NCLEX exam 3 GI problems

Which physical examination should the nurse implement first when assessing the client diagnosed with peptic ulcer disease? 1. auscultate the clients bowel sounds in all four quadrants 2. palpate the abdomincal area for tenderness 3. percuss the abdominal borders to identify organs 4. assess the tender area progressing to nontender

1

Which s/s should the nurse expect to find in a client diagnosed with ulcerative colitis? 1. twenty blood stools a day 2. oral temp of 102 F 3. hard, rigid abdomen 4. urinary stress incontinence

1

The nurse is providing discharge teaching for a client with newly diagnosed chrons disease about dietary measures to implement during exacerbation episodes. which statement made by the client indicates a need for further instruciton? 1. i should increase the fiber in my diet 2. i will need to avoid caffeinated beverages 3. im going to learn some stress reduction techniques 4. i have exacerbations and remissions with chrons disease

1

The client diagnosed with IBD is prescribed total parental nutrition. which intervention should the nurse implement? 1. check the clients blood glucose 2. administer an oral gypoglycemic 3. assess the peripheral IV site 4. monitor the clients oral food intake

1

The client diagnosed with acute diverticulitis is complaining of severe abdominal pain. On assessment, the nurse finds a hard, rigid abdomen and T 102 which intervention should the nurse implement? 1. notify the HCP 2. prepare to administer a fleets enema 3. administer an antipyretic suppository 4. continue to monitor the client closely

1

a client with hiatal heria chronically experiences heartburn following meals. the nurse should plan to teach the client to avoid which action because it constraindicated with hiatal hernia? 1. lying recumbent following meals 2. consuming small frequent meals 3. take H2 receptor antagnoist meals 4. raising the head of the bed on 6 inch blocks

1

the client diagnosed with a hiatal hernia is scheduled for a laparoscopic Nissen fundoplication. which statement indicates the nurses teaching is effective? 1. i have four to five small incisions 2. i will be in the hospital for at least one week 3. i will not have any pain because this is laparoscopic surgery 4. i will be returning to work the day after my surgery

1

the client has end stage liver failure secondary to alcoholic cirrhosis. which complication indicates the client is at risk for developing hepatic encephalopathy? 1. gastrointestinal bleeding 2. hypoalbuminemia 3. splenomegaly 4. hyperaldosteronism

1

the client is diagnosed with chrons disease also known as regional anteritis. which statement by the client supports this diagnosis? 1. my pain goes away when i have a bowl movement 2. i have bright res blood in my stool all the time 3. i have episodes of diarrhea and constipation 4. my abdomen is hard and rigid and i have a fever

1

the client with acute diverticulitis has a Ng tube draining green liquid bile. which intervention should the nurse implement? 1. document the findings as norma 2. assess the clients bowel sounds 3. determine the clients last bowel movement 4. insert the NG tube at least 2 more inches

1

The client diagnosed with liver failure is experiencing pruritus secondary to severe jaundice. which action by the unlicensed assistive personnel warrants intervention by the nurse? 1. assisting the client to take a hot soapy shower 2. applies an emollient to the clients legs and back 3. puts mittens on both hands of the client 4. pats the clients skin dry with clean towel

1

The client recieving antibiotic therapy complains of white, cheesy plaques in the mouth. which intervention should the nurse implement? 1. notify the HCP ot obtain an antifungal med 2. explain the patches will go away naturally in about two weeks 3. instruct to rinse the mouth with diluted hydrogen peroxide and water dialy 4. allow the client to verbalize feelings about having the plaques

1

The client two hours post op laparoscopic cholecystectomy is complaining of severe pain in the right shoulder. which nursing intervention should the nurse implement? 1. apply a heating pad to the abdomen for 15-20 mins 2. administer morphine sulfate IV after diluting the saline 3. contact the surgeion for an order to X ray right shoulder 4. apply a sling to the arm which was injuring during surgery

1

The nurse provides instructions to a client about measures to treat IBS. which statement by the client indicates a need for further teaching? 1. i need to limit intake of dietary fiber 2. i need to drink plenty at least 8 to 10 cups daily 3. i need to eat regular measl and chew my food well 4. i will take the prescribed medications because they will regulate my bowl pattern

1

The nurse writes the problem "imbalanced nutrition: less than body requirements" for the client diagnosed with hepatitis. Which intervention should the nurse include in the plan of care? 1. Provide a high-calorie intake diet. 2. Discuss total parenteral nutrition (TPN). 3. Instruct the client to decrease salt intake. 4. Encourage the client to increase water intake.

1

The nurse is caring for a client diagnosed with GERD writes the client problem of behavior modification. which intervention should be incldued for this problem? 1. teach the client to sleep with a foam wedge under the head 2. encourage the client to decrease the amount of smoking 3. instruct the client to take over the counter meds for relief of pain 4. discuss the need to attend alcogolics anonymous to quite drinking

1

The nurse is caring for a client diagnosed with a rule out peptic ulcer disease. which test confirms the diganosis? 1. esophagogastroduodenoscopy 2. magnetic resonance imaging 3. occult blood test 4. gastric acid stimulation

1

The nurse is caring for an adult diagnosed with GERD. which condition is the most common comorbid disease associated with GERD? 1. adult onset asthma 2. pancreatitis 3. peptic ulcer disease 4. increased gastric emptying

1

The nurse is monitoring a client for early signs and symptoms of dumping syndrome. which findings indicate this occurence? 1. sweating and pallor 2. bradycardia and indigestion 3. double vision and chest pain 4. abdominal cramping and pain

1

Which data should the nurse expect to assess in the client who had an upper gastrointestinal (UGI) series? 1. Chalky white stools. 2. Increased heart rate. 3. A firm hard abdomen. 4. Hyperactive bowel sounds.

1

The nurse is performing an admission assessment on a client diagnosed with GERD. which s/s would indicate GERD? 1. pyrosis, water brash, flatulence 2. weight loss, dysarthria, and diarrhea 3. decreased abdominal fat, proteinuria, and constipation 4. midepigastric pain, positive h pylori test, and melena

1

Which oral med should the nurse question before administering to the client with peptic ulcer disease? 1. E-mycin 2. prilosec 3. flagyl 4. tylenol

1

which priority teaching information should the nurse discuss with the client to help prevent contracting hep b? 1. explain the importance of good hand washing 2. recommend the client take the hep b vaccine 3. tell the client no to ingest unsanitary food or water 4. discuss how to implement standard precautions

2

which type of precaution should the nurse implement to protect from being expoed to any of the hep viruses? 1. airborn 2. standard 3. droplet 4. exposure

2

The nurse is discussing the therapeutic diet for the client diagnosed with diverticulosis. Which meal indicates the client understands the discharge teaching? 1. fried fish, mashed potatoes, and ice tea 2. ham sandwhich, applesauce and whole milk 3. chicken salad on whole wheat bread and water 4. lettuce, tomato, and cucumber salad and coffee

3

The nurse is doing an admission assessment on a client with a history of a duodenal ulcer. to determine whether the problem is currently active, the nurse should assess the client for which manifestation of duodenal ulcer? 1. weight loss 2. nausea and vomiting 3. pain relieved by food intake 4. pain radiating down the arm

3

The nurse is planning the care of a client diagnosed with lower resophageal sphincter dysfunction. which dietary modifications should be included in the plan of care? 1. allow any of the clients favorite foods as long as the amount is limited 2. have the client perform erucation exercise several times a day 3. eat four to six small meals a day and limit fluids during mealtime 4. encourage the client to consume a glass of red wine with one meal a day

3

The nurse is preparing a client diagnosed with GERD for surgery. which information warrants notifying the HCP? 1. the client bernstein esophgeal test was positive 2. the clients abdominal x-ray shows hiatal hernia 3. clients WBC count is 14,000 4. the client hemoglobin is 13.8

3

The nurse is providing discharge instructions to a client following gastrectomy and should instruct the client to take which measure to assist in preventing dumping syndrome? 1. ambulate following a meal 2. eat high-carb foods 3. limit the fluids taken with meals 4. sit in a high fowlers position during meals

3

The nurse is reviewing the record of a client with a diagnosis of cirrhosis and notes that there is a documentation of the presence of asterixis. how should the nurse assess for its presence? 1. dorsiflex the clients foot 2. measure the abdominal girth 3. ask the client to extend the arms 4. instruct the client to lean forward

3

The nurse is reviweing the lab results for a client with cirrhosis and notes that the ammonia level is 85. which dietary selection does the nurse suggest to the client? 1. roast pork 2. cheese omlet 3. pasta with sauce 4. tuna fish sandwhich

3

The nurse is working in an outpatient clinic. which client is most likely to have a diagnosis of diverticulosis? 1. 60 year old male with a sedentary lifestyle 2. 72 year old female with multiple childbirths 3. a 63 year old female with hemorrhoids 4. a 40 year old male with a family history

3

Which disease is the client diagnosed with GERD at greatest risk for developing ? 1. hiatal hernia 2. gastroenteritis 3. esophageal cancer 4. gastric cancer

3

Which information should the nurse teach the client post-barium ennema procedure? 1. client should not eat or drink anything for four hours 2. client should remain on bedrest until the sedatives wears off 3. client should take a mild laxative to help expel the barrium 4. client will have normal elimination color and pattern

3

Which task is most appropriate for the nurse to delegate to the unlicensed assistive personnel (UAP)? 1. draw the serum liver function test 2.. evaluate the clients intake and output 3. perform the bedside glucometer check 4. help the ward clerk transcribe orderes

3

the client diagnosed with ulcerative colitis. which s/s warrants immediate intervention by the nurse? 1. client has 20 bloody stools a day 2. oral temp is 99.8 3. abdomen is hard and rigid 4. complains of urinating when coughing

3

the client has had a liver biopsy. which postprocedure intervention should the nurse implement? 1. instruct the client to void immediatley 2. keep the client NPO for 8 hours 3. place the client on the right side 4. monitor BUN and creatinine levels

3

the client is being prepared for discharge after a laparoscopic cholecystectomy. which intervention should the nurse implement? 1. discuss the need to change the abdominal dressing daily 2. tell the client to check the t-tube output every 8 hours 3. include the significant other in the discharge teaching 4. instruct the client to stay off clear liquids for 2 days

3

the client is diagnosed with end stage liver failure. the client asks the nurse, why is my doctor decreasing the doses of my medications? which statement is the nurses best response? 1.you are worried because you doctor has decreased the dosage 2. you really should ask your doctor. i am sure there is a good reason 3. you may have an overdose of the medication because your liver is damaged 4. the hald life of the medication is altered because the liver is damaged

3

the client with type 2 diabetes is prescribed a prednisone, a steroid, for an acute exacerbation of IBD. which intervention should the nurse discuss with the client? 1. take this med on an empty stomach 2. notify the HCP if experiencing a moon face 3. take the steroid med as prescribed 4. notify the HCP if blood glucose if over 160

3

the emergency department nurse is working in a comuunity hospital. during the past two hours, 15 clients have been admitted with salmonella food poisoning. which information should the nurse discuss with clients? 1. explain the incubation period is 48 to 72 hours 2. explain the source of this poisoning is contaminated water 3. explain sources of contamination are eggs and chicken 4. explain the bacterial contaminant came from canned food

3

the nurse has been assigned to care for a client diagnosed with peptic ulcer disease, which assessment data require further intervention? 1. bowel sounds auscultated fifteen times in one min 2. belching after eating a heavy and fatty meal late at night 3. a decrease in systolic BP of 20 mm Hg from lying to sitting 4. a decreased frequency of distress located in the epigastric region.

3

the nurse is caring for a client diagnosed with ulcerative colitis. which s/s support this diagnosis? 1. increased appetite and thirst 2. elevated hemoglobin 3. multiple blood, liquid stools 4. exacerbations unrelated to stress

3

the nurse is caring for the client diagnosed with ascites secondary to hepatic cirrhosis. which information should the nurse report to the HCP? 1. a decrease in the clients daily weight of one pound. 2. an increase in urine output after administration of a diuretic 3. an increase in abdominal girth of two inches 4. a decrease in the serum direct bilirubin to 0.6

3

the nurse is caring for the client diganosed with hemorrhoids. which statement indicates further teaching is needed? 1. i should increase fruits, bran, and fluids in my diet 2. i will use wam compresses and take sitz baths daily 3. i must take a laxative every night and have a stool daily 4. i can use an analgesic ointment or suppository for pain

3

the nurse is caring for the immediate post op client who has a laparoscopic cholec. which task could the nurse delegate to the UAP? 1. check the abdominal dressings for bleeding 2. increase the IV fluid if the BP is low 3. ambulate the client to the bathroom 4. ausculatate the breath sounds in all lobes

3

which assessment question is priority for the nurse to ask the client diagnosed with end stage liver failure secondary to alcoholic cirrhosis? 1. how many years have you been drinking 2. have you completed an advance directive? 3. when did you have your last alcoholic drink 4. what foods did you eat at your last meal

3

which gastrointestinal assessment data should the nurse expect to find when assessing the client in end stage liver failure? 1. hypoalbuminemia and muscle wasting 2. oligomenorrhea and decreased body hair 3. clay colored stools and hemorrhoids 4. dyspnea and caput medusae

3

which instruction should be discussed with the client diagnosed with GERD? 1. eat a low carb, low sodium diet 2. lie down for 30 mins after eating 3. do not eat spicy foods or acidic foods 4. drink two glassess of water before bedtime

3

which intervention should the nurse include when discussing ways to prevent food poisioning? 1. wash hands for ten seconds after handling raw meat 2. clean all cutting boards between meats and fruits 3. maintain food temp at 140 during extended servings 4. explain fruits do not require washing prior to eating or preparing

3

The client diagnosed with IBD is prescribed sulfasalazine, a sulfonamide antibiotics. which statement best descried the rationale for administering this med? 1. it is administered rectally to help decrease colon inflammation 2. this med slows GI motility and reduces diarrhea 3. this med kills the bacteria causing the exacerbation 4. it acts topically on the colon mucosa to decrease inflammation

4

The client diagnosed with diverticulitis is complaining of severe pain the LLQ and has an oral temp of 100.6. which intervention should the nurse implement first? 1. notify the HCP 2. document the findings in the chart 3. administer an oral antipyretic 4. assess the clients abdomen

4

The client diagnosed with end stage lier failure is admitted with hepatic encephalopathy. which dietary restriction should be implemented by the nurse to address this complication? 1. restrict sodium 2. limit oral fluids 3. decreased daily fat intake 4. reduce protein intake to 60

4

The client is four hours post op cholectystectomy. which data warrant immediate intervention by the nurse? 1. absent bowel sounds in all four quadrants 2. the T-tube has 60 mL of green drainage 3. urine output of 100mL in the past three hours 4. refusal to turn, deep breathe, and cough

4

The client is two (2) hours post-colonoscopy. Which assessment data warrant intermediate intervention by the nurse? 1. The client has a soft, nontender abdomen. 2. The client has a loose, watery stool. 3. The client has hyperactive bowel sounds. 4. The client's pulse is 104 and BP is 98/60.

4

The nurse is caring for a client following a gastrojejunostomy. which postoperative prescription should the nurse question and verify? 1. leg exercise 2. early ambulation 3. irrigating the NG tube 4. coughing and deep breathing exercise

3

The charge nurse is monitoring client lab values. Which value is expected in the client with cholecystitis who has chronic inflammation? 1. a elevated WBC 2. a decreased lactate dehydrogenase 3. an elevated alkaline phosphatase 4. a decreased direct bilirubin level

1

A client had a new colostomy created 2 days earlier and is beginning to pass malodorous flatus from the stoma. What is the correct interpretation by the nurse? 1. This is a normal, expected event. 2. The client is experiencing early signs of ischemic bowel. 3. The client should not have the nasogastric tube removed. 4. This indicates inadequate preoperative bowel preparation.

1

A client has developed hepatitis A after eating contaminated oysters. The nurse assess the client for which expected assessment findings? 1. malaise 2. dark stools 3. weight gain 4. left upper quadrant discomfort

1

the nurse is administering a proton pump inhibitor to a client diagnosed with peptic ulcer disease. Which statement supports the rationale for administering this medications? 1. it prevents the final transport of hydrgen ions into the gastric lumen 2. it blocks the receptors controlling hydrochloric acid secretion by the parietal cells 3. it protects the ulcer from the destructive action of the digestive enzyme pepsin. 4. it neutralizes the hydrocholoric acid secreted by the stomach

1

the nurse is assessing the client in end stage liver failure who is diagnosed with portal hypertension. which intervention should the nurse include in the plan of care? 1. assess the abdomen for a tympanic wave 2. monitor the clients blood pressure 3. percuss the liver for size and location 4. weigh the client twice each week

1

the nurse is caring for an elderly client diagnosed with acute gastritis. which client problem is priority for this client? 1. fluid volume deficit 2. altered nutrition: less than body requirements 3. impaired tissue perfusion 3. alteration in comfort

1

the nurse is caring for the client who is one day pot UGI series. which assessment data warrant intervention? 1. no bowel movement 2. O2 of 96% 3. vital signs within normal baseline 4. intact gag reflex

1

the nurse is facilitating a support group for clients diagnosed with Chrons disease. which information is most important for the nurse to discuss with the clients? 1. discuss coping skills to assist with adaptation to lifestyle modifications 2. teach about drug administration, dosages, and scheduled times 3. teach dietary changes necessary to control s/s 4. explain the care of the ileostomy and necessary equipment

1

the nurse is preparing the postopt nursing care plan for the client recovering from a hemorrhoidectomy. which intervention should the nurse implement? 1. establish rapport with the client to decrease embarrasment of assessing site 2.encourage the client to lie in the lithotomy position twice a day. 3. milk the tube inserted during surgery to allow the passage of flatus 4. digitally dilate the rectal sphincter to express old blood

1

the public health nurse is teaching day care workers. which type of hepatitis is tranmistted by the fecal-oral route via contaminated food, water, or direct contact with an infected person? 1. hep a 2. hep b 3. hep c 4. hep d

1

which data should the nurse report to the HCP when assessing the oral cavity of an elderly client? 1. tounge is rough and beefy red 2. tonsils are +1 on a grading scale 3. mucosa is pink and moist 4. uvula rises with the mouth open

1

which intervention should the nurse implement specifically for the client in end stage liver failure who is experiencing hepatic encaphalopathy? 1. assess the clients neurological status 2. prepare to administer a loop diuretic 3. check the clients stool for blood 4. assess for an abdominal fluid wave

1

which outcome should the nurse identify for the client diagnosed with aphthous stomatitis? 1. client will be able to cope with percieved stress 2. client will consume a balanced diet 3. client will deny any difficulty swallowing 4. client will take antacids as prescribed

1

which problem is most appropriate for the nurse to identify for the client with diarrhea? 1. alteration in skin integrity 2. chronic pain perception 3. fluid volume excess 4. ineffective coping

1

the public health nurse is discussing hep b with a group in the community. Which health promotion activities should the nurse discuss with the group? select all that apply 1. do not share needles or eqipment 2. use barrier protection during sex 3. get the hep b vaccine 4. obtain immune globlin injections 5. avoid any type of hepatotoxic meds

1,2,3

the client in end stage liver failure has vitamin K deficiency. which interventions should the nurse implement? select all that apply 1. avoid rectal temperatures 2. use only a soft toothbrush 3. monitor the platelet count 4. use small gauge needles 5. assess for asterixis

1,2,3,4

The nurse is planning to teach a client with GERD about substances to avoid. Which items should the nurse include on this list? select all that apply 1. coffee 2. choclate 3. peppermint 4. nonfat milk 5. fried chicken 6. scrambled eggs

1,2,3,5

The nurse is teaching a class on diverticulosis. which intervention should the nurse discuss when teaching ways to prevent an acute exacerbation of divertiulosis? select all the apply 1. eat high fiber 2. increase fluid intake 3. elevate the HBO after eating 4. walk 30 mins a day 5. take an antacid every 2 hours

1,2,4

The nurse is reviweing the prescription for a client admitted to the hospital with a diagnosis of acute pancreasitits. which interventions would the nurse expect to be prescribed for the client? select all that apply 1. maintain NPO 2. encourage coughing and deep breathing 3. give small, frequent high calori feedings 4. maintain the client in a supine and flat position 5. give hydromorphone IV as prescribed for pain 6. maintian IV fluids at 10mL/hr to keep the vein open

1,2,5

Which s/s should the nruse report to the HCP for the client recovering from an open cholecystectomy? select all that apply 1. clay color stools 2. yellow tinited sclera 3. amber colored urine 4. wound approximated 5. abdominal pain

1,2,5

A client has just had a hemorrhoidectomy. Which nursing intervention are appropriate for this client? select all that apply 1. administer stool softeners as prescribed 2. instruct the client to limit fluid intake to avoid urinary retention 3. encourage a high fiber diet to promote bowel movement without straining 4. apply cold packs to the anal rectal area over the dressing until the packing is removed 5. help the client to fowlers position to place pressure on the rectal area and decrease bleeding

1,3,4

The nurse is assessing a client who is experiencing an acute episode of cholecystitis. Which of these clinical manifestations support this diagnosis? select all that apply 1. fever 2.positive cullen signs 3. complaints of indgestion 4. pain in the upper right quadrant after a fatty meal 5. vague lower right quadrant abdominal discomfort

1,3,5

"The client with hepatitis asks the nurse ""I went to an herbalist, who recommended I take milk thistle. What do you think about the herb?"" Which statement is the nurse's best response? "1. ""You are concerned about taking an herb"" 2. ""The herb has been used to treat liver disease"" 3. ""I would not take anything that is not prescribed"" 4. ""Why would you want to take any herbs?""

2

A client is diagnosed with viral hepatitis, complaining of no appetite, and losing my tatse for food. What instruction should the nurse give the client to provide adequate nutrition? 1. select foods high in fat 2. increase intake of fluids, including juices 3. eat a good supper when anorexia is not as severe 4. eat less often preferable only large 3 meals daily

2

The HCP had determined that a client has contracted hepatitis A on the flu like symtpms and jaundice. Which statement made by the client supports this medical diagnosis? 1. i have had unprotected sex with multiple partners 2. i ate shellfish about 2 weeks ago at a local resturant 3. i was an IV drug abuser in teh past and shared needles 4. i had a blood transfusion 30 years ago after major abdominal surgery

2

The client diagnosed with IBD has a serum potassium level of 3.4. which action should the nurse first implement? 1. notify the HCP 2. assess the client for muscle weakness 3. request telemetry for the client 4. prepare to administer potassium IV

2

The client is admitted to the medical floor with acute diverticulitis. which collaborative intervention should the nurse anticipate the HCP ordering? 1. administer total parenteral nutrition 2. maintain NPO and NG tube 3. maintain on a high fiber diet and increase fluids 4. obtain consent for abdominal surgery

2

The client is diagnosed with an acute exacerbation of ulcerative colitis. which intervention should the nurse implement? 1. provide a low residure diet 2. rest the clients bowels 3. assess vital signs daily 4. administer antacids orally

2

The client with a history of peptic ulcer disease is admitted into the ICU with frank gastric bleeding. which priority intervention should the nurse implement? 1. maintain a strict record of intake and output 2. insert a NG tube and begin saline lavage 3. assist the client with keeping a detailed calorie count 4. provide a quiet envrionment to promote rest

2

The male client tells the nurse he has been experiencing heartbrun at night that awakens him. which assessment questions should the nurse ask? 1. how much weight have you gained recently 2. what have you done to alleviate the heartburn 3. do you consume many milk and dairy products 4. have you been around anyone with a stomach virus

2

The nurse identifies the client problem" excess fluid volume" for the client in lier failure. which short term goal would be most appropriate for this problem? 1. client will not gain more than two kg a day 2. client will have no increase in abdominal girth 3. client vital signs will remain within normal limits 4. client will receive a slow sodium diet

2

The nurse is caring for the client with castoidium difficle. which intervention should the nurse implement to prevent nosocomial spread to other clients? 1. wash hands with betadine for two mins before giving care 2. wear nonsterile gloves when handling GI excretions 3. clean the perianal area with soap and water after each stools 4. flush the commode twice when disposing of stool

2

A client has just had surgery to create an ileostomy. The nurse assess the client in the immediate postoperatuve period for which most frequent complication of this type of surgery? 1. folate deficiency 2. malabsorption of fat 3. intenstinal obstruction 4. fluid and electrolyte imbalance

4

The nurse is monitoring a client admitted to the hospital with a diagnosis of appendicitis who is scheduled for surgery in 2 hours. The client begins to complain of increased abdominal pain and begins to vomit. On assessment, the nurse notes that the abdomen is distended and bowel sounds are diminished. Which is the most appropriate nursing intervention? 1. administer the prescribed pain med 2. notify the HCP 3. call and ask the operating room team to perform surgery as soon as possible 4. resposition the client and apply a heating pad on the warm setting to the clients abdomen.

2

The nurse is preparing to administer the intial dose of aminoglycoside antibiotic to the client diagnosed with acute diverticulitis. Which intervention should the nurse implement? 1. obtain a serum trough level 2. ask about drug allergies 3. monitor the peak level 4. assess the vital signs

2

The nurse is providing care for a client with a recent transverse colostomy. which observation requires immediate notification of the HCP? 1. stoma is beefy red and shiny 2. purple discoloration of the stoma 3. skin excoriation around the stoma 4. semiformed stool noted in the ostomy pouch

2

The nurse is teaching a client recovering from a laparoscopic cholecystectomy. which statement indicates the discharge teaching is effective? 1. i will take my lipid lowering medicine at the same time each night 2. i may experience some discomfort when i eat a high fate meal 3. i need someone to stay with me for about a week after surgery 4. i should not splint my incision when i deep breath and cough

2

Which assessment data indicate to the nurse the clients gastric ulcer has perforated? 1. complaints of sudden sharp substernal pain 2. rigid, boardlike abdomen with rebound tenderness 3. frequent, clay-colored liquid stool 4. complaints of vague abdominal pain in the URQ

2

Which expected outcome should the nurse include for a client diagnosed with peptic ulcer disease? 1. the clients pain is controlled with the use of NSAIDs 2. the client maintains lifestyle modifications 3. the client has no s/s of hemoptysis 4. the client take antacids with each meal

2

Which specific data should the nurse obtain from the client who is suspected of having peptic ulcer disease? 1. history of side effects experienced from all medications 2. use of nonsteroidal anti-inflammatory drugs 3. any known allergies to drugs and environmental factors 4. medical histories of at least three generations

2

Which statement made by the client indicates to the nurse the client may be experiencing GERD? 1. my chest hurts when i walk up the stairs in my home 2. i take antacid tablets with me wherever i go 3. my spouse tells me i snore vert loudly at night 4. i drink 6 to 7 soft drinks every day

2

the client diagnosed with end stage liver failure is admitted with esophageal bleeding, The HCP inserts and inflates a triple lumen NG tube. which nursing intervention should the nurse impement for this treatment? 1. assess the gag reflex every shift 2. stay with client at all times 3. administer the laxative lactulose 4. monitor the clients ammonia level

2

the client diagnosed with liver problems asks the nurse " why are my stools clay colored" on which scientific rationale should the nurse base the response? 1. there is an increase in serum ammonia level 2. the liver is unable to excrete bilirubin 3. the liver is unable to metabolize fatty foods 4. a damaged liver cannot detoxify vitamins

2

the client diagnosed with ulcerative colitis has an ilesotomy. which statement indicates the client needs more teaching concerning the ileostomy? 1. my stoma should be pink and moist 2. i will irrigate my ileostomy every morning 3. if i get a red, bumpy, itchy rash i will call the HCP 4. i will change my puch if it start leaking

2

the client is admitted with end stage liver failure and is prescribed the laxative lactulose. which statement indicates the clients needs more teaching concerining this medication? 1. i should have two or three soft stools a day 2. i must check my ammonia level daily 3. if i have diarrhea i will call my doctor 4. i should heck my stool for any blood

2

the client is diagnosed with esophageal diverticula. which lifestyle modification should be taught by the nurse? 1. raise the foot of the bed to 45 degree to increase peristalsis 2. eat the evening meal at least two hours prior to bed 3. eat a low fat low cholesterol high fiber diet 4. wear an abdominal binder to strengthen the abdominal muscles

2

the female nurse sticks herself with a contaminated needle. which action should the nurse implement first. 1. notify the infection control nurse 2. cleanse the area with soap and water 3. request postexposure prophylaxis 4. check the hepatitis status of the client

2

the nurse is assessing the client diagnosed with chronic gastritis. which s/s support the diagnosis? 1. rapid onset of midsternal discomfort 2. epigastric pain relieved by eating food 3. dyspepsia and hematemesis 4. nausea and projectile vomiting

2

the nurse is caring for the client diagnosed with hepatic encephalopathy. which s/s indicate the disease is progressing? 1. client has a decrease in serum ammonia level 2. client is not able to circle choices on the menu 3. client is able to take deep breaths as directed 4. client is able to eat previously restricted food items

2

the nurse is caring for the client one day postop sigmoid colostomy. which independent nursing intervention should the nurse implement? 1. change the infusion rate of the IV fluid 2. encourage the client to ventilate feelings about body image 3. administer opiod narcotic med for pain 4. assist the client out of bed to sit in the chair twice daily

2

which assessment data indicate to the nurse the client recovering from an open scholectystectomy may require pain medication? 1. the clients pulse is 64 beats per min 2. the client has shallow respirations 3. the client bowel sounds are 20 per min 4. the client uses a pillow to splint when coughing

2

which instructions should the nurse discuss with the client who is in the icteric phase of hep c? 1. decrease alcohol intake 2. encourage rest periods 3. eat a large evening meal 4. drink diet drinks and juices

2

which intervention should the nurse implement when administering a potassium supplement? 1. determine the clients allergies 2. ask the client about leg cramps 3. monitor the clients blood pressure 4. monitor the clients complete blood count

2

which interventions should the nurse discuss regarding prevention of an acute exacerbation of diverticulosis? select all that apply 1. eat a low fiber diet 2. drink 2,5000 mL of water daily 3. avoid eating foods with seeds 4. walk 30 mins a day 5. take an antacid every 2 hours

2,3,4

The client diagnosed with ulcerative colitis is prescribed a low residue diet. which meal selection indicates the client understand the diet teaching? 1, grilled hamburger on a wheat bun and fried potatoes 2. a chicken salad sandwhich and lettuce and tomato salad 3. roast pork, white rice, and plain custard 4. fried fish, whole grain pasta, and fruit salad

3

The client is admitted to the medical unit with a diagnosis of acute diverticulitis. which HCP orders should the nurse question? 1. insert a ng tube 2. insert an IV with D5W at 125 mL/hr 3. put a client on a clear liquid diet 4. place a client on bedrest with bathroom privilages

3

The client is diagonised with acute exacerbation of IBD. which priotiy intervention should the nurse first implement? 1. i understand how frusturating this must be for you 2. you must keep thinking about the good things in life 3. i can see you are very upset, ill sit down and we can talk 4. are you thinking about doing anything like committing suicide?

3

The client is one (1) hour post-endoscopic retrograde cholangiopancreatogram (ERCP). Which intervention should the nurse include in the plan of care? 1. Instruct the client to cough forcefully. 2. Encourage early ambulation. 3. Assess for return of a gag reflex. 4. Administer held medications.

3

The nurse assess a large amount of red drainage on the dressing of a client who is six hours post op choectystectomy which intervention should the nurse implement? 1. measure abdominal girth 2. palpate the lower abdomen for a mass 3. turn client onto side to assess for further drainage 4. remove the dressing to determine the source

3

The nurse has taught the client about an upcoming endoscopic retrograde cholangiopancreatography procedure. The nurse determined that the client needs further information if the client makes which statement? 1. i know i must sign the consent form 2. i hope the throat spray keeps me from gagging 3. im glad i dont have to lie still for this procedure 4. im glad some IV med will be given to relax me

3

The nurse is assessing a client 24 hours following a cholecystectomy. The nurse notes that the T tue has drained 750mL of green-brown drainage since the surgery. which nursing intervention is most appropriate? 1. clam the t tube 2. irrigate the t tube 3. document the findings 4. notify the HCP

3

the nurse is caring for a client diagnosed with hemorrhaging duodenal ulcer, which collaborative interventions should the nurse implement? select all that apply 1. perform a complete pain assessment 2. assess the clients vitals signs frequently 3. administer a proton pump inhibitor iv 4. obtain permission and administer blood prodcuts 5. monitor the intake of a soft bland diet

3,4

A client had undergone esophagogastroduodenoscopy. The nurse should place highest priority on which item as part of the clients care plan? 1. monitoring the temperature 2. monitoring complaints of heartburn 3. giving warm gargles for a soft throat 4. assessing for the return of gag reflex

4

The nurse identifies the client problem "alteration in GI system" for the elderly client. which statement reflects the most appropriate rationale for this problem? 1. elderly clients have the ability to chew food more thoroughly with dentures 2. elderly clients have an increase in digestive enzymes which helps with digestion 3. elderly clients have an increased need for laxatives because of the decrease in bile 4. elderly clients have an increase in bacteria in the GI system, resulting in diarrhea

4

The nurse is caring for a client diagnosed with GERD. which nursing intervention should be implemented? 1. place the client prone in bed and administer nonsteroidal anti-inflammatory meds 2. have the client remain upright at all times and walk for 30 mins three times a week 3. instruct the client to maintain a right lateral side lying position and take antacids before meals 4. elevate the head of the bed 30 degrees and discuss lifestyle modifications with the client

4

The nurse is monitoring a client with a diagnosis of peptic ulcer. which assessment findings would most likely indicate perforation of the ucler? 1. bradycardia 2. numbness in the legs 3. nausea and vomiting 4. a rigid, board like adbomen

4

The nurse is preparing a client diagnosed with GERD for discharge following an esophagogastrodudenoscopy. which statement indicated the client understand the discharge instructions? 1. i should not eat for a least one day following this procedure 2. i can lie down whenever i want after a meal. it wont make a difference 3. the stomach contents wont bother my esophagus but will make me nauseous 4. i should avoid OJ and eating tomatoes until my esophagus heals

4

The nurse is teaching the client diagnosed with diverticulosis. which instructions should the nurse include in the teaching session? 1. discuss the importance of drinking 1,000mL of water daily 2. instruct the client to exercise at least three times a week 3. teach the client about a eating a lower residue diet 4. explain the need to have daily bowel movement

4

Which problems should the nurse include in the plan of care for the client diagnosed with peptic ulcer disease to observe for physiological complications? 1. Alteration in bowel elimination patterns. 2. Knowledge deficit in the causes of ulcers. 3. Inability to cope with changing family roles. 4. Potential for alteration in gastric emptying.

4

the client is diagnosed with acute exacerbation IBD. which food selection would be the best choice for a meal? 1. roast beef on wheat bread and milk shake 2. hamburger, french fries and a coke 3. pepper steak, brown rice and ice tea 4. roasted turkey, instant mashed potatoes and water

4

the client is in the preicteric phase of hepatitis. which s/s should the nurse expect the client to exhibit during this phase? 1. clay colored stools and jaundice 2. normal appetite and pruritus 3. being afebrile and left upper quadrant pain 4. c/o fatigue and diarrhea

4

the nurse has administered an antibotic, a proton inhibitor, and pepto-bismol for peptic ulcer disease secondary to H pylori. which data would indicate to the nurse the meds are effective? 1. a decrease in alcohol intake 2. maintaing a bland diet 3. a return to previous activities 4. a decrease in gastric distress

4

the nurse identifies the problem of fluid volume deficit for a client diagnosed with gastritis. which intervention should be included in the plan of care? 1. obtain permission for a blood transufusion 2. prepare the client for TPN 3. monitor the clients lung sounds every shift 4. assess the clients IV site.

4

the nurse is administering morning medications at 0730. Which medication should have priority? 1. a proton pump inhibitor 2. a nonnarcotic analgesic 3. a histamine receptor antagonist 4. a muscosal barrier agent

4

the nurse is assessing a client complaining of abdominal pain. which data support the diagnosis of a bowel obstruction? 1. steady, aching pain in one specific area 2. sharp back pain radiating to the flank 3. sharp pain increases with deep breaths 4. intermitten colicky pain near the umbilicus

4

the school nurse is discussing methods to prevent an outbreak of hep a with a group of high school teachers. Which action is the most important to each the high school teachers? 1. do not allow students to eat or drink after each other 2. drink bottled water as much as possible 3. encourage protected sex 4. sing the happy birthday song while washing hands

4

which assessment data support to the nurse the clients diagnosis of gastric ulcer? 1. presence of blood in the clients stool for the past month 2. reports of a burning sensation moving like a wave 3. sharp pain in the upper abdomen after eating a heavy meal 4. complaints of epigastric pain 30 to 60 mins after ingesting food

4

which outcome should the nurse identify for the client scheduled to have a cholecstectomy? 1. decreased pain management 2. ambulate first day op 3. no break in skin integrity 4. knowledge of post op care

4

which problem is highest priority for the nurse to identify in the client who has an open cholecystectomy surgery? 1. alteration in nutrition 2. alteration in skin integrity 3. alteration in urinary pattern 4. alteraion in comfort

4

which statement by the client diagosed with hepatitis warrants immediate intervention by the clinic nurse? 1. i will not drink any type of beer or mixed drink 2. i will get adequate rest so i dont get exhausted 3. i had a big hearty breakfast this morning 4. i took some cough syrup for this nasty head cold

4

A client admitted to the hospital with a suspected diagnosis of acute pancreatitis is being assessed by the nurse. Which assessment findings would be consistent with acute pancreatitis? select all that apply 1. diarrhea 2. black, tarry stools 3. hyperactive bowel sounds 4. gray-blue color at the flank 5. abdominal guarding and tenderness 6. left upper quadrant pain with radiation to the back

4,5,6

The nurse is preparing to administer 250 mL of IV antibiotic to the client. the med must infuse in one hour. An iv pump is not available and the nurse must administer the med via gravity with IV tubin at 10gtt/min. At what rate should the nurse infuse the medication?

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