Lipincott Adult GI
A client with diverticular disease is receiving psyllium hydrophilic mucilloid (Metamucil). The drug has been effective when the client tells the nurse that he: A. Passes stool without cramping. B. Does not have diarrhea any longer. C. has firm, well-formed stool. D. Does not expel gas like he used to.
Ans A; Passes stool without cramping.
Which goal for the client's care should take priority during the first days of hospitalization for an exacerbation of ulcerative colitis? A. Promoting self-care and independence. B. Managing diarrhea. C. Maintaining adequate nutrition. D. Promoting rest and comfort.
Ans B; Managing diarrhea
An adult with appendicitis has severe abdominal pain. Which action will be the most effective to assist the client to manage pain prior to surgery? A. Place the client in semi-fowlers position B. Apply moist heat to the abdomen C. Teach client to massage the painful area D. Provide distraction with music
Ans A; Place the client in semi-fowlers position
A client is receiving Total Parenteral Nutrition (TPN) soulution. The nurse should assess a client's ability to metabolize the TPN solution adequately by monitoring the client for which of the following signs? A. Tachycardia. B. Hypertension. C. Elevated blood urea nitrogen concentration. D. Hyperglycemia.
Ans D; Hyperglycemia.
The client with an intestinal obstruction continues to have acute pain even though the nasoenteric tube is patent and draining. The nurse should first: A. Reassure the client that the nasoenteric tube is functioning. B. Assess the client for a rigid abdomen. C. Administer an opioid as ordered. D. Reposition the client on the left side.
Ans B; Assess the client for a rigid abdomen.
Which of the following adverse effects would the nurse expect the client to exhibit in the event of too rapid an infusion of TPN solution? A. Negative nitrogen balance. B. Circulatory overload. C. Hypoglycemia. D. Hypokalemia.
Ans B; Circulatory overload.
Which of the following diets would be most appropriate for the client with ulcerative colitis? A. High-calorie, low-protein. B. High-protein, low-residue. C. Low-fat, high-fiber. D. Low-sodium, high-carbohydrate.
Ans B; High-protein, low-residue.
Which of the following should be a priority focus of care for a client experiencing an exacerbation of Crohn's disease? A. Encouraging regular ambulation. B. Promoting bowel rest. C. Maintaining current weight. D. Decreasing episodes of rectal bleeding.
Ans B;
A client who has a history of Crohn's disease is admitted to the hospital with fever, diarrhea, cramping, abdominal pain, and weight loss. The nurse should monitor the client for: A. Hyperalbuminemia. B. Thrombocytopenia. C. Hypokalemia. D. Hypercalcemia.
Ans C; Hypokalemia.
A client with inflammatory bowel disease is receiving total parenteral nutrition (TPN). The basic component of the client's TPN solution is most likely to be: A. An isotonic dextrose solution. B. A hypertonic dextrose solution. C. A hypotonic dextrose solution. D. A colloidal dextrose solution.
Ans B; A hypertonic dextrose solution.
A nurse is assisting with the removal of a CVAD. The nurse should: A. turn the client on the left side B. have the client exhale slowly and evenly C. elevate the head of the bed D. Instruct the client to take a deep breath and hold it
Ans D; Instruct the client to take a deep breath and hold it
A client is admitted to the hospital with a diagnosis of cholecystitis from cholelithiasis. The client has severe abdominal pain, nausea, and has vomited several times. Based on these data, which nursing diagnosis would have the highest priority for intervention at this time? A. Manage anxiety B. Restore fluid loss C. Manage the pain D. Replace nutritional loss
Ans C; Manage the pain
The nurse administers fat emulsion solution during TPN as ordered based on the understanding that this type of solution: A. Provides essential fatty acids. B. Provides extra carbohydrates. C. Promotes effective metabolism of glucose. D. Maintains a normal body weight.
Ans A; Provides essential fatty acids.
A client with a peptic ulcer reports epigastric pain that frequently causes the client to wake up during the night. The nurse should instruct the client to do which activities? Select all that apply. A. obtain adequate rest to reduce stimulation B. Eat small, frequent meals throughout the day C. Take all medications on time as prescribed D. Sit up for 1 hour when awakened at night E. Stay away from crowded areas
Ans A, B, C, D
A client with ulcerative colitis is to take sulfasalazine. Which instructions should the nurse give the client about taking this medication at home? Select all that apply. A. Drink enough fluids to maintain a urine output of at least 1.200-1,500 ml/day B. Discontinue therapy is symptoms of acute intolerance develop, and notify the HCP C. Stop taking the medication if the urine turns orange-yellow D. avoid activities that require alertness E. If dose is missed, skip and continue with the next dose
Ans A, B, D
A client who has had ulcerative colitis for the past 5 years is admitted to the hospital with an exacerbation of the disease. Which factor is of greatest significance in causing an exacerbation of ulcerative colitis? A. a demanding and stressful job B. changing to a modified vegetarian diet C. beginning a weight-training program D. walking 2 miles every day
Ans A; a demanding and stressful job
A client who has ulcerative colitis has persistent diarrhea and has lost 12 lb since the exacerbation of the disease. which approach will be most effective in helping the client meet nutritional needs? A. continuous eternal feedings B. following a high-calorie, high protein diet C. TPN D. eating six small meals a day
Ans C; TPN Promotes bowel rest
A client admitted to the hospital after vomiting bright red blood and is diagnosed with a bleeding duodenal ulcer. The client develops a sudden, sharp pain in the midepigastric region along with a rigid, board-like abdomen. After obtaining the client's vital signs, what should the nurse do next? A. Administer pain medications as prescribed B. Raise the head of the bed C. Prepare to insert a NG tube D. Notify the HCP
Ans D; Notify the HCP Experiencing a perforation, medical emergency
A client with acute appendicitis develops a fever, tachycardia, and hypotension. Based on these assessment findings, the nurse should further assess the client for which of the following complications? A. Deficient fluid volume. B. Intestinal obstruction. C. Bowel ischemia. D. Peritonitis.
Ans D; Peritonitis.
The nurse should teach the client with diverticulitis to integrate which of the following into a daily routine at home? A. Using enemas to relieve constipation. B. Decreasing fluid intake to increase the formed consistency of the stool. C. Eating a high-fiber diet when symptomatic with diverticulitis. D. Refraining from straining and lifting activities.
Ans D; Refraining from straining and lifting activities.
A client has undergone a laparoscopic cholecystectomy. Which of the following instructions should the nurse include in the discharge teaching? A. Empty the bile bag daily. B. If you become nauseated, breathe deeply into a paper bag. C. Keep adhesive dressings in place for 6 weeks. D. Report bile-colored drainage from any incision.
Ans D; Report bile-colored drainage from any incision.
After a cholecystectomy, the client is to follow a low-fat diet. Which of the following foods would be most appropriate to include in a low-fat diet? A. Cheese omelet. B. Peanut butter. C. Ham salad sandwich. D. Roast beef.
Ans D; Roast beef.
A client who has had ulcerative colitis says to the nurse, "I cannot take this anymore; I am constantly in pain, and I cannot leave my room because I need to stay by the toilet. I do not know how to deal with this." Based on these comments, the nurse should determine the client is experiencing: A. extreme fatigue B. disturbed thought C. a sense of isolation D. difficulty coping
Ans D; difficulty coping
A client with PUD is taking ranitidine. What is the expected outcome of this drug? A. heal the ulcer B. protect the ulcer surface from acids C. reduce acid concentration D. limit gastric acid secretion
Ans D; limit gastric acid secretion
A client admitted to the hospital with PUD tells the nurse about having black, tarry stools. The nurse should: A. encourage the client to increase fluid intake B. advise the client to avoid iron-rich foods C. place the patient on contact precautions D. report the finding to the HCP
Ans D; report the finding to the HCP Important warning sign of bleeding in PUD
A client diagnosed with PUD has an H. pylori infection. The client is following a 2-week drug regimen that includes clarithromycin along with omeprazole and amoxicillin. The nurse should instruct the client to: A. alternate the use of the drugs B. Take the drugs at different times of the day C. discontinue all drugs if nausea occurs D. take the drugs for the entire 2-week period
Ans D; take the drugs for the entire 2-week period
Which foods should the nurse encourage a client with diverticulosis to incorporate into the diet? Select all that apply. A. Bran cereal. B. Broccoli. C. Tomato juice. D. Navy beans. E. Cheese.
Ans A, B, D
A client with diverticulitis has developed peritonitis following diverticular rupture. The nurse should assess the client to determine which of the following? Select all that apply. A. Percuss the abdomen to note resonance and tympany. B. Percuss the liver to note lack of dullness. C. Monitor the vital signs for fever, tachypnea, and bradycardia. D. Assess presence of polyphagia and polydipsia. E. Auscultate bowel sounds to note frequency.
Ans A, B, E
When obtaining a nursing history from a client with a suspected gastric ulcer, which signs and symptoms should the nurse assess? Select all that apply. A. epigastric pain at night B. relief of epigastric pain after eating C. Vomiting D. weight loss E. melena
Ans C, D, E
After a client who has had a laparoscopic cholecystectomy receives discharge instructions, which of the following client statements would indicate that the teaching has been successful? Select all that apply. A. "I can resume my normal diet when I want." B. "I need to avoid driving for about 4 weeks." C. "I may experience some pain in my right shoulder." D. "I should spend 2 to 3 days in bed before resuming activity." E. "I can take a shower 2 days later"
Ans A, C, E
A nurse is assessing a client who has been admitted with a diagnosis of an obstruction in the small intestine. The nurse should assess the client for? Select all that apply. A. Projectile vomiting. B. Significant abdominal distention. C. Copious diarrhea. D. Rapid onset of dehydration. E. Increased bowel sounds.
Ans A, D, E
A client's stools are light gray in color. The nurse should assess the client further for which of the following? Select all that apply. A. Intolerance to fatty foods. B. Fever. C. Jaundice. D. Respiratory distress. E. Pain at McBurney's point. F. Peptic ulcer disease.
Ans A,B,C
Which of the following interventions should the nurse include in the client's plan of care to prevent complications associated with TPN administered through a central line? Select all that apply A. use strict aseptic technique for all dressing changes B. Tape all connections of the system. C. Encourage bed rest. D. Cover the insertion site with a moisture-proof dressing.
Ans A,B,D
What should the nurse tell the client who is preparing for insertion of a nasoduodenal tube? Select all that apply. A. The nose and throat will be numbed with a vicious anesthetic B. The tube will be placed at the bedside C. X-rays with the use of contrast dye will be used to verify placement D. The client will be closely monitored for 30 minutes following the procedure E. The tube will be taped to the nose
Ans A,C,D,E
Using a sliding-scale schedule, the nurse is preparing to administer an evening dose of regular insulin to a client who is receiving total parenteral nutrition (TPN). Which action is most appropriate for the nurse to take to determine the amount of insulin to give? A. Base the dosage on the glucometer reading of the client's glucose level obtained immediately before administering the insulin. B. Base the dosage on the fasting blood glucose level obtained earlier in the day. C. Calculate the amount of TPN fluid the client has received since the last dose of insulin and adjust the dosage accordingly. D. Assess the client's dietary intake for the evening meal and snack and adjust the dosage accordingly.
Ans A; Base the dosage on the glucometer reading of the client's glucose level obtained immediately before administering the insulin.
The nurse is aware that the diagnostic tests typically ordered for acute diverticulitis do not include a barium enema. The reason for this is that a barium enema: A. Can perforate an intestinal abscess. B. Would greatly increase the client's pain. C. Is of minimal diagnostic value in diverticulitis. D. Is too lengthy a procedure for the client to tolerate.
Ans A; Can perforate an intestinal abscess.
The physician orders intestinal decompression with a Cantor tube for a client with an intestinal obstruction. In order to determine effectiveness of intestinal decompression the nurse should evaluate the client to determine if: A. Fluid and gas have been removed from the intestine. B. The client has had a bowel movement. C. The client's urinary output is adequate. D. The client can sit up without pain.
Ans A; Fluid and gas have been removed from the intestine.
A client with cholecystitis continues to have severe right upper quadrant pain. The nurse obtains the following vital signs: temperature 38.4° C; pulse 114; respirations 22; blood pressure 142/90. Using the SBAR (Situation-Background-Assessment-Recommendation) technique for communication, the nurse recommends to the primary care provider for the client to receive: A. Hydromorphone I.V. B. Diltiazem PO. C. Meperidine I.M. D. Promethazine IM
Ans A; Hydromorphone I.V.
A client who has been scheduled to have a choledocholithotomy expresses anxiety about having surgery. Which nursing intervention would be the most appropriate to achieve the outcome of anxiety reduction? A. Providing the client with information about what to expect postoperatively. B. Telling the client it is normal to be afraid. C. Reassuring the client by telling her that surgery is a common procedure. D. Stressing the importance of following the physician's instructions after surgery.
Ans A; Providing the client with information about what to expect postoperatively.
The nurse is caring for a client who has just had an upper GI endoscopy. The client's vital signs must be taken every 30 minutes for 2 hours after the procedure. The nurse assigns an UAP to take the vital signs. One hour later, the UAP reports the client, who was previously afebrile, has developed a temp of 101.8 F. The nurse should: A. promptly assess the client for potential perforation B. tell the assistant to change thermometers and retake the temperature C. plan to give the client acetaminophen to lower the temp D. ask the UAP to bathe the client with tepid water
Ans A; promptly assess the client for potential perforation
Two weeks before a client was scheduled for an ileostomy, and the nurse should instruct the client to: A. stop taking drugs that will interfere with clotting (aspirin, ibuprofen) B. follow a low-residue diet C. abstain from having sex D. report having a temp above 99 F
Ans A; stop taking drugs that will interfere with clotting (aspirin, ibuprofen)
TPN is ordered for a client with Crohn's disease. Which of the following indicate the TPN soloution is having an intended outcome? A. the client's nutritional needs are met B. The client does not have metabolic acidosis. C. The client is hydrated. D. The client is in a negative nitrogen balance.
Ans A; the client's nutritional needs are met
A client with PUD reports being nauseated most of the day and now feeling light-headed and dizzy. Based upon these findings, which nursing actions would be most appropriate for the nurse to take? Select all that apply. A. administering an antacid hourly until nausea subsides B. monitoring the clients Vital signs C. notifying the HCP of the symptoms D. initiating oxygen therapy E. reassessing the client in an hour
Ans B, C
The nurse is caring for a client who has had a gastroscopy. Which findings indicate that the client is developing a complication related to the procedure? Select all that apply. A. The client has a sore throat B. The client has a temp of 100 f C. Client appears drowsy following the procedure D. The client has epigastric pain E. The client experiences hematemesis
Ans B, D, E
The nurse finds the client who has had an ileostomy crying. The client explains to the nurse, "I'm upset because I know I won't be able to have children now that I have an ileostomy." Which of the following would be the best response for the nurse? A. "Many women with ileostomies decide to adopt. Why don't you consider that option?" B. "Having an ileostomy does not necessarily mean that you can't bear children. Let's talk about your concerns." C. "I can understand your reasons for being upset. Having children must be important to you." D. "I'm sure you will adjust to this situation with time. Try not to be too upset."
Ans B; "Having an ileostomy does not necessarily mean that you can't bear children. Let's talk about your concerns."
The nurse is teaching the client how to care for her ileostomy. The client asks the nurse how long she can wear her pouch before changing it. The nurse responds: A. "The pouch is changed only when it leaks." B. "You can wear the pouch for about 4 to 7 days." C. "You should change the pouch every evening before bedtime." D. "It depends on your activity level and your diet."
Ans B; "You can wear the pouch for about 4 to 7 days."
A 40-year-old client is admitted to the hospital with a diagnosis of acute cholecystitis. The nurse should contact the physician to question which of the following orders? A. I.V. fluid therapy of normal saline solution to be infused at 100 mL/hour until further orders. B. Administer morphine sulfate 10 mg I.M. every 4 hours as needed for severe abdominal pain. C. Nothing by mouth (NPO) until further orders. D. Insert a nasogastric tube and connect to low intermittent suction.
Ans B; Administer morphine sulfate 10 mg I.M. every 4 hours as needed for severe abdominal pain.
A client with Crohn's disease has concentrated urine, decreased urinary output, dry skin with decreased turgor, hypotension, and weak, thready pulses. The nurse should do which of the following first? A. Encourage the client to drink at least 1,000 mL per day. B. Provide parenteral rehydration therapy ordered by the physician. C. Turn and reposition every 2 hours. D. Monitor vital signs every shift.
Ans B; Provide parenteral rehydration therapy ordered by the physician.
A client who is scheduled for an ileostomy has an order for oral neomycin (Mycifradin) to be administered before surgery. The intended outcome of administering oral neomycin before surgery is to: A. Prevent postoperative bladder infection. B. Reduce the number of intestinal bacteria. C. Decrease the potential for postoperative hypostatic pneumonia. D. Increase the body's immunologic response to the stressors of surgery.
Ans B; Reduce the number of intestinal bacteria.
After insertion of a nasoenteric tube, the nurse should place the client in which position? A. Supine. B. Right side-lying. C. Semi-Fowler's. D. Upright in a bedside chair.
Ans B; Right side-lying.
A client has anemia resulting from bleeding from ulcerative colitis and is to receive two units of packed RBCs. The client is receiving an infusion of TPN. In preparing to administer PRBCs, what should the nurse do to ensure client comfort and safety? A. Discontinue the TPN infusion B. Start an IV infusion of normal saline C. Administer PRBCs in the same IV as the TPN D. Wait until the TPN infusion is completed, and use the same IV line to infuse the PRBCs
Ans B; Start an IV infusion of normal saline
A client newly diagnosed with ulcerative colitis who has been placed on steroids asks the nurse why steroids are prescribed. The nurse should tell the client: A. Ulcerative colitis can be cured by the use of steroids B. Steroids are used in severe flare-ups because they can decrease the incidence of bleeding C. long-term use of steroids will prolong periods of remission D. The side effects of steroids outweigh their benefits to clients with ulcerative colitis
Ans B; Steroids are used in severe flare-ups because they can decrease the incidence of bleeding
Which is an expected outcome for a client with PUD? The client will: A. demonstrate appropriate use go analgesics to control pain B. explain the rationale for eliminating alcohol from the diet C. verbalize the importance of monitoring hemoglobin and hematocrit every 3 mos D. eliminate in engaging in contact sports
Ans B; explain the rationale for eliminating alcohol from the diet
A client has been placed on long-term sulfasalazine therapy for treatment of ulcerative colitis. The nurse should encourage the client to eat which foods to help avoid the nutrient deficiencies that may develop as a result of this medication? A. citrus fruits B. green, leafy vegetables C. Eggs D. milk products
Ans B; green, leafy vegetables
TPN is prescribed for a client who has recently had a small and large bowel resection and who is currently not taking anything by mouth. The nurse should: A. administer TPN through a NG or gastrostomy tube B. handle TPN using strict aseptic technique C. auscultate for the presence of bowel sounds prior to administering TPN D. designate a peripheral IV site for TPN administration
Ans B; handle TPN using strict aseptic technique
Postoperative nursing care for a client after an appendectomy should include: A. administering sitz baths four times a day B. noting the first bowel movement after surgery C. Limiting the client's activity to bathroom privileges D. measuring abdominal girth every 2 hours
Ans B; noting the first bowel movement after surgery
A client who has had an appendectomy for a perforated appendix returns from surgery with a drain inserted in the incisional site. The purpose of the drain is to: A. Provide access for a wound irrigation B. promote drainage of wound exudate C. minimize development of scar tissue D. decrease postoperative discomfort
Ans B; promote drainage of wound exudate
The client with ulcerative colitis is to be on bed rest with bathroom privileges. When evaluating the effectiveness of this level of activity, the nurse should determine if the client has: A. conserved energy B. reduced intestinal peristalsis C. obtained needed rest D. minimized stress
Ans B; reduced intestinal peristalsis
After instructing a client with diverticulosis about appropriate self-care activities, which of the following client comments indicate effective teaching? Select all that apply. A. "With careful attention to my diet, my diverticulosis can be cured." B. "Using a cathartic laxative weekly is okay to control bowel movements." C. "I should follow a diet that's high in fiber." D. "It is important for me to drink at least 2,000 mL of fluid every day." E. "I should exercise regularly."
Ans C, D, E
A client undergoes a laparoscopic cholecys-tectomy. Which of the following dietary instructions should the nurse give the client immediately after surgery? A. "You cannot eat or drink anything for 24 hours." B. "You may resume your normal diet the day after your surgery." C. "Drink liquids today and eat lightly for a few days." D. "You can progress from a liquid to a bland diet as tolerated."
Ans C; "Drink liquids today and eat lightly for a few days."
The nurse evaluates the client's understanding of ileostomy care. Which of the following statements indicates that discharge teaching has been effective? A. "I should be able to resume weight lifting in 2 weeks." B. "I can return to work in 2 weeks." C. "I need to drink at least 3,000 mL a day of fluid." D. "I will need to avoid getting my stoma wet while bathing."
Ans C; "I need to drink at least 3,000 mL a day of fluid."
The nurse should instruct the client with an ileostomy to report which of the following signs and symptoms immediately? A. Passage of liquid stool from the stoma. B. Occasional presence of undigested food in the effluent. C. Absence of drainage from the ileostomy for 6 or more hours. D. Temperature of 99.8 ° F (37.7 ° C).
Ans C; Absence of drainage from the ileostomy for 6 or more hours. If onset of severe abdominal pain was there instead that should also be reported immediatley
The client asks the nurse, "Is it really possible to lead a normal life with an ileostomy?" Which action by the nurse would be the most effective to address this question? A. Have the client talk with a member of the clergy about these concerns. B. Tell the client to worry about those concerns after surgery. C. Arrange for a person with an ostomy to visit the client preoperatively. D. Notify the surgeon of the client's question.
Ans C; Arrange for a person with an ostomy to visit the client preoperatively.
When a client has an acute attack of diverticulitis, the nurse should first: A. prepare the client for a colonoscopy B. encourage the client to eat a high-fiber diet C. Assess the client for signs of peritonitis D. Encourage the client to drink a glass of water every 2 hours
Ans C; Assess the client for signs of peritonitis
A client has an open cholecystectomy with bile duct exploration. Following surgery, the client has a T-tube. To evaluate the effectiveness of the T-tube, the nurse should: A. Irrigate the tube with 20 mL of normal saline every 4 hours. B. Unclamp the T-tube and empty the contents every day. C. Assess the color and amount of drainage every shift. D. Monitor the multiple incision sites for bile drainage.
Ans C; Assess the color and amount of drainage every shift.
The nurse is caring for a client 1 day after having a colectomy. The client is lethargic and difficult to arouse; the temperature is 101.5 F blood pressure is 92/36, and heart rate is 114 bpm with SpO2 of 88% on oxygen at 2L/min (previously 94%). A saline lock has been established and is patent. Which prescription should the nurse implement first? A. obtain stat portable chest x-ray B. Administer vancomycin IV C. Draw blood cultures D. Insert an indwelling urinary catheter
Ans C; Draw blood cultures
Which of the following discharge instructions would be appropriate for a client who has had a laparoscopic cholecystectomy? A. Avoid showering for 48 hours after surgery. B. Return to work within 1 week. C. Leave dressings in place until you see the surgeon at the postoperative visit. D. Use acetaminophen (Tylenol) to control any fever.
Ans C; Leave dressings in place until you see the surgeon at the postoperative visit.
A client has returned to the medical surgical unit after having surgery to create an ileostomy. Which goal has the highest priority at this time? A. Providing relief from constipation. B. Assisting the client with self-care activities. C. Maintaining fluid and electrolyte balance. D. Minimizing odor formation.
Ans C; Maintaining fluid and electrolyte balance.
The nurse is changing the subclavian dressing of a client who is receiving total parenteral nutrition. When assessing the catheter insertion site, the nurse notes the presence of yellow drainage from around the sutures that are anchoring the catheter. Which action should the nurse take first? A. Clean the insertion site and redress the area. B. Document assessment findings in the client's chart. C. Obtain a culture specimen of the drainage. D. Check the clients temp
Ans C; Obtain a culture specimen of the drainage.
A client is scheduled for an ileostomy. Which of the following interventions would be most helpful in preparing the client psychologically for the surgery? A. Include family members in preoperative teaching sessions. B. Encourage the client to ask questions about managing an ileostomy. C. Provide a brief, thorough explanation of all preoperative and postoperative procedures. D. Invite a member of the ostomy association to visit the client.
Ans C; Provide a brief, thorough explanation of all preoperative and postoperative procedures.
Three weeks after the client has had an ileostomy, the nurse is following up with instruction about using a skin barrier around the stoma at all times. The client has been applying the skin barrier correctly when: A. There is no odor from the stoma. B. The client is adequately hydrated. C. There is no skin irritation around the stoma. D. The client only changes the ostomy pouch once a day.
Ans C; There is no skin irritation around the stoma.
The nurse is teaching a client with a peptic ulcer about the diet that should be followed after discharge. The nurse should explain that the diet should include: A. bland foods B. high-protein foods C. any foods that are tolerated D. a glass of milk with each meal
Ans C; any foods that are tolerated
A client is to take one daily dose of ranitidine at home to treat peptic ulcer. The client understands proper drug administration of ranitidine when the client will take the drug: A. before meals B. with meals C. at bedtime D. when pain occurs
Ans C; at bedtime
A client has had an exacerbation of ulcerative colitis with cramping and diarrhea persisting longer than 1 week. The nurse should assess the client for which complication? A. heart failure B. deep vein thrombosis C. hypokalemia D. hypocalcemia
Ans C; hypokalemia
A client has been taking aluminum hydroxide 30 ml six times per day at home to treat a peptic ulcer. The client has been unable to have a bowel movement for 3 days. Based on this information, the nurse would determine that the most likely cause of the client's constipation is because the client: A. has not been including enough fiber in the diet B. needs to increase the daily exercise C. is experiencing an adverse effect of the aluminum hydroxide D. has developed a GI obstruction
Ans C; is experiencing an adverse effect of the aluminum hydroxide
A client with PUD is admitted to the hospital for a gastric resection. The client reports a sudden sharp pain in the midepigastric area that radiates to the shoulder. The nurse should first: A. establish an IV line B. administer pain medication C. notify the surgeon D. call for a stat ECG
Ans C; notify the surgeon
A client with a well-managed ilesostomy calls the nurse to report the sudden onset of abdominal cramps, vomiting, and watery discharge from the ileostomy. The nurse should: A. Tell the client to take an antiemetic. B. Encourage the client to increase fluid intake to 3 L/ day to replace fluid lost through vomiting. C. Instruct the client to take 30 mL of milk of magnesia to stimulate a bowel movement. D. Advise the client to notify the physcian.
Ans D; Advise the client to notify the physician. All are likely symptoms of an obstruction.
A nurse is providing wound care to a client 1 day after the client underwent an appendectomy. A drain was inserted into the incisional site during surgery. Which action should the nurse perform when providing wound care? A. Remove the dressing and leave the incision open to air. B. Remove the drain if wound drainage is minimal. C. Gently irrigate the drain to remove exudate. D. Clean the area around the drain moving away from the drain.
Ans D; Clean the area around the drain moving away from the drain.
Which of the following should the nurse interpret as an indication of a complication after the first few days of TPN therapy? A. Glycosuria. B. A 1- to 2-pound weight gain. C. Decreased appetite. D. Elevated temperature.
Ans D; Elevated temperature.
Before abdominal surgery for an intestinal obstruction, the nurse monitors the client's urine output and finds that the total output for the past 2 hours was 35 mL. The nurse then assesses the client's total intake and output over the last 24 hours and notes that he had 2,000 mL of I.V. fluid for intake, 500 mL of drainage from the nasogastric tube, and 700 mL of urine for a total output of 1,200 mL. This would indicate which of the following? A. Decreased renal function. B. the nasogastric tube is not draining well C. Extension of the obstruction. D. Inadequate fluid replacement.
Ans D; Inadequate fluid replacement.
A client is taking an antacid for treatment of a peptic ulcer. Which statement best indicates that the client understands how to correctly take the antacid? A. I should take my antacid before I take my other medications B. I need to decrease my intake of fluids so that I do not dilute the effects of my antacid C. My antacid will be most effective if I take it whenever I experience stomach pains D. It is best for me to take my antacid 1-3 hours after meals
Ans D; It is best for me to take my antacid 1-3 hours after meals
The nurse discovers that a client's TPN solution was running at an incorrect rate and is now 2 hours behind schedule. Which action is most appropriate for the nurse to take to correct the problem? A. Readjust the solution to infuse the desired amount B. Continue the infusion at the current rate, but run the the next bottle at an increased rate C. Double the infusion rate for 2 hours D. Notify the HCP
Ans D; Notify the HCP
