MED SURG3 EXAM 3

Pataasin ang iyong marka sa homework at exams ngayon gamit ang Quizwiz!

Which patient should the nurse plan symptomatic treatment for hepatitis in the plan of care? 1)Hepatitis A 2)Hepatitis B 3)Hepatitis C 4)Hepatitis D

1)Hepatitis A

What clinical manifestations are consistent with a diagnosis of ulcerative colitis? (Select all that apply.) A. Bloody stools B. Constipation C. Belching D. Chest pain E. Dysphagia

A. Bloody stools

The nurse correlates which laboratory data to decreased liver function secondary to liver cancer or cirrhosis? A. Elevated serum globulin level B. Elevated serum ammonia level C. Elevated serum protein level D. Elevated serum amylase

B. Elevated serum ammonia level

The nurse is providing care to a patient who is status post partial gastrectomy for the treatment of gastric carcinoma. Which should the nurse include in the plan of care to decrease the risk of dumping syndrome? 1. Providing smaller meals at more frequent intervals 2. Providing meals high in simple carbohydrates 3. Providing liquids and solids together 4. Providing liquids only

1. Providing smaller meals at more frequent intervals

The nurse is interpreting laboratory values for a patient suspected of having ulcerative colitis. Which finding does the nurse anticipate based on the diagnosis? 1)Protein in the urine 2)Increased sedimentation rate 3)Decreased white blood cell count 4)Antineutrophil cytoplasmic antibodies

2)Increased sedimentation rate

Which clinical manifestation assessed by the nurse supports the patient's diagnosis of liver cancer? 1)Increased appetite 2)Shortness of breath 3)Decreased liver enzymes 4)Pain in the left upper quadrant

2)Shortness of breath

Which oral agent should the nurse include in the plan of care for a patient who is diagnosed with hepatitis B? 1)Ribavirin 2)Tenofovir 3)Interferon-alpha 4)Pegylated interferon

2)Tenofovir

Which data collected by the nurse after a liver biopsy indicates the need for immediate action by the nurse? 1)The patient is awake and alert. 2)The patient's blood pressure is 90/60 mm Hg. 3)The patient's heart rate is 80 beats per minute. 4)The patients respiratory rate is 16 breaths per minute.

2)The patient's blood pressure is 90/60 mm Hg.

The nurse is providing care to a patient who is diagnosed with hepatic encephalopathy. Which clinical manifestation supports the documentation of stage 1? 1)Coma 2)Tremors 3)Disorientation 4)Difficulty to awaken

2)Tremors

For which hepatitis infections would the nurse include interferon and antivirals in the plan of care? Select all that apply. 1) Hepatitis A 2) Hepatitis B 3) Hepatitis C 4) Hepatitis D 5) Hepatitis E

2,3,4

The nurse is preparing care for a patient recovering from surgery for colorectal cancer. Which interventions should the nurse use when creating a pain management plan for this patient? Select all that apply. 1) Provide pain medication upon request 2) Assess surgical site for inflammation 3) Assess bowel sounds 4) Administer pain medication after painful procedures 5) Instruct to use a pillow to splint when deep breathing and coughing

2,3,5

A nurse is caring for a patient who has had a double-barrel colostomy. Which statement is true regarding the proximal stoma? Select all that apply. 1) Is also called the mucous fistula 2) Diverts feces to the abdominal wall 3) Expels mucus from the distal colon 4) It is a functional stoma 5) Expels mucus from the proximal colon

2,4

Which information found in the patient's health history supports the current diagnosis of cirrhosis? 1)Biliary disease 2)Social alcohol use 3)Hepatitis D infection 4)Chronic intravenous drug use

1)Biliary disease

Which complementary and alternative medicine (CAM) therapy should the nurse suggest for muscular relaxation for a patient who is experiencing pain due to esophageal cancer? 1) Yoga 2) Vibration 3) Meditation 4) Spirituality

2) Vibration

The patient with which condition is at the highest risk for fistula formations? A. Crohn's disease B. Ulcerative colitis C. Diverticulitis D. Irritable bowel disease

A. Crohn's disease

The liver receives deoxygenated blood from the: A. Portal vein B. Gastric artery C. Hepatic artery D. Hepatorenal vein

A. Portal vein

The nurse is monitoring for the early clinical manifestations of dumping syndrome. Which findings are consistent with this complication? A. Sweating and pallor B. Bradycardia and indigestion C. Double vision and chest pain D. Abdominal cramping and pain

A. Sweating and pallor

A patient with liver disease is being evaluated for varices. The nurse prepares the patient for which procedure? A. Liver biopsy B. EGD C. ERCP D. TIPS

B. EGD

The nurse is planning education for an adolescent patient recently diagnosed with hepatitis. The patient moved back to the parent's home. Which recommendation to the patient's parents will best prevent them from acquiring hepatitis B (HBV)? 1)Refuse to donate blood 2)Avoid contaminated water 3)Obtain post-exposure prophylaxis 4)Abstain from alcohol

3)Obtain post-exposure prophylaxis

The multidisciplinary care team is meeting to discuss care for a patient who exhibits symptoms of the prodromal phase of hepatitis. Lab results include a positive anti-HAV IgM. The nurse creates an action plan to present to the team. Which intervention is appropriate? 1)Early treatment with lamivudine 2)Referral to the liver transplant team 3)Patient education on acceptable pain medication 4)High-fat, low-calorie, and no-alcohol diet teaching

3)Patient education on acceptable pain medication

Which statement by the patient taking proton pump inhibitors for peptic ulcer disease indicates understanding about the action of this medication? 1. "This medication coats the lining of my stomach." 2. "This medication suppresses secretion of acid in my stomach." 3. "This medication decreases vomiting." 4. "This medication neutralizes the acid in my stomach"

2. "This medication suppresses secretion of acid in my stomach."

The nurse is evaluating care provided to a patient recovering from surgery for colorectal cancer. Which assessment data indicates the need for further intervention by the nurse? 1)Patient has an hourly urine output of 45 mL. 2)Patient performs morning care with assistance. 3)Patient states family members will care for the ostomy at home. 4)Patient tolerates full liquid diet and is requesting solid food.

3)Patient states family members will care for the ostomy at home.

The nurse correlates which assessment data in the patient diagnosed with early gastric cancer? 1. Anorexia 2. Nausea and vomiting 3. Iron-deficiency anemia 4. Palpable epigastric mass

1. Anorexia

You are providing postoperative care for a client who underwent laparoscopic cholecystectomy. What should be reported immediately to the physician? 1. The client cannot void 5 hours postoperatively. 2. The client reports shoulder pain. 3. The client reports right upper quadrant pain. 4. Output does not equal input for the first few hours.

3

Which therapeutic prescription should the nurse question when providing care to a patient who is diagnosed with ascites? 1)Furosemide 2)Spironolactone 3)Placement of a shunt 4)Three gram per day sodium diet

4)Three gram per day sodium diet

Which assessment finding requires an immediate intervention by the nurse for the patient after surgery for the treatment of gastric cancer? 1. Anorexia 2. Nausea 3. Pain 4. Diaphoresis

4. Diaphoresis

The nurse monitors for which clinical manifestation in the patient diagnosed with advanced gastric cancer? 1. Anorexia 2. Indigestion 3. Epigastric pain 4. Iron-deficiency anemia

4. Iron-deficiency anemia

The nurse is caring for a patient who has had surgery for colon cancer and has a permanent colostomy. Which assessment must the nurse report to the provider immediately? A. The stoma is reddish pink and moist. B. The stoma is flat against the skin. C. The stoma has not expelled any flatus or stool in the first 24 hours. D. The stoma is dark and bluish in appearance.

D. The stoma is dark and bluish in appearance

A nurse discusses medications prescribed to a patient who is diagnosed with Crohn's disease. Which is the typical prescribed pharmacological option for treatment? 1)Ciprofloxacin (Cipro) 2)Diazepam (Valium) 3)Furosemide (Lasix) 4)Digoxin (Lanoxin)

1)Ciprofloxacin (Cipro)

The nurse is providing care to a patient who is diagnosed with hepatic encephalopathy. Which clinical manifestation supports the documentation of stage 4? 1)Coma 2)Tremors 3)Disorientation 4)Difficulty to awaken

1)Coma

Which assessment data indicates to the nurse that the patient may be experiencing decreased clotting factors as a complication of cirrhosis? 1)Epistaxis 2)Yellow skin 3)Clay-colored stool 4)Personality changes

1)Epistaxis

A patient is diagnosed with viral hepatitis transmitted by the fecal-oral route. Which conditions may be acquired by this mode of transmission? 1)Hepatitis A (HAV) 2)Hepatitis B (HBV) 3)Hepatitis C (HCV) 4)Hepatitis D (HDV)

1)Hepatitis A (HAV)

When planning care for a patient with chronic hepatitis, which collaborative discipline will be most helpful in treating continued alcohol use? 1)Social worker 2)Primary provider 3)Pharmacist 4)Dietitian

1)Social worker

Which common site of metastasis should the nurse anticipate when providing care to a pt diagnosed with oral cancer? 1) skin 2) liver 3) breast 4) brain

2) liver

Which patient statement regarding the incubation period of hepatitis requires further education from the nurse? 1)"Hepatitis A has an incubation period of 15 to 50 days." 2)"Hepatitis B has an incubation period of 30 to 60 days." 3)"Hepatitis C has an incubation period of 2 to 25 weeks." 4)"Hepatitis D has an incubation period of 2 to 8 weeks."

2)"Hepatitis B has an incubation period of 30 to 60 days."

Select the type of epithelial cells that line the oral cavity. A) Basal B) Squamous C) Columnar D) Parietal

B) Squamous

The liver receives what percentage of cardiac output? A. 10% B. 25% C. 40% D. 50%

B. 25%

The nurse is providing information about hepatitis to a high school health occupations class. The students all volunteer examples of how hepatitis is transmitted. Which student statement indicates the need for further education? 1)"Body piercing or tattoo with infected equipment" 2)"Contaminated food or fluids" 3)"Alcoholism or drug overdose" 4)"Bite of an infected mosquito or tick"

4)"Bite of an infected mosquito or tick"

Which patient statement regarding toxins causing hepatitis indicates the need for further education by the nurse? 1)"Exposure to industrial chemicals is a risk factor for hepatitis." 2)"Exposure to carbon tetrachloride is a risk factor for hepatitis." 3)"Exposure to phosphorus is a risk factor for hepatitis." 4)"Exposure to valproic acid is a risk factor for hepatitis."

4)"Exposure to valproic acid is a risk factor for hepatitis."

The nurse monitors for which clinical manifestations in the patient diagnosed with a duodenal ulcer? (Select all that apply.) A. Intermittent abdominal pain, which is relieved after eating and taking antacids but becomes worse at night B. Nausea and vomiting C. Right upper quadrant tenderness and is positive for occult blood in stool D. Complaints of heartburn or regurgitation and vomiting E. Bloating and flatulence

A,C,D

The nurse is providing care to a patient who is suspected of having esophageal cancer. Which diagnostic test should the nurse anticipate for this patient first? 1) Barium swallow 2) Computed tomography 3) Endoscopic ultrasonography 4) Positron emission tomography

1) Barium swallow

The nurse monitors for which clinical manifestations in the patient diagnosed with esophageal cancer? Select all that apply. 1) Eructation 2) Melena 3) Odynophagia 4) Sialorrhea 5) Trismus

1) Eructation 2) Melena 3) Odynophagia

The nurse is providing education to a patient who will receive surgical intervention for the treatment of ulcerative colitis. Which patient statement indicates correct understanding of a proctocolectomy with a permanent ileostomy? 1)"My colon and rectum will be removed, and my anus will be closed." 2)"My colon will be removed, and my ileum is sutured to the anal canal." 3)"My colon will be removed while the distal portion of my ileum is used to create a pouch." 4)"My colon and rectal mucosa will be removed and a reservoir created using a portion of my ileum."

1)"My colon and rectum will be removed, and my anus will be closed."

A patient recovering from surgery to place a permanent colostomy as treatment for colon cancer is concerned that her spouse will no longer find her sexually attractive. Which response by the nurse is the most appropriate? 1)"Tell me more about the concerns you are having." 2)"Would you like me to speak with your husband for you?" 3)"Do not worry about sex right now. It is more important to focus on recovery." 4)"I will refer you to a counselor to talk about your concerns."

1)"Tell me more about the concerns you are having."

The nurse is providing education to a patient, diagnosed with colorectal cancer, who will be treated with chemotherapy. Which drug action should the nurse include in the teaching session for a patient who is prescribed 5-Fluorouracil? 1)"This drug is cell-cycle specific and interferes with the synthesis of DNA and RNA, causing its death." 2)"This drug is converted in the tissue to 5-FU, which inhibits DNA and RNA synthesis by preventing thymidine production, causing death of rapidly replicating cells." 3)"This drug is a platinum-based antineoplastic agent that binds to DNA and RNA, miscoding information and/or inhibiting DNA replication, causing cell death." 4)"This drug is an antiangiogenesis medication that reduces blood flow to the tumor cells, depriving them of nutrients needed for replication."

1)"This drug is cell-cycle specific and interferes with the synthesis of DNA and RNA, causing its death."

Which information should the nurse include in a teaching session for a patient who is to receive the hepatitis B vaccine? 1)"You will receive three injections over a 6 to 12 month period." 2)"This vaccine provides protection within two to four weeks of vaccine." 3)"You will receive one shot followed by a booster 6 to 12 months later." 4)"This vaccine is recommended for those who engage in risky behavior, such as illegal injected drug users."

1)"You will receive three injections over a 6 to 12 month period."

A young adult waiter has been treated for viral hepatitis at a health-care clinic. Which patient outcome indicates the need for additional intervention? 1)Body mass index (BMI) changes from 24 to 21. 2)Return demonstration of hand washing is correctly performed. 3)Social Services notified the Health Department of the occurrence. 4)Patient denies abdominal or epigastric pain.

1)Body mass index (BMI) changes from 24 to 21.

You are caring for an obese postoperative client who underwent surgery for bowel resection. As the client is moving in bed, he comments, "Something popped open." Upon examination you note wound evisceration. Place in order the steps for handling this complication. 1. Stay calm and stay with the client. 2. Check the vital signs, especially blood pressure and pulse. 3. Have a colleague gather sterile supplies and contact the physician. 4. Put the client into semi-Fowler position with knees slightly flexed. 5. Prepare the client for surgery as ordered. 6. Cover the intestine with sterile moistened gauze.

1, 4, 2, 3, 6, 5

The nurse is providing care to several patients who are diagnosed with hepatitis. Which patients could have avoided infection with a vaccination? Select all that apply. 1) Hepatitis A 2) Hepatitis B 3) Hepatitis C 4) Hepatitis D 5) Hepatitis E

1,2,4

The nurse is providing care to several patients who are diagnosed with hepatitis. Which diagnoses indicate an acute infection? Select all that apply. 1) Hepatitis A 2) Hepatitis B 3) Hepatitis C 4) Hepatitis D 5) Hepatitis E

1,4,5

A client hospitalized with ulcerative colitis reports 10 to 20 small diarrhea stools per day, with abdominal pain before defecation. The client appears depressed and underweight and is uninterested in self-care or suggested therapies. What is the priority nursing diagnosis? 1. Diarrhea related to irritated bowel 2. Imbalanced Nutrition: Less Than Body Requirements related to nutrient loss 3. Acute Pain related to increased GI motility 4. Ineffective Self-Health Management related to treatment plan

1. Diarrhea related to irritated bowel

The nurse is providing education to a patient who will undergo diagnostic studies for colorectal cancer. Which patient statement indicates correct understanding regarding a double contract barium enema? 1)"A stool sample is collected by my doctor by digital rectal examination." 2)"After I have expelled most of the contrast, my intestine is filled with air and x-rays are taken." 3)"Constipation may occur as a result of this procedure, so I will increase my water and fiber intake." 4)"A flexible tube with a light and camera is inserted into my rectum so that tissue can be biopsied."

2)"After I have expelled most of the contrast, my intestine is filled with air and x-rays are taken."

The nurse is providing education to a patient who will receive surgical intervention for the treatment of ulcerative colitis. Which patient statement indicates correct understanding of an abdominal colectomy with ileoanal anastomosis? 1)"My colon and rectum will be removed, and my anus will be closed." 2)"My colon will be removed, and my ileum is sutured to the anal canal." 3)"My colon will be removed while the distal portion of my ileum is used to create a pouch." 4)"My colon and rectal mucosa will be removed and a reservoir created using a portion of my ileum."

2)"My colon will be removed, and my ileum is sutured to the anal canal."

The nurse is providing education to a patient, diagnosed with colorectal cancer, who will be treated with chemotherapy. Which drug action should the nurse include in the teaching session for a patient who is prescribed capecitabine? 1)"This drug is cell-cycle specific and interferes with the synthesis of DNA and RNA, causing its death." 2)"This drug is converted in the tissue to 5-FU, which inhibits DNA and RNA synthesis by preventing thymidine production, causing death of rapidly replicating cells." 3)"This drug is a platinum-based antineoplastic agent that binds to DNA and RNA, miscoding information and/or inhibiting DNA replication, causing cell death." 4)"This drug is an antiangiogenesis medication that reduces blood flow to the tumor cells, depriving them of nutrients needed for replication."

2)"This drug is converted in the tissue to 5-FU, which inhibits DNA and RNA synthesis by preventing thymidine production, causing death of rapidly replicating cells."

The nurse is providing care to a patient who is experiencing five to six loose, nonbloody stools each day. Which diagnosis does the nurse anticipate when planning care for this patient? 1)Diverticulitis 2)Crohn's disease 3)Ulcerative colitis 4)Colorectal cancer

2)Crohn's disease

The nurse recognizes which patient at greatest risk for the development of gastric cancer? 1. African American female with a history of chronic gastritis 2. Asian American male with a history of high alcohol consumption 3. Caucasian female with a history of cigarette smoking 4. Hispanic male who works as an architect

2. Asian American male with a history of high alcohol consumption

Which medication noted in the patient's health history interview is a risk factor for developing hepatitis? 1) Aspirin 2) Ibuprofen 3) Acetaminophen 4) Naproxen sodium

3) Acetaminophen

In completing a health history in the patient diagnosed with esophageal cancer, the nurse monitors for which finding as the highest risk factor for the development of squamous cell carcinoma? 1) High-fat diet 2) Body mass index 17 3) Consumes 2 to 3 alcoholic beverages daily 4) Intravenous drug use

3) Consumes 2 to 3 alcoholic beverages daily

The nurse is providing care to a patient who is diagnosed with esophageal cancer. Which assessment finding indicates metastasis to the liver? 1) Emesis 2) Rhonchi 3) Jaundice 4) Dysphagia

3) Jaundice

The nurse is speaking with a patient who wants information regarding colorectal cancer. Which statement indicates the patient understood the information presented by the nurse? 1)"The risk of colorectal cancer decreases with age." 2)"Colorectal cancer can be detected in early stages by measuring the level of the carcinogenic embryonic antigen (CEA)." 3)"Colorectal cancer occurs more frequently in patients who have a history of ulcerative colitis." 4)"Colorectal cancer has no symptoms in the early stage, and there are no definitive diagnostic tests."

3)"Colorectal cancer occurs more frequently in patients who have a history of ulcerative colitis."

The nurse is providing education to a patient who is will undergo diagnostic studies for colorectal cancer. Which patient statement indicates correct understanding regarding a lower-GI series? 1)"A stool sample is collected by my doctor by digital rectal examination." 2)"After I have expelled most of the contrast, my intestine is filled with air and x-rays are taken." 3)"Constipation may occur as a result of this procedure, so I will increase my water and fiber intake." 4)"A flexible tube with a light and camera is inserted into my rectum so that tissue can be biopsied."

3)"Constipation may occur as a result of this procedure, so I will increase my water and fiber intake."

The nurse provides an educational session for community members about the risk factors for colorectal cancer. Which participant statement indicates the need for further education? 1)"There is a genetic link in the development of colorectal cancer." 2)"People with other bowel disease are at increased risk for developing this cancer." 3)"Eating a diet high in red meat reduces the risk for developing this type of cancer." 4)"Taking aspirin and a multivitamin each day reduces the risk of colorectal cancer."

3)"Eating a diet high in red meat reduces the risk for developing this type of cancer."

The nurse is providing education to a patient who will receive surgical intervention for the treatment of ulcerative colitis. Which patient statement indicates correct understanding of a proctocolectomy with continent ileostomy? 1)"My colon and rectum will be removed, and my anus will be closed." 2)"My colon will be removed, and my ileum is sutured to the anal canal." 3)"My colon will be removed while the distal portion of my ileum is used to create a pouch." 4)"My colon and rectal mucosa will be removed and a reservoir created using a portion of my ileum."

3)"My colon will be removed while the distal portion of my ileum is used to create a pouch."

The nurse is providing education to a patient, diagnosed with colorectal cancer, who will be treated with chemotherapy. Which drug action should the nurse include in the teaching session for a patient who is prescribed oxaliplatin? 1)"This drug is cell-cycle specific and interferes with the synthesis of DNA and RNA, causing its death." 2)"This drug is converted in the tissue to 5-FU, which inhibits DNA and RNA synthesis by preventing thymidine production, causing death of rapidly replicating cells." 3)"This drug is a platinum-based antineoplastic agent that binds to DNA and RNA, miscoding information and/or inhibiting DNA replication, causing cell death." 4)"This drug is an antiangiogenesis medication that reduces blood flow to the tumor cells, depriving them of nutrients needed for replication."

3)"This drug is a platinum-based antineoplastic agent that binds to DNA and RNA, miscoding information and/or inhibiting DNA replication, causing cell death."

Which information should the nurse provide to a patient who will be receiving the hepatitis A vaccine? 1)"The vaccine is considered effective for 15 years or longer." 2)"You will receive a series of three shots over 6 to 12 months." 3)"You will receive one shot with a booster 6 to 12 months later." 4)"The vaccine is recommended for everyone including newborns."

3)"You will receive one shot with a booster 6 to 12 months later."

The nurse is providing care to a patient who is diagnosed with irritable bowel syndrome (IBS). Which drug prescription should the nurse anticipate to relieve diarrhea? 1)Tegaserod 2)Loperamide 3)Dicyclomine 4)Amitriptyline

3)Dicyclomine

The nurse is providing care to a patient who is diagnosed with hepatic encephalopathy. Which clinical manifestation supports the documentation of stage 2? 1)Coma 2)Tremors 3)Disorientation 4)Difficulty to awaken

3)Disorientation

Which laboratory data supports the patient's diagnosis of liver failure? 1)Decreased AST 2)Elevated albumin 3)Elevated ammonia 4)Decreased total bilirubin

3)Elevated ammonia

The nurse is providing care to a patient who is diagnosed with hepatic encephalopathy. Which term should the nurse use to document a sweet fecal smell of the breath? 1)Asterixis 2)Euphoria 3)Fetor hepaticus 4)Rigid extremities

3)Fetor hepaticus

The nurse is providing care to a patient who is experiencing 10 liquid, bloody stools each day. Which diagnosis does the nurse anticipate when planning care for this patient? 1)Diverticulitis 2)Crohn's disease 3)Ulcerative colitis 4)Colorectal cancer

3)Ulcerative colitis

The nurse is providing education to a patient who will receive surgical intervention for the treatment of ulcerative colitis. Which patient statement indicates correct understanding of an ileal pouch-anal anastomosis (IPAA) procedure? 1)"My colon and rectum will be removed, and my anus will be closed." 2)"My colon will be removed, and my ileum is sutured to the anal canal." 3)"My colon will be removed while the distal portion of my ileum is used to create a pouch." 4)"My colon and rectal mucosa will be removed and a reservoir created using a portion of my ileum."

4)"My colon and rectal mucosa will be removed and a reservoir created using a portion of my ileum."

A patient has just been told that a colectomy and ileostomy are needed to treat a new diagnosis of colon cancer. Which diagnosis should the nurse use to plan this patient's preoperative nursing care?1)Knowledge Deficit 2)Risk for Disuse Syndrome 3)Risk for Perioperative-Positioning Injury 4)Anticipatory Grieving

4)Anticipatory Grieving

The nurse is providing care to a patient who is diagnosed with hepatic encephalopathy. Which clinical manifestation supports the documentation of stage 3? 1)Coma 2)Tremors 3)Disorientation 4)Difficulty to awaken

4)Difficulty to awaken

Which assessment data indicates to the nurse that the patient may be experiencing an increased ammonia level, a complication of cirrhosis? 1)Epistaxis 2)Yellow skin 3)Clay-colored stool 4)Personality changes

4)Personality changes

Which clinical manifestations will the nurse expect to find when taking care of a patient diagnosed with oral cancer? (Select all that apply.) A) Pain radiating to the ear B) Otitis media C) Leukoplakia D) Presence of HPV E) Nasal polyposis

A) Pain radiating to the ear C) Leukoplakia D) Presence of HPV

A patient admitted to the MedSurg unit. Which diagnosis does the nurse suspect, when a positive shifting dullness during abdominal percussion is noted? a) Ascites b) Liver enlargement c) Pancreatitis d) An abdominal mass

A)ascites

A patient is admitted through the ED. The nurse performs an abdominal assessment. Which structures can be assessed by palpation in the right upper quadrant (RUQ)? Select all that apply. a) Liver b) Gallbladder c) Duodenum d) Spleen e) Stomach

A,B,C

The function of the liver includes which of the following? (Select all that apply.) A. Metabolism of proteins B. Production and secretion of bile salts C. Production of vitamins A B D E K D. Filters blood of toxins E. Production of red blood cells

A,B,D

What other priority information may the nurse assess in order to care for a patient presenting with abdominal pain and watery, bloody stools? A. Psychosocial history, family history, vital signs, previous bowel history B. Vaccine history, medication history, heart rate C. Orientation status, ability to participate in sports, blood pressure D. Cranial nerves, sensation, skin assessment

A. Psychosocial history, family history, vital signs, previous bowel history

The nurse implements which interventions to decrease the risk of dumping syndrome in the patient after esophageal resection for cancer? A) Limit diet to clear liquids only. B) Increase protein in diet. C) Increase simple sugars in the diet. D) Provide eight to ten small meals.

B) increase protein in diet

The nurse assesses for which clinical manifestations in the patient diagnosed with liver cancer? (Select all that apply.) A. Peri-umbilical pain B. Anorexia C. Hemoptysis D. Fatigue E. Jaundice

B,D,E

The nurse incorporates which information into the teaching plan for a patient diagnosed with a duodenal ulcer? A. "You will probably have increased pain after eating." B. "Smoking cigarettes can make the PUD worse." C. "Antacids are not usually effective for the pain." D. "Eating bland foods will aid in healing."

B. "Smoking cigarettes can make the PUD worse."

Which information does the nurse include in the teaching to Jack related to his diagnosis of ulcerative colitis? A. "Decrease fluid intake to decrease diarrhea." B. "Spread out your meals to six times per day." C. "Avoid foods high in potassium." D. "Increase your intake of simple sugars for energy."

B. "Spread out your meals to six times per day."

The nurse is caring for a patient with colorectal cancer who just had a total colectomy with placement of a permanent ileostomy. Which nursing diagnosis is a priority for the immediate postoperative period? A. Disturbed body image B. Acute pain C. Potential for infection D. Knowledge deficit

B. Acute pain

A patient just returned from the procedure area after having a liver biopsy. The primary nursing intervention includes which action? A. Ambulation B. Monitor blood pressure and assess the site for bleeding C. Heparin drip D. Obtain a culture from the biopsy site

B. Monitor blood pressure and assess the site for bleeding

Where is the primary location of nutrient absorption in the gastrointestinal system? A. Stomach B. Small intestine C. Large intestine D. Pancreas

B. Small intestine

In a patient with cirrhosis, the nursing diagnosis"risk for injury and bleeding related to prolonged clotting factors" is most appropriate related to which disorder? A. Pruritus B. Vitamin K deficiency C. Hyponatremia D. Ascites

B. Vitamin K deficiency

The nurse recognizes which patient is at greatest risk for type 1 autoimmune hepatitis? A. A 45-year-old postmenopausal female B. A 30-year-old female with a history of hyperthyroidism C. A 16-year-old female with type 1 diabetes mellitus D. A 12-year-old female with autism

C. A 16-year-old female with type 1 diabetes mellitus

The nurse correlates which clinical manifestation to the pathophysiology of a gastric ulcer? A. Pernicious anemia B. Constipation C. Acute epigastric pain after eating D. Hypertension

C. Acute epigastric pain after eating

A patient presents to the ED with complaints of abdominal pain and watery, bloody stools. What diagnostic tests does the nurse expect to be ordered on the basis of these symptoms? A. CBC, MRI, electrolytes, stool analysis B. CT scan, MRI, chemistry panel, ERCP C. Colonoscopy, CBC, wireless capsule endoscopy, upper GI endoscopy D. BUN, creatinine, ultrasound, chest x-ray

C. Colonoscopy, CBC, wireless capsule endoscopy, upper GI endoscopy

Following a partial gastrectomy for gastric cancer, a patient complains of nausea, abdominal pain and cramping, and diarrhea after eating. Recognizing manifestations of dumping syndrome, what should the nurse recommend? A. Fasting for a period of 6 to 12 hours before meals B. Decreasing the protein content of meals C. Decreasing the amount of fluid taken at meals and avoiding high-carbohydrate foods, including fluids such as fruit nectars D. A diet rich in carbohydrates to maintain blood glucose levels

C. Decreasing the amount of fluid taken at meals and avoiding high-carbohydrate foods, including fluids such as fruit nectars

What is the most distal section of the small intestine? A. Cecum B. Duodenum C. Ileum D. Jejunum

C. Ileum

Reabsorption of the majority of the water from the gastrointestinal tract occurs in the: A. Liver B. Small intestine C. Large intestine D. Rectum

C. Large intestine

In reviewing diagnostic results of a patient with suspected hepatitis, the nurse correlates which result as consistent with hepatitis A? A. Prolonged prothrombin time (PT) B. Decreased white blood cell count C. Presence of IgM anti-HAV D. Detectable serum HBV DNA

C. Presence of IgM anti-HAV

Elevated ammonia levels can lead to hepatic encephalopathy. Which provider order best reduces this risk in patients with cirrhosis? A. Administer furosemide and spironolactone. B. Administer antibiotics. C. Restrict protein intake. D. Restrict caloric intake.

C. Restrict protein intake.

A nurse working in an endoscopy clinic is screening patients for the risk of developing Barrett's esophagus. The nurse should consider which patient at greatest risk? A) The patient with a 20-year history of alcohol abuse B) The patient with a 30-pack-per-year smoking history C) The patient who ingested lye as a child and is now 47 years old D) The patient who has had untreated GERD for 30 years

D) The patient who has had untreated GERD for 30 years

The nurse caring for a patient with liver failure notes a change in mental status and elevated ammonia level. Which ordered interventions are most directly related to treating these clinical manifestations? A. Diuretics B. High-protein diet C. Coumadin D. Lactulose and neomycin

D. Lactulose and neomycin

On the basis of the presenting symptoms of abdominal pain with watery, bloody stools, what will the nurse consider a priority to notify the provider? A. Height and weight B. Temperature C. Blood pressure D. Hemoglobin and hematocrit

D. Hemoglobin and hematocrit


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