GI GU MED SURGE EXAM

Evaluate the client's understanding of the procedure

As a nurse completes the admission assessment of a client admitted for gastric bypass surgery, the client states, "finally! I'll be thin and able to eat without much concern." How should the nurse intervene?

metabolic acidosis

In a client with enteritis and frequent diarrhea, the nurse should anticipate:

Maintaining fluid balance

When Planning care for a client with a small-bowel obstruction, the nurse should consider the primary goal to be:

Hemoglobin levels and HCT

Which diagnostic test is used first to evaluate a client with upper GI bleeding?

voiding pattern

Which factor should be checked when evaluating the effectiveness of an alpha-adrenergic blocker given to a client with BPH?

gloves

Which infection control equipment is necessary for the client diagnosed with CDIF

the client reports engaging in a regular exercise regimen

Which outcome indicates effective client teaching to prevent constipation?

Liver

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

Tell the client he shouldn't eat or drink for 6-12 hours before the procedure & Inform the client that he'll receive a sedative before the procedure

While preparing a client for an upper GI endoscopy (espophagogastroduodenoscopy), the nurse should implement which interventions? select all that apply:

Continue to take antacids even if your symptoms subside

A client admitted for tx of a gastric ulcer is being prepared for discharge on antacid therapy. Discharge teaching should include which instructions?

cirrhosis

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:

Rupture of the appendix

A client is admitted from the emergency department with complaints of severe abdominal pain and an elevated white blood cell count. The physician diagnoses appendicitis. The nurse knows the client is at greatest risk for:

black and tarry

A client is admitted to the health care facility with a diagnosis of a bleeding gastric ulcer. The nurse expects this client's stools to be:

Vitamin B12

A client is admitted to the hospital with an exacerbation of is chronic gastritis. When assessing his nutritional status, the nurse should expect a deficiency in

corticosteroid therapy, antidiarrheal medications

A client is admitted with inflammatory bowel syndrome (Crohns disease). Which therapies should the nurse expect to be part of the care plan? Select all that apply.

"I appreciate your concern, but i can't give out any information"

A client is diagnosed with Crohn's disease after undergoing two weeks of testing. The client's boss calls the medical - surgical floor requesting to speak with the nurse-manager. He expresses concern over the client and explains that he must know the client's diagnosis for insurance purposes. Which response by the nurse is best?

"I didn't eat anything I shouldn't have; I just ate roast beef on rye bread"

A client is readmitted with an exacerbation of celiac disease 2 weeks after discharge. Which statement by the client indicates the need for a dietary consult?

Increasing fluid intake to prevent dehydration

A client is recovering from an ileostomy that was performed to treat IBD. during discharge teaching, the nurse should stress the importance of:

Ulcerative colitis

A client presents to the emergency department with complaints of acute GI distress, bloody diarrhea, weight loss, and fever. Which condition in the family history is most pertinent to the client's current health problem?

It has a short duration of action

A client takes 30 mls of magnesium hydroxide and aluminum hydroxide with simethicone (Maalox TC) P.O. 1 hour and 3 hours after each meal and at bedtime for treatment of a duodenal ulcer. Why does the client take this antacid so frequently?

Notify the physician

A client undergoes total gastrectomy. Several hours after surgery , the nurse notes that the client's nasogastric tube has stopped draining. How should the nurse respond?

Use sterile technique when irrigating the catheter

A client underwent transurethral of the prostate gland 24 hours ago and is on continuous bladder irrigation. Which nursing intervention is appropriate?

"I'm not at liberty to discuss your case with anyone except those directly involved in your care unless you authorize me to do so"

A client who is about to undergo gastric bypass surgery calls the nurse into the room. The client whispers to the nurse her concern that friends will learn about her upcoming surgery. She pleads with the nurse to keep her surgery a secret. Which response by the nurse is best?

Transurethral resection of the Prostate (TURP)

A client with BPH doesn't respond to medical tx and is admitted to the facility for prostate gland removal. Before providing preoperative and postoperative instructions to the client, the nurse asks the surgeon which prostatectomy procedure will be done. What is the most widely used procedure for prostate gland removal?

Administering morphine I.V. as ordered

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

Avoid aspirin and products that contain aspirin

A client with a peptic ulcer is about to begin a therapeutic regimen that includes a bland diet, antacids, and famotidine (Pepcid). Before the client is discharged, the nurse should provide which instruction?

surgery

A client with appendicitis is experiencing excruciating abdominal pain. An abdominal X-ray film reveals intraperotoneal air. The nurse should prepare the client for:

cryoprecipitate and fresh frozen plasma

A client with hepatitis C develops liver failure and GI hemorrhage. The blood products that most likely bring about hemostasis in the client are:

Blood supply to the stoma has been interrupted

A client with inflammatory bowel disease undergoes an ileostomy. On the first day after surgery, the nurse notes that the client's stoma appears dusky. How should the nurse interpret this finding?

Monitoring the client's weight everyday

A client with pancreatitis has been receiving total parenteral nutrition (TPN) for the past week. Which nursing intervention helps determine if TPN is providing adequate nutrition

water

A client with peptic ulcer disease is ordered aluminum-magnesium complex (Riopan). When teaching about this antacid preparation, the nurse should instruct the client to take it with:

hyperglycemia

A client with severe inflammatory bowel disease is receiving TPN. When administering, the nurse must take care to maintain the ordered flow rate because giving TPN too rapidly may cause

Atrophy of the gastric mucosa

A client, age 82, is admitted to an acute care facility for treatment of an acute flare-up of a chronic GI condition. In addition to assessing the client for complications of current illness, the nurse monitors for age-related changes in the GI tract. Which age related change increases the risk of anemia

The newly admitted client with acute abdominal pain

A graduate nurse and her preceptor are establishing priorities for their morning assessment. Which client should they assess first?

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

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

" I should increase my intake of fresh fruits and vegetables during remissions"

A home health nurse who sees a client with diverticulitis is evaluating teaching about dietary modifications necessary to prevent future episodes. Which statement made by the client indicates effective teaching?

Teaching the client about a bland diet

A nurse and a nursing assistant are caring for a paraplegic client admitted with peptic ulcer disease. Which intervention should be performed by the registered nurse?

administering IV fluids

A nurse caring for a client with small-bowel obstruction should plan to implement which nursing intervention first

"You have the right to refuse any medication. Would you like to discuss your feelings about this disease?"

A nurse is administering medications to a client diagnosed with hepatitis B. When the nurse hands the clients his medications, the client says, "I would rather not take that pill or any others. I know there is no cure for hepatitis B." the nurse recognizes that the client is expressing feelings of hopelessness about his diagnosis. Which response by the nurse respects the client's rights concerning medication administration?

Gently washing the area surrounding the stoma using a facecloth and mild soap

A nurse is applying an stony appliance to the ileostomy of a client with ulcerative colitis. which action is appropriate

IBD

A nurse is assessing a client and obtains the following findings: abdominal discomfort, mild diarrhea, blood pressure 100/80 mmHg, pulse rate 88, rest rate 20, temp 100

registered nurse

A nurse is assigning the care of a client admitted with appendicitis. She should assign this client's care to a:

acute pain

A nurse is caring for a client following an appendectomy. The nurse should assign which nursing diagnosis the highest priority?

duodenal ulcers

A nurse is caring for a client who is undergoing a diagnostic workup for a suspected GI problem. The client reports gnawing epigastric pain following meals and heartburn. The nurse suspects the client has:

Constipation

A nurse is caring for a client who just had an appendectomy. The client is receiving opioid analgesics routinely for pain. The nurse should focus her follow-up assessment on which complication?

drink liquids only between meals

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

aspiration

A nurse is caring for a client with an endotracheal tube who receives enteral feedings through a feeding tube. Before each tube feeding, the nurse checks for tube placement in the stomach as well as residual volume. The purpose of the nurse's actions are to prevent:

Determine if the client has had any more loose stools

A nurse is caring for a client with gastroenteritis. The nurse administers an as-needed dose of kaolin and pectin mixture (Kaopectate) as ordered. The nurse should complete which assessment 30 minutes after administering the medication

Prostate problems, UTI, liver failure

A nurse is caring for an elderly male client who complains that he can't pass urine. A bladder scan reveals 600 ml of urine present in the bladder. The nurse attempts to place the indwelling catheter the physician ordered, but resistance prevents her from placing it. A serum prostate-specific antigen (PSA) test indicates a level of 29 g/l. The physician places an indwelling catheter and the urine specimen returns positive for nitrites, leukocytes, and bacteriuria. Which conditions should the nurse suspect?

Oxygen saturation of 85%

A nurse is monitoring a client recovering from moderate sedation that was administered during a colonoscopy. Which finding requires the nurse's immediate attention?

paralytic ileus

A nurse is performing focused assessment on her clients. She expects to hear hypoactive bowel sounds in a client with:

Review the instructions with the person accompanying the client at home

A nurse is providing postprocedure instructions for a client who had an esophagogastroduodenoscopy. The nurse should perform which action?

alcohol abuse and smoking

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

" I need to use laxatives regularly to prevent constipation"

A nurse is teaching an elderly client about good bowel habits. Which statement by the client indicates to the nurse that additional teaching is required?

"The action occurs in the stomach by increasing the pH of the stomach contents and decreasing pepsin activity"

A nurse preceptor is working with a student nurse who is administering medications. Which statement by the student indicates an understanding of the action of an antacid

collect the specimen in a sterile container

A physician orders a stool culture to help diagnose a client with prolonged diarrhea. The nurse who obtains the stool specimen should:

requires assistance with ambulation

A registered nurse should assign a nursing student to care for a client with inflammatory bowel disease who:

continuous inflow and outflow of irrigation solution.

A triple lumen indwelling urinary catheter is inserted for continuous bladder irrigation following a transurethral resection of the prostate. In addition to the balloon inflation, the functions of the three lumens include:

Kegel exercises

After a radical prostatectomy for prostate cancer, a client has an indwelling catheter removed, the client then begins to have periods of incontinence. During the postoperative period, which intervention should be implemented first?

The client reports bladder spasms and the urge to void

After having transurethral resection of the prostate (TURP) , a client returns to the unit with a three-way indwelling urinary catheter and continuous bladder irrigation. Which finding suggests that the client's catheter is occluded?

Assess the irrigation catheter for patency and drainage

After undergoing transurethral resection of the prostate to treat BPH, a client returns to the room with continuous bladder irrigation. On the first day after surgery, the client reports bladder pain. What should the nurse do first.

Take a stool softener such as docusate sodium (solace) daily

An elderly client asks the nurse how to treat chronic constipation. What is the best recommendation the nurse can make

Vitamin K

During preparation for bowel surgery, a client receives an antibiotic to reduce intestinal bacteria. The nurse knows that hypoprothrobinemia may occur as a result of antibiotic therapy interfering with synthesis of which vitamin

Decrease the intestinal bacteria count

For a client who must undergo colon surgery, the physician orders preoperative cleansing enemas and neomycin. The rationale for neomycin use in this client is to:

MAO inhibitor

The nurse is checking the client's chart for possible contraindications, before administering meperidine (Demerol), 50 mg IM, to a client with pain after an appendectomy. The nurse should hold the meperidine when she sees an order for what type of drug?

maintaining fluid balance

When planning care for a client with a small bowel obstruction, the nurse should consider the primary goal to be:

Obstruction of the appendix reduces arterial flow, leading to ischemia, inflammation, and rupture of the appendix.

When preparing a client for surgery to treat appendicitis, the nurse formulates a nursing diagnosis of Risk for infection related to inflammation, perforation, and surgery. What is the rationale for choosing this nursing diagnosis?

present with a rigid, birdlike abdomen

Which client requires immediate nursing intervention? the client who:

Pancreatitis

Which condition is most likely to have a nursing diagnosis of fluid volume defect?

Irrigate the tube with cola

While a client is being prepared for discharge, the nasogastric (NG) feeding tube becomes clogged. To remedy this problem and teach the client's family how to deal with it at home, what should the nurse do?

Antacids

While obtaining a client's medication history , the nurse learns that the client takes ranitidine (Zantac), as ordered, to treat a peptic ulcer. The nurse continues gathering medication history data to assess for potential drug interactions. The nurse should intervene when she learns the client takes which class of drugs

administer breathing treatments, as ordered, and closely assess the client's respiratory status

While reviewing the admission assessment of a client scheduled for colorectal surgery, the nurse discovers that the client stopped taking her medications to treat emphysema 3 months ago. When questioned, the client states that she stopped taking the meds because she couldn't afford them. The nurse should collaborate with the respiratory therapist to plan care for this client to: