GI/GU Questions
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? A - Apple B - Orange C - Tomato D - Grapefruit
A
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? A - Instill normal saline into the tube to maintain patency B - Obtain an x-ray to verify that the tube is in the stomach C - Auscultate the epigastric area while instilling 15mL of air D - Withdraw 30mL of stomach contents to verify tube placement
B
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? A - Strain all urine output B - Increase oral fluid intake (pass naturally) C - Obtain urine specimen for culture D - Administer prescribed analgesic
B
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? A - Weight loss B - Peripheral edema (third spacing) C - Capillary refill of 5 seconds D - Bleeding from previous puncture sites
B
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? A - Measurements of urine specific gravity B - Auscultation of bowel sounds/ passing of flatus (fart) C - Inspection of first stool passed D - Measurement of gastric output
B
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: A - Increase albumin levels ( decreased - not enough protein to keep fluid in bld stream) B - Ascites C - Splenomegaly D - Fluid volume deficient E - Esophageal varices
B, E
Which diet choice by the patient with an acute exacerbation of inflammatory bowel disease (IBD) indicates a need for more teaching? a. Scrambled eggs b. White toast and jam c. Oatmeal with cream d. Pancakes with syrup
C
The nurse is caring for a client with a bowel obstruction. Which assessment findings indicate the possible onset of peritonitis? Select All that apply a. Diarrhea - obstruction b. Bradycardia - tachycardia c. Rebound tenderness d. Diminished bowel sounds e. Rigid, board-like abdomen
C, D, E
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: A. "Take acetaminophen as needed for pain." (no bc Tylenol is metabolized in the liver) B. "Eat large meals that are spread out through the day." C. "Follow a diet low in fat and high in carbs." D. "Do not share toothbrushes, razors, utensils, drinking cups, or any other type of personal hygiene product." E. "Perform aerobic exercises daily to maintain strength." (no bc they get fatigued easily)
C, D, E
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? A - Tachycardia B - Hypertension C - Elevated BUN concentration D - Hyperglycemia (bc tpn is swimming in glucose so doo frequent glucometer checks)
D
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 A - Food allergy B - Infectious agent C - Dietary components D - Genetic predisposition
D
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? a. "When was your last menstrual cycle?" b. "Have you noticed any change in the color of the urine?" c. "Are you sexually active?" d. "What have you taken for the pain?"
c
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? SATA A - Institute fall prevention/safety measures. B - Monitor respiratory status. C - Measure abdominal girth daily. D - Test stool specimens for blood
A, B
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? A - Antibiotic therapy B - Peritoneal dialysis C - Removal of the transplanted kidney D - Increased immunosuppression therapy
D
The nurse is caring for a client with ulcerative colitis. Which finding does the nurse determine is consistent with this diagnosis? A - Hypercalcemia B - Hypernatremia C - Frothy, fatty stools D - Decreased hemoglobin
D
The nurse is monitoring a client with a diagnosis of peptic ulcer. Which assessment finding would most likely indicate perforation of the ulcer? A - Bradycardia B - Numbness in the legs C - Nausea and vomiting D - A rigid, boardlike abdomen (peritonitis)
D
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. A - Diarrhea B - Black, tarry stools C - hyperactive bowel sounds D - gray-blue color at the flank E - abdominal guarding and tenderness F - left upper quadrant pain with radiation to the back.
D, E, F
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. a. Diarrhea b. Black, tarry stools c. Hyperactive bowel sounds d. Gray-blue color at the flank (Cullens sign ublicus and flank) e. Abdominal guarding and tenderness f. Left upper quadrant pain with radiation to the back
D, E, F
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? A - Check the vital signs B - Draw hemoglobin and hematocrit C - Lower the head of the bed D - Maintain an IV line with normal saline
A
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? a. Assessment of vital signs b. Completion of abdominal examination c. Insertion of the prescribed nasogastric tube d. Thorough investigation of precipitating events
A
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? A - Decreased bowel sounds (so much inflammation there is obstruction) B - Loose, blood-tinged stools C - Distention of the abdomen D - Intense abdominal discomfort
A
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: A - Continuous inflow and outflow of irrigation solution. B - Intermittent inflow and continuous outflow of irrigation solution. C - Continuous inflow and intermittent outflow of irrigation solution. D - Intermittent flow of irrigation solution and prevention of hemorrhage.
A
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? A. Explain that the traction helps control bleeding B. Adjust tension on the catheter to relieve pressure C. Untape the catheter and retape it closer to the urinary meatus D. Assess the degree of tension on the catheter and contact the primary healthcare provider
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? A - Hold the feeding (don't reinsert if that high bc there is clearly an issue) B - Reinstill the amount and continue with administering the feeding C - Elevate the client's head at least 45 degrees and administer the feeding D - Discard the residual amount and proceed with administering the feeding
A
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? A - Hepatitis A B - Hepatitis B C - Hepatitis C D - Hepatitis D
A
The client is reporting chills, fever, and left costovertebral pain. Which diagnostic test should the nurse expect the HCP to prescribe first? a. A midstream urine for culture b. A sonogram of the kidney c. An intravenous pyelogram for renal calculi d. A CT scan of the kidneys
A
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 - A gelatin dessert B - Yogurt (high in K) C - An orange D - Peanuts (nuts high in K)
A
The nurse assesses a client with benign prostatic hyperplasia. Which client statement requires further assessment A - "I have a burning sensation when I urinate." (UTI) B - "I have been having some dribbling after I finish urinating." C - "I missed 3 days of finasteride while on a trip last week." D - "I was awakened 3 times last night by the need to urinate."
A
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? A - Check the client's oxygen saturation level. B - Recheck the vital signs to verify the findings. C - Raise the client's legs above the level of the heart. D - Slow the rate of the intravenous (IV) fluid infusing.
A
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? a. Twitching b. Hypoactive bowel sounds c. Negative Trousseau's sign d. Hypoactive deep tendon reflexes
A
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? A - Notify the health care provider (HCP). B - Administer the prescribed pain medication. C - Call and ask the operating room team to perform the surgery as soon as possible. (HCP must do this) D - Reposition the client and apply a heating pad on the warm setting to the client's abdomen.
A
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? A - "I should increase the fiber in my diet." (bc you don't want to increase fiber during an exacerbation and poop more) B - "I will need to avoid caffeinated beverages." C - "I'm going to learn some stress reduction techniques." D - "I can have exacerbations and remissions with Crohn's disease."
A
The nurse monitors for which acid-base disorder that can likely occur in a client with an ileostomy? A - Metabolic acidosis B - Metabolic alkalosis (vomiting/loss of stomach contents) C - Respiratory acidosis D - Respiratory alkalosis
A
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. A - coffee B - chocolate C - peppermint D - nonfat milk E - fried chicken F - scrambled eggs
A, B, C, E
Which clinical findings would the nurse expect a client diagnosed with ulcerative colitis to report? Select all that apply. A - Fever B - Diarrhea C - Gain in weight D - Spitting up blood E -Abdominal cramps
A, B, E
During the admission assessment of a client with a small-bowel (intestine) obstruction, the nurse anticipates which clinical manifestations? Select all that apply. A - Abdominal distention B - Absolute constipation (small bowel obstructions may be partial or complete) C - Colicky abdominal pain D - Frequent vomiting E - Pain during defecation
A, C, D
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: A. Unexplained Weight loss B. Jelly-like stools (peds - intersection) C. Mouth ulcers D. Menstrual irregularities E. Pain at McBurney's Point F. Ribbon-like stools (peds - Hirschsprung's) G. Inability to tolerate dairy products H. Enamel changes
A, C, D, G, H
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. A - Fever B - Positive Cullen's sign C - Complaints of indigestion D - Palpable mass in the left upper quadrant E - Pain in the upper right quadrant after a fatty meal F - Vague lower right quadrant abdominal discomfort
A, C, E
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? A - Increased secretion of bile salts B - Increased pressure in the portal vein C - Increases interstitial osmotic pressure D - Increased production of serum albumin
B
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? A - Bradycardia, tingling, weakness B - Headache, nausea, confusion (this is the highest safety concern) C - Hypotension, wheezes, increased temp D - Increased temp, hypotension, back pain
B
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? A. Oral temperature of 99.0 F (37.2 C) B. Rebound tenderness (possibly perforation/ peritonitis) C. Bloody diarrhea D. Borborygmi ( hyperactive bowel sounds normal finding)
B
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? A - Clamp the tube B - Consider this an expected event C - Instill the tube with iced normal saline D - Notify the surgeon immediately
B
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? A - Apply liberal amounts of Vaseline for 3 inches (7.6 centimeters) around the stoma B - Wash the area with soap and water and then apply a protective ointment C - Pour saline over the stoma and rub the area to remove hard fecal matter D - Rinse the area with peroxide before applying fresh gauze bandages
B
Which measure is likely to provide the most relief from the pain associated with renal calculi? A - Applying moist heat to the flank area B - Administering morphine C - Encouraging high fluid intake D - Maintaining complete bed rest
B
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: A - Get a urine sample immediately B - Ask some more questions about her current and previous symptoms C - Tell her that the drug that caused her urine to turn orange didn't correct the problem - it just made her feel better while the antibiotics healed the infection D - Tell her she should have drunk more cranberry juice
B
What should the nurse do to prevent catheter-associated urinary tract infection (CAUTI)? Select all that apply A - Change the catheter daily B - Provide perineal care several times a day C - Monitor the temperature as an indicator of the infection D - Encourage the client to drink 3,000 mL fluids daily E - Recommend the healthcare provider prescribe antibiotics (not necessary if there is no current infection)
B, C, D
A nurse is caring for a client with a ureteral calculus. Which are the most important nursing actions? Select all that apply. A - Limiting fluid intake at night B - Monitoring intake and output C - Straining urine at each voiding D - Recording the client's blood pressure E - Administering the prescribed analgesic
B, C, E
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. a. Diarrhea with black feces b. Intolerance to foods high in fat c. Vomiting of coffee-ground emesis (can be a mix of blood, bile, and food) d. Gnawing pain when stomach is empty e. Pain that radiates to the right shoulder
B, E
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? A - Supine B - Mid-Fowler C - High-Fowler D -Trendelenburg
C
A client with esophageal varices has severe hematemesis, and a Sengstaken-Blakemore tube is inserted. What design and purpose does the tube have? A - Single-lumen; for gastric lavage B - Double-lumen; for intestinal decompression C - Triple-lumen; for esophageal compression D - Multilumen; for gastric and intestinal decompression
C
An 18-year-old patient is admitted with appendicitis. Which statement by the patient requires immediate nursing intervention? A. "The pain hurts so much it is making me nauseous." B. "I have no appetite." C. "The pain seems to be gone now." D. "If I position myself on my right side, it makes the pain less intense."
C
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? A - "The other person's infection is not contagious." B - "This is the usual practice when antibiotic therapy is started." c - "It is safe to place people with the same infection in one room." D - "As soon as a private room becomes available we will move the client."
C
The client is diagnosed with a uric acid stone. Which foods should the client eliminate from the diet to help prevent re-occurrence? A - Beer and colas B - Asparagus and cabbage. C - Venison and sardines. (uric acid is a purine nf purine is found in meat (organ meat mostly) D - Cheese and eggs.
C
The nurse is assessing 4 clients in the emergency department. Which client should the nurse prioritize for care? A - Client with liver cirrhosis and ascites who has increasing abdominal distension and needs therapeutic paracentesis B - Client with new-onset ascites for a suspected ovarian mass who needs paracentesis for diagnostic studies C - Client with ulcerative colitis who has a fever, bloody diarrhea, and abdominal distension and needs an abdominal x-ray D - Nursing home client with dementia who has stool impaction and abdominal distension and needs stool disimpaction
C
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)? A - Monitor the amount, color, and consistency of urine output. B - Teach the client about care of the indwelling Foley catheter. C - Assist the client to the car when being discharged home. D - Take the client's post-procedural (initial assessment should be done by nurse) vital signs.
C
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 whichsymptom(s) of duodenal ulcer? A - weight loss b - Nausea and vomiting c - Pain relieved by food intake d - Pain radiating down the right arm
C
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? A - Ambulate following a meal B - Eat high carbohydrate foods C - Limit the fluids taken with meals D - Sit in a high Fowler's position during meals
C
What observation should the nurse instruct the client with an ileostomy to report immediately? A - Passage of liquid stool from the stoma B - Occasional presence of undigested food in the effluent (stoma) C - Absence of drainage from the ileostomy for 6 or more hours D - Temp of 99.8
C
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? A. Chest pain relieved with eating or drinking water B. Back pain 3 or 4 hours after eating a meal C. Burning epigastric pain 90 minutes after breakfast D. Rigid abdomen and vomiting following indigestion (signs of peritonitis)
D
A client is experiencing kidney failure. Which is the most serious complication for which the nurse must monitor a client with kidney failure? A. Anemia B. Weight loss C. Uremic frost (when you see a film over entire body) D. Hyperkalemia (bc of cardiac implications)
D
A client is to receive peritoneal dialysis. What should the nurse do to prepare the client for the procedure? A - Assess the dialysis access for a bruit and thrill. B - Insert an indwelling urinary catheter and drain all urine from the bladder. C - Ask the client to turn toward the left side. D - Warm the dialysis solution in the warmer.
D
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? A - Monitor urine output once per shift B - Monitor specific gravity once per shift C - Encourage an excessive intake of oral fluids D - Ensure that the catheter tubing is not kinked
D
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? A - Tingling of the fingertips and toes B - Dry and sticky mucous membranes C - Abdominal cramping and irritability D - Muscle weakness and cardiac dysrhythmias
D
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? A - Financial resources usually are unrelated to nutritional status. B - An older adult's daily fluid intake must be markedly increased. C - The client's diet should be high in carbohydrates and low in proteins. D - The nutritional needs of an older adult are basically unchanged except for a decreased need for calories.
D
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? a. relief of constipation b. relief of abdominal pain c. decreased liver enzymes d. decreased ammonia levels
D
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? A - Prone B - Supine with the legs straight C - Side-lying with the head of the bed flat D - Upright in a sitting position with the trunk flexed (fetal position)
D
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? a. Acidic pH b. Glucose negative c. Bacteria negative d. Presence of large proteins
D
The nurse understands which factor is the most likely source of hepatitis D? a. Eating infected shellfish b. Overly exerting oneself c. Practicing poor hygiene d. Receiving a blood transfusion
D
Which client is most at risk for developing a Candida urinary tract infection (UTI)? A -An obese woman. B - A man with diabetes insipidus. C - A male paraplegic on intermittent catheterization. D - A young woman on antibiotic therapy.
D