Inflammation Practice Questions
A patient newly diagnosed with peptic ulcer disease (PUD) is concerned about managing the disease because of not being able to tolerate a bland diet. Which response should the nurse make that accurately addresses this concern? "There will be restrictions, unfortunately, but we can teach you ways to enhance the flavor of your foods safely." "You will be able to consume whatever you like, because the medications will help to address any issues the foods may cause." "The only foods you will really need to avoid are those that are exceedingly spicy; otherwise, you can eat normally." "A bland diet is no longer recommended; it is best to eat balanced meals with increased fiber at regular intervals."
"A bland diet is no longer recommended; it is best to eat balanced meals with increased fiber at regular intervals."
The nurse is caring for a young female adult with Crohn disease who was married a few weeks ago. Which question should the nurse include in the assessment interview? "Do you have a history of breast cancer in your family?" "Do you have any menstrual cycle problems?" "Is your husband aware of your condition?" "Are you considering starting a family soon?"
"Are you considering starting a family soon?"
A patient with a body mass index of 32 asks what can be done to prevent the development of gastroesophageal reflux disease (GERD). Which response should the nurse make to this patient? "Consider starting a weight-loss and exercise program." "Avoid tight-fitting clothing." "Decrease or eliminate orange juice, tomatoes, coffee, chocolate, and wine." "Avoid smoking and alcohol consumption."
"Consider starting a weight-loss and exercise program."
The nurse reviews the health histories for a group of assigned patients. Which patient should the nurse identify as having the highest risk of a duodenal ulcer? 35-year-old female with poor dietary intake 70-year-old male, chronic acetaminophen user 45-year-old male, smoker 52-year-old female, chronic alcohol abuser
45-year-old male, smoker
A nurse is providing discharge instructions for a patient with peptic ulcer disease (PUD). Which statement should the nurse include regarding diet and lifestyle modifications? "Do not skip any meals." "Be sure to eat a bland diet to avoid a flare-up of PUD." "Restrict your diet to nonfat and sugar-free foods." "You must eliminate intake of all alcohol."
"Do not skip any meals."
The nurse assesses a patient with peptic ulcer disease (PUD). Which question should the nurse ask to learn if the patient is experiencing a complication of this disorder? "Has your pain radiated to your back?" "Have you had any upper left quadrant pain?" "Are you having painful defecation?" "Have you had any blood or coffee-ground vomitus?
"Have you had any blood or coffee-ground vomitus?
A patient recently diagnosed with peptic ulcer disease (PUD) is being further evaluated by the provider for suspected Zollinger-Ellison syndrome. Which question should the nurse ask to elicit information about the symptoms characteristic of this form of PUD? "Have you been feeling really full recently?" "Have you had any black, tarry-looking stools?" "Have you had diarrhea or noticed that your stools appear oily?" "Have you been experiencing any vomiting or fever?"
"Have you had diarrhea or noticed that your stools appear oily?"
An adolescent with gastroesophageal reflux disease (GERD) reports that the symptoms get worse during the day. Which question should the nurse ask to find out more information? "How old were you when the symptoms of GERD began?" "How close to bedtime do you eat your last snack or meal?" "How many times per day do you consume coffee, tea, or chocolate?" "How is it working with elevating the head of your bed at bedtime?"
"How many times per day do you consume coffee, tea, or chocolate?"
A patient with gastroesophageal reflux disease is prescribed pantoprazole, a proton pump inhibitor. Which patient statement indicates to the nurse that the patient needs additional teaching about this medication? "I should take the medicine 30 minutes before eating breakfast." "I need to increase the amount of calcium in my daily diet." "I should avoid taking ibuprofen and other NSAIDs with this medicine." "I can break the tablet in half to make it easier to swallow."
"I can break the tablet in half to make it easier to swallow."
The nurse reviews a lifestyle change goal established with a patient being treated for gastroesophageal reflux disease (GERD). Which patient statement should the nurse identify that indicates this goal has been achieved? "I have begun working out at the gym lifting weights." "I have not smoked a cigarette in 4 weeks." "I eat a small snack prior to going to bed." "I have gained 2 pounds this month."
"I have not smoked a cigarette in 4 weeks."
A patient having a follow-up examination after being diagnosed with peptic ulcer disease (PUD) reports not taking the prescribed medication since the symptoms subsided. Which response should the nurse make to this patient? "That's great that you have been able to stop taking the medication." "I will let your healthcare provider know so that you can discuss it, because you should continue treatment even if your symptoms subside." "It's very dangerous to just stop a medication like this. Make sure to call us in the future before doing so." "Do you have the medication with you? You need to resume taking it immediately."
"I will let your healthcare provider know so that you can discuss it, because you should continue treatment even if your symptoms subside."
The nurse is caring for a patient newly diagnosed with Crohn disease. Which lifestyle change should the nurse suggest to this patient? "Avoid anti-inflammatory medications to minimize irritation of the stomach lining." "Increase intake of dairy products to increase calcium levels." "Increase dietary fiber to add bulk to stools." "Limit protein to prevent irritation of the bowel."
"Increase dietary fiber to add bulk to stools."
An older patient with gastroesophageal reflux disease (GERD) asks about long-term effects from taking pantoprazole, a proton pump inhibitor. Which statement should the nurse respond to this patient? "Long-term use can lead to hip fractures." "Most people only take this medication for 1 to 2 weeks until symptoms subside." "Let me ask your healthcare provider." "Dietary and lifestyle changes would be better than taking this medication."
"Long-term use can lead to hip fractures."
A patient who has been taking a proton pump inhibitor (PPI) for symptoms of peptic ulcer disease (PUD) is scheduled for a urea breath test. Which information should the nurse provide to the patient prior to scheduling this diagnostic test? "This test requires anesthesia, so you will need to make sure that someone is available to drive you home." "This test cannot be done if you have any dye allergies, so please let me know if you have had issues with dyes in the past." "PPIs interfere with this test, so you will need to stop taking them 14 days prior to the test." "This test can only tell us how effective treatment has been; it cannot be used for diagnosis."
"PPIs interfere with this test, so you will need to stop taking them 14 days prior to the test."
A patient who was informed about having a peptic ulcer asks if that means the ulcer is not located in the stomach. Which response should the nurse make to this patient? "Peptic ulcer is just another term for gastric ulcer; they are generally located in the stomach." "Peptic ulcers are those that are caused by excessive alcohol use and improper diet." "Peptic ulcers can be located in the esophagus, stomach, and duodenum; however, the most common area is the duodenum." "When it's referred to as a peptic ulcer instead of a gastric ulcer, it means that it is located in a site other than the stomach."
"Peptic ulcers can be located in the esophagus, stomach, and duodenum; however, the most common area is the duodenum."
A patient with peptic ulcer disease (PUD) asks what can be done to prevent the ulcers from recurring. Which statement should the nurse make to this patient? "Eliminate all alcohol intake." "Eliminate all high-fat foods from your diet." "Reduce your smoking." "Reduce your stress as much as possible."
"Reduce your stress as much as possible."
The nurse is teaching a patient the use of antacids to treat gastroesophageal reflux disease (GERD). Which instruction should the nurse include? "Take antacids 1 to 2 hours before or after medications." "Do not crush tablets prior to taking antacids." "Avoid long-term use as it can cause gynecomastia." "Notify the healthcare provider of extrapyramidal effects."
"Take antacids 1 to 2 hours before or after medications."
A client is about to begin celecoxib therapy for osteoarthritis. You should instruct the client to watch for and report which of the following possible indications of a serious reaction to this drug? A. Black, tarry stools B. Polyuria C. Bone pain D. Dry mouth
A
The nurse is teaching the parents of a 1-year-old infant with gastroesophageal reflux disease (GERD) about disease management. Which parent statement should indicate to the nurse a need for further education? "I should leave my baby in an upright position during and after feeding." "Changing my dairy consumption can affect my infant if I am breastfeeding." "I should burp my baby after every 1 to 2 ounces to prevent gastroesophageal reflux." "The symptoms of GERD will decrease if I feed my baby cow's milk."
"The symptoms of GERD will decrease if I feed my baby cow's milk."
A pregnant patient with peptic ulcer disease (PUD) who has been experiencing hematemesis and weight loss is concerned about treatment and its potential impact on the fetus. Which response should the nurse provide to this patient? "While the safety of medications to treat PUD during pregnancy has not been fully studied, it is also harmful to continue to lose weight." "While I understand your concerns, you cannot continue with this kind of pain and discomfort for the rest of your pregnancy." "You are right to be concerned, and management with diet should be enough to get things under control." "There are medications that have been found safe and appropriate for use during pregnancy to treat PUD; you can discuss them with the healthcare provider."
"There are medications that have been found safe and appropriate for use during pregnancy to treat PUD; you can discuss them with the healthcare provider."
A patient is scheduled for an upper GI series to diagnose the reason for upper abdominal pain that subsides after eating. Which information should the nurse provide to the patient regarding this diagnostic test? "This procedure is a type of biopsy." "This procedure is a type of x-ray that uses contrast." "This procedure requires sedation." "This procedure requires an IV."
"This procedure is a type of x-ray that uses contrast."
The nurse is conducting a support group for parents of young children with ulcerative colitis (UC). Which suggestion made by a parent requires the nurse to intervene? "Try giving two to three larger meals per day to allow the bowel to rest in between feedings." "High-protein dietary supplements can help increase protein intake." "Try using a food diary to monitor for foods that can cause intestinal problems." "Offer cream soups or milkshakes if your child won't eat."
"Try giving two to three larger meals per day to allow the bowel to rest in between feedings."
A patient prescribed bowel rest for an acute exacerbation of Crohn disease asks what food is permitted. Which response should the nurse make to this patient? "You can only eat soft, bland foods until the bowel has healed." "We will put a tube into your stomach and give you a special type of high-protein and high-calorie solution." "We will give you IV fluids so that you don't become dehydrated, but you won't be able to eat for a few days." "You won't be able to eat or drink anything for several days or weeks until the bowel has healed."
"We will put a tube into your stomach and give you a special type of high-protein and high-calorie solution."
A patient with peptic ulcer disease (PUD) asks what needs to be done to determine if bacteria is causing the ulcer. Which statement should the nurse make to this patient? "Your healthcare provider may order a skin test to determine the presence of H. pylori." "Your healthcare provider may order an x-ray with contrast to visualize the H. pylori bacteria." "Your healthcare provider may order a test to analyze your stomach contents." "Your healthcare provider may order a breath test to determine the presence of H. pylori."
"Your healthcare provider may order a breath test to determine the presence of H. pylori."
A nurse is assessing a client who has a bleeding duodenal ulcer. Which of the following findings should the nurse expect? A. Emesis with a coffee-ground appearance B. Increased blood pressure C. Decrease heart rate D. Bright green stools
A
A nurse is caring for a client who has a new diagnosis of rheumatoid arthritis. The nurse should anticipate a prescription from the provider for which of the following medications for daily management of this condition? A. Celecoxib B. Prednisone C. Adalimumab D. Abatacept
A
A patient seeks medical attention for blood in the stool. Which laboratory test should the nurse anticipate to be prescribed first for this patient? Complete blood count (CBC) Liver enzymes Blood chemistry panel BUN/creatinine
Complete blood count (CBC)
A nurse is caring for a client who has a new prescription for etanercept. Which of the following actions should the nurse take? A. Administer a tuberculin skin test prior to starting the medication B. Teach the client that fevers are common while taking this medication C. Determine if the client has chronic hypertension D. Mix the medication with methotrexate prior to administration
A
A nurse is caring for a client who has a prescription for etanercept. The nurse should identify that etanercept treats rheumatoid arthritis by which of the following actions? A. Inactivation of tumor necrosis factor B. Inhibition of osteoclast activity C. Decreasing the reuptake of serotonin D. Interference with production of lymphocytes
A
A nurse is caring for a client who has an acute exacerbation of Crohn's disease. Which of the following actions should nurse take? A. Ensure bowel rest B. Offer sparkling water frequently C. Administer a stool softener D. Offer plain warm tea frequently
A
A nurse is caring for a client who has an acute exacerbation of Crohn's disease. Which of the following actions should the nurse take? A. Ensure bowel rest B. Have the client sleep on a wedge C. Offer plain, warm tea frequently D. Offer sparkling water frequently
A
A nurse is caring for a client who has asthma and advanced rheumatoid arthritis and deformity of the hands. The nurse should anticipate that the client receive which of the following medication-delivery devices for the treatment of asthma? A. Dry-powder inhaler B. Metered-dose inhaler with spacer C. Respimat D. Nebulizer
A
A nurse is caring for a client who is experiencing an acute gout attack. The nurse should anticipate a prescription from the provider for which of the following medications? A. Colchicine B. Allopurinol C. Probenacid D. Pegloticase
A
A nurse is caring for a client who is experiencing an acute gout attack. The nurse should anticipate a prescription from the provider for which of the following medications? A. Naproxen B. Pegloticase C. Probenacid D. Allopurinol
A
A nurse is caring for a client who is receiving TPN solution. The current bag of solution was hung 24hr ago, and 400mL remains to infuse. Which of the following is the appropriate action for the nurse to take? A. Remove the current bag and hang a new bag B. Infuse the remaining solution at the current rate and then hang a new bag C. Increase the infusion rate so the remaining solution is administered within the hour and hang a new bag D. Remove the current bag and hang a bag of lactated Ringer's
A
A nurse is caring for a client who was recently diagnosed with rheumatoid arthtitis. The nurse should expect the provider to prescribe methotrexate at which of the following times? A. Within 3 months of the initial diagnosis B. When NSAIDs have not provided pain relief C. During an exacerbation of symptoms D. Once bone degeneration progresses
A
A nurse is caring for an older adult client who has gout and refuses to eat. The client's provider has authorized the client's family to bring food from home. Which of the following foods should the nurse recommend that the client avoid? A. Lentil soup B. Cheese sandwich C. Yogurt D. Raisins
A
A nurse is developing a plan of care for a client who has GERD. The nurse should plan to monitor the client for which of the following complications? A. Aspiration B. Infection C. Anemia D. Weight loss
A
A nurse is having difficulty arousing a client following an esophagogastroduodenoscopy (EGD). Which of the following is the priority action by the nurse? A. Assess the client's airway B. Allow the client to sleep C. Prepare to administer an antidote to the sedative D. Evaluate preprocedure laboratory findings
A
A nurse is performing discharge teaching about ostomy care while at home for a client who has a newly placed ileostomy. Which of the following instructions should the nurse include in the teaching? A. "Empty your ostomy pouch when it becomes half full." B. "Place an aspirin in the ostomy pouch to eliminate odor." C. "Change the ostomy appliance every week." D. "Cleanse the site around the stoma with hydrogen peroxide and water."
A
A nurse is planning care for a client who has a new prescription for methotrexate. The nurse should plan to monitor the client for which of the following adverse effects? A. Bone marrow depression B. Thrombocythemia C. Double vision D. Constipation
A
A nurse is planning care for a client who has started taking prednisone. Which of the following interventions should the nurse include? A. Monitor the client's blood glucose B. Administer an antacid 30 min prior to prednisone C. Administer aspirin rather than NSAIDs if the client has pain D. Monitor the client for hyperkalemia
A
A nurse is preparing to administer medication to a client who has gout. The nurse discovers that an error was made during the previous shift in which the client received atenolol instead of allopurinol. Which of the following interventions is the nurse's priority? A. Measure the client's apical pulse B. Administer the allopurinol to the client C. Inform the nurse manager D. Complete an incident report
A
A nurse is providing teaching to a client who has rheumatoid arthritis and a prescription for long-term prednisone therapy. The nurse should instruct the client to monitor for which of the following adverse effects? A. Stress fractures B. Orthostatic hypotension C. Gingival ulcers D. Weight loss
A
A nurse is recommending dietary modifications for a client who has GERD. The nurse should suggest eliminating which of the following foods from the client's diet? A. Oranges and tomatoes B. Carrots and bananas C. Potatoes and squash D. Whole wheat and beans
A
A nurse is reviewing bowel prep using polyethylene glycol with a client scheduled for a colonoscopy. Which of the following instructions should the nurse include? A. Check with the provider about taking current medications when consuming bowel prep B. Consume a normal diet until starting the bowel prep C. Expect the bowel prep to not begin acting until the day after all the prep is consumed D. Discontinue the bowel prep once feces start to be expelled
A
A nurse is reviewing the drug list for a client who has a new prescription for allopurinol. The nurse should identify that which of the following drugs interacts with allopurinol? A. Warfarin B. Ibuprofen C. Insulin D. Furosemide
A
A nurse is teaching a client about adverse effects of etanercept. Which of the following statements by the client indicates understanding of the teaching? A. "I will need to get my blood drawn periodically while on this medication." B. "I may lose part or all of my hair." C. "I may wake up with a very dry mouth." D. "I will leave the needle cap off during the time the medication comes to room temperature."
A
A nurse is teaching a client about methotrexate therapy for rheumatoid arthritis. Which of the following statements by the client indicates understanding of the teaching? A. "I will take a birth control pill every day." B. "Methotrexate decreases my changes of developing an infection." C. "I will take methotrexate every day with breakfast." D. "I will aim to drink five 8oz glasses of water per day."
A
A nurse is teaching a client who has a new diagnosis of rheumatoid arthritis. Which of the following statements should the nurse include in the teaching? A. "You can experience morning stiffness when you get out of bed." B. "You can experience abdominal pain." C. "You can experience weight gain." D. " You can experience low blood sugar."
A
A nurse is teaching a client who has a new prescription for allopurinol. Which of the following instructions should the nurse include? A. Avoid driving or activities that require mental alertness B. Avoid crushing the tablets C. Limit fluid intake during therapy D. Limit potassium while taking allopurinol
A
A nurse is teaching a client who is taking allopurinol about minimizing adverse effects. Which of the following instructions should the nurse include? A. Eat a small meal before taking the drug B. Suck on hard candy or chew gum C. Take a stool softener daily D. Avoid the use of NSAIDS
A
A nurse is teaching a client who is taking etanercept for rheumatoid arthritis. The nurse should instruct the client to monitor for which of the following indications of an adverse reaction to this drug? A. Skin rash B. Tinnitus C. Diarrhea D. Dysphagia
A
A nurse working in the emergency department is admitting a client who has a gastric ulcer and GI bleeding. Which of the following factors in the client's medical history should the nurse report to the provider? A. Arthritis treated with ibuprofen q8hr PRN B. Previous tobacco smoking with cessation 5 years ago C. Negative h. pylori breath test 1 year prior D. Prescribed bismuth subsalicylate as needed for GI upset
A
The health care professional instructs a client about the therapeutic actions of sucralfate. She explains that this drug promotes ulcer healing by which action? A. Creates a protective barrier B. Increases gastric pH C. Inhibits the proton pump D. Neutralizes gastric acid
A
The nurse is caring for a patient with a new diagnosis of GERD. Which pathophysiological change should the nurse identify as the cause of this disease? A. Weakened lower esophageal sphincter pressure B. Decreased gastric acid production C. Herniation of the stomach through the diaphragm D. Thickening of the muscle between the stomach and intestines
A
Which client statement is indicted of ulcerative colitis? A. "I have pain in my lower left side." B. "I have burning pain 1 or 2 hours after I eat." C. "I have pain my lower right side." D. "I have burning pain almost immediately after I eat."
A
A client is about to start taking sulfasalazine to treat IBD. You should instruct the client to watch for and report which of the following adverse drug reactions of this drug? SATA A. Sore throat B. Fever C. Joint pain D. Constipation E. Dry mouth
A B
A nurse is teaching a client who will undergo a sigmoidoscopy. Which of the following information about the procedure should the nurse include? SATA A. Increased flatulence can occur following the procedure B. NPO status should be maintained preprocedure C. Conscious sedation is used D. Repositioning will occur throughout the procedure E. Fluid intake is limited the day after the procedure
A B
A nurse is providing teaching to a client who has gout and urolithiasis. The client asks how to prevent future uric acid stones. Which of the following suggestions should the nurse provide? SATA A. Take allopurinol as prescribed B. Exercise several times a week C. Limit intake of foods high in purine D. Decrease daily fluid intake E. Avoid citrus juices
A B C
A female client of childbearing potential is starting therapy with misoprostol to prevent a gastric ulcer. Which of the following instructions should you include when teaching this client? SATA A. Mid-cycle spotting can occur B. Take a pregnancy test prior to therapy C. Report excessive menstrual pain D. Use effective contraception E. Avoid taking the drug at bedtime
A B C D
A nurse in a provider's office is assessing a client who has GERD. The nurse should expect the client to report which of the following manifestations? SATA A. Regurgitation B. Nausea C. Belching D. Heartburn E. Weight loss
A B C D
A nurse is caring for a client who is about to begin taking aspirin. The nurse should instruct the client to report which of the following manifestations of salicylism? SATA A. Fever B. Tinnitus C. DiaphoresisA D. Thrombophlebitis E. DIzziness
A B C E
During a home visit, the nurse is concerned that a client is experiencing acute inflammation. Which finding caused the nurse to make this determination? A. Pain level of 7 on a scale of 1-10 B. Skin area reddened C. Skin area hot to touch D. Pink and red wound tissue E. Skin area swollen
A B C E
A nurse is teaching a client about methotrexate therapy for RA. Which of the following information should the nurse include? SATA A. Avoid being near people who are sick with a communicable illness B. Periodic laboratory tests are required C. The drug's effects are immediate D. Report bruising or petechiae E. Avoid drinking alcohol
A B D E
A nurse is caring for a client who has a new diagnosis of gastroesophageal reflux disease (GERD). The nurse should expect prescriptions for which of the following medications? SATA A. Antacids B. Histamine 2 receptor antagonists C. Opioid analgesics D. Fiber laxatives E. proton pump inhibitors
A B E
A nurse is discussing gout with a client who is concerned about developing the disorder. Which of the following findings should the nurse identify as risk factors for this disease? SATA A. Diuretic use B. Obesity C. Deep sleep deprivation D. Depression E. Cardiovascular disease
A B E
A nurse working in an outpatient clinic is assessing a client who has rheumatoid arthritis. The client reports increased joint tenderness and swelling. Which of the following findings should the nurse expect? SATA A. Recent influenza B. Decreased range of motion C. Hypersalivation D. Increased BP E. Pain at rest
A B E
A nurse is planning care for a client who has a new prescription for TPN. Which of the following interventions should be included in the plan of care? SATA A. Obtain a capillary blood glucose 4 times daily B. Administer prescribed medications through a secondary port on the TPN IV tubing C. Monitor vital signs three times during the 12hr shift D. Change the TPN IV tubing every 24hr E. Ensure a daily aPTT is obtained
A C D
The health care professional is providing instructions to the client on taking aluminum hydroxide. Which information should be included? SATA A. Check labels for sodium and phosphate content B. Decrease activity and exercise C. Increase fluid and fiber intake D. Report whitish colored stools E. Monitor for signs of constipation
A C E
The nurse reviews the patients scheduled for examinations in the community clinic. Which patient should the nurse identify as having the highest risk for the development of gastroesophageal reflux disease (GERD)? A 25-year-old female who is pregnant A 70-year-old female being treated for cardiovascular disease A 40-year-old male recovering from colorectal surgery A 55-year-old male recovering from pneumonia and asthma
A 25-year-old female who is pregnant
The nurse is preparing to assess a group of patients. Which patient should the nurse anticipate to be at a higher risk for developing inflammatory bowel disease (IBD)? A South American male with a history of high animal-protein intake A Jewish male with a history of high NSAID use A female of Hispanic descent with a prior surgical history of appendectomy A female of Asian descent with a history of a high-fat diet
A Jewish male with a history of high NSAID use
The nurse reviews the medical records of patients with a history of gastroesophageal reflux disease (GERD) scheduled to be seen during the GI clinic hours. Which patient should the nurse identify to benefit the most from ablation therapy? A patient who has an increased risk of esophageal cancer A patient who has lost weight and has stopped smoking A patient with GERD unresponsive to medication A patient with a new diagnosis of GERD
A patient who has an increased risk of esophageal cancer
A nurse is teaching a client who is newly diagnosed with inflammation. Which systemic manifestation should the nurse include in the teaching? SATA A. Respiratory rate of 22 breaths per minute B. White blood cell count of 4000/mm3 C. Increased ESR D. Oral temp of 101F E. HR 97bpm
A. Respiratory rate of 22 breaths per minute C. Increased ESR D. Oral temp of 101F
A nurse is assessing a female client who reports severe joint pain. The nurse should identify which of the following risk factors places the client at risk for developing gout? A. Diuretic use B. Irritable bowel syndrome C. Migraine headaches D. Premenopause
A. diuretic use
A patient with known peptic ulcer disease (PUD) experiences severe upper abdominal pain that began within the past half hour. The nurse suspects possible perforation. Which additional assessment information should the nurse identify that helps support a definitive diagnosis? Nausea and vomiting and electrolyte imbalances Abdominal rigidity and absence of bowel sounds Hematemesis and occult blood in the stool Steatorrhea and low sodium and potassium levels
Abdominal rigidity and absence of bowel sounds
A patient is scheduled for a surgical procedure to treat gastroesophageal reflux disease (GERD) which reduces the risk for developing esophageal cancer. For which surgical procedure should the nurse plan to prepare teaching for this patient? Antireflux surgery Laparoscopic fundoplication Nissen fundoplication Ablation therapy
Ablation therapy
The nurse reviews the health histories for a group of assigned pediatric patients. Which patient should the nurse consider as at the highest risk for peptic ulcer disease (PUD)? Acutely ill child experiencing health disparities Child with known gastrointestinal defects Premature infant receiving tube feedings since birth Infant born with multiple congenital anomalies
Acutely ill child experiencing health disparities
The nurse plans care for a patient experiencing nausea, vomiting, and epigastric pain caused by peptic ulcer disease (PUD). Which action should the nurse take to best address this patient's risk for deficient fluid volume? Assess gastric drainage to estimate the amount and rapidity of hemorrhage. Administer fluid volume and electrolyte solutions. Monitor serum electrolytes, BUN, and creatinine. Insert a nasogastric tube and maintain its position and patency.
Administer fluid volume and electrolyte solutions.
The nurse notes that a patient with inflammatory bowel disease (IBD) has lost 3 pounds since the day before. Which should be the priority intervention by the nurse? Administering an anti-inflammatory drug Assessing the perianal area Filling in the stool chart Administering intravenous fluids as prescribed
Administering intravenous fluids as prescribed
A pediatric patient with gastroesophageal reflux disease (GERD) is coughing frequently. Which nursing diagnosis should the nurse use to guide this patient's care? Infection, Risk for Airway Clearance, Ineffective Communication: Verbal, Impaired Knowledge, Readiness for Enhanced
Airway Clearance, Ineffective
The nurse is caring for an older adult patient with a new diagnosis of ulcerative colitis (UC). Which medication prescription should the nurse anticipate for this patient? High-dose probiotics An immunosuppressive agent Anti-inflammatories Total parenteral nutrition (TPN)
An immunosuppressive agent
A patient taking a proton pump inhibitor for peptic ulcer disease (PUD) asks if there is anything else that can be taken to help reduce the symptoms. Which medication should the nurse recommend to help provide rapid relief of ulcer symptoms? Misoprostol Sucralfate Pepto-Bismol Antacid
Antacid
The nurse suspects that an infant is experiencing gastroesophageal reflux disease (GERD). Which symptom did the infant's mother most likely share with the nurse? Frequent drooling Arching back Watery stools Swollen extremities
Arching back
The nurse is assessing a patient with Crohn disease for systemic manifestations. For symptoms of which disorder should the nurse assess this patient? Edema Arthritis Decreased urine output Headache
Arthritis
The nurse is assessing a patient with a history of gastroesophageal reflux disease (GERD). Which assessment finding should the nurse identify that requires immediate intervention? Epigastric tenderness Use of over-the-counter antacids Dyspepsia Atypical chest pain
Atypical chest pain
A client who is receiving chemotherapy takes allopurinol prior to the chemotherapy to reduce the risk for which condition? A. Agranulocytosis B. Hyperuricemia C. Aplastic anemia D. Thrombocytopenia
B
A nurse in a provider's office is assessing a client who has GERD. When documenting the client's history, the nurse should expect the client to report that symptoms worsen with which of the following actions? A. Stair-climbing B. Bending over C. Sitting D. Walking
B
A nurse is administering a client's first dose of sucralfate. Which of the following explanations should the nurse provide about the action of sucralfate? A. "Sucralfate decreases gastric acid secretions." B. "Sucralfate forms a gel-like substance that protects ulcers." C. "Sucralfate inactivates H. pylori." D. "Sucralfate inhibits the production of gastric acid."
B
A nurse is administering the client's first dose of sucralfate. Which of the following explanations should the nurse provide about the action of sucralfate? A. "Sucralfate decreases gastric acid secretion." B. "Sucralfate produces a gel-like substance that protects ulcers." C. "Sucralfate increases gastric emptying." D. "Sucralfate inhibits H. Pylori bacteria."
B
A nurse is caring for a client who has a new prescription for celecoxib. The nurse should tell the client to report which of the following adverse drug reactions? A. Tinnitus B. Chest pain C. Constipation D. Diaphoresis
B
A nurse is caring for a client who has rheumatoid arthritis and a new prescription for etanercept. Which of the following values should the nurse review prior to the administration of the medication? A. Ability to swallow B. Results of last PPD test C. Serum creatinine level D. Blood glucose level
B
A nurse is caring for a client who has ulcerative colitis. The provider prescribes bed rest with bathroom privileges. When the client asks the nurse why he has to stay in bed, which of the following responses should the nurse provide? A. "You need to conserve energy at this time." B. "Lying quietly in bed slows down the activity in your intestines." C. "Staying in bed promotes the rest and comfort you need." D. "Staying in bed will help prevent injury and minimize your fall risk."
B
A nurse is caring for a client who is currently taking methotrexate for rheumatoid arthritis. The nurse should identify that which of the following is an adverse effect of this medication? A. Hypertension B. Thrombocytopenia C. Glaucoma D. Edema
B
A nurse is caring for a client who is experiencing an acute exacerbation of rheumatoid arthritis. The nurse should anticipate that the client's affected joints will require which of the follow treatments? A. An assistive device to use when the client is ambulating B. Heat paraffin therapy applied to the client's joints C. Gentle massage of the client's hands D. Active ROM on the client's affected joints
B
A nurse is caring for a client who is experiencing an acute exacerbation of rheumatoid arthritis. The nurse should anticipate that the client's affected joints will require which of the following treatments? A. An assistive device when the client is ambulating B. Heat paraffin therapy applied to the client's joints C. Gentle massage of the client's hands D. Active ROM exercises on the client's affected joints
B
A nurse is caring for a client who is taking allopurinol to treat gout. The nurse should monitor the client for which of the following manifestations of hypersensitivity syndrome? A. Muscle pain B. Fever C. Anxiety D. Tremors
B
A nurse is caring for a client who is taking glucocorticoids. The nurse should monitor the client for which of the following adverse effects of the medication? A. Weight loss B. Peptic ulcer C. Hyperkalemia D. Diplopia
B
A nurse is caring for a client who takes a low-dose aspirin to prevent cardiovascular events. The client asks the nurse about taking ibuprofen to treat rheumatoid arthritis. Which of the following responses should the nurse make? A. "Ibuprofen will increase your risk for developing salicylism." B. "Ibuprofen will reduce the cardioprotective effects of low-dose aspirin." C. "Low-dose aspirin will reduce the anti-inflammatory effects of ibuprofen." D. "Low-dose aspirin will reduce the analgesic effects of ibuprofen."
B
A nurse is caring for an older adult client who has gout and refuses to eat. The provider has authorized the client's family to bring him food from home. Which of the following foods should the nurse recommend the client avoid? A. Broccoli with low-fat cheese B. Chicken livers with gravy C. Peanut butter with sugar-free jelly sandwich D. Low-fat Yogurt parfait
B
A nurse is completing an assessment of a client who has GERD. Which of the following is an expected finding? A. Absence of saliva B. Painful swallowing C. Sweet taste in mouth D. Absence of eructation
B
A nurse is preparing a client who is scheduled to have an arthroscopy the following day. Which of the following statements indicates that the client understands the pre-procedure teaching? A. "I have to keep my leg straight throughout the whole procedure." B. "The doctor will be able to see if I have signs of rheumatoid arthritis." C. "I should expect to stay overnight untiI I can walk around." D. "I'll have a scar that will be about an inch long."
B
A nurse is providing care to a client who is 1 day postoperative following a paracentesis. The nurse observes clear, pale-yellow fluid leaking from the operative site. Which of the following is an appropriate nursing intervention? A. Place a clean towel near the drainage site B. Apply a dry, sterile dressing C. Apply direct pressure to the site D. Place the client in a supine position
B
A nurse is providing dietary teaching to a client who has ulcerative colitis. Which of the following food selections by the client indicates an understanding of the teaching? A. Raw vegetable salad with low-fat dressing B. Roast chicken and white rice C. Fresh fruit salad and milk D. Peanut butter on whole wheat bread
B
A nurse is reviewing the laboratory results for a client who reports bilateral pain and swelling in her finger joints, with stiffness in the morning. The nurse should recognize that an increase in which of the following laboratory tests can indicate arthritis? A. Reticuloclyte count B. Rheumatoid factor C. Direct Coombs' test D. Platelet count
B
A nurse is reviewing the laboratory results for a client who reports bilateral pain and swelling in her finger joints, with stiffness in the morning. The nurse should recognize that an increase in which of the following laboratory values can indicate arthritis? A. Reticulocyte count B. Rheumatoid factor C. Direct Coomb's test D. Platelet count
B
A nurse is reviewing the medical record of a client with rheumatoid arthritis who has a prescription for infliximab. Which of the following findings should the nurse identify as a contraindication to the client receiving this medication? A. Psoriatic arthritis B. Hepatitis B virus C. Ulcerative colitis D. Ankylosing spondylitis
B
A nurse is teaching a client who has a hiatal hernia. Which of the following client statements indicates an understanding of the teaching? A. "I can take my medications with soda." B. "peppermint tea will increase my indigestion." C. "Wearing an abdominal binder will limit my manifestations." D. "I will drink hot chocolate at bedtime to help me sleep." E. "I can lift weights as a way to exercise."
B
A nurse is teaching a client who has a new prescription for etanercept. Which of the following statements should the nurse make? A. "You will inject this medication once a week in your thigh muscle." B. "You should report signs of infection to your provider immediately." C. "You will need to avoid taking ibuprofen while on this medication." D. "You will need to receive a MMR vaccine 1 months after starting this medication."
B
A nurse is teaching a client with Barrett's esophagus who is scheduled to undergo an esophagogastroduodenoscopy (EGD). Which of the following statements should the nurse include in the teaching? A. "This procedure is performed to measure the presence of acid in your esophagus." B. "This procedure can determine how well the lower part of your esophagus works.: C. "This procedure is performed while you are under general anesthesia." D. "This procedure can determine if you have colon cancer."
B
A nurse should identify that a client who has diabetes mellitus and is taking etanercept is at an increased risk for which of the following adverse effects? A. Kidney toxicity B. Infection C. Gout D. DVT
B
Because the client is taking celecoxib for osteoarthritis, he knows to watch for and report which of the following possible indications of an adverse reaction to celecoxib? A. Tinnitus B. Weight gain C. anxiety D. tremor
B
Knowing the adverse drug reactions of cimetidine, the primary care provider's assistant should instruct a client to watch for and report which of the following? A. Hyperactivity B. Confusion C. Hypertension D. Bone pain
B
Which of the following instructions should the health care provider give the client regarding the use of aspirin prior to the surgery? A. continue to take it once a day B. stop taking it 1 week before surgery C. Increase the dose to twice a day D. Reduce the dose to every other day
B
A client is about to start taking aluminum hydroxide tablets to reduce gastric acid. Which instructions should you include when talking with the client about taking this drug? SATA A. Take the drug with a large meal B. Chew the tablets thoroughly C. Drink a glass of water after taking it D. Increase fluid and fiber intake E. Take it once daily
B C D
A nurse is teaching a client who has a new prescription for allopurinol. The nurse should instruct the client to report which of the following adverse drug reactions? SATA A. Palpitations B. Sore throat C. Veritgo D. Bruising E. Vision changes
B C D E
A nurse is teaching a client who has a new prescription for prednisone. Which of the following instructions should the nurse include? SATA A. Reduce the dose during periods of stress B. Discontinue the drug gradually C. Report illness of infection D. Increase intake of calcium and vitamin D E. Monitor for signs of gastric bleeding
B C D E
A nurse is caring for a client who has rheumatoid arthritis. Which of the following laboratory tests are used to diagnose this disease? SATA A. Urinalysis B. Erythrocyte sedimentation rate (ESR) C. BUN D. ANA titer E. WBC count
B D E
The nurse is providing discharge teaching for a client diagnosed with rheumatoid arthritis (RA). Which client statement indicates to the nurse that further teaching is required? A. "I am looking forward to going to physical therapy so that I can improve my mobility." B. "I am so glad that this medication will cure my RA in a few weeks." C. "I will make sure to perform range-of-motion exercises daily." D. "I understand that the medications I am taking work to reduce inflammation."
B. "I am so glad that this medication will cure my RA in a few weeks."
A nurse is reviewing the medical record of a client who has a new prescription for tramadol. The nurse should identify that which of the following conditions is a contraindication for tramadol? A. Hyperthyroidism B. Seizure disorder C. Rheumatoid arthritis D. Urinary incontinence
B. Seizure disorder
A patient with gastroesophageal reflux disease (GERD) asks when the procedure that involves instilling saline and an acid into the esophagus to observe for symptoms will be done. Which diagnostic procedure should the nurse schedule for this patient? Barium swallow Bernstein test Upper endoscopy 24-hour ambulatory pH monitoring
Bernstein test
The nurse prepares materials about ulcerative colitis (UC) for a community health fair. Which age group should the nurse focus on when preparing this material? Between the ages of 25 and 55 years Between the ages of 15 and 30 years Between the ages of 30 and 60 years Between the ages of 5 and 15 years
Between the ages of 15 and 30 years
A patient is scheduled for stricturoplasty surgery. For which health problem should the nurse prepare teaching for this patient? Bowel strictures Bowel obstruction Bowel strangulation Bowel perforation
Bowel strictures
A client is about to start taking omeprazole to treat a duodenal ulcer. Which of the following instructions should you include when talking with the client about taking this drug? A. Take it with food B. Avoid using aluminum-based antacids C. Consume adequate amounts of fluids D. Do not drink grapefruit juice
C
A nurse in a provider's office is providing teaching to a client who has a recent diagnosis of rheumatoid arthritis and has a new prescription for naproxen tablets. Which of the following statements by the client requires further teaching? A. "This medication will take 4 weeks for me to notice relief in my joints." B. "I can take antacid with this medication for indigestion." C. "I can take this medication with aspirin." D. "The naproxen goes down easier when I crush it and put it in applesauce."
C
A nurse in a provider's office is teaching a client with a recent diagnosis of rheumatoid arthritis who has a new prescription for naproxen tablets. Which of the following statements by the client indicates the need for further teaching? A. "After taking this medication for 4 weeks, I'll start to notice relief in my joints." B. "I can take an antacid with this medication for indigestion." C. "I can take this medication with aspirin." D. "The naproxen goes down easier when I crush it and put it in applesauce."
C
A nurse is assessing a client who is experiencing perforation of a peptic ulcer. Which of the following manifestations should the nurse expect? A. 2+ pitting edema bilateral lower legs B. Bradycardia C. Boardlike abdomen D. Mucus in the stool
C
A nurse is assessing a client who was admitted with a bowel obstruction. The client reports severe abdominal pain. Which of the following findings indicates that a possible bowel perforation has occurred? A. Elevated blood pressure. B. Bowel sounds increased in frequency and pitch C. Rigid abdomen D. Emesis of undigested food
C
A nurse is assessing a female client who reports severe joint pain. The nurse should identify that which of the following factors places the client at risk for gout? A. Perimenopause B. Migraine headaches C. Diuretic use D. Irritable bowel syndrome
C
A nurse is caring for a client who has a new prescription for prednisone for long-term treatment of rheumatoid arthritis. The nurse should monitor the client for which of the following adverse drug reactions? A. Pulmonary embolism B. Hepatitis C. Bone loss D. Breast cancer
C
A nurse is completing discharge teaching with a client who is 3 days postoperative following a transverse colostomy. Which of the following should the nurse include in the teaching? A. Mucus will be present in stool for 5-7 days after surgery B. Expect 500-1000mL of semiliquid stool after 2 weeks C. Stoma should be moist and pink D. Change the ostomy bag when it is full
C
A nurse is completing discharge teaching with a client who is postoperative following fundoplication. Which of the following statements by the client indicates understanding of the teaching? A. When sitting in my lounge chair after a meal, I will lower the back of it." B. "I will try to eat three large meals a day." C. "I will elevate the head of my bed on blocks." D. "I will avoid eating within 1 hr of bedtime."
C
A nurse is performing medication reconciliation for a newly admitted client who has rheumatoid arthritis (RA). Which of the following medications should the nurse identify as the treatment for this condition? A. Misoprostol B. Dantrolene C. Celecoxib D. Colchicine
C
A nurse is providing preoperative teaching to a client who will undergo surgery to create a temporary colostomy. The client asks the nurse about the difference between colostomies and ileostomies. Which of the following responses should the nurse make? A. "A colostomy drains stool, and an ileostomy drains urine." B. "A colostomy is temporary, and an ileostomy is permanent." C. "A colostomy is from the large intestine, and an ileostomy is from the small intestine." D "An ileostomy requires dietary restrictions, while a colostomy does not."
C
A nurse is providing teaching about disease management to a client who has rheumatoid arthritis. Which of the following responses by the client indicates an understanding of the teaching? A. "I will take a hot bath every morning to decrease my stiffness." B. "When my arthritis acts up, I will rest all day and avoid exercising." C. "I will have handrails installed in my bathroom and hall." D. "I will avoid taking naps so I sleep better at night."
C
A patient with gastroesophageal reflux disease (GERD) reports heartburn and reflux after eating. Which instruction should the nurse provide? Adding coffee with each meal Consuming smaller meals with in between meal snacks Administering antacids prior to eating meals Encouraging to select foods that are high in fat
Consuming smaller meals with in between meal snacks
A nurse is providing teaching about disease management to a client who has rheumatoid arthritis. Which of the following responses by the client indicates an understanding of the teaching? A. "I will take a hot bath every morning to decrease my stiffness." B. "When my arthritis acts up, I will rest all day and avoid exercising." C. "I will have handrails installed in my bathroom and hall." D. "I will avoid taking naps so I sleep better at night."
C
A nurse is providing teaching for a client who has gout and a prescription for allopurinol. Which of the following statements by the client should indicate to the nurse that the teaching was effective? A. "I should start taking this medication at 800mg daily." B. "I will have an increased risk for diabetes with this medication." C. "I will increase my fluids to at least 2L per day." D. "I should take this medication twice daily."
C
A nurse is providing teaching to a client who has gout and a new prescription for allopurinol. The nurse should instruct the client to discontinue taking the medication for which of the following adverse effects? A. Nausea B. Metallic taste C. Fever D. Drowsiness
C
A nurse is reviewing the medical record of a client who has a new prescription for celecoxib. the nurse should identify that which of the following conditions is a contraindication to celecoxib? A. Rheumatoid arthritis B. Ankylosing spondylitis C. Sulfonamide allergy D. Adrenocortical insufficiency
C
A nurse is reviewing the medical record of a client who has a prescription for probenecid to treat gout. The nurse should identify that which of the following medications can interact with probenecid? A. Cochicine B. Naproxen C. Aspirin D. Prednisone
C
A nurse is teaching a client about methotrexate. The nurse should inform the client to monitor for which of the following as an adverse effect of this drug? A. muscle pain B. Peripheral edema C. Black, tarry stools D. Redness in calf
C
A nurse is teaching a client who has been taking an NSAID to treat rheumatoid arthritis. During the client's first month checkup, the provider prescribed methotrexate to be added to the medication regimen Which of the following statements should the nurse include in the teaching about the purpose of this change in the client's medication? A. "Your current medication was not strong enough to manage this condition." B. "Once your blood levels of methotrexate are within the therapeutic range, the NSAID will be discontinued." C. "This medication was added to delay the disease progression." D. "Treating this disease with 2 medications will help protect you from becoming treatment-resistant."
C
A nurse is teaching a client who has severe generalized rheumatoid arthritis and is scheduled to start taking prednisone for long-term therapy. The nurse should instruct the client to report which of the following as an adverse effect of prednisone? A. Thrombosis B. Immunosuppression C. Gastric ulceration D. Liver toxicity
C
A nurse is teaching a client with a new diagnosis of peptic ulcer disease who has a prescription for bismuth salicylate. The client asks the nurse, "How will this medication help my ulcer?" Which of the following statements should the nurse make? A. "This medication will decrease prostaglandins." B. "The amount of bicarbonate in your body will be increased." C. "This medication can decrease bacteria in the gastrointestinal tract." D. "This medication acts by increasing blood flow to the stomach."
C
A nurse is teaching a female client who has a new prescription for misoprostol to treat peptic ulcer disease. Which of the following client statements should indicate to the nurse that the teaching was effective? A. "I should avoid taking NSAIDs while using this medication." B. "Misoprostol is used to treat stress-induced gastric ulcers." C. "I should avoid becoming pregnant while taking this medication." D. "This medication is also used to treat dysmenorrhea."
C
A nurse is teaching about self-administering methotrexate to a client who has RA. Which of the following statements should the nurse make? A. "Use a non-steroidal anti-inflammatory drug to reduce toxicity." B. "If you miss a dose, go ahead and take it with the next scheduled dose." C. "Drink a minimum of 2 L of water per day to promote the drug's excretion." D. "Take it in the morning to prevent insomnia."
C
In addition to celecoxib, the client takes low-dose aspirin daily for which of the following purposes? A. decreases the risk for anaphylaxis B. potentiates the therapeutic effects of celecoxib C. Reduces the risk of cardiovascular event D. Increases renal perfusion
C
a nurse is caring for a client who has a new prescription for aspirin to treat an ankle sprain. The nurse should instruct the client to report which of the following adverse reactions? A. Polyuria B. Bone pain C. Weight gain D. Infection
C
A nurse is reviewing the health record of a client who has a suspected tumor of the jejunum. The nurse should expect a prescription for which of the following tests? SATA A. Blood alpha-fetoprotein B. Endoscopic retrograde cholangiopancreatography (ERCP) C. Gastrointestinal x-ray with contrast D. Small bowel capsule endoscopy (M2A) E. Colonoscopy
C D
A nurse in the emergency department is caring for a 2-year-old child who was found by his parents crying, and holding a container of bathroom cleaner. The child's lips are edematous and inflamed, and he is drooling. Which of the following is the priority action of the nurse? A. Remove the child's contaminated clothing B. Check the child for suspected leukocytosis C. Check the child's respiratory status D. Administer an antidote to the child
C. Check the child's respiratory status
The nurse admits a client to the hospital who is suspected of having rheumatoid arthritis (RA). Which diagnostic test should the nurse expect to be ordered for this client? SATA A. Antinuclear antibody (ANA) B. Renal function tests C. Erythrocyte sedimentation rate (ESR) D. C-reactive protein (CRP) E. Kidney biopsy
C. ESR D. CRP
A patient suspected of having Crohn disease is scheduled to have a colonoscopy. Which finding should the nurse expect from the colonoscopy if the patient has Crohn disease? Inflammation that begins at the crypts of Lieberkühn in the distal large intestine and rectum Cobblestone appearance of bowel Continuous inflammatory lesions of bowel Red, edematous, and friable tissue
Cobblestone appearance of bowel
A patient seeks medical care for diarrhea and lower abdominal pain. Which diagnostic test should the nurse anticipate being prescribed for this patient? Colonoscopy CT scan PET scan Abdominal flat plate
Colonoscopy
While conducting a health history, the patient states, "I have had constant heart burn for the past month." The nurse should suspect that the patient most likely has which condition? Gastroesophageal reflux disease (GERD) Acute pancreatitis Barrett esophagus Intestinal malabsorption
Gastroesophageal reflux disease (GERD)
A client is about to start taking aspirin to prevent cardiovascular events. You should instruct the client to watch for and report which adverse drug reaction of aspirin? A. Dyspnea B. Constipation C. Calf pain D. Petechiae
D
A client with GERD reports difficulty sleeping due to reflux and asks how to make this better. How should the nurse respond? A. "Have you tried a sleeping pill before bed?" B. "Take an antacid with your PPI at bedtime." C. "Try eating a snack before going to sleep." D. "Sleep with the head of your bed elevated."
D
A nurse in a clinic is instructing a client about a fecal occult blood test, which requires mailing three specimens. Which of the following statements by the client indicates understanding? A. "I will continue taking my warfarin while I complete these tests." B. "I'm glad I don't have to follow any special diet at this time." C. "This test determines if I have parasites in my bowel." D. "This is an easy way to screen for colon cancer."
D
A nurse is admitting a client who has bleeding esophageal varices. The nurse should expect a prescription for which of the following medications? A. Propranolol B. Metoclopramide C. Famotidine D. Vasopressin
D
A nurse is assessing a client who is experiencing perforation of a peptic ulcer. Which of the following manifestations should the nurse expect? A. Increased blood pressure B. Decreased heart rate C. Yellowing of the skin D. Boardlike abdomen
D
A nurse is assessing a client with rheumatoid arthritis who has been taking high doses of prescribed hydroxychloroquine. Which of the following client statements should indicate to the nurse that the client is experiencing an adverse effect of hydroxychloroquine? A. "I have developed sores in my mouth." B. "I often feel like the room is spinning." C. "I noticed that the whites of my eyes look yellow." D. "I have had a change in my vision recently."
D
A nurse is caring for a child who has a viral infection. The nurse should identify that which of the following drugs can increase the risk of Reye syndrome in children who have viral infections? A. Butorphanol B. Acetaminophen C. Tramadol D. Asprin
D
A nurse is caring for a client following a paracentesis. Which of the following findings indicate the bowel was perforated during the procedure? A. Client report of upper chest pain B. Decreased urine output C. Pallor D. Temperature elevation
D
A nurse is caring for a client who currently takes furosemide and has a new prescription for prednisone. The nurse should monitor the client for which of the following manifestations during concurrent use of the two drugs? A. Hypercalcemia B. Hypoglycemia C. Hypothermia D. Hypokalemia
D
A nurse is caring for a client who has colitis and reported increased exacerbations due to stress at work. Which of the following responses should the nurse make? A. "I will contact the social worker so you can discuss career alternatives." B. "Have you thought about discussing the possibility of a part-time assignment with your employer?" C. "Why don't you ask your employer to relieve you of some work until you are stronger? D. "Perhaps we should review your coping mechanisms and talk about other alternatives."
D
A nurse is caring for a client who has gastrointestinal bleeding. The provider suspects a bleeding lesion in the colon. The initial approach to treatment likely will involve which of the following procedures? A. Exploratory laparatomy B. Double-contrast barium enema C. Magnetic resonance imaging D. Colonoscopy
D
A nurse is caring for a client who has peptic ulcer disease and reports a headache. Which of the following medications should the nurse plan to administer? A. Ibuprofen B. Naproxen C. Aspirin D. Acetaminophen
D
A nurse is caring for a client who is receiving TPN and has just returned to the room following physical therapy. THe nurse notes that the infusion pump for the client's TPN is turned off. After restarting the infusion pump, the nurse should monitor the client for which of the following findings? A. Hypertension B. Excessive thirst C. Fever D. Diaphoresis
D
A nurse is caring for a client who is taking budesonide to treat Crohn's disease. Which of the following findings should indicate to the nurse that the treatment is effective? A. Decreased blood glucose B. Increased potassium C. Increased prostaglandin synthesis D. Decreased inflammation
D
A nurse is caring for a client who is taking etanercept for RA. The nurse should monitor the client for which of the following indications of serious adverse reaction to the drug? A. Excessive salivation B. Increased thirst C. Blood in the urine D. Shortness of breath
D
A nurse is caring for a client who takes sulfasalazine twice daily for rheumatoid arthritis. Which of the following values should the nurse review prior to the administration of the medication? A. Respirations B. Serum creatinine level C. Blood pressure D. Complete blood count
D
A nurse is discussing the difference between rheumatoid arthritis and osteoarthritis with a newly licensed nurse. Which of the following pieces of information should the nurse include about osteoarthritis? A. "Osteoarthritis is caused by autoimmune processes." B. "Osteoarthritis leads to a decreased erythrocyte sedimentation rate." C. "Osteoarthritis affects the other organ systems." D. "Osteoarthritis can impair a joint on a single side of the body."
D
A nurse is providing teaching to a client who is scheduled for a sigmoid colon resection with colostomy. Which of the following statements by the client indicates a need for further teaching? A. "Because most of my colon is still intact and functioning, my stool will be formed." B. "My stoma will appear large at first, but it will shrink over the next several weeks." C. "My colostomy will begin to function in 2-6 days after surgery." D. "I'll have to consume a soft diet after surgery."
D
A nurse is teaching a client who has severe chronic gout and a new prescription for pegloticase. The client has been taking allopurinol for 1 month. Which of the following instructions should the nurse include about pegloticase? A. "You will take this medication along with allopurinol." B. "You will take this medication by mouth." C. "There are very few adverse effects of this medication." D. "If you experience a flare-up, you can take an NSAID while receiving this medication."
D
A nurse of a client who has a prescription for methotrexate. Which of the following drugs would likely be prescribed in conjunction during the initial treatment for rheumatoid arthritis? A. Aspirin B. Salicylates C. Sulfonylureas D. Ibuprofen
D
A provider prescribes prednisone for a client who has type 1 diabetes mellitus. Recognizing the risk for an adverse drug reaction to the prednisone, which of the following precautions should the primary care provider take for this client? A. Reduce the insulin dose B. Increase carbohydrate intake C. Reduce the prednisone dose D. Increase serum glucose monitoring
D
Which of the following instructions should the health care professional give a client about taking sucralfate to treat an acute duodenal ulcer? A. Take it with a prescribed antacid B. Reduce potassium intake C. Take it with food D. Increase fluid and fiber intake
D
After a mosquito bite, the area becomes erythematous. What is the cause of erythema? A. Vasoconstriction B. Hemorrhage C. Increased vascular permeability D. Vasodilation
D. Vasodilation
A patient with peptic ulcer disease (PUD) is experiencing nausea, heartburn, and epigastric pain. Which nursing intervention should the nurse plan to implement? Discourage the patient from eating a nighttime snack. Allow the patient to have bathroom privileges. Insert a nasogastric tube upon patient admission. Listen to the patient's bowel sounds every shift.
Discourage the patient from eating a nighttime snack.
The nurse is completing an assessment on a patient with peptic ulcer disease (PUD). Which activity should the nurse include when assessing this patient's discomfort? Eating Bowel movements Body position Activity
Eating
The nurse is caring for a patient with a strong family history of Crohn disease. Which action should the nurse suggest to help prevent this patient from developing the disease? Decrease protein intake Avoid dietary fats Reduce caffeine intake Eliminate smoking
Eliminate smoking
A patient is prescribed ranitidine, an H2-receptor antagonist, for gastroesophageal reflux disease (GERD). Which adverse effect should the nurse counsel the patient to report to the healthcare provider? Enlarged or tender breasts Black, tarry stools Decreased stomach acid production Extrapyramidal symptoms
Enlarged or tender breasts
A patient taking prescribed medication and following dietary changes for gastroesophageal reflux disease (GERD) continues to experience severe symptoms. Which plan of treatment should the nurse expect the healthcare provider to consider next? Fundoplication Gastric bypass surgery Proton pump inhibitors Stress management techniques
Fundoplication
The nurse is preparing an educational seminar about the development of peptic ulcer disease. Which information should the nurse include that best characterizes the pathophysiological changes secondary to Helicobacter pylori (H. pylori) infection leading to the development of peptic ulcer disease (PUD)? H. pylori crosses the lipid membranes of gastric epithelial cells, damaging the cells themselves. H. pylori reduces the efficacy of the mucosal gel protecting the gastric mucosa. Infection with H. pylori inhibits the secretion of bicarbonate by the pancreas, causing a marked rapid transit of gastric acid into the duodenum. Prostaglandin synthesis is interrupted by H. pylori, affecting the gastric mucosal barrier.
H. pylori reduces the efficacy of the mucosal gel protecting the gastric mucosa.
The nurse notes that a patient with severe ulcerative colitis (UC) has decreased hemoglobin and hematocrit levels. Which complication should cause the nurse to have the most concern? Toxic megacolon Perforation Fulminant colitis Hemorrhage
Hemorrhage
While conducting a health history, the nurse learns that an older adult patient regularly uses NSAIDs. Which medication should the nurse encourage the patient to discuss with the healthcare provider to reduce the risk of developing peptic ulcer disease (PUD)? Histamine-receptor blockers Antacids Sucralfate Bismuth compound
Histamine-receptor blockers
The nurse instructs a patient with peptic ulcer disease (PUD) about dietary approaches to manage the disorder. Which dietary change indicates that teaching provided to the patient was effective? Increase in dietary fiber Decrease in dietary fatty foods Moderate alcohol intake Decrease in acidic foods
Increase in dietary fiber
A patient with peptic ulcer disease (PUD) is prescribed a proton-pump inhibitor. Which information should the nurse recall before administering this medication? It stimulates gastric mucosal defenses. It stimulates secretion of mucus, bicarbonate, and prostaglandin. It inhibits an acid-secreting enzyme to reduce gastric acid content. It inhibits histamine binding to the receptors on the gastric parietal cells to reduce acid secretion.
It inhibits an acid-secreting enzyme to reduce gastric acid content.
The nurse reviews medications prescribed for a patient with gastroesophageal reflux disease (GERD) and a history of osteoporosis. Which prescribed medication should the nurse question? Ranitidine Lansoprazole Aluminum hydroxide Metoclopramide
Lansoprazole
The nurse is assessing abdominal pain in a patient with peptic ulcer disease. Which body area should the nurse specifically question the patient about? Left-lower-quadrant area Right-lower-quadrant area Left-upper-quadrant area Right-upper-quadrant area
Left-upper-quadrant area
The nurse is caring for a patient with inflammatory bowel disease (IBD). Which intervention should the nurse make a priority for this patient? Maintaining skin integrity Weighing every other day Encouraging deep breathing and coughing Discussing coping strategies
Maintaining skin integrity
The nurse suspects that a patient with gastroesophageal reflux disease (GERD) is experiencing severe regurgitation. Which finding caused the nurse to make this clinical determination? Extrapyramidal effects Mouth sores Black, tarry stools Gynecomastia
Mouth sores
The nurse evaluates care provided to a patient with gastroesophageal reflux disease (GERD). Which outcome should the nurse identify that indicates treatment has been effective? Understands the role of surgery to treat the disorder. Participates in teaching. No symptoms of pain with routine administration of pain medication. Asks appropriate questions about the disease process.
No symptoms of pain with routine administration of pain medication.
The nurse is completing a physical assessment of a patient with peptic ulcer disease (PUD). Which vital sign abnormality should the nurse identify that could indicate a potential complication of the disorder? Pulsus paradoxus Orthostatic hypotension Widening pulse pressure Pulse deficit
Orthostatic hypotension
A patient with a history of peptic ulcer disease (PUD) reports severe abdominal pain that radiates to the right shoulder. The patient's heart rate is 114 beats/min and blood pressure is 90/56 mmHg. The patient's skin is cool and clammy, the abdomen is hard, and bowel sounds are absent. Which complication associated with PUD should the nurse suspect? Hemorrhage Gastric outlet obstruction Zollinger-Ellison syndrome Perforation
Perforation
A patient with severe exacerbation of Crohn disease is prescribed bowel rest. Which additional prescription should the nurse anticipate for this patient? Soft, bland diet Insertion of a central line for parenteral feedings Initiation of a large-bore IV for fluid administration Placement of a nasogastric tube for enteral feedings
Placement of a nasogastric tube for enteral feedings
A patient with inflammatory bowel disease (IBD) asks about dietary supplements to help with the symptoms. Which suggestion should the nurse make to this patient? Glucose tablets Probiotics Vitamin K tablets Energy drinks
Probiotics
A patient with peptic ulcer disease (PUD) is draining coffee-ground emesis through a nasogastric tube. Which action should the nurse take to help maintain homeostasis? Assess the abdomen, including bowel sounds, distention, girth, and tenderness every 4 hours. Administer whole blood and packed red blood cells. Administer PPIs, H2-receptor antagonists, antacids, or mucosal protective agents as ordered. Replace gastric output milliliter for milliliter with a balanced electrolyte solution.
Replace gastric output milliliter for milliliter with a balanced electrolyte solution.
A patient with diarrhea containing both blood and mucus experiences seven to eight stools per day. The nurse notes decreased red blood cells on the patient's complete blood count (CBC). Which condition should the nurse suspect in this patient? Fulminant colitis Crohn disease Severe ulcerative colitis Mild ulcerative colitis
Severe ulcerative colitis
An adolescent with a new ileostomy is observed crying. Which action is best for the nurse take at this time? Reassure the patient that everything will be okay. Call the parents to come into the room. Pull the curtains closed to provide privacy. Sit next to the patient.
Sit next to the patient.
The nurse prepares teaching material for a patient with gastroesophageal reflux disease. Which position should the nurse instruct the patient to assume to reduce the symptoms of this disorder after eating? Lying supine Any comfortable position Sitting upright Right-side lying
Sitting upright
The nurse is caring for a patient with persistent diarrhea. Which assessment finding should indicate to the nurse that the patient is experiencing ulcerative colitis (UC)? Stools with blood and mucus Palpable mass in the lower right quadrant Right-sided abdominal cramping Anorectal lesions
Stools with blood and mucus
Which outcome best demonstrates that the patient has met the goals of the nursing care plan for the nursing diagnosis of Ineffective Health Maintenance? Crushes PPI to swallow easier Sleeps flat on stomach Stopped smoking Works 60 hours a week
Stopped smoking
Which outcome best demonstrates that the patient has met the goals of the nursing care plan for the nursing diagnosis of Ineffective Health Maintenance? Stopped smoking Crushes PPI to swallow easier Works 60 hours a week Sleeps flat on stomach
Stopped smoking
A patient with a history of being treated with antibiotics and steroids for Crohn disease is being considered for surgery because of strictures in the colon. Which surgery should the nurse anticipate for the patient? Total colectomy ileal pouch-anal anastomosis Sigmoidoscopy Bowel resection Strictureplasty
Strictureplasty
A patient with inflammatory bowel disease (IBD) has an allergy to sulfonamides. Which medication prescription should the nurse question? Clarithromycin Sulfasalazine Ciprofloxacin Metronidazole
Sulfasalazine
The nurse is discussing the incidence of inflammatory bowel disease (IBD) with a community group. Which information should the nurse include? The disease occurs less frequently in the United States and northern European nations than it does elsewhere in the world. The disease is often linked to heredity. Inflammatory bowel disease does not affect older adults. Environmental factors have no effect on the etiology of inflammatory bowel disease.
The disease is often linked to heredity.
The nurse is planning care for a patient with inflammatory bowel disease (IBD). Which outcome should the nurse consider as most appropriate for this patient? The patient has no symptoms of infection. The patient recognizes the early signs of a flare-up. The patient's skin excoriation is improving. The patient loses less than 5% of pre-illness body weight.
The patient has no symptoms of infection.
The nurse is developing a plan of care for a patient with nausea, vomiting, and epigastric pain caused by peptic ulcer disease (PUD). Which outcome should the nurse identify for this patient? The patient will have minimal bleeding. The patient will maintain adequate fluid volume. The patient will report pain as 5 or less on a standard pain scale. The patient will maintain a urine output of at least 0.1 mL/kg/hr.
The patient will maintain adequate fluid volume.
A patient with ulcerative colitis is scheduled for surgery to remove the bowel and place a temporary ostomy. For which surgical procedure should the nurse prepare teaching material for this patient? Stricturoplasty Total colectomy ileal pouch-anal anastomosis (IPAA) Gastric resection Pyloroplasty
Total colectomy ileal pouch-anal anastomosis (IPAA)
A patient presents with suspected peptic ulcer disease (PUD). Which diagnostic test should the nurse expect to be ordered first for this patient? Biopsy Urea breath test Gastroscopy Upper GI series
Upper GI series
A patient is diagnosed with gastroesophageal reflux disease (GERD). Which patient behavior should the nurse identify that would make the GERD symptoms worse? Elevating the head of the bed at night Use of mint to alleviate heartburn Use of proton-pump inhibitors Limited health insurance plan
Use of mint to alleviate heartburn
The nurse notes that a patient with gastroesophageal reflux disease (GERD) is prescribed famotidine, an H2-blocker. Which additional prescribed medication should the nurse identify as a contraindication to famotidine? Paroxetine Heparin Warfarin Lisinopril
Warfarin
The nurse is caring for a patient with a new diagnosis of gastroesophageal reflux disease (GERD). Which pathophysiological change should the nurse identify as the cause of this disease? Weakened lower esophageal sphincter pressure Herniation of the stomach through the diaphragm Decreased gastric acid secretion Thickening of the muscle between the stomach and intestines
Weakened lower esophageal sphincter pressure
An older adult patient continues to experience chest pain and dysphagia after having an examination that eliminated the cause as being heart disease. Which other symptom should the nurse assess that might indicate peptic ulcer disease? Weight loss and anemia Vomiting and acute upper abdominal pain Diarrhea and constant hunger Altered electrolyte levels and fluid intake
Weight loss and anemia
An older patient seeks medical attention for a new onset of symptoms. For which atypical symptom should the nurse suspect that this patient is experiencing gastroesophageal reflux disease (GERD)? Wheezing Regurgitation Barrett esophagus Heartburn
Wheezing
