Module 2 study exam

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The nurse is caring for a client diagnosed with Parkinson disease. Which situation should the nurse anticipate while caring for this​ client? A. Constipation B. Alterations in fecal volume C. Changes in fecal composition D. Bowel incontinence

Bowel incontinence

hemorrhoids

Dilated veins at the rectum, internalor external. Pregnancy, constipation, lifting, obesity

a nurse is caring for a client who has an acute exacerbation of Crohn's disease. Which of the following actions should the nurse take? - ensure bowel rest - offer sparkling water frequently - administer a stool softener - offer plain warm tea frequently

Ensure bowel rest

hemorrhagic exudate

Exudate contains blood: indicates bleeding

The nurse is assessing an older adult client who presents with fecal incontinence. Which statement by the nurse indicates understanding of the etiology of fecal​ incontinence? A. ​"Fecal incontinence is a normal response to the aging​ process." B. ​"Older adults are not at an increased risk for fecal​ incontinence." C. ​"Older adults with fecal incontinence are not candidates for treatment to alleviate their​ condition." D. ​"Fecal incontinence is abnormal and should be addressed in clients who are cognitively intact and physically​ able."

Fecal incontinence is abnormal and should be addressed in clients who are cognitively intact and physically​ able

The nurse instructs the client with chronic diarrhea to increase soluble fiber intake. Which statement by the client indicates an understanding of the​ instruction? A. ​"Fiber pulls fluid from my​ body." B. ​"Fiber increases the fluid in​ chyme." C. ​"Fiber increases the fecal​ volume." D. ​"Fiber decreases the fecal​ volume."

Fiber increases the fecal volume

Your patient had surgery yesterday. Upon assessment ofthe surgical incision you notice some erythema and slightedema. What is your thought process regarding yourpatient's incision? A. He has a severe infection B. He has normally functioning immune system C. He needs immediate irrigation and debridement of theincision D. Call the provider with an update

He has normally functioning immune system

The nurse is giving a presentation about anaphylacticshock to a group of teachers. The nurse would not include which information as a sign and symptom of anaphylaxis? 1. Hives and itching 2. Wheezing and labored breathing 3. Hypertension and frequent urination 4. Nausea and vomiting

Hypertension and frequent urination

The client and the nurse are discussing fluid consumption to aid in decreasing the risk of constipation. Which statement demonstrates proper client​ understanding? A. ​"I should not drink fruit juice as I do​ normally." B. ​"I should consume 2000-3000 mL of fluid​ daily." C. ​"I should drink milk products only in the​ morning." D. ​"I should consume 10001500 mL of fluid​ daily."

I should consume 2000-3000 mL of fluid daily

The nurse is teaching a client with chronic constipation about ways to decrease the likelihood of fecal impaction. Which statement indicates understanding by the​ client? A. ​"I should increase my intake of​ fiber." B. ​"I should limit my fluid​ intake." C. ​"Exercise will not help decrease​ impaction." D. ​"I should strain to​ defecate."

I should increase my fiber intake

The nurse is teaching a client about interventions to treat chronic constipation. Which client statement indicates that the teaching was​ effective? A. ​"I should eat small meals​ frequently." B. ​"I should limit my fluid​ intake." C. ​"I should increase my fluid​ intake." D. ​"I should take laxatives twice a​ day."

I should increase my fluid intake

a nurse is planning an in-service training session regarding nutrition. Which of the following minerals should the nurse identify as involved in oxygen transportation? - zinc - Iron - Phosphorus - Magnesium

Iron

diverticulosis

Occurrence of non inflamedpouches within the interior of the colon

The nurse is auscultating the abdomen prior to palpating it. Which statement supports the rationale for this​ action? A. Palpation moves the bowel. B. Palpation can be uncomfortable for the client. C. Palpation can alter peristalsis. D. Palpation causes the client to move.

Palpation can alter peristalsis

purulent exudate

Pus: indicates a bacterial infection

Soft tissue injury treatment

RICE (rest, ice, compression, elevation)

Catarrhal exudate

Thick mucous exudate

fibrinous exudate

Thick, clotted exudate: indicates more advanced inflammation

Serous exudate

Watery exudate: indicates early inflammation

A nurse is providing preoperative teaching to a client who will undergo surgery to create temporary colostomy. The client asks the nurse about the difference between colostomies and ileostomies. Which of the following responses should the nurse make? - a colostomy drains stool, and ileostomy drains urine - a colostomy is temporary, and an ileostomy is permanent - a colostomy is from the large intestine, and an ileostomy is from the small intestine - an ileostomy requires dietary restrictions, while a colostomy does not

a colostomy is from the large intestine, and an ileostomy is from the small intestine.

symptoms of appendicitis

abdominal pain in RLQ, rebound tenderness, fever, N/A, anorexia, diminished bowel sounds, inability to pass flatus or feces

appendicitis

acute inflammation of vermiform appendix

fistulas

an opening or tract that occurs abnormally andspontaneously between 2 hollow organs

A nurse is deviling a plan of care for a client who has GERD. The nurse should plan to monitor the client for which of the following complications? - aspiration - infection - anemia - weight loss

aspiration

In caring for a client four days after cholecystectomy, thenurse notices the drainage from the T-tube is 600mL/24 hr.Which is the appropriate action by the nurse? A. Clamp the tube for 30 minutes Q 2hr. B. Place the client in supine position. C. Assess drainage characteristics and notify thephysician. D. Encourage an increased fluid intake.

assess drainage characteristics and notify physician

A nurse in a provider's office is assessing a client who has GERD. When documenting the client's history, the nurse should expect the client to report that symptoms worsen with which of the following actions? - stair-climbing - Bending over - Sitting - Walking

bending over

a nurse is assessing a client who has cholecystitis. Which of the following findings should the nurse expect? - blumberg's sign - ascites - GI bleeding - Kehr's sign

blumberg's sign --> rebound tenderness

A nurse is assessing a client who is experiencing perforation of a peptic ulcer. Which of the following manifestations should the nurse expect? - increased blood pressure - decreased heart rat e - yellowing of the skin - Boardlike abdomen

boardlike abdoment

A nurse is caring for a client who has diverticulitis and a new prescription for a low-fiber diet. Which of the following food items should the nurse remove from the client's meal tray? - canned fruit - white bread - broiled hamburger - coleslaw

coleslaw

A nurse is caring for a client who has GI bleeding. The provider suspects a bleeding lesion in the colon. The initial approach to treatment likely will involve which of the following procedures? - Exploratory laparotomy - Double- contrast barium enema - Magnetic resonance imaging - Colonoscopy

colonoscopy

A nurse is planning discharge teaching for a client who is post-op following a traditional open cholecystectomy. Which of the following learning needs of the client is the nurse's priority? - dietary recommendations - incision care - coughing and deep-breathing exercises - pain management

coughing and deep-breathing exercises

A nurse is planning care for a client who has cholelithiasis. Which of the following interventions should the nurse include in the plan? - restrict the clients fluid intake - restrict the clients calcium intake - decrease the clients fat intake - decrease the client's potassium intake

decrease the clients fat intake

repair

destroyed cell replaced with scar tissue

constipation

difficult or infrequent stools that are hard to pass

A nurse is providing postoperative teaching about the management of dumping syndrome to a client who had a partial gastrectomy. Which of the following instructions should the nurse include in the teaching? - COnsume at least 4 oz of fluid with meals - take a short walk after each meal - use honey to flavor foods such as cereal - eat protein with each meal

eat protein with each meal

A nurse is providing teaching to a client who has constipation. Which of the following instructions should the nurse include? - use bismuth subsalicylate regularly - consume a low-fiber diet - eat yogurt with live cultures - use bisacodyl suppositories regularly

eat yogurt with live cultures

The nurse in the emergency department assists with the care of a12-year-old diagnosed with appendicitis. The parents ask thenurse why something more isn't being done to reduce the child'spain. The nurse's best response is :A."The child will not obtain pain relief until the appendix isremoved." B."To prevent toxicity, analgesics can't be given prior tosurgery." C."Appendicitis is not very painful, so powerful narcotics arenot needed." D."Eliminating all pain prevents monitoring for rupture of theappendix.

eliminating pain prevents monitoring for rupture of the appendix

A nurse is assessing a client who has a bleeding duodenal ulcer. which of the following findings should the nurse expect? - emesis with a coffee-ground appearance - increased blood pressure - decreased heart rate - bright green stools

emesis with coffee-round appearance explanation: the nurse should expect a client who has a bleeding duodenal ulcer to have emesis that resembles coffee-grounds or is bright red in color. Hematemesis indicates upper GI bleeding, occurring at or above the duodenojejunal junction.

A nurse is performing discharge teaching about ostomy care while at home for a client who has a newly placed ileostomy. Which of the following instructions should the nurse include in the teaching? - empty your ostomy such when it becomes half full - place an aspirin in the ostomy such to eliminate odor - change the ostomy appliance every week - cleanse the site around the stoma with hydrogen peroxide and water

empty your ostomy much when it becomes half full

A nurse is providing dietary teaching to a client who has diverticulitis about preventing acute attack. Which of the following foods should the nurse recommend? - Foods high in vitamin C - Foods low in fat - Food high in fiber - Foods low in calories

food high in fiber

what type of bowel sounds will be auscultated with a patient whose admitted for diarrhea?

frequent, active bowel sounds

acute inflammation

healing occurs 2-3 weeks, no residual damage

a nurse is assessing a client who has a. complete intestinal obstruction. Which of the following findings should the nurse expect? - absence of bowel sounds in all 4 abdominal quadrants - passage of blood-tinged liquid stool - presence of flatus - hyperactive bowel sounds above the obstructions

hyperactive bowel sounds above the obstruction

a nurse is teaching about secondary prevention actions for colorectal cancer for a health fair for adults in the community. Which of the following topics should the nurse include? - smoking cessation - Benefits of a diet high in cruciferous veggies - New types of ostomy appliances - Importance of colonoscopy screening starting at age 50 years old

importance of colonoscopy screening starting at age of 50 years old

a nurse is caring for a client who has abdominal pain and possible pancreatitis. Which if the following lab. results should the nurse identify as an infection of pancreatitis? - decreased white blood cell (WBC) count - Increased albumin level - Increased serum lipase level - decreased blood glucose level

increased serum lipase level

diverticulitis

inflammation of the diverticula. perforation into perineum

function of mast cells in the inflammation process

initiate the inflammation response

fecal incontinence

involuntary passage of stool

The parent of a child undergoing an emergencyappendectomy tells the nurse, "If I had brought my child inyesterday at the first complaint of an upset stomach, thiswouldn't have happened." Which of the following is thebest response by the nurse? A."It's ok, you got here just in time before it ruptured." B."It can be difficult to predict when a simple complaintwill become more serious." C."Next time your child seems sick, come in right away." D."Sometimes parents can make a mistake withoutmeaning to do so."

it can be difficult tp predict when a simple complaint will become more serious

how to identify chronic cholecystitis

light tan colored stools

A nurse is caring for a client who has ulcerative colitis. The provider prescribes bed rest with bathroom privileges. When the client asks the nurse why he has to stay in bed, which of the following responses should the nurse provide? - you need to conserve energy at this time - lying quietly in bed helps slow down the activity in your intestines - staying in bed promotes the rest and comfort you need - staying in bed will help prevent injury and minimize your fall risk

lying quietly in bed helps slow down the activity in your intestines

The client with cholelithiasis is scheduled for acholangiogram and the nurse instructs the client about thetest. The nurse determines the client understands thepurpose of the test when the client states: A."My gallbladder and ducts will be checked." B."The procedure will drain the gallbladder." C."They will flush my gallbladder." D."A medication to prevent stones will be placed in mygallbladder

my gallbladder and ducts will be checked

5 signs of inflammation

pain, swelling, redness, heat, impaired function of the body part

obstruction

partial, complete mechanical or non mechanical. contents cannot pass

a nurse is planning an in-service training session for a group of nurses regarding the role of enzymes in digestion. Which of the following enzymes plays a role in the digestions of protein? - amylase - lipase - steapsin - pepsin

pepsin

Prior to surgery, the nurse should monitor a client with appendicitis forwhich of the following complications of the condition? A. Decreased white blood count B. Decreased temperature C. Kidney failure D. Peritonitis

peritonitis

The nurse caring for a client admitted with suspected appendicitisappropriately plans which of the following? A. Initiate bowel preparation for a barium enema. B. Restrict intake to clear liquids. C. Prepare for a possible appendectomy D. Insert a saline lock only for antibiotic therapy.

prepare for possible appendectomy

cholelithiasis

presence of abnormal concretions (gallstones) in the gallbladder

Which clinical manifestation does the nurse expect with acute​ appendicitis? A. Nausea and vomiting B. Rebound tenderness C. High fever D. Pain relieved with ambulation

rebound tenderness

regeneration

replacement of destroyed cells with the same type

a nurse is assessing a client who was admitted with a bowel obstruction. The client reports a severe abdominal pain. Which of the following findings indicates that a possible bowel perforation has occurred? - elevated blood pressure - bowel sounds increased in frequency and pitch - rigid abdomen - emesis of undigested food

rigid abdomen

nurse is providing dietary teaching to a client who has ulcerative colitis. Which of the following food selections by the client indicates an understanding of the teaching? - raw veggie salad with low-fat dressing - roast chicken and white rice - fresh fruit and milk - peanut butter on whole wheat bread

roast chicken and white rice

sudden disappearance of pain indicates

rupture of the appendix

A client telephones the health clinic with complaints of generalized abdominal pain which is aggravated by moving or walking. The client has not been able to eat for a day and is nauseated. Which advice should the nurse provide to this​ client? A. ​"Rest in bed and drink warm​ fluids." B. ​"Seek immediate medical​ attention." C. ​"Take an​ over-the-counter laxative." D. ​"Take a warm shower and apply a heating pad to the​ abdomen."

seek immediate medical attention

what external factor does diarrhea put the patient at higher risk for

skin breakdown

ostomy

surgically created loop of bowel outside thebody to allow discharge of waste

A nurse is performing a GI assessment of a client who has liver cirrhosis with abdominal distention. Which of the following actions should the nurse take to assess for changes in the client's abdominal distention? - Percuss the abdomen for tympanic sounds - inspect the contour of the abdominal wall - instruct the client to report increased abdominal discomfort - take serial measurements of the abdomen with a tape measure

take serial measurements of the abdomen with a tape measure

A nurse is caring for a client who has acute diverticulitis. While the client has active inflammation, the nurse should instruct the client to include which of the following foods in her diet? - white bread and plain yogurt - shredded wheat cereal and blueberries - broccoli and kidney beans - oatmeal and fresh pears

white bread and plain yogurt

A teenage boy presents with suspected appendicitis. The caregiver​ asks, "Why did my son get​ this?" Which response by the nurse is the most​ appropriate? A. ​"Your adolescent son is in a risk​ group." B. ​"Your son is eating too many fruits and​ vegetables." C. ​"Your son has been eating too much​ fiber." D. ​"Your son has not been getting enough​ exercise."

your adolescent son is in a risk group

diarhhea

3 or more loose/liquid stools perday. Infectious, intolerance, malabsorption

inflammation

An immunologic defense against tissue injury, infection, allergy, heat. chemical and autoimmune reaction

cholecystitis

inflammation og gallbladder

Treatment of appendicitis includes

laparotomy or laparoscopy

chronic inflammation

lasts months or years, repetitive tissue injury

The nurse is planning care for a client who has bowel incontinence. Which intervention should the nurse​ include? A. Digital stimulation procedure B. Cardiovascular exercise C. Use of cathartic medications D. Pelvic floor exercises

pelvic floor exercises

etiology of cholecystitis

- abnormal bile composition - bile supersaturated with cholesterol

clinical manifestations of cholecystitis

- abrupt onset - severe, steady pain --> RUQ - anorexia N/V - Chills, fever - guarding

risk factors of cholecystitis

- age - family history - obesity - rapid weight loss - use of oral contraceptives - biliary stasis

signs and symptoms of hemorrhoids

- bleeding at site - pain - puritis - prolapse - can be visible

function of histamine and heparin with inflammation

- dilation of vessels; increasing permeability - prevents clotting

signs and symptoms of diverticulosis

- discomfort - bloat - Gas - changes in bowel pattern

which is a risk factor for constipation? - immobility - lack of privacy - Chronic laxative use - Suppressing the urge to defecate - Intake of high levels of dietary fiber

- immobility - lack of privacy - chronic laxative use - suppressing the urge to defecate

signs and symptoms of diarrhea

- possible fever - cramping - watery stools - nausea - dehydration

diagnostic tests r/t cholecystitis

- serum bilirubin - CBC - Serum amylase & lipase

signs and symptoms of constipation

- slow GI function - GI disorders - Drug induced - Functional - Neuro - Partial Obstruction

signs & symptoms of fecal incontinence

- trauma - inflammatory - functional - neuro - weakness of sphincter - radiation

signs and symptoms of obstruction

-nausea and vomiting - pain - distension - constipation - malaise - poor appetite

Which factor may lead to constipation and fecal​ impaction? (Select all that​ apply.) A. Tumor B. Antacids C. Regular exercise D. Psychogenic factors E. Ingestion of a​ high-fiber diet

A, B, D

Which assessment should the nurse include when completing the health history of a client who has fecal​ incontinence? (Select all that​ apply.) A. Obstetrical history B. Psychologic history C. History of urinary disease D. History of radiation exposure E. History of neurologic diseases

A, B, D, E

The nurse is planning to teach a family about the causes of encopresis. Which topic should the nurse​ include? (Select all that​ apply.) A. Diet B. Stress C. Anger issues D. Fecal impaction E. Premature birth

A,B,C,D

The nurse is planning to teach a client about the consequences of persistent diarrhea. Which clinical manifestation should the nurse​ include? (Select all that​ apply.) A. Emaciation B. Weakness C. Dehydration D. Loss of appetite E. Skin breakdown

A,B,C,E

When performing a health history on a client admitted for fecal​ impaction, the nurse​ asks, "What is your pattern for defecation at​ home?" Which is the rationale for the nurse asking this​ question? (Select all that​ apply.) A. Determines normal bowel pattern B. Describes the usual pattern of defecation C. Supports plan for evacuation of the impaction D. Determines the extent of needed bowel training E. Identifies changes that may have caused the current issue

A,B.E

Which statement represents the rationale for encouraging a client with constipation to increase​ activity? A. Activity strengthens the muscles in the abdomen. B. Activity moves the chyme. C. Activity prevent blood clots. D. Activity stimulates peristalsis.

Activity Stimulates peristalsis

A nurse is caring for a client who has acute pancreatitis. Which of the following serum lab values should return to the expected reference range within 72 hours of treatment beginning? - Adolase - Lipase - Amylase - Lactic dehydrogenase

Amylase

The nurse is planning to teach a client dietary changes to prevent diarrhea. Which intervention should the nurse​ include? A. Avoiding spicy food B. Avoiding foods that contain cabbage C. Limiting fluid intake D. Taking medications at night versus in the morning

Avoiding spicy food

The nurse is assessing a client who is taking an opioid analgesic. Which side effect should the nurse​ monitor? Q A. Muscle cramping B. Constipation C. Rectal bleeding D. Diarrhea

B

The nurse is caring for an older adult client suffering from chronic constipation. The nurse should monitor the client for which​ condition? A. Parkinson disease B. Urinary tract infection C. Stroke D. Renal calculi

B

Which condition may occur if the client does not seek medication attention for acute appendicitis within 24-36 ​hours? (Select all that​ apply.) A. Constipation B. Perforation C. Peritonitis D. Seizure E. Nausea

B,C

The nurse is planning care for a child experiencing encopresis. Which collaborative intervention should be​ included? (Select all that​ apply.) A. Limiting fluid intake B. Behavioral modification C. Psychological treatment D. Pharmacologic treatment of constipation E. Collaboration with school nurses and teachers

B,C,D,E

The nurse is planning care for a client who has fecal incontinence. Which intervention should the nurse​ include? (Select all that​ apply.) Question content area bottom Part 1 A. Administer a bulk laxative per order. B. Provide privacy when using the bathroom. C. Insert a glycerin suppository at the same time every morning per order. D. Demonstrate the correct positioning for bowel evacuation to avoid straining. E. Assist the client to the bathroom each day around the​ client's standard time of defecation.

B,C,D,E


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