Med Surg I - Exam 3 All Sets

What to teach the 23 y/o diagnosed with lactose intolerance:

Live culture yogurt is usually tolerated

Peptic ulcer disease occurs most frequently in people with which blood type?

O

Esophageal diverticulum s/s

Regurgitation of undigested food

A client has been placed on prednisone therapy. The client asks the nurse if there are any adverse reactions that occur when taking the medication. What is the nurse's most appropriate response? a. Decreased appetite b. Sodium loss and constipation c. Hypotension d. Hyperglycemia and slowed healing

a. Decreased appetite

A nurse is monitoring a client with peptic ulcer disease. Which of the following assessment findings would most likely indicate perforation of the ulcer? Choose all that apply. a. Tachycardia b. Hypotension c. Mild epigastric pain d. A rigid, board-like abdomen e. Diarrhea

a. Tachycardia b. Hypotension d. A rigid, board-like abdomen

Which information obtained by the nurse interviewing a 30 y/o male patient is most important to communicate to the HCP? a. Hx of constipation b. Blood in stool c. Appendectomy at the age of 27 d. Smokes a pack/day of cigarettes

b. Blood in stool

Following the removal of an NG tube, the nurse should monitor the client for which possible adverse reaction?

Gastric distention

A patient's colorectal cancer has necessitated a hemicolectomy with the creation of a colostomy. In the 4 days since surgery, the patient has been unwilling to look at the ostomy or participate in any aspects of ostomy care. What is the nurse's most appropriate response to this observation? a. Ensure that the patient knows that he/she will be responsible for care after discharge b. Reassure the patient that many people are fearful after the creation of an ostomy c. Acknowledge the patient's reluctance and initiate discussion of the factors underlying it d. Arrange for the patient to be seen by a social worker or spiritual advisor

c. Acknowledge the patient's reluctance and initiate discussion of the factors underlying it

The nurse is evaluating a client's ulcer symptoms to differentiate ulcer as duodenal or gastric. Which symptom should the nurse attribute to a duodenal ulcer? a. Vomiting b. Hemorrhage c. Awakening in pain d. Weight loss

c. Awakening in pain Ingesting food will bring relief

A client just returned to the surgical unit after a gastric bypass. What action by the nurse is the priority? a. Assess the client's pain b. Check the surgical incision c. Ensure an adequate airway d. Program the morphine pump

c. Ensure an adequate airway

Which diagnostic test would be used to FIRST evaluate a client with upper GI bleeding? a. Upper GI series b. Endoscopy c. H/H levels d. Arteriography

c. H/H levels

A nurse is planning a discharge teaching for a 21 y/o patient with a new dx of ulcerative colitis. When planning family assessment, the nurse should recognize that which of the following factors will likely have the greatest impact on the patients coping after discharge? a. The family's ability to take care of the pt's special diet needs b. The family's ability to monitor the pt's changing health status c. The family's ability to provide emotional support d. The family's ability to manage the patient's medication regimen

c. The family's ability to provide emotional support

Which of the following diseases is suspected of having an autoimmune component? a. Celiac disease b. Crohn's disease c. Ulcerative colitis d. All of the above

d. All of the above

A client with Crohns disease has 10 stools in 24 hours. What is the priority for this client? a. Heart rate b. Urine output c. Blood pressure d. Electrolyte

d. Electrolytes

A patient has been diagnosed with a small bowel obstruction and has been admitted to the medical unit. The nurses care should prioritize which of the following outcomes? a. Preventing infection b. Maintaining skin and tissue integrity c. Preventing n/v d. Maintaining fluid and electrolyte balance

d. Maintaining fluid and electrolyte balance

What agent is used in ZES to decrease bleeding and decrease gastric acid secretions? a. Rantidine (Zantac) b. Omeprazole (Prilosec) c. Vasopressin (Pitressin) d. Octreotide (Sandostatin)

d. Octreotide (Sandostatin)

A nurse practitioner prescribes drug therapy for a patient with peptic ulcer disease. Choose the drug that can be used for 4 weeks and has a 90% chance of healing the ulcer: a. Ranitidine (Zantac) b. Cimetidine (Tagamet) c. Famotidine (Pepcid) d. Omeprazole (Prilosec)

d. Omeprazole (Prilosec)

A patient has been experiencing occasional episodes of constipation and has been unable to achieve consistent relief by increasing physical activity and improving his diet. What pharmacologic intervention should the nurse recommend to the patient for ongoing use? a. Mineral oil enemas b. Bisacodyl (dulcolax) c. Senna (senokot) d. Psyliium hydrophilic mucilloid (Metamucil)

d. Psyliium hydrophilic mucilloid (Metamucil)

The nurse is preparing to insert a NG tube into an adult client. Place the following steps in the correct order:

1. Place client in high fowlers position 2. Measure the intended length to insert the NG tube 3. Lubricate the tube tip with water-soluble lubricant 4. Direct the tube upward and backward along the floor of the nose 5. Instruct the client to place their chin to their chest 6. Advance the tube while the client swallows

A nurse is talking with a patient who is scheduled to have a hemicolectomy with the creation of a colostomy. The patient admits to being anxious, and has many questions concerning the surgery, the care of a stoma, and necessary lifestyle changes. Which of the following nursing actions is most appropriate? a. Reassure the patient that the procedure is relatively low risk and that patients are usually successful b. Provide the patient with educational materials that match the patient's learning style c. Encourage the patient to write down these concerns and questions to bring forward to the surgeon d. Maintain an open dialogue with the patient and facilitate a referral to the wound-ostomy-continence (WOC) nurse

d. Maintain an open dialogue with the patient and facilitate a referral to the wound-ostomy-continence (WOC) nurse

Which of the following represents the medication classification of a proton pump inhibitors? a. Famotidine (Pepcid) b. Metronidazole (Flagyl) c. Sucralfate (Carafate) d. Omeprazole (Prilosec)

d. Omeprazole (Prilosec)

A patient is in the hospital for the treatment of peptic ulcer disease. The nurse finds the patient vomiting and complaining of a sudden severe pain in the abdomen. The nurse then assesses a board-like abdomen. What does the nurse suspect these symptoms indicate? a. The treatment for the peptic ulcer is ineffective b. A reaction to the medication given for the ulcer c. Gastric penetration d. Perforation of the peptic ulcer

d. Perforation of the peptic ulcer

After several days of antibiotic therapy, an older hospitalized patient develops watery diarrhea. Which action should the nurse take first? a. Notify the HCP b. Obtain a stool specimen for analysis c. Teach the patient about handwashing d. Place the pt on contact precautions

d. Place the pt on contact precautions

A nurse is caring for an older adult who has been experiencing severe c. diff related diarrhea. When reviewing the patient's most recent lab tests, the nurse should prioritize which of the following? a. WBC b. Creatinine c. Hemoglobin d. Potassium

d. Potassium

A patients large bowel obstruction has failed to resolve spontaneously and the patients worsening condition has warranted admission to the medical unit. Which of the following aspects of nursing care is most appropriate for this patient? a. Administering bowel stimulants as ordered b. Administering bulk-forming laxatives as ordered c. Performing deep palpation as ordered to promote peristalsis d. Preparing the patient for surgical bowel resection

d. Preparing the patient for surgical bowel resection

A client is recovering from gastric surgery. Toward what goal should the nurse progress the client's enteral intake? a. Three meals and 120 mL fluid daily b. Three meals and three snacks and 120 mL fluid daily c. Six small meals and 120 mL fluid daily d. Six small meals daily with 120 mL fluid between meals

d. Six small meals daily with 120 mL fluid between meals

After vertical banded gastroplasty, a 42-year-old male patient returns to the surgical nursing unit with a nasogastric tube to low, intermittent suction and a patient-controlled analgesia (PCA) machine for pain control. Which nursing action should be included in the postoperative plan of care? a. Offer sips of fruit juices at frequent intervals b. Irrigate the nasogastric (NG) tube frequently c. Remind the patient that PCA use may slow the return of bowel function d. Support the surgical incision during patient coughing and turning in bed

d. Support the surgical incision during patient coughing and turning in bed

Which statement correctly identifies a difference between duodenal and gastric ulcers? a. Malignancy is associated with duodenal ulcers b. Weight gain may occur with a gastric ulcer c. A gastric ulcer is caused by hyper secretion of stomach acid d. Vomiting is uncommon in clients with duodenal ulcers

d. Vomiting is uncommon in clients with duodenal ulcers

Achalasia - Endoscopic procedures will be used for treatment Drink fluids with meals Keep head elevated after eating Semisoft diet recommended

failure of the lower esophagus sphincter muscle to relax

The nurse reviews dietary guidelines with a patient who had a gastric banding. Which of the following teaching points are included?

Do not eat and drink at the same time Drink plenty of water from 90 minutes after each meal to 15 minutes before each meal Avoid fruit drinks and soda

In what position would the nurse place the client prior to removing the NG tube?

In an upright position (high fowlers) with the nearest bedrail down

Rebleeding may occur from a peptic ulcer and often warrants surgical interventions. Signs of bleeding include which of the following? a. Mental confusion b. Bradycardia c. Bradypnea d. Hypertension

Mental confusion Also: tachycardia, tachypnea, hypotension, thirst, and oliguria

To monitor the effectiveness of aluminum hydroxide/magnesium hydroxide (Maalox) given via NG tube, the nurse will

Periodically aspirate and test the gastric pH It is an antacids whose purpose is to increase gastric pH

The nurse has begun inserting the NG tube when the client coughs. After assessing that the client can speak without difficult, what does the nurse do next?

Proceed with NG tube placement

If a perforated ulcer is suspected, the nurse should expect to

Provide IV fluids and insert an NG tube

A patient comes to the clinic with the complain "I think I have an ulcer". What is a characteristic associated with peptic ulcer pain that the nurse should inquire about? Select all that apply. a. Burning sensation localized in the back or mid-epigastrium b. Feeling of emptiness that precedes meals from 1-3 hours c. Severe gnawing pain that increases in severity as the day progresses d. Pain that radiates to the shoulder or jaw e. Vomiting without associated nausea

a. Burning sensation localized in the back or mid-epigastrium b. Feeling of emptiness that precedes meals from 1-3 hours c. Severe gnawing pain that increases in severity as the day progresses

A morbidly obese client asks the nurse if medications are available to assist with weight loss. The nurse knows that the client would not be a candidate for phentermine if the following is part of the client's health history? a. Coronary artery disease b. Diabetes c. Use of lithium d. Peptic ulcer disease

a. CAD

Inflammatory bowel disease (IBD) refers to which of the following diseases? Select all that apply. a. Crohn's disease b. Ulcerative colitis c. Gastritis d. Celiac disease

a. Crohn's disease b. Ulcerative colitis

A patient is complaining of diarrhea after having bariatric surgery. What nonpharmacologic treatment can the nurse suggest to decrease the incidence of diarrhea? a. Decrease the fat content in the diet b. Increase the fiber content in the diet c. Decrease the amount of fluid the patient is drinking d. Increase the protein content in the diet

a. Decrease the fat content in the diet

Which of the following appears to be a significant factor in the development of gastric cancer? a. Diet b. Age c. Ethnicity d. Gender

a. Diet

A nurse is administering phenytoin via a gastric tube to a patient who is receiving tube feedings. What would be an appropriate action of the nurse in this situation? a. Discontinue the tube feeding and leave the tube clamped for required period of time before and after med administration b. Notify the primary care provider that medication cannot be given to the patient at this time via the gastric tube c. Remove the tube in place and replace it with another tube prior to administering the medication d. Flush the tube with 60 mL of water prior to administering the medication

a. Discontinue the tube feeding and leave the tube clamped for required period of time before and after med administration

The nurse will be teaching self-management to patients after gastric bypass surgery. Which information will the nurse plan to include? a. Drink fluids between meals but not with meals. b. Choose high-fat foods for at least 30% of intake. c. Developing flabby skin can be prevented by exercise. d. Choose foods high in fiber to promote bowel function.

a. Drink fluids between meals but not with meals.

The nursing student approaches his instructor to discuss the POC for his client diagnosed with peptic ulcer disease. The student asks what is the most common site for peptic ulcer formation? The instructor would state which of the following? a. Duodenum b. Esophagus c. Pylorus d. Stomach

a. Duodenum

Suggestions for a clients who have recently had a gastric bypass include which of the following? a. Eat small amounts frequently b. Drink liquids with every feeding to wash the food down c. Follow a high-fiber diet d. Use drinking straws

a. Eat small amounts frequently

The nurse is talking with a group of nursing students about clients with GERD. The students ask what advice could be given to a client with GERD to aid in controlling symptoms. What advice would the nurse give? a. Eat small meals b. Lie down 30 mins after eating c. Drink fruit juices with meals d. Eat 30 mins before bedtime

a. Eat small meals

Which medication is classified as a histamine-2 receptor antagonist? a. Famotidine b. Lansoprazole c. Metronidazole d. Esomeprazole

a. Famotidine b and d are PPI c is abx

A 51 y/o woman with Crohn's disease who is taking infliximab (Remicade) calls the nurse in the outpatient clinic about new symptoms. Which symptom is most important to communicate to the HCP? a. Fever b. Nausea c. Joint pain d. Headache

a. Fever B/c infliximab is an immunosuppressant, rapid treatment of infection is essential

A nurse is caring for a patient who has a new diagnosis of GERD. The nurse should anticipate prescriptions for which of the following medications? Select all that apply. a. H2 receptor antagonist b. Proton pump inhibitor c. Opioid analgesic d. Fiber laxative

a. H2 receptor antagonist b. Proton pump inhibitor

The nurse is assessing a client with an ulcer for s/s of hemorrhage. The nurse interprets which condition as a s/s of possible hemorrhage? a. Hematemesis b. Bradycardia c. Hypertension d. Polyuria

a. Hematemesis

The nurse is cautiously assessing a client admitted with peptic ulcer disease because the most common complication that occurs in 10-20% of clients is: a. Hemorrhage b. Intractable ulcer c. Perforation d. Pyloric obstruction

a. Hemorrhage

A nurse is presenting an educational event to a local community group. When speaking about colorectal cancer, what risk factor should the nurse cite? a. High levels of alcohol consumption b. History of bowel obstruction c. History of diverticulitis d. Longstanding psychological stress

a. High levels of alcohol consumption

You're providing diet teaching to a patient with ulcerative colitis about what types of foods to avoid during a flare up. Which foods below should the patient avoid? Select all that apply. a. Ice cream b. White rice c. Fresh apples and pears d. Popcorn e. Cooked carrot

a. Ice cream c. Fresh apples and pears d. Popcorn

During assessment of a patient with gastritis, the NP attempts to distinguish acute from chronic pathology. One criteria, characteristic of the gastritis would be the: a. Immediacy of the occurrence b. Presence of vomiting c. Frequency of abdominal discomfort d. Incidence of anorexia

a. Immediacy of the occurrence

A client has been prescribed lorcaserin (Belviq). What teaching is most appropriate? a. Increase the fiber and water in your diet b. Reduce fat to less than 30% each day c. Report dry mouth and decreased sweating d. Lorcaserin may cause loose stools for a few days

a. Increase the fiber and water in your diet

A patient is admitted to the medical unit with a diagnosis of intestinal obstruction. When planning this patient's care, which of the following nursing diagnoses should the nurse prioritize? a. Ineffective tissue perfusion r/t bowel ischemia b. Imbalanced nutrition: less than body requirements r/t impaired absorption c. Anxiety r/t bowel obstruction and subsequent hospitalization d. Impaired skin integrity r/t bowel obstruction

a. Ineffective tissue perfusion r/t bowel ischemia

The client has been taking famotidine at home. The nurse prepares a teaching plan for the client indicating that the medications acts primarily to achieve which of the following? a. Inhibit gastric acid secretions b. Neutralize acid in the stomach c. Shorten the time required for digestion in the stomach d. Improve the mixing of foods and gastric secretions

a. Inhibit gastric acid secretions

A 35 y/o male patient presents at the ED with symptoms of a small bowel obstruction. In collaboration with the PCP, what intervention should the nurse prioritize? a. Insertion of a nasogastric tube b. Insertion of a central venous catheter c. Administration of a mineral oil enema d. Administration of a glycerin suppository and an oral laxative

a. Insertion of a nasogastric tube

A 66-year-old African-American client has recently visited a physician to confirm a dx of gastric cancer. The client has a hx of tobacco use and was diagnosed 10 years ago with pernicious anemia. He and his family are shocked about the possibility of cancer because he was asymptomatic prior to recent complaints of pain and multiple GI symptoms. On the basis of knowledge of disease progression, the nurse assumes that organs adjacent to the stomach may be affected. Which of the following organs may be affected? Select all that apply. a. Liver b. Pancras c. Bladder d. Duodenum e. Lungs

a. Liver b. Pancras d. Duodenum

Which information will the nurse include when teaching a patient how to avoid chronic constipation? SATA a. Many OTC meds can cause constipation b. Stimulant and saline laxatives can be used regularly c. Bulk-forming laxatives are an excellent source of fiber d. Walking or cycling frequently will help bowel motility e. A good time for a BM may be after breakfast

a. Many OTC meds can cause constipation c. Bulk-forming laxatives are an excellent source of fiber d. Walking or cycling frequently will help bowel motility e. A good time for a BM may be after breakfast

A 51 y/o male patient has a new diagnosis of Crohn's disease after having frequent diarrhea and a weight loss of 10 pounds over 2 months. The nurse will plan to teach about: a. Medication use b. Fluid restriction c. Enteral nutrition d. Activity restrictions

a. Medication use

A client undergoes total gastrectomy. Several hours later, the nurse notes that the client's NG tube has stopped draining. How should the nurse respond? a. Notify the HCP b. Reposition the tube c. Irrigate the tube d. Increase the suction level

a. Notify the HCP

Risk factors for the development of hiatal hernias are those that lead to increased abdominal pressure. Which of the following complications can caused increased abdominal pressure? a. Obesity b. Volvulus c. Constipation d. Intestinal obstruction

a. Obesity

A nurse is providing care for a patient who has a diagnosis of IBS. When planning this patient's care, the nurse should collaborate with the patient and prioritize what goal? a. Patient will accurately identify foods that trigger symptoms b. Patient will demonstrate appropriate care of his ileostomy c. Patient will demonstrate appropriate use of standard infection control precautions d. Patient will adhere to recommended guidelines for mobility and activity

a. Patient will accurately identify foods that trigger symptoms

A nurse is caring for a client who is undergoing a diagnostic workup for a suspected GI problem. The client reports gnawing epigastric pain following meals and heartburn. The nurse suspects the client has: a. Peptic ulcer disease b. Ulcerative colitis c. Appendicitis d. Diverticulitis

a. Peptic ulcer disease

Which of the following manifestations are associated with deficiency of vitamin B12? Select all that apply. a. Pernicious anemia b. Macrocytic anemia c. Thrombocytopenia d. Loss of hair e. Lethargy

a. Pernicious anemia b. Macrocytic anemia c. Thrombocytopenia

A female patient is awaiting surgery for acute peritonitis. What action will the nurse include in the plan of care? a. Position patient with the knees flexed b. Avoid use of opioids or sedatives c. Offer frequent small sips of clear liquids d. Assist patient to breathe deeply and cough

a. Position patient with the knees flexed This position helps with pain

Which of the following is the most successful treatment for gastric cancer? a. Removal of the tumor b. Chemotherapy c. Radiation d. Palliation

a. Removal of the tumor

A patient with ulcerative colitis is scheduled for ileoanal anastomosis (J-Pouch) surgery. You know that this procedure: a. Removes the colon and rectum which allows a pouch to be created that will attach to the ileum. This will allow stool to pass from the small intestine to the anus b. Removes the colon and rectum and creates a permanent ileostomy c. Removes the colon and creates a temporary colostomy d. Removes the rectum which allows a pouch to be created from the colon. This will allow still to pass from the colon to the anus

a. Removes the colon and rectum which allows a pouch to be created that will attach to the ileum. This will allow stool to pass from the small intestine to the anus

A teenage patient with a pilonidal cyst has been brought for care by her mother. The nurse who is contributing to the patient's care knows that treatment will be chosen based on what risk? a. Risk for infection b. Risk for bowel incontinence c. Risk for constipation d. Risk for impaired tissue perfusion

a. Risk for infection Pilondal cysts frequently develop into an abscess requiring surgical repair.

A client with peptic ulcer disease wants to know nonpharmacologic ways that he can prevent recurrence. Which of the following measures would the nurse recommend? Select all that apply. a. Smoking cessation b. Substitution of coffee with decaffeinated products c. Avoidance of alcohol d. Eating whenever hungry e. Following a regular schedule for rest, relaxation, and meals

a. Smoking cessation c. Avoidance of alcohol e. Following a regular schedule for rest, relaxation, and meals

Which is an accurate statement regarding gastric cancer? a. The incidence of stomach cancer continues to decrease in the US b. Most gastric cancer related deaths occur in people younger than 40 y/o c. Females have a higher incidence of gastric cancers than males d. A diet high in smoked foods and low in fruits and vegetables may decrease the risk of gastric cancer

a. The incidence of stomach cancer continues to decrease in the US

A nurse is providing care for a client recovering from gastric bypass surgery. During the assessment, the client exhibits pallor, perspiration, palpitations, headache, and feelings of warmth, dizziness, and drowsiness. The client reports eating 90 minutes ago. The nurse suspects: a. Vasomotor symptoms associated with dumping syndrome b. Dehiscence of the surgical wound c. Peritonitis d. A normal reaction to surgery

a. Vasomotor symptoms associated with dumping syndrome

The nurse is coaching a community group for individuals who are overweight. Which participant behavior is an example of the best exercise plan for weight loss? a. Walking for 40 minutes 6 or 7 days/week b. Lifting weights with friends 3x/week c. Playing soccer for an hour on the weekend d. Running for 10-15 minutes 3x/week

a. Walking for 40 minutes 6 or 7 days/week

A nurse is preparing to provide care for a patient whose exacerbation of ulcerative colitis has required hospital admission. During an exacerbation of this health problem, the nurse would anticipate that the patient's stools will have what characteristics? a. Watery with blood and mucus b. Hard and black or tarry c. Dry and streaked with blood d. Loose with visible fatty streaks

a. Watery with blood and mucus

A 40-year-old obese woman reports that she wants to lose weight. Which question should the nurse ask first? a. What factors led to your obesity? b. Which types of food do you like best? c. How long have you been overweight? d. What kind of activities do you enjoy?

a. What factors led to your obesity?

The nurse teaches the client with GERD about ways to minimize symptoms. Which of the following statements made by the client indicates that MORE teaching is needed? a. "I will be sure to drink tea instead of coffee" b. "I will take a walk after I eat" c. "I will try to eat smaller meals more frequently" d. "I will try to sleep with the head of the bed elevated about 12 inches"

b. "I will take a walk after I eat"

After bariatric surgery, a patient who is being discharged tells the nurse, "I prefer to be independent. I am not interested in any support groups." Which response by the nurse is best? a. "I hope you change your mind so that I can suggest a group for you" b. "Tell me what types of resources you think you might use after this surgery" c. "Support groups have been found to lead to more successful weight loss after surgery" d. "Because there are many lifestyle changes after surgery, we recommend support groups"

b. "Tell me what types of resources you think you might use after this surgery"

The nurse is caring for a patient who has been diagnosed with gastritis. To promote fluid balance when treating gastritis, the nurse knows that what minimal daily intake of fluids is required? a. 1.0 L b. 1.5 L c. 2.0 L d. 2.5 L

b. 1.5 L

A nursing student is preparing a teaching plan about peptic ulcer disease. The student knows to include teaching about the % of clients with peptic ulcers who experience bleeding. The % is: a. Less than 5% b. 15% c. 25% d. Greater than 50%

b. 15%

After the nurse teaches a patient about the recommended amounts of foods from animal and plant sources, which menu selections indicate that the initial instructions about diet have been understood? a. 3 oz of lean beef, 2 oz of low-fat cheese, and a tomato slice b. 3 oz of roasted pork, a cup of corn, and a cup of carrot sticks c. Cup of tossed salad and nonfat dressing topped with a chicken breast d. Half cup of tuna mixed with nonfat mayonnaise and a half cup of celery

b. 3 oz of roasted pork, a cup of corn, and a cup of carrot sticks Diet should be 2/3 plant source and 1/3 animal

After change of shift report, which patient should the nurse assess first? a. 40 y/o male with celiac disease who has frequent frothy diarrhea b. 30 y/o female with a femoral hernia who has abdominal pain and vomiting c. 30 y/o male with ulcerative colitis who has severe perianal skin breakdown d. 40 y/o female with a colostomy bag that is pulling away from the adhesive wafer

b. 30 y/o female with a femoral hernia who has abdominal pain and vomiting Suggests possible strangulation which would need emergency surgery

A nursing instructor is discussing hemorrhoids with the nursing class. Which patients would the nursing instructor identify as most likely to develop hemorrhoids? a. A 45 y/o teacher who stands for 6 hours/day b. A pregnant woman at 28 weeks gestation c. A 37 y/o construction worker who does heavy lifting d. A 60 y/o professional who is under stress

b. A pregnant woman at 28 weeks gestation

A client has a family history of stomach cancer. Which of the following factors would further increase the client's risk for developing gastric cancer? Select all that apply. a. High intake of fruits and vegetables b. Age 55 y/o c. Female gender d. Caucasian ancestry d. Previous infection with H. pylori

b. Age 55 y/o d. Previous infection with H. pylori

The nurse is assessing an 80 y/o client for s/s of gastric cancer. The nurse differentiates which as a s/s of gastric cancer in the geriatric client, but not in a client under the age of 75? a. Abdominal mass b. Agitation c. Hepatomegalia d. Ascites

b. Agitation

A patient has had an ileostomy created for the treatment of IBD and the patient is now preparing for discharge. What should the patient be taught about changing this device in the home setting? a. Apply antibiotic ointment as ordered after cleaning the stoma b. Apply a skin barrier to the peristomal skin prior to applying the pouch c. Dispose of the clamp with each bag use d. Cleanse the area surrounding the stoma with alcohol or chlorhexidine

b. Apply a skin barrier to the peristomal skin prior to applying the pouch

A 25 y/o male patient calls the clinic complaining of diarrhea for 24 hours. Which action should the nurse take first? a. Inform the patient that lab testing of blood and stools will be necessary b. Ask the patient to describe the character of the stools and any associated symptoms c. Suggest that the patient drink clear liquid fluids with electrolytes such as gatorade and pedialyte d. Advise the patient to use OTC loperamide to slow GI motility

b. Ask the patient to describe the character of the stools and any associated symptoms

Which nursing action is appropriate when coaching obese adults enrolled in a behavior modification program? a. Having the adults write down the caloric intake of each meal b. Asking the adults about situations that tend to increase appetite c. Suggesting that the adults plan rewards, such as sugarless candy, for achieving their goals d. Encouraging the adults to eat small amounts frequently rather than having scheduled meals

b. Asking the adults about situations that tend to increase appetite

An older adult who resides in a SNF has sought care from the nurses because of recurrent episodes of constipation. Which of the following actions should the nurse first perform? a. Encourage the patient to take stool softener daily b. Assess the patient's food and fluid intake c. Assess the patient's surgical history d. Encourage the patient to take fiber supplements

b. Assess the patient's food and fluid intake

A nurse is caring for a patient with constipation whose PCP has recommended Senna for the management of this condition. The nurse should provide which of the following education points? a. Limit your fluid intake temporarily so you don't get diarrhea b. Avoid taking the drug on a long term basis c. Make sure to take a multivitamin with each dose d. Take this on an empty stomach to ensure maximum effect

b. Avoid taking the drug on a long term basis

A client is awaiting bariatric surgery in the morning. What action by the nurse is most important? a. Answering questions the client has about surgery b. Beginning venous thromboembolism prophylaxis c. Informing the client that he or she will be out of bed tomorrow d. Teaching the client about needed dietary changes

b. Beginning venous thromboembolism prophylaxis

Which assessment action will help the nurse determine if an obese patient has metabolic syndrome? a. Take the patient's apical pulse b. Check the patient's BP c. Ask the patient about dietary intake d. Dipstick the patient's urine for protein

b. Check the patient's BP Elevated BP is one of the characteristics of metabolic syndrome

A patient admitted with acute diverticulitis has experienced a sudden increase in temperature and complains of a sudden onset of exquisite abdominal tenderness. The nurses rapid assessment reveals that the patient's abdomen is uncharacteristically rigid on palpation. What is the nurse's best response? a. Administer a fleet enema as ordered and remain with patient b. Contact the PCP promptly and report these signs of perforation c. Position the patient supine and insert an NG tube d. Page the PCP and report that the patient may be obstructed

b. Contact the PCP promptly and report these signs of perforation

Which ulcer is associated with extensive burn injury? a. Cushing ulcer b. Curling ulcer c. Peptic ulcer d. Duodenal ulcer

b. Curling ulcer Curling ulcers are usually observed about 72 hours after an extensive burn

The nurse is creating a discharge POC for a client with a peptic ulcer. The nurse tells the client to avoid: a. Acetaminophen b. Decaffeinated coffee c. Skim milk d. Octreotide

b. Decaffeinated coffee Decaff can still cause overstimulation of acid secretions

Symptoms associated with pyloric obstruction include all of the following except: a. Anorexia b. Diarrhea c. Nausea and vomiting d. Epigastric fullness

b. Diarrhea

A patient who had a Roux-en-Y bypass procedure for morbid obesity ate a chocolate chip cookie after a meal. After ingestion of the cookie, the patient complained of cramping pains, dizziness, and palpitation. After having a BM the symptoms resolved. What should the patient be educated about regarding this event? a. Gastric outlet obstruction b. Dumping syndrome c. Bile reflux d. Celiac disease

b. Dumping syndrome

A physician suspects that a client has peptic ulcer disease. With which of the following diagnostic procedures would the nurse most likely prepare to assist? a. Barium study of the upper GI tract b. Endoscopy c. Gastric secretion study d. Stool antigen test

b. Endoscopy

A nurse is providing care for a patient whose recent colostomy has contributed to a nursing diagnosis of disturbed body image r/t colostomy. What intervention best addresses this diagnosis? a. Encourage the patient to conduct online research into colostomies b. Engage the patient in the care of the ostomy to the extent that the patient is willing c. Emphasize the fact that the colostomy was needed to alleviate a much more serious health problem d. Emphasize the fact that the colostomy is a temporary measure and is not permanent

b. Engage the patient in the care of the ostomy to the extent that the patient is willing

The nurse is caring for a patient who is undergoing diagnostic testing for suspected malabsorption. When taking this patient's H&P, the nurse should recognize what finding as most consistent with this diagnosis? a. Recurrent constipation coupled with weight loss b. Foul-smelling diarrhea that contains fat c. Fever accompanied by a rigid, tender abdomen d. Bloody bowel movements accompanied by fecal incontinence

b. Foul-smelling diarrhea that contains fat Malabsorption hallmarks are diarrhea or frequent loose foul-smelling stools that have increased fat content and are often grayish (steatorrhea)

A patient with a diagnosis of colon cancer is 2 days post-op following bowel resection and anastomosis. The nurse has planned the patient's care in the knowledge of potential complications. What assessment should the nurse prioritize? a. Close monitoring of temperature b. Frequent abdominal auscultation c. Assessment of Hgb, Hct, and RBC levels d. Palpation of peripheral pulses and length girth

b. Frequent abdominal auscultation

The nurse is conducting a community education program on peptic ulcer disease prevention. The nurse includes that the most common cause of peptic ulcers is: a. Stress and anxiety b. Gram-negative bacteria c. Alcohol and tobacco d. Ibuprofen and aspirin

b. Gram-negative bacteria H. pylori

After teaching a client who has had a Roux-en-Y gastric bypass, which client statement indicates the need for additional teaching? a. I need to chew my food slowly and thoroughly b. I need to drink 8 ounces of water before eating c. A total serving should amount to be less than one cup d. I should pick cereals with less than 2g of fiber per serving

b. I need to drink 8 ounces of water before eating

A nurse performing discharge teaching with a client who had a total gastrectomy. Which statement indicates the need for further teaching? a. I'm going to visit my pastor weekly for awhile b. I will have to take vitamin B12 shots up to 1 year after surgery c. I will call my physician if I begin to have abdominal pain d. I will weigh myself each day and record the weight

b. I will have to take vitamin B12 shots up to 1 year after surgery

A mother is concerned for her 4 y/o daughter putting on too much weight. Which of the following are suggestions the nurse can make to help the mother? Select all that apply. a. Switch the child to a 1000-calorie diet b. Increase her activity level c. Switch to sugar-free soda d. Keep healthy snacks on hand e. Read labels to reduce sugar intake

b. Increase her activity level d. Keep healthy snacks on hand e. Read labels to reduce sugar intake

An adult patient has been diagnosed with diverticular disease after ongoing challenge with constipation. The patient will be treated on an outpatient basis. What components of treatment should the nurse anticipate. Select all that apply. a. Anticholinergic medications b. Increased fiber intake c. Enemas on alternating days d. Reduced fat intake e. Fluid reduction

b. Increased fiber intake d. Reduced fat intake

During a patient's scheduled home visit, an older adult patient has stated to the community health nurse that she has been experiencing hemorrhoids of increasing severity in recent months. The nurse should recommend which of the following? a. Regular application of an OTC antibiotic ointment b. Increased fluid and fiber intake c. Daily use of OTC glycerin suppositories d. Use of an NSAID to reduce inflammation

b. Increased fluid and fiber intake

Which information will the nurse prioritize in planning preoperative teaching for a patient undergoing Roux-en-Y gastric bypass? a. Educating the patient about the NG tube b. Instructing the patient on coughing and breathing techniques c. Discussing necessary postoperative modifications in lifestyle d. Demonstrating PROM exercises for the legs

b. Instructing the patient on coughing and breathing techniques

Which adult will the nurse plan to teach about risks associated with obesity? a. Man who has a BMI of 18 kg/m2 b. Man with a 42 in waist and 44 in hips c. Woman who has a body mass index (BMI) of 24 kg/m2 d. Woman with a waist circumference of 34 inches (86 cm)

b. Man with a 42 in waist and 44 in hips

A 74 y/o patient preparing to undergo a colon resection for cancer of the colon asks about the elevated carcinoembryonic antigen (CEA) test result. The nurse explains that the test is used to: a. Identify any metastasis of the cancer b. Monitor the tumor status after surgery c. Confirm the diagnosis of a specific type of cancer d. Determine the need for post-op chemotherapy

b. Monitor the tumor status after surgery

A nurse is teaching a client who has experienced an episode of acute gastritis and knows further education is necessary when the client makes the following statement: a. I should feel better in about 24-36 hours b. My appetite should come back by tomorrow c. I should limit my alcohol intake, at least until symptoms subside d. Once I can eat again, I should stick with bland foods

b. My appetite should come back by tomorrow The gastric mucosa can repair itself allowing the client to feel better in about 1 day, but the appetite can take 2-3 days to return

Which of the following medications used for obesity improves cardiovascular disease risk factors in obese patients with metabolic syndrome? a. Rimonabant (Acomplia) b. Orlistat (Xenical) c. Alli d. Sibutramine (Meridia)

b. Orlistat (Xenical)

A 58 y/o man with blunt abdominal trauma from a motor vehicle crash undergoes peritoneal lavage. If the lavage returns brown fecal drainage, which action will the nurse plan to take next? a. Auscultate the bowel sounds b. Prepare the patient for surgery c. Check the patient's oral temperature d. Obtain information about the accident

b. Prepare the patient for surgery Suggests perforation of the bowel and requires emergency surgery

The nurse advises the patient who has just been diagnosed with acute gastritis to: a. Take an emetic to rid the stomach of the irritating products b. Refrain from food until the GI symptoms subside c. Restrict food and fluids for 12 hours d. Restrict all food for 72 hours to rest the stomach

b. Refrain from food until the GI symptoms subside

A nurse caring for patient with a newly created ileostomy assesses the patient and notes that the patient has not had ostomy output for the past 12 hours. The patient also complains of worsening nausea. What is the nurse's priority action? a. Facilitate a referral to the wound-ostomy-continence (WOC) nurse b. Report signs and symptoms of obstruction to the physician c. Encourage the patient to mobilize in order to enhance motility d. Contact the physician and obtain a swab of the stoma for culture

b. Report signs and symptoms of obstruction to the physician

A 16 y/o presents at the ED complaining of right lower quadrant pain and is subsequently diagnosed with appendicitis. When planning this patient's nursing care, the nurse should prioritize what nursing diagnosis? a. Imbalanced nutrition: less than body requirements r/t decreased oral intake b. Risk for infection r/t possible rupture of appendix c. Constipation r/t decreased bowel motility and decreased fluid intake d. Chronic pain r/t appendicitis

b. Risk for infection r/t possible rupture of appendix

A new 19 y/o male patient has familial adenomatous polyposis (FAP). Which action will the nurse in the GI clinic include in the plan of care? a. Obtain blood samples for DNA analysis b. Schedule the patient for yearly colonoscopy c. Provide preoperative teaching about total colectomy d. Discuss lifestyle modifications to decrease risk of cancer

b. Schedule the patient for yearly colonoscopy

A nurse at an outpatient surgery center is caring for a patient who had a hemorrhoidectomy. What discharge education topics should the nurse address with this patient? a. The appropriate use of antibiotics to prevent postoperative infection b. The correct procedure for taking a sitz bath c. The need to eat a low-residue, low-fat diet for the next 2 weeks d. The correct technique for keeping the perianal region clean without the use of water

b. The correct procedure for taking a sitz bath

Which finding for a patient who has been taking orlistat (Xenical) is most important to report to the HCP? a. The patient frequently has liquid stools b. The patient is pale and has many bruises c. The patient complains of bloating after meals d. The patient is experiencing a weight loss plateau

b. The patient is pale and has many bruises

A nurse caring for a patient with colorectal cancer is preparing the patient for upcoming surgery. The nurse administers cephalexin (Keflex) to the patient and explains what rationale? a. To treat any undiagnosed infections b. To reduce intestinal bacteria levels c. To reduce bowel motility d. To reduce abdominal distention postoperatively

b. To reduce intestinal bacteria levels Cephalexin (Keflex) is an antibiotic

A patient admitted with inflammatory bowel disease asks the nurse for help with menu selections. What menu selection is most likely the best choice for this patient? a. Spinach b. Tofu c. Multigrain bagel d. Blueberries

b. Tofu IBD requires ingestion of low residue, high-protein, and high vitamin. Tofu meets all the requirements. The other options are not low-residue.

The nurse is caring for a client with chronic gastritis. The nurse monitors the client knowing that this client is at risk for which vitamin deficiency? a. Vitamin A b. Vitamin B12 c. Vitamin C d. Vitamin E

b. Vitamin B12

After a client received a diagnosis of gastric cancer, the surgical team decides that a billroth II would be the best approach to treatment. The nurse explains to the family that this procedure involves: a. Limited resection in the distal portion of the stomach and removal of about 25% of the stomach b. Wide resection of the middle and distal portions of the stomach with removal of about 75% of the stomach c. Proximal subtotal gastrectomy d. Total gastrectomy and esophagogastrectomy

b. Wide resection of the middle and distal portions of the stomach with removal of about 75% of the stomach

A few months after bariatric surgery, a 56-year-old man tells the nurse, "My skin is hanging in folds. I think I need cosmetic surgery." Which response by the nurse is most appropriate? a. "The important thing is that you are improving your health" b. "The skinfolds will disappear once most of the weight is lost" c. "Cosmetic surgery is a possibility once your weight has stabilized" d. "Perhaps you would like to talk to a counselor about your body image"

c. "Cosmetic surgery is a possibility once your weight has stabilized"

The client has IBS and asks the nurse what causes the disease. Which of the following responses by the nurse would be most appropriate? a. "This is an inflammation of the bowel caused by eating too much roughage" b. "IBS is caused by a stressful lifestyle" c. "The cause of IBS is unknown" d. "There is a thinning of the intestinal mucosa caused by the ingestion of gluten"

c. "The cause of IBS is unknown"

An 18 y/o patient is admitted with appendicitis. Which statement by the patient requires immediate nursing intervention? a. "The pain hurts so much it is making me nauseous" b. "I have no appetite" c. "The pain seems to be gone now" d. "If I position myself on my right side, it makes the pain less intense"

c. "The pain seems to be gone now" ?????

The nurse is educating a patient about the discharge medication. When should the nurse instruct the patient to take the antacid medication? a. With the meal b. 30 minutes before the meal c. 1-3 hours after the meal d. Immediately after the meal

c. 1-3 hours after the meal

A patients health history is suggestive of inflammatory bowel disease. Which of the following would suggest Crohns disease, rather that ulcerative colitis, as the cause of the patients signs and symptoms? a. A pattern of distinct exacerbations and remissions b. Severe diarrhea c. An absence of blood in stool d. Involvement of the rectal mucosa

c. An absence of blood in stool

Which would be most appropriate for the nurse to do when removing an NG tube? a. Ask the client to turn their head to the side with the chin tilted up b. Ask the client to take short shallow breaths and pull out the tube slowly and carefully c. Ask the client to take a deep breath and pull out the tube quickly and carefully

c. Ask the client to take a deep breath and pull out the tube quickly and carefully

After successfully losing 1 lb weekly for several months, a patient at the clinic has not lost any weight for the last month. The nurse should first: a. Review the diet and exercise guidelines with the patient b. Instruct the patient to weigh and record weights weekly c. Ask the patient whether there have been any changes in exercise or diet patterns d. Discuss the possibility that the patient has reached a temporary weight loss plateau

c. Ask the patient whether there have been any changes in exercise or diet patterns

A 61 y/o man is being admitted for bariatric surgery. Which nursing action can the nurse delegate to unlicensed assistive personnel (UAP)? a. Demonstrate use of the incentive spirometer b. Plan methods for bathing and turning the patient c. Assist with IV insertion by holding adipose tissue out of the way d. Develop strategies to provide privacy and decrease embarrassment

c. Assist with IV insertion by holding adipose tissue out of the way

The HCP prescribes a combination of three drugs to treat peptic ulcer disease. The nurse, preparing to review the drugs actions and side effects with the patient, understands that the triple combination should be in which order? a. Antibiotics, prostaglandin E1 analogs, and bismuth salts b. Proton pump inhibitors, prostaglandin E1 analogs, and bismuth salts c. Bismuth salts, antibiotics, and proton pump inhibitors d. Prostaglandin E1 analogs, antibiotics, and proton pump inhibitors

c. Bismuth salts, antibiotics, and proton pump inhibitors

A client is admitted to the health care facility with a diagnosis of a bleeding gastric ulcer. The nurse expects this client's stools to be: a. Coffee-ground like b. Clay colored c. Black and tarry d. Bright red

c. Black and tarry

A nurse is working with a patient who has chronic constipation. What should be included in patient teaching to promote normal bowel function? a. Use of glycerin suppositories on a regular basis b. Limit physical activity in order to promote bowel peristalsis c. Consume high-residue, high-fiber foods d. Resist the urge to defecate until the urge becomes intense

c. Consume high-residue, high-fiber foods

A nurse is assessing a patients stoma on post-op day 3. The nurse notes that the stoma has a shiny appearance and a bright red color. How should the nurse best respond to this assessment finding? a. Irrigate the stoma to clear a possible obstruction b. Contact the PCP to report this finding c. Document that the stoma appears healthy and well perfused d. Document a nursing diagnosis on impaired skin integrity

c. Document that the stoma appears healthy and well perfused

The nurse is caring for a 54 y/o female patient on the first postoperative day after a Roux-en-Y gastric bypass procedure. Which assessment finding should be reported immediately to the surgeon? a. Bilateral crackles audible in both lungs b. Redness, irritation, and skin breakdown in skin folds c. Emesis of bile-colored fluid past the NG tube d. Use of PCA several times an hour for pain

c. Emesis of bile-colored fluid past the NG tube Vomiting with an NG tube in place indicates the tube needs to be repositioned by the surgeon to avoid putting stress on the gastric sutures

If a client is overweight or obese, setting the goal of reaching the "ideal" weight may be very hard to accomplish. To achieve health benefits from weight loss, how much weight does an individual have to lose? a. Health benefits occur only when ideal body weight is achieved b. Health benefits do not always occur, even if weight loss is significant, if obesity is chronic c. Health benefits can be realized with only a modest weight loss d. Health benefits cannot be measured

c. Health benefits can be realized with only a modest weight loss

The nurse determines that teaching for the client with peptic ulcer disease has been effective when the client states: a. I should stop all my medications if I develop side effects b. I should continue my treatment regimen as long as I have pain c. I have learned some relaxation strategies that decrease my stress d. I can buy whatever antacids are on sale because they all have the same effect

c. I have learned some relaxation strategies that decrease my stress

A nurse is working with a patient who is learning to care for a continent ileostomy (Kock pouch). Following the initial period of healing, the nurse is teaching the patient how to independently empty the ileostomy. The nurse should teach the patient to do which of the following actions? a. Aim to eventually empty the pouch every 90 minutes b. Avoid emptying the pouch until it is visibly full c. Insert the catheter approximately 5 cm into the pouch d. Aspirate the content of the pouch using a 60 mL piston syringe

c. Insert the catheter approximately 5 cm into the pouch

The nurse is caring for a client who underwent a subtotal gastrectomy 36 hours ago. The client has an NG tube. The nurse knows to do the following with an NG: a. Apply suction to the NG tube every hour b. Clamp the NG tube if the client complains of nausea c. Irrigate the NG tube gently with NS if ordered d. Reposition the NG tube if pulled out

c. Irrigate the NG tube gently with NS if ordered

What information will the nurse include for an overweight 35 y/o woman who is starting a weight loss plan? a. Weight yourself at the same time every morning and evening b. Stick to a 600-800 calorie diet for the most rapid weight loss c. Low carb diets lead to rapid weight loss but are difficult to maintain d. Weighing all foods on a scale is necessary to choose appropriate portion sizes

c. Low carb diets lead to rapid weight loss but are difficult to maintain

Which documentation does the nurse complete after inserting an NG tube? a. Amount of time it took to complete the procedure b. Vital signs and bowel sounds c. Measurement of the exposed tube d. Number of attempts to pass the tubing through the nostril

c. Measurement of the exposed tube

Which of the following is a true statement regarding gastric cancer? a. Most cases are discovered prior to metastasis b. Women have a higher incidence of gastric cancer c. Most patients are asymptomatic during the early stage of the disease d. The prognosis for gastric cancer is good

c. Most patients are asymptomatic during the early stage of the disease Men have a higher incidence and the prognosis is poor/likely to have metastasized because it's found late

Which diet choice by the patient with an acute exacerbation of IBD indicates the need for more teaching? a. Scrambled eggs b. White toast with jam c. Oatmeal with cream d. Pancakes with syrup

c. Oatmeal with cream During acute exacerbations of IBD, patients should avoid high-fiber foods such as whole grains. Also high-fat foods and high-residue foods.

The nurse is teaching a client with peptic ulcer disease who has been prescribed misoprostol (Cytotec). What information from the nurse would be most accurate about misprostol? a. Works best when taken on an empty stomach b. Increases the speed of gastric emptying c. Prevents ulceration in clients taking NSAIDs d. Decreases mucous production

c. Prevents ulceration in clients taking NSAIDs

A 74 y/o male with an NG tube to suction complains of nausea and abdominal distention. The first action by the nurse should be to?

c. Reposition the tube and check for placement

Following insertion of an NG tube, the nurse needs to stabilize the tubing for the client. Which action is appropriate for the nurse to take? a. Attach the tubing to the bed linens with a rubber band and a safety pin b. Tape the tubing to the clients sleeve below shoulder level c. Secure the tubing with a safety pin to the clients gown at shoulder level d. Allow the tubing to hang freely to allow for freedom of movement

c. Secure the tubing with a safety pin to the clients gown at shoulder level

A HCP counsels a patient about bariatric surgery. He recommends the Roux-en-Y gastric bypass. The nurse explains to the patient that this procedure involves which of the following? a. Gastroplasty with a vertical band allowing for a pouch with a 15-20 mL capacity b. Biliopancreatic diversion with a duodenal switch c. Separation of the jejunum with an anastomosis d. Gastric banding that incorporates a prosthetic device to restrict oral intake

c. Separation of the jejunum with an anastomosis

Which of the following are characteristics associated with the Zollinger-Ellison syndrome (ZES)? Select all that apply. a. Constipation b. Hypocalcemia c. Severe peptic ulcers d. Extreme gastric hyperacidity e. Gastrin-secreting tumors of the pancreas

c. Severe peptic ulcers d. Extreme gastric hyperacidity e. Gastrin-secreting tumors of the pancreas

A client with a peptic ulcer is diagnosed with H. pylori infection. The nurse is teaching the client about the medications prescribed, including metronidazole (Flagyl), omeprazole (Prilosec), and clarithromycin (Biaxin). Which statement by the client indicates the best understanding of the medication regimen? a. My ulcer will heal because these medications will kill the bacteria b. I should take these medications only when I have pain from ulcer c. The medications will kill the bacteria and stop the acid production d. These medications will coat the ulcer and decrease the acid production in my stomach

c. The medications will kill the bacteria and stop the acid production

A patient's screening colonoscopy revealed the presence of numerous polyps in the large bowel. What principle should guide the subsequent treatment of this patient's health problem? a. Adherence to a high-fiber diet will help the polyps resolve b. The patient should be assured that these are a normal, age-related physiologic change c. The patient's polyps constitute a risk factor for cancer d. The presence of polyps is associated with an increased risk of bowel obstruction

c. The patient's polyps constitute a risk factor for cancer

An older adult has a diagnosis of Alzheimer's disease and has recently been experiencing fecal incontinence. However, the nurse has observed no recent change in the character of the patient's stools. What is the nurse's most appropriate intervention? a. Keep a food diary to determine the foods that exacerbate these symptoms b. Provide the patient with a bland, low-residue diet c. Toilet the patient on a frequent, scheduled basis d. Liaise with the PCP to obtain an order for loperamide

c. Toilet the patient on a frequent, scheduled basis

The nurse is administering a medication via an enteral feeding tube. Which are the accurate guidelines r/t this procedure? Select all that apply. a. Crush the enteric-coated pill for mixing in a liquid b. Flush open the tube with 60 mL of very warm water c. Use the recommended procedure for checking tube placement in the stomach or intestine d. Give each medication separately and flush with water between each drug e. Lower the head of the bed to prevent reflux f. Adjust the amount of water used if the patient's fluid intake is restricted

c. Use the recommended procedure for checking tube placement in the stomach or intestine d. Give each medication separately and flush with water between each drug f. Adjust the amount of water used if the patient's fluid intake is restricted

Which statement by the nurse inmost likely to help a morbidly obese 22 y/o man in losing weight on a 1,000 calorie diet? a. It will be necessary to change lifestyle habits permanently to maintain weight loss b. You will decrease your risk of future health problems such as diabetes by losing weight now c. You are likely to notice changes in how you feel with just a few weeks of diet and exercise d. Most of the weight that you lose during the first weeks of dieting is water weight

c. You are likely to notice changes in how you feel with just a few weeks of diet and exercise

A client scheduled for the removal of a nasogastric tube asks the nurse, "Will taking out the tube hurt?". What is the nurse's best response? a. Don't worry, Iv'e done this procedure many times and no one has complained of pain b. We will numb your throat prior to removal so you will not experience any pain c. You may experience minor discomfort as the tube is being removed d. We will give you pain medication since tube removal causes moderate pain

c. You may experience minor discomfort as the tube is being removed

A 42 y/o male patient has had a herniorrhaphy to repair and incarcerated inguinal hernia. What patient teaching should the nurse provide before discharge?

Apply a scrotal support and ice to reduce swelling

The nurse has just confirmed proper placement of a nasogastric tube. Which action should the nurse take next?

Apply skin barrier to the tip and end of the nose

The home health nurse is providing care to a client with a history of constipation. The healthcare provider prescribed psyllium mucilloid (Metamucil) for the client. After providing medication teaching for this client, which statement indicates the need for further education? a. "This medication is a lot more natural than other laxatives" b. "I may be able to stop my Lipitor with this medication" c. "This medication takes several days to work" d. "I don't need to drink extra fluids while I take this medication"

d. "I don't need to drink extra fluids while I take this medication"

Rigid fixation of a mandibular fracture would have discharge teaching about:

Avoiding chewing food for 1-4 weeks post-op

A nurse is teaching a group of middle-aged men about peptic ulcers. When discussing risk factors for peptic ulcers, the nurse should mention: a. Sedentary lifestyle and smoking b. History of hemorrhoids and smoking c. Alcohol abuse and a history of acute renal failure d. Alcohol abuse and smoking

d. Alcohol abuse and smoking

A 27 y/o female patient is admitted to the hospital for evaluation of right lower quadrant abdominal pain with nausea and vomiting. Which action should the nurse take? a. Encourage the patient to sip clear liquids b. Assess the abdomen for rebound tenderness c. Assist the patient to cough and deep breathe d. Apply an ice pack to the RLQ

d. Apply an ice pack to RLQ

When caring for a client with an acute exacerbation of a peptic ulcer, the nurse finds the client doubled up in bed with severe pain to his right shoulder. The initial appropriate action by the nurse is to: a. Notify the HCP b. Irrigate the client's NG tube c. Place the client in high-fowlers position d. Assess the client's abdomen and vital signs

d. Assess the client's abdomen and vital signs

A nurse is teaching a group of adults about screening and prevention of colorectal cancer. The nurse should describe which of the following as the most common sign of possible colon cancer? a. Development of new hemorrhoids b. Abdominal bloating and flank pain c. Unexplained weight gain d. Change in bowel habits

d. Change in bowel habits Second most common is passage of blood

The HCP has written a prescription for a client's NG tube to be removed. What should the nurse do first? a. Remove the tube from the client's gown b. Take off the adhesive tape from the client's nose c. Separate the NG tube from the suction tubing d. Discontinue the suction

d. Discontinue the suction

A patient has been experiencing disconcerting GI symptoms that have been worsening in severity. Following medical assessment, the patient has been diagnosed with lactose intolerance. The nurse should recognize an increased need for what form of health promotion? a. Annual screening colonoscopies b. Adherence to recommended immunization schedules c. Regular BP monitoring d. Frequent screening for osteoporosis

d. Frequent screening for osteoporosis

A nurse is assessing a client who has recently had bowel surgery and will be receiving an NG tube. Which finding would most likely contraindicate placement of the tube? a. One are being less patent than the other b. Abdominal distention c. Bleeding in the gastrointestinal tract d. Hx of facial fractures

d. Hx of facial fractures These patients present a higher risk of the tube being misplaced in the brain

A client with diverticular disease should avoid which of the following: a. Pasta b. Popcorn c. BBQ chips d. Ice cream

d. Ice cream Avoid foods high in FODMAP such as onions, mushrooms, garlic, and dairy products (ice cream, yogurt, milk, cheese)

Which of the following is the most plausible nursing diagnosis for a patient whose treatment for colon cancer has necessitated a colonostomy? a. Risk for unstable blood glucose d/t changes in digestion and absorption b. Unilateral neglect r/t decreased physical mobility c. Risk for excess fluid volume r/t dietary changes and changes in absorption d. Ineffective sexuality patterns r/t changes in self-concept

d. Ineffective sexuality patterns r/t changes in self-concept

Which is a true statement regarding the nursing considerations in administration of metronidazole? a. It may cause weight gain b. The drug should be given before meals c. Metronidazole decreases the effect of warfarin d. It leaves a metallic taste in the mouth

d. It leaves a metallic taste in the mouth

What individual faces the highest risk for parotitis?

An older adult whose medication regimen includes an anticholinergic

A client weighs 215 lbs and is 5' 8" tall. The nurse would calculate this client's body mass index (BMI) as which of the following?

215lb/62in * 703 = 32.7

What factor would contribute to the development of a client's hiatal hernia?

Being 5'3 and weighing 190lbs (obesity)

Morbid obesity is defined as being how many pounds over the person's ideal body weight? a. 100 b. 90 c. 75 d. 59

a. 100

The nurse, removing an NG tube from a client, flushes the NG tube prior to removing it. Which would be most appropriate for the nurse to do?

30-50 ml of air to flush out the tube or 10 ml of water or saline solution depending on hospital policy

The average daily ileostomy drainage is about:

500 mL or 2 cups

A patient is scheduled for a billroth I procedure for ulcer management. What does the nurse understand will occur when this procedure is performed?

A partial gastrectomy is performed with anastomosis of the stomach segment to the duodenum

The nurse admitting a patient with acute diverticulitis explains that the initial plan of care is to:

Administer IV fluids Pt will be NPO and given parenteral fluids

A patient with diverticulosis has a large bowel obstruction. The nurse will monitor for:

Abdominal distention

What criteria would be used to detmeurine whether or not the NG tube could be taken out?

Client's appetite returned, bowel sounds returned, and passing flatus

A client admitted for treatment of a gastric ulcer is being prepared for discharge. The client will follow a regimen of antacid therapy. Discharge teaching should include which instructions?

Continue to take antacids even if your symptoms subside You may be prescribed H2-receptor antagonists for up to 1 year

Ecchymosis around the umbilicus is what sign?

Cullen

A client is prescribed tetracycline to treat peptic ulcer disease. Which of the following instructions would the nurse give the client? a. Be sure to wear sunscreen while taking this medication b. Do not drive when taking this medication c. Expect a metallic taste when taking this medication d. Take the medication with milk

a. Be sure to wear sunscreen while taking this medication This also applies to sulfasalazine (azulfidine) for UC

When teaching a patient about testing to diagnose metabolic syndrome, which topic would the nurse include? a. Blood glucose test b. Cardiac enzyme tests c. Postural blood pressures d. Resting ECG

a. Blood glucose test

The nurse is slowly advancing a nasogastric (NG) tube when the client begins to gasp and is unable to vocalize. What has likely occurred?

The NG tube is in the client's airway

Pre-op teaching for a 61 y/o male scheduled for an abdominal perineal resection should include:

The patient will drink golytely preoperatively

Which information will the nurse include in teaching a patient who had a proctocolectomy and ileostomy for ulcerative colitis?

Use care when eating high-fiber foods to avoid obstruction of the ileum

After putting on gloves, the nurse lubricates the NG tube prior to insertion into the client's nares. Which lubricant is appropriate to use?

Water soluble lubricant

After measuring from the client's nostril to the ear lobe, how does the nurse continue to measure the length of the NG tube to be inserted for a client?

Xiphoid process

A patient is newly diagnosed with mild ulcerative colitis. What type of anti-inflammatory medication is typically prescribed as first-line treatment for this condition? a. 5-Aminosalicylates (Sulfasalazine) b. Immunomodulators (Adalimumab) c. Corticosteroids (Prednisone) d. Immunosuppressors (Azathioprine)

a. 5-Aminosalicylates (Sulfasalazine)

Which of the following clients is at highest risk for peptic ulcer disease? a. A 52 y/o male accountant b. A 19 y/o female college student c. A 72 y/o grandfather of four d. A 31 y/o pregnant woman

a. A 52 y/o male accountant Most common in people 40-60 y/o. Mostly men

A client reports to the clinic that she rapidly developed headache, abdominal pain, nausea, hiccuping, and fatigue about 2 hours ago. For dinner, she ate buffalo chicken wings and beer. Which of the following medical conditions is most consistent with the client's presenting problems? a. Acute gastritis b. Duodenal ulcer c. Gastric cancer e. Gastric ulcer

a. Acute gastritis

A nurse is caring for a patient who has been admitted to the hospital with diverticulitis. Which of the following nursing diagnoses would be appropriate for this patient? Select all that apply. a. Acute pain r/t increased peristalsis and GI inflammation b. Activity intolerance r/t generalized weakness c. Bowel incontinence r/t increased intestinal peristalsis d. Deficient fluid volume r/t anorexia, nausea, and diarrhea e. Impaired urinary elimination r/t GI pressure on the bladder

a. Acute pain r/t increased peristalsis and GI inflammation b. Activity intolerance r/t generalized weakness d. Deficient fluid volume r/t anorexia, nausea, and diarrhea

A nurse is caring for a patient admitted with symptoms of an anorectal infection; cultures indicate that the patient has a viral infection. The nurse should anticipate the administration of what drug? a. Acyclovir (Zovirax) b. Doxycycline (Vibramycin) c. Penicillin d. Metronidazole (Flagyl)

a. Acyclovir (Zovirax) The other three are for bacterial infections

The nurse practitioner suspects that a patient may have a gastric ulcer after completing H&P exam. Select an indicator that can be used to help diagnose this: a. Amount of HCL secretion in the stomach b. Sensitivity to NSAIDS c. Presence of H. pylori d. Patient's age

a. Amount of HCL secretion in the stomach

The nurse is providing care for a patient whose inflammatory bowel disease has necessitated hospital treatment. Which of the following would most likely be included in the patient's medication regimen? a. Anticholinergic medications 30 mins before a meal b. Antiemetics on a PRN basis c. Vitamin B12 injections to prevent pernicious anemia d. Beta adrenergic blockers to reduce bowel motility

a. Anticholinergic medications 30 mins before a meal

A client is in the bariatric clinic 1 month after having gastric bypass surgery. The client is crying and says "I didn't know it would be this hard to live like this." What response by the nurse is best? a. Assess the client's coping and support systems b. Inform the client that things will get easier c. Re-educate the client on needed dietary changes d. Tell the client lifestyle changes are always hard

a. Assess the client's coping and support systems

A physician has written an order for ranitidine (Zantac) once daily. The nurse schedules the medications for which of the following times? a. At bed time b. After lunch c. With supper d. Before breakfast

a. At bed time