Exam 4 GI/GU
A nurse in a long-term care facility is caring for an older adult client who has dementia and begins to have frequent episodes of urinary incontinence. After the provider determines no medical cause for the client's incontinence, which of the following interventions should the nurse initiate to manage this behavior? A.Request a prescription for an indwelling urinary catheter. B.Take the client to the bathroom every 2 hr. C.Use adult diapers to prevent frequent clothing changes. D.Remind the client to tell the nurse when he has to urinate.
B. Take the client to the bathroom every 2 hr.
The nurse is caring for a client who has been diagnosed with peptic ulcer disease. For which complication would the nurse monitor? A. Large bowel obstruction B. Upper gastrointestinal (GI) bleeding C. Dyspepsia D. Gastric cancer
B. Upper gastrointestinal (GI) bleeding
The nurse notes that the primary health care provider documented the presence of mucosal erythroplasia in a client. What does the nurse understand that this most likely means for this client? A. Obvious oral tumor B. Inflammation of the gums C. Early sign of oral cancer D. Fungal mouth infection
C. Early sign of oral cancer
A client having a tube feeding begins vomiting. What action by the nurse is most appropriate? A. Reduce the rate of feedings by half. B. Administer an antiemetic. C. Hold the feedings until the nausea subsides. D. Check the client's residual.
C. Hold the feedings until the nausea subsides.
A nurse is caring for a female client who has recurrent kidney stones and is scheduled for an intravenous pyelogram. Which of the following statements by the client should the nurse report to the provider? A. "I don't eat shellfish because it gives me hives." B. "I drink at least 2 quarts of fluid every day." C. "The last time I voided it was painful and red-tinged." D. "My period ended 2 days ago."
A. "I don't eat shellfish because it gives me hives."
After teaching a client who has diverticulitis, a nurse assesses the client's understanding. Which statement made by the client indicates a need for additional teaching? A. "I will take a laxative nightly at bedtime to avoid becoming constipated." B. "I'll ride my bike or take a long walk at least three times a week." C. "I must try to include at least 25 grams of fiber in my diet every day." D. "I should use my legs rather than my back muscles when I lift heavy objects."
A. "I will take a laxative nightly at bedtime to avoid becoming constipated."
A nurse cares for an older adult who is admitted to the hospital with complications of diverticulitis. Which actions would the nurse include in the client's plan of care? (Select all that apply.) A. Administer pain medications as prescribed. B. Evaluate stools for occult blood. C. Provide the client with a high-fiber diet. D. Assess for sudden changes in mental status. E. Palpate the abdomen for distention.
A. Administer pain medications as prescribed. B. Evaluate stools for occult blood. D. Assess for sudden changes in mental status. E. Palpate the abdomen for distention.
The nurse is teaching a client about the risk of uncontrolled or untreated the client's gastroesophageal reflux disease (GERD). What complication(s) may occur if the GERD is not successfully managed? (Select all that apply.) A. Asthma B. Cancer C. Cardiac disease D. Dental caries E. Laryngitis
A. Asthma B. Cancer C. Cardiac disease D. Dental caries E. Laryngitis
The nurse is caring for a client diagnosed with probable gastroesophageal reflux disease (GERD). What assessment finding(s) would the nurse expect? (Select all that apply.) A. Belching B. Dyspepsia C. Regurgitation D. Dysphagia E. Coughing F. Chest discomfort
A. Belching B. Dyspepsia C. Regurgitation D. Dysphagia E. Coughing F. Chest discomfort
The nurse reviews the laboratory results for a client who has possible appendicitis. Which laboratory test finding would the nurse expect? A. Elevated leukocyte count B. Decreased potassium level C. Decreased thrombocyte count D. Increased sodium level
A. Elevated leukocyte count
A nurse plans care for an older adult patient. Which interventions should the nurse include in this client's plan of care to promote kidney health? (Select all that apply.) A. Ensure adequate fluid intake. B. Encourage use of the toilet every 6 hours. C. Delegate bladder training instructions to the assistive personnel (AP). D. Provide thorough perineal care after each voiding. E. Assess for urinary retention and urinary tract infection. F. Leave the bathroom light on at night.
A. Ensure adequate fluid intake. D. Provide thorough perineal care after each voiding. E. Assess for urinary retention and urinary tract infection. F. Leave the bathroom light on at night.
A nurse assesses a client who has ulcerative colitis and severe diarrhea. Which assessment should the nurse complete first? A. Heart rate and rhythm B. Recent dietary intake C. Inspection of oral mucosa D. Percussion of abdomen
A. Heart rate and rhythm
The nurse caring for clients with gastrointestinal disorders should understand that which category best describes the mechanism of action of sucralfate (Carafate)? A. Mucosal barrier fortifier B. Histamine receptor blocker C. Gastric acid inhibitor D. Proton pump inhibitor
A. Mucosal barrier fortifier
The nurse is caring for a client with peptic ulcer disease who reports sudden onset of sharp abdominal pain. On palpation, the client's abdomen is tense and rigid. What action takes priority? A. Notify the health care provider immediately. B. Percuss all four abdominal quadrants. C. Administer pantoprazole (Protonix) IV push D. Administer the prescribed pain medication.
A. Notify the health care provider immediately.
The nurse is caring for a client with sialadenitis. What comfort measures are appropriate for this client? (Select all that apply.) A. Offering fluids every hour B. Reminding the patient to avoid speaking C. Providing lemon-glycerin swabs D. Applying ice to salivary glands E. Applying warm compresses
A. Offering fluids every hour E. Applying a warm compress
The nurse assesses a client who has possible gastritis. Which assessment finding(s) indicate(s) that the client has chronic gastritis? (Select all that apply.) A. Pernicious anemia B. Dyspepsia C. Anorexia D. Intolerance of fatty foods E. Nausea and vomiting
A. Pernicious anemia
A nurse is assessing a client who has peritonitis. Which of the following findings should the nurse expect? A. Rigid abdomen B. Frequent bowel movements C. Increased urinary output D. Hyperactive bowel sounds
A. Rigid abdomen
After teaching a client who has diverticulitis, a nurse assesses the client's understanding. Which statement made by the client indicates a need for further teaching? A."I will take a laxative nightly at bedtime to avoid becoming constipated." B."I must try to include at least 25 g of fiber in my diet every day." C."I'll ride my bike or take a long walk at least three times a week." D."I should use my legs rather than my back muscles when I lift heavy objects."
A."I will take a laxative nightly at bedtime to avoid becoming constipated."
The nurse working with clients who have gastrointestinal problems knows that which laboratory values are related to which organ functions or dysfunctions? (Select all that apply.) A.Ammonia: liver B.Amylase: liver C.Urine urobilinogen: stomach D.Alanine aminotransferase: biliary system E.Lipase: pancreas
A.Ammonia: liver E. Lipase: Pancreas
A client has dumping syndrome. What menu selections indicate the client understands the correct diet to manage this condition? (Select all that apply.) A.Apricots B.Steamed broccoli C.Coffee cake D.Milk shake E.Potato soup
Answer Key: A,E A. Apricots E. Potato Soup
A nurse assesses a client recovering from a cystoscopy. Which assessment findings would alert the nurse to urgently contact the primary health care provider? (Select all that apply.) A. Burning sensation when urinating B. Decrease in urine output C. Tolerating oral fluids D. Prescription for metformin E. Blood clots present in the urine
B. Decrease in urine output E. Blood clots present in the urine
An older female client has been prescribed esomeprazole (Nexium) for treatment of chronic gastric ulcers. What teaching is particularly important for this client? A. Report any worsening of symptoms to the provider. B. Increase intake of calcium and vitamin D. C. Take the medication as prescribed by the provider. D. Check with the pharmacist before taking other medications.
B. Increase intake of calcium and vitamin D.
A client with a history of kidney disease is admitted with acute shoulder pain. Which order will the nurse discuss with the prescribing health care provider? A. Pan cultures for a temperature >38.5 C. B. Digoxin 0.125 mg by mouth daily. C. Ibuprofen 800 mg by mouth every 4 hours. D. Metoprolol 50 mg by mouth twice daily.
C. Ibuprofen 800 mg by mouth every 4 hours.
The nurse is teaching a client diagnosed with stomatitis about special mouth care. Which statement by the client indicates a need for further teaching? A. "I need to take out my dentures until my mouth heals." B. "I'll try to eat soft foods that aren't spicy and acidic." C. "I'll be sure to rinse my mouth often with warm salt water." D. "I will use a more firm toothbrush to keep my mouth clean."
D. "I will use a more firm toothbrush to keep my mouth clean."
The nurse cares for an older adult client who has Salmonella food poisoning. The client's vital signs are heart rate: 102 beats/min, blood pressure: 98/55 mm Hg, respiratory rate: 22 breaths/min, and oxygen saturation: 94%. Which action should the nurse complete first? A. Teach proper food preparation to prevent contamination. B. Apply oxygen via nasal cannula. C. Provide perineal care with a premedicated wipe. D. Administer intravenous fluids.
D. Administer intravenous fluids
A client has a metastatic bone tumor in the left leg. What action by the nurse is appropriate? A. Elevate the extremity and apply moist heat. B. Place the client on protective precautions. C. Teach the client about amputation care. D. Administer pain medication as prescribed.
D. Administer pain medication as prescribed.
