GI disorder nclex

Fowler's

A nurse is preparing to administer an enteral feeding through a nasogastric tube. The nurse would place the client in which position during and after the feedings

Hepatitis A

It has been determined that a client with hepatitis has contracted the infection from contaminated food. What type of hepatitis is this client most likely experiencing?

Hepatitis B vaccine

Of the following infection control methods, which would be the priority to include in the plan of care to specifically prevent hepatitis B in a client considered to be at high risk for exposure?

Limit the fluids taken with meals.

The nurse is providing discharge instructions to a client after gastrectomy. Which measure will the nurse instruct the client to follow to help prevent dumping syndrome?

Brush the client's teeth frequently. Use diluted mouthwash and water to rinse the mouth

The nurse observes that a client with a nasogastric tube connected to continuous gastric suction is mouth breathing, has dry mucous membranes, and has a foul breath odor. In planning care, which nursing intervention would be best to maintain the integrity of this client's oral mucosa?

Nasogastric

Treatment measures have been implemented for a client with bleeding esophageal varices and have been unsuccessful. The health care provider states that a Sengstaken-Blakemore tube will be used to control the resulting hemorrhage. The nurse prepares for insertion via which of the following routes?

This opioid will cause very deep sleep, which is what my husband needs."

Which statement by the spouse of a client with end-stage liver failure indicates the need for additional teaching by the multidisciplinary team regarding the management of pain?

History of the use of acetaminophen (Tylenol) for pain and discomfort

nurse is collecting data on a client with a diagnosis of peptic ulcer disease. Which of the following is least likely associated with this disease?

Position the client supine and flat

nurse is reviewing the health care provider's prescriptions written for a client admitted with acute pancreatitis. Which health care provider prescription would the nurse verify if noted on the client's chart?

Diarrhea

nurse is reviewing the record of a client with Crohn's disease. Which of the following stool characteristics would the nurse expect to see documented in the record

Lying flat

A client with acute pancreatitis is experiencing severe pain from the disorder. The nurse tells the client to avoid which position that could aggravate the pain?

4.0

A nurse is checking a client for the correct placement of a nasogastric (NG) tube. The nurse aspirates the client's stomach contents and checks their pH level. Which of the following pH values indicates the correct placement of the tube?

Be sure to sleep with your head elevated in bed."

A nurse is teaching a client who is newly diagnosed with a hiatal hernia about measures to prevent recurrence of symptoms. The nurse makes which statement to the client?

Be sure to sleep with your head elevated in bed."

A nurse is teaching a client with a newly diagnosed hiatal hernia about measures to prevent recurrence of symptoms. Which statement would be included in the teaching?

Left Sims' position

A nurse is teaching the client about an upcoming colonoscopy procedure. The nurse would include in the instructions that the client will be placed in which of the following positions for the procedure?

Monitoring prothrombin and partial thromboplastin values

A nurse planning care for a client with hepatitis plans to meet the client's safety needs by:

Lie on the right side for 2 hours

A nurse provides instructions to a client after a liver biopsy. The nurse tells the client to:

The nizatidine (Axid) will cause me to produce less stomach acid."

A nurse provides medication instructions to a client with peptic ulcer disease. Which statement by the client indicates the best understanding of the medication therapy?

Regular monthly injections of vitamin B12 will prevent this complication

A nurse reinforces instructions to a client following a gastrectomy about the signs and symptoms of pernicious anemia, knowing that:

Maintaining a patent nasogastric (NG) tube

A nurse who is assisting in the care of a client within the first 24 hours following a total gastrectomy for gastric cancer should focus interventions on which of the following?

Take action to prevent dumping syndrome.

A nurse who is providing instructions to a client following gastric resection would include which of the following suggestions

Learn to use stress reduction techniques.

A nurse would include which of the following when reinforcing home care instructions for a client who has peptic ulcer disease?

A right side-lying position with a small pillow or folded towel under the puncture site

After a liver biopsy, the nurse places the client in which of the following positions?

Hemorrhage

After the deflation of the balloon of a client's Sengstaken-Blakemore tube, the nurse monitors the client closely for which esophageal complication

70 mcg/dL

An adult client with hepatic encephalopathy has a serum ammonia level of 120 mcg/dL and receives treatment with lactulose (Chronulac) syrup. The nurse determines that the client has the best and most optimal response if the level changes to which of the following after medication administration?

Requires the client to lie still for short intervals

An ultrasound of the gallbladder is scheduled for the client with a suspected diagnosis of cholecystitis. The nurse explains to the client that this test:

Evaluate absorption of the last feeding

Before administering an intermittent tube feeding through a nasogastric tube, the nurse checks for gastric residual volume. The nurse understands that the rationale for checking gastric residual volume before administering the tube feeding is to:

Vitamin B12 injections

A client has been diagnosed with chronic gastritis and has been told that there is too little intrinsic factor being produced. The nurse tells the client about the need for:

Offer small, frequent meals

A client with viral hepatitis has no appetite, and food makes the client nauseated. Which nursing intervention would be appropriate

"Everyone in my immediate family has died from gastrointestinal cancer."

A generally healthy 63-year-old man is seen in the health care provider's office for a routine examination. Which statement made by the client is important for the nurse to follow up on?

Turkey and lettuce sandwich

A nurse is evaluating the effect of dietary counseling on the client with cholecystitis. The nurse determines that the client understands the instructions given if the client states that which food item is acceptable to include in the diet?

Sweating and pallor

A nurse is monitoring a client for the early signs and symptoms of dumping syndrome. Which of the following symptoms indicate this occurrence?

Protruding and swollen

A nurse is monitoring for stoma prolapse in a client with a colostomy. The nurse would observe which of the following appearances in the stoma if prolapse occurred

Personal history of ulcerative colitis or gastrointestinal (GI) polyps

A nurse is participating in a health screening clinic and is preparing teaching materials about colorectal cancer. The nurse would plan to include which risk factor for colorectal cancer in the material?

Hold the feeding

A nurse is preparing to administer an intermittent tube feeding to a client with a nasogastric tube. The nurse checks the residual and obtains an amount of 200 mL. The nurse would:

Administration of an analgesic

A client arrives at the emergency department and complains of severe abdominal pain. The initial diagnosis is acute abdomen, and an x-ray and an abdominal ultrasonogram are prescribed to be obtained immediately. The nurse prepares the client for these diagnostic tests and reviews the health care provider's prescriptions. Which of the following prescriptions would the nurse question if written on the health care provider's prescription form?

Nasogastric

A client arrives in the emergency department with bleeding esophageal varices, and the health care provider states that a Sengstaken-Blakemore tube will need to be used to try to control the gastrointestinal hemorrhage. The nurse prepares for insertion of the tube via which of the following routes?

History of alcohol use, smoking, and weight loss

A client complains of stomach pain 30 minutes to 1 hour after eating. The pain is not relieved by further intake of food, although it is relieved by vomiting. A gastric ulcer is suspected. Which of the following data would further support this diagnosis?

I should take a laxative, and my stool will then return to a normal color.

A client who has undergone barium enema is being readied for discharge. The nurse determines that the client has understood discharge instructions when the client states:

Avoid eating or drinking after midnight before the test.

A client will undergo a barium swallow to confirm a diagnosis of a hiatal hernia. In preparation for the test, the nurse instructs the client to:

The aspirate from the tube has a pH of 7.45.

A client had a Miller-Abbott tube inserted 24 hours ago. The nurse is asked to check the client to determine whether the tube is in the appropriate location at this time. Which of the following findings would indicate adequate location of the tube?

High-fiber diet

A client has asymptomatic diverticular disease. What type of diet should the nurse anticipate to be prescribed

Low fiber

A client has been diagnosed with acute gastroenteritis. Which of the following diets should the nurse anticipate would be prescribed for the client

"That is because the empty stomach sends signals to the brain to stimulate hunger."

A client has had extensive surgery on the gastrointestinal tract and has been started on parenteral nutrition (PN). The client tells the nurse, "I think I'm going crazy...I feel like I'm starving and yet that bag is supposed to be feeding me." The best response of the nurse would be:

laxative

A client has just returned from the radiology department following an upper gastrointestinal (GI) series. The nurse reviews the health care provider's prescriptions, expecting to note which of the following needed for routine post-procedure care?

Monitoring for the gag reflex

A client has just undergone a gastroscopy. Which action should be taken by the nurse as the essential post-procedure nursing intervention?

Avoid eating or drinking after midnight before the test

A client will undergo a barium swallow to determine whether the client has a hiatal hernia. The nurse provides pre-procedure instructions and tells the client to:

Difficulty swallowing both liquids and solids

A client with a possible hiatal hernia complains of frequent heartburn and regurgitation. Which sign or symptom would support this diagnosis?

Nasogastric (NG) tube

A client with a tentative diagnosis of gastroesophageal reflux is going to undergo ambulatory pH monitoring. The nurse brings which of the following items to the bedside?

Upright

A client with ascites is scheduled for a paracentesis. The nurse is assisting the health care provider in performing the procedure. Which of the following positions will the nurse assist the client to assume for this procedure?

Lying recumbent after meals

A client with hiatal hernia chronically experiences heartburn after meals. The nurse would teach the client to avoid which of the following, which is contraindicated with hiatal hernia?

Protect the gastric mucosa

A client with peptic ulcer disease has been prescribed misoprostol (Cytotec) and sucralfate (Carafate). The nurse teaches the client that these two medications will work primarily to:

A tube with a larger lumen and an air vent

A health care provider asks the nurse to obtain a Salem Sump tube for gastric intubation. The nurse would correctly select which of the following tubes from the unit storage area?

Document the finding in the client's record.

A health care provider places a Miller-Abbott tube in a client who has a bowel obstruction. Six hours later, the nurse measures the length of the tube outside of the nares and notes that the tube has advanced 6 cm since it was first placed. Based on this finding, which action should the nurse take next?

Take and hold a deep breath.

A licensed practical nurse (LPN) is preparing to assist a registered nurse (RN) with removing a nasogastric (NG) tube from the client. The LPN would instruct the client to do which of the following?

A decrease in sour eructation

A nurse has been reinforcing dietary teaching for a client with peptic ulcer disease who has a routine follow-up visit. Which behavior is the best indicator of a successful outcome for this client?

Resume full activity level within 1 week

A nurse has given the client with hepatitis instructions about postdischarge management during convalescence. The nurse determines that the client needs further teaching if the client states to:

Left Sims' position

A nurse is administering a cleansing enema to a client with a fecal impaction. Before administering the enema, the nurse assists the client to which of the following positions?

Esophageal varices

A nurse is assigned to care for a client with a Sengstaken-Blakemore tube. The nurse should suspect that the client has which diagnosis?

Learn measures such as biofeedback or progressive relaxation.

A nurse is assisting in planning stress management strategies for the client with irritable bowel syndrome. Which suggestion would the nurse give to the client?

High Fowler's position

A nurse is assisting with the insertion of a nasogastric tube into a client. The nurse places the client in which position for insertion?

No oral intake of liquids or food

A nurse is caring for a client suspected of having appendicitis. Which of the following would the nurse anticipate will be prescribed for this client?

Provide frequent oral and nasal care on a regular basis.

A nurse is caring for a client with a Sengstaken-Blakemore tube. To prevent ulceration and necrosis of oral and nasal mucosa, the nurse should plan to:

Vitamin B12

A nurse is caring for a client with a diagnosis of chronic gastritis. The nurse anticipates that this client is at risk for which vitamin deficiency?

Placement of the NG tube is accurate.

A nurse is caring for a client with a nasogastric (NG) tube and tests the pH of the aspirate to determine correct placement. The nurse notes that the pH is 5 and determines that the:

Impaired nutritional status

A nurse is caring for a client with anorexia. The nurse plans care for the client, focusing on which of the following as the primary problem?

Drowsiness

A nurse is collecting admission data on the client with hepatitis. Which of the following findings would be a direct result of this client's condition

The transfer of digested food molecules from the GI tract into the bloodstream

A nurse is collecting data about how well a client with a gastrointestinal (GI) disorder is able to absorb food. While carrying out this function, the nurse recalls that absorption is best defined as:

Apply disposable gloves,Lubricate the enema tube and insert it approximately 4 inches,Clamp the tubing if the client expresses discomfort during the procedure,Ensure that the temperature of the solution is between 100° F (37.8° C) and 105° F (40.5° C).

A nurse is preparing to administer an enema to an adult client. Choose the interventions that the nurse would perform for this procedure

2

A nurse is preparing to perform an abdominal assessment on a client. The nurse places the client in which best position to perform the assessment? Refer to figure.

Vitamin B12 and folic acid studies

A nurse is providing discharge instructions to a client who has had a total gastrectomy. The nurse tells the client about the importance of returning to the health care clinic as scheduled for which priority assessment?

Eat anything as long as it does not aggravate or cause pain

A nurse is reinforcing dietary instructions to a client with peptic ulcer disease. The nurse encourages the client to:

Steatorrhea

A nurse is reviewing the health care record of a client with a diagnosis of chronic pancreatitis. Which data noted in the record indicate poor absorption of dietary fats?

Smaller and more frequent meals should be eaten.

A client who has undergone a subtotal gastrectomy is being prepared for discharge. Which item concerning ongoing self-management should the nurse reinforce to the client?

One day

A licensed practical nurse (LPN) is providing follow-up teaching after a client underwent an upper gastrointestinal (GI) series. The nurse reminds the client that the stools will remain white for approximately:

Semi-Fowler's

A nurse assigned to care for a client with cirrhosis reviews the medical record and notes that the client has difficulty maintaining an effective breathing pattern due to pressure on the diaphragm. The nurse plans care, knowing that which client position will best assist in facilitating breathing?

Consuming low-fat or nonfat foods

A nurse documents that a client with a hiatal hernia is complying with the prescribed treatment if the client reports doing which of the following

Eating low-fat or nonfat foods

A nurse documents that a client with a hiatal hernia is implementing effective health maintenance measures after the client reports doing which of the following

Low and intermittent

A nurse has assisted in the insertion of a Levin tube for gastrointestinal (GI) decompression. The nurse plans to set the suction to which of the following pressures?

Hematemesis

A nurse has been caring for a client with a Sengstaken-Blakemore tube. The health care provider arrives on the nursing unit and deflates the esophageal balloon. Following deflation of the balloon, the nurse should monitor the client most closely for which of the following

Check the gag reflex before giving oral foods or fluids.

A client has just undergone gastroscopy. Which of the following is the essential post-procedure nursing intervention

Checking for return of a gag reflex

A client has undergone esophagogastroduodenoscopy (EGD). The nurse places highest priority on which of the following items as part of the client's care plan?

Milk of magnesia

A client in the emergency department reports right lower quadrant abdominal pain. After noting a white blood cell count of 16,500/mm3, the nurse would question a prescription for which of the following

What is your understanding of celiac disease?"

A client is admitted to an acute care facility with complications of celiac disease. Which question would be helpful initially in obtaining information for the nursing care plan?

Remain with the client and be silent.

A client is admitted to the hospital with a bowel obstruction secondary to a recurrent malignancy, and the health care provider plans to insert a Miller-Abbott tube. When the nurse tries to explain the procedure, the client interrupts the nurse and states, "I don't want to hear about that. Just let the doctor do it." Based on the client's statement, the nurse determines that the best action is to:

Fatigue

A client is admitted to the hospital with acute viral hepatitis. Which signs or symptoms would the nurse expect to note, based upon this diagnosis?

Increase intake of fluids.

A client is admitted to the hospital with viral hepatitis and is complaining of a loss of appetite. In order to provide adequate nutrition, the nurse encourages the client to:

I just lost a family to gastrointestinal cancer."

A client is seen in the ambulatory care office for a routine examination. Which statement by the client would be important for the nurse to follow up?

Occult blood

A client who has been prescribed indomethacin (Indocin) for gout is asked to provide a stool sample for guaiac testing. The nurse explains that the purpose of the test is to determine:

Occult blood

A client who has been taking indomethacin (Indocin) for gout has a prescription for guaiac testing of the stool. The nurse explains to the client that this test is necessary because it detects which of the following that may be caused or affected by this medication?

I should take a laxative and my stool should return to normal color."

A client who has undergone a barium enema is being readied for discharge from the ambulatory care unit. The nurse determines that the client has understood the discharge instructions if the client states:

Ask a member of the local ostomy club to visit with the client before discharge, Ask the enterostomal nurse specialist to consult with the client before discharge,Ask the client to begin doing one part of the ostomy care and increase tasks daily.

A client who has undergone a colostomy several days ago is reluctant to leave the hospital and has not yet looked at the ostomy site. Which measures are most likely to promote coping?

Give frequent oral and nasal care.

A nurse is assisting in caring for a client with a Sengstaken-Blakemore tube. To prevent ulceration and necrosis of oral and nasal mucosa, the nurse plans to

Irrigating the nasogastric (NG) tube

A nurse is caring for a client after a Billroth II procedure. On review of the postoperative prescriptions, which of the following, if prescribed, would the nurse question and verify?

The pH of the aspirate is 5.

A nurse is caring for a client with a nasogastric tube. Which observation is reliable in determining that the tube is correctly placed?

Inability to pass flatus

A nurse is caring for a client with acute pancreatitis and a history of alcoholism and is monitoring the client for complications. Which of the following data would be a sign of paralytic ileus?

My pain comes shortly after I eat, maybe a half hour or so later

A nurse is collecting data from a client admitted to the hospital with a diagnosis of suspected gastric ulcer and is asking the client questions about pain. Which statement, if made by the client, would support the diagnosis of gastric ulcer?

Pruritus

A nurse is collecting data on a client admitted to the hospital with hepatitis. Which data would indicate that the client may have liver damage?

Administer antacids, as prescribed,Encourage coughing and deep breathing,Administer anticholinergics, as prescribed

A nurse is reviewing the prescriptions of a client admitted to the hospital with a diagnosis of acute pancreatitis. Choose the interventions that the nurse would expect to be prescribed for the client.

Difficulty swallowing

A client with possible hiatal hernia complains of frequent heartburn and regurgitation. The nurse should gather further information about the presence of which signs or symptoms