GI last quiz

A patient with acute pancreatitis is at risk for the development of paralytic (adynamic) ileus. Which action provides the nurse with the best indication of bowel function? a. Observing contents of the nasogastric drainage b. Weighing the patient every day at the same time c. Asking the patient if he or she has passed flatus or had a stool d. Obtaining a computed tomography (CT) scan of the abdomen with contrast medium

c

The daughter of a patient with cholelithiasis has heard that there is a genetic disposition for cholelithiasis. The daughter asks the nurse about the risk factors. How does the nurse respond? a. "There is no evidence that first- degree relatives have an increased risk for this disease." b. "Cholecystitis is seen more frequently in patients who are underweight." c. "Hormone replacement therapy has been associated with increased risk for cholecystitis." d. "Patients with diabetes mellitus are at increased risk for cholecystitis."

c

The female patient is to have her gallbladder removed by natural orifice transluminal endoscopic surgery. What does the nurse teach about this surgery? a. The surgeon will use powerful shock waves to break up the gallstones. b. The surgeon will insert a transhepatic biliary catheter to open blocked bile ducts. c. The surgeon will use a vaginal approach to remove your gallbladder. d. The surgeon will inject ursodeoxycholic acid to dissolve any remaining gallstone fragments.

c

The nurse has instructed a patient in the recovery phase of acute pancreatitis about diet therapy. Which statement by the patient indicates that teaching has been successful? a. "I will eat the usual three meals a day that I am used to." b. "I am eating tacos for my first meal back home." c. "I will avoid eating chocolate and drinking coffee." d. "I will limit the amount of protein in my diet."

c

The nurse is assessing a patient with acute cholecystitis whose abdominal pain is severe. The patient is pale, is diaphoretic, and describes extreme fatigue. Vital signs are: heart rate of 118, BP 95/70, respirations 32/min, temp 101. What is priority a. Instruct the UAP to check a complete set of vital signs. b. Auscultate the patient's abdomen in all four quadrants. c. Notify the patient's health care provider. d. Administer the ordered opioid analgesic

c

The nursing student is caring for a patient with chronic pancreatitis who is receiving pancreatic enzyme replacement therapy. Which statement by the student indicates the need for further study concerning this therapy? a. "The enzymes will be administered with meals." b. "The patient will take the drugs with a glass of water." c. "If the patient has difficulty swallowing the enzyme preparation, I will crush it and mix it with foods." d. "The effectiveness of pancreatic enzyme treatment is monitored by the frequency and fat content of stools."

c

The patient comes to the emergency department (ED) with severe abdominal pain in the midepigastric area. The patient states that the pain began suddenly, is continuous, radiates to his back, and is worst when he lies flat on his back. What condition does the nurse suspect? a. Acute cholecystitis b. Pancreatic cancer c. Acute pancreatitis d. Pancreatic pseudocyst

c

Which patient is at low risk for the development of gallbladder disorders? a. Patient with sickle cell anemia b. Patient who is Mexican American c. Patient who is 20 years old and male d. Patient with a history of prolonged parenteral nutrition

c

After removal of the gallbladder, a patient experiences abdominal pain with vomiting for several weeks. What does the nurse recognize? a. Chronic cholecystitis b. Recurrence of acute cholecystitis c. Unremoved gallstones d. Postcholecystectomy syndrome

d

Disseminated intravascular coagulation (DIC) is a complication of pancreatitis. What pathophysiology leads to this complication? a. Hypovolemia b. Peritoneal irritation and seepage of pancreatic enzymes c. Disruption of alveolar-capillary membrane d. Consumption of clotting factors and microthrombi formation

d

The health care provider has assessed a patient's abdomen and found rebound tenderness on deep palpation. What does the nurse recognize? a. Steatorrhea b. Eructation c. Biliary colic d. Blumberg's sign

d

Which condition is most likely to be treated with antibiotics? a. Cancer of the gallbladder b. Acute cholelithiasis c. Chronic pancreatitis d. Acute necrotizing pancreatitis

d

Which statement about the care of a patient with a Jackson-Pratt (JP) drain after a traditional cholecystectomy is true? a. The patient is maintained in the prone position. b. When the patient is allowed to eat, the JP drain is clamped continuously. c. The JP drain is irrigated every hour for the first 24 hours. d. Serosanguineous drainage stained with bile is expected for 24 hours.

d

Which type of drug is used to treat acute severe biliary pain? a. Acetaminophen (Tylenol) b. Nonsteroidal antiinflammatory drugs (NSAIDs) (Ibuprofen) c. Antiemetics (Compazine) d. Opioids (Morphine)

d

The nurse is collaborating with the dietitian to provide diet teaching for a patient with chronic pancreatitis and his family. Which are important teaching points for this teaching plan? select all that apply

the patient will need increased calorie intake (4000-6000) per day to maintain weight alcohol intake should be avoided provide a bland diet with frequent meals avoid irritating substances such as caffeinated beverages which stimulate the GI system

which are potential cardiovascular complications for a patient after surgery for a Whipple procedure

thrombophlebitis myocardial infarction heart failure hemorrhage at anastomosis sites with hypovolemia

Which statements about pancreatic cancer are accurate

venous throm is a common complication of pancreatic cancer pancreatic cancer often presents in a slow and vague manner there are no specific blood tests to diagnose pancreatic cancer chronic pancreatitis predisposes a patient to pancreatic cancer

The nurse is caring for an obese post-op patient who underwent surgery for bowel resection. As the client is moving in the bed, he comments 'Somethings popped open." Upon examination, the nurse notes wound evisceration. Place the steps in order for this situation

1. Stay calm and stay with the client. 2. Put the client into semi-fowler position with knees slightly flexed. 3. Check the vital signs, especially blood presure and pulse 4. Have a colleague gather sterile supplies and contact the HCP 5. Cover the intestine with sterile moistened gauze 6. Prepare the client for surgery as ordered.

14. The nurse is reviewing the medication administration record for Ms. T (ulcerative colitis). Which situation needs immediate investigation? a. Two tablets of senna were given yesterday morning b. One dose of atropine sulfate was given yesterday c. IV infusion of infliximab 5 mg/kg was given last. d. IV hydrocortisone 100 mg was given last evening

A

19. Psychosocial assessment reveals that Mr. A (appendectomy) faces several financial and personal problems. Which finding has the most impact on discharge teaching for wound care and other follow-up issues? a. He is homeless and has no family in the city b. He has no money for the prescribed medications c. He has no transportation to the follow-up appointment d. He cannot read or write very well

A

30. What information regarding Mr. R (acute pancreatitis) is appropriate to report to the HCP? Select all that apply a. Hematocrit is decreased by more than 10% b. Calcium level is less than 9mg/dL c. Partial O2 pressure (PO2) is less than 60 d. Pain is unrelieved by medication e. Blood type is O+ f. NGT and IV line are intact

A, B, C, D

3. Which tasks can be delegated to the UAP? Select all that apply a. Assisting Ms. T with perineal care after diarrheal episodes b. Measuring vital signs Q2 hours for Mr. R c. Transporting Ms. H off the unit for a procedure d. Gently cleaning the nares around Ms. D's NGT e. Removing Mr. A's dressing f. Helping Mr. K to brush his teeth

A, B, C, D, F

25. In the care of Mr. K (PEG tube), which health care team members are demonstrating the roles and responsibilities that support interprofessional collaboration? Select all that apply a. The UAP tells Mr. K's family that she will be in at 10:00AM to assist Mr. K with hygiene b. The RN gives the UAP specific instructions about how to clean around Mr. K's PEG tube c. The RN acknowledges that the UAP has the best working relationship with Mr. K's daughter d. The enterostomal therapist performs care for Mr. K, but staff and family are unsure about follow-up e. The nursing student reorganizes that dealing with Mr. K's family dynamics exceeds her abilities f. The surgeon does mini-grand rounds with nursing students to explain the purpose of Mr. K's PEG tube

A, B, C, E, F

9. The RN is observing the nursing student perform an abdominal assessment on Ms. D, who was admitted for a bowel obstruction. For which actions will the supervising nurse intervene? Select all that apply a. Palpating for abdominal distension with the index fingertip b. Auscultating for bowel sounds with the NGT attached to low wall suction c. Performing the physical assessment before asking about pain d. Checking the NG collection canister for quantity and quality of drainage e. Inspecting for visible signs of peristaltic waves or abdominal distension f. Checking for skin turgor over the lower abdominal area

A, B, C, F

2. Which clients would be best to assign to the new RN? Select all that apply a. Ms. H (acute cholecystitis) b. Ms. D (bowel obstruction) c. Ms. T (ulcerative colitis) d. Mr. A (appendectomy) e. Mr. K (PEG-tube) f. Mr. R (acute pancreatitis)

A, B, D

21. To provide good continuity of care for Mr. A (appendectomy), who is homeless, which members of the interdisciplinary team should routinely have access to Mr. A's medical records? Select all that apply a. Hospital social worker who is helping Mr. A to locate resources b. Surgeon who performed Mr. A's appendectomy c. An epidemiologist who is collecting data on the homeless d. All of the UAP's who work in the medical-surgical area e. Administrator of the shelter where Mr. A frequently stays f. Nurse who works at the shelter where Mr. A frequently stays

A, B, F

24. Because of Mr. K's (PEG tube) advanced age, complications of enteral feedings may occur? Select All that apply a. Hyperglycemia b. Hypotension c. Aspiration d. Diarrhea e. Fluid overload f. Weight loss

A, C, D, E

A client underwent an exploratory laparotomy 2 days ago. THe HCP should be called immediately for which physical assessment finding?

Abdominal distention and rigidity

16. The UAP asks, "Why can't Ms. T (ulcerative colitis) get out of bed and do things for herself? She's only29 years old." What is the team leader's best response? a. "The HCP ordered bed rest for a few days." b. "Decreasing activity helps to decrease the diarrhea." c. "I see you're frustrated; just do your best to help." d. "She is too depressed to get out of bed"

B

22. The RN is teaching the nursing student about enteral feedings for clients such as Mr. K, who has a PEG tube. In the postoperative period, when can enteral feedings be started? a. Within 6-8 hours after the procedure b. When bowel sounds occur, usually within 24 hours c. When the client reports feelings hungry d. On a schedule determined by the pharmacy

B

23. "Mr. K (PEG tube) needs 1200 kcal/day. The enteral feeding formula provides 1 kcal/mL. Yesterday's formula feedings were 100 mL at 7:00 AM, 50 mL at 11:00 AM, 200 mL at 3:00 PM, and 100 mL at 7:00 PM. What should the nurse do first? a. Give additional feedings to catch up on nutritional needs b. Look at the original prescription to determine the frequency and amount c. Look at weight trends to see if client is losing or maintaining weight d. Call the nurse who cared for Mr. K yesterday and ask what happened

B

27. What instructions will the nurse give to th eUAP about how to reposition Mr. R to relieve discomfort related to acute pancreatitis? a. Place him in a high fowler position b. Help him to lie in a side-lying fetal position c. Lay the bed flat and put the clients legs on a pillow d. Help him to dit to edge of bed and dangle his legs

B

28. MR. R (acute pancreatitis) demonstrates a dry cough. He reports left-sided chest pain when breathing deeply and SOB. He also has a low-grade fever. Which potential complication does the nurse suspect? a. Hypovolemic shock b. Pleural effusion c. Paralytic ileus d. Acute respiratory distress syndrome

B

5. Which question should the oncoming RN team leader pose to the night shift nurse to help determine the priority actions for Ms. H who was admitted for acute cholecystitis? a. "What are her vital signs?" b. "Is she going to surgery or radiology this morning?" c. "Is she still having pain?" d. "Does she need any morning medications?"

B

11. The new RN asks the team leader if it is okay to give Ms. D (bowel obstruction) a dose of psyllium using the HCP's standing orders. Ms. D says."she feels constipated and takes psyllium on a regular basis at home." What is the team leader's best response? a. "Call the HCP to see if the standing orders apply to Ms. D" b. "Give psyllium according to the standing orders" c. "Laxatives can cause perforation if there is a bowel obstruction" d. "The client can't be constipated because she is NPO"

C

12. Ms. D (bowel obstruction) reports feeling weak. She seems more confused compared with her baseline. The NG drainage container has a large amount of watery bile-colored fluid. Which lab value should be checked first? a. BUN and creatinine levels b. Platelet count and WBC count c. Na & K levels, pH of blood d. Bilirubin, hematocrit, and hemoglobin

C

15. Ms. T is receiving an oral dose of sulfasalazine 500 mg every 6 hours for treatment of ulcerative colitis. Which assessment finding is cause for greatest concern? a. Decreased appetite b. Nausea and vomiting c. Decreased urine output d. Headache

C

18. While the nurse is teaching Mr. A about dressing changes for his appendectomy wound, he says,"When you live on the street, you can't do everything the way you nurses do in the hospital." What is the most important thing to emphasize in helping him to accomplish self-care? a. "Change the dressing in the AM and the PM." b. "Use the gauze package to make a sterile field." c. "Wash your hands before a dressing change." d. "Discard any opened packages of unused gauze."

C

20. Mr. A (appendectomy) will be discharged with prescriptions for pain medication and an antibiotic. What is the most important point that the nurse will emphasize about the medications a. "Take the pain medication before the pain becomes severe" b. "The pain medication may make you feel drowsy or sleepy" c. "All of the antibiotics should be taken, even if you feel good." d. "The antibiotics should not be shared with any other person"

C

29. The nurse notes that Mr. R (acute pancreatitis) has a small amount of blood oozing from the IV insertion site, and there is a palm-shaped bruise on the anterior lateral humerus. What action should the nurse take first? a. Remove the IV line and restart it at different site b. Remind the UAP to handle Mr. R very gently c. Assess for other signs of obvious or occult bleeding d. Obtain an order for coagulation studies

C

32. The HCP arrives while the RN team leader is caring for Mr. R. Because of Mr. R's deteriorating status, the team leader would advocate for which intervention? a. Perform additional lab tests and continue monitoring b. Prepare Mr. R for emergency surgery c. Prepare Mr. R for transfer to the ICU d. Reestablish NG suction and apply restraints or use 1:1

C

6. The health care provider (HCP) told Ms. H (acute cholecystitis) that she would probably need a laparo-scopic cholecystectomy; however, the hepatobiliary iminodiacetic acid (HIDA) scan and laboratory results are still pending. Ms. H asks, "What should I expect?"What is the best intervention at this point? a. Describe the surgical procedure b. Call the HCP to come and speak with her c. Provide some written material about gallbladder disease and options d. Explain general postoperative care, such as coughing and deep breathing exercises

C

4. "Which reporting tasks are appropriate to delegate to the UAP? Select all that apply. a. Reporting on the condition of Ms. T's perineal area after application of ointment b. Reporting the quality and color of NG drainage forMs. D c. Reporting whether Mr. R's blood pressure is below100/60 mm Hg d. Reporting if any of the clients indicate pain e. Reporting if Mr. A is seen leaving the unit to smoke a cigarette f. Reporting that Mr. K's family has questions. The night nurse gives a brief and incomplete report

C, D, E, F

17. Because of Ms. T's (ulcerative colitis) severe diarrhea, the nurse is reviewing the laboratory results. Which Laboratory results are cause for greatest concern? a. The WBC count is slightly increased b. The hemoglobin and hematocrit are slightly decreased c. The erythrocyte sedimentation (ESR)rate is increased d. The serum sodium and potassium levels are decreased

D

26. For Mr. K (PEG tube), several new medications and a change in the enteral feeding solution are included in the discharge plan. Which team member is the nurse most likely to consult before teaching the client and family about these new medications and enteral solution> a. Nutritionist to verify that the calories and other nutrients are sufficient b. Home health nurse to verify that follow-up teaching will be performed c. Social worker to verify that medications and formula are covered by insurance d. Pharmacist to verify that medications are compatible with feeding solution

D

33. Towards the end of the shift, the team leader finds the new RN in the bathroom crying. The new nurse says," I'm a terrible nurse. I'm so disorganized, and I'm so far behind. I'm going to quit. I hate this job." What is the best thing to do? a. Have her take a short break off the unit b. Offer to take one of her clients c. Ask the UAP to help her d. Calm her down and help her prioritize

D

7. Ms. H's (acute cholecystitis) (HIDA) scan shows a decreased bile flow with gallbladder disease and obstruction. Because of the obstruction, the nurse is vigilant for the complication of biliary colic. What are they key signs and symptoms that the nurse will watch for? a. Rebound tenderness and a sausage-shaped mass in the right upper quadrant b. Flatulence, dyspepsia, and eructation after eating or drinking c. Right upper quadrant abdominal pain that radiates to the right shoulder or scapula d. Severe abdominal pain with tachycardia, pallor, diaphoresis, and prostration

D

8. All of these clients must receive their routine morning medications. Which client should receive his or her medication last? a. Ms. H (acute cholecystitis) b. Ms. D (bowel obstruction) c. Ms. T (ulcerative colitis) d. Mr. K (PEG-tube)

D

For which clinical indicator should the nurse monitor when caring for a client with cholelithiasis and obstructive jaundice ?

Dark urine, yellow skin, clay colored stool

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

Dilated space of necrotic tissue and blood

The nurse is caring for a client with a nasogastric (NG) tube. Which task can be delegated to experienced unlicensed assistive personnel (UAP)?

Disconnecting the suction to allow ambulation to the toilet

Before a cholecystectomy, vitamin K is prescribed, which element, should the nurse determine is the purpose of administering this medication?

Prothrombin

The nurse is providing post-op care for a client who underwent laparoscopic cholecystectomy. What should be reported immediately to the health care provider?

The client reports right upper quadrant pain

A patient is admitted to the patient care unit with obstructive jaundice. Which sign/symptom does the nurse expect to find upon assessment of the patient? a. Pruritus b. Pale urine in increased amounts c. Pink discoloration of sclera d. Dark, tarry stools

a

The nurse is administering ketorolac (Toradol) to a 78-year-old patient for mild to moderate pain management. Which assessment finding indicates the patient is experiencing a side effect of this drug? a. Abdominal bloating and cramping b. Ventricular cardiac dysrhythmias c. Decreased urinary output d. Jaundice

a

The nurse on a medical-surgical unit is caring for several patients with acute cholecystitis. Which task is best to delegate to the unlicensed assistive personnel (UAP)? a. Obtain the patients' vital signs. b. Determine if any foods are not tolerated. c. Assess what measures relieve the abdominal pain. d. Ask the patients to describe their daily activity or exercise routines.

a

The patient with acute pancreatitis experiences abdominal pain. What is the best intervention to begin management of this pain? a. IV opioids by means of patient-controlled analgesia (PCA) b. Oral opioids such as morphine sulfate given as needed c. Intramuscular opioids given every 6 hours d. Oral hydromorphone (Dilaudid) given twice a day

a

Which factor renders a patient the least likely to benefit from ESWL for the treatment of gallstones? a. Height 5 feet 10 inches, 325 lbs. b. Cholesterol-based stones c. Height 5 feet 7 inches, 138 lbs. d. Small gallstones

a

Which abnormal laboratory findings are cardinal findings in acute pancreatitis? (Select all that apply.) a. Elevated serum lipase b. Increased serum amylase c. Decreased serum trypsin d. Elevated serum elastase e. Elevated serum glucose

a, b, d

Which statements are true regarding laparoscopic cholecystectomy? (Select all that apply.) a. Laparoscopic cholecystectomy is considered the "gold standard" and is performed far more often than the traditional open approach. b. Patients with chronic lung disease or heart failure who are unable to tolerate the oxygen used in the laparoscopic procedure are examples of patients who have the open surgical approach (abdominal laparotomy). c. Removing the gallbladder with the laparoscopic technique reduces the risk of wound complications. d. Patients who have their gallbladders removed by the laparoscopic technique should be taught the importance of early ambulation to promote absorption of carbon dioxide. e. Use of laparoscopic cholecystectomy puts the patient at increased risk for bile duct injuries.

a, c, d

Which are common manifestations of acute cholecystitis? (Select all that apply.) a. Anorexia b. Ascites c. Eructation d. Steatorrhea e. Jaundice f. Rebound tenderness

a, c, e, f

Which are manifestations of pancreatic cancer

all answers right but light colored urine and dark colored stools

The nurse is caring for a patient with pancreatic cancer who had a whipple procedure. which interventions and assessments does the nurse implement

all but answers right but monitor NG drainage, which should be nile tinged and contain blood

Which is a key feature of pancreatic cancer

anorexia

A patient is scheduled for tests to verify the medical diagnosis of cholecystitis. For which diagnostic test does the nurse provide patient teaching? a. Extracorporeal shock wave lithotripsy (ESWL) b. Ultrasonography of the right upper quadrant c. Endoscopic retrograde cholangiopancreatography (ERCP) d. Serum level of aspartate aminotransferase (AST)

b

The nurse detects an epigastric mass while assessing a patient with acute pancreatitis. The patient describes epigastric pain that radiates to his back. What does the nurse suspect? a. Liver cirrhosis b. Pancreatic pseudocyst c. Gallstones d. Chronic pancreatitis

b

The nurse is caring for an older adult patient with acute biliary pain. Which drug order does the nurse question? a. Ketorolac (Toradol, Acular) b. Meperidine (Demerol) c. Morphine d. Hydromorphone (Dilaudid)

b

The nurse is evaluating electrolyte values for a patient with acute pancreatitis and notes that the serum calcium is 6.8 mEq/L. How does the nurse interpret this finding? a. Within normal limits considering the diagnosis of acute pancreatitis b. A result of the body not being able to use bound calcium c. A protective measure that will reduce the risk of complications d. Full compensation of the parathyroid gland

b

The nurse is teaching a patient and family how to prevent exacerbations of chronic pancreatitis. Which teaching point does the nurse include? a. Moderation in the use of caffeinated beverages b. Avoidance of alcohol and nicotine c. Consume a bland, high-fat, low-protein diet d. Regular exercise, stressing aerobic activities

b

The patient is to continue pancreatic enzyme replacement therapy (PERT) after discharge. Which statement indicates that the patient understands teaching about this therapy? a. "I will take the enzymes before meals with a full glass of water." b. "I will take the enzymes after I take my ranitidine (Zantac)." c. "I will mix the enzymes with chopped meat." d. "I will chew the capsules before swallowing the enzymes."

b

The patient with acute cholecystitis had a pacemaker. Which diagnostic test is contraindicated? a. ERCP b. Magnetic resonance cholangiopancreatography (MRCP) c. Ultrasonography of the right upper quadrant d. Hepatobiliary (HIDA) scan

b

Which diagnostic test is the most accurate in verifying a diagnosis of acute pancreatitis? a. Trypsin b. Lipase c. Alkaline phosphatase d. Alanine aminotransferase

b

31. The HCP has been paged and is en route to see Mr. R for complications related to acute pancreatitis. The client is increasingly agitated and confused. He pulls out his IV line and NGT and removes the O2 nasal cannula. His skin is pale and clammy. His HR is 140, BP is 140/60. List the following steps, in order of priority, in caring for Mr. R with 1 bring the first and 6 being the last 2,3,4,1,5,6 1. Restart IV 2. Stay with client and call for assistance 3. Replace nasal cannula for supplemental O2 4. Have a colleague gather IV supplies, glucometer, pulse oximeter, and non rebreather mask 5. Check blood glucose level 6. Delegate UAP to take vital signs every 15 minutes

2,3,4,1,5,6

A client is admitted with tentative diagnosis of pancreatitis, the medical and nursing measures for this client are aimed towards maintaining nutrition, promoting rest, maintaining fluid and electrolyte balance and decreasing anxiety. Which intervention should the nurse implement? select all

Administer analgesics, teach relaxation exercises, monitor cardiac rate and rhythm

A nurse is preparing a teaching plan for a client with a history of cholelithiasis, which information about why the ingestion of fatty foods will cause discomfort should the nurse include in the teaching plan?

Bile flow into the intestine is obstructed

Which clinical indicator should the nurse identify before scheduling a client for an endoscopic retrograde cholangiopancreatography (ERCP)?

Bilirubin level

13. Ms. T is discouraged and dispirited about her ulcerative colitis. She is resistant to TPN because "I'm being kept alive with tubes." Which explanation will encourage Ms. T to continue with the TPN therapy? a. "It will help you regain your weight." b. "It will create a positive nitrogen balance" c. "Your HCP has ordered this important therapy for you" d. "Your bowel can rest, and the diarrhea will decrease"

D

10. The RN is supervising the nursing student in administering Ms. D's (bowel obstruction) medications through the NGT. When would the nurse intervene? a. The student compares medication administration record with the original prescription b. The student draws up 30 mL of sterile water for flush in a large-bore syringe c. The student performs three checks of medication names and dosages d. The student crushes tablets and puts all medications in the same cup

D

A nurse is caring for a client with cholelithiasis and obstructive jaundice, when assessing this client, the nurse should be alert for which common clinical indicators associated with these conditions?

Ecchymosis, yellow sclera, pain in right upper quadrant

1. The night shift nurse has just finished giving the team leader a report on the six clients. Which client has the highest acuity level and is at greatest risk for shock during the shift? a. Ms. H (acute cholecystitis) b. Ms. D (bowel obstruction) c. Ms. T (ulcerative colitis) d. Mr. A (appendectomy) e. Mr. K (PEG-tube) f. Mr. R (acute pancreatitis)

F

what is the most common and serious complication after a whipple procedure

Fistula development

The home health nurse sees that the client is taking cimetidine. What question is the nurse most likely to ask to evaluate the efficacy of this therapy?

Has the medication helped to relive the acid indigestion?

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

Incision is in close proximity to the clients diaphragm

A nurse is caring for a client with a diagnosis of acute pancreatitis and alcoholism, the client asks what does my drinking have to do with my diagnosis, what effect of alcohol should the nurse include when responding?

Increases in enzyme secretion and pancreatic duct pressure that causes backflow of enzymes into the pancreas

What is one of the main advantages of cholecystectomy by the natural orifice transluminal endoscopic surgery (NOTES) procedure?

No visible incision lines

Which are advantages of minimally invasive surgery laparoscopic cholecystectomy? select all

complications are uncommon patients recover more rapidly postoperative pain is less severe bile duct injuries are rare

a client is discharged the same day after ambulatory surgery for a laparoscopic cholecystectomy. the nurse is providing discharge teaching about how many days the client should way to engage in activities

getting out of bed performing light exercise showering driving lifting

The patient with acute necrotizing pancreatitis experiences a temperature spike to 104 F what does the nurse suspect

pancreatic abscess