Nursing Board Exam Reviewer Part 2 of 5

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181. When gastric analysis testing reveals excess secretion of gastric acid, which of the following diagnoses is supported?

a)      Duodenal ulcer
Patients with duodenal ulcers usually secrete an excess amount of hydrochloric acid.

b)      Chronic atrophic gastritis
Patients with chronic atrophic gastritis secrete little or no acid.

c)      Gastric cancer
Patients with gastric cancer secrete little or no acid.

d)      Pernicious anemia
Patients with pernicious anemia secrete no acid under basal conditions or after stimulation.

182. Which of the following terms is used to describe stone formation in a salivary gland, usually the submandibular gland?

a)      Sialolithiasis
Salivary stones are formed mainly from calcium phosphate.

b)      Parotitis
Parotitis refers to inflammation of the parotid gland.

c)      Sialadenitis
Sialadenitis refers to inflammation of the salivary glands.

d)      Stomatitis
Stomatitis refers to inflammation of the oral mucosa.

183. Irritation of the lips associated with scaling, crust formation, and fissures is termed

a)      leukoplakia.
Leukoplakia is characterized by white patches, usually on the buccal mucosa.

b)      lichen planus.
Lichen planus refers to white papules at the intersection of a network of interlacing lesions.

c)      actinic cheilitis.
Actinic cheilitis is the result of cumulative exposure to sun.

d)      chancre.
A chancre is demonstrated as a reddened circumscribed lesion that ulcerates and becomes crusted and is a primary lesion of syphilis.

184. Regarding oral cancer, the nurse provides health teaching to inform the patient that

a)      many oral cancers produce no symptoms in the early stages.
As the cancer progresses, the patient may complain of tenderness or difficulty in chewing, swallowing, or speaking.

b)      most oral cancers are painful at the outset.
The most frequent symptom of oral cancer is a painless sore that will not heal.

c)      Blood testing is used to diagnose oral cancer.
Biopsy is used to diagnose oral cancer.

d)      a typical lesion is soft and crater-like.
A typical lesion in oral cancer is a painless hardened ulcer with raised edges.

185. The most common symptom of esophageal disease is

a)      dysphagia.
This symptom may vary from an uncomfortable feeling that a bolus of food is caught in the upper esophagus to acute pain on swallowing.

b)      nausea.
Nausea is the most common symptom of gastrointestinal problems in general.

c)      vomiting.
Vomiting is a nonspecific symptom that may have a variety of causes.

d)      odynophagia.
Odynophagia refers specifically to acute pain on swallowing.

186. Halitosis and a sour taste in the mouth are signs and symptoms associated most directly with

a)      esophageal diverticula.
Because the diverticula may retain decomposed food, halitosis and a sour taste in the mouth are frequent complaints.

b)      achalasia.
Achalasia presents as difficulty in swallowing both liquids and solids.

c)      gastroesophageal reflux.
Gastroesophageal reflux presents as burning in the esophagus, indigestion, and difficulty in or pain upon swallowing.

d)      hiatal hernia.
Hiatal hernia presents as heartburn, regurgitation, and dysphagia in many patients while at least 50% are asymptomatic.

187. Which of the following terms refers to the symptom of gastroesophageal reflux disease (GERD) which is characterized by a burning sensation in the esophagus?

a)      Pyrosis
Pyrosis refers to a burning sensation in the esophagus and indicates GERD.

b)      Dyspepsia
Indigestion is termed dyspepsia.

c)      Dysphagia
Difficulty swallowing is termed dysphagia.

d)      Odynophagia
Pain on swallowing is termed odynophagia.

188. The nurse teaches the patient with gastroesophageal reflux disease (GERD) which of the following measures to manage his disease?

a)      Avoid eating or drinking 2 hours before bedtime.
The patient should not recline with a full stomach.

b)      Minimize intake of caffeine, beer, milk, and foods containing peppermint and spearmint.
The patient should be instructed to avoid the listed foods and food components.

c)      Elevate the foot of the bed on 6- to 8-inch blocks
The patient should be instructed to elevate the head of the bed on 6- to 8-inch blocks.

d)      Eat a low carbohydrate diet
The patient is instructed to eat a low-fat diet

189. Which of the following statements accurately describes cancer of the esophagus?

a)      Chronic irritation of the esophagus is a known risk factor.
In the United States, cancer of the esophagus has been associated with the ingestion of alcohol and the use of tobacco.

b)      It is three times more common in women in the U.S. than men.
In the United States, carcinoma of the esophagus occurs more than three times as often in men as in women.

c)      It is seen more frequently in Caucasians than in African Americans.
It is seen more frequently in African Americans than in Caucasians.

d)      It usually occurs in the fourth decade of life.
It usually occurs in the fifth decade of life.

190. Which of the following venous access devices can be used for no more than 30 days in patients requiring parenteral nutrition?

a)      Non-tunneled catheter
The subclavian vein is the most common vessel used because the subclavian area provides a stable insertion site to which the catheter can be anchored, allows the patient freedom of movement, and provides easy access to the dressing site.

b)      Peripherally-inserted central catheter (PICC)
PICC lines may be used for intermediate terms (3-12 months).

c)      Tunneled catheters
Tunneled central catheters are for long-term use and may remain in place for many years.

d)      Implanted ports
Implanted ports are devices also used for long term home IV therapy (eg, Port A Cath, Mediport, Hickman Port, P.A.S. Port).

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