CH 52 Gastrointestinal System

The nurse is providing discharge teaching for a client with newly diagnosed Crohn's disease about dietary measures to implement during exacerbation episodes. Which statement made by the client indicates a need for further instruction? 1. " i should increase the fiber in my diet" 2. "i will need to avoid caffeinated beverages" 3. "im going to learn some stress reduction techniques" 4. "i can have exacerbations and remissions with Crohn's disease"

1. " i should increase the fiber in my diet"

The nurse provides instructions to a client about measures to treat inflammatory bowel syndrome (IBS). Which statement by the client indicates a need for further teaching? 1. "i need to limit my intake of dietary fiber" 2. "i need to drink plenty, at least 8-10 cups daily" 3. "i need to eat regular meals and chew my food well" 4. "i will take the prescribed medications because they will regulate my bowel patterns"

1. "i need to limit my intake of dietary fiber"

The nurse is reviewing the prescription for a client admitted to the hospital with a diagnosis of acute pancreatitis. Which interventions would the nurse expect to be prescribed for the client? Select all that apply. 1. Maintain NPO status 2. Encourage coughing and deep breathing 3. Give small frequent high calorie feedings 4. Maintain the client in a supine and flat position 5. Give hydromorphone IV as prescribed for pain 6. Maintain IV fluids at 10 mL/hour to keep the vein open

1. Maintain NPO status 2. Encourage coughing and deep breathing 5. Give hydromorphone IV as prescribed for pain

A client has just had a hemorrhoidectomy. Which nursing interventions are appropriate for this client? Select all that apply. 1. administer stool softeners as prescribed 2. instruct the client to limit fluid intake to avoid urinary retention 3. encourage a high fiber diet to promote bowel movements without straining 4. apply cold packs to the anal-rectal area over the dressing until the packing is removed 5. help the client to a fowlers position to place pressure on the rectal area and decrease bleeding

1. administer stool softeners as prescribed 3. encourage a high fiber diet to promote bowel movements without straining 4. apply cold packs to the anal-rectal area over the dressing until the packing is removed

The nurse is planning to teach a client with GERD about substances to avoid. Which items should the nurse include on this list? Select all that apply. 1. coffee 2. chocolate 3. peppermint 4. nonfat milk 5. fried chicken 6. scrambled eggs

1. coffee 2. chocolate 3. peppermint 5. fried chicken

The nurse is assessing a client who is experiencing an acute episode of cholecystitis. Which of these clinical manifestations support this diagnosis? Select all that apply. 1. fever 2. positive Cullen's sign 3. complaints of indigestion 4. palpable mass in the left upper quadrant 5. pain in the upper right quadrant after a fatty meal 6. vague lower right quadrant abdominal discomfort

1. fever 3. complaints of indigestion 5. pain in the upper right quadrant after a fatty meal

A client with hiatal hernia chronically experiences heartburn following meals. The nurse should plan to teach the client to avoid which action because it is contraindicated with a hiatal hernia? 1. lying recumbent following meals 2. consuming small, frequent, bland meals 3. taking H2-receptor antagonist medication 4. raising the head of the bed on 6-inch blocks

1. lying recumbent following meals

A client has developed hepatitis A after eating contaminated oysters. The nurse assesses the client for which expected assessment finding? 1. malaise 2. dark stools 3. weight gain 4. left upper quadrant discomfort

1. malaise

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 most appropriate nursing intervention? 1. notify the HCP 2. administer the prescribed pain medication 3. call and ask the operating room team to perform surgery as soon as possible 4. reposition the client and apply a heating pad on the warm setting to the client's abdomen

1. notify the HCP

The nurse is providing dietary teaching for a client with a diagnosis of chronic gastitis. The nurse instructs the client to include which foods rich in vitamin B12 in the diet? Select all that apply. 1. nuts 2. corn 3. liver 4. apples 5. lentils 6. bananas

1. nuts 3. liver 5. lentils

The nurse is monitoring a client for the early signs and symptoms of dumping syndrome. Which findings indicate this occurrence? 1. sweating and pallor 2. bradycardia and indigestion 3. double vision and chest pain 4. abdominal cramping and pain

1. sweating and pallor

A client had a new colostomy created 2 days earlier and is beginning to pass malodorous flatus from the stoma. What is the correct interpretation by the nurse? 1. this is a normal expected event 2. the client is experiencing early signs of ischemic bowel 3. the client should not have the NG tube removed 4. this indicates inadequate preoperative bowel preparation

1. this is a normal expected event

The health care provider has determined that client has contracted hepatitis A based on flulike symptoms and jaundice. Which statement made by the client supports this medical diagnosis? 1. "i have had unprotected sex with multiple partners" 2. "i ate shellfish about 2 weeks ago at a local restaurant" 3. "i was an intravenous drug abuser in the past and shared needles" 4. "i had a blood transfusion 30 years ago after major abdominal surgery"

2. "i ate shellfish about 2 weeks ago at a local restaurant"

A client is diagnosed with viral hepatitis, complaining of "no appetite" and "losing my taste for food". What instruction should the nurse give the client to provide adequate nutrition? 1. select foods high in fat 2. increase intake of fluids, including juices 3. eat a good super when anorexia is not as severe 4. eat less often, preferably only 3 large meals daily

2. increase intake of fluids, including juices

The nurse is providing care for a client with a recent transverse colostomy. Which observation requires immediate notification of the HCP? 1. stoma is beefy red and shiny 2. purple discoloration of the stoma 3. skin excoriation around the stoma 4. semi-formed stool noted in the ostomy pouch

2. purple discoloration of the stoma

The nurse has taught the client about upcoming endoscopic retrograde cholangiopancreatography (ERCP) procedure. The nurse determines that the client needs further information if the client makes which statement? 1. "i know i must sign the consent form" 2. "i hope the throat spray keeps me from gagging" 3. "im glad i dont have to lie still for this procedure" 4. "im glad some intravenous medications will be given to relax me"

3. "im glad i dont have to lie still for this procedure"

The nurse is assessing a client 24 hours following a cholecystectomy. The nurse notes that the T-tube has drained 750 mL of green-brown drainage since the surgery. Which nursing intervention is most appropriate? 1. Clamp the T-tube 2. Irrigate the T-tube 3. Document the findings 4. Notify the HCP

3. Document the findings

The nurse is reviewing the record of a client with a diagnosis of cirrhosis and notes that there is documentation of the presence of asterixis. How should the nurse assess for its presence? 1. dorsiflex the client's foot 2. measure the abdominal girth 3. ask the client to extend the arms 4. instruct the client to lean forward

3. ask the client to extend the arms

The nurse is caring for a client following a gastrojejunostomy (Billroth II procedure). Which postoperative prescription should the nurse question and verify? 1. leg exercises 2. early ambulation 3. irrigating the NG tube 4. coughing and deep-breathing exercises

3. irrigating the NG tube

The nurse is providing discharge instructions to a client following gastrectomy and should instruct the client to take which measure to assist in preventing dumping syndrome? 1. ambulate following a meal 2. eat high carbohydrate foods 3. limit the fluids taken with meals 4. sit in a high fowlers position during meals

3. limit the fluids taken with meals

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 should assess the client for which signs/symptoms of duodenal ulcer? 1. weight loss 2. N/V 3. pain relieved by food intake 4. pain radiating down the right arm

3. pain relieved by food intake

The nurse is reviewing the lab results for a client with cirrhosis and notes that the ammonia level is 85 mcg/dL. Which dietary selection does the nurse suggest to the client? 1. roast pork 2. cheese omelet 3. pasta with sauce 4. tuna fish sandwich

3. pasta with sauce

The nurse is monitoring a client with a diagnosis of peptic ulcer. Which assessment finding would most likely indicate perforation of the ulcer? 1. bradycardia 2. numbness in the legs 3. nausea and vomiting 4. a rigid boardlike abdomen

4. a rigid boardlike abdomen

A client has undergone esophagogastroduodednoscopy. The nurse should place highest priority on which item as part of the client's care plan? 1. monitoring the temperature 2. monitoring complaints of heartburn 3. giving warm gargles for a sore throat 4. assessing for the return of the gag reflex

4. assessing for the return of the gag reflex

A client has just had surgery to create an ileostomy. The nurse assesses the client in the immediate postoperative period for which most frequent complication of this type of surgery? 1. folate deficiency 2. malabsorption of fat 3. intestinal obstruction 4. fluid and electrolyte imbalance

4. fluid and electrolyte imbalance

A client admitted to the hospital with a suspected diagnosis of acute pancreatitis is being assessed by the nurse. Which assessment findings would be consistent with acute pancreatitis? Select all that apply. 1. diarrhea 2. black tarry stools 3. hyperactive bowel sounds 4. gray blue color at the flank 5. abdominal guarding and tenderness 6. left upper quadrant pain with radiation to the back

4. gray blue color at the flank 5. abdominal guarding and tenderness 6. left upper quadrant pain with radiation to the back