GI

the nurse is caring for a pt with acute pancreatitis. Which nursing assessment should receive highest priority?

assess cardiovascular status and fluid vol status

the first priority for a nurse admitting a pt with severe diarrhea to an acute unit would be to:

assess the pt's fluid vol. status

during the insertion of a NG tube, the pt begins to gag. The nurse should:

briefly halt the insertion

a 58 yr old male is admitted with the diagnosis of esophageal cancer with erosion to the middle portion of the esophagus. Which of the following is most important to report immediately?

bright bleeding from the mouth

when a pt is prescribed a low-residue diet, which of the following menu choices indicate an understanding of the diet?

broiled chicken breast, mashed potatoes, whipped squash, and angel food cake

a client with crohn's disease is scheduled to receive an infusion of infliximab. The nurse assisting with caring for the client should take with action to monitor the effectiveness of treatment?

checking the frequency/ consistency of BM

an older client has recently been taking cimitidine. The nurse should monitor the client for which most frequent CNS side effect of this med?

confusion

the nurse is reviewing the record of a client with Crohn's Disease. Which stool characteristic should the nurse expect to see documented in the record?

diarrhea

the nurse caring for pt with dry mouth knows that this can affect the pt's nutrition because:

digestion begins in the mouth

during the initial assessment, the nurse notes a small, painless, dark-colored lesion on the pt's tongue. The pt states that the sore has been in his mouth for several months. Which of the following interventions should be the next priority?

document findings and notify HCP

when assessing the abdomen of a pt, the nurse notes dullness to percussion in the LLQ. One possible explanation for this finding is:

fecal mass in the sigmoid colon

the client has been taking omeprazole for 4 weeks. The nurse evaluates that the client is receiving the optimal intended effect of the medication if the client reports the absence of which symptom?

heartburn

It has been determined that a client with hepatitis has contracted the infection from contaminated food. What type of hepatitis is this client most likely experiencing?

hepatitis A

the nurse caring for a patient with a possible bowel obstruction would immediately report which of the following?

increased pain with a rigid, boardlike abdomen

a pt scheduled to undergo a colonoscopy asks the nurse just how the test is done. The nurse explains that this test involves:

inserting a flexible fiberoptic scope into the colon to visualize its mucous membranes

the nurse is preparing to perform an abdominal examination. What step should be taken first?

inspection

the nurse is caring for a client after a billroth 2 procedure. During revew of the post-op prescriptions, which should the nurse clarify?

irrigating the NG tube

the nurse is reinforcing teaching to a client about an upcoming colonoscopy procedure. The nurse should include in the instructions that the client will be placed in which position for the procedure?

left sims' position

the nurse reinforces post-op liver biopsy instructions to a client. Which should the nurse tell the client?

lie on the R side for 2 hrs

the nurse is reinforcing discharge instructions to a client after a gastrectomy. Which measure should the nurse include during client teaching to help prevent dumping syndrome?

limit the fluids taken with meals

The client with a hiatal hernia chronically experiences heartburn following meals. The nurse planc to teach the client to avoid which action because it is contraindicated with hiatal hernia?

lying recumbent after meals

a pt diagnosed with cholelithiasis requests medication for pain relief. Which of the following meds is the physician most likely to prescribe?

morphine sulfate

the client with a gastric ulcer has a prescription for sucralfate 1g by mouth 4x daily. The nurse should schedule the medication to be administered at which times?

one hour before meals and at bedtime

a pt is admitted to the nursing unit with a diagnosis of acute pancreatitis. The pt complains of severe pain. Place the following nursing activities to promote patient comfort in the order in which the nurse would do them.

1 administer prescribed parenteral narcotic analgesic 2 insert the ordered NG tube and connect to low intermittent suctioning 3 place an NPO sign over the pt's bed and notify dietary services 4 place in a side-lying position with knees flexed and elevate the head of bed 45 degrees 5 promote rest by darkening room and placing a sign on the door to limit visitors

a pt with cirrhosis is scheduled for discharge. The LPN recognizes the need for further teaching if the pt states:

"i will limit alcohol intake to two servings per day."

an older adult pt complains that her bowels move only 2 or 3 times a week. The most appropriate response by the nurse would be:

"that pattern may be normal for you. tell me about your stool-is it hard or difficult to expell?"

the HCP has prescribed an antibiotic for a pt with a peptic ulcer. the pt asks you why this type of med is given. The appropriate response is:

"the antibiotic will help to rid the stomach of H. Pylori bacteria."

a client with a peptic ulcer is diagnosed with H. Pylori infection. The nurse is reinforcing teaching for the client about the meds prescribed including clarithromycin, esomeprazole, and amoxicillin. Which statement made by the client indicates the best understanding of the medication regimen?

"the medications will kill the bacteria and stop the acid production."

the nurse talking to a community group includes which of the following in her discussion of colorectal cancer?

"when you have reached the age of 50, you should have an annual digital rectal exam and a flexible sigmoidoscopy or colonoscopy every 10 yrs."

a pt recovering from bowel surgery is asking for regular food. the nurse's most appropriate response would be:

"when you start passing gas and your bowel is working again, it will be safe to start eating again."

a pt with a newly created sigmoid colostomy asks if the bag will need to be worn constantly. Your best response would be:

"your colostomy is at the level of the lower bowel, so you may be able to have regular daily bowel movements."

the nurse is teaching a pt with newly diagnosed ulcerative colitis about her prescription for sulfasalazine (azulfitidine.) Which of the following does the nurse include in teaching?

- "use sunscreen while you are taking this drug to prevent sunburns." - "if you use oral contraceptives, use additional protection while taking this drug.

the nurse is reviewing the prescriptions of a client admitted to the hospital with a diagnosis of acute pancreatitis. Which interventions should the nurse expect to be prescribed?

- administer antacids as prescribed - encourage coughing and deep breathing - administer anticholinergics as prescribed

the nurse reinforcing teaching for a pt with GERD includes which of the following in the instructions?

- avoid lying down for several hrs after eating - raise the head of the bed on 6 in blocks

PPI

- azoles

a H2 receptor antagonist will be prescribed for a client. the nurse understands that which meds are H2 receptor antagonists?

- nizatidine - ranitidine - famotidine - cimetidine

the nurse evaluates a 54 yr old pt with cirrhosis for improvement in her ascites. Which of the following assessment findings may indicate improvement?

- weight loss of 3 lb in past 72 hrs - abdominal girth 2 cm less than previous measurement

the pt is receiving enteral feedings of ensure 240 ml at a rate of 60 ml/hr. the nurse anticipates that each can of the formula will run for _______ hours.

4

the client has a PRN prescription for odansetron. For which condition should the nurse administer this med?

N/V

a pt returns to his room after an open cholecystectomy. he has a t-tube in place attached to a drainage bag. the nurse would report which of the following assessments to the charge nurse or physician?

N/V 30 min after eating

a pt comes to the walk-in clinic complaining of abdominal pain that started about 2 hrs previously. In his assessment, the nurse notes tenderness in the RLQ, and checks for rebound. Rebound tenderness is characterized by:

a relief of pain with palpation followed by pain when pressure is released

a pt is admitted with stenosis of the cardiac sphincter. the nurse knows that this will affect the pts:

ability to swallow

a pt will manage her cholelithiasis at home using medical interventions. The nurse reinforces which of the following in discharge teaching?

adhere to a low fat, low calorie diet

when caring for a pt who has stomatitis, the nurse should give priority to which of these treatment measures?

administer viscous lidocaine before each meal

the client has an as needed prescription for loperamide hydrochloride. For which condition should the nurse administer this medication?

an episode of diarrhea

the nurse is reviewing the primary HCP's prescriptions written for a client admitted with acute pancreatitis. Which PHCP prescription should the nurse verify if noted in the client's chart?

position the client supine and flat

the nurse is monitoring for stoma prolapse in a client with a colostomy. Which stoma observation should indicate that a prolapse has ocurred?

protruding and swollen

a pt who was diagnosed with hepatitis A states he was told by the CNA that his disease could be transmitted only through blood contact. The appropriate action by the nurse would be to:

provide the correct info to the pt and nursing assistant

a 45 yr old pt with liver disease is prescribed lactulose (chronulac) 30 ml every 6 hrs. Recognizing the action of this med in the treatment of liver disease, the nurse would expect to assess which positive response to the med?

reduced serum ammonia levels

the client has begun medication therapy with pancrelipase. The nurse evaluates that the medication is having the optimal intended benefit if which is observed?

reduction of steatorrhea

the client who frequently uses NSAIDDS has been taking misoprostol. The nurse determines that this med is having the intended therapeutic effect if which is noted?

relief of epigastric pain

when developing a teaching plan for a pt who has undergone a partial gastrectomy, which of the following would the nurse include r/t dumping syndrome?

resting in a semirecumbent position after eating

a pt is diagnosed with hep B. which of the following info, if obtained during the admission assessment, would indicate a risk factor?

she is an IV drug user

a pt has been admitted with severe diarrhea. The nurse bases his decision on whether to administer the prescribed antidiarrheal medication on the understanding that antidiarrheal medication:

should not be used until the cause of diarrhea has been determined

the nurse is monitoring for the early signs of dumping syndrome. Which indicates this occurence?

sweating and pallor

a pt loses a significant portion of the small intestine as a result of a gunshot wound. The nurse caring for the pt knows that this is likely to affect:

the absorption of most nutrients from food

An ultrasound of the gallbladder is scheduled for the client with a suspected diagnosis of cholecystitis. The nurse explains to the client that this test:

the test requires the client to lie still for short intervals

A client with ascites is scheduled for a paracentesis. The nurse is assisting the health care provider in performing the procedure. Which of the following positions will the nurse assist the client to assume for this procedure?

upright

the nurse is caring for a client with a diagnosis of chronic gastritis. The nurse anticipates that the client is at risk for vitamin deficiency in what?

vitamin b-12

which of the following would be an expected finding when assessing a pt who has central or upper body obesity?

waist circumference 38'', hip circumference 37''

when planning care for a pt who has a diagnosis of malnutrition, the nurse would include which of these goals?

will gain 1-2 lbs/ week