final

A client with a peptic ulcer is about to begin a therapeutic regimen that includes a bland diet, antacids, and famotidine. Before the client is discharged, the nurse should provide which instruction? "Eat three balanced meals every day." "Stop taking the drugs when your symptoms subside." "Avoid aspirin and products that contain aspirin." "Increase your intake of fluids containing caffeine."

"Avoid aspirin and products that contain aspirin."

A client who is scheduled for a barium swallow asks the nurse why a laxative is necessary following the procedure. Which of the following responses should the nurse make? "The laxative will prevent the absorption of magnesium." "The laxative helps eliminate the barium." "The laxative is the protocol at this facility." "The laxative makes the barium turn brown."

"The laxative helps eliminate the barium." The nurse's statement that the laxative will help eliminate the barium is appropriate and provides the client with the reason for the laxative.

The nurse is presenting health education to a 48-year-old man who was just diagnosed with type 2 diabetes. The client has a BMI of 35 and leads a sedentary lifestyle. The nurse gives the client information on the risk factors for his diagnosis and begins talking with him about changing behaviors around diet and exercise. The nurse knows that further client teaching is necessary when the client tells you what? "I need to start slow on an exercise program approved by my doctor." "I know there's a chance I could have avoided this if I'd always eaten better and exercised more." "There is nothing that can be done anyway, because chronic diseases like diabetes cannot be prevented." "I want to have a plan in place before I start making a lot of changes to my lifestyle."

"There is nothing that can be done anyway, because chronic diseases like diabetes cannot be prevented."

A nurse is assessing four female clients for obesity. Which of the following clients have manifestations of obesity? A client who has a body fat of 22% A client who has a BMI of 28 A client who has a waist circumference of 81.3 cm (32 in) A client who weighs 28% above ideal body weight

A client who weighs 28% above ideal body weight For a female client, obesity is classified as a weight 20% greater than ideal weight. A client whose weight is 28% above ideal body weight is classified as obese.

A client is evaluated for severe pain in the right upper abdominal quadrant, which is accompanied by nausea and vomiting. The physician diagnoses acute cholecystitis and cholelithiasis. For this client, which nursing diagnosis takes top priority? Acute pain related to biliary spasms Deficient knowledge related to prevention of disease recurrence Anxiety related to unknown outcome of hospitalization Imbalanced nutrition: Less than body requirements related to biliary inflammation

Acute pain related to biliary spasms

A nurse caring for a client with small-bowel obstruction should plan to implement which nursing intervention first? Administering pain medication Obtaining a blood sample for laboratory studies Preparing to insert a nasogastric (NG) tube Administering I.V. fluids

Administering I.V. fluids

When caring for a client with an acute exacerbation of a peptic ulcer, the nurse finds the client doubled up in bed with severe pain in the right shoulder. What is the initial appropriate action by the nurse? Notify the health care provider. Irrigate the client's NG tube. Place the client in the high-Fowler's position. Assess the client's abdomen and vital signs.

Assess the client's abdomen and vital signs

A patient is admitted to the hospital after not having had a bowel movement in several days. The nurse observes the patient is having small liquid stools, a grossly distended abdomen, and abdominal cramping. What complication can this patient develop related to this problem? Appendicitis Rectal fissures Bowel perforation Diverticulitis

Bowel perforation

A nurse is providing teaching for a client who has a new diagnosis of gastroesophageal reflux disease (GERD). The client asks about foods he should avoid eating. Which of the following foods should the nurse tell him to avoid Nonfat milk Chocolate Apples Oatmeal

Chocolate

Which is a clinical manifestation of cholelithiasis? Epigastric distress before a meal Clay-colored stools Abdominal pain in the upper left quadrant Nonpalpable abdominal mass

Clay-colored stools

A nurse is aware that both the sympathetic and parasympathetic portions of the autonomic nervous system affect GI motility. What are the actions of the sympathetic nervous system? Select all that apply. Decreases gastric motility Relaxes the sphincters Increases secretary activities Causes blood vessel constriction Creates an inhibitory effect on the GI tract

Decreases gastric motility Causes blood vessel constriction Creates an inhibitory effect on the GI tract

A client is being treated for diverticulosis. Which points should the nurse include in this client's teaching plan? Select all that apply. Do not suppress the urge to defecate. Drink at least 8 to 10 large glasses of fluid every day. Use bulk-forming laxatives Encourage an individualized exercise program Avoid high-fiber foods

Do not suppress the urge to defecate. Drink at least 8 to 10 large glasses of fluid every day. Use bulk-forming laxatives Encourage an individualized exercise program

A nurse is instructing a client who has GERD about positions that can help minimize the effects of reflux during sleep. Which of the following statements indicates to the nurse that the client understands the instructions? "I will lie on my left side to sleep at night." "I will lie on my right side to sleep at night." "I will sleep on my back with my head flat." "I will sleep on my stomach with my head flat."

I will lie on my right side to sleep at night." Sleeping in a right side-lying position helps reduce the manifestations of nighttime reflux. The client can also elevate the head of the bed about 10.2 cm (4 in) to 30.5 cm (12 in) on blocks.

A nurse is planning care for a client who will be arriving to the unit postoperatively from bariatric surgery. In an effort to decrease the risk of venous thromboembolism (VTE), which health care provider orders does the nurse anticipate? Mechanical compression and prophylactic anticoagulation Mechanical compression only Prophylactic anticoagulation only Early ambulation only

Mechanical compression and prophylactic anticoagulation

A nurse is caring for a client who is postoperative following a cholecystectomy and reports pain. Which of the following actions should the nurse take? (Select all that apply.) Offer the client a back rub. Remind the client to use incisional splinting. Identify the client's pain level. Assist the client to ambulate. Change the client's position.

Offer the client a back rub. Remind the client to use incisional splinting. Identify the client's pain level. Change the client's position.

A nurse is assessing a client who is on long term omeprazole therapy. Which of the following findings should indicate to the nurse the medication is effective? Increased appetite Regular bowel movements Absence of headache Reduced dyspepsia

Reduced dyspepsia Omeprazole, a proton pump inhibitor, reduces gastric acid secretion and treats duodenal and gastric ulcers, prolonged dyspepsia, gastrointestinal reflux disease, and erosive esophagitis.

The nurse cares for a client after an endoscopic examination and prepares the client for discharge. The nurse includes which instruction? Avoid driving for 24 hours. Continue a clear liquid diet. Resume regular diet. Increase fluid intake.

Resume regular diet.

A nurse is caring for a client who has just returned from the PACU after a traditional cholecystectomy. In which of the following positions should the nurse place the client? Prone Semi-Fowler's Supported Sims' Dorsal recumbent

Semi-Fowler's

A patient is admitted to the hospital with possible cholelithiasis. What diagnostic test of choice will the nurse prepare the patient for? X-ray Oral cholecystography Cholecystography Ultrasonography

Ultrasonography

A nurse is planning care for a client who has pernicious anemia. Which of the following interventions should the nurse plan to implement?

Vitamin B12 injections

A nurse is performing gastric lavage on a client using a large-bore NG tube. Which of the following actions should the nurse take? Instill 500 mL of sterile saline. Position the client on her right side. Withdraw fluid until it is clear. Connect the NG tube to intermittent suction.

Withdraw fluid until it is clear. The nurse should continue to instill and withdraw the lavage fluid until it is clear.

A client is admitted to the hospital with an exacerbation of chronic gastritis. When assessing the client's nutritional status, the nurse should expect to find what type of deficiency? vitamin A vitamin B6 vitamin B12 vitamin C

vitamin B12

A nurse is providing discharge instruction for a client who is postoperative bariatric surgery. What statement will the nurse include when providing teaching aimed at decreasing the risk of gastric ulcers? "Sit in a semi-recumbent position while eating." "Keep the head of your bed propped on blocks at night." "Avoid taking non-steroidal anti-inflammatory drugs." "Avoid taking antacid drugs."

"Avoid taking non-steroidal anti-inflammatory drugs."

A nurse is providing instructions for a 52-year-old client who is scheduled for a colonoscopy. The client reports that he has not had the procedure before and is very anxious about feeling pain during the procedure. Which of the following responses by the nurse is appropriate? "Don't worry; most clients dislike the prep more than the procedure itself." "Before the examination, your provider will give you a sedative that will make you sleepy." "I know you're anxious, but this procedure is recommended for people your age." "After you have signed the consent form, we can talk more about this."

"Before the examination, your provider will give you a sedative that will make you sleepy."

A nurse is providing teaching for a client who has gastroesophageal reflux disease (GERD) about ways to manage his condition. Which of the following instructions should the nurse include? "Sleep on your left side." "Drink milk to soothe your stomach." "Eat four small meals each day." "Wait to go to bed for 1 hr after eating."

"Eat four small meals each day."

A nurse is teaching a client how to do fecal occult blood testing. Which of the following statements by the client indicates a need for further teaching? "I will continue my low-dose aspirin therapy regimen." "I will refrain from eating raw fruits and vegetables." "I will avoid steak and other red meats." "I will continue taking my Coumadin as prescribed."

"I will continue taking my Coumadin as prescribed." The client should discontinue anticoagulants for one week prior to this testing. This statement requires clarification.

A nurse is teaching a client about strategies to manage gastroesophageal reflux disease (GERD). Which of the following statements should the nurse include? "Elevate the head of your bed by 18 inches." "Avoid snacking between meals." "Limit foods that are high in fiber." "Lie on your right side when sleeping."

"Lie on your right side when sleeping." The nurse should instruct the client to lie on the right side when sleeping to prevent nighttime reflux.

The nurse is conducting a community education class on gastritis. The nurse includes that chronic gastritis caused by Helicobacter pylori is implicated in which disease/condition? Pernicious anemia Systemic infection Peptic ulcers Colostomy

Peptic ulcers

A client's large bowel obstruction has failed to resolve spontaneously and the client's worsening condition has warranted admission to the medical unit. Which of the following aspect of nursing care is most appropriate for this client? Administering bowel stimulants as prescribed Administering bulk-forming laxatives as prescribed Performing deep palpation as prescribed to promote peristalsis Preparing the client for surgical bowel resection

Preparing the client for surgical bowel resection

The nurse is preparing to check for tube placement in the client's stomach as well as measure the residual volume. What is the main purpose of these nursing actions? Prevent gastric ulcers Prevent aspiration Prevent abdominal distention Prevent diarrhea

Prevent aspiration

The nurse is caring for a client with a duodenal ulcer and is relating the client's symptoms to the physiologic functions of the small intestine. What do these functions include? Select all that apply. Secretion of hydrochloric acid (HCl) Reabsorption of water Secretion of mucus Absorption of nutrients Movement of nutrients into the bloodstream

Secretion of mucus Absorption of nutrients Movement of nutrients into the bloodstream

A patient is receiving continuous tube feedings. The nurse would maintain the patient in which position at all times? Supine with a small pillow under the patient's head Semi-Fowler's with the head of the bed elevated 30 to 45 degrees Side-lying with the head slightly lower than the chest High Fowler's with the patient sitting erect

Semi-Fowler's with the head of the bed elevated 30 to 45 degrees

A nurse is caring for a client who has peptic ulcer disease. The nurse should monitor the client for which of the following findings as an indication of gastrointestinal perforation? Hyperactive bowel sounds Sudden abdominal pain Increased blood pressure Bradycardia

Sudden abdominal pain Classic indications of gastrointestinal perforation include sudden sharp abdominal pain with a rigid abdomen, declining peristalsis, and progression to septicemia and hypovolemic shock.

The nurse is caring for a hospitalized client who has class II obesity and who has limited mobility. The nurse should address the client's risk for skin breakdown by: cleaning and drying regularly within the client's skin folds. avoiding the use of pillows to position the client. making a referral to physical therapy. ensuring the client receives a high-calorie, high-protein diet.

cleaning and drying regularly within the client's skin folds.

The most significant complication related to continuous tube feedings is the interruption of GI integrity. a disturbance of intestinal and hepatic metabolism. the increased potential for aspiration. an interruption in fat metabolism and lipoprotein synthesis.

the increased potential for aspiration.

A nurse is caring for an older adult client who reports taking bisacodyl tablets daily. Which of the following responses should the nurse make? "Irregular bowel movements are an indication of poor intestinal health." "Excessive laxative use may cause an electrolyte imbalance." "Chronic use of laxatives can lead to a tear in the rectal mucosa." "Decrease your intake of foods high in fiber."

"Excessive laxative use may cause an electrolyte imbalance." Bisacodyl is a stimulant laxative that acts by stimulating intestinal motility and increasing the amount of water and electrolytes within the intestines; therefore, chronic use of laxatives can lead to fluid and electrolyte imbalance.

The management of the client's gastrostomy is an assessment priority for the home care nurse. What statement would indicate that the client is managing the tube correctly? "I clean my stoma twice a day with alcohol." "The only time I flush my tube is when I'm putting in medications." "I flush my tube with water before and after each of my medications." "I try to stay still most of the time to avoid dislodging my tube."

"I flush my tube with water before and after each of my medications."

A nurse at a provider's office is instructing a client who is scheduled for an outpatient barium swallow. Which of the following statements by the client indicates an understanding of the teaching? "I can have clear liquids up to 4 hours before the test." "I should expect light-colored stools after the procedure." "I will require an IV catheter for this test." "I need to bring a snack because I'll be here all day."

"I should expect light-colored stools after the procedure." The client should expect bowel movements after the procedure to appear white, which indicates presence of the barium. The client can require a cathartic medication to promote bowel movement after the procedure.

A nurse is teaching a client who has a new prescription for ranitidine to treat peptic ulcer disease. Which of the following statements by the client indicate an understanding of the teaching? (Select all that apply.) "I can take this medication with or without food." "I will take this medication in the morning." "I should expect my stools to turn black." "I will take this medication with an antacid." "I will take this medication when I need it for pain." "I will eat five small meals each day."

"I will eat five small meals each day." "I can take this medication with or without food."

A nurse is providing discharge teaching to a client who has gastroesophageal reflux disease. Which of the following statements by the client indicates an understanding of the teaching? "The type of foods I eat does not affect this condition." "I will sleep on my left side." "I will eat a snack just before going to bed." "I will sleep with the head of my bed elevated."

"I will sleep with the head of my bed elevated." The client should sleep with the head of the bed elevated by 6 to 12 inches to prevent reflux at night.

The nurse is assessing a client with has a percutaneous endoscopic gastrostomy (PEG) tube in place. On inspection, the nurse observes moist, white patches on the skin below the external retention bolster. What is the nurse's best action? Perform skin care and apply antibiotic ointment as prescribed Apply an antifungal ointment as prescribed Irrigate the PEG tube with sterile water Ask the dietitian to reevaluate the client's feeding formula

Apply an antifungal ointment as prescribed

The nurse is planning care for a client following an incisional cholecystectomy for cholelithiasis. Which intervention is the highest nursing priority for this client? Assisting the client to turn, cough, and deep breathe every 2 hours Teaching the client to choose low-fat foods from the menu Performing range-of-motion (ROM) leg exercises hourly while the client is awake Assisting the client to ambulate the evening of the operative day

Assisting the client to turn, cough, and deep breathe every 2 hours

A nurse is providing care for a client who is postoperative day 2 following gastric surgery. The nurse's assessment should be planned in light of the possibility of what potential complications? Select all that apply. Malignant hyperthermia Atelectasis Pneumonia Hemorrhage Chronic gastritis

Atelectasis Pneumonia Hemorrhage

An adult client with a history of dyspepsia has been diagnosed with chronic gastritis. The nurse's health education should include what guidelines? Select all that apply. Avoid drinking alcohol Adopt a low-residue diet Avoid nonsteroidal anti-inflammatories Take calcium gluconate as prescribed Prepare for the possibility of surgery

Avoid drinking alcohol Avoid nonsteroidal anti-inflammatories

A nurse is providing teaching for a client who has experienced an acute episode of gastritis. Which of the following instructions should the nurse include in the teaching? Limit drinking milk. Take NSAIDs for pain. Avoid drinking alcohol. Limit strenuous exercise.

Avoid drinking alcohol. The nurse should teach the client to avoid drinking alcohol because it increases manifestations of gastritis.

The nurse teaches the client with gastroesophageal reflux disease (GERD) which measure to manage the disease? Minimize intake of caffeine, beer, milk, and foods containing peppermint or spearmint. Avoid eating or drinking 2 hours before bedtime. Elevate the foot of the bed on 6- to 8-inch blocks. Eat a low-carbohydrate diet.

Avoid eating or drinking 2 hours before bedtime.

A nurse is preparing dietary instructions for a client who has episodes of biliary colic from chronic cholecystitis. Which of the following instructions should the nurse include in the teaching plan? Include foods high in starch and proteins. Include foods high in fiber. Avoid foods high in fat. Avoid foods high in sodium.

Avoid foods high in fat. The nurse should instruct the client to follow a low-fat diet to decrease episodes of biliary colic. A client who has chronic cholecystitis has intolerance to fatty foods.

A nurse is caring for a client who has suspected cholecystitis. The nurse should expect the client's urine to appear which of the following colors? Pale yellow Greenish-brown Red Dark and foamy

Dark and foamy

A nurse is teaching a client who has a prescription of a nasogastric tube (NG) to treat a pyloric obstruction. Which of the following rationales for the use of the nasogastric tube should the nurse include in the teaching? Determine the pH of the gastric secretions. Supply nutrients via tube feedings. Decompress the stomach. Administer medications.

Decompress the stomach.

An older adult client seeks help for chronic constipation. What factor related to aging can cause constipation in elderly clients? Increased intestinal motility Decreased abdominal strength Increased intestinal bacteria Decreased production of hydrochloric acid

Decreased abdominal strength

A client has been experiencing significant psychosocial stress in recent weeks. The nurse is aware of the hormonal effects of stress, including norepinephrine release. Release of this substance would have what effect on the client's gastrointestinal function? Select all that apply. Decreased motility Increased sphincter tone Increased enzyme release Inhibition of secretions Increased peristalsis

Decreased motility Increased sphincter tone Inhibition of secretions

A nurse is caring for a client who has a postoperative ileus and an NG tube that has drained 2,500 mL in the past 6 hr. Which of the following electrolyte imbalances should the nurse monitor the client for? Elevated sodium level Decreased potassium level Elevated magnesium level Decreased calcium level

Decreased potassium level Hypokalemia is an electrolyte imbalance in which the serum potassium level is less than 3.5 mEq/L. Hypokalemia may be the result of diuretic use, diarrhea, vomiting, and prolonged nasogastric suctioning.

A nurse is providing care for a client who had a laparoscopic cholecystectomy. Which of the following is an appropriate nursing action? Place the client in a supine position postoperatively. Encourage ambulation once fully awake. Offer the client ice cream postoperatively. Instruct the client not to lift over 4.5 kg (10 lb).

Encourage ambulation once fully awake. The nurse should encourage ambulation once the client is fully awake to promote absorption of the carbon dioxide used during the laparoscopy. This minimizes the client's discomfort. The nurse should check the client for nausea before ambulating, and administer an anti-emetic medication if necessary.

A client has recovered well from bariatric surgery 3 weeks ago, but during the nurse's most recent assessment, the client states, "I'm having some trouble swallowing my food, and that was never an issue before." What is the nurse's best initial action? Encourage the client to eat slowly and chew food thoroughly Arrange for the client to receive a soft or pureed diet Assess the client for signs and symptoms of dumping syndrome Teach the client about the need to avoid raw fruits and vegetables as well as complex carbohydrates

Encourage the client to eat slowly and chew food thoroughly

A client's enteral feedings have been determined to be too concentrated based on the client's development of dumping syndrome. What physiologic phenomenon caused this client's complication of enteral feeding? Increased gastric secretion of HCl and gastrin because of high osmolality of feeds Entry of large amounts of water into the small intestine because of osmotic pressure Mucosal irritation of the stomach and small intestine by the high concentration of the feed Acid-base imbalance resulting from the high volume of solutes in the feed

Entry of large amounts of water into the small intestine because of osmotic pressure

A nurse is caring for a client who just has been diagnosed with a peptic ulcer. When teaching the client about his new diagnosis, how should the nurse best describe it? Inflammation of the lining of the stomach Erosion of the lining of the stomach or intestine Bleeding from the mucosa in the stomach Viral invasion of the stomach wall

Erosion of the lining of the stomach or intestine

A nurse is caring for a client who is postoperative following an open cholecystectomy. Which of the following actions should the nurse take when caring for the client's Jackson-Pratt (JP) drain? Measure the drainage every hour for the first 8 hr postoperative. Secure the drain to the client's bed sheet. Expel the air from the JP bulb after emptying to re-establish suction. Remove the JP drain when the drainage has ceased, covering the opening with sterile gauze.

Expel the air from the JP bulb after emptying to re-establish suction.

Which of the following is a function of the stomach? Select all that apply. Food storage Secretion of digestive fluids Propels partially digested food into small intestine Secretion of digestive enzymes Secretion of bile

Food storage Propels partially digested food into small intestine Secretion of digestive enzymes

A nurse is providing nutritional teaching to a client who has dumping syndrome following a hemi-colectomy. Which of the following foods should the nurse instruct the client to avoid? Rice Poached eggs Fresh apples White bread

Fresh apples Clients with dumping syndrome following a hemi-colectomy should avoid fresh fruits and choose canned or well-cooked fruits instead.

A nurse is caring for a client following an esophagogastroduodenoscopy (EGD) procedure. Which of the following assessments is the nurse's priority? Pain Nausea Gag reflex LOC

Gag reflex The greatest risk to the client's safety following an EGD is aspiration. Until the client's gag reflex returns, the nurse must keep the client NPO and prepare to intervene to keep the airway open and unobstructed.

A client has a new order for metoclopramide. The nurse identifies that this medication can be safely administered for which condition? Gastroesophageal reflux disease Peptic ulcer with melena Diverticulitis with perforation Gastritis

Gastroesophageal reflux disease

A patient describes a burning sensation in the esophagus, pain when swallowing, and frequent indigestion. What does the nurse suspect that these clinical manifestations indicate? Peptic ulcer disease Esophageal cancer Gastroesophageal reflux disease Diverticulitis

Gastroesophageal reflux disease

A nurse is assessing a client who has peptic ulcer disease. Which of the following findings should the nurse identify as the priority? Epigastric discomfort Dyspepsia Epigastric discomfort Hematemesis

Hematemesis When using the urgent vs. non-urgent approach to client care, the nurse should determine that the priority finding is hematemesis, which indicates massive bleeding.

A client with severe peptic ulcer disease has undergone surgery and is several hours postoperative. During assessment, the nurse notes that the client has developed cool skin, tachycardia, labored breathing, and appears to be confused. Which complication has the client most likely developed? Hemorrhage Penetration Perforation Pyloric obstruction

Hemorrhage

Place the pathophysiological steps in correct order for the development of dumping syndrome. 1Hypertonic food bolus from the stomach to the small intestine 2Release of metabolic peptides 3Tachycardia, dizziness, sweating, nausea, vomiting, bloating, abdominal cramping, and diarrhea 4Rapid rise of glucose, release of insulin, reactive hypoglycemia

Hypertonic food bolus from the stomach to the small intestine Release of metabolic peptides Tachycardia, dizziness, sweating, nausea, vomiting, bloating, abdominal cramping, and diarrhea Rapid rise of glucose, release of insulin, reactive hypoglycemia

During assessment of a patient with gastritis, the nurse practitioner attempts to distinguish acute from chronic pathology. One criteria, characteristic of gastritis would be the: Immediacy of the occurrence. Presence of vomiting. Frequency of abdominal discomfort. Incidence of anorexia.

Immediacy of the occurrence.

A nurse is planning care for a client who is postoperative and at risk for paralytic ileus. Which of the following interventions should the nurse plan to take to promote peristalsis? Increase ambulation. Decrease fluid intake. Increase protein intake. Offer the client the bedpan every 2 hr.

Increase ambulation. Decreased bowel motility is an adverse effect of anesthesia. The nurse should encourage the client to ambulate and increase fiber intake as prescribed to promote a return of bowel function and reduce the risk for paralytic ileus.

The school nurse is working with a female high school junior whose BMI is 31. When planning this girl's care, the nurse should identify what goal? Continuation of current diet and activity level Increase in exercise and reduction in calorie intake Possible referral to an eating disorder clinic Increase in daily calorie intake

Increase in exercise and reduction in calorie intake

A nurse caring for clients with obesity understands these clients are at increased risk for developing pressure ulcers. What does the nurse recognize increases the client's risk for developing pressure ulcers? Select all that apply. Increased adipose tissue decreases the supply of blood, oxygen, and nutrients to peripheral tissue. Skin folds are associated with more moisture and friction. Normal healing mechanisms are impaired. Increased adipose tissue causes thinning of the skin and risk for decreased integrity. Inflammation is worse and leads to risk of infection.

Increased adipose tissue decreases the supply of blood, oxygen, and nutrients to peripheral tissue. Skin folds are associated with more moisture and friction.

A nurse is reviewing the provider's prescriptions for a client experiencing a paralytic ileus following an appendectomy. Which of the following actions should the nurse expect to take? Administer an antacid. Provide a bulk-forming agent. Insert nasogastric tube. Apply a truss.

Insert nasogastric tube. The nurse should expect to insert a nasogastric tube for the client who has no peristaltic activity to decompress the gastrointestinal system of draining fluid and flatus.

Which of the following is a proton pump inhibitor used in the treatment of gastroesophageal reflux disease (GERD)? Select all that apply. Lansoprazole (Prevacid) Rabeprazole (AcipHex) Esomeprazole (Nexium) Famotidine (Pepcid) Nizatidine (Axid)

Lansoprazole (Prevacid) Rabeprazole (AcipHex) Esomeprazole (Nexium)

A client with a cholelithiasis has been scheduled for a laparoscopic cholecystectomy. Why is laparoscopic cholecystectomy preferred by surgeons over an open procedure? Laparoscopic cholecystectomy poses fewer surgical risks than an open procedure. Laparoscopic cholecystectomy can be performed in a clinic setting, while an open procedure requires an OR. A laparoscopic approach allows for the removal of the entire gallbladder. A laparoscopic approach can be performed under conscious sedation.

Laparoscopic cholecystectomy poses fewer surgical risks than an open procedure.

A patient is not having daily bowel movements and has begun taking a laxative for this problem. What should the nurse educate the patient about regarding laxative use? When taking the laxatives, plenty of fluid should be taken as well. The laxatives should be taken no more than 3 times a week or laxative addiction will result. Laxatives should not be routinely taken due to destruction of nerve endings in the colon. Laxatives should never be the first response for the treatment of constipation; natural methods should be employed first.

Laxatives should not be routinely taken due to destruction of nerve endings in the colon.

A nurse is caring for a client who has diverticular disease. When palpating the client's abdomen, in which of the following locations should the nurse expect the client to report abdominal pain?

Lower left quadrant The nurse should expect the client to have abdominal pain in the lower left quadrant of the abdomen. The disease is usually found in the sigmoid colon, where high pressure to move fecal contents from the rectum causes pouch formation.

A nurse is caring for a client who has a diagnosis of GI bleed. During shift assessment, the nurse finds the client to be tachycardic and hypotensive, and the client has an episode of hematemesis while the nurse is in the room. In addition to monitoring the client's vital signs and level of conscious, what would be a priority nursing action for this client? Place the client in a prone position. Provide the client with ice water to slow any GI bleeding. Prepare for the insertion of an NG tube. Notify the health care provider.

Notify the health care provider.

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? Drowsiness Constipation Oily fecal spotting Dark-colored stools

Oily fecal spotting Oily fecal spotting is an adverse effect of orlistat, because of the GI tract's decreased absorption of fat.

A nurse is assessing a client who is 3 days postoperative following abdominal surgery and notes the absence of bowel sounds, abdominal distention, and the client passing no flatus. Which of the following conditions should the nurse suspect? Ulcerative colitis Cholecystitis Paralytic ileus Wound dehiscence

Paralytic ileus

A nurse is caring for a client who is postoperative following abdominal surgery. Which of the following findings should indicate to the nurse the client's peristalsis is returning? Hypoactive bowel sounds in two quadrants Request for a cup of tea and some toast Passage of flatus Abdominal distention

Passage of flatus

A client is in the hospital for the treatment of peptic ulcer disease. The client reports vomiting and a sudden severe pain in the abdomen. The nurse then assesses a board-like abdomen. What does the nurse suspect these symptoms indicate? Ineffective treatment for the peptic ulcer A reaction to the medication given for the ulcer Gastric penetration Perforation of the peptic ulcer

Perforation of the peptic ulcer

Diagnostic imaging and physical assessment have revealed that a client with peptic ulcer disease has suffered a perforated ulcer. The nurse recognizes that emergency interventions must be performed as soon as possible in order to prevent the development of what complication? Peritonitis Gastritis Gastroesophageal reflux Acute pancreatitis

Peritonitis

A client who is postoperative from bariatric surgery reports foul-smelling, fatty stools. What is the nurse's understanding of the primary reason for this finding? Rapid gastric dumping Excessive fat intake Decreased motility Decreased gastric size

Rapid gastric dumping

A nurse is taking a health history of a client who reports occasionally taking several over-the-counter medications, including an H2 receptor antagonist (H2RA). Which of the following outcomes indicates the H2RA is therapeutic?

Relief of heartburn Histamine2 receptor antagonists are used to treat duodenal ulcers and prevent their return. In over-the-counter strengths, these medications, such as cimetidine and ranitidine, are used to relieve or prevent heartburn, acid indigestion, and sour stomach.

A nursing instructor is preparing a class about gastrointestinal intubation. Which of the following would the instructor include as reason for this procedure? Select all that apply. Remove gas and fluids from the stomach Diagnose gastrointestinal motility disorders Flush ingested toxins from the stomach Evaluate for masses in the large colon Administer nutritional substances

Remove gas and fluids from the stomach Diagnose gastrointestinal motility disorders Flush ingested toxins from the stomach Administer nutritional substances

A nurse is providing teaching to a client who has gastroesophageal reflux disease and a new prescription for omeprazole. Which of the following instructions should the nurse provide? Take NSAIDs if headaches occur. Decrease intake of vitamin D. Expect muscle cramps for several weeks. Report diarrhea to the provider.

Report diarrhea to the provider. Omeprazole is associated with an increased risk of C. difficile infection. The nurse should instruct the client to contact the provider if diarrhea occurs.

A nurse researcher examines the risk factors of obesity. Which statements does the nurse find true? Select all that apply. Risk factors that identify the odds of being diagnosed with obesity are not clearly defined. Risk factors that identify the odds of being diagnosed with obesity are predictable and defined. Causes of obesity are complex and multifactorial. Obesity increases the risk of mortality. Obesity decreases the overall life expectancy.

Risk factors that identify the odds of being diagnosed with obesity are not clearly defined. Causes of obesity are complex and multifactorial. Obesity increases the risk of mortality. Obesity decreases the overall life expectancy.

A client who experienced an upper GI bleed due to gastritis has had the bleeding controlled and the client's condition is now stable. For the next several hours, the nurse caring for this client should assess for what signs and symptoms of recurrence? Tachycardia, hypotension, and tachypnea Tarry, foul-smelling stools Diaphoresis and sudden onset of abdominal pain Sudden thirst, unrelieved by oral fluid administration

Tachycardia, hypotension, and tachypnea

While preparing a client for an upper GI endoscopy (esophagogastroduodenoscopy), the nurse should implement which interventions? Choose all that apply. Administer a preparation to cleanse the GI tract, such as Golytely or Fleets Phospha-Soda. Tell the client he shouldn't eat or drink for 6 to 12 hours before the procedure. Tell the client he must be on a clear liquid diet for 24 hours before the procedure. Inform the client that he will receive a sedative before the procedure. Tell the client that he may eat and drink immediately after the procedure.

Tell the client he shouldn't eat or drink for 6 to 12 hours before the procedure. Inform the client that he will receive a sedative before the procedure.

The nurse is providing care for a client whose peptic ulcer disease will be treated with a Billroth I procedure (gastroduodenostomy). The nurse should address which of the following topics when providing health education? Select all that apply. The procedure carries a risk for dumping syndrome The client is likely to require long-term total parenteral nutrition (TPN) The client's vagus nerve may be altered The client can resume a usual diet in 3 to 5 weeks Part of the client's stomach and colon will be removed

The procedure carries a risk for dumping syndrome The client's vagus nerve may be altered

A client has been experiencing occasional episodes of constipation and has been unable to achieve consistent relief by increasing physical activity and improving his diet. When introducing the client to the use of laxatives, what teaching should the nurse emphasize? The effect of laxatives on electrolyte levels The underlying causes of constipation The risk of fecal incontinence The risk of becoming laxative-dependent

The risk of becoming laxative-dependent

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." "Soon those shock waves will get rid of my gallstones." "I'll have a camera put down my throat so they can see my gallbladder." "They'll put medication into my gallbladder to dissolve the stones."

They are going to examine my gallbladder and ducts." With oral cholangiography, the client receives an iodide-containing contrast agent 10 to 12 hr before the procedure. Then, the examiner can evaluate the gallbladder for filling, contracting, and emptying and can also see the gallstones on the x-rays.

A nurse is caring for a client who has a Jackson-Pratt (JP) drain in place after surgery for an open reduction and internal fixation. The nurse should understand that the JP drain was placed for which of the following purposes? To prevent fluid from accumulating in the wound To limit the amount of bleeding from the surgical site To provide a means for medication administration To eliminate the need for wound irrigations

To prevent fluid from accumulating in the wound The purpose of a JP drain is to promote healing by draining fluid from a wound. This prevents pooling of blood and fluid, which can contribute to discomfort, delay healing, and provide a medium for infection. The JP drainage tube is threaded through the skin into the wound near the surgical incision and is held in place by sutures.

A nurse is caring for a client admitted with a suspected malabsorption disorder. The nurse knows that one of the accessory organs of the digestive system is the pancreas. What digestive enzymes does the pancreas secrete? Select all that apply. Pepsin Lipase Amylase Trypsin Ptyalin

Trypsin Lipase Amylase

Which of the following interventions are appropriate for clients with gastritis? Select all that apply. Use a calm approach to reduce anxiety. Give the client food and fluids every 4 hours. Discourage cigarette smoking. Notify the physician of indicators of hemorrhagic gastritis. Provide general education about how to prevent recurrences.

Use a calm approach to reduce anxiety. Discourage cigarette smoking. Notify the physician of indicators of hemorrhagic gastritis.

A nurse is creating a care plan for a client with a nasogastric tube. How should the nurse direct other members of the care team to check correct placement of the tube? Auscultate the client's abdomen after injecting air through the tube. Assess the color and pH of aspirate. Locate the marking made after the initial x-ray confirming placement. Use a combination of at least two accepted methods for confirming placement.

Use a combination of at least two accepted methods for confirming placement.

A client receives tube feedings after an oral surgery. The nurse manages tube feedings to minimize the risk of aspiration. Which measure should the nurse include in the care plan to reduce the risk of aspiration? Change the tube feeding container ,tubing, and adjust patient head of bed . Avoid cessation of feedings and adjust patient head of bed. Use semi-Fowler position during, and 60 minutes after, an intermittent feeding. Administer 15 to 30 mL of water before and after medications and feedings.

Use semi-Fowler position during, and 60 minutes after, an intermittent feeding.

The nurse is providing discharge instructions for a slightly overweight client seen in the Emergency Department with gastroesophageal reflux disease (GERD). The nurse notes in the client's record that the client is taking carbidopa/levodopa. Which order for the client by the health care provider should the nurse question? a low-fat diet elevation of upper body on pillows pantoprazole metoclopramide

metoclopramide

A nurse is caring for a client who is undergoing a diagnostic workup for a suspected gastrointestinal problem. The client reports gnawing epigastric pain following meals and heartburn. What would the nurse suspect this client has? peptic ulcer disease ulcerative colitis appendicitis diverticulitis

peptic ulcer disease

Which enzyme aids in the digestion of protein? trypsin lipase pepsin ptyalin

trypsin

A client with cholelithiasis has a gallstone lodged in the common bile duct. When assessing this client, the nurse expects to note: yellow sclerae. light amber urine. circumoral pallor. black, tarry stools.

yellow sclerae.