GI prep u practice questions

Which of the following diet instructions are appropriate when teaching a client in the early stages of cirrhosis about nutritional needs? Select all that apply. a) "Restrict your fluid intake to 1,000 ml/day." b) "Limit your caloric intake so that you don't become overweight." c) "I encourage you to eat small, frequent meals." d) "An adequate intake of protein is important to your health." e) "Limit your alcohol intake to one glass of wine daily."

• "I encourage you to eat small, frequent meals." • "An adequate intake of protein is important to your health." Explanation: Appropriate diet instructions for the client in the early stages of cirrhosis include ensuring an adequate intake of protein and eating small, frequent meals. There is no need to limit protein intake unless the patient has evidence of hepatic encephalopathy. Additionally, fluid intake is not restricted unless the client has significant ascites or edema (these typically occur later in the disease). Because of gastrointestinal dysfunction, small, frequent meals are frequently better tolerated than three regular meals. Clients with cirrhosis should be encouraged to increase their caloric intake instead of restricting it. Alcohol intake in any amount is discouraged.

After instructing a client with diverticulosis about appropriate self-care activities, which of the following client comments indicate effective teaching? Select all that apply. a) "With careful attention to my diet, my diverticulosis can be cured." b) "I should exercise regularly." c) "I should follow a diet that's high in fiber." d) "Using a cathartic laxative weekly is okay to control bowel movements." e) "It is important for me to drink at least 2,000 ml of fluid every day."

• "I should follow a diet that's high in fiber." • "It is important for me to drink at least 2,000 ml of fluid every day." • "I should exercise regularly." Explanation: Clients who have diverticulosis should be instructed to maintain a diet high in fiber and, unless contraindicated, should increase their fluid intake to a minimum of 2,000 ml/day. Participating in a regular exercise program is also strongly encouraged. Diverticulosis can be controlled with treatment but cannot be cured. Clients should be instructed to avoid the regular use of cathartic laxatives. Bulk laxatives and stool softeners may be helpful to maintain regularity and decrease straining.

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. a) Stop smoking. b) Take antacids 1 hour and 3 hours after meals. c) Sleep with the head of bed flat. d) Limit alcohol consumption to one drink per day. e) Avoid caffeine and carbonated beverages. f) Follow a high-fat, low-fiber diet.

• Avoid caffeine and carbonated beverages. • Stop smoking. • Take antacids 1 hour and 3 hours after meals. Explanation: The nurse should instruct the client with GERD to follow a low-fat, high-fiber diet. Caffeine, carbonated beverages, alcohol, and smoking should be avoided because they aggravate GERD. In addition, the client should take antacids as prescribed (typically 1 hour and 3 hours after meals and at bedtime). Lying down with the head of bed elevated, not flat, reduces intra-abdominal pressure, thereby reducing the symptoms of GERD

Which of the following is included in a focused assessment of a client who has been diagnosed with hepatic cirrhosis? Select all that apply. a) Nutritional status. b) Capillary refill time. c) Mental status. d) Current use of alcohol. e) Heart sounds.

• Current use of alcohol. • Nutritional status. • Mental status. Explanation: For the client with hepatic cirrhosis, it would be important to assess the client's current use of alcohol because alcohol consumption can have a significant impact on liver function and is, in fact, the major cause of cirrhosis. Continued use of alcohol further destroys liver cells and affects liver function. Assessing the client's nutritional status is also important because impaired nutrition develops in many clients due to gastrointestinal problems and the inability of the liver to metabolize nutrients. Mental status can be affected by the accumulation of ammonia in the blood, leading to hepatic coma if left untreated. The assessment of heart sounds and capillary refill time, while important components of a physical examination, are not priority assessments in the patient with cirrhosis

The nurse should assess the client who is being admitted to the hospital with upper GI bleeding for which of the following? Select all that apply. a) Tachycardia. b) Thirst. c) Rapid respirations. d) Decreased urine output. e) Widening pulse pressure. f) Dry, flushed skin.

• Decreased urine output. • Tachycardia. • Rapid respirations. • Thirst. Explanation: The client who is experiencing upper GI bleeding is at risk for developing hypovolemic shock from blood loss. Therefore, the signs and symptoms the nurse should expect to find are those related to hypovolemia, including decreased urine output, tachycardia, rapid respirations, and thirst. The client's skin would be cool and clammy, not dry and flushed. The client would also be likely to develop hypotension, which would lead to a narrowing pulse pressure, not a widening pulse pressure.

A client is preparing to undergo abdominal paracentesis. Which nursing interventions should be performed before the procedure? Select all that apply. a) Make sure informed consent was obtained. b) Explain the procedure to the client. c) Have the client lie flat in bed. d) Instruct the client to void. e) Open the paracentesis tray using clean technique.

• Explain the procedure to the client. • Make sure informed consent was obtained. • Instruct the client to void. Explanation: The nurse should explain the procedure to the client and make sure informed consent has been obtained. The nurse should instruct the client to void before the procedure to minimize the risk of accidental bladder injury from the needle or trocar and cannula. The nurse should then help the client sit up in bed, expose the client's abdomen, wash hands, and then open the paracentesis tray using sterile technique.

A nurse is assessing a client who has a potential diagnosis of pancreatitis. Which risk factors predispose the client to pancreatitis? Select all that apply. a) Gallstones. b) Hyperlipidemia with excessive triglycerides. c) Hypertension. d) Hypothyroidism. e) Abdominal trauma. f) Excessive alcohol use.

• Gallstones. • Hyperlipidemia with excessive triglycerides. • Abdominal trauma. • Excessive alcohol use. Explanation: Pancreatitis, a chronic or acute inflammation of the pancreas, is a potentially life-threatening condition. Excessive alcohol intake and gallstones are the greatest risk factors. Abdominal trauma can potentiate inflammation. Hyperlipidemia is a risk factor for recurrent pancreatitis. Hypertension and hypothyroidism are not associated with pancreatitis.

A 58-year-old client with osteoarthritis is admitted to the hospital with peptic ulcer disease. Which findings are commonly associated with peptic ulcer disease? Select all that apply. a) Tachycardia b) History of nonsteroidal anti-inflammatory drug (NSAID) use c) Epigastric pain that is relieved by antacids d) Nausea and weight loss e) Low-grade fever f) Localized, colicky periumbilical pain

• History of nonsteroidal anti-inflammatory drug (NSAID) use • Epigastric pain that is relieved by antacids • Nausea and weight loss Explanation: Peptic ulcer disease is characterized by nausea, hematemesis, melena, weight loss, and left-sided epigastric pain, occurring 1 to 2 hours after eating and that is relieved with antacids. Use of NSAIDs is also associated with peptic ulcer disease. Appendicitis begins with generalized or localized colicky periumbilical or epigastric pain, followed by anorexia, nausea, a few episodes of vomiting, low-grade fever, and tachycardia.

A client's stools are light gray in color. The nurse should assess the client further for which of the following? Select all that apply. a) Jaundice. b) Respiratory distress. c) Intolerance to fatty foods. d) Peptic ulcer disease. e) Fever. f) Pain at McBurney's point.

• Jaundice. • Intolerance to fatty foods. • Fever. Correct Explanation: Bile is created in the liver, stored in the gallbladder, and released into the duodenum giving stool its brown color. A bile duct obstruction can cause pale colored stools. Other symptoms associated with cholelithiasis are right upper quadrant tenderness, fever from inflammation or infection, jaundice from elevated serum bilirubin levels, and nausea or right upper quadrant pain after a fatty meal. Pain at McBurney's point lies between the umbilicus and right iliac crest and is associated with appendicitis. A bleeding ulcer produces black, tarry stools. Respiratory distress is not a symptom of cholelithiasis

A client reports vomiting every hour for the past 8 to 10 hours. The nurse should assess the client for risk of which of the following? Select all that apply: a) Hypokalemia b) Hyponatremia c) Metabolic alkalosis d) Metabolic acidosis e) Hyperkalemia

• Metabolic alkalosis • Hypokalemia Explanation: Gastric acid contains a substantial amount of potassium, hydrogen ions, and chloride ions. Frequent vomiting can induce an excessive loss of these acids to alkalosis. Excessive loss of potassium produces hypokalemia. Frequent vomiting does not lead to the condition of too much potassium (hyperkalemia) or too little sodium (hyponatremia).

Which nursing interventions would be most appropriate when caring for a client during the first 24 hours after an appendectomy? Select all that apply. a) Placing the client in a semi-Fowler's position. b) Applying an abdominal binder. c) Teaching the client how to care for the incision. d) Maintaining a clear-liquid diet for 48 hours. e) Monitoring temperature every 2 hours.

• Placing the client in a semi-Fowler's position. • Teaching the client how to care for the incision. Explanation: Following an appendectomy, the client should be placed in a semi-Fowler's position to relieve tension on the abdomen and the surgical incision and promote comfort. Because the client will likely be discharged within 24 to 48 hours of surgery, teaching the client how to care for the wound is a priority. The client does not need to be limited to a clear-liquid diet, but may resume a diet as desired following surgery. Although monitoring temperature is important, unless the temperature is elevated, it does not need to be assessed every 2 hours; every 4 hours is sufficient. An abdominal binder is typically not necessary following an appendectomy

When planning the care for a client diagnosed with hepatitis A, which of the following nursing interventions should the nurse include? Select all that apply. a) Administering pain medication. b) Providing relief from nausea and vomiting. c) Encouraging multiple small meals daily. d) Implementing an exercise program. e) Planning frequent rest periods.

• Providing relief from nausea and vomiting. • Encouraging multiple small meals daily. • Planning frequent rest periods. Explanation: Clients with hepatitis A commonly experience fatigue and altered nutrition due to anorexia and nausea. Because of the severe fatigue associated with hepatitis, clients are encouraged to rest and restrict activity during the active phase of the disease. It is important that frequent rest periods be planned throughout the day. Clients may experience nausea and vomiting; thus, providing relief is important. Small, frequent meals help clients manage the anorexia associated with hepatitis. An exercise program is not appropriate due to the need for rest. Clients with hepatitis do not experience pain. All medications administered to clients with hepatitis need to be evaluated for their potential for hepatotoxicity.

What should the nurse teach a client about how to avoid the dumping syndrome? Select all that apply. a) Eat a diet with high carbohydrate foods with each meal. b) Eat in a relaxing environment. c) Reduce fluids with meals, but take them between meals. d) Consume three regularly-spaced meals per day. e) Obtain adequate amounts of protein and fat in each meal.

• Reduce fluids with meals, but take them between meals. • Obtain adequate amounts of protein and fat in each meal. • Eat in a relaxing environment. Explanation: Dumping syndrome results in excessive, rapid emptying of gastric contents. The nurse should instruct the client to avoid dumping syndrome by eating small, frequent meals rather than three large meals, having a diet high in protein and fat and low in carbohydrates, reducing fluids with meals but taking them between meals, and relaxing when eating. The client should eat slowly and regularly and rest after meals.