6. Which of the following definitions 11.

Medical management of the client

best describes diverticulosis? with diverticulitis should include which
of the following treatments?
A. An inflamed outpouching of
the intestine A. Reduced fluid intake
B. A noninflamed outpouching B. Increased fiber in diet
of the intestine C. Administration of antibiotics
C. The partial impairment of D. Exercises to increase intra-
the forward flow of abdominal pressure
intestinal contents
D. An abnormal protrusion of 12. Crohn’s disease can be described as
an organ through the a chronic relapsing disease. Which of the
structure that usually holds following areas in the GI system may be
it. involved with this disease?

7. Which of the following types of diets A. The entire length of the

is implicated in the development of large colon
diverticulosis? B. Only the sigmoid area
C. The entire large colon
A. Low-fiber diet through the layers of
B. High-fiber diet mucosa and submucosa
C. High-protein diet D. The small intestine and
D. Low-carbohydrate diet colon; affecting the entire
thickness of the bowel
8. Which of the following mechanisms
can facilitate the development of 13. Which area of the alimentary canal
diverticulosis into diverticulitis? is the most common location for Crohn’s
disease?
A. Treating constipation with
chronic laxative use, leading A. Ascending colon
to dependence on laxatives B. Descending colon
B. Chronic constipation C. Sigmoid colon
causing an obstruction, D. Terminal ileum
reducing forward flow of
intestinal contents 14. Which of the following factors is
C. Herniation of the intestinal believed to be linked to Crohn’s disease?
mucosa, rupturing the wall
of the intestine A. Constipation
D. Undigested food blocking B. Diet
the diverticulum, C. Hereditary
predisposing the area to D. Lack of exercise
bacteria invasion.
15. Which of the following factors is
9. Which of the following symptoms believed to cause ulcerative colitis?
indicated diverticulosis?
A. Acidic diet
A. No symptoms exist B. Altered immunity
B. Change in bowel habits C. Chronic constipation
C. Anorexia with low-grade D. Emotional stress
fever
D. Episodic, dull, or steady 16. Fistulas are most common with
midabdominal pain which of the following bowel disorders?

10. Which of the following tests should A. Crohn’s disease

be administered to a client suspected of B. Diverticulitis
having diverticulosis? C. Diverticulosis
D. Ulcerative colitis
A. Abdominal ultrasound
B. Barium enema 17. Which of the following areas is the
C. Barium swallow most common site of fistulas in clients
D. Gastroscopy with Crohn’s disease?
 A. Anorectal D. Increasing physical activity
B. Ileum 24. In a client with Crohn’s disease,
C. Rectovaginal which of the following symptoms should
D. Transverse colon not be a direct result from antibiotic
therapy?
18. Which of the following associated
disorders may a client with ulcerative A. Decrease in bleeding
colitis exhibit? B. Decrease in temperature
C. Decrease in body weight
A. Gallstones D. Decrease in the number of
B. Hydronephrosis stools
C. Nephrolithiasis
D. Toxic megacolon 25. Surgical management of ulcerative
colitis may be performed to treat which
19. Which of the following associated of the following complications?
disorders may the client with Crohn’s
disease exhibit? A. Gastritis
B. Bowel herniation
A. Ankylosing spondylitis C. Bowel outpouching
B. Colon cancer D. Bowel perforation
C. Malabsorption
D. Lactase deficiency 26. Which of the following medications
is most effective for treating the pain
20. Which of the following symptoms associated with irritable bowel disease?
may be exhibited by a client with
Crohn’s disease? A. Acetaminophen
B. Opiates
A. Bloody diarrhea C. Steroids
B. Narrow stools D. Stool softeners
C. N/V
D. Steatorrhea 27. During the first few days of
recovery from ostomy surgery for
21. Which of the following symptoms is ulcerative colitis, which of the following
associated with ulcerative colitis? aspects should be the first priority of
client care?
A. Dumping syndrome
B. Rectal bleeding A. Body image
C. Soft stools B. Ostomy care
D. Fistulas C. Sexual concerns
D. Skin care
22. If a client had irritable bowel
syndrome, which of the following 28. Colon cancer is most closely
diagnostic tests would determine if the associated with which of the following
diagnosis is Crohn’s disease or conditions?
ulcerative colitis?
A. Appendicitis
A. Abdominal computed B. Hemorrhoids
tomography (CT) scan C. Hiatal hernia
B. Abdominal x-ray D. Ulcerative colitis
C. Barium swallow
D. Colonoscopy with biopsy 29. Which of the following diets is most
commonly associated with colon cancer?
23. Which of the following
interventions should be included in the A. Low-fiber, high fat
medical management of Crohn’s B. Low-fat, high-fiber
disease? C. Low-protein, high-
carbohydrate
A. Increasing oral intake of D. Low carbohydrate, high
fiber protein
B. Administering laxatives
C. Using long-term steroid
therapy
30. Which of the following diagnostic nursing management priority for the
tests should be performed annually over preoperative client with gastric cancer?
age 50 to screen for colon cancer?
A. Discharge planning
A. Abdominal CT scan B. Correction of nutritional
B. Abdominal x-ray deficits
C. Colonoscopy C. Prevention of DVT
D. Fecal occult blood test D. Instruction regarding
radiation treatment
31. Radiation therapy is used to treat
colon cancer before surgery for which of 37. Care for the postoperative client
the following reasons? after gastric resection should focus on
which of the following problems?
A. Reducing the size of the
tumor A. Body image
B. Eliminating the malignant B. Nutritional needs
cells C. Skin care
C. Curing the cancer D. Spiritual needs
D. Helping the bowel heal after
surgery 38. Which of the following
complications of gastric resection should
32. Which of the following symptoms is the nurse teach the client to watch for?
a client with colon cancer most likely to
exhibit? A. Constipation
B. Dumping syndrome
A. A change in appetite C. Gastric spasm
B. A change in bowel habits D. Intestinal spasms
C. An increase in body weight
D. An increase in body 39. A client with rectal cancer may
temperature exhibit which of the following
symptoms?
33. A client has just had surgery for
colon cancer. Which of the following A. Abdominal fullness
disorders might the client develop? B. Gastric fullness
C. Rectal bleeding
A. Peritonitis D. Right upper quadrant pain
B. Diverticulosis
C. Partial bowel obstruction 40. A client with which of the following
D. Complete bowel obstruction conditions may be likely to develop
rectal cancer?
34. A client with gastric cancer may
exhibit which of the following A. Adenomatous polyps
symptoms? B. Diverticulitis
C. Hemorrhoids
A. Abdominal cramping D. Peptic ulcer disease
B. Constant hunger
C. Feeling of fullness 41. Which of the following treatments is
D. Weight gain used for rectal cancer but not for colon
cancer?
35. Which of the following diagnostic
tests may be performed to determine if a A. Chemotherapy
client has gastric cancer? B. Colonoscopy
C. Radiation
A. Barium enema D. Surgical resection
B. Colonoscopy
C. Gastroscopy 42. Which of the following conditions is
D. Serum chemistry levels most likely to directly cause peritonitis?

36. A client with gastric cancer can A. Cholelithiasis

expect to have surgery for resection. B. Gastritis
Which of the following should be the C. Perforated ulcer
D. Incarcerated hernia
 C. Metabolic alkalosis with
43. Which of the following symptoms hyperkalemia
would a client in the early stages of D. Metabolic alkalosis with
peritonitis exhibit? hypokalemia

A. Abdominal distention 49. Five days after undergoing surgery,

B. Abdominal pain and rigidity a client develops a small-bowel
C. Hyperactive bowel sounds obstruction. A Miller-Abbott tube is
D. Right upper quadrant pain inserted for bowel decompression.
Which nursing diagnosis takes priority?
44. Which of the following laboratory
results would be expected in a client A. Imbalanced nutrition: Less
with peritonitis? than body requirements
B. Acute pain
A. Partial thromboplastin time C. Deficient fluid volume
above 100 seconds D. Excess fluid volume
B. Hemoglobin level below 10
mg/dL 52. When teaching a community group
C. Potassium level above 5.5 about measures to prevent colon cancer,
mEq/L which instruction should the nurse
D. White blood cell count include?
above 15,000
A. “Limit fat intake to 20% to
45. Which of the following therapies is 25% of your total daily
not included in the medical management calories.”
of a client with peritonitis? B. “Include 15 to 20 grams of
fiber into your daily diet.”
A. Broad-spectrum antibiotics C. “Get an annual rectal
B. Electrolyte replacement examination after age 35.”
C. I.V. fluids D. “Undergo sigmoidoscopy
D. Regular diet annually after age 50.”

46. Which of the following aspects is 54. After a right hemicolectomy for
the priority focus of nursing treatment of colon cancer, a 57-year old
management for a client with peritonitis? client is reluctant to turn while on bed
rest. Which action by the nurse would be
A. Fluid and electrolyte balance appropriate?
B. Gastric irrigation
C. Pain management A. Asking a co-worker to help
D. Psychosocial issues turn the client
B. Explaining to the client why
47. A client with irritable bowel turning is important.
syndrome is being prepared for C. Allowing the client to turn
discharge. Which of the following meal when he’s ready to do so
plans should the nurse give the client? D. Telling the client that the
physician’s order states he
A. Low fiber, low-fat must turn every 2 hours
B. High fiber, low-fat
C. Low fiber, high-fat 60. The nurse is caring for a
D. High-fiber, high-fat hospitalized client with a diagnosis of
ulcerative colitis. Which finding, if
48. A client presents to the emergency noted on assessment of the client, would
room, reporting that he has been the nurse report to the physician?
vomiting every 30 to 40 minutes for the
past 8 hours. Frequent vomiting puts him A. Bloody diarrhea
at risk for which of the following? B. Hypotension
C. A hemoglobin of 12 mg/dL
A. Metabolic acidosis with D. Rebound tenderness
hyperkalemia
B. Metabolic acidosis with 61. The nurse is reviewing the record of
hypokalemia a client with Crohn’s disease. Which of
the following stool characteristics would
the nurse expect to note documented on 82. A client’s ulcerative colitis
the client’s record? symptoms have been present for longer
than 1 week. The nurse recognizes that
A. Chronic constipation the client should be assessed carefully
B. Diarrhea for signs of which of the following
C. Constipation alternating complications?
with diarrhea
D. Stool constantly oozing A. Heart failure
from the rectum B. DVT
C. Hypokalemia
65. The nurse is doing an admission D. Hypocalcemia
assessment on a client with a history of
duodenal ulcer. To determine whether 83. A client who has ulcerative colitis
the problem is currently active, the nurse has persistent diarrhea. He is thin and
would assess the client for which of the has lost 12 pounds since the
following most frequent symptom(s) of exacerbation of his ulcerative colitis.
duodenal ulcer? The nurse should anticipate that the
physician will order which of the
A. Pain that is relieved by food following treatment approaches to help
intake the client meet his nutritional needs?
B. Pain that radiated down the
right arm A. Initiate continuous enteral
C. N/V feedings
D. Weight loss B. Encourage a high protein,
high-calorie diet
76. The client with Crohn’s disease has C. Implement total parenteral
a nursing diagnosis of acute pain. The nutrition
nurse would teach the client to avoid D. Provide six small meals a
which of the following in managing this day.
problem?
90. The nurse would monitor a patient
A. Lying supine with the legs using sodium bicarbonate to treat gastric
straight hyperacidity for signs and symptoms of:
B. Massaging the abdomen
C. Using antispasmodic A. Metabolic alkalosis
medication B. Metabolic acidosis
D. Using relaxation techniques C. Hyperkalemia
D. Hypercalcemia
77. 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

B. On an empty stomach
C. After meals
D. On arising

81. 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
B. Managing diarrhea
C. Maintaining adequate
nutrition
D. Promoting rest and comfort