Exam #9, Adult Health, Review Topics w/ PrepU Questions

A nurse is caring for a client newly diagnosed with hepatitis A. Which statement by the client indicates the need for further teaching? "How did this happen? I've been faithful my entire marriage." "I'll be very careful when preparing food for my family." "I'll wash my hands often." "I'll take all my medications as ordered."

"How did this happen? I've been faithful my entire marriage."

A home care nurse is caring for a client with reports of epigastric discomfort who is scheduled for a barium swallow. Which statement by the client indicates an understanding of the test?

"I'll avoid eating or drinking anything 6 to 8 hours before the test."

A client with an H. pylori infection asks why bismuth subsalicylate is prescribed. Which response will the nurse make?

"It aids in the healing of the stomach lining."

A client with a diagnosis of peptic ulcer disease has just been prescribed omeprazole. How should the nurse best describe this medication's therapeutic action? A- "This medication will reduce the amount of acid secreted in your stomach." B-"This medication will make the lining of your stomach more resistant to damage." C-"This medication will specifically address the pain that accompanies peptic ulcer disease." D-"This medication will help your stomach lining to repair itself."

"This medication will reduce the amount of acid secreted in your stomach."

A client is scheduled for a urea breath test to detect for H. pylori as a reason for gastric distress. Which instruction will the nurse provide to the client to prepare for this test? Select all that apply. - Do not use antibiotics for 1 month. - Take cimetidine 24 hours before the test. - Avoid bismuth subsalicylate for 1 month. - Do not take proton pump inhibitors for 2 weeks. - Take famotidine for 1 week before the test.

- Do not use antibiotics for 1 month. - Avoid bismuth subsalicylate for 1 month. - Do not take proton pump inhibitors for 2 weeks.

What is the approximate length of the large intestine?

4-5 feet

The nurse is caring for a client recovering from a colonoscopy. Which assessment finding will the nurse expect in the client after the procedure?

Abdominal cramps

A client diagnosed with colon cancer presents with the characteristic symptoms of a LEFT-sided lesion. Which symptoms are indicative of this disorder? Select all that apply. A. Abdominal distention B. Constipation C. Narrowing stools D. Black, tarry stools E. Dull abdominal pain

Abdominal distention, constipation, narrowing stools Melena and dull abdominal pain are associated with right-sided lesions. The other symptoms are found with left-sided lesions.

​​After assessing a client with peritonitis, how would the nurse most likely document the client's bowel sounds?

Absent

A client comes to the clinic after developing a headache, abdominal pain, nausea, hiccupping, and fatigue about 2 hours ago. The client tells the nurse that the last food was buffalo chicken wings and beer. Which medical condition does the nurse find to be most consistent with the client's presenting problems?

Acute gastritis

What is the most common cause of small-bowel obstruction?

Adhesions (scar tissue)

A client with a history of alcohol abuse comes to the emergency department and complains of abdominal pain. Laboratory studies help confirm a diagnosis of acute pancreatitis. The client's vital signs are stable, but the client's pain is worsening and radiating to his back. Which intervention takes priority for this client?

Administering morphine I.V. as ordered

A client is admitted for suspected GI disease. Assessment data reveal muscle wasting, a decrease in chest and axillary hair, and increased bleeding tendency. The nurse suspects the client has:

Cirrhosis

Which is a clinical manifestation of cholelithiasis?

Clay-colored stools

The nurse prepares a client for a barium enema. The nurse should place the client on which diet prior to the procedure?

Clear liquids the day before

A client is having a diagnostic workup for reports of frequent diarrhea, right lower abdominal pain, and weight loss. The nurse is reviewing the results of the barium study and notes the presence of "string sign." What does the nurse understand that this is significant of?

Crohn's disease

The nurse is investigating a client's report of pain in the duodenal area. Where should the nurse perform the assessment? a) Left lower quadrant b) Periumbilical area, followed by the right lower quadrant c) Hypogastrium in the right or left lower quadrant d) Epigastric area and consider possible radiation of pain to the right subscapular region

Epigastric area and consider possible radiation of pain to the right subscapular region

Which characteristic is a risk factor for colorectal cancer?

Familial polyposis

The mode of transmission of hepatitis A virus (HAV) includes which of the following?

Fecal-oral

An adult client is scheduled for an upper GI series that will use a barium swallow. What teaching should the nurse include about what the client should expect after the test is completed?

Fluids must be increased to facilitate the evacuation of the stool.

A client receiving tube feedings is experiencing diarrhea. The nurse and the health care provider suspects that the client is experiencing dumping syndrome. What intervention is most appropriate?

Keep the client in semi-Fowler position for 1 hour after feedings

While palpating a client's right upper quadrant (RUQ), the nurse would expect to find which structure?

Liver

What is the recommended dietary treatment for a client with chronic cholecystitis?

Low fat diet

Diet modifications for patient diagnosed with chronic inflammatory bowel disease (IBD) include which of the following?

Low residue

When providing health education to a client scheduled for a colonoscopy the nurse should explain that they will be placed in what position during this diagnostic test?

Lying on the left side with legs drawn toward the chest

A client is admitted to the hospital with acute hemorrhage from esophageal varices. What medication should the nurse anticipate administering that will reduce pressure in the portal venous system and control esophageal bleeding?

Octreotide

A client is in the hospital for the treatment of peptic ulcer disease. The client reports vomiting and a sudden severe pain in the abdomen. The nurse then assesses a board-like abdomen. What does the nurse suspect these symptoms indicate?

Perforation of the peptic ulcer

A client with a diagnosis of acute appendicitis is awaiting surgical intervention. The nurse listens to bowel sounds and hears none and observes that the abdomen is rigid and board-like. What complication does the nurse determine may be occurring at this time?

Peritonitis

A nurse is performing an admission assessment of a client with a diagnosis of cirrhosis. What technique should the nurse use to palpate the client's liver?

Place hand under right lower rib cage and press down lightly with the other hand.

The most common cause of esophageal varices includes which of the following?

Portal hypertension

After a liver biopsy on the client with cirrhosis, which nursing intervention is most appropriate to add to the plan of care?

Position the client on his or her right side

When caring for a client with acute pancreatitis, the nurse should use which comfort measure?

Positioning the client on the side with the knees flexed

A nurse practitioner, who is treating a patient with GERD, knows that this type of drug helps treat the symptoms of the disease. The drug classification is:

Proton pump inhibitors

A client with cirrhosis has portal hypertension, which is causing esophageal varices. What is the goal of the interventions that the nurse will provide?

Reduce fluid accumulation and venous pressure.

The nurse advises the patient who has just been diagnosed with acute gastritis to:

Refrain from food until the GI symptoms subside.

A nurse is caring for a client with cirrhosis secondary to heavy alcohol use. The nurse's most recent assessment reveals subtle changes in the client's cognition and behavior. What is the nurse's most appropriate response?

Report this finding to the primary provider due to the possibility of hepatic encephalopathy

A nurse is assessing a client who has been diagnosed with cholecystitis, and is experiencing localized abdominal pain. When assessing the characteristics of the client's pain, the nurse should anticipate that it may radiate to what region?

Right shoulder

A nurse inspects a breakfast tray for a client with pancreatitis who has not had any food for several days, and had a nasogastric tube removed. The client is now on a bland, low-fat diet. Which food item, if found on the client's breakfast tray, should be removed?

Scrambled eggs

A health care provider counsels a client about bariatric surgery and recommends the Roux-en-Y gastric bypass. What is the best response by the nurse to further explain this procedure to the client?

Separation of the jejunum with an anastomosis

The nurse should assess for an important early indicator of acute pancreatitis, which is a prolonged and elevated level of:

Serum lipase

The nurse is answering questions regarding fecal matter for a client who is scheduled for a colon resection. The client is asking questions regarding the composition of the fecal matter and when it becomes a formed mass. The nurse is most correct to state at which location?

Sigmoid colon

A client suspected of having colorectal cancer requires which diagnostic study to confirm the diagnosis?

Sigmoidoscopy

A nurse is teaching a client with malabsorption syndrome about the disorder and its treatment. The client asks which part of the GI tract absorbs food. What is the nurse's best response?

Small intestine

A nurse is completing a health history on a client whose diagnosis is chronic gastritis. Which of the data should the nurse consider most significantly related to the etiology of the client's health problem? - Consumes one or more protein drinks daily - Takes over-the-counter antacids frequently throughout the day - Smokes one pack of cigarettes daily - Reports a history of social drinking on a weekly basis.

Smokes one pack of cigarettes daily.

Which is a true statement regarding regional enteritis (Crohn's disease)?

The clusters of ulcers take on a cobblestone appearance.

The nurse is caring for a patient with acute pancreatitis. The patient has an order for an anticholinergic medication. The nurse explains that the patient will be receiving that medication for what reason?

To reduce gastric and pancreatic secretions

A patient with bleeding esophageal varices has had pharmacologic therapy with Octreotide (Sandostatin) and endoscopic therapy with esophageal varices banding, but the patient has continued to have bleeding. What procedure that will lower portal pressure does the nurse prepare the patient for?

Transjugular intrahepatic portosystemic shunting (TIPS)

A nurse is teaching a group of middle-aged men about peptic ulcers. When discussing risk factors for peptic ulcers, the nurse should mention:

alcohol abuse and smoking

A client has just been diagnosed with hepatitis A. On assessment, the nurse expects to note:

anorexia, nausea, and vomiting

Total parental nutrition (TPN) should be used cautiously in clients with pancreatitis because such clients:

cannot tolerate high-glucose concentration

A nurse is caring for a client who underwent a subtotal gastrectomy. To manage dumping syndrome, the nurse should advise the client to:

drink liquids only between meals.

The most common symptom of esophageal disease is:

dysphagia

A nurse is assessing a client and obtains the following findings: abdominal discomfort, mild diarrhea, blood pressure of 100/80 mm Hg, pulse rate of 88 beats/minute, respiratory rate of 20 breaths/minute, temperature 100° F (37.8° C). What diagnosis will the nurse suspect for this client?

inflammatory bowel disease (IBD)

What is the recommended order for performing an abdominal examination?

inspection, auscultation, percussion, palpation

A nursing assessment of a client with peritonitis reveals hypotension, tachycardia, and signs and symptoms of dehydration. What else would the nurse expect to find?

severe abdominal pain with direct palpation or rebound tenderness

Which symptoms will a nurse observe most commonly in clients with pancreatitis?

severe, radiating abdominal pain

To prevent gastroesophageal reflux in a client with hiatal hernia, the nurse should provide which discharge instruction? a. "Lie down after meals to promote digestion." b. "Avoid coffee and alcoholic beverages." c. "Take antacids with meals." d. "Limit fluid intake with meals."

"Avoid coffee and alcoholic beverages."

A client with a gastrointestinal condition asks why the mouth needs to be examined. Which response will the nurse make?

"Changes in the mouth can help explain why your condition is occurring."

A client has sought care because of recent dark-colored stools. As a result, a fecal occult blood test has been ordered. The nurse should give what instructions to the client? - "Do not take any NSAIDs within 72 hours of the test." - "Take prescribed medications as usual." - "Avoid over-the-counter (OTC) vitamin C supplements." - "Do not use fiber supplements before the test."

"Do not take any NSAIDs within 72 hours of the test."

The nurse is developing a plan of care for a patient with peptic ulcer disease. What nursing interventions should be included in the care plan? Select all that apply. - Making neurovascular checks every 4 hours - Frequently monitoring hemoglobin and hematocrit levels - Observing stools and vomitus for color, consistency, and volume - Checking the blood pressure and pulse rate every 15 to 20 minutes - Inserting an indwelling catheter for incontinence

- Frequently monitoring hemoglobin and hematocrit levels - Observing stools and vomitus for color, consistency, and volume - Checking the blood pressure and pulse rate every 15 to 20 minutes

A client has been diagnosed with chronic gastritis. The nurse knows that which of the following symptoms are indicative of gastritis? Select all that apply. - Hiccups - Belching - Early satiety - Hematemesis - Sour taste in the mouth

Belching Early satiety Sour taste in the mouth

The nurse is planning care for a client following an incisional cholecystectomy for cholelithiasis. Which intervention is the highest nursing priority for this client? Assisting the client to turn, cough, and deep breathe every 2 hours

Assisting the client to turn, cough, and deep breathe every 2 hours

The nurse is performing a focused abdominal assessment of a client with a history of bowel obstruction. The nurse has positioned the client appropriately and inspected the client's abdomen carefully. What action should the nurse perform next?

Auscultate the client's abdomen

A client has a history of inflammatory bowel disease and is undergoing procedures to determine the best treatment for the current symptoms. What is believed to cause inflammatory bowel disease?

Autoimmunity

The nurse teaches the client with gastroesophageal reflux disease (GERD) which measure to manage the disease?

Avoid eating or drinking 2 hours before bedtime

Cystic fibrosis, a genetic disorder characterized by pulmonary and pancreatic dysfunction, usually appears in young children but can also affect adults. If the pancreas was functioning correctly, where would the bile and pancreatic enzymes enter the GI system?

Duodenum

Which of the following would a nurse expect to assess in a client with peritonitis? A. Board-like abdomen B. Decreased pulse rate C. Deep slow respirations D. Hyperactive bowel sounds

Board-like abdomen

During a colonoscopy with moderate sedation, the patient groans with obvious discomfort and begins bleeding from the rectum. The patient is diaphoretic and has an increase in abdominal girth from distention. What complication of this procedure is the nurse aware may be occurring?

Bowel perforation

The nurse is reviewing the laboratory test results of a client with Crohn's disease. Which of the following would the nurse most likely find?

Stool cultures negative for microorganisms or parasite

Which is the most common presenting symptom of colon cancer?

Change in bowel habits

A client with calculi in the gallbladder is said to have

Cholelithiasis

A client informs the nurse that he has been having abdominal pain that is relieved when having a bowel movement. The client states that the physician told him he has irritable bowel syndrome. What does the nurse recognize as characteristic of this disorder?

Chronic constipation with sporadic bouts of diarrhea

A healthcare provider prescribes a combination of drugs to treat reoccurring peptic ulcer disease, and the client asks the nurse the reason for all the medications. What teaching should the nurse review with the client? A- Bismuth salts, antivirals, and histamine-2 (H2) antagonists B- H2 antagonists, antibiotics, and bicarbonate salts C- Bicarbonate salts, antibiotics, and ZES D- Antibiotics, proton pump inhibitors, and bismuth salts

D- Antibiotics, proton pump inhibitors, and bismuth salts The bismuth salts, antibiotics, and proton pump inhibitors will work together to suppress or eradicate H. pylori.

A patient is being treated for diverticulosis. Which information should the nurse include in this patient's teaching plan?

Drink at least 8 to 10 large glasses of fluid every day.

A client who had a Roux-en-Y bypass procedure for morbid obesity ate a chocolate chip cookie after a meal. After ingestion of the cookie, the client reported cramping pains, dizziness, and palpitation. After having a bowel movement, the symptoms resolved. What should the nurse educate the client about regarding this event?

Dumping syndrome

The nurse is caring for a client who has developed dumping syndrome while recovering from a gastrectomy. What recommendation should the nurse make to the client? - Drink a minimum of 12 ounces of fluid with each meal - Eat several small meals daily spaced at equal intervals - Sit upright when eating and for 30 minutes afterward - Choose foods that are high in simple carbohydrates.

Eat several small meals daily spaced at equal intervals

A patient is diagnosed with mild acute pancreatitis. What does the nurse understand is characteristic of this disorder?

Edema and inflammation

During a health education session, a participant has asked about the hepatitis E virus. What prevention measure should the nurse recommend for preventing infection with this virus?

Following proper hand-washing techniques

A nurse is assessing the abdomen of a client just admitted to the unit with a suspected gastrointestinal (GI) disease. Inspection reveals several diverse lesions on the client's abdomen. How should the nurse best interpret this assessment finding?

GI diseases often produce skin changes.

The nurse identifies which type of jaundice in an adult experiencing a transfusion reaction?

Hemolytic

A client and spouse are visiting the clinic. The client recently experienced a seizure and says she has been having difficulty writing. Before the seizure, the client says that for several weeks she was sleeping late into the day but having restlessness and insomnia at night. The client's husband says that he has noticed the client has been moody and slightly confused. Which of the following problems is most consistent with the client's clinical manifestations?

Hepatic encephalopathy

A client who has been experiencing changes in his bowel function is scheduled for a barium enema. What instruction should the nurse provide for post procedure recovery?

Increase fluid intake to evacuate the barium.

A client is recovering from an ileostomy that was performed to treat inflammatory bowel disease. During discharge teaching, what would the nurse stress the importance of?

Increasing fluid intake to prevent dehydration

Crohn's disease is a condition of malabsorption caused by which pathophysiological process?

Inflammation of all layers of intestinal mucosa

A client has experienced symptoms of dumping syndrome following gastric surgery. To what physiologic phenomenon does the nurse attribute this syndrome?

Influx of extracellular fluid into the small intestine

A client is scheduled for an upper gastrointestinal barium study. Which teaching will the nurse provide for the client to prepare for this diagnostic test?

Ingest nothing by mouth after midnight

A client has returned to the medical unit after a barium enema. When assessing the client's subsequent bowel patterns and stools, what finding would warrant reporting to the health care provider?

Streaks of blood present in the stool

A nursing student is caring for a client with gastritis. Which of the following would the student recognize as a common cause of gastritis? Choose all that apply. - Ingestion of strong acids - Irritating foods - DASH diet - Overuse of aspirin - Participation in highly competitive sports

Ingestion of strong acids Irritating foods Overuse of aspirin

The nurse is comparing Crohn's disease (regional enteritis) with ulcerative colitis. Which of the following describes Crohn's disease?

Its course is prolonged and variable

A nurse is caring for a client who has experienced an acute exacerbation of Crohn's disease. Which statement best indicates that the disease process is under control?

The client exhibits signs of adequate GI perfusion. (sorry I can't find the full answer options list)

The nurse is conducting a gastrointestinal assessment. When the client reports the presence of mucus and pus in the stool, the nurse assesses for additional signs/symptoms of which disease/condition?

Ulcerative colitis

Which of the following medications is used to decrease portal pressure, halting bleeding of esophageal varices? - Spironolactone - Vasopressin - Nitroglycerin - Cimetidine

Vasopressin

A client with chronic pancreatitis is treated for uncontrolled pain. Which complication does the nurse recognize is most common in the client with chronic pancreatitis?

Weight loss

What symptoms of perforation might the nurse observe in a client with an intestinal obstruction? Select all that apply. A. abdominal distention B. sudden drop in body temperature C. sudden, sustained abdominal pain D. intermittent, severe pain

abdominal distention sudden, sustained abdominal pain

Which client requires immediate nursing intervention? The client who: Presents with a rigid, board-like abdomen A. complains of epigastric pain after eating B. complains of anorexia and periumbilical pain C. presents with a rigid, boardlike abdomen D. presents with ribbonlike stools.

presents with a rigid, boardlike abdomen A rigid, boardlike abdomen is a sign of peritonitis, a possibly life-threatening condition. Epigastric pain occurring 90 minutes to 3 hours after eating indicates a duodenal ulcer. Anorexia and periumbilical pain are characteristic of appendicitis. Risk of rupture is minimal within the first 24 hours, but increases significantly after 48 hours. A client with a large-bowel obstruction may have ribbonlike stools.