GI/Biliary

Which instructions should the nurse include when providing discharge teaching to a client with peptic ulcer disease due to Helicobacter pylori infection? (Select all that apply.) 1) "Avoid foods that may cause epigastric distress such as spicy or acidic foods" 2) "It is best if you refrain from consuming alcohol products" 3) "Report black tarry stools to your health care provider immediately" 4) "Take your amoxicillin, clarithromycin, and omeprazole for the next 14 days" 5) "You may take over-the-counter drugs such as aspirin if you have mild epigastric pain"

1) "Avoid foods that may cause epigastric distress such as spicy or acidic foods" 2) "It is best if you refrain from consuming alcohol products" 3) "Report black tarry stools to your health care provider immediately" 4) "Take your amoxicillin, clarithromycin, and omeprazole for the next 14 days"

Which statement made by the client demonstrates a correct understanding of the home care of an ascending colostomy? 1) "I will avoid eating foods such as broccoli and cauliflower" 2) "I will empty the pouch when it is one-half full of stool" 3) "I will irrigate the colostomy to promote regular bowel movements" 4) "I will restrict my fluid intake to 2,000 milliliters of fluid a day"

1) "I will avoid eating foods such as broccoli and cauliflower"

1. A client is 1-day postoperative abdominoplasty and is discharged to go home with a Jackson-Pratt (JP) closed-wound system drain in place. The nurse teaches the client how to care for the drain and empty the collection bulb. Which statement indicates that the client needs further instruction? 1) "I'll empty the JP bulb when it is totally full so that I don't have to unplug it so many times" 2) "I'll pull the plug on the JP bulb and pour the drainage into the measurable specimen cup" 3) "I'll squeeze the JP bulb from side-to-side as I hold it in my hand" 4) "While the JP bulb is totally compressed, I'll clean the spout with alcohol and replace the plug"

1) "I'll empty the JP bulb when it is totally full so that I don't have to unplug it so many times"

A healthy 50-year-old client asks the nurse, "What must I do in preparation for my screening colonoscopy?" Which statements by the nurse correctly answer the client's question? Select all that apply. 1) "No food or drink is allowed 8 hours prior to the test" 2) "Prophylactic antibiotics are taken as prescribed" 3) "Smoking must be avoided after midnight" 4) "The day prior to the procedure your diet will be clear liquids" 5) "You will drink polyethylene glycol as directed the day before"

1) "No food or drink is allowed 8 hours prior to the test" 4) "The day prior to the procedure your diet will be clear liquids" 5) "You will drink polyethylene glycol as directed the day before"

1. During the admission assessment of a client with a small-bowel obstruction, the nurse anticipates which clinical manifestations? Select all that apply. 1) Abdominal distention 2) Absolute constipation 3) Colicky abdominal pain 4) Frequent vomiting 5) Pain during defecation

1) Abdominal distention 3) Colicky abdominal pain 4) Frequent vomiting

The nurse who is caring for a client with acute diverticulitis will immediately report which finding to the health care provider? 1) Abdominal pain has progressed to the left upper quadrant 2) Hemoglobin of 11.2 g/dL (112 g/L) 3) Lying on side with knees drawn up to abdomen and truck flexed 4) White blood cell

1) Abdominal pain has progressed to the left upper quadrant

The post-anesthesia care unit nurse receives report on a client after abdominal surgery. What sounds would the nurse expect to hear when auscultating the bowel? 1) Absent bowel sounds 2) Borborygmi sounds 3) High-pitched and gurgling sounds 4) Swishing or buzzing sounds

1) Absent bowel sounds

A client with ulcerative colitis (UC) reports abdominal pain, 10 bloody stools per day, and decreased appetite. The client states, "What's the point of taking medication? It doesn't help anyway." Which nursing diagnoses (NDs) are appropriate to include in the client's plan of care? Select all that apply. 1) Acute pain 2) Altered nutritional status 3) Hopelessness 4) Noncompliance 5) Risk for deficient fluid volume

1) Acute pain 2) Altered nutritional status 3) Hopelessness 5) Risk for deficient fluid volume

The nurse is caring for a client who has a postoperative paralytic ileus following a bowel resection for colon cancer. The client is receiving patient-controlled analgesia (PCA) with morphine. Which nursing diagnoses (NDs) are appropriate to include in the client's care plan? Select all that apply. 1) Acute pain 2) Dysfunctional gastric motility 3) Imbalanced nutrition, less than body requirements 4) Ineffective self-health management 5) Risk for infection

1) Acute pain 2) Dysfunctional gastric motility 3) Imbalanced nutrition, less than body requirements 5) Risk for infection

1. Which of the following nursing interventions would the nurse implement when caring for a client newly diagnosed with acute viral hepatitis? Select all that apply. 1) Administer antiemetic medication as needed 2) Encourage a good breakfast and small, frequent meals 3) Promote rest periods alternating with periods of activity 4) Provide a diet high in protein and low in fat 5) Teach the client to abstain from alcohol

1) Administer antiemetic medication as needed 2) Encourage a good breakfast and small, frequent meals 3) Promote rest periods alternating with periods of activity 5) Teach the client to abstain from alcohol

1. Which interventions would the nurse expect to be included in the care plan for a client with acute diverticulitis who has acute pain rated 8/10, nausea and vomiting, blood pressure 126/64 mm Hg, apical pulse 102/min, respirations 20/min, and temperature 101.2 F (38.4 C)? Select all that apply. 1) Administration of morphine sulfate 2 mg via intravenous (IV) push 2) Instruction to avoid straining 3) Maintenance of nothing-by-mouth (NPO) status 4) Placement of an IV line and infusion of normal saline 75mL/hr 5) Protection of the skin from diarrhea by insertion of rectal tube

1) Administration of morphine sulfate 2 mg via intravenous (IV) push 2) Instruction to avoid straining 3) Maintenance of nothing-by-mouth (NPO) status 4) Placement of an IV line and infusion of normal saline 75mL/hr

A client with abdominal pain and vomiting is feeling dizzy and "out of it." The blood pressure is 153/83 mm Hg and pulse is 70/min supine; blood pressure is 119/81 mm Hg and pulse is 90/min sitting. What should the nurse do next? 1) Anticipate administering normal saline intravenous fluids 2) Complete the orthostatic vital signs by having the client stand 3) Document that orthostatic vital signs are "within normal limits" 4) Perform further neurological assessment with tandem walking

1) Anticipate administering normal saline intravenous fluids

A client admitted 3 days ago with upper gastrointestinal bleeding underwent an endoscopic procedure to stop the bleeding. The client is started on a clear liquid diet today. Which foods are appropriate for the nurse to offer the client? Select all that apply. 1) Apple juice 2) Cherry popsicle 3) Chicken bouillon 4) Frozen yogurt 5) Unsweetened tea 6) Vanilla ice cream

1) Apple juice 3) Chicken bouillon 5) Unsweetened tea

A client diagnosed with cirrhosis is experiencing pruritus. Which actions will the nurse take to promote comfort and minimize pruritus? Select all that apply. 1) Apply cool, wet cloths to skin 2) Encourage hot showers 3) Gently apply calamine lotion 4) Promote the use of cotton gloves 5) Request that the client cut nails short

1) Apply cool, wet cloths to skin 3) Gently apply calamine lotion 4) Promote the use of cotton gloves 5) Request that the client cut nails short

1. The nurse is caring for a client with liver cirrhosis who was admitted for cellulitis of the leg. Which assessments would the nurse perform to determine if the client's condition has progressed to hepatic encephalopathy? Select all that apply. 1) Ask is the client knows what day it is 2) Ask the client to extend the arms 3) Assess for telangiectasia (spider nevi) 4) Determine if the conjunctiva is jaundice 5) Note amylase and lipase serum levels

1) Ask is the client knows what day it is 2) Ask the client to extend the arms

During morning rounds, the nurse notices that a client admitted 3 days ago with hepatic encephalopathy is sleepy and confused. The client is scheduled for discharge later today. Which interventions are appropriate for the nurse to implement? Select all that apply. 1) Assess the client's hand movements with the arms extended 2) Compare current mental status findings with those from previous shifts 3) Contact the health care provider to request a blood draw for ammonia level 4) Encourage the client to ambulate in the hallway 5) Hold the client's morning dose of lactulose

1) Assess the client's hand movements with the arms extended 2) Compare current mental status findings with those from previous shifts 3) Contact the health care provider to request a blood draw for ammonia level

Which lifestyle and nutritional strategies can help clients reduce and manage the signs and symptoms of gastroesophageal reflux disease? Select all that apply. 1) Avoid caffeine, chocolate, and peppermint 2) Choose foods that are low in fat 3) Eat 3 meals a day with minimal or no snacking 4) Minimize intake of dairy products 5) Sip water with meals

1) Avoid caffeine, chocolate, and peppermint 2) Choose foods that are low in fat 5) Sip water with meals

The nurse assessing a client with an upper gastrointestinal bleed would expect the client's stool to have which appearance? 1) Black tarry 2) Bright red bloody 3) Light gray "clay-colored" 4) Small, dry, rocky-hard masses

1) Black tarry

The nurse understands that which of these body substances are modes of transmission for hepatitis B? Select all that apply. 1) Blood 2) Feces 3) Semen 4) Urine 5) Vaginal secretions

1) Blood 3) Semen 5) Vaginal secretions

A nurse is precepting a new graduate nurse who is caring for a client with a paralytic ileus and a Salem sump tube attached to continuous suction. The preceptor should intervene when the graduate nurse performs which interventions? Select all that apply. 1) Checks for residual every 4 hours 2) Places client in semi-Fowler's position 3) Plugs the air vent if gastric content refluxes 4) Provides mouth care every 4 hours 5) Turns off suction when auscultating bowel sounds

1) Checks for residual every 4 hours 3) Plugs the air vent if gastric content refluxes

1. A client with diabetes receiving peritoneal dialysis experiences chills and abdominal discomfort. The nurse assesses the client's abdomen by pressing one hand firmly into the abdominal wall. The client experiences pain when the nurse quickly withdraws the hand. The client's most recent blood glucose level is 210 mg/dL (11.65 mmol/L). What is the priority action by the nurse? 1) Collect peritoneal fluid for culture and sensitivity 2) Heat the remaining dialysate fluid and increase the dwell time 3) Place the client in Fowler's position 4) Prepare to administer regular insulin intravenously

1) Collect peritoneal fluid for culture and sensitivity

1. A client with a history of diverticular disease is being discharged after an episode of acute diverticulitis. Which instructions should be included in the discharge teaching plan to reduce the risk of future episodes? Select all that apply. 1) Drink plenty of fluids 2) Exercise regularly 3) Follow a low-residue diet 4) Include whole grains, fruits, and vegetables in the diet 5) Increase intake of red meat

1) Drink plenty of fluids 2) Exercise regularly 4) Include whole grains, fruits, and vegetables in the diet

1. The nurse will implement which nursing actions when caring for a client recently diagnosed with a hiatal hernia? Select all that apply. 1) Elevate the head of the hospital bed 2) Instruct the client to avoid tobacco and caffeine 3) Offer, frequent, low-fat meals 4) Provide a girdle to reduce the hernia 5) Teach the client to avoid lifting or straining

1) Elevate the head of the hospital bed 2) Instruct the client to avoid tobacco and caffeine 3) Offer, frequent, low-fat meals 5) Teach the client to avoid lifting or straining

1. A client with a history of cirrhosis has a new prescription for lactulose 30 mL four times a day. What does the nurse explain to the client about this medication? 1) It will decrease intestinal absorption of ammonia 2) It will facilitate diuresis of excess fluid 3) It will promote renal excretion of bilirubin 4) It will reduce portal pressure contributing to esophageal varices

1) It will decrease intestinal absorption of ammonia

During assessment of a client who had major abdominal surgery a week ago, the nurse notes that the incision has dehisced and evisceration has occurred. The nurse stays with the client while another staff member gets sterile gauze and saline. How should the nurse position the client while waiting to cover the wound? 1) Low Fowler's position with knees bent 2) Prone to prevent further evisceration 3) Side-lying lateral position 4) Supine with head of the bed flat

1) Low Fowler's position with knees bent

The nurse is preparing a client who had a Roux-en-Y gastric bypass (RYGB) for discharge from the hospital. What information should the nurse plan to include related to the prevention of dumping syndrome? 1) Meals should be small and low in carbohydrate content 2) Fluid should be encouraged with each meal 3) Take a multivitamin with iron and calcium supplements daily 4) You will need to take your cobalamin injection monthly

1) Meals should be small and low in carbohydrate content

1. The health care provider (HCP) orders a small bowel follow-through (SBFT) for a client. Which instructions should the nurse include when teaching the client about this test? 1) "After the test, you may notice your stools are tarry black for a few days" 2) "During the test, a series of x-rays will be taken to assess the function of the small bowel" 3) "The HCP will use an endoscope to visualize your small bowel" 4) "Your examination is scheduled for 8:00 AM. Please drink all of the polyethylene glycol by midnight"

2) "During the test, a series of x-rays will be taken to assess the function of the small bowel"

1. A student nurse asks why enteral (tube) feedings, rather than total parenteral nutrition (TPN), are being administered to a client with sepsis and respiratory failure. Which is the best response by the registered nurse? 1) "Enteral feedings have no complications" 2) "Enteral feedings maintain gut integrity and help prevent stress ulcers" 3) "Enteral feedings provide higher calorie content" 4) "Risk of hyperglycemia is lower with enteral feeding than with TPN"

2) "Enteral feedings maintain gut integrity and help prevent stress ulcers"

The registered nurse (RN) is supervising a graduate nurse (GN) providing postoperative teaching for a male client after an inguinal hernia repair. Which statement by the GN would cause the RN to intervene? 1) "Elevate your scrotum and apply an ice bag to reduce swelling" 2) "Practice coughing to clear secretions and prevent pneumonia" 3) "stand up to use the urinal if you have difficulty voiding" 4) "Turn in bed and perform deep breathing every 2 hours"

2) "Practice coughing to clear secretions and prevent pneumonia"

1. The nurse is caring for a client with cirrhosis of the liver. Which blood test values would the nurse typically anticipate to be elevated when reviewing the client's morning laboratory results? Select all that apply. 1) Albumin 2) Ammonia 3) Bilirubin 4) Prothrombin time 5) Sodium

2) Ammonia 3) Bilirubin 4) Prothrombin time

1. A client is being discharged today following a partial gastrectomy. Which instructions for recuperating at home should be included? Select all that apply. 1) Avoid high-fiber foods 2) Avoid intake of fluids with meals 3) Consume low-carbohydrate meals 4) Decrease intake of fat 5) Eat small, frequent meals

2) Avoid intake of fluids with meals 3) Consume low-carbohydrate meals 5) Eat small, frequent meals

The nurse is providing nutritional teaching for a client with a new ileostomy. Which foods should the nurse instruct the client to avoid? Select all that apply. 1) Bananas 2) Broccoli with cheese 3) Multigrain bagel 4) Popcorn 5) Spaghetti with sauce

2) Broccoli with cheese 3) Multigrain bagel 4) Popcorn

The nurse receives the hand-off shift report on assigned clients. Which information is most concerning and prompts the nurse to assess that client first? 1) Client 2 day post colon resection who is receiving continual epidural morphine and reports severe itching 2) Client admitted 2 hours ago with gastroenteritis who has been vomiting for 36 hours and has muscle cramps and weakness 3) Client who has received IV bumetanide foe 3 days for heart failure and experiences dizziness when standing up 4) Client with acute poststreptococcal glomerulonephritis who is receiving antibiotics and has gross hematuria

2) Client admitted 2 hours ago with gastroenteritis who has been vomiting for 36 hours and has muscle cramps and weakness

The nurse is caring for a client with a balloon tamponade tube in place due to bleeding esophageal varices. The client suddenly develops respiratory distress, and the nurse finds that the tube has been partially pulled out. Which intervention should be the nurse's priority? 1) Contact the health care provider 2) Cut the tube with scissors 3) Increase gastric suction level 4) Place the client in high Fowler position

2) Cut the tube with scissors

The nurse is caring for a client with right upper quadrant pain and jaundice. The client's alanine aminotransferase /aspartate aminotransferase (ALT/AST) levels are 7 times the normal values. What questions would be most helpful regarding the etiology for these findings? Select all that apply. 1) Do you have black tarry stool? 2) Do you use intravenous (IV) illicit drugs? 3) How much alcohol do you typically drink? 4) Were you recently immunized for pneumonia? 5) What over-the-counter drugs do you take?

2) Do you use intravenous (IV) illicit drugs? 3) How much alcohol do you typically drink? 5) What over-the-counter drugs do you take?

1. During the immediate postoperative period after a colostomy, which stoma appearance requires the nurse to contact the health care provider (HCP) immediately? 1) Brick red with slight moisture noted 2) Dusky with moderate edema present 3) Pink with slight oozing of blood 4) Rosy with no stool produced

2) Dusky with moderate edema present

A client comes to the clinic for a follow up visit following a Billroth II surgery (gastrojejunostomy). The client reports occasionally experiencing sweating, palpitations, and dizziness 30 minutes after eating. What action should the nurse take? 1) Check serum blood glucose 2) Encourage dry foods with a low carbohydrate content 3) Take vital signs lying and standing 4) Teach the client to sit up after eating

2) Encourage dry foods with a low carbohydrate content

The nurse is providing postoperative care to a client returning from a hemorrhoidectomy. Which action is the priority for the nurse to perform? 1) Administer docusate and teach the client to avoid straining during defecation 2) Give pain medication and instructions related to pain control 3) Remove the rectal dressing and check the client for bleeding 4) Teach the client how to self-administer a sitz bath 2-3 times daily

2) Give pain medication and instructions related to pain control

1. A client is receiving an infusion of total parenteral nutrition (TPN) with 20% dextrose through a central line at 75 mL/hr. The nurse responds to the client's IV pump alarm, which indicates that the bag is empty. The new bag is not expected to arrive from the pharmacy for an hour. What is the most appropriate nursing action? 1) Hang 0.9 normal saline until new bag arrives, then increase TPN to 150 mL/hr for 1 hour 2) Hang 10% dextrose in water until the new bag arrives, then resume TPN at 75 ml/hr 3) Hang dextran in saline until the new bag arrives, then resume TPN at 75 mL/hr 4) Hang lactated Ringer's until the new bag arrives, then resume TPN at 75 mL/hr

2) Hang 10% dextrose in water until the new bag arrives, then resume TPN at 75 ml/hr

The nurse admits a postoperative client following weight loss surgery. Which prescription should the nurse question? 1) Begin a sugar-free, cleat liquid diet 2) Insert nasogastric tube for uncontrolled nausea 3) Place client in Fowler position during mealtimes 4) Start morphine via patient-controlled analgesia

2) Insert nasogastric tube for uncontrolled nausea

1. The nurse assesses a client with suspected acute pancreatitis and anticipates the client reporting pain in which anatomical area? 1) Left flank radiating to the left groin area 2) Left upper quadrant radiating to the back 3) Periumbilical area shifting to the right lower quadrant 4) Right upper quadrant radiating to the right shoulder

2) Left upper quadrant radiating to the back

The nurse is caring for a client with cirrhosis. Assessment findings include ascites, peripheral edema, shortness of breath, fatigue, and generalized discomfort. Which interventions would be appropriate for the nurse to implement to promote the client's comfort? Select all that apply. 1) Encourage adequate sodium intake 2) Place client in semi-Fowler position 3) Place client in Trendelenburg position 4) Provide alternating air pressure mattress 5) Use music to provide a distraction

2) Place client in semi-Fowler position 4) Provide alternating air pressure mattress 5) Use music to provide a distraction

The registered nurse is developing a nursing care plan for a client who has just undergone surgery for treatment of ulcerative colitis with the creation of a permanent ileostomy. What is the priority outcome for this client? 1) The client will contact the United Ostomy Association of America 2) The client will look and touch the stoma 3) The client will read the materials provided on ostomy care 4) The client will verbalize methods to control gas and odor

2) The client will look and touch the stoma

The nurse is caring for an alert client with jaundice, scleral icterus, and a bilirubin level of 12.3 mg/dL (210 µmol/L). Which instruction would be most important to include when delegating the client's morning hygiene tasks to unlicensed assistive personnel? 1) Do not leave the client alone in the shower 2) Use cool water in the shower 3) Use hot water in the shower 4) Wash client with antibacterial soap

2) Use cool water in the shower

The nurse provides discharge instructions to a client with cirrhosis who has portal hypertension, ascites, and esophageal varices. Which statement by the client indicates that the teaching was effective? 1) "I may have one alcoholic drink a day, but no more" 2) "I may take aspirin instead of acetaminophen for fever or pain" 3) "I should avoid straining while having a bowel movement" 4) "I should eat a protein- and sodium- restricted diet"

3) "I should avoid straining while having a bowel movement"

The nurse assessing a client's pain would expect the client to make which statement when describing the abdominal pain associated with appendicitis? 1) "My pain is a burning sensation in my upper abdomen" 2) "My pain is an 8 out of 10 and on my left side below my belly button" 3) "My pain is excruciating in my lower abdomen above my right hip" 4) "My pain is intermittent in my abdomen and right shoulder"

3) "My pain is excruciating in my lower abdomen above my right hip"

The nurse is developing teaching materials for a client diagnosed with ulcerative colitis. The client will receive sulfasalazine. Which of the following instructions are included in the discharge teaching plan? Select all that apply. 1) Avoid small, frequent meals 2) Can have a cup of coffee with each meal 3) Eat a low-residue, high-protein, high calorie diet 4) Increase fluid intake to at least 200 mL/day 5) Medication should be continued even after the resolution of symptoms 6) Take daily vitamin and mineral supplements

3) Eat a low-residue, high-protein, high calorie diet 4) Increase fluid intake to at least 200 mL/day 5) Medication should be continued even after the resolution of symptoms 6) Take daily vitamin and mineral supplements

The nurse administers lactulose to a client diagnosed with cirrhosis and hepatic encephalopathy. Which nursing action is inappropriate when administering this medication? 1) Assess mental status and orientation 2) Give on an empty stomach for rapid effect 3) Hold if 3 soft stools occur in a day 4) Mix with fruit juice to improve flavor

3) Hold if 3 soft stools occur in a day

1. When assessing a client with cholelithiasis and acute cholecystitis, which findings might the nurse note during the health history and physical examination? Select all that apply. 1) Flank pain radiating to the groin 2) High-protein food ingestion before the onset of pain 3) Low-grade fever with chills 4) Pain at the umbilicus 5) Right upper-quadrant (RUQ) pain radiating to the right shoulder

3) Low-grade fever with chills 5) Right upper-quadrant (RUQ) pain radiating to the right shoulder

1. A client calls the primary care clinic reporting diarrhea for 4 days and a low grade fever. What instruction is mostimportant for the nurse to give to the client? 1) Encourage client to eat bulk-forming foods such as whole grain bread 2) Encourage rest, fluids, and acetaminophen for the fever 3) Make an appointment for the client with the health care provider today 4) Take 2 tablets of loperamide followed by 1 tablet after each loose stool

3) Make an appointment for the client with the health care provider today

When caring for a client immediately after a laparoscopic cholecystectomy, which nursing intervention has the highest priority? 1) Apply anti-thromboembolism stockings 2) Assist with ambulation 3) Place client in the Sims' position 4) Teach about the importance of a low-fat diet

3) Place client in the Sims' position

A client with ascites due to cirrhosis has increasing shortness of breath and abdominal pain. The health care provider (HCP) requests that the nurse prepare the client for a paracentesis. Which nursing actions would the nurse implement prior to the procedure? Select all that apply. 1) Immediately place the client on nothing-by-mouth (NPO) status 2) Obtain informed consent for the procedure 3) Place the client in high Fowler's position 4) Request that the client empty the bladder 5) Take baseline vital signs and weight

3) Place the client in high Fowler's position 4) Request that the client empty the bladder 5) Take baseline vital signs and weight

The nurse is caring for a client who has undergone a colonoscopy. Which client assessment finding should mostconcern the nurse? 1) Abdominal cramping 2) Frequent, watery stools 3) Positive rebound tenderness 4) Recurring flatus

3) Positive rebound tenderness

The nurse is caring for a client with end-stage liver failure from hepatitis C who is being seen in the clinic for worsening ascites. The client is treated in the infusion center with intravenous (IV) albumin, IV furosemide, and oral spironolactone. The following day the nurse checks the client's labs. Which of the following lab findings is most important for the nurse to communicate to the health care provider? 1) Albumin 2.5 g/dL (25 g/L) 2) INR 1.4 3) Potassium 3.0 mEq/L (3.0 mmol/L) 4) Sodium 131 mEq/L (131 mmol/L)

3) Potassium 3.0 mEq/L (3.0 mmol/L)

1. The clinic nurse provides teaching for a client scheduled for a barium enema the next day. Which statement by the client shows a need for further instruction? 1) "I can expect chalky white stool after the procedure" 2) "I cannot eat or drink 8 hours before the procedure" 3) "I may have abdominal cramping during the procedure" 4) "I will avoid laxatives after the procedure"

4) "I will avoid laxatives after the procedure"

The nurse determines that further teaching is needed if a client with constipation makes which statement? Select all that apply. 1) "I will go to the restroom when I have the urge to have a bowel movement" 2) "I will increase my exercise to at least 3 times a week" 3) "I will increase my intake of fruits and vegetables" 4) "I will increase tea or coffee consumption to stimulate the bowel" 5) "I will use a laxative every other day if needed"

4) "I will increase tea or coffee consumption to stimulate the bowel" 5) "I will use a laxative every other day if needed"

The nurse provides discharge instructions to a client one day after laparoscopic cholecystectomy. Which statement by the client indicates that further teaching is required? 1) "I can resume a regular diet but will avoid fatty foods for several weeks after surgery." 2) "I can return to work within a week of surgery." 3) "I will report to the health care provider if my temperature is higher than 101 F (38.3 C)." 4) "Tomorrow I can remove the puncture site bandages and take a bath."

4) "Tomorrow I can remove the puncture site bandages and take a bath."

A client is admitted with severe acute pancreatitis. While obtaining the client's blood pressure, the nurse notices a carpal spasm. What laboratory result would the nurse assess in response to this symptom? 1) Decreased albumin 2) Elevated troponin 3) Hyperkalemia 4) Hypocalcemia

4) Hypocalcemia

1. The nurse is admitting a client with cholelithiasis and acute cholecystitis. Suddenly, the client vomits 250 mL of greenish-yellow stomach contents and reports severe pain in the right upper quadrant with radiation to the right shoulder. Which intervention would have the highest priority? 1) Administer promethazine 25 mg suppository 2) Infuse normal saline 100 mL/hour 3) Insert nasogastric tube to low suction 4) Maintain nothing-by-mouth (NPO) status

4) Maintain nothing-by-mouth (NPO) status

Which prescription should the nurse question when caring for a hospitalized client diagnosed with acute diverticulitis? 1) Metronidazole 500 mg IV every 8 hours 2) Nasogastric (NG) tube to suction 3) Nothing by mouth (NPO) 4) Prepare for barium enema in AM

4) Prepare for barium enema in AM

1. Which nursing interventions for a client recovering from a gastroduodenostomy (Billroth I) are contraindicated? Select all that apply. 1) Applying a sequential compression device and antiembolism stockings 2) Encouraging turn, cough, and deep-breathing exercises every 2 hours 3) Keeping the head of the bed raised and positioned at a 45-degree angle 4) Repositioning and irrigating a clogged nasogastric tube as needed 5) Teaching the importance of small, frequent, high-carbohydrate meals

4) Repositioning and irrigating a clogged nasogastric tube as needed 5) Teaching the importance of small, frequent, high-carbohydrate meals

A client is admitted to the emergency room with right lower quadrant pain and suspected acute appendicitis. Which health care provider prescription should the nurse implement first? 1) Administer 5-325 mg hydrocodone/acetaminophen PO for pain 2) Draw blood for complete blood count and electrolyte levels 3) Obtain urine specimen for urinalysis 4) Start intravenous (IV) line with normal saline 100 mL/hr

4) Start intravenous (IV) line with normal saline 100 mL/hr

The nurse is reinforcing education to a client with irritable bowel syndrome who is experiencing diarrhea. Which of these meals selected by the client indicates an understanding of diet management? 1) Beans, yogurt, and a fruit cup 2) Beef, broccoli, and a glass of wine 3) Eggs, a bagel, and black coffee 4) Steak, tomato basil soup, and cornbread

4) Steak, tomato basil soup, and cornbread

The nurse is caring for a client with acute pancreatitis. Which subjective and objective assessments would the nurse report immediately? 1) Clients is lying with knees drawn up to the abdomen and trunk flexed 2) Client states, "My lips are tingling and numb" 3) Foul-smelling, fatty stool 4) Temperature of 102.2 F (39 C) and increasing abdominal pain

4) Temperature of 102.2 F (39 C) and increasing abdominal pain

1. The nurse is assessing a client who had an esophagogastroduodenoscopy (EGD) 2 hours ago. Which finding requires an immediate report to the health care provider? 1) Blood pressure drop from 122/88 mm Hg to 106/72 mm Hg 2) Gag reflex has not returned 3) Sore throat when swallowing 4) Temperature spike to 101.2 F (38.4 C)

4) Temperature spike to 101.2 F (38.4 C)

A client receiving total parenteral nutrition complains of nausea, abdominal pain, and excessive thirst. What is the best action for the nurse to take?' 1) Assess the client's vital sings 2) Check the client's blood glucose 3) Report the findings to the health care provider 4) Slow down the rate of infusion

Check the client's blood glucose