Gastointestinal

The nurse is caring for a client with a stress-related mucosal disorder (SRMD). The nurse uses clinical reasoning to determine that this client most likely developed this gastrointestinal disorder as a result of which condition? 1. Burn trauma 2. Hypertension 3. History of gastric cancer 4. History of myocardial infarction

1. Burn trauma

A client with a history of gastric ulcer suddenly reports experiencing a sharp, severe pain in the midepigastric area that now spreads throughout the entire abdomen. The client is lying in a knee-chest position, and the abdomen is rigid and boardlike to palpation. Which action should the nurse take at this time? 1. Call the primary health care provider. 2. Apply warm moist heat to the abdomen. 3. Administer the next dose of famotidine ½ hour early. 4. Give the client a dose of antacid that is prescribed PRN.

1. Call the primary health care provider.

A client reporting abdominal pain has a diagnosis of acute abdominal syndrome but the cause has not been determined. Which prescription should the nurse question at this time? 1. Clear liquid diet only 2. Insertion of a nasogastric tube 3. Administration of an analgesic 4. Insertion of an intravenous (IV) line

1. Clear liquid diet only

A diet consisting of bland foods has been prescribed for a client diagnosed with symptomatic peptic-ulcer disease. The nurse provides dietary instructions encouraging the client to avoid which food? 1. Cola 2. White bread 3. Scrambled eggs 4. Mashed potatoes

1. Cola

The nurse instructing a client with chronic pancreatitis about measures to prevent its exacerbation should provide which information? Select all that apply. 1. Eat bland foods. 2. Avoid alcohol ingestion. 3. Avoid cigarette smoking. 4. Avoid caffeinated beverages. 5. Eat small meals and snacks high in calories. 6. Eat high-fat, low-protein, high-carbohydrate meals.

1. Eat bland foods. 2. Avoid alcohol ingestion. 3. Avoid cigarette smoking. 4. Avoid caffeinated beverages. 5. Eat small meals and snacks high in calories.

A hospitalized client is diagnosed with mild ulcerative colitis. The nurse determines that the client understands how to alter the diet if the client selects which foods from the dinner menu? 1. Hamburger on a white roll with apple juice 2. Baked potato with its skin and tea with milk 3. Fried eggs and bacon on a croissant with milk 4. Garden salad with chickpeas and a glass of 2% milk

1. Hamburger on a white roll with apple juice

The nursing instructor teaching a group of nursing students about preventive measures for diverticular disease should recommend which intervention for the prevention of this disease? Select all that apply. 1. High fluid intake 2. A high-fiber diet 3. High intake of fat 4. Low intake of red meat 5. A diet consisting mainly of fruits and vegetables

1. High fluid intake 2. A high-fiber diet 4. Low intake of red meat 5. A diet consisting mainly of fruits and vegetables

The nurse is providing preoperative teaching to a client who will undergo creation of a Kock pouch. The nurse includes which piece of information in the discussion? 1. The pouch must be drained regularly with a catheter. 2. The drainage from this type of ostomy will be formed. 3. You will be able to pass stool by the rectum eventually. 4. You will need to wear a drainage bag for the rest of your life.

1. The pouch must be drained regularly with a catheter.

The nurse reviews home care management instructions with a client who was recently diagnosed with cirrhosis. Which statement by the client indicates a need for further instructions? 1. "I will eat a balanced diet." 2. "I will take Tylenol for discomfort." 3. "I will weigh myself on a regular basis." 4. "I will eat a diet with sufficient carbohydrates."

2. "I will take Tylenol for discomfort."

A client diagnosed with cirrhosis is beginning to show signs/symptoms of hepatic encephalopathy. Because of these signs/symptoms, the nurse should obtain a substitute food for which item on the client's meal tray? 1. Green peas 2. Hamburger patty 3. Strawberry gelatin 4. Whole-wheat bread

2. Hamburger patty

The nurse understands that which bacterial organisms are a primary cause of gastritis? Select all that apply. 1. Escherichia coli 2. Helicobacter pylori 3. Enterococcus organisms 4. Streptococcal organisms 5. Staphylococcus organisms

2. Helicobacter pylori 5. Staphylococcus organisms

A client with a colostomy complains to the nurse of appliance odor. The nurse recommends that the client take in which deodorizing foods? 1. Eggs 2. Yogurt 3. Cucumbers 4. Mushrooms

2. Yogurt

The nurse provides dietary instructions to a client with asymptomatic diverticular disease. Which statement by the client indicates a need for further teaching? 1. "I should drink plenty of fluids." 2. "I should eat foods that contain fiber." 3. "Foods high in carbohydrate are usually high in fiber." 4. "It is important to include fruits and vegetables in my diet."

3. "Foods high in carbohydrate are usually high in fiber."

A client diagnosed with Crohn's disease is experiencing pain, and the nurse provides the client with information about measures that will relieve the pain. Which statement by the client indicates the need for further teaching? 1. "I can put heat on my abdomen." 2. "I need to use relaxation techniques." 3. "I need to lie on my back with my legs straight." 4. "I need to take antispasmodic medication as prescribed."

3. "I need to lie on my back with my legs straight."

The home care nurse visits a client who was recently diagnosed with cirrhosis and provides home care management instructions to the client. Which statement by the client indicates the need for further teaching? 1. "I will obtain adequate rest." 2. "I should monitor my weight regularly." 3. "I will take Tylenol if I get a headache." 4. "I should include sufficient carbohydrates in my diet."

3. "I will take Tylenol if I get a headache."

The home care nurse provides instructions about the management of pruritus to a client diagnosed with jaundice. Which statement made by the client suggests to the nurse that the client needs further teaching? 1. "I need to wear loose cotton clothing." 2. "A tepid water bath should help stop the itching." 3. "Keeping the house warmer is likely to lessen the itching" 4. "I need to take the prescribed antihistamines as I'm supposed to."

3. "Keeping the house warmer is likely to lessen the itching"

A hospitalized client diagnosed with hepatitis reports fatigue and feelings of depression. Which strategy should the nurse incorporate to help the client cope effectively during recuperation? 1. Encourage lengthy visits by the family. 2. Have the client remain in the unit lounge during the day. 3. Concentrate all activities requiring exertion early in the day. 4. Encourage restful diversional activities per client preference.

3. Concentrate all activities requiring exertion early in the day

The nurse is planning care for a client who is convalescing from hepatitis. Recognizing the need for psychosocial support for this client, what action should the nurse suggest? 1. Joining an aerobic exercise class 2. That the client stays in her room to facilitate resting 3. Diversionary activities that are not physically taxing 4. That the client speaks with her doctor about a prescription for an antidepressant medication

3. Diversionary activities that are not physically taxing

The nurse performing a history and physical assessment on a client diagnosed with peptic ulcer disease determines that which datum is unrelated to the client's current disorder? Select all that apply. 1. Daily ingestion of alcohol 2. Report of tarry black stools 3. Frequent use of acetaminophen 4. Smokes 1 pack of cigarettes per day 5. Consumes noncaffeinated beverages only 6. Complaints of gastric pain 1 to 2 hours after meals

3. Frequent use of acetaminophen 5. Consumes noncaffeinated beverages only

A client is scheduled for a subtotal gastrectomy (Billroth II procedure). The nurse explains that the procedure will have which surgical results? 1. Proximal end of the distal stomach is anastomosed to the duodenum. 2. Entire stomach is removed and the esophagus is anastomosed to the duodenum. 3. Lower portion of the stomach is removed and the remainder is anastomosed to the jejunum. 4. Antrum of the stomach is removed and the remaining portion is anastomosed to the duodenum.

3. Lower portion of the stomach is removed and the remainder is anastomosed to the jejunum.

The nurse is assisting a primary health care provider with abdominal paracentesis. What position should the nurse assist the client into for this procedure? 1. Prone 2. Supine 3. Semi-Fowler's on the back 4. Low Fowler's on the right side

3. Semi-Fowler's on the back

The surgery center nurse is performing discharge teaching to a postoperative laparoscopic cholecystectomy (gallbladder surgery) client who is reporting thoracic discomfort. What comment by the client indicates that further teaching is needed? 1. "I can take a shower tomorrow." 2. "I will use ice for incisional pain." 3. "I need to make sure to rest for the first 24 hours." 4. "I know that heat to my chest area will make the discomfort worse

4. "I know that heat to my chest area will make the discomfort worse."

The nurse is caring for a client diagnosed with pneumonia who has a history of bleeding esophageal varices. Based on this information, the nurse plans care knowing that it is most important to prevent which sign/symptom from occurring? 1. Pain 2. Nausea 3. Diarrhea 4. Constipation

4. Constipation

What intervention should the nurse plan to implement to prevent tracheal aspiration in a client diagnosed with a hiatal hernia? 1. Administer antacids as needed. 2. Instruct the client not to smoke. 3. Instruct the client to lose weight. 4. Elevate the head of bed after meals.

4. Elevate the head of bed after meals.

To stop the bleeding in a client with esophageal varices, a Sengstaken-Blakemore tube is inserted. After insertion of the tube, the nurse implements safety measures and takes which additional actions? 1. Monitors intake and output 2. Elevates the head of bed 90 degrees 3. Checks level of consciousness every hour 4. Has suction available and scissors at the bedside

4. Has suction available and scissors at the bedside

The nurse caring for a client with a diagnosis of cirrhosis and hepatopulmonary syndrome should maintain the client in what position while in bed? 1. Sims' 2. Lateral recumbent 3. Supine with head elevated on one pillow 4. Head of the bed elevated at least 30 degrees

4. Head of the bed elevated at least 30 degrees

The nurse notes that the stoma of a client with a new colostomy is a dark, dusky color. Which is the action the nurse should take initially? 1. Irrigate the colostomy. 2. Document the findings. 3. Obtain a larger colostomy bag. 4. Notify the primary health care provider.

4. Notify the primary health care provider.

The nurse caring for a client in the postrecovery period of a colonoscopy monitors the client's temperature and notes a sudden temperature elevation. The nurse interprets this finding as being associated with which potential complication of the procedure? 1. Severe dehydration 2. Internal hemorrhage 3. A nosocomial infection 4. Perforation of the intestine

4. Perforation of the intestine

A client with gastroesophageal reflux disease (GERD) reports chest discomfort that feels like heartburn, especially following each meal. After teaching the client to take antacids as prescribed, the nurse suggests that the client lie in which position during sleep? 1. Prone with the head of the bed flat 2. Supine with the head of the bed flat 3. On the left side with the head of the bed flat 4. With the head of the bed elevated 8 to 12 inches

4. With the head of the bed elevated 8 to 12 inches

A client is admitted to the hospital with dehydration after creation of an ileostomy. The nurse notes that the client has lost 3 pounds, has poor skin turgor, and has concentrated urine. The nurse tells the client that which as-needed medication used before hospital admission is likely causing the dehydration? 1. Folate 2. Furosemide 3. Sennosides 4. Ferrous sulfate

3. Sennosides

The nurse is planning discharge teaching for a client diagnosed with viral hepatitis. Which dietary considerations should the nurse include in the instructions? 1. Fluid restriction 2. Diet high in fat 3. Small, frequent meals 4. Diet low in carbohydrate

3. Small, frequent meals

A client who underwent creation of a colostomy requires instruction about colostomy irrigation. Which instructions should the nurse encourage the client to follow? 1. Use 2000 mL warm tap water for the irrigation. 2. Insert the irrigation cone ¼ inch into the stoma. 3. Suspend the irrigant solution 18 inches above the stoma. 4. Call the primary health care provider if cramping occurs during the irrigation.

.3. Suspend the irrigant solution 18 inches above the stoma.

The nurse provides information to a client diagnosed with gastroesophageal reflux disease (GERD). What information should the nurse include when discussing foods that contribute to decreased lower esophageal sphincter (LES) pressure and thus worsen the condition? Select all that apply. 1. Alcohol 2. Fatty foods 3. Citrus fruits 4. Baked potatoes 5. Caffeinated beverages 6. Tomatoes and tomato products

1. Alcohol 2. Fatty foods 3. Citrus fruits 5. Caffeinated beverages 6. Tomatoes and tomato products

A client admitted to the hospital with a diagnosis of Laënnec's cirrhosis is ready for discharge and expresses the motivation to prevent this condition from worsening. To assist this client, which resource should the nurse inform the client about? 1. Alcoholics Anonymous 2. Overeaters Anonymous 3. American Heart Association 4. American Cancer Society

1. Alcoholics Anonymous

A client is admitted to the hospital with a diagnosis of acute pancreatitis. The nurse plans care knowing that the client is at risk for developing which problem? 1. Alteration in comfort related to abdominal pain 2. Excess fluid volume related to sodium retention 3. Alteration in fluid and electrolyte balance related to hyperkalemia 4. Potential for hypoglycemia related to a low blood glucose secondary to increased insulin secretion

1. Alteration in comfort related to abdominal pain

A client is diagnosed with cholecystitis. The nurse reviews the client's medical record, expecting to note documentation of which manifestations of this disorder? Select all that apply. 1. Dyspepsia 2. Dark stools 3. Light-colored and clear urine 4. Feelings of abdominal fullness 5. Rebound tenderness in the abdomen 6. Upper abdominal pain that radiates to the right shoulder

1. Dyspepsia 4. Feelings of abdominal fullness 5. Rebound tenderness in the abdomen 6. Upper abdominal pain that radiates to the right shoulder

The home care nurse is visiting a client who is reporting heartburn. Which dietary measure should the nurse suggest to the client to alleviate the heartburn? 1. Eat a high-protein, low-fat diet. 2. Drink at least 3 or 4 fruit juices a day as a main beverage. 3. Lie down for 20 to 30 minutes after eating to help the food digest. 4. Try to eat a little more food after feeling full to keep the stomach at full capacity.

1. Eat a high-protein, low-fat diet

A client diagnosed with chronic pancreatitis has received information on needed dietary changes. The nurse determines that the client understands the information if the client states the need to limit intake of which item? 1. Fat 2. Protein 3. Carbohydrate 4. Water-soluble vitamins

1. Fat

The nurse is assessing a client diagnosed with esophageal cancer. What risk factors are associated to this condition? Select all that apply. 1. Gender 2. Tobacco use 3. Slender frame 4. History of alcohol consumption 5. Diet with a lot of fruits and vegetables 6. Gastroesophageal reflux disease (GERD)

1. Gender 2. Tobacco use 4. History of alcohol consumption 6. Gastroesophageal reflux disease (GERD)

The nurse monitors a patient with acute pancreatitis. Which assessment finding indicates that paralytic ileus has developed? 1. Inability to pass flatus 2. Loss of anal sphincter control 3. Severe, constant pain with rapid onset 4. Firm, nontender mass palpable at the lower right costal margin

1. Inability to pass flatus

The nurse is developing a teaching plan for a client diagnosed with viral hepatitis. What information should the nurse incorporate in the teaching session? 1. Measures to prevent fatigue 2. The importance of limiting alcohol intake 3. The importance of eating three meals per day 4. Diet measures to ensure dietary intake that is low in calories and carbohydrates

1. Measures to prevent fatigue

The nurse is discharging a client diagnosed with ulcerative colitis who has been prescribed a low-residue diet. What foods should the nurse teach this client to avoid? Select all that apply. 1. Nuts 2. Grains 3. Raw fruit 4. White rice 5. Whole wheat 6. Cooked vegetables

1. Nuts 2. Grains 3. Raw fruit 5. Whole wheat

The nurse suspects that the client who experienced gastric bypass surgery 3 days ago has developed an anastomotic leak. What assessment findings most likely validate this suspicion? Select all that apply. 1. Oliguria 2. Restlessness 3. Abdominal pain 4. Nausea and vomiting 5. Unexplained tachycardia

1. Oliguria 2. Restlessness 3. Abdominal pain 5. Unexplained tachycardia

A client who undergoes a gastric resection is at risk for developing dumping syndrome. Which manifestation should the nurse monitor the client for? Select all that apply. 1. Pallor 2. Dizziness 3. Diaphoresis 4. Bradycardia 5. Constipation 6. Extreme thirst

1. Pallor 2. Dizziness 3. Diaphoresis

The home care nurse visits a client with a diagnosis of cirrhosis and ascites. Which action should the nurse encourage the client to take when providing dietary instructions? 1. Restrict sodium intake. 2. Maintain a low-calorie diet. 3. Decrease carbohydrate intake. 4. Restrict calories to 1500 daily.

1. Restrict sodium intake.

The nurse caring for a client with a diagnosis of chronic pancreatitis collects data on the client, knowing that which sign/symptom indicates poor absorption of dietary fats? 1. Steatorrhea 2. Bloody diarrhea 3. Electrolyte disturbances 4. Gastrointestinal reflux disease

1. Steatorrhea

A client diagnosed with peptic ulcer disease has been taught dietary modifications to reduce episodes of epigastric pain. The nurse determines that the client understands the information if the client states the intention to limit or eliminate which item from the diet? Select all that apply. 1. Tea 2. Beer 3. Green beans 4. Fresh apples 5. Baked chicken

1. Tea 2. Beer 4. Fresh apples

A client who has undergone creation of a colostomy has difficulty accepting the body image changes that have occurred postprocedure. The nurse should base this conclusion on which observation? 1. The client is reluctant to look at the ostomy site. 2. The client practices cutting the ostomy appliance. 3. The client has read all of the ostomy product literature. 4. The client does not know how to empty the ostomy bag.

1. The client is reluctant to look at the ostomy site.

A client who had a colostomy created 2 days earlier tells the nurse of being concerned about passing malodorous flatus from the stoma. The nurse formulates a response based on which information? 1. This occurrence is a normal, expected event. 2. This occurrence is an early sign of bowel ischemia. 3. This condition indicates inadequate preoperative bowel preparation. 4. This condition indicates that the nasogastric tube should not be removed.

1. This occurrence is a normal, expected event.

The nurse is preparing to teach colostomy irrigation to a client with a new colostomy. Which point should the nurse include when developing the teaching plan? 1. Use 500 to 1000 mL of warm tap water. 2. Suspend the irrigant 36 inches above the stoma. 3. Insert the irrigation cone 0.5 inch into the stoma. 4. If cramping occurs, open the irrigation clamp farther.

1. Use 500 to 1000 mL of warm tap water.

A client is being taught to eliminate factors that might cause an attack of acute pancreatitis. The nurse determines that teaching is effective when the client makes which statement? 1. "Starchy foods are strictly taboo." 2. "I'm going to try using a nicotine patch." 3. "It's okay to drink my favorite brands of coffee." 4. "A glass of wine before dinner will be good for my appetite."

2. "I'm going to try using a nicotine patch."

During the admission assessment of a client with a history of alcohol abuse for diagnosis of ruptured esophageal varices, the client says, "I deserve this. I brought it on myself." Which response is most therapeutic for the nurse to make to the client? 1. "Would you like to talk to the chaplain?" 2. "Is there some reason you feel you deserve this?" 3. "Not all esophageal varices are caused by alcohol." 4. "That is something to think about when you leave the hospital."

2. "Is there some reason you feel you deserve this?"

The nurse is performing an assessment on a client with a diagnosis of hiatal hernia. The nurse expects the client to make which statements that are characteristic of this disorder? Select all that apply. 1. "The pain in my chest is aggravated by exercise." 2. "The pain in my chest is worse after a large meal." 3. "The pain in my chest is relieved when I lie down." 4. "The pain in my chest is always tight and feels like pressure." 5. "The pain in my chest worsens when I drink a large amount of liquids."

2. "The pain in my chest is worse after a large meal." 5. "The pain in my chest worsens when I drink a large amount of liquids."

A client diagnosed with a bowel tumor is scheduled for radiation and surgery to create an ileostomy. The client asks the nurse about sexual function after the procedure. Which statement by the nurse is accurate? 1. "Vaginal lubrication is never affected." 2. "You will still be able to experience orgasm." 3. "You will no longer be able to become pregnant." 4. "Nerve-sparing techniques allow the sexual experience to remain completely unchanged."

2. "You will still be able to experience orgasm."

Vasopressin therapy is prescribed for a client with a diagnosis of bleeding esophageal varices. The nurse preparing to administer the medication should obtain which essential item needed for use during administration of this medication? 1. A suction setup 2. A cardiac monitor 3. A tracheotomy set 4. An artificial airway

2. A cardiac monitor

A client diagnosed with pernicious anemia asks the nurse what caused the deficiency. The nurse replies that it is likely caused by which condition identified during the client's health history? 1. Chronic hypothyroidism 2. A recent hemigastrectomy 3. Excessive vitamin C intake 4. A decreased dietary intake of iron

2. A recent hemigastrectomy

An assessment of a client has confirmed the presences of ascites and slight jaundice. The nurse should assess for the chronic use of which medication to suggest a cause for these assessment findings? 1. Ranitidine 2. Acetaminophen 3. Docusate sodium 4. Acetylsalicylic acid

2. Acetaminophen

The nurse providing discharge instructions to a client with peptic ulcer disease reinforces that it is acceptable to take which over-the-counter medication for mild non-ulcer-related pain? 1. Ibuprofen 2. Acetaminophen 3. Diphenhydramine 4. Acetylsalicylic acid

2. Acetaminophen

The nurse administers an antiemetic to a client prescribed a clear diet who reports nausea and vomits. After sleeping for 3 hours the client awakens and requests something to eat. Which food item would be appropriate for the nurse to give the client? 1. Hot tea 2. Apple juice 3. Buttered toast 4. Chicken broth

2. Apple juice

The laboratory results of a client with a history of chronic ulcerative colitis indicate anemia. The nurse determines that which factor is most likely responsible for this laboratory finding? 1. Diarrhea 2. Blood loss 3. Intestinal malabsorption 4. Decreased intake of dietary iron

2. Blood loss

The nurse is caring for a client diagnosed with cirrhosis. Which assessment finding indicates that the problem of excessive fluid volume is resolving? 1. Increasing pulse 2. Decreasing body weight 3. Decreasing urine output 4. Increasing central venous pressur

2. Decreasing body weight

The nurse is monitoring a client diagnosed with a ruptured appendix for signs of peritonitis. The nurse should assess for which manifestations of this complication? Select all that apply. 1. Bradycardia 2. Distended abdo men 3. Subnormal temperature 4. Rigid, boardlike abdomen 5. Diminished bowel sounds 6. Inability to pass flatus or feces

2. Distended abdomen 4. Rigid, boardlike abdomen 5. Diminished bowel sounds 6. Inability to pass flatus or feces

A client admitted to the hospital with a diagnosis of cirrhosis demonstrates massive ascites causing dyspnea. The nurse performs which intervention as a priority measure to assist the client with this complication? 1. Repositions side to side every 2 hours 2. Elevates the head of the bed 60 degrees 3. Auscultates the lung fields every 4 hours 4. Encourages deep breathing exercises every 2 hours

2. Elevates the head of the bed 60 degrees

A client diagnosed with cirrhosis complicated by ascites has stated a 10-pound weight gain over the last 7 days. A physical assessment notes 3+ edema in both feet and ankles. The client's abdomen is distended, taut, and shiny with striae. The nurse should assign highest priority to which problem? 1. Inability to breathe 2. Excessive fluid volume 3. Potential difficulties with activity 4. Potential for diminished break in skin integrity

2. Excessive fluid volume

A client with ascites from cirrhosis is being discharged to home. Which foods should the nurse encourage the client to include in the diet? 1. Dried beef 2. Fresh apples 3. Potato chips 4. Canned vegetables

2. Fresh apples

The nurse is providing dietary instructions to a client with a diagnosis of ulcerative colitis. Which food should the nurse instruct the client to avoid? 1. Whole-grain cereals 2. Fresh corn on the cob 3. Broiled chicken breast 4. Bagels with cream cheese

2. Fresh corn on the cob

Which laboratory value indicates a complication associated with peptic ulcer disease? 1. Creatinine 1 mg/dL (88.3 mcmol/L) 2. Hemoglobin 10.2 g/dL 102 mmol/L) 3. Platelet count of 400,000 mm3 (400 × 109/L) 4. White blood cell count of 5000 mm3 (5 × 109/L)

2. Hemoglobin 10.2 g/dL 102 mmol/L

client diagnosed with acute viral hepatitis 4 months ago continues to have clinical manifestations of the disease. The client asks, "When will I be able to return to work? I can't stand being tired and not being able to do anything." The spouse confides to the nurse that the client has started drinking a couple of beers every day. The nurse should formulate interventions for the client based on what demonstrated emotional characteristic? 1. Depression due to the inability to work 2. Lack of coping skills manifested by alcohol use 3. Feelings of hopelessness due to a chronic disease state 4. Spousal stress due to caring for a family member with alcohol addiction

2. Lack of coping skills manifested by alcohol use

everal months after a subtotal gastrectomy, a client reporting vertigo, tachycardia, pallor, and sweating shortly after eating is diagnosed with dumping syndrome. Which nutritional intervention should the nurse prepare to teach the client about? 1. Decrease fat intake. 2. Lie down after meals. 3. Follow a high-carbohydrate diet. 4. Drink plenty of fluids with meals.

2. Lie down after meals.

A client has cirrhosis complicated by ascites. Which expected but adverse laboratory result should the nurse monitor for? 1. High urine sodium 2. Low serum albumin 3. High serum calcium 4. Low urine specific gravity

2. Low serum albumin

A client with a new colostomy has received dietary instructions. The client indicates an understanding when stating the intention to eat which type of diet for the first 4 to 6 postoperative weeks? 1. Low-calorie 2. Low-residue 3. High-protein 4. High-carbohydrate

2. Low-residue

A client diagnosed with a hiatal hernia routinely experiences heartburn after eating. The nurse tells the client to avoid which activity known to aggravate this condition? 1. Sitting upright after meals 2. Lying recumbent after meals 3. Taking in small, frequent, bland meals 4. Taking histamine-receptor antagonist medication

2. Lying recumbent after meals

What are the expected outcomes for the client diagnosed with peptic ulcer disease who is experiencing pain? Select all that apply. 1. Client awakens at 3 am with heartburn. 2. Pain medication is relieving discomfort. 3. Client reports absence of pain before meals. 4. Client eliminates foods that exacerbate the condition. 5. Client reports ability to sleep through the night without pain.

2. Pain medication is relieving discomfort. 3. Client reports absence of pain before meals. 4. Client eliminates foods that exacerbate the condition. 5. Client reports ability to sleep through the night without pain.

A client who has a subtotal gastrectomy is prescribed an oral diet. The nurse should plan to monitor the client for which signs/symptoms of dumping syndrome? 1. Diarrhea, chills, and hiccoughs 2. Weakness, diaphoresis, and diarrhea 3. Fever, constipation, and rectal bleeding 4. Abdominal pain, elevated temperature, and weakness

2. Weakness, diaphoresis, and diarrhea

A client diagnosed with hepatitis C is informed that the possibility of developing a chronic carrier state or liver cancer is very high. When the client asks, "Am I going to die from this?" which response should the nurse make to address the client's concern? 1. "Here is a pamphlet on hepatitis C that explains the complications and prognosis." 2. "Would you like to speak to a chaplain about your concerns, to get your affairs in order?" 3. "You seem very upset. What did your primary health care provider tell you about these possibilities?" 4. "If you take good care of yourself and follow your primary health care provider's prescriptions, everything will be okay."

3. "You seem very upset. What did your primary health care provider tell you about these possibilities?"

A primary health care provider has discontinued a prescription for continuous suction to a catheter inserted into a newly created Kock pouch. Which solution should the nurse plan to use for periodic catheter irrigations prescribed by the primary health care provider? 1. 50 to 60 mL tap water 2. 30 to 40 mL sterile water 3. 10 to 20 mL normal saline 4. 80 to 100 mL normal saline

3. 10 to 20 mL normal saline

The nurse caring for a client diagnosed with acute pancreatitis should give which client problem priority? 1. Compromised skin integrity due to pruritus 2. Inability to tolerate activity due to debilitation 3. Acute pain related to inflammation and enzyme leakage 4. Inadequate fluid volume from blood and gastrointestinal losses

3. Acute pain related to inflammation and enzyme leakage

The nurse is obtaining a health history of a client diagnosed with chronic calcifying pancreatitis. Which finding will the nurse expect to most likely note when obtaining information regarding the client's health history? 1. Weight gain 2. History of smoking 3. Chronic use of alcohol 4. Abdominal pain relieved with food or antacids

3. Chronic use of alcohol

A client diagnosed with viral hepatitis reports having a poor appetite and that the presence of food causes nausea. The nurse should encourage which intervention to help assure adequate nutrition? 1. Consume a low-calorie diet. 2. Eat numerous low-calorie snacks during the day. 3. Consume the majority of calories in the morning hours. 4. Consume high-fat foods that are usually well tolerated.

3. Consume the majority of calories in the morning hours.

The nurse provides a client with dietary information about measures to prevent dumping syndrome after a gastric resection. Which instructions should the nurse give the client? Select all that apply. 1. Eat high-fiber foods. 2. Eat three large meals a day. 3. Drink liquids between meals only. 4. Eat foods that are high in carbohydrates. 5. Eat foods that are low in fat and protein. 6. Eliminate milk, sweets, and sugars from the diet.

3. Drink liquids between meals only. 6. Eliminate milk, sweets, and sugars from the diet.

The nurse is planning postoperative care for the client who has undergone an esophagogastrostomy. To provide a safe environment, which interventions should be included in the plan of care? Select all that apply. 1. Irrigate the NG tube as needed to promote drainage. 2. Reposition the nasogastric (NG) tube if drainage stops. 3. Place the bed in semi-Fowler's or high-Fowler's position. 4. Provide oral hygiene every 2 hours while the NG tube is in place. 5. Instruct the client to take extra fluids with meals as soon as diet is resumed. 6. Encourage deep breathing exercises and the use of the incentive spirometer.

3. Place the bed in semi-Fowler's or high-Fowler's position. 4. Provide oral hygiene every 2 hours while the NG tube is in place. 6. Encourage deep breathing exercises and the use of the incentive spirometer.

A client is prescribed a solid oral diet after subtotal gastrectomy. Which strategy should the nurse teach the client in order to decrease the risk of developing dumping syndrome? 1. Sit up for an hour after eating. 2. Eat three large meals per day. 3. Plan fluid intake so that it is between meals. 4. Eat concentrated, high-carbohydrate foods.

3. Plan fluid intake so that it is between meals

A postgastrectomy client is at high risk for hyperglycemia related to uncontrolled gastric emptying of fluid and food into the small intestine (dumping syndrome). Because of this risk, which finding should the nurse monitor? 1. Client's daily weights 2. Fasting blood glucose readings 3. Postprandial blood glucose readings 4. Calorie counts from the dietary department

3. Postprandial blood glucose readings

One week after teaching a client about the relationship of the intake of excessive amounts of alcohol to liver cancer, the home care nurse visits the client. The nurse determines whether the teaching from the last visit was effective by asking what the client remembers from the last nursing visit. The client responds, "You said I can never have another drink." What determination should the nurse make based on this statement? 1. The client should never drink again. 2. The client understood what was taught. 3. The client needs clarification and reinforcement. 4. The client understood, but reinforcement is necessary.

3. The client needs clarification and reinforcement

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

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

The nurse is monitoring a client who may be started on total parenteral nutrition (TPN). The nurse reviews the client's laboratory results and determines that the client is at risk for severe malnutrition if the albumin level report indicates which critical level? 1. 5 g/dL (50 g/L) 2. 4.5 g/dL (45 g/L) 3. 3.9 g/dL (39 g/L) 4. 2.8 g/dL (28 g/L)

4. 2.8 g/dL (28 g/L)

The nurse has taught a client with a new colostomy about odor control in the ostomy drainage bag. The client indicates an understanding of the information presented when stating the intention to include which food in the diet? 1. Eggs 2. Broccoli 3. Cucumbers 4. Beet greens

4. Beet greens

The nurse educates a client diagnosed with hepatitis about measures to use to control fatigue. The nurse determines that the client needs additional instructions if the client states the need to take which action? 1. Rest between activities. 2. Plan rest periods after meals. 3. Perform personal hygiene if not fatigued. 4. Complete all daily activities in the morning when the client is most rested

4. Complete all daily activities in the morning when the client is most rested.

A client has just had surgery to create an ileostomy. The nurse reminds the nursing student who is caring for the client to assess for which frequent complication of this surgery in the immediate postoperative period? 1. Folate deficiency 2. Malabsorption of fat 3. Intestinal obstruction 4. Fluid and electrolyte imbalance

4. Fluid and electrolyte imbalance

A client diagnosed with a duodenal ulcer questions why an antibiotic has been prescribed. The response by the nurse is based on what information regarding antibiotic therapy? 1. It will reduce the inflammation. 2. It will prevent secondary infections. 3. It will soothe the irritated mucosal surface. 4. It will eliminate a germ that impairs mucosal function.

4. It will eliminate a germ that impairs mucosal function

A client who had a small-bowel resection is 1 day postoperative and has continuous gastric suction attached to the nasogastric tube. Which intravenous (IV) solution should the nurse anticipate is likely to be prescribed for the client? 1. 25% Albumin 2. Normal saline 3. 5% Dextrose in water 4. Lactated Ringer's solution

4. Lactated Ringer's solution

The nurse is planning stress management strategies for the client diagnosed with irritable bowel syndrome (IBS). Which suggestion should the nurse give to the client? 1. Rest in bed as much as possible. 2. Limit exercise to reduce bowel stimulation. 3. Try to avoid every possible stressful situation. 4. Learn measures such as biofeedback or progressive relaxation.

4. Learn measures such as biofeedback or progressive relaxation

The nurse is monitoring drainage from a nasogastric (NG) tube inserted into a client who had a gastric resection. No drainage is noted during the past 4 hours, and the client complains of severe nausea. What is the appropriate nursing action? 1. Irrigate the tube. 2. Reposition the tube. 3. Medicate for nausea. 4. Notify the primary health care provider.

4. Notify the primary health care provider.

The nurse caring for a client with a suspected diagnosis of acute pancreatitis would assess for which characteristic sign of this disorder? 1. Back pain 2. Hypothermia 3. Epigastric pain radiating to the neck area 4. Severe abdominal pain that is unrelieved by vomiting

4. Severe abdominal pain that is unrelieved by vomiting

A client with an ileostomy has excessively watery stools. The nurse tells the client to avoid which food in the diet? 1. Pasta 2. Boiled rice 3. Low-fat cheese 4. Shredded wheat

4. Shredded wheat

The clinic nurse is assessing a client who had a total gastrectomy 2 months ago. Which assessment would indicate a specific complication of this surgical procedure if it exists? 1. Calcium levels 2. Blood urea nitrogen levels 3. Pupillary response to light 4. Signs/symptoms of vitamin B12 deficiencies

4. Signs/symptoms of vitamin B12 deficiencies

The nurse provides dietary measures to a client with diverticulosis. Which food types should the nurse encourage the client to eat? 1. High in fat 2. Low residue 3. Soft and low in fiber 4. Soft and high in fiber

4. Soft and high in fiber

The nurse is caring for a client with a diagnosis of peptic ulcer disease. When monitoring the client for possible gastrointestinal perforation, the nurse identifies the importance of what assessment data? 1. Slow, strong pulses 2. Increase in bowel sounds 3. Positive guaiac stool tests 4. Sudden, severe abdominal pain

4. Sudden, severe abdominal pain

The nurse has given parenteral pain medication to a client experiencing an acute episode of cholecystitis. Thirty minutes later, the nurse determines whether the client obtained relief from the pain that had originated in which location? 1. Lower quadrant radiating to the back 2. Lower quadrant radiating to the umbilicus 3. Upper quadrant radiating to the left scapula and shoulder 4. Upper quadrant radiating to the right scapula and shoulder

4. Upper quadrant radiating to the right scapula and shoulder

A client is being treated with a Sengstaken-Blakemore tube for bleeding esophageal varices. The client asks the nurse why the bleeding occurs from the esophagus when the problem is with the liver. The nurse bases the response to the client's question on which statement? 1. Because of poor nutrition, the blood vessels in the esophagus weaken and bleed. 2. Alcohol weakens the veins in the esophagus, and then coughing causes the veins to rupture. 3. Because of poor liver function, the blood does not clot correctly, and bleeding occurs in the esophagus. 4. Because of the hardening of the liver, the blood that circulates through the liver backs up and causes dilated esophageal veins that can bleed.

4. Because of the hardening of the liver, the blood that circulates through the liver backs up and causes dilated esophageal veins that can bleed.