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A client admitted for treatment of a gastric ulcer is being prepared for discharge on antacid therapy. Discharge teaching should include which instruction?

"Continue to take antacids even if your symptoms subside."

Which statement about ileostomy care indicates that the client understands the discharge instruction?

"I need to drink at least 3,000 mL a day of fluid."

While preparing a client for an upper GI endoscopy (esophagogastroduodenoscopy), the nurse would be correct to implement which intervention? Select all that apply.

Instruct not to eat or drink for 6 to 12 hours before the procedure. • Inform the client of receiving a sedative before the procedure.

A client is in a metabolic acidosis from severe diarrhea. What assessment finding would be most concerning?

Irregular heart rate

The nurse is preparing to administer medications to a client through a nasogastric (NG) tube. The nurse has verified placement of the NG tube. Which of the following steps would the nurse perform next?

Flushing with water

Which position would be appropriate for a client with severe ascites?

Fowler's

A nurse must administer an enema to an adult client. The appropriate depth for inserting an enema into an average-sized adult is:

3″ to 4″

When caring for a client with nonresectable colon cancer, which nursing diagnosis requires the nurse to function collaboratively to achieve the best outcome related to client comfort?

Acute pain

A 40-year-old client is admitted to the hospital with a diagnosis of acute cholecystitis. The nurse should contact the health care provider (HCP) to question which prescription?

Administer morphine sulfate 10 mg IM every 4 hours as needed for severe abdominal pain.

An adolescent girl with severe malnutrition is admitted to an acute care facility. After a thorough examination, the physician diagnoses anorexia nervosa. When developing the care plan for this client, the nurse is most likely to include which nursing diagnosis?

Chronic low self-esteem

A client is admitted to the hospital with an exacerbation of his chronic gastritis. What recommendation should the nurse make when evaluating his nutritional status?

Consume yogurt with probiotics daily.

A client reports abdominal pain and vomiting for 24 hours. The client's blood pressure is 98/48 mm Hg. The client is diagnosed with large-bowel obstruction. What is the priority nursing diagnosis for the client

Deficient fluid volume

A nurse is caring for an unconscious client recovering from a closed-head injury following placement of a percutaneous endoscopic gastrostomy (PEG) tube. Which of the following actions has the highest priority?

Elevate the head of the bed during and after the PEG tube feedings.

An older adult client seeks help for chronic constipation. Which recommendation would be most beneficial for the nurse to suggest?

Try eating an apple each day with peanut butter.

The nurse teaches the client who has had rectal surgery the proper timing for cleansing sitz baths. The client has understood the teaching when the client states that it is most important to take a sitz bath:

after a bowel movement.

Which hospitalized client is at risk to develop parotitis?

an 80-year-old client who has poor oral hygiene and is dehydrated

A client has severe diarrhea that has lasted for 2 days. The nurse should now assess the client for:

arrhythmia.

A client undergoes a barium swallow fluoroscopy that confirms gastroesophageal reflux disease (GERD). Based on this diagnosis, the client should be instructed to take which action? Select all that apply.

aspiration of gastric contents.

A client is to take one daily dose of ranitidine at home to treat a peptic ulcer. The client understands proper drug administration of ranitidine when the client will take the drug:

at bedtime.

A client who is scheduled for an open cholecystectomy has been smoking a pack of cigarettes a day for 20 years. For which postoperative complication is the client most at risk?

atelectasis

A client has an elective hemorrhoidectomy. Immediately after surgery, the priority goal of nursing care is to:

control pain.

The nurse should assess the client with chronic pancreatitis for the development of which disorder?

diabetes mellitus

A client with gastroenteritis is admitted to an acute care facility and presents with severe dehydration and electrolyte imbalances. Diagnostic tests reveal the Norwalk virus as the cause of gastroenteritis. Based on this information, the nurse knows that:

enteric precautions must be continued.

The health care provider (HCP) prescribes intestinal decompression with a Cantor tube for a client with an intestinal obstruction. In order to determine effectiveness of intestinal decompression, the nurse should evaluate the client to determine if:

intestinal fluid and gas have been removed.

Which symptom would the nurse most likely observe in a client with cholecystitis from cholelithiasis?

nausea after ingestion of high-fat foods

When assessing a client's inguinal hernia, the nurse should place the client in which position?

standing

When caring for a client with ulcerative colitis the nurse should:

suggest sitz baths as needed.

A client has a positive serologic test for anti-HCV (hepatitis C virus). The nurse should instruct the client:

that follow-up testing for HCV genotype testing is required.

TPN is ordered for a client with Crohn's disease. The TPN solution is having an intended outcome when:

the client's nutritional needs are met.

Which rationale best explains why the nurse should evaluate gastric residual before administering the client's next enteral feeding?

to prevent overdistention of the stomach

The nurse assesses a client who is receiving a tube feeding. Which situation would require prompt intervention from the nurse?

The feeding that is infusing has been hanging for 8 hours.

A client is diagnosed with pancreatitis. Which assessment would be of most concern to the nurse?

Bluish discoloration in periumbilical area

A client with gastric cancer is having a resection. What is the nursing management priority for this client?

Correcting nutritional deficits

A home health nurse who sees a client with diverticulitis is evaluating teaching about dietary modifications necessary to prevent future episodes. Which statement by the client indicates effective teaching?

"I should increase my intake of fresh fruits and vegetables during remissions."

A client is readmitted with an exacerbation of celiac disease 2 weeks after discharge. Which statement by the client indicates the need for a dietary consult?

"I didn't eat anything I shouldn't have; I just ate roast beef on rye bread."

The nurse is admitting a client with acute appendicitis to the emergency department. The client has abdominal pain of 10 on a pain scale of 1 to 10. The client will be going to surgery as soon as possible. The nurse should:

place the client on nothing-by-mouth (NPO) status

The nurse is assessing a client with cirrhosis who has developed hepatic encephalopathy. The nurse should notify the health care provider (HCP) of a decrease in which serum lab value that is a potential precipitating factor for hepatic encephalopathy?

potassium

Which sign or symptom is related primarily to small-bowel obstruction rather than large-bowel obstruction?

profuse vomiting

A physician orders spironolactone, 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

A nurse is providing follow-up teaching at a clinic visit for a client recovering from gastric resection. The client reports sweating, diarrhea, nausea, palpitations, and the desire to lie down 15 to 30 minutes after meals. The nurse suspects the client has dumping syndrome and instructs the client to:

sit upright at least 30 minutes after eating.

The nurse is caring for a client who had a bowel resection one week ago. Which of the following interventions are most appropriate to promote wound healing and reduce risk of infection at the incision site? Select all that apply.

• Provide the client with Ensure supplements. • Increase intake of protein and vitamin C in the diet. • Teach the client to wash hands before touching the incision.

A nurse is caring for a client with a retroperitoneal abscess who is receiving gentamicin 300 mg intravenously every 8 hours. Which client data would the nurse monitor? Select all that apply.

• Urine output • Hearing • BUN and serum creatinine levels

A nurse is assisting with the removal a of central venous access device (CVAD). The nurse should:

instruct the client to take a deep breath and hold it

A nurse should expect to administer which vaccine to the client after a splenectomy?

Pneumococcal vaccine-injection

A client has been prescribed propantheline as part of the treatment for a peptic ulcer. The nurse should assess the client for:

nausea.

The nurse is caring for a client with an exacerbation of ulcerative colitis. The nurse should instruct the client to:

obtain frequent rest periods.

When planning care for a client with hepatitis A, the nurse should review labororatory reports for which laboratory value?

prolonged prothrombin time

The nurse administers fat emulsion solution during TPN as prescribed based on the understanding that this type of solution:

provides essential fatty acids.

A client's nutritional status has been severely compromised through prolonged episodes of nausea and vomiting. Which nutritional therapy will be the most effective in correcting nutritional deficits before surgery?

total parenteral nutrition (TPN) for several days

A client is diagnosed with shigellosis. The nurse teaches the client and family how the disease is transmitted and treated and discusses the need for enteric precautions. The nurse should explain that enteric precautions must be maintained:

until three fecal cultures are negative for Shigella

Diphenoxylate/atropine has been prescribed to treat a client's diarrhea. The nurse should teach the client to report:

urine retention.

A 53-year-old client undergoes colonoscopy for colorectal cancer screening. A polyp was removed during the procedure. Which nursing interventions are necessary when caring for the client immediately after colonoscopy? Select all that apply.

• Monitor vital signs frequently until they are stable. • Observe the client closely for signs and symptoms of bowel perforation. • Inform the client that there may be blood in the stool and to report excessive blood immediately.

A client with a peptic ulcer reports epigastric pain that frequently awakens her during the night. The nurse should instruct the client to do which activities? Select all that apply.

• Obtain adequate rest to reduce stimulation. • Eat small, frequent meals throughout the day. • Take all medications on time as ordered. • Sit up for 1 hour when awakened at night.

A nurse is caring for a client with watery diarrhea and dehydration. Given the client's recent history of heavy antibiotic use, what interventions should the nurse consider?

Wearing gown and gloves when working in the room

The nurse judges that the parents of a newborn with imperforate anus know what a low defect is when they say that the rectum:

has descended through the puborectalis muscle.

A client with a bleeding peptic ulcer is admitted to an acute care facility. As part of therapy, the physician orders cimetidine I.V. Infusing this medication too rapidly may cause:

hypotension

A client has a Jackson-Pratt drainage tube in place the first day after surgical repair of a ruptured diverticulum. The client asks the nurse the purpose of the drain. What is the nurse's best response? "The drainage tube is used to prevent:

infection in the peritoneal cavity."

A client with cholecystitis is receiving propantheline bromide. The client is given this medication because it:

inhibits contraction of the bile duct and gallbladder.

A client is taking an antacid for treatment of a peptic ulcer. Which statement best indicates that the client understands how to correctly take the antacid?

"It is best for me to take my antacid 1 to 3 hours after meals."

Which nursing intervention would most likely promote self-care behaviors in the client with a hiatal hernia?

Ask the client to identify other situations in which the client changed health care habits.

One hour before a client is to undergo abdominal surgery, the physician orders atropine, 0.6 mg I.M. The client asks the nurse why this drug must be administered. How should the nurse respond?

Atropine decreases salivation and gastric secretions."

A nurse is teaching a client how to irrigate his stoma. Which action indicates that the client needs more teaching?

Hanging the irrigation bag 24″ to 36″ (60 to 90 cm) above the stoma

A client has been diagnosed with hepatitis A. Which goal is most appropriate for the client?

Increase activity levels gradually.

A client had surgery for a bowel obstruction 4 days ago. The nurse assesses that the client has not passed any flatus, and there are no bowel sounds. Even though the abdomen has become more distended, the client feels little discomfort. In considering the plan of care, what is the most appropriate first step for the nurse to take?

Insert a nasogastric tube.

A client has been diagnosed with an intestinal obstruction and has a nasogastric tube set to low continuous suction. Which acid-base disturbance is this client at risk for developing?

Metabolic alkalosis

A nurse is caring for a client who has had paraplegia for 6 years. The client is admitted with a bleeding peptic ulcer. What would be a priority teaching concern for the nurse?

Recommending foods included in a bland diet

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. The client's morning ammonia level is 110 mcg/dl. The nurse should suspect which situation?

The client's hepatic function is decreasing.

Before an incisional cholecystectomy is performed, the nurse instructs the client in the correct use of an incentive spirometer. Why is incentive spirometry essential after surgery in the upper abdominal area?

The operative incision is near the diaphragm.