Targeted Med Surge Gastrointestinal
A nurse is providing discharge teaching for a client who has GERD. Which of the following statements by the client indicates an understanding of the teaching? A. "I will decrease the amount of carbonated beverages I drink" B. "I will avoid drinking liquids for 30 mins after taking a chewable antacid tab" C. "I will eat a snack before going to bed" D. "I will lie down for at least 30 mins after eating each meal"
A. "I will decrease the amount of carbonated beverages I drink" The nurse should instruct the client to limit or eliminate fatty foods, coffee, cola, tea, carbonated beverages, and chocolate from his diet because they irritate the lining of the stomach.
A nurse is assessing a client who has Crohn's disease. Which of the following findings should the nurse expect? A. Fatty diarrheal stools B. Hyperkalemia C. Weight gain D. Sharp epigastric pain
A. Fatty diarrheal stools Steatorrhea, or fatty stool, is an expected finding in a client who has Crohn's disease.
A nurse is developing a plan of care for a client who has cirrhosis and ascites. Which of the following interventions should the nurse include in the plan? A. Measure the client's abdominal girth daily B. Check mental status once daily C. Provide a daily intake of 4g of Sodium D. Assess the clients breath sounds q12 hr
A. Measure the client's abdominal girth daily The nurse should measure the client's abdominal girth and weigh the client daily to monitor the amount of fluid accumulation in the abdomen and the effectiveness of treatment measures.
A nurse is assessing a client who has appendicitis. Which of the following should the nurse expect? (select all that apply) A. Oral temperature 38.4 (101.1) B. WBC 6000 C. Bloody diarrhea D. Nausea and vomiting E. RLQ pain
A. Oral temperature 38.4 (101.1) D. Nausea and vomiting E. RLQ pain Oral temperature 38.4° C (101.1° F) is correct. A low-grade temperature is an expected finding in a client who has appendicitis. WBC 6,000/mm3 is incorrect. A WBC of 10,000 to 18,000/mm3 is an expected finding in a client who has appendicitis. Bloody diarrhea is incorrect. Bloody diarrhea is an expected finding in a client who has colorectal cancer. Nausea and vomiting is correct. Nausea and vomiting are expected findings in a client who has appendicitis. Right lower quadrant pain is correct. Right lower quadrant pain is an expected finding in a client who has appendicitis.
A nurse is caring for a client who has ulcerative colitis. the client had several exacerbations over the past 3 years. which of the following instructions should the nurse include in the plan of care to minimize the risk of further exacerbation? (select all that apply) A. Use progressive relaxation techniques B. Increase dietary fiber intake C. Drink 2 240ml glasses of milk per day D. Arrange activities to allow for daily rest periods E. Restrict intake of carbonated beverages
A. Use progressive relaxation techniques D. Arrange activities to allow for daily rest periods E. Restrict intake of carbonated beverages Use progressive relaxation techniques is correct. Progressive relaxation techniques, a form of biofeedback, are recommended to help the client minimize stress, which can precipitate an exacerbation. Increase dietary fiber intake is incorrect. The client should restrict intake of dietary fiber, which can cause diarrhea and cramping. Drink two 240 mL (8 oz) glasses of milk per day is incorrect. Dairy products, such as milk, are poorly tolerated by clients who have ulcerative colitis and should be avoided. Arrange activities to allow for daily rest periods is correct. Daily rest periods decrease stress and reduce intestinal motility. Restrict intake of carbonated beverages is correct. The client should avoid gastrointestinal stimulants, such as carbonated beverages, nuts, peppers, and smoking.
A nurse is providing discharge teaching for a client who has chronic hepatits C. Which of the following statements by the client indicates an understanding of the teaching? A. "I will avoid alcohol until I'm no longer contagious" B. "I will avoid medications that contain acetaminophen" C. "I will decrease my intake of calories" D. "I will need treatments for 3 months"
B. "I will avoid medications that contain acetaminophen" A client who has hepatitis C should avoid medications that contain acetaminophen, which can cause additional liver damage.
A nurse is caring for a client who has colorectal cancer and is receiving chemotherapy. The client asks the nurse why his blood is being drawn for a carcinoembryonic antigen (CEA) level. Which of the following responses should the nurse make? A. "The CEA determines the current stage of your colon cancer" B. "The CEA determines the efficacy of your chemotherapy" C. "The CEA determines if the neutrophil count is below the expected reference range" D. "The CEA determines if you are experiencing occult bleeding from the GI tract"
B. "The CEA determines the efficacy of your chemotherapy" A provider uses the CEA level to determine the efficacy of the chemotherapy. The client's CEA levels will decrease if the chemotherapy is effective.
A nurse is providing dietary teaching for a client who is postoperative following a gastrectomy. Which of the following foods should the nurse encourage the client to include in her diet to prevent dumping syndrome? A. Ice cream B. Eggs C. Grape juice D. Honey
B. Eggs The nurse should instruct the client to increase dietary intake of protein-containing foods, such as eggs, to decrease the risk for manifestations of dumping syndrome. The client should eat some form of protein at each meal. high sugar causes dumping
A nurse is providing teaching for a client who has cirrhosis and a new prescription for lactulose. The nurse should include which of the following instructions in the teaching? A. Notify the provider if bloating occurs B. Expect to have 2-3 soft stools per day C. Restrict carbs D. Limit oral intake to 1000mL/day of clear liquids
B. Expect to have 2-3 soft stools per day The purpose of administering lactulose is to promote the excretion of ammonia in the stool. The nurse should instruct the client to take the medication every day and inform the client that two to three bowel movements every day is the treatment goal.
A nurse is providing discharge teaching for a client who has a new prescription for medications to treat peptic ulcer disease. the nurse should identify that which of the following medications inhibits gastric acid secretion? A. Calcium carbonate B. Famotidine C. Aluminum hydroxide D. Sucralfate
B. Famotidine The nurse should inform the client that famotidine is an H2-receptor antagonist that is prescribed for the treatment of peptic ulcer disease to inhibit the secretion of gastric acid.
A nurse is reviewing the laboratory results of a client who has acute pancreatitis. Which of the following findings should the nurse expect? A. Blood glucose 100 mg/dL B. Increased serum amylase C. WBC 9000 D. Decreased bilirubin
B. Increased serum amylase Serum amylase levels are increased in a client who has acute pancreatitis due to pancreatic cell injury.
A nurse is reviewing the prescriptions for a client who has Campylobacter enteritis. Which of the following prescriptions should the nurse clarify with the provider? A. 0.45% sodium chloride IV B. Magnesium hydroxide C. Ciprofloxacin D. Potassium
B. Magnesium hydroxide Nausea, vomiting, and diarrhea are manifestations of enteritis. The nurse should clarify a prescription for magnesium hydroxide, also known as milk of magnesia, with the provider. This medication increases gastrointestinal motility, which can increase the client's risk for an electrolyte imbalance and contribute to dehydration.
A nurse is providing discharge teaching for an older adult client who has mild diverticulitis. Which of the following statements by the client indicates an understanding of the teaching? A. "I may experience RLQ pain" B. "I will remain active by working in my garden everyday" C. "I should eat foods that are low in fiber" D. "I will use a mild laxative every day"
C. "I should eat foods that are low in fiber" The nurse should instruct the client who has diverticulitis to follow a low-fiber diet. When the inflammation subsides, the client should consume foods that are high in fiber.
A nurse is providing dietary teaching for a client who has a new diagnosis of celiac disease. Which of the following statements by the client indicates an understanding of the teaching? A. "I can return to my regular diet when i am free of symptoms" B. "I will need to avoid taking vitamin supplements while on this diet" C. "I will eat beans to ensure I get enough fiber in my diet." D. "I need to avoid drinking liquids with my meals while on this diet"
C. "I will eat beans to ensure I get enough fiber in my diet." Clients who have celiac disease must maintain a gluten-free diet which eliminates fiber-rich whole wheat products. Clients should eat beans, nuts, fruits, and vegetables to ensure an adequate intake of fiber
A nurse is assessing a client who has cirrhosis. which of the following findings is a priority for the nurse to report to the provider? A. Spider angiomas B. Peripheral edema C. Bloody stools D. Jaundice
C. Bloody stools The greatest risk to the client who has cirrhosis of the liver is hemorrhagic shock due to bleeding in the esophageal varices. Therefore, bloody stools is the priority finding to report to the provider.
A nurse is providing discharge teaching for a client following an ileostomy. The nurse should instruct the client to report which of the following findings to the provider? A. Intolerance to high-fiber foods B. Liquid ileostomy output C. Dark purple stoma D. Sensation of burning during bowel elimination
C. Dark purple stoma The nurse should instruct the client to contact the provider if the stoma is a dark purple color, which is an indication of bowel ischemia.
A nurse is teaching a client how to prepare for a colonoscopy. Which of the following instructions should the nurse include in the teaching? A. Begin drinking the oral liquid prep for bowel cleansing on the morning of the procedure B. Drink full liquids for breakfast the day of the procedure, and then take nothing PO for 2 hr before the procedure C. Drink clear liquids for 24 hr prior to the procedure, and then NPO for 6 hr before the procedure. D. Drink the oral liquid prep for bowel cleansing slowly
C. Drink clear liquids for 24 hr prior to the procedure, and then NPO for 6 hr before the procedure. The nurse should instruct the client to drink clear liquids for 24 hr prior to the colonoscopy to promote adequate bowel cleansing. Maintaining NPO status for 4 to 6 hr prior to the colonoscopy preserves the bowel's cleansed state.
A nurse is assessing a client who has upper GI bleeding. Which of the following findings should the nurse expect? A. Bradycardia B. Bounding peripheral pulses C. Hypotension D. Increased hematocrit levels
C. Hypotension A client who has upper gastrointestinal bleeding is at risk for hemorrhagic shock. Hypotension is a manifestation of hemorrhagic shock.
A nurse is admitting a client who has acute pancreatitis. Which of the following actions should the nurse take first? A. Insert a NG tube B. Administer ceftazidime C. Identify the client's current level of pain D. Instruct the client to remain NPO
C. Identify the client's current level of pain The first action the nurse should take when using the nursing process is to assess the client. Clients who have acute pancreatitis often have severe abdominal pain. By assessing the client's level of pain, the nurse can identify the need for and implement interventions to alleviate the client's pain.
A nurse is providing discharge teaching for a client who has a new colostomy and is concerned about flatus and odor. Which of the following foods should the nurse recommend to the client? A. Eggs B. Fish C. Yogurt D. Broccoli
C. Yogurt The nurse should recommend yogurt, crackers, and toast, which can prevent flatus and stool odor.
A nurse is providing dietary teaching for a client who has chronic pancreatitis. Which of the following food selections by the client indicates an understanding of the teaching? A. 8oz whole milk B. 1 Slice beef bologna C. 1oz cheddar cheese D. 1 cup banana
D. 1 cup banana Foods that are high in fat can cause diarrhea for clients who have pancreatitis. One cup of sliced banana, which contains 0.49 g of fat, is a low-fat food option. Clients who have pancreatitis should consume a high-protein and low-fat diet with an adequate amount of carbohydrates and calories.
A nurse is reviewing the laboratory results of a client who has hepatic cirrhosis. Which of the following findings should the nurse report to the provider? A. Albumin 4.0 g/dL B. INR 1.0 C. Direct bilirubin 0.5 mg/dL D. Ammonia 180 mcg/dL
D. Ammonia 180 mcg/dL An ammonia level of 180 mcg/dL is above the expected reference range of 10 to 80 mcg/dL. The nurse should report an increased ammonia level because it can indicate portal-systemic encephalopathy.
A nurse is caring for a client who has GERD and a new prescription for metoclopramide. The nurse should plan to monitor for which of the following adverse effects? A. Thrombocytopenia B. Hearing loss C. Hypersalivation D. Ataxia
D. Ataxia The nurse should plan to monitor the client for extrapyramidal symptoms, such as ataxia, and should report any of these findings to the provider.
A nurse is reviewing the laboratory values for a client who has colorectal cancer. Which of the following findings should the nurse expect? A. Negative fecal occult blood test B. Decreased serum carcinoembryonic antigen (CEA) level C. Hematocrit 43% D. Hemoglobin 9.1 g/dL
D. Hemoglobin 9.1 g/dL A hemoglobin level of 9.1 g/dL is below the expected reference range. Decreased hemoglobin is an expected finding in a client who has colorectal cancer due to occult intestinal bleeding.
A nurse is assessing a client who has a duodenal ulcer. which of the following findings should the nurse expect? A. The client states that the pain is in the upper eipgrastrium B. The client is malnourished C. The client states that ingesting food intensifies pain D. The client reports that the pain occurs during the night
D. The client reports that the pain occurs during the night Pain associated with a duodenal ulcer occurs when the stomach is empty, which is typically 1.5 to 3 hr after meals and during the night.
A nurse is providing discharge teaching for a client who has peptic ulcer disease and a new prescription for famotidine. Which of the following statements by the client indicates an understanding of the teaching? A. "I should take this medication at bedtime" B. "I should expect this medication to discolor my stools" C. "I will drink iced tea with my meals and snacks" D. "I will monitor my blood glucose level regularly while taking this medication"
A. "I should take this medication at bedtime" The nurse should instruct the client to take the medication at bedtime to inhibit the action of histamine at the H2-receptor site in the stomach.
A nurse is assessing a client who is post-op following a gastrectomy. The nurse should identify which of the following findings as an indication of abdominal distention? A. Hiccups B. Hypertension C. Bradycardia D. Chest pain
A. Hiccups Following surgery, hiccups can be caused by irritation of the phrenic nerve due to abdominal distension. If the hiccups are intractable, the nurse should anticipate a prescription for chlorpromazine because persistent hiccups are distressful to the client and can lead to complications, such as vomiting.
A nurse is assessing a client who has acute hepatitis B. Which of following findings should the nurse expect? A. Joint pain B. Obstipation C. Abdominal distention D. Periumbilical discoloration
A. Joint pain Joint pain is an expected finding in a client who has acute hepatitis B.
A nurse is assessing a client who has peritonitis. Which of the following should the nurse expect? A. Bloody diarrhea B. Board-like abdomen C. Periumbilical cyanosis D. Increased bowel sounds
B. Board-like abdomen A board-like, distended abdomen, accompanied by extreme pain and tenderness, is an expected finding in a client who has peritonitis.
A nurse is assessing a client immediately following a paracentesis for the treatment of ascites. Which of the following findings indicates the procedure was effective? A. Presence of a fluid wave B. Increased HR C. Equal pre- and post-procedure weights D. Decreased SOB
D. Decreased SOB Increased abdominal fluid can limit the expansion of the diaphragm and prevent the client from taking a deep breath. Once excess peritoneal fluid is removed, the diaphragm will expand more freely. The nurse should identify this finding as an indicator the procedure was effective.
