GI/GU

The nurse is caring for a client in the postanesthesia care unit immediately after the client had a subtotal gastrectomy. The nurse identifies small blood clots in the client's gastric drainage. What action should the nurse take?

Consider this an expected event

A nurse is performing a physical assessment of a client with ulcerative colitis. Which of the following symptoms is most often associated with a serious complication of this disorder?

Decreased bowel sounds

You're providing education to a patient with an active Hepatitis B infection. What will you include in their discharge instructions? Select all that apply:

Follow a diet low in fat and high in carbs. Do not share toothbrushes, razors, utensils, drinking cups, or any other type of personal hygeine product.

A client is to have gastric lavage following an overdose of acetaminophen. In which position should the nurse place the client when the nasogastric tube is being inserted?

High-fowler

The nurse assesses a client with benign prostatic hyperplasia. Which client statement requires further assessment?

I have a burning sensation when I urinate

A client is admitted to the hospital with severe flank pain, nausea, and hematuria caused by a ureteral calculus. What should be the nurse's initial intervention?

Increase oral fluid intake

An older client with diarrhea is admitted to the hospital from a nursing home. A stool specimen confirms a diagnosis of a methicillin-resistant Staphylococcus aureus (MRSA) infection. The nurse making room assignments asks if it is possible to place the new client with another client that also has MRSA in the same isolation room. How should the nurse respond?

It is safe to place people with the same infection in one room

A nurse is caring for a client with a ureteral calculus. Which are the most important nursing actions? Select all that apply.

Monitoring intake and output. Strain urine at each voiding. administering the perscribed analgesics.

The nurse is monitoring a client admitted to the hospital with a diagnosis of appendicitis who is scheduled for surgery in 2 hours. The client begins to complain of increased abdominal pain and begins to vomit. On assessment, the nurse notes that the abdomen is distended, and bowel sounds are diminished. Which is the most appropriate nursing intervention?

Notify the health care provider

A patient diagnosed with ulcerative colitis is admitted to the medical unit. When assessing the patient, which of these findings would be of the most concern?

Rebound tenderness

The nurse is caring for a client with a bowel obstruction. Which assessment findings indicate the possible onset of peritonitis? Select All that apply

Rebound tenderness. Diminished bowel sounds. Rigid-board like abdomen.

An 18-year-old patient is admitted with appendicitis. Which statement by the patient requires immediate nursing intervention?

The pain seems to be gone now

A client with esophageal varices has severe hematemesis, and a Sengstaken-Blakemore tube is inserted. What design and purpose does the tube have?

Triple-lumen; for esophageal compression

During an outpatient clinic visit, a female patient reports feeling abdominal bloating/pain, and diarrhea when eating foods that contain wheat or rye. The patient states her mother was diagnosed with Celiac Disease 5 years ago. What other symptoms will you assess the patient for that can be present in Celiac Disease? SELECT-ALL-THAT-APPLY:

Unexplained weight loss. Mouth ulcers. Menstrual irregularities. Inability to tolerate dairy products. Enamel changes

The client is diagnosed with a uric acid stone. Which foods should the client eliminate from the diet to help prevent re-occurrence?

Venison and sardines

The nurse is monitoring a client with a diagnosis of peptic ulcer. Which assessment finding would most likely indicate perforation of the ulcer?

a rigid, boardlike abdomen

During the admission assessment of a client with a small-bowel obstruction, the nurse anticipates which clinical manifestations? Select all that apply.

abdominal distension. cockily abdominal pain. frequent vomiting.

What observation should the nurse instruct the client with an ileostomy to report immediately?

absence of draining from the ileostomy for 6 or more hours

A client with gastroesophageal reflux disease (GERD) is being treated with dietary management. The client states, "I like to have a glass of juice every day." Which juice will the nurse recommend?

apple

The nurse is examining a 15-year-old female who is complaining of pain, frequency, and urgency when urinating. After asking the parent to leave the room, which question should the nurse ask the client?

are you sexually active?

Your client states " I came in here last year and got some medication for mybladder infection. It turned my urine orange but it helped. Can I get thatagain? What is the first action the nurse must take:

ask some more questions about her current and previous symptoms

A client presents to the emergency department with upper gastrointestinal bleeding and is in moderate distress. In planning care, what is the priority nursing action for this client?

assessment of vital signs

The nurse is caring a client diagnosed with renal calculi is scheduled for lithotripsy. Which post- procedure nursing task would be most appropriate to delegate to the unlicensed nursing assistant (UAP)?

assist the client to the car when being discharged home

The nurse caring for a client after a bowel resection notes that the client is restless. The nurse takes the client's vital signs and notes that the pulse rate has increased and that the blood pressure has dropped significantly since the previous readings. The nurse suspects that the client is going into shock and should take which immediate action?

check the client's oxygen saturation level

The nurse is assessing 4 clients in the emergency department. Which client should the nurse prioritize for care?

client with ulcerative colitis who has a fever, bloody diarrhea, and abdominal distention and needs an abdominal x-ray

The nurse is planning to teach a client with gastroesophageal reflux disease (GERD) about substances to avoid. Which items should the nurse include on this list? Select all that apply.

coffee. chocolate. peppermint. fried chicken.

A triple-lumen indwelling urinary catheter is inserted for continuous bladder irrigation following a transurethral resection of the prostate. In addition to balloon inflation, the nurse is aware that the functions of the three lumens include:

continuous inflow and outflow of irrigation solution

The health care provider orders lactulose for a patient with hepatic encephalopathy. The nurse will monitor for effectiveness of this medication for this pt by assessing what?

decreased ammonia levels

The nurse is caring for a client with ulcerative colitis. Which finding does the nurse determine is consistent with this diagnosis?

decreased hemoglobin

A client with a bladder injury has had surgical repair of the injured area with placement of a suprapubic catheter. Which is the most appropriate nursing action to prevent complications of this procedure?

ensure that the catheter tubing is not kinked

After a prostatectomy, the client reports that the urinary catheter tubing is pulling too tightly on the leg. The nurse observes that the indwelling catheter tubing is taut and taped properly to the thigh. Which action should the nurse take?

explain that the traction helps control bleeding

The nurse is assessing a client who is experiencing an acute episode of cholecystitis. Which of these clinical manifestations support this diagnosis? Select all that apply.

fever. complaints of indigestion. pain in the upper right quadrant after a fatty meal

Which clinical findings would the nurse expect a client diagnosed with ulcerative colitis to report? Select all that apply.

fever. diarrhea. abdominal cramps

A nurse is eliciting a health history from a client with ulcerative colitis. Which factor does the nurse consider to be most likely associated with the client's colitis?

genetic predisposition

A client admitted to the hospital with a suspected diagnosis of acute pancreatitis is being assessed by the nurse. Which assessment findings would be consistent with acute pancreatitis? Select all that apply.

gray-blue color at the flank. abdominal guarding and tenderness. left upper quadrant pain with radiation to the back

A dialysis nurse is treating a client with newly diagnosed acute renal failure who is receiving dialysis for the first time. Which common complication must the nurse look out for?

hedache, nausea, confusion

The HCP has determined that a client with hepatitis has contracted the infection from contaminated food. The nurse understands that this client is most likely experiencing what type of hepatitis?

hepatitis A

Nurse Oliver checks for residual before administering a bolus tube feeding to a client with a nasogastric tube and obtains a residual amount of 150 mL. What is the appropriate action for the nurse to take?

hold the feeding

A client is receiving total parenteral nutrition (TPN) solution. The nurse should assess a client's ability to metabolize the TPN solution adequately by monitoring the client for which sign?

hyperglycemia

*A client is experiencing kidney failure. Which is the most serious complication for which the nurse must monitor a client with kidney failure?

hyperkalemia

The nurse is providing discharge teaching for a client with newly diagnosed Crohn's disease about dietary measures to implement during exacerbation episodes. Which statement made by the client indicates a need for further instruction?

i should increase the fiber in my diet

A week after kidney transplantation, a client develops a temperature of 101°F (38.3°C), the blood pressure is elevated, and there is tenderness over the transplanted kidney. The serum creatinine is rising and urine output is decreased. The x-ray indicates that the transplanted kidney is enlarged. Based on these assessment findings, the nurse anticipates which treatment?

increased immunosuppression therapy

A client with a history of alcoholism and cirrhosis is admitted with severe dyspnea as a result of ascites. Which process that most likely caused thee ascites should the nurse consider when planning care?

increased pressure in the portal vein

A client with a long history of alcohol abuse is admitted to the hospital with ascites and jaundice. A diagnosis of hepatic cirrhosis is made. Which is a nursing priority?

institute fall prevention/safety measures

A primary healthcare provider diagnoses a client with acute cholecystitis with biliary colic. Which clinical findings should the nurse expect when performing a health history and physical assessment? Select all that apply.

intolerance to foods high in fat. Pain that radiates to the right shoulder

The nurse is providing discharge instructions to a client following gastrectomy and should instruct the client to take which measure to assist in preventing dumping syndrome?

limit the fluids taken with meals

A 70-year-old client is admitted to the hospital with a lower gastrointestinal bleed. After assisting the client back to bed, the nurse finds approximately 600 mL of frank red blood in the commode. The client is now pale and diaphoretic and reports dizziness. Which action should the nurse perform first?

lower the head of the bed

The nurse monitors for which acid-base disorder that can likely occur in a client with an ileostomy?

metabolic acidosis

The client is reporting chills, fever, and left costovertebral pain. Which diagnostic test should the nurse expect the HCP to prescribe first?

midstream urine for culture

A nurse is caring for a postoperative client who has a nasogastric tube attached to low continuous suction. Which assessment findings indicate that the client may be experiencing hypokalemia?

muscle weakness and cardiac dysrhythmias

Which diet choice by the patient with an acute exacerbation of inflammatory bowel disease (IBD) indicates a need for more teaching?

oatmeal with cream

A client has a nasogastric feeding tube inserted, and the healthcare provider prescribes the feeding to be instituted immediately. What should the nurse do first?

obtain an x-ray to verify that the tube is in the stomach

The nurse is doing an admission assessment on a client with a history of duodenal ulcer. Todetermine whether the problem is currently active, the nurse should assess the client for which symptom(s) of duodenal ulcer?

pain relieved by food intake

The nurse is assessing a client with liver disease for signs and symptoms of low albumin. Which sign or symptom should the nurse expect to note?

peripheral edema

The nurse providing postoperative care for a client who had kidney surgery reviews the client's urinalysis report. Which urinary finding indicates the need to notify the primary health care provider?

presence of large proteins

What should the nurse do to prevent catheter-associated urinary tract infection (CAUTI)? Select all that apply

provide perineral care several times a day. monitor the temperature as an indicator of the infection. encourage the client to drink 3,000 mL of fluids daily.

The nurse understands which factor is the most likely source of hepatitis D?

recieving a blood transfusion

A 72-year-old patient was admitted with epigastric pain due to a gastric ulcer. Which patient assessment warrants an urgent change in the nursing plan of care?

rigid abdomen and vomiting following indigestion

An older adult is hospitalized for weight loss and dehydration because of nutritional deficits. What should the nurse consider when planning care for this client?

the nutrtional needs of an older adult are basically unchanged except for a decreased need for calories

The nurse is assessing a client with a lactose intolerance disorder for a suspected diagnosis of hypocalcemia. Which clinical manifestation would the nurse expect to note in the client?

twitching

The nurse is caring for a hospitalized client with a diagnosis of acute pancreatitis. The nurse should assist the client to which position that will decrease the abdominal pain?

upright in a sitting position with the trunk flexed

*A client is to receive peritoneal dialysis. What should the nurse do to prepare the client for the procedure?

warm the dialysis solution in the warmer

Three days after surgery for cancer of the colon, a nurse introduces the client to colostomy care. Which should the nurse teach the client about skin care around the stoma?

wash the area with soap and water and then apply a protective ointment

The client with acute renal failure asks the nurse for a snack. Because the client's potassium level is elevated, which snack is most appropriate?

A gelitan dessert

Which client is most at risk for developing a Candida urinary tract infection (UTI)?

A young woman on antibiotic therapy

Which measure is likely to provide the most relief from the pain associated with renal calculi?

Administering morphine

A patient with late-stage cirrhosis develops portal hypertension. Which of the following options below are complications that can develop from this condition? Select all that apply:

Ascities. Splenomegaly. Esophageal varices.

Which assessment should be a priority for an infant who had surgery to correct an intussusception and is not at risk for development of a paralytic ileus postoperatively?

Auscultation of bowel sounds