AH1

A client is diagnosed with celiac disease. Which foods should the nurse teach the client to avoid? Select all that apply. Select all that apply Corn Cheese Oatmeal Rye bread Fruit juice

CD

A nurse cares for a client who has a Giardia infection. Which medication should the nurse anticipate being prescribed for this client?a. Metronidazole (Flagyl)b. Ciprofloxacin (Cipro)c. Sulfasalazine (Azulfidine)d. Ceftriaxone (Rocephin)

A

A client is admitted with the diagnosis of acute pancreatitis. Which clinical manifestations should a nurse assess in the client? Select all that apply. Select all that apply Jaundice Acute pain Hypertension Hypoglycemia Increased amylase

ABE

A nurse educator of a college health course is discussing tattoos with the class. Which type of hepatitis associated with tattoos should the nurse include in the teaching plan? A C D E

B

When an intestinal obstruction is suspected, a client has a nasogastric tube inserted and attached to suction. What response should the nurse critically assess on this client? Edema Belching Fluid deficit Excessive salivation

C

After teaching a client with diverticular disease, a nurse assesses the client's understanding. Which menu selection made by the client indicates the client correctly understood the teaching?a. Roasted chicken with rice pilaf and a cup of coffee with creamb. Spaghetti with meat sauce, a fresh fruit cup, and hot teac. Garden salad with a cup of bean soup and a glass of low-fat milkd. Baked fish with steamed carrots and a glass of apple juice

D

A client with a long history of alcohol abuse is admitted to the hospital with ascites and jaundice. A diagnosis of hepatic cirrhosis is made. Which is a nursing priority? Institute fall prevention/safety measures. Monitor respiratory status. Measure abdominal girth daily. Test stool specimens for blood.

A

An emergency department nurse assesses an older client who reports cramping pain in the left lower quadrant, weakness, bloating, and malaise. The client also has a low-grade fever. Which condition does the nurse suspect as the most likely cause of the client's clinical findings? Pancreatitis Appendicitis Cholecystitis Diverticulitis

D

The charge nurse delegates the task to the healthcare team to provide an IV medication to a group of people who were diagnosed with gastroenteritis due to food poisoning. Which healthcare team member is suitable to provide medication in this situation? Registered nurse Healthcare provider Licensed practical nurse Unlicensed assistive personnel

A

A nurse is assessing a client with Crohn disease who is to have an upper gastrointestinal series. Which condition necessitates the cancellation of the upper gastrointestinal series? Hemorrhoids Hyperkalemia Inflamed colon Colon perforation

D

A nurse is caring for a client who had surgery for cancer of the pancreas. Which nutrients will the nurse most closely observe after surgery? Beef and chicken Proteins and grains Vitamins and minerals Fats and carbohydrates

D

After teaching a client who has a femoral hernia, the nurse assesses the client's understanding. Which statement indicates the client needs additional teaching related to the proper use of a truss?a. "I will put on the truss before I go to bed each night."b. "I'll put some powder under the truss to avoid skin irritation."c. "The truss will help my hernia because I can't have surgery."d. "If I have abdominal pain, I'll let my health care provider know right away."

A

A client with cancer of the pancreas has a pancreaticoduodenectomy (Whipple procedure). The nurse expects that the client will have which tube after surgery? Chest Intestinal Nasogastric Gastrostomy

C

A client is scheduled for surgery to repair an irreducible (incarcerated) hernia. What nursing intervention is of primary importance? Assessing the client's bowel movement Maintaining the client in the supine position Checking the client's vital signs periodically Monitoring the client's serum enzyme levels

A

A nurse cares for a client with ulcerative colitis. The client states, "I feel like I am tied to the toilet. This disease is controlling my life." How should the nurse respond?a. "Let's discuss potential factors that increase your symptoms."b. "If you take the prescribed medications, you will no longer have diarrhea."c. "To decrease distress, do not eat anything before you go out."d. "You must retake control of your life. I will consult a therapist to help."

A

A self-help group of clients with irritable bowel syndrome have invited a nurse to present a program on nutrition. Which substance should the nurse teach the clients to minimize in the diet to decrease gastrointestinal (GI) irritability? Cola drinks Gelatin Fiber Rice

A

A nurse is assessing a client with the diagnosis of hemorrhoids. Which factors in the client's history most likely played a role in the development of the client's hemorrhoids? Select all that apply. Select all that apply Some correct answers were not selected Constipation Hypertension Eating spicy foods Bowel incontinence Numerous pregnancies

AE

A nurse assesses a client who is recovering from a hemorrhoidectomy that was done the day before. The nurse notes that the client has lower abdominal distention accompanied by dullness to percussion over the distended area. Which action should the nurse take?a. Assess the client's heart rate and blood pressure.b. Determine when the client last voided.c. Ask if the client is experiencing flatus.d. Auscultate all quadrants of the client's abdomen.

B

A telehealth nurse speaks with a client who is recovering from a liver transplant 2 weeks ago. The client states, "I am experiencing right flank pain and have a temperature of 101° F." How should the nurse respond?a. "The anti-rejection drugs you are taking make you susceptible to infection."b. "You should go to the hospital immediately to have your new liver checked out."c. "You should take an additional dose of cyclosporine today."d. "Take acetaminophen (Tylenol) every 4 hours until you feel better."

B

A client tells the nurse about recent recurrent episodes of bleeding hemorrhoids. What should the nurse advise the client to do to help prevent future hemorrhoidal episodes? Exercise to improve circulation Eat bland foods and avoid spices Consume a high-fiber diet and drink adequate water Use laxatives to avoid constipation and the Valsalva maneuver

C

A client with cirrhosis is scheduled for a liver biopsy. The client asks if there are any risks after the procedure. Which response by the nurse is the best? "There are relatively no risks associated with this procedure." "The major risk is infection at the biopsy site." "The major risk is bleeding postprocedure." "The major risk is liver failure postprocedure."

C

A client with esophageal varices has severe hematemesis, and a Sengstaken-Blakemore tube is inserted. What design and purpose does the tube have? Single-lumen; for gastric lavage Double-lumen; for intestinal decompression Triple-lumen; for esophageal compression Multilumen; for gastric and intestinal decompression

C

A client with ulcerative colitis has experienced frequent severe exacerbations over the past several years. The client is admitted to the hospital with intense pain, severe diarrhea, and cachexia. Which therapeutic course should the nurse expect the primary healthcare provider to explore with this client? Intensive psychotherapy Continued medical therapy Surgical therapy (colectomy) Diet therapy (low-residue, high-protein diet)

C

A nurse assesses a client who has ulcerative colitis and severe diarrhea. Which assessment should the nurse complete first?a. Inspection of oral mucosab. Recent dietary intakec. Heart rate and rhythmd. Percussion of abdomen

C

A nurse cares for a client who has chronic cirrhosis from substance abuse. The client states, "All of my family hates me." How should the nurse respond?a. "You should make peace with your family."b. "This is not unusual. My family hates me too."c. "I will help you identify a support system."d. "You must attend Alcoholics Anonymous."

C

A nurse cares for a teenage girl with a new ileostomy. The client states, "I cannot go to prom with an ostomy." How should the nurse respond?a. "Sure you can. Purchase a prom dress one size larger to hide the ostomy appliance."b. "The pouch won't be as noticeable if you avoid broccoli and carbonated drinks prior to the prom."c. "Let's talk to the enterostomal therapist about options for ostomy supplies and dress styles."d. "You can remove the pouch from your ostomy appliance when you are at the prom so that it is less noticeable."

C

A teenager is admitted with an acute onset of right lower quadrant pain at McBurney point. Appendicitis is suspected. For which clinical indicator should the nurse assess the client to determine if the pain is secondary to appendicitis? Urinary retention Gastric hyperacidity Rebound tenderness Increased lower bowel

C

After teaching a client who has plans to travel to a non-industrialized country, the nurse assesses the client's understanding regarding the prevention of viral hepatitis. Which statement made by the client indicates a need for additional teaching?a. "I should drink bottled water during my travels."b. "I will not eat off another's plate or share utensils."c. "I should eat plenty of fresh fruits and vegetables."d. "I will wash my hands frequently and thoroughly."

C

A nurse is caring for a client with cirrhosis of the liver. Which laboratory test should the nurse monitor that, when abnormal, might identify a client who may benefit from neomycin enemas? Ammonia level Culture and sensitivity White blood cell count Alanine aminotransferase (ALT) level

A

A nurse is caring for a client with cholelithiasis and obstructive jaundice. When assessing this client, the nurse should be alert for which findings that are consistent with these conditions? Select all that apply. Select all that apply Ecchymosis Yellow sclera Dark brown stool Straw-colored urine Pain in right upper quadrant

ABE

After teaching a client who has a new colostomy, the nurse provides feedback based on the client's ability to complete self-care activities. Which statement should the nurse include in this feedback?a. "I realize that you had a tough time today, but it will get easier with practice."b. "You cleaned the stoma well. Now you need to practice putting on the appliance."c. "You seem to understand what I taught you today. What else can I help you with?"d. "You seem uncomfortable. Do you want your daughter to care for your ostomy?"

B

After teaching a client who has alcohol-induced cirrhosis, a nurse assesses the client's understanding. Which statement made by the client indicates a need for additional teaching?a. "I cannot drink any alcohol at all anymore."b. "I need to avoid protein in my diet."c. "I should not take over-the-counter medications."d. "I should eat small, frequent, balanced meals."

B

The nurse is providing care to a client with ascites secondary to liver failure. What is appropriate to include in this client's care? Select all that apply. Select all that apply Some correct answers were not selected High protein diet Low sodium diet Daily abdominal girth measurements Encourage increased by mouth fluid intake Daily weights

BCE

A nurse cares for a client with colon cancer who has a new colostomy. The client states, "I think it would be helpful to talk with someone who has had a similar experience." How should the nurse respond?a. "I have a good friend with a colostomy who would be willing to talk with you."b. "The enterostomal therapist will be able to answer all of your questions."c. "I will make a referral to the United Ostomy Associations of America."d. "You'll find that most people with colostomies don't want to talk about them."

C

A nurse assesses a client with a mechanical bowel obstruction who reports intermittent abdominal pain. An hour later the client reports constant abdominal pain. Which action should the nurse take next?a. Administer intravenous opioid medications.b. Position the client with knees to chest.c. Insert a nasogastric tube for decompression.d. Assess the client's bowel sounds.

D

A nurse obtains a client's health history at a community health clinic. Which statement alerts the nurse to provide health teaching to this client?a. "I drink two glasses of red wine each week."b. "I take a lot of Tylenol for my arthritis pain."c. "I have a cousin who died of liver cancer."d. "I got a hepatitis vaccine before traveling."

B

An emergency room nurse assesses a client after a motor vehicle crash and notes ecchymotic areas across the client's lower abdomen. Which action should the nurse take first?a. Measure the client's abdominal girth.b. Assess for abdominal guarding or rigidity.c. Check the client's hemoglobin and hematocrit.d. Obtain the client's complete health history.

B

Three days before surgery for a permanent colostomy for cancer of the colon, a client is receptive of all procedures, responds pleasantly when approached, and does not question staff about what is being done. What is the most appropriate conclusion for the nurse to make based on these behaviors? The client has been fully informed about what to expect. The client is not verbalizing feelings about what will happen. The client cannot accept the illness and the need for surgery. The client feels reassured by frequent contact with health team members.

B

A nurse assesses a client who is hospitalized with an exacerbation of Crohn's disease. Which clinical manifestation should the nurse expect to find?a. Positive Murphy's sign with rebound tenderness to palpitationb. Dull, hypoactive bowel sounds in the lower abdominal quadrantsc. High-pitched, rushing bowel sounds in the right lower quadrantd. Reports of abdominal cramping that is worse at night

C

A nurse assessing a client with colorectal cancer auscultates high-pitched bowel sounds and notes the presence of visible peristaltic waves. Which action should the nurse take?a. Ask if the client is experiencing pain in the right shoulder.b. Perform a rectal examination and assess for polyps.c. Contact the provider and recommend computed tomography.d. Administer a laxative to increase bowel movement activity.

C

A nurse assesses a client who has appendicitis. Which clinical manifestation should the nurse expect to find?a. Severe, steady right lower quadrant painb. Abdominal pain associated with nausea and vomitingc. Marked peristalsis and hyperactive bowel soundsd. Abdominal pain that increases with knee flexion

A

A nurse plans care for a client with Crohn's disease who has a heavily draining fistula. Which intervention should the nurse indicate as the priority action in this client's plan of care?a. Low-fiber dietb. Skin protectionc. Antibiotic administrationd. Intravenous glucocorticoids

B

The nurse is providing care for a client diagnosed with invasive pancreatic cancer. The client has a permanent biliary drainage tube (T-tube) inserted to provide palliative care. Which action should the nurse take postoperatively? Maintain intermittent low suction to limit trauma. Cleanse the area around the insertion site to prevent skin breakdown. Attach the tube to a negative-pressure drainage system to promote drainage. Reposition the client frequently to increase the flow of bile through the tube.

B

After teaching a client with a parasitic gastrointestinal infection, a nurse assesses the client's understanding. Which statements made by the client indicate that the client correctly understands the teaching? (Select all that apply.) a. "I'll have my housekeeper keep my toilet clean."b. "I must take a shower or bathe every day."c. "I should have my well water tested."d. "I will ask my sexual partner to have a stool test."e. "I must only eat raw vegetables from my own garden."ANS: B, C, D

BCD

The nurse is administering lactulose to a client with a history of cirrhosis of the liver. The client asks the nurse why this medication is needed because the client is not constipated. How will the nurse respond? "This medication helps you to stop drinking so much alcohol." "This medication helps you relax and not feel anxious." "This medication helps you lower the high ammonia level caused by your liver disease." "This medication helps you keep your abdomen from being so distended."

C

A client was diagnosed with cancer of the head of the pancreas two months ago. The client is admitted to the hospital with weight loss, severe epigastric pain, and jaundice. When performing the client's assessment, the nurse expects the client's stool to be what color? Green Brown Red-tinged Clay-colored

D

A nurse assesses a client who is prescribed an infusion of vasopressin (Pitressin) for bleeding esophageal varices. Which clinical manifestation should alert the nurse to a serious adverse effect?a. Nausea and vomitingb. Frontal headachec. Vertigo and syncoped. Mid-sternal chest pain

D

A nurse assesses clients at a community health center. Which client is at highest risk for the development of colorectal cancer?a. A 37-year-old who drinks eight cups of coffee dailyb. A 44-year-old with irritable bowel syndrome (IBS)c. A 60-year-old lawyer who works 65 hours per weekd. A 72-year-old who eats fast food frequently

D

For which clinical indicator associated with a complication of portal hypertension should the nurse assess the client? Liver abscess Intestinal obstruction Perforation of the duodenum Hemorrhage from esophageal varices

D

An emergency room nurse assesses a client after a motor vehicle crash. The nurse notices a "steering wheel mark" across the client's chest. Which action should the nurse take?a. Ask the client where in the car he or she was sitting during the crash.b. Assess the client by gently palpating the abdomen for tenderness.c. Notify the laboratory to draw blood for blood type and crossmatch.d. Place the client on the stretcher in reverse Trendelenburg position.

B

After many years of coping with ulcerative colitis, a client makes the decision to have a colectomy as advised by the primary healthcare provider. Which is most likely the significant factor that impacted on the client's decision? It is temporary until the colon heals. Surgical treatment cures ulcerative colitis. Ulcerative colitis can progress to Crohn disease. Without surgery, eating table foods is contraindicated.

B

The nurse instructs a client with a new colostomy to avoid foods and drinks that produce a large amount of gas, specifically to avoid the intake of what? Milk Cheese Coffee Cabbage

D

A nurse cares for a client with hepatopulmonary syndrome who is experiencing dyspnea with oxygen saturations at 92%. The client states, "I do not want to wear the oxygen because it causes my nose to bleed. Get out of my room and leave me alone!" Which action should the nurse take?a. Instruct the client to sit in as upright a position as possible.b. Add humidity to the oxygen and encourage the client to wear it.c. Document the client's refusal, and call the health care provider.d. Contact the provider to request an extra dose of the client's diuretic.

A

A nurse is taking care of a client with cirrhosis of the liver. Which clinical manifestations should the nurse assess in the client? Select all that apply. Select all that apply Ascites Hunger Pruritus Jaundice Headache

ACD

A nurse is caring for a client who is scheduled to have an abdominal perineal resection for colorectal cancer. The client has type B negative blood. If a blood infusion is needed, which type is preferred for administration? A positive B negative O negative AB positive

B

A client who is in a late stage of pancreatic cancer intellectually understands the terminal nature of the illness. What are behaviors that indicate the client is emotionally accepting the impending death? Revising the client's will and planning a visit to a friend Alternately crying and talking openly about death Getting second, third, and fourth medical opinions Refusing to follow treatments and stating they won't help anyway

A

A nurse is performing a health history and physical assessment of a client with cholelithiasis and obstructive jaundice. Which clinical finding should the nurse expect this client to exhibit? Hematuria Bloody stools Straw-colored urine Pain in the right upper quadrant

D

A client is at high risk for developing ascites because of cirrhosis of the liver. How should the nurse assess for the presence of ascites? Observe the client for signs of respiratory distress. Percuss the client's abdomen and listen for dull sounds. Palpate the lower extremities over the tibia and observe for edema. Listen for decreased or absent bowel sounds while auscultating the abdomen.

B

A client has a diagnosis of hemorrhoids. Which signs and symptoms does the nurse expect the client to report? Select all that apply. Select all that apply Flatulence Anal itching Blood in stool Rectal bulging Pain when defecating

BCDE

A client has been diagnosed with cholelithiasis. Which fact about cholelithiasis should the nurse recall when assessing this client for risk factors? Men are more likely to be affected than women. Young people are affected more frequently than older people. Individuals who are obese are more prone to this condition than those who are thin. People who are physically active are more apt to develop this condition than those who are sedentary.

C

A nurse is caring for a client who is positive for hepatitis A. Which precautions should the nurse take? Wear a gown when entering the client's room. Use caution when bringing in the client's food. Use gloves when removing the client's bedpan. Wear a protective mask when entering the client's room.

C

The serum ammonia level of a client with hepatic cirrhosis and ascites is elevated. What nursing intervention is the priority? Weigh the client daily. Restrict the client's oral fluid intake. Measure the client's urine specific gravity. Observe the client for increasing confusion.

D

A client with Crohn disease is admitted to the hospital with a history of chronic, bloody diarrhea, weight loss, and signs of general malnutrition. The client has anemia, a low serum albumin level, and signs of negative nitrogen balance. The nurse concludes that the client's health status is related to what major deficiency? Ferrous sulfate Protein Ascorbic acid Linoleic acid

A

A client with colon cancer is receiving hospice care at home. What is the focus of hospice care? To ease the pain from illness To provide curative treatment To assist with activities of daily living To adapt to the limitations due to illness

A

A client is about to have a blood transfusion and asks the nurse which type of hepatitis is most frequently transmitted through food. Which type of hepatitis should the nurse teach the client about being most associated with food? A B C D

A

A client is diagnosed with hepatitis A. The nurse takes the client's history. Which employment history is most likely linked to the development of hepatitis A? Works at a plumbing business Works in a hemodialysis unit at a hospital Works as a dishwasher at a local restaurant Works at an occupational arsenic compound business

A

A client was diagnosed with ulcerative colitis. Two months after the diagnosis, the client is readmitted for an exacerbation of the illness. The client is weak, thin, and irritable. The client states, "I am now ready for surgery to create an ileostomy." Which nursing intervention will best meet the client's priority need? Replace the client's fluids and electrolytes Help the client gain weight Teach the client how to use the ileostomy appliance Encourage client interaction with other clients who have an ileostomy

A

A client with esophageal varices is admitted with hematemesis, and two units of packed red blood cells are prescribed. The client complains of flank pain halfway through the first unit of blood. What should be the nurse's first action? Stop the transfusion. Obtain the vital signs. Assess the pain further. Monitor the hourly urinary output.

A

A nurse assesses a client who is prescribed 5-fluorouracil (5-FU) chemotherapy intravenously for the treatment of colon cancer. Which assessment finding should alert the nurse to contact the health care provider?a. White blood cell (WBC) count of 1500/mm3b. Fatiguec. Nausea and diarrhead. Mucositis and oral ulcers

A

A nurse assesses a client who is recovering from a paracentesis 1 hour ago. Which assessment finding requires action by the nurse?a. Urine output via indwelling urinary catheter is 20 mL/hrb. Blood pressure increases from 110/58 to 120/62 mm Hgc. Respiratory rate decreases from 18 to 14 breaths/mind. A decrease in the client's weight by 6 kg

A

A nurse plans care for a client who has chronic diarrhea. Which actions should the nurse include in this client's plan of care? (Select all that apply.)a. Using premoistened disposable wipes for perineal careb. Turning the client from right to left every 2 hoursc. Using an antibacterial soap to clean after each stoold. Applying a barrier cream to the skin after cleaninge. Keeping broken skin areas open to air to promote healing

ABD

A client is admitted to the hospital for surgery for rectosigmoid colon cancer, and the nurse is obtaining a health history as part of the admission process. What clinical findings associated with rectosigmoid colon cancer does the nurse expect the client to report? Select all that apply. Select all that apply Feeling tired Rectal bleeding Inability to digest fat Change in the shape of stools Feeling of abdominal bloating

ABDE

An infection control nurse develops a plan to decrease the number of health care professionals who contract viral hepatitis at work. Which ideas should the nurse include in this plan? (Select all that apply.)a. Policies related to consistent use of Standard Precautionsb. Hepatitis vaccination mandate for workers in high-risk areasc. Implementation of a needleless system for intravenous therapyd. Number of sharps used in client care reduced where possiblee. Postexposure prophylaxis provided in a timely manner

ACDE

A nurse cares for a client who has a nasogastric (NG) tube. Which actions should the nurse take? (Select all that apply.)a. Assess for proper placement of the tube every 4 hours.b. Flush the tube with water every hour to ensure patency.c. Secure the NG tube to the client's upper lip.d. Disconnect suction when auscultating bowel peristalsis.e. Monitor the client's skin around the tube site for irritation.ANS: A, D, E

ADE

A client is experiencing an exacerbation of ulcerative colitis. A low-residue, high-protein diet and IV fluids with vitamins have been prescribed. When implementing these prescriptions, which goal is the nurse trying to achieve? Reduce gastric acidity Reduce colonic irritation Reduce intestinal absorption Reduce bowel infection rate

B

After teaching a client who has been diagnosed with hepatitis A, the nurse assesses the client's understanding. Which statement by the client indicates a correct understanding of the teaching?a. "Some medications have been known to cause hepatitis A."b. "I may have been exposed when we ate shrimp last weekend."c. "I was infected with hepatitis A through a recent blood transfusion."d. "My infection with Epstein-Barr virus can co-infect me with hepatitis A."

B

After teaching a client who was hospitalized for Salmonella food poisoning, a nurse assesses the client's understanding. Which statement made by the client indicates a need for additional teaching?a. "I will let my husband do all of the cooking for my family."b. "I'll take the ciprofloxacin until the diarrhea has resolved."c. "I should wash my hands with antibacterial soap before each meal."d. "I must place my dishes into the dishwasher after each meal."

B

After teaching a client with irritable bowel syndrome (IBS), a nurse assesses the client's understanding. Which menu selection indicates that the client correctly understands the dietary teaching? a. Ham sandwich on white bread, cup of applesauce, glass of diet cola b. Broiled chicken with brown rice, steamed broccoli, glass of apple juice c. Grilled cheese sandwich, small banana, cup of hot tea with lemon d. Baked tilapia, fresh green beans, cup of coffee with low-fat milk

B

After teaching a client with perineal excoriation caused by diarrhea from acute gastroenteritis, a nurse assesses the client's understanding. Which statement by the client indicates a need for additional teaching?a. "I'll rinse my rectal area with warm water after each stool and apply zinc oxide ointment."b. "I will clean my rectal area thoroughly with toilet paper after each stool and then apply aloe vera gel."c. "I must take a sitz bath three times a day and then pat my rectal area gently but thoroughly to make sure I am dry."d. "I shall clean my rectal area with a soft cotton washcloth and then apply vitamin A and D

B

Three days after surgery for cancer of the colon, a nurse introduces the client to colostomy care. Which should the nurse teach the client about skin care around the stoma? Apply liberal amounts of Vaseline for 3 inches (7.6 centimeters) around the stoma Wash the area with soap and water and then apply a protective ointment Pour saline over the stoma and rub the area to remove hard fecal matter Rinse the area with peroxide before applying fresh gauze bandages

B

A 50-year-old client being seen for a routine physical asks why a stool specimen for occult blood testing has been prescribed when there is no history of health problems. What is an appropriate nursing response? "You will need to ask your healthcare provider; it is not part of the usual tests for people your age." "There must be concern of a family history of colon cancer; that is a primary reason for an occult blood stool test." "It is performed routinely starting at your age as part of an assessment for colon cancer." "There must have been a positive finding after a digital rectal examination performed by your healthcare provider."

C

A client scheduled for a hemicolectomy because of a small lesion in the colon asks if having a hemicolectomy means "that I have to deal with one of those pouches and have bowel movements into the pouch." Which is the best response by the nurse? "Yes, a hemicolectomy means that you will need a colostomy." "Yes, but it will be temporary until the colon has healed." "No, only part of the colon is removed and the rest reattached." "No, that is necessary only when a tumor is blocking the rectum."

C

A client who has cancer of the sigmoid colon is to have an abdominoperineal resection with a permanent colostomy. Before surgery a low-residue diet is prescribed. What is the nurse's explanation for the necessity of this diet? Limit production of flatus in the intestine Prevent irritation of the intestinal mucosa Reduce the amount of stool in the large bowel Lower the bacterial count in the gastrointestinal tract

C

A client is diagnosed with cancer of the rectum and has surgery for an abdominoperineal resection and colostomy. Which nursing care should be implemented during the postoperative period? Limiting fluid intake for several days Withholding fluids for 72 hours Having the client change the colostomy bag Keeping the client's skin around the stoma clean

D

A nurse is assessing two clients. One client has ulcerative colitis, and the other client has Crohn disease. Which is more likely to be identified in the client with ulcerative colitis than in the client with Crohn disease? Inclusion of transmural involvement of the small bowel wall Higher occurrence of fistulas and abscesses from changes in the bowel wall Pathology beginning proximally with intermittent plaques found along the colon Involvement starting distally with rectal bleeding that spreads continuously up the colon

D

After surgery for cancer of the pancreas, the client's nutrition and fluid regimen are influenced by the remaining amount of functioning pancreatic tissue. The nurse considers both the exocrine and the endocrine functions of the pancreas and expects that, postoperatively, the client's dietary regimen will be focused on the management of what substances? Alcohol and caffeine Fluids and electrolytes Vitamins and minerals Fats and carbohydrates

D

An emergency room nurse cares for a client who has been shot in the abdomen and is hemorrhaging heavily. Which action should the nurse take first?a. Send a blood sample for a type and crossmatch.b. Insert a large intravenous line for fluid resuscitation.c. Obtain the heart rate and blood pressure.d. Assess and maintain a patent airway.

D

The nurse is teaching a client about the prescribed diet after a Whipple procedure for cancer of the pancreas. Which statement should the nurse include in the dietary teaching? "There are no dietary restrictions because the tumor has been removed." "Your diet should be low in calories to prevent taxing your diseased pancreas." "Meals should be restricted in protein because of your compromised liver function." "Low-fat meals should be eaten to prevent interference with your fat digestion mechanism."

D

The postoperative diet prescription for a client who had a colostomy states, "Diet as tolerated." Which principle should the nurse include in the teaching plan to help guide the client with food choices? Specific foods will cause most clients the same discomfort. A low-residue diet should be followed to avoid overstimulating the intestine. More rigid dietary rules limiting food choices are needed to provide security. A return to a regular diet as soon as possible promotes physical rehabilitation.

D

A nurse plans care for a client who has hepatopulmonary syndrome. Which interventions should the nurse include in this client's plan of care? (Select all that apply.)a. Oxygen therapyb. Prone positionc. Feet elevated on pillowsd. Daily weightse. Physical therapy

ACD

A client is admitted to the hospital with a diagnosis of Crohn disease. What is mostimportant for the nurse to include in the teaching plan for this client? Controlling constipation Meeting nutritional needs Preventing increased weakness Anticipating a sexual alteration

B

A client is returned to the surgical unit after an abdominal cholecystectomy. What is the main reason why the nurse should assess for clinical indicators of respiratory complications? Length of time required for surgery is prolonged. Incision is in close proximity to the client's diaphragm. Client's resistance is lowered because of bile in the blood. Bloodstream is invaded by microorganisms from the biliary tract.

B

A nurse cares for a client with a new ileostomy. The client states, "I don't think my friends will accept me with this ostomy." How should the nurse respond?a. "Your friends will be happy that you are alive."b. "Tell me more about your concerns."c. "A therapist can help you resolve your concerns."d. "With time you will accept your new body."

B

A nurse cares for a client with hepatic portal-systemic encephalopathy (PSE). The client is thin and cachectic in appearance, and the family expresses distress that the client is receiving little dietary protein. How should the nurse respond?a. "A low-protein diet will help the liver rest and will restore liver function."b. "Less protein in the diet will help prevent confusion associated with liver failure."c. "Increasing dietary protein will help the client gain weight and muscle mass."d. "Low dietary protein is needed to prevent fluid from leaking into the abdomen."

B

A client with a diagnosis of incarcerated hernia asks the nurse for an explanation of the diagnosis. What does the nurse explain is the meaning of an incarcerated hernia? The bowel has twisted on itself. A piece of the intestine gets stuck in a hole in the abdominal wall. The intestinal blood supply has been cut off. The involved intestine has developed an erosion.

B

A client with a recent colostomy expresses concern about the inability to control the passage of gas. What precaution should the nurse teach the client to take? Eliminate foods high in cellulose Decrease fluid intake at mealtimes Avoid foods that in the past caused flatus Adhere to a bland diet before social events

C

A client with irritable bowel syndrome has instructions to take psyllium 2 rounded teaspoons full twice a day for constipation. What is most important for the nurse to include in the teaching plan? Urine may be discolored. Stop taking the laxative once a bowel movement occurs. Each dose should be taken with a full glass of water or juice. Daily use may inhibit the absorption of some fat-soluble vitamins.

C

A nurse assesses clients on the medical-surgical unit. Which client is at greatest risk for the development of carcinoma of the liver?a. A 22-year-old with a history of blunt liver traumab. A 48-year-old with a history of diabetes mellitusc. A 66-year-old who has a history of cirrhosisd. An 82-year-old who has chronic malnutrition

C

A client with a history of alcoholism and cirrhosis is admitted with severe dyspnea as a result of ascites. Which process that most likely caused the ascites should the nurse consider when planning care? Increased secretion of bile salts Increased pressure in the portal vein Increased interstitial osmotic pressure Increased production of serum albumin

B

A client with cirrhosis of the liver and ascites has been taking chlorothiazide, a thiazide diuretic. Why did the provider add spironolactone to the client's medication regimen? To stimulate sodium excretion To help prevent potassium loss To increase urine specific gravity To reduce arterial blood pressure

B

A client with jaundice associated with hepatitis expresses concern over the change in skin color. What does the nurse explain is the cause of this color change? Stimulation of the liver to produce an excess quantity of bile pigments Inability of the liver to remove normal amounts of bilirubin from the blood Increased destruction of red blood cells during the acute phase of the disease Decreased prothrombin levels, leading to multiple sites of intradermal bleeding

B

A client with severe Crohn disease develops a small bowel obstruction. Which clinical finding should the nurse expect the client to report? Bloody vomitus Projectile vomiting Bleeding with defecation Pain in the left lower quadrantB

B

A nurse administers lactulose to a client with cirrhosis of the liver. Which laboratory test change leads the nurse to determine that the lactulose is effective? Decreased amylase Decreased ammonia Increased potassium Increased hemoglobin

B

A nurse cares for a client who has cirrhosis of the liver. Which action should the nurse take to decrease the presence of ascites?a. Monitor intake and output.b. Provide a low-sodium diet.c. Increase oral fluid intake.d. Weigh the client daily.

B

A nurse assesses a client with Crohn's disease and colonic strictures. Which clinical manifestation should alert the nurse to urgently contact the health care provider?a. Distended abdomenb. Temperature of 100.0° F (37.8° C)c. Loose and bloody stoold. Lower abdominal cramps

A

A nurse assesses clients at a community health fair. Which client is at greatest risk for the development of hepatitis B?a. A 20-year-old college student who has had several sexual partnersb. A 46-year-old woman who takes acetaminophen daily for headachesc. A 63-year-old businessman who travels frequently across the countryd. An 82-year-old woman who recently ate raw shellfish for dinner

A

A client with cholelithiasis has a laser laparoscopic cholecystectomy. What is most appropriate for the nurse to do postoperatively? Maintain the client's nothing by mouth status for the first 24 hours Monitor the client's abdominal incision for bleeding Offer clear carbonated beverages to the client Ambulate the client when the client is alert and oriented

D

A client develops peritonitis and sepsis after the surgical repair of a ruptured diverticulum. What signs should the nurse expect when assessing the client? Select all that apply. Select all that apply Some correct answers were not selected Fever Tachypnea Hypertension Abdominal rigidity Increased bowel sounds

ABD

A nurse cares for a client who has food poisoning resulting from a Clostridium botulinum infection. Which assessment should the nurse complete first?a. Heart rate and rhythmb. Bowel soundsc. Urinary outputd. Respiratory rate

D

that most commonly are spread by consuming contaminated food and water or by fecal contamination if the student identifies which of these diseases? Select all that apply. Select all that apply Hepatitis A Hepatitis B Hepatitis C Hepatitis D Hepatitis E

AE

A nurse cares for a client who has been diagnosed with a small bowel obstruction. Which assessment findings should the nurse correlate with this diagnosis? (Select all that apply.)a. Serum potassium of 2.8 mEq/Lb. Loss of 15 pounds without dietingc. Abdominal pain in upper quadrantsd. Low-pitched bowel soundse. Serum sodium of 121 mEq/L

ACE

A nurse cares for a client who had a colostomy placed in the ascending colon 2 weeks ago. The client states, "The stool in my pouch is still liquid." How should the nurse respond?a. "The stool will always be liquid with this type of colostomy."b. "Eating additional fiber will bulk up your stool and decrease diarrhea."c. "Your stool will become firmer over the next couple of weeks."d. "This is abnormal. I will contact your health care provider."

A

A nurse cares for a client who has a new colostomy. Which action should the nurse take?a. Empty the pouch frequently to remove excess gas collection.b. Change the ostomy pouch and wafer every morning.c. Allow the pouch to completely fill with stool prior to emptying it.d. Use surgical tape to secure the pouch and prevent leakage.

A

A nurse assesses a client with ulcerative colitis. Which complications are paired correctly with their physiologic processes? (Select all that apply.)a. Lower gastrointestinal bleeding - Erosion of the bowel wallb. Abscess formation - Localized pockets of infection develop in the ulcerated bowel liningc. Toxic megacolon - Transmural inflammation resulting in pyuria and fecaluriad. Nonmechanical bowel obstruction - Paralysis of colon resulting from colorectal cancere. Fistula - Dilation and colonic ileus caused by paralysis of the colon

ABD

A nurse inserts a nasogastric (NG) tube for an adult client who has a bowel obstruction. Which actions does the nurse perform correctly? (Select all that apply.)a. Performs hand hygiene and positions the client in high-Fowler's position, with pillows behind the head and shouldersb. Instructs the client to extend the neck against the pillow once the NG tube has reached the oropharynxc. Checks for correct placement by checking the pH of the fluid aspirated from the tubed. Secures the NG tube by taping it to the client's nose and pinning the end to the pillowcasee. Connects the NG tube to intermittent medium suction with an anti-reflux valve on the air vent

ACE

A nurse teaches a community group ways to prevent Escherichia coli infection. Which statements should the nurse include in this group's teaching? (Select all that apply.)a. "Wash your hands after any contact with animals."b. "It is not necessary to buy a meat thermometer."c. "Stay away from people who are ill with diarrhea."d. "Use separate cutting boards for meat and vegetables."e. "Avoid swimming in backyard pools and using hot tubs."

AD

A primary healthcare provider diagnoses a client with acute cholecystitis with biliary colic. Which clinical findings should the nurse expect when performing a health history and physical assessment? Select all that apply. Select all that apply Some correct answers were not selected Diarrhea with black feces Intolerance to foods high in fat Vomiting of coffee-ground emesis Gnawing pain when stomach is empty Pain that radiates to the right shoulder

BD

An emergency room nurse assesses a client with potential liver trauma. Which clinical manifestations should alert the nurse to internal bleeding and hypovolemic shock? (Select all that apply.)a. Hypertensionb. Tachycardiac. Flushed skind. Confusione. Shallow respirations

BD

A client appears depressed since the surgical creation of a colostomy five days ago. The nurse determines that there is some movement toward adaptation to the change in body image when the client exhibits which behavior? Discusses the necessity of the colostomy Requests the nurse to change the dressing Looks at the face of the nurse during care Stares at the stoma during dressing changes

D

A nurse cares for a client who is hemorrhaging from bleeding esophageal varices and has an esophagogastric tube. Which action should the nurse take first?a. Sedate the client to prevent tube dislodgement.b. Maintain balloon pressure at 15 and 20 mm Hg.c. Irrigate the gastric lumen with normal saline.d. Assess the client for airway patency.

D

Which clinical indicator should the nurse identify before scheduling a client for an endoscopic retrograde cholangiopancreatography (ERCP)? Urine output Bilirubin level Blood pressure Serum glucose

B

A client is admitted to the hospital with suspected liver disease, and a needle biopsy of the liver is performed. After the procedure, the nurse should maintain the client in what position? Supine Semi-Fowler Right side-lying

C

The client receives dosages of sedative and opioid drugs during the postoperative period following surgical correction of a small bowel obstruction. What is the most critical assessment to be performed as a nursing safety priority? Urinary assessment Respiratory assessment Cardiovascular assessment Neuromuscular assessment

B

The nurse is caring for a client following a laparoscopic cholecystectomy. Which nursing action is priority? Monitor the abdominal dressing for bleeding Instruct on using patient-controlled analgesia Teach about six-week activity restriction Assess puncture sites for bleeding

D

A nurse assesses a client who is recovering from an ileostomy placement. Which clinical manifestation should alert the nurse to urgently contact the health care provider?a. Pale and bluish stomab. Liquid stoolc. Ostomy pouch intactd. Blood-smeared output

A

A client is diagnosed as having the hepatitis B virus (HBV). The nurse reviews the client's health history for possible situations in which exposure may have occurred. Which event does the nurse determine is most likely the source of this infection? Had a small tattoo on the arm three months ago Assisted in the emergency birth of a baby two weeks ago Worked for a month in an undeveloped area in Mexico four months ago Attended an ecologic conference in a large urban center two months ago

A

A client is scheduled to begin chemotherapy 2 weeks after surgery for colon cancer. What explanation does the nurse give to explain the delay following surgery? Chemotherapy interferes with cell growth and delays wound healing. Because chemotherapy causes vomiting, it endangers the integrity of the incisional area. Chemotherapy decreases red blood cell production, and the resultant anemia will add to postoperative fatigue. Chemotherapy increases edema in areas distal to the incision by blocking lymph channels with destroyed lymphocytes.

A

A client with cirrhosis of the liver and ascites is scheduled to have a paracentesis. What should the nurse do to prepare the client for the procedure? Instruct the client to void. Tell the client not to eat for four hours. Give the client an analgesic. Have the client turn to the lateral position.

A

A nurse teaches a client how to avoid becoming ill with Salmonella infection again. Which statements should the nurse include in this client's teaching? (Select all that apply.)a. "Wash leafy vegetables carefully before eating or cooking them."b. "Do not ingest water from the garden hose or the pool."c. "Wash your hands before and after using the bathroom."d. "Be sure meat is cooked to the proper temperature."e. "Avoid eating eggs that are sunny side up or undercooked."

ACDE

A nurse teaches a community group about food poisoning and gastroenteritis. Which statements should the nurse include in this group's teaching? (Select all that apply.)a. "Rotavirus is more common among infants and younger children."b. "Escherichia coli diarrhea is transmitted by contact with infected animals."c. "To prevent E. coli infection, don't drink water when swimming."d. "Clients who have botulism should be quarantined within their home."e. "Parasitic diseases may not show up for 1 to 2 weeks after infection."

ACE

. A nurse assesses a client who is hospitalized for botulism. The client's vital signs are temperature: 99.8° F (37.6° C), heart rate: 100 beats/min, respiratory rate: 10 breaths/min, and blood pressure: 100/62 mm Hg. Which action should the nurse take?a. Decrease stimulation and allow the client to rest.b. Stay with the client while another nurse calls the provider.c. Increase the client's intravenous fluid replacement rate.d. Check the client's blood glucose and administer orange juice.

B

A client was admitted to the hospital with blunt trauma as a result of a collision with the steering wheel during a motor vehicle accident. The client was treated for a lacerated liver and abdominal hemorrhage. Which clinical findings should the nurse be alert for when assessing the client for peritonitis during the recovery period? Select all that apply. Select all that apply Some correct answers were not selected Jaundice Boardlike abdomen Abdominal tenderness Decreased bowel sounds Rapid decrease in coagulation ability

BCD

The registered nurse determines that the new graduate understands the type(s) of hepatitis that generally develop into a chronic hepatitis infection if the graduate identifies which disease(s)? Select all that apply. Select all that apply Some correct answers were not selected Hepatitis A Hepatitis B Hepatitis C Hepatitis D Hepatitis E

BCD

A client has a new colostomy. The nurse has provided teaching related to when the client should irrigate the colostomy. Which client statement indicates correct understanding of the teaching? "After it gets done healing in a few weeks, I will begin irrigating it just before going to bed each day." "It will need to be irrigated each morning before I can eat any food." "I plan to irrigate it in the late morning, the same time I had a bowel movement every day before I had my surgery." "I can wait to start irrigating it until after I have gotten used to this bag and change in lifestyle."

C

The nurse is creating a dietary plan for a client with cholecystitis who has been placed on a modified diet. Which will be most appropriate to include in the client's dietary plan? Offer soft-textured foods to reduce the digestive burden Offer low-cholesterol foods to avoid further formation of gallstones Increase protein intake to promote tissue healing and improve energy reserves Decrease fat intake to avoid stimulation of the cholecystokinin mechanism for bile release

D

A nurse assesses a client with peritonitis. Which clinical manifestations should the nurse expect to find? (Select all that apply.)a. Distended abdomenb. Inability to pass flatusc. Bradycardiad. Hyperactive bowel soundse. Decreased urine output

ABE

A nurse assesses a male client who has symptoms of cirrhosis. Which questions should the nurse ask to identify potential factors contributing to this laboratory result? (Select all that apply.)a. "How frequently do you drink alcohol?"b. "Have you ever had sex with a man?"c. "Do you have a family history of cancer?"d. "Have you ever worked as a plumber?"e. "Were you previously incarcerated?"

ABE

A nurse teaches a client who is at risk for colon cancer. Which dietary recommendation should the nurse teach this client?a. "Eat low-fiber and low-residual foods."b. "White rice and bread are easier to digest."c. "Add vegetables such as broccoli and cauliflower to your new diet."d. "Foods high in animal fat help to protect the intestinal mucosa."

C

A nurse assesses a client with irritable bowel syndrome (IBS). Which questions should the nurse include in this client's assessment? (Select all that apply.)a. "Which food types cause an exacerbation of symptoms?"b. "Where is your pain and what does it feel like?"c. "Have you lost a significant amount of weight lately?"d. "Are your stools soft, watery, and black in color?"e. "Do you experience nausea associated with defecation?"

ABE

A nurse is reviewing the history, physical examination, and diagnostic test results of a client with colitis. What clinical findings are associated with this disorder? Select all that apply. Select all that apply Some correct answers were not selected Anemia Diarrhea Hemoptysis Abdominal cramps Decreased white blood cells

ABD

A nurse plans care for a client who is recovering from an inguinal hernia repair. Which interventions should the nurse include in this client's plan of care? (Select all that apply.)a. Encouraging ambulation three times a dayb. Encouraging normal urinationc. Encouraging deep breathing and coughingd. Providing ice bags and scrotal supporte. Forcibly reducing the hernia

ABD

A nurse cares for a client who is prescribed mesalamine (Asacol) for ulcerative colitis. The client states, "I am having trouble swallowing this pill." Which action should the nurse take?a. Contact the clinical pharmacist and request the medication in suspension form.b. Empty the contents of the capsule into applesauce or pudding for administration.c. Ask the health care provider to prescribe the medication as an enema instead.d. Crush the pill carefully and administer it in applesauce or pudding.

C

A nurse prepares a client for a colonoscopy scheduled for tomorrow. The client states, "My doctor told me that the fecal occult blood test was negative for colon cancer. I don't think I need the colonoscopy and would like to cancel it." How should the nurse respond?a. "Your doctor should not have given you that information prior to the colonoscopy."b. "The colonoscopy is required due to the high percentage of false negatives with the blood test."c. "A negative fecal occult blood test does not rule out the possibility of colon cancer."d. "I will contact your doctor so that you can discuss your concerns about the procedure."

C

A client is admitted with a diagnosis of acute pancreatitis. The medical and nursing measures for this client are aimed toward maintaining nutrition, promoting rest, maintaining fluid and electrolytes, and decreasing anxiety. Which interventions should the nurse implement? Select all that apply. Select all that apply Some correct answers were not selected Provide a low-fat diet Administer analgesics Teach relaxation exercises Encourage walking in the hall Monitor cardiac rate and rhythm Observe for signs of hypercalcemia

BCE

A nurse is providing discharge instructions to a client diagnosed with cirrhosis and varices. Which information should the nurse include in the teaching session? Select all that apply. Select all that apply Some correct answers were not selected Adhering to a low-carbohydrate diet Avoiding aspirin and aspirin-containing products Limiting alcohol consumption to two drinks weekly Avoiding acetaminophen and products containing acetaminophen Avoiding coughing, sneezing, and straining to have a bowel movement

BDE

A nurse assesses a male client with an abdominal hernia. Which abdominal hernias are correctly paired with their physiologic processes? (Select all that apply.)a. Indirect inguinal hernia - An enlarged plug of fat eventually pulls the peritoneum and often the bladder into a sacb. Femoral hernia - A peritoneum sac pushes downward and may descend into the scrotumc. Direct inguinal hernia - A peritoneum sac passes through a weak point in the abdominal walld. Ventral hernia - Results from inadequate healing of an incisione. Incarcerated hernia - Contents of the hernia sac cannot be reduced back into the abdominal cavity

CDE

A nurse is assessing a malnourished client with a history of cirrhosis. The client is experiencing nausea, ascites, and gastrointestinal bleeding. What is the primary cause of the client's ascites? A decrease in vitamins to maintain cell coenzyme functions A decrease in iron to maintain adequate hemoglobin synthesis A decrease in sodium to maintain its concentration in tissue fluid A decrease in plasma protein to maintain adequate capillary-tissue circulation

D

A child is diagnosed with hepatitis A. The client's parent expresses concern that the other members of the family may get hepatitis because they all share the same bathroom. What is the nurse's best reply? "I suggest that you buy a commode exclusively for your child's use." "Your child may use the bathroom, but you need to use disposable toilet covers." "You will need to clean the bathroom from top to bottom every time a family member uses it." "All family members, including your child, need to wash their hands after using the bathroom."

D

A client experiences occasional right upper quadrant pain attributed to cholecystitis. The nurse is providing discharge instructions, including a list of foods that cause dyspepsia. Which foods should be on the list the nurse provided the client? Nuts and popcorn Meatloaf and baked potato Chocolate and boiled shrimp Fried chicken and buttered corn

D

A nurse assesses a client who is prescribed alosetron (Lotronex). Which assessment question should the nurse ask this client? a. "Have you been experiencing any constipation?"b. "Are you eating a diet high in fiber and fluids?"c. "Do you have a history of high blood pressure?"d. "What vitamins and supplements are you taking?"

A

A nurse cares for a client who is prescribed lactulose (Heptalac). The client states, "I do not want to take this medication because it causes diarrhea." How should the nurse respond?a. "Diarrhea is expected; that's how your body gets rid of ammonia."b. "You may take Kaopectate liquid daily for loose stools."c. "Do not take any more of the medication until your stools firm up."d. "We will need to send a stool specimen to the laboratory."

A

A nurse cares for a client who states, "My husband is repulsed by my colostomy and refuses to be intimate with me." How should the nurse respond?a. "Let's talk to the ostomy nurse to help you and your husband work through this."b. "You could try to wear longer lingerie that will better hide the ostomy appliance."c. "You should empty the pouch first so it will be less noticeable for your husband."d. "If you are not careful, you can hurt the stoma if you engage in sexual activity."

A

After teaching a client who is prescribed adalimumab (Humira) for severe ulcerative colitis, the nurse assesses the client's understanding. Which statement made by the client indicates a need for additional teaching?a. "I will avoid large crowds and people who are sick."b. "I will take this medication with my breakfast each morning."c. "Nausea and vomiting are common side effects of this drug."d. "I must wash my hands after I play with my dog."

A

"I will eat soft foods that are more easily digested and absorbed by my large intestine." Which information would the nurse include regarding appliance care and maintenance, when teaching a client with a new colostomy? Select all that apply. Select all that apply Change the ostomy pouch on a routine basis. Replace the ostomy wafer weekly or sooner as needed. Remove the ostomy pouch when showering. Empty the ostomy pouch when three-quarters full of stool or gas. Empty the ostomy pouch before exercise and at bedtime.

ABE

A client is diagnosed with Crohn disease, and parenteral vitamins are prescribed. The client asks why the vitamins have to be given intravenously (IV) rather than by mouth. What rationales for this route should the nurse include in a response to the question? Select all that apply. Select all that apply More rapid action results. They decrease colon irritability. Oral vitamins are less effective. Intestinal absorption may be inadequate. Allergic responses are less likely to occur.

ACD

The nurse is caring for a client scheduled to have a percutaneous liver biopsy. Which assessment findings warrant the postponement of the procedure? Select all that apply. Select all that apply Hemosiderosis Marked ascites Hepatic cirrhosis Hemoglobin of less than 9 g/dL (90 mmol/L) Platelet count of 150,000/mm 3(150 × 10 9/L)

BD

A nurse is teaching a client about prophylactic measures that minimize the risk of contracting hepatitis B. Which actions should be included in this teaching plan? Select all that apply. Select all that apply Preventing constipation Screening of blood donors Avoiding shellfish in the diet Limiting hepatotoxic drug therapy Maintaining a monogamous sexual relationship

BE

Which type of hepatitis virus spreads through contaminated food and water? Hepatitis A virus Hepatitis B virus Hepatitis C virus Hepatitis D virus

A

While awaiting surgery, a client with a long history of Crohn disease is receiving total parenteral nutrition (TPN) on an outpatient basis. The nurse teaches the client that TPN helps to prepare for surgery by which process? Decreasing fecal bulk Preventing bowel infection Providing stimulation of secretions Maintaining negative nitrogen balance

A

A client who had surgery for a resection of the colon and the formation of a colostomy is to be discharged in several days. What is a primary nursing intervention for this client? Determine the client's ability to care for the colostomy Show the client how to change the abdominal dressing Encourage the client to apply heat to the stoma opening Teach the client about the special lifelong dietary precautions

A

A nurse reviews the chart of a client who has Crohn's disease and a draining fistula. Which documentation should alert the nurse to urgently contact the provider for additional prescriptions?a. Serum potassium of 2.6 mEq/Lb. Client ate 20% of breakfast mealc. White blood cell count of 8200/mm3d. Client's weight decreased by 3 pounds

A

A nurse teaches a client who has viral gastroenteritis. Which dietary instruction should the nurse include in this client's teaching?a. "Drink plenty of fluids to prevent dehydration."b. "You should only drink 1 liter of fluids daily."c. "Increase your protein intake by drinking more milk."d. "Sips of cola or tea may help to relieve your nausea."

A

A nurse teaches a client with hepatitis C who is prescribed ribavirin (Copegus). Which statement should the nurse include in this client's discharge education?a. "Use a pill organizer to ensure you take this medication as prescribed."b. "Transient muscle aching is a common side effect of this medication."c. "Follow up with your provider in 1 week to test your blood for toxicity."d. "Take your radial pulse for 1 minute prior to taking this medication."

A

A nurse is caring for a client with acute pancreatitis. Which elevated laboratory test result is most indicative of acute pancreatitis? Blood glucose Serum lipase Serum bilirubin level White blood cell count

B

After teaching a client with an anal fissure, a nurse assesses the client's understanding. Which client actions indicate that the client correctly understands the teaching? (Select all that apply.)a. Taking a warm sitz bath several times each dayb. Utilizing a daily enema to prevent constipationc. Using bulk-producing agents to aid eliminationd. Self-administering anti-inflammatory suppositoriese. Taking a laxative each morning

ACD

A client has surgery for an incarcerated hernia. The healthcare provider returns the incarcerated tissue to the abdominal cavity and uses a mesh to reinforce the muscle wall. What specific instructions should be included in the discharge instructions? Reduce dietary roughage. Avoid lifting heavy items. Increase dietary potassium intake. Keep the head of the bed elevated.

B

A nurse cares for a client newly diagnosed with colon cancer who has become withdrawn from family members. Which action should the nurse take?a. Contact the provider and recommend a psychiatric consult for the client.b. Encourage the client to verbalize feelings about the diagnosis.c. Provide education about new treatment options with successful outcomes.d. Ask family and friends to visit the client and provide emotional support.

B

A nurse cares for a client who is recovering from a hemorrhoidectomy. The client states, "I need to have a bowel movement." Which action should the nurse take?a. Obtain a bedside commode for the client to use.b. Stay with the client while providing privacy.c. Make sure the call light is in reach to signal completion.d. Gather supplies to collect a stool sample for the laboratory.

B

A nurse cares for a client who is scheduled for a paracentesis. Which intervention should the nurse delegate to an unlicensed assistive personnel (UAP)?a. Have the client sign the informed consent form.b. Assist the client to void before the procedure.c. Help the client lie flat in bed on the right side.d. Get the client into a chair after the procedure.

B

A client with cholecystitis is placed on a low-fat, high-protein diet. Which nutrient should the nurse teach the client to include in this diet? Skim milk Boiled beef Poached eggs Steamed broccoli

A

A nurse delegates hygiene care for a client who has advanced cirrhosis to an unlicensed nursing personnel (UAP). Which statements should the nurse include when delegating this task to the UAP? (Select all that apply.)a. "Apply lotion to the client's dry skin areas."b. "Use a basin with warm water to bathe the client."c. "For the client's oral care, use a soft toothbrush."d. "Provide clippers so the client can trim the fingernails."e. "Bathe with antibacterial and water-based soaps."

ACD

A nurse is teaching a group of adults about the signs and symptoms of colorectal cancer. Which common clinical manifestations should the nurse include in the teaching program? Select all that apply. Select all that apply Anemia Rectal pain Rectal bleeding Change in bowel habits Severe abdominal distention

ACD

After teaching a client who is recovering from a colon resection, the nurse assesses the client's understanding. Which statements by the client indicate a correct understanding of the teaching? (Select all that apply.)a. "I must change the ostomy appliance daily and as needed."b. "I will use warm water and a soft washcloth to clean around the stoma."c. "I might start bicycling and swimming again once my incision has healed."d. "Cutting the flange will help it fit snugly around the stoma to avoid skin breakdown."e. "I will check the stoma regularly to make sure that it stays a deep red color."f. "I must avoid dairy products to reduce gas and odor in the pouch."

BCD

A client with Crohn disease is admitted to the hospital with abdominal pain, fever, poor skin turgor, and diarrhea, with 10 stools in the past 24 hours. Which signs are evidence that the client most likely is dehydrated? Select all that apply. Select all that apply Moist skin Sunken eyes Decreased apical pulse Dry mucous membranes Increased blood pressure

BD

The nurse provides dietary teaching for a client with a colostomy. Which response by the client is indicative of successful learning? "I will eat food low in fiber so that there is less stool." "I will eat bland foods so that my intestines do not become irritated." "I will eat everything I ate before the operation and avoid foods that cause gas." "I will eat soft foods that are more easily digested and absorbed by my large intestine."

C

When monitoring a client 24 to 48 hours after abdominal surgery, the nurse should assess for which problem associated with anesthetic agents? Colitis Stomatitis Paralytic ileus Gastrocolic reflux

C

Which explanation should the nurse consider when formulating a response to a client's inquiry about intussusception of the bowel? Kinking of the bowel onto itself A band of connective tissue compressing the bowel Telescoping of a proximal loop of bowel into a distal loop A protrusion of an organ or part of an organ through the wall that contains it

C

A client is admitted to the hospital with a diagnosis of intestinal obstruction. The healthcare provider prescribes intestinal suction via a nasoenteric decompression tube. The loss of which constituents associated with intestinal suctioning is most important to consider when caring for this client? Protein enzymes Energy carbohydrates Vitamins and minerals Water and electrolytes

D

A client who has been caring for a colostomy on the left side of the abdomen for several years is admitted to the hospital for an unrelated health problem. Which type of stool should the nurse expect? Pencil-shaped Mucus-coated Loose and liquid Moist and formed

D

A client with chronic liver disease reports, "My gums have been bleeding spontaneously." The nurse identifies small hemorrhagic lesions on the client's face. The nurse concludes that the client needs which additional supplement? Bile salts Folic acid Vitamin A Vitamin K

D

A nurse cares for a client who has a family history of colon cancer. The client states, "My father and my brother had colon cancer. What is the chance that I will get cancer?" How should the nurse respond?a. "If you eat a low-fat and low-fiber diet, your chances decrease significantly."b. "You are safe. This is an autosomal dominant disorder that skips generations."c. "Preemptive surgery and chemotherapy will remove cancer cells and prevent cancer."d. "You should have a colonoscopy more frequently to identify abnormal polyps early."

D

A nurse is admitting a client with the diagnosis of celiac disease to the medical unit at lunchtime. Which foods can be included on the client's prescribed diet? Breaded veal cutlet with cheese Roast beef sandwich with pickles Chicken noodle soup with crackers Cheese omelet with chopped spinach

D

A nurse is caring for a client with a diagnosis of acute pancreatitis and alcoholism. The client asks, "What does my drinking have to do with my diagnosis?" What effect of alcohol should the nurse include when responding? Promotes the formation of calculi in the cystic duct Stimulates the pancreas to secrete more insulin than it can immediately produce Alters the composition of enzymes so they are capable of damaging the pancreas Increases enzyme secretion and pancreatic duct pressure that causes backflow of enzymes into the pancreas

D

A nurse cares for a client with hepatitis C. The client's brother states, "I do not want to contract this infection, so I will not go into his hospital room." How should the nurse respond?a. "If you wear a gown and gloves, you will not get this virus."b. "Viral hepatitis is not spread through casual contact."c. "This virus is only transmitted through a fecal specimen."d. "I can give you an update on your brother's status from here."

B

A nurse cares for a middle-aged male client who has irritable bowel syndrome (IBS). The client states, "I have changed my diet and take bulk-forming laxatives, but my symptoms have not gotten better. I heard about a drug called Amitiza. Do you think it might help?" How should the nurse respond?a. "This drug is still in the research phase and is not available for public use yet."b. "Unfortunately, lubiprostone is approved only for use in women."c. "Lubiprostone works well. I will recommend this prescription to your provider."d. "This drug should not be used with bulk-forming laxatives."

B

A nurse is caring for a client with a new colostomy. Which client outcome is most important for achievement of long-range goals associated with adjusting to a new colostomy? Mastery of techniques of colostomy care Readiness to accept an altered body function Awareness of available community resources Knowledge of the necessary dietary modifications

B

A client has a colostomy as a result of surgery for cancer of the colon. Which nurse's statement will most effectively minimize the client's stress the first time self-irrigation is done? "If you are still a little nervous because this is the first time, I'll be happy to do it for you, and you can do it next time." "You have to learn how to do this yourself before discharge. The best place to start is to assemble all the equipment needed for the irrigation." "I'll draw the curtain and assemble all the equipment. Would you like me to stay, or do you prefer to try it yourself and call me if you need help?" "You have a gown on, so I won't draw the curtain unless you want me to. Do you feel comfortable doing the irrigation, or do you want me to do it instead?"

C

A client has a surgically created colostomy. What is the most effective nursing intervention initially to help the client accept the colostomy? Provide literature containing factual data about colostomies. Ask a member of a support group to come to speak with the client. Begin to teach self-care of the colostomy by introducing equipment. Point out the number of important people who have had colostomies.

C

A client is admitted to the hospital with jaundice. After numerous diagnostic tests, the healthcare provider makes the diagnosis of cancer of the pancreas. What does the nurse conclude is the most likely cause of the client's jaundice? Necrosis of the parenchyma caused by the neoplasm Excessive serum bilirubin caused by red blood cell destruction Obstruction of the common bile duct by the pancreatic neoplasm Impaired liver function, resulting in incomplete bilirubin metabolism

C

A client is diagnosed with gastroenteritis. What does the nurse determine is the basic intention underlying the unique dietary management for this client? Provide optimal amounts of all important nutrients. Increase the amount of bulk and roughage in the diet. Eliminate chemical, mechanical, and thermal irritation. Promote psychological support by offering a wide variety of foods.

C

A nurse teaches a client who is recovering from a colon resection. Which statement should the nurse include in this client's plan of care?a. "You may experience nausea and vomiting for the first few weeks."b. "Carbonated beverages can help decrease acid reflux from anastomosis sites."c. "Take a stool softener to promote softer stools for ease of defecation."d. "You may return to your normal workout schedule, including weight lifting."

C

After teaching a client who has diverticulitis, a nurse assesses the client's understanding. Which statement made by the client indicates a need for additional teaching?a. "I'll ride my bike or take a long walk at least three times a week."b. "I must try to include at least 25 grams of fiber in my diet every day."c. "I will take a laxative nightly at bedtime to avoid becoming constipated."d. "I should use my legs rather than my back muscles when I lift heavy objects."

C

A client with a history of ulcerative colitis is admitted to the hospital because of severe rectal bleeding. The client engages in angry outbursts and places excessive demands on the staff. One day an unlicensed healthcare worker tells the nurse, "I've had it. I am not putting up with that behavior. I'm not going in there again." What is the best response by the nurse? "You need to try to be patient. The client is going through a lot right now." "I'll talk with the client. Maybe I can figure out the best way for us to handle this." "Just ignore it and get on with your work. I'll assign someone else to take a turn." "The client's frightened and taking it out on the staff. Let's think of approaches we can take."

D

A client with cirrhosis of the liver has a prolonged prothrombin time and a low platelet count. A regular diet is prescribed. What should the nurse instruct the client to do considering the client's condition? Avoid foods high in phytonadione. Check the pulse several times a day. Drink a glass of milk when taking aspirin. Report signs of bleeding no matter how slight.

D

A nurse is teaching a client with an acute exacerbation of ulcerative colitis about the most appropriate diet. Which food selected by the client indicates that the dietary teaching is effective? Orange juice Scrambled eggs Vanilla milkshake Creamed potato soup

B

A nurse cares for an older adult client who has Salmonella food poisoning. The client's vital signs are heart rate: 102 beats/min, blood pressure: 98/55 mm Hg, respiratory rate: 22 breaths/min, and oxygen saturation: 92%. Which action should the nurse complete first?a. Apply oxygen via nasal cannula.b. Administer intravenous fluids.c. Provide perineal care with a premedicated wipe.d. Teach proper food preparation to prevent contamination.

B

A nurse assesses a client who has liver disease. Which laboratory findings should the nurse recognize as potentially causing complications of this disorder? (Select all that apply.)a. Elevated aspartate transaminaseb. Elevated international normalized ratio (INR)c. Decreased serum globulin levelsd. Decreased serum alkaline phosphatasee. Elevated serum ammoniaf. Elevated prothrombin time (PT)

BEF

Neomycin 1 gram is prescribed preoperatively for a client with cancer of the colon. The client asks why this is necessary. How should the nurse respond? "It is used to prevent you from getting a bladder infection before surgery." "It will decrease your kidney function and lessen urine production during surgery." "It will kill the bacteria in your bowel and decrease the risk for infection after surgery." "It is used to alter the body flora, which reduces spread of the tumor to adjacent organs."

C