GI NCLEX Practice Questions

A male client is recovering from a small-bowel resection. To relieve pain, the physician prescribes meperidine (Demerol), 75 mg IM every 4 hours. How soon after administration should meperidine onset of action occur? - 5 to 10 minutes - 15 to 30 minutes - 30 to 60 minutes - 2 to 4 hours

15 to 30 minutes Meperidine's onset of action is 15 to 30 minutes. It peaks between 30 and 60 minutes and has a duration of action of 2 to 4 hours

Which condition is most likely to have a nursing diagnosis of fluid volume deficit? - Appendicitis - Pancreatitis - Cholecystitis - Gastric ulcer

Pancreatitis Hypovolemic shock from fluid shifts is a major factor in acute pancreatitis.

Nurse Hannah is teaching a group of middle-aged men about peptic ulcers. When discussing risk factors for peptic ulcers, the nurse should mention: - a sedentary lifestyle and smoking. - a history of hemorrhoids and smoking. - alcohol abuse and a history of acute renal failure. - alcohol abuse and smoking.

alcohol abuse and smoking Risk factors for peptic (gastric and duodenal) ulcers include alcohol abuse, smoking, and stress.

The primary health care provider has determined that a client has contracted hepatitis A based on flu-like symptoms and jaundice. Which statement made by the client supports this medical diagnosis? - "I have had unprotected sex with multiple partners." - "I ate shellfish about two weeks ago at a local restaurant." - "I was an intravenous drug abuser in the past and shared needles." - "I had a blood transfusion 30 years ago after major abdominal surgery."

"I ate shellfish about two weeks ago at a local restaurant." Hepatitis A is transmitted by the fecal-oral route via contaminated water or food (improperly cooked shellfish), or infected food handlers.

The nurse is providing discharge teaching for a client with newly diagnosed Crohn's disease about dietary measures to implement during exacerbation episodes. Which statement made by the client indicates a need for further instruction? - "I should increase the fiber in my diet." - "I will need to avoid caffeinated beverages." - "I'm going to learn some stress reduction techniques." - "I can have exacerbations and remissions with Crohn's disease."

"I should increase the fiber in my diet." Crohn's disease is an inflammatory disease that can occur anywhere in the gastrointestinal tract but most often affects the terminal ileum and leads to thickening and scarring, a narrowed lumen, fistulas, ulcerations, and abscesses. It is characterized by exacerbations and remissions. If stress increases the symptoms of the disease, the client is taught stress management techniques and may require additional counseling. The client is taught to avoid gastrointestinal stimulants containing caffeine and to follow a high-calorie and high-protein diet. A low-fiber diet may be prescribed, especially during periods of exacerbation.

The nurse has taught the client about an upcoming endoscopic retrograde cholangiopancreatography (ERCP) procedure. The nurse determines that the client needs further information if the client makes which statement? - "I know I must sign the consent form." - "I hope the throat spray keeps me from gagging." - "I'm glad I don't have to lie still for this procedure." - "I'm glad some intravenous medication will be given to relax me."

"I'm glad I don't have to lie still for this procedure." The client does have to lie sill for ERCP, which takes about 1 hour to perform. The client also has to sign a consent form. Intravenous sedation is given to relax the client, and an anesthetic spray is used to help keep the client from gagging as the endoscope is passed.

A male client with extreme weakness, pallor, weak peripheral pulses, and disorientation is admitted to the emergency department. His wife reports that he has been "spitting up blood." A Mallory-Weiss tear is suspected, and the nurse begins taking a client history from the client's wife. The question by the nurse that demonstrates her understanding of Mallory-Weiss tearing is: -"Tell me about your husband's alcohol usage." -"Is your husband being treated for tuberculosis?" -"Has your husband recently fallen or injured his chest?" -"Describe spices and condiments your husband uses on food."

"Tell me about your husband's alcohol usage." A Mallory-Weiss tear is associated with massive bleeding after a tear occurs in the mucous membrane at the junction of the esophagus and stomach. There is a strong relationship between ethanol usage, resultant vomiting, and a Mallory-Weiss tear.

A female client who has just been diagnosed with hepatitis A asks, "How could I have gotten this disease?" What is the nurse's best response? - "You may have eaten contaminated restaurant food." - "You could have gotten it by using I.V. drugs." - "You must have received an infected blood transfusion." - "You probably got it by engaging in unprotected sex.""

"You may have eaten contaminated restaurant food." Hepatitis A virus typically is transmitted by the oral-fecal route-- commonly by consuming food contaminated by infected food handlers.

A client has just had a hemorrhoidectomy. Which nursing interventions are appropriate for this client? Select all that apply. - administer stool softeners as prescribed - instruct the client to limit fluid intake to avoid urinary retention - encourage a high-fiber diet to promote bowel movements without straining - apply cold packs to the anal-rectal area over the dressing until the packing is removed - help the client to a Fowler's position to place pressure on the rectal area and decrease bleeding

- administer stool softeners as prescribed - encourage a high-fiber diet to promote bowel movements without straining - apply cold packs to the anal-rectal area over the dressing until the packing is removed Nursing interventions after a hemorrhoidectomy are aimed at management of pain and avoidance of bleeding and incision rupture. Stool softeners and high-fiber diet will help the client avoid straining, thereby reducing the chances of rupturing the incision.

The nurse is planning to teach a client with gastro-esophageal reflux disease (GERD) about substances to avoid. Which items should the nurse include on this list? Select all that apply. - Coffee - Chocolate - Peppermint - Nonfat milk - Fried chicken - Scrambled eggs

- coffee - chocolate - peppermint - fried chicken Foods that decrease lower esophageal sphincter (LES) pressure and irritate the esophagus will increase reflux and exacerbate the symptoms of GERD and therefore should be avoided. Aggravating substances including coffee, chocolate, peppermint, fried or fatty foods, carbonated beverages, and alcohol.

The nurse is assessing a client who is experiencing an acute episode of cholecystitis. Which of these clinical manifestations support this diagnosis? Select all that apply. - fever - positive Cullen's sign - complaints of indigestion - palpable mass in the left upper quadrant - pain in the upper right quadrant after a fatty meal - vague lower right quadrant abdominal discomfort

- fever - complaints of indigestion - pain in the upper right quadrant after a fatty meal During an acute episode of cholecystitis, the client may complain of severe right upper quadrant pain that radiates to the right scapula or shoulder or experience epigastric pain after a fatty or high-volume meal. Fever and signs of dehydration would also be expected, as well as complaints of indigestion, belching, flatulence, nausea, and vomiting. (Cullen's sign is associated with pancreatitis)

A client admitted to the hospital with a suspected diagnosis of acute pancreatitis is being assessed by the nurse. Which assessment findings would be consistent with acute pancreatitis? Select all that apply. - diarrhea - black, tarry stools - hyperactive bowel sounds - gray-blue color at the flank - abdominal guarding and tenderness - left upper quadrant pain with radiation to the back

- gray-blue color at the flank - abdominal guarding and tenderness - left upper quadrant pain with radiation to the back Grayish-blue discoloration at the flank is known as Grey-Turner's sign and occurs as a result of pancreatic enzyme leakage to cutaneous tissue from the peritoneal cavity. The client may demonstrate abdominal guarding and may complain of tenderness with palpation. The pain associated with acute pancreatitis is often sudden in onset and is located in the epigastric region or left upper quadrant with radiation to the back.

The nurse is reviewing the prescription for a client admitted to the hospital with a diagnosis of acute pancreatitis. Which interventions would the nurse expect to be prescribed for the client? Select all that apply. - maintain NPO (nothing by mouth) status - encourage coughing and deep breathing - give small, frequent high-calorie feedings - maintain the client in a supine and flat position - give hydromorphone intravenously as prescribed for pain - maintain intravenous fluids at 10 ml/hr to keep vein open

- maintain NPO status - encourage coughing and deep breathing - give hydromorphone intravenously as prescribed for pain The client with acute pancreatitis normally is placed on NPO status to rest the pancreas and suppress gastrointestinal secretions, so adequate intravenous hydration is necessary. Because abdominal pain is a prominent symptom of pancreatitis, pain medications such as morphine or hydromorphone are prescribed. Meperidine is avoided, as it may cause seizures. Some clients experience lessened pain by assuming positions that flex the trunk, with the knees drawn up to the chest. A side-lying position with the head elevated 45 degrees decreases tension on the abdomen and may help ease the pain. The client is susceptible to respiratory infections because the retroperitoneal fluid raises the diaphragm, which causes the client to take shallow, guarded breaths. Therefore, measures such as turning, coughing, and deep breathing are instituted.

A male client is recovering from an ileostomy that was performed to treat inflammatory bowel disease. During discharge teaching, the nurse should stress the importance of: -increasing fluid intake to prevent dehydration - wearing an appliance pouch only at bed time - consuming a low-protein, high-fiber diet - taking only enteric-coated medications

Increasing fluid intake to prevent dehydration Because stool forms in the large intestine, an ileostomy typically drains liquid waste. To avoid fluid loss through ileostomy drainage, the nurse should instruct the client to increase fluid intake.

While a female client is being prepared for discharge, the nasogastric (NG) feeding tube becomes clogged. To remedy this problem and teach the client's family how to deal with it at home, what should the nurse do? - Irrigate the tube with cola - Advance the tube into the intestine - Apply intermittent suction to the tube - Withdraw the obstruction with a 30-ml syringe

Irrigate the tube with cola The nurse should irrigate the tube with cola because its effervescence and acidity are suited to the purpose, it's inexpensive, and it's readily available in most homes.

The nurse is providing discharge instructions to a client following gastrectomy and should instruct the client to take which measure to assist in preventing dumping syndrome? - ambulate following a meal - eat high-carbohydrate foods - limit the fluids taken with meals - sit in a high-fowler's position during meals

Limit the fluids taken with meals Dumping syndrome is a term that refers to a constellation of vasomotor symptoms that occurs after eating, especially following a gastrojejunostomy (Billroth II procedure). The nurse should instruct the client to decrease the amount of fluid taken at meals and to avoid high-carbohydrate foods, including fluids such as fruit nectars; to assume a low-Fowler's positions during meals; to lie down for 30 minutes after eating to delay gastric emptying; and to take antispasmodics as prescribed.

A male client with a recent history of rectal bleeding is being prepared for a colonoscopy. How should the nurse position the client for this test initially? -Lying on the right side with legs straight -Lying on the left side with knees bent -Prone with the torso elevated -Bent over with hands touching the floor

Lying on the left side with knees bent For a colonoscopy, the nurse initially should position the client on the left side with knees bent; this allows for proper visualization of the large intestine.

A male client with pancreatitis complains of pain. The nurse expects the physician to prescribe meperidine (Demerol) instead of morphine to relieve pain because: - meperidine provides a better, more prolonged analgesic effect. - morphine may cause spasms of Oddi's sphincter. - meperidine is less addictive than morphine. - morphine may cause hepatic dysfunction.

Morphine may cause spasms of Oddi's sphincter. For a client with pancreatitis, the physician will probably avoid prescribing morphine because this drug may trigger spasms of the sphincter of Oddi (a sphincter at the end of the pancreatic duct), causing irritation of the pancreas.

The nurse is caring for a female client with active upper GI bleeding. What is the appropriate diet for this client during the first 24 hours after admission? - regular diet - skim milk - nothing by mouth - clear liquids

Nothing by mouth Shock and bleeding must be controlled before oral intake, so the client should receive nothing by mouth.

A male client undergoes total gastrectomy. Several hours after surgery, the nurse notes that the client's nasogastric (NG) tube has stopped draining. How should the nurse respond? - Notify the physician - Reposition the tube - Irrigate the tube - Increase the suction level

Notify the physician An NG tube that fails to drain during the postoperative period should be reported to the physician immediately. It may be clogged, which could increase pressure on the suture site because fluid isn't draining adequately.

The nurse is monitoring a client admitted to the hospital with a diagnosis of appendicitis who is scheduled for surgery in 2 hours. The client begins to complain of increased abdominal pain and begins to vomit. On assessment, the nurse notes that the abdomen is distended and bowel sounds are diminished. Which is the MOST appropriate nursing intervention? - administer the prescribed pain medication - notify the primary health care provider (PHCP) - call and ask the operating room team to perform surgery as soon as possible - reposition the client and apply a heating pad on the warm setting to the client's abdomen

Notify the primary health care provider (PHCP) On the basis of the signs and symptoms presented in the question, the nurse should suspect peritonitis and notify the PHCP.

"When preparing a male client, age 51, 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? - Obstruction of the appendix may increase venous drainage and cause the appendix to rupture. - Obstruction of the appendix reduces arterial flow, leading to ischemia, inflammation, and rupture of the appendix. - The appendix may develop gangrene and rupture, especially in a middle-aged client. - Infection of the appendix diminishes necrotic arterial blood flow and increases venous drainage.

Obstruction of the appendix reduces arterial flow, leading to ischemia, inflammation, and rupture of the appendix A client with appendicitis is at risk for infection related to inflammation, perforation, and surgery because obstruction of the appendix causes mucus fluid to build up, increasing pressure in the appendix and compressing venous outflow drainage.

A male client has undergone a colon resection. While turning him, would dehiscence with evisceration occurs. The nurse's first response is to: - call the physician - place saline-soaked sterile dressings on the wound - take a blood pressure and pulse - pull the dehiscence closed

Place saline-soaked sterile dressings on the wound The nurse should first place saline-soaked sterile dressings on the open wound to prevent tissue drying and possible infection

A female client with viral hepatitis A is being treated in an acute care facility. Because the client requires enteric precautions, the nurse should: - place the client in a private room - wear a mask when handling the client's bedpan - wash the hands after touching the client - wear a gown when providing personal care for the client

Wash the hands after touching the client To maintain enteric precautions, the nurse must wash the hands after touching the client or potentially contaminated articles and before caring for another client.

A male client has just been diagnosed with hepatitis A. On assessment, the nurse expects to note: - severe abdominal pain radiating to the shoulder - anorexia, nausea, and vomiting - eructation and constipation - abdominal ascites

anorexia, nausea, and vomiting Hallmark signs and symptoms of hepatitis A include anorexia, nausea, vomiting, fatigue, and weakness.

The nurse is reviewing the record of a client with a diagnosis of cirrhosis and notes that there is documentation of the presence of asterixis. How should the nurse assess for its presence? - dorsiflex the client's foot - measure the abdominal girth - ask the client to extend the arms - instruct the client to lean forward

ask the client to extend the arms Asterixis is irregular flapping movements of the fingers and wrists when the hands and arms are outstretched, with the palms down, wrists bent up, and fingers spread. Asterixis is the most common and reliable sign that hepatic encephelopathy is developing.

A client has undergone esophagogastroduodenoscopy. The nurse should place highest priority on which item as part of the client's care plan? - monitoring the temperature - monitoring complaints of heartburn - giving warm gargles for a sore throat - assessing for the return of the gag reflex

assessing for the return of the gag reflex The nurse places highest priority on assessing for return of the gag reflex. This assessment addresses the client's airway.

The nurse is assessing a client 24 hours following a cholecystectomy. The nurse notes that the T-tube has drained 750 mL of green-brown drainage since the surgery. Which nursing intervention is most appropriate? - clamp the T-tube - irrigate the T-tube - document the findings - notify the primary health care provider

document the findings Following cholecystectomy, drainage from the T-tube is initially bloody and then turns a greenish-brown color. The drainage is measured as output. The amount of expected drainage will range from 500 to 1000 mL/day. The nurse would document the output.

The nurse is reviewing the laboratory results for a client with cirrhosis and notes that the ammonia level is 85 mcg/dL (51 mcmol/L). Which dietary selection does the nurse suggest to the client? - roast pork - cheese omelet - pasta with sauce - tuna fish sandwich

pasta with sauce Cirrhosis is a chronic, progressive disease of the liver characterized by diffuse degeneration and destruction of hepatocytes. The serum ammonia level assesses the ability of the liver to deaminate protein byproducts. Normal reference interval is 10 to 80 mcg/dL (6 to 47 mcmol/L). Most of the ammonia in the body is found in the gastrointestinal tract. Protein provided by the diet is transported to the liver by the portal vein. The liver breaks down protein, which results in the formation of ammonia. Foods high in protein should be avoided since the client's ammonia level is elevated above normal range; therefore, pasta with sauce would be the best selection.

The nurse is providing care for a client with a recent transverse colostomy. Which observation requires immediate notification of the primary health care provider? - stoma is beefy red and shiny - purple discoloration of the stoma - skin excoriation around the stoma - semiformed stool noted in the ostomy pouch

purple discoloration of the stoma Ischemia of the stoma would be associated with a dusky or bluish or purple color. Skin excoriation needs to be addressed and treated but does not require as immediate attention as purple discoloration of the stoma.

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

"Avoid coffee and alcoholic beverages." To prevent reflux of stomach acid into the esophagus, the nurse should advise the client to avoid foods and beverages that increase stomach acid, such as coffee and alcohol. The nurse should also teach the client to avoid lying down after meals, which can aggravate reflux, and to take antacids after eating.

The nurse is monitoring a client with a diagnosis of peptic ulcer. Which assessment finding would most likely indicate perforation of the ulcer? - bradycardia - numbness in the legs - nausea and vomiting - a rigid, board-like abdomen

A rigid, board-like abdomen. Perforation of an ulcer is a surgical emergency and is characterized by sudden, sharp, intolerable severe pain beginning in the midepigastric area and spreading over the abdomen, which becomes rigid and board-like. Nausea and vomiting may occur. Tachycardia may occur as hypovolemic shock develops.

A female client with dysphagia is being prepared for discharge. Which outcome indicates that the client is ready for discharge? - The client doesn't exhibit rectal tenesmus - The client is free from esophagitis and achalasia - The client reports diminished duodenal inflammation - The client has normal gastric structures

The client is free from esophagitis and achalasia Dysphagia may be the reason why a client with esophagitis or achalasia seeks treatment.

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

Yellow sclera Yellow sclerae may be the first sign of jaundice, which occurs when the common bile duct is obstructed.

A client has just had surgery to create an ileostomy. The nurse assess the client in the immediate postoperative period for which most frequent complication of this type of surgery? - folate deficiency - malabsorption of fat - intestinal obstruction - fluid and electrolyte imbalance

fluid and electrolyte imbalance A frequent complication that occurs following ileostomy is fluid and electrolyte imbalance. The client requires constant monitoring of intake and output to prevent this from occurring. Losses require replacement by intravenous infusion until the client can tolerate a diet orally.

A client with hiatal hernia chronically experiences heartburn following meals. The nurse should plan to teach the client to avoid which action because it is contraindicated with a hiatal hernia? - lying recumbent following meals - consuming small, frequent, bland meals - taking H2 receptor antagonist medication - raising the head of the bed on 6-inch (15 cm) blocks

lying recumbent following meals Hiatal hernia is caused by a protrusion of a portion of the stomach above the diaphragm where the esophagus usually is positioned. The client usually experiences pain from reflux caused by ingestion of irritating foods, lying flat following meals or at night, and eating large or fatty meals.

The nurse is doing an admission assessment on a client with a history of duodenal ulcer. To determine whether the problem is currently active, the nurse should assess the client for which manifestation of duodenal ulcer? - weigh loss - nausea and vomiting - pain relieved by food intake - pain radiating down the right arm

pain relieved by food intake A frequent symptom of duodenal ulcer is pain that is relieved by. food intake. These clients generally describe the pain as a burning, heavy, sharp, or "hungry" pain that often localizes in the midepigastric area. The client with a duodenal ulcer usually does not experience weight loss or nausea and vomiting. These symptoms are more typical in the client with a gastric ulcer.

A client had a new colostomy created 2 days earlier and is beginning to pass malodorous flatus from the stoma. What is the correct interpretation by the nurse? - this is a normal, expected event - the client is experiencing early signs of ischemic bowel - the client should not have the nasogastric tube removed - this indicates inadequate preoperative preparation

this is a normal, expected event As peristalsis returns following creation of a colostomy, the client begins to pass malodorous flatus. This indicates returning bowel function and is an expected event. Within 72 hours of surgery, the client should begin passing stool via the colostomy.

A client has developed hepatitis A after eating contaminated oysters. The nurse assesses the client for which of the following? - Malaise - Dark stools - Weight gain - Left upper quadrant discomfort

Malaise Hepatitis causes gastrointestinal symptoms such as anorexia, nausea, right upper quadrant discomfort, and weight loss. Fatigue and malaise are common. Stools will be light-clay-colored if conjugated bilirubin is unable to flow out of the liver because inflammation or obstruction of the bile duct.

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

Administering IV fluids IV infusions containing normal saline solution and potassium should be given first to maintain fluid and electrolyte balance. For the client's comfort and to assist in bowel decompression, the nurse should prepare to insert an NG tube next. A blood sample is then obtained for laboratory studies to aid in the diagnosis of bowel obstruction and guide treatment (CBC, electroyltes, BUN). Pain medication often is withheld until obstruction is diagnosed because analgesics can decrease intestinal motility.

The nurse is monitoring a female client receiving paregoric to treat diarrhea for drug interactions. Which drugs can produce additive constipation when given with an opium preparation? - antiarrhythmic drugs - anticholinergic drugs - anticoagulant drugs - antihypertensive drugs

Anticholinergic drugs Paregoric has an additive effect of constipation when used with anticholinergic drugs.

Which of the following nursing interventions should the nurse perform for a female client receiving enteral feedings through a gastrostomy tube? -Change the tube feeding solutions and tubing at least every 24 hours. -Maintain the head of the bed at a 15-degree elevation continuously. -Check the gastrostomy tube for position every 2 days. -Maintain the client on bed rest during the feedings.

Change the tube feeding solutions and tubing at least every 24 hours. Tube feeding solutions and tubing should be changed every 24 hours, or more frequently if the feeding requires it. Doing so prevents contamination and bacterial growth.

Mandy, an adolescent girl is admitted to an acute care facility with severe malnutrition. After a thorough examination, the physician diagnoses anorexia nervosa. When developing the plan of care for this client, the nurse is most likely to include which nursing diagnosis? - Hopelessness - Powerlessness - Chronic low self esteem - Deficient knowledge

Chronic low self-esteem Young women with Chronic low self-esteem -- are at highest risk for anorexia nervosa because they perceive being thin as a way to improve their self confidence.

A female client with hepatitis C develops liver failure and GI hemorrhage. The blood products that would most likely bring about hemostasis in the client are: - whole blood albumin - platelets and packed red blood cells - fresh frozen plasma and whole blood - cryoprecipitate and fresh frozen plasma

Cryoprecipitate and fresh frozen plasma The liver is vital in the synthesis of clotting factors, so when it's diseased or dysfunctional, as in hepatitis C, bleeding occurs. Treatment consists of administering blood products that aid in clotting. These include fresh frozen plasma containing fibrinogen and cryoprecipitate, which have most of the clotting factors.

While palpating a female client's right upper quadrant (RUQ), the nurse would expect to find which of the following structures? - sigmoid colon - appendix - spleen - liver

Liver The RUQ contains the liver, gallbladder, duodenum, head of the pancreas, hepatic flexure of the colon, portions of ascending and transverse colon, and a portion of the right kidney.

When evaluating a male client for complications of acute pancreatitis, the nurse should observe for: -Increased intracranial pressure -decreased urine output -bradycardia -hypertension

Decreased urine output Acute pancreatitis can cause decreased urine output, which results from the renal failure that sometimes accompanies this condition.

Which of the following factors can cause hepatitis A? - contact with infected blood - blood transfusions with infected blood - eating contaminated shellfish - sexual contact with an infected person

Eating contaminated shellfish Hepatitis A can be caused by consuming contaminated water, milk, or food - especially shellfish from contaminated water.

Which laboratory finding is the primary diagnostic indicator for pancreatitis? - Elevated blood urea nitrogen (BUN) - Elevated serum lipase - Elevated aspartate aminotransferase (AST) - Increased lactate dehydrogenase (LD)

Elevated lipase Elevation in serum lipase is the most reliable indicator of pancreatitis because this enzyme is produced solely by the pancreas.

Which diagnostic test would be used first to evaluate a client with upper GI bleeding? - Endoscopy - Upper GI series - Hemoglobin (Hgb) levels and Hematocrit (Hct) - Arteriography

Endoscopy Endoscopy permits direct evaluation of the upper GI tract and can detect 90% of bleeding lesions.

A client is diagnosed with viral hepatitis, complaining of "no appetite" and "losing my taste for food." What instruction should the nurse give the client to provide adequate nutrition? - select foods high in fat - increase intake of fluids, including juices - eat a good supper when anorexia is not as severe - eat less often, preferably only 3 large meals daily

Increase intake of fluids, including juices Although no special diet is required to treat viral hepatitis, it is generally recommended that clients consume a low-fat, as fat may be tolerated poorly because of the decreased bile production. Small, frequent meals are preferable and may even prevent nausea. Frequently, appetite is better in the morning, so it is easier to eat a good breakfast. An adequate fluid intake of 2500 to 3000 mL/day that includes nutritional juices is also important.

The nurse is caring for a male client with cirrhosis. Which assessment findings indicate that the client has deficient vitamin K absorption caused by this hepatic disease? - Dyspnea and fatigue - Ascites and orthopnea - Purpura and petechiae - Gynecomastia and testicular atrophy

Purpura and petechiae A hepatic disorder, such as cirrhosis, may disrupt the liver's normal use of vitamin K to produce prothrombin (a clotting factor). Consequently, the nurse should monitor the client for signs of bleeding, including purpura and petechiae.

During preparation for bowel surgery, a male client receives an antibiotic to reduce intestinal bacteria. Antibiotic therapy may interfere with synthesis of which vitamin and may lead to hypoprothrombinemia? -Vitamin A -Vitamin D -Vitamin E -Vitamin K

Vitamin K Intestinal bacteria synthesize such nutritional substances as vitamin K, thiamin, riboflavin, vitamin B12, folic acid, biotin, and nicotinic acid.