GI
A client who is about to have a blood transfusion asks the nurse, "Which type of hepatitis is most frequently transmitted by transfusions?" The nurse should respond, "Although the risk is minimal, the type of hepatitis associated with blood transfusions is hepatitis: 1.A 2.B 3.C 4.D
3.C
After a bilateral inguinal hernia repair (herniorrhaphy) the nurse should assess the client for the development of: 1.Hydrocele 2.Paralytic ileus 3.Urinary retention 4.Thrombophlebitis
3.Urinary retention
To help prevent long-term complications associated with gastric bypass surgery, the nurse needs to educate the client. Identify the factors that should be included in the nurse's teaching plan for this client. (Select all that apply.) 1.Eat foods rich in calcium. 2.Ingest three small feedings daily. 3.Limit fluids to 1500 mL daily. 4.Consume a diet high in protein. 5.Receive vitamin B12 injections routinely
1.Eat foods rich in calcium. 4.Consume a diet high in protein. 5.Receive vitamin B12 injections routinely
Thiamine (vitamin B1) and niacin (vitamin B3) are prescribed for a client with alcoholism. Which body function maintained by these vitamins should the nurse include in a teaching plan? 1.Neuronal activity 2.Bowel elimination 3.Efficient circulation 4.Prothrombin development
1.Neuronal activity
A client is admitted to the hospital with a diagnosis of acute salmonellosis. What does the nurse expect the health care provider to prescribe? 1.Cathartics 2.Electrolytes 3.Antidiarrheals 4.Antispasmodics
2.Electrolytes
A nurse is obtaining a history and performing a physical assessment of a client who has cancer of the tongue. Which clinical findings should the nurse expect to identify? (Select all that apply.) 1.Halitosis 2.Leukoplakia 3.Bleeding gums 4.Substernal pain 5.Alterations in taste 6.Enlarged cervical lymph nodes
2.Leukoplakia 5.Alterations in taste 6.Enlarged cervical lymph nodes
On the third postoperative day after a subtotal gastrectomy, a client complains of severe abdominal pain. The nurse palpates the client's abdomen and identifies rigidity. What action should the nurse take? 1 Assist the client to ambulate 2.Obtain the client's vital signs 3.Administer the prescribed analgesic 4.Encourage the use of spirometry
2.Obtain the client's vital signs
A client appears depressed since the surgical creation of a colostomy five days ago. The nurse determines that there is some movement toward adaptation to the change in body image when the client: 1.Discusses the necessity of the colostomy 2.Requests the nurse to change the dressing 3.Looks at the face of the nurse during care 4.Stares at the stoma during dressing changes
4.Stares at the stoma during dressing changes
When comparing ulcerative colitis and Crohn's disease, a nurse considers that they are similar yet dissimilar in many ways. What clinical manifestation is common to clients with Crohn's disease and not to clients with ulcerative colitis? 1.Diarrhea 2.Weight loss 3.Right lower quadrant pain 4.Decreased hematocrit
3.Right lower quadrant pain
A client is admitted for repair of bilateral inguinal hernias. Before surgery the nurse assesses the client for signs that strangulation of the intestine may have occurred. What is an early sign of strangulation? 1.Increased flatus 2.Projectile vomiting 3.Sharp abdominal pain 4.Decreased bowel sounds
3.Sharp abdominal pain
A low-residue diet is recommended for a client. Which food should the nurse encourage the client to select from a menu? 1.Steamed broccoli 2.Creamed potatoes 3.Raw spinach salad 4.Baked sweet potato
2.Creamed potatoes
An 85-year-old client has a three-day history of nausea, vomiting, and diarrhea. The client develops weakness and confusion and is admitted to the hospital. To best monitor the client's rehydration status, the nurse should assess the client's: 1.Skin turgor 2.Daily weight 3.Urinary output 4.Mucous membranes
2.Daily weight
After many years of coping with colitis, a client makes the decision to have a colectomy as advised by the health care provider. Which is most likely the significant factor that impacted on the client's decision? 1.It is temporary until the colon heals. 2.Surgical treatment cures ulcerative colitis. 3.Ulcerative colitis can progress to Crohn's disease. 4.Without surgery, eating table foods is contraindicated
2.Surgical treatment cures ulcerative colitis.
A nurse is caring for a client who had surgery for cancer of the pancreas. Which nutrients are most influenced by the effects of this surgery? 1.Proteins and grains 2.Vitamins and minerals 3.Fluids and electrolytes 4.Fats and carbohydrates
4.Fats and carbohydrates
A client had a colon resection and formation of a colostomy two days ago. What color does the nurse expect the stoma to be when assessing its viability? 1.Pink 2.Gray 3.Brick red 4.Dark purple
3.Brick red
A nurse is caring for a client with chronic inflammation of the bowel. What is the most serious complication associated with this condition? 1.Ileus 2.Bleeding 3.Perforation 4.Obstruction
3.Perforation
A client with Laënnec cirrhosis has ascites and jaundice and is confused. What is the nursing priority when caring for this client? 1.Correcting nutritional deficiencies 2.Measuring abdominal girth every day 3.Providing for the client's physical safety 4.Placing the client in the high-Fowler position
3.Providing for the client's physical safety
A client with cholelithiasis has a laser laparoscopic cholecystectomy. Postoperatively it is most appropriate for the nurse to: 1.Maintain the client's nothing by moth status for the first 24 hours 2.Monitor the client's abdominal incision for bleeding 3.Offer clear carbonated beverages to the client 4.Ambulate the client when the client is alert and oriented
4.Ambulate the client when the client is alert and oriented
For which clinical indicator associated with a complication of portal hypertension should the nurse assess the client? 1.Liver abscess 2.Intestinal obstruction 3.Perforation of the duodenum 4.Hemorrhage from esophageal varices
4.Hemorrhage from esophageal varices
A client is experiencing chronic constipation and the nurse discusses how to include more bulk in the diet. The nurse concludes that learning has occurred when the client states, "Bulk in the diet promotes defecation by: 1.Irritating the bowel wall." 2.Stimulating the intestinal mucosa chemically." 3.Acting on the microorganisms in the large intestine." 4.Stretching intestinal smooth muscle, which causes it to contract."
4.Stretching intestinal smooth muscle, which causes it to contract."
An older adult is hospitalized for weight loss and dehydration because of nutritional deficits. What should the nurse consider when caring for this client? 1.Financial resources usually are unrelated to nutritional status. 2.An older adult's daily fluid intake must be markedly increased. 3.The client's diet should be high in carbohydrates and low in proteins. 4.The nutritional needs of an older adult are unchanged except for a decreased need for calories
4.The nutritional needs of an older adult are unchanged except for a decreased need for calories
What therapeutic effect should the nurse identify as the reason for administration of neomycin sulfate to a client before colon surgery? 1.Destroy intestinal bacteria. 2.Increase production of vitamin K. 3.Decrease the incidence of any secondary infection. 4.Prevent the possibility of postoperative urinary tract infection
1.Destroy intestinal bacteria.
A client was recently diagnosed with a cancerous lesion of the mouth. What should the nurse ask when analyzing the client's need for health education in relation to this health problem? 1."Are you having difficulty sleeping?" 2."Do feel like your gums are inflamed?" 3."How frequently are you seeing the dentist?" 4."Have you noticed any change in your appetite?"
4."Have you noticed any change in your appetite?"
A client with a high cholesterol level says to the nurse, "Why can't the doctor just give me a medication to eliminate all the cholesterol in my body so it isn't a problem?" Which factor related to why cholesterol is important in the human body should the nurse include in a response to the client's question? 1.Blood clotting 2.Bone formation 3.Muscle contraction 4.Cellular membranes
4.Cellular membranes
Which food selections by a client with malabsorption syndrome indicate that the nurse's dietary teaching was successful? (Select all that apply.) 1.Green beans 2.Baked potato 3.Noodle pudding 4.Turkey sandwich 5.Whole wheat cereal
1.Green beans 2.Baked potato
A client who has been caring for a colostomy on the left side of the abdomen for several years is admitted to the hospital for an unrelated health problem. What type of stool should the nurse expect? 1.Pencil-shaped 2.Mucus-coated 3.Loose and liquid 4.Moist and formed
4.Moist and formed
A client with Crohn's disease is admitted to the hospital with a history of chronic, bloody diarrhea, weight loss, and signs of general malnutrition. The client has anemia, a low serum albumin level, and signs of negative nitrogen balance. The nurse concludes that the client's health status is related to a major deficiency of: 1.Iron 2.Protein 3.Vitamin C 4.Linoleic acid
2.Protein
A nurse is assessing a client for dehydration, The client has had diarrhea and vomiting for 48 hours. What are indicators of dehydration? (Select all that apply.) 1.Headache 2.Protruding eyeballs 3.The client reporting drinking an average of two glasses of water daily 4.The skin on the client's forehead remains tented after being pinched 5.Within four days, the client lost two pounds of weight
1.Headache 4.The skin on the client's forehead remains tented after being pinched
Following surgery, a client asks the nurse if he or she can help measure intake and output. What is the best nursing response? 1.Determine the client's willingness to really help 2.Identify the client's reason for wanting to do this task 3.Assess the client's ability to measure the intake and output 4.Explain that measuring intake and output is the responsibility of the nurse
3.Assess the client's ability to measure the intake and output
A nurse is caring for a client who just had a gastrectomy. What should the nurse emphasize when teaching the client how to avoid dumping syndrome? 1.Increase activity after eating 2.Drink at least two to three glasses of fluid with each meal 3.Eat small meals with low carbohydrate and moderate fat content 4.Sit in a high-Fowler position for 30 minutes after eating
3.Eat small meals with low carbohydrate and moderate fat content
A client is being prepared for surgery to have placement of a percutaneous endoscopic gastrostomy (PEG) tube. The client asks why the PEG tube is preferred over the existing nasogastric tube that is being used for feedings. The nurse explains that a PEG tube is preferred for administering a tube feeding because: 1.There is less chance of aspiration 2.This procedure does not require a pump 3.Self-administration of the feeding is possible 4.More tube feeding mixture can be given each time
1.There is less chance of aspiration
A client is diagnosed with sprue (adult celiac disease). What should the nurse teach the client to avoid when providing dietary teaching? (Select all that apply.) 1.Meat 2.Oranges 3.Oatmeal 4.Spaghetti 5.Tomatoes
3.Oatmeal 4.Spaghetti
A nurse is preparing to administer a nasogastric tube feeding. List the steps of the procedure in the order in which they should be performed. 1.Verify the solution to be administered 2.Wash the hands. 3.Instill the prescribed solution. 4.Document the client's response to the procedure 5.Aspirate the contents of the stomach.
1.Wash the hands. 2.Verify the solution to be administered. 3.Aspirate the contents of the stomach. 4.Instill the prescribed solution. 5.Document the client's response to the procedure
The menu for a client with malabsorption syndrome must be limited because of a sensitivity to gluten. Which foods cannot be served to this client? (Select all that apply.) 1.Cheese omelet 2.Creamed spinach 3.Roast beef sandwich 4.Chicken noodle soup 5.Spaghetti and meatballs
3.Roast beef sandwich 4.Chicken noodle soup 5.Spaghetti and meatballs
A nurse is assessing two clients. One client has ulcerative colitis and the other client has Crohn's disease. Which is more likely to be identified in the client with ulcerative colitis than the client with Crohn's disease? 1.Inclusion of transmural involvement of the small bowel wall 2.Correlation with increased malignancy because of malabsorption syndrome 3.Pathology beginning proximally with intermittent plaques found along the colon 4.Involvement starting distally with rectal bleeding that spreads continuously up the colon
4.Involvement starting distally with rectal bleeding that spreads continuously up the colon
A client with advanced bone cancer is experiencing cachexia. The nurse discusses the nutritional aspect of palliative care with the family. Why is it important to explain these nutritional interventions to the family? 1.Enhance the quality of the client's life 2.Reduce the likelihood of a respiratory infection 3.Prevent the malabsorption syndrome from occurring 4.Decrease the consequences of impaired glucose metabolism
1.Enhance the quality of the client's life
A nurse is caring for a client with a hiatal hernia. Which risk factor is associated most commonly with this diagnosis? 1.Obesity 2.Alcoholism 3.Chronic bronchitis 4.Esophageal varices
1.Obesity
A client who recently had an abdominoperineal resection and colostomy accuses the nurse of being uncomfortable during a dressing change because the "wound looks terrible." Which defense mechanism does the nurse conclude the client is using as a form of self-protection? 1.Projection 2.Sublimation 3.Intellectualization 4.Reaction formation
1.Projection
A client is admitted with dehydration. Which findings should the nurse expect the client to exhibit? (Select all that apply.) 1.Rapid, thready pulse 2.Increased skin turgor 3.Decreased hematocrit 4.Elevated specific gravity 5.Adventitious breath sounds
1.Rapid, thready pulse 4.Elevated specific gravity
A client has a new colostomy. The nurse has provided teaching related to when the client should irrigate the colostomy. Which client statement indicates correct understanding of the teaching? 1."After it gets done healing in a few weeks, I will begin irrigating it just before going to bed each day." 2."It will need to be irrigated each morning before I can eat any food." 3."I plan to irrigate it in the late morning, the same time I had a bowel movement every day before I had my surgery." 4."I can wait to start irrigating it until after I have gotten used to this bag and change in lifestyle."
3."I plan to irrigate it in the late morning, the same time I had a bowel movement every day before I had my surgery."
A client has a suspected peptic ulcer in the duodenum. What should the nurse expect the client to report when describing the pain associated with this disease? 1.An ache radiating to the left side 2.An intermittent colicky flank pain 3.A gnawing sensation relieved by food 4.A generalized abdominal pain intensified by moving
3.A gnawing sensation relieved by food
An obese client with a hiatal hernia asks the nurse how to prevent esophageal reflux. What is the nurse's best response? 1."Lie down after eating." 2."Eat less food at each meal." 3."Increase your intake of fat." 4."Drink more fluid with each meal."
2."Eat less food at each meal."
A client who was admitted with severe abdominal pain and vomiting states, "I know I am very sick. Do you think I have cancer?" What is the best response by the nurse? 1."You must be upset to think that you have cancer." 2."Did you receive information about what therapy will be prescribed?" 3."Your primary health care provider will need to talk with you about that." 4."What are your feelings about the diagnosis of cancer?"
4."What are your feelings about the diagnosis of cancer?"
Which statement by a client who is scheduled for bariatric surgery indicates to the nurse that further preoperative teaching is necessary? 1."I need to eat more high protein foods." 2."I'm going to have a figure like a model in about a year." 3."I'm going to be out of bed and sitting in a chair the first day after surgery." 4."I will be limiting my intake to 600 to 800 calories a day once I start eating again."
2."I'm going to have a figure like a model in about a year."
Six hours after major abdominal surgery, a client complains of severe abdominal pain and feeling faint. The nurse identifies a thready, rapid pulse. The nurse checks the Physiological Aspects of Care record and determines that the client can receive another injection of pain medication in an hour. What is the most appropriate action by the nurse? 1.Explain to the client that it is too early to have an injection for pain. 2.Call the health care provider and report the client's symptoms. 3.Reposition the client for greater comfort and turn on the television as a distraction. 4.Prepare the injection and administer it to the client early because of the severe pain
2.Call the health care provider and report the client's symptoms.
A nurse is teaching a client about prophylactic measures that minimize the risk of contracting hepatitis B. Which actions should be included in this teaching plan? (Select all that apply.) 1.Preventing constipation 2.Screening of blood donors 3.Avoiding shellfish in the diet 4.Limiting hepatotoxic drug therapy 5.Maintaining a monogamous sexual relationship
2.Screening of blood donors 5.Maintaining a monogamous sexual relationship
A health care provider prescribes an upper gastrointestinal (GI) series and a barium enema. The client asks, "Why do I have to have barium for these tests?" The nurse's best response is "Barium: 1.Gives off visible light, illuminating the alimentary tract." 2.Provides fluorescence, thereby lighting up the alimentary tract." 3.Dyes the structures of the alimentary tract, making them more visible." 4.Gives more contrast to the soft tissue of the alimentary tract, allowing absorption of x-rays."
4.Gives more contrast to the soft tissue of the alimentary tract, allowing absorption of x-rays."