Nurs 240 E4
The nurse is caring for a patient with acute pancreatitis. The patient has an order for an anticholinergic medication. The nurse explains that the patient will be receiving that medication for what reason? a) To relieve nausea and vomiting b) To decrease metabolism c) To depress the central nervous system and increase the pain threshold d) To reduce gastric and pancreatic secretions
To reduce gastric and pancreatic secretions
Which of the following is considered a bulk-forming laxative? a) Milk of Magnesia b) Dulcolax c) Mineral oil d) Metamucil
Metamucil
The nurse should assess for an important early indicator of acute pancreatitis, which is a prolonged and elevated level of: a) Serum amylase b) Serum bilirubin c) Serum calcium d) Serum lipase
Serum lipase
The nurse should assess for an important early indicator of acute pancreatitis, which is a prolonged and elevated level of: a) Serum bilirubin b) Serum amylase c) Serum calcium d) Serum lipase
Serum lipase
Several clinical manifestations are associated with a tumor of the head of the pancreas. Choose all that apply. a) Dark urine b) Amber-colored urine c) Dark-colored stools d) Jaundice e) Clay-colored stools
• Clay-colored stools • Dark urine • Jaundice
A client is admitted to the health care facility with abdominal pain, a low-grade fever, abdominal distention, and weight loss. The physician diagnoses acute pancreatitis. What is the primary goal of nursing care for this client? a) Preventing fluid volume overload b) Relieving abdominal pain c) Maintaining adequate nutritional status d) Teaching about the disease and its treatment
Relieving abdominal pain
A patient with an ileostomy should avoid which of the following? a) Antacids and antibiotics b) Nonlayered tablets c) Enteric-coated products d) Wax matrix coated products
Enteric-coated products
A nurse is planning care for a patient with acute pancreatitis. Which of the following patient outcomes does the nurse assign as the highest priority? a) Maintaining satisfactory pain control b) Maintenance of normal respiratory function c) Adequate fluid and electrolyte balance d) Developing no acute complications from the pancreatitis
Maintenance of normal respiratory function
A nursing student has learned about many collaborative interventions to achieve pain relief for clients with acute pancreatitis. Which of the following are appropriate? Choose all that apply. a) Encourage bed rest to decrease the client's metabolic rate. b) Allow the client to have sips of clear liquids. c) Withhold oral feedings to limit the release of secretin. d) Teach the client about the correlation between alcohol intake and pain.
Encourage bed rest to decrease the client's metabolic rate. Withhold oral feedings to limit the release of secretin. Teach the client about the correlation between alcohol intake and pain.
A nurse is providing preoperative teaching to a client undergoing a cholecystectomy. Which topic should the nurse include in her teaching plan? a) Improve nutritional status during recovery. b) Eliminate the need for nasogastric intubation. c) Decrease the amount of postoperative analgesia needed. d) Increase respiratory effectiveness.
Increase respiratory effectiveness.
A critical care nurse is caring for a client with acute pancreatitis. One potentially severe complication involves the respiratory system. Which of the following would be an appropriate intervention to prevent complications associated with the respiratory system? a) Withhold oral feedings. b) Administer enteral or parenteral nutrition. c) Carry out wound care as prescribed. d) Maintain the client in a semi-Fowler's position.
Maintain the client in a semi-Fowler's position.
A client with anorexia complains of constipation. Which of the following nursing measures would be most effective in helping the client reduce constipation? a) Obtain complete food history. b) Obtain medical and allergy history. c) Assist client to increase dietary fiber. d) Provide adequate quantity of food.
Assist client to increase dietary fiber.
A patient is admitted to the hospital with a possible common bile duct obstruction. What clinical manifestations does the nurse understand are indicators of this problem? (Select all that apply.) a) Pruritus b) Pain in the left upper abdominal quadrant c) Jaundice d) Amber-colored urine e) Clay-colored feces
Clay-colored feces Pruritus Jaundice
A nurse is reviewing lab results for a client with an intestinal obstruction, and infection is suspected. Which of the following would be an expected finding? a) Leukopenia, decreased hematocrit; low sodium, potassium, and chloride b) Leukocytosis; metabolic alkalosis; elevated sodium, potassium, and chloride c) Leukocytosis; elevated hematocrit; low sodium, potassium, and chloride d) Leukopenia; metabolic acidosis; elevated sodium, potassium, and chloride
Leukocytosis; elevated hematocrit; low sodium, potassium, and chloride
As part of the management of constipation, the client is instructed to take 30 ml of mineral oil orally. Mineral oil facilitates bowel evacuation by a) Irritating nerve endings in the intestinal mucosa b) Lubricating and softening fecal matter c) Decreasing water retention of stool d) Increasing the volume of intestinal contents
Lubricating and softening fecal matter
From the following profiles of clients, which client would be most likely to undergo the diagnostic test of cholecystography? a) Andrew, suspected of having esophageal abnormalities b) Sandra, suspected of having lesions in the liver c) Steven, suspected of having a tumor in the colon d) Mark, suspected of having stones in the gallbladder
Mark, suspected of having stones in the gallbladder
Because clients with pancreatitis cannot tolerate high-glucose concentrations, total parental nutrition (TPN) should be used cautiously with them. Which of the following interventions has shown great promise in the prognosis of clients with severe acute pancreatitis? a) Providing intensive insulin therapy b) Allowiing a clear liquid diet during the acute phase c) Maintaining a high-Fowler's position d) Administering oral analgesics around the clock
Providing intensive insulin therapy
A client with cholelithiasis has a gallstone lodged in the common bile duct. When assessing this client, the nurse expects to note: a) black, tarry stools. b) circumoral pallor. c) light amber urine. d) yellow sclerae.
yellow sclerae.
A client with cholelithiasis has a gallstone lodged in the common bile duct. When assessing this client, the nurse expects to note: a) circumoral pallor. b) light amber urine. c) yellow sclerae. d) black, tarry stools.
yellow sclerae.
The nurse teaches the patient whose surgery will result in a sigmoid colostomy that the feces expelled through the colostomy will be a) mushy. b) solid. c) fluid. d) semimushy.
solid.
A client has been recently diagnosed with an anorectal condition. The nurse is reviewing interventions that will assist the client with managing his therapeutic regimen. Which of the following would not be included? a) Encourage client to avoid exercise. b) Teach client how to do sitz baths at home using warm water three to four times each day. c) Instruct client to cleanse perianal area with warm water. d) Encourage client to follow diet and medication instructions.
Encourage client to avoid exercise.
A patient diagnosed with colon cancer presents with the characteristic symptoms of a left-sided lesion. Which of the following symptoms are indicative of this disorder? Select all that apply. a) Constipation b) Dull abdominal pain c) Narrowing stools d) Black, tarry stools e) Abdominal distention
Narrowing stools Constipation Abdominal distention
Which of the following is the major cause of morbidity and mortality in patients with acute pancreatitis? a) Pancreatic necrosis b) Tetany c) Shock d) MODS
Pancreatic necrosis
After undergoing a total cystectomy and urinary diversion, a client has a Kock pouch (continent internal reservoir) in place. Which statement by the client indicates a need for further teaching? a) "I'll need to drink at least eight glasses of water a day." b) "I should eat foods from all the food groups." c) "I'll have to catheterize my pouch every 2 hours." d) "I'll have to wear an external collection pouch for the rest of my life."
"I'll have to wear an external collection pouch for the rest of my life."
A patient underwent a continent ileostomy. Within which timeframe should the patient expect to empty the reservoir? a) At least once every 2 days b) Three or four times daily c) Every 4 to 6 hours d) At least once a day
Every 4 to 6 hours
Which of the following is accurate regarding regional enteritis? a) Severe bleeding b) Fistulas are common c) Exacerbations and remissions d) Severe diarrhea
Exacerbations and remissions
The nurse knows that serum amylase levels return to normal within which timeframe? a) 12 hours b) 24 hours c) 36 hours d) 48 hours
48 hours
The nurse knows that serum amylase levels return to normal within which timeframe? a) 12 hours b) 24 hours c) 48 hours d) 36 hours
48 hours
A client reports to the clinic, stating that she rapidly developed headache, abdominal pain, nausea, hiccuping, and fatigue about 2 hours ago. For dinner, she ate buffalo chicken wings and beer. Which of the following medical conditions is most consistent with the client's presenting problems? a) Gastric ulcer b) Duodenal ulcer c) Acute gastritis d) Gastric cancer
Acute gastritis
A client is evaluated for severe pain in the right upper abdominal quadrant, which is accompanied by nausea and vomiting. The physician diagnoses acute cholecystitis and cholelithiasis. For this client, which nursing diagnosis takes top priority? a) Anxiety related to unknown outcome of hospitalization b) Deficient knowledge related to prevention of disease recurrence c) Imbalanced nutrition: Less than body requirements related to biliary inflammation d) Acute pain related to biliary spasms
Acute pain related to biliary spasms
A nurse is caring for a client diagnosed with cholelithiasis. Which of the following would be most appropriate for a client who is experiencing biliary colic? a) Avoid administering antispasmodics. b) Ensure that the client rests. c) Ensure that the client has eaten a full meal. d) Administer analgesics to the client.
Administer analgesics to the client.
A nurse is caring for a client diagnosed with cholelithiasis. Which of the following would be most appropriate for a client who is experiencing biliary colic? a) Ensure that the client has eaten a full meal. b) Administer analgesics to the client. c) Avoid administering antispasmodics. d) Ensure that the client rests.
Administer analgesics to the client.
A patient admitted with severe epigastric abdominal pain radiating to the back is vomiting and complaining of difficulty breathing. Upon assessment, the nurse determines that the patent is experiencing tachycardia and hypotension. Which of the following actions is a priority intervention for this patient? Select all that apply. a) Administer plasma. b) Administer a low-fat diet. c) Administer electrolytes. d) Administer pain-relieving medication. e) Assist the patient to a semi-Fowler's position
Administer pain-relieving medication. Administer electrolytes. Administer plasma. Assist the patient to a semi-Fowler's position
A patient admitted with severe epigastric abdominal pain radiating to the back is vomiting and complaining of difficulty breathing. Upon assessment, the nurse determines that the patent is experiencing tachycardia and hypotension. Which of the following actions is a priority intervention for this patient? Select all that apply. a) Assist the patient to a semi-Fowler's position b) Administer a low-fat diet. c) Administer plasma. d) Administer electrolytes. e) Administer pain-relieving medication.
Administer pain-relieving medication. Administer electrolytes. Administer plasma. Assist the patient to a semi-Fowler's position
A client with a history of alcohol abuse comes to the emergency department and complains of abdominal pain. Laboratory studies help confirm a diagnosis of acute pancreatitis. The client's vital signs are stable, but the client's pain is worsening and radiating to his back. Which intervention takes priority for this client? a) Providing mouth care b) Maintaining nothing-by-mouth (NPO) status c) Placing the client in a semi-Fowler's position d) Administering morphine I.V. as ordered
Administering morphine I.V. as ordered
Clinical manifestations of common bile duct obstruction include all of the following except: a) Pruritus b) Clay-colored feces c) Amber-colored urine d) Jaundice
Amber-colored urine
A nurse applies an ostomy appliance to a patient who is recovering from ileostomy surgery. Which of the following interventions should the nurse utilize to prevent leakages from the appliance? a) Ensure that no air is trapped in the pouch b) Ensure that there are no holes in the pouch c) Press the adhesive faceplate from the stomal edge inward d) Ask the patient to remain inactive for 5 minutes.
Ask the patient to remain inactive for 5 minutes.
The nurse is planning care for a patient following an incisional cholecystectomy for cholelithiasis. Which of the following interventions is the highest nursing priority for this patient? a) Teaching the patient to choose low-fat foods from the menu b) Performing range-of-motion (ROM) leg exercises hourly while the patient is awake c) Assisting the patient to turn, cough, and deep breathe every 2 hours d) Assisting the patient to ambulate the evening of the operative day
Assisting the patient to turn, cough, and deep breathe every 2 hours
A patient who had developed jaundice 2 months previous is brought to the ED after attending a party and developing excruciating pain that radiated over the abdomen and into the back. Upon assessment, which additional symptom would the nurse expect this patient to have? a) Bile-stained vomiting b) Hypertension c) Weight loss d) Warm, dry skin
Bile-stained vomiting
Which of the following is considered a stimulant laxative? a) Bisacodyl (Dulcolax) b) Magnesium hydroxide (milk of Magnesia) c) Psyllium hydrophilic mucilloid (Metamucil) d) Mineral oil
Bisacodyl (Dulcolax)
Which of the following is considered a stimulant laxative? a) Magnesium hydroxide (Milk of Magnesia) b) Bisacodyl (Dulcolax) c) Psyllium hydrophilic mucilloid (Metamucil) d) Mineral oil
Bisacodyl (Dulcolax)
Which of the following is considered a stimulant laxative? a) Psyllium hydrophilic mucilloid (Metamucil) b) Magnesium hydroxide (milk of Magnesia) c) Bisacodyl (Dulcolax) d) Mineral oil
Bisacodyl (Dulcolax)
Which of the following would a nurse expect to assess in a client with peritonitis? a) Decreased pulse rate b) Deep slow respirations c) Hyperactive bowel sounds d) Board-like abdomen
Board-like abdomen
Which of the following would a nurse expect to assess in a client with peritonitis? a) Decreased pulse rate b) Hyperactive bowel sounds c) Board-like abdomen d) Deep slow respirations
Board-like abdomen
The nurse is performing and documenting the findings of an abdominal assessment. When the nurse hears intestinal rumbling and the patient then experiences diarrhea, the nurse documents the presence of which of the following? a) Diverticulitis b) Azotorrhea c) Borborygmus d) Tenesmus
Borborygmus
A patient is admitted to the hospital after not having had a bowel movement in several days. The nurse observes the patient is having small liquid stools, a grossly distended abdomen, and abdominal cramping. What complication can this patient develop related to this problem? a) Bowel perforation b) Rectal fissures c) Appendicitis d) Diverticulitis
Bowel perforation
A patient is admitted to the hospital after not having had a bowel movement in several days. The nurse observes the patient is having small liquid stools, a grossly distended abdomen, and abdominal cramping. What complication can this patient develop related to this problem? a) Diverticulitis b) Bowel perforation c) Rectal fissures d) Appendicitis
Bowel perforation
The nurse is talking with a group of clients that are older than age 50 years about the recognition of colon cancer to access early intervention. What should the nurse inform the clients to report immediately to their primary care provider? a) Daily bowel movements b) Excess gas c) Change in bowel habits d) Abdominal cramping when having a bowel movement
Change in bowel habits
Which of the following terms most precisely refers to the incision of the common bile duct for removal of stones? a) Choledochotomy b) Choledocholithotomy c) Cholecystostomy d) Choledochoduodenostomy
Choledocholithotomy
Which of the following terms most precisely refers to the incision of the common bile duct for removal of stones? a) Choledochotomy b) Choledocholithotomy c) Choledochoduodenostomy d) Cholecystostomy
Choledocholithotomy
A client with calculi in the gallbladder is said to have a) Cholelithiasis b) Cholecystitis c) Choledochotomy d) Choledocholithiasis
Cholelithiasis
A client with calculi in the gallbladder is said to have a) Cholelithiasis b) Choledochotomy c) Choledocholithiasis d) Cholecystitis
Cholelithiasis
The nurse is irrigating a patient's colostomy when the patient begins to complain of cramping. What is the appropriate action by the nurse? a) Increase the rate of administration. b) Discontinue the irrigation immediately. c) Clamp the tubing and allow patient to rest. d) Change irrigation fluid to normal saline.
Clamp the tubing and allow patient to rest.
A patient has a BMI ranger greater than 40 kg/m2. What would this patient's obesity classification be? a) Class II b) Class III c) Class I d) Overweight
Class III
Which of the following laxatives should be used by a cardiac patient who should avoid straining? a) Dulcolax b) Milk of Magnesia c) Mineral oil d) Colace
Colace
A 70-year-old patient is admitted with acute pancreatitis. The nurse understands that the mortality rate associated with acute pancreatitis increases with advanced age and attributes this to which of the following gerontologic considerations associated with the pancreas? a) Increases in the bicarbonate output by the kidneys b) Decreases in the physiologic function of major organs c) Development of local complications d) Increases in the rate of pancreatic secretion
Decreases in the physiologic function of major organs
What is the most appropriate nursing diagnosis for the client with acute pancreatitis? a) Deficient fluid volume b) Ineffective gastrointestinal tissue perfusion c) Decreased cardiac output d) Excess fluid volume
Deficient fluid volume
A client has a 10-year history of Crohn's disease and is seeing the physician in the GI group where you practice nursing due to increased diarrhea and fatigue. What is the recommended dietary approach to treat Crohn's disease? a) Dietary approach varies. b) Lactose-rich foods c) Low-fiber diet d) High-fiber diet
Dietary approach varies.
A client with acute gastritis asks the nurse what might have caused the problem. Which of the following are possible causes? a) Radiation therapy b) Overuse of allergy medicine c) Dietary indiscretion d) Drinking fruit juices e) Excessive alcohol intake
Dietary indiscretion Excessive alcohol intake Radiation therapy
The nurse is caring for a patient who has malabsorption syndrome with an undetermined cause. What procedure will the nurse assist with that is the best diagnostic test for this illness? a) Stool specimen for ova and parasites b) Ultrasound c) Pancreatic function tests d) Endoscopy with mucosal biopsy
Endoscopy with mucosal biopsy
The nurse is reinforcing diet teaching for a patient s diagnosed with IBS. The nurse instructs the patient to include which of the following in his diet? a) Fluids with meals b) High-fiber diet c) Spicy foods d) Caffeinated products
High-fiber diet
An elderly patient diagnosed with diarrhea is taking digoxin (Lanoxin). Which of the following electrolyte imbalances should the nurse be alert to? a) Hyponatremia b) Hyperkalemia c) Hypokalemia d) Hypernatremia
Hypokalemia
The nurse is caring for a patient diagnosed with abdominal perforation. Which of the following is a clinical manifestation of this disease process? a) Bradycardia b) Subnormal temperature c) Normal erythrocyte sedimentation rate (ESR) d) Hypotension
Hypotension
A nurse is preparing a patient for an endoscopic retrograde cholangiopancreatography (ERCP). The patient asks what this test is used for. Which of the following statements made by the nurse explains how an ERCP can determine the difference between pancreatitis and other biliary disorders? Select all that apply. a) It can assess for ecchymosis in the body. b) It can assess the anatomy of the pancreas and the pancreatic and biliary ducts. c) It is used in the diagnostic evaluation of acute pancreatitis. d) It can detects unhealthy tissues in the pancreas and assess for abscesses and pseudocysts. e) It can evaluate the presence and location of ductal stones and aid in stone removal.
It can evaluate the presence and location of ductal stones and aid in stone removal. It can assess the anatomy of the pancreas and the pancreatic and biliary ducts. It can detects unhealthy tissues in the pancreas and assess for abscesses and pseudocysts.
A client comes to the clinic complaining of not having a bowel movement in several days, abdominal cramping, and nausea. When the nurse puts the client on the stretcher, he vomits a large amount of fecal material. What should the first action by the nurse be? a) Insert an intestinal tube. b) Notify the physician. c) Insert a nasogastric tube. d) Start an IV of Ringer's lactate.
Notify the physician.
Which of the following would be included as a postoperative intervention for the patient undergoing a laparoscopic cholecystectomy? a) Semi-Fowler's position b) Observe color of sclera c) Low-carbohydrate, low-protein diet immediately after surgery d) NPO status postop for 2 days
Observe color of sclera
When preparing a client for surgery to treat appendicitis, the nurse formulates a nursing diagnosis of Risk for infection related to inflammation, perforation, and surgery. What is the rationale for choosing this nursing diagnosis? a) The appendix may develop gangrene and rupture, especially in a middle-aged client. b) Infection of the appendix diminishes necrotic arterial blood flow and increases venous drainage. c) Obstruction of the appendix reduces arterial flow, leading to ischemia, inflammation, and rupture of the appendix. d) Obstruction of the appendix may increase venous drainage and cause the appendix to rupture.
Obstruction of the appendix reduces arterial flow, leading to ischemia, inflammation, and rupture of the appendix.
When caring for a client with acute pancreatitis, the nurse should use which comfort measure? a) Encouraging frequent visits from family and friends b) Administering an analgesic once per shift, as ordered, to prevent drug addiction c) Positioning the client on the side with the knees flexed d) Administering frequent oral feedings
Positioning the client on the side with the knees flexed
When interviewing a client with internal hemorrhoids, which of the following would the nurse expect the client to report? a) Rectal bleeding b) Itching c) Pain d) Soreness
Rectal bleeding
When interviewing a client with internal hemorrhoids, which of the following would the nurse expect the client to report? a) Soreness b) Rectal bleeding c) Pain d) Itching
Rectal bleeding
A client with pancreatitis is admitted to the medical intensive care unit. Which nursing intervention is most appropriate? a) Limiting I.V. fluid intake according to the physician's order b) Reserving an antecubital site for a peripherally inserted central catheter (PICC) c) Providing the client with plenty of P.O. fluids d) Providing generous servings at mealtime
Reserving an antecubital site for a peripherally inserted central catheter (PICC)
A client is admitted with a diagnosis of acute appendicitis. When assessing the abdomen, the nurse would expect to find rebound tenderness at which location? a) Right upper quadrant b) Left upper quadrant c) Right lower quadrant d) Left lower quadrant
Right lower quadrant
Which of the following categories of laxatives draws water into the intestines by osmosis? a) Fecal softeners (Colace) b) Bulk-forming agents (Metamucil) c) Saline agents (Milk of Magnesia) d) Stimulants (Dulcolax)
Saline agents
The nurse should assess for an important early indicator of acute pancreatitis. What prolonged and elevated level would the nurse determine is an early indicator? a) Serum bilirubin b) Serum lipase c) Serum calcium d) Serum amylase
Serum lipase
The nurse is admitting a patient to the intensive care unit with a diagnosis of acute pancreatitis. What does the nurse expect was the reason the patient came to the hospital? a) Jaundice b) Severe abdominal pain c) Mental agitation d) Fever
Severe abdominal pain
A client is recovering from gastric surgery. Toward what goal should the nurse progress the client's enteral intake? a) Three meals and 120 ml fluid daily b) Six small meals and 120 mL fluid daily c) Three meals and three snacks and 120 mL fluid daily d) Six small meals daily with 120 mL fluid between meals
Six small meals daily with 120 mL fluid between meals
A patient who has been having recurrent attacks of severe abdominal pain over the past few months informs the physician about a 25-pound weight loss in the last year. The nurse attributes which of the following as the most likely cause of this weight loss? a) Malabsorption b) Ingesting a low-fat diet to prevent abdominal pains c) Vomiting after heavy meals d) Skipping meals out of fear of painful attacks
Skipping meals out of fear of painful attacks
Effie Geitgey, a 93-year-old retired waitress, obsesses about the regularity of her bowel movements, which is a common complaint among the residents of the long-term care facility where you practice nursing. During one of your education sessions, you reinforce the medically acceptable definition of "regularity." What is the actual measurement of "regular"? a) One bowel movement daily b) Two bowel movements daily c) One bowel movement every other day d) Stool consistency and client comfort are the proper measurements.
Stool consistency and client comfort are the proper measurements.
The nurse is reviewing the laboratory test results of a client with Crohn's disease. Which of the following would the nurse most likely find? a) Decreased erythrocyte sedimentation rate b) Stool cultures negative for microorganisms or parasite c) Decreased white blood cell count d) Increased albumin levels
Stool cultures negative for microorganisms or parasite
A nurse is caring for a client who has experienced an acute exacerbation of Crohn's disease. Which statement best indicates that the disease process is under control? a) The client exhibits signs of adequate GI perfusion. b) The client expresses positive feelings about himself. c) The client maintains skin integrity. d) The client verbalizes a manageable level of discomfort.
The client exhibits signs of adequate GI perfusion.
The physician has written the following orders: bed rest, nothing by mouth (NPO), and administration of total parenteral nutrition (TPN) for a new patient admitted with pancreatitis. The nurse attributes which of the following as the cause for NPO status? a) To avoid inflammation of the pancreas b) To aid opening up of pancreatic duct c) To drain the pancreatic bed d) To prevent the occurrence of fibrosis
To avoid inflammation of the pancreas
A patient is admitted to the health care center with severe abdominal pain rated at 10 on a 1-10 scale, tachycardia, hypertension, and muscle spasms. The nurse immediately administers morphine sulfate 4 mg slow intravenous pyelogram (IVP) as ordered. The nurse plans for which of the following goals following the administration of this mediation? a) To increase the patient's pain threshold b) To control muscle spasms c) To control BP d) To diagnose the cause of abdominal pain
To increase the patient's pain threshold
The nurse knows that the client with cholelithiasis can have a nutritional deficiency. The obstruction of bile flow due to cholelitiasis can interfere with the absorption of a) Vitamin C b) Vitamin B6 c) Vitamin B12 d) Vitamin A
Vitamin A
A patient who had developed jaundice 2 months previous is brought to the ED after attending a party and developing excruciating pain that radiated over the abdomen and into the back. Upon assessment, which additional symptom would the nurse expect this patient to have? a) Bile-stained vomiting b) Weight loss c) Warm, dry skin d) Hypertension
bile stained vomiting
The nurse is teaching a patient with an ostomy how to change the pouching system. Which of the following should the nurse include in the teaching of a patient with no peristomal skin irritation? a) Apply barrier powder b) Dry skin thoroughly after washing c) Apply Kenalog spray d) Dust with nystatin powder
dry skin thoroughly after washing
A client with carcinoma of the head of the pancreas is scheduled for surgery. Which of the following should a nurse administer to the client before surgery? a) Vitamin K b) Vitamin B c) Potassium d) Oral bile acids
Vitamin K
A patient is admitted to the health care center with hyperglycemia, a 15-pound weight loss, and complaints of vague upper and midabdominal pain that increases in intensity at night. His health history record indicates that he is an alcoholic, smokes a pack of cigarettes daily, and has had diabetes for the past 20 years. On examination, the nurse finds swelling in his feet and abdominal ascites. Based on the clinical manifestations, which of the following is most likely to be the diagnosis? a) Pancreatic carcinoma b) Cholecystitis c) Pancreatic pseudocysts d) Acute pancreatitis with edema
Pancreatic carcinoma
Which of the following conditions is most likely to involve a nursing diagnosis of fluid volume deficit? a) Appendicitis b) Peptic ulcer c) Cholecystitis d) Pancreatitis
Pancreatitis
Which of the following categories of laxatives draws water into the intestines by osmosis? a) Saline agents (Milk of Magnesia) b) Bulk-forming agents (Metamucil) c) Fecal softeners (Colace) d) Stimulants (Dulcolax)
Saline agents (Milk of Magnesia)
A patient is suspected to have pancreatic carcinoma and is having diagnostic testing to determine insulin deficiency. What would the nurse determine is an indicator for insulin deficiency in this patient? (Select all that apply.) a) Hypoglycemia b) Glucosuria c) An abnormal glucose tolerance d) Hyperglycemia e) Elevated lipase level
an abnormal glucose tolerance glucosuria hyperglycemia
A client is admitted to the health care facility with a diagnosis of a bleeding gastric ulcer. The nurse expects this client's stools to be: a) bright red. b) coffee-ground-like. c) black and tarry. d) clay-colored.
black and tarry.
In a client with enteritis and frequent diarrhea, the nurse should anticipate: a) respiratory acidosis. b) respiratory alkalosis. c) metabolic alkalosis. d) metabolic acidosis.
metabolic acidosis.
The nurse is conducting a gastrointestinal assessment. When the patient complains of the presence of mucus and pus in his stools, the nurse assesses for additional signs/symptoms of which of the following disease/conditions? a) Disorders of the colon b) Ulcerative colitis c) Intestinal malabsorption d) Small-bowel disease
Ulcerative colitis
A nurse is preparing a presentation for a local community group of older adults about colon cancer. Which of the following would the nurse include as the primary characteristic associated with this disorder? a) A change in bowel habits b) Frank blood in the stool c) Abdominal distention d) Abdominal pain
A change in bowel habits
When caring for the patient with acute pancreatitis, the nurse must consider pain relief measures. What nursing interventions could the nurse provide? (Select all that apply.) a) Encouraging bed rest to decrease the metabolic rate b) Assisting the patient into the prone position c) Withholding oral feedings to limit the release of secretin d) Administering parenteral opioid analgesics as ordered e) Administering prophylactic antibiotics
Administering parenteral opioid analgesics as ordered Encouraging bed rest to decrease the metabolic rate Withholding oral feedings to limit the release of secretin
A client with carcinoma of the head of the pancreas is scheduled for surgery. Which of the following should the nurse administer to the client before surgery? a) Potassium b) Packed red blood cells c) Oral bile acids d) Vitamin C
Packed red blood cells
A patient is suspected to have pancreatic carcinoma and is having diagnostic testing to determine insulin deficiency. What would the nurse determine is an indicator for insulin deficiency in this patient? (Select all that apply.) a) Hypoglycemia b) An abnormal glucose tolerance c) Elevated lipase level d) Hyperglycemia e) Glucosuria
An abnormal glucose tolerance Glucosuria Hyperglycemia
Which of the following laxatives should be used by a cardiac patient who should avoid straining? a) Milk of Magnesia b) Colace c) Dulcolax d) Mineral oil
Colace
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? a) CT scan b) Colonoscopy c) Flexible sigmoidoscopy d) Barium enema
Colonoscopy
A patient is having a diagnostic workup for complaints of frequent diarrhea, right lower abdominal pain, and weight loss. The nurse is reviewing the results of the barium study and notes the presence of "string sign." What does the nurse understand that this is significant of? a) Irritable bowel syndrome b) Diverticulitis c) Ulcerative colitis d) Crohn's disease
Crohn's disease
A client is admitted to the healthcare facility suspected of having acute pancreatitis and undergoes laboratory testing. Which of the following would the nurse expect to find? a) Decreased white blood cell count b) Elevated urine amylase levels c) Decreased liver enzyme levels d) Increased serum calcium levels
Elevated urine amylase levels
A patient is not having daily bowel movements and has begun taking a laxative for this problem. What should the nurse educate the patient about regarding laxative use? a) Laxatives should never be the first response for the treatment of constipation; natural methods should be employed first. b) When taking the laxatives, plenty of fluid should be taken as well. c) The laxatives should be taken no more than 3 times a week or laxative addiction will result. d) Laxatives should not be routinely taken due to destruction of nerve endings in the colon.
Laxatives should not be routinely taken due to destruction of nerve endings in the colon.
The nurse is assessing a patient with appendicitis. The nurse is attempting to elicit a Rovsing's sign. Where should the nurse palpate for this indicator of acute appendicitis? a) Right lower quadrant b) Left lower quadrant c) Left upper quadrant d) Right upper quadrant
Left lower quadrant
The nurse admits a woman who is 8 weeks postpartum. The client presents with reports of severe right upper quadrant pain that radiates to her back. She states she just finished eating Thanksgiving dinner earlier that evening. The nurse suspects gallbladder disease. Statistics show that incidence of gallbladder disease is greater for women who are which of the following? Select all that apply. a) Obese b) Thin c) Older than 60 years d) Wealthy e) Multiparous
Multiparous Obese
The nurse admits a woman reporting severe right upper quadrant pain after eating Christmas dinner. The nurse suspects gallbladder disease. Statistics show that incidence of gallbladder disease is greater for women who are a) Multiparous b) Thin c) Older than 40 years d) Obese
Multiparous Obese Older than 40 years
The nurse identifies a potential collaborative problem of electrolyte imbalance for a patient with severe acute pancreatitis. Which of the following assessment findings would alert the nurse to an electrolyte imbalance associated with acute pancreatitis? a) Hypotension b) Muscle twitching and finger numbness c) Paralytic ileus and abdominal distention d) Elevated blood glucose levels
Muscle twitching and finger numbness
Patients with irritable bowel disease (IBS) are at significantly increased risk for which of the following? a) Osteoporosis b) Pneumonia c) DVT d) Hypotension
Osteoporosis
The nurse is teaching a client with peptic ulcer disease who has been prescribed misoprostol (Cytotec). What information from the nurse would be most accurate about misoprostol? a) Prevents ulceration in clients taking nonsteroidal anti-inflammatory drugs (NSAIDs) b) Works best when taken on an empty stomach c) Increases the speed of gastric emptying d) Decreases mucus production
Prevents ulceration in clients taking nonsteroidal anti-inflammatory drugs (NSAIDs)
A client presents to the ED with acute abdominal pain, fever, nausea, and vomiting. During the client's examination, the lower left abdominal quadrant is palpated, causing the client to report pain in the RLQ. This positive sign is referred to as ________ and suggests the client may be experiencing ________. a) McBurney's sign; acute appendicitis b) McBurney's sign; perforation c) Rovsing's sign; perforation d) Rovsing's sign; acute appendicitis
Rovsing's sign; acute appendicitis
Which of the following is the most common symptom of a polyp? a) Diarrhea b) Rectal bleeding c) Anorexia d) Abdominal pain
Rectal bleeding
A client is admitted to the health care facility with abdominal pain, a low-grade fever, abdominal distention, and weight loss. The physician diagnoses acute pancreatitis. What is the primary goal of nursing care for this client? a) Preventing fluid volume overload b) Maintaining adequate nutritional status c) Relieving abdominal pain d) Teaching about the disease and its treatment
Relieving abdominal pain
A nurse is caring for a client who has experienced an acute exacerbation of Crohn's disease. Which statement best indicates that the disease process is under control? a) The client expresses positive feelings about himself. b) The client exhibits signs of adequate GI perfusion. c) The client verbalizes a manageable level of discomfort. d) The client maintains skin integrity.
The client exhibits signs of adequate GI perfusion.
Which of the following is a true statement regarding regional enteritis (Crohn's disease)? a) It has a progressive disease pattern. b) The lesions are in continuous contact with one another. c) The clusters of ulcers take on a cobblestone appearance. d) It is characterized by lower left quadrant abdominal pain.
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 boardlike and no bowel sounds are detected. What is the major concern for this patient? a) The patient is developing a paralytic ileus. b) The patient has developed peritonitis. c) The patient requires more pain medication. d) The patient has developed renal failure.
The patient has developed peritonitis.
What is a major concern for the nurse when caring for a patient with chronic pancreatitis? a) Weight loss b) Pain c) Mental status changes d) Nausea
Weight loss
Which nursing action is most appropriate for a client hospitalized with acute pancreatitis? a) Administering meperedine, as ordered, to relieve severe pain b) Keeping the client supine to increase comfort c) Withholding all oral intake, as ordered, to decrease pancreatic secretions d) Limiting I.V. fluids, as ordered, to decrease cardiac workload
Withholding all oral intake, as ordered, to decrease pancreatic secretions
Which nursing action is most appropriate for a client hospitalized with acute pancreatitis? a) Limiting I.V. fluids, as ordered, to decrease cardiac workload b) Administering meperedine, as ordered, to relieve severe pain c) Withholding all oral intake, as ordered, to decrease pancreatic secretions d) Keeping the client supine to increase comfort
Withholding all oral intake, as ordered, to decrease pancreatic secretions
A patient is admitted to the hospital with a possible common bile duct obstruction. What clinical manifestations does the nurse understand are indicators of this problem? (Select all that apply.) a) Amber-colored urine b) Clay-colored feces c) Jaundice d) Pain in the left upper abdominal quadrant e) Pruritus
clay colored feces jaundice pruritus
A patient is admitted to the hospital with a possible common bile duct obstruction. What clinical manifestations does the nurse understand are indicators of this problem? (Select all that apply.) a) Pruritus b) Clay-colored feces c) Amber-colored urine d) Pain in the left upper abdominal quadrant e) Jaundice
clay-colored feces pruritus jaundice
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? a) Barium enema b) CT scan c) Flexible sigmoidoscopy d) Colonoscopy
colonoscopy
Which dietary modification is utilized for a patient diagnosed with acute pancreatitis? a) Low-carbohydrate diet b) High-protein diet c) Elimination of coffee d) High-fat diet
elimination of coffeee
A patient has a nasogastric (NG) tube for suction and is NPO following a pancreaticoduodenectomy. Which of the following explanations made by the nurse is the major purpose of this treatment? a) The tube will allow the removal of toxins. b) The tube will help control fluid and electrolyte imbalance. c) The tube will allow the gastrointestinal (GI) tract to rest. d) The tube will provide relief from nausea and vomiting.
he tube will allow the gastrointestinal (GI) tract to rest.
The nurse is assessing a patient for constipation. Which of the following is the first review that the nurse should conduct in order to identify the cause of constipation? a) Alcohol consumption b) Current medications c) Usual pattern of elimination d) Activity levels
Usual pattern of elimination
When planning care for a client with a small-bowel obstruction, the nurse should consider the primary goal to be: a) maintaining fluid balance. b) maintaining body weight. c) reestablishing a normal bowel pattern. d) reporting pain relief.
maintaining fluid balance.
A nurse is planning care for a patient with acute pancreatitis. Which of the following patient outcomes does the nurse assign as the highest priority? a) Maintaining satisfactory pain control b) Maintenance of normal respiratory function c) Developing no acute complications from the pancreatitis d) Adequate fluid and electrolyte balance
maintenance of normal respiratory function
Typical signs and symptoms of appendicitis include a) left lower quadrant pain. b) pain when pressure is applied to the right lower quadrant of the abdomen. c) high fever. d) nausea.
nausea.
The nurse should assess for an important early indicator of acute pancreatitis, which is a prolonged and elevated level of: a) Serum calcium b) Serum amylase c) Serum lipase d) Serum bilirubin
serum lipase
The nurse teaches the patient whose surgery will result in a sigmoid colostomy that the feces expelled through the colostomy will be a) semimushy. b) solid. c) mushy. d) fluid.
solid
Management of a patient with ascites includes nutritional modifications and diuretic therapy. Which of the following interventions would a nurse expect to be part of patient care? Select all that apply. a) Aldactone, an aldosterone-blocking agent would be used. b) A daily weight change of 0.5 pounds would require health care provider notification. c) Daily salt intake would be restricted to 2 grams or less. d) Zaroxolyn would be the thiazide diuretic of choice. e) The diuretic will be held if the serum sodium level decreases to <134 m Eq/L.
• Aldactone, an aldosterone-blocking agent would be used. • Daily salt intake would be restricted to 2 grams or less. • The diuretic will be held if the serum sodium level decreases to <134 m Eq/L.
A nursing student has learned about many collaborative interventions to achieve pain relief for clients with acute pancreatitis. Which of the following are appropriate? Choose all that apply. a) Withhold oral feedings to limit the release of secretin. b) Encourage bed rest to decrease the client's metabolic rate. c) Teach the client about the correlation between alcohol intake and pain. d) Allow the client to have sips of clear liquids.
Encourage bed rest to decrease the client's metabolic rate. Teach the client about the correlation between alcohol intake and pain. Withhold oral feedings to limit the release of secretin.
The nurse is caring for a patient diagnosed with abdominal perforation. Which of the following is a clinical manifestation of this disease process? a) Hypotension b) Bradycardia c) Subnormal temperature d) Normal erythrocyte sedimentation rate (ESR)
Hypotension
A home health nurse who sees a client with diverticulitis is evaluating teaching about dietary modifications necessary to prevent future episodes. Which statement by the client indicates effective teaching? a) "I'll incorporate foods rich in omega-3 fatty acids into my diet." b) "I'll snack on nuts, olives, and popcorn during flare-ups." c) "I should increase my intake of fresh fruits and vegetables during remissions." d) "I'll increase my intake of protein during exacerbations."
I should increase my intake of fresh fruits and vegetables during remissions."
Which of the following is a gerontological consideration associated with the pancreas? a) Increased rate of pancreatic secretion b) Increase in fibrous material c) Increased bicarbonate output d) Increased calcium absorption
Increase in fibrous material
A 68-year-old resident at a long-term care facility lost the ability to swallow following a stroke 4 years ago. She receives nutrition via a PEG tube. The client remains physically and socially active and has adapted well to the tube feedings. Occasionally, the client develops constipation that requires administration of a laxative to restore regular bowel function. Which of the following is the most likely cause of this client's constipation? a) Lack of free water intake b) Lack of solid food c) Lack of exercise d) Increased fiber
Lack of free water intake
A 74-year-old gentleman is a client on the hospital unit where you practice nursing. He is scheduled to undergo rhinoplasty in the morning, and you are completing his admission assessment and paperwork. He reports medications he uses on a daily basis, which you record on his chart. Which of his daily medications have the potential to result in constipation? a) NSAIDs b) Multivitamin without iron c) Laxative d) Acetaminophen
Laxative
The nurse is caring for a client with intussusception of the bowel. What does the nurse understand occurs with this disorder? a) The bowel protrudes through a weakened area in the abdominal wall. b) One part of the intestine telescopes into another portion of the intestine. c) The bowel twists and turns itself and obstructs the intestinal lumen. d) A loop of intestine adheres to an area that is healing slowly after surgery.
One part of the intestine telescopes into another portion of the intestine.
Because clients with pancreatitis cannot tolerate high-glucose concentrations, total parental nutrition (TPN) should be used cautiously with them. Which of the following interventions has shown great promise in the prognosis of clients with severe acute pancreatitis? a) Providing intensive insulin therapy b) Maintaining a high-Fowler's position c) Administering oral analgesics around the clock d) Allowiing a clear liquid diet during the acute phase
Providing intensive insulin therapy
A client is admitted to the health care facility with abdominal pain, a low-grade fever, abdominal distention, and weight loss. The physician diagnoses acute pancreatitis. What is the primary goal of nursing care for this client? a) Relieving abdominal pain b) Maintaining adequate nutritional status c) Teaching about the disease and its treatment d) Preventing fluid volume overload
Relieving abdominal pain
A client being treated for pancreatitis faces the risk of atelectasis. Which of the following interventions would be important to implement to minimize this risk? a) Instruct the client to avoid coughing. b) Monitor pulse oximetry every hour. c) Withhold oral feedings for the client. d) Reposition the client every 2 hours.
Reposition the client every 2 hours.
The nurse is assessing a client for constipation. Which of the following is the first review that the nurse should conduct to identify the cause of constipation? Choose the correct option. a) Review the client's activity levels. b) Review the client's current medications. c) Review the client's alcohol consumption. d) Review the client's usual pattern of elimination.
Review the client's usual pattern of elimination.
A patient has a nasogastric (NG) tube for suction and is NPO following a pancreaticoduodenectomy. Which of the following explanations made by the nurse is the major purpose of this treatment? a) The tube will provide relief from nausea and vomiting. b) The tube will help control fluid and electrolyte imbalance. c) The tube will allow the removal of toxins. d) The tube will allow the gastrointestinal (GI) tract to rest.
The tube will allow the gastrointestinal (GI) tract to rest.
The physician has written the following orders: bed rest, nothing by mouth (NPO), and administration of total parenteral nutrition (TPN) for a new patient admitted with pancreatitis. The nurse attributes which of the following as the cause for NPO status? a) To aid opening up of pancreatic duct b) To drain the pancreatic bed c) To avoid inflammation of the pancreas d) To prevent the occurrence of fibrosis
To avoid inflammation of the pancreas
A nurse is caring for a client in the emergency department who is complaining of severe abdominal pain. The client is diagnosed with acute pancreatitis. Which laboratory value requires immediate intervention? a) Serum glucose level of 240 mg/dl b) Troponin of 2.3 mcg/L c) White blood cell (WBC) count of 18,000 mm3 d) Calcium level of 7.8 mg/dl
Troponin of 2.3 mcg/L
The nurse is conducting a gastrointestinal assessment. When the patient complains of the presence of mucus and pus in his stools, the nurse assesses for additional signs/symptoms of which of the following disease/conditions? a) Small-bowel disease b) Disorders of the colon c) Intestinal malabsorption d) Ulcerative colitis
Ulcerative colitis
Which of the following is a gerontological consideration associated with the pancreas? a) Increased calcium absorption b) Increased rate of pancreatic secretion c) Increase in fibrous material d) Increased bicarbonate output
increased in fibrous material
A client is recovering from an ileostomy that was performed to treat inflammatory bowel disease. During discharge teaching, the nurse should stress the importance of: a) taking only enteric-coated medications. b) increasing fluid intake to prevent dehydration. c) wearing an appliance pouch only at bedtime. d) consuming a low-protein, high-fiber diet.
increasing fluid intake to prevent dehydration
A nurse is assessing a client and obtains the following findings: abdominal discomfort, mild diarrhea, blood pressure of 100/80 mm Hg, pulse rate of 88 beats/minute, respiratory rate of 20 breaths/minute, temperature 100° F (37.8° C). The nurse suspects the client will be diagnosed with: a) diverticulitis. b) colorectal cancer. c) inflammatory bowel disease (IBD). d) liver failure.
inflammatory bowel disease