Medsurg Exam 4 Practice Questions

A nurse teaches a patient who has viral gastroenteritis. Which dietary instruction would the nurse include in this patient's teaching? A. "Drink plenty of fluids to prevent dehydration." B. "You should only drink 1 L of fluids daily." C. "Increase your protein intake by drinking more milk." D. "Sips of cola or tea may help to relieve your nausea."

A. "Drink plenty of fluids to prevent dehydration."

A nurse cares for a patient with ulcerative colitis. The patient states, "I feel like I am tied to the toilet. This disease is controlling my life." How would the nurse respond? A. "Let's discuss potential factors that increase your symptoms." B. "If you take the prescribed medications, you will no longer have diarrhea." C. "To decrease distress, do not eat anything before you go out." D. "You must retake control of your life. I will consult a therapist to help."

A. "Let's discuss potential factors that increase your symptoms."

A nurse assesses a patient who is recovering from an ileostomy placement. Which clinical manifestation would alert the nurse to urgently contact the health care provider? A. Pale and bluish stoma B. Liquid stool C. Ostomy pouch intact D. Blood-smeared output

A. Pale and bluish stoma blood is expected because theyre recovering from ileostomy placement

After teaching a patient with perineal excoriation caused by diarrhea from acute gastroenteritis, a nurse assesses the patient's understanding. Which statement by the patient indicates a need for additional teaching? A. "I'll rinse my rectal area with warm water after each stool and apply zinc oxide ointment." B. "I will clean my rectal area thoroughly with toilet paper after each stool and then apply aloe vera gel." C. "I must take a sitz bath three times a day and then pat my rectal area gently but thoroughly to make sure I am dry." D. "I shall clean my rectal area with a soft cotton washcloth and then apply vitamin A and D ointment."

B"I will clean my rectal area thoroughly with toilet paper after each stool and then apply aloe vera gel." question is asking which answer is wrong

After teaching a patient who is prescribed adalimumab (Humira) for severe ulcerative colitis, the nurse assesses the patient's understanding. Which statement made by the patient indicates a need for additional teaching? A. "I will avoid large crowds and people who are sick." B. "I will take this medication with my breakfast each morning." C. "Nausea and vomiting are common side effects of this drug." D. "I must wash my hands after I play with my dog."

B. "I will take this medication with my breakfast each morning." main issue with ulcerative colitis= immune disorder so they need to avoid crowds, n

An older female patient has been prescribed esomeprazole (Nexium) for treatment of chronic gastric ulcers. What teaching is particularly important for this patient? A. Check with the pharmacist before taking other medications. B. Increase intake of calcium and vitamin D. C. Report any worsening of symptoms to the provider. D. Take the medication as prescribed by the provider.

B. Increase intake of calcium and vitamin D This med is a PPI, a side effect of it is osteoporosis

A nurse cares for a patient with colon cancer who has a new colostomy. The patient states, "I think it would be helpful to talk with someone who has had a similar experience." How would the nurse respond? A. "I have a good friend with a colostomy who would be willing to talk with you." B. "The enterostomal therapist will be able to answer all of your questions." C. "I will make a referral to the United Ostomy Associations of America." D. "You'll find that most people with colostomies don't want to talk about them."

C. "I will make a referral to the United Ostomy Associations of America." B is wrong because the therapist can not address the issues bc they dont have an ostomy. C will get them in contact with people who have ostomys

A nurse assesses a patient who has ulcerative colitis and severe diarrhea. Which assessment would the nurse complete first? A. Inspection of oral mucosa B. Recent dietary intake C. Heart rate and rhythm D. Percussion of abdomen

C. Heart rate and rhythm worried about potassium imbalance

A patient has dumping syndrome after a partial gastrectomy. Which action by the nurse would be most helpful? A. Increase fluid intake. B. Limit the patient's foods. C. Make the patient NPO D. Arrange dietary consult

D. Arrange dietary consult

A nurse assesses a patient with a mechanical bowel obstruction who reports intermittent abdominal pain. An hour later the patient reports constant abdominal pain. Which action would the nurse take next? A. Administer intravenous opioid medications. B. Position the patient with knees to chest. C. Insert a nasogastric tube for decompression. D. Assess the patient's bowel sounds.

D. Assess the patient's bowel sounds. Need to get more data. you can only do C without an order when youre doing CPR

A nurse cares for a patient who had a colostomy placed in the ascending colon 2 weeks ago. The patient states, "The stool in my pouch is still liquid." How would the nurse respond? A. "The stool will always be liquid with this type of colostomy." B. "Eating additional fiber will bulk up your stool and decrease diarrhea." C. Allow the pouch to completely fill with stool prior to emptying it. D. Use surgical tape to secure the pouch and prevent leakage.

A. "The stool will always be liquid with this type of colostomy." the ascending colon is at the beginning, so the stool is still very watery at this point. an ostomy at a further part would be more stool like

A nurse plans care for a patient with Crohn's disease who has a heavily draining fistula. Which intervention would the nurse indicate as the priority action in this patient's plan of care? A. Low-fiber diet B. Skin protection C. Antibiotic administration D. Intravenous glucocorticoids

B. Skin protection they are leaking fluid, we want to protect the skin from those digestive acids and enzymes that could be pouring onto the skin

After teaching a patient who has a new colostomy, the nurse provides feedback based on the patient's ability to complete self-care activities. Which statement would the nurse include in this feedback? A. "I realize that you had a tough time today, but it will get easier with practice." B. "You cleaned the stoma well. Now you need to practice putting on the appliance." C. "You seem to understand what I taught you today. What else can I help you with?" D. "You seem uncomfortable. Do you want your daughter to care for your ostomy?"

B. "You cleaned the stoma well. Now you need to practice putting on the appliance." saying "you seem to understand what i taught you" is not confirming if they understand

A patient had an upper gastrointestinal hemorrhage and now has a nasogastric (NG) tube. What comfort measure may the nurse delegate to the unlicensed assistive personnel (UAP)? A. Lavaging the tube with ice water B. Performing frequent oral care C. Re-positioning the tube every 4 hours D. Taking and recording vital signs

B. Performing frequent oral care this is a comfort measure

After teaching a patient with irritable bowel syndrome (IBS), a nurse assesses the patient's understanding. Which menu selection indicates that the patient correctly understands the dietary teaching? A. Ham sandwich on white bread, cup (236 mL) of applesauce, glass of diet cola B. Broiled chicken with brown rice, steamed broccoli, glass of apple juice C. Grilled cheese sandwich, small banana, cup (236 mL) of hot tea with lemon D. Baked tilapia, fresh green beans, cup (236 mL) of coffee with low-fat milk

B. Broiled chicken with brown rice, steamed broccoli, glass of apple juice

A nurse assesses a patient who is hospitalized with an exacerbation of Crohn's disease. Which clinical manifestation would the nurse expect to find? A. Positive Murphy's sign with rebound tenderness to palpitation B. Dull, hypoactive bowel sounds in the lower abdominal quadrants C. High-pitched, rushing bowel sounds in the right lower quadrant D. Reports of abdominal cramping that is worse at night

C. High-pitched, rushing bowel sounds in the right lower quadrant chrons= inflammation, so wont be hypoactive

The nurse caring for patients with gastrointestinal disorders would understand that which category best describes the mechanism of action of sucralfate (Carafate)? A. Gastric acid inhibitor B. Histamine receptor blocker C. Proton pump inhibitor D. Mucosal barrier fortifier

D. Mucosal barrier fortifier We use this med for someone who has PUD, chronic gastritis

A nurse reviews the chart of a patient who has Crohn's disease and a draining fistula. Which documentation would alert the nurse to urgently contact the provider for additional prescriptions? A. Serum potassium of 2.6 mEq/L (2.6 mmol/L) B. Patient ate 20% of breakfast meal C.White blood cell count of 8200/mm3 (8.2 ´ 109/L) D. Patient's weight decreased by 3 lbs (1.4 kg)

A. Serum potassium of 2.6 mEq/L (2.6 mmol/L) losing gi secretions this low potassium level can kill them