NHI Test #6 GI
The nurse is caring for the patient following abdominal surgery. Which symptom, if demonstrated by the patient, indicates the development of peritonitis? A. Fever B. Projectile vomiting C. Severe abdominal pain D. Anorexia with weight loss
C. Severe abdominal pain
A magnetic resonance imaging (MRI) test is scheduled. What should be included in the information provided to the patient? A .The test will take approximately 60 minutes. B. The patient will have an intravenous (IV) line started prior to the test. C. Solid foods are restricted for 6 to 8 hours prior to the test. D. There is only a limited amount of radiation exposure associated with the test.
A .The test will take approximately 60 minutes.
Which statement made by a patient might indicate a precipitating factor of acute gastritis? A. "I really like tequila." B. "I never touch alcohol." C. "I just started a new diet." D. "I try to get in a 2-mile walk every day."
A. "I really like tequila."
The nurse is reviewing the chart of a patient who recently underwent a total gastrectomy and notes the patient is receiving total parenteral nutrition (TPN). The nurse understands which information about TPN? A. A form of intravenous (IV) feeding B. A type of intestinal decompression C. A new method of tube-feeding a patient with dysphagia D. A method of feeding a patient through a tube inserted through an incision in the stomach
A. A form of intravenous (IV) feeding
The nurse is reviewing the prescriptions of a client admitted to the hospital with a diagnosis of acute pancreatitis. Which interventions should the nurse expect to note? select all that apply A. Administer antacids and prescribed B. encourage small, frequent, high calorie feedings C. Encourage coughing and deep breathing D. Administer anticholinergics as prescribed E. Maintain the client in a supine and flat position
A. Administer antacids and prescribed C. Encourage coughing and deep breathing D. Administer anticholinergics as prescribed
What are the three most common symptoms of cancer of the pancreas? A. Dark urine, jaundice, and weight loss B. Jaundice, abdominal distention, and edema C. Dark stools, food intolerance, and weight loss D. Pruritus, right upper quadrant pain, and weight gain
A. Dark urine, jaundice, and weight loss
The nurse is reviewing the record of a client with Crohns Disease. Which stool characteristic the nurse expect to see documented in the record? A. Diarrhea B. Constipation C. Bloody Stools D. Stool constantly oozing from rectum
A. Diarrhea
A 57-year-old man is admitted with a diagnosis of cirrhosis. The nurse is aware that he will most likely require which intervention(s)? (Select all that apply.) A. Diuretics B. Increased fluids C. Bleeding precautions D. Vegetable-based proteins E. Lactulose administration
A. Diuretics C. Bleeding precautions D. Vegetable-based proteins E. Lactulose administration
The nurse is caring for a patient 24 hours after the surgical insertion of a T-tube for a common bile duct obstruction. After assisting the patient to the restroom, the nurse notes that the patient's stool is soft, formed, and brown. What should the nurse do first? A. Document the assessment. B. Stat-page the health care provider. C. Request to administer a Fleet enema. D. Encourage the patient to ambulate frequently
A. Document the assessment.
The patient presents to the clinic complaining of constipation, abdominal pain, and mucous in her stool. The patient states, "I have the same stomach problems my mom had when she was my age. It's always worse after I eat ice cream, so I try to avoid that. I only drink water because I'm on my feet all day. I'm a teacher, so my job can be very stressful at times. I've tried stool softeners and laxatives that help sometimes, but my stomach only feels better after I stool." The nurse suspects irritable bowel syndrome (IBS) due to the patient having which triggers? (Select all that apply.) A. Family history B. Female gender C. Dairy sensitivity D. Stressful lifestyle E. Frequent laxative use F. Lack of caffeine in the diet
A. Family history B. Female gender C. Dairy sensitivity D. Stressful lifestyle
The patient in the clinic has recently been diagnosed with viral hepatitis. The nurse anticipates that which test will be used to predict the virus's response to therapy? A. Genotype assay B. Molecular assay C. Western blot test D. Enzyme immunoassay
A. Genotype assay
A patient questions the use of herbal remedies to manage motion sickness on an upcoming trip. Which has been used with success to manage this health complaint? A. Ginger B. Ginkgo C. Ginseng D. Goldenrod
A. Ginger
A 56-year-old man is admitted with a diagnosis of gastroesophageal reflux disease (GERD). The nurse anticipates the patient to report gastroesophageal discomfort after which meal? A. Hamburger, peas, and cola B. Turkey, salad, and a glass of red wine C. Chicken in lemon sauce, rice, and fruit juice D. Poached salmon, mashed potatoes, and milk
A. Hamburger, peas, and cola
It has been determined that a client with hepatitis has contracted the infection from contaminated food. Which type of hepatitis is this client most likely experiencing? A. Hepatitis A B. Hepatitis B C. Hepatitis C D. Hepatitis D.
A. Hepatitis A
The nurse is caring for an older adult patient who reports continued problems with constipation. What intervention can be implemented to promote timely bowel movements? A. Increase fiber intake. B. Limit fluid intake to 1500 mL daily. C. Administration of an oil retention enema weekly. D. Take a mild over-the-counter laxative each evening.
A. Increase fiber intake.
The nurse is providing discharge education to a patient after a gastric bypass procedure. Which nutritional supplements must this patient take for the rest of his life? (Select all that apply.) A. Iron B. Calcium C. Folic acid D. Vitamin C E. Vitamin D F. Vitamin B12
A. Iron B. Calcium C. Folic acid F. Vitamin B12
The nurse is caring for a patient with late-stage cirrhosis. The nurse considers which factor when participating in a patient care conference? A. Late-stage cirrhosis is irreversible. B. Late-stage cirrhosis can be managed with lifestyle changes. C. Late-stage cirrhosis can be cured with lactulose and spironolactone. D. Late-stage cirrhosis is characterized by periods of remission alternating with flare-ups.
A. Late-stage cirrhosis is irreversible.
The nurse is reinforcing teaching to a client about an upcoming colonoscopy procedure. The nurse should include in the instructions that the client will be placed in which position for the procedure? A. Left Sims Position B. Lithotomy position C. Knee-chest postion D. Right Sims position
A. Left Sims position
A client with hiatal hernia chronically experiences heartburn after meals. Which should the nurse teach the client to avoid? A. Lying recumbent after meals B. Eating small, frequent, bland meals C. Raising the head of bed on 6 inch blocks D. Taking histamine receptor agonist medication as prescribed
A. Lying recumbent after meals
A patient has been admitted to the hospital with GI bleeding. Which is a priority nursing action for this patient? A. Obtain complete vital signs. B. Administer prescribed medication for pain. C. Administer prescribed antacids every 2 hours. D. Administer prescribed medication for nausea and vomiting
A. Obtain complete vital signs
When planning care for the patient with acute pancreatitis, the LPN/LVN knows that which intervention is a priority of care? A. Pain control B. Nutritional supplementation C. Observation for mental changes D. Observation for intestinal obstruction
A. Pain control
A patient with a history of peptic ulcer disease has presented to the emergency department reporting severe abdominal pain and has a rigid, board-like abdomen that prompts the health care team to suspect a perforated ulcer. What intervention should the nurse anticipate? A. Providing IV fluids and inserting a nasogastric (NG) tube B. Administering oral bicarbonate and testing the patient's gastric pH level C. Performing a fecal occult blood test and administering IV calcium gluconate D. Starting parenteral nutrition and placing the patient in a high-Fowler's position
A. Providing IV fluids and inserting a nasogastric (NG) tube
The nurse is monitoring a client for the early signs and symptoms of dumping syndrome. Which indicated this occurrence? A. Sweating and pallor B. Dry skin and stomach pain C. Bradycardia and indigestion D. Double vision and chest pain
A. Sweating and pallor
A patient complains of nausea. When administering a dose of metoclopramide (Reglan), the nurse should teach the patient to report which potential adverse effect? A. Tremors B. Constipation C. Double vision D. Numbness in fingers and toes
A. Tremors Rationale:Extrapyramidal side effects, including tremors and tardive dyskinesias, may occur as a result of metoclopramide (Reglan) administration. Constipation, double vision, and numbness in fingers and toes are not adverse effects of metoclopramide.
Two days following a colectomy for an abdominal mass, a patient reports gas pains and abdominal distention. The nurse plans care for the patient based on the knowledge that the symptoms are occurring as a result of A. impaired peristalsis. B. irritation of the bowel. C. nasogastric suctioning. D. inflammation of the incision site.
A. impaired peristalsis.
Patients with ileostomies should be given which instruction? A."Do not take enteric-coated tablets." B. "Increase your intake of dried fruits." C. "Add more high-fiber foods to your diet." D. "If you notice a blockage, take a laxative."
A."Do not take enteric-coated tablets."
The nurse is assessing the stooling patterns of an assigned patient. The patient reports stools as being clay colored. The nurse knows this may indicate which condition? A.Bile is not reaching the intestines. B. The stool contains undigested fat. C. The stool has an excessive amount of bilirubin. D. The patient is experiencing upper gastrointestinal (GI) bleeding.
A.Bile is not reaching the intestines.
The nurse is caring for a patient with ulcerative colitis who recently underwent a colectomy and the creation of an ileal reservoir. How will this patient eliminate stool from his body? A. Continuously into a collection pouch B. With a catheter inserted into the reservoir C. Via his anus, over which he retains control D. Intermittently via the ostomy into a collection pouch
B. With a catheter inserted into the reservoir
A 61-year-old patient with suspected bowel obstruction had a nasogastric tube inserted at 4:00 AM. The nurse shares in the morning report that the day shift staff should check the tube for patency at what times? A. 7:00 AM, 10:00 AM, and 1:00 PM B. 8:00 AM, 12:00 PM, and 4:00 PM C. 9:00 AM and 3:00 PM D. 9:00 AM, 12:00 PM, and 3:00 PM
B. 8:00 AM, 12:00 PM, and 4:00 PM Rationale: A nasogastric tube should be checked for patency routinely at 4-hour intervals. Thus if the tube were inserted at 4:00 AM, it would be due to be checked at 8:00 AM, 12:00 PM, and 4:00 PM.
A patient reports discomfort from flatus after surgery. What action(s) can be suggested by the nurse to help to relieve the flatus buildup? (Select all that apply.) A. Drink hot coffee B. Encourage ambulation C. Trendelenburg position D. Drink chilled carbonated beverages E. Encourage bed rest until the pain subsides
B. Encourage ambulation C.Trendelenburg position
The nurse practices Universal Precautions to protect himself from which blood-borne types of hepatitis viruses? (Select all that apply.) A. Hepatitis A B. Hepatitis B C. Hepatitis C D. Hepatitis D E. Hepatitis E
B. Hepatitis B C. Hepatitis C D. Hepatitis D
What information would have the highest priority to be included in preoperative teaching for a 68-year-old patient scheduled for a colectomy? A. How to care for the wound B. How to deep breathe and cough C. The location and care of drains after surgery D. Which medications will be used during surgery
B. How to deep breathe and cough
The nurse is providing education to a patient with a body mass index (BMI) of 42. The nurse should educate the patient about which conditions for which he is at risk? (Select all that apply.) A. Insomnia B. Hypertension C. Hyperlipidemia D. Hyperthyroidism E. Obstructive sleep apnea F. Type 1 diabetes mellitus
B. Hypertension C. Hyperlipidemia E. Obstructive sleep apnea
The nurse is preparing to preform an abdominal examination. The initial step should be which? A. Palpation B. Inspection C. Percussion D. Auscultation
B. Inspection
The nurse is reviewing the health history of an assigned patient. Which data in a patient's history might indicate a predisposition to diverticular disease? (Select all that apply.) A. Frequent laxative use B. Low dietary fiber intake C. High dietary fiber intake D. History of passing scant, small stools E. History of chronic diarrhea; vomiting
B. Low dietary fiber intake D. History of passing scant,small stools
A client with ascites is scheduled for a paracentesis. The nurse is assisting the health care provider in preforming the procedure. Which position should the nurse assist the client into for this position? A. Flat B. Upright C. Left-side laying D. Right-side laying
B. Upright
A 74-year-old 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 postoperative chemotherapy.
B: CEA is used to monitor for cancer recurrence after surgery
A 24-year-old woman with Crohn's disease develops a fever and symptoms of a urinary tract infection (UTI) with tan, fecal-smelling urine. What information will the nurse add to a general teaching plan about UTIs in order to individualize the teaching for this patient? a. Bacteria in the perianal area can enter the urethra. b. Fistulas can form between the bowel and bladder. c. Drink adequate fluids to maintain normal hydration. d. Empty the bladder before and after sexual intercourse
B: Fistulas between the bowel and bladder occur in Crohn's disease and can lead to UTI
A patient is to collect a specimen for a stool guaiac test. Which direction should the patient be given? A. "Be sure to use a sterile container to collect the specimen." B. "Be sure to take a laxative 2 days prior to collecting the stool." C. "Do not eat red meat for at least 3 days before collecting the specimen." D. "Do not drink carbonated beverages for 8 hours before collecting the specimen."
C. "Do not eat red meat for at least 3 days before collecting the specimen.
The nurse is reviewing the health care providers prescriptions written for a client admitted with acute pancreatitis. Which health care provider prescription should the nurse verify if noted in the clients chart? A. NPO Status B. An anticholinergic medication C. Position the client supine and flat D. Prepare to insert a nasogastric tube
C. Position the client supine and flat
The patient with chronic gastritis is being put on a combination of medications to eradicate H. pylori. Which drugs does the nurse know will probably be used for this patient? A. Antibiotic(s), antacid, and corticosteroid B. Antibiotic(s), aspirin, and antiulcer/protectant C. Antibiotic(s), proton pump inhibitor, and bismuth D. Antibiotic(s) and nonsteroidal antiinflammatory drugs (NSAIDs)
C. Antibiotic(s), proton pump inhibitor, and bismuth
A patient is admitted with anorexia, nausea and vomiting, and weight loss. When developing the plan of care, which information is a priority to be obtained? (Select all that apply.) A. Ability to cook own food B. Cultural preferences for food C. Dietary history D. Pattern of anorexia E. Factors that cause vomiting
C. Dietary history D. Pattern of anorexia E. Factors that cause vomiting
The nurse determines that a patient has experienced the beneficial effects of therapy with famotidine (Pepcid) when which symptom is relieved? A. Nausea B. Belching C. Epigastric pain D. Difficulty swallowing
C. Epigastric pain
A female patient has a sliding hiatal hernia. What nursing interventions will prevent the symptoms of heartburn and dyspepsia that she is experiencing? A. Keep the patient NPO. B. Put the bed in the Trendelenberg position. C. Have the patient eat 4 to 6 smaller meals each day. D. Give various antacids to determine which one works for the patient.
C. Have the patient eat 4 to 6 smaller meals each day.
The nurse is caring for a client after a Billroth II ( gastojejunostomy) procedure. On review of the post-op prescriptions should the nurse clarify? A. Leg exercises B. Early ambulation C. Irrigating the nasogastic tube (NG) D. Coughing an deep breathing exercises
C. Irrigating the nasogastic tube (NG)
The nurse reinforces post-op liver biopsy procedure to a client. Which should the nurse tell the client? A. Avoid alcohol for 8 hours B. Remain NPO for 24 hours C. Lie on right side for 2 hours D. Save all stool to be checked for blood
C. Lie on right side for 2 hours
The nurse is reinforcing discharge instructions to a client after a gastrectomy. Which measure should the nurse include in the client teaching to help prevent dumping syndrome? A. Ambulate after a meal B. Eat high carbohydrate foods C. Limit the fluids taken with meals D. Sit in a high fowlers position during meals
C. Limit the fluids taken with meals
An ultrasound of the gallbladder is scheduled for the client with a suspected diagnosis of cholecystitis. Which should the nurse explain to the client about this test? A. The test is uncomfortable B. The test requires that the client be NPO C. The test requires the client to lie still for short intervals D. The test is preceded by the administration of oral tablets
C. The test requires the client to lie still for short intervals
One week postoperatively, the LPN/LVN notes that the stoma of a patient who had a colostomy has a purple hue. The nurse's actions are based on which understanding about this finding? A. This is a normal finding. B. There may be too much blood flow. C. There may be an obstruction in blood flow. D. The stoma is healing more quickly than expected.
C. There may be an obstruction in blood flow.
For which reason are patients with esophageal varices prone to hemorrhage? A. They have portal hypotension. B. There is poor circulation within the veins. C. They are no longer able to produce vitamin K. D. There is an accumulation of ammonia in the blood
C. They are no longer able to produce vitamin K
A 62-year-old patient has had a hemorrhoidectomy at an outpatient surgical center. Which instructions will the nurse include in discharge teaching? a. Maintain a low-residue diet until the surgical area is healed. b. Use ice packs on the perianal area to relieve pain and swelling. c. Take prescribed pain medications before a bowel movement is expected. d. Delay having a bowel movement for several days until healing has occurred
C: Bowel movements may be very painful, and patients may avoid defecation unless pain medication is taken before the bowel movement
A patient is suspected of having colon cancer. Which question is most important to ask to see if the patient is at risk? A. "Do you eat a lot of wild mushrooms?" B. "Do you eat a lot of barbecued foods?" C. "Has anyone in your family had rectal polyps?" D. "Has anyone in your family had bowel cancer?"
D. "Has anyone in your family had bowel cancer?"
The nurse is caring for a patient who has been recently diagnosed with hepatitis caused by the hepatitis B virus and who is taking lamivudine (Epivir). Which statement, if made by the patient, indicates the need for further teaching about this medication? A. "I will still need to use condoms." B. "I will call my provider if I develop a fever or sore throat." C. "I should anticipate difficulties sleeping for the next month." D. "I will be cured of the virus when I have finished the course."
D. "I will be cured of the virus when I have finished the course."
The nurse is caring for a patient who is preparing for discharge after having had an upper GI series. Which patient statement demonstrates a need for further discharge instruction? A. "I'll take a laxative." B. "I'll drink lots of water." C. "I can expect my stool to be white for up to 3 days." D. "I will not be able to drink fluids that contain any caffeine."
D. "I will not be able to drink fluids that contain any caffeine."
When a patient experiences a severe exacerbation of Crohn disease, the priority pharmacologic treatment would be administration of which class of medication? A. Analgesics B. Antibiotics C. Antidiarrheals D. Corticosteroids
D. Corticosteroids
The older adult patient presents to the emergency department complaining of severe vomiting for 3 days. The nurse knows which is the major complication of continuous vomiting? A. Weight loss B. Cardiac dysrhythmias C. Aspiration of vomitus D. Dehydration
D. Dehydration
A patient with a sigmoid colostomy is taught to irrigate her colostomy daily to accomplish which goal? A. Prevent infection B. Keep the bowel sterile C. Increase the diameter of the bowel D. Gain control over the time elimination occurs
D. Gain control over the time elimination occurs
The nurse is educating a patient who has been recently diagnosed with inflammatory bowel disease about a therapeutic diet. Which meal selection, if made by the patient, indicates an understanding of the teaching? A. Broiled fish with rice and roasted broccoli B. Fried shrimp with french fries and coleslaw C. Whole-grain pasta with marinara sauce and meatballs D. Grilled chicken, mashed potatoes, and strawberry gelatin
D. Grilled chicken, mashed potatoes, and strawberry gelatin
The nurse is caring for a 68-year-old patient admitted with abdominal pain, nausea, and vomiting. The patient has an abdominal mass, and a bowel obstruction is suspected. The nurse auscultating the abdomen listens for which type of bowel sounds that are consistent with the patient's clinical picture? A. Low-pitched and rumbling above the area of obstruction B. High-pitched and hypoactive below the area of obstruction C. Low-pitched and hyperactive below the area of obstruction D. High-pitched and hyperactive above the area of obstruction
D. High-pitched and hyperactive above the area of obstruction
The nurse is caring for a patient who underwent a cholecystectomy 8 hours ago. The patient calls the nurse to the room to report severe pain in the abdomen. What should the nurse do first? A. Prepare the patient to return to surgery. B. Instruct the patient to ambulate in the halls. C. Palpate the patient's abdomen for tenderness. D. Inspect the patient's abdomen for distention or rigidity.
D. Inspect the patient's abdomen for distention or rigidity.
A patient has been diagnosed with gastric cancer. What is associated with increased incidence of this disease? A. Refined sugars B. Dairy products C. Carbonated beverages D. Luncheon meats ("cold cuts")
D. Luncheon meats ("cold cuts")
The nurse would question the use of which cathartic agent in a patient with renal insufficiency? A. Bisacodyl (Dulcolax) B. Lubiprostone (Amitiza) C. Cascara sagrada (Senekot) D. Magnesium hydroxide (Milk of Magnesia)
D. Magnesium hydroxide (Milk of Magnesia)
The nurse is caring for a patient experiencing stomatitis. Which factor is most likely to have contributed to development of stomatitis? A. Morbid obesity B. Vegetarian diet C. Good oral hygiene D. Nutritional deficiencies
D. Nutritional deficiencies
The specific cause of dysphagia can be determined more easily when the LPN/LVN obtains which information about the patient? A. Patient's vital signs, especially rate and depth B. Level of physical activity tolerated by the patient C. Patient's bowel habits and whether laxatives are taken habitually D. Observing conditions under which the patient experiences difficulty swallowing
D. Observing conditions under which the patient experiences difficulty swallowing
The nurse is monitoring for stoma prolapse in a client with a colostomy. Which stoma observation should indicate that a prolapse has occurred? A. Dark and bluish B. Sunken and hidden C. Narrowed and flattened D. Protruding and swollen
D. Protruding and swollen
A patient has been diagnosed with gastritis. Which medication can the nurse anticipate will be prescribed? A. Aspirin B. Carafate C. Ampicillin D. Ranitidine
D. Ranitidine
A 72-year-old patient was admitted with epigastric pain due to a gastric ulcer. Which patient assessment warrants an urgent change in the nursing plan of care? A. Chest pain relieved with eating or drinking water B. Back pain 3 or 4 hours after eating a meal C. Burning epigastric pain 90 minutes after breakfast D. Rigid abdomen and vomiting following indigestion
D. Rigid abdomen and vomiting following indigestion
An elderly patient reports a loss of interest in eating. The patient's history indicates the patient's spouse died a few months ago. When providing information to the patient, which action by the nurse is likely to be most helpful in increasing the patient's intake? A. Having the patient keep a food diary. B. Giving the patient a list of high-calorie foods. C. Reminding the patient of the importance of eating. D. Suggesting to the patient's family members that someone join the patient for meals.
D. Suggesting to the patient's family members that someone join the patient for meals.
The nurse is caring for a client with a diagnosis of chronic gastritis. The nurse anticipates that the client is at risk for which vitamin deficiency? A. Vitamin A B. Vitamin C C. Vitamin E D. Vitamin B12
D. Vitamin B12
A 34-year-old female patient with a new ileostomy asks how much drainage to expect. The nurse explains that after the bowel adjusts to the ileostomy, the usual drainage will be about _____ cups. a. 2 b. 3 c. 4 d. 5
a. 2 Rationale: the average amount of ileostomy drainage is about 500 mL daily. One cup is about 240 mL.
The nurse is assessing a 31-year-old female patient with abdominal pain. The nurse, who notes that there is ecchymosis around the area of umbilicus, will document this finding as a. Cullen sign. b. Rovsing sign. c. McBurney sign. d. Grey-Turner's signt
a. Cullen sign. Rationale: A positive Cullen sign is bruising and discoloration of the fatty tissue around the Navel and is indicative of pancreatitis.
Which nursing action will be included in the plan of care for a 35-year-old male patient with bowel irregularity and a new diagnosis of irritable bowel syndrome (IBS)? a. Encourage the patient to express concerns and ask questions about IBS. b. Suggest that the patient increase the intake of milk and other dairy products. c. Educate the patient about the use of alosetron (Lotronex) to reduce symptoms. d. Teach the patient to avoid using non-steroidal anti-inflammatory drugs (NSAIDs).
a. Encourage the patient to express concerns and ask questions about IBS.
A 51-year-old 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 health care provider? a. Fever b. Nausea c. Joint pain d. Headache
a. Fever
A female patient is awaiting surgery for acute peritonitis. Which action will the nurse include in the plan of care? a. Position patient with the knees flexed. b. Avoid use of opioids or sedative drugs. c. Offer frequent small sips of clear liquids. d. Assist patient to breathe deeply and cough.
a. Position patient with the knees flexed.
A 51-year-old male patient has a new diagnosis of Crohn's disease after having frequent diarrhea and a weight loss of 10 pounds (4.5 kg) 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. Rationale:Medications are used to induce and maintain remission in patients with inflammatory bowel disease (IBD)
The nurse is admitting a 67-year-old patient with new-onset steatorrhea. Which question is most important for the nurse to ask? a. "How much milk do you usually drink?" b. "Have you noticed a recent weight loss?" c. "What time of day do your bowels move?" d. "Do you eat meat or other animal products?"
b. "Have you noticed a recent weight loss?"
Which patient statement indicates that the nurse's teaching about sulfasalazine (Azulfidine) for ulcerative colitis has been effective? a. "The medication will be tapered if I need surgery." b. "I will need to use a sunscreen when I am outdoors." c. "I will need to avoid contact with people who are sick." d. "The medication will prevent infections that cause the diarrhea."
b. "I will need to use a sunscreen when I am outdoors."
After change-of-shift report, which patient should the nurse assess first? a. 40-year-old male with celiac disease who has frequent frothy diarrhea b. 30-year-old female with a femoral hernia who has abdominal pain and vomiting c. 30-year-old male with ulcerative colitis who has severe perianal skin breakdown d. 40-year-old female with a colostomy bag that is pulling away from the adhesive wafer
b. 30-year-old female with a femoral hernia who has abdominal pain and vomiting
After a total proctocolectomy and permanent ileostomy, the patient tells the nurse, "I cannot manage all these changes. I don't want to look at the stoma." What is the best action by the nurse? a. Reassure the patient that ileostomy care will become easier. b. Ask the patient about the concerns with stoma management. c. Develop a detailed written list of ostomy care tasks for the patient. d. Postpone any teaching until the patient adjusts to the ileostomy.
b. Ask the patient about the concerns with stoma management.
A 27-year-old 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 right lower quadrant.
b. Assess the abdomen for rebound tenderness.
A 71-year-old male patient tells the nurse that growing old causes constipation so he has been using a suppository for constipation every morning. Which action should the nurse take first? a. Encourage the patient to increase oral fluid intake. b. Assess the patient about risk factors for constipation. c. Suggest that the patient increase intake of high-fiber foods. d. Teach the patient that a daily bowel movement is unnecessary.
b. Assess the patient about risk factors for constipation.
A patient in the emergency department has just been diagnosed with peritonitis caused by a ruptured diverticulum. Which prescribed intervention will the nurse implement first? a. Insert a urinary catheter to drainage. b. Infuse metronidazole (Flagyl) 500 mg IV. c. Send the patient for a computerized tomography scan. d. Place a nasogastric (NG) tube to intermittent low suction.
b. Infuse metronidazole (Flagyl) 500 mg IV.
Which nursing action will the nurse include in the plan of care for a 35-year-old male patient admitted with an exacerbation of inflammatory bowel disease (IBD)? a. Restrict oral fluid intake. b. Monitor stools for blood. c. Ambulate four times daily. d. Increase dietary fiber intake.
b. Monitor stools for blood. Rationale: Because anemia or hemorrhage may occur with IBD, stools should be assessed for the presence of blood
A 58-year-old 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.
Which prescribed intervention for a 61-year-old female patient with chronic short bowel syndrome will the nurse question? a. Ferrous sulfate (Feosol) 325 mg daily b. Senna (Senokot) 1 tablet every day c. Psyllium (Metamucil) 2.1 grams 3 times daily d. Diphenoxylate with atropine (Lomotil) prn loose stools
b. Senna (Senokot) 1 tablet every day Rationale:Patients with short bowel syndrome have diarrhea because of decreased nutrient and fluid absorption and would not need stimulant laxatives
A 54-year-old critically ill patient with sepsis is frequently incontinent of watery stools. What action by the nurse will prevent complications associated with ongoing incontinence? a. Apply incontinence briefs. b. Use a fecal management system c. Insert a rectal tube with a drainage bag. d. Assist the patient to a commode frequently.
b. Use a fecal management system
A patient being admitted with an acute exacerbation of ulcerative colitis reports crampy abdominal pain and passing 15 or more bloody stools a day. The nurse will plan to a. administer IV metoclopramide (Reglan). b. discontinue the patient's oral food intake. c. administer cobalamin (vitamin B12) injections. d. teach the patient about total colectomy surgery
b. discontinue the patient's oral food intake.
The nurse will determine that teaching a 67-year-old man to irrigate his new colostomy has been effective if the patient a. inserts the irrigation tubing 4 to 6 inches into the stoma. b. hangs the irrigating container 18 inches above the stoma. c. stops the irrigation and removes the irrigating cone if cramping occurs. d. fills the irrigating container with 1000 to 2000 mL of lukewarm tap water.
b. hangs the irrigating container 18 inches above the stoma.
A 26-year-old woman is being evaluated for vomiting and abdominal pain. Which question from the nurse will be most useful in determining the cause of the patient's symptoms? a. "What type of foods do you eat?" b. "Is it possible that you are pregnant?" c. "Can you tell me more about the pain?" d. "What is your usual elimination pattern?"
c. "Can you tell me more about the pain?"
A 71-year-old patient had an abdominal-perineal resection for colon cancer. Which nursing action is most important to include in the plan of care for the day after surgery? a. Teach about a low-residue diet. b. Monitor output from the stoma. c. Assess the perineal drainage and incision. d. Encourage acceptance of the colostomy stoma.
c. Assess the perineal drainage and incision.
Which diet choice by the patient with an acute exacerbation of inflammatory bowel disease (IBD) indicates a need for more teaching? a. Scrambled eggs b. White toast and jam c. Oatmeal with cream d. Pancakes with syrup
c. Oatmeal with cream
A 22-year-old female patient with an exacerbation of ulcerative colitis is having 15 to 20 stools daily and has excoriated perianal skin. Which patient behavior indicates that teaching regarding maintenance of skin integrity has been effective? a. The patient uses incontinence briefs to contain loose stools. b. The patient asks for antidiarrheal medication after each stool. c. The patient uses witch hazel compresses to decrease irritation. d. The patient cleans the perianal area with soap after each stool.
c. The patient uses witch hazel compresses to decrease irritation.
The nurse is providing preoperative teaching for a 61-year-old man scheduled for an abdominal-perineal resection. Which information will the nurse include? a. Another surgery in 8 to 12 weeks will be used to create an ileal-anal reservoir. b. The patient will begin sitting in a chair at the bedside on the first postoperative day. c. The patient will drink polyethylene glycol lavage solution (GoLYTELY) preoperatively. d. IV antibiotics will be started at least 24 hours before surgery to reduce the bowel bacteria.
c. The patient will drink polyethylene glycol lavage solution (GoLYTELY) preoperatively.
Four hours after a bowel resection, a 74-year-old male patient with a nasogastric tube to suction complains of nausea and abdominal distention. The first action by the nurse should be to a. auscultate for hypotonic bowel sounds. b. notify the patient's health care provider. c. reposition the tube and check for placement. d. remove the tube and replace it with a new one.
c. reposition the tube and check for placement.
A 42-year-old male patient has had a herniorrhaphy to repair an incarcerated inguinal hernia. Which patient teaching will the nurse provide before discharge? a. Soak in sitz baths several times each day. b. Cough 5 times each hour for the next 48 hours. c. Avoid use of acetaminophen (Tylenol) for pain. d. Apply a scrotal support and ice to reduce swelling.
d. Apply a scrotal support and ice to reduce swelling.
A 45-year-old patient is admitted to the emergency department with severe abdominal pain and rebound tenderness. Vital signs include temperature 102° F (38.3° C), pulse 120, respirations 32, and blood pressure (BP) 82/54. Which prescribed intervention should the nurse implement first? a. Administer IV ketorolac (Toradol) 15 mg. b. Draw blood for a complete blood count (CBC). c. Obtain a computed tomography (CT) scan of the abdomen. d. Infuse 1 liter of lactated Ringer's solution over 30 minutes.
d. Infuse 1 liter of lactated Ringer's solution over 30 minutes. Rationale: The priority for this patient is to treat the patient's hypovolemic shock with fluid infusion
After several days of antibiotic therapy, an older hospitalized patient develops watery diarrhea. Which action should the nurse take first? a. Notify the health care provider. b. Obtain a stool specimen for analysis. c. Teach the patient about handwashing. d. Place the patient on contact precautions.
d. Place the patient on contact precautions.
A 73-year-old patient with diverticulosis has a large bowel obstruction. The nurse will monitor for a. referred back pain. b. metabolic alkalosis. c. projectile vomiting. d. abdominal distention.
d. abdominal distention.
The nurse will plan to teach a patient with Crohn's disease who has megaloblastic anemia about the need for a. oral ferrous sulfate tablets. b. regular blood transfusions. c. iron dextran (Imferon) infusions. d. cobalamin (B12) spray or injections.
d. cobalamin (B12) spray or injections.
A 47-year-old female patient is transferred from the recovery room to a surgical unit after a transverse colostomy. The nurse observes the stoma to be deep pink with edema and a small amount of sanguineous drainage. The nurse should a. place ice packs around the stoma. b. notify the surgeon about the stoma. c. monitor the stoma every 30 minutes. d. document stoma assessment findings.
d. document stoma assessment findings.
