Med surg final

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A client has a plaster cast applied to the left leg. Which comment by the client following the procedure should the nurse address first? a. "My toes are stiff." b. "My toes are pink." c. "My cast is still wet." d. "My pain is a 3."

"My toes are stiff."

A patient has a cast removed after bone healing takes place. What should the nurse instruct the patient to do after removal? (Select all that apply.) a. Apply an emollient lotion to soften the skin. b. Control swelling with elastic bandages, as directed. c. Gradually resume activities and exercise. d. Use friction to remove dead surface skin by rubbing the area with a towel. e. Use a razor to shave the dead skin off.

- Apply an emollient lotion to soften the skin. - Control swelling with elastic bandages, as directed. - Gradually resume activities and exercise

what are the assessments for tumors of the small intestine

- CBC - bilirubin - carcinoembryonic antigen

The nurse is caring for a patient with a pelvic fracture. What nursing assessment for a pelvic fracture should be included? (Select all that apply.) a. Checking the urine for hematuria b. Palpating peripheral pulses in both lower extremities c. Testing the stool for occult blood d. Assessing level of consciousness e. Assessing pupillary response

- Checking the urine for hematuria - Palpating peripheral pulses in both lower extremities - Testing the stool for occult blood

what are causes of respiratory alkalosis

- Fast RR - hyperventilation - panic/anxiety attacks

what are risk factors for gastric cancer

- H. Pylori - pernicious anemia - smoking - achlorhydria - gastrectomy - gastric ulcers

what 3 things are a risk and a cause of PUD

- H. pylori - NSAIDs - Stress

what medications can you give a pt who has peptic ulcer disease that will help heal the ulcer

- H2 receptor antagonist (-tidine) - PPI (-azole)

if a pt has acute gastritis, what are supportive therapies they can have

- IV fluids - NG tube - antiacids - H2 receptors - PPI

A client with chronic obstructive pulmonary disease has recently begun a new bronchodilator. Which therapeutic effect(s) should the nurse expect from this medication? Select all that apply. a. Negative sputum culture b. Increased viscosity of lung secretions c. Increased respiratory rate d. Increased expiratory flow rate e. Relief of dyspnea

- Increased expiratory flow rate - Relief of dyspnea

A nurse is caring for a client with a hip fracture after a fall from a ladder. Which actions will the nurse provide to prevent complications associated with this injury? Select all that apply. a. Keep ahead of the pain by administering analgesia as scheduled and PRN. b. Administer supplementary oxygen when transferring or mobilizing. c. Increase fluid intake. d. Remain on bed rest for 14 days or until instructed by the orthopedic surgeon. e. Perform prescribed ankle and foot exercises as ordered.

- Keep ahead of the pain by administering analgesia as scheduled and PRN - Increase fluid intake - Perform prescribed ankle and foot exercises as ordered

what class of meds can you give a pt who has chronic gastritis

- PPI - H2 receptors antagonist

Why would a client with COPD report feeling fatigued? Select all that apply. a. The client is using all expendable energy just to breathe. b. Muscle function gradually decreases over time in clients with COPD. c. The client is using all expendable energy for activities of daily living (ADLs). d. Lung function gradually decreases over time in clients with COPD.

- The client is using all expendable energy just to breathe. - Lung function gradually decreases over time in clients with COPD

The client has just been diagnosed with osteomyelitis. What are possible causes of osteomyelitis? Select all that apply. a. Trauma, such as penetrating wounds or compound fractures b. Vascular insufficiency in clients with diabetes or peripheral vascular disease c. Surgical contamination, such as pin sites of skeletal traction d. Progressive osteoporosis

- Trauma, such as penetrating wounds or compound fractures - Vascular insufficiency in clients with diabetes or peripheral vascular disease - Surgical contamination, such as pin sites of skeletal traction

The nurse is caring for a client with a duodenal ulcer. Which assessment findings indicate to the nurse that the client is experiencing perforation from the ulcer? Select all that apply. a. Vomiting b. Tender and rigid abdomen c. Sudden drop in blood pressure d. Pulsating mass in the left abdominal region e. Abdominal pain referred to the right shoulder

- Vomiting - Tender and rigid abdomen - Sudden drop in blood pressure - Abdominal pain referred to the right shoulder

what is gastritis caused by

- acid - medication's - GERD

what are s/s of celiac disease

- diarrhea - steatorrhea - abdominal pain - weight loss - stunted growth & delay puberty in children

status asthmaticus is the most severe form of an asthma attack. it is characterized as: select all that apply a. diffuse wheezing, which can eventually lead to silent chest as ventilation is compromised b. genetic mutation changes affecting chloride transport and increased mucus plugging c. having a rapid onset, not responsive to conventional pharmacologic therapy d. constriction of the bronchiolar muscles with diffuse mucus plugging e. hyperinflation of the alveolar sacs and cor pulmonale and pneumothorax

- diffuse wheezing, which can eventually lead to silent chest as ventilation is compromised - having a rapid onset, not responsive to conventional pharmacologic therapy - constriction of the bronchiolar muscles with diffuse mucus plugging

what are gas producing foods that lead to IBS

- legumes (beans) - eggs - dairy products - fruits

what are 2 cancers that can start in the bone

- leukemia - lymphomas

what causes chronic gastritis

- malignant ulcers of the stomach or H. pylori - autoimmune diseases - dietary factors - chronic reflux of pancreatic secretions or bile

what NSAIDs should not be taken with acute gastritis

- naproxen - indomethacin - ibuprofen

A client with a short arm cast is suspected to have compartment syndrome. What actions should the nurse include in the plan of care? Select all that apply. a. Elevate the arm above the heart. b. Prepare to remove the cast. c. Provide support to the injured extremity. d. Assess neurovascular status every 8 hours. e. Apply ice to extremity

- prepare to remove the cast - provide support to the injured extremity

what are the 4 early complications of fractures

- shock - fat embolism - compartment syndrome - VTE, PE

what are causes are respiratory acidosis

- slow RR - sleep apnea - head trauma - opioid OD - alcohol intoxication - COPD/asthma - pneumonia

Which solution is hypotonic? a. Lactated Ringer solution b. 0.45% NaCl c. 0.9% NaCl d. 5% NaCl

0.45% NaCl

PaCO2 normal range

35-45

what is the duration of treatment for PPI in a pt diagnosed with peptic ulcer disease? o 1-2 weeks o 7 days o At least 2 years based on risk factors o 4-8 weeks

4-8 weeks rationale: Proton pump inhibitors should be used for 4-8 weeks to allow complete peptic ulcer heading. Patients at high risk require a maintenance dose for 1 year.

pH range for asthma

7.35-7.45

A patient with COPD requires oxygen administration. What method of delivery does the nurse know would be best for this patient? a. A nasal cannula b. An oropharyngeal catheter c. A nonrebreathing mask d. A Venturi mask

A Venturi mask

After teaching a group of students about intestinal obstruction, the instructor determines that the teaching was effective when the students identify which of the following as a cause of a functional obstruction? a. Volvulus b. Intussusception c. Tumor d. Abdominal surgery

Abdominal surgery

The nurse is providing care for a client whose inflammatory bowel disease has necessitated hospital treatment. Which of the following would most likely be included in the client's medication regimen? a. Antidiarrheal medications 30 minutes before a meal b. Antiemetics on a PRN basis c. Vitamin B12 injections to prevent pernicious anemia d. Beta adrenergic blockers to reduce bowel motility

Antidiarrheal medications 30 minutes before a meal

The nurse caring for a client with diverticulitis is preparing to administer the client's medications. The nurse anticipates administration of which category of medication because of the client's diverticulitis? a. Antianxiety b. Antispasmodic c. Antiemetic d. Anti-inflammatory

Antispasmodic

The Emergency Department (ED) nurse is caring for a client with a possible acidbase imbalance. The physician has ordered an arterial blood gas (ABG). What is one of the most important indications of an acid-base imbalance that is shown in an ABG? a. PaO b. PO c. Carbonic acid d. Bicarbonate

Bicarbonate

A client has been admitted to the medical unit for the treatment of Paget disease. When reviewing the medication administration record, the nurse should anticipate what medication? a. Estrogen b. Bisphosphonates c. Alkaline phosphatase d. Calcium gluconate

Bisphosphonates

A patient is admitted to the hospital after not having had a bowel movement in several days. The nurse observes the patient is having small liquid stools, a grossly distended abdomen, and abdominal cramping. What complication can this patient develop related to this problem? a. Appendicitis b. Rectal fissures c. Bowel perforation d. Diverticulitis

Bowel perforation

Which of the following is a leading cause of chronic obstructive pulmonary disease (COPD) exacerbation? a. Bronchitis b. Pneumonia c. Common cold d. Asthma

Bronchitis

what lab test can be done for a pt who might be anemic or bleeding

CBC

The nurse is caring for a client being treated with isotonic IV fluid for hypernatremia. What complication of hypernatremia should the nurse continuously monitor for? a. Red blood cell crenation b. Red blood cell hydrolysis 2 3 3 c. Cerebral edema d. Renal failure

Cerebral edema

Which cleansing solution is the most effective for use in completing pin site care? a. Betadine b. Chlorhexidine c. Hydrogen peroxide d. Alcohol

Chlorhexidine

A client informs the nurse of having abdominal pain that is relieved when having a bowel movement. The health care provider diagnosed the client with irritable bowel syndrome. What does the nurse recognize as characteristic of this disorder? a. Weight loss due to malabsorption b. Blood and mucus in the stool c. Chronic constipation with sporadic bouts of diarrhea d. Client is awakened from sleep due to abdominal pain.

Chronic constipation with sporadic bouts of diarrhea

What finding by the nurse may indicate that the client has chronic hypoxia? a. Crackles b. Peripheral edema c. Clubbing of the fingers d. Cyanosis

Clubbing of the fingers

Which of the following vitamin is necessary for maintenance of normal calcium levels? a. D b. A c. C d. E

D

Which is one of the primary symptoms of irritable bowel syndrome (IBS)? a. Diarrhea b. Pain c. Bloating d. Abdominal distention

Diarrhea

Nursing management of the client with a urinary tract infection should include: a. Teaching the client to douche daily b. Discouraging caffeine intake c. Instructing the client to limit fluid intake d. Administering morphine sulfate

Discouraging caffeine intake

What information should the nurse include in the teaching plan for a client being treated for diverticulosis? a. Avoid unprocessed bran in the diet b. Avoid daily exercise; indulge only in mild activity c. Drink at least 8 to 10 large glasses of fluid every day d. Use laxatives or enemas at least once a week

Drink at least 8 to 10 large glasses of fluid every day

Clients with Type O blood are at higher risk for which of the following GI disorders? a. Gastric cancer b. Duodenal ulcers c. Esophageal varices d. Diverticulitis

Duodenal ulcers

The nurse is performing a community screening for colorectal cancer. Which characteristic should the nurse include in the screening? a. Age younger than 40 years b. Low-fat, low-protein, high-fiber diet c. History of skin cancer d. Familial polyposis

Familial polyposis

The nurse in an extended-care facility reports that a resident has clinical manifestations of fecal incontinence. The health care provider orders a diagnostic study to rule out inflammation. Which study will the nurse prepare the client for? a. Anorectal manometry b. Transit study c. Flexible sigmoidoscopy d. Barium enema

Flexible sigmoidoscopy

Which term refers to a break in the continuity of a bone? a. Malunion b. Dislocation c. Fracture d. Subluxation

Fracture

what bacteria causes gastric cancer

H. Pylori

what disease is associated with peptic ulcer disease

H. Pylori

A client is scheduled for the creation of a continent ileostomy. What dietary guidelines should the nurse encourage during the weeks following surgery? a. A minimum of 30 g of soluble fiber daily b. Increased intake of free water and clear juices c. High intake of strained fruits and vegetables d. A high-calorie, high-residue diet

High intake of strained fruits and vegetables

Which condition might occur with respiratory acidosis? a. Increased intracranial pressure b. Decreased blood pressure c. Decreased pulse d. Mental alertness

Increased intracranial pressure

A client has a respiratory rate of 38 breaths/min. What effect does breathing faster have on arterial pH level? a. No effect b. Increases arterial pH c. Decreases arterial pH d. Provides long-term pH regulation

Increases arterial pH

A client is recovering from an ileostomy that was performed to treat inflammatory bowel disease. During discharge teaching, what would the nurse stress the importance of? a. Increasing fluid intake to prevent dehydration b. Wearing an appliance pouch only at bedtime c. Consuming a low-protein, high-fiber diet d. Taking only enteric-coated medications

Increasing fluid intake to prevent dehydration

A client is admitted to the medical unit with a diagnosis of intestinal obstruction. When planning this client's care, which of the following nursing diagnoses should the nurse prioritize? a. Ineffective tissue perfusion related to bowel ischemia b. Imbalanced nutrition: Less than body requirements related to impaired absorption c. Anxiety related to bowel obstruction and subsequent hospitalization d. Impaired skin integrity related to bowel obstruction

Ineffective tissue perfusion related to bowel ischemia

The nurse is caring for a client with an arterial blood pH of 7.48 and bicarbonate level of 29 mEq/L (29 mmol/L). Which treatment will the nurse expect to be prescribed for this client? a. Bronchodilator b. Potassium supplements c. Intravenous 0.9% normal saline d. Oxygen through a rebreather mask

Intravenous 0.9% normal saline

A nurse would most likely expect the need for open reduction for a client with which of the following? a. Closed fracture b. Little bone separation c. Soft tissue free of bone ends d. Joint fracture

Joint fracture

A client undergoes open reduction with internal fixation to treat an intertrochanteric fracture of the right hip. The nurse should include which intervention in the postoperative care plan? a. Performing passive range-of-motion (ROM) exercises on the client's legs once each shift b. Keeping a pillow between the client's legs at all times c. Turning the client from side to side every 2 hours d. Maintaining the client in semi-Fowler's position

Keeping a pillow between the client's legs at all times

A physician orders an isotonic I.V. solution for a client. Which solution should the nurse plan to administer? a. 5% dextrose and normal saline solution b. Lactated Ringer's solution c. Half-normal saline solution d. 10% dextrose in water

Lactated Ringer's solution

The nurse is assessing a patient with appendicitis. The nurse is attempting to elicit a Rovsing's sign. Where should the nurse palpate for this indicator of acute appendicitis? a. Right lower quadrant b. Left lower quadrant c. Right upper quadrant d. Left upper quadrant

Left lower quadrant

A positive Rovsing's sign is indicative of appendicitis. A nurse knows to assess for this indicator by palpating the: a. Right lower quadrant. b. Left lower quadrant. c. Right upper quadrant. d. Left upper quadrant.

Left lower quadrant.

What is status asthmaticus?

Life-threatening episode of airway obstruction that is unresponsive to common treatment

The instructor is teaching a group of students about irritable bowel syndrome (IBS) and antidiarrheal agents, the instructor determines that the teaching was effective when the students identify which of the following as an example of an antidiarrheal agent commonly administered for IBS? a. Loperamide b. Lubiprostone c. Dicyclomine d. Peppermint oil

Loperamide

A client has the following arterial blood gas (ABG) values: pH, 7.12; partial pressure of arterial carbon dioxide (PaCO ), 40 mm Hg; and bicarbonate (HCO ), 15 mEq/L. These ABG values suggest which disorder? a. Respiratory alkalosis b. Respiratory acidosis c. Metabolic alkalosis d. Metabolic acidosis

Metabolic acidosis

The nurse is caring for a patient with diabetes type I who is having severe vomiting and diarrhea. What condition that exhibits blood values with a low pH and a low plasma bicarbonate concentration should the nurse assess for? a. Respiratory acidosis b. Respiratory alkalosis c. Metabolic acidosis d. Metabolic alkalosis

Metabolic acidosis

A 65-year-old client with possible pyloric stenosis has been on a Salem Sump tube and low continuous suction ever since being admitted 72 hours ago. Upon reviewing the latest blood work, the nurse notices that the client's potassium is below reference range, placing the client at risk for what imbalance? a. Hypercalcemia b. Metabolic acidosis c. Metabolic alkalosis d. Respiratory acidosis

Metabolic alkalosis

An unresponsive client had a plaster cast applied to the right lower leg 8 hours ago. When moving the client, the nurse notices an indentation on the posterior lower portion of the cast. What is the best action by the nurse? a. Document the findings. b. Notify the physician. c. Remove the cast immediately. d. Assess for pedal pulse and mobility of toes

Notify the physician.

A client was fitted with an arm cast after fracturing the humerus. Twelve hours after the application of the cast, the client tells the nurse that the injured arm hurts. Analgesics do not relieve the pain. What would be the most appropriate nursing action? a. Prepare the client for opening or bivalving of the cast. b. Obtain a prescription for a different analgesic. c. Encourage the client to wiggle and move the fingers. d. Petal the edges of the client's cast

Prepare the client for opening or bivalving of the cast.

A nurse is preparing to discharge a client newly diagnosed with peptic ulcer disease. The client's diagnostic test results were positive for H. pylori bacteria. The health care provider has ordered the "triple therapy" regimen. Which medications will the nurse educate the client on? a. H2-receptor antagonist and two antibiotics b. H2-receptor antagonist, proton-pump inhibitor, and an antibiotic c. Proton-pump inhibitor, an antibiotic, and bismuth salts d. Proton-pump inhibitor and two antibiotics

Proton-pump inhibitor and two antibiotics

A client has just been diagnosed with acute gastritis after presenting in distress to the emergency department with abdominal symptoms. What would be the nursing care most needed by the client at this time? a. Teaching the client about necessary nutritional modification b. Helping the client weigh treatment options c. Teaching the client about the etiology of gastritis d. Providing the client with physical and emotional support

Providing the client with physical and emotional support

When the nurse interviews a client with internal hemorrhoids, what would the nurse expect the client to report? a. Rectal bleeding b. Constipation c. Severe pain d. Discharge that includes pus

Rectal bleeding

22. Which of the following electrolytes is the primary determinant of extracellular fluid (ECF) osmolality? a. Sodium b. Potassium c. Calcium d. Magnesium

Sodium

A nurse is assessing a client for risk factors known to contribute to osteoarthritis. What assessment finding should the nurse interpret as a risk factor? a. The client has a 30 pack-year smoking history. b. The client's body mass index is 34. c. The client has primary hypertension. d. The client is 58 years old.

The client's body mass index is 34.

A client realizes that regular use of laxatives has lead to bowel pattern improvement. However, the nurse cautions this client against the prolonged use of laxatives for which reason? a. The client may develop inflammatory bowel disease. b. The client may develop arthritis or arthralgia. c. The client's natural bowel function may become sluggish. d. The client may lose their appetite.

The client's natural bowel function may become sluggish.

A client is being discharged home with a long arm cast. What education should the nurse include to prevent disuse syndrome in the arm? a. Use of isometric exercises b. Proper use of a sling c. Repositioning the arm in the cast d. Abduction and adduction of the shoulder

Use of isometric exercises

A client is admitted to the hospital with an exacerbation of chronic gastritis. When assessing the client's nutritional status, the nurse should expect to find what type of deficiency? a. vitamin A b. vitamin B6 c. vitamin B12 d. vitamin C

Vitamin B12

The nurse is helping to set up Buck's traction on an orthopedic client. How often should the nurse assess circulation to the affected leg? a. Within 30 minutes, then every 1 to 2 hours b. Within 30 minutes, then every 4 hours c. Within 30 minutes, then every 8 hours d. Within 30 minutes, then every shift

Within 30 minutes, then every 1 to 2 hours

when doing a physical assessment on a pt with gastric cancer, what is one part of the body that is important to assess

abdomen

what is a carcinoembryonic antigen

antigen that is specific to cancer

A client is taking spironolactone to control hypertension. The client's serum potassium level is 6 mEq/L. What is the nurse's priority during assessment? a. neuromuscular function b. bowel sounds c. respiratory rate d. electrocardiogram (ECG) results

electrocardiogram (ECG) results

inflammation of the lining of the stomach is known as what

gastritis

what is secondary diarrhea

high volume diarrhea

The nurse caring for an older adult client diagnosed with diarrhea is administering and monitoring the client's medications. Because one of the client's medications is digitalis (digoxin), the nurse monitors the client closely for: a. hyperkalemia. b. hypokalemia. c. hyponatremia. d. hypernatremia.

hypokalemia

The nurse is conducting a lecture on the difference between hypovolemia and dehydration. When completing a verbal comparison, which point needs clarified? a. Similar causes are present in both conditions. b. Hypovolemia contains only low blood volume. c. In dehydration, only extracellular is depleted. d. Both conditions result in abnormal laboratory studies.

in dehydration, only extracellular is depleted

what discharge teaching should you give a pt who just has a barium contrast

increase fluids to wash out the barium contrast and take laxatives

What is gastritis?

inflammation of the gastric mucosa

A nurse is assessing a client and obtains the following findings: abdominal discomfort, mild diarrhea, blood pressure of 100/80 mm Hg, pulse rate of 88 beats/minute, respiratory rate of 20 breaths/minute, temperature 100° F (37.8° C). What diagnosis will the nurse suspect for this client? a. inflammatory bowel disease (IBD) b. colorectal cancer c. diverticulitis d. liver failure

inflammatory bowel disease (IBD)

A client with symptoms of mild persistent asthma is now initiating treatment. Which of the following is the preferred therapy that the nurse will teach the client to use at home? a. Inhaled beclomethasone b. Oral sustained-release albuterol c. Subcutaneous omalizumab d. Oral prednisone

inhaled beclomethasone

A client with a history of anxiety experiences respiratory alkalosis. The nurse measures a respiratory rate of 46 breaths/minute, a heart rate of 110 beats/minute, a blood pressure of 162/90 mm Hg, and a temperature of 98.6° F (37° C). To help correct respiratory alkalosis, the nurse should: a. insert a nasogastric tube (NG) as ordered. b. administer acetaminophen as ordered. c. instruct the client to breathe into a paper bag. d. administer antibiotics as ordered.

instruct the client to breathe into a paper bag.

Lifestyle risk factors for osteoporosis include a. lack of aerobic exercise. b. a low-protein, high-fat diet. c. an estrogen deficiency or menopause. d. lack of exposure to sunshine.

lack of exposure to sunshine.

what part of the intestine is affected when it comes to irritable bowel syndrome

large intestine

The nurse is recording the medications a client uses on a daily basis for a client who is scheduled to undergo surgery in the morning. Which daily medication has the potential to result in constipation? a. laxative b. multivitamin without iron c. NSAIDs d. acetaminophen

laxative

Diet modifications for patient diagnosed with chronic inflammatory bowel disease include which of the following? a. Low residue b. Low protein c. Calorie restriction d. Iron restriction

low residue

if acute gastritis, is the pt allowed to take foods by mouth

no

is COPD reversable

no

What is osmotic diarrhea?

occurs when water is pulled into the intestines by the osmotic pressure of unabsorbed particles

The nurse is educating a patient with asthma about preventative measures to avoid having an asthma attack. What does the nurse inform the patient is a priority intervention to prevent an asthma attack? a. Using a long-acting steroid inhaler when an attack is coming b. Avoiding exercise and any strenuous activity c. Preparing a written action plan d. Staying in the house if it is too cold or too hot

prepare a written action plan

what does air trapping lead to

prolonged exhalation

what is chronic gastritis

prolonged inflammation, atrophy of gastric tissue

how do you treat a tumor in the small intestine

surgery and chemotherapy

how might fissures happen

tears that can happen from the passing of hard stools

A client is diagnosed with hypocalcemia and the nurse is teaching the client about symptoms. What symptom would the nurse include in the teaching? a. tingling sensation in the fingers b. polyuria c. flank pain d. hypertension

tingling sensation in the fingers

why do we give an NG tube with acute gastritis

to preserve the stomach and help it heal

T/F pt who have chronic gastritis will be asymptomatic

true

how can you reduce anxiety for a pt who might be having a procedure for gastritis

use a calm approach and explain the procedure and treatment

what should you ask a pt who presents with a potential disease process

what are the signs and symptoms

when does pain happen with a gastric ulcer

when the pt is eating food

A client with a peptic ulcer is about to begin a therapeutic regimen that includes a bland diet, antacids, and famotidine. Before the client is discharged, the nurse should provide which instruction? a. "Eat three balanced meals every day." b. "Stop taking the drugs when your symptoms subside." c. "Avoid aspirin and products that contain aspirin." d. "Increase your intake of fluids containing caffeine."

"Avoid aspirin and products that contain aspirin."

A nurse is caring for a client taking a laxative daily containing senna to manage "my constipation." Which education will the nurse provide to the client to prevent complications? a. "Limit fluid intake temporarily so that diarrhea doesn't occur." b. "Avoid taking the laxative on a long-term basis." c. "Make sure to take a multivitamin with each dose." d. "Take this on an empty stomach to ensure maximum absorption."

"Avoid taking the laxative on a long-term basis."

A client is prescribed tetracycline to treat peptic ulcer disease. Which instruction would the nurse give the client? a. "Take the medication with milk." b. "Be sure to wear sunscreen while taking this medicine." c. "You will not experience GI upset while taking this medication." d. "Do not drive when taking this medication."

"Be sure to wear sunscreen while taking this medicine."

A client with gastric ulcers caused by H. pylori is prescribed metronidazole. Which client statement indicates to the nurse that teaching about this medication was effective? a. "It might cause a metallic taste in my mouth." b. "I can take this medication with my blood thinner." c. "I can have an alcoholic drink in the evenings." d. "My appetite may increase while taking this medication."

"It might cause a metallic taste in my mouth."

A nurse is teaching a client who has experienced an episode of acute gastritis. The nurse knows further education is necessary when the client makes which statement? a. "I should feel better in about 24 to 36 hours." b. "My appetite should come back tomorrow." c. "I should limit alcohol intake, at least until symptoms subside." d. "Once I can eat again, I should stick with bland foods."

"My appetite should come back tomorrow."

A client with recurrent peptic ulcer disease asks, "How long do I have to take the medication?" Which response will the nurse make? a. "One month or so." b. "For the rest of your life." c. "Prophylactically for now." d. "Until the prescription is gone.

"Prophylactically for now."

A client with a peptic ulcer asks, "How does something that goes into my lungs, like smoking, affect my stomach?" Which response by the nurse is most appropriate? a. "Smoking is overall bad for the health." b. "Smoking decreases gastric acid secretion." c. "Cigarette smoke contains irritants that affects all body organs." d. "Smoking reduces the amount of bicarbonate needed to buffer stomach acid."

"Smoking reduces the amount of bicarbonate needed to buffer stomach acid."

A nurse is educating a client diagnosed with osteomalacia. Which statement by the nurse is appropriate? a. "You will need to decrease the amount of dairy products you consume." b. "You will need to avoid foods high in phosphorus and vitamin D." c. "You may need to be evaluated for an underlying cause, such as renal failure." d. "You will need to engage in vigorous exercise three times a week for 30 minutes."

"You may need to be evaluated for an underlying cause, such as renal failure."

The nurse is caring for the client with chronic osteomyelitis of the jaw with a draining wound. Which nursing diagnosis is appropriate for the client? Select all that apply. a. Acute pain b. Disturbed body image c. Imbalanced nutrition: less than body requirements d. Risk for injury e. Ineffective airway clearance

- Acute pain - Disturbed body image - Imbalanced nutrition: less than body requirements

A client has been diagnosed with chronic gastritis. The nurse knows that which of the following symptoms are indicative of gastritis? Select all that apply. a. Hiccups b. Belching c. Early satiety d. Hematemesis e. Sour taste in the mouth

- Belching - Early satiety - Hematemesis - sour taste in mouth

A nurse is educating a client with a family history of colorectal cancer about sign(s) to immediately report to the health care provider. Which early sign(s) of colorectal cancer will the nurse inform the client to report? Select all that apply. a. Development of new hemorrhoids b. Abdominal bloating and flank pain c. Unexplained weight gain d. Change in bowel habits e. Occasional rectal bleeding

- Change in bowel habits - Occasional rectal bleeding

A client recovering from surgery for gastric cancer develops dumping syndrome. Which teachings will the nurse provide to reduce the symptoms of this condition? Select all that apply. a. Drink fluids with meals. b. Select foods high in sugar. c. Ingest 6 small meals a day. d. Remain upright after meals. e. Eat foods low in carbohydrates.

- Ingest 6 small meals a day - Eat foods low in carbohydrates

A bone graft may be used for which of the following reasons? Select all that apply. a. Joint stabilization b. Defect filling c. Stimulation of bone healing d. Improvement of motion e. Reduction of a fracture

- Joint stabilization - Defect filling - Stimulation of bone healing

A 75-year-old client had surgery for a left hip fracture yesterday. When completing the plan of care, the nurse should include assessment for which complications? Select all that apply. a. Pneumonia b. Necrosis of the humerus c. Skin breakdown d. Sepsis e. Delirium

- Pneumonia - Skin breakdown - sepsis - delirium

A nurse is caring for a client hospitalized with acute on chronic gastritis. Which health promotion topic(s) should the nurse emphasize? Select all that apply. a. Strategies for maintaining an alkaline gastric environment b. Safe techniques for reducing stress c. Techniques for positioning correctly to promote gastric healing d. The need to avoid alcohol e. Proper use of appropriate medications

- Safe techniques for reducing stress - The need to avoid alcohol - Proper use of appropriate medications

The nurse is caring for a client who is undergoing diagnostic testing for a suspected gastrointestinal malabsorption issue. When taking this client's health history and performing the physical assessment, which finding is most consistent with this diagnosis? Select all that apply. a. Recurrent constipation coupled with weight loss b. Foul-smelling stool that contains fat c. Fever accompanied by a rigid, tender abdomen d. Bloody bowel movements accompanied by fecal incontinence e. Stool with characteristics of diarrhea

- Stool with characteristics of diarrhea - Foul-smelling stool that contains fat

what medications fall under acid reducers

- antiacids - Histamine receptor blockers (-tidine) - PPIs (-azole)

what class of meds can you give a pt who has PUD

- antibiotics to kill the H. pylori - acid reducers - mucosal protectants

what are 3 diagnostic tests that can be done to see if a pt is constipated

- barium enema - sigmoidoscopy - stool testing

Pts who have gastritis should avoid what

- caffeinated beverages - alcohol - smoking

what are 4 kinds of treatment for gastric cancer

- chemotherapy - targeted therapy - radiation therapy - surgical removal of the tumor is possible

what are 3 kinds of primary bone cancers

- chondrosarcoma - ewing sarcoma - fibrosarcoma

what medications help treat H. Pylori

- clarithromycin - metronidazole - amoxicillin - tetracycline

if a pt is NPO from gastritis and they are starting to eat again, how should you start them

- clear liquids - full liquids (soup, milk, yogurt) - soft foods

what are 4 s/s of IBS

- cramping - abdominal pain - bloating/gas - diarrhea or constipation

what are causes of metabolic acidosis

- diarrhea - renal failure - DKA

what can erosive gastritis lead to

- melena (black tarry stool) - hematemesis (blood in the vomit) - hematochezia (bright red blood in stool)

what are the medical managements for chronic gastritis

- modify diet - promote rest - reduce stress - avoid alcohol and NSAIDs

what are the s/s of anemia or bleeding

- tired - cold - tachycardia due to not having enough O2 in the blood

how do you diagnose a tumor in the small intestine

- upper GI radiography - abdominal CT

A client with suspected osteomalacia has a fractured tibia and fibula. What test would give a definitive diagnosis of osteomalacia? a. A bone biopsy b. Demineralization of the bone c. Increased and decreased areas of bone metabolism d. Elevated levels of alkaline phosphatase

A bone biopsy

A nurse is conducting health screening with a diverse group of clients. Which client likely has the most risk factors for developing hemorrhoids? a. A 45-year-old teacher who stands for 6 hours per day b. A pregnant woman at 28 weeks' gestation c. A 37-year-old construction worker who does heavy lifting d. A 60-year-old professional who is under stress

A pregnant woman at 28 weeks' gestation

A client with exacerbation of chronic obstructive pulmonary disease (COPD) is scheduled for a thoracentesis. Which nursing intervention would be appropriate for client safety? a. Administering a cough suppressant as needed b. Assisting the client to a prone position c. Obtaining arterial blood gas values immediately after the procedure d. Applying oxygen via nasal cannula

Administering a cough suppressant as needed

The American Cancer Society recommends routine screening to detect colorectal cancer. Which screening test for colorectal cancer should a nurse recommend? a. Carcinoembryonic antigen (CEA) test after age 50 b. Proctosigmoidoscopy after age 30 c. Annual digital examination after age 40 d. Barium enema after age 20

Annual digital examination after age 40

The nurse is preparing a client for a surgical procedure that will allow visualization of the extent of joint damage of the knee for a client with rheumatoid arthritis and also obtain a sample of synovial fluid. What procedure will the nurse prepare the client for? a. Open reduction b. Needle aspiration c. Arthroplasty d. Arthroscopy

Arthroscopy

A 55-year-old client is scheduled for spirometry testing for evaluation of chronic obstructive pulmonary disease (COPD). The nurse a. Asks the client, "What are your allergies?" b. Explains to the client not to eat or drink before the spirometry test c. States that various blood tests must also be done d. Tells the client that arterial blood gas is performed after spirometry testing

Asks the client, "What are your allergies?"

A nurse is caring for a client placed in traction to treat a fractured femur. Which nursing intervention has the highest priority? a. Assessing the extremity for neurovascular integrity b. Keeping the client from sliding to the foot of the bed c. Keeping the ropes over the center of the pulley d. Ensuring that the weights hang free at all times

Assessing the extremity for neurovascular integrity

Which of the following is a term used to describe intestinal rumbling? a. Borborygmus b. Tenesmus c. Malabsorption d. Atony

Borborygmus

A nurse is teaching a client with osteomalacia about the role of diet. What would be the best choice for breakfast for a client with osteomalacia? a. Cereal with milk, a scrambled egg, and grapefruit b. Poached eggs with sausage and toast c. Waffles with fresh strawberries and powdered sugar d. A bagel topped with butter and jam with a side dish of grapes

Cereal with milk, a scrambled egg, and grapefruit

The nurse is assisting with the application of a cast. What will the nurse expect to be done first? a. Covering the skin with a stockinette. b. Applying strips of the cast material evenly. c. Arranging for an x-ray to check bone alignment. d. Cleaning the skin surface.

Cleaning the skin surface.

Which of the following clients is at highest risk for peptic ulcer disease? a. Client with blood type A b. Client with blood type B c. Client with blood type AB d. Client with blood type O

Client with blood type O

The nurse is assessing a patient in respiratory failure. What finding is a late indicator of hypoxia? a. Clubbing of fingers b. Cyanosis c. Crackles d. Restlessness

Cyanosis

The nurse is caring for a client with laboratory values indicating dehydration. Which clinical symptom is consistent with the dehydration? a. Cool and pale skin b. Crackles in the lung fields c. Distended jugular veins d. Dark, concentrated urine

Dark, concentrated urine

Which is an inappropriate use of traction? a. Immobilize a fracture b. Decrease space between opposing structures c. Reduce deformity d. Minimize muscle spasms

Decrease space between opposing structures

Which term refers to the first portion of the small intestine? a. Pylorus b. Peritoneum c. Omentum d. Duodenum

Duodenum

The nurse is caring for a patient who has malabsorption syndrome with an undetermined cause. What procedure will the nurse assist with that is the best diagnostic test for this illness? a. Ultrasound b. Endoscopy with mucosal biopsy c. Stool specimen for ova and parasites d. Pancreatic function tests

Endoscopy with mucosal biopsy

A client with a simple arm fracture is receiving discharge education from the nurse. What would the nurse instruct the client to do? a. Elevate the affected extremity to shoulder level when at rest. b. Engage in exercises that strengthen the unaffected muscles. c. Apply topical anesthetics to accessible skin surfaces as needed. d. Avoid using analgesics so that further damage is not masked.

Engage in exercises that strengthen the unaffected muscles.

A nurse is providing care for a client whose recent colostomy has contributed to a nursing diagnosis of Disturbed Body Image Related to Colostomy. What intervention best addresses this diagnosis? a. Encourage the client to conduct online research into colostomies. b. Engage the client in dialogue about the implications of having the colostomy. c. Emphasize the fact that the colostomy was needed to alleviate a much more serious health problem. d. Emphasize the fact that the colostomy is temporary measure and is not permanent.

Engage the client in dialogue about the implications of having the colostomy.

A nurse is caring for a client who just has been diagnosed with a peptic ulcer. When teaching the client about this new diagnosis, how should the nurse best describe a peptic ulcer? a. Inflammation of the lining of the stomach b. Erosion of the lining of the stomach or intestine c. Bleeding from the mucosa in the stomach d. Viral invasion of the stomach wall

Erosion of the lining of the stomach or intestine

A client underwent a continent ileostomy. Within which time frame should the client expect to empty the reservoir? a. At least once a day b. At least once every 2 days c. Two to three times daily d. Every 4 to 6 hours

Every 4 to 6 hours

Which of the following is a cause of a calcium renal stone? a. Excessive intake of vitamin D b. Gout c. Neurogenic bladder d. Foreign bodies

Excessive intake of vitamin D

31. Which characteristic is a risk factor for colorectal cancer? a. Age younger than 40 years b. Low-fat, low-protein, high-fiber diet c. History of skin cancer d. Familial polyposis

Familial polyposis

The nurse is caring for a client with a suspected megacolon. The nurse anticipates that one of the findings of assessment will be a. Diarrhea b. Hemorrhoids c. Fecal incontinence d. Dark, tarry stools

Fecal incontinence

A nurse is applying an ostomy appliance to the ileostomy of a client with ulcerative colitis. Which action is appropriate? a. Cutting the faceplate opening no more than 2 inches larger than the stoma b. Gently washing the area surrounding the stoma using a facecloth and mild soap c. Scrubbing fecal material from the skin surrounding the stoma d. Maintaining wrinkles in the faceplate so it doesn't irritate the skin

Gently washing the area surrounding the stoma using a facecloth and mild soap

what causes chronic gastritis

H. pylori

A healthcare provider asks a nurse to test a client for Tinel's sign to diagnose carpal tunnel syndrome. What should the nurse do to perform this assessment? a. Have the client make a fist and open the hand against resistance. b. Have the client stretch the fingers around a ball and squeeze with force. c. Have the client hold the palm of the hand up while the nurse percusses over the median nerve. d. Have the client pronate the hand while the nurse palpates the radial nerve

Have the client hold the palm of the hand up while the nurse percusses over the median nerve

During assessment of a patient with gastritis, the nurse practitioner attempts to distinguish acute from chronic pathology. One criteria, characteristic of gastritis would be the: a. Immediacy of the occurrence. b. Presence of vomiting. c. Frequency of abdominal discomfort. d. Incidence of anorexia.

Immediacy of the occurrence

Radiographic evaluation of a client's fracture reveals that a bone fragment has been driven into another bone fragment. The nurse identifies this as which type of fracture? a. Comminuted b. Compression c. Impacted d. Greenstick

Impacted

Which type of fracture occurs when a bone fragment is driven into another bone fragment? a. Impacted b. Oblique c. Spiral d. Transverse

Impacted

A client is diagnosed with carpal tunnel syndrome. Which assessment findings would the nurse expect? a. Pain radiating down the dorsal surface of the forearm b. Tenderness in the affected wrist c. Inability to flex index and middle fingers d. A decrease in grasp strength

Inability to flex index and middle fingers

Patients with urolithiasis need to be encouraged to: a. Increase their fluid intake so that they can excrete up to 4 liters every day. b. Participate in strenuous exercises so that the tone of smooth muscle in the urinary tract can be strengthened to help propel calculi. c. Supplement their diet with calcium needed to replace losses to renal calculi. d. Limit their voiding to every 6 to 8 hours so that increased volume can increase hydrostatic pressure, which will help push stones along the urinary system.

Increase their fluid intake so that they can excrete up to 4 liters every day.

A nurse is assisting a client with mild chronic obstructive pulmonary disease (COPD) to set a goal related to the condition. Which of the following is an appropriate goal for this client? a. Maintain activity level of walking to the mailbox. b. Continue with current level of mobility at home. c. Increase walking distance around a city block without shortness of breath. d. Relieve shortness of breath to a level as close as possible to tolerable.

Increase walking distance around a city block without shortness of breath.

The nurse is caring for a client who has undergone creation of a urinary diversion. Forty-eight hours postoperatively, the nurse's assessment reveals that the stoma is a dark purplish color. What is the nurse's most appropriate response? a. Document the presence of a healthy stoma. b. Assess the client for further signs and symptoms of infection. c. Inform the primary care provider that the vascular supply may be compromised. d. Liaise with the wound-ostomy-continence (WOC) nurse because the ostomy appliance around the stoma may be too loose.

Inform the primary care provider that the vascular supply may be compromised.

A client is undergoing diagnostic testing for a tumor of the small intestine. What are the most likely symptoms that prompted the client to first seek care? a. Hematemesis and persistent sensation of fullness b. Abdominal bloating and recurrent constipation c. Intermittent pain and bloody stool d. Unexplained bowel incontinence and fatty stools

Intermittent pain and bloody stool

Which is the most prominent sign of inflammatory bowel disease? a. Abdominal distention and constipation b. Intermittent pain and diarrhea c. Hyperactive bowel sounds and constipation d. Increased peristalsis and diarrhea

Intermittent pain and diarrhea

The nurse is comparing Crohn's disease (regional enteritis) with ulcerative colitis. Which of the following describes Crohn's disease? a. Fistulas are rare b. Diarrhea is more severe c. Bleeding is common and severe d. Its course is prolonged and variable

Its course is prolonged and variable

A client hospitalized for treatment of a pulmonary embolism develops respiratory alkalosis. Which clinical findings commonly accompany respiratory alkalosis? a. Headache or blurry vision b. Abdominal pain or diarrhea c. Hallucinations or tinnitus d. Light-headedness or paresthesia

Light-headedness or paresthesia

A client is undergoing diagnostic testing for osteomalacia. Which of the following laboratory results are most suggestive of this diagnosis? a. High chloride, calcium, and magnesium levels b. High parathyroid and calcitonin levels c. Low serum calcium and magnesium levels d. Low serum calcium and low phosphorus level

Low serum calcium and low phosphorus level

As part of the management of constipation, the client is instructed to take 30 mL of mineral oil orally. How does mineral oil facilitate bowel evacuation? a. Lubricates and softens fecal matter b. Increases the volume of intestinal contents c. Irritates nerve endings in the intestinal mucosa d. Decreases water retention of stool

Lubricates and softens fecal matter

A client has been diagnosed with an intestinal obstruction and has a nasogastric tube set to low continuous suction. Which acid-base disturbance is this client at risk for developing? a. Respiratory acidosis b. Respiratory alkalosis c. Metabolic acidosis d. Metabolic alkalosis

Metabolic alkalosis

The nurse is caring for a client who is suspected to have developed a peptic ulcer hemorrhage. Which action should the nurse include in the plan of care? a. Prepare the client for emergency antrectomy. b. Insert a nasogastric tube to drain stomach contents. c. Assess vital signs every shift. d. Monitor hourly urine output.

Monitor hourly urine output.

how should you prepare your pt for a barium contrast

NPO and no smoking 8 hours before procedure

Which of the following is considered an early symptom of gastric cancer? a. Pain relieved by antacids b. Weight loss c. Bloating after meals d. Dyspepsia

Pain relieved by antacids

A client is being treated for prolonged diarrhea. Which foods should the nurse encourage the client to consume? a. Protein-rich foods b. Potassium-rich foods c. High-fiber foods d. High-fat foods

Potassium-rich foods

A client has just been diagnosed with acute gastritis after presenting in distress to the emergency department with abdominal symptoms. Which of the following actions should the nurse prioritize? a. Teaching the client about necessary nutritional modification b. Helping the client weigh treatment options c. Teaching the client about the etiology of gastritis d. Providing the client with physical and emotional support

Providing the client with physical and emotional support

A patient with a UTI is having burning and pain when urinating. What urinary analgesic is prescribed for relief of these symptoms? a. Bactrim b. Levaquin c. Pyridium d. Septra

Pyridium

Which of the following is the most successful treatment for gastric cancer? a. Removal of the tumor b. Chemotherapy c. Radiation d. Palliation

Removal of the tumor

A patient with a longstanding diagnosis of generalized anxiety disorder presents to the emergency department (ED). The triage nurse notes upon assessment that the patient has been experiencing rapid, deep respirations since before arriving at the ED 20 minutes ago. This observation suggests that the patient is at risk for developing which form(s) of acid-base imbalance? Select all that apply. a. Respiratory acidosis b. Respiratory alkalosis c. Metabolic acidosis d. Metabolic alkalosis e. Mixed Acid--Based Disorder

Respiratory alkalosis

A client is admitted with a diagnosis of acute appendicitis. When assessing the abdomen, the nurse would expect to find rebound tenderness at which location? a. Right upper quadrant b. Right lower quadrant c. Left upper quadrant d. Left lower quadrant

Right lower quadrant

The nurse observes the physician palpating the abdomen of a client that is suspected of having acute appendicitis. When the abdomen is pressed in the left lower quadrant the client complains of pain on the right side. What does the nurse understand this assessment technique is referred to? a. Referred pain b. Rebound pain c. Rovsing sign d. Cremasteric reflex

Rovsing sign

A client with peptic ulcer disease has been prescribed sucralfate. What health education should the nurse provide to this client? a. Take the medication 2 hours before or after other medications b. Blood levels will be evaluated after 1 week c. Take the medication at bedtime to accommodate sedative effects d. Ensure adequate potassium intake during therapy

Take the medication 2 hours before or after other medications

A nurse is admitting a client diagnosed with late-stage gastric cancer. The client's family is distraught and angry that the client was not diagnosed earlier in the course of her disease. What factor contributes to the fact that gastric cancer is often detected at a later stage? a. Gastric cancer does not cause signs or symptoms until metastasis has occurred. b. Adherence to screening recommendations for gastric cancer is exceptionally low. c. Early symptoms of gastric cancer are usually attributed to constipation. d. The early symptoms of gastric cancer are usually not alarming or highly unusual.

The early symptoms of gastric cancer are usually not alarming or highly unusual.

A client has been experiencing occasional episodes of constipation and has been unable to achieve consistent relief by increasing physical activity and improving the client's diet. When introducing the client to the use of laxatives, what teaching should the nurse emphasize? a. The effect of laxatives on electrolyte levels b. The underlying causes of constipation c. The risk of fecal incontinence d. The risk of becoming laxative-dependent

The risk of becoming laxative-dependent

A client admitted with inflammatory bowel disease asks the nurse for help with menu selections. What menu selection is most likely the best choice for this client? 12 a. Spinach b. Tofu c. Multigrain bagel d. Blueberries

Tofu

when it comes to asthma. what is the priority

absent breath sounds

a PaCO2 over 45 means the pt is in what kind of state

acidosis

how do most gastric cancers occur

adenocarcinomas and lymph node involvement with metastasis occurs early

The nurse working in the emergency department is caring for a client with signs and symptoms of appendicitis. Which order from the health care provider should the nurse question? a. administer an enema b. intravenous antibiotic therapy c. nothing by mouth (NPO) d. complete blood count

administer an enema

what is the one and only rescue drug for asthma

albuterol

if a pt has acute gastritis, what should they avoid to help the symptoms subside

alcohol and certain foods

a PaCO2 under 35 means the pt is in what kind of state

alkalosis

Which of the following are risk factors for the development of chronic obstructive pulmonary disease (COPD)? Select all that apply. a. Tobacco smoke b. Occupational dust c. Air pollution d. Infection e. Second-hand smoke

all choices

if your anemic and a doctor prescribes iron, what could be a complications of this

constipation

which of the following is a common irritant that acts as a trigger of asthma a. Esophageal reflux b. Peanuts c. Aspirin sensitivity d. Molds

esophageal reflux

how is constipation defined

fewer than 3 bowel movements weekly or bowel movements that are hard, dry, small, of difficult to pass

what is dumping syndrome

food, especially food high in sugar, move from your stomach into your small bowel too quickly after you eat

a pt with peptic ulcer disease might present with what kind of symptoms

heartburn and vomiting

what is the treatment for constipation

high fiber and fluids with ambulation

the nurse understands that the main indicators for a person with end stage renal disease to being hemodialysis are a. hyperkalemia and hypervolemia b. hypotension and hypophosphatemia c. hypokalemia and hypovolemia d. hypertension and hypernatremia

hyperkalemia and hypervolemia

A client is experiencing edema in the tissue. What type of intravenous fluid would the nurse expect to be prescribed? a. isotonic fluid b. no intravenous solution c. hypertonic solution d. hypotonic solution

hypertonic solution

it is important for the nurse to provide required information and appropriate explanations of diagnostic procedures to client with respiratory disorders in order to a. ensure adequate rest periods b. manage decreased energy levels c. manage respiratory distress d. aid the client's caregivers

manage decreased energy levels

what is the first sign of hypoxia

mental status change

An older adult client who complains of an "acid stomach" has been taking baking soda (sodium bicarbonate) regularly as a self-treatment. This may place the client at risk for which acid-base imbalance? a. metabolic alkalosis b. metabolic acidosis c. respiratory acidosis d. respiratory alkalosis

metabolic acidosis

when should you take sucralfate

on am empty stomach 1-2 hours before taking meds

what is single word dyspnea

only being able to get one word out between breaths

Clients with inflammatory bowel disease (IBD) are at significantly increased risk for which condition? a. Osteoporosis b. DVT c. Hypotension d. Pneumonia

osteoporosis

what is the most common and most often fatal primary bone tumor

osteosarcoma

what is acute gastritis

rapid onset of symptoms usually caused by dietary indiscretion

is asthma reversable

yes

A nurse is teaching a client with gastritis about the need to avoid the intake of caffeinated beverages. The client asks why this is so important. Which explanation from the nurse would be most accurate? a. "Caffeine stimulates the central nervous system and thus gastric activity and secretions, which need to be minimized to promote recovery." b. "Caffeine increases the fluid volume in your system, which irritates your digestive organs." c. "Caffeine intake can cause tears in your esophagus and intestines, which can lead to hemorrhage." d. "Caffeine can interfere with absorption of vitamin B , which leads to anemia and further digestive problems."

"Caffeine stimulates the central nervous system and thus gastric activity and secretions, which need to be minimized to promote recovery."

A client comes to the clinic reporting pain in the epigastric region. What assessment question during the health interview would most help the nurse determine if the client has a peptic ulcer? a. "Does your pain resolve when you have something to eat?" b. "Do over-the-counter pain medications help your pain?" c. "Does your pain get worse if you get up and do some exercise?" d. "Do you find that your pain is worse when you need to have a bowel movement?"

"Does your pain resolve when you have something to eat?"

A patient is scheduled for a test with contrast to determine kidney function. What statement made by the patient should the nurse inform the physician about prior to testing? a. "I don't like needles." b. "I am allergic to shrimp." c. "I take medication to help me sleep at night." d. "I have had a test similar to this one in the past."

"I am allergic to shrimp."

The nurse determines that teaching for the client with peptic ulcer disease has been effective when the client makes which statement? a. "I should stop all my medications if I develop any side effects." b. "I should continue my treatment regimen as long as I have pain." c. "I have learned some relaxation strategies that decrease my stress." d. "I can buy whatever antacids are on sale because they all have the same effect."

"I have learned some relaxation strategies that decrease my stress."

A client comes to the clinic reporting pain in the epigastric region. What statement by the client is specific to the presence of a duodenal ulcer? a. "My pain resolves when I have something to eat." b. "The pain begins right after I eat." 12 c. "I know that my father and my grandfather both had ulcers." d. "I seem to have bowel movements more often than I usually do."

"My pain resolves when I have something to eat."

A client with peptic ulcer disease asks for pain medication. Which response will the nurse make? a. "Eating more food will help reduce the pain." b. "The medications for the ulcer will reduce the pain." c. "Using pain medication is what caused the ulcer to develop." d. "I will ask the health care provider to prescribe pain medication."

"The medications for the ulcer will reduce the pain."

A client is admitted to the orthopedic unit in skeletal traction for a fractured proximal femur. Which explanation should the nurse give the client about skeletal traction? a. "Skeletal traction temporarily stabilizes the fracture before surgery." b. "Weights are attached to the leg using a boot." c. "Traction involves passing a pin through the bone." d. "Light weights must be used with skeletal traction."

"Traction involves passing a pin through the bone."

An older adult client informs the nurse about having recurrent episodes of constipation. Which action(s) will the nurse perform first? Select all that apply. a. Encourage the use of a stool softener daily. b. Assess food intake history. c. Assess surgical history. d. Encourage the use of fiber supplements. e. Assess fluid intake history.

- Assess food intake history - Assess fluid intake history.

The nurse has been asked to provide health information to a female patient diagnosed with a urinary tract infection. What appropriate instructions will the nurse provide? Select all that apply. a. Cleanse around the perineum and urethral meatus after each bowel movement to reduce pathogens. b. Drink caffeinated beverages twice a day to increase urination. c. Drink liberal amounts of fluid to flush out bacteria. d. Void every 2-3 hours to prevent overdistention of the bladder e. Bathe in warm water to soak the affected area

- Cleanse around the perineum and urethral meatus after each bowel movement to reduce pathogens - Drink liberal amounts of fluid to flush out bacteria. - Void every 2-3 hours to prevent overdistention of the bladder

A nurse is caring for a client who is being assessed following reports of severe and persistent low back pain. The client is scheduled for diagnostic testing in the morning. Which of the following are appropriate diagnostic tests for assessing low back pain? Select all that apply. a. Computed tomography (CT) b. Angiography c. Magnetic resonance imaging (MRI) d. Ultrasound e. X-ray

- Computed tomography (CT) - Magnetic resonance imaging (MRI) - Ultrasound - X-ray

The nurse suspects "compartment syndrome" for a casted extremity. What characteristic symptoms would the nurse assess that would confirm these suspicions? (Select all that apply.) a. Decreased sensory function b. Excruciating pain c. Loss of motion d. Capillary refill less than 3 seconds e. 2+ peripheral pulses in the affected distal pulse

- Decreased sensory function - Excruciating pain - Loss of motion

A client with acute gastritis asks the nurse what might have caused the problem. What is a possible cause of acute gastritis? Select all that apply. a. Dietary indiscretion b. Overuse of allergy medicine c. Excessive alcohol intake d. Drinking fruit juices e. Radiation therapy

- Dietary indiscretion - Excessive alcohol intake - Radiation therapy

A client is being treated for diverticulosis. Which points should the nurse include in this client's teaching plan? Select all that apply. a. Do not suppress the urge to defecate. b. Drink fluids, especially water and fluids that are sugar-free c. Limit high-fat meat and dairy products d. Engage in regular physical activity e. Limit high-fiber foods

- Do not suppress the urge to defecate. - Drink fluids, especially water and fluids that are sugar-free - Limit high-fat meat and dairy products - Engage in regular physical activity

A client presents to the ED experiencing symptoms of COPD exacerbation. The nurse understands that goals of therapy should be achieved to improve the client's condition. Which statements reflect therapy goals? Select all that apply. a. Provide medical support for the current exacerbation. b. Treat the underlying cause of the event. c. Return the client to their original functioning abilities. d. Provide long-term support for medical management. e. Teach the client to suspend activity

- Provide medical support for the current exacerbation. - Treat the underlying cause of the event. - Return the client to their original functioning abilities. - Provide long-term support for medical management.

what medications cause constatation

- anticholinergics - antidepressants - anticonvulsants - antispasmodics - CCB - diuretic agents - opioids - calcium based antiacids - iron

how might a tumor in the small intestine present

- asymptomatic or pain - occult bleeding - weight loss - nausea and vomiting - intestinal obstruction

The nurse is caring for a client with osteoporosis. Which information will the nurse include when teaching actions to manage the condition? Select all that apply. a. Avoid excessive alcohol intake b. Plan for smoking cessation c. Consider estrogen replacement therapy d. Engage in regular weight-bearing exercise e. Swim for 30 minutes four to five times a week

- avoid excessive alcohol intake - plan for smoking cessation - engage in regular weight-bearing exercise

A client is diagnosed with a peptic ulcer after having an upper endoscopy procedure. Which medication regimen will the nurse educate the client regarding? Select all that apply. a. Bismuth salts b. Antibiotics c. Bicarbonate salts d. Proton pump inhibitors (PPIs) e. Histamine-2 (H2) antagonists f. Antivirals

- bismuth salts - antibiotics - PPIs

for a pt with a peptic ulcer disease, what is some pt teaching that they should do

- change diet - decrease stress - NSAIDs

what are 6 complications that can develop from constipation

- decreased cardiac output - fecal impaction - hemorrhoids - fissures - rectal prolapse - megacolon

what are 3 ways to diagnosis gastritis

- endoscopy - histologic examinations - biopsy of stomach lining

A client with a fractured ulna has a plaster cast applied to the forearm. Which action(s) will the nurse take when caring for the client and cast? Select all that apply. a. Ensure a free flow of air around the cast. b. Apply a dry towel over the cast until it is dry. c. Test cast dryness with the palm of the hand. d. Determine the cast is dry when it is white and shiny. e. Position the cast on a plastic pillow to dry

- ensure a free flow of air around the cast - test cast dryness with the palm of the hand - determine the cast is dry when it is white and shiny

what the s/s of acute gastritis

- epigastric pain - dyspepsia - anorexia - hiccups - nausea - vomiting

The nurse is caring for a client experiencing unintentional weight loss and occasional abdominal pain. Which additional symptoms will the nurse expect to assess if the client has a tumor In the small intestine? Select all that apply. a. Fatigue b. Nausea c. Jaundice d. Vomiting e. Weakness

- fatigue - nausea - vomiting - weakness

what are 3 s/s to report to the HCP when it comes to peptic ulcer disease

- fever over 100.3F - rebound tenderness - "ridged" or "board-like abdomen"

The nurse notes that a client has lost 5 lbs. (2.27 kg) of body weight over 5 days. Which additional assessment findings indicate to the nurse that the client is experiencing hypovolemia? Select all that apply. a. Lung crackles b. Flat neck veins c. Bounding pulse d. Muscle cramps e. Concentrated urine

- flat neck veins - muscle cramps - concentrated urine

what is acute gastritis caused by

- food poisoning - alcohol - NSAIDs - spicy foods - radiations therapy - bile reflux

A nurse is caring for a client after stabilization of a radial fracture. Which actions by the nurse would be appropriate for the client following arm casting? Select all that apply. a. Elevate the arm on a plastic-covered pillow b. Protect the cast by covering with a sheet c. Handle the cast with the palms of hands d. Circulate room air with a portable fan e. Petal and smooth the edges of the cast

- handle the cast with the palms - circulate room air with a portable fan - petal and smooth the edges of the cast

what are the manifestations of acute gastritis

- hematemesis - epigastric pain (heart burn) - cramps - bloating - loss of appetite

what should you teach a pt who has IBS

- keep a diary of the symptoms, diet, & stress level - exercise 3 times a week

A client is recovering from a below-the-knee traumatic amputation and is 72 hours post surgery. Which actions will the nurse take to promote healing of the wound? Select all that apply. a. Measure the residual limb every 8 to 12 hours. b. Elevate the residual limb on a pillow when seated. c. Assess neurovascular function of the residual limb. d. Apply an elastic compression bandage over the wound site. e. Remind to place the residual limb in a dependent position when sitting.

- measure the residual limb every 8 to 12 hours - assess neurovascular function to the residual limb - apply an elastic compression bandage over the wound site

what causes constipation

- medications - chronic laxative use - weakness - immobility - fatigue

A client is newly diagnosed with a peptic ulcer. For which medications will the nurse prepare teaching for this client? Select all that apply. a. Metronidazole b. Bismuth subsalicylate c. Warfarin d. Diphenhydramine e. Omeprazole

- metronidazole - bismuth subsalicylate - omeprazole

how can you promote fluid balance for a pt with gastritis

- monitor I&Os - signs of dehydration - electrolyte imbalance - hemorrhage

who are more likely to get a tumor of the small intestine

- older adults age 60 and - African American - men

who are more likely to get a gastric ulcer

- older age >68 - men - Hispanic Americans - African Americans - Asian/pacific - Caucasians

A patient has been involved in a traumatic accident and is hemorrhaging from multiple sites. The nurse expects that the compensatory mechanisms associated with hypovolemia would cause what clinical manifestations? (Select all that apply.) a. Hypertension b. Oliguria c. Tachycardia d. Bradycardia e. Tachypnea

- oliguria - tachycardia - tachypnea

A patient is diagnosed with osteomyelitis of the right leg. What signs and symptoms does the nurse recognize that are associated with this diagnosis? (Select all that apply.) a. Pain b. Erythema c. Fever d. Leukopenia e. Purulent drainage

- pain - erythema - fever

what are the s/s of a duodenal ulcer

- pain decreased with food - worse at night - weight gain - melena

what are manifestations for gastric cancer

- pain relieved by antiacids - dyspepsia - weight loss - abdominal pain - bloating after meals - intestinal obstruction

for a pt who has a gastric ulcer, what are the signs and symptoms

- pain the increase with food 30-60 minutes after eating - weight loss - hematemesis

what are 3 s/s of constipation

- passing fewer than 3 stools per week - lumpy hard stool - straining to have a bowel movement

what are manifestation of chronic gastritis

- pyrosis (heartburn) - belching - sour taste in the mouth - halitosis (bad breath)

A client is placed in traction for a femur facture. The nurse would document which expected outcomes of traction? Select all that apply. a. Realignment of the fracture b. Decreased pedal pulse c. Reduction of deformity d. Minimization of muscle spasms e. Increased ability to bear weight f. Full range of motion to extremity

- realignment of the fracture - reduction of deformity - minimization of muscle spasms

a client with COPD has recently begun a new bronchodilator. which therapeutic effects should the nurse expect from this medication a. relief of dyspnea b. increased respiratory rate c. increased viscosity of lung secretions d. increased expiratory flow rate e. negative sputum culture

- relief of dyspnea - increased expiratory flow rate

what are the major goals of peptic ulcer disease

- relief of pain - reduce anxiety - maintenance of nutritional requirements - absence of complications

what are the goals for peptic ulcer disease, gastritis, and gastric cancer

- relief of pain - reduce anxiety - optimal nutrition - absence of complications

what should you teach your pt to avoid doing or eating when it comes to PUD

- spicy, fried, acidic foods - no caffeine - no alcohol - no cigarettes

A client with asthma has developed obstruction of the airway. Which of the following does the nurse understand as having potentially contributed to this problem? Choose all that apply. a. Thick mucus b. Swelling of bronchial membranes c. Destruction of the alveolar wall d. Airway remodeling

- thick mucus - swelling of bronchial membrane - airway remodeling

what are causes of metabolic alkalosis

- vomiting - NG tube suctioning

A nurse's assessment reveals that a client with COPD may be experiencing bronchospasm. What assessment finding would suggest that the patient is experiencing bronchospasm? a. Fine or coarse crackles on auscultation b. Wheezes or diminished breath sounds on auscultation c. Reduced respiratory rate or lethargy d. Slow, deliberate respirations e. labored and rapid breathing

- wheezes or diminished breath sounds on auscultation - labored and rapid breathing

A nurse's assessment reveals that a client with chronic obstructive pulmonary disease may be experiencing bronchospasm. Which assessment findings would suggest that the client is experiencing bronchospasm? Select all that apply. a. Fine or coarse crackles on auscultation b. Wheezes or diminished breath sounds on auscultation c. Reduced respiratory rate or lethargy d. Slow, deliberate respirations and diaphoresis e. Labored and rapid breathing

- wheezes or diminished breath sounds on auscultation - labored and rapid breathing

The physician has prescribed a hypotonic IV solution for a patient. Which IV solution should the nurse administer? a. 0.45% sodium chloride b. 0.9% sodium chloride c. 5% glucose in water d. 5% glucose in normal saline solution

0.45% sodium chloride

Which is considered an isotonic solution? a. 0.9% normal saline b. Dextran in normal saline c. 0.45% normal saline d. 3% NaC

0.9% normal saline

what are the 3 dugs that you give when a pt is having an asthma attack

1. albuterol 2. ipratropium 3. methylprednisolone

what are 6 risk factors associated with peptic ulcer disease

1. excessive secretion of stomach acid 2. dietary factors 3. chronic use of NSAIDs 4. alcohol 5. smoking 6. family history

what are 4 nursing managements of gastritis

1. reduce anxiety 2. promote nutrition 3. promote fluid balance 4. measures to relieve pain

what are the 5 kinds of diarrhea

1. secondary 2. osmotic 3. malabsorptive 4. infectious 5. exudative

A client with peptic ulcer disease must begin triple medication therapy. For how long will the client follow this regimen? a. 4 to 6 days b. 7 to 9 days c. 10 to 14 days d. 15 to 20 days

10 to 14 days

The nurse is caring for a client in the intensive care unit (ICU) following a neardrowning event in saltwater. The client is restless, lethargic, and demonstrating tremors. Additional assessment findings include swollen and dry tongue, flushed skin, and peripheral edema. The nurse anticipates that the client's serum sodium value would be a. 155 mEq/L (155 mmol/L) b. 145 mEq/L (145 mmol/L) c. 135 mEq/L (135 mmol/L) d. 125 mEq/L (125 mmol/L)

155 mEq/L (155 mmol/L)

when does pain happen with duodenal ulcer

2-3 hours after eating but pain is decreased with food

When providing care for a client who has a diagnosis of irritable bowel syndrome (IBS), the nurse should collaborate with the client and prioritize what goal? a. Accurate identification of foods that trigger symptoms b. Demonstration of appropriate care of the ileostomy c. Demonstration of appropriate use of standard infection control precautions d. Accurate adherence to recommended guidelines for mobility and activity

Accurate identification of foods that trigger symptoms

A client's colorectal cancer has necessitated a hemicolectomy with the creation of a colostomy. In the 4 days since the surgery, the client has been unwilling to look at the ostomy or participate in any aspects of ostomy care. What is the nurse's most appropriate response to this observation? a. Ensure that the client knows that he or she will be responsible for care after discharge. b. Reassure the client that many people are fearful after the creation of an ostomy. c. Acknowledge the client's reluctance and initiate discussion of the factors underlying it. d. Arrange for the client to be seen by a social worker or spiritual advisor

Acknowledge the client's reluctance and initiate discussion of the factors underlying it.

Which of the following is the most common cause of symptomatic hypomagnesemia in the United States? a. Alcoholism b. Intestinal resection c. Inflammatory bowel disease d. Loss of gastric acid

Alcoholism

The nurse practitioner suspects that a patient may have a gastric ulcer after completing a history and physical exam. Select an indicator that can be used to help establish the distinction between gastric and duodenal ulcers. a. Amount of hydrochloric acid (HCL) secretion in the stomach b. Sensitivity to the use of nonsteroidal anti-inflammatory drugs (NSAIDs) c. Presence of H. pylori d. Patient's age

Amount of hydrochloric acid (HCL) secretion in the stomach

A nurse is caring for a client with Paget disease and is reviewing the client's most recent laboratory values. Which of the following values are most characteristic of Paget disease? a. An elevated level of parathyroid hormone and low calcitonin levels b. A low serum alkaline phosphatase level and a low serum calcium level c. An elevated serum alkaline phosphatase level and a normal serum calcium level d. An elevated calcitonin level and low levels of parathyroid hormone

An elevated serum alkaline phosphatase level and a normal serum calcium level

A client who has sustained a fracture reports an increase in pain and decreased function of the affected extremity. What will the nurse suspect? a. Infection b. Pulmonary embolism c. Avascular necrosis d. Hypovolemic shock

Avascular necrosis

The nurse is evaluating a client's ulcer symptoms to differentiate ulcer as duodenal or gastric. Which symptom should the nurse at attribute to a duodenal ulcer? a. Vomiting b. Hemorrhage c. Awakening in pain d. Constipation

Awakening in pain

The nurse is assessing a client with advanced gastric cancer. The nurse anticipates that the assessment will reveal which finding? a. Abdominal pain below the umbilicus b. Weight gain c. Bloating after meals d. Increased appetite

Bloating after meals

A patient has been diagnosed with osteomalacia. What common symptoms does the nurse recognize that correlate with the diagnosis? a. Bone fractures and kyphosis b. Bone pain and tenderness c. Muscle weakness and spasms d. Softened and compressed vertebrae

Bone pain and tenderness

A patient comes to the clinic suspecting a possible UTI. What symptoms of a UTI would the nurse recognize from the assessment data gathered? a. Rebound tenderness at McBurney's point b. An output of 200mL with each voiding c. Cloudy urine d. Urine with a specific gravity of 1.005-1.022

Cloudy urine

A patient is suspected to have diverticulosis without symptoms of diverticulitis. What diagnostic test does the nurse anticipate educating the patient about prior to scheduling? a. Colonoscopy b. Barium enema c. Flexible sigmoidoscopy d. CT scan

Colonoscopy

Which of the following type of fracture is associated with osteoporosis? a. Compression b. Stress c. Oblique d. Simple

Compression

Which of the following is the diagnostic of choice if the suspected diagnosis is diverticulitis? a. Computed tomography scan b. Magnetic resonance imaging c. Colonoscopy d. Barium enema

Computed tomography scan

The nurse is educating a client with diabetes about prevention of infection. Which action does the nurse encourage to reduce the risk of osteomyelitis? a. Increase calcium and vitamin intake. b. Control blood sugar levels. c. Exercise 3 to 4 times weekly for at least 30 minutes. d. Take corticosteroids as ordered.

Control blood sugar levels.

A client comes to the emergency department and reports localized pain and swelling in the lower leg. Ecchymotic areas are noted. History reveals that the client got hit in the leg with a baseball bat. What will the nurse most likely suspect? a. Fracture b. Contusion c. Sprain d. Strain

Contusion

A client presents with an infection in the area between the internal and external sphincters. In which chronic disease is this condition commonly seen? a. Crohn disease b. diverticulosis c. ulcerative colitis d. irritable bowel syndrome

Crohn disease

A client is having a diagnostic workup for reports of frequent diarrhea, right lower abdominal pain, and weight loss. The nurse is reviewing the results of the barium study and notes the presence of "string sign." What does the nurse understand that this is significant of? a. Crohn's disease b. Ulcerative colitis c. Irritable bowel syndrome d. Diverticulitis

Crohn's disease

The client who had a total hip replacement was discharged home and developed acute groin pain in the affected leg, shortening of the leg, and limited movement of the fractured leg. The nurse interprets these findings as indicating which complication? a. Dislocation of the hip b. Re-fracture of the hip c. Contracture of the hip d. Avascular necrosis of the hip

Dislocation of the hip

When describing malignant bone tumors to a group of students, which of the following would the instructor cite as the usual location? a. Proximal humerus b. Wrist-hand junction c. Distal femur around the knee d. Femur-hip area

Distal femur around the knee

The nurse is assessing a client who had an ileostomy created three days ago for the treatment of irritable bowel disease. The nurse observes that the client's stoma is bright red and there are scant amounts of blood on the stoma. What is the nurse's best action? a. Contact the care provider to have the client's hemoglobin and hematocrit measured. b. Document these expected assessment findings. c. Apply barrier ointment to the stoma as prescribed. d. Cleanse the stoma with alcohol or chlorhexidine.

Document these expected assessment findings.

Which instruction would be included in a teaching plan for a client diagnosed with a urinary tract infection? a. Use tub baths as opposed to showers. b. Drink coffee or tea to increase diuresis. c. Drink liberal amount of fluids. d. Void every 4 to 6 hours.

Drink liberal amount of fluids.

A client who had a Roux-en-Y bypass procedure for morbid obesity ate a chocolate chip cookie after a meal. After ingestion of the cookie, the client reported cramping pains, dizziness, and palpitation. After having a bowel movement, the symptoms resolved. What should the nurse educate the client about regarding this event? a. Gastric outlet obstruction b. Dumping syndrome c. Bile reflux d. Celiac disease

Dumping syndrome

A nurse is providing follow-up teaching at a clinic visit for a client recovering from gastric resection. The client reports sweating, diarrhea, nausea, palpitations, and the desire to lie down 15 to 30 minutes after meals. Based on the client's assessment, what will the nurse suspect? a. Dumping syndrome b. Dehiscence of the surgical wound c. Peritonitis d. A normal reaction to surgery

Dumping syndrome

what is expected during and after of a diagnostic test for PUD using barium contrast

During: abdominal cramping After: expect chalk white stool

The nurse is caring for a client who has developed dumping syndrome while recovering from a gastrectomy. What recommendation should the nurse make to the client? a. Drink a minimum of 12 ounces of fluid with each meal. b. Eat several small meals daily spaced at equal intervals. c. Choose foods that are high in simple carbohydrates. d. Sit upright when eating and for 30 minutes afterward.

Eat several small meals daily spaced at equal intervals.

A client has given a confirmed diagnosis of gastric cancer. Which procedure is important to assess tumor depth? a. Barium x-ray of the upper GI tract b. Esophagogastroduodenoscopy (EGD) c. Computed tomography (CT) d. Endoscopic ultrasound

Endoscopic ultrasound

The femur fracture that commonly leads to avascular necrosis or nonunion because of an abundant supply of blood vessels in the area is a fracture of the: a. Condylar area. b. Femoral neck. c. Shaft of the femur. d. Trochanteric region.

Femoral neck.

An elderly client diagnosed with diarrhea is taking digoxin. Which electrolyte imbalance should the nurse be alert to? a. Hyperkalemia b. Hypokalemia c. Hyponatremia d. Hypernatremia

Hypokalemia

The nurse is monitoring a patient who sustained an open fracture of the left hip. What type of shock should the nurse be aware can occur with this type of injury? a. Cardiogenic b. Hypovolemic c. Neurogenic d. Septicemic

Hypovolemic

A patient has suffered a femoral shaft fracture in an industrial accident. What is an immediate nursing concern for this patient? a. Hypovolemic shock b. Infection c. Knee and hip dislocation d. Pain resulting from muscle spasm

Hypovolemic shock

A client with Crohn's disease is losing weight. For which reason will the nurse anticipate the client being prescribed parenteral nutrition? a. Insufficient oral intake b. Impaired ability to absorb food c. Unwilling to ingest nutrients orally d. Prolonged preoperative nutritional needs

Impaired ability to absorb food

A nurse is talking with a client who is scheduled to have a hemicolectomy with the creation of a colostomy. The client admits to being anxious, and has many questions concerning the surgery, the care of a stoma, and necessary lifestyle changes. What nursing action is most appropriate? a. Reassure the client that the procedure is relatively low risk and that clients are usually successful in adjusting to an ostomy. b. Provide the client with educational materials that match the client's learning style. c. Encourage the client to write down these concerns and questions to bring forward to the surgeon. d. Maintain an open dialogue with the client and facilitate a referral to the wound-ostomy-continence (WOC) nurse.

Maintain an open dialogue with the client and facilitate a referral to the wound-ostomy-continence (WOC) nurse.

A client undergoes surgery to remove a malignant tumor, followed by a urinary diversion procedure. The nurse's postoperative plan of care should include which action? a. Determine the client's ability to manage stoma care. b. Show pictures and drawings of placement of the stoma. c. Maintain skin and stomal integrity. d. Suggest a visit to a local ostomy group.

Maintain skin and stomal integrity.

The nurse is caring for an older adult patient experiencing fecal incontinence. When planning the care of this patient, what should the nurse designate as a priority goal? a. Maintaining skin integrity b. Beginning a bowel program to establish continence c. Instituting a diet high in fiber and increase fluid intake d. Determining the need for surgical intervention to correct the problem

Maintaining skin integrity

A nurse is providing care for a client who has osteomalacia. What major goal should guide the choice of medical and nursing interventions? a. Maintenance of skin integrity b. Prevention of bone metastasis c. Maintenance of adequate levels of activated vitamin D d. Maintenance of adequate parathyroid hormone function

Maintenance of adequate levels of activated vitamin D

Which of the following is a true statement regarding gastric cancer? a. Most patients are asymptomatic during the early stage of the disease. b. Women have a higher incidence of gastric cancer than men. c. The prognosis for gastric cancer is generally considered good. d. Most cases of gastric cancer are discovered prior to metastasis.

Most patients are asymptomatic during the early stage of the disease

Celiac disease (celiac sprue) is an example of which category of malabsorption? a. Infectious diseases b. Mucosal disorders causing generalized malabsorption c. Luminal problems causing malabsorption d. Postoperative malabsorption

Mucosal disorders causing generalized malabsorption

During a home visit the nurse notes that a client recovering from peptic ulcer disease is experiencing cool clammy skin and has a heart rate of 96 beats a minute. Which action will the nurse take? a. Notify the primary health care provider. b. Provide a dose of a proton pump inhibitor. c. Encourage the client to drink a warm beverage. d. Discuss the types of foods the client has been eating.

Notify the primary health care provider.

A client broke his arm in a sports accident and required the application of a cast. Shortly following application, the client reported an inability to straighten his fingers and was subsequently diagnosed with Volkmann contracture. What pathophysiologic process caused this complication? a. Obstructed arterial blood flow to the forearm and hand b. Simultaneous pressure on the ulnar and radial nerves c. Irritation of Merkel cells in the client's skin surfaces d. Uncontrolled muscle spasms in the client's forearm

Obstructed arterial blood flow to the forearm and hand

A nurse practitioner prescribes drug therapy for a patient with peptic ulcer disease. Choose the drug that can be used for 4 weeks and has a 90% chance of healing the ulcer. a. Nizatidine b. Cimetidine c. Famotidine d. Omeprazole

Omeprazole

A client with carpal tunnel syndrome has had limited improvement with the use of a wrist splint. The nurse knows that which procedure will show the greatest improvement in treatment for this client? a. Laser therapy b. Ultrasound therapy c. Open nerve release d. Injection of lidocaine

Open nerve release

Which orthopedic surgery is done to correct and align a fracture after surgical dissection and exposure of the fracture? a. Arthrodesis b. Joint arthroplasty c. Total joint arthroplasty d. Open reduction

Open reduction

Which is the preferred route of administration for potassium? a. Subcutaneous b. Intramuscular c. Oral d. IV (intravenous) push

Oral

A client is informed of having a benign bone tumor but that this type of tumor that may become malignant. The nurse knows that this is characteristic of which type of tumor? a. Osteochondroma b. Enchondroma c. Osteoclastoma d. Osteoid osteoma

Osteoclastoma

Which of the following is the most common and most fatal primary malignant bone tumor? a. Osteogenic sarcoma (osteosarcoma) b. Osteochondroma c. Enchondroma d. Rhabdomyoma

Osteogenic sarcoma (osteosarcoma)

Which condition is a metabolic bone disease characterized by inadequate mineralization of bone? a. Osteoporosis b. Osteomyelitis c. Osteomalacia d. Osteoarthritis

Osteomalacia

Localized rapid bone turnover, most commonly affecting the skull, femur, tibia, pelvic bones, and vertebrae, is characterized by which bone disorder? a. Osteomalacia b. Ganglion c. Osteomyelitis d. Paget disease

Paget disease

A client with metastatic bone cancer sustained a left hip fracture without injury. What type of fracture does the nurse understand occurs without trauma or fall? a. Impacted fracture b. Transverse fracture c. Compound fracture d. Pathologic fracture

Pathologic fracture

What is an example of a laxative osmotic agent? o Bisacodyl (Dulcolax) o Dioctyl sodium sulfosuccinate (Colace) o Magnesium hydroxide (milk of magnesia) o Polyethylene glycol and electrolytes (Colyte)

Polyethylene glycol and electrolytes (Colyte) Rationale: o Polyethylene glycol and electrolytes (Colyte) is an osmotic agent. Bisacodyl (Dulcolax) is a stimulant laxative. Dioctyl sodium sulfosuccinate (Colace) is a fecal softener. Magnesium hydroxide (Milk of magnesia) is a saline agent

A nurse is interviewing a client about past medical history. Which preexisting condition may lead the nurse to suspect that a client has colorectal cancer? a. Duodenal ulcers b. Hemorrhoids c. Weight gain d. Polyps

Polyps

The nurse advises the patient who has just been diagnosed with acute gastritis to: a. Take an emetic to rid the stomach of the irritating products. b. Refrain from food until the GI symptoms subside. c. Restrict food and fluids for 12 hours. d. Restrict all food for 72 hours to rest the stomach

Refrain from food until the GI symptoms subside

A woman comes to her health care provider's office with signs and symptoms of kidney stones. Which of the following should be the primary medical management goal? a. Determine the stone type. b. Relieve any obstruction. c. Relieve the pain. d. Prevent nephron destruction.

Relieve the pain

A client presents to the ED with acute abdominal pain, fever, nausea, and vomiting. During the client's examination, the lower left abdominal quadrant is palpated, causing the client to report pain in the RLQ. This positive sign is referred to as ________ and suggests the client may be experiencing ________. a. Rovsing sign; acute appendicitis b. McBurney sign; acute appendicitis c. Rovsing sign; perforation d. McBurney sign; perforation

Rovsing sign; acute appendicitis

Which type of diarrhea is caused by increased production of water and electrolytes by the intestinal mucosa and their secretion into the intestinal lumen? a. Osmotic diarrhea b. Secretory diarrhea c. Mixed diarrhea d. Diarrheal disease

Secretory diarrhea

Which of the following arterial blood gas results would be consistent with metabolic alkalosis? a. Serum bicarbonate of 28 mEq/L b. PaCO2 less than 35 mm Hg c. Serum bicarbonate of 21 mEq/L d. pH 7.26

Serum bicarbonate of 28 mEq/L

What assessment findings of the leg are consistent with a fracture of the femoral neck? a. Shortened, adducted, and externally rotated b. Shortened, abducted, and internally rotated c. Adducted and internally rotated d. Abducted and externally rotated

Shortened, adducted, and externally rotated

A client suspected of having colorectal cancer requires which diagnostic study to confirm the diagnosis? a. Stool Hematest b. Carcinoembryonic antigen (CEA) c. Sigmoidoscopy d. Abdominal computed tomography (CT) scan

Sigmoidoscopy

An elderly client's hip joint is immobilized prior to surgery to correct a femoral head fracture. What is the nurse's priority assessment? a. The presence of leg shortening b. The client's complaints of pain c. Signs of neurovascular compromise d. The presence of internal or external rotation

Signs of neurovascular compromise

what is the difference between a skin and skeletal traction

Skin traction doesn't use a pin, but instead a splint or an adhesive is used to pull the skin and soft tissues surrounding a bone. Skeletal traction uses a pin, wire or screw inserted into the fractured bone to which a weight(s) is attached. The weight will then pull the broken bone into place over time

Most cases of osteomyelitis are caused by which microorganism? a. Staphylococcus aureus b. Proteus species c. Pseudomonas species d. Escherichia coli

Staphylococcus aureus

A nurse is collaborating with the physical therapist to plan the care of a client with osteomyelitis. What principle should guide the management of activity and mobility in this client? a. Stress on the weakened bone must be avoided. b. Increased heart rate enhances perfusion and bone healing. c. Bed rest results in improved outcomes in clients with osteomyelitis. d. Maintenance of baseline ADLs is the primary goal during osteomyelitis treatment.

Stress on the weakened bone must be avoided.

A client is recently diagnosed with Crohn's disease and is beginning treatment. What first-line treatment does the nurse expect that the client will be placed on to decrease the inflammatory response? a. Ciprofloxacin b. Methotrexate c. Azathioprine d. Sulfasalazine

Sulfasalazine

A nurse is caring for a client with a bone tumor. The nurse is providing education to help the client reduce the risk for pathologic fractures. What should the nurse teach the client? a. Strive to achieve maximum weight-bearing capabilities. b. Gradually strengthen the affected muscles through weight training. c. Support the affected extremity with external supports such as splints. d. Limit reliance on assistive devices in order to build strength.

Support the affected extremity with external supports such as splints.

A provider prescribes a subcutaneous anabolic agent for an older adult client to prevent fractures associated with osteoporosis. What is the most likely prescribed drug? a. Alendronic acid b. Calcitonin c. Raloxifene d. Teriparatide

Teriparatide

A nurse is caring for a client who has experienced an acute exacerbation of Crohn's disease. Which statement best indicates that the disease process is under control? a. The client exhibits signs of adequate GI perfusion. b. The client expresses positive feelings about himself. c. The client verbalizes a manageable level of discomfort. d. The client maintains skin integrity.

The client exhibits signs of adequate GI perfusion

The nurse is caring for a client who has been diagnosed with chronic obstructive pulmonary disease (COPD) and is experiencing respiratory acidosis. The client asks what is making the acidotic state. What does the nurse identify as the result of the disease process that causes the fall in pH? a. The lungs are unable to breathe in sufficient oxygen. b. The lungs are unable to exchange oxygen and carbon dioxide. c. The lungs have ineffective cilia from years of smoking. d. The lungs are not able to regulate carbonic acid levels.

The lungs are not able to regulate carbonic acid levels.

A female client has been prescribed a course of antibiotics for the treatment of a urinary tract infection (UTI). When providing health education for the client, the nurse should address what topic? a. The risk of developing a vaginal yeast infection as a consequence of antibiotic therapy b. The need to expect a heavy menstrual period following the course of antibiotics c. The risk of developing antibiotic resistance after the course of antibiotics d. The need to undergo a series of three urine cultures after the antibiotics have been completed

The risk of developing a vaginal yeast infection as a consequence of antibiotic therapy

65. A client asks the nurse why cystitis is more common in women than in men. Which of the following body parts will the nurse include in the answer? a. The urethra b. The bladder c. The rectum d. The ureters

The urethra

A nurse is providing a class on osteoporosis at the local center for older adults. Which statement related to osteoporosis is most accurate? a. High levels of vitamin D can cause osteoporosis. b. A nonmodifiable risk factor for osteoporosis is a person's level of activity. c. Secondary osteoporosis occurs in women after menopause. d. The use of corticosteroids increases the risk of osteoporosis.

The use of corticosteroids increases the risk of osteoporosis.

An older adult has a diagnosis of Alzheimer disease and has recently been experiencing fecal incontinence. However, the nurse has observed no recent change in the character of the client's stools. What is the nurse's most appropriate intervention? a. Keep a food diary to determine the foods that exacerbate the client's symptoms. b. Provide the client with a bland, low-residue diet. c. Toilet the client on a frequent, scheduled basis. d. Liaise with the primary provider to obtain an order for loperamide

Toilet the client on a frequent, scheduled basis.

A client has a serum calcium level of 7.2 mg/dl (1.8 mmol/L). During the physical examination, the nurse expects to assess: a. Trousseau's sign. b. Homans' sign. c. Hegar's sign. d. Goodell's sign.

Trousseau's sign.

T/F: older adults with gastric cancer may have no gastric symptoms

True Rationale: confusion, agitation, restlessness, and reduced functional ability may be the only symptoms in older adults with gastric cancer. These clinical manifestations are often due to metastasis

A client presents to the emergency department with complaints of acute GI distress, bloody diarrhea, weight loss, and fever. Which condition in the family history is most pertinent to the client's current health problem? a. Ulcerative colitis b. Hypertension c. Gastroesophageal reflux disease d. Appendicitis

Ulcerative colitis

The presence of mucus and pus in the stools suggests which condition? a. Small-bowel disease b. Ulcerative colitis c. Disorders of the colon d. Intestinal malabsorption

Ulcerative colitis

A group of students is reviewing for a test on the urinary and renal system. The students demonstrate understanding of the information when they identify which of the following as part of the upper urinary tract? a. Bladder b. Urethra c. Ureters d. Pelvic floor muscles

Ureters

The nurse advises a patient with renal stones to avoid eating shellfish, asparagus, and organ meats. She emphasizes these foods because she knows that his renal stones are composed of which of the following substances? a. Calcium b. Uric acid c. Struvite d. Cystine

Uric acid

Which statement correctly identifies a difference between duodenal and gastric ulcers? a. Malignancy is associated with duodenal ulcer. b. Weight gain may occur with a gastric ulcer. c. A gastric ulcer is caused by hypersecretion of stomach acid. d. Vomiting is uncommon in clients with duodenal ulcers.

Vomiting is uncommon in clients with duodenal ulcers.

A school nurse is caring for a 10-year-old client who is having an asthma attack. What is the preferred intervention to alleviate this client's airflow obstruction? a. Administer corticosteroids by metered dose inhaler. b. Administer inhaled anticholinergics. c. Administer an inhaled beta-adrenergic agonist. d. Utilize a peak flow monitoring device.

administer an inhaled beta-adrenergic agonist

what is pernicious anemia associated with and what does is it

associated with chronic gastritis and the body cant absorb B12

A client with diabetes punctured the foot with a sharp object. Within a week, the client developed osteomyelitis of the foot. The client was admitted for IV antibiotic therapy. How long does the nurse anticipate the client will receive IV antibiotics? a. 6 months b. 3 months c. 7 to 10 days d. At least 4 weeks

at least 4 weeks

A client has received a diagnosis of gastric cancer and is awaiting a surgical date. During the preoperative period, the client should adopt what dietary guidelines? a. Eat small, frequent meals with high calorie and vitamin content. b. Eat frequent meals with an equal balance of fat, carbohydrates, and protein. c. Eat frequent, low-fat meals with high protein content. d. Try to maintain the pre-diagnosis pattern of eating.

at small, frequent meals with high calorie and vitamin content.

the nurse is explaining the importance of using the incentive spirometer to a post-surgical patient. the nurse explains that using the incentive spirometer can help decrease the risk of A. pulmonary embolism B. pleuristy C. atelectasis D. emphysema

atelectasis

what does Gastric cancer have a poor prognosis

because the symptom's mimic GERD, peptic ulcers so it goes undiagnosed and is not discovered till its at stage 3 or 4

what are eosinophils

blood test that indicates that asthma attack was triggered by an allergic reaction

A client has low back pain and the healthcare provider needs to rule out the presence of a tumor. Which diagnostic procedure would the nurse anticipate to be ordered for the client? a. Bone scan b. Computed tomography c. Magnetic resonance imaging d. Electromyogram

bone scan

a nurse is reviewing the pathophysiology of cystic fibrosis in anticipation of a new admission. the nurse should identify what characteristic aspects of CF a. alveolar mucus plugging, infection, and eventual bronchiectasis b. bronchial mucus plugging, inflammation, and eventual bronchiectasis c. bronchial mucus plugging, infection, and eventual COPD d. atelectasis, infection, and eventual COPD

bronchial mucus plugging, infection, and eventual COPD

what is erosive gastritis

chronic gastric irritation that creates a hole in the mucosa of the stomach

A client with emphysema is at a greater risk for developing which acid-base imbalance? a. chronic respiratory acidosis b. metabolic alkalosis c. metabolic acidosis d. respiratory alkalosis

chronic respiratory acidosis

A patient is prescribed a mast cell stabilizer for the treatment of asthma. Which commonly used medication will the nurse educate the patient about? a. Albuterol b. Budesonide c. Cromolyn sodium d. Theophylline

cromolyn sodium

what is a common mast cell stabilizer for asthma

cromolyn sodium

The nurse is creating a discharge plan of care for a client with a peptic ulcer. The nurse tells the client to avoid a. acetaminophen. b. decaffeinated coffee. c. skim milk. d. octreotide.

decaffeinated coffee.

An x-ray demonstrates a fracture in which the fragments of bone are driven inward. This type of fracture is referred to as a. depressed. b. compound. c. comminuted. d. impacted.

depressed

A nurse is caring for a client who underwent a subtotal gastrectomy. To manage dumping syndrome, the nurse should advise the client to: a. restrict fluid intake to 1 qt (1,000 ml)/day. b. drink liquids only with meals. c. don't drink liquids 2 hours before meals. d. drink liquids only between meals.

drink liquids only between meals.

who will a pt present with peptic ulcer disease

dull gnawing pain or burning in the mid epigastrium

what is something that you should educate your pts on who is post-op from gastric cancer

dumping syndrome

what is peptic ulcer disease

erosion of the mucosal lining of the stomach, pylorus, duodenum, or esophagus

T/F regular bowel habits can be established for a pt with an ileostomy

false rationale: regular bowel habits can not be established for a pt with an ileostomy

T/F: The most common site for peptic ulcer formation is the pylorus

false its the duodenum

the nurse is doing discharge teaching in the ED with a client who had a nosebleed. what should the nurse include in the discharge teaching of this client a. avoid blowing the nose for the next 45 minutes b. do not take aspirin for the next 2 weeks c. seek immediate medical attention if the nosebleed recurs d. in case of recurrence, apply direct pressure for 15 minutes

in case of recurrence, apply direct pressure for 15 minutes

how many bowel movements does a pt usually have when they have diarrhea

more than 3 per day

A typical sign/symptom of appendicitis is: a. nausea. b. left lower quadrant pain. c. pain when pressure is applied to the right upper quadrant. d. high fever.

nausea.

When evaluating arterial blood gases (ABGs), which value is consistent with metabolic alkalosis? a. HCO 21 mEq/L b. pH 7.48 c. PaCO 36 d. O saturation 95%

pH 7.48

The nurse is analyzing the arterial blood gas (ABG) results of a client diagnosed with severe pneumonia. Which of the following ABG results indicates respiratory acidosis? a. pH: 7.20, PaCO : 65 mm Hg, HCO : 26 mEq/L b. pH: 7.32, PaCO : 40 mm Hg, HCO : 18 mEq/L c. pH: 7.50, PaCO : 30 mm Hg, HCO : 24 mEq/L d. pH: 7.40, PaCO : 40 mm Hg, HCO : 24 mEq /L

pH: 7.20, PaCO : 65 mm Hg, HCO : 26 mEq/L

Which arterial blood gas (ABG) result would the nurse anticipate for a client with a 3-day history of vomiting? a. pH: 7.55, PaCO : 60 mm Hg, HCO : 28 b. pH: 7.45, PaCO : 32 mm Hg, HCO : 21 2 3- 2 3- c. pH: 7.28, PaCO : 25 mm Hg, HCO : 15 d. pH: 7.34, PaCO2: 60 mm Hg, HCO : 34

pH: 7.55, PaCO : 60 mm Hg, HCO : 28

The nurse recognizes that the client diagnosed with a duodenal ulcer will likely experience a. vomiting. b. hemorrhage. c. pain 2 to 3 hours after a meal. d. weight loss

pain 2 to 3 hours after a meal.

A client has a suspected bladder cancer. What is the most common first symptom of a malignant tumor of the bladder? a. painless hematuria b. fever c. dysuria d. urgency

painless hematuria

A nurse is caring for a client who is undergoing a diagnostic workup for a suspected gastrointestinal problem. The client reports gnawing epigastric pain following meals and heartburn. What would the nurse suspect this client has? a. peptic ulcer disease b. ulcerative colitis c. appendicitis d. diverticulitis

peptic ulcer disease

open sores in the esophagus, stomach, or duodenum is described as what

peptic ulcer disease

for a pt who has chronic gastritis, what can it lead to

peptic ulcers and gastric cancer

A client has been classified as status asthmaticus. The nurse understands that this client will likely initially exhibit symptoms of: a. Respiratory alkalosis b. Metabolic alkalosis c. Respiratory acidosis d. Metabolic acidosis

respiratory alkalosis

A client is admitted from the emergency department with complaints of severe abdominal pain and an elevated white blood cell count. The physician diagnoses appendicitis. The nurse knows the client is at greatest risk for: a. rupture of the appendix. b. ulceration of the appendix. c. inflammation of the gallbladder. d. emotional distress related to the pain.

rupture of the appendix.

The nurse is assessing a client for constipation. To identify the cause of constipation, the nurse should begin by reviewing the client's: a. usual pattern of elimination. b. alcohol consumption. c. activity levels. d. current medications.

usual pattern of elimination.


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