GI
Which manifestation identified by the nurse supports the presence of fecal impaction in a client?
Abdominal cramps Fecal liquid seepage Hyper active bowel sounds
Which action will the nurse perform to address the potential for injury because of possible bowel obstruction?
Auscultate bowel sounds as directed
Which symptom would be expected by the nurse is providing care for a client with gastritis?
Belching Anorexia Nausea and vomiting Fullness in the upper abdomen after eating Burning pain in the upper abdomen
Which fluid and electrolyte imbalance is expected in a client reporting diarrhea for the past 4 to 5 days he reports feeling lethargic and weak?
Dehydration Hypokalemia Hypernatremia Metabolic acidosis Respiratory alkalosis
Which response with a nurse give when a client admitted with a ruptured appendix asks why surgery is being delayed for several hours?
Delaying surgery for a few hours allows us to start treating the infection and inflammation in your abdomen before starting surgery
Which discipline with the nurse choose to consult regarding lifestyle modifications for a client with gastroesophageal reflux disease who reports being a truck driver who has irregular hours, eat fast food, and sleeps in the cab on occasion?
Dietician
The nurse is caring for a client in the immediate postoperative period after a subtotal gastrectomy. Which nursing action is appropriate after identifying small blood clots in the clients gastric drainage?
Documenting this as an expected event
Which information would be important for the nurse to teach a client prescribed psyllium 3.5g twice a day for constipation?
Each dose should be taken with a full glass of water
Which instruction would the nurse include in educational materials on the prevention of dental caries and gingivitis?
Eat a well-balanced diet See your dentist regularly Floss your teeth every day Brush your teeth at least twice a day Limit intake of sugary foods and drinks
Which manifestation of digestive fluid leakage at the anastomoses site with the nurse monitor for in a client 5 to 7 days after surgery for esophageal cancer?
Fever Cough Tachypnea Tachycardia Neck wound swelling Accumulation of purulent materials
Which immediate action will the nurse take when the client has bright red, bloody emesis?
Have the client sit upright
For which complication with the nurse assess a client with autoimmune hemolytic anemia in the immediate postoperative period following a splenectomy?
Hemorrhage
Which finding in a client reporting abdominal pain would the nurse report to the healthcare provider immediately
High pitched-tinkling bowel sounds
Nurse provides education to a client about how to prevent constipation. The nurse concludes that the teaching has been understood when the client makes which statement?
I should drink a glass of water every day I can include bran muffins in my breakfast daily Walk every day as part of my exercise regimen
Which information about vitamin A would the nurse consider when assessing a client for clinical indicators of vitamin A deficiency?
It is necessary element rhodopsin, which controls responses to light and dark environments
Which associated risk factor with the nurse assess for when collecting a health history on a client with tongue cancer?
Large amounts of alcohol consumption
Which intervention with the nurse recommend for a client who underwent a Billroth 11 procedure and is experiencing dumping syndrome after consulting the dietitian?
Lay down for 30 minutes after meals
Which important strategy that will most likely be a requirement for life will the nurse include in the discharge teaching for a client after a total gastrectomy?
Small, frequent meals
Who would the nurse expect to work with to meet the goal of eating food again in a client who underwent a tracheostomy insertion and had a temporary gastrostomy tube place?
Speech therapist
Which manifestation would the nurse recognize as an indication of esophageal perforation in a client with a recent dilation of the lower esophageal sphincter (LES)?due to achalasia?
Subcutaneous emphysema
Which action will the nurse determine is needed for a client who has undergone gastric bypass surgery?
Teach the client how to avoid dumping syndrome
A client is being prepared for surgery to have placement of a percutaneous endoscopic gastrostomy (PEG) tube. The client asked why the PEG tube is preferred over the existing nasogastric tube that is being used for feedings. Which explanation with the nurse give?
There is less chance of aspiration
Which response would be given by a nurse to a client with dysphasia who states that swallowing can be more easily accomplished with the head tilted back quickly?
Tilting the head back actually makes swallowing more difficult and increases the risk for aspiration
Which Finding in a client with suspected small bowel obstruction who is placed on metoclopramide would the nurse report to the healthcare provider immediately?
Tongue protrusion
Which statement made by the nurse is correct regarding total parenteral nutrition?
Total parenteral nutrition must be administered through a central intravenous catheter
Which action will the nurse perform first one assessing the abdomen of a client with a nasogastric tube on low intermediate suction for a bowel obstruction?
Turning off nasogastric suction
Which intervention would be included by the nurse is providing postoperative care for a client with stomach cancer?
Weigh the client daily Provide oral care frequently Monitor nutritional intake Maintain nasogastric suction Stress the importance of ongoing vitamin B 12 injections
Which information with the nurse collect to coordinate the plan of care for a client with dysphasia?
Weight loss Coughing and choking Presence of hoarseness Recurrent chest infections Conditions under which the problem occurs
Which laboratory value would be most important for the nurse to monitor to detect possible complications of bleeding esophageal varices in a client with severe cirrhosis?
Ammonia level
Which direction will the nurse provide to a client with cancer who is receiving ondansetron for chemotherapy associated nausea and vomiting to ensure safe administration?
Allow the tablet to dissolve in your mouth Swallow several times as a tablet dissolves Use dry, clean hands to remove the pill from the package Keep the tablet in the blister pack until you are ready to take it Store at room temperature and keep away from moisture, heat, and light
Which intervention would the nurse perform to help an anorexic client reporting a "bad taste"in the mouth when eating?
Assist with oral hygiene before and after meals
Which information would the nurse include in the discharge teaching plan for a client hospitalized with gastritis?
Avoid alcohol and tobacco use
Which specific post operative care need would be addressed by the nursing team of a client undergoing bariatric surgery?
Avoiding strain on incision and inspecting wound for intact margins Maintaining compression devices for feet or lower legs and early ambulation Ensuring that the prescribed imaging studies have been done before advancing diet Maintaining strict compliance with coughing and deep breathing every 4 hours while awake Helping the client avoid discouragement and negativities by focusing on wt loss accomplishments
Which statement by the client is accurate regarding constipation?
I will exercise by walking at least 30 minutes daily
Which client statement indicates to the nurse that a client who is receiving cyanocobalamin (vit B 12) Therapy for an intrinsic factor deficiency understands the treatment?
I will have a vitamin B 12 injection every month
Which outcome is a primary goal of the nurse administering medication to a client with a hiatal hernia?
Increase lower esophageal sphincter pressure
Which statement would the nurse include in the dietary teaching about the prescribed diet after a Whipple procedure for cancer of the pancreas?
Low fat meals will be eaten to prevent interference with your fat digestion mechanism
Which intervention with the nurse perform on a client presenting with appendicitis?
Maintain nothing by mouth status
Which factor would increase the risk for esophageal cancer?
Obesity, chronic trauma, male gender, cigarette smoking, excessive alcohol intake
Which is the primary preoperative nursing intervention for a client admitted for a surgical repair of an incarcerated indirect inguinal hernia?
Observing the clients bowel movements
Which complication of peritonitis would cause a client to be admitted to the intensive care unit?
Organ failure severe hypotension shock occurring due to septicemia deficient intravascular fluid volume cardiac output failing with a reduction and perfusion of vital organs
Which goal or outcome would be important to a client suffering from stomatitis?
Pain relief, stable body weight, effective oral hygiene, absence of oral lesions, oral mucous membranes intact
Which reason for elevating the head When providing postoperative care for a client with esophageal cancer would a nurse explain to the nurse assistant?
Reduces the risk for reflux of gastric materials into the esophagus
Which item would be specifically included on a full liquid diet?
Refined cooked cereals
Which adverse reaction with the nurse monitor for in obstetric client with hyperemesis gravidarum who is prescribed promethazine?
Seizures, dystonia, parkinsonism, tardive dyskinesia, orthostatic hypotension