Adult Health Mod 3

An exploratory laparotomy is performed on a client with melena, and gastric cancer is discovered. A partial gastrectomy is performed, and a jejunostomy tube is surgically implanted. A nasogastric tube to suction is in place. What should the nurse expect regarding the client's nasogastric tube drainage during the first 24 hours after surgery? Minimal to no drainage Contains some blood and clots Contains large amounts of frank blood Similar to coffee grounds in color and consistency

contains some blood and clots

A client with a history of gastrointestinal varices develops severe hematemesis, and insertion of a Sengstaken-Blakemore tube has been scheduled. What information about the design and purpose of the tube does the nurse provide the client? Single-lumen for gastric lavage Double-lumen for intestinal decompression Triple-lumen to compress the esophagus Multilumen for gastric and intestinal decompression

triple lumen to compress the esophagus

A nurse is reviewing the laboratory reports of four clients. Which client may have peptic ulcer disease? hameofilus helicobactor pylori staflacacus aureus

B

During chemotherapy, altered nutrition is a common side effect. Knowing that compromised nutrition can contribute to an increased risk of infection and other problems, what can the nurse do to offset nutritional deficiencies? Provide oral supplements. Offer the client's favorite foods. Restrict intake from dairy products. Encourage the client to drink low-protein shakes.

Provide oral supplements.

A nurse is reviewing a list of current medications with a client who has developed gastrointestinal bleeding. Which medication prescription should the nurse discuss with the primary healthcare provider? Digoxin Ibuprofen Famotidine Atorvastatin

Ibuprofen

The nurse is obtaining a history and performing a physical assessment on a client who has received a new diagnosis of cancer of the tongue. Which clinical findings should the nurse expect to identify? Select all that apply. Halitosis Leukoplakia Bleeding gums Substernal pain Alterations in taste Enlarged cervical lymph nodes

Leukoplakia Alterations in taste Enlarged cervical lymph nodes

A child has unknowingly swallowed a poisonous substance and has fallen unconscious. Which nursing intervention is advisable for the child? Administer ipecac immediately. Run tap water over the child's face for some time. Make a call to the national poison control hotline. Make arrangements so that the child is taken to a hospital. Rationale

Make arrangements so that the child is taken to a hospital.

During chemotherapy, altered nutrition is a common side effect. Knowing that compromised nutrition can contribute to an increased risk of infection and other problems, what can the nurse do to offset nutritional deficiencies? Provide oral supplements. Offer the client's favorite foods. Restrict intake from dairy products. Encourage the client to drink low-protein shakes. Rationale

Provide oral supplements.

A nurse is caring for a client who is scheduled for a gastric bypass to treat morbid obesity. Which diet should the nurse teach the client to maintain because it will help minimize clinical manifestations of dumping syndrome? Low-residue, bland diet Fluid intake below 500 mL Small, frequent feeding schedule Low-protein, high-carbohydrate diet

small frequent feeding schedule

Which client care can be safely delegated to the unlicensed nursing personnel (UNP) to provide oral hygiene? Client A Dental Carries Client B Oral Cancer Client C Jaw Fracture Client D Thrombocytopenia

A Dental Carries

A client with radiation therapy for neck cancer reports, "I feel a lump while swallowing and foods get stuck." What does the nurse document in the client's medical history? Dysgeusia Dysphagia Xerostomia Odynophagia

Dysphagia

A nurse is evaluating a client's response to receiving an intermittent gravity flow percutaneous endoscopic gastrostomy (PEG) tube feeding. Which clinical finding indicates that the client is unable to tolerate a continuation of the feeding? Passage of flatus Rise of formula in the tube Rapid inflow of the feeding Tenderness of epigastric area

Rise of formula in the food

A client is scheduled for a computed tomography (CT) scan of the chest with intravenous (IV) contrast. Which assessment is the priority before the test is performed? Breath sounds Serum creatinine level Any allergies to betadine History of claustrophobia

Serum creatinine level

A client who has gastroesophageal reflux disease (GERD) is unable to tolerate a back rest elevation. The nurse should place the client in what position in the illustration? Position A Position B Position C Position D

The reverse Trendelenburg position uses gravity to help keep gastric contents in the stomach, thereby minimizing reflux of gastric contents into the esophagus. The high-Fowler and the semi-Fowler position would not be tolerated by the client. The flat position may permit the flow of gastric contents through the cardiac sphincter into the esophagus, contributing to GERD and increasing the risk of aspiration.

The practitioner prescribes a diet high in vitamin B 1 (thiamine) for a client with a long history of alcohol abuse. The nurse concludes that the client understands the teaching about foods high in thiamine when the client makes which statement? "I'll choose fish, aged cheese, and breads." "I'll choose lean beef, organ meat, and nuts." "I'll choose poultry, milk products, and eggs." "I'll choose green vegetables, lentils, and citrus fruits."

"I'll choose lean beef organ meat and nuts."

After an acute episode of gastrointestinal (GI) bleeding, a client is diagnosed with a gastric ulcer. The client receives a prescription for ranitidine 150 mg twice a day. What concern prompts the nurse to contact the health care provider about the prescription? Ranitidine can increase bleeding risk. An administration route is not specified. Ranitidine is contraindicated for gastric ulcers. The recommended dose is higher than prescribed. Rationale

An administration route is not specified.

A nurse is providing discharge instructions for a client with a diagnosis of gastroesophageal reflux disease (GERD). What should the nurse advise the client to do to limit symptoms of GERD? Select all that apply. Avoid heavy lifting. Lie down after eating. Avoid drinking alcohol. Eat small, frequent meals. Increase fluid intake with meals. Wear an abdominal binder or girdle.

Avoid heavy lifting. Avoid drinking alcohol. Eat small, frequent meals.

The nurse is preparing to administer a nasogastric tube feeding to a client via infusion pump. What is the most important assessment the nurse needs to perform before beginning the pump? Checking for the last bowel movement Checking for residual stomach contents Checking to determine time of last medication for nausea Checking to make sure the head of bed is elevated at least 15 degrees

Checking residual stomach contents

A healthcare provider prescribes dietary and medication therapy for a client with the diagnosis of gastroesophageal reflux disease (GERD). What is most appropriate for the nurse to teach the client about meal management? Snack daily in the evenings Divide food into four to six meals a day Eat the last of three daily meals by 8:00 PM Suck a peppermint candy after each meal

Divide food into four or six meals a day

A client had a gastric bypass procedure to treat morbid obesity. After surgery the client reports weakness, sweating, palpitations, and dizziness after eating. What should the nurse encourage the client to do? Reduce the intake of protein-rich foods Drink 8 ounces (240 mL) of water with meals Divide the daily caloric intake into six smaller meals Remain in an upright position for one hour after eating

Divide the daily caloric intake into six smaller meals

A client with a history of pulmonary emboli is taking warfarin daily. The nurse teaches the client about foods that are appropriate to consume when taking this medication. The nurse evaluates that the client needs further teaching when the client makes which statement? "Eggs provide a good source of iron, which is needed to prevent anemia." "Yellow vegetables are high in vitamin A and should be included in the diet." "Fish and shrimp are iodine-rich food sources that can prevent hypothyroidism." "Dark green leafy vegetables are high in vitamin K so I should eat them more often."

"Dark green leafy vegetables are high in vitamin K so I should eat them more often."

A nurse is teaching a client about gastroesophageal reflux disease (GERD). Which statement made by the client indicates correct understanding of GERD management? "Three meals per day is the best regimen to avoid GERD symptoms." "I can reduce my GERD symptoms through a high-carbohydrate, low-fat diet." "A snack at bedtime will help reduce the acidity of my stomach during the night." "I will place a 6-inch (15 cm) block under the head of my bed to help with digestion."

"I will place a 6-inch (15 cm) block under the head of my bed to help with digestion."

A nurse has provided teaching to a client with a newly prescribed proton pump inhibitor (PPI). The nurse determines that the teaching is effective when the client states that the medication is used for the treatment of which condition? Diarrhea Vomiting Cardiac dysrhythmias Gastroesophageal reflux disease (GERD)

Gastroesophageal reflux disease (GERD)

A client is admitted to the hospital with a diagnosis of peptic ulcer. Which most common complication should the nurse assess for in this client? Perforation Hemorrhage Pyloric obstruction Esophageal varices

Hemorrhage

Ranitidine has been prescribed to help treat a client's gastric ulcer. The nurse expects this drug to act specifically by which mechanism? Lowering the gastric pH Promoting the release of gastrin Regenerating the gastric mucosa Ranitidine has been prescribed to help treat a client's gastric ulcer. The nurse expects this drug to act specifically by which mechanism? Lowering the gastric pH Promoting the release of gastrin Regenerating the gastric mucosa I Inhibiting the histamine at H 2 receptors

Inhibiting the histamine at H 2 receptors

A nurse in the surgical intensive care unit is caring for a client with a large surgical incision. The nurse reviews a list of vitamins and expects that which medication may be prescribed because of its major role in wound healing? Vitamin A (retinol) Vitamin K (phytonadione) Vitamin C (ascorbic acid) Vitamin B 12 (cyanocobalamin)

Vitamin C (ascorbic acid)

A client reports pain as a result of a gastric ulcer. What clinical findings is the nurse most likely to identify during an assessment of the client's pain? Select all that apply. Vomiting relieves pain. Eating food prevents pain. Pain is described as gnawing. Flatulence accompanies pain. Pain occurs half an hour after meals.

Vomiting relieves pain Pain is described as gnawing Pain occurs half an hour after meals

A client weighs 150 lb and is 5 feet 7 inches tall. What is this client's body mass index (BMI)? Record your answer using two decimal places.

23.53

A client has a suspected peptic ulcer in the duodenum. What should the nurse expect the client to report when describing the pain associated with this disease? An ache radiating to the left side An intermittent colicky flank pain A gnawing sensation often caused by H. pylori A generalized abdominal pain intensified by moving

A gnawing sensation often caused by H. pylori

A primary health care provider prescribes 1000 mL total parenteral nutrition (TPN) to be infused over 12 hours via a central venous access device. What is most important for the nurse to obtain when preparing the equipment? An infusion pump A steady intravenous (IV) pole An infusion set delivering 60 gtts/mL A set of hemostats to be taped at the bedside

An infusion set delivering 60 gtts/mL

A health care provider prescribes famotidine for a client with dyspepsia. What is important to include about this medication in a teaching program for this client? Lowers the stress level Neutralizes gastric acidity Reduces gastrointestinal peristalsis Decreases secretions in the stomach

Decreases secretions in the stomach

An older adult client states, "I walk 2 miles [3.2 km] a day for exercise, but now that the weather is hot, I am worried about becoming dehydrated." What should the clinic nurse teach the client? "Drink fruit juices if you start to feel dehydrated." "Thirst is a good guide to use to determine fluid intake." "Fluids should be increased if the urine is getting darker." "Water should be consumed when the skin becomes dry." Rationale

Fluids should be increased if the urine is getting darker." "

An obese adult develops an abscess after abdominal surgery. The wound is healing by secondary intention and requires repacking and redressing every 4 hours. Which diet should the nurse expect the healthcare provider to prescribe to best meet this client's immediate nutritional needs? Low in fat and vitamin D High in calories and fiber Low in residue and bland High in protein and vitamin C

High protein and Vitamin C

What client factor does the nurse consider to have the greatest impact on the effectiveness of bariatric surgery? Freedom from concurrent high-risk conditions Motivation to cooperate with required lifestyle changes Willingness to have a panniculectomy a year after weight is stabilized Ability to tolerate the large abdominal incision necessary for this surgery

Motivation to cooperate with required lifestyle changes

A nurse is performing the initial history and physical examination of a client with a diagnosis of duodenal ulcer. Which type of pain does the nurse expect the client to describe? Pain that is relieved with eating Pain that is worse with antacids Pain that is relieved with sleep Pain that is worse one hour after eating

Pain is relieved with eating

What is the priority of care to promote client safety directly after esophagogastroduodenoscopy? Select all that apply. Preventing aspiration Reminding the client not to drive Monitoring for signs of perforation Advising the client to use throat lozenges Teaching the client about hoarseness of voice

Preventing aspiration Monitoring for signs of perforation

Three days after bariatric surgery, the client puts the call light on and states, "I felt a 'pop' in my belly after I had a coughing spell." The nurse assesses the client's incision site for signs of dehiscence. Which clinical finding supports the nurse's conclusion that the client is experiencing wound dehiscence? Loosening of the sutures Sharp increase in serosanguineous drainage Purplish color of the incision Protrusion of organs through an open incision

Sharp increase in serosanguineous drainage

Which information should be included in the teaching plan for the elderly client with peptic ulcer disease who is taking an antacid and sucralfate? Antacids should be taken 30 minutes before a meal. Sucralfate should be taken on an empty stomach one hour before meals. Sucralfate is prescribed for the long-term maintenance of peptic ulcer disease. Sodium bicarbonate is an inexpensive over-the-counter antacid with few adverse effect

Sucralfate should be taken on an empty stomach one hour before meals.

A client who has a gastric ulcer asks what to do if epigastric pain occurs. The nurse evaluates that teaching is effective when the client makes which statement? "Eliminating fluids with meals will prevent pain." "I will increase my food intake to avoid an empty stomach." "Taking an aspirin with milk will relieve my pain and coat my ulcer." "Taking an antacid preparation will decrease pain due to gastric acid."

Taking an antacid preparation will decrease pain due to gastric acid

A nurse, understanding the possible cause of alcohol-induced amnestic disorder, should take into consideration that the client is probably experiencing which imbalance? Thiamine deficiency A reduced iron intake An increase in serotonin Riboflavin malabsorption

Thiamine deficiency

A client with gastric ulcer disease asks the nurse why the health care provider has prescribed metronidazole. What purpose does the nurse provide? To augment the immune response To potentiate the effect of antacids To treat Helicobacter pylori infection To reduce hydrochloric acid secretio

To treat Helicobacter pylori infection

A client with esophageal varices has severe hematemesis, and a Sengstaken-Blakemore tube is inserted. What design and purpose does the tube have? Single-lumen; for gastric lavage Double-lumen; for intestinal decompression Triple-lumen; for esophageal compression Multilumen; for gastric and intestinal decompression

Triple-lumen; for esophageal compression

A client is taking warfarin. If an antidote is needed, which agent will the nurse anticipate being prescribed? Vitamin K Fibrinogen Prothrombin Protamine sulfate

Vitamin K

A nurse is providing teaching to a client who is learning how to self-administer gastrostomy tube feedings. What should the teaching include? Administering water after the feeding is completed Maintaining the supine position during the feeding Heating the feeding to slightly above body temperature Determining tube placement by instilling water before the feeding

administering water after feeding is completed

A nurse is planning care for a client with substance-induced persisting dementia resulting from long-term alcohol use. Which nutritional problem, in addition to the effect of alcohol on brain tissue, has contributed to substance-induced persisting dementia? Increase in serotonin Deficiency of thiamine Reduction in iron intake Malabsorption of riboflavin

deficency of thiamine

A client has a nasogastric feeding tube inserted, and the healthcare provider prescribes the feeding to be instituted immediately. What should the nurse do first? Instill normal saline into the tube to maintain patency. Obtain an x-ray to verify that the tube is in the stomach. Auscultate the epigastric area while instilling 15 mL of air. Withdraw 30 mL of stomach contents to verify tube placement.

obtain an x ray to verify that the tube is in the stomach

A client with esophageal varices is admitted with hematemesis, and two units of packed red blood cells are prescribed. The client complains of flank pain halfway through the first unit of blood. What should be the nurse's first action? Stop the transfusion. Obtain the vital signs. Assess the pain further. Monitor the hourly urinary output.

stop transfusion

Which malnutrition condition may predispose a client to secondary immunodeficiency? Cachexia Cirrhosis Diabetes mellitus Hodgkin's lymphoma

Cachexia

A client is diagnosed with acquired immunodeficiency syndrome (AIDS). When examining the client's oral cavity, the nurse assesses white patchy plaques on the mucosa. The nurse recognizes that this finding most likely represents what opportunistic infection? Cytomegalovirus Histoplasmosis Candida albicans Human papillomavirus

Candida albicans

Six weeks after discharge, a client with a jejunoileal bypass for morbid obesity returns to the outpatient clinic reporting palpitations, abdominal cramps, diarrhea, and dizziness 30 minutes after meals. What complication should the nurse consider that the client is most likely experiencing? Gastric reflux Reflux gastritis Dumping syndrome Abdominal peritonitis

Dumping syndrome

The nurse is caring for a client who is scheduled for a gastric bypass to treat morbid obesity. Which statement by the client indicates a good understanding of preventing dumping syndrome after meals? Select all that apply . <p>The nurse is caring for a client who is scheduled for a gastric bypass to treat morbid obesity. Which statement by the client indicates a good understanding of preventing dumping syndrome after meals? <b>Select all that apply</b> <i>.</i> </p> "I will eat a bland diet." "I will not drink fluids when I eat meals." "I will avoid artificially-sweetened foods." "I will eat a low-protein, high-carbohydrate diet." "I will eat small, frequent meals instead of three large meals a day."

I will not drink fluids when I eat meals I will avoid artificial sweetened food I will eat small frequent meals instead of three large meals a day

To help prevent complications associated with gastric bypass surgery, the nurse needs to educate the client. Identify the factors that should be included in the nurse's teaching plan for this client. Select all that apply. Eat foods rich in calcium. Ingest three small feedings daily. Limit fluids to 1500 mL daily. Avoid consuming alcoholic beverages. Receive cyanocobalamin injections routinely.

eat foods rich in calcium avoid consuming alcohol beverages receive cyanocobalamin injections routinely

A client comes for an annual physical examination. To provide appropriate nutritional counseling, the nurse calculates the client's body mass index (BMI). The client's weight is 65 kg, and the height is 1.7 meters. What is the client's BMI? Record your answer using one decimal place.

22.5

A nurse is caring for a client who is receiving total parenteral nutrition (TPN). The nurse would monitor the client for which complications? Select all that apply. Hyperglycemia Infection Hepatitis Anorexia Dysrhythmias

Hyperglycemia Infection

Which statement by a client scheduled for bariatric surgery indicates to the nurse that further preoperative teaching is necessary? "I need to eat more high-protein foods." "I'm going to have a figure like a model in about a year." "I'm going to be out of bed and sitting in a chair the first day after surgery." "I will be limiting my intake to 600 to 800 calories a day once I start eating again."

I'm going to have a figure like a model in about a year

A client is being prepared for surgery to have placement of a percutaneous endoscopic gastrostomy (PEG) tube. The client asks why the PEG tube is preferred over the existing nasogastric tube that is being used for feedings. What explanation does the nurse give for why a PEG tube is preferred for administering a tube feeding? There is less chance of aspiration. This procedure does not require a pump. Self-administration of the feeding is possible. More tube feeding mixture can be given each time.

There is less chance of aspiration

On the third postoperative day after a subtotal gastrectomy, a client reports having severe abdominal pain. The nurse palpates the client's abdomen and determines rigidity. What should be the nurse's first action? Assist the client to ambulate. Obtain the client's vital signs. Administer the prescribed analgesic. Encourage using the incentive spirometer.

Obtain the client's vital signs.

The nurse is caring for a 76-year-old obese client with a history of epigastric distress, esophageal burning, binge drinking, and frequent episodes of bronchitis. A diagnosis of hiatal hernia is made. Which health problems most likely contributed to the development of the hiatal hernia? Select all that apply. Aging Obesity Bronchitis Esophagitis Binge drinking

Aging Obesity

A nurse is providing education about excellent food sources of vitamin A for a client who is deficient in this vitamin. Which foods should the nurse include in the teaching? Select all that apply. Carrots Oranges Tomatoes Green leafy greens Yellow/orange vegetables

Carrots Green Leafy greens yellow/orange vegetables

A client is diagnosed with osteoporosis. During teaching about high-calcium foods, the nurse and client evaluate the client's dietary intake from the previous day. The client recorded the intake. Which contains the best sources of calcium? Breakfast two eggs toast coffee Lunch Grilled cheddar cheese salad spinach milk Dinner grilled chicken breast carrots milk Snack strawberry yogurt

Lunch

The nurse is instructing the student nurse how to administer percutaneous enterostomal gastrostomy (PEG) tube feeding to a client. What should the nurse tell the student? Select all that apply. A. Keep the client's head of bed elevated at least 10 degrees. B. Connect tube feeding bag to client and feeding pump. C. Flush with warm water before beginning feeding. D. Check prescription for correct client formula. E. Set correct rate and initiate pump. F. Check for diarrhea.

B, C, D, E, F

Famotidine (Pepcid) is prescribed for a client with peptic ulcer disease. The client asks the nurse what this medication does. Which action does the nurse mention when replying? Increases gastric motility Neutralizes gastric acidity Facilitates histamine release Inhibits gastric acid secretion

Inhibits gastric secretions

A client with early-stage cancer of the esophagus is treated with laser therapy. Which type of food should the nurse instruct the client to select when oral intake is permitted? Cold Liquid Low in protein Low in calories

Liquid

A client with gastroesophageal reflux disease (GERD) receives a prescription for an H 2 receptor antagonist. Which medications are within the classification of an H 2 receptor antagonist? Select all that apply. Nizatidine Ranitidine Famotidine Lansoprazole Metoclopramide Rationale

Nizatidine Ranitidine Famotidine

For two months a client has been taking nonprescription medications and has made dietary changes for symptoms of gastritis. Following assessment by a primary healthcare provider, a diagnosis of extensive carcinoma of the stomach is made. The client asks how the disease got so advanced. On which information about carcinoma of the stomach should the nurse base a response? Presents symptoms of severe pain for the client when in the early stages of the disease process Is a risk factor for clients who have an absence of pylori in the stomach Usually is diagnosed after the discovery of enlarged lymph nodes in the epigastric area Often is diagnosed late because symptoms are nonspecific during the early stages

Often is diagnosed late because symptoms are nonspecific during the early stages

Which task can the registered nurse safely delegate to the unlicensed assistive personnel (UAP) while caring for a client with gastroesophageal reflex disease? Positioning the bed Evaluating the vitals Tube feeding the client Determining calorie needs

Positioning the bed

A health care provider prescribes ranitidine for a client with heartburn. During a teaching session, which information will the nurse share with the client about how this drug works? Ranitidine increases gastrointestinal peristalsis. Ranitidine reduces gastric acidity in the stomach. Ranitidine neutralizes the acid that is present in the stomach. Ranitidine stops production of hydrochloric acid in the stomach.

Ranitidine reduces gastric acidity in the stomach.