NCA2 CH. 52 Quiz 2

A male client with a long history of ulcerative colitis experienced massive bleeding and had emergency surgery for creation of an ileostomy. He is very concerned that sexual intercourse with his wife will be impossible because of his new ileostomy pouch. How would the nurse respond? A. "A change in position may be what is needed for you to have intercourse with your wife." B. "Have you considered going to see a marriage counselor with your wife?" C. "What has your wife said about your pouch system?" D. "You must get clearance from your primary health care provider before you attempt to have intercourse."

A

The nurse is instructing a client with recently diagnosed diverticular disease about diet. What food does the nurse suggest the client include? A. A slice of 5-grain bread B. Chuck steak patty (6 ounces [170 g]) C. Strawberries (1 cup [160 g]) D. Tomato (1 medium)

A

The nurse is preparing to administer natalizumab for a client who has Crohn disease (CD). What is the most important client assessment for the nurse to perform before giving this drug? A. Body temperature B. Breath sounds C. Peripheral pulses D. Skin integrity

A

The nurse is teaching a client with Crohn disease about managing the disease with the adalimumab Which instruction does the nurse emphasize to the client? A. "Avoid large crowds and anyone who is sick." B. "Do not take the medication if you are allergic to foods with fatty acids." C. "Expect difficulty with wound healing while you are taking this drug." D. "Monitor your blood pressure and report any significant decrease in it."

A

The nurse is teaching a group of senior citizens in a residential facility about how to prevent gastrointestinal (GI) infectious outbreaks, such as norovirus. What information will the nurse include as a priority intervention for the group? A. Handwashing and hand sanitizing B. Keeping at least 6 feet apart C. Avoiding group dining D. Cooking all food and boiling water

A

The nurse is teaching a family how to prevent the client's transmission of gastroenteritis at home. Which instructions will the nurse include in the health teaching? (Select all that apply.) A. "Everyone in the home should wash their hands for at least 30 seconds with an antibacterial soap using friction." B. "Do not share dishes, glasses, and silverware among members of the family." C. "Clean and disinfect all bathrooms often to avoid stool exposure." D. "Contact the primary health care provider if GI symptoms last more than 3 days." E. "Wear a mask at home to prevent transmission of the disease."

A, B, C, D

The nurse is caring for a client who has an enterocutaneous fistula. For what complications will the nurse monitor? (Select all that apply.) A. Dehydration B. Hyperkalemia C. Malnutrition D. Hypernatremia E. Bowel obstruction F. Skin breakdown

A, C, F

A client developed gastroenteritis while traveling outside the country. What is the most likely cause of the client's symptoms? A. Bacteria on the patient's hands B. Ingestion of parasites in the water C. Insufficient vaccinations D. Overcooked food

B

A client who developed viral gastroenteritis with vomiting and diarrhea is scheduled to be seen in the clinic the following day. What intervention would the nurse recommend for the client to do? A. "Avoid all solid foods to allow complete bowel rest." B. "Consume extra fluids to replace fluid losses." C. "Take an over-the-counter antidiarrheal medication." D. "Contact your primary health care provider for an antibiotic medication."

B

The nurse is assessing an older client who has had frequent vomiting and diarrhea for the last 24 hours. Which vital sign change would be of most concern to the nurse? A. Decreased pulse rate B. Decreased blood pressure C. Increased oxygen saturation D. Increased temperature

B

The nurse is teaching a client about caring for a new ileostomy. What information is most important to include? A. "After surgery, output from your ileostomy may be a loose, dark-green liquid with some blood present." B. "Call your primary health care provider if your stoma has a bluish or pale look." C. "Notify the primary health care provider if output from your stoma has a sweetish odor." D. "Remember that you must wear a pouch system at all times."

B

The nurse is teaching a client about dietary methods to help manage exacerbations (flare-ups) of diverticulitis. What does the nurse advise the client? A. "Be sure to maintain an exclusively low-fiber diet to prevent pain on defecation." B. "Consume a low-fiber diet while your diverticulitis is active. When inflammation resolves, consume a high-fiber diet." C. "Maintain a high-fiber diet to prevent the development of hemorrhoids that frequently accompany this condition." D. "Make sure you consume a high-fiber diet while diverticulitis is active. When inflammation resolves, consume a low-fiber diet."

B

A client has been newly diagnosed with ulcerative colitis (UC). What does the nurse teach the client about diet and lifestyle choices? A. "Drinking carbonated beverages will help with your abdominal distress." B. "It's OK to smoke cigarettes, but you should limit them to ½ pack per day." C. "Lactose-containing foods should be reduced or eliminated from your diet." D. "Raw vegetables and high-fiber foods may help to diminish your symptoms."

C

A client is admitted to the hospital with right lower quadrant abdominal pain, nausea, and vomiting. What assessment would the nurse monitor to identify a potentially life-threatening complication based on the client's condition? A. Intake and output B. Abdominal assessment C. Vital signs D. Electrolyte values

C

A client returns to the unit after having an exploratory abdominal laparotomy. How does the nurse position this client after being situated in bed? A. High Fowler B. Lateral Sims' (side-lying) C. Semi-Fowler D. Supine

C

A client with ulcerative colitis (UC) is prescribed sulfasalazine and corticosteroid therapy. As the disease improves, what change does the nurse expect in the client's medication regimen? A. Corticosteroid therapy will be stopped. B. Sulfasalazine will be stopped. C. Corticosteroid therapy will be tapered. D. Sulfasalazine will be tapered.

C

The nurse is reinforcing teaching provided by the registered dietitian nutritionist about dietary restrictions needed for a client who has a new ileostomy. Although each client can tolerate different foods, what food would the nurse suggest that the client avoid? A. Green beans B. Potatoes C. Corn D. Bread

C

An older client with a 2-day history of myalgia, nausea, vomiting, and diarrhea is admitted to the medical-surgical unit with a diagnosis of gastroenteritis. Which primary health care provider request does the nurse implement first? A. Administer acetaminophen 650 mg rectally. B. Draw blood for a complete blood count and serum electrolytes. C. Obtain a stool specimen for culture and sensitivity. D. Start an IV solution of 5% dextrose in 0.45 normal saline.

D

The nurse is caring for a client admitted with a long-term diagnosis of ulcerative colitis (UC). For what potentially life-threatening complication would the nurse monitor? A. Hyperkalemia B. Metabolic acidosis C. Chronic kidney disease D. Lower gastrointestinal (GI) bleeding

D

The nurse is preparing to provide health teaching for a client who is starting sulfasalazine. Which statement by the client indicates a need for further teaching? A. "I will be sure to take a folic acid supplement while on this drug." B. "I'll let my primary health care provider know if the drug upsets my stomach." C. "I will follow up with getting labs done to check my blood counts." D. "This drug can make me dehydrated because I'm already on a diuretic."

D