GI exam 2 practice questions

A histamine (H2) receptor antagonist will be prescribed for a client. The nurse understands that which medications are H2 receptor antagonists? Select all that apply. a. Nizatidine b. Ranitidine c. Famotidine d. Cimetidine e. Esomeprazole f. Lansoprazole

a, b, c, d

A client has begun medication therapy with pancrelipase (Pancrease MT). The nurse evaluates that the medication is having the optimal intended benefit when which effect is observed? a. Weight loss b. Relief of heartburn c. Reduction of streatorrhea d. Absence of abdominal pain

c

The nurses is doing an admission assessment on a client with a hx of a duodenal ulcer. To determine whether the problem is currently active, the nurse should assess the client for which symptom(s) of a duodenal ulcer? a. Weight loss b. Nausea and vomiting c. Pain relieved by food d. Pain radiating down the arm

c

When admitting a patient with a stroke who is unconscious and unresponsive to stimuli, the nurse learns from the patient's family that the patient has a history of gastroesophageal reflux disease (GERD). The nurse will plan to do frequent assessments of the patient's a. apical pulse. b. bowel sounds. c. breath sounds. d. abdominal girth.

c

Which assessment findings indicate the patient may have metabolic syndrome? a. Blood pressure of 125/50 mm Hg b. Serum albumin of 3.7 g/dL c. Fasting blood sugar level of 150 mg/dL d. High-density lipoprotein (HDL) level of 64 mg/dL

c

The patient is admitted with acute pancreatitis. He is complaining of severe abdominal pain and nausea. He has hyperactive bowel sounds and abdominal distention. His temperature is 103° F and his blood pressure is 86/40 mm Hg. His WBC count is over 20,000/mL. He is jaundiced and the nurse notes a bluish discoloration around the umbilical area. Which of the following is indicated first in managing this patient? a. Administration of fluids to manage hypotension b. Administration of narcotics to manage acute pain c. Application of a cooling blanket to manage fever d. Collection of blood culture specimens to assess etiology of infection

a

The post-anesthesia care nurse is caring for a patient who just had gastric banding surgery. The client's blood gases are as follows: pH, 7.22; HCO3-, 21 mEq/L; PCO2, 65 mm Hg; and PO2 58 mm Hg. Which is the priority action by the nurse? a. Assessing the client's airway b. Increasing the client's oxygen flow rate c. Checking the client's oxygen saturation level d. Documenting the findings in the client's chart

a

While caring for a comatose patient who is receiving continuous enteral nutrition through a soft nasogastric tube, the nurse notes the presence of new crackles in the patient's lungs. Which of the following action will the nurse do first? a. Turn off the tube feeding. b. Obtain the patient's oxygen saturation. c. Check the tube feeding residual volume. d. Notify the patient's health care provider.

a

The nurse is reviewing the prescription for a client admitted to the hospital with a diagnosis of acute pancreatitis. Which interventions would the nurse expect to be part of the plan of care? SELECT ALL APPLY. a. Administer antacids as prescribed b. Encourage coughing and deep breathing c. Administer anticholinergics as prescribed d. Give small, frequent, high-calorie feedings e. Maintain the client in the supine position f. Give meperidine (demerol) as prescribed for pain

a, b, c, f

A client has been taking omeprazole for 4 weeks. The ambulatory care nurse evaluates that the client is receiving the optimal intended effect of the medication if the client reports the absence of which symptoms? a. Diarrhea b. Heartburn c. Flatulence d. Constipation

b

A patient is admitted to the hospital with acute cholecystitis. Which assessment information will be most important for the nurse to report to the health care provider? a. The patient's urine is bright yellow. b. The patient's stools are clay colored. c. The patient complains of chronic heartburn. d. The patient has an increase in pain after eating.

b

A patient with Crohn's disease develops a fever and symptoms of a urinary tract infection (UTI) with tan, fecal-smelling urine. The nurse will teach the patient a. to clean the perianal area carefully after any stools. b. about fistula formation between the bowel and bladder. c. to empty the bladder before and after sexual intercourse. d. about the effects of corticosteroid use on immune function.

b

A patient with hepatic failure becomes increasingly confused. What is a likely diagnosis, and what test is done to confirm the diagnosis? a. Cerebral edema; computed tomography scan b. Encephalopathy; serum ammonia level c. Hypoxemia; arterial blood gas analysis d. Infection; WBC count

b

The nurse is caring for a patient with acute pancreatitis. Which nursing intervention will best reduce discomfort for the patient? a. Administering morphine sulfate subcutaneously every 4 to 6 hours as needed b. Maintaining NPO status for the patient with IV fluids c. Providing small frequent feedings, with no concentrated sweets d. Placing the client in a semi-Fowler's position at 30 degrees elevation

b

A patient is admitted with an abrupt onset of jaundice, nausea, and abnormal liver function studies. Serologic testing is negative for viral causes of hepatitis. Which question by the nurse is most appropriate? a. "Is there any history of IV drug use?" b. "Are you taking corticosteroids for any reason?" c. "Do you use any over-the-counter (OTC) drugs?" d. "Have you recently traveled to a foreign country?"

c

Laboratory findings that the nurse would expect in the patient with persistent vomiting include A. decreased pH, increased sodium decreased hematocrit B. increased pH, decreased chloride, decreased hematocrit C. increased pH, decreased potassium, increased hematocrit D. decreased pH, decreased potassium increased hematocrit

c

The RN teaches the patient with diverticulosis to: A. use anticholinergic drugs routinely to prevent bowel spasms B. have and annual colonoscopy to detect malignant changes in the lesions C. maintain a high-fiber diet and use bulk laxatives to increase fecal volume D. exclude whole grain breads and cereals from the diet to prevent irritating the bowel

c

The nurse is caring for an anorexic patient who is severely malnourished. A nasogastric feeding tube is inserted and tube feedings are started. Which laboratory finding is the best indication that the patient's nutritional status is improving? a. The client's sodium has risen from 130 to 144 mg/dL. b. The client's creatinine has dropped from 1.9 to 0.5 mg/dL. c. The client's prealbumin level has risen from 9 to 13 mg/dL. d. The client's blood urea nitrogen (BUN) level has dropped from 15 to 11 mg/dL.

c

The nurse is monitoring a client admitted to the hospital with a diagnosis of appendicitis who is scheduled for surgery in 12 hours. The client begins to c/o increased abdominal pain, and begins to vomit. On assessment the abdomen is distended and bowel sounds are diminished. What is the priority nursing intervention? a. Administer the prescribed pain medication b. Call and ask the operating room team to perform the surgery as soon as possible c. Notify the health care provider d. Reposition the client and apply a heating pad to abdomen

c

The nurse is providing discharge teaching for a patient who will be receiving pancreatic enzyme replacement at home. Which statement by the patient indicates that additional teaching is needed? a. "I will mix the enzyme powder in water or fruit juice." b. "I will wipe my lips carefully after I drink the enzyme preparation." c. "I will take the enzymes immediately after I have a meal or a snack." d. "I will not mix the enzyme powder with food or liquids that contain protein."

c

A client has undergone a endoscopy. The nurse should place the highest priority on which item as part of the client's care plan? a. Monitoring the temperature b. Monitoring complaints of pain c. Giving warm compresses to rectum d. Assessing for return of gag reflex

d

A client is receiving parenteral nutrition. The nurse monitors for complications of the therapy and should assess the client for which manifestations of hyperglycemia? A. Fever, weak pulse, and thirst B. Nausea, vomiting, and oliguria C. Sweating, chills, and abdominal pain D. Weakness, thirst, and increased urine output

d

Following a Billroth II procedure, a patient develops dumping syndrome. The nurse explains that the symptoms associated with this problem are caused by A. distention of the smaller stomach by too much food and fluid intake B. hyperglycemia caused by uncontrolled emptying into the small intestine C. irritation of the stomach lining by reflux of bile salts because the pylorus has been removed D. movement of fluid into the small bowel because of concentrated food and fluids move rapidly into the intestine

d

The nurse is caring for a patient who has received multiple serious injuries in a motor vehicle accident. The patient asks the nurse why ranitidine (Zantac) is prescribed because she does not have any abdominal pain. Which is the nurse's best response? a. "Zantac will help prevent nausea and vomiting from the narcotic pain medications that you are taking." b. "Zantac will help prevent aspiration pneumonia when you are anesthetized during surgery tomorrow." c. "Zantac will help your throat heal after it was irritated from the nasogastric tube." d. "Zantac will help prevent the development of a stomach ulcer from the stress of your injuries."

d

The nurse is caring for a patient with liver failure. Which nursing action is a high priority for this client? a. Auscultation for bowel sounds b. Assessing for deep vein thrombosis c. Monitoring blood pressure hourly d. Assessing for signs of bleeding

d