Mtec adult health exam 7# Dan c

A nurse is providing care for a client who has a diagnosis of irritable bowel syndrome (IBS). When planning this client's care, the nurse should collaborate with the client and prioritize what goal?

Client will accurately identify foods that trigger symptoms

A client has come to the outpatient radiology department for diagnostic testing that will allow the care team to evaluate and remove polyps. The nurse should prepare the client for what procedure?

Colonoscopy

The nurse is assessing a client who had an ileostomy created three days ago for the treatment of irritable bowel disease. The nurse observes that the client's stoma is bright red and there are scant amounts of blood on the stoma. What is the nurse's best action?

Document these expected assessment findings

Crohn's disease has a distinguishing pattern in the gastrointestinal (GI) tract. The surface has granulomatous lesions surrounded by normal-appearing mucosal tissue. A complication of the pattern includes which of the following?

Fistula formation.

A client with human immunodeficiency virus (HIV) comes to the clinic and is experiencing white patches on the lateral border of the tongue. What type of lesions does the nurse document?

Hairy leukoplakia

A patient is diagnosed with Crohn's disease. The nurse instructs the patient on which of the following types of dietary needs?

High-calorie, vitamin, and protein diet.

Diet therapy for clients diagnosed with irritable bowel syndrome includes

High-fiber diet

A client is diagnosed with a hiatal hernia. Which statement indicates effective client teaching about hiatal hernia and its treatment?

I'll eat frequent, small, bland meals that are high in fiber."

Which of the following is the most plausible nursing diagnosis for a patient whose treatment for colon cancer has necessitated a colonostomy?

Ineffective Sexuality Patterns Related to Changes in Self-Concept

Crohn's disease is a condition of malabsorption caused by which pathophysiological process?

Inflammation of all layers of intestinal mucosa

A client seeking care because of recurrent heartburn and regurgitation is subsequently diagnosed with a hiatal hernia. Which of the following should the nurse include in health education?

Instead of eating three meals a day, try eating smaller amounts more often."

A health care provider counsels a patient about bariatric surgery. He recommends the Roux-en-Y gastric bypass. The nurse explains to the patient that this procedure involves which of the following?

Separation of the jejunum with an anastomosis

A nursing assessment of a client with peritonitis reveals hypotension, tachycardia, and signs and symptoms of dehydration. What else would the nurse expect to find?

Severe abdominal pain with direct palpation or rebound tenderness

A nurse is teaching a group of adults about screening and prevention of colorectal cancer. The nurse should describe which of the following as the most common sign of possible colon cancer?

- Change in bowel habits

A patient is suspected to have diverticulosis without symptoms of diverticulitis. What diagnostic test does the nurse anticipate educating the patient about prior to scheduling?

- Colonoscopy

A client with acute diverticulitis has experienced a sudden increase in temperature and reports a sudden onset of exquisite abdominal tenderness. The nurse's rapid assessment reveals that the client abdomen is uncharacteristically rigid on palpation. What is the nurse's best response?

- Contact the primary provider promptly and report these signs of perforation

A patient is being treated for diverticulosis. Which information should the nurse include in this patient's teaching plan?

- Drink at least 8 to 10 large glasses of fluid every day

A nurse is caring for a client who underwent a subtotal gastrectomy. To manage dumping syndrome, the nurse should advise the client to

- Drink liquids only between meals

A patient has been diagnosed with peptic ulcer disease and the nurse is reviewing his prescribed medication regimen with him. What is currently the most commonly used drug regimen for peptic ulcers?

- Antibiotics, proton pump inhibitors, and bismuth salts

A nurse is providing follow-up teaching at a clinic visit for a client recovering from gastric resection. The client reports sweating, diarrhea, nausea, palpitations, and the desire to lie down 15 to 30 minutes after meals. Based on the client's assessment, what will the nurse suspect?

- Dumping syndrome

A client with a diagnosis of colon cancer is 2 days postoperative following a bowel resection and anastomosis. The nurse has planned the client's care in the knowledge of potential complications. What assessment should the nurse prioritize?

- Frequent abdominal auscultation

A nurse is assessing a client who has peptic ulcer disease. The client requests more information about the typical causes of helicobacter pylori infection. What would it be appropriate for the nurse to instruct the client?

- Infection typically occurs due to ingestion of contaminated food and water

A client presents to the clinic reporting vomiting and burning in her mid-epigastria. The nurse knows that in the process of confirming peptic ulcer disease, the healthcare provider is likely to order a diagnostic test to detect the presence of what?

- Infection with helicobacter pylori

A 35-year-old male client presents at the emergency department with symptoms of a small bowel obstruction. In collaboration with the primary provider, what intervention should the nurse prioritize?

- Insertion of a nasogastric tube

A client has been diagnosed with a small bowel obstruction and has been admitted to the medical unit. The nurse's care should prioritize which of the following outcomes?

- Maintaining fluid and electrolyte balance

A client is in the hospital for the treatment of peptic ulcer disease. The client reports vomiting and a sudden severe pain in the abdomen. The nurse then assesses a board-like abdomen. What does the nurse suspect these symptoms indicate?

- Perforation of the peptic ulcer

Diagnostic imaging and physical assessment have revealed that a client with peptic ulcer disease has suffered a perforated ulcer. The nurse recognizes that emergency intervention must be performed as soon as possible to prevent the development of what complication?

- Peritonitis

A nurse is caring for a client who is suspected to have developed a peptic ulcer hemorrhage. Which action would the nurse perform first?

- Place the client in a recumbent position with the legs elevated.

A patient has been diagnosed with a hiatal hernia. The nurse explains the diagnosis to the patient and his family by telling them that a hernia is a

- Protrusion of the upper stomach into the lower portion of the thorax

A 16-year-old presents at the emergency department reporting right lower quadrant pain and is subsequently diagnosed with appendicitis. When planning the client's nursing care, the nurse should prioritize what nursing diagnosis?

- Risk for infection related to possible rupture of appendix

The nurse is conducting a gastrointestinal assessment. When the client reports the presence of mucus and pus in the stool, the nurse assesses for additional signs/symptoms of which disease/condition?

- Ulcerative colitis

A nurse is providing care for a client recovering from gastric bypass surgery. During assessment, the client exhibits pallor, perspiration, palpitations, headache, and feelings of warmth, dizziness, and drowsiness. The client reports eating 90 minutes ago. What will the nurse expect?

- Vasomotor symptoms associated with dumping syndrome

A home care nurse is caring for a client with reports of epigastric discomfort who is scheduled for a barium swallow. Which statement by the client indicates an understanding of the test?

-"I'll avoid eating or drinking anything 6 to 8 hours before the test."

A patient has been diagnosed with acute gastritis and asks the nurse what could have caused it. What is the best response by the nurse?

-"It can be caused by ingestion of strong acids", "You may have ingested some irritating foods", "It is possible that you are overusing aspirin"

To prevent gastroesophageal reflux in a client with hiatal hernia, the nurse should provide which discharge instruction?

-"avoid coffee and alcoholic beverages."

A patient with a diagnosis of peptic ulcer disease has just been prescribed omeprazole (Prilosec) . How should the nurse best describe this medication's therapeutic action?

-- "This medication will reduce the amount of acid secreted in your stomach."

A client reports frequent episodes of reflux and described regurgitating small amounts of stomach contents into the esophagus. What sphincter is most likely not performing its normal physiologic function?

-- Lower esophageal sphincter

A client who underwent surgery for esophageal cancer is admitted to the critical care unit following postanesthetic recovery. What should the nurse include in the client's immediate postoperative plan of care?

-- Positioning the client to prevent gastric reflux

A nurse is caring for a client hospitalized with an exacerbation of chronic gastritis. What health promotion topic should the nurse emphasize?

-- Strategies for avoiding irritating foods and beverages

The nurse is conducting a community class on gastritis. The nurse includes that chronic gastritis caused by helicobacter pylori is implicated in which disease/condition?

-- peptic ulcers

In client education with a client who has a lower GI study scheduled, the nurse describes the organs involved and their characteristics. Approximately how long are the jejunum and the ileum if their lengths are combined?

-23 feet

What is the approximate length of the large intestine?

-4-5 feet long

A participant in a health fair has asked the nurse about the role of drugs in liver disease. What health promotion teaching has the most potential to prevent drug-induced hepatitis?

-Adhere to dosing recommendations of OTC analgesics.

A local public health nurse is informed that a cook in a local restaurant has been diagnosed with hepatitis A. What should the nurse advise individuals to obtain who ate at this restaurant and have never received the hepatitis A vaccine?

-An immune globulin injection

The nurse is caring for a client who has just returned from the ERCP removal of gallstones. The nurse should monitor the client for signs of what complications?

-Bleeding and perforation

During a colonoscopy with moderate sedation, the patient groans with obvious discomfort and begins bleeding from the rectum. The patient is diaphoretic and has an increase in abdominal girth from distention. What complication of this procedure is the nurse aware may be occurring?

-Bowel perforation

A nurse is caring for a patient with severe hemolytic jaundice. Laboratory tests show free bilirubin to be 24 mg/dL. For what complication is this patient at risk?

-Central nervous system damage

A patient admitted with acute diverticulitis has experienced a sudden increase in temperature and complains of a sudden onset of exquisite abdominal tenderness. The nurse's rapid assessment reveals that the patient's abdomen is uncharacteristically rigid on palpation. What is the nurse's best response?

-Contact the primary care provider promptly and report these signs of perforation.

As a nurse completes the admission assessment of a client admitted for gastric bypass surgery, the client states, "Finally! I'll be thin and able to eat without much concern." How should the nurse intervene?

-Evaluate the client's understanding of the procedure.

An adult client is scheduled for an upper GI series that will use a barium swallow. What teaching should the nurse include when the client has completed the test?

-Fluids must be increased to facilitate the evacuation of the stool.

A client with a recent history of rectal bleeding is being prepared for a colonoscopy. How should the nurse position the client for this test initially?

-For a colonoscopy, the nurse initially should position the client on the left side with knees bent.

A patient with a diagnosis of colon cancer is 2 days postoperative following bowel resection and anastomosis. The nurse has planned the patient's care in the knowledge of potential complications. What assessment should the nurse prioritize?

-Frequent abdominal auscultation

Patient asks the nurse about lesions on the patient abdomen. The nurse responds

-GI diseases often produce skin changes.

A client with suspected biliary obstruction due to gallstones reports changes to the color of his stools. Which stool color does the nurse recognize as common to biliary obstruction?

-Gray

A client with severe peptic ulcer disease has undergone surgery and is several hours postoperative. During assessment, the nurse notes that the client has developed cool skin, tachycardia, and labored breathing; the client also appears to be confused. Which of the following complications has the client most likely developed?

-Hemmorrhage

The nurse identifies which type of jaundice in an adult experiencing a transfusion reaction?

-Hemolytic

A clinic client has described recent dark-colored stools and the nurse recognizes the need for fecal occult blood testing (FOBT). What aspect of the client's current health status would contraindicate FOBT?

-Hemorrhoids

A nurse is presenting an educational event to a local community group. When speaking about colorectal cancer, what risk factor should the nurse cite?

-History of diverticulitis

The nurse is caring for a patient diagnosed with abdominal perforation. Which of the following is a clinical manifestation of this disease process?

-Hypotension

A patient with a liver mass is undergoing a percutaneous liver biopsy. What action should the nurse perform when assisting with this procedure?

-Immediately after a percutaneous liver biopsy, assist the patient to turn onto the right side and place a pillow under the costal margin

A client who has been experiencing changes in his bowel function is scheduled for a barium enema. What instruction should the nurse provide for postprocedure recovery?

-Increase fluid intake to evacuate the barium.

A nurse is caring for a client who is scheduled for a colonoscopy and whose preparation will include polyethylene glycol electrolyte lavage prior to the procedure. The presence of what health problem would contraindicate the use of this form of bowel preparation?

-Inflammatory bowel disease

The nurse is caring for a client who has a diagnosis of AIDS. Inspection of the client's mouth reveals the new presence of white lesions on the client's oral mucosa. What is the nurse's most appropriate response?

-Inform the primary provider of this finding.

A client with a diagnosis of esophageal varices has undergone endoscopy to gauge the progression of this complication of liver disease. Following the completion of this diagnostic test, what nursing intervention should the nurse perform?

-Keep client NPO until the patient's gag reflex returns.

A focused GI assessment begins with a complete history and physical examination. Identify the quadrant of the abdomen to be palpated or percussed for a patient with pancreatitis?

-Left upper

While palpating a client's right upper quadrant (RUQ), the nurse would expect to find which structure?

-Liver

A physician has ordered a liver biopsy for a client with cirrhosis whose condition has recently deteriorated. The nurse reviews the client's recent laboratory findings and recognizes that which of the following findings will place the client at risk for complications?

-Low platelet count

A patient's large bowel obstruction has failed to resolve spontaneously and the patient's worsening condition has warranted admission to the medical unit. Which of the following aspects of nursing care is most appropriate for this patient?

-Preparing the patient for surgical bowel resection

After undergoing a liver biopsy, a client should be placed in which position?

-Right lateral decubitus position

The nurse is caring for a client with a duodenal ulcer and is relating the client's symptoms to the physiologic functions of the small intestine. What do these functions include? Select all that apply.

-Secretion of mucus Absorption of nutrients Movement of nutrients into the bloodstream

-During chronic pancreatitis, the patient's stool may become frothy and foul-smelling. This would be documented as which of the following?

-Steatorrhea

A client has returned to the medical unit after a barium enema. When assessing the client's subsequent bowel patterns and stools, what finding would warrant reporting to the health care provider?

-Streaks of blood present in the stool

Which of the following will the nurse observe as symptoms of perforation in a patient with intestinal obstruction?

-Sudden, sustained abdominal pain

A client who experienced an upper GI bleed due to gastritis has had the bleeding controlled and the client's condition is now stable. For the next several hours, the nurse caring for this client should assess for what signs and symptoms of recurrence?

-Tachycardia, hypotension, and tachypnea

A client has sought care because of recent dark-colored stools. As a result, a fecal occult blood test has been ordered. The nurse should give what instructions to the client?

-Take no NSAIDs within 48 hours of the test

A patient with severe chronic liver dysfunction comes to the clinic with bleeding of the gums and blood in the stool. What vitamin deficiency does the nurse suspect the patient may be experiencing?

-V k deficiency

The nurse prepares a client for a barium enema. The nurse should place the client on which diet prior to the procedure?

-clear liquids day before

Which is one of the primary symptoms of irritable bowel syndrome?

-diarrhea

A client receives a local anesthetic to suppress the gag reflex for a diagnostic procedure of the upper GI tract. The nurse determines which nursing intervention is advised for this client?

-do not give any food and fluids until the gag reflex returns

Cystic fibrosis, a genetic disorder characterized by pulmonary and pancreatic dysfunction, usually appears in young children but can also affect adults. If the pancreas was functioning correctly, where would the bile and pancreatic enzymes enter the GI system?

-duodenum

A client tells the nurse that the stool was colored yellow. The nurse assesses the client for

-recent foods ingested.

the nurse is assisting the physician in a percutaneous liver biopsy. In assisting with positioning, the nurse should assist the client into a:

-supine position.

A nurse is monitoring a client with peptic ulcer disease. Which of the following assessment findings would most likely indicate perforation of the ulcer? Choose all that apply.

-• Tachycardia • Hypotension • A rigid, board-like abdomen

A nurse is caring for a patient who has been admitted to the hospital with diverticulitis. Which of the following would be appropriate nursing diagnoses for this patient? Select all that apply.

A) Acute Pain Related to Increased Peristalsis and GI Inflammation B) Activity Intolerance Related to Generalized Weakness D) Deficient Fluid Volume Related to Anorexia, Nausea, and Diarrhea

A nurse educator is teaching a group of recent nursing graduates about their occupational risks for contracting hepatitis

A) Immunization B) Use of standard precautions

A nurse is planning discharge teaching for a 21-year-old client with a new diagnosis of ulcerative colitis. When planning family assessment, the nurse should recognize which of the following factors will likely have the greatest impact on the client's coping after discharge?

The family's ability to provide emotional support.

Which type of jaundice seen in adults is the result of increased destruction of red blood cells?

Hemolytic

A patient is admitted to the medical surgical unit with a history of inflammatory bowel disease. The nurse knows that the clinical manifestations of both Crohn's disease and ulcerative colitis are the result of activation of which of the following cells?

Inflammatory.

A client has been taking a 10-day course of antibiotics for pneumonia. The client has been having white patches that look like milk curds in the mouth. What treatment will the nurse educate the client about?

Nystatin

A nurse is caring for a patient with a blocked bile duct from a tumor. What manifestation of obstructive jaundice should the nurse anticipate?

Orange and foamy urine

The nurse is monitoring a client's postoperative course after an appendectomy. The nurse's assessment reveals that the client has vomited, has abdominal tenderness and rigidity, and has tachycardia. The nurse reports to the physician that the client has signs/symptoms of which complication?

Peritonitis

Inflammatory bowel disease (IBD) is used to designate two related inflammatory intestinal disorders: Crohn's disease and ulcerative colitis. The nurse recognizes the difference between the distribution pattern between Crohn's disease and ulcerative colitis. Which of the following patterns describes Crohn's disease?

Skip lesions

A client with peptic ulcer disease has been prescribed sucralfate. What education should the nurse provide to this client?

Take the medication 2 hours before or after other medications

Which is a true statement regarding regional enteritis (Crohn's disease)?

The clusters of ulcers take on a cobblestone appearance

A patient with acute pancreatitis puts the call bell on to tell the nurse about an increase in pain. The nurse observes the patient guarding; the abdomen is board-like and no bowel sounds are detected. What is the major concern for this patient?

The patient has developed peritonitis

A patient is admitted with an exacerbation of Crohn's disease and has been experiencing a weight loss of 20 pounds in 2 weeks. The patient is unable to absorb nutrients from the intestine. The nurse would expect which of the following types of diet to be ordered for this patient?

Total parenteral nutrition (TPN).

The client described a test previously completed to detect a small bowel obstruction prior to admission to the hospital. The client states that the test involved insertion of a tube through the nose and lasted over 6 hours. The nurse determines which test name should be documented?

Upper GI enterocylsis

The nurse's review of a client's most recent laboratory results indicates a bilirubin level of 3.0 mg/dL (51 mmol/L). The nurse assesses the client for:

jaundice.

A client has symptoms suggestive of peritonitis. Nursing management would not include

limiting analgesics to avoid the formation of paralytic ileus

Post appendectomy, a nurse should assess the patient for abdominal rigidity and tenderness, fever, loss of bowel sounds, and tachycardia, all clinical signs of

peritonitis