EAQ Study questions for MedSurg EXAM 3

An older client's colonoscopy reveals the presence of extensive diverticulosis. Which type of diet would the nurse encourage the client to follow? Low-fat High-fiber High-protein Low-carbohydrate

B

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

B

When auscultating the mid-abdomen of a client with an intestinal obstruction in the descending colon, which type of sound would the nurse expect to hear? • Tympany • Borborygmi • Abdominal bruit • Pleural friction rub

B) Borborygmi

The nurse is creating a dietary plan for a client with cholecystitis who has been placed on a modified diet. Which is appropriate to include in the client's dietary plan? A) Soft-textured foods to reduce the digestive burden B) Low-cholesterol foods to avoid further formation of gallstones C) Increased protein to promote tissue healing and improve energy reserves D) Reduced fat intake to avoid stimulation of the cholecystokinin mechanism for bile release

D

Which food or drink would the nurse instruct a client with a new colostomy to avoid because it produces large amounts of gas? Milk Cheese Coffee Cabbage

D

The nurse is assessing a client with a diagnosis of hemorrhoids. Which factors in the client' history most likely played a role in the development of hemorrhoids? Select all that apply.One, some, or all responses may be correct. Constipation Hypertension Eating spicy foods Bewel Incontinence Numerous pregnancies

Constipation Numerous pregnancies

The nurse is caring for a client with a history of alcoholism and cirrhosis who is hospitalized with severe dyspnea as a result of ascites. An increase in which process most likely caused the ascites? Secretion of bile salts Pressure in the portal vein Interstitial osmotic pressure Production of serum albumin

B The enlarged cirrhotic liver impinges on the portal system, causing increased hydrostatic pressure from increased pressure in the portal vein, resulting in ascites

The nurse is taking care of a client with cirrhosis of the liver. Which clinical manifestations would the nurse assess in the client? Select all that apply. One, some, or all responses may be correct. Ascites Hunger Pruritus Jaundice Headache

A, C, D

A client with an intestinal obstruction is prescribed intestinal suction via a nasoenteric decompression tube. When caring for the client, the nurse would consider the loss of which constituents associated with this type of suctioning? • Protein enzymes • Energy carbohydrates •Vitamins and minerals •Water and electrolytes

D) Water and electrolytes

When teaching a client with a new colostomy about appliance care and maintenance, which information would the nurse include? Select all that apply. One, some, or all responses may be correct. A) Change the ostomy pouch on a routine basis. B) Replace the ostomy wafer weekly or sooner as needed. C) Remove the ostomy pouch when showering. D) Empty the ostomy pouch when 3/4 full of stool or gas. E) Empty the ostomy pouch before exercise and at bedtime.

A, B, E

The nurse is caring for a client with cholelithiasis. Which clinical manifestation would the nurse expect if the client develops obstructive jaundice? • Yellow sclera • Pain on urination Dark brown stools • Coffee-ground emesis

A) Yellow sclera

Which instruction would the nurse include in a teaching plan for a client who has a new colostomy and is learning how to care for the skin around the stoma? • Cut an opening about ½ inch (0.85 cm) larger than the stomal pattern. • Avoid the use of soap and other irritating agents. • Eat yogurt and drink buttermilk and parsley. • Empty the pouch before it is one-third full.

D

Which nursing assessment would help confirm the diagnosis of intussusception? • Auscultating for bowel sounds Listening for high-pitched crying • Measuring fluid intake and output • Observing characteristics of stools

D ationale itussusception is a type of intestinal obstruction in which the intestine telescopes and becomes trapped ithin its lumen; the resulting stools are red and currant jelly-like due to the mixture of stool with blood and mucus.

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

D) hemorrhage from esophageal varices The increased pressure within the portal circulatory system causes increased pressure in areas of portal systemic collateral circulation. Hemorrhage from esophageal varicose is a possible complication.

A client with a diagnosis of incarcerated hernia asks the nurse for an explanation of the condition. Which description should the nurse give? A) The bowel has twisted upon itself. B) A piece of the intestine has become stuck in a hole in the abdominal wall. C) The intestinal blood supply has been cut off. D) The involved intestine has developed an erosion.

B

Which sign or symptom would the nurse expect a client with hemorrhoids to report? Select all that apply. One, some, or all responses may be correct. A) Flatulence B) Anal itching C)Blood in stool D) Rectal bulging E) Pain when defeating

B, C, D, E

A client is admitted via the emergency department with a tentative diagnosis of diverticulitis. The nurse anticipates that which test will be prescribed? A) Computed tomography (CT) scan B) Gastroscopy C) Colonoscopy D) Barium enema

A

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

A

The nurse is providing education, including specific information about what to expect postoperatively, for a client who is scheduled for gastric bypass surgery. Which is an appropriate instruction? A) "You will need to take medications in a liquid form." B) "You will need to lie on the right side for 1 hour after meals." C) "You will need to follow a high-carbohydrate diet once eating is resumed." D) "You will need patient-controlled analgesia for approximately 1 week after surgery."

A

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

B

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

C

Which teaching would the nurse provide when discussing the therapeutic regimen of vitamin B 12 for pernicious anemia with a client? A) Weekly Z-track injections provide needed control. B) Daily intramuscular injections are required for control. C) Intramuscular injections once a month will maintain control. D) Oral vitamin B 12 tablets taken daily will provide symptom control.

C

A client had a gastric bypass procedure to treat morbid obesity. After surgery, the client reports weakness, sweating, palpitations, and dizziness after eating. Which should the nurse recommend? A) Reduce the intake of protein-rich foods. B) Drink 8 ounces (240 mL) of water with each meal. C) Divide daily caloric intake into six smaller meals. D) Remain in an upright position for 1 hour after eating.

C) The clients clinical manifestations are related to dumping syndrome from the gastric bypass procedure. Smaller meals along with other interventions will help minimize this response

Which clinical manifestation is an early indicator of intestinal strangulation from bilateral inguinal hernias? • Increased flatus • Projectile vomiting • Sharp abdominal pain • Decreased bowel sounds

C) Sharp abdominal pain Pain is wavelike, colicky, and sharp because of obstruction and localized ischemia.

A client tells the nurse about recent recurrent episodes of bleeding hemorrhoids. Which instruction would the nurse provide to the client to help prevent future hemorrhoidal episodes? A)Exercise to improve circulation. B)Eat bland foods and avoid spices. C)Consume a high-fiber diet and drink adequate water. D)Use laxatives to avoid constipation and use of the Valsalva maneuver.

C) consume a high fiber diet and drink adequate water

After assessing a client with a 25-year history of excessive alcohol use, which finding would the nurse consider consistent with the client's history? • An elevated temperaure • Signs of liver infection • A low blood ammonia level • A small liver with a rough surface

D

Assessment findings of a client who is admitted to the emergency department include cramping pain in the left lower quadrant, weakness, bloating, malaise, and a low-grade fever. The nurse suspects which condition? Pancreatitis Appendicitis Cholecystitis Diverticulitis

D

The nurse is caring for a client admitted with peritonitis. Which finding in the medical record is most likely the cause? Gastritis Hiatal hernia Diverticulosis Bowel obstruction

D

The nurse is caring for a client after surgical creation of an ostomy. The nurse observes that the stool is formed. The stool is this consistency in which part of the colon? A) Ileum B) Ascending C) Transverse D) Descending

D

For which clinical indicator would the nurse monitor when caring for a client with cholelithiasis and obstructive jaundice? Select all that apply. One, some, or all responses may be correct. Dark urine Yellow skin Pain on urination Clay-colored stool Coffee-ground vomitus

Dark Urine Yellow skin Clay-colored stool