Custom ATI GI Interventions

A nurse is providing teaching for a client who has binge-eating disorder and is morbidly obese. The client has been prescribed orlistat. Which of the following statements indicates to the nurse that the client understands the teaching?

"I will stop taking orlistat and call my doctor if my urine gets darker in color."

A nurse is teaching a client who is obese and has obstructive sleep apnea how to decrease the number of nightly apneic episodes. Which of the following client statements indicates an understanding of the teaching?

"If I could lose about 50 pounds, I might stop having so many apneic episodes."

A nurse is talking with a client who has cholelithiasis and is about to undergo an oral cholangiogram. Which of the following client statements indicates to the nurse understanding of the procedure?

"They are going to examine my gallbladder and ducts."

A nurse is providing discharge teaching for a client who has chronic pancreatitis. Which of the following statements should the nurse make?

"You should increase your daily intake of protein"

A nurse is caring for a group of clients. Which of the following clients should the nurse identify as having an increased risk of aspiration while eating? (Select all that apply)

-A client who has had a cerebrovascular accident -A client who is 4hr postoperative following a leg amputation with general anesthesia -A client who has had radiation therapy for head and neck cancer

A nurse is planning care for a client who has cirrhosis of the liver. Which of the following actions should the nurse include in the plan? (Select all that apply)

-Administer furosemide -Implement a low-sodium diet -Measure the client's abdominal girth

A nurse is providing discharge teaching to a client who will be receiving total parenteral nutrition (TPN) at home. Which of the following instructions should the nurse include? (Select all that apply)

-Keep the TPN refrigerated when not in use -Infuse 10% dextrose and water if the solution runs out -Maintain TPN infusion rate when behind schedule

A nurse is caring for a client who is receiving total parenteral nutrition (TPN). The nurse notices that the solution bag is almost empty and there is not another bag of TPN to administer. Which of the following IV solutions should the nurse administer until the next bag of TPN solution is available?

10% dextrose in water (D10W)

A nurse is preparing to instill 840mL of enteral nutrition via a client's gastrostomy tube over 24hr using an infusion pump. The nurse should set the infusion pump to deliver how many mL/hr?

35

A nurse is caring for four clients. Which of the following client's should the nurse identify as having the highest risk for aspiration?

A client receiving continuous enteral feeding through NG tube

A nurse is assessing clients in a health clinic for risk factors for contracting hepatitis. Which of the following clients is at risk for developing hepatitis C?

A client who has multiple tattoos

A nurse is teaching a community education course about the physical complications related to substance use disorder. Which of the following findings should the nurse identify as the primary cause of liver cirrhosis?

Alcohol

A nurse is preparing to administer a dose of lactulose to a client who has cirrhosis. The client states, "I don't need this medication. I am not constipated." The nurse should explain that in clients who have cirrhosis, lactulose is used to decrease levels of which of the following components in the blood stream?

Ammonia

A nurse is reviewing the laboratory data of a client who has acute pancreatitis. The nurse should expect to find an elevation of which of following values?

Amylase

A nurse is teaching a class about preventive care to clients who are at risk for acquiring viral hepatitis. Which of the following information should the nurse include in the presentation?

Avoid foods prepared with tap water

A nurse notices an assistive personnel (AP) preparing to deliver a food tray to a client who practices the Orthodox Jewish faith. On the tray is roast beef dinner with nonfat milk. Which of the following actions should the nurse take?

Call the dietary department and ask for a kosher tray

A nurse is providing teaching to a client who has a history of pancreatitis. Which of the following food choices should the nurse instruct the client to avoid?

Cheddar Cheese

A nurse is planning care for a client who has cirrhosis and ascites. Which of the following interventions should the nurse include in the plan of care?

Decrease the client's fluid intake

A nurse is caring for a client who is receiving enteral tube feeding and has a new prescription to dilute the formula. The nurse recognizes this is being done to resolve which of the following conditions?

Diarrhea

A nurse is preparing to initiate continuous enteral feeding through an open system to a client. Which of the following actions should the nurse take?

Discard unused formula after 8hr

A nurse is caring for a client who has liver cirrhosis with ascites, bleeding esophageal varices, and portal hypertension. The nurse recognizes which of the following laboratory findings as indicating the client's gastrointestinal (GI) tract is digesting and absorbing blood?

Elevated blood urea nitrogen (BUN) -Rationale: As the body digests blood, BUN rises which indicates GI bleeding

A nurse is planning care for a client who has hepatitis B. Which of the following interventions should the nurse include in the plan?

Encourage short periods of ambulation

A nurse is interviewing a client who has acute pancreatitis. Which of the following factors should the nurse anticipate finding in the client's history?

Gallstones -Rationale: A biliary obstruction from gallstones can cause bile to inflame in the pancreas

A nurse is caring for a client who has cirrhosis and has a prescription for bumetanide. When delivering the client's lunch tray, which of the following items should the nurse identify as contraindicated for the client?

Ham sandwich -Rationale: Ham is high in sodium and can increase fluid retention, leading to edema.

A nurse on the day shift is preparing to change a client's total parenteral nutrition (TPN) solution, but the new TPN solution has not arrived from the pharmacy. The client receives addition IV fat emulsion during the night shift. Which of the following actions should the nurse take?

Hang dextrose 10% in water (D10W) until the TPN solution is delivered

A nurse is caring for a newborn whose mother is positive for the hepatitis B surface antigen. Which of the following should the infant receive?

Hepatitis B immune globulin and hepatitis B vaccine within 12hr of birth

A nurse is caring for a client who has esophageal varices and is hypotensive after vomiting 500mL of blood. Which of the following actions is the nurse's priority?

Increase the client's IV fluid rate

A nurse admits a client to the emergency department who reports nausea and vomiting that worsens when he lies down. Antacids do not help. The provider suspects acute pancreatitis. Which of the following laboratory test results should the nurse expect to see?

Increased serum amylase -Rationale: With acute pancreatitis, serum amylase rises within 24hr of the start of the client's symptoms.

A nurse is preparing to turn a client who is obese following a spinal fusion. The nurse should plan to use which of the following techniques to turn this client?

Log Roll

A nurse is caring for a client who has bleeding esophageal varices and is being treated with a Sengstaken-Blakemore tube. Which of the following actions should the nurse perform?

Maintain constant observation while the balloons are inflated -Rationale: This tube is used to stop or slow bleeding from the esophagus and stomach. When balloons are inflated they put pressure on areas that are hemorrhaging to tamponade the bleeding. The client must be observed constantly because displacement of the balloons can cause airway obstruction

A nurse is caring for a client who has Crohn's disease and is receiving parenteral nutrition. Which of the following interventions should the nurse include in the care of this client?

Monitor daily laboratory values and report as needed

A nurse teaching a client about causes of biliary cirrhosis. Which of the following information should the nurse include in the teaching?

Obstruction of the bile duct

A nurse is teaching a client who is obese about orlistat. The nurse should instruct the client to report which of the following findings as an adverse effect of the medication?

Oily fecal spotting

A nurse is admitting a client who has acute pancreatitis. Which of the following provider prescriptions should the nurse anticipate?

Pantoprazole 80mg IV bolus twice daily

A nurse is assessing a client who has advanced cirrhosis. Which of the following manifestations should the nurse expect?

Petechiae

A nurse is preparing to administer the hepatitis B vaccine to a client. Which of the following techniques should the nurse use to locate the deltoid muscle?

Place one finger across the acromion process and measure 3 fingerbreadths below to the midpoint and center of the lateral aspect of the upper arm

A nurse is caring for a client who was admitted with bleeding esophageal varices and has an esophagogastric balloon tamponade with a Sengstaken-Blakemore tube to control the bleeding. Which of the following actions should the nurse take?

Provide frequent oral and nares care

A nurse is planning care for a client who has end-stage cirrhosis of the liver with encephalopathy. Which of the following interventions should the nurse plan to implement to decrease the client's ammonia level?

Reduce the client's intake of protein -Rationale: Ammonia is formed in the GI tract by the action of bacteria on protein. Limiting protein helps decrease the ammonia level

A nurse is teaching self-management to a client who has hepatitis B. Which of the following instructions should the nurse include in the teaching?

Rest frequently throughout the day

A nurse is preparing a client for placement of a catheter for total parenteral nutrition. Which of the following access sites should the nurse plan to prepare for catheter insertion?

Right subclavian vein

A nurse is caring for a client who requires total parenteral nutrition (TPN). Which of the following actions should the nurse take when finding that the TPN solution is infusion too rapidly?

Sit the client upright

A nurse is assessing a client who has cirrhosis. Which of the following is an expected finding for this client?

Spider Angiomas

A nurse is admitting a client who has hepatitis C. Which of the following precautions should the nurse implement?

Standard

A nurse is planning care for a client who is postoperative following a liver transplant and weighs 65kg. Which of the following actions should the nurse plan to take?

Stress the importance of safe food-handling practices

A nurse is caring for a client in a long-term care facility who is receiving enteral feedings via an NG tube. Which of the following actions should the nurse take prior to administering the tube feeding?

Test the pH of gastric aspirate

A nurse is planning care for a client who is to start receiving total parenteral nutrition (TPN). Which of the following interventions should the nurse include in the plan of care?

Use a 1.2 micron filter when infusing TPN with fat emulsions added

A nurse is providing discharge teaching for a client who has acute pancreatitis and has a prescription for fat-soluble vitamin supplements. The nurse should instruct the client to take a supplement for which of the following?

Vitamin A

A nurse is caring for a client who has cirrhosis and a prothrombin time of 30 seconds. Which of the following medications should the nurse plan to administer?

Vitamin K

A nurse is caring for a client who has cirrhosis and a new prescription for lactulose. Which of the following manifestations indicates an adverse effect of the medication?

Vomiting

A nurse is caring for a client who has acute pancreatitis. After treating the client's pain, which of the following should the nurse address as the priority intervention?

Withhold oral fluids and food -Rationale: NPO status is initiated and maintained to rest the pancreas and reduce secretion of pancreatic enzymes during the acute phase of pancreatitis