HC3A Exam 4 FINAL

Which priority teaching will the nurse provide to an older client with GERD who is prescribed omeprazole for symptom relief? A) "Older adults taking this drug may be at increased risk for hip fracture because it interferes with calcium absorption." B) "Because of this drug's side effect of decreasing potassium, you may be prescribed a potassium supplement." C) "This drug causes sodium retention, so you may be prescribed a dietary sodium restriction." D) "A pacemaker may be necessary because this drug changes magnesium levels which can lead to life-threatening dysrhythmias."

A) "Older adults taking this drug may be at increased risk for hip fracture because it interferes with calcium absorption."

A client with cholecystitis has severe pain unrelieved by ibuprofen. The client feels nauseated. The nurse obtains the following vital signs: temperature 101°F, pulse 114 bpm, respirations 22 breaths/min, BP 142/90. Using the SBAR (situation-background-assessment-recommendation) technique for communication, what should the nurse recommend to the HCP for this client? A) Medication for severe pain B) Medication for increased temperature C) Medication for elevated BP D) Medication for nausea

A) Medication for severe pain

An adult client with appendicitis has severe abdominal pain. Which action will be the most effective to assist the client to manage pain prior to surgery? A) Place the client in a semi-Fowler's position with the knees to the chest B) Apply moist heat to the abdomen C) Teach the client to massage the painful area D) Provide distraction with music

A) Place the client in a semi-Fowler's position with the knees to the chest

A client's stools are light gray in color. What additional information should the nurse obtain from the client? SATA. A) Intolerance to fatty foods B) Fever C) Jaundice D) Respiratory distress E) Bleeding ulcer

A, B, C

A client with a peptic ulcer reports epigastric pain that frequently causes the client to wake up during the night. The nurse should instruct the client to do which activities? SATA. A) Obtain adequate rest to reduce stimulation B) Eat small, frequent meals throughout the day C) Take all medications on time as prescribed D) Sit up for 1 hour when awakened at night E) Stay away from crowded areas

A, B, C, D

The nurse is admitting a client with a probable diagnosis of meningitis. What signs and symptoms might the nurse expect when assessing the client? SATA. A) Photophobia B) Nystagmus C) Decreased LOC D) Decreased movement, such as hemiparesis E) Disorientation to person, place, and time

A, B, C, D, E

The nurse is caring for a an older adult who experiences an exacerbation of ulcerative colitis with severe diarrhea and rectal bleeding that have lasted a week. For which complication(s) will the nurse assess? SATA. A) Increased BUN B) Hypokalemia C) Leukocytosis D) Anemia E) Hyponatremia

A, B, C, D, E

Which actions will the nurse teach a client with GERD to use to prevent harm? SATA. A) Do not consume caffeinated or carbonated beverages B) Avoid peppermint, chocolate, and fried foods C) Eat slowly and chew food thoroughly D) Consume 4-6 small meals each day E) Do not eat for 3 hours before going to bed F) Sleep on your side to prevent regurgitation

A, B, C, D, E

Which priority actions will the nurse take to manage a client's active upper GI bleeding? SATA. A) Administering oxygen B) Starting two large-bore IVs C) Infusing 0.9% NS as prescribed D) Collecting a urine sample for urinalysis E) Inserting an NG tube F) Monitoring serum electrolytes

A, B, C, E

Which interventions will the nurse include when care of a client with peritonitis is focused on restoring fluid volume balance? SATA. A) Administering IV isotonic fluids and broad-spectrum antibiotics B) Assigning the UAP to weight the client daily and record I&O C) Providing NG tube care and keeping the stomach decompressed D) Administering opioid pain medications as prescribed by the HCP E) Maintaining the client on NPO status while the NG tube is in place to low suction F) Assessing whether the client retains fluid used for irrigation by comparing and recording the amount of fluid returned with the amount of fluid instilled

A, B, C, E, F

What health teaching will the nurse include to promote gastric health for an adult client? SATA. A) "Stop smoking or using tobacco of any form." B) "Do not drink excessive amounts of alcohol." C) "Consume high-fat foods and decrease carbs." D) "Avoid excessive amounts of pickled or smoked food." E) "Avoid taking large amounts of NSAIDs."

A, B, D, E

Which client will the nurse advise to receive the meningococcal vaccine? SATA. A) Healthy 18-year-old who has enlisted in the military B) 25-year-old who had a splenectomy after an auto accident C) Healthy 24-year-old who interning with a lawyer for the summer D) Healthy 20-year-old who plans to live in a university dorm E) Healthy 22-year-old who unsure about vaccination and plans to visit Asia F) 21-year-old who has a summer job with a moving company

A, B, D, E

The nurse is instructing a client about post-op care following an appendectomy. What information should the nurse include in the teaching plan? SATA. A) "Nausea, gas, and diarrhea are normal for several days." B) "You can return to work in 1-3 weeks." C) "Follow a low-residue diet until the incision is healed." D) "Take a tub bath to relieve abdominal swelling." E) "You can drive when you are not taking pain medications."

A, B, E

Which signs and symptoms does the nurse expect to assess when a client experiences an upper GI bleed? SATA. A) Decreased BP B) Decreased heart rate C) Dizziness or light-headedness D) Melena (tarry or dark sticky) stools E) Weak peripheral pulses F) Increased hemoglobin and hematocrit levels

A, C, D, E

A client who has had a laprascopic cholecystectomy has adhesive strips over the puncture sites. When preparing the client for discharge, which client statements indicate that the teaching has been successful? SATA. A) "I can resume my normal diet when I feel okay." 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

When providing discharge teaching, for which symptoms will the nurse teach a client with PUD to seek immediate medical attention? SATA. A) Bloody or black stools B) Dyspepsia or reflux C) Bloody vomit or vomit that looks like coffee grounds D) Odynophagia with nausea E) Sharp, sudden, persistent pain, and severe epigastric or abdominal pain F) Loss of appetite with dysphagia

A, C, E

Which actions will the nurse teach a client with severe GERD that causes pain after each meal, lasts for at least 45 minutes, and worsens when he or she lies down? SATA. A) "Drink fluids right away." B) "When you lie down, try lying on your side." C) "Take an antacid as prescribed by the HCP." D) "Eat something bland such as a slice of white bread." E) "Maintain an upright position for at least an hour after you eat." F) "Try pressing over your abdomen to mobilize the food in your stomach."

A, C, E

Which simple noninvasive tests can be used to detect H. pylori in a client with PUD? SATA. A) Serologic testing for antibodies B) Abdominal ultrasound C) Urea breath test D) Computerized tomography scan E) Stool antigen test F) MRI

A, C, E

For which reasons will the nurse insert a large bore NG tube in a client with active upper GI bleeding or possible obstruction? SATA. A) To provide nutritional supplements B) To determine the presence or absence of blood in the stomach C) To assess the rate of bleeding D) to administer medications E) To prevent gastric dilation F) To administer gastric lavage

B, C, E, F

The nurse is caring for a client who has had a gastroscopy. Which findings indicate that the client is developing a complication related to the procedure? SATA. A) The client has a sore throat B) The client has a temperature of 100°F C) The client appears drowsy following the procedure D) The client has epigastric pain E) The client experiences hematemesis

B, D, E

A client is to take one daily dose of ranitidine at home to treat a peptic ulcer. Which response from the client indicates that the client understands how to take the medication? I'll take the drug: A) Before meals B) With meals C) At bedtime D) When pain occurs

C) At bedtime

Which dietary measure would be useful to preventing esophageal reflux? A) Eating small, frequent meals B) Increasing fluid intake C) Avoiding air swallowing with meals D) Adding a bedtime snack to the dietary plan

A) Eating small, frequent meals

Which drug does the nurse expect to administer to a client in order to decrease hydrochloric acid secretion in the stomach? A) Famotidine B) Gaviscon C) Mylanta D) Antibiotic

A) Famotidine

Which potential causes will the nurse be sure to ask about when taking a history from an older client suspected of having a mechanical obstruction? SATA. A) Fecal impaction B) Strictures from previous radiation therapy C) Fibrosis related to endometriosis D) Recent bowel surgery E) Benign tumor F) Diverticulitis

A, B, C, E, F

The nurse provides care for a client diagnosed with a peptic ulcer. Which nursing action is most appropriate? A) Identify stress factors in the client's environment B) Avoid giving the client choices to make C) Encourage the client to become angry D) Avoid discussing the client's symptoms

A) Identify stress factors in the client's environment

A client is admitted with a bowel obstruction. The client has nausea, vomiting, and crampy abdominal pain. The HCP has written the following prescriptions: for the client to be up ad lib, have narcotics for pain, have NG tube inserted if needed, and for IV, Ringer's lactate, and hyperalimentation fluids (parenteral nutrition). What should the nurse do in order of priority from first to last? 1) Assist with ambulation to promote peristalsis 2) Insert an NG tube 3) Administer IV Ringer's lactate 4) Start an infusion of hyperalimentation fluids

1, 3, 2, 4

The nurse in the outpatient clinic instructs a client taking lansoprazole for the first time. The nurse determines further teaching is required if the client makes which statement? A) "I should take the medication on a full stomach." B) "The capsules are not to be crushed or chewed." C) "I can take this medication with antacids." D) "I can open the capsule and sprinkle the contents on soft food, such as applesauce, and swallow immediately."

A) "I should take the medication on a full stomach."

A client has a diagnosis of meningitis. The nurse assesses the client. The nurse notes that when the client flexes the head, the client also flexes the hip and knee. Which nursing action is best? A) Immediately report this finding to the HCP B) Document the finding and continue with the nursing assessment C) Give 10 mg of morphine sulfate for the pain D) Place the client in high Fowler's position and start oxygen at 2 liters

A) Immediately report this finding to the HCP

What is the nurse's best first action when a client with a gastric ulcer is found lying in the knee-chest (fetal) position with a rigid, tender, and painful abdomen? A) Notify the HCP B) Administer the opioid pain medication C) Reposition the client supine D) Measure the abdominal circumference

A) Notify the HCP

A client who had the Stretta procedure to treat severe GERD is being discharged. Which client statement requires further nursing teaching? SATA. A) "Dysphagia after this procedure is normal." B) "It's important to stop my proton pump inhibitor." C) "I will not take NSAIDs and aspirin for at least 10 days." D) "I might cough up some blood following this procedure." E) "Today I will drink clear liquids and tomorrow I can eat soft food."

A, B, D

A nurse is caring for a 34-year-old client newly diagnosed with GERD. Which lifestyle change will the nurse suggest? SATA. A) Lose weight if needed B) Do not eat before bed C) Elevate the foot of your bed by 6-12 inches D) Avoid pants with a tight waistband or belt

A, B, D

The nurse is developing a care management plan with a client who has been diagnosed with GERD. What should the nurse instruct the client to do? SATA. A) Avoid a diet high in fatty foods B) Avoid beverages that contain caffeine C) Eat 3 meals a day, with the largest meal being at dinner in the evening D) Avoid all alcoholic beverages E) Lie down after consuming each meal for 30 minutes F) Use OTC antisecretory agents rather than prescriptions

A, B, D

Which signs and symptoms are commonly assessed by the nurse when a client is diagnosed with meningitis? SATA. A) Disorientation to person, place, and time B) Nuchal rigidity (stiff neck) C) Severe, unrelenting headaches D) Positive Kernig's sign E) Decreased LOC F) Generalized muscle aches and pain (myalgia)

A, C, E, F

A nurse is assessing a client who has been admitted with a diagnosis of an obstruction in the small intestine. The nurse should assess the client for which signs and symptoms? SATA. A) Projectile vomiting B) Significant abdominal distention C) Copious diarrhea D) Rapid onset of dehydration E) Increased bowel sounds

A, D, E

The nurse is caring for a client with a complete large bowel obstruction. What assessment findings would the nurse expect? SATA. A) Obstipation B) Dehydration C) Metabolic alkalosis D) Abdominal distention E) Abdominal pain F) Profuse vomiting

A, D, E

The nurse obtains a history from a client suspected of having a duodenal ulcer. The nurse expects the client to make which statement? A) "I have been vomiting bright red blood." B) "I have abdominal pain and tenderness." C) I have frequent loose stools every day." D) "I have increased pain immediately after eating."

B) "I have abdominal pain and tenderness."

The nurse cares for a client receiving famotidine for a gastric ulcer. The client reports resuming smoking and experiencing gastric pain about one hour after meals. Which response by the nurse is best? A) "Smoking decreases stomach acid production, so you will not digest foods as easily." B) "Smoking interferes with the medication's effectiveness, and you are no longer receiving the full anti-ulcer effect." C) "Nicotine can increase feelings of anxiety and restlessness, which the medication lowers." D) "If you smoke too much, you will become dizzy."

B) "Smoking interferes with the medication's effectiveness, and you are no longer receiving the full anti-ulcer effect."

The HCP prescribes bismuth subsalicylate for a client as part of treating H. pylori infection. What health teaching will the nurse include for the client about this drug? A) "Do not crush this drug before taking." B) "The drug may cause your tongue and stool to turn black." C) "Take the drug at night only." D) "The drug may cause you to have diarrhea."

B) "The drug may cause your tongue and stool to turn black."

A client has anemia resulting from bleeding from ulcerative colitis and is to receive two units of packed red blood cells. The client is receiving an infusion of total parenteral nutrition (TPN). In preparing to administer the packed red blood cells, what should the nurse do to ensure client comfort and safety? A) Discontinue the TPN infusion B) Start an IV infusion of normal saline C) Administer the PRBCs in the same IV as the TPN D) Wait until the TPN infusion is completed, and use the same IV line to infuse the PRBCs

B) Start an IV infusion of normal saline

Bethanechol has been prescribed for a client with GERD. The nurse should assess the client for which adverse effect? A) Constipation B) Urinary urgency C) Hypertension D) Dry oral mucosa

B) Urinary urgency

A client had an exploratory laparotomy to treat the cause of peritonitis and has a large incision that is closed with staples and two abdominal drains. Which findings would the nurse report immediately to the surgeon? SATA. A) Serosanguineous drainage B) Increased abdominal distention C) Fever and chills D) Pain level 2 on a scale of 0-10 E) Passing flatus

B, C

Which types of ulcers does the nurse teach a client about when discussing peptic ulcer disease (PUD)? A) Pressure ulcers B) Gastric ulcers C) Duodenal ulcers D) Stress ulcers E) Esophageal ulcers F) Colon ulcers

B, C, D

When the nurse is providing discharge instructions for a client recovering from peritonitis, which essential findings will the client and family be instructed to report immediately to the HCP? SATA. A) Completion of broad-spectrum antibiotics as prescribed B) Unusual or foul-smelling drainage C) Signs of wound dehiscence or ileus D) Swelling, redness, warmth, or bleeding from the incision site E) A temperature higher than 101°F F) Abdominal pain or board-like stiffness in the abdomen

B, C, D, E, F

Which priority teaching will the nurse provide to a client who is prescribed bismuth for PUD? A) "Take this drug with aspirin." B) "You may experience dyspepsia between doses." C) "Bismuth may cause your tongue and stool to appear black." D) "Be sure to take this drug before each meal and snack."

C) "Bismuth may cause your tongue and stool to appear black."

Which statement by a client indicates to the nurse that teaching about the action of sucralfate has been successful? A) "The main side effect of sucralfate is diarrhea." B) "I will take my sucralfate with each meal." C) "Sucralfate will work to heal my ulcer." D) "I will take my sucralfate with my antacid."

C) "Sucralfate will work to heal my ulcer."

A client with peptic ulcer disease is admitted to the hospital for a gastric resection. The client reports a sudden sharp pain in the midepigastric area that radiates to the shoulder. What should the nurse do first? A) Establish an IV line B) Administer the pain medications C) Notify the surgeon D) Call for a stat ECG

C) Notify the surgeon

A client has been taking aluminum hydroxide 30 mL six times per day at home to treat a peptic ulcer. The client has been unable to have a bowel movement for 3 days. What should the nurse determine is the most likely cause of the client's constipation? A) The client has not been including enough fiber in the diet B) The client needs to increase the daily exercise C) The client is experiencing an adverse effect of aluminum hydroxide D) The client has developed a GI obstruction

C) The client is experiencing an adverse effect of aluminum hydroxide

Which are the most common symptoms of GERD reported to the nurse by a client? SATA. A) Eructation B) Water brash C) Dyspepsia D) Regurgitation E) Odynophagia F) Flatulence

C, D

When obtaining a history from a client with a suspected gastric ulcer, which signs and symptoms should the nurse assess? SATA. A) Epigastric pain at night B) Relief of epigastric pain after eating C) Vomiting D) Weight loss E) Melena (blood in stools)

C, D, E

A client is taking an antacid for treatment of a peptic ulcer. Which statement best indicates that the client understands how to correctly take the antacid? A) "I should take my antacid before I take my other medications." B) "I need to decrease my intake of fluids so that I do not dilute the effects of my antacid." C) "My antacid will be effective if I take it whenever I experience stomach pains." D) "It is best for me to take my antacid 1-3 hours after meals."

D) "It is best for me to take my antacid 1-3 hours after meals."

Which surgical client will the nurse recognize as having the highest risk for development of peritonitis? A) 35-year-old having a laprascopic appendectomy B) 45-year-old having a vaginal hysterectomy C) 60-year-old having a traditional cholecystectomy for cholelithiasis D) 72-year-old having a bowel resection for colon cancer

D) 72-year-old having a bowel resection for colon cancer

Which cardinal signs will the nurse expect to assess in a client diagnosed with peritonitis? A) Fever with headache and confusion B) Dizziness with nausea and vomiting C) Loss of appetite with nausea and weight loss D) Abdominal pain with distention and tenderness

D) Abdominal pain with distention and tenderness

The client with GERD has a chronic cough. The nurse should further assess the client for which other problem? A) Development of laryngeal cancer B) Irritation of the esophagus C) Esophageal scar tissue formation D) Aspiration of gastric contents

D) Aspiration of gastric contents

The nurse should instruct the client to avoid taking which drug while taking metoclopramide hydrochloride? A) Antacids B) Antihypertensives C) Anticoagulants D) CNS depressants

D) CNS depressants

Which acid-base imbalance does the nurse expect when a client experiences a bowel obstruction high in the small intestines? A) Respiratory acidosis B) Respiratory alkalosis C) Metabolic acidosis D) Metabolic alkalosis

D) Metabolic alkalosis Rationale: An obstruction high in the small intestine causes a loss of gastric hydrochloric acid, which can lead to metabolic alkalosis

A client is admitted to the hospital after vomiting bright red blood and is diagnosed with a bleeding duodenal ulcer. The client develops a sudden, sharp pain in the midepigastric region along with a rigid, board-like abdomen. After obtaining the client's vital signs, what should the nurse do next? A) Administer pain medication as prescribed B) Raise the head of the bed C) Prepare to insert an NG tube D) Notify the HCP

D) Notify the HCP

Which nursing care action will the nurse delegate to the UAP when caring for a client with a bowel obstruction? A) Discussing surgical procedures with the client B) Checking the client's abdomen for distention C) Assessing the client's level of discomfort D) Providing mouth care every 2 hours as needed

D) Providing mouth care every 2 hours as needed

A client admitted to the hospital with peptic ulcer disease tells the nurse about having black, tarry stools. What should the nurse do? A) Encourage the client to increase fluid intake B) Advise the client to avoid iron-rich foods C) Place the client on contact precautions D) Report the findings to the HCP

D) Report the findings to the HCP

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

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 omeprazole and amoxicillin. How should the nurse instruct the client to take these medications? A) Alternate the use of the drugs B) Take the drugs at different times during the day C) Discontinue all drugs if nausea occurs D) Take the drugs for entire 2-week period

D) Take the drugs for entire 2-week period

From where does the nurse suspect a client with PUD is bleeding when massive coffee ground emesis occurs? A) Colon B) Rectum C) Small intestine D) Upper GI system

D) Upper GI system

What color do you want an ileostomy stoma to be? A) Beefy, red B) Purple, rigid C) Gray D) Black

A) Beefy, red

Which assessment findings on a client with peritonitis indicate to the nurse the probability that the fluid shift into the peritoneal cavity is continuing? SATA. A) Weight loss B) Tachycardia C) Hypertension D) Decreasing urine output E) Hyperactive bowel sounds F) Skin tenting over the forehead and sternum

B, D, F

You should empty an ileostomy bag when it is: A) 1/2 or 1/3 full B) 2/3 full C) 3/4 full D) 1/4 full

A) 1/2 or 1/3 full

Which client with symptoms of chronic abdominal pain and frequent bowel movements will the nurse consider at highest risk for a diagnosis of ulcerative colitis (UC)? A) 26-year-old white woman of Jewish ancestry who has an identical twin sister with the disorder B) 40-year-old black man who has just returned home from a business trip to southeast Asia C) 50-year-old Latino man with liver cirrhosis whose uncle died of colon cancer D) 65-year-old obese Asian woman who has chronic inflammatory cystitis

A) 26-year-old white woman of Jewish ancestry who has an identical twin sister with the disorder

Which condition will the nurse most likely suspect as the cause of a client's symptoms of obstipation and failure to pass flatus? A) Complete obstruction B) Partial obstruction C) Colorectal cancer D) Singultus

A) Complete obstruction

What is the nurse's priority action when caring for a client with acute cholecystitis who now has severe abdominal pain, diaphoresis, heart rate of 118 bpm, BP 95/70, respirations 32 breaths/min, and temperature 101°F? A) Initiating the Rapid Response Team B) Assisting the client to a semi-Fowler position C) Administering the prescribed opioid analgesic D) Auscultating the client's abdomen in all four quadrants

A) Initiating the Rapid Response Team

The HCP prescribes intestinal decompression with a Cantor tube for a client with an intestinal obstruction. What should the nurse evaluate in order to determine the effectiveness of intestinal decompression? A) Intestinal fluid and gas have been removed B) The client has had a bowel movement C) The client's urinary output is adequate D) The client can sit up without pain

A) Intestinal fluid and gas have been removed

What individuals are at risk of getting Shingles? A) Older patients B) Had chickenpox C) Had the varicella vaccine D) Had the Shingrix vaccine

A) Older patients

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 post-op B) Telling the client to not be afraid C) Reassuring the client by saying that this surgery is a common procedure D) Stressing the importance of following the HCPs instructions after surgery

A) Providing the client with information about what to expect post-op

In which position will the nurse place a client with peritonitis to promote comfort and prevent harm from potential complications? A) Semi-Fowler B) Left side-lying with knees to chest C) Right side-lying with knees to chest D) Supine flat with hips and knees flexed

A) Semi-Fowler

To prevent harm after a surgical procedure for peritonitis, which action will the nurse teach a client to avoid? A) Taking additional acetaminophen to prevent liver toxicity B) Lifting for at least 6 months after an open surgical procedure C) Resuming normal activities for at least 3-4 days after the procedure D) Using stool softeners and laxatives to prevent diarrhea

A) Taking additional acetaminophen to prevent liver toxicity

Which common signs and symptoms will the nurse expect to find on assessment of a 60-year-old client who has had gastroenteritis for the past 2 days? SATA. A) Weight loss B) Elevated temperature C) Dry mucous membranes D) Hypotension E) Oliguria F) Poor skin turgor

A, B, C, D, E, F

Which actions will the nurse perform when caring for a client with acute appendicitis before surgical management? SATA. A) Maintaining the client on NPO status B) Administering IV fluids as prescribed C) Providing laxatives and enemas to clear the bowel D) Advising the client to maintain semi-Fowler position E) Giving adequate medications to control the client's pain F) Applying hot compresses to the right lower quadrant

A, B, D, E

Which signs or symptoms will the nurse assess for in a client who is suspected of having cholecystitis? SATA. A) Anorexia B) Jaundice C) Ascites D) Steatorrhea E) Eructation (belching) F) Rebound tenderness

A, B, D, E, F

Which care actions does the nurse expect to perform when caring for a client who had an appendectomy with an abscess? SATA. A) Providing care for wound drains inserted during the surgery B) Administering IV antibiotics as prescribed by the surgeon C) Providing the client with a clear liquid diet D) Assessing the NG tube position and drainage E) Providing non-steroidal anti-inflammatory drugs (NSAIDs) for pain control F) Helping the patient out of bed on the evening of surgery

A, B, D, F

Which action will the nurse teach a client to take to prevent the spread of gastroenteritis? SATA. A) Washing hands well for at least 30 seconds B) Using easily accessible hand sanitizers C) Taking broad-spectrum antibiotics prophylactically D) Testing all food preparation employees E) Sanitizing all surfaces that may be contaminated F) Properly preparing food and beverages

A, B, E

Which statement by a client with gastroenteritis due to infection with the norovirus indicates that the nurse's teaching about this illness has been successful? A) "I got this infection from being around my grandchildren when they had respiratory illnesses." B) "It is most likely that I got this infectious illness from either contaminated food or water." C) "I may have gotten sick when I was traveling last month to Florida." D) "It's really important that I don't go to restaurants for at least a month after I am well."

B) "It is most likely that I got this infectious illness from either contaminated food or water."

A client with acute cholecystitis has severe pain. Which prescription will be most effective in relieving the pain? A) Infusing normal saline solution at 100 mL/hr B) Administering morphine sulfate 10 mg IM every 3-4 hours C) Receiving nothing by mouth D) Having an NG tube connected to low intermittent suction

B) Administering morphine sulfate 10 mg IM every 3-4 hours

What intervention will help a patient with post cholecystectomy gas pain? A) Laying in bed B) Ambulation C) Zofran D) Stooling

B) Ambulation

What is the most important assessment for the nurse to perform before administering the first dose of sulfasalazine to a client diagnosed with ulcerative colitis? A) Obtaining an accurate weight B) Asking whether he or she has an allergy to sulfa drugs C) Measuring heart and respiratory rate and BP D) Determining the number of times the client has had a stool today

B) Asking whether he or she has an allergy to sulfa drugs

The nurse is caring for a client with peritonitis from a perforated appendix. Which abdominal assessment finding will the nurse most likely expect? A) Soft abdomen B) Board-like abdomen C) Slightly distended abdomen D) Absent bowel sounds

B) Board-like abdomen

An adult male client takes finasteride for benign prostatic hyperplasia. The nurse knows the most likely adverse effect of finasteride includes which finding? A) Hypertension B) Decreased libido and impotence C) Depression D) Arthritic joints

B) Decreased libido and impotence

Which instruction should the nurse include in the teaching plan for a client who is experiencing GERD? A) Limit caffeine intake to two cups of coffee per day B) Do not lie down for 2 hours after eating C) Follow a low-protein diet D) Take medications with milk to decrease irritation

B) Do not lie down for 2 hours after eating

Good patient care for an NPO patient is: A) Letting them smell food B) Oral care C) Letting them drink water D) Nothing

B) Oral care

What complication is associated with Crohn's Disease? A) Ulcers B) Vomiting C) Fistulas D) Hemorrhoids

C) Fistulas

How does the nurse interpret a serum sodium finding of 126 mEq/L for a client with bacterial meningitis? A) An early warning sign that the electrolyte imbalance will potentiate an acute MI B) Evidence of syndrome of inappropriate antidiuretic hormone which is a complication of bacterial meningitis C) Within normal limits considering the diagnosis of bacterial meningitis but test should be repeated looking for downward trend D) A protective measure that causes increased urination and therefore reduces the risk of increased intracranial pressure

B) Evidence of syndrome of inappropriate antidiuretic hormone which is a complication of bacterial meningitis

PUD is most commonly caused by: A) Staph infection B) H. Pylori bacteria C) Hepatitis B D) Strep

B) H. Pylori bacteria

What is the most definitive diagnostic test for Meningitis? A) Sputum culture B) Lumbar puncture C) Blood culture D) X-ray

B) Lumbar puncture

Which complications does the nurse suspect when a client with PUD suddenly develops sharp epigastric pain that spreads over the entire abdomen? A) Gastric erosion B) Perforation C) Hemorrhage D) Gastric cancer

B) Perforation

Which new-onset assessment finding in a client with Crohn's disease indicates to the nurse the possibility of fistula development? A) Anorexia B) Pyuria with fever C) Smooth, beefy red tongue D) Decreased serum albumin

B) Pyuria with fever

After insertion of an NG tube, the nurse should place the client in which position? A) Supine B) Right side-lying C) Semi-Fowler's D) Upright in a bedside chair

B) Right side-lying

Which of the following medications is a mucosal barrier fortifier (protector)? A) Omeprazole B) Sucrafalate C) Zofran D) Prevacid

B) Sucrafalate

Which action is appropriate for the nurse to take to prevent harm when caring for a client with ulcerative colitis who has undergone a total proctocolectomy with placement of a permanent ileostomy? A) Irrigating the ileostomy to maintain patency B) Using a skin barrier to prevent excoriation C) Monitoring the client for nausea due to decreased intestinal motility D) Giving small, frequent feedings to compensate for malnutrition from short-gut syndrome

B) Using a skin barrier to prevent excoriation

In collaboration with the registered dietitian nutritionist, which nutrients and substances will the nurse instruct a client with ulcerative colitis to avoid to reduce symptoms? SATA. A) Eggs B) Corn C) Caffeine D) Vitamin C E) Dried fruits F) Carbs G) Dairy products H) Pepper-based spices

B, C, E, G, H

Which disease features will the nurse commonly associate with a client who has Crohn's disease that are rare or absent in a client with ulcerative colitis? SATA. A) The problem first appears in the rectum and proceeds in a continuous manner toward the cecum B) Fistulas commonly develop C) Clients have 5-6 soft, loose, non-bloody stools per day D) There is a greatly increased risk for colon cancer E) Many clients have one or more extra-intestinal problems such as arthritis, ankylosing spondylitis, and erythema nodosum F) The appearance of the affected intestine areas resemble "cobblestone"

B, C, F

Which lab assessment findings will the nurse expect in a client who is diagnosed with ulcerative colitis? SATA. A) Increased albumin B) Decreased hemoglobin C) Decreased sodium D) Decreased potassium E) Elevated WBC count F) Elevated erythrocyte sedimentation rate

B, D, E, F

A client undergoes a laprascopic cholecystectomy. Which instructions should the nurse give the client about a diet immediately after surgery? A) "You can't eat or drink anything for 24 hours." B) "You may resume your normal diet the day after your surgery." C) "Start with liquids and see how you feel." D) "You can progress from a liquid to a bland diet as tolerated."

C) "Start with liquids and see how you feel." Rationale: A light or regular diet can be resumed when the client can tolerate the liquids. There is no need for the client to stay on a bland diet after a laprascopic cholecystectomy, however, they should avoid excessive fats.

The nurse provides care for a client with the diagnosis of a small bowel obstruction, and has severe abdominal distention. Which finding best describes the reason for the distention? A) Increased gastric acid pH levels B) Vagal nerve stimulation C) Accumulation of fluid in the intestine D) Decreased perfusion of intestine

C) Accumulation of fluid in the intestine

A young adult client admitted with a diagnosis of cholecystitis from cholelithiasis has severe abdominal pain, nausea, and vomiting. Based on these assessment findings, which client problem is the highest priority for nursing intervention at this time? A) Anxiety B) Risk for dehydration C) Acute pain D) Malnutrition

C) Acute pain

Which most accurate diagnostic test will the nurse expect to be ordered for a client to verify the diagnosis of GERD? A) EGD B) Esophageal manometry C) Ambulatory esophageal pH monitoring D) Motility testing

C) Ambulatory esophageal pH monitoring

The purpose of an NG tube is to? A) Make a patient skinnier B) Prevent ulcers C) Decompress the stomach D) Drainage

C) Decompress the stomach

A client who has been diagnosed with GERD has heartburn. To decrease the heartburn, the nurse should instruct the client to eliminate which item from the diet? A) Lean beef B) Air-popped popcorn C) Hot chocolate D) Raw vegetables

C) Hot chocolate

Which laboratory finding will the nurse expect to see in a client who is suspected of having an acute, uncomplicated appendicitis? A) Decreased serum potassium level B) Increased INR C) Increased WBC count D) Decreased erythrocyte sedimentation rate

C) Increased WBC count

The nurse provides care for a client after an appendectomy. The day after surgery, the client has severe abdominal pain, a temperature of 101°F, and a rigid abdomen. The nurse suspects the client is experiencing which complication? A) Anesthesia intolerance B) Atelectasis and pneumonia C) Infection of the peritoneal sac D) Bladder distention

C) Infection of the peritoneal sac

Which discharge instructions would be appropriate for a client who has had a laprascopic cholecystectomy and has sutures covered by a dressing? A) Avoid showering for 1 week after surgery B) Return to work within 1 week C) Leave dressing in place until seeing the surgeon at the post-op visit D) Use Tylenol to control any fever

C) Leave dressing in place until seeing the surgeon at the post-op visit

Which complications will a nurse suspect when a client with peritonitis reports increased pain in the upper left abdominal quadrant and in the left shoulder, especially during inhalation? A) Sepsis B) Pneumonia C) Localized abscess D) Bacterial hepatits

C) Localized abscess

A client is admitted to the hospital with a diagnosis of cholecystitis. 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

Which serum lab value is most important for the nurse to monitor when caring for an older adult client with gastroenteritis who has irregular heart rate and reports "feeling weak?" A) Albumin B) Sodium C) Potassium D) Leukocyte count

C) Potassium

A complication of benign prostatic hyperplasia is: A) Headaches B) Falls C) UTI D) Gas

C) UTI

Which statement indicates to the nurse that a client who is experiencing frequent episodes of "indigestion" and flatulence may have cholecystitis? A) "My stools are sometimes very dark and tarry looking." B) "Sometimes at night I have bad-tasting fluid in my mouth." C) "Usually about a half hour after I eat, I become sweaty and nauseated." D) "My right arm and shoulder always seem to hurt after I eat fried foods."

D) "My right arm and shoulder always seem to hurt after I eat fried foods." Rationale: Cholecystitis can cause referred pain to the right shoulder area, including under the right shoulder blade.

For which client assessment finding will the nurse withhold the scheduled monthly dose of prescribed parenteral biologic for management of ulcerative colitis? A) 5 lb weight gain B) Increase number of diarrhea stools per day C) Presence of occult blood in today's stool sample D) Cough and fever of 102°F

D) Cough and fever of 102°F

While bathing a client diagnosed with a basilar skull fracture, the nurse notes drainage from the client's left ear has stained the bed sheet with a halo-type effect. When the drainage tests positive for glucose, the nurse knows the client is at greatest risk for which complication? A) Otitis media B) Herniation of the brainstem C) Increased intracranial pressure D) Meningitis

D) Meningitis

Which drug will the nurse be sure to question to prevent harm when prescribed for an older adult with gastroenteritis? A) Azithromycin B) Protective skin barrier cream C) Ciprofloxacin D) Diphenoxylate hydrochloride with atropine sulfate

D) Diphenoxylate hydrochloride with atropine sulfate Rationale: This drug is not recommended for older adults because it causes drowsiness and could contribute to falls.

A patient with gallbladder issues should avoid foods high in: A) Sugar B) Gluten C) Sodium D) Fat

D) Fat

What do anti-emetics do? A) Prevent diarrhea B) Promote absorption of Vitamin D C) Make you feel happy D) Prevent nausea/vomiting

D) Prevent nausea/vomiting

Antacids do not interfere with a lot of medications. True or False?

False

Knees to chest position can help post-appendectomy pain. True or False?

True

The nurse is teaching a client with a peptic ulcer about the diet that should be followed after discharge. What types of food should the nurse suggest the client include in the diet? A) Bland foods B) High-protein foods C) Any foods that are tolerated D) A glass of milk with each meal

C) Any foods that are tolerated

When planning care for a client with ulcerative colitis who is experiencing an exacerbation of symptoms, which client care activities can the nurse appropriately delegate to the UAP? SATA. A) Assessing the client's bowel sounds B) Providing skincare following bowel movements C) Evaluating the client's response to antidiarrheal medications D) Maintaining intake and output records E) Obtaining the client's weight

B, D, E

What does the nurse suspect when a client comes into the ED with right lower quadrant cramping pain, nausea, vomiting, and guarding with rigidity of the abdomen? A) Gastroenteritis B) Ulcerative colitis C) Appendicitis D) Crohn's disease

C) Appendicitis

A client with peptic ulcer disease is taking ranitidine. What is the expected outcome of this drug? A) Heal the ulcer B) Protect the ulcer surface from acids C) Reduce acid concentration D) Limit gastric acid secretion

D) Limit gastric acid secretion

Which diagnostic test does the ED nurse anticipate for a client admitted with headache, fever, nausea, and light sensitivity, and who has been living with two people recently diagnosed with meningitis? A) Skull x-rays B) Myelography C) Cerebral angiogram D) Lumbar puncture

D) Lumbar puncture

The nurse is assigning clients for the evening shift. Which clients are appropriate for the nurse to assign to an LPN to prove client care? SATA. A) Crohn's disease client who receiving TPN B) An inguinal hernia repair surgery 3 hours ago; vital signs are stable C) An intestinal obstruction who needs a Cantor tube inserted D) Diverticulitis who needs teaching about take home medications E) An exacerbation of ulcerative colitis who is ambulatory

B, E

Which client statement about GERD triggers requires further teaching? SATA. A) "I will decrease my alcohol intake." B) "Smoking one or two cigarettes a day won't hurt." C) "My plan is to eat six small meals daily." D) "Tomato-based foods should be avoided." E) "I love soda but I'm going to stop drinking it." F) "Our family eats tacos and burritos several times weekly."

B, F

Which important information will the nurse include when teaching a client about peritonitis? SATA. A) Peritonitis is caused by contamination of the peritoneal cavity by bacteria or chemicals B) Respiratory problems associated with peritonitis are related to increased abdominal pressure against the diaphragm C) White blood cell counts are often decreased when a client is diagnosed with peritonitis D) Chemical peritonitis is caused by leakage of pancreatic enzymes or gastric acids E) Fairly common causes of peritonitis include invasive tumors and continuous ambulatory peritoneal dialysis (CAPD) F) When the peritoneal cavity is contaminated by bacteria, the body begins an inflammatory reaction, walling off a localized area to fight the infection

A, B, D, F

When the nurse is teaching a client about bowel obstructions, which conditions will be described as mechanical bowel obstructions? SATA. A) Adhesions B) Paralytic ileus C) Tumors D) Functional obstruction E) Crohn's disease F) Absent peristalsis

A, C, E

The nurse in the outpatient clinic counsels the client with a diagnosis of cholecystitis. The nurse determines teaching is successful if the client makes which statement? A) "I really like a lot of cream on my oatmeal." B) "We eat a lot of broiled fish and chicken." C) "I can't wait to eat the chocolates my children gave me." D) "My favorite dish is broccoli with cheese sauce."

B) "We eat a lot of broiled fish and chicken."

Which drugs will the nurse expect to administer to a client with PUD, caused by an H. pylori infection, who is prescribed PPI-triple therapy? A) A PPI, two antibiotics, and bismuth B) A PPI and two antibiotics C) An opioid drug, PPI, and an antibiotic D) An H2 histamine blocker, an antibiotic, and a PPI

B) A PPI and two antibiotics

The client with an intestinal obstruction continues to have acute pain even though the NG tube is patent and draining. what should the nurse do first? A) Reassure the client that the NG tube is functioning B) Assess the client for peritonitis C) Administer an opioid as prescribed D) Reposition the client on the left side

B) Assess the client for peritonitis

Which assessment findings will the nurse expect to find when a client is experiencing an early mechanical small bowel obstruction? SATA. A) Absence of bowel sounds B) Abdominal distention C) Visible peristaltic waves D) High-pitched bowel sounds E) Abdominal rigidity F) Cramping

B, C, D, F

The nurse is caring for a client diagnosed with peptic ulcer disease (PUD). For which potential complications will the nurse monitor? SATA. A) Pneumonia B) Peritonitis C) Anemia D) Stroke E) Hypotension F) Cirrhosis

B, C, E

A client has an open cholecystectomy with bile duct exploration. Following surgery, the client has a T tube. What should the nurse do to determine the effectiveness of the T tube? A) Irrigate the tube with 20 mL of NS every 4 hours B) Unclamp the T tube and empty the contents every day C) Assess the color and amount of drainage every shift D) Monitor the incision sites for bile drainage

C) Assess the color and amount of drainage every shift