Semester 2 - Exam 1 Practice Questions

A nurse is caring for a patient with suspected cholecystitis. Which diagnostic test is most commonly used as the initial test to confirm the diagnosis?

A. CT scan

B. MRI

C. Ultrasound

D. Endoscopic retrograde cholangiopancreatography (ERCP)

C - Ultrasound

Explanation: Ultrasound of the right upper quadrant (URQ) is the initial and most effective non-invasive test for confirming gallbladder inflammation or gallstones.

A patient with cholecystitis reports clay-colored stools. What is the most likely cause?

A. Decreased bile flow to the intestines

B. Increased fat absorption

C. Impaired kidney function

D. Excessive bile production

A. Decreased bile flow to the intestines

Explanation: Clay-colored stools occur due to bile obstruction, which prevents urobilinogen from being excreted in the stool.

A nurse is teaching a patient with cholecystitis about dietary management. Which food should the patient avoid?

A. Whole grains

B. Leafy green vegetables

C. Fried chicken

D. Apples

C. Fried Chicken

Explanation: High-fat foods, such as fried chicken, can trigger gallbladder pain due to increased bile production demand.

A patient with chronic cholecystitis presents with pruritus. What is the likely cause of this symptom?

A. Increased serum bilirubin levels

B. Elevated ammonia levels

C. Vitamin K deficiency

D. Infection

A. Increased serum bilirubin levels

Explanation: Pruritus occurs due to excess bile salts in the skin from impaired bile flow.

Which of the following is a risk factor for developing cholecystitis?

A. Male gender

B. Rapid weight loss

C. Low cholesterol levels

D. Vegetarian diet

B. Rapid Weight Loss

Explanation: Rapid weight loss can lead to biliary stasis, increasing the risk of gallstone formation and cholecystitis.

A patient with cholecystitis has a positive Murphy's sign. What does this indicate?

A. Enlarged spleen

B. Pain on inspiration when the gallbladder is palpated

C. Pain radiating to the left shoulder

D. Rebound tenderness in the lower abdomen

B. Pain on inspiration when the gallbladder is palpated.

Explanation: Murphy's sign is a key clinical indicator of cholecystitis and involves pain upon deep inspiration during palpation of the gallbladder.

A patient with suspected acalculous cholecystitis is most likely to have which predisposing condition?

A. Crohn's disease

B. Sepsis

C. Sickle cell disease

D. Gastric bypass surgery

B. Sepsis

Explanation: Acalculous cholecystitis often occurs due to biliary stasis associated with critical illnesses like sepsis, trauma, or burns.

What is the priority nursing intervention for a patient experiencing biliary colic?

A. Administer an antiemetic

B. Provide opioid pain relief

C. Increase oral fluids

D. Place the patient in a high Fowler's position

B. Provide opioid pain relief

Explanation: Biliary colic causes severe pain, and opioids are needed for immediate relief.

A patient is scheduled for a cholecystectomy. What is the primary nursing intervention to prevent deep vein thrombosis (DVT) postoperatively?

A. Encourage leg exercises

B. Administer antiemetics

C. Provide a low-fat diet

D. Maintain strict bedrest

A. Encourage leg exercises

Explanation: Leg exercises improve circulation and prevent blood clots after surgery.

What is a classic clinical manifestation of chronic cholecystitis?

A. Dark-colored stools

B. Jaundice and steatorrhea

C. Hypotension

D. Bloody urine

B. Jaundice and Steatorrhea

Explanation: Chronic cholecystitis can lead to bile backup, resulting in jaundice and fatty stools (steatorrhea).

A nurse is preparing to administer ursodiol to a patient with gallstones. What is the purpose of this medication?

A. Relieve pain

B. Dissolve gallstones

C. Prevent infection

D. Reduce inflammation

B. Dissolve gallstones

Explanation: Ursodiol is used to dissolve cholesterol-based gallstones as part of long-term management.

What lab value is most commonly elevated in acute cholecystitis?

A. Serum amylase

B. White blood cell count

C. Blood glucose

D. Potassium

B. White Blood Cell Count

Explanation: Acute cholecystitis is often associated with an elevated white blood cell count due to inflammation.

A patient with cholecystitis is prescribed a low-fat diet. What meal selection is most appropriate?

A. Grilled chicken with steamed broccoli

B. Cheeseburger and fries

C. Fried fish with coleslaw

D. Pasta with Alfredo sauce

A. Grilled Chicken with steamed broccoli

Explanation: Low-fat diets help reduce symptoms and prevent further gallbladder irritation.

During assessment, the nurse notices the patient has jaundice and dark urine. What complication might these symptoms indicate?

A. Pancreatitis

B. Bile duct obstruction

C. Perforated gallbladder

D. Hepatitis

B. Bile Duct obstruction

Explanation: Obstruction of the bile duct causes bile buildup, leading to jaundice and dark urine.

Which patient is at highest risk for developing gallstones?

A. A 40-year-old female with obesity

B. A 25-year-old male on a high-fat diet

C. A 70-year-old male with anemia

D. A 30-year-old female who exercises regularly

A. A 40-year-old female with obesity

Explanation: Risk factors include being female, middle-aged, and obese.

Which complication should the nurse monitor for after a cholecystectomy?

A. Bile peritonitis

B. Hyperkalemia

C. Pulmonary edema

D. Hypoglycemia

A. Bile Peritonitis

Explanation: Bile leakage into the peritoneal cavity is a potential postoperative complication.

A patient with cholecystitis has rebound tenderness in the abdomen. What does this finding suggest?

A. Infection or inflammation of the peritoneum

B. Gallstone movement into the small intestine

C. Chronic gallbladder atrophy

D. Impaired liver function

A. Infection or inflammation of the peritoneum

Explanation: Rebound tenderness is a sign of peritonitis, often resulting from gallbladder inflammation or perforation.

Which intervention is most appropriate for managing nausea in a patient with acute cholecystitis?

A. Encourage clear liquids

B. Administer IV antiemetics

C. Provide ginger tea

D. Position the patient supine

B. Administer IV antiemetics

Explanation: IV antiemetics manage nausea effectively and prevent dehydration.

What is the most significant risk of untreated cholecystitis?

A. Pancreatitis

B. Liver failure

C. Gallbladder perforation and peritonitis

D. Stomach ulcers

C. Gallbladder perforation and peritonitis

Explanation: Perforation and subsequent peritonitis are severe complications of untreated cholecystitis.

A patient with chronic cholecystitis reports a burning sensation in the skin. What is the cause?

A. Excess bile salts

B. Infection

C. Vitamin B12 deficiency

D. Reduced pancreatic enzymes

A. Excess bile salts

Explanation: Burning and pruritus are due to excess bile salts accumulating in the skin.

A patient with cholecystitis asks why they are experiencing nausea and vomiting. What is the best explanation?

A. Inflammation affects stomach motility

B. Bile accumulation irritates the stomach lining

C. Increased pancreatic enzymes lead to nausea

D. Obstruction in the bile duct disrupts digestion

D. Obstruction in the build duct disrupts digestion

Explanation: Obstruction of the bile duct causes impaired bile flow, disrupting digestion and leading to nausea and vomiting.

What finding should the nurse expect in a patient with chronic cholecystitis?

A. Abdominal pain radiating to the left shoulder

B. Persistent fatigue

C. Fatty stools (steatorrhea)

D. Increased appetite

C. Fatty Stools (steatorrhea)

Explanation: Chronic bile flow obstruction leads to steatorrhea due to poor fat digestion.

A patient with cholecystitis reports sudden, severe pain in the right upper quadrant (RUQ) radiating to the right shoulder. This symptom is most consistent with:

A. Acute pancreatitis

B. Peritonitis

C. Biliary colic

D. Hepatitis

C. Biliary Colic

Explanation: Biliary colic involves severe RUQ pain radiating to the right shoulder, often triggered by gallstone obstruction.

What complication can develop if a gallstone completely obstructs the cystic duct?

A. Peritonitis

B. Biliary stasis and inflammation

C. Chronic hepatitis

D. Gastritis

B. Biliary Stasis and inflammation

Explanation: Complete cystic duct obstruction leads to bile stasis, inflammation, and potentially necrosis of the gallbladder.

Which clinical finding is most indicative of late-stage chronic cholecystitis?

A. Clay-colored stools

B. Dyspepsia

C. Anorexia

D. Heartburn

A. Clay-colored stools

Explanation: Late-stage chronic cholecystitis often involves bile obstruction, causing clay-colored stools.

A patient is diagnosed with acalculous cholecystitis. What condition most likely contributed to this diagnosis?

A. Long-term total parenteral nutrition (TPN)

B. High-fat diet

C. Gallstones

D. High cholesterol levels

A. Long-term total Parenteral nutrition (TPN)

Explanation: Acalculous cholecystitis can occur with long-term TPN due to lack of bile flow stimulation.

What is the priority nursing intervention for a patient with signs of gallbladder perforation?

A. Encourage fluid intake

B. Monitor abdominal girth

C. Notify the provider immediately

D. Administer antiemetics

C. Notify the provider immediately

Explanation: Gallbladder perforation is a medical emergency, requiring immediate provider notification.

Which nursing action is essential when caring for a patient after a laparoscopic cholecystectomy?

A. Keep the patient NPO for 48 hours

B. Encourage early ambulation

C. Avoid administering pain medication

D. Limit fluid intake to prevent bile leakage

B. Encourage early ambulation

Explanation: Early ambulation promotes recovery and reduces the risk of complications like gas retention and DVT.

Which finding is most concerning in a patient with acute cholecystitis?

A. Rebound tenderness

B. Increased appetite

C. Hyperactive bowel sounds

D. Pain that improves with eating

A. Rebound tenderness

Explanation: Rebound tenderness can indicate peritonitis, a potential complication of cholecystitis.

Which intervention is most appropriate for managing pain associated with cholecystitis?

A. Administer acetaminophen

B. Provide small, high-fat meals

C. Position the patient in a semi-Fowler's position

D. Administer ketorolac

D. Administer Ketorolac

Explanation: Ketorolac is often used for moderate pain in cholecystitis due to its anti-inflammatory properties.

What is the most common cause of hepatitis?

A. Alcohol consumption

B. Viral infection

C. Toxic drug exposure

D. Autoimmune disorders

B. Viral Infection

Explanation: Viral infections caused by hepatitis A, B, C, D, or E are the most common causes of hepatitis.

A patient with hepatitis reports dry skin and pruritus. What is the likely cause of this symptom?

A. Dehydration

B. Bile salt deposits in the skin

C. Low serum bilirubin levels

D. Decreased liver enzymes

B. Bile salt deposits in the skin

Explanation: Pruritus in hepatitis occurs due to bile salt deposits in the skin caused by impaired bile flow.

A nurse is teaching a patient about preventing hepatitis A. Which statement indicates the patient understands the teaching?

A. "I will avoid sharing needles with others."

B. "I need to wash my hands after using the restroom."

C. "I should avoid unprotected sex."

D. "I need to get tested for bloodborne diseases."

B. "I need to wash my hands after using the restroom."

Explanation: Hepatitis A is transmitted via the fecal-oral route, so handwashing is critical for prevention.

Which lab result is most consistent with acute hepatitis?

A. Elevated serum amylase

B. Low white blood cell count

C. Elevated ALT and AST levels

D. Decreased total bilirubin

C. Elevated ALT and AST levels

Explanation: ALT and AST are liver enzymes that become elevated due to liver cell inflammation and damage.

What is the primary mode of transmission for hepatitis B?

A. Fecal-oral contamination

B. Blood and bodily fluids

C. Airborne droplets

D. Ingestion of contaminated food

B. Blood and Bodily fluids

Explanation: Hepatitis B is transmitted through blood, unprotected sex, needle sharing, and perinatal transmission.

A patient is diagnosed with hepatitis C. What is the recommended treatment?

A. Peginterferon alfa-2a and ribavirin

B. Immunoglobulin injection

C. Supportive care only

D. Hepatitis C vaccine

A. Peginterferon Alfa-2a and ribavirin

Explanation: Peginterferon alfa-2a and ribavirin are used to treat hepatitis C, which can lead to chronic infection.

Which clinical manifestation is commonly associated with late-stage hepatitis?

A. Muscle pain

B. Jaundice

C. High fever

D. Rebound tenderness

B. Jaundice

Explanation: Jaundice occurs in later stages due to impaired bile flow and accumulation of bilirubin.

A nurse is teaching a community about hepatitis A prevention. Which recommendation is appropriate?

A. Avoid sharing razors and toothbrushes

B. Ensure proper handwashing and food hygiene

C. Get vaccinated before traveling to Europe

D. Use barrier protection during sexual activity

B. Ensure proper handwashing and food hygiene

Explanation: Hepatitis A is transmitted through the fecal-oral route, making food hygiene and handwashing essential.

A patient with hepatitis B is prescribed antiviral therapy. What is the purpose of this treatment?

A. Cure the infection

B. Prevent cirrhosis

C. Eliminate the virus completely

D. Reduce symptoms temporarily

B. Prevent Cirrhosis

Explanation: Antiviral therapy for hepatitis B helps prevent complications like cirrhosis and liver cancer.

What complication is most concerning in a patient with hepatitis?

A. Pruritus

B. Joint pain

C. Fulminant hepatitis

D. Constipation

C. Fulminant hepatitis

Explanation: Fulminant hepatitis is a severe and often fatal complication characterized by rapid liver failure.

Which patient is at highest risk for developing hepatitis E?

A. A healthcare worker exposed to blood

B. A person who consumes raw shellfish

C. A traveler to a country with poor sanitation

D. A patient undergoing immunosuppressive therapy

C. A traveler to a country with poor sanitation

Explanation: Hepatitis E is transmitted through the fecal-oral route, commonly due to contaminated water in areas with inadequate sanitation.

What is the purpose of a liver biopsy in a patient with hepatitis?

A. Detect the presence of viral antibodies

B. Assess the extent of liver damage

C. Evaluate bile duct obstruction

D. Measure serum bilirubin levels

B. Assess the extent of liver damage

Explanation: A liver biopsy provides a definitive assessment of liver damage and the intensity of infection.

Which symptom is most indicative of hepatitis A?

A. Constipation

B. Dark urine

C. Elevated blood pressure

D. Weight gain

B. Dark Urine

Explanation: Dark urine is a common symptom due to increased bilirubin excretion from impaired liver function.

A nurse is caring for a patient with chronic hepatitis C. What long-term complication should the nurse monitor for?

A. Liver cancer

B. Acute kidney injury

C. Portal hypertension

D. Heart failure

A. Liver Cancer

Explanation: Chronic hepatitis C increases the risk of developing liver cancer due to prolonged liver inflammation.

Which statement about hepatitis B vaccination is true?

A. It is effective only when given after exposure.

B. It prevents all types of hepatitis.

C. It is part of the standard vaccination schedule for children.

D. It eliminates the virus completely.

C. It is part of the standard cavitation schedule for children.

Explanation: The hepatitis B vaccine is included in the routine vaccination schedule for children to prevent infection.

What type of diet should be recommended for a patient with hepatitis?

A. High-fat, low-carb

B. Low-calorie, high-protein

C. High-calorie, high-carbohydrate

D. High-protein, high-fat

C. High-calorie, High-Carbohydrate

Explanation: A high-calorie, high-carbohydrate diet supports liver function and energy needs in hepatitis patients.

Which mode of transmission is associated with hepatitis D?

A. Fecal-oral route

B. Coinfection with hepatitis B

C. Contaminated water

D. Unpasteurized dairy products

B. Confection with hepatitis B

Explanation: Hepatitis D occurs only as a coinfection with hepatitis B.

A patient with hepatitis is experiencing fatigue. What nursing intervention is most appropriate?

A. Encourage frequent exercise

B. Provide a high-protein diet

C. Promote rest and energy conservation

D. Administer diuretics

C. Promote rest and energy conversation

Explanation: Fatigue is a common symptom of hepatitis, and rest helps conserve energy for recovery.

A nurse is teaching a patient with hepatitis about transmission prevention. What should the nurse emphasize for hepatitis C?

A. Handwashing after using the restroom

B. Avoiding needle sharing

C. Getting vaccinated before traveling

D. Avoiding contaminated food

B. Avoiding needle sharing

Explanation: Hepatitis C is primarily transmitted through infected needles or blood exposure.

Which clinical manifestation should the nurse monitor for in a patient with fulminant hepatitis?

A. Increased appetite

B. Rapid onset of liver failure

C. Low serum bilirubin

D. Decreased clotting ability

B. Rapid onset of liver failure

Explanation: Fulminant hepatitis leads to rapid and severe liver failure, often requiring emergency intervention.

A nurse is providing care for a patient diagnosed with hepatitis A. What is the priority teaching for this patient?

A. Avoid sharing personal items like razors and toothbrushes

B. Wash hands thoroughly after using the bathroom

C. Avoid raw shellfish

D. Complete the prescribed antiviral medication

B. Wash hands thoroughly after using the bathroom

Explanation: Hepatitis A is transmitted via the fecal-oral route, so proper hand hygiene is crucial to prevent spread.

Which hepatitis virus is most commonly associated with the development of chronic hepatitis?

A. Hepatitis A

B. Hepatitis C

C. Hepatitis E

D. Hepatitis D

B. Hep C

Explanation: Hepatitis C often leads to chronic infection, with many cases progressing to liver damage or cancer.

A patient with hepatitis reports anorexia and weight loss. Which dietary intervention is most appropriate?

A. High-protein, high-fat meals

B. Small, frequent meals with high-calorie snacks

C. Low-fat, low-carb meals

D. High-protein shakes only

B. Small, frequent meals with high-calorie snacks

Explanation: Small, frequent, high-calorie meals combat weight loss and help patients meet nutritional needs.

What complication is most likely to occur in a patient with hepatitis and persistent jaundice?

A. Portal hypertension

B. Bile duct obstruction

C. Cirrhosis

D. Pruritus

D. Pruritus

Explanation: Jaundice leads to bile salt deposition in the skin, causing pruritus.

A patient has been diagnosed with hepatitis B. What measure should the nurse prioritize to prevent transmission to others?

A. Avoid raw food

B. Avoid sharing needles or engaging in unprotected sex

C. Wear a mask in public

D. Avoid eating shellfish

B. Avoid sharing needles or engaging in unprotected sex

Explanation: Hepatitis B is transmitted through blood and bodily fluids, so avoiding risky behaviors is essential.

A nurse is caring for a patient with hepatitis E. Which group is at the highest risk for severe complications?

A. Older adults

B. Pregnant women

C. Adolescents

D. Immunocompromised patients

B. Pregnant Women

Explanation: Hepatitis E can cause severe complications, particularly fulminant hepatitis, in pregnant women.

A patient with chronic hepatitis C asks about their risk of cirrhosis. How should the nurse respond?

A. "Cirrhosis is rare in hepatitis C patients."

B. "Most patients with hepatitis C develop cirrhosis within 5 years."

C. "Chronic hepatitis C increases the risk of cirrhosis over time."

D. "Treatment for hepatitis C eliminates the risk of cirrhosis."

C. "Chronic hepatitis C increases the risk of cirrhosis over time."

Explanation: Chronic hepatitis C causes liver inflammation, increasing the risk of cirrhosis over time.

Which statement by a patient with hepatitis A indicates a need for further teaching?

A. "I will avoid preparing food for others until cleared by my doctor."

B. "I need to avoid alcohol to protect my liver."

C. "I can resume sexual activity as soon as I feel better."

D. "I need to report severe nausea or vomiting to my doctor."

C. "I can resume sexual activity as soon as i feel better."

Explanation: Sexual activity should be avoided until the patient is no longer infectious, as hepatitis A can spread through contact.

A nurse is evaluating the lab results of a patient with hepatitis. Which lab finding is most consistent with liver damage?

A. Elevated serum bilirubin

B. Decreased hemoglobin

C. Elevated blood glucose

D. Low potassium

A. Elevated serum bilirubin

Explanation: Elevated bilirubin occurs due to impaired bile metabolism, which is a hallmark of liver damage.

A patient is receiving education on hepatitis B prevention. Which statement indicates understanding?

A. "The hepatitis B vaccine also prevents hepatitis C."

B. "The vaccine will protect me even if I am already infected."

C. "The vaccine is effective at preventing infection if given before exposure."

D. "The vaccine eliminates the virus from my body if I am infected."

C. "The Vaccine is effective at preventing infection if given before exposure."

Explanation: The hepatitis B vaccine is a preventive measure, providing immunity before exposure to the virus.

What is diverticulitis?

A. The presence of inflamed diverticula in the colon

B. Weakness in the intestinal wall causing herniations

C. A condition characterized by lower GI bleeding without inflammation

D. Obstruction of the large intestine

A. The presence of inflamed diverticula in the colon.

Explanation: Diverticulitis refers to the inflammation or infection of diverticula, which are pouch-like herniations in the colon.

Which dietary factor is most associated with the development of diverticulosis?

A. High-protein diet

B. Low-fiber diet

C. High-fat diet

D. High-sugar diet

B. Low-fiber diet

Explanation: A low-fiber diet contributes to decreased stool bulk and increased pressure in the colon, leading to diverticulosis.

A patient with diverticulitis reports left lower quadrant pain. What does this symptom indicate?

A. Normal bowel function

B. Peritonitis

C. Inflammation in the sigmoid colon

D. Intestinal obstruction

C. Inflammation in the sigmoid colon

Explanation: Diverticula are most commonly found in the sigmoid colon, and left lower quadrant (LLQ) pain is a hallmark symptom of diverticulitis.

What is the priority diagnostic test for confirming diverticulitis?

A. Colonoscopy

B. Abdominal ultrasound

C. CT scan

D. Fecal occult blood test

C. CT Scan

Explanation: A CT scan is the most definitive test for diverticulitis as it identifies inflamed diverticula and potential complications.

A nurse is assessing a patient with diverticulitis. Which symptom indicates possible peritonitis?

A. Diarrhea

B. Abdominal rigidity and rebound tenderness

C. Frequent urination

D. Hyperactive bowel sounds

B. Abdominal rigidity and rebound tenderness

Explanation: Peritonitis, a serious complication of diverticulitis, causes abdominal rigidity and rebound tenderness.

Which lab finding is most consistent with diverticulitis?

A. Decreased hematocrit

B. Increased white blood cell count

C. Elevated potassium levels

D. Decreased serum bilirubin

B. Increased white blood cell count

Explanation: Increased WBC count indicates infection or inflammation, which is typical in diverticulitis.

A patient with diverticulitis is receiving IV fluids and antibiotics. What dietary recommendation is most appropriate during an acute episode?

A. High-fiber diet

B. Low-fiber diet

C. Clear liquid diet

D. Regular diet

C. Clear liquid diet

Explanation: A clear liquid diet is recommended during acute episodes to allow the bowel to rest and prevent further irritation.

What dietary advice should a nurse provide for a patient recovering from diverticulitis?

A. Avoid all carbohydrates

B. Gradually increase fiber intake

C. Consume high-fat meals

D. Limit water intake

B. Gradually increase fiber intake

Explanation: Once symptoms resolve, increasing dietary fiber helps promote regular bowel movements and prevents further episodes.

Which food should a patient with diverticulitis avoid?

A. White rice

B. Popcorn

C. Bananas

D. Grilled chicken

B. Popcorn

Explanation: Foods with seeds, like popcorn, should be avoided as they can irritate or lodge in diverticula.

What is the primary purpose of avoiding laxatives in a patient with diverticulitis?

A. To prevent dehydration

B. To avoid straining during defecation

C. To prevent increased bowel pressure

D. To avoid electrolyte imbalance

C. To prevent increased bowel pressure

Explanation: Laxatives can increase bowel pressure and worsen inflammation or risk of perforation in diverticulitis.

A nurse is caring for a patient with suspected peritonitis secondary to diverticulitis. Which finding supports this diagnosis?

A. Hyperactive bowel sounds

B. Hypotension and tachycardia

C. Bright red blood in stool

D. Decreased appetite

B. Hypotension and tachycardia

Explanation: Hypotension and tachycardia are signs of peritonitis, a severe complication of diverticulitis.

A patient with diverticulitis has rebound tenderness. What does this indicate?

A. Inflammation of the bladder

B. Irritation of the peritoneum

C. Bowel obstruction

D. Colon cancer

B. Irritation of the peritoneum

Explanation: Rebound tenderness is a classic sign of peritoneal irritation, often due to diverticular perforation.

A patient with recurrent diverticulitis is scheduled for a colon resection with colostomy. What is the purpose of this surgery?

A. Treat bowel obstruction

B. Remove cancerous tissue

C. Prevent recurrent inflammation

D. Cure irritable bowel syndrome

C. Prevent recurrent inflammation

Explanation: A colon resection removes affected portions of the bowel to prevent future diverticulitis episodes.

Which symptom indicates a possible bowel obstruction in a patient with diverticulitis?

A. Constipation alternating with diarrhea

B. Fever and chills

C. Nausea with abdominal distention

D. Blood-tinged stools

C. Nausea with abdominal distention

Explanation: Nausea, abdominal distention, and lack of bowel movements are hallmark signs of bowel obstruction.

What complication of diverticulitis is characterized by the formation of an abnormal connection between the bowel and another organ?

A. Fistula

B. Abscess

C. Paralytic ileus

D. Peritonitis

A. Fistula

Explanation: Fistulas are abnormal connections that may form between the bowel and other organs, such as the bladder, due to perforation.

What is the best way to monitor for bleeding in a patient with diverticulitis?

A. Check stools for occult blood

B. Monitor blood pressure and heart rate

C. Assess skin for bruising

D. Measure abdominal girth

A. Check Stools for occult blood

Explanation: Occult blood testing helps detect hidden blood in the stool, indicating GI bleeding.

Which intervention is most appropriate for preventing complications in a patient with chronic diverticulosis?

A. Administer stool softeners as needed

B. Prescribe laxatives daily

C. Recommend a low-protein diet

D. Encourage bedrest

A. Administer stool softeners as needed

Explanation: Stool softeners prevent constipation and straining, reducing pressure on the diverticula.

Which clinical manifestation would require immediate medical attention in a patient with diverticulitis?

A. Mild abdominal cramping

B. Persistent fever and chills

C. Increased flatulence

D. Occasional diarrhea

B. Persistent fever and chills

Explanation: Fever and chills suggest worsening infection or possible complications, such as peritonitis or abscess.

Which factor increases the risk of developing diverticulosis?

A. Sedentary lifestyle

B. High-protein diet

C. Excessive water intake

D. Chronic diarrhea

A. Sedentary lifestyle

Explanation: A sedentary lifestyle, combined with a low-fiber diet, increases the risk of developing diverticulosis.

A patient with diverticulitis is prescribed antibiotics. What is the purpose of this treatment?

A. Prevent constipation

B. Eliminate infection

C. Promote bowel motility

D. Heal existing diverticula

B. Eliminate infection

Explanation: Antibiotics target infection caused by bacteria trapped in inflamed diverticula.

A nurse is educating a patient with diverticulitis on preventing future flare-ups. Which statement by the patient indicates a need for further teaching?

A. "I will gradually increase my fiber intake after my symptoms resolve."

B. "I should drink plenty of fluids to help soften my stools."

C. "I will avoid foods with seeds, such as popcorn and tomatoes."

D. "I will take a laxative daily to prevent constipation."

D. "I will take a laxative daily to prevent constipation."

Explanation: Laxatives are not recommended for diverticulitis as they can increase bowel pressure and worsen inflammation.

A patient with acute diverticulitis is receiving IV antibiotics. Which additional order should the nurse anticipate?

A. Full liquid diet

B. Clear liquid diet

C. High-fiber diet

D. Regular diet

B. Clear liquid diet

Explanation: A clear liquid diet allows the bowel to rest and reduces inflammation during an acute episode.

A nurse is assessing a patient with diverticulitis. Which symptom suggests the need for urgent intervention?

A. Mild left lower quadrant pain

B. Hyperactive bowel sounds

C. Rigid abdomen with absent bowel sounds

D. Intermittent nausea

C. Rigid abdomen with absent bowel sounds

Explanation: A rigid abdomen with absent bowel sounds suggests peritonitis or bowel perforation, requiring immediate intervention.

A patient with a history of diverticulosis asks how to prevent diverticulitis. What is the best response?

A. "Avoid all dairy products."

B. "Increase your intake of fiber-rich foods like vegetables and whole grains."

C. "Limit physical activity to reduce bowel strain."

D. "Eat a diet high in fats and proteins."

B. "Increase your intake of fiber-rich foods like vegetables and whole grains."

Explanation: A high-fiber diet promotes regular bowel movements and helps prevent diverticulitis by reducing colonic pressure.

A patient with diverticulitis reports bright red blood in the stool. What is the most appropriate action by the nurse?

A. Reassure the patient that mild bleeding is normal

B. Assess vital signs and monitor for signs of hypovolemia

C. Increase fluid intake to prevent dehydration

D. Offer a high-protein diet to support healing

B. Assess vital signs and monitor for signs of hypovolemia

Explanation: Bright red blood in the stool can indicate lower GI bleeding, which may lead to hypovolemia and requires close monitoring.

A nurse is reviewing the medication list for a patient with diverticulitis. Which medication should the nurse question?

A. Acetaminophen

B. Docusate sodium (stool softener)

C. Ibuprofen

D. Metronidazole (antibiotic)

C. Ibuprofen

Explanation: NSAIDs like ibuprofen can irritate the gastrointestinal tract and increase the risk of complications like perforation.

Which intervention is most appropriate for a patient with diverticulitis and a history of constipation?

A. Encourage bedrest to reduce strain on the abdomen

B. Administer a bulk-forming fiber supplement as prescribed

C. Offer a high-fat diet to lubricate the intestines

D. Suggest withholding fluids to slow bowel movements

B. Administer a bulk-forming fiber supplement as prescribed.

Explanation: Bulk-forming fiber supplements (e.g., psyllium) can help regulate bowel movements without increasing pressure in the colon.

A nurse is monitoring a patient with suspected diverticulitis for complications. Which finding suggests the development of a bowel abscess?

A. High fever and localized tenderness

B. Increased appetite and weight gain

C. Green, bilious vomiting

D. Frequent small, loose stools

A. High fever and localized tenderness

Explanation: A fever and localized tenderness suggest an abscess formation, a common complication of diverticulitis.

A patient with severe diverticulitis is scheduled for a colon resection with colostomy. Which preoperative intervention is a priority?

A. Administering an antacid to reduce gastric irritation

B. Providing education about ostomy care

C. Encouraging high-fiber foods before surgery

D. Administering a suppository to prevent constipation

B. Providing education about ostomy care

Explanation: Ostomy education is essential before surgery to help the patient understand colostomy care and lifestyle changes.

A nurse is providing discharge instructions to a patient recovering from diverticulitis. Which statement by the patient indicates understanding of the instructions?

A. "I should avoid drinking more than 2 cups of water per day."

B. "I will increase my fiber intake gradually and stay well-hydrated."

C. "I should take an over-the-counter laxative daily to prevent constipation."

D. "I should remain on a clear liquid diet permanently to prevent flare-ups."

B. "I will increase my fiber intake gradually and stay well-hydrated.

Explanation: Gradual fiber increase and adequate hydration help prevent constipation and future diverticulitis episodes.

What is the primary cause of appendicitis?

A. Viral infection

B. Obstruction of the appendix by fecaliths

C. Poor dietary intake

D. Autoimmune response

B. Obstruction of the appendix by fecaliths

Explanation: Appendicitis occurs when the lumen of the appendix is blocked by fecaliths, leading to increased pressure, bacterial growth, and inflammation.

A nurse is assessing a patient with suspected appendicitis. Which symptom is most characteristic?

A. Left lower quadrant pain

B. Right lower quadrant pain at McBurney's point

C. Generalized abdominal pain that improves with movement

D. Pain that radiates to the left shoulder

B. Right lower quadrant pain at McBurney's point

Explanation: McBurney's point (located between the umbilicus and anterior iliac crest in the RLQ) is the classic location for appendicitis pain.

Which assessment finding suggests a ruptured appendix?

A. Sudden relief of pain followed by increased abdominal tenderness

B. Persistent nausea with vomiting

C. Hyperactive bowel sounds

D. Low-grade fever

A. Sudden relief of pain followed by increased abdominal tenderness

Explanation: Sudden relief of pain followed by worsening symptoms suggests rupture, leading to peritonitis.

A nurse is assessing a patient with appendicitis and notes a rigid, board-like abdomen. What complication should the nurse suspect?

A. Bowel obstruction

B. Peritonitis

C. Gastroenteritis

D. Intussusception

B. Peritonitis

Explanation: A rigid, board-like abdomen is a key sign of peritonitis, which occurs when the appendix perforates, leading to infection in the peritoneal cavity.

Which diagnostic test is most commonly used to confirm appendicitis?

A. Colonoscopy

B. CT scan

C. MRI

D. Upper endoscopy

B. CT Scan

Explanation: CT scans provide the most accurate visualization of the inflamed appendix.

A patient with appendicitis has a WBC count of 18,500/mm³. What does this indicate?

A. Chronic infection

B. Mild viral illness

C. Severe infection or possible perforation

D. Normal immune response

C. Severe infection or possible perforation

Explanation: A WBC count > 18,000 suggests severe infection or possible perforation.

A nurse is caring for a patient with appendicitis. Which intervention is contraindicated?

A. Keeping the patient NPO

B. Administering IV fluids

C. Applying heat to the abdomen

D. Administering opioid analgesics

C. Applying heat to the abdomen

Explanation: Applying heat can increase inflammation and risk of rupture, making it contraindicated.

A nurse is preparing a patient for an emergency appendectomy. Which preoperative intervention is most important?

A. Administering oral pain medication

B. Placing the patient in a Trendelenburg position

C. Ensuring the patient is NPO

D. Encouraging deep breathing exercises

C. Ensuring the patient is NPO

Explanation: NPO status is crucial to prevent aspiration during surgery.

A patient with suspected appendicitis asks why they can't take a laxative for constipation relief. What is the best response?

A. "Laxatives can cause nausea and vomiting."

B. "Laxatives can increase the risk of perforation."

C. "Laxatives may reduce pain but won't treat the condition."

D. "Laxatives will delay surgical treatment."

B. "Laxatives can increase the risk of perforation."

Explanation: Laxatives and enemas increase bowel motility, which can lead to rupture of the inflamed appendix.

Which sign is most concerning in a patient with appendicitis?

A. Mild nausea

B. Increased heart rate and low blood pressure

C. Moderate abdominal pain that improves with movement

D. Mild diarrhea

B. Increased heart rate and low blood pressure

Explanation: Tachycardia with hypotension suggests sepsis or shock, a medical emergency.