EAQ - GI/GU

A client is experiencing chronic constipation, and the nurse discusses how to include more bulk in the diet. Which statement by the client indicates teaching by the nurse is successful?

"Bulk promotes defecation by absorbing water, which softens stool and promotes peristalsis."

Before major abdominal surgery for cancer, a client says to a nurse, "I really don't think this is cancer at all. I'll bet they won't find anything." Which is the most appropriate initial response by the nurse?

"I can understand why you'd like to believe that."

A client had a cholecystectomy and asks whether there will be any dietary restrictions after the client's discharge. The nurse evaluates that the dietary teaching is understood when the client makes what comment to a family member?

"I need to eat smaller amounts of food at a time, and they should contain low to moderate fats."

A nurse is obtaining a health history from a client with the diagnosis of peptic ulcer disease. Which client statement provides evidence to support the identification of a possible contributory factor?

"I smoke one pack of cigarettes a day."

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.

"I will avoid sweetened foods."

A client who was admitted to the hospital with a diagnosis of a renal calculus is successful in passing the stone. The nurse is preparing the client for discharge and should include what in the client's instructions?

"Increase fluid intake."

A healthcare provider prescribes an upper gastrointestinal (GI) series and a barium enema. The client asks, "Why do I have to have barium for these tests?" Which explanation by the nurse of barium's function is the best?

"It gives more contrast to the soft tissue of the alimentary tract, allowing absorption of x-rays."

A client with an ileal conduit is being prepared for discharge. As part of the discharge teaching, which instruction should the nurse include?

"Maintain fluid intake of at least 2 L daily."

A client is treated with a radium implant for cancer of the cervix. Which information is important for the nurse to teach the client when giving discharge instructions?

"Return for follow-up care."

A client is admitted to the hospital with ascites. The client reports drinking a quart (liter) of vodka mixed in orange juice every day for the past three months. To assess the potential for withdrawal symptoms, which question would be appropriate for the nurse to ask the client?

"When was your last drink of vodka?"

A client with a parotid tumor expresses anxiety about the surgery to remove the tumor. The client states that perhaps surgery should be performed soon, even if the preoperative radiotherapy is not completed. What response by the nurse is the best?

"You are concerned about the delay of surgery?"

The student nurse is collecting a clean-catch midstream urine specimen from a client suspected of urinary tract infection. After reviewing the results, the head nurse instructs the student nurse to repeat the procedure. Which finding in the urinalysis report supports the head nurse's instruction?

10 to the power of 4 organisms/mL

A client is to be on a 1500 calorie diet. For breakfast the client consumes 1 cup of milk (12 grams of carbohydrate, 8 grams of protein, 10 grams of fat), ¾ cup cornflakes (15 grams of carbohydrate, 2 grams of protein), and half an orange (5 grams of carbohydrate). How many calories will the nurse document that the client has ingested?

258

A nurse is caring for a client who is scheduled to have a paracentesis. Immediately before the procedure, the nurse asks the client to void. What is the rationale for asking the client to void?

A full bladder increases the danger of puncture during the procedure.

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

Which hormone influences kidney function?

Aldosterone

A nurse is caring for a client with cirrhosis of the liver. Which laboratory test should the nurse monitor that, when abnormal, might identify a client who may benefit from neomycin enemas?

Ammonia level

A client with acute kidney failure becomes lethargic and fatigued. Upon reviewing the client's medical record, which finding does the nurse determine is the most likely cause of this behavior?

An increased blood urea nitrogen level

A client expresses a complete lack of interest in food. How should the nurse document this finding in the client's medical record?

Anorexia

A client with kidney dysfunction is about to undergo renal testing using a contrast medium. Which nursing interventions should be conducted before the procedure to ensure the client's safety? Select all that apply.

Assessing client for a history of cirrhosis Asking client if he/she has a shellfish allergy Assessing client's hydration status by checking BP and respirations

The nurse has taught a client about a low-sodium diet. Which food choice by the client indicates successful learning?

Banana

A client has a surgically created colostomy. What is the most effective nursing intervention initially to help the client accept the colostomy?

Begin to teach self-care of the colostomy by introducing equipment.

Which condition should be reported immediately to the primary healthcare provider?

Body temperature of 102° F with vaginal discharge 48 hours after cervical biopsy

A client had a colon resection and formation of a colostomy two days ago. Which color indicates to the nurse the stoma is viable?

Brick red

A female client reports a white, thick, odorless discharge from the vulva. Upon examination, the nurse finds that the vulva are swollen. What does the nurse suspect in the client?

Candida infection

A nurse is teaching a group of adults about the signs and symptoms of colorectal cancer. Which common clinical manifestations should the nurse include in the teaching program? Select all that apply.

Change in bowel habits Anemia Rectal bleeding

A nurse identifies that clients with cancer often lose weight and may become cachectic. What common response do clients with cancer experience, regardless of the site of the cancer that accounts for this weight loss?

Changes in taste and food aversions

A nurse is caring for a client who had major abdominal surgery one day ago. What factor increases the risk of this client developing a wound dehiscence?

Client being overweight

A nurse is assessing the urine of a client with a urinary tract infection. Which assessment finding is consistent with a urinary tract infection?

Cloudy

A self-help group of clients with irritable bowel syndrome have invited a nurse to present a program on nutrition. Which substance should the nurse teach the clients to minimize in the diet to decrease gastrointestinal (GI) irritability?

Cola drinks

A client is admitted with a diagnosis of cancer of the colon. What information about malignant tumors of the colon should the nurse consider when caring for this client?

Colon obstructions usually are malignant.

For which clinical indicators should the nurse monitor when caring for a client with cholelithiasis and obstructive jaundice? Select all that apply.

Dark urine Yellow skin

The nurse is preparing a blood transfusion for a client with renal failure. Why does anemia often complicate renal failure?

Decrease in erythropoietin

A nurse is caring for a client with end-stage kidney disease after a kidney transplant. Which finding indicates the transplant is successful?

Decreasing serum creatinine

A client who had an abdominoperineal resection and colostomy refuses to allow any family members to see the incision or stoma. The client is noncompliant with most of the dietary recommendations. The nurse concludes that the client is experiencing what response?

Denial; the client is having difficulty accepting reality

A nurse is caring for a client after surgical creation of an ostomy. The nurse observes that the stool is formed. In which part of the colon should the nurse assess the ostomy?

Descending

Immediately after a subtotal gastrectomy, a client is admitted to the postanesthesia care unit (PACU). The nurse irrigates the nasogastric tube and observes small blood clots in the return. Which is the best nursing intervention?

Document this expected response

Which instructions given to a client with renal calculi would be most beneficial? Select all that apply.

Drink plenty of water Substitute lemon juice for tea

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?

Dumping syndrome

The nurse is providing postoperative care 8 hours after a client had a total cystectomy and the formation of an ileal conduit. Which assessment finding should be reported immediately?

Dusky-colored stoma

A healthcare provider prescribes a sigmoidoscopy for one client and a barium enema for another client. What is a nursing responsibility common to preparing both of these clients for these procedures?

Ensuring an understanding of the procedure

A nurse is caring for a client who recently had a kidney transplant. Which priority assessment finding requires follow up by the nurse?

Fever

A client who had surgery for a ruptured appendix develops peritonitis. Which clinical findings related to peritonitis should the nurse expect the client to exhibit? Select all that apply

Fever Abdominal muscle rigidity

The blood urea nitrogen (BUN)/creatinine ratio of a client is 3. Which condition does the nurse suspect in the client?

Fluid volume excess

A nurse is caring for a client who is learning how to take care of a newly created colostomy. When observing a return demonstration of the colostomy irrigation, the nurse evaluates that more teaching is required when the client carries out what procedure?

Hangs the irrigation bag on the door clothes hook during fluid insertion

A client with acute glomerulonephritis reports thirst. Which is the most appropriate choice that the nurse can offer to relieve the client's thirst?

Hard candy

Immediately after a liver biopsy the nurse places the client onto the right side. Which reason explains the use of the right side-lying position?

Helps stop bleeding if any should occur

While receiving a blood transfusion, a client develops flank pain, chills, and fever. What type of transfusion reaction does the nurse conclude that the client probably is experiencing?

Hemolytic

A nurse is caring for a client receiving hemodialysis for chronic kidney disease. The nurse should monitor the client for which complication?

Hepatitis B

A nurse is providing dietary instructions to a client who is being treated with continuous ambulatory peritoneal dialysis (CAPD) for chronic glomerulonephritis. Which should the nurse include when discussing what the client needs?

High-quality protein

A nurse reviews the history of a client who is hospitalized with a diagnosis of urinary calculi and identifies that which factor may have contributed to the development of the calculi?

History of hyperparathyroidism

A client reports swelling of the scrotum with no pain. Which condition does the nurse anticipate in the client?

Hydrocele

A client is admitted to the hospital with severe renal colic caused by a ureteral calculus. Later that evening the client's urinary output is much less than the intake. When it is confirmed that the bladder is not distended, what should the nurse suspect developed?

Hydroureter

A nurse is caring for a client with a diagnosis of chronic kidney failure who has just been told by the primary healthcare provider that hemodialysis is necessary. Which clinical manifestation indicates the need for hemodialysis?

Hyperkalemia

A client is diagnosed as having kidney failure. During the oliguric phase, what should the nurse assess for in this client?

Hyperphosphatemia

A client who is suspected of having Cushing syndrome is admitted to the hospital. When checking the laboratory reports, which condition should the nurse expect?

Hypokalemia

A client with a long history of alcohol abuse develops cirrhosis of the liver. The client exhibits the presence of ascites. What does the nurse conclude is the most likely cause of this client's ascites?

Impaired portal venous return

A client is returned to the surgical unit after an abdominal cholecystectomy. What is the main reason why the nurse should assess for clinical indicators of respiratory complications?

Incision is in close proximity to the client's diaphragm.

What does the nurse find in the laboratory report of a client who is suspected of having a urinary disorder and is on steroid therapy?

Increased blood urea nitrogen levels

A nurse is discussing the regaining of bowel control with a client who recently had surgery for a colostomy in the descending colon. What is most important to emphasize in this teaching?

Irrigation routine

A client who recently immigrated to the United States (Canada) has a chronic vitamin A deficiency. What information about vitamin A should the nurse consider when assessing this client for clinical indicators of this deficiency?

It is a necessary element of rhodopsin, which controls responses to light and dark environments.

A client is admitted to the hospital in the oliguric phase of acute kidney injury. The nurse estimates that the urine output for the last 12 hours is about 200 mL. The nurse reviews the plan of care and notes a prescription for 900 mL of water to be given orally over the next 24 hours. What does the nurse conclude about the amount of fluid prescribed?

It will compensate for both insensible and expected output over the next 24 hours.

Which part of the kidney produces the hormone bradykinin?

Juxtaglomerular cells of the arterioles

A nurse is assisting a healthcare provider to perform a sigmoidoscopy. In which position should the nurse place the client for this procedure?

Knee-chest

A client who had a laparoscopic cholecystectomy reports pain in the shoulder. In what position should the nurse place the client?

Left Sims

A nurse provides dietary instructions to a client with calcium oxalate kidney stones. Which instruction should the nurse give to the client?

Limit sodium intake

A client has a low hemoglobin level that is attributed to a nutritional deficiency. Which foods should the nurse teach the client to increase in the diet? Select all that apply.

Liver Spinach

A nurse is caring for a client who had a nephrectomy because of cancer of the kidney. Which factor will influence the client's ability to deep breathe and cough postoperatively?

Location of the surgical incision

The nurse is providing care to a client with ascites secondary to liver failure. What is appropriate to include in this client's care? Select all that apply.

Low sodium diet Daily abdominal girth measurements Daily weights

A nurse is caring for a male client 10 days after a Billroth II procedure for treatment of a large malignant gastric tumor. The nurse reviews the client's medical record, cares for the client for 8 hours and collects additional data. Which problem does the nurse determine that the client is experiencing?

Malabsorption of fat

A client arrives in the emergency department with epigastric pain and prolonged vomiting. Assessment findings include rapid and shallow respirations, dry and flushed skin, weakness, and lethargy. Which is the primary nursing concern?

Metabolic alkalosis

After a transurethral prostatectomy, a client returns to the postanesthesia care unit with a three-way indwelling catheter with continuous bladder irrigation. Which nursing action is the priority?

Monitoring for bright red blood in the drainage bag

After surgical implantation of radon seeds for oral cancer, what side effects of the radiation does the nurse observe in the client?

Nausea or vomiting

To prevent bleeding after a suprapubic prostatectomy, the client should be instructed to avoid straining on defecation. Which foods should the nurse encourage the client to eat to help prevent constipation during the recovery period? Select all that apply.

Oatmeal Apples Green peas

A client is admitted to the hospital for the surgical repair of an incarcerated indirect inguinal hernia. What is the primary preoperative nursing intervention for this client?

Observing the client's bowel movements

A nurse is planning care for a client admitted to the hospital with abdominal spasms and pain associated with severe diarrhea. What primary serum blood level should the nurse monitor?

Potassium

The nurse identifies a decrease in serum sodium when reviewing the laboratory reports of an older client with diarrhea. A decrease in which additional electrolyte is a cause for the greatest concern for this client?

Potassium

Which serum laboratory values in a client with urinary problems may indicate the risk of developing muscle weakness and cardiac arrhythmias?

Potassium of 7.02 mEq/L (7.02 mmol/L)

Two weeks after sustaining a spinal cord injury, a client begins vomiting thick coffee-ground material and appears restless and apprehensive. What is the most important initial nursing action?

Prepare for insertion of a nasogastric tube

A client with severe Crohn disease develops a small bowel obstruction. Which clinical finding should the nurse expect the client to report?

Projectile vomiting

After a subtotal gastrectomy a client is returned to the surgical unit. Which is the best nursing action to prevent pulmonary complications?

Promoting frequent turning and deep breathing to mobilize secretions

While reviewing the result of an intravenous pyelogram, the nurse discovers that the client has a shortened urethra. The client also complains of urinary incontinence. Which nursing intervention is beneficial for the client?

Providing thorough perineal care after each voiding

A client is admitted to the hospital with a history of cancer of the liver and jaundice. In relation to the jaundice, the nurse expects the client to report the presence of what symptom?

Pruritus

After a subtotal gastrectomy (Billroth I), a client begins to eat more food in varied forms. After meals, the client experiences a cramping discomfort, a rapid pulse, and waves of weakness, which often are followed by nausea and vomiting. What does the nurse conclude is the cause of this response?

Quick passage of hyperosmolar food solution into the small intestine

A nurse is caring for a client with a new colostomy. Which client outcome is most important for achievement of long-range goals associated with adjusting to a new colostomy?

Readiness to accept an altered body function

A nurse is teaching menu planning to a client who has a high triglyceride level. Which item avoided by the client indicates that teaching about foods that are high in saturated fat is understood?

Red meat

A nurse is caring for a client who recently is diagnosed with a gastric ulcer. The nurse expects that the plan of care will include a prescription for which type of diet?

Regular diet with foods that are tolerated

A healthcare provider prescribes intermittent nasogastric tube feedings to supplement a client's oral nutritional intake. Which hazard associated with a nasogastric tube feeding will be reduced if the nurse administers this feeding over 30 to 60 minutes?

Regurgitation

A healthcare provider discusses with a client the need for an abdominoperineal resection and a colostomy. After the healthcare provider leaves, the client tells the nurse about being relieved that only minor surgery is necessary. Which psychologic process best explains this client's reaction?

Repudiation

The nurse is caring for a client one hour after the client had esophageal surgery. Which assessment is the priority for this client?

Respiratory assessment

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?

Serum creatinine level

A nurse is caring for a client with acute pancreatitis. Which elevated laboratory test result is most indicative of acute pancreatitis?

Serum lipase

A client's serum albumin value is 2.8 g/dL (28 g/L). Which food selected by the client indicates that the nurse's dietary teaching is successful?

Sliced turkey

A client who has a history of alcohol abuse now has recurrent exacerbations of chronic pancreatitis. The nurse asks the client to obtain a stool specimen. When assessing the client's stool, what would the nurse expect to observe?

Steatorrhea

A client who is suspected of having salmonellosis asks the nurse how the diagnosis is confirmed. The nurse responds that the medical diagnosis is established with what laboratory test?

Stool culture

During administration of an enema, a client reports having intestinal cramps. What should the nurse do?

Stop the fluid until the cramps subside

A client with ulcerative colitis has experienced frequent severe exacerbations over the past several years. The client is admitted to the hospital with intense pain, severe diarrhea, and cachexia. Which therapeutic course should the nurse expect the primary healthcare provider to explore with this client?

Surgical therapy (colectomy)

A client is diagnosed with calcium oxalate renal calculi. Which foods should the nurse teach the client to avoid? Select all that apply.

Tea Spinach Rhubarb

A client has a tentative diagnosis of primary biliary cirrhosis. What skin change does the nurse expect to observe when performing a physical assessment?

Telangiectasia

During the assessment, the nurse discovers the client takes megadoses of vitamin A. How should the nurse interpret this finding?

The body stores excess vitamin A, even to toxic amounts

A nurse is caring for a client after surgical creation of a conduit diversion (ileal conduit). Which information will the nurse consider when planning care for this client?

Urine continuously drains from it.

A lithotripsy to break up renal calculi is unsuccessful, and a nephrolithotomy is performed. Which postoperative clinical indicator should the nurse report to the primary healthcare provider?

Urine output of 20 to 30 mL/hr

The nurse is performing bedside sonography for a female client who underwent a hysterectomy. Which nursing intervention needs correction?

Using the female icon on the bladder scanner

A client with a history of pancreatitis is scheduled for surgery to excise a pseudocyst of the pancreas. The client asks, "What is a pseudocyst?" Which information should the nurse include in a response to this question?

Walled-off space of pancreatic enzymes and exudate

Three days after surgery for cancer of the colon, a nurse introduces the client to colostomy care. Which should the nurse teach the client about skin care around the stoma?

Wash the area with soap and water and then apply a protective ointment

What should transmission-based precautions for a client with salmonellosis include?

Wearing a gown if soiling is likely