Adult II Exam 1 Practice Qs

A nurse at a long-term care facility is conducting an intake assessment and health history with a new female resident and the resident's daughter. The daughter states that her mother had a Billroth II gastrectomy performed several years ago, a fact that must be accommodated into her care. The nurse would be justified in questioning the resident about her history of:

stomach cancer

A nurse is performing discharge teaching with a client who had a total gastrectomy. Which statement indicates the need for further teaching?

"I will have to take vitamin B12 shots up to 1 year after surgery."

An older adult patient with a diagnosis of chronic gastritis has achieved acceptable control of his condition with the use of an H2 receptor antagonist. This patient's symptom control is a result of what therapeutic action of this drug?

A decrease in HCl production by parietal cells

A patient is scheduled for a Billroth I procedure for ulcer management. What does the nurse understand will occur when this procedure is performed?

A partial gastrectomy is performed with anastomosis of the stomach segment to the duodenum.

The nurse is caring for a patient who has been diagnosed with gastritis. To promote fluid balance when treating gastritis, the nurse knows that what minimal daily intake of fluids is required?

1.5 L

Percentage of PUD clients who experience bleeding

15%

A client with chronic peptic ulcers is considering a vagotomy. Which information will the nurse provide to the client about this surgical procedure?

Adverse effects such as dumping syndrome and gastritis can occur.

While caring for a patient who has had radical neck surgery, the nurse notices an abnormal amount of serosanguineous secretions in the wound suction unit during the first postoperative day. What does the nurse know is an expected amount of drainage in the wound unit?

Approximately 80 to 120 mL

A client is postoperative following a graft reconstruction of the neck. What intervention is the most important for the nurse to complete with the client?

Assess the graft for color and temperature

A client is scheduled for removal of the lower portion of the antrum of the stomach and a small portion of the duodenum and pylorus. What surgical procedure will the nurse prepare the client for?

Billroth I

A patient comes to the clinic with the complaint, "I think I have an ulcer." What is a characteristic associated with peptic ulcer pain that the nurse should inquire about? Select all that apply.

Burning sensation localized in the back or mid-epigastrium Feeling of emptiness that precedes meals from 1 to 3 hours Severe gnawing pain that increases in severity as the day progresses

A client is receiving a continuous tube feeding through an open system. Which action(s) will the nurse take when caring for the tube feeding system? Select all that apply.

Change the tubing every 24 hours. Use a pump to control the formula rate. Flush the feeding tube with sterile water every 4 hours. Change the formula according to the manufacturer recommendations.

Which type of ulcer can be seen in patients with significant burn injuries?

Curling's ulcer

What information should the nurse include in the teaching plan for a client being treated for diverticulosis?

Drink at least 8 to 10 large glasses of fluid every day

Postoperatively, a client with a radical neck dissection should be placed in which position?

Fowler

Vomiting results in which of the following acid-base imbalances?

Metabolic alkalosis

A client is prescribed a histamine (H2)-receptor antagonist. The nurse understands that this might include which medication(s)? Select all that apply

Nizatidine Famotidine Cimetidine

During a home visit the nurse notes that a client recovering from peptic ulcer disease is experiencing cool clammy skin and has a heart rate of 96 beats a minute. Which action will the nurse take?

Notify HCP. (sign of hemorrhage)

A client is receiving continuous tube feedings at 75 mL/h. When the nurse checked the residual volume 4 hours ago, it was 250 mL, and now the residual volume is 325 mL. What is the priority action by the nurse?

Notify the healthcare provider.

When a central venous catheter dressing becomes moist or loose, what should a nurse do first?

Remove the dressing, clean the site, and apply a new dressing.

Which of the following are characteristics associated with the Zollinger-Ellison syndrome (ZES)? Select all that apply.

Severe peptic ulcers Extreme gastric hyperacidity Gastrin-secreting tumors of the pancreas

Which term is used to describe stone formation in a salivary gland, usually the submandibular gland?

Sialolithiasis

A client is recovering from gastric surgery. Toward what goal should the nurse progress the client's enteral intake?

Six small meals daily with 120 mL fluid between meals

An older client is diagnosed with parotitis. What bacterial infection does the nurse suspect caused the client's parotitis?

Staphylococcus aureus

A client tells the nurse, "I am not having normal bowel movements." When differentiating between what are normal and abnormal bowel habits, what indicators are the most important?

The consistency of stool and comfort when passing stool

The primary source of microorganisms for catheter-related infections are the skin and which of the following?

catheter hub

If a client's central venous catheter accidentally becomes disconnected, what should a nurse do first?

clamp the catheter

To ensure patency of central venous line ports, diluted heparin flushes are used

daily when not in use

The nurse is obtaining a history on a patient who comes to the clinic. What symptom described by the patient is one of the first symptoms associated with esophageal disease?

dysphagia

Side effect of metronidazole

metallic taste in mouth

When bowel sounds are heard about every 15 seconds, the nurse would record that the bowel sounds are

normal

A client recovering from gastric bypass surgery accidentally removes the nasogastric tube. What is the best action by the nurse?

notify the surgeon about the tube's removal

A client has been taking a 10-day course of antibiotics for pneumonia. The client has been having white patches that look like milk curds in the mouth. What treatment will the nurse educate the client about?

nystatin

A nurse practitioner prescribes drug therapy for a patient with peptic ulcer disease. Choose the drug that can be used for 4 weeks and has a 90% chance of healing the ulcer.q

omeprazole

The nurse recognizes that the client diagnosed with a duodenal ulcer will likely experience

pain 2 to 3 hours after a meal.

The nurse is completing a health history on a patient whose diagnosis is chronic gastritis. Which of the data below should the nurse consider most significantly related to the etiology of the patient's health problem?

smokes 2 packs cigarettes daily

The nurse is assisting the physician in a percutaneous liver biopsy. In assisting with positioning, the nurse should assist the client into a:

supine

A client has been diagnosed with Zenker's diverticulum. What treatment does the nurse include in the client education?

surgical removal of the diverticulum

The most significant complication related to continuous tube feedings is

the increased potential for aspiration.

The nurse provides client education to a client about to undergo hydrogen breath testing. The nurse evaluates that the client understands the test when the client makes which statement?

"I should avoid antibiotics for 1 month before the test." The client should avoid loperamide, sucralfate, and omeprazole for 1 week prior to the test, and cimetidine, famotidine, and nizatidine for 24 hours before the test.

A 50-year-old male patient with a history of cholelithiasis (gallstones) has presented to the emergency department (ED) with severe upper right quadrant pain. The ED nurse should anticipate the need to facilitate which of the following diagnostic tests?

Abdominal ultrasound

The nurse practitioner suspects that a patient may have a gastric ulcer after completing a history and physical exam. Select an indicator that can be used to help establish the distinction between gastric and duodenal ulcers.

Amount of HCL secretion in stomach -gastric will by hyposecretion/normosecretion -duodenal will be hypersecretion

The nurse is evaluating a client's ulcer symptoms to differentiate ulcer as duodenal or gastric. Which symptom should the nurse at attribute to a duodenal ulcer?

awakening in pain

A client has been diagnosed with chronic gastritis. The nurse knows that which of the following symptoms are indicative of gastritis? Select all that apply.

belching early satiety sour taste in mouth

The nurse is caring for a patient who is postoperative day 3 following bowel resection and the creation of a colostomy. While changing the dressing, the nurse notes the stoma is dusky in color. How should the nurse interpret this assessment finding?

circulation to the stoma is compromised