MODULE 5 PRACTICE QUESTIONS

Question 1

Which clinical finding in the compensatory stage of shock should a nurse expect?

Answer 1

Cool, clammy skin

This finding is typical due to vasoconstriction in compensatory shock.

Question 2

A patient with hypovolemic shock after trauma has rapid breathing and decreased urine output. Which intervention is priority?

Answer 2

Start IV fluids

Fluid resuscitation is the priority to restore perfusion.

Question 3

What is the hallmark sign of septic shock?

Answer 3

Warm, flushed skin with hypotension despite fluids

This sign indicates a severe response to infection.

Question 4

Which lab result would indicate worsening sepsis?

Answer 4

Lactate 4.2 mmol/L

A lactate level >2.0 indicates tissue hypoperfusion.

Question 5

Which of the following patients is at highest risk for multiple organ dysfunction syndrome (MODS)?

Answer 5

A septic client with hypotension and altered mental status

Sepsis with hypotension and altered mental status is a risk factor for MODS.

Question 6

A patient in early septic shock should receive which intervention first?

Answer 6

Broad-spectrum antibiotics

Antibiotics should be started within the first hour.

Question 7

A nurse caring for a patient in the progressive stage of shock expects which finding?

Answer 7

Mottled skin and lactic acidosis

Progressive shock leads to mottling, confusion, and acidosis.

Question 8

What is the nurse’s priority action when a patient’s MAP drops below 60 mmHg in shock?

Answer 8

Initiate fluid resuscitation

A low MAP suggests inadequate perfusion and needs fluids.

Question 9

In cardiogenic shock, what medication is used to improve myocardial contractility?

Answer 9

Dobutamine

Dobutamine is used to improve contractility in cardiogenic shock.

Question 10

Which sign indicates anaphylactic shock?

Answer 10

Wheezing and stridor

These signs suggest airway compromise in anaphylaxis.

Question 11

A nurse is monitoring a patient on parenteral nutrition (PN). Which assessment finding requires immediate action?

Answer 11

Fever and chills

Fever may indicate catheter-related bloodstream infection.

Question 12

Which condition is characterized by autoimmune damage to the intestinal villi from gluten ingestion?

Answer 12

Celiac disease

Celiac disease causes villous atrophy in response to gluten.

Question 13

Which dietary teaching is essential for a client with celiac disease?

Answer 13

Avoid gluten-containing foods

A gluten-free diet is lifelong and essential.

Question 14

Which clinical sign supports a diagnosis of appendicitis?

Answer 14

Periumbilical pain radiating to RLQ

RLQ pain at McBurney’s point is classic for appendicitis.

Question 15

A patient with Crohn’s disease is at high risk for which complication?

Answer 15

Fistulas

Fistula formation is common in Crohn’s due to transmural lesions.

Question 16

A nurse is caring for a client with ulcerative colitis. Which is the priority concern?

Answer 16

Fluid volume deficit

Dehydration from diarrhea is the top concern.

Question 17

Which symptom is more specific to ulcerative colitis than Crohn’s disease?

Answer 17

Bloody diarrhea

Bloody stools are more specific to ulcerative colitis.

Question 18

The best dietary recommendation for a patient with irritable bowel syndrome (IBS) is to:

Answer 18

Avoid high FODMAP foods

Avoiding FODMAPs helps reduce IBS symptoms.

Question 19

What is the nurse’s first action when caring for a patient with suspected intestinal obstruction?

Answer 19

Keep the patient NPO

NPO status is necessary to rest the bowel.

Question 20

A patient with diverticulitis reports LLQ pain and fever. What dietary recommendation is appropriate during the acute phase?

Answer 20

Clear liquids only

Clear liquids help reduce bowel stimulation.

Question 21

Which is the most appropriate nursing action for a patient with fecal incontinence?

Answer 21

Teach bowel training techniques

Bowel training can improve continence.

Question 22

A nurse recognizes that skin breakdown in fecal incontinence is best prevented by:

Answer 22

Frequent perineal hygiene

Good perineal care prevents skin breakdown.

Question 23

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

Answer 23

I will take laxatives daily

Daily laxative use is not recommended for IBS.

Question 24

What is the best way to evaluate nutritional goals in a patient receiving PN?

Answer 24

Body weight

Weight monitoring tracks nutritional effectiveness.

Question 25

What is a priority nursing action during PN administration?

Answer 25

Use aseptic technique ## Footnote Aseptic technique reduces infection risk with PN.

Question 26

A client with hemorrhoids is instructed to:

Answer 26

Take frequent sitz baths ## Footnote Sitz baths reduce inflammation and promote healing.

Question 27

A patient post-hemorrhoidectomy complains of rectal pain. The most appropriate intervention is:

Answer 27

Opioid analgesia and sitz bath ## Footnote Pain management and warm soaks are standard care.

Question 28

What is the nurse's best response to a patient newly diagnosed with colorectal cancer who asks about treatment?

Answer 28

Treatment may involve surgery, chemo, or both ## Footnote Colorectal cancer treatment is individualized.

Question 29

In patients with toxic megacolon, which complication should the nurse monitor for?

Answer 29

Perforation ## Footnote Toxic megacolon can lead to perforation.

Question 30

Which finding suggests effectiveness of corticosteroids in IBD?

Answer 30

Decreased abdominal pain ## Footnote Decreased pain shows inflammation control.

Question 31

A nurse is planning care for a patient with Crohn’s disease and severe diarrhea. The priority nursing diagnosis is:

Answer 31

Fluid volume deficit ## Footnote Fluid balance is the top concern in severe diarrhea.

Question 32

A patient with parenteral nutrition via central line has a temp of 101.4°F. The nurse should:

Answer 32

Notify the provider and obtain blood cultures ## Footnote Blood cultures are needed with fever in central lines.

Question 33

Which lab value should be monitored in a patient receiving lipids with PN?

Answer 33

Triglycerides ## Footnote Lipids can elevate triglycerides.

Question 34

A patient with ulcerative colitis develops 8 bloody stools/day. The nurse anticipates which intervention?

Answer 34

Begin IV fluids and corticosteroids ## Footnote Fluids and steroids manage flares.

Question 35

Which food should a patient with celiac disease avoid?

Answer 35

Whole wheat bread ## Footnote Wheat contains gluten and should be avoided.

Question 36

A nurse recognizes that rebound tenderness in the RLQ may indicate:

Answer 36

Appendicitis ## Footnote RLQ rebound tenderness is classic for appendicitis.

Question 37

A patient with colostomy expresses fear about body image. What is the nurse’s best response?

Answer 37

Let’s talk to an ostomy nurse and support group ## Footnote Emotional support and education promote adaptation.

Question 38

In inflammatory GI disorders, which lab values should the nurse monitor?

Answer 38

ESR and CRP ## Footnote ESR and CRP measure inflammation in IBD.

Question 39

The most appropriate goal for a patient with IBD is:

Answer 39

Maintain hydration and reduce symptoms ## Footnote The goal is symptom management and hydration.

Question 40

Which is the correct action for collecting a stool sample for ova and parasites?

Answer 40

Label and send to lab immediately ## Footnote Stool for O&P should be labeled and sent promptly.