med surg gastroinstinal

a nurse is preparing a community education program about hepatitis B which of the following statements should the nurse include in the teaching

A hepatitis B immunization is given to infants and children

a nurse is caring for a client who is receiving total parenteral nutrition therapy and has just returned to the room following physical therapy. the nurse notes that the infusion pump for the client TPN is turned off. after restarting the infusion pump, the nurse should monitor the client for which of the following findings

Diaphoresis weakness anxiety confusion hunger all due to hypoglycemia

a nurse is assessing a client who is experiencing perforation of a peptic ulcer. which of the following manifestation should the nurse expect a. increased blood pressure b. decreased heart rate c. yellowing of the skin d. board-like abdomen

board-like abdomen

a nurse is caring for a client who has recovered from acute diverticulitis. the nurse should instruct the client to increase his intake of which of the following foods when the inflammation subsides a. cucumber and tomatoes b. cabbage and peaches c. strawberries and corn d. figs and nuts

cabbage and peaches

a community health nurse is planning an educational program about hepatitis A. when preparing the materials, the nurse should identify that which of the following groups is most at risk for developing hepatitis A? a. children b. older adults c. women who are pregnant d. middle-ages men

children

a nurse is caring for a client who has diverticulitis and a new prescription for a low-fiber diet. which of the following food items should the nurse remove from the client's meal tray a. canned fruit b. white bread c. broiled hamburger d. coleslaw

coleslaw

a nurse is assessing a client who has a complete intestinal obstruction. which of the following findings should the nurse expect

hyperactive bowel sounds above the obstruction.

a nurse is caring for a client who is postoperative following a laparotomy. the client has an indwelling urinary catheter and a jackson-pratt drain in place. which of the following findings indicates that the client is developing a postoperative complication

pulse oximetry 85%

a nurse in a provider's office is assessing a client who has GERD. the nurse should expect the client to report which of the following manifestations a. regurgitation b. nausea c. belching d. heartburn e. weight loss

regurgitation nausea belching heartburn

a nurse is caring for a client who is 4 hr postoperative following a laparoscopic cholecystectomy. which of the following findings should the nurse expect? a. right shoulder pain b. urine output 20mL/hr c. temperature 38.4 (101.1) d. oxygen saturation 92%

right shoulder pain

a nurse is caring for a client who is 2 days postoperative following gastric surgery and has an NG tube inserted. which of the following findings should the nurse report to the provider

200mL of bright red drainage from the NG tube: must be yellow-green or clear

a nurse is presenting an in-service training session about nutrition. how many amino acids must be obtained from dietary intake

9 (histidine, isoleucine, leucine, lysine, methionine, phenylalanine, threonine, trytophan, and valine) get from sex

a nurse is providing providing preoperative teaching to a client who will undergo surgery to create a temporary colostomy. the client ask the nurse about the difference between colostomies and ileostomies. which of the responses should the nurse make

a colostomy is from the large intestine, and an ileostomy is from the small intestine

a nurse is completing a history and physical assessment for a client who has chronic pancreatitis. which of the following should the nurse identify as a likely cause of the client's condition.

alcohol use

a nurse is caring for a client who has acute pancreatitis. which of the following serum laboratory values should return to the expected reference range within 72 hr of treatment beginning? a. aldose b. lipase c. amylase d. lactic dehydrogenase

amylase

a nurse is assessing a client who is in the early stages of hepatits A. which of the following manifestations should the nurse expect? a. jaundice b. anorexia c. dark urine d. pale feces

anorexia

a nurse is assessing a provider with performing a paracentesis on a client. which of the following actions should the nurse take

ask the client to empty his bladder before the procedure

a nurse is developing a plan of care for a client who has gastroesophageal reflux disease (GERD). the nurse should plan to monitor the client for which of the following complication a. aspiration b. infection c. anemia d. weight loss

aspiration

a nurse in a provider's office is assessing a client who has GERD. when documenting the client's history, the nurse should expect the client to report that symptoms worsen with which of the following actions a. stair-climbing b. bending over c. sitting d. walking

bending over

a nurse is obtaining a guiac test from a client. this test is performed to detect which of the following

blood in stool

a nurse is assessing a client who has cholecystitis. which of the following findings should the nurse expect

blumberg's sign: rebound tenderness

a nurse is caring for a client who is 2 days postoperative following a gastric bypass. the nurse notes that bowel sounds are present. which of the following foods should the nurse provide at the initial feeding a. vanilla pudding b. apple juice c. diet ginger ale d. clear liquids

clear liquid

a nurse is caring for a client who has gastrointestinal bleeding. the provider suspects a bleeding lesion in the colon. the initial approach to treatment likely will involve which of the following procedure a. exploratory laparotomy b. double-contrast barium enema c. magnetic resonance imaging d. colonoscopy

colonoscopy

a nurse is providing teaching to a client who has constipation. which of the following instructions should the nurse include. a. use bismuth subsalicylate regularly (anti-diarrheal) b. consume a low-fiber diet c. eat yogurt with live cultures d. use bisacodyl suppositories regularly

consume a low-fiber diet

a nurse is planning discharge teaching for a client who is postoperative following a traditional open cholecystectomy. which of the following learning needs of the client is the nurse priority

coughing and deep-breathing exercises

a nurse is caring for a client who is 3 days postoperative following abdominal surgery the client states , something just popped when i coughed. which of the following actions should the nurse take first a. cover the client wound with a sterile moist dressing b. flex the client's knees c. reassure the client d. instruct the client to avoid cughing

cover the client wound with a sterile moist dressing

a nurse is planning care for a client who has cholelithiasis. which of the following interventions should the nurse include in the plan

decrease the client's fat intake

a nurse is caring for a child who had her spleen removed following a bicycle accident. the child-parent asks the nurse about the role of the spleen in the body. the nurse should explain that the spleen performs which of the following functions a. maintains fluid balance (renal and endocrine system) b. regulates calcium in the blood---(parathyroid glands) c. destroy old blood cells d. produce prothrombin

destroy old blood cells, filters antigens, and stores platelets

a nurse is teaching a client who has cirrhosis of the liver and s history of alcohol consumption. the nurse should explain that alcohol can cause liver cirrhosis through which of the following actions

destroying liver cells that are later replaced with scar tissue

a nurse is caring for a client from the middle east who has celiac disease. which of the following actions should the nurse perform regarding the client's diet

determine the client's dietary preferences

a nurse is teaching a group of client about the functions of the liver and gallbladder. which of the following should the nurse include in the teaching as the purpose of bile

digesting fats

a nurse is updating the plan of care for a client who has dumping syndrome. which of the following instruction should the nurse include

eat a source of protein with each meal

a nurse is teaching a client who has a colostomy about ways to reduce flatus and odor. which of the following strategies should the nurse include

eat crackers and yogurt regularly

a nurse is providing postoperative teaching about the management of dumping syndrome to a client who had a partial gastrectomy. which of the following instructions should the nurse include in the teaching

eat protein with each meal

a nurse is assessing a client who has a bleeding duodenal ulcer. which of the following findings should the nurse expect

emesis with a coffee ground appearance

A nurse is demonstrating colostomy care to a client who has a new colostomy. which of the following actions should the nurse teach the client to perform a.

empty the bag when it is one-third to one-half full -cut the skin barrier opening a little larger than the ostomy -wash the peristomal skin with mild soap and water

a nurse is caring for a client who has an indwelling urinary catheter. which of the following actions should the nurse take

empty the drainage bag when half-full of urine

a nurse is performing discharge teaching about ostomy care while at home for a client who has a newly placed ileostomy. which of the following instructions should the nurse include in the teaching

empty your ostomy pouch when it becomes half full

a nurse is providing discharge teaching to the partner of a client who has a new diagnosis of hepatitis A. which of the following instructions should the nurse include the teaching

encourage her to eat foods that are high in carbohydrate

a nurse is caring for a client who has an acute exacerbation of crohn's disease. which of the following actions should the nurse take?

ensure bowel rest: place client on NPO to promote healing

a nurse is providing dietary teaching to a client who has diverticulitis about preventing acute attacks. which of the following foods should the nurse recommend

foods high in fiber

a nurse is caring for a client with a history of cirrhosis who has been admitted with manifestations of hepatic encephalopathy. the nurse should anticipate a prescription for which of the following laboratory tests to determine the possibility of recent excessive alcohol use a. gamma-glutamyl transferase (GGT) b. alkaline phosphatase ALP c. serum bilirubin d. Alanine aminotransferase (ALP)

gamma-glutamyl transferase (GGT)

a nurse is teaching dietary-modification strategies to a client who has been newly diagnosed with cirrhosis. which of the following foods should the nurse recommend a. grilled chicken b. potato soup c. fish sticks d. baked ham

grilled chicken

a nurse is providing teaching to a client who is scheduled for a sigmoid colon resection with colostomy. which of the following statements by the client indicates a need for further teaching a. because most of my colon is still intact and functioning my stool will be formed b. my stoma will appear large at first, but it will shrink over the next several weeks c. my colostomy will begin to function in 2 to 6 days after surgery d. i will have to consume a soft diet after surgery

i will have to consume a soft diet after surgery

a nurse is teaching about secondary prevention actions for colorectal cancer for a health fair adults in the community. which of the following topics should the nurse include

importance of colonoscopy screening starting at age 50 years old

a nurse is monitoring the laboratory result of a client who has end-stage liver failure. which of the following results should the nurse expect? a. decreased lactate dehydrogenase b. increased serum albumin c. decreased serum ammonia d. increased prothrombin time

increased prothrombin time

a nurse is caring for a client who has abdominal pain and possible pancreatitis. which of the following results should the nurse identify as an indication of pancreatitis a. decreased white blood cell count b. increased albumin level c. increased serum lipase level d . decreased blood glucose level

increased serum lipase level

a nurse is assessing a client who is 12hr postoperative following an open cholecysteomy. which of the following findings should the nurse report to the provider a. hypoactive bowel sounds b. indwelling urinary catheter output of 25mL/hr c. heart rate of 96/min d. serous drainage at the surgical incision site

indwelling urinary catheter output of 25mL/hr

a nurse is planning an in-service training session regarding nutrition. which of the following minerals should the nurse identify as involved in oxygen transportation a. zinc b. iron c. phosphorus d. magnesium

iron

a nurse is caring for a client who is NPO and has an NG tube to suction. when the client report nausea, which of the following actions should the nurse take a. irrigate the tube with normal saline solution b. provide oral hygiene c. clamp the tube for 30 min d. increase the amount of suction

irrigate the tube with normal saline solution

a nurse is caring for a who has fulminant hepatic failure. which of the following procedures should the nurse anticipate for this client? a, endoscopic sclerotherapy b. liver lobectomy c. liver transplant d. transjugular intrahepatic portal-systemic shunt placement

liver transplant

a nurse is caring for a client who has ulcerative colitis. the provider prescribed bed rest with bathroom privileges. when the client asks the nurse why he has to stay in bed, which of the following responses should the nurse provide?

lying quietly in bed helps slow down the activity in your intestines

a nurse is providing dietary teaching to a client who has dumping syndrome following gastric bypass surgery 4 days ago. which of the following recommendations should the nurse include in the teaching a. avoid foods containing protein b. drink liquids during each meal c. eat foods that contain simple sugar d. maintain a supine position after meals

maintain a supine position after meals

a nurse is admitting a client who has cirrhosis. which of the following prescriptions should the nurse anticipate

obtain the client's PT and INR measurement -administer lactulose 30 ml PO 4 times daily -obtain daily weight and abdominal girth measurements -administer a daily multivitamin

a nurse is recommending dietary modifications for a client who has GERD. the nurse should suggest eliminating which of the following foods from client diet a. oranges and tomatoes b. carrot and bananas c. potatoes and squash d. whole wheat and beans

oranges and tomatoes

a nurse is planning an in-service training session for a group of nurses regarding the role of enzymes in digestion. which of the following enzymes play a role in the digestion of protein a. amylase:glucose b. lipase: breaks down triglyceride into monoglyceride c. steapsin: monoglycerides

pepsin

a nurse is caring for a client who has colitis and reported increased exacerbations due to stress at work. which of the following responses should the nurse make

perhaps we should review your coping mechanisms and talk about other alternatives

a nurse is caring for a client who has percutaneous endoscopic gastrostomy (PEG) tube and is receiving intermittent feedings. prior to initiating the feeding, which of the following actions should the nurse take first a. flush the tube with water b. place the client in the semi-fowler's position c. cleanse the skin around the tube site d. aspirate the tube for residual content

place the client in the semi-fowler's position

a nurse is caring for a client who had a gastric resection to treat adenocarcinoma of the stomach. the client tells the nurse in the PACU that he does not remember why the surgeon said he had to have a tube in his nose. the nurse should explain that the NG tube serves which of the following purposes a. prevents excessive pressure on suture lines b. allows gastric lavage after surgery c. allows early postoperative feeding d. facilitates obtaining gastric specimens for testing

prevents excessive pressure on suture lines

a nurse is providing teaching about nutrients to a client. which of the following statement should the nurse include

protein builds and repairs body tissue

a nurse is caring for a client who is scheduled to undergo a liver biopsy for a suspected malignancy. which of the following laboratory findings should the nurse monitor prior to the procedure a. prothrombin time b. serum lipase c. bilirubin d. calcium

prothrombin time

a nurse is assessing a client who was admitted with a bowel obstruction. the client report severe abdominal pain. which of the following findings indicates that a possible bowel perforation has occurred a. elevated blood pressure---hypotension b. bowel sounds increased in frequency and pitch c. rigid abdomen d. emesis of undigested food

rigid abdomen

a nurse is providing dietary teaching to a client who has ulcerative colitis. which of the following food selections by the client indicates an understanding of the teaching? a. raw vegetable salad with low-fat dressing b. roast chicken and white rice c. fresh fruit salad and milk d. peanut butter on whole wheat bread

roast chicken and white rice

a nurse is teaching a client who has diabetes mellitus about hypoglycemia. which of the following manifestations should the nurse include

shakiness palpitations diaphoresis

a nurse is caring for a client who has cholelithiasis and will undergo a cholecystectomy. the client state she does not understand how she will be alright without her gallbladder. the nurse should explain to the client that which of the following is the main function of the gall bladder a. producing bile b. adding digestive enzymes to bile c. storing bile d. eliminating bile

storing bile

a nurse is performing a gastrointestinal assessment of a client who has liver cirrhosis with abdominal distension. which of the following actions should the nurse take assess for changes in the client's abdominal distension

take serial measurement of the abdomen with a tape measure

a nurse is teaching a newly licensed nurse about caring for a client who is scheduled for an esophagogastric balloon tamponade tube to treat bleeding esophageal varices. which of the following pieces of information should the nurse include in the teaching

the client will be placed on mechanical ventilation prior to this procedure

a nurse is caring for a client who is dehydrates and is receiving continuous tube feeding through a pump at 75 ml/hr. when the nurse assesses the client at 0800, which of the following findings require interventions

the head of the bed is elevated to 20 degrees instead of 30 (semi fowler's position)

a nurse is teaching a client with barret's esophagus who is scheduled to undergo an esophagogastroduodenoscopy (EGD). which of the following statements should the nurse include in the teaching

the procedure can determine how well the lower part of your esophagus works

a nurse is caring for a client who is scheduled to undergo an esophagogastroduodenoscopy (EGD). the nurse should identify that this procedure is for which of the following reasons a. to visualize polyps in the colon b. to detect an ulceration in the stomach c. to identify an obstruction the biliary tract d. to determine the presence of free air in the abdomen

to detect an ulceration in the stomach

a nurse enters a client room and notes smoke coming from a wastebasket in the adjacent bathroom. which of the following actions should the nurse take first

transport the client to an area away from the smoke. R: rescue A: activate fire alarm C: confine the fire E: extinguish the fire

a nurse in the emergency department is caring for a client who has bleeding esophageal varices. the nurse should anticipate a prescription for which of the following medications? a. famotidine b. esomeprazole c. vasopressin d. omeprazole

vasopressin

a nurse is providing teaching to the guardian of a child who has celiac disease. which of the following food should the nurse instruct the guardian to omit from the child's diet a. cornflakes b. reduced-fat milk c. canned fruits d. wheat bread

wheat bread

a nurse is caring for a client who has celiac disease. which of the following foods should the nurse remove from the client's meal tray a. wheat toast, barley, and rye b. tapioca pudding c. hard-boiled egg d. mashed potatoes

wheat toast

a nurse is caring for a client who has acute diverticulitis. while the client has active inflammation, the nurse should instruct the client to include which of the following foods in her diet a. white bread and plain yogurt b. shredded wheat cereal and blueberries c. broccoli and kidney beans d. oatmeal and fresh pears

white bread and plain yogurt