Med surg ch.27,2829,30 test 4
The nurse is caring for a patient diagnosed with acute pancreatitis who complains of significant pain. Which nursing action holds the highest priority for this patient? a. Instruct the patient to sit and lean forward. b. Monitor intake and output. c. Monitor laboratory values and note changes. d. Check blood glucose values frequently
A
The nurse is talking with a patient who has been experiencing nausea and vomiting. The patient indicates an interest in using alternative therapies for the condition. Which product may aid in nausea management? a. Ginger b. Ginseng c. Chamomile d. Soy
A
During a morning assessment, the nurse observes that a patient displays bulging flanks when supine with the knees flexed. Which action should the nurse take next? a. Measure the patient's abdominal girth. b. Auscultate each quadrant of the abdomen for 5 minutes. c. Document the finding. d. Notify the charge nurse.
A
For which patient should the nurse question an order for esomeprazole (Nexium)? a. A 55-year-old female who takes digoxin b. A 52-year-old male who is noncompliant c. A 38-year-old female who has asthma d. A 56-year-old male who has epistaxsis
A
In caring for a patient with hepatitis B, a nurse would employ which precautions? a. Standard Precautions b. Strict isolation c. Contact Precautions d. Surgical asepsis
A
The nurse calculates the body mass index (BMI) of a man who is 6 feet tall and weighs 150 pounds. Which value is correct? a. 21.0 b. 25.0 c. 43.1 d. 66.3
A
The nurse explains that the laparoscopic adjustable gastric banding surgery is best described as which type of bariatric surgery? a. Restrictive b. Malabsorptive c. Restrictive/malabsorptive d. Obstructive
A
The nurse is aware that a definitive diagnosis of cirrhosis is made based on the results of which diagnostic or laboratory test? a. Liver biopsy b. Elevated aspartate aminotransferase (AST) c. Elevated alanine aminotransferase (ALT) d. Elevated lactate dehydrogenase (LDH)
A
The nurse is aware that the person with ulcerative colitis is a risk factor for developing which disorder? a. Colon cancer b. Chronic urinary infections c. Intussusception d. Volvulus
A
The nurse points out to a patient recently diagnosed with hepatitis B virus (HBV) that the virus is found which type(s) of body fluid(s) or secretions? (select all that apply.) a. Semen b. Vaginal secretions c. Sweat d. Breast milk e. Human feces
A,B,D,E
The nurse is presenting a program about bulimia nervosa to a group of student nurses. After the program, the participants correctly identify which method(s) of treatment? (select all that apply.) a. Appetite suppressants b. Antidepressant medications c. Psychotherapy d. Behavior modification
B,C,D
Conservative treatment of diverticulosis includes which management? (select all that apply.) a. Eating a low-fiber diet b. Increasing fluid intake c. Taking stool softeners d. Taking nonsteroidal anti-inflammatory drugs (NSAIDs) for discomfort e. Taking bulk laxatives
B,C,D,E
The nurse is caring for a patient with anorexia nervosa. Which intervention(s) might the nurse use to stimulate appetite? (select all that apply.) a. Offer oral care after meals. b. Arrange for preferred foods to be served. c. Encourage family members to bring food from home. d. Suggest that family members or friends come and socialize during the meal. e. Allow ample time to eat and enjoy the meal.
B,C,D,E
The presence of which diagnostic criteria are used to confirm the diagnosis of irritable bowel syndrome (IBS)? (select all that apply.) a. Abdominal pain that increases with defecation b. Abdominal pain with a change in stool consistency c. Mucorrhea d. Clay colored stools that float e. Bloating
B,C,E
A patient with advanced cirrhosis develops esophageal varices. The nurse anticipates that this complication will be addressed by which type of medication(s)? (select all that apply.) a. Vasodilators b. Intravenous (IV) vasopressin (Pitressin) c. IV iron d. Beta blockers e. Vitamin K
B,D,E
Match each term with its correct definition. a. Absorption b. Peristalsis c. Metabolism d. Anabolism e. Catabolism
(B) Rhythmic squeezing action of intestinal tract (B) (C) Chemical process to make substances needed by the body (D)Repair of body tissue (E) Breaking down larger molecules into smaller molecules (A) Transfer of nutrients from intestine to bloodstream
Match the hepatitis virus (HV) with the characteristics that best describe it. a. HAV b. HBV c. HCV d. HDV e. HEV
(B) Transmission by contact with blood and body fluids, perinatal transmission from mother to infant (E) Prevalent in less developed countries (C) Most likely to lead to cirrhosis (D) Coexists with HBV (A) Fecal-oral transmission, acute onset
Match the types of ostomies with the expected type of effluent. a. Ascending colostomy b. Transverse colostomy c. Descending colostomy d. Ileostomy e. Continent ileostomy
(C) Formed stool on relatively regular basis (B) Semiliquid stool at unpredictable times (A) liquid and unformed stool (E) No effluent (D) Extremely watery stool with concentrations of digestive enzymes
A nurse is caring for a patient who is 4 hours postoperative after a laparoscopic cholecystectomy. The patient reports abdominal fullness and mild discomfort. After verifying that the patient's vital signs are stable, what action is most important for the nurse to take next? a. Ambulate the patient. b. Notify the charge nurse. c. Position the patient in high Fowler. d. Administer the ordered PRN analgesic.
A
The nurse demonstrates that the person whose recommended weight is 150 pounds based on height, age, and body type would be considered obese if the person weighed a minimum of ______ pounds.
180
The nurse is caring for a patient who complains, "I don't see why I can't have a CT scan instead of the expensive MRI!" Which response is most appropriate for the nurse to make? a. "The MRI provides better contrast between normal and pathologic tissue." b. "The MRI requires less analysis and is easier to read." c. "The MRI produces a digital image that can be transmitted via e-mail." d. "The MRI exposes the patient to less radiation."
A
The nurse is caring for a patient who is complaining of postoperative gas pain. What intervention should nurse implement? a. Assist the patient with ambulation. b. Apply a cold compress on the abdomen. c. Offer a cup of coffee or tea. d. Offer chilled vegetable juice.
A
The nurse is caring for a patient who is postoperative after esophageal resection. Shortly after the nurse starts a feeding, the patient suddenly becomes dyspneic and complains of substernal pain. What should the nurse do first? a. Stop the feeding. b. Ambulate the patient. c. Notify the charge nurse. d. Reassure the patient.
A
The nurse is caring for a patient who is suspected of having oral cancer. When reviewing the patient's health history, which finding provides supportive data for the diagnosis? a. Presence of leukoplakia b. History of oral herpes simplex c. History of an oral yeast infection d. Reports of a dry oral cavity
A
The nurse is caring for a patient who presents to the emergency department with severe nausea and vomiting with stomach pain that radiates to his right scapula. The patient has a temperature of 101.2° F. The nurse anticipates that this patient will undergo workup for which problem? a. Cholecystitis b. Hepatitis c. Pancreatitis d. Gastroenteritis
A
The nurse is caring for a patient who returns to the floor at lunch time after undergoing an upper GI (UGI series). Which action is most important for the nurse to perform first? a. Administer a laxative. b. Educate the patient about the possibility of white stools. c. Offer the patient a small snack. d. Provide oral care.
A
The nurse is caring for a patient with esophageal varices with a new order for vasopressin (Pitressin). The nurse reviews the patient's history and notes that the patient's comorbidities include coronary artery disease (CAD), type 2 diabetes, gastroesophageal reflux disease (GERD), and fibromyalgia. The nurse should immediately notify the physician about which component of the patient's history? a. CAD b. Diabetes mellitus (DM) type 2 c. GERD d. Fibromyalgia.
A
The nurse is caring for patient with a history of a chronic incarcerated hernia. The patient suddenly complains of abdominal pain and vomits dark material with a fecal odor. The nurse recognizes these signs as indications of which complication? a. Complete intestinal obstruction b. Rupture c. Gastroenteritis d. Duodenal ulcer
A
The nurse is educating a group of patients about high-fiber dietary selections. Which patient menu selection indicates that the nurse's teaching has been successful? a. Turkey sandwich on whole wheat toast, pears, and tea b. Grilled chicken, corn, and water c. Cheese pizza, salad, and milk d. Bacon, lettuce, and tomato sandwich on sourdough, blackberry compote, and orange juice
A
The nurse is educating a patient who has gastroesophageal reflux disease (GERD) about dietary modification. Which information is most important for the nurse to include in the teaching plan? a. Avoid highly seasoned or spiced foods. b. Drink ginger ale or lemon lime soda rather than cola. c. Use a straw to drink all fluids. d. Eating three meals spaced evenly apart.
A
The nurse is educating a patient with a hiatal hernia. Which statement indicates that the patient understands the nurse's teaching? a. "I should avoid tea and chocolate." b. "I should wear an abdominal binder for added support. c. "I should sleep flat on a single pillow." d. "I should not eat within an hour of going to bed."
A
The nurse is educating a patient with inflammatory bowel disease (IBD) about recommended nutritional choices. Which statement indicates that the nurse's teaching has been successful? a. "I should try to eat foods like white rice and lean poultry." b. "I should avoid red meats and eat large amounts of whole grains." c. "I should eat food that is mushy in consistency." d. "I should increase my intake of green leafy vegetables."
A
The nurse is percussing a patient's abdomen and hears a dull thud in the right upper quadrant. This sound indicates that nurse is percussing over which location? a. The liver b. The small intestine c. The stomach d. The lungs
A
The nurse is reviewing the laboratory results of an assigned patient. The serum bilirubin is 2.8 mg/dL. The nurse anticipates that the patient's urine will display which finding? a. Dark color b. Low specific gravity c. Very scant amount d. Foul odor
A
The nurse is teaching a group of patients about the process of a mechanical bowel obstruction. Which example should the nurse include in the teaching? a. A tumor obstructs the lumen of the bowel. b. A paralytic ileus causes cessation of peristalsis. c. The bowel is inflamed by diverticulitis. d. The bowel motility is slowed by antidiarrheal drugs.
A
When assessing a patient's bowel sounds, nurse auscultates loud bowel sounds in each quadrant every 3 seconds. The nurse understands that these findings could indicate that the patient is experiencing which condition? a. Diarrhea b. Paralytic ileus c. Vomiting d. Constipation
A
Which causative agent is the primary cause of Barrett esophagus? a. Gastroesophageal reflux disease (GERD) b. Eating hot, spicy foods c. Anorexia nervosa d. Esophageal polyps
A
Which type of hernia can lead to necrosis? a. Strangulated hernia b. Indirect hernia c. Direct hernia d. Irreducible hernia
A
The nurse explains to an obese patient that initial medically supervised weight reduction includes which components(s)? (select all that apply.) a. General health assessment b. Specialized exercise program c. Participation in a support group d. Stress reduction e. Surgery
A B,C,D
The nurse is caring for a 70-year-old patient who was diagnosed with gastroenteritis after returning from a camping trip to Mexico. Which manifestation(s) is/are consistent with this diagnosis? (select all that apply.) a. Positive stool culture for Giardia or Shigella b. Abdominal cramping c. Fat in the stool d. Mucus in stool e. Blood in stool
A,B, D,E
Which foods or beverages may trigger an attack of irritable bowel syndromes (IBS)? (select all that apply.) a. Coffee b. Yogurt c. Whole wheat bread d. White rice e. Orange juice
A,B,C
The nurse is discussing the impact of cirrhosis on liver function with the family of a dying patient. The nurse explains that, when the damage caused by cirrhosis blocks the blood flow through the liver, it can lead to which complication(s)? (select all that apply.) a. Portal hypertension b. Decrease in metabolic processes of the liver c. Decrease in clotting factors d. Increase in ascites e. Decrease in aldosterone
A,B,C,D
To best assist a patient with dysphagia, the nurse should implement which action(s)? (select all that apply.) a. Encourage "practice swallowing" before the meal. b. Coach the patient to chew thoroughly. c. Assist the patient to sit upright with the head forward and chin tucked. d. Offer fluid during the meal. e. Give the patient thin liquids, such as water.
A,B,C,D
Which action(s) should the nurse recommend to promote a patient's bowel health? (select all that apply.) a. Exercise regularly. b. Include adequate bulk in the diet. c. Drink adequate water. d. Defecate at approximately the same time every day. e. Take a laxative to maintain a regular defecation pattern.
A,B,C,D
Which contributing factor(s) may lead to hernia development? (select all that apply.) a. Heavy lifting b. Chronic cough c. Straining with defecation d. Ascites e. Strenuous sexual activity
A,B,C,D
The nurse is caring for a patient immediately following a liver biopsy. Which actions are appropriate for the nurse to take? (select all that apply.) a. Position the patient on the right side. b. Assess the patient's pain. c. Monitor vital signs every 15 minutes for the first hour. d. Instruct patient to cough and deep-breathe. e. Assess for hematoma at puncture site.
A,B,C,E
The nurse preparing a teaching plan for a 20-year-old woman who is taking sulfasalazine (Azulfidine) for Crohn disease. Which information should the nurse include in the teaching plan? (select all that apply.) a. Avoid tanning beds or going outside during peak hours of sun while taking sulfasalazine (Azulfidine). b. If taking sulfasalazine (Azulfidine) while on oral contraceptives, use a backup method of birth control. c. Sulfasalazine (Azulfidine) decreases the effect of hypoglycemic agents. d. Be aware that sulfasalazine (Azulfidine) may turn the urine orange. e. Be aware that sulfasalazine (Azulfidine) may cause gastrointestinal (GI) upset.
A,B,D,E
The nursing is planning care for a patient with an acute exacerbation of inflammatory bowel disease (IBD). Which action(s) is/are most important for the nurse to include in the care plan? (select all that apply.) a. Assess number and character of stools. b. Auscultate bowel sounds. c. Obtain weights each shift. d. Encouraging periods of rest. e. Assess for internal bleeding.
A,B,D,E
The nurse is teaching a patient about peristomal skin care. Which information is most important for the nurse to include? (select all that apply.) a. Gently remove the faceplate of the appliance to avoid skin irritation. b. Washing the peristomal area with a scrubbing motion to rid the skin of fecal waste. c. Thoroughly rinse the skin. d. Apply a skin barrier to the peristomal area. e. Cut the faceplate to allow a -inch opening around the stoma.
A,C,D
The nurse caring for a patient recently admitted with acute pancreatitis. Which action(s) should the nurse include in the daily assessments? (select all that apply.) a. Auscultate bowel sounds. b. Carefully evaluate amount of food eaten each meal. c. Measure abdominal girth. d. Monitor for effectiveness of pain control. e. Monitor urine output.
A,C,D,E
The nurse explains that the older adult is prone to digestive disorders related to which age-related change(s)? (select all that apply.) a. Decreased hydrochloric acid b. Increased enzyme levels c. Inadequate chewing d. Diminished intestinal motility e. Gastroesophageal sphincter incompetence
A,C,D,E
The nurse instructs the patient on the weight reduction drug Orlistat (Xenical, Alli) that he may experience which side effect(s)? (select all that apply.) a. Diarrhea b. Hypoglycemia c. Abdominal cramping d. Constipation e. Nausea
A,C,E
Which factor(s) increase the risk for developing pancreatic cancer? (select all that apply.) a. Obesity b. Jewish ethnicity c. Diabetes mellitus (DM) d. Hepatitis A e. Smoking
A,C,E
The nurse correctly recognizes that esophageal cancer is associated with which risk factor(s)? (select all that apply.) a. Cigarette smoking b. Diabetes c. Hypertension d. Heavy alcohol use e. Smokeless tobacco
A,D,E
The nurse caring for an 80-year-old woman who is undergoing the extensive bowel preparation for a colonoscopy. The nurse should most closely monitor the patient for which potential complication? a. Diarrhea b. Metabolic acidosis c. Fatigue d. Dyspnea
B
The nurse caring for the patient who is immediately postoperative with a new ileostomy. Which intervention is most important for the nurse to implement at this time? a. Change the ostomy pouch frequently. b. Provide emotional support. c. Administer a stool softener. d. Offer the patient frequent snacks.
B
A patient has reported to the clinic with concerns about contracting hepatitis A from her boyfriend. What response by the nurse is most appropriate? a. "If you are having unprotected sexual intercourse with your partner, there is a relatively high risk for hepatitis A." b. "Hepatitis A is not transmitted as a result of close contact with an infected individual." c. "Hepatitis A transmission is associated with contact with infected body fluids." d. "Hepatitis A is relatively uncommon in our country and seen more in underdeveloped countries."
B
The home health nurse is caring for the patient with tuberculosis who is taking rifampin and isoniazid (INH). The nurse should carefully monitor the patient for which potential side effect? a. Gallstones b. Liver disorders c. Bleeding ulcers d. Esophagitis
B
The nurse caring for a patient with acute pancreatitis assesses a bluish tinge around the patient's umbilicus. The nurse recognizes that this finding likely results from which underlying problem? a. Increased amylase b. Retroperitoneal hemorrhage. c. Inflammatory response to a pseudocyst d. Ascites
B
The nurse explains that a hernioplasty is a surgery that involves which process? a. Reducing the hernia by manual pressure. b. Sewing synthetic mesh over the abdominal wall defect to reduce the hernia. c. Applying an individualized truss for the reduction of the hernia. d. Reducing the hernia and suturing the defect in the abdominal wall.
B
The nurse explains to the patient receiving bevacizumab (Avastin) for a tumor in the colon that the drug slows cancer cell growth by which process? a. Changing the pH of the cell environment b. Reducing blood flow to the tumor c. Overhydrating cells of the tumor, causing them to burst d. Interfering with DNA of tumor cells
B
The nurse explains which advantage benefits patients with a Kock pouch ileostomy? a. The patient can expel feces from the rectum in the normal fashion. b. The patient does not have to wear a collection device. c. The patient only has to evacuate the pouch once a day. d. The patient can have the pouch reanastomosed to the colon at a later time.
B
The nurse is assessing a patient's bowel sounds. After auscultating each quadrant for 30 seconds, the nurse fails to hear any sounds. How should the nurse document this finding? a. Absent bowel sounds b. Hypoactive bowel sounds c. Active bowel sounds d. Hyperactive bowel sounds
B
The nurse is aware that an unresolved intestinal obstruction can lead to which complications? a. Systemic infection and fever b. Intestinal rupture and shock c. Adhesions and pain d. Bloating and expelling gas
B
The nurse is aware that patients who have chronic gastritis from renal failure may present with which first sign of this disorder? a. An increase in the white blood cell count b. Sudden massive hemorrhage c. Asthma-like symptoms d. Extreme dyspnea
B
The nurse is caring for a patient who has been diagnosed with Crohn disease. When providing education concerning dietary recommendations, which statement indicates that the nurse's teaching has been successful? a. "I should try to eat as much fiber daily as I can." b. "Reducing dietary fat and fiber will be helpful in managing my condition." c. "I should not have lactose-containing products." d. "Eating a larger breakfast and smaller lunch and dinner portions is recommended.
B
The nurse is caring for a patient who underwent a cholecystectomy 3 days ago. Which assessment finding best indicates to the nurse that the bile flow is no longer obstructed from entering the bowel? a. Excessive flatus b. Dark brown stool c. Dark urine d. Increased appetite
B
The nurse is caring for a patient with cirrhosis. The nurse is educating the patient about nutritional implications related to his diagnosis. Which statement indicates that the nurse's teaching has been successful? a. "I should eat lots of sweet potatoes and carrots for vitamin A." b. "I should choose proteins like cottage cheese and quinoa instead of chicken." c. "I should eat oysters and shellfish for a good source of copper." d. "I should eat red meat and dark, leafy vegetables to boost my iron stores
B
The nurse is caring for a patient with suspected dysphagia. Which action is most appropriate for the nurse to take? a. Encourage incentive spirometry use. b. Instruct the patient to take practice swallows before the meal. c. Encourage patient attempts to communicate, and pay attention to nonverbal cues. d. Encourage the patient to keep a food diary.
B
The nurse is caring for an older adult patient diagnosed with diverticulitis. Which medication is the best choice to manage the patient's pain? a. Meperidine (Demerol) b. Morphine c. Nalbuphine hydrochloride (Nubain) d. Naloxone (Narcan)
B
The nurse is discussing bariatric surgery complications with a patient. Which statement indicates that the patient accurately understands the nurse's teaching about common procedural side effects? a. "I understand that gastric ulcers frequently occur in patients who have bariatric surgery." b. "Gallstones are a common occurrence in patients who have bariatric surgery." c. "I know an umbilical hernia might happen after I have bariatric surgery." d. "Unfortunately, I may experience gastritis after having bariatric surgery.
B
The nurse is planning care for a patient who has experienced moderate diarrhea for 3 days. Which collaborative intervention is most important to include in the plan of care? a. Place the patient on NPO status. b. Limit the patient's diet to clear liquids. c. Administer parenteral nutrition. d. Restrict the patient's diet to soft foods only.
B
Which age-related change predisposes older adult patients to diverticula? a. Loss of bowel tone reduces motility. b. Chronic constipation increases intra-abdominal pressure and allows herniation. c. The diet may be deficient in bulk. d. Multipharmacy has altered bowel mucosa.
B
Before a nurse can document the presence of diarrhea, which criteria must be met? (select all that apply.) a. One loose stool in a 24-hour period b. Multiple liquid or semiliquid stools in a 24-hour period c. Hyperactive bowel sounds d. Cramping e. Fever
B,C,D
The nurse is planning skin care of the patient with ascites. Which actions should the nurse include? (select all that apply.) a. Bathe the patient in hot water. b. Apply emollients to decrease itching. c. Closely trim the patient's fingernails. d. Change the patient's position every 1 to 2 hours. e. Coach the patient in deep-breathing exercises.
B,C,D
The nurse is caring for a patient scheduled to have an MRI study. Which instruction(s) should the nurse include in the teaching? (select all that apply.) a. Radiation exposure is extremely minimal. b. All metal objects, including dental bridges, jewelry, and body piercings, must be removed. c. Do not eat or drink for 4 hours before the procedure. d. A radiopaque medium may be injected during the procedure. e. There may be a tingling sensation in metal alloy filling of the teeth.
B,D,E
A patient who had gastric bypass surgery 5 weeks ago calls the office to report feelings of nausea, sweating, and diarrhea shortly after eating meals. What response by the nurse is most appropriate? a. "This is common after the type of surgery you had." b. "How much, if any, alcohol do you consume each day?" c. "Avoid large meals, limit sweets, and drink small amounts of liquids between meals." d. "You may be experiencing a postoperative infection."
C
A patient with a gastrostomy tube gets a bolus feeding of 200 mL every 4 hours. Before giving the bolus, the nurse aspirates a residual of 100 mL. Which action is most appropriate? a. Give the 200 mL feeding. b. Record the residual and give 100 mL of the feeding. c. Document the residual and hold the feeding. d. Position the patient in high Fowler position and give the feeding.
C
The nurse caring for a patient admitted with peritonitis who has developed a paralytic ileus. While auscultating bowel sounds, the nurse assesses flatus. What is the significance of this finding? a. Gas has formed in bowel contents. b. Flatus results from forceful vomiting. c. Flatus indicates returning peristalsis. d. Flatus indicates inadequate decompression.
C
The nurse cautions that constant stress can cause which alteration to the gastrointestinal (GI) system? a. Slowed GI mobility resulting in constipation b. Reversed peristalsis resulting in projectile vomiting c. Increased digestive juices resulting in a gastric ulcer d. Decreased digestive juices resulting in ineffective metabolism
C
The nurse documenting the presence of pain in a patient with possible gastric ulcer would anticipate that the pain would occur at which time? a. In the morning b. Erratically, without pattern c. At bedtime d. With meals
C
The nurse is caring for a patient being treated for new onset of gallstones. The patient asks the nurse if he will have to have surgery. How should the nurse respond? a. "You will have to have surgery if you continue to have gallstones." b. "Tell me more about your concern." c. "Treatment for gallstones may include diet modification and weight loss, medications, or surgery." d. "You need to ask the doctor about your concerns."
C
The nurse is caring for a patient diagnosed with gallstones who requires a cholecystectomy. The patient is upset and asks the nurse why he cannot have lithotripsy instead. Which response is most appropriate for the nurse to make? a. "Is there a reason that you want to have lithotripsy?" b. "Your doctor decides which procedure will be best." c. "Gallstones are usually treated with surgery. Tell me more about your concerns." d. "I understand that you are upset. Would you like to speak with a chaplain?"
C
The nurse is caring for a patient who has been experiencing severe diarrhea and can now resume solid foods. The nurse educates the patient about appropriate food choices. Which food choice indicates that the nurse's teaching has been successful? a. Whole-grain rice b. Wheat toast c. Applesauce d. Grapes
C
The nurse is caring for a patient who is being treated for a gunshot wound to the abdomen. The patient is receiving total parenteral nutrition (TPN), and the physician has prescribed insulin coverage on a sliding scale. The patient reports he has never had diabetes before. What response is best for the nurse to make? a. "It is likely you have developed diabetes as a result of your illness." b. "Do you have a family history for diabetes?" c. "The TPN you are receiving has high amounts of glucose." d. "Insulin is needed to manage your stomach's inability to adequately metabolize food at this time."
C
The nurse is caring for a patient with a 4-day-old ileostomy. The patient complains of cramping, the nurse notes a drop in the effluent for the ileostomy, and the bowel sounds are rapid with a "tinkling" sound. What action should the nurse take? a. Ambulate the patient to help expel gas. b. Irrigate the ileostomy with 500 mL of warm water. c. Notify the charge nurse immediately. d. Turn the patient on the left side to help drain the ileostomy
C
The nurse is caring for a patient with a Salem sump tube for decompression. The patient displays dyspnea and reports feeling full and nauseated. What action should the nurse take first? a. Increase suction from low to high. b. Notify the charge nurse. c. Irrigate the tube with normal saline. d. Withdraw the tube about three inches.
C
The nurse is caring for a patient with a peptic ulcer. The patient also has a history of chronic bronchitis, diabetes, and arthritis. Which component of the patient's history is the most likely contributing factor to the patient's ulcer? a. The patient requires insulin to manage his diabetes. b. The patient uses a daily inhaler to decrease incidence of asthma attacks. c. The patient takes ibuprofen daily for arthritis pain. d. The patient takes a multivitamin daily
C
The nurse is caring for a patient with cholelithiasis who is scheduled to undergo a cholescintigraphy (HIDA scan). Which statement accurately describes the purpose of the HIDA scan? a. To visualize the location of gallstones b. To assess amounts of inflammation and swelling c. To diagnose abnormal contraction of the gallbladder d. To assess composition of gallstones
C
The nurse is caring for a patient with cirrhosis. Which assessment finding warrants the nurse's immediate attention? a. Shiny, tight abdomen b. Yellow sclera c. Confusion d. Paired horizontal bands on the fingernails
C
The nurse is educating a patient with Barrett esophagus. Which statement indicates that the patient requires a need for further instruction? a. "I should eat smaller meals and avoid foods that cause reflux." b. "I can still have a small glass of wine with dinner." c. "I should consider switching to smokeless tobacco." d. "I should stay upright after eating."
C
The nurse is educating a patient with diverticulitis. Which statement indicates that the nurse's teaching about the importance of seeking treatment has been successful? a. "If left untreated, the inflamed bowel could spread to the entire bowel." b. "If left untreated, the inflamed bowel could cause ulcers." c. "If left untreated, the inflamed bowel can perforate and cause peritonitis." d. "If left untreated, the inflamed bowel can cause appendicitis."
C
The physician has prescribed rifaximin (Xifaxan) for a patient with cirrhosis. The patient questions why he must take this medication. Which response by the nurse is most appropriate? a. Rifaximin (Xifaxan) helps prevent infection. b. Rifaximin (Xifaxan) helps reduce straining during a bowel movement. c. Rifaximin (Xifaxan) kills intestinal flora. d. Rifaximin (Xifaxan) aids in reducing ascites.
C
A 20-year-old college student who has not been immunized against hepatitis B virus (HBV) comes to the clinic and reports that he has been exposed to hepatitis B. The nurse anticipates that the health care provider will likely recommend which treatment? a. A prescription for a broad-spectrum antibiotic b. A prescription for an antiviral agent c. The first of the three immunizations for HBV d. An injection of hepatitis B immune globulin (HBIG)
D
A 36-year-old woman who had an ascending colostomy angrily declares, "I don't want this hateful thing on my body! This nasty thing is not me." Which response is most appropriate for the nurse to make? a. "The colostomy is part of you now." b. "Let me change the collection bag so you don't stay nasty." c. "All ostomates feel this way at first. I'll go get a list of support groups you may want to join." d. "What about this colostomy concerns you the most?"
D
The nurse explains that the diagnosis of morbidly obese is reserved for people who exceed which percentage of their recommended weight? a. 50% b. 70% c. 90% d. 100%
D
The nurse is caring for a patient 1-day postoperative after a transverse colostomy. When assessing the stoma, which finding requires the nurse's immediate action? a. A wet, glistening stoma b. A stoma with scant marginal bleeding c. An edematous stoma d. A purplish-red stoma
D
The nurse is caring for a patient admitted with suspected acute viral hepatitis. Which laboratory value would best support this diagnosis? a. Decreased aspartate aminotransferase (AST) b. Decreased alanine aminotransferase (ALT) c. Decreased gamma-glutamyl transpeptidase (GGT) d. Increased prothrombin time
D
The nurse is caring for a patient who is being treated for extensive burns. The nurse notes the presence of coffee-ground material in the Salem sump catheter. The nurse correctly recognizes which factor as the likely cause? a. Esophagitis b. Perforated gastric ulcer c. Gastric irritation from the Salem sump tube d. A physiologic stress ulcer
D
The nurse is caring for a patient whose home medications include bismuth subsalicylate (Pepto Bismol). The nurse should educate the patient about which side effect of this medication? a. Pink urine b. Sunburn-like rash c. Stained teeth d. Black stools
D
The nurse is caring for a patient with hepatitis. The nurse explains that jaundice occurs in conjunction with hepatitis based on which underlying pathophysiology? a. Liver ischemia in hepatitis causes jaundice. b. Increased bile production by the enlarged Kupffer cells causes jaundice. c. The hepatitis virus destroys red blood cells and causes jaundice. d. Hepatitis causes liver congestion that obstructs bile flow
D
The nurse is caring for multiple patients. The nurse determines that which patient has the highest risk for developing gallstones? a. A 37-year-old white man of normal weight on long-term corticosteroids for asthma. b. A 42-year-old African American man of normal weight who has smoked for 25 years. c. A 46-year-old Indonesian woman who is under normal weight and has recently had radiation treatments. d. A 50-year-old obese Mexican American woman who has type 1 diabetes.
D
The nurse is obtaining a history of a patient with hepatitis A. Which question is most appropriate for the nurse to ask? a. "If using drugs, do you share needles?" b. "Do you always practice safe sex?" c. "Have you traveled to Canada in the last month?" d. "Do you eat shellfish or oysters often?
D
The nurse is performing preprocedure teaching for a patient scheduled to undergo a liver biopsy. After listening to the information, the patient states, "I am so scared. I just don't know if I can do this procedure." Which response is best? a. "The procedure will only last about 15 minutes." b. "Most patients say it feels similar to a punch in the shoulder." c. "You do not have to have the procedure." d. "I understand that you are afraid. Tell me more about your concerns
D
The nurse is preparing a teaching plan for a patient with gastroesophageal reflux disease (GERD) who has been prescribed multi-drug therapy for treatment. Which information is most important for the nurse to obtain? a. "Can you identify triggers for your reflux?" b. "Can you commit to changing your diet?" c. "Do you understand how each type of medication works?" d. "Do you think you can afford these prescriptions?"
D
The nurse is preparing to administer liquid laxative to a patient in preparation for a colonoscopy. Which action should the nurse take? a. Offer a small snack. b. Take the patient's temperature. c. Mix the laxative with orange juice. d. Chill the laxative and pour it over ice
D
The nurse is providing discharge teaching for a patient who underwent a laparoscopic cholecystectomy. Which statement indicates that the nurse's teaching has been successful? a. "I should call my doctor if I have any pain." b. "I should be able to go back to work tomorrow." c. "I should avoid fatty foods for a few weeks." d. "I should let these Steri-Strips fall off on their own."
D
The nurse is reviewing a student nurse's charting and notes that the student has documented absent bowel sounds. The nurse reminds the student that in order to document absent bowel sounds, one must auscultate each quadrant at what period of time? a. 30 seconds b. 1 minute c. 2 minutes d. 5 minutes
D
The nurse reinforces that the immunization for HBV is believed to provide _____ immunity.
Lifelong Lifetime
The nurse cautions that increased morbidity from hypertension and cardiac disease, even in children, is related to the modifiable risk factor of __________.
Obesity
The nurse caring for the patient who has diarrhea from taking a protocol of oral amoxicillin will use __________ Precautions in the care
Standard
The nurse explains that bile salts deposited in the skin cause jaundice and also cause _____.
pruritus
The mechanical bowel obstruction caused when the bowel twists on itself is known as _________.
volvulus
