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Adult Practice Questions

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A 61-year-old patient with suspected bowel obstruction had a nasogastric tube inserted at 4:00 am. The nurse shares in the morning report that the day shift staff should check the tube for patency at what times? 1 7:00 am, 10:00 am, and 1:00 pm 2 8:00 am, 12:00 pm, and 4:00 pm 3 9:00 am and 3:00 pm 4 9:00 am, 12:00 pm, and 3:00 pm

A colectomy is scheduled for a 38-year-old woman with ulcerative colitis. The nurse should plan to include what prescribed measure in the preoperative preparation of this patient? 1 Instruction on irrigating a colostomy 2 Administration of a cleansing enema 3 A high-fiber diet the day before surgery 4 Administration of intravenous (IV) antibiotics for bowel preparation

A female patient with critical limb ischemia has had peripheral artery bypass surgery to improve her circulation. What care should the nurse provide on postoperative day 1? 1 Keep the patient on bed rest 2 Assist the patient with walking several times 3 Have the patient sit in the chair several times 4 Place the patient on her side with knees flexed

A patient with gastroesophageal reflux disease (GERD) has undergone an esophagogastroduodenoscopy (EGD). A nurse assessing the patient after the procedure notes a sudden spike in body temperature. What could be the cause of the increase in temperature? 1 Bleeding ulcer 2 Organ perforation 3 Obstruction in the gastrointestinal tract 4 Severe esophageal stricture

A patient's colostomy stoma is scheduled to be irrigated on the fifth postoperative day. What does the nurse understand to be the main purpose of the irrigation? 1 Act as an enema 2 Help regulate the colon 3 Remove any blood clots 4 Assess the patency of the colostomy

The nurse is aware that the primary symptoms of a sliding hiatus hernia are associated with reflux and should assess the patient for: 1 Jaundice, ascites, and edema 2 Heartburn, regurgitation, and dysphagia 3 Abdominal cramps, diarrhea, and anorexia 4 Pelvic pain, fever, and boardlike abdominal rigidity

A patient has a newly formed ileostomy and asks the nurse, "When can I start training my ostomy to only produce stool at certain times?" What is the nurse's appropriate response? 1 "We will start training when the stoma heals." 2 "When your stools transition from liquid to semisolid." 3 "Because you have an ileostomy and not a colostomy, we can start any time." 4 "We will not be able to train your ileostomy because of the frequent drainage from the site."

A patient has an inguinal hernia. The patient asks the nurse to explain the diagnosis. How should the nurse respond? 1 Tell the patient not to worry because hernias are common 2 Refer the patient to the primary health care provider for additional information 3 Explain that a hernia is often the result of prenatal growth abnormalities that appear later in life 4 Explain that a hernia is a loop of bowel protruding through a weak spot in the muscles of the abdomen

After assessing a patient, the nurse identifies that the patient is in the initial stage of Raynaud's disorder. Which symptom most likely supports the nurse's observation? 1 Throbbing, tingling, and swelling of the limbs 2 Chronic ischemic pain and ulcers on both feet 3 Hypertension, hyperglycemia, and inflamed arteries 4 Color changes of fingers and toes from white to blue to red

Before abdominal surgery for an intestinal obstruction, the nurse monitors the client's urine output and finds that the total output for the past 2 hours was 35 mL. The nurse then assesses the client's total intake and output over the last 24 hours and notes that he had 2,000 mL of I.V. fluid for intake, 500 mL of drainage from the nasogastric tube, and 700 mL of urine for a total output of 1,200 mL. This would indicate which of the following? 1. Decreased renal function. 2. Inadequate pain relief. 3. Extension of the obstruction. 4. Inadequate fluid replacement

During rounds, the nurse notes that a patient who had a total gastrectomy the day before has a very small amount of fluid draining from the nasogastric (NG) tube. What is the nurse's priority action? 1 Increase the power on the suction device. 2 Irrigate the NG tube with 50 mL of sterile saline. 3 Notify the primary health care provider immediately. 4 Continue to monitor the patient and NG tube drainage.

The nurse asks a 68-year-old patient scheduled for colectomy to sign the operative permit as directed in the health care provider's preoperative prescriptions. The patient states that the health care provider has not explained very well what is involved in the surgical procedure. What is the most appropriate action by the nurse? 1 Ask family members whether they have discussed the surgical procedure with the health care provider. 2 Have the patient sign the form and state that the health care provider will visit to explain the procedure before surgery. 3 Explain the planned surgical procedure as well as possible, and have the patient sign the consent form. 4 Delay the patient's signature on the consent and notify the health care provider about the conversation with the patient.

The nurse is assisting a patient who has been admitted with severe abdominal pain. Suddenly, the patient vomits a large amount of emesis that looks similar to coffee grounds. Which action by the nurse is a priority? 1 Ask the patient about the timing of the last meal. 2 Offer the patient sips of water to prevent dehydration. 3 Monitor the patient for any further episodes of nausea and vomiting. 4 Notify the primary health care provider about the patient's condition

The nurse is discussing postoperative care with a patient who had inguinal hernia repair the previous day. Which statement by the patient reflects a need for additional education? 1 "If I have to cough, I will cough with my mouth open." 2 "I will place an ice bag against my scrotum for support." 3 "I will hold a pillow against my incision if I have to sneeze" 4 "I can go back to my job at the moving company in four weeks."

The patient reports tenderness when the patient touches the leg over a vein. The nurse assesses warmth and a palpable cord in the area. The nurse knows the patient needs treatment to prevent what? 1 Pulmonary embolism 2 Pulmonary hypertension 3 Postthrombotic syndrome 4 Venous thromboembolism

fter assessing a patient, the nurse identifies that the patient is in the initial stage of Raynaud's disorder. Which symptom most likely supports the nurse's observation? 1 Throbbing, tingling, and swelling of the limbs 2 Chronic ischemic pain and ulcers on both feet 3 Hypertension, hyperglycemia, and inflamed arteries 4 Color changes of fingers and toes from white to blue to red

A patient who has had a femoral-popliteal bypass graft to the right leg is being cared for on the surgical unit. Which action by an LPN/LVN caring for the patient requires the RN to intervene? A. The LPN/LVN places the patient in a Fowler's position for meals. B. The LPN/LVN has the patient sit in a bedside chair for 90 minutes. C. The LPN/LVN assists the patient to ambulate 40 feet in the hallway. D. The LPN/LVN administers the ordered aspirin 160 mg after breakfast.

The patient who is admitted with a diagnosis of diverticulitis and a history of irritable bowel disease and gastroesophageal reflux disease (GERD) has received a dose of Mylanta 30 mL PO. The nurse should evaluate its effectiveness by questioning the patient as to whether which symptom has been resolved? A. Diarrhea B. Heartburn C. Constipation D. Lower abdominal pain

During the assessment of a patient with acute abdominal pain, the nurse should: A. perform deep palpation before auscultation B. obtain pulse rate and blood pressure to determine hypovolemic changes C. auscultate bowel sounds because hyperactive bowel sounds suggest paralytic ileus D. measure body temperature because an elevated temp may indicate an inflammatory or infectious process

Surgical management of ulcerative colitis may be performed to treat which of the following complications? A. Gastritis B. Bowel herniation C. Bowel outpouching D. Bowel perforation

The health care provider has prescribed bed rest with the feet elevated for a patient admitted to the hospital with deep vein thrombosis. The best method for the nurse to use in elevating the patient's feet is to a place the patient in the Trendelenburg position. b. place two pillows under the calf of the affected leg. c. elevate the bed at the knee and put pillows under the feet. d. put one pillow under the thighs and two pillows under the lower legs.

The nurse is caring for a postoperative patient with a colostomy. The nurse is preparing to administer a dose of famotidine (Pepcid) when the patient asks why the medication was ordered since the patient does not have a history of heartburn or gastroesophageal reflux disease (GERD). What response by the nurse would be the most appropriate? A. "This will prevent air from accumulating in the stomach, causing gas pains." B. "This will prevent the heartburn that occurs as a side effect of general anesthesia." C. "The stress of surgery is likely to cause stomach bleeding if you do not receive it." D. "This will reduce the amount of HCl in the stomach until the nasogastric tube is removed and you can eat a regular diet again."

To help prevent embolization of the thrombus in a patient with VTE, the nurse teaches the patient to do what? A. dangle the feet over the edge of the bed q2-3hr B. ambulate for short periods three to four times a day C. keep the affected leg elevated above the level of the heart D. maintain bed rest until edema is relieved and anticoagulation is established

Following a gastrectomy performed for peptic ulcer disease, the patient has recovered and is ready for discharge. What instructions should the nurse include in discharge teaching to prevent dumping syndrome? 1 Divide meals into six small feedings. 2 Take fluids along with meals. 3 Use concentrated sweets like honey, jam, and jelly. 4 Reduce protein and fats in the diet.

The nurse is comparing the clinical manifestations of ulcerative colitis and Crohn's disease. Which clinical manifestations are specific to ulcerative colitis? Select all that apply. 1 Diarrhea 2 Tenesmus 3 Constipation 4 Rectal bleeding 5 Abdominal cramping pain

2.4

The nurse is assessing a colostomy in a patient who had a colectomy 24 hours ago. Which of these assessment findings is considered normal for a new stoma? 1 Pale pink color 2 Dusky blue color 3 Brown or black color 4 Dark pink to red color

The nurse explains to the patient undergoing ostomy surgery that the procedure that maintain the most normal functioning of the bowel is: A. a sigmoid colostomy B. a transverse colostomy C. a descending colostomy D. an ascending colostomy

T or F A patient with VTE is scheduled for surgical treatment. The nurse recognizes that surgery is most commonly performed for this condition to insert a vena cava interruption device to prevent pulmonary embolism.

What needs immediate intervention of a stoma A: Beefy red stoma B: scant bleeding from stoma C: Dusky Stoma D: Edematous Stoma

What description of a pts diarrhea supports ulcerative colitis dx A. Bloody B. green and frothy C, Gray D. Clay colored

-blood

A patient with gastroesophageal reflux disease (GERD) is on cimetidine therapy. Which parameter does the nurse monitor to provide effective care? 1 Bowel sounds 2 Motor movements 3 Serum calcium levels 4 Serum magnesium levels

The nurse is monitoring a client diagnosed with appendicitis who is scheduled for surgery in 2 hours. The client begins to complain of increased abdominal pain and begns to vomit. On assessment, the nurse notes that the abdomen is distended and bowel sounds are diminished. Which is the appropriate nursing intervention? "1. Notify the Physician 2. Administer the prescribed pain medication 3. Call and ask the operating room team to perform the surgery as soon as possible 4. Reposition the client and apply a heating pad on warm setting to the client's abdomen

The nurse is preparing to insert a nasogastric (NG) tube into a 68-year-old female patient who is nauseated and vomiting. The patient has an abdominal mass and suspected small intestinal obstruction. The patient asks the nurse why this procedure is necessary. What response by the nurse is most appropriate? 1 "The tube will help to drain the stomach contents and prevent further vomiting." 2 "The tube will push past the area that is blocked and thus help to stop the vomiting." 3 "The tube is just a standard procedure before many types of surgery to the abdomen." 4 "The tube will let us measure your stomach contents so that we can plan what type of intravenous (IV) fluid replacement would be best."

The wound, ostomy, and continence (WOC) nurse selects the site where the ostomy will be placed. What should be included in the consideration for the site? 1 The patient must be able to see the site. 2 Outside the rectus muscle area is the best site. 3 It is easier to seal the drainage bag to a protruding area. 4 The ostomy will need irrigation so the area should not be tender.

Two days following a colectomy for an abdominal mass, a patient reports gas pains and abdominal distention. The nurse plans care for the patient based on the knowledge that the symptoms are occurring as a result of: 1 Impaired peristalsis 2 Irritation of the bowel 3 Nasogastric suctioning 4 Inflammation of the incision site

A nurse is teaching an obese patient with gastroesophageal reflux disease (GERD) measures that should be taken to prevent complications. What instructions should the nurse give? Select all that apply. 1 Maintain a low-fat diet. 2 Avoid smoking cigarettes. 3 Use anticholinergic drugs, as prescribed. 4 Avoid tea and coffee. 5 Lie down immediately after having food.

1, 2, 4

"The nurse is admitting a client with acute appendicitis to the emergency department. The client has abdominal pain of 10 on a pain scale of 1 to 10. The client will be going to surgery as soon as possible. The nurse should: "1. Contact the surgeon to request an order for a narcotic for the pain. 2. Maintain the client in a recumbent position. 3. Place the client on nothing-by-mouth (NPO) status. 4. Apply heat to the abdomen in the area of the pain."

"A client has an appendectomy and develops peritonitis. The nurse should asses the client for an elevated temperature and which additional clinical indication commonly associated with peritonitis? "1. hyperactivity 2. extreme hunger 3. urinary retention 4. local muscular rigidity

"A client with acute appendicitis develops a fever, tachycardia, and hypotension. Based on these assessment findings, the nurse should further assess the client for which of the following complications?" " 1. Deficient fluid volume. 2. Intestinal obstruction. 3. Bowel ischemia. 4. Peritonitis.

"A nurse is providing wound care to a client 1 day after the client underwent an appendectomy. A drain was inserted into the incisional site during surgery. Which action should the nurse perform when providing wound care? 1. Remove the dressing and leave the incision open to air. 2. Remove the drain if wound drainage is minimal. 3. Gently irrigate the drain to remove exudate. 4. Clean the area around the drain moving away from the drain.

"The nurse is caring for a patient in the emergency department with complaints of acute abdominal pain, nausea, and vomiting. When the nurse palpates the patient's left lower abdominal quadrant, the patient complains of pain in the right lower quadrant. The nurse will document this as which of the following diagnostic signs of appendicitis? "a. Rovsing sign b. referred pain c. Chvostek's sign d. rebound tenderness

A key aspect of teaching for the patient on anticoagulant therapy includes which instructions? A. monitor for and report any signs of bleeding B. do not take acetaminophen for a headache C. decrease your dietary intake of foods containing vitamin K D. arrange to have your blood drawn regularly to check drug levels

A nurse is reviewing the history and physical of a teenager admitted to a hospital with a diagnosis of ulcerative colitis. Based on this diagnosis, which information should the nurse expect to see on this client's medical record? A. Abdominal pain and bloody diarrhea. B. Weight gain and elevated blood glucose. C. Abdominal distention and hypoactive bowel sounds. D. Heartburn and regurgitation.

A patient is admitted to the hospital with a diagnosis of chronic venous insufficiency. Which of these statements by the patient is most consistent with the diagnosis? A. "I can't get my shoes on at the end of the day." B. "I can never seem to get my feet warm enough." C. "I wake up during the night because my legs hurt." D. "I have burning leg pains after I walk three blocks."

A patient with a history of peptic ulcer disease has presented to the emergency department reporting severe abdominal pain and has a rigid, boardlike abdomen that prompts the health care team to suspect a perforated ulcer. What intervention should the nurse anticipate? A. Providing IV fluids and inserting a nasogastric (NG) tube B. Administering oral bicarbonate and testing the patient's gastric pH level C. Performing a fecal occult blood test and administering IV calcium gluconate D. Starting parenteral nutrition and placing the patient in a high-Fowler's position

Fistulas are most common with which of the following bowel disorders? A. Crohn's disease B. Diverticulitis C. Diverticulosis D. Ulcerative colitis

The client being seen in a physician's office has just been scheduled for a barium swallow the next day. The nurse writes down which of the following instructions for the client to follow before the test? A. Fast for 8 hours before the test B. Eat a regular supper and breakfast C. Continue to take all oral medications as scheduled. D. Monitor own bowel movement pattern for constipation

The client with Crohn's disease has a nursing diagnosis of acute pain. The nurse would teach the client to avoid which of the following in managing this problem? A. Lying supine with the legs straight B. Massaging the abdomen C. Using antispasmodic medication D. Using relaxation techniques

The client with a new colostomy is concerned about the odor from the stool in the ostomy drainage bag. The nurse teaches the client to include which of the following foods in the diet to reduce odor? A. Yogurt B. Broccoli C. Cucumbers D. Eggs

The nurse has initiated discharge teaching for a patient who is to be maintained on warfarin (Coumadin) following hospitalization for venous thromboembolism (VTE). The nurse determines that additional teaching is needed when the patient says, A. "I should reduce the amount of green, leafy vegetables that I eat." B. "I should wear a Medic Alert bracelet stating that I take Coumadin." C. "I will need to have blood tests routinely to monitor the effects of the Coumadin." D. "I will check with my health care provider before I begin or stop any medication."

The nurse instructs the ileostomy client to do which of the following as a part of essential care of the stoma? A. Cleanse the peristomal skin meticulously B. Take in high-fiber foods such as nuts C. Massage the area below the stoma D. Limit fluid intake to prevent diarrhea.

The nurse is admitting a client with the diagnosis of appendicitis to the surgical unit. Which question is essential to ask? A."When did you last eat?" B."Have you had surgery before?" C."Have you ever had this type of pain before?" D."What do you usually take to relieve your pain?"

The nurse is conducting discharge teaching for a patient with metastatic lung cancer who was admitted with a bowel impaction. Which instructions would be most helpful to prevent further episodes of constipation? A. Maintain a high intake of fluid and fiber in the diet. B. Reduce intake of medications causing constipation. C. Eat several small meals per day to maintain bowel motility. D. Sit upright during meals to increase bowel motility by gravity.

The nurse is doing an admission assessment on a client with a history of duodenal ulcer. To determine whether the problem is currently active, the nurse would assess the client for which of the following most frequent symptom(s) of duodenal ulcer? A. Pain that is relieved by food intake B. Pain that radiated down the right arm C. N/V D. Weight loss

The nurse is reviewing the laboratory test results for a patient whose warfarin (Coumadin) therapy was terminated during the preoperative period. The nurse concludes that the patient is in the most stable condition for surgery after noting which international normalized ratio (INR) results? A 1 B 1.8 C 2.7 D 3.4

The nurse is teaching the client how to perform a colostomy irrigation. To enhance the effectiveness of the irrigation and fecal returns, what measure should the nurse instruct the client to do? A. Increase fluid intake B. Reduce the amount of irrigation solution C. Perform the irrigation in the evening D. Place heat on the abdomen

The nurse teaches the patient with any venous disorder that the best way to prevent venous stasis and increase venous return is to... A. walk B. sit with the legs elevated C. frequently rotate the ankles D. continuously wear graduated compression stockings

The wound, ostomy, and continence (WOC) nurse selects the site where the ostomy will be placed. What should be included in the consideration for the site? A. The patient must be able to see the site. B. Outside the rectus muscle area is the best site. C. It is easier to seal the drainage bag to a protruding area. D. The ostomy will need irrigation, so area should not be tender.

Two days following a colectomy for an abdominal mass, a patient reports gas pains and abdominal distention. The nurse plans care for the patient based on the knowledge that the symptoms are occurring as a result of A. impaired peristalsis. B. irritation of the bowel. C. nasogastric suctioning. D. inflammation of the incision site.

When caring for a patient with critical limb ischemia who has just arrived on the nursing unit after having percutaneous transluminal balloon angioplasty, which action should the nurse take first? A. Take the blood pressure and pulse rate. B. Check for the presence of pedal pulses. C. Assess the appearance of any ischemic ulcers. D. Start discharge teaching about antiplatelet drugs.

When caring for a patient with critical limb ischemia who has just arrived on the nursing unit after having percutaneous transluminal balloon angioplasty, which action should the nurse take first? a.Take the blood pressure and pulse rate. b.Check for the presence of pedal pulses. c.Assess the appearance of any ischemic ulcers. d. Start discharge teaching about antiplatelet drugs.

When caring for a patient with critical limb ischemia who has just arrived on the nursing unit after having percutaneous transluminal balloon angioplasty, which action should the nurse take first? a. Take the blood pressure and pulse rate. b. Check for the presence of pedal pulses. c. Assess the appearance of any ischemic ulcers. d. Start discharge teaching about antiplatelet drugs.

When evaluating the patient's understanding about the care of the ileostomy, what statement by the patient indicates the patient needs more teaching? A. "I will be able to regulate when I have stools." B. "I will be able to wear the pouch until it leaks." C. "Dried fruit and popcorn must be chewed very well." D. "The drainage from my stoma can damage my skin."

When preparing a patient for a capsule endoscopy study, what should the nurse do? A) Ensure the patient understands the required bowel preparation. B) Have the patient return to the procedure room for removal of the capsule. C) Teach the patient to maintain a clear liquid diet throughout the procedure. D) Explain to the patient that conscious sedation will be used during placement of the capsule.

Which of the following areas is the most common site of fistulas in client's with Crohn's disease? A. Anorectal B. Ileum C. Rectovaginal D. Transverse colon

While conducting a home visit with a client who had a partial resection of the ileum for Chron's Disease 4 weeks previously, a nurse becomes concerned when the client states: A. My stools float and seem to have fat in them. B. I have gaiend 5 pounds since I left the hospital. C. I am still avoiding milk products. D. I only have 2 formed stools per day.

"A client with appendicitis is experiencing excruciating abdominal pain. An abdominal X-ray film reveals intraperitoneal air. The nurse should prepare the client for: a) colonoscopy. b) surgery. c) nasogastric (NG) tube insertion. d) barium enema."

"When preparing a male client, age 51, for surgery to treat appendicitis, the nurse formulates a nursing diagnosis of Risk for infection related to inflammation, perforation, and surgery. What is the rationale for choosing this nursing diagnosis? "a. Obstruction of the appendix may increase venous drainage and cause the appendix to rupture. b. Obstruction of the appendix reduces arterial flow, leading to ischemia, inflammation, and rupture of the appendix. c. The appendix may develop gangrene and rupture, especially in a middle-aged client. d. Infection of the appendix diminishes necrotic arterial blood flow and increases venous drainage."

A nurse is monitoring a client admitted to the hospital with a diagnosis of appendicitis. The client is scheduled for surgery in 2 hours. The client begins to complain of increased abdominal pain and begins to vomit. On assessment the nurse notes that the abdomen is distended and the bowel sounds are diminished. Which of the following is the most appropriate nursing intervention? A. Administer dilaudid B. Notify the physician C. Call and ask the operating room team to perform the surgery as soon as possible D. Reposition the client and apply a heating pad on a warm setting to the client's abdomen.

A patient hospitalized with acute exacerbation of ulcerative colitis. The nurse will expect to find the following: A: hard brown stools B: 14-20 bloody stools a day C: Firm distended abdomen D: Absent bowel sounds

A patient is admitted with venous thromboembolism (VTE) and prescribed unfractionated heparin. What laboratory test should the nurse assess while the patient is receiving this medication? A. International normalized ratio (INR) B. Activated partial thromboplastin time (APTT) C. Anti-factor Xa D. Platelet count

A patient who has an exacerbation of Crohn's disease has exoirated perianal skin. which nursing diagnosis is appropriate A: Altered nutrition B: Risk for Skin integrity C: Risk for Falls D: Risk for infection

A patient with Raynaud's phenomenon is prescribed diltiazem (Cardizem). To evaluate the patient's response to this medication, what is most important for the nurse to assess in this patient? A. Increased prothrombin time (PT) B. Improved perfusion to distal fingers C. Increased mean arterial pressure D. Increased capillary refill time

An enema is prescribed for a client with suspected appendicitis. Which of the following actions should the nurse take? A. Prepare 750 ml of irrigating solution warmed to 100*F B. Question the physician about the order C. Provide privacy and explain the procedure to the client D. Assist the client to left lateral Sim's position

During the first few days of recovery from ostomy surgery for ulcerative colitis, which of the following aspects should be the first priority of client care? A. Body image B. Ostomy care C. Sexual concerns D. Skin care

In contrast to diverticulitis, the patient with diverticulosis: A. has rectal bleeding B. often has no symptoms C. has localized cramping pain D. frequently develops peritonitis

The client has just had surgery to create an ileostomy. The nurse assesses the client in the immediate post-op period for which of the following most frequent complications of this type of surgery? A. Intestinal obstruction B. Fluid and electrolyte imbalance C. Malabsorption of fat D. Folate deficiency

The nurse evaluates the client's stoma during the initial post-op period. Which of the following observations should be reported immediately to the physician? A. The stoma is slightly edematous B. The stoma is dark red to purple C. The stoma oozes a small amount of blood D. The stoma does not expel stool

The nurse is caring for a patient treated with intravenous fluid therapy for severe vomiting. As the pt recovers and begins to tolerate oral intake, the N understands that which of the following food choices would be most appropriate? A) Ice tea B) Dry toast C) Warm broth D) Plain hamburger

The nurse is reviewing the record of a client with Crohn's disease. Which of the following stool characteristics would the nurse expect to note documented on the client's record? A. Chronic constipation B. Diarrhea C. Constipation alternating with diarrhea D. Stool constantly oozing from the rectum

The nurse would increase the comfort of a patient with appendicitis by: A. having the patient lie prone B. flexing the patient's right knee C. sitting the patient upright in a chair D. turning the patient onto his left side

The nurse would increase the comfort of the patient with appendicitis by: a. Having the patient lie prone b. Flexing the patient's right knee c. Sitting the patient upright in a chair d. Turning the patient onto his or her left side

The patient with VTE is receiving therapy with heparin and asks the nurse whether the drug will dissolve the clot in her leg. The best response by the nurse is... A. "The drug will break up and dissolve the clot so that circulation in the vein can be restored." B. "The purpose of the heparin is to prevent growth of the clot or formation of new clots where the circulation is slowed." C. "Heparin won't dissolve the clot, but it will inhibit the inflammation around the clot and delay the development of new clots." D. "The heparin will dilate the vein, preventing turbulence of blood flow around the clot that may cause it to break off and travel to the lungs."

The pt had a sigmoidscopy for ulcerative colits. It is imortant for the nurse to call the MD when what is assessed A. headache B. Abdominal guarding C. Concentrated urine D. skin tenting

Two serious complications of PAD that frequently lead to lower limb amputation are ______________ and ___________. A. intermittent claudication B. non-healing ischemic ulcers and gangrene C. 0.77; mild D. rest

What information would have the highest priority to be included in preoperative teaching for a 68-year-old patient scheduled for a colectomy? A. How to care for the wound B. How to deep breathe and cough C. The location and care of drains after surgery D. Which medications will be used during surgery

When preparing a male client, age 51, for surgery to treat appendicitis, the nurse formulates a nursing diagnosis of Risk for infection related to inflammation, perforation, and surgery. What is the rationale for choosing this nursing diagnosis?"a. Obstruction of the appendix may increase venous drainage and cause the appendix to rupture. b. Obstruction of the appendix reduces arterial flow, leading to ischemia, inflammation, and rupture of the appendix. c. The appendix may develop gangrene and rupture, especially in a middle-aged client. d. Infection of the appendix diminishes necrotic arterial blood flow and increases venous drainage."

Which goal of the client's care should take priority during the first days of hospitalization for an exacerbation of ulcerative colitis? A. Promoting self-care and independence B. Managing diarrhea C. Maintaining adequate nutrition D. Promoting rest and comfort

Which information about a patient who has been admitted with a right calf venous thromboembolism (VTE) requires immediate action by the nurse? A. Complaint of left calf pain B. New onset shortness of breath C. Red skin color of left lower leg D. Temperature of 100.4° F (38° C)

Which of the following symptoms is associated with ulcerative colitis? A. Dumping syndrome B. Rectal bleeding C. Soft stools D. Fistulas

Which of the following symptoms would a client in the early stages of peritonitis exhibit? A. Abdominal distention B. Abdominal pain and rigidity C. Hyperactive bowel sounds D. Right upper quadrant pain

pt suddenly develops fever and tachycardia. pt complains of abdominal fullness, has no bowel sounds and is restless and confused. what complication does the nurse suggest A. peritonitis B. Toxic Mega Colon C. Perforation D. Rectal Fitula

.The nurse is caring for a hospitalized client with a diagnosis of ulcerative colitis. Which finding, if noted on assessment of the client, would the nurse report to the physician? A. Hypotension B. Bloody diarrhea C. Rebound tenderness D. A hemoglobin level of 12 mg/dL

A 50yr old woman weighs 85 kg and has a history of cigarette smoking, high blood pressure, high sodium intake, and sedentary lifestyle. When developing an individualized care plan for her, the nurse determines that the most important risk factors for peripheral artery disease (PAD) that need to be modified are: A. weight and diet B. activity level and diet C. cigarette smoking and high blood pressure D. sedentary lifestyle and high blood pressure

A client has surgery for a perforated appendix with localized peritonis. In which position should the nurse place the client? A) Sims position B) trendelenburg C) semi-fowlers D)dorsal recumbant

A client who has ulcerative colitis has persistent diarrhea. He is thin and has lost 12 pounds since the exacerbation of his ulcerative colitis. The nurse should anticipate that the physician will order which of the following treatment approaches to help the client meet his nutritional needs? A. Initiate continuous enteral feedings B. Encourage a high protein, high-calorie diet C. Implement total parenteral nutrition D. Provide six small meals a day.

A client's ulcerative colitis symptoms have been present for longer than 1 week. The nurse recognizes that the client should be assessed carefully for signs of which of the following complications? A. Heart failure B. DVT C. Hypokalemia D. Hypocalcemia

A female patient has a sliding hiatal hernia. What nursing interventions will prevent the symptoms of heartburn and dyspepsia that she is experiencing? A. Keep the patient NPO. B. Put the bed in the Trendelenberg position. C. Have the patient eat 4 to 6 smaller meals each day. D. Give various antacids to determine which one works for the patient.

A patient has a venous ulcer related to chronic venous insufficiency. The nurse should provide education on which type of diet for this patient? A.1200-calorie-restricted diet B. High-carbohydrate diet C. High-protein diet D. Low-fat diet

A patient tells the health care provider about experiencing cold, numb fingers when running during the winter and is diagnosed with Raynaud's phenomenon. The nurse will anticipate teaching the patient about tests for hypertension. b. hyperlipidemia. c. autoimmune disorders. d. coronary artery disease.

A patient with infective endocarditis develops sudden sudden left leg pain with pallor, paresthesia, and a loss of peripheral pulses. The nurse's initial action should be to: A. elevate the leg to promote venous return B. start anticoagulant therapy with IV heparin C. notify the physician of the change in peripheral perfusion D. place the bed in reverse Trandelelbrug to promote perfusion

During care of the patient following femoral bypass graft surgery, the nurse immediately notifies the health care provider if the patient experiences... A. Fever and redness at the incision site B. 2+ edema of the extremity and pain at the incision site C. A loss of palpable pulses and numbness and tingling of the feet D. Decreasing ankle-brachial indices and serous drainage from the incision

Five days after undergoing surgery, a client develops a small-bowel obstruction. A Miller-Abbott tube is inserted for bowel decompression. Which nursing diagnosis takes priority? A. Imbalanced nutrition: Less than body requirements B. Acute pain C. Deficient fluid volume D. Excess fluid volume

Following bowel resection, a patient has a nasogastric (NG) tube to suction, but complains of nausea and abdominal distention. The nurse irrigates the tube as necessary as ordered, but the irrigating fluid does not return. What should be the priority action by the nurse? A. Notify the physician. B. Auscultate for bowel sounds. C. Reposition the tube and check for placement. D. Remove the tube and replace it with a new one

In a client with Crohn's disease, which of the following symptoms should not be a direct result from antibiotic therapy? A. Decrease in bleeding B. Decrease in temperature C. Decrease in body weight D. Decrease in the number of stools

In planning care for the patient with Crohn's disease, the nurse recognizes that a major difference between ulcerative colitis and Crohn's disease is that Crohn's disease: A. frequently results in toxic megacolon B. causes fewer nutritional deficiencies than does ulcerative colitis C. often recurs after surgery, whereas ulcerative colitis is curable with a colectomy D. is manifested by rectal bleeding and anemia more frequently than is ulcerative colitis

Pt stoma is draining a dark green liquid. Pt asks if this is normal, what does the nurse respond with? A. yes. this is the appearance of the drainage you will always have B. Your bowel movements will remain green and become more solid C. The drainage will become thicker and turn yellowish brown D. No, eventually you will have normal brown bowel movements

Rest pain is a manifestation of PAD that occurs due to a chronic: A. vasospasm of small cutaneous arteries in the feet B. increase in retrograde venous blood flow in the legs C. decrease in arterial blood flow to the nerves of the feet D. decrease in arterial blood flow to the leg muscles during exercise

The nurse determines that a patient has experienced the beneficial effects of therapy with famotidine (Pepcid) when which symptom is relieved? A. Nausea B. Belching C. Epigastric pain D. Difficulty swallowing

The nurse has given instructions to the client with an ileostomy about foods to eat to thicken the stool. The nurse determines that the client needs further instructions if the client stated to eat which of the following foods to make the stools less watery? A. Pasta B. Boiled rice C. Bran D. Low-fat cheese

The nurse instructs a patient with a pulmonary embolism about enoxaparin (Lovenox). Which statement by the patient indicates understanding about the instructions? a. "The medicine will dissolve the clot in my lung." b. "I need to take this medicine with meals." c. "The medicine will be prescribed for 10 days." d. "I will inject this medicine into my abdomen."

The nurse is caring for a patient who has been receiving warfarin (Coumadin) and digoxin (Lanoxin) as treatment for atrial fibrillation. Because the warfarin has been discontinued before surgery, the nurse should diligently assess the patient for which complication early in the postoperative period until the medication is resumed? A. Decreased cardiac output B. Increased blood pressure C. Cerebral or pulmonary emboli D. Excessive bleeding from incision or IV sites

The nurse is performing a colostomy irrigation on a client. During the irrigation, a client begins to complain of abdominal cramps. Which of the following is the most appropriate nursing action? A. Notify the physician B. Increase the height of the irrigation C. Stop the irrigation temporarily. D. Medicate with dilaudid and resume the irrigation

The nurse is preparing a discharge teaching plan for the client who had an umbilical hernia repair. Which of the following would the nurse include in the plan? A. Restricting pain medication B. Maintaining bedrest C. Avoiding coughing D. Irrigating the drain

The nurse performing an assessment with a patient who has chronic peripheral artery disease (PAD) of the legs and an ulcer on the left great toe would expect to find A. a positive Homans' sign. B. swollen, dry, scaly ankles. C. prolonged capillary refill in all the toes. D. a large amount of drainage from the ulce

The patient with chronic gastritis is being put on a combination of medications to eradicate H. pylori. Which drugs does the nurse know will probably be used for this patient? A. Antibiotic(s), antacid, and corticosteroid B. Antibiotic(s), aspirin, and antiulcer/protectant C. Antibiotic(s), proton pump inhibitor, and bismuth D. Antibiotic(s) and nonsteroidal antiinflammatory drugs (NSAIDs)

The patient with chronic gastritis is being put on a combination of medications to eradicate H. pylori. Which drugs does the nurse know will probably be used for this patient? A) Antibiotic(s), antacid, and corticosteroid B) Antibiotic(s), aspirin, and antiulcer/protectant C) Antibiotic(s), proton pump inhibitor, and bismuth D) Antibiotic(s) and nonsteroidal antiinflammatory drugs (NSAIDs)

Which of the following associated disorders may the client with Crohn's disease exhibit? A. Ankylosing spondylitis B. Colon cancer C. Malabsorption D. Lactase deficiency

Which of the following conditions is most likely to directly cause peritonitis? A. Cholelithiasis B. Gastritis C. Perforated ulcer D. Incarcerated hernia

Which of the following definitions best describes gastritis? A. Erosion of the gastric mucosa B. Inflammation of a diverticulum C. Inflammation of the gastric mucosa D. Reflux of stomach acid into the esophagus

Which of the following factors is believed to be linked to Crohn's disease? A. Constipation B. Diet C. Hereditary D. Lack of exercise

Which of the following interventions should be included in the medical management of Crohn's disease? A. Increasing oral intake of fiber B. Administering laxatives C. Using long-term steroid therapy D. Increasing physical activity

Which of the following medications is most effective for treating the pain associated with irritable bowel disease? A. Acetaminophen B. Opiates C. Steroids D. Stool softeners

"A client is admitted with a diagnosis of acute appendicitis. When assessing the abdomen, the nurse would expect to find rebound tenderness at which location? a) Left lower quadrant b) Left upper quadrant c) Right upper quadrant d) Right lower quadrant

A 72 yr old male client has a total hip replacement for long-standing degenerative bone disease of the hip. When assessing this client postoperatively, the nurse considers that the most common complication of hip surgery is: A. Pneumonia B. Hemorrhage C. Wound Infection D. Pulmonary Embolism

A client presents to the emergency room, reporting that he has been vomiting every 30 to 40 minutes for the past 8 hours. Frequent vomiting puts him at risk for which of the following? A. Metabolic acidosis with hyperkalemia B. Metabolic acidosis with hypokalemia C. Metabolic alkalosis with hyperkalemia D. Metabolic alkalosis with hypokalemia

A client with acute appendicitis develops a fever, tachycardia, and hypotension. Based on these assessment findings, the nurse should further assess the client for which of the following complications?... "1. Deficient fluid volume. 2. Intestinal obstruction. 3. Bowel ischemia. 4. Peritonitis

A client with complaints of right lower quadrant pain is admitted to the emergency department. Blood specimens are drawn and sent to the laboratory. Which laboratory finding should be reported to the physician immediately? "a) Hematocrit 42% b) Serum potassium 4.2 mEq/L c) Serum sodium 135 mEq/L d) White blood cell (WBC) count 22.8/mm3.

A nurse is making a home health visit and finds the client experiencing right lower quadrant abdominal pain, which has decreased in intensity over the last day. The client also has a rigid abdomen and a temperature of 103.6 F. The nurse should intervene by: a) administer Tylenol (acetaminophen) for the elevated temperature b) advising the client to increase oral fluids c) asking the client when she last had a bowel movement d) notifying the physician

A patient with VTE is to be discharged on long-term warfarin therapy and is taught about prevention and continuing treatment of VTE. The nurse determines that discharge teaching for the patient has been effective when the patient states... A. "I should expect the Coumadin will cause my stools to be somewhat black." B. "I should avoid all dark green and leafy vegetables while I am taking Coumadin." C. "Massaging my legs several times a day will help increase my venous circulation." D. "Swimming is a good activity to include in my exercise program to increase my circulation."

Colon cancer is most closely associated with which of the following conditions? A. Appendicitis B. Hemorrhoids C. Hiatal hernia D. Ulcerative colitis

Crohn's disease can be described as a chronic relapsing disease. Which of the following areas in the GI system may be involved with this disease? A. The entire length of the large colon B. Only the sigmoid area C. The entire large colon through the layers of mucosa and submucosa D. The small intestine and colon; affecting the entire thickness of the bowel

If a client had irritable bowel syndrome, which of the following diagnostic tests would determine if the diagnosis is Crohn's disease or ulcerative colitis? A. Abdominal computed tomography (CT) scan B. Abdominal x-ray C. Barium swallow D. Colonoscopy with biopsy

The client who has undergone creation of a colostomy has a nursing diagnosis of Disturbed body image. The nurse would evaluate that the client is making the most significant progress toward identified goals if the client: A. Watches the nurse empty the colostomy bag B. Looks at the ostomy site C. Reads the ostomy product literature D. Practices cutting the ostomy appliance

The nurse is assessing a patient with gastroesophageal reflux disease (GERD) who is experiencing increasing discomfort. Which patient statement indicates that additional patient education about GERD is needed? a. "I take antacids between meals and at bedtime each night." b. "I quit smoking several years ago, but I still chew a lot of gum." c. "I sleep with the head of the bed elevated on 4-inch blocks." d. "I eat small meals throughout the day and have a bedtime snack."

The recommended treatment for an initial VTE in an otherwise healthy person with no significant comorbidities would include: A. IV agratoban (Acova) as an inpatient B. IV unfractionated heparin as an inpatient C. subcutaneous unfractionated heparin as an outpatient D. subcutaneous low-molecular weight heparin as an outpatient

What food demonstrates correct understanding of diet teaching of a pt with ulcerative colitis A. Butter-free popcorn and a diet soda B. An apple and flavored water C. Nachos and a light beer D. angel food cake and apple juce

When obtaining a health history from a 72-year-old man with peripheral arterial disease(PAD) of the lower extremities, the nurse asks about a history of related conditions such as: a) Venous thrombosis b) Venous stasis ulcers c) Pulmonary embolism d) Carotid artery disease

Which action by a nurse who is administering fondaparinux (Arixtra) to a patient with venous thromboembolism (VTE) indicates that more education about the medication is needed? A. The nurse avoids rubbing the injection site after giving the medication. B. The nurse injects the medication into the abdominal subcutaneous tissue. C. The nurse fails to assess the partial thromboplastin time (PTT) before administration of the medication. D. The nurse ejects the air bubble in the syringe before administering the Arixtra.

Which area of the alimentary canal is the most common location for Crohn's disease? A. Ascending colon B. Descending colon C. Sigmoid colon D. Terminal ileum

Which of the following associated disorders may a client with ulcerative colitis exhibit? A. Gallstones B. Hydronephrosis C. Nephrolithiasis D. Toxic megacolon

Which of the following laboratory results would be expected in a client with peritonitis? A. Partial thromboplastin time above 100 seconds B. Hemoglobin level below 10 mg/dL C. Potassium level above 5.5 mEq/L D. White blood cell count above 15,000

Which of the following would indicate that Bobby's appendix has ruptured? " a) diaphoresis b) anorexia c) pain at Mc Burney's point d) relief from pain

Which of the nursing interventions should be implemented to manage appendicitis? a. Assess pain b. encourage oral intake of clear fluids. c. provide discharge teaching D. assess for symptoms of peritonitis.

While working in the outpatient clinic, the nurse notes that the medical record states that a patient has intermittent claudication. Which of these statements by the patient would be consistent with this information? A. "When I stand too long, my feet start to swell up." B. "Sometimes I get tired when I climb a lot of stairs." C. "My fingers hurt when I go outside in cold weather." D. "My legs cramp whenever I walk more than a block."

True or False (venous thromboembolism should be replaced with superficial vein thrombosis) T or F A tender, red, inflamed induration along the course of a subcutaneous vein is chararcteristic of a venous thromboembolism (VTE).

The results of a patients recent endoscopy indicate the presence of peptic ulcer disease (PUD). Which of the following teaching points should the nurse provide to the pt in light of his new diagnosis? A) "You'll need to drink at least two to three glasses of milk daily." B) "It would likely be beneficial for you to eliminate drinking alcohol." C) "Many people find that a minced or pureed diet eases their sxs of PUD." D) "Your medications should allow you to maintain your present diet while minimizing symptoms."

A nurse is preparing to remove a nasogartric tube from a client. The nurse should instruct the client to do which of the following just before the nurse removes the tube? A. Exhale B. Inhale and exhale quickly C. Take and hold a deep breath D. Perform a Valsalva maneuver

After the nurse teaches a patient with gastroesophageal reflux disease (GERD) about recommended dietary modifications, which statement by the patient indicates that the teaching has been effective? A. "I can have a glass of low-fat milk at bedtime." B. "I will have to eliminate all spicy foods from my diet." C. "I will have to use herbal teas instead of caffeinated drinks." D. "I should keep something in my stomach all the time to neutralize the excess acids."

The nurse expects which test to be performed to confirm ulcerative colittis A. sigmoidoscopy B. Adominal xray C. EGD D. ERCP

sigmoidscopy

A 55-year-old man weighs 115 kg and has a history of tobacco use, high blood pressure, and a sedentary lifestyle. When developing a plan of care for this patient, the nurse recalls that the most important risk factor for peripheral artery disease (PAD) includes which of these? 1 Tobacco use 2 Excess weight 3 Sedentary lifestyle 4 High blood pressure.

"A nurse is caring for a client admitted to the hospital with a suspected diagnosis of acute appendicitis. Which of the following laboratory results would the nurse expect to note if the client does have appendicitis? 1. Leukopenia with a shift to the right 2. Leukocytosis with a shift to the right 3.Leukocytosis with a shift to the left 4. Leukopenia with a shift to the left"

The nurse is assessing an adolescent who is admitted to the hospital with appendicitis. The nurse should report which of the following to the HCP? "1) change in pain rating of 7 to 8 on a 10 point scale. 2) sudden relief of sharp pain, shifting to diffuse pain. 3)shallow breathing with normal vital signs. 4) decrease of pain rating from 8 to 6 when parents visit.

The nurse is caring for the following clients on a surgical unit. Which client would the nurse assess ﬁrst? 1.The client who had an inguinal hernia repair and has not voided in four (4) hours. 2.The client who was admitted with abdominal pain who suddenly has no pain. 3.The client four (4) hours postoperative abdominal surgery with no bowel sounds. 4.The client who is one (1) day postoperative appendectomy who is being discharged"

The postoperative patient states that he or she has never taken pantoprozole (Protonix) in the past. The patient asks why he or she is getting this medication if the patient has never had heartburn. What is the best response by the nurse? 1 "The stress of surgery is likely to cause stomach bleeding if you do not receive it." 2 "This will reduce the amount of acid in your stomach until you can eat a regular diet again." 3 "This will prevent the heartburn that occurs as a side effect of your diabetes." 4 "This will prevent gas pains from the excess air in your small intestine."

The results of a patient's recent endoscopy indicate the presence of peptic ulcer disease (PUD). Which teaching point should the nurse provide to the patient based on this new diagnosis? 1 "You'll need to drink at least two to three glasses of milk daily." 2 "It would likely be beneficial for you to eliminate drinking alcohol." 3 "Many people find that a minced or pureed diet eases their symptoms of PUD." 4 "Your medications should allow you to maintain your present diet while minimizing symptoms."

which statement made by the client who is postoperative abdominal surgery indicates the discharge teaching has been effective? 1. "i will take my temp each week and report any elevation." 2. "i will not need any pain meds when i go home." 3. i will take all of my antibiotics until they are gone." 4. i will not take a shower until my three month check up.

A postoperative patient is being discharged from the hospital following a surgery for Crohn's disease. The nurse understands that the patient is at risk for bowel obstruction. What early symptoms of bowel obstruction should the nurse advise this patient to be observant for? Select all that apply. 1 Constipation 2 Decreased flatus 3 Colicky abdominal pain 4 Nausea and vomiting 5 Abdominal distention

3,4,5

A patient experiences pain in the calf while exercising and reports that the pain disappears after a few minutes of resting. The nurse recognizes the finding as most consistent with: 1 Venous obstruction in the leg 2 Claudication resulting from venous abnormalities 3 Ischemia resulting from complete blockage of an artery 4 Ischemia resulting from partial blockage of an artery

Which of the following aspects is the priority focus of nursing management for a client with peritonitis? A. Fluid and electrolyte balance B. Gastric irrigation C. Pain management D. Psychosocial issues

"When preparing a male client, age 51, for surgery to treat appendicitis, the nurse formulates a nursing diagnosis of Risk for infection related to inflammation, perforation, and surgery. What is the rationale for choosing this nursing diagnosis? a. Obstruction of the appendix may increase venous drainage and cause the appendix to rupture. b. Obstruction of the appendix reduces arterial flow, leading to ischemia, inflammation, and rupture of the appendix. c. The appendix may develop gangrene and rupture, especially in a middle-aged client. d. Infection of the appendix diminishes necrotic arterial blood flow and increases venous drainage.

15. Which of the following factors is believed to cause ulcerative colitis? A. Acidic diet B. Altered immunity C. Chronic constipation D. Emotional stress

A CT scan reveals an intestinal obstruction. what does the nurse anticipate? a. forcing fluid B. inserting an NG tube C. giving a tap water enema D. ambulating pt

A client with irritable bowel syndrome is being prepared for discharge. Which of the following meal plans should the nurse give the client? A. Low fiber, low-fat B. High fiber, low-fat C. Low fiber, high-fat D. High-fiber, high-fat

A nurse is caring for a client diagnosed with Chron's disease, who has undergone a barium enema that demonstrated the presence of strictures in the ileum. Based on this finding, the nurse should monitor the client closely for signs of: A. peritonitis B. obstruction C. malaborsorption. D. fluid imbalance.

A nurse is performing an initial post op assessment on a client following upper GI surgery. The client has a NG tube to low, intermittent suction. To best assess the client for the presence of bowel sounds, the nurse should: A. place the stethoscope to the left of the umbilicus. B. turn off the nasogastric suction. C. use the bell of the stethoscope. D. turn the suction on the NG tube to continuous.

A patient at the highest risk for venous thromboembolism, VTE, is: A. a 62 year old man with spider veins who is having arthroscopic knee surgery B. a 32 year old woman who smokes, takes oral contraceptives, and is planning a trip to Europe C. a 26 year old woman who is 3 days postpartum and received maintenance IV fluid for 12 hours during her labor D. an active 72 year old man at home recovering from transuerthral resection of the prostate for benign prostatic hyperplasia

A patient with recurring heartburn receives a new prescription for esomeprazole (Nexium). In teaching the patient about this medication, the nurse explains that this drug a. reduces the reflux of gastric acid by increasing the rate of gastric emptying. b. coats and protects the lining of the stomach and esophagus from gastric acid. c. treats gastroesophageal reflux disease by decreasing stomach acid production. d. neutralizes stomach acid and provides relief of symptoms in a few minutes.

Following teaching about medications for PAD, the nurse determines that additional instruction is necessary when the patient says, a) I should take one ASA a day to prevent clotting in my legs b) The lisinipril (Zestril) I use for my BP may help me walk further without pain c) I will need to have frequent blood tests to evaluate the effect of the oral anticoagulant I will be taking. d) Pletal should help me be able to increase my walking distance and keep clots from forming in my legs

When assessing a patient's abdomen, what would be most appropriate for the nurse to do? A) Palpate the abdomen before auscultation. B) Percuss the abdomen before auscultation. C) Auscultate the abdomen before palpation. D) Perform deep palpation before light palpation.

Which topic will the nurse include in patient teaching for a patient with a venous stasis ulcer on the right lower leg? A. Adequate carbohydrate intake B. Prophylactic antibiotic therapy C. Application of compression to the leg D. Methods of keeping the wound area dry

Which of the following substances is most likely to cause gastritis? A. Milk B. Bicarbonate of soda, or baking soda C. Enteric coated aspirin D. Nonsteriodal anti-imflammatory drugs

Which of the following symptoms may be exhibited by a client with Crohn's disease? A. Bloody diarrhea B. Narrow stools C. N/V D. Steatorrhea

Which of the following terms best describes the pain associated with appendicitis? A. Aching B. Fleeting C. Intermittent D. Steady

Which of the following therapies is not included in the medical management of a client with peritonitis? A. Broad-spectrum antibiotics B. Electrolyte replacement C. I.V. fluids D. Regular diet

Which of the following comments made by the patient indicates that additonal instruction about the care of a new ilesotomy is needed? A. I should change the appliance daily to prevent ordors B. When I change the appliance, I should check the skin for irritation C. I should clean around the stoma with mild soap and water and Pat dry

-A

"The nurse is caring for a patient following an appendectomy. The patient takes a deep breath, coughs, and then winces in pain. Which of the following statements, if made by the nurse to the patient, is BEST? "A.) "Take three deep breaths, hold your incision, and then cough." B.) "That was good. Do that again and soon it won't hurt as much." C.) "It won't hurt as much if you hold your incision when you cough." D.) "Take another deep breath, hold it, and then cough deeply."

A patient with peripheral vascular disease has marked peripheral neuropathy. An appropriate nursing diagnosis for the patient is 1. risk for injury related to decreased sensation. 2. impaired skin integrity related to decreased peripheral circulation. 3. ineffective peripheral tissue perfusion related to decreased arterial blood flow. 4. activity intolerance related to imbalance between oxygen supply and demand.

Assessment of a patient's peripheral intravenous (IV) site reveals that phlebitis has developed over the past several hours. Which intervention should the nurse implement first? 1 Remove the patient's IV catheter 2 Apply an ice pack to the affected area 3 Decrease the IV rate to 20 to 30 mL/hr 4 Administer prophylactic anticoagulants

The nurse is monitoring a client admitted to the hospital with a diagnosis of appendicitis who is scheduled for surgery in 2 hours. The client begins to complain of increased abdominal pain and begins to vomit. On assessment, the nurse notes that the abdomen is distended and bowel sounds are diminished. Which is the appropriate nursing intervention? Saunders Comprehensive Review for the NCLEX-RN Examination 5th ed. 1. Notify the physician 2. Administer the prescribed pain medication 3. Call and ask the operating room team to perform the surgery as soon as possible 4. Reposition the client and apply a heating pad on warm setting to the clien't abdomen

A patient presents with claudication, pain in the legs and numbness of the feet. The patient is diagnosed with peripheral arterial disease (PAD). The nurse expects that what will be included in the patient's treatment plan? Select all that apply. 1 Antiplatelet therapy 2 Exercise therapy 3 Nutritional therapy 4 Sympathectomy 5 Calcium channel blockers

1,2,3

The nurse is reviewing discharge instructions with a patient who is taking warfarin (Coumadin) as treatment for venous thromboembolism (VTE). Which substances will the patient need to avoid while taking warfarin? Select all that apply. 1 Aspirin 2 Gingko biloba 3 Fish oil supplements 4 Acetaminophen (Tylenol) 5 Foods containing vitamin K

1,2,3

"The client diagnosed with appendicitis has undergone an appendectomy. At two hours postoperative, the nurse takes the vital signs and notes T 102.6 F, P 132, R 26, and BP 92/46. Which interventions should the nurse implement? List in order of priority. 1. Increase the IV rate. 2. Notify the health care provider. 3. Elevate the foot of the bed. 4. Check the abdominal dressing. 5. Determine if the IV antibiotics have been administered.

1,3,4,5,2

A 72-year-old patient was admitted with epigastric pain due to a gastric ulcer. Which patient assessment warrants an urgent change in the nursing plan of care? A. Chest pain relieved with eating or drinking water B. Back pain 3 or 4 hours after eating a meal C. Burning epigastric pain 90 minutes after breakfast D. Rigid abdomen and vomiting following indigestion

A 72-year-old patient was admitted with epigastric pain due to a gastric ulcer. Which patient assessment warrants an urgent change in the nursing plan of care? A) Chest pain relieved with eating or drinking water B) Back pain 3 or 4 hours after eating a meal C) Burning epigastric pain 90 minutes after breakfast D) Rigid abdomen and vomiting following indigestion

A RN overhears a LPN talking with a client who is being prepared for a total colectomy with the creation of an ileoanal reservoir for ulcerative colitis. To decrease the client's anxiety, the RN should intervene to clarify the information given by the LPN when the LPN is heard saying: A. this surgery will prevent you from developing colon cancer. B. after this surgery you will no longer have ulcerative colitis. C. when you return from surgery you will not be able to eat solid food for several days. D. you will have an ileostomy when you return from the surgery.

A client complains of severe pain in the right lower quadrant of the abdomen. To assist with pain relief, the nurse should take which of the following actions? "1. Encourage the client to change positions frequently in bed 2. Massage the right lower quadrant fo the abdomen 3. Apply warmth to the abdomen with a heating pad 4. Use comfort measures and pillows to position the client"

The nurse is assessing for stoma prolapse in a client with a colostomy. The nurse would observe which of the following if stoma prolapse occurred? A. Sunken and hidden stoma B. Dark- and bluish-colored stoma C. Narrowed and flattened stoma D. Protruding stoma

The nurse is caring for a 68-year-old patient admitted with abdominal pain, nausea, and vomiting. The patient has an abdominal mass, and a bowel obstruction is suspected. The nurse auscultating the abdomen listens for which type of bowel sounds that are consistent with the patient's clinical picture? A. Low-pitched and rumbling above the area of obstruction B. High-pitched and hypoactive below the area of obstruction C. Low-pitched and hyperactive below the area of obstruction D. High-pitched and hyperactive above the area of obstruction

The nurse is caring for a 68-year-old patient admitted with abdominal pain, nausea, and vomiting. The patient has an abdominal mass, and a bowel obstruction is suspected. The nurse auscultating the abdomen listens for which type of bowel sounds that are consistent with the patient's clinical picture? A) Low-pitched and rumbling above the area of obstruction B) High-pitched and hypoactive below the area of obstruction C) Low-pitched and hyperactive below the area of obstruction D) High-pitched and hyperactive above the area of obstruction

The nurse is caring for a hospitalized client with a diagnosis of ulcerative colitis. Which finding, if noted on assessment of the client, would the nurse report to the physician? A. Bloody diarrhea B. Hypotension C. A hemoglobin of 12 mg/dL D. Rebound tenderness

Which of the following position should the client with appendicitis assume to relieve pain ? A. Prone B. Sitting C. Supine D. Lying with legs drawn up

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