Med Surg Exam 4

The nurse is asked to explain the common laboratory values associated with acute pancreatitis. Which should the nurse include as the cause of an elevated WBC count?

Inflammatory process

Which is the correct sequence for the abdominal exam?

Inspection, auscultation, percussion, and palpation

A nurse assesses a client who has appendicitis. Which clinical manifestation should the nurse expect to find?

Severe, steady right lower quadrant pain

Which diagnostic test should the nurse anticipate to rule out peritonitis when providing care to a patient diagnosed with peptic ulcer disease?

White Blood Cell

The nurse is providing patient education for a patient who is diagnosed with gastritis. Which statement indicates the need for further education?

"I will take aspirin for headaches from now on."

The nurse has implemented a care plan for an adult patient with gastroesophageal reflux disorder (GERD). On the next clinic visit, which statement by the patient indicates adherence to the plan of care?

"I've lost six pounds because I eat every three hours and never before bed."

The nurse is teaching a patient about the approved therapeutic agents for acute pancreatitis. Which patient statement indicates the need for further education?

"Proton pump inhibitors are used to increase gastric acid secretions."

Order: morphine sulfate 6 mg IM q.4h p.r.n., pain Supply: morphine sulfate 10 mg/mL Give: __________ mL

0.6

Order: Axid 0.15 g p.o. b.i.d. Supply: Bottle containing 60 capsules of Axid, 150 mg per capsule Give: __________ capsule(s)

1

The nurse is providing care to a patient who is diagnosed with acute gastritis. Which assessment data supports this diagnosis?

Epigastric pain

The nurse is providing care to several patients in an outpatient clinic. Which patient is at high risk of developing gastroesophageal reflux disorder (GERD)?

A patient who is morbidly obese

Which principal risk factor should the nurse assess for during the health history in a patient who is suspected of having peptic ulcer disease?

H. pylori infection

Which bowel sound noted by the nurse during the gastrointestinal assessment indicates an early bowel obstruction?

Absent

A patient is admitted to the emergency department reporting a burning pain in the chest of a 7 on a 0 to 10 pain scale. Gastroesophageal reflux disorder (GERD) secondary to hiatal hernia is diagnosed. Based on this data, which is the priority nursing diagnosis?

Acute Pain

The nurse is performing an abdominal assessment of a patient who is exhibiting pain in the area of McBurney's point. Based on this data, which diagnosis does the nurse suspect?

Appendicitis

A client is in the emergency department with an esophageal trauma. The nurse palpates subcutaneous emphysema in the mediastinal area and up into the lower part of the client's neck. What action by the nurse takes priority?

Assess the client's oxygenation.

The nurse is providing care to a patient who reports diffuse abdominal pain. Upon assessment, the nurse notes absent bowel sounds and abdominal distension. Based on this data, which medical diagnosis does the nurse suspect?

Bowel obstruction

Which assessment data would indicate active bleeding for a patient who is diagnosed with peptic ulcer disease?

Bright red blood in emesis

After teaching a client with irritable bowel syndrome (IBS), a nurse assesses the client's understanding. Which menu selection indicates that the client correctly understands the dietary teaching?

Broiled chicken with brown rice, steamed broccoli, glass of apple juice

Which food should the nurse encourage for a patient, diagnosed with gastritis, when a clear liquid diet is prescribed?

Broth

A nurse works on the surgical unit. After receiving the hand-off report, which client should the nurse see first?

Client who had an esophagectomy with a respiratory rate of 32/min

The nurse is reviewing the health history for a patient who is diagnosed with chronic pancreatitis. Which data supports the patient's current diagnosis?

Cystic fibrosis

Which diagnostic test should the nurse anticipate when providing care to a patient who is suspected of having a hiatal hernia?

Esophagogastroduodenoscopy (EGD)

The nurse is providing care to a patient who scores a 4 with the Ranson's score. Which conclusion by the nurse is most appropriate?

This patient has a 15% chance of mortality.

The nurse is providing care to a patient who is hospitalized for complications associated with peptic ulcer disease. Which data supports the patient is experiencing a perforation?

Absent bowel sounds

Which patient activity should the nurse discourage for a patient who is diagnosed with stomatitis?

Alcohol-based mouth rinses

A client had a colonoscopy and biopsy yesterday and calls the gastrointestinal clinic to report a spot of bright red blood on the toilet paper today. What response by the nurse is best?

Remind the client that a small amount of bleeding is possible.

Which is the priority nursing diagnosis when providing care for a patient with oral trauma?

Risk for ineffective airway clearance

The nurse is providing care to a patient who is hospitalized for complications associated with peptic ulcer disease. Which data supports the patient is experiencing a gastrointestinal bleed?

Tarry stools

Which patient data supports Ranson's criteria for acute pancreatitis at admission?

Glucose greater than 200 mg/dL or >10 mmol/L

Which drug prescription should the nurse anticipate for a patient, diagnosed with hemorrhoids, to decrease pain?

Benzocaine

The nurse is conducting patient education regarding prescribed drugs for acute pancreatitis. Which agent should the nurse include as one that is used to decrease gastric acid secretions?

H2 Antagonist

The nurse is providing care to a patient who is being admitted to rule out acute pancreatitis. Which item found in the patient's history increases the patient's risk for this disease process?

Hypertriglyceridemia

The nurse is providing care to a patient who is diagnosed with esophageal cancer. Which assessment finding indicates metastasis to the liver?

Jaundice

Which organ functions as a main site for metabolizing drugs and may become impaired with the aging process?

Liver

The nurse is providing care to a patient who is suspected of having esophageal cancer. Which diagnostic test should the nurse anticipate for this patient first?

Upper GI/ Barium Swallow

The nurse is providing care to a patient who is status post partial gastrectomy for the treatment of gastric carcinoma. Which should the nurse include in the plan of care to decrease the risk of dumping syndrome?

Providing smaller meals at more frequent intervals

A client is 1 day postoperative after having Zenker's diverticula removed. The client has a nasogastric (NG) tube to suction, and for the last 4 hours there has been no drainage. There are no specific care orders for the NG tube in place. What action by the nurse is most appropriate?

Notify the surgeon about this finding.

Which assessment data indicates to the nurse that the patient may be experiencing hepatic encepalopathy due to increased ammonia level, a complication of cirrhosis?

Personality changes