GI

What should the nurse avoid contamination from to prevent the transmission of hepatitis A? 1.food or water 2. neeles 3. blood transfusion 4. sexual contact

1.

Why is morphine contradicted in the patient with pancreatitis? 1. these patients do not experience pain 2. tylenol is more effective at managing this type of pain 3. morphine may cause spasms of the sphincter of Oddi 4. Demerol(meperidine) is the less expensive

3.

The nurse is reinforcing discharge instructions to a client after a billroth II(gastrojejunostomy) procedure. During review of the postoperative prescription, which should the nurse clarify? 1. irrigating the NG tube 2. coughing and deep breathing exercises 3. early ambulation 4. leg exercises

1.

How does the administration of neomycin (mycifradin) reduce the production of ammonia? 1. by helping to digest fats and proteins 2. by decreasing the bacteria in the gut 3. by reducing ascites 4. by assisting the hepatic cells to regenerate

2.

The nurse caring for a patient who had an open cholecystectomy with a T-Tube will: 1. irrigate the T-tube with normal saline to ensure the free flow of bile. 2. position and secure the drainage bag at the chest level 3. open the T-Tube to air so that it will drain freely 4. place the collection bag so the tube is not kinked

2.

The nurse would make provisions in the plan of care for a person who has a liver transplant to prevent: 1. urinary retention 2. fatigue 3. infection 4. fluid congestion

3.

The home health nurse caring for a patient who has dysarthria to radiation therapy for an oral cancer would recommend that the family provide: 1. a walkie -talkie 2. a bell to summon help 3. a TV for diversion 4. a tablet and pencil as a communication aid

4.

A nurse caring for a client with a diagnosis of peptic ulcer is monitoring the client for signs of perforation. Which findings would cause the nurse to suspectperforation? Select all that apply. 1. Sudden sharp pain in the midepigastrium 2. Abdominal rigidity 3. A sudden bout of diarrhea 4. Projectile vomiting of bile 5. Bradycardia

1,2

Hepatitis A vaccine is prescribed for a client who is planning a trip out of the country. The nurse reinforces which information to the client? 1. A booster dose is needed 6 to 12 months after the initial injection 2. The vaccine contains the active virus of Hep A 3. The vaccine is available in an oral form 4. The vaccine protects against Hep A and B

1.

The nurse anticipates that the patient who has had a subtotal gastrectomy will need supplemental : 1. vitamin B12 due to the loss of the intrinsic factor 2. protein due to the loss of some of the digestive process 3. bulk to prevent constipation 4. itamin A due to the loss of the gastric lining

1.

The nurse is caring for a client with a diagnosis of chronic gastritis. The e nurse anticipate that the client is at risk for which vitamin deficiency? 1. vitamin B12 2. Vitamin K 3. vitamin E 4. vitamin C

1.

The nurse is reviewing the primary health care provider's (PHCP's) prescriptions written for a client admitted with acute pancreatitis. Which PHCP prescription should the nurse verify if noted in the client's chart? 1. position the client supine and flat 2. prepare to insert a nasogastric tube 3. an anticholinergic medication 4. NPO status

1.

The patient as come to the PACU following an ileostomy for the treatment of ulcerative colitis. The patient is conscious and has a nasogastric tube in place and a pouch over the stoma. Which should be the nurse's initial action? 1. attach NG tube to suction 2. irrigate NG tube 3. give patient ice chips to moisten mouth 4. turn patient to right side

1.

The patient with a peptic ulcer has been placed on regular doses of bismuth salicylate( Peto-Bismol) to combat Helicobacter pylori. What color will this drug turn the stool? 1. gray-black 2. dark green 3. Yellow 4. red-orange

1.

The nurse is monitoring a client for early signs and symptoms of dumping syndrome. Which indicates this occurrence? 1. Bradycardia and indigestion 2. sweating and palor 3. double vision and chest pain 4. dry skin and stomach pain

2

The patient with cirrhosis has an albumin of 2.5g/dL The nurse is aware that normal is 3.5 to 5 g/dL. Based on theses findings what would the nurse expect the patient to exhibit? 1. copious urine output 2. edema 3. pallor 4. jaundice

2

A patient was scheduled for a laparoscopic cholecystectomy, but complications developed and he underwent an open cholecystectomy with T-tube inserted into the common bile duct. What is the purpose of the T-tube? 1. to decompress the duct and relieve pain caused by stimulation of the sphincter of Oddi 2. to keep the duct open and allow drainage of the bile duct until edema resolves 3. to improve diaphragmatic expansion and prevention of atelectasis 4. to shorten postoperative recovery and hasten the healing process

2.

A patient with a large inguinal hernia has abdominal distention and inguinal pain. The nurse recognizes these indicators of which type of hernia 1. strangulated 2. Hiatal 3. umbilical 4. ventral

2.

Dumping syndrome after a Billroth II procedure occurs when high-carbohydrate foods are ingested over a period of less than 20 minutes. What would the nurse suggest to reduce the risk of dumping syndrome? 1. Drinking 10 oz of fluids with meals 2. Eating six small daily meals high in protein and fat 3. Remaining upright for 2 hours after meals 4. Eating a high-carbohydrate diet

2.

It has been determined that a client with hepatitis has contracted the infection from contaminated food. Which type of hepatitis in the client most likely experiencing? 1. hepatitis B 2. hepatitis A 3. hepatitis D 4. hepatitis C

2.

The nurse clarifies that the end product of carbohydrate metabolism is absorbed and put into the bloodstream by the: 1. excretion from the cecum 2. bile of the liver in the large intestine. 3. villi of the small intestine. 4. gastric lining of the stomach

2.

The nurse clarifies that unconjugated bilirubin, which is made of broken -down red cells, is? 1. stored in the gallbladder to make bile 2. water--insoluble bilirubin that must be converted by the liver 3. a by-product which is excreted directly into the bowel for excretion 4. necessary for digestion of fats

2.

The nurse is preparing to perform an abdominal examination. Which step should be taken first? 1. percussion 2. inspection 3. palpation 4. auscultation

2.

What should the nurse include in a teaching plan for a patient with a hiatal hernia to reduce the frequency of heartburn? 1. drinking 10 oz of milk with every meal 2. eating small meals 3. lie down after eating 4. panting through mouth when symptoms begin

2.

Which recommendation is most appropriate for a patient who has had an esophageal dilation related to achalasia? 1. lie down for 30 minutes after each meal 2. drink 10oz of fluid with each meal 3. avoid fruit juices 4. consume only liquids

2.

A nurse is preparing to care for a client who just returned from the recovery room after a Billroth II procedure. Which intervention in the plan of care does the nurse question? 1. Maintain NPO status until the bowel sounds return 2. Reposition the NG tube if drainage ceases 3. Encourage coughing and deep-breathing exercises every hour 4. Perform active ROM exercised every 4 hours

2

The client has an as needed prescription for ondansetron. For which condition should the nurse administer this medication? 1. paralytic ileus 2. nausea and vomiting 3. incisional pain 4. urinary retention

2

What should the nurse expect of a patient with a malabsorption of vitamin K? 1. lowered hemoglobin 2. elevated hematocrit 3. increased prothrombin time 4. diminished white blood cell count

3

A client with Crohns's disease is scheduled to receive infusion of influximab. The nurse assisting with caring for the client should take which action to monitor the effectiveness of the treatment.? 1. carrying out a hematest on gastric fluids after the infusion is completed 2. checking serum liver enzymes levels before and after the infusion 3. checking the frequency and consistency of bowel movements 4. monitoring the leukocyte count for 2 days after the infusion

3.

A client with a peptic ulcer is diagnosed with a Helicobactor pylori infection. The nurse is reinforcing teaching for the client about the medications prescribed including 1. " these medications are only taken when I have pain from my ulcer" 2. " my ulcer will heal because these medications will kill the bacteria" 3. "the medications will kill the bacteria and stop the acid production"

3.

Because bowel contents from an ileostomy are virtually liquid, what should the nurse include in the plan of care? 1. Evaluation and assessment of the adequacy of the collection device 2. Evaluation and assessment of patient cleanliness 3. Evaluation and assessment of peristomal skin integrity 4. Evaluation and assessment of dietary intake of fiber

3.

Dumping syndrome after a Billroth II procedure occurs when high-carbohydrate foods are ingested over a period of less than 20 minutes. What would the nurse suggest to reduce the risk of dumping syndrome? 1.Eating a high-carbohydrate diet 2. Drinking 10 oz of fluids with meals 3. Eating six small daily meals high in protein and fat 4. Remaining upright for 2 hours after meals

3.

The nurse is monitoring for stoma prolapse in a client with a colostomy. Which stoma observation should indicate that a prolapse has occurred? 1. narrowed and flattened 2. sunken and hidden 3. protruding and swollen 4. dark and bluish

3.

The nurse is reinforcing teaching to a client about an upcoming colonoscopy procedure. The nurse should include the instructions that the client will be placed in which position for the procedure? 1. right sims position 2. lithotomy 3. left sims position 4. knee-chest position

3.

The nurse reinforces postoperative liver biopsy instructions to a client. Which should the nurse tell the client? 1. avoid alcohol for 8 hours 2. remain NPO for 24 hours 3. lie on the right side for 2 hours 4. save all tools to be checked for blood

3.

The client with gastric ulcer has a prescription for sucrate 1 gm by mouth four times daily. The nurse should schedule the medication to be administered at which times? 1. with meals and at bedtime 2. one hour after meals and at bedtime 3. every 6 hours around the clock 4. one hour before meals and at bedtime

4.

An older client has recently been taking cimetide. The nurse should monitor the client for which most frequent central nervous system side effect of the medication? 1. hallucination 2. dizziness 3. tremors 4. confusion

4

The nurse is reinforcing discharge instructions to a client after a gastrectomy. Which measure should the nurse include during client teaching to help prevent dumping syndrome? 1. eat high carbohydrate foods 2. ambulate after a meal 3. sit in a high fowler's position during meals 4. limit fluids taken with meals

4

A client with ascites is scheduled for a paracentesis. The nurse is assisting the primary health care provider(PHCP) with performing the procedure. Which position should the nurse assist the client into for this procedure? 1. right-side 2. flat 3. left- side lying 4. upright

4.

A patient who is being evaluated for episodes of hematemesis and dyspepsia tells the nurse that pain occurs when he eats, but pain does not waken him. The nurse recognizes a diagnostic sign of which condition? 1. Achalasia 2. Duodenal ulcer 3. Gastritis 4. Peptic ulcer

4.

An ultrasound of the gallbladder is scheduled for the client with a suspected diagnosis of cholecystitis. Which should the nurse explain to the client about the test? 1. the test requires that the client be NPO 2. the test is preceded by the administration of oral tablets the 3. test is uncomfortable 4. the test requires the client to be still for short intervals

4.

In caring for a patient with gastric bleeding who has a nasogastric tube in place, the nurse should include in the plan of care to ensure that the NG tube is: 1. changed every 72 hours 2. clamped for 10 minutes every hour 3. frequently repositioned to the opposite nostril 4. kept patent with irrigation

4.

The client has been taking omeprazole for 4 weeks. The nurse evaluates that the client is receiving the optimal intended effect of the medication if the client reports the absence of which symptoms? 1. constipation 2. diarrhea 3. flatulence 4. heartburn

4.

The home health nurse evaluates a patient being treated for a peptic ulcer with Riopan (antacid) and famotidine (histamine receptor blocker). Which statement made by the patient indicates a need for further instruction? 1. Itake the Riopan at least 2 hours after any of my other drugs." 2. "I know famotidine will not interfere with my Coumadin." 3. "Boy! That Riopan keeps my stomach happy!" 4. "I take both those meds at the same time every morning."

4.

The nurse clarifies that the end product of carbohydrate metabolism is absorbed and put into the bloodstream by the: 1. Bile of the liver in the large intestine 2. Gastric Lining of the stomach 3. Excretion from the cecum 4. Villi of the small intestine

4.

The patient with cirrhosis has a rising ammonia level and is becoming disoriented. The patient waves to the nurse as she enters the room, How should the nurse interpret this? 1. as spasticity 2. as an attempt to get the nurse's attention 3. as indication of respiratory obstruction from varices 4. as asterixis

4.

The patient with cirrhosis has a rising ammonia level and is becoming disoriented. The patient waves to the nurse as she enters the room. How should the nurse interpet this? 1. as an indication of respiratory obstruction from varices 2. as an attempt to get the nurse's attention 3. as spasticity 4. an asterixis

4.

What is an essential measure to prevent injury to the patient who is to receive a paracentesis? 1. pad side rails 2. make the patient sign a permit 3. check for allergy to contrast media or to shellfish 4. have the patient void immediately before procedure

4.

What should the nurse point out as a significant advantage of the laparoscopic cholecystectomy 1. can be performed even when there are large stones in the bile duct 2. can be performed all patients of any age 3. slightly more invasive, but there is less pain 4. less invasive procedure

4.

Which is the most appropriate method used by high-risk health workers to prevent hepatitis B? 1. wear protective gear 2. Hb immune globulin injections 3. diligent hand washing 4. hepatitis B vaccine

4.