Archer - Gastro
When caring for a client with TPN, what is the most important action by the nurse? A. Record the number of stools per day B. Maintain strict intake and output records C. Sterile technique for dressing changes at IV site D. Monitor for cardiac arrhythmias
C
Which of the following interventions is helpful in reducing the effects of GERD? A. lie down after eating B. wear a girdle C. elevate the head of the bed on 4-6 inch blocks D. increase fluid intake just before bedtime
C
the nurse is caring for a client with appendicitis experiencing pain. Which pain relief method would be inappropriate for this client? A. applying ice packs to the abdomen B. Practicing breathing exercises with the patient C. Using heating pad D. Encouraging rest
C
The nurse assists a client with diverticulitis select appropriate foods on a menu. Which food choice, if made by the client, would require further teaching? SATA A. bran cereal B. fresh peaches C. white toast D. scrambled eggs E. cabbage soup
C, D
The nurse is conducting a telephone call following up with a client with a colostomy placed two weeks ago. Which findings reported by the client require follow-up by the nurse? A. the client reports that he has no pain at the stoma B. he states that the stoma is red and moist C. he reports changing the appliance daily D. he reports using moisturizing soap around the stoma E. the client notes that he empties the pouch when it is 1/2 - 1/3 full of stool F. the client stated that his stoma has been
C, D
The nurse is explaining the different aspects of ostomy care to a client with a newly created ileostomy. Which statement from the client indicates an understanding of the nurses teaching? A. "I need to cut the pouch to fit the stoma, allowing one-sixteenth of an inch of room around it" B. "I must avoid eating spinach, parsley, and yogurt" C. "I need to drink at least 800 mL of water daily" D. "I can eat a large meal during dinner"
A
The nurse is performing teaching for a client scheduled for gastric bypass surgery. Which client statement requires follow up by the nurse? A. "Once i am home, i can advance my diet as tolerated" B. "I will have to take a multivitamin after this surgery" C. "I will be encouraged to perform leg exercises while I am in bed" D. "My weight may increase if I do not change my eating habits"
A
The nurse is teaching a 57 year old client about screening for colorectal cancer. Which of the following information should the nurse include? A. "its recommended that colon cancer screening with a colonoscopy begin at age 45" B. "its recommended that colon cancer screening with a colonoscopy begin at age 70" C. "its recommended that colon cancer screening with a colonoscopy begin at age 40" D. "its recommended that colon cancer screening with a colonoscopy begin at age 65"
A
The nurse is teaching a client about prescribed metronidazole. Which of the following statements if made by the client would indicate effective teaching? A. "I should not drink alcohol while I'm taking metronidazole" B. "It is okay for me to be in the sun while I'm taking this medication" C. "I should take the medicine until my stomach stops hurting then stop" d. "I should take the medicine on an empty stomach"
A
The nurse observes a client clutching her abdomen and complaining of cramping, which is accompanied by sharp pain. Which of the following types of pain is the client experiencing? A. Cutaneous or superficial somatic B. Visceral C. Deep somatic D. Radiating
A
A patient with cholecystitis is reporting acute pain. Where should the nurse expect to find the location of this pain? A. RUQ, radiating to right shoulder B. RUQ, radiating to left shoulder C. RLQ, radiating to pelvic bones D. RLQ, radiating to umbilicus
A
During shift change, a nurse receives report regarding a client with ulcerative colitis, learning the client has experienced severe diarrhea over the past 24 hours. When assessing the client, the nurse should watch for signs of: A. metabolic acidosis B. metabolic alkalosis C. malnutrition D. malabsorption
A
The nurse cares for a 78-year old client receiving antibiotics for ten days. The client reports frequent watery stools. Which action should the nurse take first? A. place the client on contact enteric precautions B. instruct the client about correct hand washing C. obtain stool specimens for culture D. notify the PHCP about the loose stools
A
The nurse has instructed self-management strategies for a client diagnosed with GERD. Which statement by the client would indicate a correct understanding of the teaching? A. "It's much better for me to wear loose fitting clothes right now" B. "I stopped eating grilled chicken and now eat more ground hamburger" C. "If i wake up with GERD symptoms, I should lower the head of my bed while sleeping" D. "I should take my prescribed Omeprazole after meals"
A
The nurse is assessing a client diagnosed with necrotizing pancreatitis. Which of the following assessment findings would be expected? A. ecchymotic discoloration in the periumbilical region B. dysuria C. hyperactive bowel sounds D. hematuria
A
The nurse is caring for a client who is diagnosed with acute appendicitis. After several hours of pain the client suddenly states a relief in his pain. What is the initial action of the nurse? A. notify the physician B. document the finding C. insert an IV cannula D. administer a laxative
A
The nurse is caring for a client who recently had a partial gastrectomy. Which of the following medications should the nurse anticipate that the PHCP will order? A. Cyanocobalamin B. Metoclopramide C. Succralfate D. Hydroxyzine
A
The nurse is developing a plan of care for a client who had bariatric surgery. Which of the following should the nurse include? A. Applying pneumatic compression devices B. Inserting an indwelling urinary catheter C. Placing the client on strict bed rest D. Measuring the abdominal girth
A
A 30-year old male client in the medical ward was admitted for a hiatal hernia and is being discharged today. The nurse talks to him regarding methods to prevent and reduce pain associated with his condition. Which of the following statements from the client indicate the teaching is successful? A. "I need to wear loose fitting clothes" B. "After a meal, I must lie down to avoid dumping syndrome" C. "I need to eat three large meals a day" D. "I can go to my favorite Indian restaurant anytime of t
A
A client comes to the outpatient clinic complaining of abdominal pain, diarrhea, shortness of breath and epistaxis. What should the nurses first action be? A. Ask the client about any recent travel to asia or the Middle East B. Screen clients for upper respiratory tract symptoms C. Review the clients history of recommended immunizations D. Call an ambulance to take the client immediately to the hospital
A
A client with a peptic ulcer is prescribed Sucralfate. Which statement by the client indicates an understanding of the medication? A. "I should take sucralfate at least 1 hour before meals and at bedtime" B. "I will avoid taking antacids while im on sucralfate" C. "I should take sucralfate right before meals and at bedtime" D. "I can expect immediate relief of my ulcer symptoms after taking sucralfate"
A
A patient presents with enlarged tonsillar nodes. Acutely infected nodes would be A. Firm but movable and tender B. Hard and no tender C. Fixed and soft D. Irregular and hard
A
While caring for a patient who is suspected of having appendicitis, the nurse overhears his conversation with a loved one. Which of the following statements would prompt immediate intervention? A. "The pain doesnt feel as bad now. I think it was just a stomach ache" B. "Would you mind getting me an ice pack" C. "I know im not supposed to eat anything right now, but im hungry" D. "I wounder if i can play in the basketball game on Monday"
A
Your client has just undergone a fecal diversion surgery and will be discharged to their home. Which type of social support network is most likely to benefit this client in terms of post discharge self care and physical adaptions necessary for this client? A. A peer support network like an ostomy group in the community to promote self care B. An emotional support person to help the client cope with the altered body image C. An instrumental support network to help with activities of daily living
A
a 52 yr old client with a 20 yr history of alcohol abuse is hospitalized with mild ascites, jaundice, and bruising. Imaging demonstrates the presence of esophageal varcies, while the client's elevated serum ammonia level indicates hepatic encephalopathy. The nurse is concerned the clients esophageal varcies may rupture and proceeds to educate the client accordingly. Which item should the nurse include in the clients education session? a. "do not life heavy objects" b. "avoid walking briskly" c.
A
the nurse is taking care of a client that is scheduled to undergo a gastric analysis at 8:00 AM tomorrow. Which should be included in the clients plan of care? A. Instruct the client that she should not eat or drink anything after midnight B. Teach the client that in case she feels hungry, she can chew some gum C. Instruct the client that she needs to be on bed rest or 2 hours after the procedure D. Tell the client that she is allowed to smoke 1 hour prior to surgery
A
The nurse is conducting a health screening at a local health fair. Which of the following should the nurse recognize as risk factors to PUD? SATA A. prolonged ibuprofen use B. tobacco use C. irritable bowel syndrome D. H. Pylori E. alcohol consumption
A, B, D, E
Which imbalance would the nurse monitor for a client with fluid imbalance related to the development of ascites? SATA a. effective exxtracellular fluid volume deficit b. protein deficit c. metabolic alkalosis d. sodium deficit e. plasma to interstitial fluid shift f. metabolic acidosis
A, B, D, E
The nurse is caring for a client with appendicitis. Which of the following statements are correct regarding this condition? A. McBurney's point tenderness is a sign of appendicitis B. appendicitis is more common among males C. a low carbohydrate diet is a risk factor for appendicitis D. diagnosis of appendicitis is confirmed by endoscopic retrograde colangiopancreatography E. the client may have an elevated WBC count
A, B, E
The nurse is assessing a client who has appendicitis. Which of the following would be an expected finding? A. leukocytosis B. melena C. fever D. nausea and vomiting E. anorexia
A, C, D, E
The nurse is conducting a health screening at a local health fair. Which of the following should the nurse recognize as risk factors for developing colorectal cancer? A. ulcerative colitis B. BMI of 21 C. HIV infection D. low-fiber diet E. excessive alcohol consumption F. african-american ethnicity
A, D, E, F
The process by which drugs are reassured before elimination after being excreted into bile and delivered to the intestines is known as: A. Hepatic clearance B. Total clearance C. Enterohepatic cycling D. First-pass effect
C
A nurse is assigned to care for a client with liver dysfunction and ascites and is ordered to measure the clients abdominal girth daily. To ensure accuracy, the nurse should utilize which landmark? A. Xiphoid process B. Umbilicus C. Iliac crest D. Symphysis pubis
B
The nurse assesses the new stoma of a client diagnosed with Crohn's disease. Which of these assessment findings will alert the nurse that the stoma has retracted? A. narrowed and flattened B. concave and bowl-shaped C. dry and reddish-purple D. pinkish red and moist
B
The nurse cares for a client who had a liver transplant 48 hours ago. It would be a priority for the nurse to notify the HCP if the client has A. An increase in oral temperature from 97.8 F to 98.6 F B. Rising aspartame aminotransferase (AST) and alanine aminotransferase (ALT) levels C. A moderate amount of serosanguinous drainage to the incision D. Nausea following the admission of oral pain medication
B
The nurse is admitting a client newly diagnosed with acute pancreatitis. The nurse should anticipate a prescription for which medication? A. 3% saline infusion B. fentanyl C. diphenoxylate-atropine D. sucralfate
B
The nurse is assessing a client with pancreatitis. Which of the following type of pain would be expected? A. burning, aching pain in the LLQ radiating to the hip B. severe pain in the mid-epigastric area radiating to the back C. burning, aching pain in the epigastric area radiating to the umbilicus D. severe pain in the LLQ radiating to the groin
B
The nurse is assessing a client with ulcerative colitis. Which of the following would be an expected finding? A. projectile vomiting B. frequent bloody stools C. absent bowel sounds D. periumbilical bruising
B
The nurse is caring for a client with a paralytic ileus following an appendectomy. Which intervention would be appropriate for the nurse to take? A. assess the client for hyperkalemia B. prepare for the insertion of a NGT C. assess the surgical wound for approximation D. instruct the client to chew their food more slowly
B
The nurse is caring or a client with a paralytic ileus following an appendectomy. Which interventions would be appropriate for the nurse to take? A. Assess the client for hyperkalemia B. Prepare for the insertion of a NGT C. Assess he surgical wound for approximation D. Instruct the client to chew their food more slowly
B
The nurse is helping a client prepare for a peritoneoscopy tomorrow. All of the following statements from the nurse are accurate regarding the procedure, except: A. "The doctor will inflate your abdomen using carbon dioxide gas" B. "We will be injecting a dye into your vein in order for us to see the organs better" C. "You need to avoid eating or drinking after midnight to prepare for the procedure" d. "Expect to have one discomfort on your shoulders after the procedure, this is be
B
The nurse is performing an initial assessment on a patient being admitted for acute pancreatitis. Which assessment data would support this diagnosis? A. homans sign B. cullens sign C. hyperactive bowel sounds D. kernigs sign
B
The nurse is providing teaching to a client experiencing chronic constipation. Which of the following meals would be the best choice for this client in order to promote a bowel movement? A. Steak and a baked potato B. Brussels sprouts and a whole grain roll C. White rice with chicken D. A ham sandwich with tomato soup
B
The nurse is reviewing gastrointestinal assessment with a group of student nurses. It would be correct if the student identifies which of the following would cause hyperactive bowel sounds? A. paralytic ileus B. gastroenteritis C. late bowel obstruction D. peritonitis
B
The nurse is teaching a client who is scheduled for a colonoscopy. Which of the following information should the nurse include? A. "The day before the procedure you may have a regular diet" B. "You will not have anything to eat or drink by mouth for 4-6 hours prior to the test" C. "You may notice chalky white stools immediately after the procedure: D. "Your abdomen will be painful and distended after the test"
B
What percussion sound is heard over most of the abdomen? A. hyperresonance B. tympany C. resonance D. dullness
B
Which of the following conditions would be a possible cause of hyperactive bowel sounds? A. Paralytic ileus B. Gastroenteritis C. Late bowel obstruction D. Peritonitis
B
While teaching a client who has recently begun a vegan diet, the nurse should highly recommend supplementing with which of the folllowing vitamins? A. Vitamin C B. Vitamin b12 C. Vitamin A D. Vitamin D
B
While working in a post-operative unit, the nurse is assigned to take care of a 32-year old who is post-op day one after an appendectomy. The patient has not eaten for the past 3 days and is asking when she will be allowed to have a meal again. Upon consulting with the interdisciplinary team, the provider decides it is time to place a diet order for your patient. Which diet does the nurse expect the provider will order? A. full liquid diet B. clear liquid diet C. soft diet D. mechanical diet
B
The nurse has educated a client to have an endoscopic retrograde cholangiopancreatography (ERCP). Which of the following client statements would indicate the need for further teaching by the nurse? SATA A. "I will not be able to eat or drink anything for 6-8 hours before this procedure" B. "I will have to do a bowel prep before this procedure: C. "Someone will have to drive me home after this procedure" D. "I should expect that I will have abdominal pain and distention for 1-2 days following thi
B, D, E
The nurse observes a newly hired nurse care for a client with a colostomy. Which action by the newly hired nurse requires follow up? SATA. the newly hired nurse: A. empties the pouch when its 1/3 - 1/2 full B. washes the surrounding skin with moisturizing soap C. indicates that the reddish appearance of the stoma as normal D. applies sterile gloves prior to changing the device E. applies isopropyl alcohol to the surrounding skin to promote adherence with the water
B, D, E
A client with PUD from chronic NSAID use is prescribed Misprostol. In educating the client regarding this drugs mechanism of action, the nurse would be most accurate in informing the client that this medication: A. decrease gas formation B. increases the speed of gastric emptying C. lines the stomach for protection D. increases the lower esophageal sphincter pressure
C
A nurse is caring for a client diagnosed with a duodenal ulcer. Which medication facilitates healing by forming a protective lining over the client's ulcer? A. Famotidine B. Ranitidine C. Sucralfate D. Cimetidine
C
A nurse is evaluating an 83 year old client hospitalized after a fall. The client has not had a bowel movement for 5 days, and a fecal impaction is suspected. Which assessment finding would be most indicative of fecal impaction? A. Rigid, boardlike abdomen B. The client has lost the urge to defecate C. Liquid stools D. Complaints of abdominal pain without distention
C
Primary nutrients that are essential for optimal body function include: A. Iron, zinc, and calcium B. Folate, vitamin b12 and iron C. Carbohydrates, proteins and fats D. Vitamins A, D, E,K
C
The emergency department nurse is caring for a client reporting colicky abdominal pain, nausea, vomiting and yellowing of their eyes. The nurse suspects the client has A. peptic ulcer disease B. Hepatitis C C. cholecystitis D. hepatic encephalopathy
C
The nurse has just finished assisting the physician performing a paracentesis. What should the priority nursing intervention following the procedure? A. Administer analgesics to control pain B. Monitor for signs of infection C. Monitor for signs of hypovolemia D. Ensure that the ascetic fluid is sent to the lab for analysis
C
The nurse is assessing a client with acute cholecystitis. Which of the following physical assessment findings would be expected? A. stools that contain blood and mucus B. pain with urination C. episodic upper abdominal pain D. hypoactive bowel sounds
C
The nurse is caring for a client with suspected bowel perforation. Which of the following would be contraindicated? A. Administering gastrografin for an upper GI x-ray B. An exploratory laparotomy procedure C. Administering milk of magnesia following an upper GI study D. An abdominal CT scan
C
The nurse is caring for a client with suspected bowel perforation. Which of the following would be contraindicated? A. administering gastrografin for an upper GI x-ray B. an exploratory laparotomy procedure C. administering milk of magnesia following an upper GI study D. an abdominal CT scan
C
The nurse is checking the tray of a patient with celiac disease. Of the following, which meal would be most appropriate for this patient? A. macaroni and cheese B. a ham sandwich on a wheat roll C. salmon oven roasted beets D. turkey, potatoes and garlic bread
C
The nurse is educating a client about their newly prescribed soft diet. It would be appropriate for the nurse to suggest which food item? A. Chunky peanut butter B. Raw carrot sticks C. Applesauce D. Beef jerky
C
The nurse is teaching a client about PUD. Which of the following statements should the nurse include? A. "You should take aspirin if you have mild aches or pains" B. "You will need to consume liquids one hour after each meal" C. "It will be important to reduce the stress in your life" D. "Take your prescribed Omeprazole with food"
C
The nurse is teaching a client about peptic ulcer disease. Which of the following statements should the nurse include? A. "You should take aspiring if you have mild aches or pains" B. "You will need to consume liquids one hour after each meal" C. "It will be important to reduce the stress in your life" D. "Take your prescribed omeprazole with food"
C
A nurse is conducting a dysphagia screening on a client who was recently extubated. Which assessment finding requires intervention? A. Sight cough after sipping water B. Hoarseness of voice during speech C. Complaint of throat discomfort when swallowing D. Presence of a wet, gurgling cough after drinking water
D
A nurse is in charge of a client scheduled for a liver biopsy at 0800. In preparation for the procedure, the nurse should do which of the following? A. inform the client that they will be NPO for 24 hours before the biopsy B. have the client practice holding their breath for one minute C. inform the client that a laxative will be administered to prevent bowel distention and avoid potentially placing pressure on the liver D. inform the client that their vitals will be closely monitored after the
D
A nurse is taking care of a client with acute peritonitis. The urgent focus of care is the clients nutritional needs. To meet this, the nurse should do which of the following? A. Administer feedings via NGT B. Administer gastric enteral feedings C. Feed the client orally D. Administer parenteral nutrition
D
A patient receiving intermittent feedings through a NGT must have their residual volumes checked before administering more formula. Which is the best rationale for checking residual capacity? A. Evaluate electrolyte status B. Observe the color of the stomach contents C. Confirm placement of the NGT D. Evaluate absorption from the last feeding
D
The HCP places an order to administer gentamicin intravenously to a client with acute diverticulitis. It is important the nurse knows that intravenous gentamicin is administered: A. over 1 minute via IV push B. over 2 minutes via IV push C. as an IV infusion over 15-20 minutes D. as an IV infusion over 30 minutes to 2 hours
D
The emergency department nurse cares for a client who reports persistent nausea and vomiting for three days. Which acid based arrangement would the nurse expect based on the clients manifestations? A. A decreased pH and an elevated CO2 B. An elevated pH and a decreased CO2 C. A decreased pH and a decreased HCO3 D. An increased pH with an increased HCO3
D
The nurse in the ICU is caring for a client being treated for necrotizing pancreatitis. Which of the following findings would indicate the client is experiencing a complication? A. periumbilical bruising B. abdominal pain rated 5/10 on the numerical rating scale C. WBC count 13,500 mm3 (5,000 - 10,000 mm3) D. decreased lung sounds in the left lower lung fields
D
The nurse is assessing a client with suspected acute cholecystitis. Which of the following findings would support a diagnosis of acute cholecystitis? A. decreased serum bilirubin B. increased high density lipoprotein cholesterol (HDL-C) C. decreased serum aminotransferases D. increased WBC count
D
The nurse is caring for a client with H. Pylori. The nurse should anticipate a prescription for which of the following medications? A. Dicyclomine B. Metoclopramide C. Valacyclovir D. Amoxicillin
D
The nurse is caring for a post-abdominal surgery client four days after surgery. The nurse notes a temperature of 37 C, no complaints of pain at the incision site or elsewhere, a dry and intact wound dressing, and hypoactive bowel sounds in all 4 quadrants. Based on all the assessment data, what conclusion can the nurse make? A. The clients wound is becoming infected B. Pain relief measures should be implemented C. There are no current concerns for the client D. Additional gastrointestinal asses
D
The nurse is helping develop a care plan for a client with a low serum albumin level. The nurse should take which action? A. Obtain a capillary blood glucose B. Implement seizure precautions C. Implement strict bed rest D. Collaborate with a registered dietitian
D
The nurse is positioning a client following a liver biopsy. Which position is best suited for this client? A. on the left side with a pillow under the ribs B. supine with a pillow under the knees C. face down with a pillow under the hips D. on the right side with a pillow under the biopsy site
D
The nurse is positioning a lien following a liver biopsy. Which position is best suited for this client? A. On the left side with a pillow under the ribs B. Supine with a pillow under the clients knees C. Face down with a pillow under the hips D. On the right side with a pillow under the biopsy site
D
The nurse is speaking with a client that underwent an ileostomy one month ago. The client states that the ostomy's odor is causing embarrassment. The nurse investigates the food that the client consumes and initiates further health teaching when the client mentions the following menu item: A. Buttermilk B. Parsley C. Yogurt D. Eggs
D
The nurse is teaching a client about their newly established colostomy. Which of the following statements by the client would require follow up? A. "I will call my PHCP immediately if my stoma becomes bluish" B. "I should slowly introduce high-fiber foods in my diet" C. "I must always wear a pouch over my stoma" D. "I should clean the skin around my stoma with rubbing alcohol"
D
What is the correct sequence when performing an abdominal assessment? A. auscultation, inspection, palpation, percussion B. inspection, palpation, percussion, auscultation C. palpation, percussion, inspection, auscultation D. inspection, auscultation, percussion, palpation
D
Which of the following clients does the nurse suspect wound benefit most from placement of a NGT? A. A 9 yr old client with a femur fracture B. An 82 yr old client with congestive heart failure C. A 65 yr old client on dialysis D. A 52 yr old client with leukemia who is receiving chemotherapy
D
a nurse is caring for an adult client receiving TPN. Which of the following assessment findings would warrant immediate action by the nurse? A. Complaint of dry skin and thirst by the client B. A temperature of 37 C C. Blood pressure of 116/74 mm Hg D. Blood glucose level of 362 mg/dL
D
the nurse is caring for a client with edentulous. It would be appropriate for the nurse to obtain an order for a A. Low sodium diet B. Mechanical soft diet C. Renal diet D. High-fiber diet
D