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When performing the initial history and physical examination of a client with tentative diagnosis of peptic ulcer, the nurse would expect the client to describe the pain as: A. Gnawing epigastric pain or boring pain in the back. B. Located in the right shoulder and preceded by nausea. C. Sudden, sharp abdominal pain, increasing in intensity. D. Heartburn and substernal discomfort when lying down.

A. Gnawing epigastric pain or boring pain in the back.

After an acute episode of Upper G.I. bleeding, a client vomits undigested antacids and complains of severe epigastric pain. The nursing assessment reveals an absence of bowel sounds, pulse rate of 134, and shallow respirations of 32 per minute. In addition to calling the physician, the nurse should: A. Keep the client NPO in preparation for surgery. B. Start oxygen per nasal cannula at 3 to 4 liters per minute. C. Place the client in the supine position with the legs elevated. D. Ask the client whether any red or black stools have been noted.

A. Keep the client NPO in preparation for surgery.

When assessing a client's abdomen, the nurse palpates the area directly above the umbilicus. This area is known as the: A. Iliac area B. Epigastric area C. Hypogastric area D. Suprasternal area

B

A client is scheduled for a barium swallow; the nurse should: A. Ask the client about allergies to iodine. B. Ensure a laxative is ordered after the test. C. Give only clear fluids on the day of the test. D. Administer cleansing enemas before the test

B. Ensure a laxative is ordered after the test.

A client is suspected of having a peptic ulcer. When obtaining a history from this client, the nurse would expect the reported pain to: A. Intensify when the client vomits. B. Occur one to three hours after meals. C. Increase when the client eats fatty foods. D. Begin in the epigastrium and radiate across the abdomen.

B. Occur one to three hours after meals.

Because of chronic crampy pain, diarrhea and cachecia, a young adult is to receive Total Parenteral Nutrition (TPN) via a central line. Before preparing the client for the insertion of the catheter, the nurse should understand that: A. There will be a moderate amount of pain. B. The feeding will be administered intermittently. C. Fluoroscopy must be done before TPN is started. D. The jugular vein is the most commonly used insertion site.

B. The feeding will be administered intermittently.

A female client, who has a hiatal hernia asks the nurse how to best prevent esophageal reflux. The nurse's best response would be: A. "Increase your intake of fat with each meal." B. "Lie down after eating to help your digestion." C. "Reduce your caloric intake to foster weight reduction." D. "Drink several glasses of fluid during each of your meals.

C. "Reduce your caloric intake to foster weight reduction."

. The physician orders Total Parenteral Nutrition 1 liter every 12 hours. The primary nursing, responsibility should be to monitor the client's: A. Electrolytes B. Urinary output C. Administration rate D. Serum glucose levels

C. Administration rate

A client with achalasia is to have bougienage to dilate the lower esophagus and cardiac sphincter. After the procedure the nurse should assess the client for esophageal perforation, which is indicated by: A. Faintness and feelings of fullness. B. Diaphoresis and cardiac palpitations C. Elevated heart rate and abdominal pain D. Increased blood pressure and urinary output

C. Elevated heart rate and abdominal pain

A male client is diagnosed with acute gastritis secondary to alcoholism and cirrhosis. When obtaining this client's history, the nurse should give priority to the client's statement that: A. His pain is increased after meals. B. He experiences nausea frequently. C. His stools have a tarry appearance. D. He recently joined Alcoholics Anonymous.

C. His stools have a tarry appearance.

Because of multiple physical injuries and emotional concerns, a hospitalized client is at high risk to develop stress Curling's ulcer. The nurse should know that stress ulcers usually are evidenced by: A. Unexplained shock B. Melena for several days C. Sudden massive hemorrhage D. A gradual drop in the hematocrit value

C. Sudden massive hemorrhage

. A 50-year-old executive reports a loss of 20 pounds in three months. The stools are black and tarry, and the physician schedules a colonoscopy. The nurse should prepare the client for the test by: A. Administering an oil retention enema just before the test. B. Instructing that a bland diet be eaten the night before the test. C. Explaining that the pretest cathartic will cause diarrhea after the test. D. Advising the client not to eat or drink anything the morning of the test.

D. Advising the client not to eat or drink anything the morning of the test

The nurse caring for a client at night insists that the client cannot tolerate the ordered intermittent tube feedings. The primary nurse should first: A. Suggest that an antiemetic be prescribed. B. Change the feeding schedule to omit nights. C. Request that the type of solution be changed. D. Gather more data from the night nurse about the technique used.

D. Gather more data from the night nurse about the technique used.

A 79-year-old client is admitted to the hospital with painful abdominal spasms and severe diarrhea of two days duration. The order of assessment the nurse should follow when performing an admitting examination of this client should be: A. Inspection, Percussion, Palpation, Auscultation B. Inspection, Palpation, Auscultation, Percussion C. Inspection, Palpation, Percussion, Auscultation D. Inspection, auscultation, percussion, palpation

D. Inspection, auscultation, percussion, palpation

The nurse should teach the client with Gastroesophageal reflux disease that after meals theclient should: A. Take a short walk. B. Drink 8 ounces of water. C. Lie down for at least 20 minutes. D. Rest in a sitting position for one-half hour.

D. Rest in a sitting position for one-half hour.

A client who has had a gastric ulcer asks what to do if the epigastric pain occurs. The nurse would know that the teaching was effective when the client states, "I will: A. Increase my food intake." B. Take the aspirin with milk." C. Eliminate fluids with meals." D. Take the antacid preparation."

D. Take the antacid preparation."


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