Adult One Exam 5 Questions!

Vitamin A

On assessment, the client is noted to have conjunctival xerosis, dry skin, follicular hyperkeratosis, and a purple tongue. Which vitamin deficiency does the nurse anticipate?

Delegating an AP to feed the client Providing mouth care before each meal Assisting the client to sit upright in a chair Ordering foods that the client like and prefers to eat

The client is ordered daily multiple vitamins with zinc and iron supplements. Which nursing intervention promotes oral nutrition intake? (Select all that apply.)

Small and frequent meals are best.

The client was initially NPO but is now tolerating food. What education will the nurse provide regarding nutrition?

"I need to check for leakage underneath my colostomy."

The home health nurse is teaching a client about the care of a new colostomy. Which client statement demonstrates a correct understanding of the instructions?

Metronidazole (Flagyl)

A nurse cares for a client who has a Giardia infection. Which medication should the nurse anticipate being prescribed for this client?

120 mg/dose

A nurse cares for a client with acute pancreatitis who is prescribed gentamicin (Garamycin) 3 mg/kg/day in 3 divided doses. The client weighs 264 lb. How many milligrams should the nurse administer for each dose? (Record your answer using a whole number.) ____ mg/dose

Ensure warm and cold items stay at appropriate temperatures. Remove bedpans, soiled linens, and other unpleasant items. Sit with the client, making the atmosphere more relaxed.

A nurse has delegated feeding a client to an unlicensed assistive personnel (UAP). What actions does the nurse include in the directions to the UAP? (Select all that apply.)

Cholesterol: 142 mg/dL

A nurse is reviewing laboratory values for several clients. Which value causes the nurse to conduct nutritional assessments as a priority?

"Consume a low-fiber diet while your diverticulitis is active. When inflammation resolves, consume a high-fiber diet."

A nurse is teaching a client about dietary methods to help manage exacerbations ("flare-ups") of diverticulitis. What does the nurse advise the client?

Ulcerative Colitis affects the entire bowel wall while Crohn's disease affects the rectum and the rectosigmoid colon.

A patient is diagnosed with ulcerative colitis and asks the nurse about the difference between Ulcerative Colitis and Crohn's disease. After education between the difference of both diseases, what statement provided by the patient demonstrates the need for further teaching?

pyloric obstruction

A patient is experiencing abdominal bloating, nausea, and projectile vomiting. Which complication of peptic ulcer disease does the nurse recognize?

GERD

A postoperative client has had a NG tube in place for 6 days. The nurse knows the client is at risk for developing which of the following

Ulcer perforation

Upon assessment of a client with a duodenal ulcer, the patient reports sudden, sharp pain in the mid-epigastric region with an abdomen that is board-like. What does the nurse anticipate has developed?

Infuse 10% dextrose at the ordered rate of the TPN

Upon making rounds, the nurse notices that the client has less than 50 mL of TPN in their bag. There is a delay from pharmacy and the next bag is not available. What is the best action for the nurse to take?

Hypercalcemia Potassium imbalance Sodium imbalance

What are potentially life threatening complications that can result from the administration of total parenteral nutrition (TPN)? (Select all that apply)

Eat small, frequent meals during the day

What dietary teaching should the nurse include for a client diagnosed with ulcerative colitis?

X-ray

What should the nurse order for the patient after an NG tube is placed?

Close monitoring is needed because toxic levels may develop.

When administering a new GI medication to an older patient, the nurse anticipates what?

Check the tubing for any obvious blockage and massage the tube gently.

When administering medications through a PEG tube bolus, what is the nurse's highest priority if the bolus stops flowing or flows unevenly?

Assess the client's gag reflex

When caring for a client recovering from an esophagogastroduodenoscopy (EGD) where conscious sedation was used, the nurse should implement which of the following?

Respiratory rate of 28 breaths/min

When caring for a client with acute pancreatitis, which assessment finding requires immediate nursing intervention?

Poultry or fish Egg whites Low-fat yogurt

When providing a client with education on IBS what foods would you tell them to help prevent flare-ups?

Diverticulosis is multiple abnormal pouch-like herniation's in the intestine, while Diverticulitis is the inflammation or infection of diverticula.

When the client asks," what the difference between diverticulosis and diverticulitis?", the correct response from the nurse is?

"I ordered scrambled eggs and yogurt for breakfast."

Which dietary choice by the patient with recurrent aphthous ulcers (ulcers in mouth) indicates that nursing teaching has been effective?

Granola Cereal

Which dietary item will the nurse remove from the client's nutrition tray?

Those who are terminally ill to provide comfort and quality of life.

Which of the following is NOT a reason for tube feeding?

"I take ibuprofen three times daily for arthritis."

Which patient statement alerts the nurse to perform a thorough GI history and focused assessment?

3.7 g/dL

Which serum albumin level does the nurse expect to see in a healthy, ambulatory adult client?

Heating pads to the affected area are helpful

Which statement made by a client diagnosed with hemorrhoids shows a need for further instruction?

"Consume extra fluids to replace fluid losses."

A client who developed viral gastroenteritis with vomiting and diarrhea is scheduled to be seen in the clinic the following day. What will the nurse teach the client to do in the meantime?

Examines the RUQ of the abdomen last

A client is admitted to the hospital with severe right upper quadrant (RUQ) abdominal pain. Which assessment technique does the nurse use for this client?

"You may have consumed contaminated food or water."

A client is admitted with severe viral gastroenteritis caused by norovirus. The client asks the nurse, "How did I get this disease?" Which answer by the nurse is correct?

Maintain NPO status and administer IV fluids.

A client is diagnosed with acute pancreatitis. Which intervention should the nurse include in the plan of care to provide rest and decrease pancreatic enzyme production?

Caffeinated drinks Stress Anxiety

A client is diagnosed with irritable bowel syndrome (IBS). What factors does the nurse suspect as possible causes of the client's problem? ( Select all that apply.)

Administer opioid analgesic medication.

A client is experiencing an attack of acute pancreatitis. Which nursing intervention is the highest priority for this client?

280 mL

A client is receiving continuous tube feeding at 70 mL/hr. When the bag is empty, how much formula does the nurse add? (Record your answer using a whole number.) _____ mL

Assess the client's gag reflex

A client is recovering from an esophagogastroduodenoscopy (EGD) and requests something to drink. What action by the nurse is best?

Anorexia Constipation Abdominal pain

A nurse assesses a patient who has celiac disease. Which signs and symptoms would the nurse expect? (Select all that apply.)

Notify the provider immediately

A client presents to the emergency department reporting severe abdominal pain. On assessment, the nurse finds a bulging, pulsating mass in the abdomen. What action by the nurse is the priority?

I will start working out in order to lose weight I will make sure to sleep with my head elevated

A client recently diagnosed with GERD is learning about how to manage his diagnosis. What statements from the patient demonstrate appropriate understanding. (Select all that apply)

"Avoid caffeine-containing foods and beverages."

A client has been diagnosed with mild gastroesophageal reflux disease and asks the nurse about nonpharmacologic treatments to prevent symptoms. What does the nurse tell this client?

Inflammation of the rectum/rectum signal colon Hyperemic mucous Do not take NSAIDS Tenesmus (urge to defecate) Blood and mucus in the stool

A 53 year old patient is diagnosed with ulcerative colitis. Which of the following are correct regarding ulcerative colitis? (select all that apply)

Serum amylase, 200 U/L

A 66-year-old client presents to the ED the day after Thanksgiving, stating that he has "eaten and drunk quite a bit." He reports experiencing a sudden onset of pain in the left upper quadrant that radiates to the left flank about an hour ago that still persists. He rates the pain as an 8 on a 0-to-10 scale. The client is admitted with acute pancreatitis. Which laboratory finding corroborates the diagnosis of acute pancreatitis?

Reducible

A 67-year-old male client reports pain in the inguinal area that occurs when he coughs. A bulge that can be pushed back into the abdomen is found in his inguinal area. What type of hernia does he have?

dizziness upon standing

A 73-year-old male is admitted with a upper GI bleed due to peptic ulcer disease (PUD). Which finding does the nurse expect to find?

Increase the client's calorie intake and encourage a soft or bland diet.

A client come to the clinic with malnutrition, what are some ways to improve their nutrition?

Encourages the client to look at and touch the colostomy stoma

A client with colorectal cancer had colostomy surgery performed yesterday. The client is very anxious about caring for the colostomy and states that the health care provider's instructions "seem overwhelming." What does the nurse do first for this client?

Determine if any of the medications come in liquid form. Flush the tube before and after administering medications. Try to flush the tube with 30 mL of water and gentle pressure.

A client's small-bore feeding tube has become occluded after the nurse administered medications. What actions by the nurse are best? (Select all that apply.)

Monitor Fluids & Electrolytes

A male patient is admitted from the ED with nausea and vomiting, severe abdominal cramps, and diarrhea. The patient and his wife tried a new restaurant in town last night. It is suspected that he has gastroenteritis. What is the nurse's main priority for this patient?

"Which food types cause an exacerbation of symptoms?" "Where is your pain and what does it feel like?" "Do you experience nausea associated with defecation?"

A nurse assesses a client with irritable bowel syndrome (IBS). Which questions should the nurse include in this client's assessment? (Select all that apply.)

"Have you passed flatus?"

After abdominal surgery, which question should the nurse ask the patient to determine whether peristaltic movement is returning?

Start an IV solution of 5% dextrose in 0.45 normal saline at 125 mL/hr.

An 80-year-old client with a 2-day history of myalgia, nausea, vomiting, and diarrhea is admitted to the medical-surgical unit with a diagnosis of gastroenteritis. Which health care provider request does the nurse implement first?

1. Decreased appetite, weight loss, dry mouth, generalized weakness, poor fitting dentures, and difficulty ambulating. (Basically, everything in his history is risk factors). 2. Weakness and unintentional weight loss

An 87-year old male has been admitted for dehydration. The nurse's assessment reveals dry mucous membranes, generalized weakness, difficulty ambulating, and anorexia. His weight is down from 112 to 98 pounds over the past 3 months. His dentures are loose and poor fitting. 1.Which assessment findings support a risk for undernutrition? 2.Which assessment findings support failure to thrive?

"Changes in your liver cause drugs to be metabolized differently."

An older client has had an instance of drug toxicity and asks why this happens, since the client has been on this medication for years at the same dose. What response by the nurse is best?

Dehydration

An older patient diagnosed with bacterial gastroenteritis reports abdominal cramping, diarrhea, nausea and vomiting, and fatigue for the past 24 hours. The nurse should monitor the patient for what priority assessment?

Hold the feeding and go back in 20 minutes to re-assess.

Before administering a bolus tube feeding, the nurse assesses the residual and obtains 120 mL of gastric contents. What action by the nurse is appropriate?

Cyclic

Feeding done through a tube that is given continuously but is stopped periodically is called?

Before meals (H2) At night (H2) In the morning (PPI)

H2 blockers and PPIs taken for GERD are usually taken when? (Select all that apply)

Pleural effusion Diabetes mellitus Pancreatic infection Acute kidney failure

In preparing to care for the client, which condition does the nurse recognize as potential complications of acute pancreatitis? (Select all that apply.)

PCA (IV route) morphine sulfate

The client describes the pain as intense and continuous. He states that sometimes, when he curls up in a fetal position, the pain decreases. Which medication does the nurse anticipate will be ordered to provide the most comprehensive pain relief?

If severe pain comes back, yellowing of skin or eyes (jaundice), persistent n/v, dark urine

The client is being discharged to home. What teaching will the nurse provide regarding when the client should notify the health care provider?

"I just joined a gym, so I hope that helps me lose weight." "I sure hate to give up my coffee, but I guess I have to." "I will eat three small meals and three small snacks a day." "Sitting upright and not lying down after meals will help."

The nurse has taught a client about lifestyle modifications for gastroesophageal reflux disease (GERD). What statements by the client indicate good understanding of the teaching? (Select all that apply.)

Dyspepsia Excessive salivation Flatulence Regurgitation

The nurse is assessing a client with gastroesophageal reflux disease (GERD). Which findings does the nurse expect to observe? (Select all that apply.)

Stomach and Spleen

The nurse is assessing a patient who was admitted with LUQ pain. The nurse understands that which body structures are located in the LUQ of the abdomen? Select all that apply

Side-lying position, with knees drawn up to the chest

The nurse is attempting to position a client having an acute attack of pancreatitis in the most comfortable position possible. In which position does the nurse place this client?

Delayed gastric emptying Eating large meals Hiatal hernia Obesity

The nurse is aware that which factors are related to the development of gastroesophageal reflux disease (GERD)? (Select all that apply.)

forceful coughing

The nurse is caring for a client who had an inguinal hernia repair 8 hours ago. Which activity would the nurse educate the client to avoid after surgery?

Ulcer perforation

The nurse is caring for a client with a bleeding duodenal ulcer who was admitted to the hospital after vomiting bright red blood. Which condition does the nurse anticipate when the client develops a sudden, sharp pain in the mid-epigastric region and a rigid, board-like abdomen?

Notify the health care provider immediately.

The nurse is caring for a client with peptic ulcer disease who reports sudden onset of sharp abdominal pain. On palpation, the client's abdomen is tense and rigid. What action takes priority?

Palpate the LUQ last

The nurse is examining a client reporting LUQ abdominal pain. What technique should the nurse use to assess the client's abdomen?

Regular dental checkups Managing stress as much as possible Eating a balanced diet

The nurse is instructing a client on measures to maintain effective oral health. Which measures does the nurse include in the client's teaching plan? (Select all that apply.)

Checking tube placement every 12 hours Keeping the bed flat Providing mouth care every 8 hours

The nurse is observing a co-worker who is caring for a client with a nasogastric tube following esophageal surgery. Which actions by the co-worker require the nurse to intervene? (Select all that apply.)

Rinse the mouth with warm saline or sodium bicarbonate.

The nurse is providing instructions to a client who has a history of stomatitis. Which instructions does the nurse include in the client's teaching plan?

Prealbumin 13 mg/dL

The nurse reviews the client's admission laboratory results. Which result does the nurse anticipate, given the earlier assessment findings?

Elevated lipase, elevated white blood cell count, elevated glucose

The nurse suspects that a client may have acute pancreatitis as evidenced by which group of laboratory results?

portal hypertension

The nurse understands which condition may lead to hemorrhoids.

Decreased hydrochloric acid production Diminished sensation that can lead to constipation Fat not digested as well in older adults Pancreatic vessels become calcified

The nurse working with older clients understands age-related changes in the gastrointestinal system. Which changes does this include? (Select all that apply.)