Evolve GI

The mother of a large family asks the home health nurse for inexpensive sources of B vitamins. What suggestion should the nurse make?

"Bake with whole-wheat flour."

A nurse is teaching a group of adults about the signs and symptoms of colorectal cancer. What is the most common clinical manifestation that the nurse should include in the teaching program?

Change in bowel habits

A nurse is providing discharge instructions for a client with a diagnosis of gastroesophageal reflux disease (GERD). What should the nurse advise the client to do to limit symptoms of GERD? (Select all that apply.)

Avoid heavy lifting. Avoid drinking alcohol Eat small, frequent meals

A nurse is caring for a client with a history of gastrointestinal (GI) irritability. What should the nurse advise the client to avoid to limit GI irritability?

Cola drinks

A client develops peritonitis and sepsis after the surgical repair of a ruptured diverticulum. What signs should the nurse expect when assessing the client? (Select all that apply.)

Fever Tachypnea Abdominal rigidity

A nurse is concerned that a client with a diagnosis of cirrhosis of the liver may experience the complication of hepatic coma. For which clinical indicator should the nurse assess this client?

Icterus

A client in a debilitated state is admitted for palliative treatment of cancer of the liver. Which objective information collected by the nurse is most helpful for future monitoring of the client's condition?

Present weight

A client is admitted to the hospital with a history of cancer of the liver and jaundice. In relation to the jaundice, the nurse expects the client to report the presence of:

Pruritus

A nurse is providing dietary teaching for a client with celiac disease. Which foods should the nurse teach the client to avoid when following a gluten-free diet? (Select all that apply.)

Rye Oats Wheat

For which clinical indicator associated with a complication of portal hypertension should the nurse assess the client?

Hemorrhage from esophageal varices

A client is admitted to the hospital for the surgical repair of an incarcerated indirect inguinal hernia. What is the primary preoperative nursing intervention for this client?

Observing the client's bowel movements

A nurse is teaching a client who has pancreatitis about dietary restrictions. What should the education include?

Eat small meals frequently

The nurse provides a dietary list to a client who is taking oral anticoagulants with foods that should be avoided because they are high in vitamin K. What foods should be included on the list? (Select all that apply.)

Eggs Liver Cheese

Which client responses does the nurse determine represent the highest risk for the development of pressure ulcers?

Incontinence and inability to move independently.

A client is admitted to the hospital with a diagnosis of acute salmonellosis. What does the nurse expect the health care provider to prescribe?

Electrolytes

A client who has had right upper quadrant pain for several months now experiences clay-colored stools. Laboratory results reveal elevated liver enzymes and a needle biopsy of the liver is scheduled. What should the nurse include in the client's teaching about the procedure?

Lying on the right side after the procedure is required because it will decrease the risk of hemorrhage

A home care nurse is teaching a client of the Orthodox Jewish faith about food supplements that can promote weight gain. Which client statement supports the nurse's conclusion that the teaching is successful?

"I will have cookies and a milkshake as a midafternoon snack."

A client with cholelithiasis has a laser laparoscopic cholecystectomy. Postoperatively it is most appropriate for the nurse to:

Ambulate the client when the client is alert and oriented

Discharge instructions for the client diagnosed with cirrhosis with varices should include information about the importance of: (Select all that apply.)

Avoiding aspirin and aspirin containing products Avoiding acetaminophen and products containing acetaminophen Avoiding coughing, sneezing, and straining to have a bowel movement

The nurse teaches the client about foods to help prevent constipation after pelvic surgery. Which foods selected by the client indicate that the teaching is understood? (Select all that apply.)

Green vegetables Whole grain bread

A client is diagnosed with sprue (adult celiac disease). What should the nurse teach the client to avoid when providing dietary teaching? (Select all that apply.)

Oatmeal Spaghetti

The serum ammonia level of a client with hepatic cirrhosis and ascites is elevated. The priority nursing intervention is to:

Observe the client for increasing confusion

A client follows a vegetarian diet and must compensate for the lack of vitamin B12 found in food of animal origin. Which food should the nurse encourage the client to consume each day?

One glass of soy milk

When comparing ulcerative colitis and Crohn's disease, a nurse considers that they are similar yet dissimilar in many ways. What clinical manifestation is common to clients with Crohn's disease and not to clients with ulcerative colitis?

Right lower quadrant pain

A client is recovering from an acute episode of alcoholism that included esophageal involvement. What are the components of a therapeutic diet that are most appropriate for the nurse to include in the teaching plan for this client? (Select all that apply.)

Soft diet High protein diet High carbohydrate diet

Discharge teaching for a client with hypercholesterolemia includes nutritional instructions for a diet low in saturated fat. Which items included by the client on a list of foods to avoid supports the nurse's conclusion that teaching has been effective?

Whole milk and hard cheeses

A client is returned to the surgical unit after an abdominal cholecystectomy. What is the main reason why the nurse should assess for clinical indicators of respiratory complications?

ncision is in close proximity to the client's diaphragm.

A nurse is assisting a client to plan a therapeutic diet that is high in vitamin C. What excellent sources of vitamin C should be included in the plan? (Select all that apply.)

Oranges Broccoli Strawberries

A client with a history of alcoholism and cirrhosis is admitted with severe dyspnea as a result of ascites. The nurse concludes that the ascites is most likely the result of increased:

Pressure in the portal vein

A client with severe Crohn's disease develops a small bowel obstruction. Which clinical finding should the nurse expect the client to report?

Projectile vomiting

A client with cholecystitis is placed on a low fat, high protein diet. What nutrient should the nurse teach the client is included with this diet?

Skim milk

A health care provider prescribes an upper gastrointestinal (GI) series and a barium enema. The client asks, "Why do I have to have barium for these tests?" The nurse's best response is "Barium:

Gives more contrast to the soft tissue of the alimentary tract, allowing absorption of x-rays."

During a client's paracentesis, 1500 mL of fluid is removed. The nurse monitors the client for which sign of a potentially severe response?

Heart rate increases from 80 to 135

A nurse is preparing to administer a nasogastric tube feeding. List the steps of the procedure in the order in which they should be performed.

1.Wash the hands. 2.Verify the solution to be administered. 3.Aspirate the contents of the stomach. 4.Instill the prescribed solution. 5.Document the client's response to the procedure.

A client has a suspected peptic ulcer in the duodenum. What should the nurse expect the client to report when describing the pain associated with this disease?

A gnawing sensation relieved by food

A client diagnosed with gastroesophageal reflux disease (GERD) is being treated with antacid therapy. When teaching the client about the therapy, the nurse reinforces that antacid tablets:

Are known to interfere with the absorption of other drugs

A client with gastroesophageal reflux disease (GERD) should make diet and lifestyle changes. What instructions should the nurse include in the client's discharge teaching? (Select all that apply.)

Avoid caffeine-containing products. Chew thoroughly while eating slowly

A client is admitted with a diagnosis of duodenal ulcer. Which location is most commonly indicated by the client as being painful when the nurse assesses for the presence of referred pain?

C

Immediately after a liver biopsy, a client is placed onto the right side. The nurse explains that the rationale for this positioning is to:

Compress blood vessels to prevent bleeding

A client asks the nurse to review a list of the foods the client has been choosing to combat constipation. Upon review, the nurse identifies that the food item that has the least amount of fiber content is:

Cream of wheat cereal

An 85-year-old client has a three-day history of nausea, vomiting, and diarrhea. The client develops weakness and confusion and is admitted to the hospital. To best monitor the client's rehydration status, the nurse should assess the client's:

Daily weight

The nurse is creating a dietary plan for a client with cholecystitis who has been placed on a modified diet. What would be appropriate to include in the dietary plan?

Decreased fat intake to avoid stimulation of the cholecystokinin mechanism for bile release

A client is scheduled for a pyloroplasty and vagotomy because of strictures caused by ulcers unresponsive to medical therapy. What information about the purpose of a vagotomy should the nurse include when reviewing the health care provider's discussion with the client?

Decreases acid in the stomach

A client with hepatic cirrhosis develops hepatic encephalopathy. Neomycin sulfate (Mycifradin) is prescribed. The nurse concludes that the purpose of neomycin is to:

Diminish the blood ammonia level

A nurse is planning a community health program about screening for cancer. Which information recommended by the American Cancer Society (ACS) should the nurse include?

Fecal occult blood testing should be performed yearly beginning at age 50 years.

A client with a long history of alcohol abuse develops cirrhosis of the liver. The client exhibits the presence of ascites. The nurse concludes that the most likely cause of this client's ascites is:

Impaired portal venous return

Steroid therapy is prescribed for a client with an exacerbation of ulcerative colitis. The nurse evaluates that teaching is effective when the client says, "I should take this medicine:

In the early morning with food."

After surgery a client is started on a clear liquid diet. Which should the nurse offer the client? (Select all that apply.)

Jell-O Broth Ginger ale

A nurse is assisting a health care provider to perform a sigmoidoscopy. In which position should the nurse place the client for this procedure?

Knee-chest

A client is scheduled for a colonoscopy, and the health care provider prescribes a tap water enema. In which position should the nurse place the client during the enema?

Left Sims

A client has severe diarrhea, and the health care provider prescribes intravenous fluids, sodium bicarbonate, and an antidiarrheal medication. Which most frequently prescribed antidiarrheal drug does the nurse expect the health care provider to prescribe?

Loperamide (Imodium)

A nurse is caring for a client with hepatic cirrhosis. Which elements are important to include in this client's diet? (Select all that apply.)

Low protein Low sodium High vitamins

A client with gastroesophageal reflux disease (GERD) receives a prescription for an H2 receptor antagonist. Which medications are within the classification of an H2 receptor antagonist? (Select all that apply.)

Nizatidine (Axid) Ranitidine (Zantac) Famotidine (Pepcid)

A client is admitted with dehydration. Which findings should the nurse expect the client to exhibit? (Select all that apply.)

Rapid, thready pulse Elevated specific gravity

A client is admitted to the hospital for surgery for recto-sigmoid colon cancer, and the nurse is obtaining a health history as part of the admission process. What clinical findings associated with recto-sigmoid colon cancer does the nurse expect the client to report? (Select all that apply.)

Rectal bleeding Change in the shape of stools Feeling of abdominal bloating

A nurse is teaching a client about prophylactic measures that minimize the risk of contracting hepatitis B. Which actions should be included in this teaching plan? (Select all that apply.)

Screening of blood donors Maintaining a monogamous sexual relationship

A client had surgery for a perforated appendix with localized peritonitis. In which position should the nurse place this client?

Semi-Fowler

An older adult is hospitalized for weight loss and dehydration because of nutritional deficits. What should the nurse consider when caring for this client?

The nutritional needs of an older adult are unchanged except for a decreased need for calories

Which interventions should the nurse anticipate will be prescribed initially for a client who had a hemorrhoidectomy? (Select all that apply.)

Applying moist heat Administering stool softeners

A client had surgery for a ruptured appendix. Postoperatively, the health care provider prescribes an antibiotic to be administered intravenously twice a day. The nurse administers the prescribed antibiotic via a secondary line into the primary infusion of 0.9% sodium chloride. During the administration of the antibiotic, the client becomes restless and flushed, and begins to wheeze. What should the nurse do after stopping the antibiotic infusion?

Assess the client's respiratory status

A nurse is caring for a client with chronic inflammation of the bowel. What is the most serious complication associated with this condition?

Perforation

A client is hospitalized with joint pain, loss of hair, yellow pigmentation of the skin, and an enlarged liver. The nurse suspects what type of toxicity?

Vitamin A

A client is admitted to the ambulatory surgery unit for a liver biopsy. The nurse recalls that which assessment finding will be a cause for the biopsy to be postponed?

Signs of bruising

A low-residue diet is recommended for a client. Which food should the nurse encourage the client to select from a menu?

Creamed potatoes

After many years of coping with colitis, a client makes the decision to have a colectomy as advised by the health care provider. Which is most likely the significant factor that impacted on the client's decision?

Surgical treatment cures ulcerative colitis

A client is admitted via the emergency department with the tentative diagnosis of diverticulitis. Which test commonly is prescribed to assess for this problem?

Computed tomography (CT) scan

A nurse concludes that a client understands the teaching about limiting the discomfort associated with a hiatal hernia when the client states, "After meals I will:

Rest in a sitting position for one hour."