NUR 257 Final

The nurse is assisting a client to drain his continent ileostomy (Kock pouch). The nurse should insert the catheter how far through the nipple/valve? A. 2 in. B. 3 in C. 4 in. D. 5 in.

A. 2 in.

Which of the following is the most common complication associated with peptic ulcer? A. Hemorrhage B. Vomiting C. Elevated temperature D. Abdominal pain

A. Hemorrhage

During assessment of a patient with gastritis, the nurse practitioner attempts to distinguish acute from chronic pathology. One criteria, characteristic of 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

Clients with irritable bowel disease (IBS) are at significantly increased risk for which condition? A. Osteoporosis B. DVT C. Hypotension D. Pneumonia

A. Osteoporosis

What type of feeding should be administered to a client who is at risks of diarrhea due to hypertonic feeding solutions? A. continuous feedings B. intermittent feeding C. bolus feeding D. cyclic feeding

A. continuous feedings

A client has been experiencing lower GI difficulties that have increased in severity, and the gastroenterologist is concerned that the client's bowel is not functioning properly. What function of the lower GI tract is most likely to be affected by the client's disorder? A. water and electrolyte absorption B. protein digestion C. fat digestion D. All options are correct

A. water and electrolyte absorption

A client with gastric cancer is having a resection. What is the nursing management priority for the client? A.Discharge planning B. Correcting nutritional deficits C. Preventing deep vein thrombosis (DVT) D. Teaching about radiation treatment

B. Correcting nutritional deficits

A client with a history of peptic ulcer disease has presented to the emergency department (ED) in distress. What assessment finding would lead the ED nurse to suspect that the client has a perforated ulcer? A. The client has abdominal bloating that developed rapidly B. The client has a rigid, "boardlike" abdomen that is tender C. The client is experiencing intense lower right quadrant pain D. The client is experiencing dizziness and confusion with no apparent hymodynamic changes.

B. The client has a rigid, "boardlike" abdomen that is tender

The nurse is creating a discharge plan of care 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

what is the most common cause of small-bowel obstruction? A. Hernias B. Neoplasma C. Adhesions D. Volvulus

C. Adhesions

Which diagnostic test would be used first to evaluate a cleint with upper GI bleeding? A. Upper GI series B. Endoscopy C. Hemoglobin and hematocrit D. Arteriography

C. Hemoglobin and hematocrit

A client who is being treated for pyloric obstruction has nasogastric (NG) tube in place to decompress the stomach. The nurse routinely checks for obstruction which would be indicated by what amount? A. 150 ml B. 250 ml C. 350 ml D. 450 ml

D. 450 ml

A curse caring for a client with small-bowel obstruction should plan to implement which nursing interventions first? A. Administering pain medication B. Obtaining a blood sample for laboratory studies C. Preparing to insert a nasogastric (NG) tube D. Administering I.V. fluids

D. Administering I.V. fluids

The nurse teaches the client whose surgery will result in a sigmoid colostomy that the feces expelled through the colostomy will be A. Semimushy B. mushy C. fluid D. solid

D. solid

A client with gastritis requited hospital treatment for an exacerbation the client's continuing care in the of symptoms and receives a subsequent diagnosis of pernicious anemia due to malabsorption. When planning home setting. What assessment question is most relevant? A. "Does anyone in your family have experience at giving injections?" B. "Are you going to be anywhere with strong sunlight in the next few years?" C. "Are you aware of your blood type?" D. "Do any of your family members have training in first aid?"

A. "Does anyone in your family have experience at giving injections?"

A client has recently been diagnosed with gastric cancer. On palpation, the nurse would note what two signs that confirm metastasis to the liver? Select all that apply. A. Ascites B. Hepatomegaly C. Distented bladder D. Sister Mary Joseph's nodules E. Petechiae at the palpation site

A. Ascites B. Hepatomegaly

A nurse is monitoring a client with peptic ulcer disease. Which assessment findings would most likely indicate perforation of the ulcer? Select 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

A nurse is caring for a client who has experienced an acute exacerbation of Crohn's disease. Which statement best indicates that the disease process is under control? A. The Client exhibits signs of adequate GI perfusion. B. The client expresses positive feelings about himself. C. The client verbalizes a manageable level of discomfort. D. The client maintains skin integrity.

A. The Client exhibits signs of adequate GI perfusion.

The nurse is inserting a sump tube in a patient with Crohn's disease who is suspected of having a bowel obstruction. What does the nurse understand is the benefit of the gastric (Salem) sump tube in comparison to come of the other tubes? A. The tube is radiopaque B. The tube is shorter C. The tube is less expensive D. The tube can be connected to suction and other cannot

A. The tube is radiopaque

A nurse is performing focused assessment on her clients. she expects to hear hypoactive bowel sounds in a client with: A. paralytic ileus B. Crohn's disease C. gastrogenteritis D. complete bowel obstruction

A. paralytic ileus

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

The nurse is teaching a client who has experienced an episode of acute gastritis. The nurse knows further education is necessary when the client makes which statement? A. "I should feel better in about 24 to 36 hours." B. "My appetite should come back tomorrow." C. "I should limit 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 tomorrow."

A nurse is preparing to administer a 500 mL bolus tube feeding to a patient. The nurse anticipates administering this feeding over which time frame? A. 5 to 10 minutes B. 10-15 minutes C. 15 to 20 minutes D. 20-25 minutes

B. 10-15 minutes

A nursing student is preparing a teaching plan about peptic ulcer disease. The student knows to include teaching about the percentage of clients with peptic ulcers who experience bleeding. The percentage is A. Less that 5% B. 15% C. 25% D. Greater than 50%

B. 15%

A nurse is preparing to assist a health care provider with a peripherally inserted central catheter. The nurse demonstrates understanding of this procedure by preparing which insertion site? A. Subclavian vein B. Basilic vein C. Jugular vein D. Implanted port.

B. Basilic vein

The nurse is caring for a patient who has malabsorption syndrome with an undetermined cause. What procedure will the nurse assist with that is the best diagnostic test for this illness? A. Ultrasound B. Endoscopy with mucosal biopsy C. Stool specimen for ova and parasites D. Pancreatic function tests

B. Endoscopy with mucosal biopsy

The nurse is caring for a client who was admitted to have a low-profile gastrostomy device (LPGD) placed. How soon after the original gastrostomy tube placement can an LPGD be placed? A. 2 weeks B. 4 to 6 weeks C. 1 1/2 to 3 months D. 4 to 6 months

C. 1 1/2 to 3 months

During assessment of a client for a malabsorption disorder, the nurse notes a history of abdominal pain and weight loss, marked steatorrhea, azotorrhea, and frequent glucose intolerance. Based on these clinical features, what diagnosis will the nurse suspect? A. Lactose intolerance B. Celiac disease C. Pancreatic insufficiency D. Ileal dysfunction

C. Pancreatic insufficiency

The nurse is teaching a client with peptic ulcer disease who has been prescribed misoprostol. What information from the nurse would be most accurate about misoprostol? A. Works best when taken on an empty stomach B. Increase the speed of gastric emptying C. Prevents ulceration in clients taking nonsteroidal anti-inflammatory drugs (NSAIDs) D. Decreases mucus production

C. Prevents ulceration in clients taking nonsteroidal anti-inflammatory drugs (NSAIDs)

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 community health nurse is preparing for an initial home visit to a client discharged following a total gastrectomy for treatment of gastric cancer. What would the nurse anticipate that the plan of care is most likely to include? A. Enteral feeding via gastrostomy tube (G tube) B. Gastrointestinal decompression by nasogastric tube C. Periodic assessment for esophageal distension D. Administration of injections of vitamin B12

D. Administration of injections of vitamin B12

A nurse is caring for an older adult who has been experiencing severe clostridium difficile-related diarrhea. When reviewing the client's most recent laboratory tests, the nurse should prioritize what finding? A. White blood cell level B. Creatinine level C. Hemoglobin level D. Potassium level

D. Potassium level

A client is recently diagnosed with Crohn's disease and is beginning treatment. What the first-line treatment does the nurse expect that the client will be placed on to decrease the inflammatory response? A. Ciprofloxacin B. Methotrexate C. Azathroprine D. Sulfasalazine

D. Sulfasalazine

The nurse is to insert a postpyloric feeding tube. How can the nurse aid in placement of the tube past the pylorus? A. Administer prescribed metoclopramide. B. Have the client lay on the left side. C. Assist the client to drink 8 ounces of water. D. Instruct the client to swallow several times.

A. Administer prescribed metoclopramide.

Which of the following laxatives should be used by a cardiac patient who should avoid straining? A. Colace B. Milk of Magnesia C. Dulcolax D. Mineral oil

A. Colace

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. Coronary artery disease

A client with an infection in the area between the internal and external sphincters. In which chronic disease is this condition commonly seen? A. Crohn's Disease B. diverticulosis C. ulcerative colitis D. irritable bowel syndrome

A. Crohn's Disease

The nursing student approaches his instructor ti discuss the plan of care 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 one of the following? A. Duodenum B. Esophagus C. Pylorus D. Stomach

A. Duodenum

A client has received a diagnosis of gastric cancer and is awaiting a surgical date. During the preoperative period, the client should adopt what dietary guidelines? A. Eat small, frequent meals with high calorie and vitamin content. B. Eat frequent meals with an equal balance of fate, carbohydrates, and protein. C. Eat frequent, low-fat meals with high protein content. D. Try to maintain the pre-diagnosis pattern of eating.

A. Eat small, frequent meals with high calorie and vitamin content.

The nurse is cautiously assessing a client admitted with peptic ulcer disease because the most common complication that occurs in 10% to 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 psychosocial stress

A. High levels of alcohol consumption

The client has been taking famotidine (Pepcid) at home. The nurse prepares a taching plan for the client indicating that the medication 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-year-old male client presents at the emergency department with symptoms of a small bowel obstruction. In collaboration with the primary provider, 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 edema D. Administration of a glycerin suppository and an oral laxative

A. Insertion of a nasogastric tube

A patient is to recieve parenteral nutrition. The duration of therapy is planned for 4 weeks. The nurse develops a teaching plan for the patient to prepare for insertion of which of the following as most likely? A. Nontunneled central catheter B. Peripherally inserted central catheter C. Tunneled central catheter D. Implanted port

A. Nontunneled central catheter

The nurse cares for a client who receives parenteral nutrition (PN). The nurse notes on the care plan that the catheter will need to be removed 6 weeks after insertion and that the client's venous access device is a A. Nontunneled central catheter B. peripherally inserted central catheter C. tunnedled central catheter D. implanted port.

A. Nontunneled central catheter

A client undergoes total gastrectomy. Several hours after surgery, the nurse notes that the client's nasogastric (NG) tube has stopped draining. How should the nurse respond? A. Notify the health care provider B. Reposition the tube C. Irrigate the tube D. Increase the suction level

A. Notify the health care provider

A client present to the ED with acute abdominal pain, fever, nausea, and vomiting. During the client's examination, the lower left abdominal quadrant is palpated causing the clinet to reprot pain the int RLQ. This psoitive sign is referred to as ____________ and suggests the client may be experiencing ____________. A. Rovsing's sign; acute appendicitis b. McBurney's sign; acute appendicitis C. Rovsing's sign; perforation D. McBurney's sign; perforation

A. Rovsing's sign; acute appendicitis

A client with peptic ulcer disease wants to known nonpharmacologic ways to 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

A client presents to the emergency room with a possible diagnosis of appendicitis. The health care provider asks the nusrse to assess for tenderness at McBurney's point. The nurse knows to palpate which area? A. Between the umbilicus and the left iliac crest B. Between the imnilicus and the anterior superior iliac spine C. In the left periumbilical area D. In the upper right quadrant slightly below the diaphragm

B. Between the imnilicus and the anterior superior iliac spine

The nurse is caring for a client who is undergoing diagnostic testing for suspected malabsorption. When taking this client's health history and performing the physical assessment, 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

After teaching a client about the procedure for inserting a nontunneled central catheter, the nurse determines that the client has understood the instructions based on which statement? A. I need to keep my head turned directly toward you and the health care provider B. I will be laying on my back buck my legs will be high than my head C. I will need to take long, slow, deep breaths when the catheter is inserted. D. I'll have to wear a thick, bulky dressing over the site.

B. I will be laying on my back buck my legs will be high than my head

Which is the most prominent signs of inflammatory bowel disease? A. Abdominal distention and constipation B. Intermittent pain and diarrhea C. Hyperactive bowel sounds and constipation D. Increased peristalsis and diarrhea

B. Intermittent pain and diarrhea

A positive Rovsing's sign is indicative of appendicitis. A nurse knows to assess for this indicator by palpating the: A. Right lower quadrant B. Left lower quadrant C. Right upper quadrant D. Left upper quadrant

B. Left lower quadrant

A client's physician has determined that for the next 3 to 4 weeks the client will require parenteral nutrition (PN). The nurse should anticipate the placement of what type of venous access device? A. Peripheral catheter B. Nontunneled central catheter C. Implantable port D. Tunneled central catheter

B. Nontunneled central catheter

Which type of diarrhea is caused by increased production of water and electrolytes by the intestinal mucosa and their secretion into the intestinal lumen? A. Osmotic diarrhea B. Secretory diarrhea C. Mixed diarrhea D. Diarrheal disease

B. Secretory diarrhea

What symptoms of perforation might the nurse observe in a client with an intestinal obstruction? (select all that apply). A. Sudden, sustained abdominal pain B. abdominal distention C. sudden drop in body temperature D. intermittent, severe pain

B. abdominal distention

A client with peptic ulcer is diagnosed with Helicobacter pylori infection. The nurse is teaching the client about the medications prescribed, including metronidazole, omeprazole, and clarithromycin. 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 my 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."

The nurse is evaluating a client's ulcer symptoms to differentiate ulcer as duodenal or gastric. Which symptoms should the nurse at attribute to a duodenal ulcer? A. Vomiting B. Hemorrhage C. Awakening in pain D. Weight loss

C. Awakening in pain

Which tube is a nasoenteric feeding tube? A. Levin B. Salem C. Dobbhoff D. Sengstaken-blakemore

C. Dobbhoff

The nurse in an extended-care facility reports that a resident has clinical manifestations of fecal incontinence. The health care provider orders a diagnostic study to rule out inflammation. Which study will the nurse prepare the client for? A. Anorectal manometry B. Transit study C. Flexible sigmoidoscopy D. Barium enema

C. Flexible sigmoidoscopy

The nurse is caring for a client who is postoperative from having a gastrostomy tube placed. What should the nurse do on a daily basis to prevent skin breakdown? A. Verify tube placement B. Loop adhesive tape around the tube and connect it securely to the abdomen C. Gently rotate the tube D. Change the wet-to-dry dressing

C. Gently rotate the tube

The nurse is caring for a patient who has had an appendectomy. What is the best position for the nurse to maintain the patient in after surgery? A. Prone B. Sims' left lateral C. High Fowler's D. Supine with the head of the bed elevated 15 degrees

C. High Fowler's

A nurse is providing client education for a client with peptic ulcer disease secondary to chronic nonsteroidal anti-inflammatory drug (NSAIDs) use. The client has recently been prescribed misoprostol. What would the nurse be most accurate in informing the client about the drug? A. It reduces the stomach's volume of hydrochloric acid B. It increases the speed of gastric emptying C. It protects the stomach's lining D. It increase lower esophageal sphincter pressure.

C. It protects the stomach's lining

A client was treated in the emergency department and cirtial care unit after ingestin bleach. What possible complication of the resulting gastritis should the nurse recognize? C. Prevents ulceration in clients taking nonsteroidal anti-inflammatory drugs (NSAIDs) B. Uncontrolled proliferation of H. pylori C. Gastric hyperacidity related to excessive gastrin secretion D. Chronic referred pain in the lower abdomen

C. Prevents ulceration in clients taking nonsteroidal anti-inflammatory drugs (NSAIDs)

The nurse is caring for a client who had an ileo conduit 3 days earlier. The nurse examines the stoma site and determines that she should consult with the ostomy nurse. Which assessment finding indicates the need for further consultation? A. Beefy red stoma site B. Stoma site not sensitive to touch C. Red, sensitive skin around the stoma site D. Clear mucus mixed with yellow urine drained from the appliance bag

C. Red, sensitive skin around the stoma site

The nurse observes the physician palpating the abdomen of a client that is suspected of having acute appendicitis. When the abdomen is pressed in the left lower quadrant the client complains of pain on the right side. What does the nurse understand this assessment technique is referred to? A. Referred pain B. Rebound pain C. Rovsing sign D. Cremasteric reflex

C. Rovsing sign

A client suspected of having colorectal cancer requires requires which diagnostic study to confirm the diagnosis? A. Stool Hematest B. Carcinoembryonic antigen C. Sigmiodoscopy D. Abdominal computed tomography (CT) scan

C. Sigmiodoscopy

A nurse caring for a patient with regional enteritits knows to assess for this most serious systemic complication. What is that complication? A. Pyelonephritis B. Megacolon C. Small bowel obstruction D. Nephrolithiasis

C. Small bowel obstruction

A nurse is completing a health history on a client whose diagnosis is chronic gastritis. Which of the data should the nurse consider most significantly related to the etiology of the client's health problem? A. Consumes one or more protein drinks daily. B. Takes over-the-counter antacids frequently throughout the day C. Smokes one pack of cigarettes daily. D. Reports a history of social drinking on a weekly basis.

C. Smokes one pack of cigarettes daily.

A nurse is participating in a client's care conference and the team is deciding between parenteral nutrition (PN) and a total nutritional admixture (TNA). What adcantages are associated with providing TNA rather than PN? A. TNA can be mixed by a certified registered nurse. B. TNA can be given over 8 hours, while PN requires 24-hour administration. C. TNA is less costly than PN D. TNA does not require the use of a micron filter

C. TNA is less costly than PN

When planning care for a client with a small-bowel obstruction, the nurse should consider the primary goal to be: A. reporting pain relief B. maintaining body weight. C. maintaining fluid balance D. reestablishing a normal bowel pattern

C. maintaining fluid balance

A client with enteritis reports frequent diarrhea. What assessment should the nurse should anticipate? A. respiratory acidosis B. respiratory alkalosis C. metabolic acidosis D. metabolic alkalosis

C. metabolic acidosis

The health care provider prescribes a combination of three drugs to treat peptic ulcer disease. The nurse, preparing to review the drug 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 inhibitor D. Prostaglandin E1 analogs, antibiotics, and proton pump inhibitors

C.Bismuth salts, antibiotics, and proton pump inhibitor

A client with enteritis reports frequent diarrhea. What assessment should the nurse should anticipate? A. At least once a day B. At least once every 2 days C. Three or four times daily D. Every 4 to 6 hours

D. Every 4 to 6 hours

Which of the following is accurate regarding regional enteritis? A. Fistulas are common B. Severe diarrhea C. Severe bleeding D. Exacerbation and remissions

D. Exacerbation and remissions

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 decrease the effect of warfarin D. It leaves a metallic taste in the mouth

D. It leaves a metallic taste in the mouth

A patient is not have daily bowel movements and has begun taking a laxative for this problem. What should the nurse educate the patient about regarding laxative use? A. When taking the laxatives, plenty of fluid should be taken as well. B. The laxatives should be taken no more than 3 times a week or laxative addiction will result. C. Laxatives should not be routinely taken due to destruction of nerve endings in the colon. D. Laxatives should never be the first response for the treatment of constipation; natural methods should be employed first.

D. Laxatives should not be routinely taken due to destruction of nerve endings in the colon.

Which statement correctly identifies a difference between duodenal and gastric ulcer? A. Malignancy is associated with duodenal ulcer B. Weight gain may occur with a gastric ulcer C. A gastric ulcer is caused by hypersecretion of stomach acid D. Vomiting is uncommon is clients with duodenal ulcers.

D. Vomiting is uncommon is clients with duodenal ulcers.