Med. Surg. Exam #1 (EAQ questions)

which rationale explains why the nurse also monitors a client with a history of GERD for clinical manifestations of heart disease?

esophageal pain may imitate symptoms of a heart attack

an older client's colonoscopy reveals the presence of extensive diverticulosis. Which type of diet would the nurse encourage the client to follow?

high fiber

a client experiencing an exacerbation of ulcerative colitis. A low-residue, high-protein diet and IV fluids with vitamins have been prescribed. When implementing these prescriptions, which goal is the nurse trying to achieve?

reduce colonic irritation

The nurse is caring for a client with cholelithiasis. Which clinical manifestation would the nurse expect if the client develops obstructive jaundice?

yellow sclera

a health care provider schedules a paracentesis for a client with ascites. Which would the nurse include in the client's teaching plan?

emptying bladder immediately before procedure

which reported clinical manifestations would the nurse expect from a client with ulcerative colitis?

fever diarrhea abdominal cramps

the nurse is eliciting a health history from a client with ulcerative colitis. Which factor would the nurse consider to be the most likely associated with the client's colitis?

genetic predisposition

which assessment parameter is used to determine the severity of blood loss in a client with an Upper GI bleed?

hematocrit Hgb platelet count O2 sat. BUN

The nurse is caring for a client who underwent a Whipple procedure regarding early signs of dumping syndrome. What information would the nurse include?

pallor sweating tachycardia

a client, readmitted for exacerbation of ulcer colitis, is weak, thin, and irritable. The client states, "I am now ready for surgery to create a ileostomy." Which nursing intervention best meets the client's needs at this time?

parentally replace the client's fluids and electrolytes

A client with an acute attack of cholecystitis has a cholecystectomy with a choledochotomy. The client returns from surgery with a T-tube connected to a drainage bag. What would the nurse conclude is the purpose of the T-tube?

permit drainage of bile

a client is admitted to the hospital with a history of cancer of the liver and jaundice. In relation to the jaundice, which symptom does the nurse expect the client to report?

pruritus

After a Billroth I, the client begins eating a variety of textured foods and forms. After meals, the client reports cramping discomfort, rapid pulse, and waves of weakness, often followed by N/V. Which physiological response does the nurse suspect occurs after the client eats?

quick passage of hyperosmolar food solution into the small intestine

the nurse is caring for a client with a bowel obstruction. Which assessment findings indicate the possible onset of peritonitis?

rebound tenderness diminished bowel sounds rigid, boardlike abdomen

the nurse is caring for a client with GERD. Which information would the nurse provide the client to prevent worsening of the disorder?

wear loose-fitting clothing begin weight-loss program sleep with HOB elevated

a client is admitted to the hospital with a diagnosis of peptic ulcer. Which common complication would the nurse assess for in this client?

hemorrhage

For which clinical indicator associated with a complication of portal hypertension should the nurse assess the client?

hemorrhage from varices

A client has a paracentesis, and the health care provider removes 1500 mL of fluid. The nurse would monitor the client for which reaction?

hypovolemic shock

discharging planning for a client with chronic pancreatitis includes dietary education. Which client statement indicates the nurse that further teaching is needed?

i can eat foods high in fat now that the acute stage is over

a client with a long history of alcohol abuse develops cirrhosis of the liver. The client exhibits the presence of ascites. Which would the nurse conclude is the most likely cause of the client's ascites?

impaired portal venous return

which finding is an indication of ulcer perforation in a client with PUD?

tachycardia hypotension rigid abdomen N/V back and shoulder pain

the nurse reviews the lab results of a client with acute pancreatitis. Which test is significant in determining the client's response to treatment?

amylase level

The nurse is caring for a client with a hiatal hernia. The client states that favorite beverages include ginger ale, apple juice, OJ, and cola beverages. Of the four the client listed, which is the only beverage that should remain in the client's diet?

apple juice

The nurse is caring for a client who is having difficulty digesting fatty foods. To which deficiency would the nurse attribute this problem?

bile

which clinical indicator would the nurse review before scheduling a client for an endoscopic retrograde cholangiopancreatography (ERCP)?

bilirubin level

a client with a history of recurrent cholecystitis is scheduled for an abdominal cholecystectomy. Which would the nurse specifically emphasize when planning preoperative teaching for this client?

coughing and deep breathing

a client is hospitalized with acute pancreatitis. Which would be included in the client's plan of care?

use IV fluids

A client with a history of varices develops severe hematemesis, and insertion of a Sengstaken-Blakemore tube has been scheduled. Which information about the design and purpose of the tube would the nurse provide to the client?

triple-lumen to compress the esophagus

the nurse is taking care of a client with cirrhosis of the liver. Which clinical manifestations would the nurse assess in this client?

ascites pruritus jaundice

when assessing a client's abdomen, the nurse palpates directly above the umbilicus. This location is known as which area?

epigastric area

A client has been diagnosed with cholelithiasis. Which fact about the condition would the nurse recall when assessing this client for risk factors?

individuals who are obese are more prone to this condition than those who are thin

a client with a long history of alcohol abuse is admitted to the hospital with ascites and jaundice. A diagnosis of hepatic cirrhosis is made. Which is a nursing priority?

institution of fall prevention and safety measures

a client with pancreatic cancer has a whipple procedure. The nurse expects that the client will have which type of tube after the surgery?

NG

The nurse teaches a client about limiting the discomfort associated with hiatal hernia. Which statement by the client indicates the nurse's teaching is effective?

after meals, I will rest in a sitting position for 1 hour

The nurse is caring for a client with a diagnosis of acute pancreatitis and alcoholism. The client asks "how does my drinking relate to my diagnosis?" Which effect of alcohol would the nurse include when responding?

it increased enzyme secretion and pancreatic duct pressure that causes backflow of enzymes into the pancreas

After a total subtotal gastrectomy for cancer of the stomach, a client develops dumping syndrome. The client asks the nurse, "what does that mean?" How would the nurse explain dumping syndrome?

it is a rapid passage of concentrated fluid into the small intestine

A client is admitted with the diagnosis of pancreatitis. Which clinical manifestations would the nurse assess in the client?

jaundice acute pain increased amylase

A client is admitted to the hospital with a diagnosis of Crohn's disease. Which is important for the nurse to include in the teaching plan for this client?

meeting nutritional needs

a client with severe Crohn's disease develops a small bowel obstruction. Which clinical finding would the nurse expect the client to report?

projectile vomiting

a client with hepatic cirrhosis begins to exhibit slurred speech, confusion, drowsiness, and a flapping tremor. Based upon this assessment, which prescribed diet would the nurse anticipate?

moderate protein

the nurse is caring for a client with a hiatal hernia. Which risk factor would the nurse assess for in this client?

obesity

The serum ammonia levels of a client with hepatic cirrhosis and ascites is elevated. Which is an important nursing intervention?

observe the client for increasing confusion

the nurse is performing a health history and physical assessment for a client with cholelithiasis and obstructive jaundice. What clinical finding would the nurse expect the client to exhibit?

pain in the RUQ

which dietary selections made by the client indicate an understanding of previously taught dietary principles associated with having viral hepatitis?

salad, sliced chicken sandwich, gelatin dessert

a client is scheduled for a cholecystectomy and asks the primary nurse about the function of the gallbladder. Which explanation would the nurse give?

stores and concentrates bile

a client with Crohn's disease is admitted to the hospital with abdominal pain, fever, poor skin turgor, and having experienced 10 liquid bowel movements in the past 24 hours. The nurse suspects that the client is dehydrated based on which assessment findings?

sunken eyes dry mucous membrane

Which pain-related clinical manifestation would the nurse expect in a client who had received a diagnosis of a peptic ulcer?

the pain occurs 1-2 hours after having a meal

A client is admitted to the hospital with Laennec cirrhosis and chronic pancreatitis. Bile salts are prescribed, and the client asks why they are needed. How would the nurse respond?

they aid in the absorption of fat-soluble vitamins

the nurse is reviewing the laboratory results of and collecting a health history from a client with a diagnosis of colitis. Which common manifestation of colitis would the nurse expect?

weight loss

A client is admitted via the ED with tentative diagnosis of diverticulitis. The nurse anticipates that which test will be prescribed?

CT scan

the nurse educator of a college health course is discussing tattoos with the class. Which type of hepatitis associated with tattoos would the nurse include in the teaching plan?

Hep C

A client with jaundice associated with hepatitis expresses concern over the change in skin color. The nurse explains that this color change is a result of

Inability of the liver to remove normal amounts of bilirubin from the blood

A client is a candidate for intubation as a result of bleeding esophageal varices. Which type of tube should the nurse anticipate will most likely be used to meet the needs of this client?

Sengstaken-Blakemore

Which pain descriptions would the nurse expect a client to report when describing pain associated with a suspected duodenal peptic ulcer?

a gnawing sensation of epigastric pain

a client is diagnosed with chronic pancreatitis. Which dietary instruction in important for the nurse to share with the client?

avoid ingesting alcoholic beverages

what instruction would the nurse provide the client prescribed a gastrointestinal endoscopy with a capsule endoscopic device?

avoid stooping and bending during the test

the nurse instructing a client with PUD about the diet that should be followed during the acute phase. What type of diet should the nurse stress?

bland foods

which color stool of a client have when experiencing cancer of the pancreas head, weight loss, severe epigastric pain, and jaundice?

clay-colored

a client is admitted to the hospital for a laparoscopic cholecystectomy. To monitor the flow of bile to the GI tract, which symptom would the nurse assess?

color of stool

assessment findings of a client who is admitted to the ED include cramping pain in the LLQ, weakness, bloating, malaise, and a low-grade fever. The nurse suspects which condition?

diverticulitis

A client who is obese is diagnosed with a hiatal hernia. The nurse provides teaching about how to prevent esophageal reflux and should include what instruction?

eat less food at each meal

which recommendation would the nurse provide to a client with GERD who asks how to reduce heartburn and pain without taking medication?

elevate the HOB 5 inches