Saunders Gastrointestinal

The nurse is preparing to administer an intermittent enteral feeding though a nasogastric (NG) tube. Which priority assessment should the nurse perform? 1. Observe for digestion of formula. 2. Assess fluid and electrolyte status. 3. Evaluate absorption of the last feeding. 4. Evaluate percussion tone of the stomach.

Evaluate absorption of the last feeding.

A client is admitted to the hospital with acute viral hepatitis. Which sign or symptom should the nurse expect to note based on this diagnosis? 1. Fatigue 2. Pale urine 3. Weight gain 4. Spider angiomas

Fatigue

The nurse manager is providing an educational session to nursing staff members about the phases of viral hepatitis. The nurse manager tells the staff that which clinical manifestation(s) are primary characteristics of the preicteric phase? 1. Pruritus 2. Right upper quadrant pain 3. Fatigue, anorexia, and nausea 4. Jaundice, dark-colored urine, and clay-colored stools

Fatigue, anorexia, and nausea

The nurse is providing dietary instructions to a client hospitalized for pancreatitis. Which food should the nurse instruct the client to avoid? 1. Chili 2. Bagel 3. Lentil soup 4. Watermelon

Chili

The nurse is caring for a client with biliary obstruction. The nurse interprets that obstruction of which passage is related to the client's condition? 1. Cystic duct 2. Liver canaliculi 3. Common bile duct 4. Right hepatic duct

Cystic duct

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-carbohydrate foods. 3. Limit the fluids taken with meals. 4. Sit in a high Fowler's position during meals.

Limit the fluids taken with meals.

A client with a new colostomy is concerned about the odor from stool in the ostomy drainage bag. The nurse should teach the client to include which food in the diet to reduce odor? 1. Eggs 2. Yogurt 3. Broccoli 4. Cucumbers

Yogurt

The nurse cares for a client following a Roux-en-Y gastric bypass surgery. Which nursing intervention is appropriate? 1. Encourage the client to ambulate. 2. Position the client on the left side. 3. Frequently irrigate the nasogastric tube (NG) with 30 mL saline. 4. Discourage the use of the patient-controlled analgesia (PCA) machine.

Encourage the client to ambulate.

The nurse is reviewing the medication record of a client with acute gastritis. Which medication, if noted on the client's record, should the nurse question? 1. Digoxin 2. Furosemide 3. Indomethacin 4. Propranolol hydrochloride

Indomethacin

The nurse is giving instructions to a client with cholecystitis about food to exclude from the diet. Which food item identified by the client indicates that the educational session was successful? 1. Fresh fruit 2. Brown gravy 3. Fresh vegetables 4. Poultry without skin

Brown gravy

A client with viral hepatitis is having difficulty coping with the disorder. Which question by the nurse is the most appropriate in identifying the client's coping problem? 1. "Do you have a fever?" 2. "Are you losing weight?" 3. "Have you enjoyed having visitors?" 4. "Do you rest sometime during the day?"

"Have you enjoyed having visitors?"

The nurse provides instructions to a client about measures to treat inflammatory bowel syndrome (IBS). Which statement by the client indicates a need for further teaching? 1. "I need to limit my intake of dietary fiber." 2. "I need to drink plenty, at least 8 to 10 cups daily." 3. "I need to eat regular meals and chew my food well." 4. "I will take the prescribed medications because they will regulate my bowel patterns."

"I need to limit my intake of dietary fiber."

A client with Crohn's disease is experiencing acute pain, and the nurse provides information about measures to alleviate the pain. Which statement by the client indicates the need for further teaching? 1. "I know I can massage my abdomen." 2. "I will continue using antispasmodic medication." 3. "One of the best things I can do is use relaxation techniques." 4. "The best position for me is to lie supine with my legs straight."

"The best position for me is to lie supine with my legs straight."

The nurse is creating a plan of care for a client with cirrhosis and ascites. Which nursing actions should be included in the care plan for this client? Select all that apply. 1. Monitor daily weight. 2. Measure abdominal girth. 3. Monitor respiratory status. 4. Place the client in a supine position. 5. Assist the client with care as needed.

1. Monitor daily weight. 2. Measure abdominal girth. 3. Monitor respiratory status. 5. Assist the client with care as needed.

The nurse is caring for a client with acute pancreatitis. Which medications should the nurse expect to be prescribed for treatment of this problem? Select all that apply. 1. Insulin 2. Morphine 3. Dicyclomine 4. Pancrelipase 5. Pantoprazole 6. Acetazolamide

2. Morphine 3. Dicyclomine 5. Pantoprazole 6. Acetazolamide

A client seen in the ambulatory care clinic has ascites and slight jaundice. The nurse should assess the client for a history of chronic use of which medication? 1. Ibuprofen 2. Ranitidine 3. Acetaminophen 4. Acetylsalicylic acid

Acetaminophen

The nurse is caring for a client postoperatively after creation of a colostomy. What is an appropriate potential client problem? 1. Fear 2. Sexual dysfunction 3. Disturbed body image 4. Imbalanced nutrition: more than body requirements

Disturbed body image

A client has just had surgery to create an ileostomy. The nurse assesses the client in the immediate postoperative period for which most frequent complication of this type of surgery? 1. Folate deficiency 2. Malabsorption of fat 3. Intestinal obstruction 4. Fluid and electrolyte imbalance

Fluid and electrolyte imbalance

The nurse is caring for an older client. The nurse should anticipate that medication dosages will be further adjusted if the client has dysfunction of which organ? 1. Liver 2. Stomach 3. Pancreas 4. Gallbladder

Liver

The nurse is performing an assessment on a client with suspected acute pancreatitis. Which complaint made by the client supports the diagnosis? 1. "I have epigastric pain radiating to my neck." 2. "I have severe abdominal pain that is relieved after vomiting." 3. "My temperature has been running between 96°F (35.5°C) and 97°F (36.1°C)." 4. "I've been experiencing constant, severe abdominal pain that is unrelieved by vomiting."

"I've been experiencing constant, severe abdominal pain that is unrelieved by vomiting."

The registered nurse is precepting a new nurse who is caring for a client with pernicious anemia as a result of gastrectomy. Which statement made by the new nurse indicates understanding of this diagnosis? 1. "It's due to insufficient production of vitamin B12 in the colon." 2. "Increased production of intrinsic factor in the stomach leads to this type of anemia." 3. "Overproduction of vitamin B12 in the large intestine can result in pernicious anemia." 4. "Decreased production of intrinsic factor by the stomach affects absorption of vitamin B12 in the small intestine."

"Decreased production of intrinsic factor by the stomach affects absorption of vitamin B12 in the small intestine."

A sexually active young adult client has developed viral hepatitis. Which client statement indicates the need for further teaching? 1. "I should avoid drinking alcohol." 2. "I can go back to work right away." 3. "My partner should get the vaccine." 4. "A condom should be used for sexual intercourse."

"I can go back to work right away."

The nurse has given instructions to a client with hepatitis about postdischarge management during convalescence. The nurse determines that further teaching is needed if the client makes which statement? 1. "I need to avoid alcohol and aspirin." 2. "I should eat a high-carbohydrate, low-fat diet." 3. "I can resume a full activity level within 1 week." 4. "I need to take the prescribed amounts of vitamin K."

"I can resume a full activity level within 1 week."

A client is resuming a diet after hemigastrectomy, and the nurse provides dietary instructions. Which statement by the client indicates a need for further teaching? 1. "I plan to lie down after eating." 2. "I know to avoid sweets in my diet." 3. "I will eat several small meals per day." 4. "I will drink plenty of liquids with meals."

"I will drink plenty of liquids with meals."

A home care nurse visits a client who was recently diagnosed with cirrhosis. The nurse provides home care management instructions to the client. Which client statement indicates a need for further instruction 1. "I will obtain adequate rest." 2. "I will take acetaminophen if I get a headache." 3. "I should monitor my weight on a regular basis." 4. "I need to include sufficient amounts of carbohydrates in my diet."

"I will take acetaminophen if I get a headache."

A client with viral hepatitis is discussing with the nurse the need to avoid alcohol and states, "I'm not sure I can avoid alcohol." What is the most appropriate nursing response? 1. "I don't believe that." 2. "Everything will be all right." 3. "I'm not sure that I understand. Would you please explain?" 4. "I think you should talk more with the health care provider about this."

"I'm not sure that I understand. Would you please explain?"

The nurse is completing an admission assessment for a client with suspected esophageal cancer. Which statement made by the client indicates the presence of a risk factor for esophageal cancer? 1. "I've been smoking for 20 years now." 2. "I eat plenty of fresh fruits and vegetables." 3. "I'm 5 feet, 8 inches tall and weigh 160 pounds." 4. "My alcohol consumption is about 2 beers per month."

"I've been smoking for 20 years now."

The nurse has given postprocedure instructions to a client who has undergone a colonoscopy. Which statement by the client indicates the need for further teaching? 1. "It is normal to feel gassy or bloated after the procedure." 2. "The abdominal muscles may be tender from the procedure." 3. "It is all right to drive once I've been home for an hour or so." 4. "Intake should be light at first and then progress to regular intake."

"It is all right to drive once I've been home for an hour or so."

The nurse teaches a preoperative client about the use of a nasogastric (NG) tube for the planned surgery. Which statement indicates to the nurse that the client understands when the tube can be removed in the postoperative period? 1. "When I can tolerate food without vomiting." 2. "When my gastrointestinal system is healed enough." 3. "When my health care provider says the tube can come out." 4. "When my bowels begin to function again, and I begin to pass gas."

"When my bowels begin to function again, and I begin to pass gas."

A client presents to the emergency department with upper gastrointestinal bleeding and is in moderate distress. In planning care, what is the priority nursing action for this client? 1. Assessment of vital signs 2. Completion of abdominal examination 3. Insertion of the prescribed nasogastric tube 4. Thorough investigation of precipitating events

Assessment of vital signs

The nurse is reviewing the health care provider's prescriptions written for a client admitted to the hospital with acute pancreatitis. Which prescription requires follow-up by the nurse? 1. Full liquid diet 2. Morphine sulfate for pain 3. Nasogastric tube insertion 4. An anticholinergic medication

Full liquid diet

The nurse is caring for a client admitted with severe weight loss due to dieting. Based on the data provided, which condition should the nurse suspect is occurring in this client? 1. Lactic acidosis 2. Glycogenolysis 3. Gluconeogenesis 4. Glucose metabolism

Gluconeogenesis

The nurse has implemented a bowel maintenance program for an unconscious client. The nurse would evaluate the plan as best meeting the needs of the client if which method was successful in stimulating a bowel movement? 1. Fleet enema 2. Fecal disimpaction 3. Glycerin suppository 4. Soap solution enema (SSE)

Glycerin suppository

The nurse has been caring for a client who required a Sengstaken-Blakemore tube because other treatment measures for esophageal varices were unsuccessful. The health care provider (HCP) arrives on the nursing unit and deflates the esophageal balloon. Which assessment finding by the nurse is the most important and should be reported to the HCP immediately? 1. Hematemesis 2. Bloody diarrhea 3. Swelling of the abdomen 4. An elevated temperature and a rise in blood pressure

Hematemesis

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. Notify the health care provider (HCP). 2. Administer the prescribed pain medication. 3. Call and ask the operating room team to perform surgery as soon as possible. 4. Reposition the client and apply a heating pad on the warm setting to the client's abdomen.

Notify the health care provider (HCP).

The nurse is assessing a client with a duodenal ulcer. The nurse interprets that which sign or symptom is most consistent with the typical presentation of duodenal ulcer? 1. Weight loss 2. Nausea and vomiting 3. Pain that is relieved by food intake 4. Pain that radiates down the right arm

Pain that is relieved by food intake

The nurse is reviewing laboratory test results for the client with liver disease and notes that the client's albumin level is low. Which nursing action is focused on the consequence of low albumin levels? 1. Evaluating for asterixis 2. Inspecting for petechiae 3. Palpating for peripheral edema 4. Evaluating for decreased level of consciousness

Palpating for peripheral edema

A client with a diagnosis of stomach ulcer from gastric hyperacidity asks the nurse why the acid has not caused an ulcer in the small intestine as well. The nurse responds that the pH of intestinal contents is raised by bicarbonate, which is present in which area of the body? 1. Bile 2. Parietal cells 3. Liver enzymes 4. Pancreatic juice

Pancreatic juice

The nurse is assessing a client with liver disease for signs and symptoms of low albumin. Which sign or symptom should the nurse expect to note? 1. Weight loss 2. Peripheral edema 3. Capillary refill of 5 seconds 4. Bleeding from previous puncture sites

Peripheral edema

After undergoing Billroth I gastric surgery, the client experiences fatigue and complains of numbness and tingling in the feet and difficulties with balance. On the basis of these symptoms, the nurse suspects which postoperative complication? 1. Stroke 2. Pernicious anemia 3. Bacterial meningitis 4. Peripheral arterial disease

Pernicious anemia

A client with gastric hypersecretion is scheduled for surgery. The nurse teaches the client that the procedure will lessen the stomach's production of acid by altering which structure? 1. Portal vein 2. Celiac artery 3. Vagus nerve 4. Pyloric valve

Vagus nerve

The nurse is caring for a client with pernicious anemia. Which prescription by the health care provider (HCP) should the nurse anticipate? 1. Iron 2. Folic acid 3. Vitamin B6 4. Vitamin B12

Vitamin B12

The nurse is caring for a client with a low thrombin level as a result of liver dysfunction. Based on this finding it is most important for the nurse to monitor the client for signs and symptoms of which potential complication? 1. Bleeding 2. Infection 3. Dehydration 4. Malnutrition

Bleeding

The nurse is providing dietary instructions to a client with a diagnosis of irritable bowel syndrome. The nurse determines that education was effective if the client states the need to avoid which food? 1. Rice 2. Corn 3. Broiled chicken 4. Cream of wheat

Corn

The nurse is reviewing the results of serum laboratory studies for a client admitted for suspected hepatitis. Which laboratory finding is most associated with hepatitis, requiring the nurse to contact the health care provider? 1. Elevated serum bilirubin level 2. Below normal hemoglobin concentration 3. Elevated blood urea nitrogen (BUN) level 4. Elevated erythrocyte sedimentation rate (ESR)

Elevated serum bilirubin level

The nurse is caring for a client with acute pancreatitis. Which finding should the nurse expect to note when reviewing the laboratory results? 1. Elevated serum lipase level 2. Elevated serum bilirubin level 3. Decreased serum trypsin level 4. Decreased serum amylase level

Elevated serum lipase level

A client with cirrhosis complicated by ascites is admitted to the hospital. The client reports a 10-lb weight gain over the past 1½ weeks. The client has edema of the feet and ankles, and his abdomen is distended, taut, and shiny with striae. Which client problem is most appropriate at this time? 1. Difficulty with sleeping 2. Risk for skin breakdown 3. Difficulty with breathing 4. Excessive body fluid volume

Excessive body fluid volume

A client with peptic ulcer disease states that stress frequently causes exacerbation of the disease. The nurse determines that which item mentioned by the client is most likely to be responsible for the exacerbation? 1. Sleeping 8 to 10 hours a night 2. Ability to work at home periodically 3. Eating 5 or 6 small meals per day 4. Frequent need to work overtime on short notice

Frequent need to work overtime on short notice

The nurse assists a health care provider in performing a liver biopsy. After the procedure, the nurse should place the client in which position? 1. Prone 2. Supine 3. Left side 4. Right side

Right side

The nurse has taught the client about an upcoming endoscopic retrograde cholangiopancreatography (ERCP) procedure. The nurse determines 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. "I'm glad I don't have to lie still for this procedure." 4. "I'm glad some intravenous medication will be given to relax me."

"I'm glad I don't have to lie still for this procedure."

The nurse is performing an admission assessment on a client who has been admitted to the hospital with a diagnosis of suspected gastric ulcer. The nurse is asking the client questions about pain. Which client statement supports the diagnosis of gastric ulcer? 1. "The pain doesn't usually come right after I eat." 2. "The pain gets so bad that it wakes me up at night." 3. "The pain that I get is located on the right side of my chest." 4. "My pain comes shortly after I eat, maybe a half-hour or so later."

"My pain comes shortly after I eat, maybe a half-hour or so later."

The nurse should incorporate which in the dietary plan to ensure optimal nutrition for the client during the acute phase of hepatitis? Select all that apply. 1. Select foods high in protein content. 2. Consume multiple small meals throughout the day. 3. Select foods low in carbohydrates to prevent nausea. 4. Allow the client to select foods that are most appealing. 5. Eliminate fatty foods from the meal trays until nausea subsides. 6. Eat a nutritious dinner because it is typically the best tolerated meal of the day.

1. Consume multiple small meals throughout the day. 4. Allow the client to select foods that are most appealing. 5. Eliminate fatty foods from the meal trays until nausea subsides.

The nurse is reviewing the prescription for a client admitted to the hospital with a diagnosis of acute pancreatitis. Which interventions would the nurse expect to be prescribed for the client? Select all that apply. 1. Maintain NPO (nothing by mouth) status. 2. Encourage coughing and deep breathing. 3. Give small, frequent high-calorie feedings. 4. Maintain the client in a supine and flat position. 5. Give hydromorphone intravenously as prescribed for pain. 6. Maintain intravenous fluids at 10 mL/hour to keep the vein open.

1. Maintain NPO (nothing by mouth) status. 2. Encourage coughing and deep breathing. 5. Give hydromorphone intravenously as prescribed for pain.

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. Gray-blue color at the flank 5. Abdominal guarding and tenderness 6. Left upper quadrant pain with radiation to the back .

A Penrose drain is in place on the first postoperative day in a client who has undergone a cholecystectomy procedure. Serosanguineous drainage is noted on the dressing covering the drain. Which nursing intervention is most appropriate? 1. Change the dressing. 2. Continue to monitor the drainage. 3. Notify the health care provider (HCP). 4. Use a pen to circle the amount of drainage on the dressing.

Change the dressing.

A client who has undergone gastric surgery has a nasogastric (NG) tube connected to low intermittent suction that is not draining properly. Which action should the nurse take initially? 1. Call the surgeon to report the problem. 2. Reposition the NG tube to the proper location. 3. Check the suction device to make sure it is working. 4. Irrigate the NG tube with saline to remove the obstruction.

Check the suction device to make sure it is working.

The nurse is caring for a client prescribed enteral feeding via a newly inserted nasogastric (NG) tube. Before initiating the enteral feeding, the nurse should perform which action first? 1. Warm the feeding to 103°F (39.4°C). 2. Confirm NG placement by x-ray study. 3. Make sure the continuous enteral feeding tubing is primed. 4. Position the head of the client's bed to 30 degrees or greater.

Confirm NG placement by x-ray study.

Diphenoxylate hydrochloride with atropine sulfate is prescribed for a client with ulcerative colitis. The nurse should monitor the client for which therapeutic effect of this medication? 1. Decreased diarrhea 2. Decreased cramping 3. Improved intestinal tone 4. Elimination of peristalsis

Decreased diarrhea

The nurse checks the gastric residual of an unconscious client receiving nasogastric tube feedings continuously at 50 mL/hr. The nurse notes that the residual is 250 mL at 0800 and 300 mL at 0900. The nurse determines that the client is experiencing which complication? 1. Air in the stomach 2. Too slow an infusion rate 3. Delayed gastric emptying 4. Early signs of peptic ulcer

Delayed gastric emptying

The nurse is caring for a client with pancreatitis. Which finding should the nurse expect to note when reviewing the client's laboratory results? 1. Elevated level of pepsin 2. Decreased level of lactase 3. Elevated level of amylase 4. Decreased level of enterokinase

Elevated level of amylase

During a home care visit, an adult client complains of chronic constipation. What should the nurse tell the client to do? 1. Increase potassium in the diet. 2. Include rice and bananas in the diet. 3. Increase fluid and dietary fiber intake. 4. Increase the intake of sugar-free products.

Increase fluid and dietary fiber intake.

The nurse is assisting a client with Crohn's disease to ambulate to the bathroom. After the client has a bowel movement, the nurse should assess the stool for which characteristic that is expected with this disease? 1. Blood in the stool 2. Chalky gray stool 3. Loose, watery stool 4. Dry, hard, constipated stool

Loose, watery stool

A client has developed hepatitis A after eating contaminated oysters. The nurse assesses the client for which expected assessment finding? 1. Malaise 2. Dark stools 3. Weight gain 4. Left upper quadrant discomfort

Malaise

The nurse is doing an admission assessment on a client with a history of duodenal ulcer. To determine whether the problem is currently active, the nurse should assess the client for which sign(s)/symptom(s) of duodenal ulcer? 1. Weight loss 2. Nausea and vomiting 3. Pain relieved by food intake 4. Pain radiating down the right arm

Pain relieved by food intake

The nurse is assisting a health care provider (HCP) with the insertion of a Miller-Abbott tube. The nurse understands that the procedure places the client at risk for aspiration and should therefore implement which action to decrease this risk? 1. Insert the tube with the balloon inflated. 2. Place the client in a semi Fowler's to high Fowler's position. 3. Instruct the client to cough when the tube reaches the nasal pharynx. 4. Instruct the client to perform a Valsalva maneuver if the impulse to gag and vomit occurs

Place the client in a semi Fowler's to high Fowler's position.

The nurse is caring for a group of clients on the surgical nursing unit. The nurse anticipates that the client who underwent which procedure is most likely to have some long-term residual difficulty with absorption of nutrients? 1. Colectomy 2. Appendectomy 3. Ascending colostomy 4. Small bowel resection

Small bowel resection

The nurse obtains an admission history for a client with suspected peptic ulcer disease (PUD). Which client factor documented by the nurse would increase the risk for PUD? 1. Recently retired from a job 2. Significant other has a gastric ulcer 3. Occasionally drinks 1 cup of coffee in the morning 4. Takes nonsteroidal antiinflammatory drugs (NSAIDs) for osteoarthritis

Takes nonsteroidal antiinflammatory drugs (NSAIDs) for osteoarthritis

A client is admitted to the hospital with a diagnosis of acute pancreatitis. Which would the nurse expect the client to report about the pain? 1. Eating helps to decrease the pain. 2. The pain usually increases after vomiting. 3. The pain is mostly around the umbilicus and comes and goes. 4. The pain increases when the client sits up and bends forward.

The pain usually increases after vomiting.

The nurse is caring for a hospitalized client with pancreatitis. Which findings should the nurse look for and expect to note when reviewing the laboratory results? Select all that apply. 1. Elevated lipase level 2. Elevated lactase level 3. Elevated trypsin level 4. Elevated amylase level 5. Elevated sucrase level

1. Elevated lipase level 3. Elevated trypsin level 4. Elevated amylase level

A client arrives at the hospital emergency department complaining of acute right lower quadrant abdominal pain, and appendicitis is suspected. Laboratory tests are performed, and the nurse notes that the client's white blood cell (WBC) count is elevated. On the basis of these findings, the nurse should question which health care provider (HCP) prescription documented in the client's medical record? 1. Apply a cold pack to the abdomen. 2. Administer 30 mL of milk of magnesia (MOM). 3. Maintain nothing by mouth (nil per os [NPO]) status. 4. Initiate an intravenous (IV) line for the administration of IV fluids.

Administer 30 mL of milk of magnesia (MOM).

The nurse is performing discharge teaching for a client with chronic pancreatitis. Which information should the nurse include? 1. Alcohol should be consumed in moderation. 2. Avoid caffeine because it may aggravate symptoms. 3. Diet should be high in carbohydrates, fats, and proteins. 4. Frothy, fatty stools indicate that enzyme replacement is working.

Avoid caffeine because it may aggravate symptoms.

A client with acute pancreatitis is experiencing severe pain from the disorder. The nurse determines that education about positioning to reduce pain was effective if the client avoids which action? 1. Sitting up 2. Lying flat 3. Leaning forward 4. Drawing the legs to the chest

Lying flat

The nurse is monitoring a client with cirrhosis of the liver for signs of hepatic encephalopathy. Which assessment finding would the nurse note as an early sign of hepatic encephalopathy? 1. Restlessness 2. Presence of asterixis 3. Complaints of fatigue 4. Decreased serum ammonia levels

Presence of asterixis

A home care nurse is visiting a client with a diagnosis of pernicious anemia that developed as a result of gastric surgery. The nurse instructs the client that in this disorder because the stomach lining produces a decreased amount of a substance known as the intrinsic factor, the client will need which medication? 1. Vitamin B12 injections 2. Vitamin B6 injections 3. An antibiotic 4. An antacid

Vitamin B12 injections

The nurse should anticipate that the health care provider (HCP) will prescribe which treatment for a client with pernicious anemia? 1. Oral iron tablets 2. Blood transfusions 3. Gastric tube feedings 4. Vitamin B12 injections

Vitamin B12 injections

The nurse is caring for a client admitted to the hospital with suspected acute appendicitis. Which laboratory result should the nurse expect to note if the client does have appendicitis? 1. White blood cell (WBC) count of 4000 mm3 (4 × 109/L) 2. WBC count of 8000 mm3 (8 × 109/L) 3. WBC count of 18,000 mm3 (18 × 109/L) 4. WBC count of 26,000 mm3 (26 × 109/L)

WBC count of 18,000 mm3 (18 × 109/L)

The nurse has provided dietary instructions to a client with a diagnosis of peptic ulcer disease. Which client statement indicates that education was effective? 1. "Baked foods such as chicken or fish are all right to eat." 2. "Citrus fruits and raw vegetables need to be included in my daily diet." 3. "I can drink beer as long as I consume only a moderate amount each day." 4. "I can drink coffee or tea as long as I limit the amount to 2 cups daily."

"Baked foods such as chicken or fish are all right to eat." Dietary modifications for the client with peptic ulcer disease include eliminating foods that can cause irritation to the gastrointestinal (GI) tract. Items that should be eliminated or avoided include highly spiced foods, alcohol, caffeine, chocolate, and citrus fruits. Other foods may be taken according to the client's level of tolerance for that food.

The nurse has provided home care instructions to a client who had a subtotal gastrectomy. The nurse instructs the client on the signs and symptoms associated with dumping syndrome. Which client statement indicates that teaching was effective? 1. "It will cause diaphoresis and diarrhea." 2. "I have to monitor for hiccups and diarrhea." 3. "It will be associated with constipation and fever." 4. "I have to monitor for fatigue and abdominal pain."

"It will cause diaphoresis and diarrhea."

The client with a small bowel obstruction asks the nurse to explain the purpose of the nasogastric tube attached to continuous gastric suction. The nurse determines that teaching has been effective if the client makes which statement? 1. "It will help to provide me with nourishment." 2. "It will help to relieve the congestion from excess mucus." 3. "It is used to remove gastric contents for laboratory testing." 4. "It will help to remove gas and fluids from my stomach and intestine."

"It will help to remove gas and fluids from my stomach and intestine."

Sulfasalazine is prescribed for a client with a diagnosis of ulcerative colitis, and the nurse instructs the client about the medication. Which statement made by the client indicates a need for further teaching? 1. "The medication will cause constipation." 2. "I need to take the medication with meals." 3. "I may have increased sensitivity to sunlight." 4. "This medication should be taken as prescribed."

"The medication will cause constipation."

The nurse is providing discharge teaching for a client with newly diagnosed Crohn's disease about dietary measures to implement during exacerbation episodes. Which statement made by the client indicates a need for further instruction? 1. "I should increase the fiber in my diet." 2. "I will need to avoid caffeinated beverages." 3. "I'm going to learn some stress reduction techniques." 4. "I can have exacerbations and remissions with Crohn's disease."

1. "I should increase the fiber in my diet."

The nurse caring for a client diagnosed with inflammatory bowel disease (IBD) recognizes that which classifications of medications may be prescribed to treat the disease and induce remission? Select all that apply. 1. Antidiarrheal 2. Antimicrobial 3. Corticosteroid 4. Aminosalicylate 5. Biological therapy 6. Immunosuppressant

2. Antimicrobial 3. Corticosteroid 4. Aminosalicylate 5. Biological therapy 6. Immunosuppressant

The nurse is monitoring a client with a diagnosis of peptic ulcer. Which assessment finding would most likely indicate perforation of the ulcer? 1. Bradycardia 2. Numbness in the legs 3. Nausea and vomiting 4. A rigid, boardlike abdomen

A rigid, boardlike abdomen

The nurse who is caring for a client with a diagnosis of cirrhosis is monitoring the client for signs of portal hypertension. Which finding should the nurse interpret as a sign or symptom of portal hypertension? 1. Flat neck veins 2. Abdominal distention 3. Hemoglobin of 14.2 g/dL (142 mmol/L) 4. Platelet count of 600,000 mm3 (600 × 109/L)

Abdominal distention

A client is readmitted to the hospital with dehydration after surgery for creation of an ileostomy. The nurse assesses that the client has lost 3 lb of weight, has poor skin turgor, and has concentrated urine. The nurse interprets the client's clinical picture as correlating most closely with recent intake of which medication, which is contraindicated for the ileostomy client? 1. Folate 2. Biscodyl 3. Ferrous sulfate 4. Cyanocobalamin

Biscodyl

The nurse inspects the color of the drainage from a nasogastric tube on a postoperative client approximately 24 hours after gastric surgery. Which finding indicates the need to notify the health care provider (HCP)? 1. Dark red drainage 2. Dark brown drainage 3. Green-tinged drainage 4. Light yellowish-brown drainage

Dark red drainage

The nurse is caring for a client with ulcerative colitis. Which finding does the nurse determine is consistent with this diagnosis? 1. Hypercalcemia 2. Hypernatremia 3. Frothy, fatty stools 4. Decreased hemoglobin

Decreased hemoglobin

The nurse is performing an assessment on a client with acute pancreatitis who was admitted to the hospital. Which assessment question would most specifically elicit information regarding the pain that is associated with acute pancreatitis? 1. "Does the pain in your stomach radiate to your back?" 2. "Does the pain in your lower abdomen radiate to your hip?" 3. "Does the pain in your lower abdomen radiate to your groin?" 4. "Does the pain in your stomach radiate to your lower middle abdomen?"

"Does the pain in your stomach radiate to your back?"

The nurse is providing discharge instructions for a client following a Roux-en-Y gastric bypass surgery 3 days ago. What will the nurse include in the instructions? Select all that apply. 1. Do not drink fluids with meals. 2. Avoid foods high in carbohydrates. 3. Take an extended-release multivitamin daily. 4. Maintain a clear liquid diet for about 6 weeks. 5. Eat 6 small meals a day that are high in protein.

1. Do not drink fluids with meals. 2. Avoid foods high in carbohydrates. 5. Eat 6 small meals a day that are high in protein.

The nurse is providing instructions to a client diagnosed with irritable bowel syndrome (IBS) who is experiencing abdominal distention, flatulence, and diarrhea. What interventions should the nurse include in the instructions? Select all that apply. 1. Eat yogurt. 2. Take loperamide to treat diarrhea. 3. Use stress management techniques. 4. Avoid foods such as cabbage and broccoli. 5. Decrease fiber intake to less than 15 g/day

1. Eat yogurt. 2. Take loperamide to treat diarrhea. 3. Use stress management techniques. 4. Avoid foods such as cabbage and broccoli.

A client with cirrhosis has ascites and excess fluid volume. Which assessment findings does the nurse anticipate to note as a result of increased abdominal pressure? Select all that apply. 1. Orthopnea and dyspnea 2. Petechiae and ecchymosis 3. Inguinal or umbilical hernia 4. Poor body posture and balance 5. Abdominal distention and tenderness

1. Orthopnea and dyspnea 2. Petechiae and ecchymosis 3. Inguinal or umbilical hernia 5. Abdominal distention and tenderness

The nurse has inserted a nasogastric (NG) tube to the level of the oropharynx and has repositioned the client's head in a flexed-forward position. The client has been asked to begin swallowing. The nurse starts to slowly advance the NG tube with each swallow. The client begins to cough, gag, and choke. Which actions should the nurse take that will result in proper tube insertion and promote client relaxation? Select all that apply. 1. Pull the tube back slightly. 2. Instruct the client to breathe slowly. 3. Assist the client to take sips of water. 4. Continue to slowly advance the tube to the desired distance. 5. Check the back of the pharynx using a tongue blade and flashlight.

1. Pull the tube back slightly. 2. Instruct the client to breathe slowly. 3. Assist the client to take sips of water. 5. Check the back of the pharynx using a tongue blade and flashlight.

A client is scheduled for an upper gastrointestinal (GI) endoscopy. Which assessment is essential to include in the plan of care following the procedure? 1. Assessing pulses 2. Monitoring urine output 3. Monitoring for rectal bleeding 4. Assessing for the presence of the gag reflex

Assessing for the presence of the gag reflex

The nurse is caring for a client who is receiving bolus feedings via a nasogastric tube. As the nurse is finishing the feeding, the client asks for the bed to be positioned flat for sleep. The nurse understands that which is the appropriate position for this client at this time? 1. Head of bed flat, with the client supine for 60 minutes 2. Head of bed flat, with the client in the supine position for at least 30 minutes 3. Head of bed elevated 30 to 45 degrees, with the client in the right lateral position for 60 minutes 4. Head of bed in a semi Fowler's position, with the client in the left lateral position for 60 minutes

Head of bed elevated 30 to 45 degrees, with the client in the right lateral position for 60 minutes

A client with cirrhosis is beginning to show signs of hepatic encephalopathy. The nurse should plan a dietary consultation to limit the amount of which ingredient in the client's diet? 1. Protein 2. Calories 3. Minerals 4. Carbohydrates

Protein

The nurse is teaching the postgastrectomy client about measures to prevent dumping syndrome. Which statement by the client indicates a need for further teaching? 1. "I need to lie down after eating." 2. "I need to drink liquids with meals." 3. "I need to avoid concentrated sweets." 4. "I need to eat small meals 6 times daily."

"I need to drink liquids with meals."

A client experiencing chronic dumping syndrome makes the following comments to the nurse. Which one indicates the need for further teaching? 1. "I eat at least 3 large meals each day." 2. "I eat while lying in a semirecumbent position." 3. "I have eliminated taking liquids with my meals." 4. "I eat a high-protein, low- to moderate-carbohydrate diet."

"I eat at least 3 large meals each day."

The nurse is teaching an older client about measures to prevent constipation. Which statement by the client indicates a need for further teaching? 1. "I walk 1 to 2 miles every day." 2. "I need to decrease fiber in my diet." 3. "I have a bowel movement every other day." 4. "I drink 6 to 8 glasses of water every day."

"I need to decrease fiber in my diet."

The nurse is providing instructions to a client with a colostomy about measures to reduce the odor from the colostomy. Which client statement indicates that the educational session was effective? 1. "I should be sure to eat at least 1 cucumber every day." 2. "Beet greens, parsley, or yogurt will help to control the colostomy odor." 3. "I will need to increase my egg intake and try to eat ½ to 1 egg per day." 4. "Green vegetables such as spinach and broccoli will prevent odor, and I should eat these foods every day."

"Beet greens, parsley, or yogurt will help to control the colostomy odor."

The nurse is reviewing the record of a client admitted to the nursing unit and notes that the client has a history of Laënnec's cirrhosis. Which question related to the client's history would be most important to ask? 1. "Do you abuse alcohol?" 2. "Do you have any known cardiac disease?" 3. "Does your type of employment cause you to have exposure to chemicals?" 4. "Have you ever been told that you have had obstruction to your biliary ducts?"

"Do you abuse alcohol?"

The nurse is planning to teach a client with gastroesophageal reflux disease (GERD) about substances to avoid. Which items should the nurse include on this list? Select all that apply. 1. Coffee 2. Chocolate 3. Peppermint 4. Nonfat milk 5. Fried chicken 6. Scrambled eggs

1. Coffee 2. Chocolate 3. Peppermint 5. Fried chicken

A client with liver dysfunction has low serum levels of fibrinogen and a prolonged prothrombin time (PT). Based on these findings, which actions should the nurse plan to promote client safety? Select all that apply. 1. Monitor serum potassium levels. 2. Weigh client daily, and monitor trends. 3. Monitor for symptoms of fluid retention. 4. Provide the client with a soft toothbrush. 5. Instruct the client to use an electric razor. 6. Monitor all secretions for frank or occult blood.

4. Provide the client with a soft toothbrush. 5. Instruct the client to use an electric razor. 6. Monitor all secretions for frank or occult blood.

The nurse is caring for a postoperative client who has just returned from surgery for creation of a colostomy. The nurse inspects the colostomy stoma and recognizes that which is a normal assessment finding for this client? 1. A pale color 2. A purple color 3. A brick-red color 4. A large amount of red drainage

A brick-red color

A client with a history of gastrointestinal upset has been diagnosed with acute diverticulitis. The nurse should anticipate a prescription from the health care provider for which type of diet for this client? 1. A low-fat diet 2. A low-fiber diet 3. A high-protein diet 4. A high-carbohydrate diet

A low-fiber diet

A client has a large, deep duodenal ulcer diagnosed by endoscopy. Which sign or symptom indicative of a complication should the nurse look for during the client's postprocedure assessment? 1. Bradycardia 2. Nausea and vomiting 3. Numbness in the legs 4. A rigid, boardlike abdomen

A rigid, boardlike abdomen

The nurse is caring for a client after abdominal surgery and creation of a colostomy. The nurse is assessing the client for a prolapsed stoma and should expect to note which observation if this is present? 1. A sunken and hidden stoma 2. A narrow and flattened stoma 3. A stoma that is dusky or bluish 4. A stoma that is elongated with a swollen appearance

A stoma that is elongated with a swollen appearance

A health care provider (HCP) prescribes a Salem sump tube for gastrointestinal intubation. Which item should the nurse obtain from the supply room? 1. A Dobbhoff weighted tube 2. A Sengstaken-Blakemore tube 3. A tube with a large lumen and an air vent 4. A tube with a single lumen that connects to suction

A tube with a large lumen and an air vent

A client with gastritis asks the nurse at a screening clinic about analgesics that will not cause epigastric distress. The nurse should tell the client that which medication is unlikely to cause epigastric distress? 1. Ibuprofen 2. Indomethacin 3. Acetaminophen 4. Naproxen sodium

Acetaminophen

The nurse is caring for a client on a mechanical ventilator who has a nasogastric tube in place. The nurse is assessing the pH of the gastric aspirate and notes that the pH is 4.5. Based on this finding, the nurse should take which action? 1. Document the findings. 2. Reassess the pH in 4 hours. 3. Instill 30 mL of sterile water. 4. Administer a dose of a prescribed antacid.

Administer a dose of a prescribed antacid.

The nurse is giving dietary instructions to a client who has a new colostomy. The nurse should encourage the client to eat foods representing which diet for the first 4 to 6 weeks postoperatively? 1. Low fiber 2. Low calorie 3. High protein 4. High carbohydrate

Low fiber

A client with a gastric ulcer is prescribed both magnesium hydroxide and cimetidine twice daily. How should the nurse schedule the medications for administration? 1. Drink 8 ounces of water between taking each medication. 2. Administer the cimetidine and magnesium hydroxide at the same time twice daily. 3. Administer each dose of cimetidine 1 hour prior to the administration of magnesium hydroxide. 4. Collaborate with the health care provider (HCP), as the client should not be receiving both medications.

Administer each dose of cimetidine 1 hour prior to the administration of magnesium hydroxide.

A client with ulcerative colitis has a prescription to begin a salicylate compound medication to reduce inflammation. What instruction should the nurse give the client regarding when to take this medication? 1. On arising 2. After meals 3. On an empty stomach 4. 30 minutes before meals

After meals

The nurse has taught the client with chronic pancreatitis about risk factor modification to reduce the incidence of recurrences. The nurse determines that teaching was effective if the client states that it will be necessary to control which factor? 1. Alcohol intake 2. Duodenal ulcer 3. Crohn's disease 4. Diabetes mellitus

Alcohol intake

A client arrives at the hospital emergency department complaining of acute right lower quadrant abdominal pain. Appendicitis is suspected, and appropriate laboratory tests are performed. The emergency department nurse reviews the test results and notes that the client's white blood cell (WBC) count is elevated. The nurse also reviews the prescriptions from the health care provider (HCP). The nurse should contact the HCP to question which prescription if noted in the client's record? 1. Maintain a semi Fowler's position. 2. Maintain on NPO (nothing by mouth) status. 3. Apply a heating pad to the lower abdomen for comfort. 4. Initiate an intravenous (IV) line with the administration of IV fluids.

Apply a heating pad to the lower abdomen for comfort.

The nurse is reviewing the record of a client with a diagnosis of cirrhosis and notes that there is documentation of the presence of asterixis. How should the nurse assess for its presence? 1. Dorsiflex the client's foot. 2. Measure the abdominal girth. 3. Ask the client to extend the arms. 4. Instruct the client to lean forward.

Ask the client to extend the arms.

A client presents to the emergency department with upper gastrointestinal (GI) bleeding and is in moderate distress. In planning care, which nursing action should be the priority for this client? 1. Assessment of vital signs 2. Complete abdominal examination 3. Thorough investigation of precipitating events 4. Insertion of a nasogastric tube and Hematest of emesis

Assessment of vital signs

A client with appendicitis is scheduled for an appendectomy. The nurse providing preoperative teaching for the client describes the location of the appendix by stating that it is attached to which part of the gastrointestinal (GI) system? 1. Ileum 2. Cecum 3. Rectum 4. Jejunum

Cecum

A client receiving a cleansing enema complains of pain and cramping. The nurse should take which corrective action? 1. Discontinue the enema. 2. Reassure the client, and continue the flow. 3. Raise the enema bag so that the solution can be completed quickly. 4. Clamp the tubing for 30 seconds, and restart the flow at a slower rate.

Clamp the tubing for 30 seconds, and restart the flow at a slower rate.

The nurse should instruct a client with an ileostomy to include which action as part of essential care of the stoma? 1. Massage the area below the stoma. 2. Take in high-fiber foods such as nuts. 3. Limit fluid intake to prevent diarrhea. 4. Cleanse the peristomal skin meticulously.

Cleanse the peristomal skin meticulously.

A client who has a gastrostomy tube for feeding refuses to participate in the plan of care, will not make eye contact, and does not speak to the family or visitors. The nurse interprets that the client is using which coping mechanism? 1. Distancing 2. Self-control 3. Problem solving 4. Accepting responsibility

Distancing

The nurse is caring for a client who has just returned from the operating room after the creation of a colostomy. The nurse is assessing the drainage in the pouch attached to the site where the colostomy was formed and notes serosanguineous drainage. Which nursing action is appropriate based on this assessment? 1. Apply ice to the stoma site. 2. Apply pressure to the stoma site. 3. Notify the health care provider (HCP). 4. Document the amount and characteristics of the drainage.

Document the amount and characteristics of the drainage.

The nurse is assessing a client 24 hours following a cholecystectomy. The nurse notes that the T-tube has drained 750 mL of green-brown drainage since the surgery. Which nursing intervention is most appropriate? 1. Clamp the T-tube. 2. Irrigate the T-tube. 3. Document the findings. 4. Notify the health care provider.

Document the findings.

A client with chronic pancreatitis needs information on dietary modification to manage the health problem. Which item in the diet should the nurse teach the client to limit? 1. Fat 2. Protein 3. Carbohydrate 4. Water-soluble vitamins

Fat

The medication history of a client with peptic ulcer disease reveals intermittent use of several medications. The nurse would teach the client that which of these medications are not a part of the treatment plan because of its irritating effects on the lining of the gastrointestinal tract? 1. Nizatidine 2. Sucralfate 3. Ibuprofen 4. Omeprazole

Ibuprofen

The nurse is caring for a client with acute pancreatitis and is monitoring the client for paralytic ileus. Which assessment data would alert the nurse to this occurrence? 1. Inability to pass flatus 2. Loss of anal sphincter control 3. Severe, constant pain with rapid onset 4. Firm, nontender mass palpable at the lower right costal margin

Inability to pass flatus

The nurse is caring for a client with acute pancreatitis and is monitoring the client for paralytic ileus. Which piece of assessment data should alert the nurse to this occurrence? 1. Inability to pass flatus 2. Loss of anal sphincter control 3. Severe, constant pain with rapid onset 4. Firm, nontender mass palpable at the lower right costal margin

Inability to pass flatus

A client is diagnosed with viral hepatitis, complaining of "no appetite" and "losing my taste 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, preferably only 3 large meals daily.

Increase intake of fluids, including juices

The nurse is caring for a client with altered protein metabolism as a result of liver dysfunction. Which finding should the nurse expect to note when reviewing the client's laboratory results? 1. Increased lactase level 2. Decreased albumin level 3. Increased ammonia level 4. Decreased lactic acid level

Increased ammonia level

The nurse is caring for a client following a gastrojejunostomy (Billroth II procedure). Which postoperative prescription should the nurse question and verify? 1. Leg exercises 2. Early ambulation 3. Irrigating the nasogastric tube 4. Coughing and deep-breathing exercises

Irrigating the nasogastric tube

The nurse is caring for a client admitted to the hospital with a suspected diagnosis of acute appendicitis. Which laboratory result should the nurse expect to note if the client does have appendicitis? 1. Leukopenia with a shift to the left 2. Leukocytosis with a shift to the left 3. Leukopenia with a shift to the right 4. Leukocytosis with a shift to the right

Leukocytosis with a shift to the left

The nurse is providing instructions to a client regarding measures to minimize the risk of dumping syndrome. The nurse should make which suggestion to the client? 1. Maintain a high-carbohydrate diet. 2. Increase fluid intake, particularly at mealtime. 3. Maintain a low Fowler's position while eating. 4. Ambulate for at least 30 minutes following each meal.

Maintain a low Fowler's position while eating.

A hospitalized client with liver disease has a dietary protein restriction. The nurse encourages intake of which source of complete proteins to maximize the availability of essential amino acids? 1. Nuts 2. Meats 3. Cereals 4. Vegetables

Meats

Cholestyramine resin is prescribed for a client with an elevated serum cholesterol level. The nurse should instruct the client to take the medication in which way? 1. After meals 2. Mixed with fruit juice 3. Via a rectal suppository 4. At least 3 hours before meals

Mixed with fruit juice

A client is admitted to the hospital with a diagnosis of acute diverticulitis. What should the nurse expect to be prescribed for this client? 1. NPO (nothing by mouth) status 2. Ambulation at least 4 times daily 3. Cholinergic medications to reduce pain 4. Coughing and deep breathing every 2 hours

NPO (nothing by mouth) status

The nurse is caring for a client experiencing an exacerbation of Crohn's disease. Which intervention should the nurse anticipate the health care provider prescribing? 1. Enteral feedings 2. Fluid restrictions 3. Oral corticosteroids 4. Activity restrictions

Oral corticosteroids

The nurse is reviewing the laboratory results for a client with cirrhosis and notes that the ammonia level is 85 mcg/dL (51 mcmol/L). Which dietary selection does the nurse suggest to the client? 1. Roast pork 2. Cheese omelet 3. Pasta with sauce 4. Tuna fish sandwich

Pasta with sauce

The nurse is caring for a client with cirrhosis. As part of dietary teaching to minimize the effects of the disorder, the nurse teaches the client about foods that are high in thiamine. The nurse determines that the client has the best understanding of the material if the client states to increase intake of which food? 1. Pork 2. Milk 3. Chicken 4. Broccoli

Pork

A client who has undergone creation of a colostomy has a concern about body image. What action by the client indicates the most significant progress toward identified goals? 1. Looking at the ostomy site 2. Reading the ostomy product literature 3. Watching the nurse empty the ostomy bag 4. Practicing proper cutting of the ostomy appliance

Practicing proper cutting of the ostomy appliance

The nurse is providing care for a client with a recent transverse colostomy. Which observation requires immediate notification of the health care provider? 1. Stoma is beefy red and shiny 2. Purple discoloration of the stoma 3. Skin excoriation around the stoma 4. Semi-formed stool noted in the ostomy pouch

Purple discoloration of the stoma

The nurse is caring for a hospitalized client with a diagnosis of ulcerative colitis. Which finding, if noted on assessment of the client, should the nurse report to the health care provider (HCP)? 1. Hypotension 2. Bloody diarrhea 3. Rebound tenderness 4. A hemoglobin level of 12 mg/dL (120 mmol/L)

Rebound tenderness

A client who has been advanced to a solid diet after undergoing a subtotal gastrectomy. What is the appropriate nursing intervention in preventing dumping syndrome? 1. Remove fluids from the meal tray. 2. Give the client 2 large meals per day. 3. Ask the client to sit up for 1 hour after eating. 4. Provide concentrated, high-carbohydrate foods.

Remove fluids from the meal tray.

The clinic nurse is performing an abdominal assessment on a client and preparing to auscultate bowel sounds. The nurse should place the stethoscope in which quadrant first? Click on the image to indicate your answer.

Right Lower Quadrant

The nurse is monitoring a client for the early signs and symptoms of dumping syndrome. Which findings indicate this occurrence? 1. Sweating and pallor 2. Bradycardia and indigestion 3. Double vision and chest pain 4. Abdominal cramping and pain

Sweating and pallor

The nurse is evaluating the plan of care for a client with peptic ulcer disease (PUD) who is experiencing acute pain. The nurse determines that the expected outcomes have been met if the nursing assessment reveals which result? 1. The client reports some pain before meals. 2. The client frequently is awakened at 2 a.m. with heartburn. 3. The client has eliminated any irritating foods from the diet. 4. The client's pain is minimal with histamine H2-receptor antagonists.

The client has eliminated any irritating foods from the diet.

Lactulose is prescribed for a hospitalized client with a diagnosis of hepatic encephalopathy. Which assessment finding indicates that the client is responding to this medication therapy as anticipated? 1. Vomiting occurs. 2. The fecal pH is acidic. 3. The client experiences diarrhea. 4. The client is able to tolerate a full diet.

The fecal pH is acidic.

Pancreatin is prescribed for a client with postgastrectomy syndrome. Which assessment finding would indicate a therapeutic effect of this medication? 1. The client's appetite improves. 2. The client experiences weight loss. 3. Vitamin B12 deficiency is controlled. 4. The stool is less fatty and decreases in frequency.

The stool is less fatty and decreases in frequency.

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.

This is a normal, expected event.

The nurse plans care for a client postoperatively following creation of a colostomy. Which potential client problem should the nurse include in the plan of care? 1. Fear 2. Anxiety 3. Sexual dysfunction 4. Upset about appearance

Upset about appearance

The nurse is preparing to teach a client with a new colostomy about how to perform a colostomy irrigation. Which information should the nurse include in the teaching plan? 1. Use 500 to 1000 mL of warm tap water. 2. Suspend the irrigant 36 inches above the stoma. 3. Insert the irrigation cone ½ inch into the stoma. 4. If cramping occurs, open the irrigation clamp farther.

Use 500 to 1000 mL of warm tap water.

The nurse is obtaining a health history for a client with chronic pancreatitis. The health history is most likely to include which as a most common causative factor in this client's disorder? 1. Weight gain 2. Use of alcohol 3. Exposure to occupational chemicals 4. Abdominal pain relieved with food or antacids

Use of alcohol

After performing an initial abdominal assessment on a client with nausea and vomiting, the nurse should expect to note which finding? 1. Waves of loud gurgles auscultated in all 4 quadrants 2. Low-pitched swishing auscultated in 1 or 2 quadrants 3. Relatively high-pitched clicks or gurgles auscultated in all 4 quadrants 4. Very high-pitched, loud rushes auscultated especially in 1 or 2 quadrants

Waves of loud gurgles auscultated in all 4 quadrants

The nurse is caring for a client who had a subtotal gastrectomy. The nurse should assess the client for which signs and symptoms of dumping syndrome? 1. Diarrhea, chills, and hiccups 2. Weakness, diaphoresis, and diarrhea 3. Fever, constipation, and rectal bleeding 4. Abdominal pain, elevated temperature, and weakness

Weakness, diaphoresis, and diarrhea

A client is experiencing blockage of the common bile duct. Which food selection made by the client indicates the need for further teaching? 1. Rice 2. Whole milk 3. Broiled fish 4. Baked chicken

Whole milk

The health care provider has determined that a client has contracted hepatitis A based on flulike symptoms 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 restaurant." 3. "I was an intravenous drug abuser in the past and shared needles." 4. "I had a blood transfusion 30 years ago after major abdominal surgery."

"I ate shellfish about 2 weeks ago at a local restaurant."

The nurse is caring for a client with gastroesophageal reflux disease (GERD) and provides client education on measures to decrease GERD. Which statement made by the client indicates a need for further teaching? 1. "I plan to eat 4 to 6 small meals a day." 2. "I should sleep in the right side-lying position." 3. "I plan to have a snack 1 hour before going to bed." 4. "I will stop having a glass of wine each evening with dinner."

"I plan to have a snack 1 hour before going to bed."

A client in a long-term care facility is being prepared to be discharged to home in 2 days. The client has been eating a regular diet for a week; however, he is still receiving intermittent enteral tube feedings and will need to receive these feedings at home. The client states concern that he will not be able to continue the tube feedings at home. Which nursing response is most appropriate at this time? 1. "Do you want to stay here in this facility for a few more days?" 2. "Have you discussed your feelings with your health care provider?" 3. "You need to talk to your health care provider about these concerns." 4. "Tell me more about your concerns with your diet after going home."

"Tell me more about your concerns with your diet after going home."

A client has just had a hemorrhoidectomy. Which nursing interventions 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 movements without straining. 4. Apply cold packs to the anal-rectal area over the dressing until the packing is removed. 5. Help the client to a Fowler's position to place pressure on the rectal area and decrease bleeding.

1. Administer stool softeners as prescribed. 3. Encourage a high-fiber diet to promote bowel movements without straining. 4. Apply cold packs to the anal-rectal area over the dressing until the packing is removed.

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's sign 3. Complaints of indigestion 4. Palpable mass in the left upper quadrant 5. Pain in the upper right quadrant after a fatty meal 6. Vague lower right quadrant abdominal discomfort

1. Fever 3. Complaints of indigestion 5. Pain in the upper right quadrant after a fatty meal

The nurse is teaching the client with viral hepatitis about the stages of the disease. The nurse should explain to the client that the second stage of this disease is characterized by which specific assessment findings? Select all that apply. 1. Jaundice 2. Flulike symptoms 3. Clay-colored stools 4. Elevated bilirubin levels 5. Dark or tea-colored urine

1. Jaundice 3. Clay-colored stools 4. Elevated bilirubin levels 5. Dark or tea-colored urine

A client with hiatal hernia chronically experiences heartburn following meals. The nurse should plan to teach the client to avoid which action because it is contraindicated with a hiatal hernia? 1. Lying recumbent following meals 2. Consuming small, frequent, bland meals 3. Taking H2-receptor antagonist medication 4. Raising the head of the bed on 6-inch (15 cm) blocks

1. Lying recumbent following meals

The nurse is providing dietary teaching for a client with a diagnosis of chronic gastritis. The nurse instructs the client to include which foods rich in vitamin B12 in the diet? Select all that apply. 1. Nuts 2. Corn 3. Liver 4. Apples 5. Lentils 6. Bananas

1. Nuts 3. Liver 5. Lentils

The ambulatory care nurse is providing instructions to a client who is scheduled for a small bowel biopsy. What should the nurse tell the client? 1. Clear liquids only are allowed on the day of the test. 2. A signed informed consent form will need to be obtained. 3. A tube will be inserted through the rectum to obtain the tissue sample. 4. A full liquid diet will need to be maintained for 48 hours after the procedure.

A signed informed consent form will need to be obtained.

The nurse is developing a teaching plan for a client with viral hepatitis. The nurse should plan to include which information in the teaching session? 1. The diet should be low in calories. 2. Meals should be large to conserve energy. 3. Activity should be limited to prevent fatigue. 4. Alcohol intake should be limited to 2 ounces per day.

Activity should be limited to prevent fatigue.

A client with acute ulcerative colitis requests a snack. Which is the most appropriate snack for this client? 1. Carrots and ranch dip 2. Whole-grain cereal and milk 3. A cup of popcorn and a cola drink 4. Applesauce and a graham cracker

Applesauce and a graham cracker

A client has undergone esophagogastroduodenoscopy. The nurse should place highest priority on which item as part of the client's care plan? 1. Monitoring the temperature 2. Monitoring complaints of heartburn 3. Giving warm gargles for a sore throat 4. Assessing for the return of the gag reflex

Assessing for the return of the gag reflex

A client with viral hepatitis states, "I am so yellow." What is the most appropriate nursing action? 1. Assist the client in expressing feelings. 2. Restrict visitors until the jaundice subsides. 3. Perform most of the activities of daily living for the client. 4. Provide information to the client only when he or she requests it

Assist the client in expressing feelings.

The nurse is assigned to care for a client with a Sengstaken-Blakemore tube. Which laboratory result is most focused on evaluating the effectiveness of this tube? 1. Sodium 2. Creatinine 3. Hemoglobin 4. Ammonia

Hemoglobin

The nurse is caring for a client who is prescribed a nasogastric (NG) tube for the purpose of stomach decompression. The nurse should anticipate a health care provider prescription for which type of suction? 1. High and intermittent- 2. Low and intermittent 3. High and continuous 4. Low and continuous

Low and intermittent

The nurse is caring for a client with common bile duct obstruction. The nurse should anticipate that the health care provider (HCP) will prescribe which diet for this client? 1. Low fat 2. High protein 3. High carbohydrate 4. Low in water-soluble vitamins

Low fat

A client with viral hepatitis has no appetite, and food makes the client nauseated. Which nursing intervention is appropriate? 1. Encourage foods that are high in protein. 2. Monitor for fluid and electrolyte imbalance. 3. Explain that high-fat diets usually are better tolerated. 4. Explain that most daily calories need to be consumed in the evening hours.

Monitor for fluid and electrolyte imbalance.

The nurse is caring for a client with spinal cord injury (SCI) who is participating in a bowel retraining program. What should the nurse anticipate to promote during the bowel retraining program? 1. Sufficiently low water content in the stool 2. Low intestinal roughage that promotes easier digestion 3. Constriction of the anal sphincter based on voluntary control 4. Stimulation of the parasympathetic reflex center at the S1 to S4 level in the spinal cord

Stimulation of the parasympathetic reflex center at the S1 to S4 level in the spinal cord