Gastrointestinal
a nurse is caring for a client who is 4 hour postoperative following a laparoscopic cholecystectomy. which of the following findings should the nurse expect A. right shoulder pain B. urine output 20 mL/hr C. Temperature 38.4 C (101.1 F) D oxygen saturation 92%
A. Right shoulder pain - the client can experience pain in the right upper shoulder due to gas (carbon dioxide) injected into the abdominal cavity during the laparoscopic procedure, which can irritate the diaphragm and cause referred pain in the should area. the pain disappears in 1 to 2 days. mild analgesics and recumbent position can help with client comfort
a nurse is caring for a client who has a history of cirrhosis and admitted with manifestations of hepatic encephalopathy. the nurse should anticipate a prescription for with of the following lab tests to determine the possibility of recently excessive alcohol use a. gamma-glutamyl transferase (GGT) b. Alkaline phosphatase (ALP) c. serum bilirubin d. Alanine aminotransferase (ALT
A. gamma-glutamyl transferase (GGT) - the GGT laboratory test is specific to the hepatobiliary system in which levels can be raised by alcohol and hepatic drugs. therefore, it is useful for monitoring drug toxicity and excessive alcohol use
a nurse is caring for a client who is scheduled to undergo a liver biopsy for a suspected malignancy. which of the following laboratory findings should the nurse monitor prior to the procedure A. prothrombin time B. serum lipase C. Bilirubin D. Calcium
A. prothrombin time - a major complication following a liver biopsy is hemorrhage. many clients who have liver disease have clotting defects and are at risk for bleeding. along with the prothrombin time (PT), the activated partial thromboplastin time (aPTT) and platelet count should be monitored. liver dysfunction causes the production of blood clotting factors to be reduced, which leads to an increased incidence of bruising, nosebleeds, bleeding from wounds, and gastrointestinal bleeding. this is due to deficient absorption of vitamin K from the gastrointestinal tract caused by the inability of liver cells to use Vitamin K to make prothrombin
a nurse is caring for a client who has celiac disease. which of the following foods should the nurse remove from the client's meal tray A. Wheat toasts B. tapioca budding C. Hard-boiled egg D. mashed potatoes
A. wheat toast - celiac disease is an autoimmune disorder characterized by a permanent intolerance to wheat, barley, and rye. wheat toast contains gluten and should be removed from the client's tray.
a nurse is caring for a client who has percutaneous endoscopic gastronomy (PEG) tube and is receiving intermittent feedings. prior to initiating the feeding, which of the following actions should the nurse take first a. flush the tube with water b. place the client is semi-fowler's position c. cleanse the skin around the tube site 4. aspirate the tube for residual contents
B place the client in semi-fowler position
A nurse is teaching a client who has Barrett's esophagus and is scheduled to undergo an Esophagogastrodudenoscopy (EGD). which of the following statements should the nurse include in the teaching A. "this procedure is performed to measure the presence of acid in your esophagus" B. "this procedure can determine how well the lower part of your esophagus works" C. "this procedure is performed while you are under general anesthesia" D. "this procedure will determine if you have colon cancer"
B. "this procedure can determine how well the lower part of your esophagus works" - an EGD is useful in determining the function of the esophageal lining and the extent of inflammation, potential scarring, and strictures
a nurse is preparing a community education program about hep B. which of the following statements should the nurse include in the teaching A. A hep B immunization is recommended for those who travel, especially military personnel b. A hep B immunization is given to infants and children c. hep B is acquired by eating foods that are contaminated during handling D. hep B can be prevented by using good personal hygiene habits and proper sanitations
B. a hep b immunization is given to infants and children - hep b immune globulin is given as part of the standard childhood immunizations. it can be administered as early a birth, especially in infants born to hep b surface antigen (HBsAg) negative mothers. these infants should receive second dose between 1 and 4 months of age
a nurse is assessing a client who is in the early stages of hepatitis A. which of the following manifestations should the nurse expect a. jaundice b. anorexia C. dark urine D pale feces
B. anorexia - anorexia is an early manifestation of hep A and is ofter never. it is tough to result from the release of a toxin by the damaged liver or by the failure of the damaged liver cells to detoxify an abnormal product
a nurse is caring for a client who is scheduled to undergo an esophagogastroduodenoscopy (EGD). the nurse should identify that this procedure is used to do which of the following. a. to visualize polyps in the colon B. to detect an ulceration in the stomach C. To identify an obstruction in the biliary tract D. to determine the presence of free air in the abdomen
B. to detect an ulceration in the stomach - an EGD is used to visualize the esophagus, stomach, and duodenum with a lighted tube to detect a tumor, ulceration, or obstruction
a nurse is caring for a client who has acute pancreatitis. which of the following serum laboratory values should the nurse anticipate returning to the expected reference range within 72 hr after treatment begins a. Aldolase B. Lipase C. Amylase D. Lactic dehydrogenase
C. Amylase - pancreatitis is the most common diagnosis for marked elevations in serum amylase. serum amylase begins to increase about 3 to 6 hours following the onset of acute pancreatitis. the amylase level peaks in 20 to 30 hr and returns to the expected reference range within 2 to 3 days
a nurse is completing a history and physical assessment for a client who has chronic pancreatitis. which of the following findings should the nurse identify as likely cause of the client's condition a. high calorie diet b. prior gastrointestinal illness tobacco use d. alcohol use
D. alcohol use - alcohol consumption is one of the major causes of chronic pancreatitis in the U.S. long-term alcohol use disorder produces hyper secretions of protein in pancreatic secretions. the result is protein plugs and calculi within the pancreatic ducts. alcohol also has direct toxic effect on the cells of the pancreas.. damage to these cells is more likely to occur and to be more severe in clients whose diets are poor in protein content and either very high or very low in fat
a nurse is assessing a client who is experiencing perforation of a peptic ulcer. which of the following manifestations should the nurse expect a. increase blood pressure b. decreased heart rate C. yellowing of the skin D. boardlike abdomen
D. birdlike abdomen - the nurse should expect the client who is experiencing perforation of a peptic ulcer to exhibit manifestations of a birdlike abdomen and severe pain in the abdomen or back that radiates to the right shoulder. vomiting of blood and shock can occur if the perforation causes hemorrhaging
a nurse is caring for a client who is dehydrated and receiving continuous tube feeding through a pump at 75 mL/hr. when the nurse assesses the client at 0800, which of the following findings requires intervention by the nurse a. a full pitcher of water is sitting on the client's bedside table within the client's reach b. the disposable feeding bag is from the previous day at 100 and contains 200ml of feeding c. the client is lying on the right side with a visible dependent loop in the tube D. the head of the bed is elevated 20 degrees
D. the head of the bed is elevated 20 degrees - the head of the bed should be elevated at least 30 degrees (semi-fowler's position) while the tube feeding is administered. the position uses gravity to help the feeding move down through the digestive system and lessens the possibility of regurgitation
a community health nurse is planning and educational program about hepatitis A. when preparing the materials, the nurse identify that which of the following groups is the most at risk for developing hepatitis A a. children b. older adults c. women who are pregnant d. middle-aged men
a. children - the hepatitis A virus can be contracted from the feces, bile, and blood of infected clients. the usual mode of transmission is fecal-oral route. children and young adults are the two groups most often affected by hepatitis A virus. typically, a child or young adult acquires the infection at school, through poor hygiene, hand-to-mouth contact, or another form of close contact
a nurse is providing dietary teaching to a client who has diverticulitis about preventing acute attacks. which of the following foods should the nurse recommend a.foods high in vitamin C b. foods low in fat c. foods high in fiber d. foods low in calories
c. foods high in fiber - the result of long-term, low-fiber eating habits along with increase intracolonic pressure lead to straining during model movements, causing the development of diverticula, high-fiber foods help srengthen and maintain active mortality of gastrointestinal tract
a nurse is caring for a client who has fulminant hepatic failure. which of the following procedures should the nurse anticipate for this client a. endoscopic sclerotherapy b. liver lobectomy c. liver transplant d. trans jugular portal-system shunt placement
c. liver transplant - ruminant hepatic failure, most often caused by viral hepatitis, is characterized by the development of hepatic encephalopathy within weeks of the onset of disease in a client without prior evidence of hepatic dysfunction. mortality remains high, even with treatment modalities such as blood or plasma exchanges, charcoal hemp-perfusion, and corticosteroids, consequently, liver transplantation as become the treatment of these clients
a nurse is assessing a client who was admitted with a bowel obstruction. the client reports severe abdominal pain. which of the following findings should indicate to the nurse the possible bowel perforation has occurred a. elevated blood pressure b. bowel sounds increased in frequency and pitch c. rigid abdomen d. emesis of undigested food
c. rigid abdomen - abdominal tenderness and rigidity occur with a bowel perforation. as fluid escapes into the peritoneal cavity, there is a reduction in circulating blood volume and a lowered blood pressure, or hypotension, results
a nurse in the emergency department is caring for a client who has bleeding esophageal varies. the nurse should anticipate a prescription for which of the following medications a. famotidine b. esomeparzole c. vasopressin d. omeprazole
c. vasopressin - vasopressin constrict the splanchnic bed and decreases portal pressure. vasopressin also constricts the distal esopheal and proximal gastric veins, which reduces inflow into the portal system and is used to treat bleeding varices
a nurse is caring for a client who is 2 days postoperative following gastric bypass. the nurse notes that bowel sounds are present. which of the following foods should the nurse provide to initial feeding a. vanilla pudding b. apple juice c. diet ginger ale d. clear liquids
clear liquids - clear liquids, such as water or broth, can be given for the first oral feedings, but should be limited to 30 ml (1oz per feeding. water does not contain sugar, which could cause diarrhea due to hyperosmolarity
a nurse is caring for a client who is receiving total parenteral nutrition (TPN) therapy and has just returned to the room following physical therapy. the nurse notes that the infusion pump of the clients TPPN is turned off. after restarting the infusion pump, the nurse should monitor the client for which of the following findings a. hypertension excessive thirst c. fever d. diaphoresis
d. diaphoresis - the nurse should recognize that the client has the potential for the development of hypoglycemia due to sudden withdrawal of TPN solution. in addition to diaphoresis, other potential manifestations of hypoglycemia can include weakness, anxiety, confusion and hunger
