Medical-Surgical Nursing Week 6 Part 2

A patient is prescribed a fecal occult blood test (FOBT). What teaching does the nurse provide to the patient about the test?

"Avoid vitamin C-rich foods before the test."

A patient is scheduled for a colonoscopy. What does the nurse tell the patient to do before the procedure is performed?

"Begin a clear liquid diet 12-24 hours before the test."

Which patient does the charge nurse on the adult medical unit assign to an RN who has floated from the outpatient gastrointestinal (GI) unit?

40-year-old who needs laxatives administered and effectiveness monitored before a colonoscopy

A patient is admitted to the hospital with severe right upper quadrant (RUQ) abdominal pain. Which assessment technique does the nurse use for this patient?

Examines the RUQ of the abdomen last

What does the nurse instruct the patient about barium elimination after a barium enema examination? Select all that apply.

"Take a mild laxative." "Drink plenty of fluids." "Report abdominal fullness or pain." "Observe that the stool is chalky white."

The outpatient clinic nurse is caring for a recovering patient who had a colonoscopy. The patient asks for a drink. How does the nurse respond to this request?

"When you are able to pass flatus (gas), you can have a drink."

A patient is prescribed an esophagogastroduodenoscopy (EGD), which is a visualization of the esophagus, stomach, and duodenum. Which information would the nurse provide to the patient prior to the procedure? Select all that apply.

"You may have a dry mouth after the exam." "You may take your medications on the morning of the exam." "You must withhold foods and liquids for 6 to 8 hours before the test."

The nurse is preparing a patient for sigmoidoscopy. What does the nurse tell the patient about this procedure?

"You must consume only a clear liquid diet for 24 hours before the test."

The nurse is assessing a patient who comes to the emergency department with acute abdominal pain. The nurse notes a bulging, pulsating mass when inspecting the abdomen. Which action by the nurse is correct?

Notify the provider about this finding immediately.

In what order should the nurse prepare and perform an abdominal examination of a patient?

1.Ask the patient to empty the bladder 2.Place the patient in a supine position with the knees bent 3.Place the patient's arms at the sides. Correct 4.Begin assessment with the right upper quadrant region

While working in the outpatient procedure unit, the RN is assigned to these patients. Which patient does the nurse assess first?

51-year-old who recently had an endoscopic retrograde cholangiopancreatography (ERCP)

A patient is admitted to the hospital with elevated serum amylase and lipase levels and a decreased calcium level. Which gastrointestinal health problem is indicated by these laboratory findings?

Acute pancreatitis

The nurse is preparing to perform an abdominal examination on a patient. What action does the nurse take in regards to the assessment?

Asks the patient to empty the bladder before the exam.

A patient has just returned from a colonoscopy that did not require a polypectomy or tissue biopsy. What action does the nurse take?

Avoids oral intake until the patient is alert and passes flatus.

What screening tests are recommended to determine the presence of colorectal cancer? Select all that apply.

Colonoscopy every 10 years Flexible sigmoidoscopy every 5 years Double-contrast barium enema every 5 years Computed tomography (CT) colonoscopy every 5 years

What is a common gastrointestinal problem that older adults experience more frequently as they age?

Decreased hydrochloric acid

A patient reports pain in the right upper quadrant (RUQ) after a high-fat meal. Which organ does the nurse expect to be affected?

Gallbladder

The nurse is auscultating the abdomen of a patient. What would be a normal finding with this assessment?

High-pitched irregular gurgles

Which action does the nurse perform first when assessing a patient's abdomen?

Inspection

What is the correct sequence of steps for assessing a patient's abdomen?

Inspection, auscultation, percussion, palpation

A patient is admitted for a barium swallow study. Which actions does the nurse include in preparing the patient for the study? Select all that apply.

Instructing the patient on laxative use after the exam. Instructing the patient to drink plenty of fluids after the exam.

The nurse is assessing a patient who has come to the emergency department with acute abdominal pain. The patient is very thin and the nurse observes visible peristaltic movements when inspecting the abdomen. What does the nurse suspect?

Intestinal obstruction

Which gastrointestinal secretion influences vitamin B 12 absorption?

Intrinsic factor

Which substance, produced in the stomach, facilitates the absorption of vitamin B 12?

Intrinsic factor

In assessing the abdomen, a sound of dullness is expected to be assessed over which organ?

Liver

The nurse is assessing the abdomen of a 40-year-old patient who reports acute tenderness and pain in the right upper quadrant (RUQ). What organ does the nurse consider as the plausible origin?

Liver

When palpating the right upper quadrant (RUQ) of the abdomen, what is the nurse assessing?

Liver

When a patient has gastroenteritis, what type of sound is heard during auscultation of the abdomen?

Loud, gurgling sounds

The nurse is assessing the abdomen of a 47-year-old patient. A 2-centimeter circular, pulsating mass is noted in the midline area above the patient's umbilicus. What is the nurse's priority action?

Notify the health care provider.

The nurse is auscultating a patient's abdomen and hears a "swooshing" sound known as a bruit. What should the nurse's best response be?

Notify the health care provider.

The nurse is reviewing the laboratory reports of four patients. Which patient is at risk of biliary obstruction?

Patient B

After a colonoscopy, a patient reports severe abdominal pain. The nurse obtains these data: temperature 100.2° F (37.9° C), pulse 122, blood pressure 100/45, respirations 44, and O 2 saturation 89%. Which request from the health care provider does the nurse implement first?

Provide oxygen at 6 L/min per nasal cannula.

A patient is prescribed a gastrointestinal (GI) endoscopic examination. What actions should the endoscopy nurse take after the examination? Select all that apply.

Raise the siderails of the bed. Monitor for signs of perforation. Monitor vital signs every 30 minutes. Maintain nothing by mouth (NPO) status until the gag reflex returns.

While performing an abdominal assessment, where does the nurse expect to locate the liver?

Right upper quadrant (RUQ)

Which factors place a patient at risk for gastrointestinal (GI) problems? Select all that apply.

Socioeconomic status Some herbal preparations Smoking a half-pack of cigarettes per day Use of nonsteroidal anti-inflammatory drugs (NSAIDs)

Pernicious anemia is caused by a lack of intrinsic factor, which prevents the absorption of which element?

Vitamin B 12

The health care provider has ordered a fecal occult blood test (FOBT) for a patient. What does the nurse instruct the patient to avoid for a few days before and during the sample collection? Select all that apply.

Warfarin Vitamin C Red meat Nonsteroidal anti-inflammatory drugs (NSAIDs)