NOA Ch. 27 & 28
The nurse is caring for a patient who is postoperative after esophageal resection. Shortly after the nurse starts a feeding, the patient suddenly becomes dyspneic and complains od substernal pain. What should the nurse do first?
Stop the feeding
The nurse is aware that patients who have chronic gastritis from renal failure may present with which first sign of this disorder?
Sudden massive hemorrhage
The nurse explains that the diagnosis of morbidly obese is reserved for people who exceed which percentage of their recommended weight?
100%
The nurse calculates the body mass index of a man who is 6 feet tall and weighs 150 lbs. Which value is correct?
21.0
The nurse is reviewing a student nurse's charting and notes that the student has documented absent bowel sounds. The nurse reminds the student that in order to document absent bowel sounds, one must auscultate each quadrant at what period of time?
5 minutes
The nurse is caring for multiple patients. The nurse determines that which patient has the highest risk for developing gallstones?
A 50-year-old obese Mexican American woman who has type 1 diabetes
For which patient should the nurse question an order for esomeprazole (Nexium)?
A 55-year-old female who takes digoxin
The nurse is caring for a patient who is being treated for extensive burns. The nurse notes the presence of coffee ground material in the Salem sump catheter. The nurse correctly recognizes which factor as the likely cause?
A physiologic stress ulcer
The nurse is caring for an 80-year-old woman who is undergoing extensive bowel preparation for a colonoscopy. The nurse should most closely monitor the patient for which potential complication?
Metabolic acidosis
The nurse is caring for a patient who returns to the floor at lunch time after undergoing an upper GI series. Which action is most important for the nurse to perform first?
Administer a laxative
The nurse is caring for a patient who has been experiencing severe diarrhea and can now resume solid foods. The nurse educates the patient about appropriate food choices. Which food choice indicates that the nurse's teaching has been successful?
Applesauce
The nurse is caring for a patient who is complaining of postoperative gas pain. What intervention should the nurse implement?
Assist the patient with ambulation
The nurse is documenting the presence of pain in a patient with possible gastric ulcer would anticipate that the pain would occur at which time?
At bedtime
The nurse is educating a patient who has gastroesophageal reflux disease (GERD) about dietary modification. Which information is most important for the nurse to include in the teaching plan?
Avoid highly seasoned or spiced foods
A patient who had gastric bypass surgery 5 weeks ago calls the office to report feelings of nausea, sweating, and diarrhea shortly after eating meals. What response by the nurse is most appropriate?
Avoid large meals, limit sweets, and drink small amounts of liquids between meals
The nurse is preparing to administer a liquid laxative to a patient in preparation for a colonoscopy. Which action should the nurse take?
Chill the laxative and pour it over ice
The nurse is reviewing the laboratory results of an assigned patient. The serum bilirubin is 2.8mg/dL. The nurse anticipates that the patient's urine will display which finding?
Dark color
When assessing a patient's bowel sounds, the nurse auscultates loud bowel sounds in each quadrant every 3 seconds. The nurse understands that these findings could indicate that the patient is experiencing which condition?
Diarrhea
The nurse is obtaining a history of a patient with hepatitis A. Which question is most appropriate for the nurse to ask?
Do you eat shellfish or oysters often?
The nurse is preparing a teaching plan for a patient with GERD who has been prescribed multi-drug therapy for treatment. Which information is most important for the nurse to obtain?
Do you think you can afford these prescriptions?
A patient with a gastrostomy tube gets a bolus feeding of 200 mL every 4 hours. Before giving the bolus, the nurse aspirates a residual of 100 mL. Which action is most appropriate?
Document the residual and hold the feeding
Which causative agent is the primary cause of Barrett esophagus?
GERD
The nurse is discussing bariatric surgery complications with a patient. Which statement indicates that the patient accurately understands the nurse's teaching about common procedural side effects?
Gallstones are a common occurrence in patients who have bariatric surgery
The nurse is talking with a patient who has been experiencing nausea and vomiting. The patient indicates an interest in using alternative therapies for the condition. Which product may aid in nausea management?
Ginger
The nurse is assessing a patient's bowel sounds. After auscultating each quadrant for 30 seconds, the nurse fails to hear any sounds. How should the nurse document this finding?
Hypoactive bowel sounds
The nurse is educating a patient with a hiatal hernia. Which statement indicates that the patient understands the nurse's teaching?
I should avoid tea and chocolate
The nurse is educating a patient with Barret esophagus. Which statement indicates that the patient requires a need for further instruction?
I should consider switching to smokeless tobacco
The nurse is performing preprocedure teaching for a patient scheduled to undergo a liver biopsy. After listening to the information, the patient states, "I am so scared, I just don't know if I can do this procedure." Which response is best?
I understand you are afraid. Tell me more about your concerns.
The nurse cautions that constant stress can cause which alteration to the gastrointestinal system?
Increased digestive juices resulting in a gastric ulcer
The nurse is caring for a patient with suspected dysphagia. Which action is most appropriate for the nurse to take?
Instruct the patient to take practice swallows before the meal
The nurse is caring for a patient with a Salem sump tube for decompression. The patient displays dyspnea and reports feeling full and nauseated. What action should the nurse take first?
Irrigate the tube with normal saline
The nurse is planning care for a patient who has experienced moderate diarrhea for 3 days. Which collaborative intervention is most important to include in the plan of care?
Limit the patient's diet to clear liquids
The home health nurse is caring for the patient with tuberculosis who is taking rifampin and isoniazid. The nurse should carefully monitor the patient for which potential side effect?
Liver disorders
During a morning assessment, the nurse observes that a patient displays bulging flanks when supine with knees flexed. Which action should the nurse take next?
Measure the patient's abdominal girth
The nurse is caring for a patient who is suspected of having oral cancer. When reviewing the patient's history, which finding provides supportive data for the diagnosis?
Presence of leukoplakia
The nurse explains that the laparoscopic adjustable gastric banding surgery is best described as which type of bariatric surgery?
Restrictive
The nurse is caring for a patient who complains, "I don't see why I can't have a CT scan instead of the expensive MRI!" Which response is most appropriate for the nurse to make?
The MRI provides better contrast between normal and pathologic tissue
The nurse is caring for a patient who is being treated for a gunshot wound to the abdomen. The patient is receiving TPN, and the physician has prescribed insulin coverage on a sliding scale. The patient reports he has never had diabetes before. What response is best for the nurse to make?
The TPN you are receiving has high amounts of glucose
The nurse is percussing a patient's abdomen and hears a dull thud in the right upper quadrant. This sound indicates that the nurse is percussing over which location?
The liver
The nurse is caring for a patient with a peptic ulcer. The patient also has a history of chronic bronchitis, diabetes, and arthritis. Which component of the patient's history is the most likely contributing factor to the patient's ulcer?
The patient takes ibuprofen daily for arthritis pain
