Gastrointestinal System

A client presents at the ambulatory clinic reporting recurrent sharp stomach pain that is relieved by eating. The nurse suspects that the client may have an ulcer. How should the nurse explain the formation and role of acid in the stomach to the client? "Hydrochloric acid is secreted by glands in the stomach in response to the actual or anticipated presence of food." "The acidic environment in the stomach exists to buffer the highly alkaline environment in the esophagus." "The body requires an acidic environment in order to synthesize pancreatic digestive enzymes; the stomach provides this environment." "As digestion occurs in the stomach, the stomach combines free hydrogen ions from the food to form acid."

"Hydrochloric acid is secreted by glands in the stomach in response to the actual or anticipated presence of food."

The nurse is caring for a client following gastrointestinal diagnostic testing. The client verbalizes being ashamed because he is having frequent gas. Which nursing suggestion is best? "Having gas following the procedure is normal. Expel the gas to decrease discomfort." "Nurses anticipate that client will have gas following the procedure and provide privacy." "The nursing staff is used to having clients with gas due to the procedure completed." "Do not be ashamed. Everyone has gas following the procedure."

"Having gas following the procedure is normal. Expel the gas to decrease discomfort."

A nurse is providing preprocedure education for a client who will undergo a lower GI tract study the following week. What should the nurse teach the client about bowel preparation? "Starting today, take over-the-counter (OTC) stool softeners twice daily." "You'll need to fast for at least 18 hours prior to your test." "You'll need to have enemas the day before the test." "For 24 hours before the test, insert a glycerin suppository every 4 hours."

"You'll need to have enemas the day before the test."

A patient is scheduled for a Billroth I procedure for ulcer management. What does the nurse understand will occur when this procedure is performed? The vagus nerve is cut and gastric drainage is established. The antral portion of the stomach is removed and a vagotomy is performed. A sectioned portion of the stomach is joined to the jejunum. A partial gastrectomy is performed with anastomosis of the stomach segment to the duodenum.

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

A community health nurse serves a diverse population. What individual would likely face the highest risk for parotitis? An older adult whose medication regimen includes an anticholinergic A client with poorly controlled diabetes who receives weekly wound care A client who has a chronic venous ulcer A client who is receiving intravenous antibiotic therapy in the home setting

An older adult whose medication regimen includes an anticholinergic

The nurse is caring for a young woman who is struggling with weight loss issues, without apparent physical cause. Which is the most likely nursing assessment for this nutritional disorder in which normal body weight is not maintained? Bulimia Crohn's disease Kwashiorkor Anorexia nervosa

Anorexia nervosa

A nurse is caring for a client who is acutely ill and has included vigilant oral care in the client's plan of care. What factor increases this client's risk for dental caries? Inadequate nutrition and decreased saliva production can cause cavities Systemic infections frequently migrate to the teeth Hormonal changes brought on by the stress response cause an acidic oral environment Hydration that is received intravenously lacks fluoride

Inadequate nutrition and decreased saliva production can cause cavities

A nurse is reviewing the history and physical of a client admitted for a hemorrhoidectomy. Which predisposing condition does the nurse expect to see? Hyperkalemia Lactic acidosis Constipation Hypoglycemia

Constipation

The nurse is caring for a client who received a Brooke ileostomy five days ago. The nurse, when assessing the ileostomy site, notes that the stoma appears to be extending out from the client's skin by approximately 1 inch. What is the nurse's best action at this time? Prepare the client for immediate surgery for a stoma revision. Attempt to gently push the stoma back until it is flush with the skin. Contact the health care practitioner immediately and report the finding. Document the finding. No treatment is necessary for a moderate prolapse.

Contact the health care practitioner immediately and report the finding.

A client admitted with acute diverticulitis has experienced a sudden increase in temperature and reports a sudden onset of exquisite abdominal tenderness. The nurse's rapid assessment reveals that the client's abdomen is uncharacteristically rigid on palpation. What is the nurse's best response? Position the client supine and insert an NG tube. Contact the primary provider promptly and report these signs of perforation. Administer a Fleet enema as prescribed and remain with the client. Page the primary provider and report that the client may be obstructed.

Contact the primary provider promptly and report these signs of perforation.

Which ulcer is associated with extensive burn injury? Curling ulcer Peptic ulcer Duodenal ulcer Cushing ulcer

Curling ulcer

A nurse is preparing to place a client's prescribed nasogastric tube. What anticipatory guidance should the nurse provide to the client? A narrow-gauge tube will be inserted before being replaced with a larger-gauge tube. Insertion is likely to cause some gagging. Insertion will cause some short-term pain. Topical anesthetics will be used to reduce discomfort during insertion.

Insertion is likely to cause some gagging.

A client will be having a total colectomy in 4 days. The client does not have an obstruction. What does the nurse anticipate instructing the client about doing prior to the surgery to prepare the bowel? Instructing the client about dietary restrictions and lavage agents Making sure the client drinks 2 L of fluid prior to the procedure Instructing the client to have no food except clear liquids for 4 days There will be no special preparation, and the client may eat until midnight the night prior to surgery.

Instructing the client about dietary restrictions and lavage agents

A client is to have a total colectomy and has been on prednisone 3 months ago for the treatment of Crohn's disease. What medication does the nurse anticipate administering in the preoperative phase to prevent adrenal crisis? Intravenous hydrocortisone Intravenous antibiotics A low-molecular-weight heparin Blood transfusion

Intravenous hydrocortisone

The nurse is conducting a community education program on colorectal cancer. Which statement should the nurse include in the program? The incidence of colorectal cancer decreases with age. It is the third most common cancer in the United States. The lifetime risk of developing colorectal cancer is 1 in 10. Colorectal cancer has no hereditary component.

It is the third most common cancer in the United States.

Which is a true statement regarding the nursing considerations in administration of metronidazole? It may cause weight gain. The drug should be given before meals. Metronidazole decreases the effect of warfarin. It leaves a metallic taste in the mouth.

It leaves a metallic taste in the mouth.

A client with a cholelithiasis has been scheduled for a laparoscopic cholecystectomy. Why is laparoscopic cholecystectomy preferred by surgeons over an open procedure? A laparoscopic approach can be performed under conscious sedation. A laparoscopic approach allows for the removal of the entire gallbladder. 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.

Laparoscopic cholecystectomy poses fewer surgical risks than an open procedure.

A client has been diagnosed with a small bowel obstruction and has been admitted to the medical unit. The nurse's care should prioritize which of the following outcomes? Preventing infection Maintaining fluid and electrolyte balance Maintaining skin and tissue integrity Preventing nausea and vomiting

Maintaining fluid and electrolyte balance

A male client will be having an ileoanal anastomosis for the treatment of chronic ulcerative colitis. What is the benefit to this client of having this procedure rather than a total colectomy? Select all that apply. Unlikely to experience infertility Able to have the procedure as an outpatient Unlikely to experience bladder dysfunction Unlikely to experience erectile dysfunction Maintains bowel continence

Maintains bowel continence Unlikely to experience bladder dysfunction Unlikely to experience erectile dysfunction Unlikely to experience infertility

The nurse working in the recovery room is caring for a client who had a radical neck dissection. The nurse notices that the client makes a coarse, high-pitched sound upon inspiration. Which intervention by the nurse is appropriate? Document the presence of stridor Lower the head of the bed Notify the physician Administer a breathing treatment

Notify the physician

The nurse is conducting a gastrointestinal assessment. When the client reports the presence of mucus and pus in the stool, the nurse assesses for additional signs/symptoms of which disease/condition? Disorders of the colon Intestinal malabsorption Small-bowel disease Ulcerative colitis

Ulcerative colitis

A nurse is reviewing lab results for a client with an intestinal obstruction, and infection is suspected. What would be an expected finding? leukopenia; metabolic acidosis; elevated sodium, potassium, and chloride leukopenia, decreased hematocrit; low sodium, potassium, and chloride leukocytosis; metabolic alkalosis; elevated sodium, potassium, and chloride leukocytosis; elevated hematocrit; low sodium, potassium, and chloride

leukocytosis; elevated hematocrit; low sodium, potassium, and chloride

Which client requires immediate nursing intervention? The client who: complains of epigastric pain after eating. complains of anorexia and periumbilical pain. presents with a rigid, board-like abdomen. presents with ribbonlike stools.

presents with a rigid, board-like abdomen.

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

the increased potential for aspiration.

In which part of the colon would the nurse expect to see a double-barrel colostomy? transverse descending ascending sigmoid

transverse

The client describes a test previously completed to detect a small bowel obstruction prior to admission to the hospital. The client states that the test involved insertion of a tube through the nose and lasted over 6 hours. The nurse determines which test name should be documented? abdominal ultrasound upper GI enteroclysis magnetic resonance imaging positron emission tomography

upper GI enteroclysis

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? Administer 15 to 30 mL of water before and after medications and feedings. Change the tube feeding container ,tubing, and adjust patient head of bed . Use semi-Fowler position during, and 60 minutes after, an intermittent feeding. Avoid cessation of feedings and adjust patient head of bed.

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

The nurse is assessing a client for constipation. Which review should the nurse conduct first to identify the cause of constipation? Usual pattern of elimination Alcohol consumption Current medications Activity levels

Usual pattern of elimination

The nurse is caring for a client who was admitted to have a low-profile gastrostomy device (LPGD) placed. How soon after the original gastrostomy tube placement can an LPGD be placed? 1 1/2 to 3 months 4 to 6 months 4 to 6 weeks 2 weeks

1 1/2 to 3 months

A nurse who provides care in a community clinic assesses a wide range of individuals. The nurse should identify which of the following clients as having the highest risk for chronic pancreatitis? A 51-year-old woman who smokes one-and-a-half packs of cigarettes per day A 45-year-old obese woman with a high-fat diet A 39-year-old man with chronic alcoholism An 18-year-old man who is a weekend binge drinker

A 39-year-old man with chronic alcoholism

A nurse is preparing a presentation for a local community group of older adults about colon cancer. What would the nurse include as the primary characteristic associated with this disorder? Abdominal pain Frank blood in the stool Abdominal distention A change in bowel habits

A change in bowel habits

A client is suspected of having cirrhosis of the liver. What diagnostic procedure will the nurse prepare the client for in order to obtain a confirmed diagnosis? A prothrombin time A CT scan A liver biopsy Platelet count

A liver biopsy

A patient tells the nurse that it feels like food is "sticking" in the lower portion of the esophagus. What motility disorder does the nurse suspect these symptoms indicate? Achalasia Gastroesophageal reflex disease Hiatal hernia Diffuse spasm

Achalasia

After teaching a group of students about intestinal obstruction, the instructor determines that the teaching was effective when the students identify which of the following as a cause of a functional obstruction? Volvulus Intussusception Abdominal surgery Tumor

Abdominal surgery

Which of the following is the primary function of the small intestine? Digestion Absorption Secretion Peristalsis

Absorption

The nurse is providing care for a client who has recently been diagnosed with chronic gastritis. What health practice should the nurse address when teaching the client to limit exacerbations of the disease? Maintaining a healthy body weight Taking multivitamins as prescribed and eating organic foods whenever possible Performing 15 minutes of physical activity at least three times per week Avoid taking aspirin to treat pain or fever

Avoid taking aspirin to treat pain or fever

A 55-year-old female client with hepatocellular carcinoma (HCC) is undergoing radiofrequency ablation. The nurse should recognize what goal of this treatment? Destruction of a liver abscess Restoration of portal vein patency Reversal of metastasis Destruction of the client's liver tumor

Destruction of the client's liver tumor

A patient has been diagnosed with peptic ulcer disease and the nurse is reviewing his prescribed medication regimen with him. What is currently the most commonly used drug regimen for peptic ulcers? Bismuth salts, antivirals, and histamine-2 (H2) antagonists Antibiotics, proton pump inhibitors, and bismuth salts Bicarbonate salts, antibiotics, and ZES H2 antagonists, antibiotics, and bicarbonate salts

Antibiotics, proton pump inhibitors, and bismuth salts

While caring for a patient who has had radical neck surgery, the nurse notices an abnormal amount of serosanguineous secretions in the wound suction unit during the first postoperative day. What does the nurse know is an expected amount of drainage in the wound unit? Approximately 80 to 120 mL Between 120 and 160 mL Greater than 160 mL Between 40 and 80 mL

Approximately 80 to 120 mL

A client with Crohn's disease is recovering from a recent total colectomy and ileostomy. The nurse is providing postoperative teaching with the primary focus on how to avoid complications. What would be included in the postoperative teaching? Chew food into easily digested pieces. Limit fluid intake. Only eat pureed food. Diet should regularly include nuts, corn, cabbage, coconut, dried fruit, unpeeled apples, and grapes.

Chew food into easily digested pieces.

A client with cirrhosis is complaining of severe pruritus related to the accumulation of bile salts. What can be prescribed for the client to relieve the itching? Cholestyramine Kanamycin Cyclosporine Lactulose

Cholestyramine

Which clinical manifestation is not associated with hemorrhage? Tachycardia Tachypnea Bradycardia Hypotension

Bradycardia

A client informs the nurse that he has been having abdominal pain that is relieved when having a bowel movement. The client states that the physician told him he has irritable bowel syndrome. What does the nurse recognize as characteristic of this disorder? Weight loss due to malabsorption Client is awakened from sleep due to abdominal pain. Chronic constipation with sporadic bouts of diarrhea Blood and mucus in the stool

Chronic constipation with sporadic bouts of diarrhea

The nurse is preparing a client for a test that involves inserting a thick barium paste into the rectum with radiographs taken as the client expels the barium. What test will the nurse prepare the client for? Defecography Colonic transit studies Abdominal radiography Kidneys, ureters, bladder (KUB)

Defecography

Which of the following appears to be a significant factor in the development of gastric cancer? Ethnicity Gender Diet Age

Diet

A client is scheduled to have a total colectomy due to a colon mass and is also taking prednisone for asthma. The physician has instructed the client to taper down on the prednisone and discontinue. What negative outcome does the nurse know may occur if the client does not adhere to the instructions? Increase in blood loss Delayed or altered tissue healing Hypertension Liquid stools after surgery

Delayed or altered tissue healing

A patient with severe chronic liver dysfunction comes to the clinic with bleeding of the gums and blood in the stool. What vitamin deficiency does the nurse suspect the patient may be experiencing? Vitamin K deficiency Riboflavin deficiency Folic acid deficiency Vitamin A deficiency

Vitamin K deficiency

The nurse is instructing the client on frequent sensations experienced when a contrast agent is injected into the body during diagnostic studies. Which sensation is most common? Heart palpitations Light-headedness Chills A warm sensation

A warm sensation

The nurse determines that a client who has undergone skin, tissue, and muscle grafting following a modified radical neck dissection requires suctioning. What is the nurse's priority when suctioning this client? Assess the client's ability to perform self-suctioning. Evaluate the client's ability to swallow saliva and clear fluids. Position client on the non-operative side with the head of the bed down. Avoid applying suction on or near the suture line.

Avoid applying suction on or near the suture line.

Clients with inflammatory bowel disease (IBD) are at significantly increased risk for which condition? Osteoporosis Pneumonia Hypotension DVT

Osteoporosis

A client with cirrhosis has portal hypertension, which is causing esophageal varices. What is the goal of the interventions that the nurse will provide? Cure the cirrhosis. Treat the esophageal varices. Reduce fluid accumulation and venous pressure. Promote optimal neurologic function.

Reduce fluid accumulation and venous pressure.

A client's colorectal cancer has necessitated a hemicolectomy with the creation of a colostomy. In the 4 days since the surgery, the client has been unwilling to look at the ostomy or participate in any aspects of ostomy care. What is the nurse's most appropriate response to this observation? Ensure that the client knows that he or she will be responsible for care after discharge. Acknowledge the client's reluctance and initiate discussion of the factors underlying it. Reassure the client that many people are fearful after the creation of an ostomy. Arrange for the client to be seen by a social worker or spiritual advisor.

Acknowledge the client's reluctance and initiate discussion of the factors underlying it.

A nurse is assessing a client who has peptic ulcer disease. The client requests more information about the typical causes of Helicobacter pylori infection. What would it be appropriate for the nurse to instruct the client? The H. pylori microorganism is endemic in warm, moist climates. Many people possess genetic factors causing a predisposition to H. pylori infection. Infection typically occurs due to ingestion of contaminated food and water. Most affected clients acquired the infection during international travel.

Infection typically occurs due to ingestion of contaminated food and water.

The nurse is assessing the abdomen of the client with an undiagnosed disorder. In which sequence would the nurse conduct the abdominal assessment? Use all options. Click an option, hold and drag it to the desired position, or click an option to highlight it and move it up or down in the order using the arrows to the left. 1 Auscultation 2 Percussion 3 Palpation 4 Inspection

Inspection Auscultation Percussion Palpation

A client is recovering in the hospital following gastrectomy. The nurse notes that the client has become increasingly difficult to engage and has had several angry outbursts at staff members in recent days. The nurse's attempts at therapeutic dialogue have been rebuffed. What is the nurse's most appropriate action? Make appropriate referrals to services that provide psychosocial support. Limit contact with the client in order to provide privacy. Ask the client's primary provider to liaise between the nurse and the client. Delegate care of the client to a colleague.

Make appropriate referrals to services that provide psychosocial support.

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? Colostomy Pernicious anemia Peptic ulcers Systemic infection

Peptic ulcers

A client undergoing a diagnostic examination for gastrointestinal disorder was given polyethylene glycol/electrolyte solution as a part of the test preparation. Which of the following measures should the nurse take once the solution is administered? Instruct the client to have low-residue meals. Provide saline gargles to the client. Allow the client to ingest fat-free meal. Permit the client to drink only clear liquids.

Permit the client to drink only clear liquids.

A client is having the first stage of an ileoanal anastomosis. What should the nurse inform the client they will experience? Solid stool from the anus Control of the fecal material from the anus Continuous discharge of mucus from the anus Very little discharge from the anus

Continuous discharge of mucus from the anus

A nurse is assessing a client's stoma on postoperative day 3. The nurse notes that the stoma has a shiny appearance and a bright red color. How should the nurse best respond to this assessment finding? Irrigate the ostomy to clear a possible obstruction. Document a nursing diagnosis of Impaired Skin Integrity. Contact the primary provider to report this finding. Document that the stoma appears healthy and well perfused.

Document that the stoma appears healthy and well perfused.

A nurse is providing discharge instructions for a patient with a new colostomy. Which of the following is a recommended guideline for long-term ostomy care? Use enteric-coated or sustained-release medications if needed. Increase fluid intake, preferably of water, daily. During the first 6 to 8 weeks after surgery, eat foods high in fiber. Use a mild laxative if needed.

Increase fluid intake, preferably of water, daily.

When performing a physical examination on a client with cirrhosis, a nurse notices that the client's abdomen is enlarged. Which of the following interventions should the nurse consider? Measure abdominal girth according to a set routine. Ask the client about food intake. Report the condition to the physician immediately. Provide the client with nonprescription laxatives.

Measure abdominal girth according to a set routine.

A client with acute pancreatitis has been started on total parenteral nutrition (TPN). Which action should the nurse perform after administration of the TPN? Measure abdominal girth every shift Measure blood glucose concentration every 4 to 6 hours Monitor for reports of nausea and vomiting Auscultate the abdomen for bowel sounds every 4 hours

Measure blood glucose concentration every 4 to 6 hours

An adult client has been admitted to the medical unit for the treatment of acute pancreatitis. What nursing action should be included in this client's plan of care? Measure the client's abdominal girth daily. Limit the use of opioid analgesics. Monitor the client for signs of dysphagia. Encourage activity as tolerated.

Measure the client's abdominal girth daily.

A client is preparing to have colorectal surgery and will have a colostomy created temporarily in hopes that he may be able to have it reversed in 6 months. The client is very concerned about the care of the colostomy. What preoperative interaction would the client benefit from? Discussing other options with the surgeon Meeting with an enterostomal therapist Watching a video about colostomies Going to a support group with other clients that have colostomies

Meeting with an enterostomal therapist

The nurse is working with clients with digestive tract disorders. Which of the following organs does the nurse realize has effects as an exocrine gland and an endocrine gland? Stomach Gallbladder Pancreas Liver

Pancreas

A client with a diagnosis of acute appendicitis is awaiting surgical intervention. The nurse listens to bowel sounds and hears none and observes that the abdomen is rigid and board-like. What complication does the nurse determine may be occurring at this time? Paralytic ileus Peritonitis Accumulation of gas Constipation

Peritonitis

Post appendectomy, a nurse should assess the patient for abdominal rigidity and tenderness, fever, loss of bowel sounds, and tachycardia, all clinical signs of: A pelvic abscess. Peritonitis An ileus. An abscess under the diaphragm.

Peritonitis

A nurse caring for a client with a newly created ileostomy assesses the client and notes that the client has not had ostomy output for the past 12 hours. The client also reports worsening nausea. What is the nurse's priority action? Report signs and symptoms of obstruction to the health care provider. Contact the physician and obtain a swab of the stoma for culture. Encourage the client to mobilize in order to enhance motility. Facilitate a referral to the wound-ostomy-continence (WOC) nurse.

Report signs and symptoms of obstruction to the health care provider.

A client comes to the clinic reporting pain in the epigastric region. What statement by the client suggests the presence of a duodenal ulcer? "I seem to have bowel movements more often than I usually do." "I know that my father and my grandfather both had ulcers." "The pain really interferes with my quality of life." "My pain resolves when I have something to eat."

"My pain resolves when I have something to eat."

The nurse is caring for a comatose patient and administering gastrostomy feedings. What does the nurse understand is the reason that gastrostomy feedings are preferred to nasogastric (NG) feedings in the comatose patient? Digestive process occurs more rapidly because the feedings do not have to pass through the esophagus. The patient cannot experience the deprivational stress of not swallowing. Gastroesophageal sphincter is intact, lessening the possibility of regurgitation. Feedings can be administered with the patient in the recumbent position.

Gastroesophageal sphincter is intact, lessening the possibility of regurgitation.

The nurse is assisting the health care provider with a colonoscopy for a client with rectal bleeding. The health care provider requests the nurse to administer glucagon during the procedure. Why is the nurse administering this medication during the procedure? To reduce air accumulation in the colon. The client is probably hypoglycemic and requires the glucagon. To relieve anxiety during the procedure for moderate sedation. To relax colonic musculature and reduce spasm.

To relax colonic musculature and reduce spasm.

What composes fecal matter? water mucus All options are correct microbes

All options are correct

A client comes to the ED with severe abdominal pain, nausea, and vomiting. The physician plans to rule out acute pancreatitis. The nurse would expect the diagnosis to be confirmed by an elevated result on which laboratory test? Serum bilirubin Serum potassium Serum amylase Serum calcium

Serum amylase

An older adult patient who has been living at home alone is diagnosed with parotitis. What causative bacteria does the nurse suspect is the cause of the parotitis? Staphylococcus aureus Methicillin-resistant Streptococcus aureus (MRSA) Streptococcus viridans Pneumococcus

Staphylococcus aureus

To prevent gastroesophageal reflux in a client with hiatal hernia, the nurse should provide which discharge instruction? "Take antacids with meals." "Lie down after meals to promote digestion." "Limit fluid intake with meals." "Avoid coffee and alcoholic beverages."

"Avoid coffee and alcoholic beverages."

The nurse is inserting a nasogastric tube for a patient with pancreatitis. What intervention can the nurse provide to allow facilitation of the tube insertion? Allow the patient to sip water as the tube is being inserted. Spray the oropharynx with an anesthetic spray. Have the patient maintain a backward tilt head position. Have the patient eat a cracker as the tube is being inserted.

Allow the patient to sip water as the tube is being inserted.

Which of the following digestive enzymes aids in the digesting of starch? Trypsin Lipase Amylase Bile

Amylase

An older adult who resides in an assisted living facility has sought care from the nurse because of recurrent episodes of constipation. Which of the following actions should the nurse first perform? Encourage the client to take fiber supplements. Assess the client's food and fluid intake. Encourage the client to take stool softener daily. Assess the client's surgical history.

Assess the client's food and fluid intake.

The nurse is preparing to measure the client's abdominal girth as part of the physical examination. At which location would the nurse most likely measure? In the right upper quadrant Just below the last rib At the lower border of the liver At the umbilicus

At the umbilicus

The nurse is administering total parenteral nutrition (TPN) to a client who underwent surgery for gastric cancer. Which of the nurse's assessments most directly addresses a major complication of TPN? Checking the client's capillary blood glucose levels regularly Monitoring the client's level of consciousness each shift Having the client frequently rate his or her hunger on a 10-point scale Measuring the client's heart rhythm at least every 6 hours

Checking the client's capillary blood glucose levels regularly

A client with calculi in the gallbladder is said to have Cholelithiasis Choledocholithiasis Cholecystitis Choledochotomy

Cholelithiasis

The nurse is irrigating a colostomy when the patient says, "You will have to stop, I am cramping so badly." What is the priority action by the nurse? Clamp the tubing and give the patient a rest period. Replace the fluid with cooler water since it is probably too warm. Stop the irrigation and remove the tube. Inform the patient that it will only last a minute and continue with the procedure.

Clamp the tubing and give the patient a rest period.

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

Dysphagia

A nurse has admitted a client suspected of having acute pancreatitis. The nurse knows that mild acute pancreatitis is characterized by: Disseminated intravascular coagulopathy Pleural effusion Edema and inflammation Sepsis

Edema and inflammation

A nurse is preparing a client with Crohn's disease for a barium enema. What should the nurse do the day before the test? Serve dairy products. Order a high-fiber diet. Encourage plenty of fluids. Serve the client his usual diet.

Encourage plenty of fluids.

What test should the nurse prepare the client for that will locate stones that have collected in the common bile duct? Endoscopic retrograde cholangiopancreatography (ERCP) Cholecystectomy Colonoscopy Abdominal x-ray

Endoscopic retrograde cholangiopancreatography (ERCP)

The nurse is caring for a client with severe ulcerative colitis who will be having the diseased portion of the colon removed and an ileostomy placed. The nurse knows that the client will be seen by the surgeon and which professional prior to surgery to decide the best position for the stoma? Nutritionist Circulating room nurse Home care nurse Enterostomal therapy nurse

Enterostomal therapy nurse

Which of the following statements about ostomy irrigation is true? Patients who want to self-irrigate their colostomy must sign a contract and agree to use the equipment only for its intended use. Daily irrigation is necessary to assure passage of stool from an ileostomy. Postoperative ostomy prolapse can be avoided by twice daily irrigation for the first 4 weeks after surgery. For some patients, regularly scheduled colostomy irrigation can be used to establish a predictable pattern of elimination.

For some patients, regularly scheduled colostomy irrigation can be used to establish a predictable pattern of elimination.

The nurse is caring for a client who is undergoing diagnostic testing for suspected malabsorption. When taking this client's health history and performing the physical assessment, the nurse should recognize what finding as most consistent with this diagnosis? Bloody bowel movements accompanied by fecal incontinence Recurrent constipation coupled with weight loss Foul-smelling diarrhea that contains fat Fever accompanied by a rigid, tender abdomen

Foul-smelling diarrhea that contains fat

A nurse is preparing a client for surgery. During preoperative teaching, the client asks where is bile stored. The nurse knows that bile is stored in the: Duodenum Common bile duct Gallbladder Cystic duct

Gallbladder

The nurse is assessing a client who is stating gastrointestinal upset and a feeling of bloating. Which type of meal would the nurse anticipate causing these types of symptoms? Steamed rice with pork and broccoli Hamburger and French fries Grilled chicken on a spinach salad Salmon with cheddar mashed potatoes

Hamburger and French fries

The nurse identifies which type of jaundice in an adult experiencing a transfusion reaction? Nonobstructive Obstructive Hepatocellular Hemolytic

Hemolytic

Which type of jaundice seen in adults is the result of increased destruction of red blood cells? Hepatocellular Nonobstructive Hemolytic Obstructive

Hemolytic

A client asks the nursing assistant for a bedpan. When the client is finished, the nursing assistant notifies the nurse that the client has bright red streaking of blood in the stool. The nurse's assessment should focus on what potential cause? Diet high in red meat Upper GI bleed Use of iron supplements Hemorrhoids

Hemorrhoids

A clinic client has described recent dark-colored stools and the nurse recognizes the need for fecal occult blood testing (FOBT). What aspect of the client's current health status would contraindicate FOBT? Hemorrhoids Recurrent nausea and vomiting Peptic ulcers Gastroesophageal reflux disease (GERD)

Hemorrhoids

A client has been diagnosed with pancreatic cancer and has been admitted for care. Following initial treatment, the nurse should be aware that the client is most likely to require which of the following? Hospice care Intensive physical therapy Rehabilitation in the home setting Inpatient rehabilitation

Hospice care

The nurse auscultates the abdomen to assess bowel sounds. She documents five to six sounds heard in less than 30 seconds. How does the nurse document the bowel sounds? Borborygmi Hyperactive Hypoactive Normal

Hyperactive

A nurse is participating in the emergency care of a client who has just developed variceal bleeding. What intervention should the nurse anticipate? Infusion of intravenous heparin STAT administration of vitamin K by the intramuscular route IV administration of albumin IV administration of octreotide (Sandostatin)

IV administration of octreotide (Sandostatin)

A client with ongoing back pain, nausea, and abdominal bloating has been diagnosed with cholecystitis secondary to gallstones. The nurse should anticipate that the client will undergo what intervention? Laparoscopic cholecystectomy Intracorporeal lithotripsy Methyl tertiary butyl ether (MTBE) infusion Extracorporeal shock wave therapy (ESWL)

IV hydromorphone

A 68-year-old resident at a long-term care facility lost the ability to swallow following a stroke 4 years ago. She receives nutrition via a PEG tube. The client remains physically and socially active and has adapted well to the tube feedings. Occasionally, the client develops constipation that requires administration of a laxative to restore regular bowel function. Which of the following is the most likely cause of this client's constipation? Lack of exercise Lack of free water intake Increased fiber Lack of solid food

Lack of free water intake

Which of the following aids in digestion of fats? Amylase Trypsin Secretin Lipase

Lipase

A homeless client at the neighborhood clinic has a lengthy history of alcohol addiction and is being seen for jaundice. Which of the following would the appearance of jaundice most likely indicate? Liver cancer Liver disorder Bile overproduction Glucose underproduction

Liver disorder

The nurse is caring for a geriatric client and notices polypharmacy. Which diagnostic studies are anticipated? Complete blood count Urinalysis Liver function studies Blood chemistry

Liver function studies

A client who underwent a gastric resection 3 weeks ago is having her diet progressed on a daily basis. Following her latest meal, the client reports dizziness and palpitations. Inspection reveals that the client is diaphoretic. What is the nurse's best action? Assess the client for signs and symptoms of aspiration. Reposition the client supine. Monitor the client closely for further signs of dumping syndrome. Insert a nasogastric tube promptly.

Monitor the client closely for further signs of dumping syndrome.

A nurse is caring for an older adult who has been experiencing severe Clostridium difficile-related diarrhea. When reviewing the client's most recent laboratory tests, the nurse should prioritize what finding? Hemoglobin level Potassium level White blood cell level Creatinine level

Potassium level

When the nurse is teaching the client about attachment of the faceplate around the stoma, what measure will ensure secure attachment of the pouch to the peristomal skin? Wipe the faceplate with alcohol to remove debris. Apply a large quantity of adhesive around the stoma prior to attaching the faceplate. Press the adhesive faceplate around the stoma for about 30 seconds. Press the adhesive faceplate from the outward edge of the stoma inward.

Press the adhesive faceplate around the stoma for about 30 seconds.

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 diarrhea Prevent aspiration Prevent gastric ulcers Prevent abdominal distention

Prevent aspiration

A nurse is preparing to administer the prescribed vitamin B12 to a client who has had most of his ileum removed. The nurse understands that this is necessary for which reason? Prevents constipation Aids proper digestion Prevents deficiencies Prevents thrombosis

Prevents deficiencies

Effie Geitgey, a 93-year-old retired waitress, obsesses about the regularity of her bowel movements (a common obsession among the residents of the long-term care facility where you practice nursing). In your frequent (seems like daily) client education sessions, you reinforce the medically acceptable definition of "regularity". What is the actual measurement of "regular"? One bowel movement daily Stool consistency and client comfort are the proper measurements Two bowel movements daily One bowel movement every other day

Stool consistency and client comfort are the proper measurements

A client has returned to the medical unit after a barium enema. When assessing the client's subsequent bowel patterns and stools, what finding would warrant reporting to the health care provider? Streaks of blood present in the stool Three stools during an 8-hour period of time Large, wide stools Milky white stools

Streaks of blood present in the stool

Why should total parental nutrition (TPN) be used cautiously in clients with pancreatitis? Such clients are at risk for gallbladder contraction. Such clients can digest high-fat foods. Such clients cannot tolerate high-glucose concentration. Such clients are at risk for hepatic encephalopathy.

Such clients cannot tolerate high-glucose concentration.

The nurse is collecting a stool specimen from a patient. What characteristic of the stool indicates to the nurse that the patient may have an upper GI bleed? Greasy and foamy Tarry and black Clay-colored Threaded with mucus

Tarry and black

Which is a true statement regarding regional enteritis (Crohn's disease)? It has a progressive disease pattern. The clusters of ulcers take on a cobblestone appearance. It is characterized by pain in the lower left abdominal quadrant. The lesions are in continuous contact with one another.

The clusters of ulcers take on a cobblestone appearance.

Diagnostic testing of a client with a history of dyspepsia and abdominal pain has resulted in a diagnosis of gastric cancer. The nurse's anticipatory guidance should include what information? The benefits of weight loss and exercise as tolerated during recovery The possibility of surgery, chemotherapy and radiotherapy The possibility of needing a short-term or long-term colostomy The good prognosis for clients who are treated for gastric cancer

The possibility of surgery, chemotherapy and radiotherapy

The nurse is inserting a sump tube in a patient with Crohn's disease who is suspected of having a bowel obstruction. What does the nurse understand is the benefit of the gastric (Salem) sump tube in comparison to some of the other tubes? The tube is shorter. The tube is radiopaque. The tube is less expensive. The tube can be connected to suction and others cannot.

The tube is radiopaque.

A client is postoperative day 1 following gastrostomy. The nurse is planning interventions to address the nursing diagnosis of Risk for Infection Related to Presence of Wound and Tube. What intervention is most appropriate? Administer antibiotics via the tube as prescribed. Irrigate the skin surrounding the insertion site with normal saline before each use. Wash the area around the tube with soap and water daily. Cleanse the skin within 2 cm of the insertion site with hydrogen peroxide once per shift.

Wash the area around the tube with soap and water daily.

The nurse working in the ED is evaluating a client for signs and symptoms of appendicitis. Which of the client's signs/symptoms should the nurse report to the physician? Pain when pressure is applied to the right lower quadrant Nausea High fever Left lower quadrant pain

nausea

A client tells the nurse that the stool was colored yellow. The nurse assesses the client for recent foods ingested. occult blood. pilonidal cyst. ingestion of bismuth.

recent foods ingested.

If the client is otherwise healthy, which stoma placement would result in a firm stool? jejunostomy colectomy ileostomy sigmoid colostomy

sigmoid colostomy

The nurse recognizes which change of the GI system is an age-related change? increased mucus secretion weakened gag reflex increased motility hypertrophy of the small intestine

weakened gag reflex

A client asks the nurse why the physician ordered the blood test carcinoembryonic antigen (CEA). The nurse answers: "It detects a protein normally found in the blood." "It determines functionality of the liver." "It indicates if a cancer is present." "It tells the physician what type of cancer is present."

"It indicates if a cancer is present."

A client with cirrhosis is complaining to the nurse of itching. The client asks the nurse if the itching is because he has been taking warm baths. What is the best response by the nurse? "The itching is related to dry skin from the warm baths." "The itching is caused by the accumulation of bile salts." "The itching is most likely a side effect from some of the medications used in treatment." "The itching is related to a psychological response from the illness."

"The itching is caused by the accumulation of bile salts."

A middle-aged obese female presents to the ED with severe radiating right-sided flank pain, nausea, vomiting, and fever. A likely cause of these symptoms is: acute cholecystitis hepatitis B hepatitis A pancreatitis

acute cholecystitis

What potentially life-threatening complication can the client have if corticosteroids are abruptly withdrawn or the client has significant stress due to the impending surgical procedure? Myxedema coma Thyroid storm Cushing's disease Adrenal crisis

Adrenal crisis

The nurse is performing an abdominal assessment for a patient with diarrhea and auscultates a loud rumbling sound in the left lower quadrant. What will the nurse document this sound as on the nurse's notes? Tenesmus Borborygmus Peristalsis Loud bowel sounds

Borborygmus

The nurse is talking with a group of clients who are older than age 50 years about the recognition of colon cancer to access early intervention. What should the nurse inform the clients to report immediately to their primary care provider? Excess gas Daily bowel movements Change in bowel habits Abdominal cramping when having a bowel movement

Change in bowel habits

A female client has presented to the emergency department with right upper quadrant pain; the health care provider has ordered abdominal ultrasound to rule out cholecystitis. The client expresses concern to the nurse about the safety of this diagnostic procedure. How should the nurse best respond? "Abdominal ultrasound is very safe, but it can't be performed if you're pregnant." "Current guidelines state that a person can have up to 6 ultrasounds per year." "Abdominal ultrasound poses no known safety risks of any kind." "Current guidelines state that a person can have up to 3 ultrasounds per year."

"Abdominal ultrasound poses no known safety risks of any kind."

A preoperative client scheduled to have an open cholecystectomy says to the nurse, "The doctor said that after surgery, I will have a tube in my nose that goes into my stomach. Why do I need that?" What most common reason for a client having a nasogastric tube in place after abdominal surgery should the nurse include in a response? decompression instillation lavage gavage

decompression

When gastric analysis testing reveals excess secretion of gastric acid, the nurse recognizes which medical diagnoses is supported? pernicious anemia gastric cancer duodenal ulcer chronic atrophic gastritis

duodenal ulcer

Cystic fibrosis, a genetic disorder characterized by pulmonary and pancreatic dysfunction, usually appears in young children but can also affect adults. If the pancreas was functioning correctly, where would the bile and pancreatic enzymes enter the GI system? jejunum cecum duodenum ileum

duodenum

A client underwent a continent ileostomy 2 months ago. How often should the client's reservoir be emptied? every 2 to 4 hours at least once every 2 days three or four times daily at least once a day

every 2 to 4 hours

Rebound hypoglycemia is a complication of parenteral nutrition caused by glucose intolerance. a cap missing from the port. feedings stopped too abruptly. fluid infusing rapidly.

feedings stopped too abruptly.

Diet therapy for clients diagnosed with irritable bowel syndrome (IBS) includes: high-fiber diet. fluids with meals. caffeinated products. spicy foods.

high-fiber diet.

A client seeking care because of recurrent heartburn and regurgitation is subsequently diagnosed with a hiatal hernia. Which of the following should the nurse include in health education? "Drinking beverages after your meal, rather than with your meal, may bring some relief." "It's best to avoid dry foods, such as rice and chicken, because they're harder to swallow." "Many clients obtain relief by taking over-the-counter antacids 30 minutes before eating." "Instead of eating three meals a day, try eating smaller amounts more often."

"Instead of eating three meals a day, try eating smaller amounts more often."

Which medication is classified as a histamine-2 receptor antagonist? Famotidine Lansoprazole Metronidazole Esomeprazole

Famotidine

A student nurse is caring for a client who has a diagnosis of acute pancreatitis and who is receiving parenteral nutrition. The student should prioritize which of the following assessments? Fluid output Blood glucose levels Oral intake BUN and creatinine levels

Blood glucose levels

What is a major concern for the nurse when caring for a patient with chronic pancreatitis? Pain Weight loss Mental status changes Nausea

Weight loss

A nurse is caring for a client with constipation whose primary provider has recommended senna for the management of this condition. The nurse should provide which of the following education points? "Avoid taking the drug on a long-term basis." "Make sure to take a multivitamin with each dose." "Limit your fluid intake temporarily so you don't get diarrhea." "Take this on an empty stomach to ensure maximum effect."

"Avoid taking the drug on a long-term basis."

A home care nurse is caring for a client with reports of epigastric discomfort who is scheduled for a barium swallow. Which statement by the client indicates an understanding of the test? "I'll drink full liquids the day before the test." "I'll avoid eating or drinking anything 6 to 8 hours before the test." "There is no need for special preparation before the test." "I'll take a laxative to clear my bowels before the test."

"I'll avoid eating or drinking anything 6 to 8 hours before the test."

A client is to undergo surgery for the creation of a continent ileostomy. Which statement by the client indicates successful teaching? "My stool will be loose initially but then become formed in a week or so." "I'll need to empty the appliance more frequently." "I'll just push on the valve and the drainage will flow out easily." "I'll need to learn how to empty the reservoir several times a day"

"I'll need to learn how to empty the reservoir several times a day"

A nurse is employed as a gastroenterologist's office nurse. When assessing the client, which objective data would provide useful information for diagnosis? Client seated and stating pain 22-lb weight loss in 2 months Client verbalizing symptoms of nausea Client verbalizes chills and fatigue

22-lb weight loss in 2 months

Which of the following stoma placements would result in a firm stool (under healthy circumstances)? Ileostomy Jejunostomy Colectomy Colostomy

Colostomy

The nurse is providing community education at the mall. The nurse is instructing on the muscular tube that connects the mouth to the stomach. The nurse outlines this structure on a drawing and labels it with which of the following? Esophagus Pharynx Pylorus Ileum

Esophagus

A client with a history of alcohol abuse comes to the emergency department and complains of abdominal pain. Laboratory studies help confirm a diagnosis of acute pancreatitis. The client's vital signs are stable, but the client's pain is worsening and radiating to his back. Which intervention takes priority for this client? Providing mouth care Placing the client in a semi-Fowler's position Administering morphine I.V. as ordered Maintaining nothing-by-mouth (NPO) status

Administering morphine I.V. as ordered

A client with esophageal varices is being cared for in the ICU. The varices have begun to bleed. The client has Ringer lactate at 150 cc/hr infusing. The nurse should also anticipate what intervention? Oxygen by nasal cannula Administering volume expanders Administering diuretics Positioning the client supine

Administering volume expanders

A client who is scheduled for an ileostomy surgery and been taking corticosteroids is instructed to taper the drug, eventually discontinuing it. The nurse would monitor this client for which of the following? Hypothyroidism Adrenal insufficiency Cerebral anoxia Cardiac dysrhythmias

Adrenal insufficiency

A client's NG tube has become clogged after the nurse instilled a medication that was insufficiently crushed. The nurse has attempted to aspirate with a large-bore syringe, with no success. What should the nurse do next? Remove the NG tube promptly and obtain an order for reinsertion from the primary care provider. Attach a syringe filled with warm water and attempt an in-and-out motion of instilling and aspirating. Withdraw the NG tube 2 inches (5 cm) and reattempt aspiration. Withdraw the NG tube slightly and attempt to dislodge by flicking the tube with the fingers.

Attach a syringe filled with warm water and attempt an in-and-out motion of instilling and aspirating.

A client who is recovering from bariatric surgery is returning from the postanesthesia care unit. Which nursing assessment is of greatest concern in the immediate postoperative period for this client? Impaired Gas Exchange Diarrhea Impaired Mobility Self-Care Deficit

Impaired Gas Exchange

Which is the most common cause of esophageal varices? Jaundice Asterixis Portal hypertension Ascites

Portal hypertension

A client with chronic pancreatitis is treated for uncontrolled pain. Which complication does the nurse recognize is most common in the client with chronic pancreatitis? Diarrhea Weight loss Fatigue Hypertension

Weight loss

A nurse manager prepares teaching for staff nurses who care for clients with diabetes. Which statements will the nurse manager include when discussing the differences between the endocrine and exocrine functions of the pancreas? Select all that apply. "Internal secretion of hormones is the function of the endocrine pancreas." "The exocrine pancreas secretes hormones from excretory ducts." "The exocrine pancreas secretes pancreatic enzymes into the GI tract." "The endocrine pancreas secretes hormones through a ductless gland." "Internal secretion of hormones is the function of the exocrine pancreas."

"Internal secretion of hormones is the function of the endocrine pancreas." "The endocrine pancreas secretes hormones through a ductless gland." "The exocrine pancreas secretes hormones from excretory ducts." "The exocrine pancreas secretes pancreatic enzymes into the GI tract."

When caring for a client with advanced cirrhosis and hepatic encephalopathy, which assessment finding should the nurse report immediately? Constipation for more than 2 days Anorexia for more than 3 days Weight loss of 2 pounds in 3 days Change in the client's handwriting and/or cognitive performance

Change in the client's handwriting and/or cognitive performance

The nurse is admitting a client to their room at the hospital and observes that the client's skin and sclera are jaundice. What does the nurse expect the client's total bilirubin levels to be? 2.0 mg/dL 1.0 mg/dL 3.0 mg/dL 0.2 mg/dL

3.0 mg/dL

The nurse inserts a nasogastric tube into the right nares of a patient. When testing the tube aspirate for pH to confirm placement, what does the nurse anticipate the pH will be if placement is in the lungs? 4 1 2 6

6

A client comes to the clinic after developing a headache, abdominal pain, nausea, hiccupping, and fatigue about 2 hours ago. The client tells the nurse that the last food was buffalo chicken wings and beer. Which medical condition does the nurse find to be most consistent with the client's presenting problems? Acute gastritis Gastric cancer Gastric ulcer Duodenal ulcer

Acute gastritis

When examining the skin of a client who is dehydrated due to fluid losses from the gastrointestinal tract, which of the following would be most important? Checking if the skin is discolored Checking if the mucous membranes are dry Observing for distended abdominal veins Examining the sclera if it is yellow

Checking if the mucous membranes are dry

A nurse is providing care for a client who has a diagnosis of irritable bowel syndrome (IBS). When planning this client's care, the nurse should collaborate with the client and prioritize what goal? Client will demonstrate appropriate care of his ileostomy. Client will accurately identify foods that trigger symptoms. Client will adhere to recommended guidelines for mobility and activity. Client will demonstrate appropriate use of standard infection control precautions.

Client will accurately identify foods that trigger symptoms.

A client's new onset of dysphagia has required insertion of an NG tube for feeding. What intervention should the nurse include in the client's plan of care? Keep the client in a low Fowler position when at rest. Confirm placement of the tube prior to each scheduled feeding. Have the client sip cool water to stimulate saliva production. Connect the tube to continuous wall suction when not in use.

Confirm placement of the tube prior to each scheduled feeding.

During a health education session, a participant has asked about the hepatitis E virus. What prevention measure should the nurse recommend for preventing infection with this virus? Wearing a condom during sexual contact Limiting alcohol intake Following proper hand-washing techniques Avoiding chemicals that are toxic to the liver

Following proper hand-washing techniques

A client had an open cholecystectomy with a T-tube insertion, and the nurse is measuring the bile drainage every 8 hours. When should the nurse notify the physician? If there is 100 mL in the drainage pouch after 8 hours. If there is 10 mL/hour of drainage in 24 hours. If the bile drainage is dark green. If more than 500 mL of bile drainage is present in 24 hours.

If more than 500 mL of bile drainage is present in 24 hours.

A nurse is performing health education with a client who has a history of frequent, serious dental caries. When planning educational interventions, the nurse should identify a risk for what nursing diagnosis? Aspiration Imbalanced Nutrition: Less Than Body Requirements Ineffective Tissue Perfusion Impaired Skin Integrity

Imbalanced Nutrition: Less Than Body Requirements

A client who has been experiencing changes in his bowel function is scheduled for a barium enema. What instruction should the nurse provide for postprocedure recovery? Administer a Fleet enema to cleanse the bowel of the barium. Avoid dairy products for 24 hours postprocedure. Increase fluid intake to evacuate the barium. Remain NPO for 6 hours postprocedure.

Increase fluid intake to evacuate the barium.

A client who has been experiencing changes in his bowel function is scheduled for a barium enema. What instruction should the nurse provide for postprocedure recovery? Avoid dairy products for 24 hours postprocedure. Increase fluid intake to evacuate the barium. Administer a Fleet enema to cleanse the bowel of the barium. Remain NPO for 6 hours postprocedure.

Increase fluid intake to evacuate the barium.

A medical nurse who is caring for a client being discharged home after a radical neck dissection has collaborated with the home health nurse to develop a plan of care for this client. What is a priority psychosocial outcome for this client? Demonstrates effective stress management techniques to promote muscle relaxation Compensates effectively for alteration in ability to communicate related to dysarthria Freely expresses needs and concerns related to postoperative pain management Indicates acceptance of altered appearance and demonstrates positive self-image

Indicates acceptance of altered appearance and demonstrates positive self-image

A common nursing diagnosis for a patient who had a colostomy surgically created 6 months ago would be: Dehydration due to colostomy Ineffective Coping impaired due to colostomy Fear due to loss of control of body functions Pain due to surgical incision

Ineffective Coping impaired due to colostomy

A client has been diagnosed with a malignancy of the oral cavity and is undergoing oncologic treatment. The oncologic nurse is aware that the prognosis for recovery from head and neck cancers is often poor because of what characteristic of these malignancies? Surgical complications are exceedingly common. Diagnosis rarely occurs until the cancer is end stage. Metastases are common and respond poorly to treatment. Radiation therapy often results in secondary brain tumors.

Metastases are common and respond poorly to treatment.

Which intervention would be most appropriate for a client who has undergone colostomy surgery? Monitoring the volume of gastric secretions. Minimizing the client's fluid intake. Monitoring vital signs once a day. Taking temperature by rectal route.

Monitoring the volume of gastric secretions.

Which is a true statement regarding gastric cancer? Most clients are asymptomatic during the early stage of the disease. The prognosis for gastric cancer is good. Women have a higher incidence of gastric cancer. Most cases are discovered before metastasis.

Most clients are asymptomatic during the early stage of the disease.

Which medication classification represents a proton (gastric acid) pump inhibitor? Famotidine Metronidazole Omeprazole Sucralfate

Omeprazole

A client with cirrhosis has portal hypertension, which is causing esophageal varices. What is the goal of the interventions that the nurse will provide? Cure the cirrhosis. Promote optimal neurologic function. Reduce fluid accumulation and venous pressure. Treat the esophageal varices.

Reduce fluid accumulation and venous pressure.

A nurse is caring for a client with cirrhosis secondary to heavy alcohol use. The nurse's most recent assessment reveals subtle changes in the client's cognition and behavior. What is the nurse's most appropriate response? Inform the primary provider that the client should be assessed for alcoholic hepatitis. Report this finding to the primary provider due to the possibility of hepatic encephalopathy. Implement interventions aimed at ensuring a calm and therapeutic care environment. Ensure that the client's sodium intake does not exceed recommended levels.

Report this finding to the primary provider due to the possibility of hepatic encephalopathy.

The nurse is providing care to a patient with gross ascites who is maintaining a position of comfort in the high semi-Fowler's position. What is the nurse's priority assessment of this patient? Skin assessment related to increase in bile salts Respiratory assessment related to increased thoracic pressure Peripheral vascular assessment related to immobility Urinary output related to increased sodium retention

Respiratory assessment related to increased thoracic pressure

A nurse is participating in a client's care conference and the team is deciding between parenteral nutrition (PN) and a total nutritional admixture (TNA). What advantages are associated with providing TNA rather than PN? TNA is less costly than PN. TNA does not require the use of a micron filter. TNA can be mixed by a certified registered nurse. TNA can be given over 8 hours, while PN requires 24-hour administration.

TNA is less costly than PN.

A client is admitted to the hospital for diagnostic testing to rule out colorectal cancer. Which intervention should the nurse include on the plan of care? Prepare the client for a gastrostomy tube placement. Administer morphine (Duramorph PF) routinely, as ordered. Test all stools for occult blood. Administer topical ointment to the rectal area to decrease bleeding.

Test all stools for occult blood.

A medical client's CA 19-9 levels have become available and they are significantly elevated. How should the nurse best interpret this diagnostic finding? The client has a genetic predisposition to gastric cancer. The client most likely has early-stage colorectal cancer. The client has cancer, but the site is unknown. The client may have cancer, but other GI disease must be ruled out.

The client may have cancer, but other GI disease must be ruled out.

A client with gastroesophageal reflux disease (GERD) has a diagnosis of Barrett esophagus with minor cell changes. What principle should be integrated into the client's subsequent care? The client will be monitored closely to detect malignant changes. Liver enzymes must be checked regularly, as H2 receptor antagonists may cause hepatic damage. Antacids may be discontinued when symptoms of heartburn subside. Small amounts of blood are likely to be present in the stools and are not cause for concern.

The client will be monitored closely to detect malignant changes.

An older adult has a diagnosis of Alzheimer disease and has recently been experiencing fecal incontinence. However, the nurse has observed no recent change in the character of the client's stools. What is the nurse's most appropriate intervention? Keep a food diary to determine the foods that exacerbate the client's symptoms. Liaise with the primary provider to obtain an order for loperamide. Provide the client with a bland, low-residue diet. Toilet the client on a frequent, scheduled basis.

Toilet the client on a frequent, scheduled basis.

A client has developed hepatic encephalopathy secondary to cirrhosis and is receiving care on the medical unit. The client's current medication regimen includes lactulose four times daily. What desired outcome should the nurse relate to this pharmacologic intervention? Absence of blood or mucus in stool Significant increase in appetite and food intake Absence of nausea and vomiting Two to three soft bowel movements daily

Two to three soft bowel movements daily

A nurse is providing care for a client recovering from gastric bypass surgery. During assessment, the client exhibits pallor, perspiration, palpitations, headache, and feelings of warmth, dizziness, and drowsiness. The client reports eating 90 minutes ago. What will the nurse suspect? Vasomotor symptoms associated with dumping syndrome Dehiscence of the surgical wound A normal reaction to surgery Peritonitis

Vasomotor symptoms associated with dumping syndrome

Which of the following assessment findings would be most important for indicating dumping syndrome in a postgastrectomy client? Weakness, diaphoresis, diarrhea 90 minutes after eating Abdominal distention, elevated temperature, weakness before eating Persistent loose stools, chills, hiccups after eating Constipation, rectal bleeding following bowel movements

Weakness, diaphoresis, diarrhea 90 minutes after eating

Which of the following is the most common type of diverticulum? Zenker's diverticulum Mid-esophageal Epiphrenic Intramural

Zenker's diverticulum

Which term describes a gastric secretion that combines with vitamin B12 so that it can be absorbed? amylase trypsin intrinsic factor pepsin

intrinsic factor

A patient has been diagnosed with acute gastritis and asks the nurse what could have caused it. What is the best response by the nurse? (Select all that apply.) "Is it possible that you are overusing aspirin." "It can be caused by ingestion of strong acids." "It is a hereditary disease." "It is probably your nerves." "You may have ingested some irritating foods."

"It can be caused by ingestion of strong acids." "You may have ingested some irritating foods." "Is it possible that you are overusing aspirin."

The nurse is conducting a health instruction program on oral cancer. The nurse determines that the participants understand the instructions when they state "Many oral cancers produce no symptoms in the early stages." "Most oral cancers are painful at the outset." "A typical lesion is soft and craterlike." "Blood testing is used to diagnose oral cancer."

"Many oral cancers produce no symptoms in the early stages."

A client with an ileostomy who has been discharged from the hospital calls the clinic and asks the nurse if he should take another one of his "potassium pills" because there is a waxy coating on the ileostomy from the pill. What is the best response by the nurse? "You will just have to omit the dose for today because we don't know how much of the medication was absorbed." "There must have been a defect in the medication for it to leave the waxy coating." "You should take another pill because the residue means the potassium was not absorbed." "Some medications like this leave a "ghost" of the wax matrix coating, but it doesn't mean the drug wasn't absorbed."

"Some medications like this leave a "ghost" of the wax matrix coating, but it doesn't mean the drug wasn't absorbed."

An 87-year-old client is in the ICU where you practice nursing. He was admitted for critical care due to his esophageal varices and his precarious physical condition. Which of the following could result in causing his varices to hemorrhage? Rough food All options are correct Little protective tissue to protect fragile veins Chemical irritation

All options are correct

Due to a lengthy history with Crohn's disease and the severity of symptoms, a client is being prepared for a colostomy. Which would be included in this client's individual care plan? All options are correct. appliance application presurgical medications skin care

All options are correct

A client has a gastrostomy tube that has been placed to drain stomach contents by low intermittent suction. What is the nurse's priority during this aspect of the client's care? Feed the client via the G tube as prescribed. Monitor drainage for change in color. Titrate the suction every hour. Measure and record drainage.

Measure and record drainage.

The family of a client in the ICU diagnosed with acute pancreatitis asks the nurse why the client has been moved to an air bed. What would be the nurse's best response? "Air beds allow the care team to reposition her more easily while she's on bed rest." "The bed automatically moves, so she is likely to have less pain." "The bed automatically moves, so she's less likely to develop pressure sores while she's in bed." "Air beds are far more comfortable than regular beds and she'll likely have to be on bed rest a long time."

"The bed automatically moves, so she's less likely to develop pressure sores while she's in bed."

A student accepted into a nursing program must begin receiving the hepatitis B series of injections. The student asks when the next two injections should be administered. What is the best response by the instructor? "You must have the second one in 6 months and the third in 1 year." "You must have the second one in 1 month and the third in 6 months." "You must have the second one in 2 weeks and the third in 1 month." "You must have the second one in 1 year and the third the following year."

"You must have the second one in 1 month and the third in 6 months."

A client has been brought to the emergency department with abdominal pain and is subsequently diagnosed with appendicitis. The client is scheduled for an appendectomy but questions the nurse about how his health will be affected by the absence of an appendix. How should the nurse best respond? "Your appendix doesn't play a major role, so you won't notice any difference after your recovery from surgery." "The surgeon will encourage you to limit your fat intake for a few weeks after the surgery, but your body will then begin to compensate." "Your small intestine will adapt over time to the absence of your appendix." "Your body will absorb slightly fewer nutrients from the food you eat, but you won't be aware of this."

"Your appendix doesn't play a major role, so you won't notice any difference after your recovery from surgery."

A client has been admitted to the critical care unit with a diagnosis of toxic hepatitis. When planning the client's care, the nurse should be aware of what potential clinical course of this health problem? Place the following events in the correct sequence.1. Fever rises. 2. Hematemesis. 3. Clotting abnormalities. 4. Vascular collapse. 5. Coma. 1, 2, 5, 4, 3 2, 3, 1, 4, 5 3, 1, 2, 5, 4 1, 2, 3, 4, 5

1, 2, 3, 4, 5

Which of the following measures would the nurse recommend to an ostomate to help facilitate a regular bowel pattern without relying on irrigation? Select all that apply. Using a stool softener Performing mild exercise Increasing intake of nuts Drinking prune juice Eating large meals late in the day

Drinking prune juice Performing mild exercise Using a stool softener

A client who had a Roux-en-Y bypass procedure for morbid obesity ate a chocolate chip cookie after a meal. After ingestion of the cookie, the client reported cramping pains, dizziness, and palpitation. After having a bowel movement, the symptoms resolved. What should the nurse educate the client about regarding this event? Celiac disease Gastric outlet obstruction Dumping syndrome Bile reflux

Dumping syndrome

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? Viral invasion of the stomach wall Bleeding from the mucosa in the stomach Inflammation of the lining of the stomach Erosion of the lining of the stomach or intestine

Erosion of the lining of the stomach or intestine

A client underwent a continent ileostomy 2 months ago. How often should the client's reservoir be emptied? Every 2 to 4 hours Three or four times daily At least once a day At least once every 2 days

Every 2 to 4 hours

A nurse has obtained an order to remove a client's NG tube that was placed for feeding. What is the nurse's best initial action? Assist the client into a supine position. Assess the client's appetite. Explain the process clearly to the client. Apply topical anesthetic to the client's nares as prescribed.

Explain the process clearly to the client.

The nurse assesses a patient who recently had a nasoenteric intubation. Symptoms of oliguria, lethargy, and tachycardia in the patient would indicate to the nurse what common complication? Fluid volume deficit Mucous membrane irritation A cardiac dysrhythmia Pulmonary complications

Fluid volume deficit

An elderly client comes into the emergency department reporting an earache. The client and has an oral temperature of 37.9° (100.2ºF) and otoscopic assessment of the ear reveals a pearly gray tympanic membrane with no evidence of discharge or inflammation. Which action should the triage nurse take next? Assess the temporomandibular joint for evidence of a malocclusion. Inspect the client's gums for bleeding and hyperpigmentation. Palpate the client's parotid glands to detect swelling and tenderness. Test the integrity of cranial nerve XII by asking the client to protrude the tongue.

Palpate the client's parotid glands to detect swelling and tenderness.

Which of the following conditions is most likely to involve a nursing diagnosis of fluid volume deficit? Cholecystitis Pancreatitis Appendicitis Peptic ulcer

Pancreatitis

Nathan Cooper, a 42-year-old police dispatcher, is recovering from the creation of an ileostomy due to complications of a bowel disorder. He has a history of arthritis and takes daily medication to reduce inflammation. What does the physician need to avoid when prescribing medications for Mr. Cooper? Liquid medications Antibiotics Sustained-release tablets NSAIDs

Sustained-release tablets

A nurse is caring for a client with cirrhosis. The nurse assesses the client at noon and discovers that the client is difficult to arouse and has an elevated serum ammonia level. The nurse should suspect which situation? The client didn't take his morning dose of lactulose (Cephulac). The client is avoiding the nurse. The client's hepatic function is decreasing. The client is relaxed and not in pain.

The client's hepatic function is decreasing.

A client's screening colonoscopy revealed the presence of numerous polyps in the large bowel. What principle should guide the subsequent treatment of this client's health problem? The client's polyps constitute a risk factor for cancer. Adherence to a high-fiber diet will help the polyps resolve. The client should be assured that these are a normal, age-related physiologic change. The presence of polyps is associated with an increased risk of bowel obstruction.

The client's polyps constitute a risk factor for cancer.

A nurse at an outpatient surgery center is caring for a client who had a hemorrhoidectomy. What discharge education topics should the nurse address with this client? The correct procedure for taking a sitz bath The correct technique for keeping the perianal region clean without the use of water The need to eat a low-residue, low-fat diet for the next 2 weeks The appropriate use of antibiotics to prevent postoperative infection

The correct procedure for taking a sitz bath

A client informs the nurse that he is taking a stimulant laxative in order to be able to have a bowel movement daily. What should the nurse inform the client about taking a stimulant laxative? They can be habit forming and will require increasing doses to be effective. The client should take a fiber supplement along with the stimulant laxative. The laxative is safe to take with other medication the client is taking. As long as the client is drinking 8 glasses of water per day, he can continue to take them.

They can be habit forming and will require increasing doses to be effective.

The nurse is assessing a client who had an ileostomy created three days ago for the treatment of irritable bowel disease. The nurse observes that the client's stoma is bright red and there are scant amounts of blood on the stoma. What is the nurse's best action? Document these expected assessment findings Contact the care provider to have the client's hemoglobin and hematocrit measured Cleanse the stoma with alcohol or chlorhexidine Apply barrier ointment to the stoma as prescribed

Document these expected assessment findings

What information should the nurse include in the teaching plan for a client being treated for diverticulosis? Avoid daily exercise; indulge only in mild activity Avoid unprocessed bran in the diet Use laxatives or enemas at least once a week Drink at least 8 to 10 large glasses of fluid every day

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

A client has a radical neck dissection to treat cancer of the neck. The nurse develops the care plan and includes all the following diagnoses. The nurse identifies the highest priority diagnosis as Imbalanced nutrition: less than body requirements, related to treatment Risk for infection related to surgical intervention Ineffective airway clearance related to obstruction by mucus Impaired tissue integrity related to surgical intervention

Ineffective airway clearance related to obstruction by mucus

A physician orders spironolactone (Aldactone), 50 mg by mouth four times daily, for a client with fluid retention caused by cirrhosis. Which finding indicates that the drug is producing a therapeutic effect? Loss of 2.2 lb (1 kg) in 24 hours Serum potassium level of 3.5 mEq/L Blood pH of 7.25 Serum sodium level of 135 mEq/L

Loss of 2.2 lb (1 kg) in 24 hours

The nurse is caring for a client scheduled for a colonoscopy. The nurse should assist the client into what position during this diagnostic test? Lying on the left side with legs drawn toward the chest Lying prone with legs drawn toward the chest In a knee-chest position (lithotomy position) In a prone position with two pillows elevating the buttocks

Lying on the left side with legs drawn toward the chest

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

Nystatin

Which of the following interventions would the nurse need to keep in mind when a loop colostomy of a client is to be opened? Note the color and amount of fecal material during the procedure. Prepare the client for the pungent odor before the procedure. Provide the client with plenty of fluids before the procedure. Elevate the client's legs before and during the procedure.

Prepare the client for the pungent odor before the procedure.

A nurse is assessing a client who has been diagnosed with cholecystitis, and is experiencing localized abdominal pain. When assessing the characteristics of the client's pain, the nurse should anticipate that it may radiate to what region? Left upper chest Inguinal region Neck or jaw Right shoulder

Right shoulder

The nurse is instructing the client who was newly diagnosed with peptic ulcers. Which of the following diagnostic studies would the nurse anticipate reviewing with the client? Serum antibodies for H. pylori Gastric analysis A sigmoidoscopy A complete blood count including differential

Serum antibodies for H. pylori

A nurse is caring for a client with hepatic encephalopathy. The nurse's assessment reveals that the client exhibits episodes of confusion, is difficult to arouse from sleep and has rigid extremities. Based on these clinical findings, the nurse should document what stage of hepatic encephalopathy? Stage 1 Stage 2 Stage 3 Stage 4

Stage 3

An older adult patient who has been living at home alone is diagnosed with parotitis. What causative bacteria does the nurse suspect is the cause of the parotitis? Methicillin-resistant Streptococcus aureus (MRSA) Pneumococcus Streptococcus viridans Staphylococcus aureus

Staphylococcus aureus

A client is being treated for diverticulosis. Which of the following points should the nurse include in this client's teaching plan? Choose all correct options. Avoid daily exercise; indulge only in mild activity. Drink at least 8 to 10 large glasses of fluid every day. Use laxatives or enemas at least once a week. Do not suppress the urge to defecate.

Do not suppress the urge to defecate. Drink at least 8 to 10 large glasses of fluid every day.

A nurse is talking with a client who is scheduled to have a hemicolectomy with the creation of a colostomy. The client admits to being anxious, and has many questions concerning the surgery, the care of a stoma, and necessary lifestyle changes. What nursing action is most appropriate? Reassure the client that the procedure is relatively low risk and that clients are usually successful in adjusting to an ostomy. Maintain an open dialogue with the client and facilitate a referral to the wound-ostomy-continence (WOC) nurse. Provide the client with educational materials that match the client's learning style. Encourage the client to write down these concerns and questions to bring forward to the surgeon.

Maintain an open dialogue with the client and facilitate a referral to the wound-ostomy-continence (WOC) nurse.

A client with an ileostomy calls the nurse to report that she is experiencing abdominal cramps, vomiting, and watery discharge from her ileostomy. The nurse should: Encourage the client to increase her fluid intake. Tell the client to take 30 ml of milk of magnesia. Notify the physician immediately. Have the client measure her abdominal girth.

Notify the physician immediately.

When preparing a client for surgery to treat appendicitis, the nurse formulates a nursing diagnosis of Risk for infection related to inflammation, perforation, and surgery. What is the rationale for choosing this nursing diagnosis? Infection of the appendix diminishes necrotic arterial blood flow and increases venous drainage. Obstruction of the appendix may increase venous drainage and cause the appendix to rupture. The appendix may develop gangrene and rupture, especially in a middle-aged client. Obstruction of the appendix reduces arterial flow, leading to ischemia, inflammation, and rupture of the appendix.

Obstruction of the appendix reduces arterial flow, leading to ischemia, inflammation, and rupture of the appendix.

A client who has undergone colostomy surgery is experiencing constipation. Which intervention should a nurse consider for such a client? Instruct the client to keep a record of food intake Instruct the client to avoid prune or apple juice Assist the client regarding the correct diet or to minimize food intake Suggest fluid intake of at least 2 L/day

Suggest fluid intake of at least 2 L/day

The nurse caring for an older adult client diagnosed with diarrhea is administering and monitoring the client's medications. Because one of the client's medications is digitalis (digoxin), the nurse monitors the client closely for: hyperkalemia. hypernatremia. hypokalemia. hyponatremia.

hypokalemia.

When an appliance is necessary to collect stool from an ostomy, what primarily determines the consistency of the stool that is collected? intestinal placement of the stoma last night's dinner amount of fiber in the diet amount of liquid in the diet

intestinal placement of the stoma