Pharm midterm prep u
Which statement provides accurate information regarding cancer of the colon and rectum?
Colorectal cancer is the third most common site of cancer in the United States.
The nurse should warn a client taking aluminum- and calcium-containing antacids about which adverse effects?
Constipation
A client is diagnosed with Helicobacter pylori infection. The health care provider will order amoxicillin and what other type of medication?
Proton pump inhibitors
The nursing instructor is teaching students about proper administration of sucralfate. According to the instructor, sucralfate should be administered:
an hour before meals.
A nurse is preparing to administer an insulin that is clear. Which insulin would the nurse most likely administer?
humulin R
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?
Awakening in pain
A client is admitted to the health care facility with a diagnosis of a bleeding gastric ulcer. The nurse expects the client's stools to have which description?
Black and tarry
What outcome would best indicate the nurse's teaching of a client newly diagnosed with diabetes was effective and that drug therapy is appropriate?
Blood glucose level is stable with no diabetic complications.
Clients with Type O blood are at higher risk for which of the following GI disorders?
Duodenal ulcers
A health care provider suspects that a client has peptic ulcer disease. With which diagnostic procedure would the nurse most likely prepare to assist?
Endoscopy
A client is prescribed tetracycline to treat peptic ulcer disease. Which instruction would the nurse give the client?
"Be sure to wear sunscreen while taking this medicine."
A client is readmitted with an exacerbation of celiac disease 2 weeks after discharge. Which statement by the client indicates the need for a dietary consult?
"I didn't eat anything I shouldn't have; I just ate roast beef on rye bread."
A nurse is teaching a client about omeprazole, which has been prescribed as part of a regimen to treat an H. pylori infection. What statement, made by the client, suggests that the client understands proper use of the drug?
"I need to swallow the drug whole."
A 59-year-old man with type 2 diabetes is prescribed metformin. When the client returns to the clinic, he reports that he has lost 8 pounds in a month. How should the nurse respond?
"Please continue taking the medication and monitoring your weight. This is an expected outcome of this drug therapy."
A woman with numerous chronic health problems has been diagnosed with a benign gastric ulcer has begun treatment with ranitidine (Zantac). Which of the following teaching points should the nurse provide to this patient?
"Quitting smoking will significantly increase the chance that this drug will heal your ulcer."
A client who has just been diagnosed with hepatitis A asks, "How did I get this disease?" What is the nurse's best response?
"You may have eaten contaminated restaurant food."
A nurse should take what steps prior to administering insulin glargine (Lantus) to a client? Select all that apply.
-Check the health care provider's orders for the type and dosage of insulin. -Check the expiration date on the vial. -Remove all air bubbles from the syringe barrel.
The client is scheduled to get a breakfast tray at 07:00. At what time should the client receive a prescribed dose of insulin lispro?
06:45
A nurse is teaching a client about his prescribed lansoprazole. The nurse instructs the client to take the drug at which time?
1 hour before eating
A client with peptic ulcer disease must begin triple medication therapy. For how long will the client follow this regimen?
10 to 14 days
Methimazole (Tapazole) 30 mg /day orally divided in 3 doses is prescribed for a client diagnosed with Graves' disease. The pharmacy has 5 mg tablets available. How many tablets should the nurse administer with each dose?
2
Methimazole (Tapazole) 30 mg /day orally divided in 3 doses is prescribed for a client diagnosed with Graves' disease. The pharmacy has 5 mg tablets available. How many tablets should the nurse administer with each dose?
2 30 mg/day divided in 3 doses = 10 mg/dose; 10 mg / 5 mg tablets = 2 tablets per dose
chp 41
41
Chp 42
42
Chp 47 mang intestinal and rectal disorders
47
Chp 49 Hepatic
49
Which HbA1c result would indicate that a client's diabetes is under good control?
7%
Following an endoscopy, a 66-year-old man has been diagnosed with a duodenal ulcer resulting from Helicobacter pylori infection. Which medication will likely be used in an attempt to eradicate the patient's H. pylori infection? (Select all that apply.)
A PPI Antibiotics
A client with symptomatic hyperthyroidism is prescribed propranolol. Which clinical manifestation would the nurse identify that indicates the medication is having the desired effect?
A heart rate of 72 beats/min
A patient is scheduled for a Billroth I procedure for ulcer management. What does the nurse understand will occur when this procedure is performed?
A partial gastrectomy is performed with anastomosis of the stomach segment to the duodenum.
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?
Abdominal surgery
The following patients are prescribed metformin. Which patient is likely at the greatest risk of having an adverse reaction to metformin?
An alcoholic patient
A client is admitted with a new onset of pyloric obstruction. What client symptoms should the nurse anticipate? Select all that apply.
Anorexia Epigastric fullness Nausea and vomiting
Which of the following would a nurse expect to assess in a client with peritonitis?
Board-like abdomen
The nurse is talking with a group of clients who are older than age 50 years about the recognition of colon cancer to access early intervention. What should the nurse inform the clients to report immediately to their primary care provider?
Change in bowel habits
The nurse is preparing to administer a mixture of 12 units regular insulin and 45 units NPH insulin to a client with a blood sugar of 378 mg/dL. After the nurse draws the medication into the syringe, what is the nurse's next action?
Check the dosage with another nurse.
As the nurse caring for a young child is diagnosed with type 1 diabetes (IDDM), you know that they become at high risk for what and you include assessment and management of this in their care plan?
Delayed growth and development
Which is one of the primary symptoms of irritable bowel syndrome (IBS)?
Diarrhea
Administering an antacid to a client taking which medications will decrease the absorption of the medication and result in a decreased drug effect?
Digoxin
The nurse is conducting discharge teaching for a client with diverticulosis. Which instruction should the nurse include in the teaching?
Drink 8 to 10 glasses of fluid daily.
The most common cause of subclinical hyperthyroidism is:
Excess thyroid hormone therapy.
A nurse should recognize that a client taking antithyroid medication may be developing thyrotoxicosis if the client exhibits which of the following symptoms?
Extreme tachycardia
The nurse is performing a community screening for colorectal cancer. Which characteristic should the nurse include in the screening?
Familial polyposis
Which would a nurse expect to assess in a client experiencing hyperthyroidism?
Flushed, warm skin
A nurse is applying an ostomy appliance to the ileostomy of a client with ulcerative colitis. Which action is appropriate?
Gently washing the area surrounding the stoma using a facecloth and mild soap
A client has an elevated serum ammonia concentration and is exhibiting changes in mental status. The nurse should suspect which condition?
Hepatic encephalopathy
Which adverse reaction of proton pump inhibitors is specific to menopausal women with osteoporosis?
Increased fracture risk
A client arrives at the walk-in clinic reporting vomiting and a burning sensation in the mid-epigastric region. The nurse suspects that the client has peptic ulcer disease. Which is a potential cause of peptic ulcer disease?
Infection with H. pylori
A client presents to the walk-in clinic reporting vomiting and burning in the mid-epigastria. The nurse suspects peptic ulcer disease and knows that to confirm peptic ulcer disease, the provider is likely to order a diagnostic test to detect the possible presence of what?
Infection with Helicobacter pylori
When administering insulin, what would be most appropriate?
Insert the needle at a 45-degree angle for injection.
The nurse is conducting a community education program on colorectal cancer. Which statement should the nurse include in the program?
It is the third most common cancer in the United States.
A positive Rovsing's sign is indicative of appendicitis. A nurse knows to assess for this indicator by palpating the:
Left lower quadrant.
A client is diagnosed with peptic ulcer due to H. pylori. The nurse would anticipate administering which agent in conjunction with an antibiotic?
Omeprazole
After teaching a group of students about proton pump inhibitors, the instructor determines that the students have understood the information when they identify which agent as the prototype proton pump inhibitor?
Omeprazole
Which medication classification represents a proton (gastric acid) pump inhibitor?
Omeprazole
Antacids have not been effective in managing a client's gastroesophageal reflux disease, so the health care provider is prescribing a proton pump inhibitor. Why might the health care provider prescribe a proton pump inhibitor (PPI) rather than a histamine2 receptor antagonist (H2RA)?
PPIs suppress acid more strongly and for a longer time.
A client diagnosed with type 1 diabetes suddenly reports feeling weak, shaky, and dizzy. What should be the nurse's initial response?
Perform a blood sugar analysis.
A client with a diagnosis of acute appendicitis is awaiting surgical intervention. The nurse listens to bowel sounds and hears none and observes that the abdomen is rigid and board-like. What complication does the nurse determine may be occurring at this time?
Peritonitis
The nurse is monitoring a client's postoperative course after an appendectomy. The nurse's assessment reveals that the client has vomited, has abdominal tenderness and rigidity, and has tachycardia. The nurse reports to the physician that the client has signs/symptoms of which complication?
Peritonitis
A female client presents to the health care provider's office with increasing stomach acidity. She self-administers calcium antacids. She notes that she seems to be having more issues with stomach acid, so she has been taking the calcium antacids more frequently. The nurse suspects that this may have caused what to occur in this client?
Rebound acidity
When interviewing a client with internal hemorrhoids, what would the nurse expect the client to report?
Rectal bleeding
The nurse in the emergency department receives a conscious client following a motor vehicle accident who has no known history of diabetes but whose blood glucose level is 325 mg/dL. What rationale does the nurse provide explaining this elevated blood glucose level?
The client's stress reaction likely caused an increase in blood sugar.
Which is a true statement regarding regional enteritis (Crohn's disease)?
The clusters of ulcers take on a cobblestone appearance.
A client tells the nurse, "I am not having normal bowel movements." When differentiating between what are normal and abnormal bowel habits, what indicators are the most important?
The consistency of stool and comfort when passing stool
The nurse is caring for a male client in the medical unit. He is fed via a nasogastric tube. The dose of antacid is based on what factors?
The pH of the stomach contents
Following an assessment by her primary care provider, a 70-year-old resident of an assisted living facility has begun taking daily oral doses of levothyroxine. Which assessment finding should prompt the nurse to withhold a scheduled dose of levothyroxine?
The resident's apical heart rate is 112 beats/minute with a regular rhythm.
An older adult client has been on long-term proton pump inhibitor (PPI) therapy. The nurse practitioner should focus on what assessment related to adverse effects?
bone density
What is the benefit of adding proton pump inhibitors (PPIs) to the treatment regime treating an H. pylori bacterial infection?
decreases production of gastric secretions
A nurse is caring for a client who underwent a subtotal gastrectomy. To manage dumping syndrome, the nurse should advise the client to:
drink liquids only between meals.
What is the most common cause of subclinical hyperthyroidism?
excess thyroid hormone therapy
A client reports severe pain and bleeding while having a bowel movement. Upon inspection, the health care provider notes a linear tear in the anal canal tissue. The client is diagnosed with a:
fissure.
A client's current condition requires rapid reduction of blood sugar levels. Which type of insulin will have the most rapid onset of action?
insulin lispro
A nurse is preparing to administer a rapid-acting insulin. Which medication would the nurse most likely administer?
insulin lispro
When describing thyroid function, the nurse would emphasize the need for intake of:
iodine
When considering the management of diabetic ketoacidosis (DKA), what type of insulin can be administered intravenously?
regular
A client is prescribed ranitidine for the treatment of a peptic ulcer disease and gastric reflux. The dosage of this drug should be reduced if the client has:
renal disease.
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?
vitamin B12
A client has been experiencing lower GI difficulties that have increased in severity, and the gastroenterologist is concerned that the client's bowel is not functioning properly. What function of the lower GI tract is most likely to be affected by the client's disorder?
water and electrolyte absorption
The nurse is caring for a client who is taking insulin. The nurse suspects the client is experiencing hypoglycemia when the client displays what signs?
weakness, sweating, and decreased mentation.
Which hormones are secreted by the thyroid gland? (Select all that apply.)
Thyroxine Triiodothyronine
A client is brought to the emergency department after taking an overdose of levothyroxine. When assessing this client, what adverse effects would the nurse expect to find?
Nervousness and tachycardia
A nurse is teaching an older adult client about good bowel habits. Which statement by the client indicates to the nurse that additional teaching is required?
"I need to use laxatives regularly to prevent constipation."
A young man has been diagnosed with type 2 diabetes and has been prescribed glyburide. Which statement suggests that the nurse should perform further health education?
"I'll plan to take my glyburide each night before I go to bed."
The nurse is performing and documenting the findings of an abdominal assessment. When the nurse hears intestinal rumbling and the client then experiences diarrhea, the nurse documents the presence of which condition?
Borborygmus
A client informs the nurse that he has been having abdominal pain that is relieved when having a bowel movement. The client states that the physician told him he has irritable bowel syndrome. What does the nurse recognize as characteristic of this disorder?
Chronic constipation with sporadic bouts of diarrhea
Why are histamine2 receptor antagonists preferred in the treatment of upper gastrointestinal (GI) disorders over traditional histamine1 receptor antagonists?
Histamine1 receptor antagonists do not block histamine effects on gastric acid production.
A patient visited a nurse practitioner because he had diarrhea for 2 weeks. He described his stool as large and greasy. The nurse knows that this description is consistent with a diagnosis of:
Intestinal malabsorption.
The nurse is caring for a client with intussusception of the bowel. What does the nurse understand occurs with this disorder?
One part of the intestine telescopes into another portion of the intestine.
Which of the following drug types is most likely to cause respiratory depression and myxedema coma in clients with thyroid disorders?
Opioid analgesics
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?
Polyps
A female client is self-administering cimetidine. What is the home care nurse's most important assessment of this client?
Potential drug-drug interactions
Thioamide antithyroid drugs treat hyperthyroidism by inhibiting the synthesis of thyroid hormone. What is the prototype of the thioamide anti-thyroid drugs?
Propylthiouracil
Which of the following is the most common symptom of a polyp?
Rectal bleeding
When considering the management of diabetic ketoacidosis (DKA), what type of insulin can be administered intravenously?
Regular
A student asks the nursing instructor what insulin has the quickest therapeutic effect once administered. What would be the best response?
Regular (Humulin R)
A client is prescribed ranitidine for the treatment of a peptic ulcer disease and gastric reflux. The dosage of this drug should be reduced if the client has:
Renal disease
Which hormone regulates the production and release of thyroid hormone?
Thyroid-stimulating hormone (TSH)
The following data identified during a nursing assessment and interview. When considering risks for the development of a peptic ulcer, which situation should the nurse discuss with the client?
Self medicates with a nonsteroidal anti-inflammatory drug (NSAID) daily.
A 25-year-old female client is diagnosed with hypothyroidism. The client is prescribed levothyroxine. Which instruction about the administration of this medication would be important?
She should take the medication in the morning before breakfast.
A nurse educating a client and their family about levothyroxine (Synthroid) for the treatment of hypothyroidism should advise the client to contact the health care provider if which occur? (Select all that apply.)
Significant weight changes Chest pain Palpitation Excessive diaphoresis
A client is recovering from gastric surgery. Toward what goal should the nurse progress the client's enteral intake?
Six small meals daily with 120 mL fluid between meals
A client is preparing for discharge to home following a partial gastrectomy and vagotomy. Which is the best rationale for the client being taught to lie down for 30 minutes after each meal?
Slows gastric emptying
A 75-year-old client is treating an ulcer with antacids. Based on the client's age, the nurse expects the health care provider to prescribe a dose of antacid that compares with the average prescribed dose in what way?
Smaller than the average prescribed dose
A client diagnosed with an H. pylori-associated ulcer has been prescribed treatment that includes two antimicrobials. What does the nurse identify as the reason for using multiple antimicrobials?
Two antimicrobials help prevent the emergence of drug-resistant H. pylori organisms.
A 2-month-old male child is diagnosed with diabetes. His parents are having difficulty measuring 2 units of insulin in the U-100 syringe. What would the nurse expect the health care provider to order?
U-10 (10 units/mL) insulin
A 30-year-old nonpregnant patient is prescribed misoprostol. Which of the following should the nurse instruct the patient as part of the teaching plan?
Use a reliable contraceptive.
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:
hypokalemia
Ranitidine and cimetidine are both H2RAs used in the treatment of peptic ulcer disease. Of the two, ranitidine is preferred in critically ill clients because it is less likely to:
interfere with the metabolism of other drugs.
With regard to the functioning of the thyroid gland, which is an essential element for the manufacturing of thyroxine and triiodothyronine?
iodine
When describing thyroid function, the nurse would emphasize the need for intake of:
iodine.
The nurse recognizes that the client diagnosed with a duodenal ulcer will likely experience
pain 2 to 3 hours after a meal.
A nurse is preparing a teaching plan for a patient who is prescribed a meglitinide. What instruction should the nurse include in the teaching plan for the patient?
Avoid drug administration in the case of a skipped meal.
A nurse is assigned to administer glargine to a patient at a health care facility. What precaution should the nurse take when administering glargine?
Avoid mixing glargine with other insulin.
A nurse is teaching a client who has just been prescribed lansoprazole . What statement would indicate that the client correctly understands the action of this medication?
"The medication inhibits acid secretions."
The pharmacology instructor is providing education regarding propylthiouracil to the nursing students. What would the instructor identify as the primary mode of action for this medication?
Inhibition of production of thyroid hormone
A client is receiving a thyroid hormone to treat hypothyroidism. Which would indicate to the nurse that the client needs a reduced dosage of the drug?
Tachycardia
During a general health assessment, a client indicates taking thyroid medication to increase weight loss. What statement should be the basis of the nurse's response?
Taking excessive or unnecessary thyroid medication may produce serious or life-threatening manifestations of toxicity.
A client realizes that regular use of laxatives has greatly improved his bowel pattern. However, the nurse cautions this client against the prolonged use of laxatives for which reason?
The client's natural bowel function may become sluggish.
A client informs the nurse that he is taking a stimulant laxative in order to be able to have a bowel movement daily. What should the nurse inform the client about taking a stimulant laxative?
They can be habit forming and will require increasing doses to be effective.
A patient with severe chronic liver dysfunction comes to the clinic with bleeding of the gums and blood in the stool. What vitamin deficiency does the nurse suspect the patient may be experiencing?
Vitamin K deficiency
The nurse instructs a client who has been prescribed extended-release metformin (Glucophage XR) to take the medication at what time?
With the evening meal
Diet therapy for clients diagnosed with irritable bowel syndrome (IBS) includes:
high-fiber diet.
A client has been newly diagnosed with type 2 diabetes. What statement would be appropriate for the nurse to include in the teaching?
"Regular exercise makes your body better able to use the insulin it produces."
A female client has GERD and is taking ranitidine (Zantac). She continues to have gastric discomfort and asks whether she can take an antacid. Which is an appropriate response by the nurse?
"Yes, but be sure to wait at least 2 hours to take the antacid after you take the ranitidine."
The nurse assesses a client's blood glucose level after administering insulin. Which result would the nurse interpret as indicative of severe hypoglycemia?
34 mg/dL
A nurse is preparing a presentation for a local community group of older adults about colon cancer. What would the nurse include as the primary characteristic associated with this disorder?
A change in bowel habits
After assessing a client with peritonitis, how would the nurse most likely document the client's bowel sounds?
Absent
An important message for any nurse to communicate is that drug-induced hepatitis is a major cause of acute liver failure. The medication that is the leading cause is:
Acetaminophen
chp 37
peptic ulcer disease & hyperacidity chp37
A client comes to the clinic after developing a headache, abdominal pain, nausea, hiccupping, and fatigue about 2 hours ago. The client tells the nurse that the last food was buffalo chicken wings and beer. Which medical condition does the nurse find to be most consistent with the client's presenting problems?
Acute gastritis
A primary health care provider has prescribed levothyroxine to a client with hypothyroidism. Which information would the nurse include in the teaching plan to promote an optimal response to the drug therapy?
Administer the drug early in the morning before breakfast.
A patient has been prescribed acarbose. Which of the following interventions should the nurse perform to promote an optimal response to the medication?
Administer the drug with the first bite of the meal.
A nurse caring for a client with small-bowel obstruction should plan to implement which nursing intervention first?
Administering I.V. fluids
The nurse is assessing an 80-year-old client for signs and symptoms of gastric cancer. The nurse differentiates which as a sign/symptom of gastric cancer in the geriatric client, but not in a client under the age of 75?
Agitation
Occasionally, a bismuth preparation is added to the treatment regimen for duodenal ulcers. What are bismuth's effects against H. pylori organisms.
All of these A bismuth preparation is added to some regimens. Bismuth exerts antibacterial effects against H. pylori. It also increases secretion of mucus and bicarbonate, inhibits pepsin activity, and accumulates in ulcer craters.
When describing the possible adverse effects associated with omeprazole therapy, which of the following would the nurse identify as least common?
Alopecia
The single modality of pharmacologic therapy for chronic type B viral hepatitis is:
Alpha-interferon
A nurse is caring for a patient suffering from a severe form of hyperthyroidism called thyrotoxicosis or thyroid storm. Which of the following should the nurse observe in the patient as a characteristic of thyroid storm?
Altered mental status
The nurse's assessment of a client who has presented to the emergency department reveals hyperglycemia. Which type of insulin will have the most rapid effect on the client's blood sugar levels?
Aspart
When caring for a client with an acute exacerbation of a peptic ulcer, the nurse finds the client doubled up in bed with severe pain in the right shoulder. What is the initial appropriate action by the nurse?
Assess the client's abdomen and vital signs.
A client with anorexia reports constipation. Which nursing measure would be most effective in helping the client reduce constipation?
Assist client to increase dietary fiber.
The nurse is performing an abdominal assessment for a patient with diarrhea and auscultates a loud rumbling sound in the left lower quadrant. What will the nurse document this sound as on the nurse's notes?
Borborygmus
Which would a nurse anticipate as having antiandrogenic effects?
Cimetidine
The nurse is irrigating a client's colostomy when the client begins to report cramping. What is the appropriate action by the nurse?
Clamp the tubing and allow client to rest.
The nurse is irrigating a colostomy when the patient says, "You will have to stop, I am cramping so badly." What is the priority action by the nurse?
Clamp the tubing and give the patient a rest period.
A female client visits the health care provider's office after routine labs are drawn. The nurse notes that her A1C is 9. How does the nurse interpret this finding?
Client's average blood glucose is above normal.
A nurse is caring for an elderly patient who has been administered cimetidine. Which intervention should the nurse perform?
Closely monitor the patient for confusion and dizziness.
Which ulcer is associated with extensive burn injury?
Curling ulcer
An older adult client seeks help for chronic constipation. What factor related to aging can cause constipation in elderly clients?
Decreased abdominal strength
A nurse should monitor a client taking which of the following drugs for increased adverse effects and toxicity if omeprazole (Prilosec) therapy is initiated? Select all that apply:
Digoxin (Lanoxin) Diazepam (Valium) Warfarin (Coumadin)
Ranitidine (Zantac) is preferred over cimetidine (Tagamet) therapy in critically ill clients due to decreased risk of which adverse effect?
Drug-drug interactions
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?
Dumping syndrome
The nursing student approaches his instructor to discuss the plan of care for his client diagnosed with peptic ulcer disease. The student asks what is the most common site for peptic ulcer formation? The instructor would state which one of the following?
Duodenum
Which would a nurse identify as an example of a sulfonylurea?
Glyburide
Which is the best indicator of overall diabetic control?
Glycosylated hemoglobin levels
What would expected findings during an assessment of a client with hyperthyroidism include? (Select all that apply.)
Goiter Increased appetite Tachycardia
Which adverse effect is more likely to be caused by cimetidine than by other H2RAs?
Gynecomastia
What is a common cause of primary hypothyroidism? Select all that apply.
Hashimoto's thyroiditis radiation to the neck hyperthyroidism medication therapy
The nurse is interviewing a client who was diagnosed with type 2 diabetes four months ago. The client does not records glucometer readings but reports no concerns. What laboratory test does the nurse anticipate the health care provider will order for this client?
HbA1c
Which type of jaundice seen in adults is the result of increased destruction of red blood cells?
Hemolytic
A client with severe peptic ulcer disease has undergone surgery and is several hours postoperative. During assessment, the nurse notes that the client has developed cool skin, tachycardia, labored breathing, and appears to be confused. Which complication has the client most likely developed?
Hemorrhage
Which of the following is the most common complication associated with peptic ulcer?
Hemorrhage
A client is complaining of problems with constipation. What dietary suggestion can the nurse inform the client may help facilitate the passage of stool?
Increase dietary fiber.
A nurse is caring for a client with subacute lymphocytic thyroiditis. The health care provider prescribes thyroid hormones to the client. From which sign during ongoing assessment should the nurse conclude that the client is responding to the therapy?
Increased appetite
A male client is receiving morphine sulfate for pain after an accident. The health care provider has also ordered cimetidine IV to assist in preventing a stress ulcer. The nurse will monitor for what effect that is caused by the interaction of these two drugs?
Increased incidence of respiratory depression
When describing the effects of incretins on blood glucose control to a group of students, which would an instructor include?
Increases insulin release
The nurse is providing care for a 51-year-old client who has been taking cimetidine for several months. When monitoring for adverse effects, the nurse should perform what assessment?
Inspect the client for gynecomastia.
A nurse at a health care facility is assigned to administer insulin to the patient. Which intervention should the nurse perform before administering each insulin dose?
Inspect the previous injection site for inflammation.
A nurse must recognize the duration of insulin as to not cause harm to the client with administration of the improper type of insulin. Which insulins are long-acting insulin? (Select all that apply.)
Insulin detemir (Levemir) Insulin glargine (Lantus)
A client newly diagnosed with type 1 diabetes asks the nurse why the client cannot just take a pill. The nurse would incorporate what knowledge when responding to this client?
Insulin is needed because the beta cells of the pancreas are no longer functioning.
The nurse is administering medications to a client that has elevated ammonia due to cirrhosis of the liver. What medication will the nurse give to detoxify ammonium and to act as an osmotic agent?
Lactulose
Which agent would a nurse expect to administer to a client with hypothyroidism?
Levothyroxine
An older adult has been prescribed a thyroid hormone replacement medication. The nurse should first clarify which prescription?
Levothyroxine (Synthroid) 150 mcg orally once per day
The nurse is caring for a client with cystic fibrosis who has not been taking his prescribed pancreatic enzymes recently. What is the primary assessment finding the nurse will see as a result of this nonadherence?
Malnutrition
Which would be least appropriate when administering insulin by subcutaneous injection?
Massaging the site after removing the needle
When performing a physical examination on a client with cirrhosis, a nurse notices that the client's abdomen is enlarged. Which of the following interventions should the nurse consider?
Measure abdominal girth according to a set routine.
A client who has been prescribed metformin is scheduled to undergo diagnostic testing with the administration of parenteral radiographic contrast media containing iodine. What fact should direct the nurse's plan of care for this client?
Metformin should be discontinued at least 48 hours before and after diagnostic tests that use contrast medias.
The nurse in the ED admits a client with suspected gastric outlet obstruction. The client's symptoms include nausea and vomiting. The nurse anticipates that the physician will issue which order?
Nasogastric tube insertion
The nurse working in the ED is evaluating a client for signs and symptoms of appendicitis. Which of the client's signs/symptoms should the nurse report to the physician?
Nausea
A nurse is caring for a client with active upper GI bleeding. What is the appropriate diet for this client during the first 24 hours after admission?
Nothing by mouth
The nurse is admitting a client with a diagnosis of diverticulitis and assesses that the client has a board-like abdomen, no bowel sounds, and reports of severe abdominal pain. What is the nurse's first action?
Notify the health care provider.
Peptic ulcer disease occurs more frequently in people with which blood type?
O
The nurse is caring for a client who is seeking care for a chronic condition. The nurse is aware that the FDA has issued a black box warning regarding the use of thyroid hormones for the treatment of what condition?
Obesity
The nurse administers ranitidine cautiously to clients with evidence of what condition?
Renal disease
A client realizes that regular use of laxatives has greatly improved bowel patterns. However, the nurse cautions this client against the prolonged use of laxatives for which reason?
The client's natural bowel function may become sluggish.
The nurse is assessing a client for constipation. Which factor should the nurse review first to identify the cause of constipation?
Usual pattern of elimination
The nurse is assessing a client for constipation. Which review should the nurse conduct first to identify the cause of constipation?
Usual pattern of elimination
A nurse is providing care for a client recovering from gastric bypass surgery. During assessment, the client exhibits pallor, perspiration, palpitations, headache, and feelings of warmth, dizziness, and drowsiness. The client reports eating 90 minutes ago. What will the nurse suspect?
Vasomotor symptoms associated with dumping syndrome
A client with severe and chronic liver disease is showing manifestations related to inadequate vitamin intake and metabolism. He reports difficulty driving at night because he cannot see well. Which of the following vitamins is most likely deficient for this client?
Vitamin A
A client is admitted for suspected GI disease. Assessment data reveal muscle wasting, a decrease in chest and axillary hair, and increased bleeding tendency. The nurse suspects the client has:
cirrhosis.
A client has been admitted to the intensive care unit with myxedema coma. What predisposing factor is considered when diagnosing myxedema coma?
core body temperature of 94°F (34°C)
While reviewing the medication history of a client newly prescribed omeprazole, the nurse sees that the client is also taking warfarin. What potential interaction should the nurse account for when developing the plan of care for this client?
hemorrhage
A male client tells the nurse that he takes antacid tablets several times each day. Knowing that the brand of antacid he uses contains calcium carbonate, the nurse cautions the client that overuse could place him at risk for:
metabolic alkalosis.
A hospital client's current medication administration record specifies oral administration of propylthiouracil (PTU) every 8 hours. What sign or symptom may have originally prompted the care provider to prescribe this drug?
persistent tachycardia
A nursing assessment of a client with peritonitis reveals hypotension, tachycardia, and signs and symptoms of dehydration. What else would the nurse expect to find?
severe abdominal pain with direct palpation or rebound tenderness
A client, with recent abdominal pain and a 40-pack per year smoking history, is prescribed a treatment regimen for a diagnosis of duodenal ulcer. What important teaching would the nurse include in relation to treatment?
smoking effects on the healing of ulcers
An older adult client in a long term care facility is concerned about bowel regularity. During a client education session, the nurse reinforces the medically acceptable definition of "regularity." What is the actual measurement of "regular"?
stool consistency and client comfort
