ASWERS TO BOARD EXAM QUESTIONS AND RATIONALE:

1. A patient calls the clinic reporting the presence of loose stools. Which of the following
questions should the healthcare provider ask the patient first?
A. “Have you been taking antibiotics for the treatment of an infection?”
B. Do you think you may have caught a bug during recent travel?”

C. ““How much water and other liquids do you drink in a 24-hour period?”
D. “Would you describe the number and character of your stools?”

2. The nurse is reviewing the medication record of a client with Acute Gastritis. Which
medication, if noted on the client’s record, would the nurse question?
A. Digoxin (Lanoxin)

B. Indomethacin (Indocin)
C. Furosemide (Lasix)
D. Propanolol Hcl (Inderal)

Rationale: Indomethacin (Indocin) is an NSAID and can cause ulceration of the

esophagus, stomach, duodenum, or small intestine. Indomethacin is contraindicated in
a client with GI disorders.

3. The nurse is caring for a client with chronic gastritis. The nurse monitors the client, knowing
that this client is at risk for which of the following vitamin deficiencies?
A. Vitamin A
B. Vitamin B12
C. Vitamin C
D. Vitamin E

Rationale: Chronic gastritis causes deterioration and atrophy of the lining of the
stomach, leading to loss of functioning parietal cells. The source of the intrinsic factor is
lost, which results in the inability to absorb vitamin B12. This leads to the development
of pernicious anemia.

4. When assessing a patient diagnosed with severe gastroenteritis and diarrhea, the health
care provider notes muscle weakness and decreased deep tendon reflexes. Based on these
findings, which of the following is the appropriate action by the HCP?
A. Administer the prescribed loop diuretic IV push
B. Obtain an electrocardiogram and analyze cardiac rhythm
 C. Insert a nasogastric tube and connect to low suction
D. Perform a finger stick to check the patient’s glucose level

Rationale: An early stage of Acute Gastroenteritis is hyperactive deep tendon

reflexes.

5. The health care provider is caring for a 3-month old infant diagnosed with infectious
gastroenteritis. The infant is lethargic and the mucous membranes are dry. Which additional
finding would support a diagnosis of moderate dehydration?
A. Increased capillary refill
B. Increased thirst
C. Anuria
D. Sunken fontanelle

6. When administering IV fluids to a 1-year old child experiencing severe diarrhea, which of
these assessments is the priority for the healthcare provider to monitor?
A. Status of IV site
B. Skin integrity
C. Cardiopulmonary status
D. Urine output

7. Which of the following definitions best describes gastritis?

A. Erosion of the gastric mucosa
B. Inflammation of a diverticulum
C. Inflammation of stomach acid into the esophagus
D. Reflux of stomach acid into the esophagus

Rationale: Gastritis is an inflammation of the gastric mucosa that may be acute

or chronic. Erosion of the mucosa results in ulceration. Inflammation of a
diverticulum is called diverticulitis; reflux of stomach acid is known as
gastroesophageal disease.

8. Which of the following substances is most likely to cause gastritis?

A. Milk
B. Bicarbonate of soda, or baking soda
C. Enteric coated aspirin
D. NSAID’S
Rationale: NSAIDS are a common cause of gastritis because they inhibit
prostaglandin synthesis. Milk, once thought to help gastritis, has little effect on
the stomach mucosa. Bicarbonate of soda, or baking soda, may be used to
neutralize stomach acid, but should be used cautiously because it may lead to
metabolic acidosis.
9. 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

Rationalization: C. a client with diarrhea has nursing diagnosis of deficient fluid

loss in the stool. Expected outcomes include firm skin turgor, moist mucous
membranes, and urine output of at least 30 ml/hr. the client also has a nursing
diagnosis of diarrhea, with expected outcomes of passage of formed stools at
regular intervals and a decrease in stools frequency and liquidity. The client is at
risk for impaired skin integrity related to irritation from diarrhea; expected
outcomes for this diagnosis include absence of erythema in perianal skin and
mucous membranes and absence of perinanal tenderness or burning

10. The patient with chronic gastritis is being put on a combination of medications to eradicate
H. Pylori. Which drug dose the nurse know will probably be used for this patient?
A. Antibiotic, antacid, and corticosteroid
B. Antibiotic, aspirin, and antiulcer/protectant
C. Antibiotic, proton pump inhibitor, and bismuth
D. Antibiotic, and NSAIDs

Rationalization: C. Antibiotic, proton pump inhibitor and bismuth – to eradicate

H. Pylori, a combination of the above will be used

11. The nurse is caring for a patient with a dx of chronic gastritis. The nurse monitors the client,
knowing that this patient is at risk for which vitamin deficiency?
A. A
B. B12
C. C
D. E

Rationalization: B. B12 – Chronic gastritis causes deterioration and atrophy of

the lining of the stomach, leading to the loss of function of the parietal cells. The
source of intrinsic factor is lost, which results in an inability to absorb vit B12.
This leads to the development of pernicious anemia

12. The pernicious anemia that may accompany gastritis is due to which of the following?
A. Chronic autoimmune destruction
B. Cobalamin stores in the body
C. Progressive gastric atrophy from chronic breakage in the mucosal barrier and blood loss
D. A lack of intrinsic factor normally produced by acid-secreting cells of the gastric mucosa
E. Hyperchlorhydria resulting from an increase in acid-secreting parietal cells and
degradation of RBCs
 Rationalization: C. gastritis may cause loss of parietal cells as a result in atrophy.
The source of intrinsic factor is also lost; intrinsic factor is also lost; intrinsic
factor is essential for the absorption of cobalamin in the terminal ileum which
can result in cobalamin deficiency when lost. This is essential for the growth of
RBCs.

13. A 7-month-old infant is admitted to the hospital with a diagnosis of acute gastroenteritis.
The priority goal of the infant’s care is to prevent:
A. Fluid and electrolyte imbalance
B. Nutritional deficiency
C. Skin breakdown
D. Malabsorption

Rationalization: A. the priority goal of care in gastroenteritis is preventing fluid

and electrolyte imbalance

14. The nurse speaking to the parent of a 3-year-child who has mild diarrhea, would advise the
dietary modification of
A. Soft foods with rice, banana, toast, and applesauce.
B. Small amounts of clear fluids such as gelatin
C. An oral rehydrating solution, such Pedialyte
D. Chicken soup because it is high in sodium

Rationalization: An oral rehydrating solution is recommended to replace fluid

and electrolytes lost from frequent bowel movements.

15. The nurse is caring for an adult client with acute gastroenteritis. Which of the following
observations by the nurse may indicate that the client is becoming dehydrated?
A. pulse change from 68 to 80
B. blood pressure change from 110/78 mm Hg to 120/80 mm Hg
C. musty urine odor
D. hypoactive bowel sounds

Rationalization: The correct answer is A. Indications of dehydration include

flushed skin, skin tenting, dry mucous membranes, hypotension or tachycardia.
The increasing pulse rate may indicate the client is becoming dehydrated.

16. Your client who has gastritis, reports of frequent feeling of nausea and vomiting. What is
your best health teaching in regards to physical activity?

A. Advice patient to exercise at least 3-4x a week

B. Advice patient to avoid quick or sudden movements
C. Advice to increase water intake up to 2 liters per day as tolerated
D. Advise to check pulse and note when feeling nauseated.

Rationale: Quick movements will increase gastric motility that will increase
severity of nausea.
 17. A mother is using Oresol in the management of diarrhea of her 3-year old child. She asked
you what to do if her child vomits. You will tell her to
A. Bring the child to the nearest hospital for further assessment.
B. Bring the child to the health center for intravenous fluid therapy.
C. Bring the child to the health center for assessment by the physician.
D. Let the child rest for 10 minutes then continue giving Oresol more slowly.

Rationalization: Answer: (D) Let the child rest for 10 minutes then continue giving
Oresol more slowly.
If the child vomits persistently, that is, he vomits everything that he takes in, he has
to be referred urgently to ahospital. Otherwise, vomiting is managed by letting the
child rest for 10 minutes and then continuing with Oresoladministration. Teach the
mother to give Oresol more slowly

18. A client admitted with severe diarrhea is experiencing skin breakdown from frequent stools.
What is an important comfort measure for this client?
A. Applying hydrocortisone cream
B. Cleaning the area with soap and hot water
C. Using sitz baths three times daily
D. Wearing absorbent cotton underwear

Rationalization: C. Clients with skin breakdown may use sitz baths for comfort 2 or 3
times daily. Barrier creams, not hydrocortisone creams, may be used. The skin
should be cleaned gently with soap and warm water. Absorbent cotton underwear
helps keep the skin dry, but is not a comfort measure.

19. A 30 year old client experiences weight loss, abdominal distention crampy abdominal pain, and
intermittent diarrhea after birth of her 2nd child. Diagnostic tests reveal gluten-induced enteropathy,
Which foodd must she eliminate from her diet permanently?

A. Milk and dairy products

B. Protein-containing foods
C. Cereal grains ( except rice and corn)
D. Carbohydrates
Rationale: To manage gluten-induced enteropathy, the client must eliminate gluten, which
keans avoid8ng all cereal grains except for rice and corn. In initial diseasr management, clients
eat high calorie, high-protein diet with mineral and vitamin supplements to help normalize
nutritional status.

20. For a client with acute bacterial gastroenteritis. What nursing recommendations should you
make? Select all that apply.
A. Eat a high protein diet.
B. Maintain fluid and electrolytes.
C. Avoid taking anything by mouth.
D. Take a medication for diarrhea.
E. Give antibiotics if prescribed.