NCLEX - Gastrointestinal

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The client who is scheduled for an intravenous pyelogram has been instructed to take liquid magnesium citrate on the day before the scheduled procedure. The client asks the nurse about the administration procedure for this medication. Which instruction should the nurse provide to the client? "Take the medication on ice." "Mix the medication with apple juice only." "Drink the medication at room temperature." "Mix the medication with a full glass of water."

"Take the medication on ice."

A client is admitted to the hospital with a diagnosis of acute viral hepatitis. Which sign/symptom should the nurse expect to observe based on this diagnosis? Fatigue Pale urine Weight gain Spider angiomas

The nurse caring for a client diagnosed with acute pancreatitis and has a history of alcoholism is monitoring the client for complications. The nurse determines that which data collected is most likely indicative of paralytic ileus? Inability to pass flatus Loss of anal sphincter control Severe, constant pain with rapid onset Firm, nontender mass palpable at the lower right costal margin

The nurse has been providing care for a client with a Sengstaken-Blakemore tube. While the tube is inflated the nurse should monitor for which priority sign/symptom? Respiratory distress A rise in the pulse rate Elevated blood pressure An elevated temperature

The nurse is getting a client who underwent umbilical hernia repair ready for discharge. The nurse explains to the client that it is important to continue to do which action after discharge? Avoid coughing. Irrigate the drain. Maintain bed rest. Restrict pain medication.

The nurse is interpreting the laboratory results of a client who has a history of diagnosed chronic ulcerative colitis. The nurse should determine that which result indicates a complication of ulcerative colitis? Hemoglobin 10.2 g/dL Potassium 4.1 mEq/L Prothrombin time 10.9 seconds White blood cell count 6300 mm3

The nurse has assisted with the insertion of a Levin tube for gastrointestinal (GI) decompression. Which settings should the nurse anticipate to be prescribed by the primary health care provider? Select all that apply. Low High Medium Continuous Intermittent

1,5

The nurse analyzes the results of laboratory studies performed on a client with diagnosed peptic ulcer disease (PUD). Which laboratory value would most indicate a complication associated with the disease? Creatinine 1 mg/dL Hemoglobin 10.2 g/dL Platelet count of 400,000 mm3 White blood cell count of 5000 mm3

The nurse is assisting with admitting a client to the hospital for the treatment of diagnosed dehydration. The client reports nausea, vomiting, diarrhea, and cramping for the past week. The nurse asks the client about medications being taking. The client denies taking prescription medications but states he has been taking some herbs given to him by a cousin. The nurse should alert the registered nurse when the client states he has been taking which herb? Dill Senna Kaolin Green tea

The nurse is caring for a client with a nasogastric (NG) tube and tests the pH of the aspirate to determine correct placement. The test results indicate a pH of 5. The nurse should determine this indicates which information? The NG tube needs to be reinserted. Placement of the NG tube is accurate. The pH of the aspirate needs to be rechecked. The NG tube needs to be pulled back approximately 1 inch.

The nurse is teaching a client with a newly diagnosed hiatal hernia about measures to prevent recurrence of symptoms. Which statement is most appropriate to be included in the teaching? "Be sure to sleep with your bed flat." "Avoid lying down for an hour after eating." "This problem is best resolved with a surgical procedure." "Eat foods that are higher in fat in order to slow down digestion."

Sucralfate 1 g four times daily has been prescribed for a client with a diagnosis of gastric ulcer. The nurse reinforces instructions to the client regarding administration of the medication. Which statement by the client indicates an understanding of the use of the medication? "I need to take the medication every 6 hours around the clock." "I need to take the medication with my meals and again at bedtime." "I need to take the medication 1 hour before my meals and at bedtime." "I need to take the medication 1 hour after meals and again at bedtime."

"I need to take the medication 1 hour before my meals and at bedtime."

Metoclopramide four times daily has been prescribed for a client with a diagnosis of reflux esophagitis. The nurse reinforces instructions to the client regarding the administration of the medication. Which statement by the client indicates an understanding of the use of the medication? "I need to take the medication with every meal and at bedtime." "I need to take the medication 1 hour after each meal and at bedtime." "I need to take the medication 30 minutes before meals and at bedtime." "I need to take the medication every 6 hours spaced evenly around the clock."

"I need to take the medication 30 minutes before meals and at bedtime."

Psyllium is prescribed for the client diagnosed with a cardiac disorder to facilitate defecation and prevent straining with bowel movements. The nurse reinforces instructions to the client regarding administration of the medication. Which statement by the client indicates an understanding of the use of the medication?

"I should mix the medication with a full glass of water."

The nurse reinforces medication instructions to a client with peptic ulcer disease. Which statement by the client indicates the best understanding of the medication therapy? "Antacids will coat my stomach." "Omeprazole will coat the ulcer and help it heal." "Sucralfate will change the fluid in my stomach." "The nizatidine will cause me to produce less stomach acid."

"The nizatidine will cause me to produce less stomach acid.

The nurse is caring for an 18-month-old child who has been vomiting. Which is the appropriate position to place the child during naps and sleep time? 1.A supine position 2.A side-lying position 3.Prone, with the head elevated 4.Prone, with the face turned to the side

2.A side-lying position The vomiting child should be placed in an upright or side-lying position to prevent aspiration. Options 1, 3, and 4 will place the child at risk for aspiration if vomiting occurs.

The client arrives at an emergency department complaining of severe abdominal pain. The initial diagnosis is acute abdomen, and an x-ray and an abdominal ultrasonogram are prescribed to be obtained immediately. The nurse prepares the client for these diagnostic tests and reviews the primary health care provider's prescriptions. Which prescription should the nurse most likely question if written on the primary health care provider's prescription form? Insertion of a nasogastric (NG) tube Insertion of an intravenous (IV) line Administration of an opioid analgesic Maintaining a nothing-by-mouth (NPO) status

The nurse is caring for a client with a neurogenic bowel due to a lower motor neuron spinal cord injury below T12 resulting in flaccid functionality. Besides triggering or facilitating techniques for defecation, what are some of the strategies the nurse needs to address to reestablish defecation patterns? Select all that apply. Limit fluids Low-fiber diet Suppository use Manual disimpaction Consistent toileting schedule Drinks with caffeine (coffee, tea, cocoa) and many soft drinks

3,4,5

The nurse provides instructions to the parents of an infant with gastroesophageal reflux (GER) regarding proper positioning to manage reflux. The nurse should tell the parents that the infant should be maintained in which position? 1.A 30-degree angle when supine 2.A 60-degree angle when prone 3.A 60-degree angle when supine 4.A 20-degree angle when side-lying

3.A 60-degree angle when supine Proper positioning is an important component of reflux management. Ideally the goal is to maintain the infant in an upright angle 24 hours a day, at a 60-degree angle when supine, and at a 30-degree angle when prone. This position is maintained until the infant remains asymptomatic for 6 weeks.

A long-term care nurse is caring for an older client taking cimetidine. The nurse should observe this client frequently for which most common central nervous system (CNS) side effect of this medication? Tremors Dizziness Confusion Hallucinations

Confusion

The client has a prescription for metoclopramide four times a day. The nurse determines that which is the most appropriate time to schedule this medication? With each meal and at bedtime Thirty minutes before meals and at bedtime One hour after each meal and at bedtime Every 6 hours spaced evenly around the clock

Thirty minutes before meals and at bedtime

The client complains of stomach pain 30 minutes to 1 hour after eating. The pain is not relieved by further intake of food, although it is relieved by vomiting, and a gastric ulcer is suspected. The nurse should gather which additional data from the client to support this diagnosis? History of frequent intake of spicy foods Frequent heartburn with a sour taste in the mouth Complaints of stress with a history of chronic kidney disease History of chronic obstructive pulmonary disease with weight loss

A morbidly obese client, 3 days postoperative gastric bypass surgery, comes to the clinic complaining of pain. The nurse suspects that the client has an anastomotic leak requiring hospitalization. The nurse should determine that which findings best validate this suspicion? Select all that apply. Oliguria Restlessness Abdominal pain Nausea and vomiting Unexplained tachycardia

1,2,3,5

An infant returns to the nursing unit following surgery for an esophageal atresia with tracheoesophageal fistula (TEF). The infant is receiving intravenous (IV) fluids, and a gastrostomy tube is in place. The nurse assisting in caring for the infant should ensure that which action is done to the gastrostomy tube? 1.Elevated 2.Placed to gravity 3.Attached to low suction 4.Taped to the bed linens

1.Elevated In the immediate postoperative period, the gastrostomy tube is elevated, allowing gastric contents to pass to the small intestine and air to escape. This promotes comfort and decreases the risk of leakage at the anastomosis. Options 2, 3, and 4 are incorrect

The nurse is assigned to care for a child with hypertrophic pyloric stenosis scheduled for a pyloromyotomy. In which position should the nurse place the child during the preoperative period? 1.Prone with the head of the bed elevated 2.Supine with the head of the bed at a 30-degree angle 3.Supine with the head of the bed at a 45-degree angle 4.Prone with the head of the bed lowered to promote drainage

1.Prone with the head of the bed elevated In the preoperative period, the infant is positioned prone with the head of the bed elevated to reduce the risk of aspiration. Options 2, 3, and 4 are inappropriate positions to prevent this risk

The nurse is teaching a client who is newly diagnosed with a hiatal hernia about measures to prevent recurrence of symptoms. Which statement should the nurse make to the client for consideration? "Lie down for at least an hour after eating." "Be sure to sleep with your head elevated in bed." "This problem requires surgery most of the time." "Eat foods that are higher in fat to slow down digestion."

The nurse is monitoring for fluid volume deficit in an infant who is vomiting and having diarrhea. The nurse weighs the infant's diaper after each voiding and stool and carefully calculates fluid volume based on which knowledge? 1.Each gram of diaper weight is equivalent to 0.5 mL of urine. 2.Each gram of diaper weight is equivalent to 1 mL of urine. 3.Each gram of diaper weight is equivalent to 2 mL of urine. 4.Each gram of diaper weight is equivalent to 2.5 mL of urine.

2.Each gram of diaper weight is equivalent to 1 mL of urine. When monitoring for fluid volume deficit, the nurse should weigh the infant's diaper after each voiding and stool. Each gram of diaper weight is equivalent to 1 mL of urine. Therefore, options 1, 3, and 4 are incorrect.

The nurse is collecting data on a client with a diagnosis of peptic ulcer disease. Which history should the nurse determine is least likely associated with this disease? History of alcohol abuse History of tarry black stools History of gastric pain 2 to 4 hours after meals History of the use of acetaminophen for pain and discomfort

The nurse observes that a client's nasogastric tube has suddenly stopped draining. The tube is connected to suction, the machine is on and functioning, and all connections are snug. After checking placement, the nurse gently flushes the tube with 30 mL of normal saline, but the tube still is not draining. The nurse should conclude which is the problem and what action should be taken? This is a serious complication; the primary health care provider must be notified immediately. It is a normal occurrence for a nasogastric tube to stop draining; no action is required. Thick gastric secretions may be blocking the tube; removing this tube and reinserting a new tube will correct the problem. Channels of gastric secretions may be bypassing the holes in the tube; turning the client will promote stomach emptying.

The nurse is reinforcing dietary instructions to the mother of a child with celiac disease. Which statement by the mother indicates a need for further teaching? 1."I can give my child rice." 2."My child loves corn. I will be sure to include corn in the diet." 3."I will be sure to give my child vitamin supplements every day." 4."I am so pleased that I won't have to eliminate oatmeal from my child's diet."

4."I am so pleased that I won't have to eliminate oatmeal from my child's diet." Dietary management is the mainstay of treatment for the child with celiac disease. All wheat, rye, barley, and oats should be eliminated from the diet and replaced with corn and rice. Vitamin supplements, especially fat-soluble vitamins and folate, may be needed in the early period of treatment to correct deficiencies.

A primary health care provider has written a prescription for ranitidine 300 mg once daily on the client's discharge medication list. The nurse determines to instruct the client to take the medication at which time? At bedtime After lunch With supper Before breakfast

At bedtime.

The nurse is monitoring a client for the early signs and symptoms of dumping syndrome. Which indicates this occurrence?

sweating and pallor

A client with viral hepatitis states to the nurse, "I am so yellow." The nurse should best respond by taking which action? Assist the client in expressing feelings. Restrict visitors until the jaundice subsides. Keep the client isolated from other clients and visitors. Instruct the client that skin turning yellow is the consequence of alcoholism.

The nurse is reinforcing dietary instructions for a client diagnosed with peptic ulcer disease. Which statement made by the client indicates a need for further teaching? I will eat a bland diet only. I will be sure not to skip meals. I will exclude coffee and tea from my diet. If spicy foods cause pain, I will avoid them in my diet.

The nurse notes that the medical record of a client diagnosed with cirrhosis states that the client has asterixis. To effectively verify this information the nurse should take which action? Ask the client to extend the arms. Instruct the client to lean forward. Ask the client to dorsiflex the calf. Measure the client's abdominal girth.

A child is diagnosed with lactose intolerance. The child's mother asks the nurse about the disease. Which statement is the appropriate nursing response? 1."It is the inability to tolerate sugar found in dairy products." 2."It results from the absence of ganglion cells in the rectum." 3."It results from increased bowel motility that leads to spasm and pain." 4."It is the inability to fully digest the protein part of wheat, barley, rye, and oats."

1."It is the inability to tolerate sugar found in dairy products." Lactose intolerance is the inability to tolerate lactose, the sugar found in dairy products. It results from absence or deficiency of lactase, an enzyme found in the secretions of the small intestine required for the digestion of lactose. Option 2 describes Hirschsprung's disease. Option 3 describes irritable bowel syndrome. Option 4 describes celiac disease.

A client had a Miller-Abbott tube inserted 24 hours ago. The nurse is asked to check the client to determine whether the tube is in the appropriate location at this time. Which data finding best indicates adequate location of the tube? Bowel sounds are absent. The aspirate from the tube has a pH of 7.45. The aspirate from the tube has a pH of 6.5. The tube can be palpated to the right of the umbilicus.

A client has a diagnosis of asymptomatic diverticular disease. Which type of diet should the nurse anticipate being prescribed? High-iron diet High-fiber diet Low-purine diet Low-sodium diet

A client has been diagnosed with acute gastroenteritis. Which diet should the nurse anticipate to be prescribed for the client? Low fat Low fiber High fiber High carbohydrate

A client has undergone esophagogastroduodenoscopy (EGD). The nurse should place highest priority on which action as part of the client's care plan? Monitoring the temperature Checking for return of a gag reflex Giving warm gargles for a sore throat Monitoring for complaints of heartburn

The nurse is reviewing the medication record of a client with a diagnosis of acute gastritis. Which medication noted on the client's record should the nurse most likely question? Digoxin Ibuprofen Furosemide Propranolol hydrochloride

The nurse is collecting data about how well a client diagnosed with a gastrointestinal (GI) disorder is able to digest food. The nurse determines that which processes are involved in the complete digestive process? Select all that apply. Osmosis Chemical Filtration Absorption Mechanical Active transport

2,4,5,6

A mother of an infant diagnosed with Hirschsprung's disease asks the nurse about the disorder. The nurse plans to base the response on which information? 1.It is a complete small intestinal obstruction. 2.It is a congenital aganglionosis or megacolon. 3.It is a severe inflammation of the gastrointestinal tract. 4.It is a condition that causes the pyloric valve to remain open.

2.It is a congenital aganglionosis or megacolon. Hirschsprung's disease, also known as "congenital aganglionosis" or "megacolon," is the result of an absence of ganglion cells in the rectum and to varying degrees upward in the colon. Options 1, 3, and 4 are incorrect.

A client is admitted to an acute care facility with complications of celiac disease. Which question asked by the nurse initially should be most helpful in obtaining information for the nursing care plan? "How long have you been diagnosed?" "What types of foods do you like to eat?" "What is your understanding of celiac disease?" "Have you eliminated whole wheat bread from your diet?"

A client that is postgastrectomy being discharged from the hospital tells the nurse, "I hope my stomach problems are over. I need to get back to work right away. I've missed a lot of work, and I may lose my job." Based on the client's statement, the nurse should determine that at this time, it is most appropriate to discuss which topic? Wound care An exercise program Reducing stressors in life The postgastrectomy diet

A client that is postgastrectomy is at high risk for hyperglycemia related to uncontrolled gastric emptying of fluid and food into the small intestine (dumping syndrome). Because of this risk, the nurse should plan to monitor which data? Client's daily weights Fasting blood glucose readings Postprandial blood glucose readings Calorie counts from the dietary department

A licensed practical nurse (LPN) is helping a registered nurse (RN) conduct an abdominal assessment. The LPN should assist the client into which most appropriate position? Sims' Supine with the head and feet flat Supine with the head raised slightly and the knees slightly flexed Semi-Fowler's with the head raised 45 degrees and the knees flat

Before administering an intermittent tube feeding through a nasogastric tube, the nurse checks for gastric residual volume. Which is the best rationale for checking gastric residual volume before administering the tube feeding?

The nurse gathers data from a client admitted to the hospital with a diagnosis of gastroesophageal reflux disease (GERD) scheduled for a Nissen fundoplication. Based on an understanding of this disease, the nurse should determine that the client may be most at risk for which complication? Diarrhea Belching Aspiration Abdominal pain

The nurse has assisted in the insertion of a Levin tube for gastrointestinal (GI) decompression. The nurse should anticipate a prescription to set the suction to which pressure? Low and continuous High and intermittent Low and intermittent High and continuous

The nurse is performing an abdominal assessment on a client. The nurse interprets that which finding is abnormal and should be immediately reported? Absence of a bruit Concave, midline umbilicus Pulsation between the umbilicus and pubis Bowel sound frequency of 15 sounds per minute

The nurse is reinforcing instructions to a client about insertion of a Sengstaken-Blakemore tube. Which statement by the client indicates a need for further teaching? The tube will be inserted by my primary health care provider. The tube will be inserted through my nose to my stomach. The tube will be inserted through my mouth to my stomach. The tube will be inserted to control bleeding of my esophagus.

The nurse is working with a client diagnosed with anorexia nervosa. As the nurse plans care, which should be focused on as the primary problem? Pain Depression Impaired nutritional status Lack of nutritional knowledge

The nurse is reinforcing instructions to the parents of a child with a hernia regarding measures that will promote reducing the hernia. The nurse determines that the parents understand these measures if they make which statement? 1."We will encourage our child to cough every few hours on a daily basis." 2."We will make sure that our child participates in physical activity every day." 3."We will provide comfort measures to reduce any crying periods by our child." 4."We will be sure to give our child a Fleet enema every day to prevent constipation."

3."We will provide comfort measures to reduce any crying periods by our child." A warm bath and comfort measures to reduce crying periods are all simple measures to promote reducing a hernia. Coughing and crying increase the strain on the hernia. Likewise, physical activities and enemas of any type would increase the strain on the hernia.

A 1-year-old child is diagnosed with intussusception. The mother of the child asks the nurse to describe the disorder. The nurse should base the response on which description of this disorder? 1.An acute bowel obstruction 2.A condition that causes an acute inflammatory process in the bowel 3.A condition in which a proximal segment of the bowel prolapses into a distal segment of the bowel 4.A condition in which a distal segment of the bowel prolapses into a proximal segment of the bowel

3.A condition in which a proximal segment of the bowel prolapses into a distal segment of the bowel Rationale A 1-year-old child is diagnosed with intussusception. The mother of the child asks the nurse to describe the disorder. The nurse should base the response on which description of this disorder? Rationale:Intussusception occurs when a proximal segment of the bowel prolapses into a distal segment of the bowel. It is a common cause of acute bowel obstruction in infants and young children. It is not an inflammatory process.

The nurse reinforces instructions to the mother about dietary measures for a 5-year-old child with lactose intolerance. The nurse should tell the mother that which supplement will be required as a result of the need to avoid lactose in the diet? 1.Fats and vitamin A 2.Zinc and vitamin C 3.Calcium and vitamin D 4.Thiamine and vitamin B

3.Calcium and vitamin D Lactose intolerance is the inability to tolerate lactose, the sugar that is found in dairy products. Removing milk from the diet can provide relief from symptoms. Additional dietary changes may be required to provide adequate sources of calcium and vitamin D.

An infant returns to the nursing unit after the surgical repair of a cleft lip located on the right side of the lip. Which is the best position to place this infant at this time? 1.A flat position 2.A prone position 3.On his or her left side 4.On his or her right side

3.On his or her left side After the repair of a cleft lip, the infant should be positioned on the side opposite to the repair to prevent contact of the suture lines with the bed linens. In this case it is best to place the infant on the left side. Additionally, the flat or prone position can result in aspiration if the infant vomits.

A client arrives at the emergency department complaining of severe abdominal pain and is placed on NPO status. During a quick assessment the nurse observes that the client has both Cullen's sign and Grey Turner's sign and pancreatitis is suspected. The nurse should assist to implement which action first? Place a nasogastric tube. Hydrate the client with intravenous fluids. Ensure the client receives intravenous pain medication. Obtain vital signs and draw blood for laboratory analysis.

A client diagnosed with chronic gastritis has been told that there is too little intrinsic factor being produced. The nurse should explain to the client that which therapy will be prescribed to treat the problem? Antacid use Antibiotic therapy Vitamin B6 injections Vitamin B12 injections

After the deflation of the balloon of a client's Sengstaken-Blakemore tube, the nurse should monitor the client closely for which priority esophageal complication? Varices Necrosis Rupture Hemorrhage

The nurse assigned to care for a client diagnosed with cirrhosis reviews the medical record and notes that the client has difficulty maintaining an effective breathing pattern due to pressure on the diaphragm. The nurse plans care knowing that which client position will best assist in facilitating breathing? Sims' Prone Supine Semi-Fowler's

The nurse is assigned to care for a client who had a Sengstaken-Blakemore tube inserted when more conservative treatment failed to alleviate the condition. The nurse should most likely suspect that the client has which diagnosis? Gastritis Bowel obstruction Small bowel tumor Esophageal varices

The nurse is collecting data from a client admitted to the hospital with a diagnosis of suspected gastric ulcer and is asking the client questions about pain. Which statement made by the client should the nurse recognize as best supporting the diagnosis of gastric ulcer? "The pain doesn't usually come right after I eat." "The pain gets so bad that it wakes me up at night." "The pain that I get is located on the right side of my chest." "My pain comes shortly after I eat, maybe a half hour or so later."

The nurse is monitoring for stoma prolapse in a client with a colostomy. Which stoma observation should indicate that a prolapse has occurred? Dark and bluish Sunken and hidden Narrowed and flattened Protruding and swollen

The nurse is participating in a health screening clinic and is preparing materials about colorectal cancer. The nurse should include which risk factor for colorectal cancer in the material? Age of 20 years High-fiber, low-fat diet Distant relative with colorectal cancer Personal history of ulcerative colitis or gastrointestinal (GI) polyps

The nurse is providing care for a client suspected of having appendicitis. Which priority intervention should the nurse anticipate will be prescribed for this client? Full liquid diet Clear liquid diet Mechanical soft diet No oral intake of liquids or food

The nurse is reinforcing discharge instructions to a client who has had a total gastrectomy. The nurse instructs the client about the importance of returning as scheduled to the health care clinic for which priority assessment? Renal function studies Gastric analysis studies Vital sign measurements Vitamin B12 and folic acid studies

The nurse is collecting data on an infant with a diagnosis of suspected Hirschsprung's disease. Which question to the mother will most specifically elicit information regarding this disorder? 1."Does your infant have diarrhea?" 2."Is your infant constantly vomiting?" 3."Does your infant constantly spit up feedings?" 4."Does your infant have foul-smelling, ribbon-like stools?"

4."Does your infant have foul-smelling, ribbon-like stools?" Chronic constipation, beginning in the first month of life and resulting in pellet-like or ribbon-like stools that are foul smelling, is a clinical manifestation of Hirschsprung's disease. Delayed passage or absence of meconium stool in the neonatal period is the cardinal sign. Bowel obstruction, especially in the neonatal period, abdominal pain and distention, and failure to thrive are also signs and symptoms. Options 1, 2, and 3 are not specific signs and symptoms of this disorder.

3-year-old child is seen in the health care clinic, and a diagnosis of encopresis is made. The nurse reviews the record, expecting to note which sign as evidence of this disorder? 1.Diarrhea 2.Malaise anorexia 3.Nausea and vomiting 4.Evidence of soiled clothing

4.Evidence of soiled clothing Encopresis is defined as fecal incontinence and is a major concern if the child is constipated. Signs include evidence of soiled clothing, scratching, or rubbing the anal area because of irritation, fecal odor without apparent awareness by the child, and social withdrawal.

An adult client with hepatic encephalopathy has a serum ammonia level of 120 mcg/dL (72 mcmol/L) and receives treatment with lactulose syrup. The nurse determines that the client has the best response if the level changes to which after medication administration? 2 mcg/dL (1.2 mcmol/L) 5 mcg/dL (3 mcmol/L) 70 mcg/dL (42 mcmol/L) 100 mcg/dL (60 mcmol/L)

70 mcg/dL (42 mcmol/L)

It has been determined that a client with hepatitis has contracted the infection from contaminated food. Which type of hepatitis is this client most likely experiencing? Hepatitis A Hepatitis B Hepatitis C Hepatitis D

A client is taking lansoprazole for the chronic management of Zollinger-Ellison syndrome. If prescribed, which medication would be appropriate for the client if needed for a headache? Naprosyn Ibuprofen Acetaminophen Acetylsalicylic acid

Acetaminophen

The client has an as needed prescription for loperamide hydrochloride. For which condition should the nurse administer this medication? Constipation Abdominal pain An episode of diarrhea Hematest-positive nasogastric tube drainage

An episode of diarrhea

The nurse notes that a client is taking lansoprazole. On data collection the nurse should ask the client which question to determine medication effectiveness? "Has your appetite increased?" "Are you experiencing any heartburn?" "Do you have any problems with vision?" "Do you experience any leg pain when walking?"

Are you experiencing any heartburn?"

An older client has recently been taking cimetidine. The nurse should monitor the client for which most frequent central nervous system side effect of this medication? Tremors Dizziness Confusion Hallucinations

Confusion

The client has been taking omeprazole for 4 weeks. The nurse evaluates that the client is receiving the optimal intended effect of the medication if the client reports the absence of which symptom? Diarrhea Heartburn Flatulence Constipation

Heartburn

The client uses the alternative therapy of cascara sagrada, known as Californian buckthorn, for ongoing management of chronic constipation. The nurse should monitor the client's laboratory results for which electrolyte imbalance specifically related to long-term use of this medication? Hypokalemia Hyperkalemia Hyponatremia Hypernatremia

Hypokalemia

The nurse is assigned to care for the client with a diagnosis of hepatic encephalopathy. Which prescribed medication should the nurse most anticipate administering? Phenolphthalein Lactulose syrup Magnesium hydroxide Psyllium hydrophilic mucilloid

Lactulose syrup

Atropine sulfate is prescribed for the client diagnosed with gastrointestinal hypermotility, and the nurse reviews the client's record before administering the medication. Which finding, if noted on the client's record, most indicates the need to contact the primary health care provider before administering the medication? Biliary colic Sinus bradycardia Narrow-angle glaucoma History of peptic ulcer disease

Narrow-angle glaucoma

The client with peptic ulcer disease has been prescribed to take cimetidine. The nurse determines that which is the primary action of this medication? Kills bacteria Inhibits histamine action Decreases stomach acid Protects the gastric mucosa

Protects the gastric mucosa

The client has begun medication therapy with pancrelipase. The nurse evaluates that the medication is having the optimal intended benefit if which effect is observed? Weight loss Relief of heartburn Reduction of steatorrhea Absence of abdominal pain

Reduction of steatorrhea

The client is taking docusate sodium. The nurse should monitor which result to determine the client is having a therapeutic effect from this medication? Abdominal pain Reduction in steatorrhea Hematest-negative stools Regular bowel movements

Regular bowel movements

The client who frequently uses nonsteroidal antiinflammatory drugs (NSAIDs) has been taking misoprostol. Does the nurse determine that this medication is having the intended therapeutic effect if which is noted? Resolved diarrhea Relief of epigastric pain Decreased platelet count Decreased white blood cell count

Relief of epigastric pain

The client has begun prescribed lansoprazole. The nurse should primarily monitor for which intended effect of this medication? Relief of abdominal pain Decrease in intestinal gas Relief of nighttime heartburn Absence of nausea and vomiting

Relief of nighttime heartburn

A postoperative client requests medication for flatulence (gas pains). Which medication from the PRN list should the nurse administer to this client? Ondansetron Simethicone Acetaminophen Magnesium hydroxide

Simethicone

The client diagnosed with peptic ulcer disease has a new prescription for propantheline. Which client teaching instructions should the nurse most reinforce? Take the medication with meals. Take the medication with antacids. Take the medication just after meals. Take the medication 30 minutes before meals.

Take the medication 30 minutes before meals.

The primary health care provider has written a prescription for ranitidine, for a client with gastrointestinal reflux disease. The nurse is explaining how this medication works to treat this disease. Which explanation should the nurse give? The medication neutralizes stomach acid. The medication hastens gastric emptying time. The medication suppresses the secretion of gastric acid. The medication suppresses acid secretion by blocking H2 receptors.

The medication suppresses acid secretion by blocking H2 receptors.

The client has a new prescription for metoclopramide. On review of the chart, the nurse identifies that this medication can be safely administered with which condition? Intestinal obstruction Peptic ulcer with melena Diverticulitis with perforation Vomiting following cancer chemotherapy

Vomiting following cancer chemotherapy

A licensed practical nurse (LPN) is preparing to assist a registered nurse (RN) with removing a nasogastric (NG) tube from the client. Which interventions should be included in the procedure? Select all that apply.

explain procedure to client ask patient to take deep breath and hold pull tube out remove device

The nurse is assisting with the insertion of a nasogastric tube into a client. The nurse should place the client in which position for insertion?

high fowler's position Rationale:Before insertion of a nasogastric tube the nurse places the client in a sitting or high-Fowler's position to reduce the risk of pulmonary aspiration if the client should vomit. A pillow may be placed behind the head and shoulders to promote the client's ability to swallow during procedure. Options 1, 2, and 4 do not facilitate the insertion of the tube or prevent aspiration.

The nurse is caring for a client after a Billroth II (gastrojejunostomy) procedure. During review of the postoperative prescriptions, which should the nurse clarify?

irrigating the NG tube Rationale:In a Billroth II resection, the proximal remnant of the stomach is anastomosed to the proximal jejunum. Patency of the NG tube is critical for preventing the retention of gastric secretions. The nurse, however, should never irrigate or reposition the NG tube after gastric surgery unless specifically prescribed by the PHCP. In this situation, the nurse should clarify the prescription. Options 1, 2, and 4 are appropriate postoperative interventions.

After a client undergoes a liver biopsy, the nurse places the client in the prescribed right-side lying position. The nurse understands that the purpose of this intervention is to accomplish which? Promote bile flow Limit client discomfort Promote hepatic glucose storage Limit bleeding from the biopsy site

limit bleeding from the biopsy site Rationale:After a liver biopsy, the client is assisted with assuming a right side-lying position with a small pillow or folded towel under the puncture site for at least 3 hours to apply pressure and limit bleeding from the biopsy site. The liver produces bile that flows through the common bile duct; client discomfort may be decreased; and the liver does store glucose as glycogen, but this is not the purpose of the right side-lying position.

The nurse is reinforcing discharge instructions to a client after a gastrectomy. Which measure should the nurse include during client teaching to help prevent dumping syndrome?

limit the fluids taken with meals

The nurse has inserted a nasogastric (NG) tube in a client and is checking for the correct placement of an NG tube. Which is the most reliable data to ensure that the end of the tube is in the stomach?

placement verified on x-ray

A client with a peptic ulcer is diagnosed with a Helicobacter pylori infection. The nurse is reinforcing teaching for the client about the medications prescribed, including clarithromycin, esomeprazole, and amoxicillin. Which statement by the client indicates the best understanding of the medication regimen? "My ulcer will heal because these medications will kill the bacteria." "These medications are only taken when I have pain from my ulcer." "The medications will kill the bacteria and stop the acid production." "These medications will coat the ulcer and decrease the acid production in my stomach."

"The medications will kill the bacteria and stop the acid production."

The nurse has reinforced instructions to the client who has been prescribed cholestyramine. Which statement by the client indicates a need for further teaching? "I will continue taking vitamin supplements." "This medication will help lower my cholesterol." "This medication should only be taken with water." "A high-fiber diet is important while taking this medication."

"This medication should only be taken with water."

A client has undergone subtotal gastrectomy, and the nurse is preparing the client for discharge. Which item should be included when reinforcing instructions to the client about ongoing self-management? Smaller, more frequent meals should be eaten. The client can resume full activity immediately. Stress can no longer exacerbate gastrointestinal symptoms. Follow-up visits with the primary health care provider are no longer needed.

A client is seen in the ambulatory care office for a routine examination. Which statement by the client should be most important for the nurse to follow up? "I just lost a family member to gastrointestinal cancer." "It's been over 18 months since I last had my prostate checked." "I have had a hard time following a low-sodium diet like I know I should." "I avoid overly hot or spicy foods because they always give me heartburn."

A client presents to the urgent care center with complaints of abdominal pain. Suddenly the client vomits bright red blood. The nurse should take which immediate action? Take the client's vital signs. Perform a complete abdominal assessment. Obtain a thorough history of the recent health status. Prepare to insert a nasogastric (NG) tube and test pH and occult blood.

A client with a diagnosis of acute pancreatitis is experiencing severe pain. After noting an absence of an analgesic prescription on the primary health care provider prescription sheet, the nurse should suggest contacting the primary health care provider to request a prescription for which medication? Hydromorphone Morphine sulfate Acetylsalicylic acid Acetaminophen with codeine

A client with a diagnosis of viral hepatitis has no appetite, and food makes the client nauseated. The nurse should conclude that which intervention is most appropriate? Offer small, frequent meals. Encourage foods low in calories. Explain that high-fat diets are usually better tolerated. Explain that the majority of calories needs to be consumed in the evening hours.

A client with hiatal hernia chronically experiences heartburn after meals. Which should the nurse teach the client to avoid? Lying recumbent after meals Eating small, frequent, bland meals Raising the head of the bed on 6-inch blocks Taking histamine receptor antagonist medication, as prescribed

A primary health care provider is about to perform a paracentesis on a client diagnosed with abdominal ascites. The nurse should assist the client to assume which position? Upright Supine Left side-lying Right side-lying

A sexually active 20-year-old client has been diagnosed with viral hepatitis. Which statement made by the client would indicate a need for further teaching? "I can never drink alcohol again." "I won't go back to work right away." "My close friends should get the vaccine." "A condom should be used for sexual intercourse."

The nurse has been reinforcing dietary teaching for a client diagnosed with gastroesophageal reflux disease (GERD) who has a routine follow-up visit. Which behavior is the best indicator of a successful outcome for this client? A decrease in sour eructation Taking in increased dairy products Use of only decaffeinated coffee and tea Decreased use of as-needed (PRN) medications

The nurse is caring for a client in the emergency department who has right lower quadrant abdominal pain. After noting a white blood cell count of 16,500 cells/mm3, the nurse should question which prescription? Milk of magnesia Nothing per mouth (NPO) Cold pack to the abdomen Intravenous (IV) fluids at a rate of 100 mL/hr

The nurse is collecting data on a client admitted to the hospital with a diagnosis of hepatitis. The nurse should determine which data indicates the client may have liver damage? Pruritus Cool dry skin Dark brown stools Yellow, straw-colored urine

The nurse is monitoring a client for the early signs and symptoms of dumping syndrome. Which findings indicate this occurrence? Sweating and pallor Bradycardia and indigestion Double vision and chest pain Abdominal cramping and pain

The nurse is performing colostomy irrigation on a client. During the irrigation, the client begins to complain of abdominal cramps. The nurse should take which appropriate action? Stop the irrigation temporarily. Increase the height of the irrigation. Medicate for pain and resume irrigation. Notify the registered nurse immediately.

The nurse is reviewing the health care record of a client with a diagnosis of chronic pancreatitis. The nurse should determine that which data noted in the record indicate poor absorption of dietary fats? Steatorrhea Bloody diarrhea Electrolyte disturbances Gastrointestinal reflux disease

The nurse should document that a client diagnosed with a hiatal hernia is implementing effective health maintenance measures after the client reports doing which action? Eating low-fat or nonfat foods Elevating the foot of the bed during sleep Doing household chores immediately after eating Sleeping with the head of the bed slightly down

Which infection control method should the nurse determine to be the priority to include in the plan of care to prevent hepatitis B in a client considered to be at high risk for exposure? Hepatitis B vaccine Proper personal hygiene Use of immune globulin Correct hand-washing technique

The nurse provides information to a client following a gastrectomy who is now diagnosed with pernicious anemia. Which instructions about pernicious anemia should the nurse reinforce to the client? Select all that apply. Provide meticulous and frequent oral hygiene. Use additional lightweight blankets as needed. Encourage a diet of foods with high iron content. Check blood serum vitamin B12 levels every 1 to 2 years. Administer replacement vitamin B12 monthly for the next 5 years.

1,2,4

A client with Crohn's disease is scheduled to receive an infusion of infliximab. The nurse assisting with caring for the client should take which action to monitor the effectiveness of treatment? Monitoring the leukocyte count for 2 days after the infusion Checking the frequency and consistency of bowel movements Checking serum liver enzyme levels before and after the infusion Carrying out a Hematest on gastric fluids after the infusion is completed

The client in an emergency department reports right lower quadrant abdominal pain. After noting a white blood cell count of 16,500 cells/mm3, the nurse should question which prescriptions? Select all that apply. Antacid use Iron supplements Antibiotic therapy Calcium supplements Vitamin B12 injections

1,2

The nurse is reviewing the prescriptions of a client admitted to the hospital with a diagnosis of acute pancreatitis. Which interventions should the nurse expect to be prescribed? Select all that apply. Administer antacids, as prescribed. Encourage coughing and deep breathing. Administer anticholinergics, as prescribed. Maintain the client in a supine and flat position. Encourage small, frequent, high-calorie feedings.

1,2,3

A client with possible hiatal hernia complains of frequent heartburn and regurgitation. The nurse should gather further information about the presence of which sign or symptom? Dizziness after meals Difficulty swallowing Left lower quadrant pain 2 hours after eating Moderate right upper quadrant pain unrelated to eating

A client who has undergone a colostomy several days ago is reluctant to leave the hospital and has not yet looked at the ostomy site. Which measures will most likely promote coping? Select all that apply. Ask a member of the local ostomy club to visit with the client before discharge. Ask the enterostomal nurse specialist to consult with the client before discharge. Remind the client frequently that infection is a major complication of a colostomy. Remind the client frequently that he will be responsible for caring for the colostomy at home. Ask the client to begin doing one part of the ostomy care each day and increase tasks daily.

1,2,5

An acutely ill looking client arrives at the emergency department. The client complains of "the worst pain I ever felt in my belly. I can't get comfortable." The client is quiet but with each movement the client cries out in pain. The nurse suspects the client has peritonitis. Which data should the nurse collect to assist in validating this suspicion? Select all that apply. Inspect the abdomen for rigidity. Check for the presence of hiccups. Check for the presence of bradycardia. Auscultate the abdomen for borborygmi. Inspect the client's mucous membranes.

1,2,5

A client who has undergone a subtotal gastrectomy is being prepared for discharge. Which considerations concerning ongoing self-management should the nurse reinforce to the client? Select all that apply. Eat smaller and more frequent meals. Resume full activity almost immediately. Drink fluids between meals not with them. Stress will do little to exacerbate gastrointestinal symptoms. Follow-up visits with the primary health care provider will no longer be needed.

1,3

The nurse who is reinforcing instructions to a client who has had a gastric resection should include which considerations? Select all that apply. Eat small frequent meals. Avoid iron supplementation. Take action to prevent dumping syndrome. Self-monitor for signs of lower gastrointestinal (GI) bleeding. Consume a diet that is relatively high in vitamin B12 content.

1,3

The nurse is reinforcing discharge instructions to a client with a hiatal hernia. Which considerations should the nurse include in the teaching session? Select all that apply. It is advisable to stop smoking cigarettes. Lie flat for at least 30 minutes after meals. Wait at least 1 hour after meals to perform chores. Be sure to elevate the head of the bed during sleep. Foods with moderate fat should be a part of your diet.

1,3,4

The nurse is caring for a child who is scheduled for an appendectomy. When the nurse reviews the primary health care provider's preoperative prescriptions, which should be questioned? 1.Administer a Fleet enema. 2.Maintain nothing per mouth (NPO) status. 3.Maintain intravenous (IV) fluids as prescribed. 4.Administer preoperative medication on call to the operating room

1.Administer a Fleet enema. In the preoperative period, enemas or laxatives should not be administered. No heat should be applied to the abdomen because this may increase the chance of perforation secondary to vasodilation. IV fluids would be started and the child would be NPO. Prescribed preoperative medications most likely would be administered on call to the operating room.

The nurse is caring for an infant with a diagnosis of Hirschsprung's disease. The nurse should check for which clinical findings that are consistent with Hirschsprung's disease? Select all that apply. 1.Fever 2.Constipation 3.Failure to thrive 4.Intolerance to wheat 5.Abdominal distention 6.Explosive, watery diarrhea

1.Fever 2.Constipation 3.Failure to thrive 5.Abdominal distention 6.Explosive, watery diarrhea Clinical symptoms of Hirschsprung's disease during infancy include failure to thrive, constipation, abdominal distention, episodes of diarrhea and vomiting, signs of enterocolitis, explosive and watery diarrhea, and fever. The infant appears significantly ill. Intolerance to wheat occurs in celiac disease.

A mother of a child with a diagnosis of intussusception calls the nurse into the hospital room because the child is screaming in pain. Which manifestations of perforation should the nurse report immediately? Select all that apply. 1.Fever 2.Ribbon-like stools 3.Increased heart rate 4.Hypoactive bowel sounds 5.Profuse projectile vomiting 6.Change in the level of consciousness

1.Fever 3.Increased heart rate 6.Change in the level of consciousness The child with intussusception classically presents with severe abdominal pain that is crampy and intermittent and that causes the child to draw in his or her knees to the chest. The signs of perforation and shock are evidenced by fever, an increased heart rate, a change in the level of consciousness or blood pressure, and respiratory distress and need to be reported immediately. The options for hypoactive bowel sounds, profuse projectile vomiting, and ribbon-like stools are a part of the presentation picture of a child with intussusception but are not signs of shock.

The nurse is admitting a child with a diagnosis of lactose intolerance. Which finding does the nurse expect to note? 1.Frothy stools 2.Foul-smelling ribbon stools 3.Profuse, watery diarrhea and vomiting 4.Diffuse abdominal pain unrelated to meals or activity

1.Frothy stools Lactose intolerance causes frothy stools. Abdominal distention, crampy abdominal pain, and excessive flatus may also occur. Option 2 is a clinical manifestation of Hirschsprung's disease. Option 3 is a clinical manifestation of celiac disease. Option 4 is a symptom of irritable bowel syndrome.

A newborn infant is diagnosed with gastroesophageal reflux (GER). The mother of the infant asks the nurse to explain the diagnosis. The nurse plans to base the response on which description of this disorder? 1.Gastric contents regurgitate back into the esophagus. 2.The esophagus terminates before it reaches the stomach. 3.Abdominal contents herniate through an opening of the diaphragm. 4.A portion of the stomach protrudes through the esophageal hiatus of the diaphragm.

1.Gastric contents regurgitate back into the esophagus. Gastroesophageal reflux is regurgitation of gastric contents back into the esophagus. Option 2 describes esophageal atresia. Option 3 describes a congenital diaphragmatic hernia. Option 4 describes a hiatal hernia

A primary health care provider asks the licensed practical nurse (LPN) to reinforce preprocedure instructions to a client who will undergo a barium swallow (esophagography) in a few days. The LPN should include which instruction in this discussion? Eat a regular supper and breakfast. Remove all metal and jewelry before the test. Continue to take all oral medications as scheduled. Expect diarrhea for a few days after the procedure.

A child with a diagnosis of a hernia has been scheduled for a surgical repair in 2 weeks. The nurse reinforces instructions to the parents about the signs of possible incarcerated hernia. The nurse tells the parents that which manifestation requires primary health care provider (PHCP) notification by the parents? 1.Pain 2.Diarrhea 3.Constipation 4.Increased flatus

1.Pain The parents of a child with a hernia need to be instructed about the signs of an incarcerated hernia. These signs include irritability, tenderness at the site of the hernia, anorexia, abdominal distension, and difficulty defecating. The parents should be instructed to contact the PHCP immediately if an incarcerated hernia is suspected. These signs may lead to a complete intestinal obstruction and gangrene. Diarrhea, increased flatus and constipation are not associated with an incarcerated hernia.

Which interventions should the nurse include when preparing a plan of care for a child with hepatitis? Select all that apply. 1.Providing a low-fat, well-balanced diet 2.Teaching the child effective hand-washing techniques 3.Notifying the primary health care provider if jaundice is present 4.Scheduling play time in the playroom with other children 5.Instructing the parents about the risks associated with taking medications 6.Arranging for indefinite home schooling because the child will not be able to return to school

1.Providing a low-fat, well-balanced diet 2.Teaching the child effective hand-washing techniques 5.Instructing the parents about the risks associated with taking medications Because hepatitis can be viral, standard precautions should be instituted in the hospital. The child should be discouraged from sharing toys, so playtime in the playroom with other children is not part of the plan of care. The child will be allowed to return to school 1 week after the onset of jaundice, so indefinite home schooling would not need to be arranged. Jaundice is an expected finding with hepatitis and would not warrant notification of the primary health care provider. Provision of a low-fat, well-balanced diet is recommended. Parents are cautioned about administering any medication to the child because normal doses of many medications may become dangerous because of the liver's inability to detoxify and excrete them. Hand washing is the single most effective measure in control of hepatitis in any setting, and effective hand washing can prevent the compromised child from picking up an opportunistic type of infection.

The nurse is monitoring for signs of dehydration in a 1-year-old child who has been hospitalized for diarrhea and prepares to take the child's temperature. Which method of temperature measurement should be avoided? 1.Rectal 2.Axillary 3.Electronic 4.Tympanic

1.Rectal Rectal temperature measurements should be avoided if diarrhea is present. The use of a rectal thermometer can stimulate peristalsis and cause more diarrhea. Axillary or tympanic measurements of temperature would be acceptable. Most measurements are performed via electronic devices.

The nurse reinforces home-care instructions to the parents of a child with celiac disease. Which food item should the nurse advise the parents to include in the child's diet? 1.Rice 2.Oatmeal 3.Rye toast 4.Wheat bread

1.Rice Dietary management is the mainstay of treatment for celiac disease. All wheat, rye, barley, and oats should be eliminated from the diet and replaced with corn and rice. Vitamin supplements, especially fat-soluble vitamins and folate, may be required during the early period of treatment to correct deficiencies. These restrictions are likely to be life long, although small amounts of grains may be tolerated after the gastrointestinal ulcerations have healed.

The nurse is caring for a 1-year-old child following a cleft palate repair. Which solution should the nurse use after feedings to cleanse the child's mouth? 1.Sterile water 2.Diluted hydrogen peroxide 3.A soft lemon glycerin swab 4.Half-strength povidone-iodine solution

1.Sterile water Following a cleft palate repair, the mouth is rinsed with water after feedings to clean the palate repair site. Rinsing food and residual sugars from the suture line reduces the risk of infection. Options 2, 3, and 4 are incorrect because the solutions identified in these options should not be used.

The nurse is checking the status of jaundice in a child with hepatitis. Which location should the nurse check to ascertain if the child is jaundiced? 1.The mucous membranes 2.The skin in the sacral area 3.The skin in the abdominal area 4.The membranes in the ear canal

1.The mucous membranes Jaundice, if present, is best checked in the sclera, nail beds, and mucous membranes. Generalized jaundice will appear in the skin throughout the body. Option 4 is not an appropriate assessment area for the presence of jaundice.

A client diagnosed with pernicious anemia asks the nurse what caused the deficiency. The nurse replies that it is most likely a result of which condition that is part of the client's health history? Hypothyroidism Hemigastrectomy Excessive vitamin C intake Decreased dietary intake of iron

A client is admitted to the hospital with a diagnosed bowel obstruction secondary to a recurrent diagnosed malignancy. The primary health care provider plans to insert a Miller-Abbott tube. When the nurse tries to explain the procedure, the client interrupts the nurse and states, "I don't want to hear about that. Just let the doctor do it." Based on the client's statement, which action should the nurse determine is best? Leave the room. Remain with the client and be silent. Ask the client whether he would like another nurse to care for him. Explain to the client that all clients have the right to know about medical procedures.

A client is admitted to the hospital with a diagnosis of acute pancreatitis. The nurse should plan care, knowing that most likely, which problem will occur with this disorder? Excess fluid volume related to sodium retention Alteration in comfort related to abdominal pain Alteration in fluid and electrolyte balance related to hyperkalemia Potential for hypoglycemia related to a low blood glucose secondary to increased insulin secretion

A client is resuming a diet after partial gastrectomy. To minimize complications, the nurse should instruct the client to avoid which behavior? Lying down after eating Drinking liquids with meals Eating six small meals per day Excluding concentrated sweets in the diet

Implemented treatment measures for a client with a diagnosis of bleeding esophageal varices have been unsuccessful. The primary health care provider states that a Sengstaken-Blakemore tube will be used to control the resulting hemorrhage. The nurse should prepare for insertion of this tube via which route? Oral-gastric Nasogastric Gastrostomy Percutaneous

The client admitted to the hospital with a diagnosis of viral hepatitis is complaining of a loss of appetite. In order to provide adequate nutrition, which action should the nurse encourage the client to take? Select foods high in fat. Increase intake of fluids. Eat less often, preferably only three large meals daily. Eat a large supper when anorexia is most likely not as severe.

The client diagnosed with acute pancreatitis is experiencing severe pain from the disorder. The nurse should instruct the client to avoid which position that could aggravate the pain? Sitting up Lying flat Leaning forward Flexing the left leg

The nurse is caring for a client within the first 24 hours following a total gastrectomy for gastric cancer. During this time frame, the nurse should focus on which priority intervention? Providing the client with an oral diet Maintaining a patent nasogastric (NG) tube Promoting the use of stress reduction techniques Teaching the client about the symptoms of dumping syndrome

The nurse is collecting admission data on the client with a diagnosis of hepatitis. Which finding should the nurse recognize to be a direct result of this client's condition? Diarrhea Drowsiness Blurred vision Urinary frequency

The nurse is instructing a client who had a herniorrhaphy about how to reduce postoperative swelling following the procedure. Which should the nurse suggest to the client to prevent swelling? Limit fluids. Elevate the scrotum. Apply heat to the abdomen. Maintain a low-roughage diet.

The nurse is providing care for a client with a nasogastric tube. Which observation is most appropriate in determining that the tube is correctly placed? The aspirate is dark green. The pH of the aspirate is 5. The aspirate is negative for guaiac. The tube length was correctly measured before insertion.

The nurse should include which instruction in a teaching plan for a client who has been diagnosed with peptic ulcer disease? Smoke at bedtime only. Learn to use stress reduction techniques. Continue to eat the same diet as before the diagnosis. Take nonsteroidal anti-inflammatory drugs (NSAIDs) for pain relief.

The nurse who is assisting in the care of a client within the first 24 hours following a total gastrectomy for gastric cancer should avoid which intervention? Assessing for bowel sounds Irrigating the nasogastric (NG) tube Measuring the drainage from the nasogastric (NG) tube Keeping the nasogastric (NG) tube connected to suction

A client with a possible hiatal hernia complains of difficulty swallowing. Which other sign/symptom associated with a hiatal hernia should the nurse recognize? Dry cough Left lower quadrant pain Heartburn and regurgitation Moderate right upper quadrant pain

The nurse is reinforcing instructions to a client and his family about alcohol abuse and chronic cirrhosis. The nurse determines to include which essential elements in the discharge teaching guide? Select all that apply. Limit alcohol intake to one drink a day. Avoid potentially hepatotoxic over-the-counter drugs. Teach symptoms of complications and when to seek prompt medical attention. Explain that cirrhosis of the liver is a chronic illness and the importance of continuous health care. Avoid spicy and rough foods and activities that increase portal pressure such as straining at stool, coughing, sneezing and vomiting. Avoid aspirin and non-steroidal anti-inflammatory drugs to prevent hemorrhage when esophageal varices are present and substitute with Tylenol.

2,3,4,5

A client has had a partial gastrectomy and the nurse is reinforcing discharge instructions. The nurse should reinforce instructions to the client about the need for which supplements? Select all that apply. Antacid use Iron supplements Antibiotic therapy Calcium supplements Vitamin B12 injections

2,4,5

The nurse reinforces home-care instructions to the parents of a child with hepatitis regarding the care of the child and the prevention of the transmission of the virus. Which statement by a parent indicates a need for further teaching? 1."Frequent hand washing is important." 2."I need to provide a well-balanced, high-fat diet to my child." 3."I need to clean contaminated household surfaces with bleach." 4."Diapers should not be changed near any surfaces that are used to prepare food."

2."I need to provide a well-balanced, high-fat diet to my child." The child with hepatitis should consume a well-balanced, low-fat diet to allow the liver to rest. Options 1, 3, and 4 are components of the homecare instructions to the family of a child with hepatitis.

The nurse provides instructions to the mother of an infant with cleft palate regarding feeding. Which statement by the mother indicates a need for further teaching? 1."I need to allow my infant time to swallow." 2."I need to use a nipple with a small hole to prevent choking." 3."I need to stimulate sucking by rubbing the nipple on the lower lip." 4."I need to allow my infant to rest frequently to provide time for swallowing what has been placed in the mouth."

2."I need to use a nipple with a small hole to prevent choking." The mother should be taught the ESSR method of feeding the child with a cleft palate: ENLARGE the nipple by cross-cutting a hole so that food is delivered to the back of the throat without sucking; STIMULATE sucking by rubbing the nipple on the lower lip; SWALLOW; then REST to allow the infant to finish swallowing what has been placed in the mouth

The nurse reinforces home care instructions to the parents of an infant following surgical intervention for the imperforate anus and tells the parents about the procedure for anal dilation. Which statement by the parents indicates the need for further teaching? 1."I need to use a water-soluble lubricant." 2."I will insert a glycerin suppository before the dilation." 3."I will insert the dilator no more than 1 to 2 cm into the anus." 4."I need to use only dilators supplied by the primary health care provider."

2."I will insert a glycerin suppository before the dilation." Following this surgery, anal dilation at home by the parents is necessary to achieve and maintain bowel patency. Inserting a glycerin suppository before dilation is not a component of this procedure. Options 1, 3, and 4 are accurate instructions and will prevent damage to the rectal mucosa.

The nurse prepares to administer a pancreatic enzyme powder to the child with cystic fibrosis (CF). Which food item should the nurse mix with the medication? 1.Tapioca 2.Applesauce 3.Hot oatmeal 4.Mashed potatoes

2.Applesauce Pancreatic enzyme powders are not to be mixed with hot foods or foods containing tapioca or other starches. Enzyme powder should be mixed with nonfat, nonprotein foods such as applesauce. Pancreatic enzymes are inactivated by heat and are partially degraded by gastric acids.

A 4-year-old child is hospitalized for severe gastroenteritis. The child is crying and clinging to the mother. The mother becomes very upset and is afraid to leave the child. Which nursing intervention would be most appropriate to alleviate the child's fears and the mother's anxiety? 1.Reassure the mother that the child will be fine after she leaves. 2.Ask the mother if she would like to stay overnight with the child. 3.Give the mother the telephone number of the pediatric unit, and tell the mother to call at any time. 4.Tell the mother to bring the child's favorite toys the next time she comes to the hospital to visit.

2.Ask the mother if she would like to stay overnight with the child. Although a 4-year-old may already be spending some time away from his or her parents at a day care center or preschool, illness adds a stressor that makes separation more difficult. The only option that addresses the mother's anxiety and alleviates the fears of the child is option 2. Options 1, 3, and 4 do not address the fears and anxieties of the mother and child.

The nurse is assigned to care for a child who is scheduled for an appendectomy. Which prescriptions should the nurse anticipate to be prescribed? Select all that apply. 1.Administer a Fleet enema. 2.Initiate an intravenous line. 3.Maintain nothing-by-mouth status. 4.Administer intravenous antibiotics. 5.Administer preoperative medications. 6.Place a heating pad on the abdomen to decrease pain.

2.Initiate an intravenous line. 3.Maintain nothing-by-mouth status. 4.Administer intravenous antibiotics. 5.Administer preoperative medications. During the preoperative period, enemas or laxatives should not be administered. In addition, heat should not be applied to the abdomen. Any of these interventions can cause the rupture of the appendix and resultant peritonitis. Intravenous fluids would be started, and the child should receive nothing by mouth while awaiting surgery. Antibiotics are usually administered because of the risk of perforation. Preoperative medications are administered as prescribed.

The nurse is reviewing the laboratory results of an infant suspected of having hypertrophic pyloric stenosis. Which acid-base disorder would the nurse expect to note in the infant? 1.Metabolic acidosis 2.Metabolic alkalosis 3.Respiratory acidosis 4.Respiratory alkalosis

2.Metabolic alkalosis Laboratory findings in an infant with hypertrophic pyloric stenosis include metabolic alkalosis as a result of the vomiting (depletes acid) that occurs in this disorder. Additional findings include decreased serum potassium and sodium levels, increased pH and bicarbonate, and decreased chloride level

A mother brings her 5-month-old daughter into the pediatrician's office with complaints that the child has been vomiting during feedings. The mother also states that the child is sometimes very fussy. Which should be the nurse's initial action? 1.Assess the child's growth status. 2.Obtain a complete history of the child's feeding habits. 3.Assess whether any other children in the family have had the same problem. 4.Explain to the mother that the primary health care provider will prescribe a barium swallow and upper gastrointestinal (GI) series.

2.Obtain a complete history of the child's feeding habits. In most situations, a complete history and physical examination of the child is the initial step in diagnosing gastroesophageal reflux disease. The child's feeding habits will give the nurse an indicator of the growth status. The child is weighed and measured after the initial interview is completed with the parent. Hereditary factors are not the priority. Further diagnostic studies may be prescribed but only after a complete history is obtained.

The nurse is reviewing the record of a child with a diagnosis of pyloric stenosis. Which data should the nurse expect to note as having been documented in the child's record? 1.Watery diarrhea 2.Projectile vomiting 3.Increased urine output 4.Vomiting large amounts of bile

2.Projectile vomiting Signs and symptoms of pyloric stenosis include projectile, nonbilious vomiting; irritability; hunger and crying; constipation; and signs of dehydration, including a decrease in urine output.

The nurse is assisting in admitting to the hospital a 4-month-old infant with a diagnosis of vomiting and dehydration. The nurse assists in developing a plan of care for the infant and suggests which position for the infant? 1.Prone position 2.Side-lying position 3.Modified Trendelenburg's position 4.Infant car seat with the head of the seat in a flat position

2.Side-lying position The vomiting infant or child should be placed in an upright or side-lying position to prevent aspiration. The positions identified in options 1, 3, and 4 will increase the risk of aspiration if vomiting occurs.

A client admitted to the hospital diagnosed with severe jaundice is having diagnostic testing. Because the client has no complaints of fatigue, the client is encouraged to ambulate in the hall to maintain muscle strength. The client paces around the room but will not enter the hall. The nurse should determine which concern is most likely the reason for the client's reluctance to walk in the hall? Unfamiliarity with the hospital Fear of catching another disease Feeling self-conscious about appearance Not wanting to overexert and get overtired

A client diagnosis of a peptic ulcer scheduled for a vagotomy asks the nurse about the purpose of this procedure. The nurse should explain to the client that a vagotomy primarily serves which purpose? Halts stress reactions Heals the gastric mucosa Reduces the stimulation of acid secretions Decreases food absorption in the stomach

A client with Crohn's disease has a prescription to begin taking antispasmodic medication. The nurse should schedule the medication so that each dose is taken at which time? During meals 60 minutes after meals 30 minutes before meals On arising and at bedtime

A client with a history of gastrointestinal upset has been diagnosed with acute diverticulitis. To aid the client in symptom management, the nurse should most appropriately suggest which diet during the acute phase? A low-fat diet A high-fat diet A low-fiber diet A high-carbohydrate diet

A generally healthy 63-year-old man is seen in the primary health care provider's office for a routine examination. Which statement made by the client is most important for the nurse to follow up on? "I check my stool yearly for occult blood." "I have been following the balanced diet plan that the doctor gave me." "Everyone in my immediate family has died from gastrointestinal cancer." "I try to avoid overly hot or spicy foods because they give me heartburn sometimes."

A licensed practical nurse (LPN) is assisting in the insertion of a nasogastric (NG) tube for an adult client. The LPN helps determine the correct length to insert the tube by performing which measurement? A 30-inch length on the tube An 18-inch length on the tube From the tip of the client's nose to the earlobe and then down to the xiphoid process From the tip of the client's nose to the earlobe and then down to the top of the sternum

A primary health care provider places a Miller-Abbott tube in a client who has a diagnosed bowel obstruction. Six hours later, the nurse measures the length of the tube outside of the nares and notes that the tube has advanced 6 cm since it was first placed. Based on this finding, which action should the nurse take next? Initiate a tube feeding. Notify the registered nurse. Document the finding in the client's record. Pull the tube out 6 cm, and secure the tube to the nose with tape.

The nurse has a prescription to give 30 mL of an antacid through a nasogastric (NG) tube connected to wall suction. The nurse should do which best action to perform this procedure correctly? Position the client supine to assist in medication absorption. Aspirate the NG tube following medication administration to maintain patency. Clamp the NG tube for 30 minutes following administration of the medication. Adjust the suction to a low-intermittent setting for an hour after medication administration.

The nurse has given the client diagnosed with hepatitis instructions about post discharge management during convalescence. The nurse determines a need for further teaching if the client makes which statement? "I should avoid alcohol and aspirin." "I should eat a high-carbohydrate, low-fat diet." "I should resume a full activity level within 1 week." "I should take the prescribed amounts of vitamin K."

The nurse is caring for a client with a Sengstaken-Blakemore tube. To effectively prevent ulceration and necrosis of oral and nasal mucosa, the nurse should plan to implement which action? Provide tracheal suction as needed. Keep scissors at the bedside for emergency deflation. Provide frequent oral and nasal care on a regular basis. Have a family member remain with the client as much as possible.

The nurse is preparing to administer an enteral feeding through a nasogastric tube. The nurse should place the client in which position during and after the feedings? Sims' Supine Fowler's Trendelenburg's

The nurse is reinforcing dietary instructions for a client diagnosed with peptic ulcer disease. Which action should the nurse encourage the client to do? Adhere to a strict soft, bland diet. Eat only six small meals every day. Eat anything as long as it does not aggravate or cause pain. Include only foods that will increase gastrointestinal (GI) motility.

The nurse is reinforcing home care instructions to a client following a gastric resection. The nurse should include which instruction to the client? Avoid iron supplementation. Eat a diet high in vitamin B12. Take actions to prevent dumping syndrome. Self-monitor for signs and symptoms of lower gastrointestinal hemorrhage.

The nurse is reviewing the primary health care provider's (PHCP'S) prescriptions written for a client admitted with acute pancreatitis. Which PHCP prescription should the nurse verify if noted in the client's chart? NPO status An anticholinergic medication Supine and flat client positioning Insertion of a nasogastric tube

The nurse should include which most appropriate information when reinforcing home care instructions for a client who has been diagnosed with peptic ulcer disease? Limit intake of trigger foods. Smoke only when not eating. Learn to use stress reduction techniques. Take nonsteroidal anti-inflammatory drugs (NSAIDs) for pain relief.

The nurse will be providing postprocedure care to a client who has undergone esophagogastroduodenoscopy (EGD). Based on the procedure done, the nurse should plan to do which action first? Measure the client's temperature. Give warm gargles for sore throat. Monitor for return of the gag reflex. Monitor for complaints of heartburn.

Which statement by the spouse of a client with diagnosed end-stage liver failure indicates the need for further teaching by the multidisciplinary team regarding management of the client's pain? "If constipation is a problem, increased fluids will help." "If the pain increases, I must let the doctor know immediately." "This opioid will cause very deep sleep, which is what my husband needs." "I should have my husband try the breathing exercises to help control pain."

The nurse is preparing to feed a 1-year-old hospitalized child. The nurse prepares the amount of formula to be given to this child, knowing that generally a 1-year-old consumes approximately which amount? 1.90 mL per feeding 2.100 mL per feeding 3.175 mL per feeding 4.380 mL per feeding

3.175 mL per feeding A 1-year-old child consumes approximately 175 mL (6 ounces) of formula per feeding. Options 1, 2, and 4 are incorrect.

The nurse reviews the record of an infant who is seen in the clinic. The nurse notes that a diagnosis of esophageal atresia with tracheoesophageal fistula (TEF) is suspected. The nurse expects to note which most likely manifestation of this condition in the medical record? 1.Incessant crying 2.Coughing at nighttime 3.Choking with feedings 4.Severe projectile vomiting

3.Choking with feedings Any child who exhibits the "3 Cs"—coughing and choking during feedings and unexplained cyanosis—should be suspected of having TEF. Options 1, 2, and 4 are not specifically associated with TEF.

The nurse is assigned to assist in caring for a newborn with a colostomy that was created during surgical intervention for imperforate anus. When the newborn returns from surgery, the nurse checks the stoma and notes that it is red and edematous. Which is the appropriate nursing intervention? 1.Elevate the buttocks. 2.Apply ice immediately. 3.Document the findings. 4.Notify the registered nurse immediately.

3.Document the findings. A fresh colostomy stoma will be red and edematous, but this will decrease with time. The colostomy site will then be pink without evidence of abnormal drainage, swelling, or skin breakdown. The nurse would document these findings because this is a normal expectation. Options 1, 2, and 4 are inappropriate interventions.

A nurse organizing care for a client diagnosed with hepatitis plans to meet the client's safety needs by performing which action? Bathing the client with tepid water and mild soap only Assessing and recording the client's weight twice daily Monitoring red blood cell and white blood cell counts daily Monitoring prothrombin and partial thromboplastin values

The nurse is reviewing the health record of an infant with a diagnosis of gastroesophageal reflux. Which signs/symptoms of this disorder should the nurse expect to note documented in the record? 1.Excessive oral secretions 2.Bowel sounds heard over the chest 3.Hiccupping and spitting up after a meal 4.Coughing, wheezing, and short periods of apnea

3.Hiccupping and spitting up after a meal Clinical manifestations of all types of gastroesophageal reflux include vomiting (spitting up) after a meal, hiccupping, and recurrent otitis media related to pooled secretions in the nasopharynx during sleep. Option 1 is a clinical manifestation of esophageal atresia and tracheoesophageal fistula. Option 2 is a clinical manifestation of congenital diaphragmatic hernia. Option 4 is a clinical manifestation of hiatal hernia.

The nurse is reviewing the health record of a child with a diagnosis of celiac disease. Which clinical manifestation should the nurse expect to note documented in the health record? 1.Frothy diarrhea 2.Foul-smelling ribbon stools 3.Profuse watery diarrhea and vomiting 4.Diffuse abdominal pain unrelated to meals or activity

3.Profuse watery diarrhea and vomiting Celiac disease causes profuse watery diarrhea and vomiting. Option 1 is a symptom of lactose intolerance. Option 2 is a symptom of Hirschsprung's disease. Option 4 is a symptom of irritable bowel syndrome.

The nurse is reviewing the postoperative primary health care provider's (PHCP'S) prescriptions for a 3-week-old infant with Hirschsprung's disease admitted to the hospital for surgery. Which prescriptions documented in the child's record should the nurse question? Select all that apply. 1.Measure abdominal girth daily. 2.Monitor strict intake and output. 3.Take temperature measurements rectally. 4.Start clear liquid diet after 8 hours postoperative. 5.Maintain IV fluids until the child tolerates oral intake. 6.Monitor the surgical site for redness, swelling, and drainage.

3.Take temperature measurements rectally. 4.Start clear liquid diet after 8 hours postoperative. Postoperative management of Hirschsprung's disease includes taking vital signs, but avoiding taking the temperature rectally. The client needs to remain NPO (nothing by mouth) status until bowel sounds return or flatus is passed, usually within 48 to 72 hours. The other options are correct postoperative management.

A 2-year-old child is diagnosed with constipation due to encopresis. Which description is a characteristic of this disorder? 1.Anorexia in the evening 2.Incomplete development of the anus 3.The infrequent and difficult passage of dry stools 4.Invagination of a section of the intestine into the distal bowel

3.The infrequent and difficult passage of dry stools Constipation can affect any child at any time, although its incidence peaks at ages 2 to 3 years. Option 3 describes encopresis, which can develop as a result of constipation and is one of the major concerns regarding constipation. Encopresis generally affects preschool and school-age children. Option 1 is not associated with encopresis. Option 2 describes imperforate anus, which is diagnosed in the neonatal period. Option 4 describes intussusception, which is the most common cause of bowel obstruction in children ages 3 months to 6 years.

The nurse is monitoring a newborn with a suspected diagnosis of imperforate anus. Which assessment finding is unassociated with this diagnosis? 1.The presence of stool in the urine 2.Failure to pass a rectal thermometer 3.The passage of currant jelly-like stool 4.Failure to pass meconium in the first 24 hours after birth

3.The passage of currant jelly-like stool During the newborn assessment, imperforate anus should be easily identified visually. However, a rectal thermometer or tube may be necessary to determine patency if meconium is not passed in the first 24 hours after birth. The presence of stool in the urine or vagina should be reported immediately as an indication of abnormal anorectal development. Currant jelly-like stool is not a symptom of this disorder.

A calcium supplement is prescribed for a client diagnosed with hypoparathyroidism in the management of hypocalcemia. The client arrives at the clinic for a follow-up visit and complains of chronic constipation, and the nurse reinforces instructions to the client about measures to alleviate the constipation. Which comment by the client would indicate a need for further teaching? "I need to increase my daily fluid intake." "I need to increase my intake of high-fiber foods." "I need to increase my activity level as tolerated." "I need to add 0.5 ounce of mineral oil to my daily diet."

A client complains of stomach pain 30 minutes to 1 hour after eating. The pain is not relieved by further intake of food, although it is relieved by vomiting. A gastric ulcer is suspected. The nurse should determine that which data would further support this diagnosis? History of frequent intake of spicy foods Frequent heartburn with a sour taste in the mouth Complaints of stress with a history of chronic kidney disease History of chronic obstructive pulmonary disease with weight loss

A client diagnosed peptic ulcer disease and scheduled for a pyloroplasty asks the nurse about the procedure. The nurse should base the response on which information? A pyloroplasty involves cutting the vagus nerve. A pyloroplasty involves removing the distal portion of the stomach. A pyloroplasty involves removal of the ulcer and a large portion of the cells that produce hydrochloric acid. A pyloroplasty involves an incision and resuturing of the pylorus to relax the muscle and enlarge the opening from the stomach to the duodenum.

A client is receiving bolus feedings via a nasogastric tube. The nurse plans to place the client's head of the bed (HOB) in which optimal position once the feeding is completed? Flat with the client prone for at least 60 minutes Supine with the client in the left lateral position for 10 minutes Elevated 45 to 60 degrees with the client supine for 15 minutes Elevated 30 to 45 degrees with the client in the right lateral position for 60 minutes

A client receiving a high cleansing enema complains of pain and cramping. Which corrective action is most appropriate for the nurse to take? Reassure the client and continue the flow. Discontinue the enema and notify the registered nurse (RN). Raise the enema bag so that the solution can be completed quickly. Clamp the tubing for 30 seconds and restart the flow at a slower rate.

A postoperative client has regained bowel sounds and is ready to start a clear liquid diet. The nurse is told that the primary health care provider has written a prescription to remove the nasogastric (NG) tube. The nurse assists in the procedure and should ask the client to do which during tube removal? Breath normally. Exhale until the tube is out. Perform the Valsalva maneuver. Take a breath and hold it until the tube is out.

A primary health care provider asks the nurse to obtain a Salem sump tube for gastric intubation. The nurse should correctly select which tube from the unit storage area? A feeding tube A jejunostomy tube A Sengstaken-Blakemore tube A tube with a larger lumen and an air vent

A primary health care provider asks the nurse to obtain a Salem sump tube for gastric intubation. The nurse should select which tube from the unit storage area? Miller-Abbott tube Sengstaken-Blakemore tube Tube with just a single lumen Tube with a lumen and an air vent

The nurse has assisted the primary health care provider with a liver biopsy, which was done at the bedside. Upon completion of the procedure, the nurse should assist the client into which position? Left side-lying with the right arm elevated above the head Right side-lying with the left arm elevated above the head Left side-lying with a small pillow or towel under the puncture site Right side-lying with a small pillow or towel under the puncture site

The nurse is assisting in planning stress management strategies for the client diagnosed with irritable bowel syndrome. Which suggestion is most appropriate for the nurse to give to the client? Rest in bed as much as possible. Limit exercise to reduce bowel stimulation. Try to avoid every possible stressful situation. Learn measures such as biofeedback or progressive relaxation.

The nurse is caring for a client diagnosed with a resolved intestinal obstruction who has a nasogastric tube in place. The primary health care provider has now prescribed the nasogastric tube to be discontinued. To best determine the client's readiness for discontinuation of the nasogastric tube, which measure should the nurse check? The pH of the gastric aspirate Proper nasogastric tube placement The client's serum electrolyte levels Presence of bowel sounds in all four quadrants

The nurse is caring for a client diagnosed with esophageal varices who is going to have a Sengstaken-Blakemore tube inserted. The nurse brings which priority item to the bedside so that it is available at all times? An obturator A Kelly clamp An irrigation set A pair of scissors

The nurse is caring for a client with a diagnosis of pneumonia and a history of bleeding esophageal varices. Based on this information, the nurse should plan care knowing that which could most result in a potential complication? Pain Diarrhea Frequent swallowing Vigorous coughing

The nurse is collecting data about how well a client diagnosed with a gastrointestinal (GI) disorder is able to absorb food. While doing this, the nurse recalls that absorption is most concerned with which bodily function? Removal by osmosis of digested food to the cells The chemical process involving the breakdown of foods The transfer of nutrients into the cell by active transport The transfer of digested food molecules from the GI tract into the bloodstream

The nurse is evaluating the effect of dietary counseling on the client diagnosed with cholecystitis. The nurse determines the client understands the instructions given if the client states that which food item is most appropriate to include in the diet? Beef chili Grilled steak Mashed potatoes Turkey and lettuce sandwich

The nurse is reinforcing medication instructions to a client with peptic ulcer disease. Which represents correct information given by the nurse? Antacids coat the lining of the stomach. Omeprazole will coat the ulcer to help it heal. Sucralfate changes the acidity of fluid in the stomach. Cimetidine results in decreased secretion of stomach acid.

The nurse is reviewing the primary health care provider's prescriptions for a client admitted to the hospital with a diagnosis of liver disease. Which medication prescription should the nurse most question? Lorazepam Furosemide Omeprazole Acetaminophen

The nurse observes that a client with a nasogastric tube connected to continuous gastric suction is mouth breathing, has dry mucous membranes, and has a foul breath odor. When planning care, which nursing intervention would be best to maintain the integrity of this client's oral mucosa?

The nurse should reinforce instructions to a client that has had a gastrectomy about the signs and symptoms of pernicious anemia, knowing what information? Most diets are deficient in all of the B vitamins. Once symptoms are evident, pernicious anemia is often fatal. Symptoms can occur as long as 10 years after gastric surgery. Regular monthly injections of vitamin B12 will prevent this complication.

The nurse has reinforced dietary instructions to the mother of a child with celiac disease. The nurse determines that the mother understands the dietary instructions if she indicates eliminating which products? Select all that apply. 1.Rice 2.Corn 3.Millet 4.Oatmeal 5.Rye crackers 6.Wheat bread

4.Oatmeal 5.Rye crackers 6.Wheat bread Dietary management is the mainstay of treatment for the child with celiac disease. Because gluten occurs mainly in the grains of wheat and rye, but also in smaller quantities in barley and oats, these four foods are eliminated. Corn, rice, and millet are substitute grain foods.

A nursing student is preparing to conduct a clinical conference, and the topic is hepatitis in children. The nursing instructor advises the student to further research the topic if the student plans to include which information in the discussion? 1.The child's stools will be pale and clay-colored. 2.Cases of hepatitis should be promptly reported to health care officials. 3.Vaccines are available to prevent hepatitis A (HAV) and hepatitis B (HBV). 4.Enteric precautions are necessary for hepatitis B (HBV) but not for hepatitis A (HAV).

4.Enteric precautions are necessary for hepatitis B (HBV) but not for hepatitis A (HAV). Prevention of the spread of infection is an essential intervention for hepatitis A. This should include enteric precautions for at least 1 week after the onset of jaundice and strict hand washing. Options 1, 2, and 3 are accurate regarding hepatitis.

A child is diagnosed with intussusception. The nurse collects data on the child, knowing that which is a characteristic of this disorder? 1.The presence of fecal incontinence 2.Incomplete development of the anus 3.The infrequent and difficult passage of dry stools 4.Invagination of a section of the intestine into the distal bowel

4.Invagination of a section of the intestine into the distal bowel Intussusception is an invagination of a section of the intestine into the distal bowel. It is the most common cause of bowel obstruction in children age 3 months to 6 years. Option 1 describes encopresis. Option 2 describes imperforate anus, and this disorder is diagnosed in the neonatal period. Option 3 describes constipation. Constipation can affect any child at any time, although it peaks at ages 2 to 3 years. Encopresis generally affects preschool and school-age children.

The nurse is assisting a primary health care provider with an assessment of a child with a diagnosis of suspected appendicitis. In assessing the intensity and progression of the pain, the primary health care provider palpates the child at McBurney's point. What response does the nurse expect the child to have during the examination? 1.Pain in the upper right side 2.Pain when extending the leg 3.Pain when the right thigh is drawn up 4.Pain in the lower right side between the umbilicus and the iliac crest

4.Pain in the lower right side between the umbilicus and the iliac crest Pain in the lower right side, halfway between the umbilicus and the crest of the ileum at McBurney's point is the best known symptom of appendicitis. Extending the leg causes pain but is not the McBurney's point. The client may rest with the right thigh drawn up to relieve pain.

The nurse reviews the record of a 1-year-old child seen in the clinic and notes that the primary health care provider has documented a diagnosis of celiac crisis. Which symptom should the nurse expect to note in this condition? 1.Anorexia 2.Joint pain 3.Constipation 4.Profuse, watery diarrhea

4.Profuse, watery diarrhea Clinical signs/symptoms associated with celiac crisis include profuse, watery diarrhea and vomiting that quickly lead to severe dehydration and metabolic acidosis. The cause of the crisis is usually infection or hidden sources of gluten. The child may require intravenous fluids to correct fluid and acid-base imbalances, albumin to treat shock, and corticosteroids to decrease severe mucosal inflammation.

The nurse provides feeding instructions to a mother of an infant diagnosed with gastroesophageal reflux (GER). To assist in reducing the episodes of emesis, which instruction should the nurse provide the mother 1.Provide less frequent, larger feedings. 2.Burp less frequently during feedings. 3.Thin the feedings by adding water to the formula. 4.Thicken the feedings by adding rice cereal to the formula.

4.Thicken the feedings by adding rice cereal to the formula. Small, more frequent feedings with frequent burping are often tried as the first line of treatment in gastroesophageal reflux. Feedings thickened with rice cereal may reduce episodes of emesis. However, thickened feedings do not affect reflux time. If thickened formula is prescribed, 1 to 3 teaspoons of rice cereal per ounce of formula is most commonly used and may require cross-cutting the nipple. Options 1, 2, and 3 are incorrect.

The client asks the nurse about which product should be taken for a headache. The client is taking lansoprazole for long-term management of the diagnosis of Zollinger-Ellison syndrome. The nurse should determine that which medication is the most appropriate choice for this client? Naproxen Ibuprofen Acetaminophen Acetylsalicylic acid

Acetaminophen

The client diagnosed with portosystemic encephalopathy is receiving oral lactulose daily. The nurse should check which to determine medication effectiveness? Lung sounds Blood pressure Blood ammonia level Serum potassium level

Blood ammonia level

The nurse is administering a dose of prochlorperazine to the client for nausea and vomiting. The nurse should instruct the client to report which frequent side effect of this medication? Diarrhea Drooling Blurred vision Excessive perspiration

Blurred vision

The client with a diagnosis of gastric ulcer has a prescription for oral sucralfate four times daily. The nurse reinforces instructions to the client about which adverse or side effect that can occur while taking this medication? Ataxia Restlessness Constipation Neurotoxicity

Constipation

The nurse is preparing to reinforce instructions to the client who has been given a prescription for diphenoxylate with atropine. Which instructions should the nurse include? Anticipate excitability as a side effect. Take the medication with a bulk-forming laxative. Expect increased saliva production while taking the medication. Do not exceed the recommended dose because it can be habit forming.

Do not exceed the recommended dose because it can be habit forming.

The client arrives at the clinic complaining of dyspepsia and pain that occurs about 90 minutes after eating. The client also reports that the pain became worse this afternoon about 3 hours after eating a large bowl of spaghetti with tomato sauce. Laboratory tests reveal the presence of Helicobacter pylori (H. pylori). The nurse anticipates that the primary health care provider should prescribe which medications? Select all that apply. Esomeprazole Metronidazole Clarithromycin Calcium carbonate Hydrocodone and ibuprofen

Esomeprazole Metronidazole Clarithromycin

The nurse is collecting data from a client who is taking pantoprazole. The nurse determines that the medication is most effective if the client states relief of which symptom? Heartburn Constipation A nighttime cough Migraine headaches

Heartburn

The client has an as needed prescription for ondansetron. For which condition should the nurse administer this medication? Paralytic ileus Incisional pain Urinary retention Nausea and vomiting

Nausea and vomiting

A client has just taken a dose of trimethobenzamide. The nurse determines that the medication has been effective if the client reports which outcome? Heartburn has been relieved. Passage of hard stool has occurred. Abdominal pain has been alleviated. Nausea and vomiting has been relieved.

Nausea and vomiting has been relieved.

A histamine (H2)-receptor antagonist will be prescribed for a client. The nurse understands that which medications are H2-receptor antagonists? Select all that apply. Nizatidine Ranitidine Famotidine Cimetidine Esomeprazole Lansoprazole

Nizatidine Ranitidine Famotidine Cimetidine

The client has a prescription for sucralfate 1 g by mouth 4 times daily. The nurse should best schedule the administration of the medication at which time? With meals and at bedtime Every 6 hours around the clock One hour after meals and at bedtime One hour before meals and at bedtime

One hour before meals and at bedtime

The client with a gastric ulcer has a prescription for sucralfate 1 g by mouth four times daily. The nurse should schedule the medication to be administered at which times? With meals and at bedtime Every 6 hours around the clock One hour after meals and at bedtime One hour before meals and at bedtime

One hour before meals and at bedtime

A client diagnosed with hepatic encephalopathy is receiving lactulose. The nurse determines that the medication is effective if which finding is observed? There is an absence of blood in emesis and stool. Urine output increases from 250 to 400 mL per 8-hour shift. Episodes of frequent liquid bowel movements diminish to one time per day. The client who was previously oriented to person only can now state name, year, and present location.

The client who was previously oriented to person only can now state name, year, and present location.

The client with diagnosed peptic ulcer disease has been prescribed misoprostol and sucralfate. The nurse reinforces teaching the client that these two medications will work primarily for which reason? The medications kill intestinal bacteria. The medications inhibit histamine action. The medications decrease stomach acid. The medications protect the gastric mucosa.

The medications protect the gastric mucosa.

The client with recurrent constipation has begun using psyllium. The nurse should instruct the client that this medication should be taken in which manner? With any hot beverage With any cold beverage With any type of gelatin With a full glass of liquid, followed by a second glass of liquid

With a full glass of liquid, followed by a second glass of liquid

The nurse is reviewing the record of a client with Crohn's disease. Which stool characteristic should the nurse expect to see documented in the record?

diarrhea

The nurse is caring for a client with a diagnosis of chronic gastritis. The nurse anticipates that the client is at risk for which vitamin deficiency?

vitamin B12 Rationale:Deterioration and atrophy of the lining of the stomach lead to the loss of function of the parietal cells. When the acid secretion decreases, the source of the intrinsic factor is lost, which results in the inability to absorb vitamin B12. This leads to the development of pernicious anemia. Options 1, 2, and 3 are incorrect.

NCLEX - Gastrointestinal

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