Med- Surg II ATI Gastrointestinal

A nurse is reinforcing discharge teaching with a client who has a newly placed ileostomy about ostomy care while at home. Which of the following instructions should the nurse include in the teaching ?

"Empty your ostomy pouch when it gets half full."

A nurse is caring for a client with colitis who states that the stress at work increases exacerbations. Which of the following responses should the nurse offer ?

"Perhaps we should review your coping mechanisms and talk about alternatives."

A nurse is updating the plan of care for a client who has celiac disease. Which of the following dietary selections should the nurse recommend for the client ?

Baked chicken and rice

A nurse is obtaining a guaiac test from a client. The nurse should identify that the guaiac test is performed to detect which of the following ?

Blood in stool

A nurse is assisting with the plan of care for a client who has cholelithiasis. Which of the following interventions should the nurse include in the plan ?

Decrease the client's fat intake

A nurse is reinforcing teaching with a client who has cirrhosis of the liver and a history of alcohol consumption. The nurse should explain that alcohol can cause liver cirrhosis through which of the following actions ?

Destroying liver cells that are replaced with scar tissue

A nurse is assisting with the care of a child who had her spleen removed following a bicycle accident. The child's parent asks the nurse about the role of the spleen in the body. The nurse should reply that the spleen performs which of the following functions ?

Destroys old blood cells

A nurse is reinforcing teaching with a client who has a colostomy about ways to reduce flatus and odor. Which of the following strategies should the nurse include ?

Eat crackers and yogurt regularly

A nurse is reinforcing postoperative teaching with a client who had a partial gastrectomy about the management of dumping syndrome. Which of the following instructions should the nurse include ?

Eat protein with each meal."

A nurse is reinforcing teaching with a client who has constipation. Which of the following instructions should the nurse include in the teaching ?

Eat yogurt with live cultures

A nurse is collecting data from a client who has a bleeding duodenal ulcer. Which of the following findings should the nurse expect ?

Emesis with a coffee-ground appearance

A nurse is demonstrating colostomy care to a client who has a new colostomy. Which of the following actions should the nurse instruct the client to perform (Select all that apply.)

Empty the bag when it is one-third to one-half full Cut the skin barrier opening a little larger than the ostomy Wash the peristomal skin with mild soap and water

A nurse is caring for a client who has an indwelling urinary catheter. Which of the following actions should the nurse take ?

Empty the drainage bag when it is half full of urine

A nurse is reinforcing discharge teaching with the partner of a client who has a new diagnosis of hepatitis A. Which of the following instructions should the nurse include ?

Encourage her to eat foods that are high in carbohydrates."

A nurse is caring for a client who has an acute exacerbation of Crohn's disease. Which of the following actions should the nurse take ?

Ensure bowel rest

A nurse is reinforcing teaching with a client who has diverticulitis about preventing acute attacks. Which of the following foods should the nurse recommend ?

Foods high in fiber

A nurse is assisting with the care of a client who has a history of cirrhosis and was recently admitted with manifestations of hepatic encephalopathy. The nurse should anticipate a prescription for which of the following laboratory tests to determine the possibility of recent excessive alcohol use ?

Gamma-glutamyl transferase (GGT)

A nurse is reinforcing teaching about dietary therapy with a client who has dumping syndrome following gastric bypass surgery 4 days ago. Which of the following pieces of information should the nurse include in the teaching ?

Maintain a supine position after meals

A nurse is caring for a client who has a percutaneous endoscopic gastrostomy (PEG) tube and is receiving intermittent feedings. Prior to initiating the feeding, which of the following actions should the nurse take first ?

Place the client in a semi-Fowler's position

A nurse is reinforcing teaching with a client regarding nutrition. Which of the following statements should the nurse include about nutrients ?

Protein builds and repairs body tissue."

A nurse is reinforcing teaching with a client who has Barrett's esophagus and is scheduled to undergo an esophagogastroduodenoscopy (EGD). Which of the following statements should the nurse include in the teaching ?

This procedure can determine how well the lower part of your esophagus works."

A nurse is caring for a client who is scheduled to undergo an esophagogastroduodenoscopy (EGD). The nurse should identify that the purpose of this procedure is which of the following ?

To detect an ulceration in the stomach

A nurse is assisting with the admission of a client who has bleeding esophageal varices. The nurse should anticipate a prescription for which of the following medications ?

Vasopressin

A nurse is collecting data from a client who is in the early stages of hepatitis A. Which of the following manifestations should the nurse expect ?

Anorexia

A nurse is assisting a provider with performing a paracentesis on a client. Which of the following actions should the nurse take ?

Ask the client to empty his bladder before the procedure

A nurse is caring for a client who has recovered from acute diverticulitis. The nurse should instruct the client to increase his intake of which of the following foods when the inflammation subsides ?

Cabbage and peaches

A community health nurse is planning an educational program about hepatitis A. When preparing the materials, the nurse should identify that which of the following groups is most at risk of developing hepatitis A ?

Children and young adults

A nurse is caring for a client who is 2 days postoperative following a gastric bypass. The nurse notes that bowel sounds are present. Which of the following foods should the nurse provide at the initial feeding ?

Clear liquids

A nurse is caring for a client who has diverticulitis and a new prescription for a low-fiber diet. Which of the following food items should the nurse remove from the client's meal tray ?

Coleslaw

A nurse is caring for a client from the Middle East who has celiac disease. Which of the following actions should the nurse take regarding the client's diet ?

Determine the client's dietary preferences

A nurse is reinforcing teaching about dietary modifications for a client with newly diagnosed with cirrhosis. Which of the following foods should the nurse recommend ?

Grilled chicken

A nurse is monitoring the laboratory results of a client who has end-stage liver failure. Which of the following results should the nurse expect ?

Increased prothrombin time

A nurse is caring for a client who has abdominal pain and possibly pancreatitis. Which of the following laboratory results should the nurse identify as an indication of pancreatitis ?

Increased serum lipase level

A nurse is assisting with data collection from a client who is 12 hours postoperative following an open cholecystectomy. Which of the following findings should the nurse report to the charge nurse ?

Indwelling urinary catheter output of 25 mL/hr

A nurse is assisting with the planning of an in-service training session regarding nutrition. Which of the following minerals should the nurse include as a factor in oxygen transportation ?

Iron

A nurse is recommending dietary modifications for a client who has GERD. The nurse should suggest eliminating which of the following foods from the client's diet ?

Oranges and tomatoes

A nurse is caring for a client who is 4 hours postoperative following a laparoscopic cholecystectomy. Which of the following findings should the nurse expect ?

Right shoulder pain

A nurse is checking a client who was admitted with a bowel obstruction. The client reports severe abdominal pain. Which of the following findings should indicate to the nurse that a possible bowel perforation has occurred ?

Rigid abdomen

A nurse is caring for a client who has ulcerative colitis. The provider prescribes bed rest with bathroom privileges. When the client asks why he has to say in bed, how should the nurse respond to explain the most important reason for this prescription ?

"Lying quietly in bed helps slow down the activity in your intestines."

A nurse is assisting with the planning of an in-service session about nutrition. How many of the amino acids must be obtained from dietary intake ?

. 9

A nurse is caring for a client who is 2 days postoperative following gastric surgery and has an NG tube inserted. Which of the following findings should the nurse report to the provider ?

200 mL of bright red drainage from the NG tube

A nurse is reinforcing preoperative teaching with a client who will undergo surgery to create a temporary colostomy. The client asks the nurse about the difference between colostomies and ileostomies. Which of the following responses should the nurse offer ?

A colostomy is from the large intestine and an ileostomy is from the small intestine."

A nurse is reinforcing teaching with a group of community residents about hepatitis B. Which of the following statements should the nurse include in the teaching ?

A hepatitis B immunization is given to infants and children."

A nurse is collecting data from a client who has chronic pancreatitis. Which of the following findings should the nurse identify as a likely cause of the client's condition ?

Alcohol use

A nurse is caring for a client who has acute pancreatitis. Which of the following serum laboratory values should the nurse anticipate returning to the expected reference range within 72 hours after treatment begins ?

Amylase

A nurse is helping develop a plan of care for a client who has gastroesophageal reflux disease (GERD). The nurse should suggest monitoring the client for which of the following complications ?

Aspiration

A nurse in a provider's office is collecting data from a client who has GERD. When documenting the client's history, the nurse should expect the client to report that symptoms worsen with which of the following actions ?

Bending over

A nurse is collecting data from a client who has cholecystitis. Which of the following findings should the nurse expect ?

Blumberg's sign

A nurse is collecting data from a client who is experiencing perforation of a peptic ulcer. Which of the following manifestations should the nurse expect ?

Board-like abdomen

A nurse is caring for a client who has gastrointestinal bleeding. The provider suspects a bleeding lesion in the colon. The nurse should anticipate that the most likely initial approach to treatment will involve which of the following procedures ?

Colonoscopy

A nurse is planning discharge teaching for a client who is postoperative following a traditional open cholecystectomy. Which of the following learning needs of the client is the nurse's priority ?

Coughing and deep-breathing exercises

A nurse is caring for a client who is 3 days postoperative following abdominal surgery. The client states, "Something just popped when I coughed." Which of the following actions should the nurse take first ?

Cover the client's wound with a sterile, moist dressing

A nurse is assisting with the care of a client who is receiving total parenteral nutrition (TPN) and has just returned to the room following physical therapy. The nurse notes that the infusion pump for the client's TPN is turned off. After restarting the infusion pump, the nurse should monitor the client for which of the following findings ?

Diaphoresis

A nurse is reinforcing teaching about hypoglycemia with a client who has diabetes mellitus. Which of the following manifestations should the nurse include (Select all that apply.)

Diaphoresis Palpitations Shakiness

A nurse is reinforcing teaching with a group of clients about the functions of the liver and gallbladder. Which of the following should the nurse include in the teaching as the purpose of bile ?

Digest fats

A nurse is contributing to the plan of care for a client who has dumping syndrome. Which of the following instructions should the nurse include ?

Eat a source of protein with each meal

A nurse is collecting data from a client who has a complete intestinal obstruction. Which of the following findings should the nurse expect ?

Hyperactive bowel sounds above the obstruction

A nurse is assisting with preparing a teaching plan about secondary prevention actions for colorectal cancer for a community health fair for adults. Which of the following topics should the nurse recommend including ?

Importance of colonoscopy screening starting at 50 years of age

A nurse is caring for a client who is NPO and has an NG tube to suction. The client reports nausea. Which of the following actions should the nurse take ?

Irrigate the tube with a normal saline solution

A nurse is assisting with the admission of a client who has fulminant hepatic failure. Which of the following procedures should the nurse expect for this client ?

Liver transplant

A nurse is reinforcing teaching with a client who is scheduled for a sigmoid colon resection with colostomy. Which of the following statements by the client indicates a need for further teaching ?

My diet will have to change to a soft diet after surgery."

A nurse is assisting with the admission of a client who has cirrhosis. Which of the following prescriptions should the nurse anticipate (Select all that apply.)

Obtain the client's PT and INR measurements Administer lactulose 30mL PO 4 times daily Obtain daily weight and abdominal girth measurements Administer a daily multivitamin

A nurse is assisting with the planning of an in-service session for a group of nurses regarding the role of enzymes in digestion. Which of the following enzymes has a role in the digestion of protein ?

Pepsin

A nurse is caring for a client who reports feeling a pop after coughing without properly splinting an abdominal incision. The nurse finds the client's wound has eviscerated. Which of the following actions should the nurse take (Select all that apply.)

Place the client in a supine position with hips and knees flexed Leave the room to call the surgeon Cover the wound and intestine with a sterile, moistened dressing Monitor the client for manifestations of shock

A nurse is caring for a client who had a gastric resection to treat adenocarcinoma of the stomach. The client tells the nurse in the PACU that he does not remember why the surgeon said he had to have a tube in his nose. The nurse should explain that the NG tube serves which of the following purposes ?

Preventing excessive pressure on suture lines

A nurse is caring for a client who is scheduled to undergo a liver biopsy for a suspected malignancy. Which of the following laboratory findings should the nurse monitor prior to the procedure ?

Prothrombin time

A nurse is caring for a client who is postoperative following a laparotomy. The client has an indwelling urinary catheter and a Jackson-Pratt drain in place. Which of the following findings indicates that the client is developing a postoperative complication ?

Pulse oximetry of 85%

A nurse in a provider's office is collecting data from a client who has gastroesophageal reflux disease (GERD). The nurse should expect the client to report which of the following manifestations (Select all that apply.)

Regurgitation Nausea Belching Heartburn

A nurse is reinforcing dietary teaching with a client who has ulcerative colitis. Which of the following food selections by the client indicates an understanding of the teaching ?

Roasted chicken and white rice

A nurse is caring for a client who has cholelithiasis and will undergo a cholecystectomy. The client says she does not understand how she will be alright without her gallbladder. The nurse should explain that which of the following is the main function of the gallbladder ?

Storing bile

A nurse is collecting data on a client who has liver cirrhosis with abdominal distention. Which of the following actions is the most effective way for the nurse to note a change in the client's abdominal distention ?

Take serial measurements of the abdomen with a tape measure

A nurse is caring for a client who is dehydrated and is receiving a continuous tube feeding through a pump at 75 mL/hr. When the nurse checks the client at 0800, which of the following findings requires intervention by the nurse ?

The head of the bed is elevated to 20°.

A nurse is reinforcing teaching with the parents of a child who has celiac disease. Which of the following foods should the nurse instruct the parents to omit from the child's diet ?

Wheat bread

A nurse is caring for a client who has celiac disease. Which of the following foods should the nurse remove from the client's meal tray ?

Wheat toast

A nurse is caring for a client who has acute diverticulitis. While the client has active inflammation, the nurse should instruct the client to include which of the following foods in her diet ?

White bread and plain yogurt