EXAM 2 content
A nurse is preparing a community education program about hepatitis B. Which of the following statements should the nurse include in the teaching
"A hepatitis B immunization is given to infants and children."
The nurse is teaching a patient about dietary choices to prevent dumping syndrome after gastric bypass surgery. Which statement by the patient indicates a need for further teaching?
"I can eat ice cream in moderation."
The nurse is caring for four clients. Which client is the highest risk for hepatitis B infection?
65-year-old who reports using street drugs 10 years ago when homeless
acute gastritis
S/S thickened, reddened mucosa membrane w/ prominent rugae or folds, various degrees of mucosal necrosis and inflammatory reaction
A client has just been diagnosed with pancreatic cancer. The client's upset spouse tells the nurse that they have recently moved to the area, have no close relatives, and are not yet affiliated with a church. What is the nurse's best response?
"Would you like me to contact the hospital chaplain for you?"
Which serum albumin level does the nurse expect to see in a healthy, ambulatory adult client?
3.7 g/dL (37 g/L) The normal serum albumin level for men and women is 3.5 to 5.0 g/dL (35 to 50 g/L).
The nurse is teaching a middle-aged adult client with a body mass index (BMI) of 27.5 and a height of 5'2" (157.5 cm) about what the BMI number means, and about malnutrition. Which client statement indicates a need for further instruction?
"My goal should be to get my BMI below 18.5." The least risk for malnutrition is associated with scores between 18.5 and 25.Older adults need to have a BMI between 23 and 27.
The nurse is teaching a patient with peptic ulcer disease (PUD) about the prescribed drug regimen. Which statement made by the patient indicates a need for further teaching before discharge?
"Nizatidine (Axid) needs to be taken three times a day to be effective."
The nurse is teaching a patient how to prevent recurrent chronic gastritis symptoms before discharge. Which statement by the patient demonstrates a correct understanding of the nurse's instruction?
"I should avoid alcohol and tobacco."
The community nurse is talking with for clients who have reported digestive concerns. Which client does the nurse recognize as most likely to experience gallstone production?
35-year-old American Indian who works in construction 64-year-old Mexican American who resides with grandchildren
A client has been discharged to home after being hospitalized with an acute episode of pancreatitis. The client, who is an alcoholic, is unwilling to participate in Alcoholics Anonymous (AA), and the client's spouse expresses frustration to the home health nurse regarding the client's refusal. What is the nurse's best response?
"I'll get you some information on the support group Al-Anon."
An obese client is prescribed orlistat (Xenical). The client asks the nurse how the drug works. How does the nurse respond?
"It inhibits enzymes and changes the way your body digests fats. Because fats are only partially digested and absorbed, calorie intake is decreased."
A client has developed acute pancreatitis after also developing gallstones. Which is the highest priority nursing instruction for this client to avoid further attacks of pancreatitis?
"See your healthcare provider (HCP) immediately when experiencing symptoms of a gallbladder attack."
A female client is concerned that her inability to conceive a child is connected to her morbid obesity. How does the nurse respond?
"Tell me about any changes in your menstrual cycle each month."
The nurse is performing a health assessment on an obese client who states, "I have tried many diets in an effort to lose weight, but have been unsuccessful." How does the nurse assess whether the client's response to stress is related to the client's obesity?
"Tell me what you do to relieve stress in your daily life."
A patient with peptic ulcer disease (PUD) asks the nurse whether licorice and slippery elm might be useful in managing the disease. What is the nurse's best response?
"These herbs could be helpful. However, you should talk with your primary health care provider before adding them to your treatment regimen."
An older female patient is diagnosed with gastric cancer. Which statement made by the patient's family demonstrates a correct understanding of the disorder?
"This may be related to her recurring ulcer disease."
A client diagnosed with acalculous cholecystitis asks the nurse how the gallbladder inflammation developed when there is no history of gallstones. What is the nurse's best response?
"This type of gallbladder inflammation is associated with hypovolemia."
The nurse is caring for a client recently diagnosed with type 1 diabetes mellitus who has had an episode of acute pancreatitis. The client asks the nurse how he developed diabetes when the disease does not run in the family. What is the nurse's best response?
"Type 1 diabetes can occur when the pancreas is affected or destroyed by disease."
The nurse is teaching a class of older adults in the community about engaging in "regular" exercise. What does the nurse advise them?
"Walking 30 to 40 minutes provides the same benefit as long periods of exercise."
A patient has a long-term history of Crohn's disease and has recently developed acute gastritis. The patient asks the nurse whether Crohn's disease was a direct cause of the gastritis. What is the nurse's best response?
"We know that there can be an association between Crohn's disease and chronic gastritis, but Crohn's does not directly cause acute gastritis to develop."
The nurse will include what post operative teaching when caring for the client who is preparing to undergo Endo scopic cholecystectomy?
-You'll have a small midline abdominal incision -Generally the pain associated with this procedure is minimal -This procedure has a low incidence of infection
The RN who usually works on the pediatric unit is floated to the GI medical-surgical unit. Which client is most appropriate for the charge nurse to assign to the float nurse?
A 20-year-old with anorexia nervosa receiving total parenteral nutrition through a central venous line
Which morbidly obese client is the least likely candidate for bariatric surgery?
A 34-year-old woman experiencing mental confusion
Which client on the medical-surgical unit does the charge nurse assign to the LPN/LVN?
A 39-year-old with a jejunal feeding tube who needs elemental feedings administered
An RN receives the change-of-shift report about these four clients. Which client does the nurse assess first?
A 75-year-old with dementia who is receiving nasogastric feedings and has a respiratory rate of 38 breaths/min
The nurse has placed a nasogastric (NG) tube in a patient with upper gastrointestinal (GI) bleeding to administer gastric lavage. The patient asks the nurse about the purpose of the NG tube for the procedure. What is the nurse's best response?
A fluid solution goes down the tube to help clean out your stomach."
The nurse finds a patient vomiting coffee-ground emesis. On assessment, the patient has a blood pressure of 100/74 mm Hg, is acutely confused, and has a weak and thready pulse. Which intervention is the nurse's first priority?
Administering intravenous (IV) fluids
The nurse is teaching a group of adults in the community about the 2015-2020 Dietary Guidelines for Americans. What does the nurse emphasize as a dietary strategy suggested in these guidelines?
Adults should focus on variety and nutrient density and not calories.
A nurse is completing a history and physical assessment for a client who has chronic pancreatitis. Which of the following findings should the nurse identify as a likely cause of the clients condition?
Alcohol use
When caring for a patient who has just had an upper G.I. endoscopy, the nurse assesses that the client has developed a temperature of 101.8°F. What is the appropriate nursing intervention?
Properly assess the client for potential perforation
Patient comes into the emergency department reporting rapid epigastric pain with nausea and vomiting. The client says worse than any heartburn he has not had appetite for the past day. What does the nurse suspect he has.?
Acute gastritis
A client is experiencing an attack of acute pancreatitis. Which nursing intervention is the highest priority for this client?
Administer opioid analgesic medication.
A nurse is caring for a client who has acute pancreatitis. Which of the following serum laboratory values should the nurse anticipate returning to the expected reference range within 72 hours after treatment begins?
Amylase
The nurse is assessing a client after bariatric surgery. The client has increased back pain, is restless, has a heart rate of 126/minute, and has only 15 mL of urine output for the past hour. What does the nurse suspect?
Anastomotic leak
A nurse is assessing a client who is in the early stages of hepatitis A. Which of the following manifestations should the nurse expect?
Anorexia
Which are common manifestations of a cute cholecystitis?
Anorexia eructation Jaundice Rebound tenderness
chronic gastritis
Appears as a patchy, diffuse inflammation of the mucosal lining of the stomach. Appears to be associated with an increased risk for gastric cancer
When preparing a client to undergo paracentesis, which action is necessary to reduce potential injury as a result of the procedure?
Ask the client to void prior to the procedure
A patient with gastric cancer is scheduled to undergo surgery to remove the tumor once 5 pounds (2.3 kg) of body weight has been regained. The patient is not drinking the vanilla-flavored enteral supplements that have been prescribed. Which is the highest priority nursing intervention for this patient?
Ask the patient if a change in flavor would make the supplement more palatable.
An older client is at risk for malnutrition. Which nursing intervention is most appropriate to ensure optimum nutritional intake?
Assisting the client with toileting and oral care prior to meals
The nurse asks a client with liver disease to raise the arms to shoulder level and dorsiflex the hands. A few moments later, the hand begins to flap upward and downward. How does the nurse correctly document this in the medical record?
Asterixis
How does the nurse accurately calculate a client's body mass index (BMI)?
BMI = weight (kg)/height (in meters)2
After initial placement of nasoduodenal and NG tube is confirmed, how often must placement be checked?
Before intermittent feeding For medication administration Every 4 to 8 hours during feeding According to facility policy
The nurse is monitoring a patient with gastric cancer for signs and symptoms of upper gastrointestinal bleeding. Which change in vital signs is most indicative of bleeding?
Blood pressure from 140/90 to 110/70 mm Hg
A nurse is assessing a client who is experiencing perforation of a peptic ulcer. Which of the following manifestations should the nurse expect?
Boardlike abdomen
Chronic atrophic gastritis (autoimmune)
Cellular changes that can lead to peptic ulcer disease and gastric cancer.
A client has undergone the Whipple procedure (radical pancreaticoduodenectomy) for pancreatic cancer. Which precautionary measures does the nurse implement to prevent potential complications?
Check blood glucose levels Check bowel sounds and stools. Monitor mental status.
A client has a primary problem of inadequate nutrition caused by the effects of chemotherapy. The client is receiving continuous enteral feedings through a nasogastric (NG) tube. What does the RN ask the LPN/LVN to do for this client?
Check the residual volume of the NG tube every 4 hours.
The nurse and the dietitian are planning sample diet menus for a patient who is experiencing dumping syndrome. Which sample meal is best for this patient?
Chicken and rice
A community health nurse is planning an educational program about hepatitis A. When preparing the materials, the nurse should identify that which of the following groups is most at risk for developing hepatitis A?
Children
Which lab value is usually low in clients with malabsorption, liver disease, per pernicious anemia, terminal cancer, and sepsis?
Cholesterol
A nurse is caring for a client who is today's postoperative following a gastric bypass. The nurse notes that the boss sounds are present. Which of the following foods should the nurse provide at the initial feeding?
Clear liquids
The nurse is caring for clients in the outclient clinic. Which of these phone calls would the nurse return first?
Client with severe ascites who has a temperature of 101.4°F (38°C)
When providing dietary teaching to a client with hepatitis, what practice does the nurse recommend?
Consuming increased carbohydrates and moderate protein
Which nursing action is best for the charge nurse to delegate to an experienced LPN/LVN?
Reinforce the teaching previously done by the RN about avoiding alcohol and caffeine for a patient with chronic gastritis.
An older adult with severe rheumatoid arthritis in the upper extremities is malnourished. What does the nurse suspect as the cause of this client's malnutrition?
Decreasing ability to manipulate eating utensils
A nurse is caring for a client who is receiving total parenteral nutrition TPN therapy and has just returned to the room following physical therapy. The nurse notes that the infusion pump for the clients TPN is turned off. After restarting the infusion pump, the nurse should monitor the client for which of the following findings?
Diaphoresis
Which teaching will the nurse provide when discharging a client with chronic pancreatitis?
Dietary adjustments to include avoiding high fat food, caffeine, and alcohol
The nurse is monitoring a client who is receiving an intravenous fat emulsion (IVFE) nutritional supplement. What action does the nurse take in the event that the client develops fever, increased triglycerides, and clotting problems?
Discontinues the IVFE infusion and notifies the health care provider (HCP)
The nurse closely monitors the client with acute pancreatitis for which life-threatening complications?
Disseminated intravascular coagulation (DIC)
The nurse is caring for three clients who have undergone bariatric surgery. Which activity is most appropriate for the nurse to delegate to the unlicensed assistive personnel?
Document the percentage of food eaten at meal times
The nurse suspects that a client may have acute pancreatitis as evidenced by which group of laboratory results?
Elevated lipase, elevated white blood cell (WBC) count, elevated glucose
Which activity by the nurse will best relieve symptoms associated with ascites?
Elevating the head of the bed
When caring for a client with portal hypertension, the nurse assesses for which potential complications?
Esophageal varices Ascites Hemorrhoids
A nurse is providing dietary teaching to a client who has diverticulitis about preventing acute attacks. Which of the following foods should the nurse recommend?
Foods high in fiber
A nurse is caring for a client who has a history of cirrhosis and is admitted with manifestations of hepatic encephalopathy. The nurse should anticipate a prescription for which of the following laboratory test to determine the possibility of recent excessive alcohol?
Gamma-glutamyl transferase (GGT)
Many ulcers are caused by
H. Pylori bacterium
Common complications of peptic ulcer disease
Hemorrhage, perforation, pyloric obstruction, and intractable disease
The daughter of a client with Colelithiasis has heard that there is a genetic test disposition for Colelithiasis. The daughter asked the nurse about the risk factors. How does the nurse respond?
Hormone replacement therapy has been associated with increased risk for Colelithiasis
The client with acute pancreatitis experiences abdominal pain. What is the best intervention to begin managing this pain?
IV opioids by means of patient controlled analgesia PCA
Which diagnostic results lead the nurse to suspect that a client may have gallbladder disease?
Increased white blood cell (WBC) count, visualization of calcified gallstones, edema of the gallbladder wall
The admission assessment for a patient with acute gastric bleeding indicates blood pressure 82/40 mm Hg, pulse 124 beats/min, and respiratory rate 26 breaths/min. Which admission request does the nurse implement first?
Infuse 0.9% normal saline solution at 200 mL/hr.
The nurse is caring for a client who is jaundice and reports pruritus.Which intervention will the nurse include in the plan of care?
Instruct the client to scratch with knuckles instead of nails
How is Neomycin sulfate used to treat clients with cirrhosis?
It decreases the rate of ammonia production
A client with decompensated cirrhosis is at risk for which complication?
Jaundice esophageal varices Coagulation defects Spontaneous bacterial peritonitis Ascites
An obese client has been taking orlistat (Xenical) 60 mg orally three times a day for 4 weeks, but has only lost 10 pounds (4.5 kg). The health care provider doubles the dosage and recommends behavioral changes. What behavioral changes does the nurse include in the teaching plan?
Keeping a daily food diary Identifying emotional and situational factors that stimulate eating Increasing exercise
The nurse is caring for a client who has had paracentesis performed. Which nursing intervention is appropriate?
Label fluid container and send for laboratory analysis measure, describe, and record drainage weigh client
The hospice nurse is caring for a client with pancreatic cancer who has been given 2 to 3 months to live. What is the appropriate nursing response when the clients wife states, I know he's going to get better.?
Let's talk about how you're feeling about your spouse's prognosis.
Which client statement regarding treatment for gastric cancer requires the nurse to intervene immediately?
Life just doesn't seem to be worth living anymore
A client who had been hospitalized with pancreatitis is being discharged with home health services. The client is severely weakened after this illness. Which nursing intervention is the highest priority in conserving the client's strength?
Limiting the client's activities to one floor of the home
A nurse is caring for a client who has fulminant hepatic failure. Which of the following procedures should the nurse anticipate for this client?
Liver transplant
When caring for a client with Laennec's cirrhosis, which of these does the nurse expect to find on assessment?
Prolonged partial thromboplastin time Icterus of skin Swollen abdomen
A client is placed on orlistat (Xenical) as part of a treatment regimen for morbid obesity. What side effects does the nurse tell the client to expect from using this drug?
Loose stools, abdominal cramps, and nausea
An underweight client is receiving nutritional supplements to restore nutritional status. What does the nurse do to assess the effectiveness of the supplements for the client?
Makes certain the client is weighed daily at the same time
Patients with epigastric ulcers me be
Malnourished And have pain that is worsened by ingestion of food
Which nursing care activity for a malnourished client does the nurse safely delegate to unlicensed assistive personnel (UAP)?
Measuring current height and weight
The nurse manager in a long-term care facility plans nutritional assessments of all residents. Which nutritional assessment activity does the nurse delegate to unlicensed assistive personnel (UAP) at the facility?
Measuring the daily food and fluid intake of residents
When providing community education, the nurse emphasizes that which group needs to receive immunization for hepatitis B?
Men who engage in sex with men
The nurse expects that which client will be discharged to the home environment first?
Middle-aged thin adult who has had a laparoscopic cholecystectomy
The nurse reviews a medication history for a patient newly diagnosed with peptic ulcer disease (PUD) who has a history of using ibuprofen (Advil) frequently for chronic knee pain. The nurse anticipates that the primary health care provider will request which medication for this patient?
Misoprostol (Cytotec)
Post EGD
Monitor vital signs, heart rhythm, oxygen saturation frequently until they are return to baseline. To prevent aspiration, assess the gag reflexes and ensure that it's intact before given the patient food or fluids.
Proper administration of anti-secretory agents
No mouse cannot be crushed because they are sustained release or enteric coated tablets
The nurse suspects that which client is at highest risk for developing gallstones?
Obese female receiving hormone replacement therapy
A client with acute cholecystitis is admitted to the medical-surgical unit. Which nursing activity associated with the client's care will be appropriate for the nurse to delegate to unlicensed assistive personnel (UAP)?
Obtaining the admission weight, height, and vital signs
A young adult man says that he cannot stay on a diet because of trouble finding one that will incorporate his food preferences. How does the nurse most effectively plan nutritional care for this client?
Obtains a 24-hour recall (diary) of his food intake
Proper administration of antacids
One or two after meals, can also interfere with effectiveness of certain drugs such as phenytoin (Dilantin)
Which manifestations would the nurse expect to see in a patient with vitamin D deficit?
Osteomalcia, Bone pain, rickets
The nurse is caring for an older adult male patient who reports stomach pain and heartburn. Which sign/symptom is most significant suggesting the patient's ulceration is duodenal in origin and not gastric?
Pain occurs 1½ to 3 hours after a meal, usually at night.
The client with acute nectar rising pancreatitis experiences a temperature spiked to 104°F 40°C. What does the nurse suspect
Pancreatic abscess
Which are possible complications of chronic gastritis
Percutaneous anemia Gastric cancer Decreased gastric acid secretion Peptic ulcer disease
The nurse is reviewing admitting requests for a patient admitted to the intensive care unit with perforation of a duodenal ulcer. Which request does the nurse implement first?
Place a nasogastric (NG) tube, and connect to suction.
A nurse is caring for a client who has a percutaneous endoscopic Gastrostomy (PEG) tube and is receiving intermittent feedings. Prior to initiating the feeding which of the following actions should the nurse take first?
Place the client in semi-Fowler's position.
An older malnourished client who is taking digoxin (Lanoxin), ranitidine (Zantac), and potassium chloride elixir (Kay Ciel) develops a severe case of diarrhea. What does the nurse suspect is a possible cause?
Potassium chloride (Kay Ciel)
Which set of assessment findings indicates to the nurse that a client may have acute pancreatitis?
Presence of jaundice, pain worsening when lying supine
A client has been placed on enzyme replacement for treatment of chronic pancreatitis. In teaching the client about this therapy, the nurse advises the client not to mix enzyme preparations with foods containing which element?
Protein
A nurse is caring for a client who is scheduled to undergo a liver biopsy for a suspected malignancy. Which of the following laboratory findings should the nurse monitor prior to the procedure?
Prothrombin time
A patient develops an active G.I. bleed which priority actions does the nurse take in caring for the patient?
Provide oxygen Start 1-2 large bore IV lines Prepare to infuse 0.9% normal saline solution Prepare for nasogastric tube insertion Monitor hematocrit and hemoglobin
The nurse is assessing a client who has recurrent attacks of pancreatitis and is concerned about possible alcohol abuse as an underlying cause of these attacks. To elicit this information, what will the nurse do initially?
Provide privacy and use the CAGE questionnaire (Cut down, Annoyed by criticism, Guilt about drinking, and Eye-opener drinks)
A patient is scheduled to be discharged home after a gastrectomy and will need to perform daily dressing changes on the surgical wound. What is the nurse's highest priority intervention?
Providing both oral and written instructions to the patient and his spouse on changing the dressing and on symptoms of infection that must be reported to the provider
An older adult client needs additional dietary protein, but refuses to drink the prescribed liquid protein supplements. Which nursing intervention is most effective in increasing the client's protein intake?
Providing protein modular supplements in the form of puddings
A client has undergone bariatric surgery. Which nursing intervention is the highest priority in preventing dehydration in this client?
Providing six small feedings daily and offering fluids frequently
The client developed abdominal bloating along with nausea and vomiting which complication of peptic ulcer disease does the nurse recognize?
Pyloric obstruction
Which patient assessment information is correlated with a diagnosis of chronic gastritis?
Radiation therapy, smoking, and excessive alcohol use
Acute gastritis causes
Rapid onset of epigastric pain and dyspnea
An obese client with a body mass index of 30 and hypertension has been taking prescription orlistat for 4 weeks and reports loose stools, abdominal cramps, and nausea. What does the nurse recommend for this client?
Reducing nutritional fat intake to less than 30% of the client's daily food intake.
A client who is receiving total enteral nutrition exhibits acute confusion and shallow breathing and says, "I feel weak." As the client begins to have a generalized seizure, how does the nurse interpret this client's signs and symptoms?
Refeeding syndrome is occurring.
A hospitalized client reports lack of appetite to the nurse. What nursing intervention is appropriate to encourage nutrition intake?
Remove objects from site in the clients room such as bed pans or urinals at meal time. Provide a quiet environment during meal time. Assess the clients level of pain and provide interventions as necessary. Provide washcloth and towel for washing hands before each meal.
A health care worker believes that he may have been exposed to hepatitis A. Which intervention is the highest priority to prevent him from developing the disease?
Requesting an injection of immunoglobulin
How does the home care nurse best modify the client's home environment to manage side effects of lactulose (Evalose)?
Requests a bedside commode for the client
A nurse is caring for a client who is four hour postoperative following a leper scopic Colo cystectomy. Which of the following findings should the nurse expect?
Right shoulder pain
A nurse is assessing a client who was admitted with a bowel obstruction. The client reports severe abdominal pain. Which of the following findings should indicate to the nurse that a possible bowel perforation has occurred?
Rigid abdomen
A patient has been discharged home after surgery for gastric cancer, and a case manager will follow up with the patient. To ensure a smooth transition from the hospital to the home setting, which information provided by the hospital nurse to the case manager is given the highest priority?
Schedule of the patient's follow-up examinations and diagnostic testing
The nurse is attempting to position a client having an acute attack of pancreatitis in the most comfortable position possible. In which position does the nurse place this client?
Side-lying position, with knees drawn up to the chest
A patient is experiencing bleeding related to peptic ulcer disease (PUD). Which nursing intervention is the highest priority?
Starting a large-bore IV
Proper administration of H2 antagonist
Taken at bedtime
When assessing a client with hepatitis B, the nurse anticipates which assessment findings?
Tea-colored urine Right upper quadrant tenderness Itching
A client with obesity tells the nurse, I wouldn't be overweight if it weren't for my jeans. What is the appropriate nursing response?
Tell me about your family history. Let's talk about your nutrition intake. How do you feel about exercise?
The nurse is caring for a client who has cirrhosis of the liver. The client has exhibited hand flapping and mental confusion for several weeks. Although the mental confusion is worsening, the client has stopped exhibiting hand flapping movements. How will the nurse interpret these findings?
The client's symptoms are progressing and getting worse.
A nurse is caring for a client who is dehydrated and is receiving continuous tube feeding through a pump at 75 mL/hour. When the nurse assesses the client at 0800, which of the following findings requires intervention by the nurse?
The head of the bed is elevated 20°.
The student nurse is teaching a client with cirrhosis about lactulose therapy. Which statement by the client indicates the teaching has been effective?
The therapy will promote the removal of ammonia in my stool
A nurse is teaching a client who has Barrett's esophagus and is scheduled to undergo and esophagogastroduodenoscopy EGD. Which of the following statements should the nurse include in the teaching?
This procedure can determine how well the lower part of your esophagus works."
A nurse is caring for a client who is scheduled to undergo and you suffer go gastroduodenal Scoby EGD. The nurse should identify that this procedure is used to?
To detect an ulceration in the stomach
The nurse administers lactulose (Evalose) to a client with cirrhosis for which purpose?
To promote gastrointestinal (GI) excretion of ammonia
The nurse is teaching a client with gallbladder disease about diet modification. Which meal does the nurse suggest to the client?
Turkey sandwich on wheat bread
The nurse is caring for a client with a bleeding duodenal ulcer who was admitted to the hospital after vomiting bright red blood. Which condition does the nurse anticipate when the client develops a sudden, sharp pain in the midepigastric region in a rigid board like abdomen
Ulcer perforation
The nurse obtains assessment data on a client who had bariatric surgery today. Which finding does the nurse report to the surgeon immediately?
Urine output total is 15 mL for the past 2 hours.
A client who has undergone a bariatric surgical procedure is recuperating after surgery. Which nursing intervention most effectively prevents injury to the client who is being re-positioned postoperatively?
Using a weight-rated extra-wide bed for the client
chronic gastritis causes
Vague epigastric pain and intolerance to fatty and spicy foods
A nurse in the emergency department is caring for a client who has bleeding esophageal varices. The nurse should anticipate a prescription for which of the following medications?
Vasopressin
Which actions will help prevent viral hepatitis and healthcare workers?
Wash hands before and after each client Use needeless systems Use contact and respiratory precautions report all cases of hepatitis to the health department Wear gloves during all patient contacts
A nurse is caring for a client who has celiac disease. Which of the following foods should the nurse removed from the clients meal tray?
Wheat toast
The nurse is preparing to instruct a client with chronic pancreatitis who is to begin taking pancrelipase (Cotazym). Which instruction does the nurse include when teaching the client about this medication?
Wipe your lips after taking pancrelipase.
Based on nutritional screening findings and assessments, which client will be the preferred candidate for surgical treatment for obesity?
Woman with a BMI of 42, weight 100% above ideal body weight
A client has just been diagnosed with pancreatic cancer. The client's upset spouse tells the nurse that they have recently moved to the area, have no close relatives, and are not yet affiliated with a church. What is the nurse's best response?
Would you like me to contact the hospital chaplain for you?
An 87-year-old resident from an extended care facility has not been eating for several days and is admitted to the hospital with a diagnosis of malnutrition. She has an enteral feeding tube placed in her left nostril. Her medications include digoxin (Lanoxin), ranitidine (Zantac), and potassium chloride elixir (Kay Ciel). The nurse checks the gastric pH of the feeding tube and obtains a value of 6.0, which may indicate that the feeding tube is in the client's lungs. Is there another possible explanation for the nurse to consider?
Yes; the client is taking Zantac.
After receiving change-of-shift report on these clients, which client does the nurse plan to assess first?
Young adult client with acute pancreatitis who is dyspneic and has a respiratory rate of 34 to 38 breaths/min
The nurse working during the day shift on the medical unit has just received report. Which patient does the nurse plan to assess first?
Young adult with epigastric pain, hiccups, and abdominal distention after having a total gastrectomy
patients with dudenal ulcers
are usually well-nourished, Have pain that is relieved by ingestion of food, and awaken with pain during the night.
Client with acute gastritis is receiving treatment to block and buffered gastric acid secretion's to relieve pain. Which drug does the nurse identify as an anti-secretory agent PPI
omeprazole
A main manifestation of acute stress ulcers is
bleeding caused by gastric erosion
A client receiving total parenteral nutrition (TPN) exhibits symptoms of congestive heart failure (CHF) and pulmonary edema. Which complication of TPN is the client most likely experiencing?
fluid volume overload
Three types of ulcers
gastric, duodenal, stress
What is the most serious complication of peptic ulcer disease
hemorrhage
The nurse is performing medication Reconciliation for a newly admitted client. The nurse recognizes which drugs contribute to signs and symptoms of gastritis? Select all that apply
~Aspirin, taken once daily to prevent cardiac concerns ~Naporxen, taken once daily for joint pain associated with arthritis ~Prednisone, tapered over a 14-day period to decrease inflammation associated with an acute sinus infection
The nurse is instructing a group of overweight clients on the complications of obesity that develop when weight is not controlled through diet and exercise. Which lifestyle changes does the nurse emphasize?
~Consume a diet that is moderate in salt and sugar and low in fats and cholesterol." ~"Eat a variety of foods, especially grain products, vegetables, and fruits." ~"Engage in moderate physical activity for at least 30 minutes each day." ~"Foods eaten away from home tend to be higher in fat, cholesterol, and salt and lower in calcium than foods prepared at home."
