NURS 370 Exam 4 Questions

A client's colorectal cancer has necessitated a hemicolectomy with the creation of a colostomy. In the 4 days since the surgery, the client has been unwilling to look at the ostomy or participate in any aspects of ostomy care. What is the nurse's most appropriate response to this observation? A. Ensure that the client knows that he or she will be responsible for care after discharge. B. Reassure the client that many people are fearful after the creation of an ostomy. C. Acknowledge the client's reluctance and initiate discussion of the factors underlying it. D. Arrange for the client to be seen by a social worker or spiritual advisor.

C

A nurse is assessing a client's stoma on postoperative day 3. The nurse notes that the stoma has a shiny appearance and a bright red color. How should the nurse best respond to this assessment finding? A. Irrigate the ostomy to clear a possible obstruction. B. Contact the primary provider to report this finding. C. Document that the stoma appears healthy and well perfused. D. Document a nursing diagnosis of Impaired Skin Integrity.

C

A critical care nurse is closely monitoring a patient who has recently undergone surgical repair of a bleeding peptic ulcer. The nurse should prioritize assessments of which of the following signs and symptoms of a recurrence of hemorrhage? A. Hypotension and tachycardia B. Bradypnea and pursed-lip breathing C. Restlessness and cyanosis D. Peripheral and pulmonary

A

An obese male patient has sought advice from the nurse about the possible efficacy of medications in his efforts to lose weight. What should the nurse teach the patient about pharmacologic interventions for the treatment of obesity? A. "Medications may be of some use, but they don't tend to resolve obesity on their own." B. "Medications are usually reserved for people who have had unsuccessful bariatric surgery." C. "Medications have the potential to reduce hunger but they rarely result in weight loss." D. "Medications are an excellent option for individuals who prefer not to exercise or reduce their food intake."

A

Clostridium difficile infection has been moving through an extended-care facility, and several of the elderly residents have been experiencing severe diarrhea. One particularly sick resident has told the nurse that he is now experiencing extreme fatigue and muscle cramps and that his heart feels like it occasionally "skips a beat." The nurse should facilitate a stat assessment of this resident's: A. Potassium levels B. Calcium levels C. Cardiac biomarkers D. Hemoglobin and hematocrit

A

The nurse determines that teaching for the client with peptic ulcer disease has been effective when the client makes which statement? A. "I have learned some relaxation strategies that decrease my stress." B. "I should stop all my medications if I develop any side effects." C. "I can buy whatever antacids are on sale because they all have the same effect." D. "I should continue my treatment regimen as long as I have pain."

A

The nurse is conducting a community education class on gastritis. The nurse includes that chronic gastritis caused by Helicobacter pylori is implicated in which disease/condition? A. Peptic ulcers B. Colostomy C. Systemic infection D. Pernicious anemia

A

The nurse is conducting a community education program on colorectal cancer. Which statement should the nurse include in the program? A. It is the third most common cancer in the United States. B. The lifetime risk of developing colorectal cancer is 1 in 10. C. The incidence of colorectal cancer decreases with age. D. Colorectal cancer has no hereditary component.

A

The nurse is providing care to a patient with gross ascites who is maintaining a position of comfort in the high semi-Fowler's position. What is the nurse's priority assessment of this patient? A. Respiratory assessment related to increased thoracic pressure B. Urinary output related to increased sodium retention C. Peripheral vascular assessment related to immobility D. Skin assessment related to increase in bile salts

A

The nurse is teaching a client with an ostomy how to change the pouching system. Which information should the nurse include when teaching a client with no peristomal skin irritation? A. Dry skin thoroughly after washing B. Apply barrier powder C. Apply triamcinolone acetonide spray D. Dust with nystatin powder

A

A client with cirrhosis has a massive hemorrhage from esophageal varices. Balloon tamponade is used temporarily to control hemorrhage and stabilize the client. In planning care, the nurse gives the highest priority to which goal? A. Controlling bleeding B. Maintaining the airway C. Maintaining fluid volume D. Relieving the client's anxiety

B

Which is the most common cause of esophageal varices? A. Jaundice B. Portal hypertension C. Ascites D. Asterixis

B

A nurse is caring for a client who has a diagnosis of GI bleeding. During shift assessment, the nurse finds the client to be tachycardic and hypotensive, and the client has an episode of hematemesis while the nurse is in the room. In addition to monitoring the client's vital signs and level of consciousness, what would be a priority nursing action for this client? A. Place the client in a prone position. B. Provide the client with ice water to slow any GI bleeding. C. Notify the health care provider. D. Prepare for the insertion of an NG tube.

C

A patient with a diagnosis of peptic ulcer disease has just been prescribed omeprazole (Prilosec). How should the nurse best describe this medication's therapeutic action? A. "This medication will make the lining of your stomach more resistant to damage." B. "This medication will specifically address the pain that accompanies peptic ulcer disease." C. "This medication will reduce the amount of acid secreted in your stomach." D. "This medication will help your stomach lining to repair itself."

C

The nurse is conducting discharge teaching for a client with diverticulosis. Which instruction should the nurse include in the teaching? A. Avoid unprocessed bran. B. Avoid daily exercise. C. Drink 8 to 10 glasses of fluid daily. D. Use laxatives weekly.

C

A nurse is caring for a client hospitalized with an exacerbation of chronic gastritis. What health promotion topic should the nurse emphasize? A.Strategies for maintaining an alkaline gastric environment B. Strategies for avoiding irritating foods and beverages C. Safe technique for self-suctioning D. Techniques for positioning correctly to promote gastric healing

B

A nurse is providing care for a client recovering from gastric bypass surgery. During assessment, the client exhibits pallor, perspiration, palpitations, headache, and feelings of warmth, dizziness, and drowsiness. The client reports eating 90 minutes ago. What will the nurse suspect? A. Dehiscence of the surgical wound B. Vasomotor symptoms associated with dumping syndrome C. Peritonitis D. A normal reaction to surgery

B

A nurse is providing care for a client who has a diagnosis of irritable bowel syndrome (IBS). When planning this client's care, the nurse should collaborate with the client and prioritize what goal? A. Client will demonstrate appropriate care of his ileostomy. B. Client will accurately identify foods that trigger symptoms. C. Client will demonstrate appropriate use of standard infection control precautions. D. Client will adhere to recommended guidelines for mobility and activity.

B

When caring for a client with an acute exacerbation of a peptic ulcer, the nurse finds the client doubled up in bed with severe pain in the right shoulder. What is the intial appropriate action by the nurse? A.Notify the health care provider. B. Assess the client's abdomen and vital signs. C. Irrigate the client's NG tube. D. Place the client in the high-Fowler's position.

B

Which symptoms will a nurse observe most commonly in clients with pancreatitis? A. black, tarry stools and dark urine B. severe, radiating abdominal pain C. increased and painful urination D. increased appetite and weight gain

B

When caring for a client with acute pancreatitis, the nurse should use which comfort measure? A. Administering an analgesic once per shift, as ordered, to prevent drug addiction B. Encouraging frequent visits from family and friends C. Positioning the client on the side with the knees flexed D. Administering frequent oral feedings

C

A client is in the hospital for the treatment of peptic ulcer disease. The client reports vomiting and a sudden severe pain in the abdomen. The nurse then assesses a board-like abdomen. What does the nurse suspect these symptoms indicate? A. Gastric penetration B. A reaction to the medication given for the ulcer C. Ineffective treatment for the peptic ulcer D. Perforation of the peptic ulcer

D

A nurse is caring for a client newly diagnosed with hepatitis A. Which statement by the client indicates the need for further teaching? A. "I'll wash my hands often." B. "I'll be very careful when preparing food for my family." C. "I'll take all my medications as ordered." D. "How did this happen? I've been faithful my entire marriage."

D