Med surg 2 GI ATI

A nurse admits a client to the emergency department who reports nausea and vomiting that worsens when he lies down. Antacids do not help. The provider suspects acute pancreatitis. Which of the following laboratory tests results should the nurse expect to see?

increased serum amylase

A nurse at a provider's office is instructing a client who is scheduled for an outpatient barium swallow. Which of the following statements by the client indicates an understanding of the teaching? "I can have clear liquids up to 4 hours before the test." "I should expect light-colored stools after the procedure." "I will require an IV catheter for this test." "I need to bring a snack because I'll be here all day."

"I should expect light-colored stools after the procedure." The client should expect bowel movements after the procedure to appear white, which indicates presence of the barium. The client can require a cathartic medication to promote bowel movement after the procedure.

A nurse is providing teaching about ileostomy care to a client. Which of the following statements by the client indicates a need for further teaching?

"I will be certain to take enteric-coated medications."

A nurse is providing information about pain control for a client who has acute pain following a subtotal gastric resection. Which of the following client statements indicates an understanding of pain control?

"I will call for pain medication before the previous dose wears off."

A nurse is instructing a client who has GERD about positions that can help minimize the effects of reflux during sleep. Which of the following statements indicates to the nurse that the client understands the instructions?

"I will lie on my right side to sleep at night." Sleeping in a right side-lying position helps reduce the manifestations of nighttime reflux. The client can also elevate the head of the bed about 10.2 cm (4 in) to 30.5 cm (12 in) on blocks.

A nurse is caring for a client who is 9 days postoperative following a total laryngectomy. The nurse removes the client's NG tube and initiates oral feedings. Which of the following statements would the nurse be correct is saying?

"It is no longer possible for you to choke on or aspirate food."

A nurse is teaching a client who is preoperative for a colectomy. The client asks the nurse why he needs a large-bore NG tube. How will the nurse respond to this question?

"The tube will remove gas and fluid from your stomach" The nurse should inform the client that the NG tube will decompress the stomach of gas and fluid in order to allow the bowel to rest.

A nurse is teaching a client who has a hiatal hernia about dietary recommendations. Which of the following client statements indicates an understanding of the teaching?

- "I will consume less caffeine and fewer spicy foods." - "I will sleep with the head of my bed elevated." - "I will try not to gain weight."

A nurse is planning care for a client who has cirrhosis of the liver. Which of the following actions should the nurse include in the plan?

- Administer furosemide - Implement a low-sodium diet - Measure the client's abdominal girth

A nurse is teaching a client who has a history of ulcerative colitis and a new diagnosis of anemia. Which of the following manifestations of colitis should the nurse identify as a contributing factor to the development of the anemia?

Chronic blood loss

A nurse is providing teaching for a client who has gastroesophageal reflux disease (GERD) about ways to manage his condition. Which of the following instructions should the nurse include?

Eat four small meals each day

A nurse is reviewing the laboratory data of a client who has acute pancreatitis. The nurse should expect to find an elevation of which of the following lab values? Caclium RBC count Magnesium Amylase

Amylase

A nurse is caring for a client who has gastrointestinal bleeding. Which of the following actions should the nurse take first?

Assess blood pressure

A nurse is preparing dietary instructions for a client who has episodes of biliary colic from chronic cholecystitis. What instructions should the nurse include in the teaching plan?

Avoid foods high in fat Rationale: The nurse should instruct the client to follow a low-fat diet to decrease episodes of biliary colic. A client who has chronic cholecystitis has intolerance to fatty foods.

A nurse is teaching a client who has a prescription of a nasogastric tube (NG) to treat a pyloric obstruction. Which of the following rationales for the use of the nasogastric tube should the nurse include in the teaching? Determine the pH of the gastric secretions. Supply nutrients via tube feedings. Decompress the stomach. Administer medications.

Decompress the stomach.

A nurse is caring for a client who has a postoperative ileus and an NG tube that has drained 2,500 mL in the past 6 hr. Which of the following electrolyte imbalances should the nurse monitor the client for?

Decreased potassium level Hypokalemia is an electrolyte imbalance in which the serum potassium level is less than 3.5 mEq/L. Hypokalemia may be the result of diuretic use, diarrhea, vomiting, and prolonged nasogastric suctioning.

While assessing a client who is receiving continuous IV therapy via his left forearm, a nurse notes that the site is red, swollen and painful and that the surrounding tissues are hard. Which of the following actions should the nurse take first? Discontinue existing IV live Initiate a new IV line in the opposite extremity Apply a hot packt to the irritated site Determine if the client needs to continue IV therapy

Discontinue the existing IV line

A nurse is caring for a client who has liver cirrhosis with ascites, bleeding esophageal varices, and portal hypertension. The nurse recognizes which of the following laboratory findings as indicating the client's gastrointestinal (GI) tract is digesting and absorbing blood?

Elevated Blood Urea Nitrogen elevated BUN is an indication of GI bleed, chloride levels are not affected, bilirubin levels RISE with cirrhosis

A nurse is planning care for a client who has hepatitis B. Which of the following interventions should the nurse include in the plan?

Encourage short periods of ambulation. The nurse should encourage a client who has hepatitis B to alternate between activity and rest.

A nurse is caring for a client who reports having chronic constipation. Which of the following herbal supplements should the nurse recommend?

Flaxseed

A nurse is caring for a client following an esophagogastroduodenoscopy (EGD) procedure. Which of the following assessments is the nurse's priority.

Gag reflex

A nurse is caring for a client who cirrhosis. When delivering the clients lunch tray which of the fooling food selection requires intervention by the nurse?

Ham sandwich

A nurse is assessing a client who has peptic ulcer disease. Which of the following findings should the nurse identify as the priority?

Hematemesis When using the urgent vs. non-urgent approach to client care, the nurse should determine that the priority is hematemesis, which indicates massive bleeding

A nurse is planning care for a client who is postoperative and at risk for paralytic ileus. Which of the following interventions should the nurse plan to take to promote peristalsis?Increase ambulation. Decrease fluid intake. Increase protein intake. Offer the client the bedpan every 2 hr.

Increase ambulation. Decreased bowel motility is an adverse effect of anesthesia. The nurse should encourage the client to ambulate and increase fiber intake as prescribed to promote a return of bowel function and reduce the risk for paralytic ileus.

A nurse is providing discharge instructions for a client who is post-op following inner maxillary fixation with wiring. which of the following information should the nurse include?

Keep wire cutters with you.

A nurse is caring for a client who has a gastric ulcer. Which of the following herbal supplements should the nurse recommend?

Licorice

A nurse is caring for a client who is postoperative following abdominal surgery. Which of the following findings should indicate to the nurse the client's peristalsis is returning? Hypoactive bowel sounds in two quadrants Request for a cup of tea and some toast Passage of flatus Abdominal distention

Passage of flatus

A nurse is planning care for a client with viral hepatitis. Which action should be included?

Provide a high carbohydrate diet. A client with hepatitis should have a diet high in carbohydrates due to altered nutrient metabolism.

A nurse is teaching self-management to a client who has hepatitis B. Which of the following instructions should the nurse include in the teaching? You mat donate blood 6 months after completing the medicine regimen Consume a high protein diet Rest frequently throughout the day Take acetaminophen every 4 hours, if needed, for discomfort.

Rest frequently throughout the day

A nurse is caring for a client who has just returned from the PACU after a traditional cholecystectomy. In which of the following positions should the nurse place the client?

Semi-Fowler's The nurse should expect a prescription to place pt in semi-Fowler's position to facilitate lung expansion as well as coughing and deep breathing. This position places minimal stress on abdomen and increases comfort.

A nurse is caring for a client who has peptic ulcer disease. The nurse should monitor the client for which of the following findings as an indication of gastrointestinal perforation?Hyperactive bowel sounds Sudden abdominal pain Increased blood pressure Bradycardia

Sudden abdominal pain Classic indications of gastrointestinal perforation include sudden sharp abdominal pain with a rigid abdomen, declining peristalsis, and progression to septicemia and hypovolemic shock.

A client is prescribed Lansoprazole 15 mg PO once a day. At which of the following times should the nurse administer the medication?

Thirty minutes before breakfast

A client is about to undergo an abdominal paracentesis. In which of the following positions should the nurse place the client?

Upright