C. Elevated leukocytes
B. Right upper quadrant pain D. Elevated hematocrit
11. Which sign/symptom should the nurse expect to find in s client diagnosed with ulcerative colitis?
A. Twenty bloody stools a day C. Hard, rigid abdomen
B. Oral temperature of 102F D. Urinary stress incontinence
12. The client with type 2 diabetes is prescribed prednisone, a steroid, for an acute exacerbation of
inflammatory bowel disease. Which intervention should the nurse discuss with the client?
A. Take the medication. On an empty stomach.
B. Notify the HCP if experiencing a moon face
C. Take the steroid medication as prescribed.
D. Notify the HCP if the blood glucose is over 100
13. The client diagnosed with inflammatory bowel disease has a serum potassium level of 3.4
mEq/L. Which action should the nurse implement first?
A. Notify the health-care provider C. Request telemetry for the client
B. Assess the client for muscle D. Prepare to administer potassium IV
weakness
14. The client is diagnosed with and acute exacerbation of ulcerative colitis. Which intervention
should the nurse implement?
A. Provide a low residue diet C. Assess vital signs daily
B. Rest the client’s bowel D. Administer antacids orally
15. The client diagnosed with IBD is prescribed tits, parents, nutrition (TPN). Which intervention
should the nurse implement?
A. Check the client’s glucose level C. Assess the peripheral intravenous site
B. Administer an oral hypoglycemic D. Monitor the client’s oral food intake
16. The client is diagnosed with an acute exacerbation of IBD. Which priority intervention should the
nurse implement first?
A. Weigh the client daily and document in C. Record the frequency, amount, and
the client’s chart color of stools
B. Teach coping strategies such as D. Monitor the client’s oral fluid intake
dietary modifications every shift
17. The client diagnosed with Crohn's disease is crying and tells the nurse, I can't take it anymore. I
never know when I will get sick and end up here in the hospital. Which statement is the nurses best
response?
A. I understand how frustrating this must be for you.
B. You must keep thinking about the good things in your life.
C. I can see you are very upset. I'll sit down and we can talk
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D. Are you thinking about doing anything lie committing suicide?

18. The client diagnosed with ulcerative colitis has an ileostomy. Which statement indicates the
client needs more teaching concerning the ileostomy?
A. My stoma should be pink and moist
B. I will irrigate my ileostomy every morning
C. If I get a red, bumpy, itchy rash I will call my HCP
D. I will change my pouch if it starts leaking
19. Sulfasalazine (Asulfidine), a sulfonamide antibiotic. Which statement best describes the rationale
for administering this medication?
A. It is administered re tally to help decrease colon inflammation.
B. The medications Slows gastrointestinal motility and reduces diarrhea
C. This medication kills the bacteria causing the exacerbation
D. It acts topically on the colon mucosa to decrease inflammation
20. The client is diagnosed with Crohn's disease, also known as regional enteritis. Which statement
by the client supports this diagnosis?
A. My pain goes away when I have a bowel movement
B. I have bright red blood in my stool all the time
C. I have episodes of diarrhea and constipation
D. My abdomen is hard and rigid and I have a fever
21. The client diagnosed with ulcerative colitis is prescribed a low residue diet. Which meal selection
indicates the client understands the diet teaching?
A. Grilled hamburger on a wheat bun and fried potatoes
B. A chicken salad sandwich and lettuce and tomato salad
C. Roast pork, white rice, and plain custard
D. Fried fish, whole grain pasta, and fruit salad
22. The client with ulcerative colitis is scheduled for an ileostomy. The nurse is aware the clients
stoma will be located in which area of the abdomen?
A. Right lower quadrant C. Transverse colon
B. Left lower quadrant D. Right upper quadrant
23. Which of the following complications is thought to be the most common cause of appendicitis?
A. fecalith C. Internal bowel occlusion
B. Bowel kinking D. Abdominal bowel swelling
24. Which of the following terms best describes the pain associated with appendicitis?
A. Aching C. Intermittent
B. Fleeting D. Steady
25. Which of the following nursing interventions should be implemented to manage a client with
appendicitis?
A. Assessing for pain D. Assessing for symptoms of
B. Encouraging oral intake of clear fluids peritonitis
C. Providing discharge teaching
26. Crohn’s disease can be described as a chronic relapsing disease. Which of the following areas in
the GI system may be involved with this disease?
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A. The entire length of the large colon

B. Only the sigmoid area
C. The entire large colon through the layers of mucosa and submucosa
D. The small intestine and colon; affecting the entire thickness of the bowel
27. Which area of the alimentary canal is the most common location for Crohn’s disease?
A. Ascending colon C. Sigmoid colon
B. Descending colon D. Terminal ileum
28. Which of the following factors is believed to be linked to Crohn’s disease?
A. Constipation C. Hereditary
B. Diet D. Lack of exercise
29. Which of the following factors is believed to cause ulcerative colitis?
A. Acidic diet C. Chronic constipation
B. Altered immunity D. Emotional stress
30. Fistulas are most common with which of the following bowel disorders?
A. Crohn’s disease C. Diverticulosis
B. Diverticulitis D. Ulcerative colitis
31. Which of the following areas is the most common site of fistulas in client’s with Crohn’s disease?
A. Anorectal C. Rectovaginal
B. Ileum D. Transverse colon
32. Which of the following associated disorders may a client with ulcerative colitis exhibit?
A. Gallstones C. Nephrolithiasis
B. Hydronephrosis D. Toxic megacolon
33. Which of the following associated disorders may the client with Crohn’s disease exhibit?
A. Ankylosing spondylitis C. Malabsorption
B. Colon cancer D. Lactase deficiency
34. Which of the following symptoms may be exhibited by a client with Crohn’s disease?
A. Bloody diarrhea C. N/V
B. Narrow stools D. Steatorrhea
35. Which of the following symptoms is associated with ulcerative colitis?
A. Dumping syndrome C. Soft stools
B. Rectal bleeding D. Fistulas
36. If a client had irritable bowel syndrome, which of the following diagnostic tests would determine if
the diagnosis is Crohn’s disease or ulcerative colitis?
A. Abdominal computed tomography (CT) C. Barium swallow
scan D. Colonoscopy with biopsy
B. Abdominal x-ray
37. Which of the following interventions should be included in the medical management of Crohn’s
disease?
A. Increasing oral intake of fiber B. Administering laxatives
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C. Using long-term steroid therapy D. Increasing physical activity

38. In a client with Crohn’s disease, which of the following symptoms should not be a direct result of
antibiotic therapy?
A. Decrease in bleeding C. Decrease in body weight
B. Decrease in temperature D. Decrease in the number of stools
39. Surgical management of ulcerative colitis may be performed to treat which of the following
complications?
A. Gastritis C. Bowel outpouching
B. Bowel herniation D. Bowel perforation
40. Which of the following medications is most effective for treating the pain associated with irritable
bowel disease?
A. Acetaminophen C. Steroids
B. Opiates D. Stool softeners
41. During the first few days of recovery from ostomy surgery for ulcerative colitis, which of the
following aspects should be the first priority of client care?
A. Body image C. Sexual concerns
B. Ostomy care D. Skin care
42. Colon cancer is most closely associated with which of the following conditions?
A. Appendicitis C. Hiatal hernia
B. Hemorrhoids D. Ulcerative colitis
43. A client with irritable bowel syndrome is being prepared for discharge. Which of the following meal
plans should the nurse give the client?
A. Low fiber, low-fat C. Low fiber, high-fat
B. High fiber, low-fat D. High-fiber, high-fat
44. A client presents to the emergency room, reporting that he has been vomiting every 30 to 40
minutes for the past 8 hours. Frequent vomiting puts him at risk for which of the following?
A. Metabolic acidosis with hyperkalemia C. Metabolic alkalosis with hyperkalemia
B. Metabolic acidosis with hypokalemia D. Metabolic alkalosis with hypokalemia
45. In a client with diarrhea, which outcome indicates that fluid resuscitation is successful?
A. The client passes formed stools at regular intervals
B. The client reports a decrease in stool frequency and liquidity
C. The client exhibits firm skin turgor
D. The client no longer experiences perianal burning.
46. The nurse is caring for a hospitalized client with a diagnosis of ulcerative colitis. Which finding, if
noted on assessment of the client, would the nurse report to the physician?
A. Bloody diarrhea C. A hemoglobin of 12 mg/dL
B. 2. Hypotension D. Rebound tenderness
47. The nurse is reviewing the record of a client with Crohn’s disease. Which of the following stool
characteristics would the nurse expect to note documented on the client’s record?
A. Chronic constipation B. Diarrhea
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C. Constipation alternating with diarrhea D. Stool constantly oozing from the

rectum
48. The nurse is performing a colostomy irrigation on a client. During the irrigation, a client begins to
complain of abdominal cramps. Which of the following is the most appropriate nursing action?
A. Notify the physician D. Medicate with dilaudid and resume the
B. Increase the height of the irrigation irrigation
C. Stop the irrigation temporarily.
49. The nurse is teaching the client how to perform a colostomy irrigation. To enhance the
effectiveness of the irrigation and fecal returns, what measure should the nurse instruct the client to
do?
A. Increase fluid intake C. Perform the irrigation in the evening
B. Reduce the amount of irrigation D. Place heat on the abdomen
solution
50. The nurse instructs the ileostomy client to do which of the following as a part of essential care of
the stoma?
A. Cleanse the peristomal skin C. Massage the area below the stoma
meticulously D. Limit fluid intake to prevent diarrhea.
B. Take in high-fiber foods such as nuts
51. The client who has undergone creation of a colostomy has a nursing diagnosis of Disturbed body
image. The nurse would evaluate that the client is making the most significant progress toward
identified goals if the client:
A. Watches the nurse empty the C. Reads the ostomy product literature
colostomy bag D. Practices cutting the ostomy
B. Looks at the ostomy site appliance
52. The nurse is assessing for stoma prolapse in a client with a colostomy. The nurse would observe
which of the following if stoma prolapse occurred?
A. Sunken and hidden stoma C. Narrowed and flattened stoma
B. Dark- and bluish-colored stoma D. Protruding stoma
53. The client with a new colostomy is concerned about the odor from the stool in the ostomy drainage
bag. The nurse teaches the client to include which of the following foods in the diet to reduce odor?
A. Yogurt C. Cucumbers
B. Broccoli D. Eggs
54. The nurse has given instructions to the client with an ileostomy about foods to eat to thicken the
stool. The nurse determines that the client needs further instructions if the client stated to eat which of
the following foods to make the stools less watery?
A. Pasta C. Bran
B. Boiled rice D. Low-fat cheese
55. The client has just had surgery to create an ileostomy. The nurse assesses the client in the
immediate post-op period for which of the following most frequent complications of this type of
surgery?
A. Intestinal obstruction C. Malabsorption of fat
B. Fluid and electrolyte imbalance D. Folate deficiency
56. The client with a colostomy has an order for irrigation of the colostomy. The nurse used which
solution for irrigation?
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A. Distilled water C. Sterile water

B. Tap water D. Lactated Ringer’s
57. The client with Crohn’s disease has a nursing diagnosis of acute pain. The nurse would teach the
client to avoid which of the following in managing this problem?
A. Lying supine with the legs straight C. Using antispasmodic medication
B. Massaging the abdomen D. Using relaxation techniques
58. A client with ulcerative colitis has an order to begin salicylate medication to reduce inflammation.
The nurse instructs the client to take the medication:
A. 30 minutes before meals C. After meals
B. On an empty stomach D. On arising
59. The nurse evaluates the client’s stoma during the initial post-op period. Which of the following
observations should be reported immediately to the physician?
A. The stoma is slightly edematous C. The stoma oozes a small amount of
B. The stoma is dark red to purple blood
D. The stoma does not expel stool
60. When planning care for a client with ulcerative colitis who is experiencing symptoms, which client
care activities can the nurse appropriately delegate to a unlicensed assistant? Select all that apply.
A. Assessing the client’s bowel sounds D. Maintaining intake and output
B. Providing skin care following bowel records
movements E. Obtaining the client’s weight.
C. Evaluating the client’s response to
antidiarrheal medications
61. Which goal of 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 C. Maintaining adequate nutrition
B. Managing diarrhea D. Promoting rest and comfort
62. A client’s ulcerative colitis symptoms have been present for longer than 1 week. The nurse
recognizes that the client should be assessed carefully for signs of which of the following
complications?
A. Heart failure C. Hypokalemia
B. DVT D. Hypocalcemia
63. A client who has ulcerative colitis has persistent diarrhea. He is thin and has lost 12 pounds since
the exacerbation of his ulcerative colitis. The nurse should anticipate that the physician will order which
of the following treatment approaches to help the client meet his nutritional needs?
A. Initiate continuous enteral feedings C. Implement total parenteral nutrition
B. Encourage a high protein, high-calorie D. Provide six small meals a day.
diet
64. Digoxin preparations and absorbents should not be given simultaneously. As a nurse, you are
aware that if these agents are given simultaneously, which of the following will occur?
A. Increased absorption of digoxin C. Increased absorption of the absorbent
B. Decreased absorption of digoxin D. Decreased absorption of the absorbent
65. When used with hyperacidic disorders of the stomach, antacids are given to elevate the gastric pH
to:
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A. 2.0 C. 6.0
B. 4.0 D. >8.0
66. Which of the following nursing diagnoses is appropriate for a patient receiving famotidine (Pepcid)?
A. Increased risk for infection due to immunosuppression
B. Potential risk for bleeding related to thrombocytopenia.
C. Alteration in urinary elimination related to retention
D. Alteration in tissue perfusion related to hypertension
67. In planning care for the patient with Crohn's disease, the nurse recognizes that a major difference
between ulcerative colitis and Crohn's disease is that Crohn's disease:
A. frequently results in toxic megacolon,
B. causes fewer nutritional deficiencies than does ulcerative colitis,
C. often recurs after surgery, whereas ulcerative colitis is curable with a colectomy,
D. is manifested by rectal bleeding and anemia more frequently than is ulcerative colitis.
68. What is one of the major precipitating factors in the development of irritable bowel syndrome (IBS)?
A. Peptic ulcers C. Helicobacter pylori
B. GERD D. Stress
69. A client has been placed on long-term sulfasalazine (Azulfidine) therapy for treatment of his
ulcerative colitis. The nurse should encourage the client to eat which of the following foods to help
avoid the nutrient deficiencies that may develop as a result of this medication?
A. Citrus fruits. C. Eggs.
B. Green, leafy vegetables. D. Milk products.
70. A client who has had ulcerative colitis for the past 5 years is admitted to the hospital with an
exacerbation of the disease. Which of the following factors was most likely of greatest significance in
causing an exacerbation of ulcerative colitis?
A. A demanding and stressful job. C. Beginning a weight-training program.
B. Changing to a modified vegetarian diet. D. Walking 2 miles every day.
71. A client who is experiencing an exacerbation of ulcerative colitis is receiving I.V. fluids that are to
be infused at 125 mL/ hour. The I.V. tubing delivers 15 gtt/ mL. How quickly should the nurse infuse
the fluids in drops per minute to infuse the fluids at the prescribed rate? ________________________
gtt/ minute.
31 gtt/ minute
72. The client with ulcerative colitis is following orders for bed rest with bathroom privileges. When
evaluating the effectiveness of this level of activity, the nurse should determine if the client has:
A. Conserved energy. C. Obtained needed rest.
B. Reduced intestinal peristalsis. D. Minimized stress.
73. The physician prescribes sulfasalazine (Azulfidine) for the client with ulcerative colitis to continue
taking at home. Which instruction should the nurse give the client about taking this medication?
A. Avoid taking it with food. D. Stop taking it if urine turns orange-
B. Take the total dose at bedtime. yellow.
C. Take it with a full glass (240 mL) of
water.
74. A nurse is preparing for the admission of a child with a diagnosis of acute-stage Kawasaki disease.
On assessment of the child, the nurse expects to note which clinical manifestation of the acute stage
of the disease?
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a) cracked lips c) conjunctival hyperemia

b) a normal appearance d) desquamation of the skin
75. When caring for the child with Kawasaki disease, the nurse should know which of the following?
a. Aspirin is contraindicated.
b. Principal area of involvement is the joints.
c. Child's fever is usually responsive to antibiotics within 48 hours.
d. Therapeutic management includes administration of gamma globulin and salicylates.
76. Nursing care of the child with Kawasaki disease is challenging because of:
a. the child's irritability. c. complex antibiotic therapy.
b. predictable disease course. d. the child's ongoing requests for food.
77. The nurse is caring for a child with Kawasaki disease in the acute phase. Which of the following
clinical manifestations would the nurse expect to observe?
a. Osler nodes d. Chorea
b. Cervical lymphadenopathy e. Erythematous palms
c. Strawberry tongue f. Polyarthritis
78. The nurse is caring for a child with a diagnosis of Kawasaki disease. The child's parent asks the
nurse, "How does Kawasaki disease affect my child's heart and blood vessels?" The nurse's response
is based on the understanding that:
a. inflammation weakens blood vessels, leading to aneurysm.
b. increased lipid levels lead to the development of atherosclerosis.
c. untreated disease causes mitral valve stenosis.
d. altered blood flow increases cardiac workload with resulting heart failure.
79. Which are the most serious complications for a child with Kawasaki disease (KD)?
Select all that apply.
a. Coronary thrombosis. d. Hypocoagulability.
b. Coronary stenosis. e. Decreased sedimentation rate.
c. Coronary artery aneurysm. f. Hypoplastic left heart syndrome.
80. Exposure to which illness should be a cause to discontinue therapy and substitute dipyridamole
(Persantine) in a child receiving aspirin therapy for Kawasaki disease (KD)?
a. Chickenpox or influenza. c. Mumps or streptococcus A.
b. E. coli or staphylococcus. d. Streptococcus A or staphylococcus.
81. Family discharge teaching has been effective when the parent of a toddler diagnosed with
Kawasaki disease (KD) states:
a. "The arthritis in her knees is permanent. She will need knee replacements."
b. "I will give her diphenhydramine (Benadryl) for her peeling palms and soles
of her feet."
c. "I know she will be irritable for 2 months after her symptoms started."
d. "I will continue with high doses of Tylenol for her inflammation."
82. The nurse is assessing a child admitted with possible Kawasaki's disease. A characteristic sign or
symptom that the nurse should observe and document would be:
a) cardiac dysrhythmia c) peeling skin on fingers
b) decreased urine output d) decreased level of consciousness
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83. Assessment of an IV cocaine user with infective endocarditis should focus on which signs and
symptoms (select all that apply)?
a. Retinal hemorrhages d. Painless nodules over bony
b. Splinter hemorrhages prominences
c. Presence of Osler's nodes e. Painless erythematous macules on
the palms and soles
84. The nurse is caring for a patient with chronic constrictive pericarditis. Which assessment finding
reflects a more serious complication of this condition?
a. Fatigue
b. Peripheral edema
c. Jugular venous distention
d. Thickened pericardium on echocardiography
85. A patient is admitted with myocarditis. While performing the initial assessment, the nurse may find
which clinical signs and symptoms (select all that apply)?
a. Angina d. Pericardial friction rub
b. Pleuritic chest pain e. Presence of Osler's nodes
c. Splinter hemorrhages
86. Priority nursing management for a patient with myocarditis includes interventions related to
a. meticulous skin care c. tight glycemic control
b. antibiotic prophylaxis d. oxygenation and ventilation
87. When teaching a patient about the long-term consequences of rheumatic fever, the nurse should
discuss the possibility of
a. valvular heart disease c. superior vena cava syndrome
b. pulmonary hypertension d. hypertrophy of the right ventricle
88. Which diagnostic study best differentiates the various types of cardiomyopathy?
a. Echocardiography c. Heart catheterization
b. Arterial blood gases d. Endomyocardial biopsy
89. Upon admission assessment, the nurse notes clubbing of the patient's fingers. Based on this
finding, the nurse will question the patient about which of the following disease processes?
a. Endocarditis c. Myocardial infarction
b. Acute renal failure d. Chronic thrombophlebitis
90. While admitting a patient with pericarditis, the nurse will assess for which of the following signs,
symptoms, and complications of this disorder?
a. Pulsus paradoxus c. Widened pulse pressure
b. Prolonged PR intervals d. Clubbing of the fingers
91. The nurse conducts a complete physical assessment on a patient admitted with infective
endocarditis. Which of the following findings are significant?
a. Respiratory rate of 18 and heart rate of 90
b. Regurgitant murmur at the mitral valve area
c. Heart rate of 94 and capillary refill time of 2 seconds
d. Point of maximal impulse palpable in fourth intercostal space
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92. When caring for a patient with infective endocarditis, the nurse will assess the patient for which of
the following vascular manifestations (select all that apply)?
a. Osler's nodes d. Subcutaneous nodules
b. Janeway's lesions e. Erythema marginatum lesions
c. Splinter hemorrhages
93. A 20-year old patient has acute infective endocarditis. While obtaining a nursing history, the nurse
should ask the patient about which of the following (select all that apply)
a. renal dialysis d. cardiac catheterization
b. IV drug abuse e. recent urinary tract infection
c. recent dental work
94. A patient has an admitting diagnosis of acute left-sided infective endocarditis. The nurse explains
to the patient that this diagnosis is best confirmed with
a. blood cultures c. a cardiac catheterization
b. a complete blood count d. a transesophageal echocardiogram
95. A patient with infective endocarditis of a prosthetic mitral valve develops a left hemiparesis and
visual changes. The nurse expects that collaborative management of the patient will include
a. an embolectomy c. administration of anticoagulants
b. surgical valve replacement d. higher than usual antibiotic dosages
96. A patient with aortic valve endocarditis develops dyspnea, crackles in the lungs, and restlessness.
The nurse suspects that the patient is experiencing
a. vegetative embolization to the coronary arteries
b. pulmonary embolization from valve vegetations
c. nonspecific manifestations that accompany infectious diseases
d. valvular incompetence with possible infectious invasion of the myocardium
97. A patient hospitalized for 1 week with subacute infective endocarditis is afebrile and has no signs
of heart damage. Discharge with outpatient antibiotic therapy is planned. During discharge planning
with the patient, it is most important for the nurse to
a. plan how his needs will be met while he continues on bed rest
b. teach the patient to avoid crowds and exposure to upper respiratory infections
c. encourage the use of diversional activities to relieve boredom and restlessness
d. assess the patient's home environment in terms of family assistance and hospital access
98. When teaching a patient with endocarditis how to prevent recurrence of the infection, the nurse
instructs the patient to
a. start on antibiotic therapy when exposed to persons with infections
b. take one aspirin a day to prevent vegetative lesions from forming around the valves
c. always maintain continuous antibiotic therapy to prevent the development of any systemic
infection
d. obtain prophylactic antibiotic therapy before certain invasive medical or dental
procedures (e.g. dental cleaning)
99. A patient is admitted to the hospital with a suspected acute pericarditis. To establish the presence
of a pericardial friction rub, the nurse listens to the patient's chest
a. while timing the sound with the respiratory pattern
b. with the bell of the stethoscope at the apex of the heart
c. with the diaphragm of the stethoscope at the lower left sternal bored of the chest
d. with the diaphragm of the stethoscope to auscultate a high-pitched continuous rumbling sound
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100. A patient with acute pericarditis has markedly distended jugular veins, decreased BP,
tachycardia, tachypnea, and muffled heart sounds. The nurse recognizes that these symptoms occur
when
a. the pericardial space is obliterated with scar tissue and thickened pericardium
b. excess pericardial fluid compresses the heart and prevents adequate diastolic filling
c. the parietal and visceral pericardial membranes adhere to each other, preventing normal
myocardial contraction
d. fibrin accumulation on the visceral pericardium infiltrates into the myocardium, creating
generalized myocardial dysfunction.
101. A patient with acute pericarditis has a nursing diagnosis of pain related to pericardial
inflammation. An appropriate nursing intervention for the patient is
a. administering opioids as prescribed on an around the clock schedule
b. promoting progressive relaxation exercises with the use of deep, slow breathing
c. positioning the patient on the right side with the head of the bed elevated 15 degrees
d. positioning the patient in Fowler's position with a padded over the bed table for the patient
to lean on
102. When obtaining a nursing history for a patient with myocarditis, the nurse specifically questions
the patient about
a. a history of CAD with or without an MI
b. prior use of digoxin for treatment of cardiac problems
c. recent symptoms of a viral illness, such as fever or malaise
d. a recent streptococcal infection requiring treatment with penicillin
103. The most important role of the nurse in preventing rheumatic fever is to
a. teach patients with infective endocarditis to adhere to antibiotic prophylaxis
b. identify patients with valvular heart disease who are at risk for rheumatic fever
c. encourage the use of antibiotics for treatment of all infections involving a sore throat
d. promote the early diagnosis and immediate treatment of group A streptococcal
pharyngitis
104. The nurse is caring for a adolescent with Eczema. The lesions on the antecubital area appears
honey-colored with crusts surrounding erythema. The nurse knows that this finding indicates.
a. a normal flare-up c. minute papules
b. infection d. progressing lesions
105. A nurse is assessing the skin of a patient with acne vulgaris. Which of the following primary
lesions should the nurse expect to find?
a. bulla d. papules
b. cysts e. pustules
c. macules
106. What percentage of people between the age of 12 and 24 will get Acne?
a) 3% c) 94.4%
b) 14% d) 25%
107. A 34-year-old woman who developed Stevens-Johnson syndrome while undergoing treatment
with carbamazepine (Tegretol) is being transferred in stable condition from the intensive care unit to
the medical unit. There are 4 beds available. The nurse knows the best choice of roommates for this
client is which of the following?
(a) A 40-year-old man with methicillin-resistant Staphylococcus aureus (MRSA).
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(b) A 28-year-old woman diagnosed with diarrhea.

(c) A 72-year-old man with fever of unknown origin.
(d) A 68-year-old woman with atrial fibrillation .

108. your niece asks you about the rash she "has grossed out for about a year" on her arm. You have
knowledge of chronic skin disorders and would suspect which of the following? (select all that apply)
a. vitiligo c. urticaria
b. dermatitis d. psoriasis
109. you are helping in an elementary school and the parents want to know what you are looking for
when you are looking for parasitic skin infections. You would tell them (select all that apply)
a. scabies e. bed bugs
b. carbuncles
c. lice
d. keloids
110. You are assessing a baby and notice small, pimplelike protrusions on her cheeks. These
protrusions are called:
a. pustules c. vesicles
b. papules d. macules
111. Your significant other has developed scaly, crusty areas on their lower leg. They tell you that "the
itching is driving me batty!" Since you are so smart, you suspect which of the following:
a. eczema c. impetigo
b. psoriasis d. shingles
112. Nurse Bea plans to administer dexamethasone cream to a client who has dermatitis over the
anterior chest How should the nurse apply this topical agent?
a) With a circular motion. to enhance absorption
b) With an upward motion. to increase blood supply to the affected area
c) In long. even. outward. and downward strokes in the direction of hair growth
d) In long. even. outward. and upward strokes in the direction opposite hair growth

/./