Medsurg Exam #4 Practice Questions GI
The nurse is caring for a client who has been experiencing symptoms of acute gastritis. The client is now reporting an absence of symptoms and increase in hunger. Which action will the nurse take? Call for a regular diet meal tray. Provide applesauce and toast. Ask dietary for a full liquid tray. Maintain nothing by mouth status.
Provide applesauce and toast
The nurse reviews data collected during a client assessment. Which lifestyle modifications will the nurse discuss with the client to prevent the development of gastroesophageal reflux disease (GERD)? Select all that apply. Avoid eating before bedtime Engage in intermittent fasting Achieve a BMI of 22 Limit the intake of alcohol Smoking cessation
Avoid eating before bedtime Achieve a BMI of 22 Limit the intake of alcohol Smoking cessation
Diagnostic imaging and physical assessment have revealed that a client with peptic ulcer disease has suffered a perforated ulcer. The nurse recognizes that emergency interventions must be performed as soon as possible in order to prevent the development of what complication? Gastritis Acute pancreatitis Gastroesophageal reflux Peritonitis
Peritonitis
During the assessment of a patient, the nurse finds asterixis, twitching of the extremities, and notices that the patient is displaying inappropriate behavior and disorientation. Which condition does the nurse suspect?
Hepatic encephalopathy
A patient with suspected esophageal varices is scheduled for an upper endoscopy with moderate sedation. After the procedure is performed, how long should the nurse withhold food and fluids? For 6 hours after the procedure For 2 hours after the last dose of medication is given Until the gag reflex returns Until the patient expresses thirst
Until the gag reflex returns
A client being treated for pancreatitis faces the risk of atelectasis. Which of the following interventions would be important to implement to minimize this risk? Monitor pulse oximetry every hour. Withhold analgesics unless necessary. Instruct the client to cough only when necessary. Use incentive spirometry every hour.
Use incentive spirometry every hour.
A nurse provides nutritional teaching to a client who is scheduled to have bariatric surgery. Which statements will the nurse include on fluid intake after the procedure? Select all that apply. "Avoid drinking liquid calories." "Drink plenty of water." "Drink frequent, small amounts of liquids." "Drink water at meals." "Drink liquids 30-60 minutes after eating."
"Drink plenty of water." "Avoid drinking liquid calories." "Drink frequent, small amounts of liquids." "Drink liquids 30-60 minutes after eating."
A client has been diagnosed with chronic gastritis. The nurse knows that which of the following symptoms are indicative of gastritis? Select all that apply. Early satiety Sour taste in the mouth Hematemesis Belching Hiccups
Belching Early satiety Hematemesis
Clients diagnosed with esophageal varices are at risk for hemorrhagic shock. Which is a sign of potential hypovolemia? Warm moist skin Hypotension Bradycardia Polyuria
Hypotension
A nurse is teaching a client with gastritis about the need to avoid the intake of caffeinated beverages. The client asks why this is so important. Which explanation from the nurse would be most accurate? "Caffeine intake can cause tears in your esophagus and intestines, which can lead to hemorrhage." "Caffeine stimulates the central nervous system and thus gastric activity and secretions, which need to be minimized to promote recovery." "Caffeine can interfere with absorption of vitamin B12, which leads to anemia and further digestive problems." "Caffeine increases the fluid volume in your system, which irritates your digestive organs."
"Caffeine stimulates the central nervous system and thus gastric activity and secretions, which need to be minimized to promote recovery."
The nurse is preparing to interview a client with cirrhosis. Based on an understanding of this disorder, which question would be most important to include? "How often do you drink alcohol?" "Have you had an infection recently?" "What type of over-the-counter pain reliever do you use?" "Does your work expose you to chemicals?"
"How often do you drink alcohol?"
The management of the client's gastrostomy is an assessment priority for the home care nurse. What statement would indicate that the client is managing the tube correctly? "I try to stay still most of the time to avoid dislodging my tube." "I clean my stoma twice a day with alcohol." "I flush my tube with water before and after each of my medications." "The only time I flush my tube is when I'm putting in medications."
"I flush my tube with water before and after each of my medications."
A nurse is caring for a client with suspected inflammatory bowel disease. Which statement if made by the client is most indicative of Crohn's disease? "I have a burning in my chest after I eat" "I have lost 10 pounds in the last month" "I have pain in my right lower quadrant" "I have a mass in the left lower quadrant"
"I have lost 10 pounds in the last month"
A nurse is providing dietary instructions to a client with a history of pancreatitis. Which instruction is correct? "Maintain a high-sodium, high-calorie diet." "Maintain a high-fat diet and drink at least 3 L of fluid a day." "Maintain a high-fat, high-carbohydrate diet." "Maintain a high-carbohydrate, low-fat diet."
"Maintain a high-carbohydrate, low-fat diet."
A client who has just been diagnosed with hepatitis A asks, "How did I get this disease?" What is the nurse's best response? "You could have gotten it by using I.V. drugs." "You may have eaten contaminated restaurant food." "You probably got it by engaging in unprotected sex." "You must have received an infected blood transfusion."
"You may have eaten contaminated restaurant food."
A client with worsening liver failure presents to the med-surge floor...which assessment findings should the nurse expect? Select All That Apply 1. Enlarged abdomen for ascites 2. Bruise marks on the skin 3. Fatigue and possible confusion 4. Sclera that appears yellow 5. Reports of itchy skin
1. Enlarged abdomen for ascites 2. Bruise marks on the skin 3. Fatigue and possible confusion 4. Sclera that appears yellow 5. Reports of itchy skin
A patient is receiving continuous tube feedings via a small bore feeding tube. The nurse irrigates the tube after administering medication to maintain patency. Which size syringe would the nurse use? 10-mL 20-mL 5-mL 30-mL
30-mL
The nurse is educating a patient with cirrhosis about the importance of maintaining a low-sodium diet. What food item would be permitted on a low-sodium diet? Hot dog Peanut butter Sliced ham A pear
A pear
Michael, 42 y.o. The man is admitted to the med-surg floor with a diagnosis of acute pancreatitis. His BP is 136/76, pulse 96, Resps 22, and temp 101. His past history includes hyperlipidemia and alcohol abuse. The doctor prescribes an NG tube. Before inserting the tube, you explain the purpose to the patient. Which of the following is the most accurate explanation? A. "It empties the stomach of fluids and gas." B. "It prevents spasms at the sphincter of Oddi." C. "It prevents air from forming in the small intestine and large intestine." D. "It removes bile from the gallbladder."
A. "It empties the stomach of fluids and gas."
The nurse is caring for a client who has obesity and who has been prescribed naltrexone/bupropion. What assessments should the nurse perform? Select all that apply. Mood and affect Blood pressure Cognition and orientation Alcohol intake Skin integrity
A. Alcohol intake B. Mood and affect E. Blood pressure
A clinical manifestation of acute pancreatitis is epigastric pain. Your nursing intervention to facilitate relief of pain would place the patient in a: A. Knee-chest position B. Semi-Fowler's position C. Recumbent position D. Low-Fowler's position
A. Knee-chest position
A nurse is caring for a client with gastroesophageal reflux disease (GERD). After lunch, the client states they are having 4 out of 10 chest pain. What is the most appropriate intervention? A. Tell the client this is expected and to report if it gets worse B. Call a rapid response team member to come evaluate C. Check the client's apical pulse for rate and regularity D. Administer their PRN order of calcium carbonate
Administer their PRN order of calcium carbonate
A client's health care provider has ordered a "liver panel" in response to the client's development of jaundice. When reviewing the results of this laboratory testing, the nurse should expect to review what blood tests? Select all that apply. Gamma-glutamyl transferase (GGT) C-reactive protein (CRP) Alanine aminotransferase (ALT) B-type natriuretic peptide (BNP) Aspartate aminotransferase (AST)
Alanine aminotransferase (ALT) Gamma-glutamyl transferase (GGT) Aspartate aminotransferase (AST)
What intervention does the nurse anticipate providing for the patient with ascites that will help correct the decrease in effective arterial blood volume that leads to sodium retention? Diuretic therapy Albumin infusion Therapeutic paracentesis Platelet infusions
Albumin infusion
Lactulose (Cephulac) is administered to a patient diagnosed with hepatic encephalopathy to reduce which of the following? Alcohol Ammonia Calcium Bicarbonate
Ammonia
Which blood lab values are expected to be elevated in a client with worsening liver cirrhosis? Select all that apply Ammonia Bilirubin Prothrombin time (PT) Albumin Calcium
Ammonia Bilirubin Prothrombin time (PT)
What are the liver failure labs?
Ammonia HIGH - Hepatic encephalopathy Albumin (low - under 3.5) - Calcium Low and Low platelets Bilirubin HIGH Coagulation Panel (Clotting time HIGH) HIGH PT, PTT, and INR Elevated ALT and AST (cirrhosis and hepatitis)
The digestion of carbohydrates is aided by trypsin. secretin. amylase. lipase.
Amylase
Which hematologic symptom might be noted in a patient with cirrhosis of the liver? (Select all that apply)?
Anemia Leukopenia Thrombocytopenia
Which assessments would indicate if a client with cirrhosis has progressed to hepatic encephalopathy?
Ask the client for their date of birth, name, date, and location Tell the client to extend their arms Compare ammonia blood levels with that of previous shifts (higher - more encephalopathy)
A client with a peptic ulcer is about to begin a therapeutic regimen that includes a bland diet, antacids, and famotidine. Before the client is discharged, the nurse should provide which instruction? "Stop taking the drugs when your symptoms subside." "Increase your intake of fluids containing caffeine." "Eat three balanced meals every day." "Avoid aspirin and products that contain aspirin."
Avoid aspiration and products that contain aspirin
The nurse is caring for a client receiving continuous tube feedings. The nurse knows that flushing the tube to maintain patency will be done at certain times. Which of the following times would the nurse check for patency? Select all that apply. Before and after medication administration When refilling the formula container Every 4 hours When the feeding is interrupted for any reason After checking for gastric residual
Before and after medication administration Every 4 hours After checking for gastric residual
The nurse is assessing a client with a bleeding gastric ulcer. When examining the client's stool, which characteristic would the nurse be most likely to find? Bright red blood in stool Clay-like quality Green color and texture Black and tarry appearance
Black and tarry appearance
Which complication is a patient with cirrhosis at risk for?
Bleeding
A client with advanced cirrhosis has been diagnosed with hepatic encephalopathy. The nurse expects to assess for: A. Malaise B. Stomatitis C. Hand tremors D. Weight loss
C. Hand tremors
The nurse is administering total parenteral nutrition (TPN) to a client who underwent surgery for gastric cancer. Which of the nurse's assessments most directly addresses a major complication of TPN? Monitoring the client's level of consciousness each shift Checking the client's capillary blood glucose levels regularly Having the client frequently rate his or her hunger on a 10-point scale Measuring the client's heart rhythm at least every 6 hours
Checking the client's capillary blood glucose levels regularly
A nurse is preparing to administer metoclopramide to a client. What is the expected outcome of this medication? A. Client states they are having less frequent stools B. Client states their nausea is improved C. Client states their appetite is increased D. Client states their stool are softer
Client states their nausea is improved
A nurse is providing care for a client who has a diagnosis of irritable bowel syndrome (IBS). When planning this client's care, the nurse should collaborate with the client and prioritize what goal? Client will demonstrate appropriate care of his ileostomy. Client will accurately identify foods that trigger symptoms. Client will demonstrate appropriate use of standard infection control precautions. Client will adhere to recommended guidelines for mobility and activity.
Client will accurately identify foods that trigger symptoms.
Which of the following is the diagnostic of choice if the suspected diagnosis is diverticulitis? Computed tomography scan Barium enema Colonoscopy Magnetic resonance imaging
Computed tomography scan
Crohn's disease can be described as a chronic relapsing disease. Which of the following areas in the GI system may be involved with this disease? A. The entire length of the large colon. B. Only the sigmoid area. C. The entire large colon through the layers of mucosa and submucosa. D. The small intestine and colon; affecting the entire thickness of the bowel.
D. The small intestine and colon; affecting the entire thickness of the bowel.
Which nursing assessment is most important in a client diagnosed with ascites? Palpation of abdomen for a fluid shift Auscultation of abdomen Assessment of the oral cavity for foul-smelling breath Daily measurement of weight and abdominal girth
Daily measurement of weight and abdominal girth
A client telephones the medical clinic to ask for help with pruritus and a change in stool color. Which additional symptom(s) indicates to the nurse that the client is experiencing gallbladder stones? Select all that apply. Epigastric pain Dark-colored urine Diarrhea Yellow sclera Right shoulder pain
Dark-colored urine Right Shoulder Pain Yellow sclera
A client recovering from a cholecystectomy has decreased breath sounds bilaterally in the lower lobes. Which action(s) will the nurse take to improve the client's respiratory function? Select all that apply. Deep breathe and cough every hour. Splint the affected area. Assist to ambulate as prescribed. Use the incentive spirometer as instructed. Raise the head of the bed.
Deep breathe and cough every hour. Use the incentive spirometer as instructed. Raise the head of the bed. Splint the affected area Assist to ambulate as prescribed
A client with a gastrojejunostomy is beginning to take solid food. Which finding would lead the nurse to suspect that the client is experiencing dumping syndrome? Slowed heart beat Dry skin Hyperglycemia Diarrhea
Diarrhea
The nurse is assessing a client who had an ileostomy created three days ago for the treatment of irritable bowel disease. The nurse observes that the client's stoma is bright red and there are scant amounts of blood on the stoma. What is the nurse's best action? Contact the care provider to have the client's hemoglobin and hematocrit measured. Apply barrier ointment to the stoma as prescribed. Document these expected assessment findings. Cleanse the stoma with alcohol or chlorhexidine.
Document these expected assessment findings.
A client is being treated for diverticulosis. Which points should the nurse include in this client's teaching plan? Select all that apply. Drink at least 8 to 10 large glasses of fluid every day. Encourage an individualized exercise program Do not suppress the urge to defecate. Use bulk-forming laxatives Avoid high-fiber foods
Drink at least 8 to 10 large glasses of fluid every day. Do not suppress the urge to defecate. Use bulk-forming laxatives Encourage an individualized exercise program
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. Based on the client's assessment, what will the nurse suspect? Dehiscence of the surgical wound Dumping syndrome A normal reaction to surgery Peritonitis
Dumping syndrome
Which term refers to the first portion of the small intestine? Peritoneum Pylorus Duodenum Omentum
Duodenum
Health teaching for a patient with GERD is directed toward decreasing lower esophageal sphincter pressure and irritation. The nurse instructs the patient to do which of the following? Select all that apply. Eat 1 hour before bedtime so there will be food in the stomach overnight to absorb excess acid. Elevate the head of the bed on 6- to 8-inch blocks. Elevate the upper body on pillows. Avoid beer, especially in the evening. Drink three, 8 oz. glasses of regular milk daily to coat the esophagus.
Elevate the head of the bed on 6- to 8-inch blocks. Elevate the upper body on pillows. Avoid beer, especially in the evening.
Which client should the nurse assess first? (What will usually be the answer?)
Epigastric pain after endoscopic retrograde chloangiopancreatography
A nurse is caring for a client who just has been diagnosed with a peptic ulcer. When teaching the client about his new diagnosis, how should the nurse best describe it? Viral invasion of the stomach wall Bleeding from the mucosa in the stomach Inflammation of the lining of the stomach Erosion of the lining of the stomach or intestine
Erosion of the lining of the stomach of intestine
A client has been brought into the ED via ambulance, reporting acute generalized abdominal pain, nausea, fever, and constipation. The healthcare provider suspects appendicitis, but testing has not been performed yet to make a definitive diagnosis. What will the nurse most likely do while initially caring for this client? Perform the test for rebound tenderness. Frequently palpate the abdomen to assess for changes that might indicate the onset of a perforation. Explain to the client why analgesics are being withheld. Administer a laxative to relieve the client's constipation.
Explain to the client why analgesics are being withheld.
The nurse reviews data collected during a health history with a client. Which finding(s) does the nurse identify that increases the client's risk of developing cholesterol gallbladder stones? Select all that apply. Body mass index 23 Female Age 45 History of appendicitis Vegan eating plan
Female Age 45
The nurse is caring for a client who is undergoing diagnostic testing for suspected malabsorption. When taking this client's health history and performing the physical assessment, the nurse should recognize what finding as most consistent with this diagnosis? Fever accompanied by a rigid, tender abdomen Recurrent constipation coupled with weight loss Bloody bowel movements accompanied by fecal incontinence Foul-smelling diarrhea that contains fat
Foul-smelling diarrhea that contains fat
A client with a history of pancreatitis seeks medical attention for increasing episodes of abdominal pain. Which assessment finding(s) indicate to the nurse that the client is experiencing chronic pancreatitis? Select all that apply. Rectal bleeding Foul-smelling stools Weight loss Constipation Anorexia
Foul-smelling stools Constipation Anorexia
Which condition in a client with pancreatitis makes it necessary for the nurse to check fluid intake and output, check hourly urine output, and monitor electrolyte levels? Dry mouth, which makes the client thirsty Frequent vomiting, leading to loss of fluid volume Acetone in the urine High glucose concentration in the blood
Frequent vomiting, leading to loss of fluid volume
A nurse is assisting with serving dinner trays on the unit. Upon receiving the dinner tray for a client admitted with acute gallbladder inflammation, the nurse will question which of the following foods on the tray? Mashed potatoes Fried chicken Dinner roll Tapioca pudding
Fried chicken
Physician orders were written for a client admitted to the hospital with acute pancreatitis. Which order requires follow-up by the nurse?
Full liquid diet (Client should remain NPO)
A nurse is preparing a client for surgery. During preoperative teaching, the client asks where is bile stored. The nurse knows that bile is stored in the: Common bile duct Gallbladder Cystic duct Duodenum
Gallbladder
A patient describes a burning sensation in the esophagus, pain when swallowing, and frequent indigestion. What does the nurse suspect that these clinical manifestations indicate? Gastroesophageal reflux disease Esophageal cancer Diverticulitis Peptic ulcer disease
Gastroesophageal reflux disease
A client with suspected biliary obstruction due to gallstones reports changes to the color of his stools. Which stool color does the nurse recognize as common to biliary obstruction? Gray Green Red Black
Gray
A client admitted to the hospital. Which assessment findings would be consistent with acute pancreatitis? Select All That Apply
Gray-blue color at the flank Abdominal guarding and tenderness Left upper quadrant pain that radiates to the back
Which food would be most appropriate for a patient who recently has a bout of acute pancreaititis? Select All That Apply
Grilled chicken and a baked potato Reduced fat cheese and whole wheat crackers
A nurse is assisting with a paracentesis for a patient with ascites caused by cirrhosis. Which action should the nurse take first?
Have the patient empty their bladder
A client and spouse are visiting the clinic. The client recently experienced a seizure and says she has been having difficulty writing. Before the seizure, the client says that for several weeks she was sleeping late into the day but having restlessness and insomnia at night. The client's husband says that he has noticed the client has been moody and slightly confused. Which of the following problems is most consistent with the client's clinical manifestations? Esophageal varices Hepatic encephalopathy Hepatitis C Portal hypertension
Hepatic encephalopathy
Which term refers to a protrusion of the intestine through a weakened area in the abdominal wall? Tumor Hernia Volvulus Adhesion
Hernia
Upon receiving the dinner tray for a client admitted with acute gallbladder inflammation, the nurse will question which of the following foods on the tray? Hot roast beef sandwich with gravy White rice Vanilla pudding Mashed potatoes
Hot roast beef sandwich with gravy
The nurse is assessing a client admited with suspected pancreatitis. Which question will the nurse prioritize when assessing this client? "When was the last time you took acetaminophen?" "How often and how long do you exercise each day? "How much alcohol do you consume in a day?" "How many meals do you eat every day?"
How much alcohol do you consume in a day
A client who has occasional gastric symptoms is receiving teaching on how to prevent gastroesophageal reflux disease (GERD). Which statement indicates the client understands the teaching? "I will plan to sleep flat without pillows." "I will eliminate bothersome foods from my diet." "I will start taking a nap after meals, when possible." "I will eat two large meals a day instead of three."
I will eliminate bothersome foods from my diet
After performing a physical assessment and obtaining vital signs for a client with acute pancreatitis, which nursing intervention is the priority?
IV fluids and pain control
A nurse caring for clients with obesity understands these clients are at increased risk for developing pressure ulcers. What does the nurse recognize increases the client's risk for developing pressure ulcers? Select all that apply. Increased adipose tissue decreases the supply of blood, oxygen, and nutrients to peripheral tissue. Increased adipose tissue causes thinning of the skin and risk for decreased integrity. Normal healing mechanisms are impaired. Inflammation is worse and leads to risk of infection. Skin folds are associated with more moisture and friction.
Increased adipose tissue decreases the supply of blood, oxygen, and nutrients to peripheral tissue. Skin folds are associated with more moisture and friction.
The nurse is caring for a client with chronic pancreatitis. Which symptom would indicate the client has developed secondary diabetes? Increased appetite and thirst Decreased urination and constipation Low blood pressure and pulse Vomiting and diarrhea
Increased appetite and thirst
What do we want to monitor in patients with Cirrhosis? (What are the lab values?)
Increased bilirubin levels
A client presents to the clinic reporting vomiting and burning in the mid-epigastria. The nurse knows that in the process of confirming peptic ulcer disease, the health care provider is likely to order a diagnostic test to detect the presence of what? An incompetent pyloric sphincter A metabolic acid-base imbalance Infection with Helicobacter pylori Excessive stomach acid secretion
Infection with Helicobacter pylori
A 35-year-old client presents at the emergency department with symptoms of a small bowel obstruction. In collaboration with the primary care provider, what intervention should the nurse prioritize? Administration of a glycerin suppository and an oral laxative Administration of a mineral oil enema Insertion of a central venous catheter Insertion of a nasogastric tube
Insertion of a nasogastric tube
When caring for a client with hepatitis B, the nurse should monitor closely for the development of which finding associated with a decrease in hepatic function? Fatigue during ambulation Irritability and drowsiness Pruritus of the arms and legs Jaundice
Irritability and drowsiness
A client with a lengthy history of alcohol addiction is being seen for jaundice. What does the appearance of jaundice most likely indicate? gallbladder disease glucose underproduction liver disorder bile overproduction
Liver disorder
A patient with irritable bowel syndrome has been having more frequent symptoms lately and is not sure what lifestyle changes may have occurred. What suggestion can the nurse provide to identify a trigger for the symptoms? Keep a 1- to 2-week symptom and food diary to identify food triggers. Document how much fluid is being taken to determine if the patient is overhydrating. Begin an exercise regimen and biofeedback to determine if external stress is a trigger. Discontinue the use of any medication presently being taken to determine if medication is a trigger.
Keep a 1- to 2-week symptom and food diary to identify food triggers.
A patient is not having daily bowel movements and has begun taking a laxative for this problem. What should the nurse educate the patient about regarding laxative use? When taking the laxatives, plenty of fluid should be taken as well. Laxatives should not be routinely taken due to destruction of nerve endings in the colon. The laxatives should be taken no more than 3 times a week or laxative addiction will result. Laxatives should never be the first response for the treatment of constipation; natural methods should be employed first.
Laxatives should not be routinely taken due to destruction of nerve endings in the colon.
A nurse is caring for a client with a BMI of 35 kg/m2 who is wanting to lose weight. What is the initial recommendation the nurse will expect from the client's health care provider? Surgical interventions Pharmacological management Nonsurgical interventions Lifestyle modification
Lifestyle modification
Which enzyme aids in the digestion of fats? Trypsin Lipase Amylase Secretin
Lipase
A client is suspected of having cirrhosis of the liver. What diagnostic procedure will the nurse prepare the client for in order to obtain a confirmed diagnosis? Platelet count A CT scan A liver biopsy A prothrombin time
Liver biopsy
Diet modifications for patient diagnosed with chronic inflammatory bowel disease include which of the following? Low protein Iron restriction Calorie restriction Low residue
Low residue
From the following profiles of clients, which client would be most likely to undergo the diagnostic test of cholecystography? Andrew, suspected of having esophageal abnormalities Sandra, suspected of having lesions in the liver Mark, suspected of having stones in the gallbladder Steven, suspected of having a tumor in the colon
Mark, suspected of having stones in the gallbladder
The nurse is caring for a client who has ascites as a result of hepatic dysfunction. What intervention can the nurse provide to determine if the ascites is increasing? Select all that apply. Perform daily weights. Monitor number of bowel movements per day. Measure urine output every 8 hours. Measure abdominal girth daily. Assess and document vital signs every 4 hours.
Measure abdominal girth daily. Perform daily weights. Measure urine output every 8 hours.
A client comes to the clinic reporting pain in the epigastric region. What statement by the client is specific to the presence of a duodenal ulcer? "I know that my father and my grandfather both had ulcers." "I seem to have bowel movements more often than I usually do." "My pain resolves when I have something to eat." "The pain begins right after I eat."
My pain resolves when I have something to eat
Which clinical manifestation would the nurse expect a client diagnosed with acute cholecystitis to exhibit? A. Jaundice, dark urine, and steatorrhea B. Acute right lower quadrant (RLQ) pain, diarrhea, and dehydration C. Ecchymosis petechiae, and coffee-ground emesis D. Nausea, vomiting, and anorexia
Nausea, vomiting, and anorexia
Client with a history of cirrhosis...with suspected gastroesophageal varices. Which order would the nurse question?
New nasogastric tube insertion
A nurse is caring for a client who has a diagnosis of GI bleed. During shift assessment, the nurse finds the client to be tachycardic and hypotensive, and the client has an episode of hematemesis while the nurse is in the room. In addition to monitoring the client's vital signs and level of conscious, what would be a priority nursing action for this client? Provide the client with ice water to slow any GI bleeding. Place the client in a prone position. Prepare for the insertion of an NG tube. Notify the health care provider.
Notify the health care provider
First action when a client with cirrhosis begins vomiting blood after a meal?
Obtain vital signs (probable esophageal varices)
A patient who had a recent myocardial infarction was brought to the emergency department with bleeding esophageal varices and is presently receiving fluid resuscitation. What first-line pharmacologic therapy does the nurse anticipate administering to control the bleeding from the varices? Glucagon Epinephrine Vasopressin (Pitressin) Octreotide (Sandostatin)
Octreotide (Sandostatin)
The nurse is caring for a client with diarrhea. For which finding will the nurse suspect the diarrhea is caused by pancreatic insufficiency? Voluminous greasy stools Blood, mucus, and pus in the stool Nocturnal diarrhea Oil droplets on the toilet water
Oil droplets on the toilet water
A client is in the hospital for the treatment of peptic ulcer disease. The client reports vomiting and a sudden severe pain in the abdomen. The nurse then assesses a board-like abdomen. What does the nurse suspect these symptoms indicate? Gastric penetration Ineffective treatment for the peptic ulcer A reaction to the medication given for the ulcer Perforation of the peptic ulcer
Perforation of the peptic ulcer
A patient with cirrhosis and esophageal varices is vomiting, and the nurse notes hematemesis. Which action should the nurse take first?
Place the client in the side-lying position (Think ABC)
When caring for a client with acute pancreatitis, the nurse should use which comfort measure? Administering an analgesic once per shift, as ordered, to prevent drug addiction Administering frequent oral feedings Encouraging frequent visits from family and friends Positioning the client on the side with the knees flexed
Positioning the client on the side with the knees flexed
It is important for the nurse to monitor serum electrolytes in a patient with acute diarrhea. Select the electrolyte result that should be immediately reported. Potassium of 2.8 mEq/L Chloride of 100 mEq/L Calcium of 9 mg/dL Sodium of 136 mEq/L
Potassium of 2.8 mEq/L
Which nursing intervention would be the highest priority in managing a patient with ruptured esophageal varices?
Protecting the airway (Think ABC)
A client with cirrhosis...shows signs of hepatic encephalopathy. The nurse should plan a dietary consultant to limit...which ingredient?
Protein (limit the ammonia to cause the hepatic encephalopathy)
The nurse is caring for a patient with severe liver cirrhosis and imbalanced nutrition. Which nursing intervention would prevent malnutrition in this patient?
Provide oral care before meals
The nurse is caring for a hospitalized female client with a diagnosis of ulcerative colitis. Which finding, if noted on assessment of the client, would the nurse report to the physician? A. Hypotension B. Bloody diarrhea C. Rebound tenderness D. A hemoglobin level of 12 mg/dL
Rebound tenderness
Which of the following is the most common symptom of a polyp? Diarrhea Anorexia Rectal bleeding Abdominal pain
Rectal bleeding
The nurse cares for a client who receives feedings through a nasogastric (NG) tube and assesses the client for signs and symptoms of pulmonary complications. The nurse determines the client may be experiencing pulmonary complications when which sign is noted? temperature of 97°F respiratory rate of 30 blood pressure of 110/72 pulse 88
Respiratory rate of 30
A nurse caring for a client with a newly created ileostomy assesses the client and notes that the client has not had ostomy output for the past 12 hours. The client also reports worsening nausea. What is the nurse's priority action? Report signs and symptoms of obstruction to the health care provider. Contact the health care provider and obtain a swab of the stoma for culture. Encourage the client to mobilize in order to enhance motility. Facilitate a referral to the wound-ostomy-continence (WOC) nurse.
Report signs and symptoms of obstruction to the health care provider.
Which is the most common report by clients with pancreatitis? Tarry, black stools and dark urine Severe, radiating abdominal pain Increased appetite and weight gain Increased and painful urination
Severe, radiating abdominal pain
The nurse is concerned about potassium loss when a diuretic is prescribed for a patient with ascites and edema. What diuretic may be ordered that spares potassium and prevents hypokalemia? Spironolactone (Aldactone) Furosemide (Lasix) Acetazolamide (Diamox) Bumetanide (Bumex)
Spironolactone
Leigh Ann is receiving pancrelipase (Viokase) for chronic pancreatitis. Which observation best indicates the treatment is effective? A. There is no skin breakdown. B. Her appetite improves. C. She lost more than 10 lbs. D. Stools are less fatty and decrease in frequency.
Stools are less fatty and decrease in frequency
A client is admitted with a gastrointestinal bleed. What client symptom may indicate a peptic ulcer perforation to the nurse? Bradycardia Sudden, severe upper abdominal pain Hypertension Soft abdomen
Sudden, severe upper abdominal pain
A client who experienced a large upper gastrointestinal (GI) bleed due to gastritis has had the bleeding controlled and is now stable. For the next several hours, the nurse caring for this client should assess for what signs and symptoms of recurrence? Diaphoresis and sudden onset of abdominal pain Sudden thirst, unrelieved by oral fluid administration Tarry, foul-smelling stools Tachycardia, hypotension, and tachypnea
Tachycardia, hypotension, and tachypnea
A client is receiving parenteral nutrition via central line. Which assessment finding is most concerning? A. Blood pressure of 143/77 mm Hg B. Blood glucose 178 mg/dL C. Temperature of 101 F D. Potassium 3.7 mEq/L
Temperature of 101 F
For a client in hepatic coma, which outcome would be the most appropriate? A. The client is oriented to time, place, and person. B. The client exhibits no ecchymotic areas. C. The client increases oral intake to 2,000 calories/day. D. The client exhibits increased serum albumin level.
The client is oriented to time, place, and person
The nurse is assessing a client who has a chronic pain disorder and who also has class II obesity. What principle should guide the care team's choice of pain treatments for this client? The client is more likely to experience relief with NSAIDs than with opioids. The client's renal function must be monitored more closely during pain treatment than in clients without obesity. The client may require higher doses of opioids than clients without obesity. Adverse effects of opioids may be more difficult to assess than in clients without obesity.
The client may require higher doses of opioids than clients without obesity.
The nurse is assessing a client with obesity who has been taking naltrexone/bupropion for the past several weeks. What assessment finding most clearly suggests that the medication is having a desired effect? The client reports a diminished appetite and fewer cravings. The client is able to adhere to a low-carbohydrate, high-protein diet. The client is having one to two bowel movements daily, with fat present in stool. The client is losing at least 6 pounds (2.7 kg) per week, on average.
The client reports a diminished appetite and fewer cravings.
A client with obesity is prescribed orlistat for weight loss. The client asks the nurse, "I understand the medication prevents digestion of fat, but what happens if I eat fat?" What is the nurse's best response? "The fat remains undigested in your stomach." "The fat is passed in your stools." "The fat is absorbed in your intestines." "The fat is excreted in your urine."
The fat is passed in your stools
A nurse is caring for a client who needs a nasogastric (NG) tube for a tube feeding. What is the safe method for the nurse to use to measure the appropriate length of the NG tube? The distance measured from the tip of the nose to the earlobe and from the earlobe to the xiphoid process A length of 50 cm (20 in) The distance measured from the nose to the xiphoid process The distance measured from the tragus of the ear to the xiphoid process
The distance measured from the tip of the nose to the earlobe and from the earlobe to the xiphoid process
A client reports taking a stimulant laxative in order to be able to have a bowel movement daily. What should the nurse inform the client about taking a stimulant laxative? They can be habit forming and will require increasing doses to be effective. The laxative is safe to take with other medication the client is taking. The client should take a fiber supplement along with the stimulant laxative. If the client is drinking 8 glasses of water per day, it is all right to continue taking them.
They can be habit forming and will require increasing doses to be effective.
The physician has written the following orders for a new client admitted with pancreatitis: bed rest, nothing by mouth (NPO), and administration of total parenteral nutrition (TPN) . Which does the nurse attribute as the reason for NPO status? To drain the pancreatic bed To avoid inflammation of the pancreas To aid opening up of pancreatic duct To prevent the occurrence of fibrosis
To avoid inflammation of the pancreas
A client presents to the emergency department with complaints of acute GI distress, bloody diarrhea, weight loss, and fever. Which condition in the family history is most pertinent to the client's current health problem? Gastroesophageal reflux disease Hypertension Ulcerative colitis Appendicitis
Ulcerative colitis
A client has a new order for metoclopramide. What extrapyramidal side effect should the nurse assess for in the client? Hyperactivity Anxiety or irritability Dry mouth not relieved by sugar-free hard candy Uncontrolled rhythmic movements of the face or limbs
Uncontrolled rhythmic movements of the face or limbs
A nurse is preparing a client diagnosed with benign prostatic hyperplasia (BPH) for a lower urinary tract cystoscopic examination. The nurse should caution the client about what common temporary complication of this procedure? Nausea Urinary retention Hemorrhage Bladder perforation
Urinary Retention
A client recovering from a total gastrectomy has a low red blood cell count. Which medication will the nurse expect to be prescribed for this client? Oral iron tablets Vitamin B12 injections Transfusions of packed RBCs Erythropoietin injections
Vitamin B12 injections
During assessment, a patient with chronic liver dysfunction tells the nurse that he is experiencing spontaneous episodes of bleeding and has noticed increased areas of bruising on his chest and arms. The nurse suspects a deficiency in: Vitamin C. Riboflavin Thiamine Vitamin K
Vitamin K
The nurse is caring for a client with a duodenal ulcer. Which assessment findings indicate to the nurse that the client is experiencing perforation from the ulcer? Select all that apply. Vomiting Abdominal pain referred to the right shoulder Tender and rigid abdomen Pulsating mass in the left abdominal region Sudden drop in blood pressure
Vomiting Abdominal pain referred to the right shoulder Tender and rigid abdomen Sudden drop in blood pressure
A nurse is caring for a client with obesity and diabetes after abdominal surgery. What is the client at increased risk for? Hypotension Phlebitis Contractures Wound dehiscence
Wound dehiscence
After teaching nursing students about methods to assess gastric tube placement, the instructor determines that the teaching was successful when the group identifies which of the following as the most accurate method? pH measurement of aspirate Air auscultation Measurement of exposed tubing X-ray visualization
X-ray visualization
The nurse confirms placement of a client's nasogastric (NG) tube using a combination of visual and pH assessment of the aspirate. The nurse determines that the NG tube remains properly placed when the pH of the aspirate is alkaline neutral unmeasurable acidic
acidic
The nurse is caring for a hospitalized client who has class II obesity and who has limited mobility. The nurse should address the client's risk for skin breakdown by: ensuring the client receives a high-calorie, high-protein diet. making a referral to physical therapy. cleaning and drying regularly within the client's skin folds. avoiding the use of pillows to position the client.
cleaning and drying regularly within the client's skin folds.
A client who can't tolerate oral feedings begins receiving intermittent enteral feedings. When monitoring for evidence of intolerance to these feedings, what must the nurse remain alert for? diaphoresis, vomiting, and diarrhea. manifestations of hypoglycemia. constipation, dehydration, and hypercapnia. manifestations of electrolyte disturbances.
diaphoresis, vomiting, and diarrhea
The most common symptom of esophageal disease is vomiting. odynophagia. dysphagia. nausea.
dysphagia
A nurse is caring for a client who is undergoing a diagnostic workup for a suspected gastrointestinal problem. The client reports gnawing epigastric pain following meals and heartburn. What would the nurse suspect this client has? ulcerative colitis peptic ulcer disease appendicitis diverticulitis
peptic ulcer disease
A client with advanced cirrhosis has a prothrombin time (PT) of 15 seconds, compared with a control time of 11 seconds. The nurse expects to administer: spironolactone (Aldactone). furosemide (Lasix). warfarin (Coumadin). phytonadione (Mephyton).
phytonadione (Mephyton).
The nurse is preparing to administer famotidine to a client with gastroesophageal reflux disease. Which safety warning should the nurse consider when administering the medication? that long-term use may be associated with bone fractures cardiac status and sodium restrictions not giving other oral drugs within 1 to 2 hours to not take maximum dose for more than 2 weeks without medical consultation
to not take maximum dose for more than 2 weeks without medical consultation
A nurse is caring for a client who has a history of sleep apnea. The client understands the disease process when he says: "I should become involved in a weight loss program." "I need to keep my inhaler at the bedside." "I should sleep on my side all night long." "I should eat a high-protein diet."
"I should become involved in a weight loss program."
A nurse is preparing a client for endoscopic retrograde cholangiopancreatography (ERCP). The client asks what this test is used for. Which statements by the nurse explains how ERCP can determine the difference between pancreatitis and other biliary disorders? Select all that apply. "It can assess the anatomy of the pancreas and the pancreatic and biliary ducts." "It can assess for ecchymosis in the body." "It can detect unhealthy tissues in the pancreas and assess for abscesses and pseudocysts." "It is used in the diagnostic evaluation of acute pancreatitis." "It can evaluate the presence and location of ductal stones and aid in stone removal."
"It can assess the anatomy of the pancreas and the pancreatic and biliary ducts." "It can detect unhealthy tissues in the pancreas and assess for abscesses and pseudocysts." "It can evaluate the presence and location of ductal stones and aid in stone removal."
You are developing a care plan for Sally, a 67 y.o. patient with hepatic encephalopathy. Which of the following do you include? A. Administering a lactulose enema as ordered. B. Encouraging a protein-rich diet. C. Administering sedatives, as necessary. D. Encouraging ambulation at least four times a day.
A. Administering a lactulose enema as ordered
Mr. Hasakusa is in end-stage liver failure. Which interventions should the nurse implement when addressing hepatic encephalopathy? Select all that apply. A. Assessing the client's neurologic status every 2 hours B. Monitoring the client's hemoglobin and hematocrit levels C. Evaluating the client's serum ammonia level D. Monitoring the client's handwriting daily E. Preparing to insert an esophageal tamponade tube F. Making sure the client's fingernails are short
A. Assessing the client's neurologic status every 2 hours C. Evaluating the client's serum ammonia level D. Monitoring the client's handwriting daily
Which of the following types of diets is implicated in the development of diverticulosis? A. Low-fiber diet B. High-fiber diet C. High-protein diet D. Low-carbohydrate diet
A. Low-fiber diet
A client diagnosed with chronic cirrhosis who has ascites and pitting peripheral edema also has hepatic encephalopathy. Which of the following nursing interventions are appropriate to prevent skin breakdown? Select all that apply. A. Range of motion every 4 hours B. Turn and reposition every 2 hours C. Abdominal and foot massages every 2 hours D. Alternating air pressure mattress E. Sit in chair for 30 minutes each shift
A. Range of motion every 4 hours D. Alternating air pressure mattress
Sharon has cirrhosis of the liver and develops ascites. What intervention is necessary to decrease the excessive accumulation of serous fluid in her peritoneal cavity? A. Restrict fluids. B. Encourage ambulation. C. Increase sodium in the diet. D. Give antacids as prescribed.
A. Restrict fluids
A nurse is caring for a client who recently had a Roux-en-Y gastric bypass. Which teaching will the nurse need to include for this client. Select all that apply. A. Treatment for pernicious anemia B. Need for long-term anticoagulation C. Aim for 6 small meals throughout the day D. Increased protein intake is key E. Signs and treatment of dumping syndrome F. Increase fluid intake with meals
A. Treatment for pernicious anemia C. Aim for 6 small meals throughout the day D. Increased protein intake is key E. Signs and treatment of dumping syndrome
A male client with cholelithiasis has a gallstone lodged in the common bile duct. When assessing this client, the nurse expects to note: A. Yellow sclera B. Light amber urine C. Circumoral pallor D. Black, tarry stools
A. Yellow sclera
An adult client with a history of dyspepsia has been diagnosed with chronic gastritis. The nurse's health education should include what guidelines? Select all that apply. Avoid nonsteroidal anti-inflammatories Adopt a low-residue diet Avoid drinking alcohol Take calcium gluconate as prescribed Prepare for the possibility of surgery
Avoid nonsteroidal anti-inflammatories Avoid drinking alcohol
A nurse is providing health promotion education to a client diagnosed with an esophageal reflux disorder. What practice should the nurse encourage the client to implement? Drink a cup of hot tea before bedtime. Keep the head of the bed lowered. Eat a low-protein diet. Avoid carbonated drinks.
Avoid carbonated drinks
Client with cirrhosis...portal hypertension, ascites, and esophageal varices. Which of the following is correct patient teaching?
Avoid straining when having a bowel movement
Which of the following factors is believed to cause ulcerative colitis? A. Acidic diet B. Altered immunity C. Chronic constipation D. Emotional stress
B. Altered immunity
A male client has just been diagnosed with hepatitis A. On assessment, the nurse expects to note: A. Severe abdominal pain radiating to the shoulder. B. Anorexia, nausea, and vomiting. C. Eructation and constipation. D. Abdominal ascites.
B. Anorexia, nausea, and vomiting.
For a client with hepatic cirrhosis who has altered clotting mechanisms, which intervention would be most important? A. Allowing complete independence of mobility B. Applying pressure to injection sites C. Administering antibiotics as prescribed D. Increasing nutritional intake
B. Applying pressure to injection sites
For Rico who has chronic pancreatitis, which nursing intervention would be most helpful? A. Allowing liberalized fluid intake B. Counseling to stop alcohol consumption C. Encouraging daily exercise D. Modifying dietary protein
B. Counseling to stop alcohol consumption
Matt is a 49 y.o. with a hiatal hernia that you are about to counsel. Health care counseling for Matt should include which of the following instructions? A. Restrict intake of high-carbohydrate foods. B. Increase fluid intake with meals. C. Increase fat intake. D. Eat three regular meals a day.
B. Increase fluid intake with meals
Patients with esophageal varices would reveal the following assessment: A. Increased blood pressure B. Increased heart rate C. Decreased respiratory rate D. Increased urinary output
B. Increased heart rate
Claire, a 33 y.o. is on your floor with a possible bowel obstruction. Which intervention is a priority for her? A. Obtain daily weights. B. Measure abdominal girth. C. Keep strict intake and output. D. Encourage her to increase fluids.
B. Measure abdominal girth
Your patient is complaining of abdominal pain during assessment. What is your priority? A. Auscultate to determine changes in bowel sounds. B. Observe the contour of the abdomen. C. Palpate the abdomen for a mass. D. Percuss the abdomen to determine if fluid is present.
B. Observe the contour of the abdomen
A patient comes to the clinic with the complaint, "I think I have an ulcer." What is a characteristic associated with peptic ulcer pain that the nurse should inquire about? Select all that apply. Pain that radiates to the shoulder or jaw Burning sensation localized in the back or mid-epigastrium Vomiting without associated nausea Feeling of emptiness that precedes meals from 1 to 3 hours Severe gnawing pain that increases in severity as the day progresses
Burning sensation localized in the back or mid-epigastrium Feeling of emptiness that precedes meals from 1 to 3 hours Severe gnawing pain that increases in severity as the day progresses
In a client with Crohn's disease, which of the following symptoms should not be a direct result of antibiotic therapy? A. Decrease in bleeding. B. Decrease in temperature. C. Decrease in body weight. D. Decrease in the number of stools.
C. Decrease in body weight
Nurse Farrah is providing care for Kristoff who has jaundice. Which statement indicates that the nurse understands the rationale for instituting skin care measures for the client? A. "Jaundice is associated with pressure ulcer formation." B. "Jaundice impairs urea production, which produces pruritus." C. "Jaundice produces pruritus due to impaired bile acid excretion." D. "Jaundice leads to decreased tissue perfusion and subsequent breakdown."
C. "Jaundice produces pruritus due to impaired bile acid excretion."
Pierre, who is diagnosed with acute pancreatitis, is under the care of Nurse Bryan. Which intervention should the nurse include in the care plan for the client? A. Administration of vasopressin and insertion of a balloon tamponade B. Preparation for a paracentesis and administration of diuretics C. Maintenance of nothing-by-mouth status and insertion of nasogastric (NG) tube with low intermittent suction D. Dietary plan of a low-fat diet and increased fluid intake to 2,000 ml/day
C. Maintenance of nothing-by-mouth status and insertion of nasogastric (NG) tube with low intermittent suction
Brenda, a 36 y.o. patient is on your floor with acute pancreatitis. Treatment for her includes: A. Continuous peritoneal lavage. B. Regular diet with increased fat. C. Nutritional support with TPN. D. Insertion of a T tube to drain the pancreas.
C. Nutritional support with TPN
A nurse is caring for a client with appendicitis. Upon assessment, the client is found to be having increased abdominal pain, rebound tenderness, and vomited 500 mL of gastric fluid. What should the nurse do first? A Call the physician immediately B. Administer Morphine 2 mg IVP C. Administer Ondansetron 4 mg IVP D. Reposition client to right side-lying position
Call the physician immediately
When caring for a client with cirrhosis, which symptom(s) should the nurse report immediately? Fatigue and weight loss Anorexia and dyspepsia Diarrhea or constipation Change in mental status
Change in mental status
The community health nurse is leading a health education workshop for older adults. When addressing nutrition, what guideline should the nurse provide to participants? Protein should make up around one third of daily calories. Clients should aim to get at least 30% of their caloric intake from fiber. Clients should aim to consume at least five servings of fruits or vegetables each day. Clients should eliminate fat from their diet, if possible.
Clients should aim to consume at least five servings of fruits or vegetables each day.
A client's new onset of dysphagia has required insertion of an NG tube for feeding. What intervention should the nurse include in the client's plan of care? Connect the tube to continuous wall suction when not in use. Confirm placement of the tube prior to each scheduled feeding. Keep the client in a low Fowler position when at rest. Have the client sip cool water to stimulate saliva production.
Confirm placement of the tube prior to each scheduled feeding.
A nurse administered a full strength feeding with an increased osmolality through a jejunostomy tube to a client. Immediately following the feeding, the client expelled a large amount of liquid brown stool and exhibited a blood pressure of 86/58 and pulse rate of 112 beats/min. The nurse Discusses with the nutritionist about increasing the osmolality of the feeding Increases the amount of feeding at the next feeding Consults with the physician about decreasing the feeding to half-strength Administers the feeding at a cooler temperature
Consults with the physician about decreasing the feeding to half-strength
A nurse is working with a client who has chronic constipation. What should be included in client teaching to promote normal bowel function? Limit physical activity in order to promote bowel peristalsis. Use glycerin suppositories on a regular basis. Consume high-residue, high-fiber foods. Resist the urge to defecate until the urge becomes intense.
Consume high-residue, high-fiber foods.
The nurse caring for a client with small bowel obstruction would plan to implement which nursing intervention first? A. Administering pain medication B. Obtaining a blood sample for laboratory studies C. Preparing to insert a nasogastric (NG) tube D. Administering I.V. fluids
D. Administering I.V fluids
Which of the following nursing interventions should be implemented to manage a client with appendicitis? A. Assessing pain. B. Encouraging oral intake of clear fluids. C. Providing discharge teaching. D. Assessing for symptoms of peritonitis.
D. Assessing for symptoms of peritonitis
If a client had irritable bowel syndrome, which of the following diagnostic tests would determine if the diagnosis is Crohn's disease or ulcerative colitis? A. Abdominal computed tomography (CT) scan B. Abdominal x-ray C. Barium swallow D. Colonoscopy with biopsy
D. Colonoscopy with biospy
Peritonitis can occur as a complication of: A. Septicemia B. Multiple organ failure C. Hypovolemic shock D. Peptic ulcer disease
D. Peptic ulcer disease
During the initial assessment of a patient post-endoscopy, the nurse notes absent bowel sounds, tachycardia, and abdominal distention. The nurse would anticipate: A. Ischemic bowel B. Peritonitis C. Hypovolemic shock D. Perforated bowel
D. Perforated bowel
Which of the following symptoms may be exhibited by a client with Crohn's disease? A. Bloody diarrhea B. Narrow stools C. N/V D. Steatorrhea
D. Steatorrhea
Which is the primary symptom of achalasia? Difficulty swallowing Pulmonary symptoms Chest pain Heartburn
Difficulty swallowing
A nurse is caring for a client with mild acute pancreatitis. Which health care provider prescriptions will the nurse question as it relates to evidence-based practices in the treatment of acute pancreatitis? Select all that apply. Nasogastric tube to intermittent wall suction for relief of nausea. No feedings per registered dietitian recommendations. Full liquid diet as tolerated. Nasogastric tube to intermittent wall suction for removal of gastric secretions. Initiate enteral feedings if tolerated.
Full liquid diet as tolerated Nasogastric tube to intermittent wall suction for removal of gastric secretions. Initiate enteral feedings if tolerated.
The nurse is providing care for an adult client who has expressed frustration at the inability to lose weight, despite trying to reduce food intake. What aspect of this client's current health status should the nurse address? The client has a history of gastroesophageal reflux disease. The client takes levothyroxine for the treatment of hypothyroidism. The client's spouse is also trying to lose weight at the same time. The client takes a tricyclic antidepressant and has done so for several years.
The client takes a tricyclic antidepressant and has done so for several years.
A client admitted with acute diverticulitis has experienced a sudden increase in temperature and reports a sudden onset of exquisite abdominal tenderness. The nurse's rapid assessment reveals that the client's abdomen is uncharacteristically rigid on palpation. What is the nurse's best response? Administer a Fleet enema as prescribed and remain with the client. Position the client supine and insert an NG tube. Contact the primary care provider promptly and report these signs of perforation. Page the primary provider and report that the client may be obstructed.
Contact the primary care provider promptly and report these signs of perforation.
Which of the following medications is classified as a proton pump inhibitor (PPI)? Cimetidine Omeprazole Famotidine Nizatidine
Omeprazole
A client is being discharged with an ileostomy. Which teaching should the nurse include with discharge education? A. Ensure you consume a high fiber diet B. Sleep with head-of-bed elevated at home C. Fluid intake will increase your diarrhea D. You need to wear your pouch at all times
You need to wear your pouch at all times
