Nutrition

A client is admitted with a diagnosis of ulcerative colitis. The nurse should assess the client for: constipation. alternating periods of constipation and diarrhea. steatorrhea. bloody, diarrheal stools.

bloody, diarrheal stools.

One hour before a client is to undergo abdominal surgery, the physician orders atropine, 0.6 mg I.M. The client asks the nurse why this drug must be administered. How should the nurse respond? "Atropine slows the heart rate and blood pressure." "Atropine enhances the effect of anesthetic agents." "Atropine improves ventilation by increasing the respiratory rate." "Atropine decreases salivation and gastric secretions."

"Atropine decreases salivation and gastric secretions."

A client had a colon resection yesterday. The client's hemoglobin was 14.1 g/dL yesterday and today it is 7.2 g/dL. The client's oxygen saturation is 87%. After reviewing the chart and notifying the health care provider (HCP), what should the nurse do first?

Administer oxygen at 2 liters per minute.

The nurse is managing the care of a client with a gastrointestinal hemorrhage. Which task is appropriate to assign to a unlicensed assistive personnel (UAP)? Check vital signs every 1 hour. Notify spouse. Insert an nasogastric tube (NGT). Assess stools.

Check vital signs every 1 hour.

Thirty minutes after a Sengstaken-Blakemore tube is inserted, the nurse observes that the client appears to be having difficulty breathing. What should the nurse do first? Remove the tube. Deflate the esophageal portion of the tube. Increase the oxygen flow rate. Determine whether the tube is obstructing the airway.

Determine whether the tube is obstructing the airway.

Which instruction should the nurse include in the teaching plan for a client who is experiencing gastroesophageal reflux disease? Follow a low-protein diet. Limit caffeine intake to two cups of coffee per day. Take medications with milk to decrease irritation. Do not lie down for 2 hours after eating.

Do not lie down for 2 hours after eating.

Following an emergency cholecystectomy, the client has a Jackson-Pratt drain with closed suction. After 4 hours, the drainage unit is full. What should the nurse do? Check the dressing for bleeding. Remove the drain and suction unit. Notify the surgeon. Empty the drainage unit.

Empty the drainage unit.

When administering intermittent enteral feeding to an unconscious client, what should the nurse do? Heat the formula in a microwave. Obtain a sterile gavage bag and tubing. Weigh the client before administering the feeding. Place the client in a semi-Fowler's position.

Place the client in a semi-Fowler's position.

During the first few weeks after a cholecystectomy, the client should follow a diet that includes: at least four servings daily of meat, cheese, and peanut butter to increase protein intake that aids incisional healing. a limited intake of fat distributed throughout the day so that there is not an excessive amount in the intestine at any one time. a decreased intake of fruits, vegetables, whole grains, and nuts, to minimize pressure within the small intestine. ingestion of pancreatic enzymes with meals to replace the normal enzyme secretion that has been surgically altered.

a limited intake of fat distributed throughout the day so that there is not an excessive amount in the intestine at any one time.

A client develops chronic pancreatitis. What would be the appropriate home diet for a client with chronic pancreatitis? a diabetic exchange diet distributed over three meals and two snacks daily a low-protein, high-fiber diet distributed over four to five moderate-sized meals daily a low-fat, bland diet distributed over five to six small meals daily a high-calcium, soft diet distributed over three meals and an evening snack daily

a low-fat, bland diet distributed over five to six small meals daily

In developing a teaching plan for the client with a hiatal hernia, the nurse's assessment of which work-related factors would be most useful? number and length of breaks cleaning solvents used body mechanics used in lifting temperature in the work area

body mechanics used in lifting

A client is scheduled to have surgery to relieve an intestinal obstruction. Prior to surgery, the nurse should verify that the client has followed which preoperative instructions? signed a last will and testament performed abdominal tightening exercises eaten a low-residue diet discontinued use of blood thinners

discontinued use of blood thinners

Which laboratory finding is expected when a client has diverticulitis? elevated serum blood urea nitrogen concentration decreased platelet count elevated white blood cell count elevated red blood cell count

elevated white blood cell count

The client attends two sessions with the dietitian to learn about diet modifications to minimize gastroesophageal reflux. The teaching would be considered successful if the client decreases the intake of which foods? fats carbohydrates high-sodium foods high-calcium foods

fats

A client has been taking prescribed aspirin in large doses and reports having stomach irritation, sometimes with vomiting. Which food or beverage noted from the client's diet history should the nurse suggest the client avoid? sweetened tea dry toast glass of wine scrambled eggs

glass of wine

A client has had an exacerbation of ulcerative colitis with cramping and diarrhea persisting longer than 1 week. The nurse should assess the client for which complication? deep vein thrombosis heart failure hypokalemia hypocalcemia

hypokalemia

Metoclopramide is prescribed as a premedication for a client about to undergo a gastroduodenoscopy. What expected therapeutic effect of this drug should the nurse assess in this client? increased gastric pH increased gastric emptying reduced anxiety inhibited respiratory secretions

increased gastric emptying

A client is recovering from a gastric resection for peptic ulcer disease. Which outcome indicates that the goal of adequate nutritional intake is being achieved 3 weeks following surgery? The client: drinks 2,000 mL/day of water. experiences a rapid weight gain within 1 week. increases food intake and tolerance gradually. experiences occasional episodes of nausea and vomiting.

increases food intake and tolerance gradually.

A client is recovering from an ileostomy that was performed to treat inflammatory bowel disease. During discharge teaching, the nurse should stress the importance of increasing fluid intake to prevent dehydration. taking only enteric-coated medications. wearing an appliance pouch only at bedtime. consuming a low-protein, high-fiber diet.

increasing fluid intake to prevent dehydration.

A registered nurse should assign a nursing assistant to care for a client with inflammatory bowel disease who: requires nasogastric suctioning. is receiving patient-controlled analgesia. requires continuous pulse oximetry monitoring. requires assistance with ambulation.

requires assistance with ambulation.

Immediately following endoscopy of the upper gastrointestinal tract, it is most important for the nurse to assess for: intake and output. bowel sounds. peripheral pulses. return of the gag reflex.

return of the gag reflex.

A client underwent insertion of a nasogastric (NG) tube for partial bowel obstruction the previous evening. The nurse notes that the tube is not secured to the client's face. How will the nurse proceed? Note the findings on the client's flow sheet. Verify placement of the tube. Call the healthcare provider immediately. Securely tape the tube in place.

Verify placement of the tube.

The nurse is evaluating the lifestyle modifications a client has made to prevent gastroesophageal reflux. Which statement indicates that the client understands how to prevent reflux? "I lie down and rest for 45 minutes after each meal." "I try to eat smaller amounts of food more often throughout the day." "I've increased my fluid intake at meals to help improve my digestion." "I sleep on my left side at night to help my stomach empty more quickly."

"I try to eat smaller amounts of food more often throughout the day."

After teaching the parents of a child with lactose intolerance about the disorder, the nurse determines that the teaching was effective when the mother used which statement to describe the condition? "An allergy to lactose found in milk." "Inability to digest proteins completely." "The lack of an enzyme to break down lactose." "Inability to digest fats completely."

"The lack of an enzyme to break down lactose."

After the nurse teaches the parent of an infant with pyloric stenosis about the condition, which cause, if stated by the parent, indicates effective teaching? "an enlarged muscle below the stomach" "a result of giving the baby more formula than is necessary" "a genetically smaller stomach than normal" "a telescoping of the large bowel into the smaller bowel"

"an enlarged muscle below the stomach"

A client with Crohn's disease has concentrated urine, decreased urinary output, dry skin with decreased turgor, hypotension, and weak, thready pulses. What should the nurse should do first? Turn and reposition every 2 hours. Encourage the client to drink at least 1,000 mL/day. Provide parenteral rehydration therapy as prescribed. Monitor vital signs every shift.

Provide parenteral rehydration therapy as prescribed.

A nurse is caring for a client with active upper GI bleeding. What is the appropriate diet for this client during the first 24 hours after admission? increased dairy products nothing by mouth iron-rich diet ice chips only

nothing by mouth

Which client requires immediate nursing intervention? The client who complains of epigastric pain after eating. presents with ribbonlike stools. presents with a rigid, boardlike abdomen. complains of anorexia and periumbilical pain.

presents with a rigid, boardlike abdomen.

Which client statement indicates a need for further instruction about a duodenal ulcer? "To help my ulcer heal I should develop stress management strategies." "I will remove foods from my diet that cause abdominal pain." "I will need to take an antacid before every meal." "Caffeine and alcoholic beverages may irritate my ulcer."

"I will need to take an antacid before every meal."

A nurse is teaching a client with constipation about management of the problem. Which statement by the client indicates understanding? "I'll consume a low-residue diet." "I'll limit water intake to three glasses per day." "I'll avoid heavy lifting." "I'll consume foods high in fiber."

"I'll consume foods high in fiber."

A client's abdominal incision eviscerates. What should the nurse do first? Lower the client's head and elevate the feet. Cover the incision with a dressing moistened with sterile normal saline solution. Start an emergency infusion of IV fluids. Take the client's vital signs and call the health care provider.

Cover the incision with a dressing moistened with sterile normal saline solution.

A client with Crohn's disease is scheduled for a barium enema. What should the plan of care include today to prepare for the test tomorrow? Serve the client a regular diet. Include low-fat dairy products in the evening meal. Encourage plenty of fluids. Order a high-fiber diet.

Encourage plenty of fluids.

A nurse asks a client who had abdominal surgery 3 days ago if they have moved their bowels since surgery. The client states, "I haven't moved my bowels, but I am passing gas." How should the nurse intervene? Encourage the client to ambulate at least three times per day. Administer a tap water enema. Apply moist heat to the client's abdomen. Notify the physician.

Encourage the client to ambulate at least three times per day.

Following a subtotal gastrectomy, a client has a nasogastric (NG) tube connected to low suction. What should the nurse do? Irrigate the tube with 30 ml of sterile water every hour, if needed. Change to high suction if the drainage is sluggish on low suction. Monitor the client for nausea, vomiting, and abdominal distention. Reposition the tube if it is not draining well.

Monitor the client for nausea, vomiting, and abdominal distention.

An adult client is admitted to the hospital after vomiting bright red blood and is diagnosed with a bleeding duodenal ulcer. The client develops a sudden, sharp pain in the midepigastric region along with a rigid, board-like abdomen. After obtaining the client's vital signs, what should the nurse do next? Prepare to insert a nasogastric tube. Raise the head of the bed. Notify the health care provider. Administer pain medication as prescribed.

Notify the health care provider.

An elderly client asks the nurse how to treat chronic constipation. What is the best recommendation the nurse can make? Administer a phospho-soda enema when necessary. Take a mild laxative such as magnesium citrate when necessary. Take a stool softener such as docusate sodium daily. Administer a tap-water enema weekly.

Take a stool softener such as docusate sodium daily.

A client with an esophageal stricture is about to undergo esophageal dilatation. As the bougies are passed down the esophagus, the nurse should instruct the client to do which action to minimize the vomiting urge? Bear down as if having a bowel movement. Take long, slow breaths. Use a panting breathing pattern. Hold the breath.

Take long, slow breaths.

A client diagnosed with peptic ulcer disease has an H. pylori infection. The client is following a 2-week drug regimen that includes clarithromycin along with omeprazole and amoxicillin. How should the nurse instruct the client to take these medications? Alternate the use of the drugs. Take the drugs for the entire 2-week period. Take the drugs at different times during the day. Discontinue all drugs if nausea occurs.

Take the drugs for the entire 2-week period.

Which nursing measure would be most effective in helping the client cough and deep breathe after a cholecystectomy? Have the client take rapid, shallow breaths to decrease pain. Teach the client to use a folded blanket or pillow to splint the incision. Have the client lay on the left side while coughing and deep breathing. Withhold pain medication so the client can be alert enough to follow the nurse's instructions.

Teach the client to use a folded blanket or pillow to splint the incision.

A nurse is caring for a client who had gastric bypass surgery two days ago. Which assessment finding requires immediate intervention? The client's surgical site is reddened and swollen. The client complains of significant pain at the surgical site when rising out of bed. The client's right lower leg is red, swollen, and warm to touch. The client is concerned about feeling bloated and being unable to have a bowel movement, even when pushing.

The client's right lower leg is red, swollen, and warm to touch.

A graduate nurse and the nurse's preceptor are establishing priorities for their morning assessments. Which client should they assess first? The newly admitted client with acute abdominal pain The client who underwent surgery 3 days ago and who now requires a dressing change The client receiving continuous tube feedings who needs the tube-feeding residual checked The sleeping client who received pain medication 1 hour ago

The newly admitted client with acute abdominal pain

Why are antacids administered regularly, rather than as needed, in peptic ulcer disease? To promote client compliance To increase pepsin activity To keep gastric pH at 3.0 to 3.5 To maintain a regular bowel pattern

To keep gastric pH at 3.0 to 3.5

A nurse is teaching a group of middle-aged clients about peptic ulcers. When discussing risk factors for peptic ulcers, the nurse should mention a sedentary lifestyle and smoking. alcohol abuse and smoking. alcohol abuse and a history of acute renal failure. a history of hemorrhoids and smoking.

a history of hemorrhoids and smoking.

The nurse monitors IV replacement therapy for a client with a nasogastric (NG) tube attached to low suction in order to: promote urination. maintain fluid and electrolyte balance. facilitate osmotic diuresis. equalize intake and output.

maintain fluid and electrolyte balance.

The nurse on a surgical unit is caring for a client recovering from recent surgery with the placement of a nasogastric tube on low continuous suction. Which acid-base imbalance is most likely to occur? respiratory alkalosis metabolic acidosis respiratory acidosis metabolic alkalosis

metabolic alkalosis

A client presents to the emergency department, reporting that they have been vomiting every 30 to 40 minutes for the past 8 hours. Frequent vomiting puts this client at risk for which imbalances? metabolic acidosis and hyperkalemia metabolic alkalosis and hyperkalemia metabolic acidosis and hypokalemia metabolic alkalosis and hypokalemia

metabolic alkalosis and hypokalemia

Which statement indicates that the client with a peptic ulcer understands the dietary modifications to follow at home? "I should avoid alcohol and caffeine." "I should eat a bland, soft diet." "I should drink several glasses of milk a day." "It's important to eat six small meals a day."

"I should avoid alcohol and caffeine."

A client newly diagnosed with ulcerative colitis who has been placed on steroids asks the nurse why steroids are prescribed. What should the nurse tell the client? "Long-term use of steroids will prolong periods of remission." "Steroids are used in severe flare-ups because they can decrease the incidence of bleeding." "Ulcerative colitis can be cured by the use of steroids." "The side effects of steroids outweigh their benefits to clients with ulcerative colitis."

"Steroids are used in severe flare-ups because they can decrease the incidence of bleeding."

A client refuses to look at or care for their colostomy. Which statement by the nurse would be most appropriate? "I understand how you are feeling. It is important for you to feel attractive and you think having a colostomy changes your attractiveness." "I think we will need to teach your husband to care for your colostomy if you are not going to be able to do it." "I can see that you are upset. Would you like to share your concerns with me?" "It's been 4 days since your surgery, and you'll soon be discharged. You have to learn to care for your colostomy before you leave the hospital."

"I can see that you are upset. Would you like to share your concerns with me?"