GI Practice Questions

Client with PUD has gastric resection, post-op they have a sudden sharp pain in the mid-epigastric area that radiates to their shoulder. The nurse should FIRST?

Notify the surgeon

Which risk factor would most likely contribute to the devlopment of a hiatal hernia?

Obesity It increases intra-abdominal pressure. Other factors include: abdominal straining, frequent heavy lifting, and pregnancy

When planning care for a client with hep A, the nurse should review the lab results for what lab values? A. prolonged PT B. decreased blood glucose C. elevated serum potassium D. decreased serum calcium

A. prolonged PT Because of decreased absorption of vitamin K and decreased production of prothrombin by the liver.

Client taking an antacid for a peptic ulcer should take it when?

1-3 hours after meals. This lengthens the duration of action of the drug

A 40-year old client is admitted to the hospital with a diagnosis of acute cholecystitis. The nurse should contact the HCP to question which prescription of analgesic?

A nurse should question the prescription for morphine sulfate bc it is believed to cause biliary spasm. Thus, the preferred opioid analgesic to treat cholecystitis is merperidine.

A client who has a laparoscopic cholecystectomy has adhesive strips over the puncture sites. When preparing the client for discharge, which statements made by the client indicate teaching has been successful? A. I can resume my normal diet when I want B. I need to avoid driving for about 4 weeks C. I may experience some pain in my right shoulder D. I should spend 2-3 days in bed before resuming activity E. I can take a shower 2 days later

A, C, E Following a cholecystectomy, the client can resume a normal diet as tolerated. The client may experience right shoulder pain from the gas that was used to inflate the abdomen during surgery. They can take a shower within 48 hours.

When providing care for a client hospitalized with acute pancreatitis who has acute abdominal pain, which nursing intervention(s) would be MOST appropriate for this client? Select all that apply. A. Place the client in a side-lying position B. Administer morphine sulfate for pain as needed C. Maintain the client on a high-calorie, high-protein diet D. Monitor the client's respiratory status E. Obtain daily weights

A, D, E The client with acute pancreatitis usually experiences acute abdominal pain. Placing the client in a side-lying position relieves the tension on the abdominal area and promotes comfort. Semi-folwer's is also appropriate. The nurse should also monitor the client's respiratory status because clients with pacreatitis are prone to develop respiratory complications. Daily weights are monitored to assess the client's fluid and nutritional status.

The nurse is preparing the client for a paracentesis. the nurse should: A. have the client void immediately before the procedure B. place the client in a side lying position C. initiate an IV line to administer sedatives D. place the client on an NPO status 6 hours before the procedure

A. have the client void immediately before the procedure this is to prevent perforation. the client will be placed in a high fowlers or seated on the side of the bed for this procedure. IV sedatives are not usually administered and the client does not have to be NPO

A client with cholecystitis continues to have severe RUQ pain. The nurse recommends to the HCP for the client to receive: A. Hydromorphone IV B. Diltiazem PO C. merperidine IM D. promethazine IM

A. Hydropmorphone IV This is because it is rapid acting and for severe pain. Diltiazem is a calcium channel blocker, merperidine can cause seizures, and promethazine is for nausea.

A client with cirrhosis is receiving lactulose. the nurse notes that the client is more confused and has asterixis. The nurse should: A. assess for GI bleeding B. withhold the lactulose C. increase protein in the diet D. monitor serum bili levels

A. assess for GI bleeding clients with cirrhosis can develop hepatic encephalopathy cause by increased ammonia levels. asterixis, a flapping tremor, is a characteristic symptom of increased ammonia levels. bacterial action on increased protein in the bowel will increase ammonia levels and casue the encephalopathy to worsen. GI bleeding and protein consumed in the diet increase protein in the intestine and can elevate ammonia levels. lactulose is given to reduce ammonia formation and should not be held since neurological symptoms are getting worse

A client had a liver biopsy 1 hour ago. the nurse should first: A. auscultate lung sounds B. check for fever C. obtain a CBC D. apply packing to the biopsy site

A. auscultate lung sounds because the biopsy needle insertion site is close to the lung, there is a risk of lung puncture and pneumothorax; therefore the nurse should assess for diminished or absent lung sounds in the right lung

Which dietary instruction would be appropriate for the nurse to give a client who is recovering from acute pancreatitis? A. avoid crash dieting B. restrict carb intake C. eat six small meals a day D. decrease sodium in the diet

A. avoid crash dieting Crash dieting or bingeing may cause an acute attack of pancreatitis and should be avoided. Carb intake should be increased because carbs are less stimulating to the pancreas. There is no need to maintain a diet of six meals a day; the client can eat whenever desired. Pancreas does not promote fluid retention, so sodium restriction is not needed.

The nurse monitor's a client with cirrhosis for the development of hepatic encephalopathy. Which would be an indication that the hepatic encephalopathy is devloping? A. decreased mental status B. elevated BP C. decreased urine output D. labored respirations

A. decreased mental status

What position is appropriate for a client with severe ascites? A. fowlers B. side lying C. reverse trandelemburg D. sims

A. fowlers

The nurse should question which prescription for medications for a client with acute pancreatitis? A. furosemide 20 mg IVPush B. imipenem 500 mg IV C. morphine sulfate 2mg IVPush D. famotidine 20 mg IVPush

A. furosemine 20 mg IVPush This drug can cause pancreatitis and can cause hypovolemia. Imipenem treats necrosis and infection for acute pancreatitis. Morphine and Hydromorphone are preferred opiates for pain for pancreatitis. Famotidine prevents stress/peptic ulcers.

The nurse is teaching a client with Hepatitis A about preventing transmission of the disease. The nurse should focus the teaching on: A. proper food handling B. insulin syringe disposal C. alpha-interferon D. use of condoms

A. proper food handling The main route of transmission for Hepatitis A is the fecal-oral route, rarely parenteral. Good hand washing before eating is essential to the prevention of transmission

A client who has been scheduled to have a choledocholithotomy expresses anxiety about having surgery. Which nursing intervention would be the most appropriate to achieve the outcome of anxiety reduction? A. providing the client with information about what to expect postoperatively B. telling the client not to be afraid C. reassuring the client by saying that surgery is a common procedure D. stressing the importance of following the HCP's instructions after surgery

A. providing the client with information about what to expect postoperatively

A client with cirrhosis who has ascites receives 100 ml of 25% serum albumin IV. which finding would best indicate that the albumin is having its desired effect? A. reduced ascites B. increased serum albumin levels C. decreased anorexia D. increased ease of breathing

A. reduced ascites Albumin is administered to reduce ascites.

The nurse is assessing a client with chronic HEP B who is receiving lamivudine. What information is most important to communicate to the HCP? A. the client has a 3-kg weight gain over 2 days B. the client has nausea C. the client now has a temperature of 99 orally D. the client has fatigue

A. the client has a 3-kg weight gain over 2 days the fluid weight gain is of concern since the drug should be used with caution with impaired renal function.

The nurse notes that the client with acute pancreatitis occasionally experiences muscle twitching and jerking. How should the nurse interpret the significance of these symptoms? A. the client may be developing hypocalcemia B. the client is experiencing a reaction to merperidine C. the client has a nutritional imbalance D. the client needs a muscle relaxant to promote rest

A. the client may be developing hypocalcemia Hypocalcemia develops in severe cases of acute pancreatitis. S/S of this include: muscle twitching, numbness of fingers and lips, irritability.

A client recently diagnosed with hep c states: "now that you know what is wrong with me, you can just get me thise new drugs to take care of it, right?" the nurse should tell the client: A. the treatment is complex. there are new antiviral drugs available that may make treatment more effective and help you tolerate it better B. there are drugs to help with the symptoms, but once you have Hep C you will never be cured C. the medicine currently used to treat hep C is very expensive, and your insurance probably will not pay for it D. if you continue to make the same lifestyle choices, the medicine will not make any difference

A. the treatment is complex. there are new antiviral drugs available that may make treatment more effective and help you tolerate it better Current drug therapy includes a combo of IV interferon and ribavirin that often includes unpleasant side effects and requires frequent monitoring.

Peptic ulcer diet after discharge?

Any foods that are tolerated

The client with GERD has a chronic cough. This symptom may indicate:

Aspiration of gastric contents

A client is to take one dose of ranitidine at home to treat a peptic ulcer. The client should take the drug when?

At bedtime. This drug blocks the secretion of hydrochloric acid so they should take it at bedtime to inhibit nocturnal secretion of acid. Not necessary to take the drug before meals.

A client with cirrhosis begins to develop ascites. Spironolactone is prescribed to treat the ascites. The nurse should monitor the client closely for which drug-related adverse effect? A. constipation B. hyperkalemia C. irregular pulse D. dysuria

B. hyperkalemia Because it's a potassium sparing diuretic

A client is to be discharged with a prescription for lactulose. the nurse teaches the client and the client's spouse how to administer this med. which statement would indicate that the client understood the info? A. i will take it with an antacid B. i will mix it with apple juice C. i will take it with a laxative D. i will mix the crushed tablets in some gelatin

B. i will mix it with apple juice the taste of lactulose for some client's is a problem. mixing it with fruit juice, water, or milk can make it more tolerable

The nurse should teach the client with hep a to: A. limit caloric intake and reduce weight B. increase carbs and protein in the diet C. avoid contact with others and sleep in a separate room D. intensify routine exercise and increase strength

B. increase carbs and protein in the diet Low-fat, high carbs, and high protein diet is encouraged for a client with hepatitis to promote liver rejuvination. Nutrition is important because the client may be anorexic and experiencing weight loss

A client with acute pancreatitis has a BP of 88/40, HR of 128 BPM, resp of 28/min, and Grey Turner's sign. What prescription should the nurse implement FIRST? A. I/O record B. place an IV line C. position on the left side D. Insert an NG tube

B. place an IV line

Which goal is appropriate for a client with hep a? the client will: A. demonstrate a decrease in fluid retention related to ascites B. verbalize the importance of reporting bleeding gums or bloody stools C. limit the use of alcohol to two or three drinks per week D. restrict activity to within the home to prevent disease transmission

B. verbalize the importance of reporting bleeding gums or bloody stools Could be a result of prolonged PT

Pancreatic enzyme replacements are prescribed for the client with chronic pancreatitis. When should the nurse instruct the client to take them to obtain the most therapeutic effect? A. three times daily between meals B. with each meal and snack C. in the morning and at bedtime D. every 4 hours, at specified times

B. with each meal and snack pancreatic enzymes are prescribed to facilitate the digestion of proteins and fats and should be taken in conjunction with every meal and snack

Which finding is normal during the icteric phase of hepatitis A? A. tarry stools B. yellowed sclerae C. shortness of breath D. light, frothy urine

B. yellowed sclerae

In developing a teaching plan for the client with a hiatal hernia, the nurse's assessment of which work-related factors would be most useful?

Body mechanics used in lifting

A client diagnosed with GERD has a heartburn. To decrease heartburn, the nurse should instruct the client to eliminate what food item from the diet? A. lean beef B. air-popped popcorn C. hot chocolate D. raw vegetables

C. Hot chocolate Foods that can cause a decrease in esophageal sphincter pressure are: fatty foods, chocolate, caffeine, peppermint, and alcohol.

A client is admitted to the hospital with a diagnosis of cholecystitis from cholelithiasis. The client has severe abdominal pain and nausea and has vomited 120 ml. Based on these data, which nursing action would have the highest priority at this time? A. Manage anxiety B. Restore fluid loss C. Manage the pain D. Replace nutritional loss

C. Manage the pain The priority for nursing care at this time is to decrease the clients severe abdominal pain. The pain, which is frequently accompanied by nausea and vomiting, is caused by biliary spasm. Relief of pain may decrease nausea and vomiting and thereby decrease the client's likelihood of developing further complications such as severe fluid loss and inadequate nutrition.

The nurse is assessing the client who is in the early stages of cirrhosis of the liver. Which focused assessment is appropriate? A. peripheral edema B. ascites C. anorexia D. jaundice

C. anorexia Early stages of cirrhosis are manifested by GI symptoms such as anorexia, n/v, changes in bowel patterns

A client undergoes a laparascopic cholecystectomy. Which dietary instructions should the nurse give the client immediately after surgery? A. You cannot eat or drink anything for 24 hours B. You may resume your normal diet the day after your surgery C. Drink liquids today and eat lightly for a few days D. You can progress from a liquid to a bland diet as tolerated

C. drink liquids today and eat lightly for a few days Immediately after surgery, the client will drink liquids. A light diet can be resumed the day after surgery.

A client has advanced cirrhosis of the liver. the client's spouse asks the nurse why his abdomen is swollen, making it difficult for him to fasten his pants. how should the nurse respond to provide the most accurate explanation of the disease process? A. he must have been eating too many foods with salt in them. salt pulls water with it B. the swelling in his ankles must have moved up closer to his heart so the fluid circulates better C. he must have forgotten to take his daily water pill D. blood is not able to flow readily through the liver now, and the liver cannot make protein to keep fluid inside the blood vessels

D. Portal hypertension and hypoalbuminemia as a result of cirrhosis cause a fluid shift into the peritoneal space causing ascites.

The nurse should instruct the client to avoid which drug while taking metoclopramide hydrochloride? A. antacids B. antihypertensives C. anticoagulants D. alcohol

D. alcohol

The nurse is caring for a client with esophageal varicies. The nurse should discuss which lab report finding with the HCP? A. normal serum albumin B. decreased ammonia C. slightly decreased levels of calcium D. elevated PT/INR

D. elevated PT/INR

A client who is recovering from hep A has fatigue and malaise. The client asks the nurse, "when will my strength return?" which response by the nurse is most appropriate? A. your fatigue should be gone by now, we will evaluate you for a secondary infection B. your fatigue is an adverse effect of your drug therapy. It will disappear when your treatment regimen is complete C. It is important for you to increase your activity level. That will help decrease your fatigue D. It is normal for you to feel fatigued. the fatigue should subside in the next 2-4 months

D. it is normal for you to feel fatigued. the fatigue should subside in the next 2-4 months Hep A is not treated with drug therapy. It is important that the client continue to balance activity and rest

S/S of someone with a GI bleed? (4)

Decreased urine output Tachycardia Rapid respirations Thirst

When teaching about Hepatitis B what is one important piece of information for someone to know?

Practice safe sexual practices

What is an unusual symptom of a peptic ulcer? (Duodenal)

Pt. has pain occurring during the night and is relieved by eating

Expected outcome of the drug for patient taking ranitidine (H2 blocker)?

Reduces gastric acid secretion

A client has undergone a cholecystectomy. Which instruction should the nurse include in the discharge teaching?

Report bile-colored drainage from any incision. There should be no bile-colored drainage coming from any of the incisions postoperatively. A laparoscopic cholecystectomy does not involve a bile bag.

If patient reports black tarry stools and has a peptic ulcer- the nurse should?

Report findings to HCP

The nurse measures the amount of bile drainage from a T tube and records it by which method?

T-tube bile drainage is recorded separately on the output record.

The client is scheduled to have an upper gastrointestinal tract series of x-rays. Following the x-rays, the nurse should instruct the client to:

Take a laxative This examination involves the administration of barium, which must be promptly eliminated from the body because it may harden and cause an obstruction.

A client diagnosed with peptic ulcer disease has an H. Pylori infection. The client is following a 2 week regimen that includes clarithromycin along with omeprozole and amoxacillin. The nurse should instruct the client to:

Take the drugs for the entire 2 week period

First plan of care for a patient with viral hepatitis:

obtain adequate bed rest

A client has been admitted to the med surg unit following an emergency cholecystectomy. There is a JP drain with a portable suction unit attached. After 4 hours, the drainage unit is full. What should the nurse do? A. Notify the surgeon B. Remove the drain and suction unit C. Check the dressing for bleeding D. Empty the drainage unit

D. empty the drainage unit Portable suction units should be drained and emptied when full or every shift.

The client with hep a is experiencing fatigue, weakness, and general feeling of malaise. the client tires rapidly during morning care. the most appropriate goal for this client is to: A. increase mobility B. learn new self care skills C. adapt to new levels of energy D. gradually increase activity tolerance

D. gradually increase activity tolerance

The nurse should monitor the client with acute pancreatitis for which complication? A. heart failure B. duodenal ulcer C. cirrhosis D. pneumonia

D. pneumonia A client with acute pancreatitis is prone to complications associated with the respiratory system.

The client who has been hospitalized with pancreatitis does not drink alcohol because of religious convictions. The client becomes upset when the HCP persists in asking about alcohol intake. The nurse should explain that the reason for these questions is that:

There is a strong link between alcohol use and acute pancreatitis

Bethanechol has been prescribed for a patient with GERD. The nurse should assess the client for which adverse effect?

Urinary urgency This is a cholinergic drug and may be used in GERD to increase lower esophageal sphincter pressure and facilitate gastric emptying. Cholinergic effects include: urinary urgency, diarrhea, abdominal cramping, hypotension, and increased salivation.

What are S/S of patient with suspected gastric ulcer? (4)

Vomiting Weight loss Melena Burning epigastric pain that occurs 1 hour after eating (eating aggravates the pain)

The nurse is obtaining a health history from a client who has a sliding hiatal hernia associated with reflux. The nurse should ask the client about the presence of which symptom?

Heartburn

Symptoms of nausea and dizziness in a client with peptic ulcer disease may be indicative of?

Hemorrhage and should not be ignored. Actions for the nurse: monitor vitals and notify HCP

The client asks the nurse if surgery is needed to correct a hiatal hernia. What reply by the nurse would be the most accurate?

Hiatal hernia symptoms can usually be treated successfully by diet modifications, medications, and lifestyle changes

What is the recommended diet for someone with GERD?

High in protein and low in fat Avoid: fatty foods, caffeine, alcohol

Patient with peptic ulcer reports epigastric pain frequently through the night, so the nurse should tell them to? (4)

Maintain adequate rest Small frequent meals throughout the day Take meds on time as prescribed Sit up for one hour when awakened at night

The nurse is assessing a client for ascites. where does the nurse place the hands to percuss for the presence of fluid?

The nurse places the client in a supine position and percusses each flank for shifting dullness. If fluid is present, dullness is noted.

Which nursing interventions would most likely promote self-care behaviors in the client with hiatal hernia? A. introduce the client to other ppl who are successfully managing their care B. include the client's daughter in the teaching so that she can help implement the plan C. ask the client to identify other situations in which the client changed healthcare habits D. provide reassurance that the client will be able to implement all aspects of the plan successfully

C. ask the client to identify other situations in which the client changed healthcare habits

A client's stools are light gray in color. For what finding should the nurse assess the client? Select all that apply. A. intolerance to fatty foods B. fever C. jaundice D. respiratory distress E. pain at McBurney's point F. peptic ulcer disease

A, B, and C. Bile is created in the liver, stored in the gallbladder, and released into the duodenum, giving stool its brown color. A bile-duct obstruction can cause pale-colored stools. Other symptoms associated with cholelithiasis are URQ pain, fever from inflammation or infection, jaundice from elevated serum bili levels, and nausea or upper quadrant pain after a fatty meal.

A nurse is developing a plan of care for a client with hepatic encephalopathy. which are goals for the care of this client? select all that apply A. prevent constipation B. administer lactulose to reduce blood ammonia levels C. monitor coordination while walking D. check the pupil reaction E. provide food and fluids high in carbohydrate F. encourage physical activity

A, B, C, D, E Constipation leads to increase ammonia production. lactulose is a hyperosmotic laxative that reduces blood ammonia levels. H.E. effects a person's coordination and pupil reaction.

What diet should be implemented for a client who is in the early stages of cirrhosis? A. high calorie, high carb B. high protein, low fat C. low fat, low protein D. high carb, low sodium

A. high calorie, high carb for clients who have cirrhosis without complications, a high calorie high carb diet is preferred to provide an adequate supply of nutrients. in the early stages, there's no need to restrict fat, protein, or sodium

The nurse develops a teaching plan for the client about how to prevent the transmission of hep a. Which discharge instruction is appropriate for the client? A. Spray the house to eliminate infected insects B. Tell the family members to try to stay away from the client C. Ask family members to wash their hands frequently D. Disinfect all clothing and eating utensils

C. ask family members to wash their hands frequently The hep a virus is trasmitted via fecal-oral route. it spreads through contaminated hands, water, food, and especially shellfish growing in contaminated water

A client with jaundice has pruritis and areas of irritation from scratching. what measures can the nurse suggest the client to use to prevent skin breakdown? select all that apply A. avoid lotions containing calamine B. add baking soda to the water in a tub bath C. keep nails short and clean D. rub the skin when it itches with knuckles instead of nails E. massage the skin with alcohol F. increase sodium intake in the diet

B, C, D baking soda baths can decrease pruritis. keeping nails short and rubbing the area with knuckles can decrease breakdown when scratching. calamine lotions help relieve itching.

A client with chronic hep c is experiencing nausea, anorexia, and fatigue. During the health hx, the client states that he is homosexual, drinks one to two glasses of wine with dinner, and is taking St. John's wort for a "bit of depression," and takes a acetaminophen for frequent headaches. What should the nurse do? Select all that apply. A. instruct the client that wine with meals can be beneficial for cardiovascular health B. instruct the client to ask the healthcare provider about taking any other meds as they may interact with meds the client is currently taking C. instruct the client to increase protein in his diet and eat less frequently D. advise the client of the need for additional testing for HIV E. encourage the client to obtain sufficient rest

B, D, E Client's with chronic hep c should abstain from alcohol as it can speed cirrhosis and end-stage liver disease. It is also important for client's who are infected with HCV to be tested for HIV, as clients who have both HIV and HCV have a more rapid progression of liver disease than do those who have HCV alone.

A client has an open cholecystectomy with bile duct exploration. Following surgery, the client has a T tube. To evaluate the effectiveness of the T tube, the nurse should: A. irrigate the tube with 20 ml of NS q4h B. unclamp the T tube and empty the contents every day C. assess the color and amount of drainage every shift D. monitor the multiple incision sites for bile drainage

C. assess the color and drainage every shift A T tube is inserted into the common bile duct to maintain patency when there is a likelihood of edema. The bile color should be gold to dark green and the amount of drainage should be closely monitored to ensure tube patency

A client is taking cimetidine to treat a hiatal hernia. The nurse should evaluate the client to determine that the drug has been effective in preventing which health problem? A. esophogeal reflux B. dysphagia C. esophagitis D. ulcer formation

C. esophagitis Cimetidine is a histamine receptor antagonist that decreases the quantity of gastric secretions. It may be used in hiatal hernia therapy to prevent or treat esophagitis and heartburn associated with reflux.

Interferon alpha-2b has been prescribed to treat a client with chronic hep b. the nurse should assess the client for which common adverse affect? A. retinopathy B. constipation C. flulike symptoms D. hypoglycemia

C. flulike symptoms Such as myalgia, arthralgia, headache, nausea, fever, and fatigue.

The nurse is providing discharge instructions for a client with cirrhosis. which statement best indicates that the client has understood the teaching? A. i should eat a high protein-, high carb diet to provide energy B. it is safer for me to take tylenol instead of aspirin for pain C. i should avoid constipation to decrease chances of bleeding D. if i get enough rest and follow my diet, it is possible for my cirrhosis to be cured

C. i should avoid constipation to decrease changes of bleeding clients with cirrhosis should be instructed to avoid constipation and straining at stool to prevent hemorrhage

The HCP instructs a client with alcohol-induced cirrhosis to stop drinking alcohol. The expected outcome of this intervention is: A. absence of DT's B. having a balanced diet C. improved liver function D. reduced weight

C. improved liver function

A client's serum ammonia level is elevated and the HCP prescribes 30 ml of lactulose. which effect is common for this drug? A. increased urine output B. improved LOC C. increased bowel movements D. n/v

C. increased BM's

The nurse should teach the client with chronic pancreatitis to monitor the effectiveness of pancreatic enzyme therapy by? A. recording daily fluid intake B. performing glucose fingerstick tests twice a day C. observing stools for steatorrhea D. testing urine for ketones

C. observing stools for steatorrhea if the dosage and administration of pancreatic enzymes are adequate, the clients stool will be relatively normal. Any increase in odor or fat content will indicate a need for dosage adjustment.

The nurse is assessing a client with cirrhosis who has developed hepatic encephalopathy. the nurse should notify the HCP of a decrease in which serum lab value that is a potential precipitating factor for hepatic encephalopathy? A. aldosterone B. creatnine C. potassium D. protein

C. potassium Hypokalemia is a precipitating factor in hepatic encephalopathy

A client has a positive serologic test for anti-HCV. The nurse should instruct the cleint: A. how to self administer alpha-interferon B. that the HCV will resolve in approximately 3 months C. that a follow-up appointment for HCV genotype testing is required D. to take alpha-interferon as prescribed

C. that a follow-up appointment for HCV genotype testing is required Clients with HEP C should receive genotype testing to determine the most effective treatment approach, and it must be done prior to the start of drug treatment with alpha-interferon.

Aluminum hydroxide can cause what as an adverse effect?

Constipation

The nurse is caring for a client recently diagnosed with Hep C. In reviewing the client's history, what info would be most helpful as the nurse develops a teaching plan? The client: A. has a hx of exercise-induced asthma B. is a scientist and is frequently exposed to multiple chemicals C. traveled to Central America recently and ate uncooked vegetables D. has a known hx of sexually transmitted disease

D. has a known hx of sexually transmitted disease

The nurse is assessing a client with hepatitis A and notices that the AST and ALT lab values have increased. Which statement by the client indicates the need for further instruction by the nurse? A. I require increased periods of rest B. I follow a low-fat, high carb diet C. I eat dry toast to relieve my nausea D. I take acetaminophen to relieve my arthritis pain

D. i take acetaminophen to relieve my arthritis pain Acetaminophen in toxic to the liver

The nurse is reviewing the chart info for a client with increased ascites. the date includes: temp of 98.9, HR 118, shallow resp 26/min, blood pressure 128/76, and O2 89% on room air. the nurse should FIRST: A. assess heart sounds B. obtain a prescription for blood cultures C. prepare for paracentesis D. raise the HOB

D. raise the HOB Allows increased lung expansion by decreasing the ascites pressing on the diaphragm.

After a cholecystectomy, the client is to follow a low-fat diet. Which food would be MOST appropriate to include in a low-fat diet? A. cheese omelet with onions B. peanut butter on wheat toast C. ham salad sandwich made with mayonnaise D. roast beef sandwich with lettuce and tomato

D. roast beef sandwich with lettuce and tomato Lean meats, such as beef, lamb, veal, and well trimmed lean ham and pork are low in fat. Fruits are low in fat. Rice, pasta and veggies are low in fat when not served with sauces.

The client has been taking magnesium hydroxide (milk of mag) to control hiatal hernia symptoms. The nurse should assess the client for which condition most commonly associated with the ongoing use of magnesium-based antacids?

Diarrhea

What instruction should the nurse include in the teaching plan for a patient with GERD in relation to when they eat?

Do not lie down for two hours after eating

What dietary measure would be useful in preventing esophageal reflux?

Eating small, frequent meals GERD worsens when the stomach is overdistended with food.

S/S of perforation? (4)

Elevated temp Epigastric pain Vomiting blood (hematemesis) Board-like abdominal rigidity, usually with extreme pain This is a medical emergency requiring immediate surgical intervention because peritonitis develops quickly after

Which lifestyle modification should the nurse encourage the client with a hiatal hernia to include in activities of daily living?

Eliminating smoking and alcohol use

What is an expected outcome for a client with peptic ulcer disease?

Explain the rationale for eliminating alcohol from the diet