patho test 5

Which conditions show an elevated level of white blood cells? Select all that apply. 1. Appendicitis 2. Constipation 3. Diverticular disease 4. Large bowel obstruction 5. Irritable bowel syndrome

1. Appendicitis (An elevated level of white blood cells is seen in appendicitis due to inflammation) 3. Diverticular disease (An elevated level of white blood cells is seen in diverticular disease due to inflammation) 4. Large bowel obstruction (An elevated level of white blood cells is seen in large bowel obstruction due to inflammation and perforation)

The laboratory reports of a client with gastritis reveal Helicobacter pylori is the causative organism. Which pathophysiological changes can result from this infection? Select all that apply. 1. Decreased production of pepsin 2. Increased production of gastrin 3. Increased production of intrinsic factor 4. Increased production of prostaglandins 5. Decreased production of HCl acid

1. Decreased production of pepsin (The production of pepsin is decreased during H. pylori infection due to the death of chief cells and parietal cells in the gastric mucosa) 2. Increased production of gastrin (The gastrin production is increased to increase acid production when HCl levels are very low in the body) 5. Decreased production of HCl acid (The death of chief cells and parietal cells decreases the production of HCl acid in a client with H. pylori infection)

The parent of an adolescent client tells the nurse, "My child complains of a burning sensation in the throat and refuses to eat food." On ass., the nurse finds the client also has a dry cough. Which teaching does the nurse provide if the pt is dx with GERD? Select all that apply. 1. Elevate the pt head at 70 degrees for eating 2. Provide small, frequent meals to the pt 3. Admin proton pump inhibitors to the pt 4. Promote rest/sleep to aid digestion after eating

1. Elevate the pt head at 70 degrees for eating (Symptoms such as a burning sensation in the throat and dry cough are associated with GERD. The nurse elevates the client's head to an angle greater than 60 degrees while eating to allow easy swallowing) 2. Provide small, frequent meals to the pt (As the client has a burning sensation, the nurse provides small, frequent meals to the client to meet their energy demands) 3. Admin proton pump inhibitors to the pt (Proton pump inhibitors decrease secretion of acid from the stomach and reduce a burning sensation. Therefore, the nurse will also administer proton pump inhibitors while caring for the client)

The nurse finds that a client coughs frequently while eating and makes repeated attempts to swallow. Based on these findings, the health-care team suspects dysphagia in the client. Which additional findings indicate the client is experiencing aspiration pneumonia? Select all that apply. 1. Elevated temperature 2. Hyperactive bowel sounds 3. Deviated tongue and uvula 4. Drooling of food or liquids 5. Auscultation of crackles in the lungs

1. Elevated temperature (Dysphagia is the condition in which the client coughs frequently while eating and makes repeated attempts to swallow. The client with dysphagia is also at risk for aspiration pneumonia. Elevated temperature indicates that the client is at risk for this condition.) 5. Auscultation of crackles in the lungs (Abnormal lung sounds like crackles indicate that the client is at risk for aspiration pneumonia)

The laboratory reports of a client with alcoholic liver disease reveal low hemoglobin levels. For which reasons does the nurse recognize this condition? Select all that apply. 1. Hypersplenism 2. Hemochromatosis 3. Hypoalbuminemia 4. Folic acid deficiency 5. Decreased levels of thrombopoietin

1. Hypersplenism (Low hemoglobin levels cause anemia. Hypersplenism occurs due to portal hypertension in clients with alcoholic liver disease. It is a disorder that causes the spleen to prematurely destroy the red blood cells (hemolysis), leading to anemia) 4. Folic acid deficiency ( Clients with liver disease will have disturbed folic acid metabolism, resulting in folic acid deficiency and anemia)

Prioritize the order of performing the physical examination of the abdomen in a client with bowel disorder. (Enter the number of each step in the proper sequence; do not use commas or spaces.) 1. Inspection 2. Palpation 3. Percussion 4. Auscultation

1. Inspection 4. Auscultation 3. Percussion 2. Palpation (While performing the physical examination of the abdomen, the nurse should first visually inspect the abdomen. If the abdomen is filled with gas, it appears distended. Next, the nurse should auscultate the client's abdomen. Bowel sounds will be normal in the early course of bowel disorder, but they may become quiet or rushing as the disorder progresses. Percussion of the abdomen reveals tympany when the bowel is filled with gas. Palpation should be the next step, revealing tenderness, rigidity, and involuntary guarding)

The nurse educator is teaching a group of staff nurses about the importance of inserting an NG Tube in pts w/ large bowel obstruction. Which statement made by an attending nurse indicates effective learning? "An NG Tube relieves pressure caused by bowel obstruction." "An NG Tube is primarily used to deliver medications directly to the client's stomach." "An NG Tube removes free air present under the client's diaphragm." "An NG tube removes the mechanical obstruction in the lar

"An NG Tube relieves pressure caused by bowel obstruction." (A nasogastric tube helps in the aspiration of stomach contents, thereby relieving pressure caused by bowel obstruction. This statement by an attending nurse is true and indicates effective learning)

The nurse is reviewing with a group of staff nurses the use of antibiotics in a pt dx with appendicitis. Which statement made by a nurse indicates understanding? "Antibiotics are administered before an operation and continued until 48 hours p/o." "Antibiotics are not administered before dx, as they interfere with the dx signs." "Antibiotics are to be administered after restoring the fluid and electrolyte balance." "Antibiotics are used when there is no need for surgical removal of

"Antibiotics are administered before an operation and continued until 48 hours p/o." (Antibiotics should be administered in a client with appendicitis before an operation and until 48 hours after the operation to prevent infection. This statement by the student nurse is correct and indicates effective learning)

The nurse is reviewing the treatment plan for Crohn's disease with staff nurses. Which statement made by a nurse indicates understanding? "Cholestyramine is prescribes to pts with ileal disease." "Loperamide is administered in clients to reduce abdominal cramps." "Propantheline dicyclomine is administered to relieve chronic diarrhea." "Multivitamin supplements are contraindicated in clients with decreased absorption."

"Cholestyramine is prescribes to pts with ileal disease." (Cholestyramine is a bile acid-sequestering agent, which is prescribed for clients with terminal ileal disease, which exists in clients with Crohn's disease. This helps the client to absorb bile salts normally. This statement by the nurse is true and indicates understanding)

The nurse is reviewing the pathophysiology of nonalcoholic fatty liver disease (NAFLD) with staff nurses. Which statement made by an attending nurse indicates understanding? "NAFLD is linked to metabolic syndrome." "Exposure to vinyl chloride can cause NAFLD." "Increased level of adiponectin is associated with NAFLD." "NAFLD is caused by accumulation of fat in the adipose tissue."

"NAFLD is linked to metabolic syndrome." (Metabolic syndrome is characterized by insulin resistance, obesity, and hyperlipidemia. It can lead to excess fat accumulation in the liver. Therefore, NAFLD is linked to metabolic syndrome)

The nurse is reviewing portal hypertension with a group of staff nurses. Which statement by an attending nurse indicates the need for further review? "Caput medusa is a sign of portal hypertension." "Portal hypertension can cause hematemesis." "Ascites is associated with portal hypertension." "Portal hypertension causes coagulation abnormalities."

"Portal hypertension causes coagulation abnormalities." (Liver cirrhosis leads to coagulation abnormalities because of impaired clotting factor synthesis. However, portal hypertension does not specifically cause any coagulation abnormalities)

The nursing instructor is discussing the physical assessment findings for hemorrhoids. Which statement made by the student nurse indicates effective learning? "Presence of anal fistulas is observed." "Presence of blood in stools may be observed." "McBurney's point indicates tenderness." "Auscultation indicates high-pitched bowel sounds."

"Presence of blood in stools may be observed." (Hemorrhoids are the swollen, dilated venous blood vessels in the lower rectum. The physical assessment findings for hemorrhoids may show hematochezia, which is the presence of blood in stools)

The nurse is orienting a group of staff nurses to the laparoscopic cholecystectomy procedure. Which statement by an attending nurse indicates effective learning? "The client should be on bed rest for 2 weeks." "The client will have severe pain after the surgery." "The procedure has a high risk of complications." "The client is discharged less than 24 hours after the surgery."

"The client is discharged less than 24 hours after the surgery." (Since the incisions are smaller and have a low risk of complications, this procedure requires a shorter stay in the health-care setting after the surgery; therefore, this statement from the student nurse is valid and indicates effective learning)

The staff nurses are reviewing precautions to be taken while caring for a client with suspected need of surgery for appendicitis. Which statement made by a nurse indicates understanding? "The client will not require IV fluids." "The client will not be prescribed ampicillin." "The client is given a laxative before surgery." "The client is not given prediagnosis pain medications."

"The client is not given prediagnosis pain medications." (Pain medications should be avoided in the client before the diagnosis of appendicitis because they can mask signs of the condition)

The nurse instructor is teaching a group of nursing students about the pathophysiology of cholecystitis. The nursing instructor asks, "What happens during chronic cholecystitis?" Which statement by a student nurse indicates effective learning? "The gallbladder is filled with purulent effusion." "Perforation and gangrene develop on the wall of the gallbladder." "The gallstone passes from the cystic duct into the common bile duct." "The gallbladder becomes thickened and function"

"The gallbladder becomes thickened and function" (Chronic cholecystitis is the repetitive attacks of inflammation of the gallbladder. During chronic cholecystitis, the gallbladder becomes thickened, rigid, fibrotic, and functions poorly; therefore, this statement by the student nurse is valid and indicates effective learning)

The nurse is counseling a client about high doses of NSAIDs taken to "keep aches and pains away." The nurse shares that the liver is at risk for damage. The client asks, "What does the liver do, anyway?" Which is the best answer by the nurse? "The liver plays multiple important roles in digestion." "Damage to the liver can cause serious illnesses." "The liver can be damaged by overuse of medications." "A seriously diseased liver may require a liver transplant."

"The liver plays multiple important roles in digestion." (The client has asked specifically about the function of the liver. The best answer by the nurse is the liver performs multiple roles in digestion; fats, proteins, and carbohydrates are all affected by the liver)

The nurse is reviewing the functions of the liver with a group of staff nurses. Which response by one of the attending nurses indicates the need for additional review? "The liver synthesizes glucagon." "The liver synthesizes thrombopoietin." "The liver synthesizes angiotensinogen." "The liver synthesizes insulin-like growth factor 1."

"The liver synthesizes thrombopoietin." (Glucagon is a hormone produced by the alpha cells of the pancreas, but acts in the liver. It stimulates lipolysis, hepatic glycogenolysis, and gluconeogenesis. Therefore, this statement of the client is incorrect and indicates the need for further teaching)

The client reports nausea, vomiting, abdominal cramping, and diarrhea. On assessment, the nurse finds high-pitched bowel sounds. Which nursing interventions help the client improve the manifestations of the condition? Select all that apply. 1. Administer antibiotics 2. Administer IV fluids 3. Administer frequent, small tube feedings 4. Administer antiemetic medications 5. Administer NSAIDs

1. Administer antibiotics (The nurse administers antibiotics as ordered after identifying the cause of gastroenteritis is bacterial) 2. Administer IV fluids (The nurse administers IV fluids to replace fluids lost through vomiting and diarrhea) 4. Administer antiemetic medications (The nurse administers antiemetic medications to control vomiting and antidiarrheal medications to reduce diarrhea)

Which suggestions does the nurse provide to a client with chronic pancreatitis? Select all that apply. 1. "You should consume low-fat food." 2. "You can drink sweetened beverages." 3. "You should drink plenty of fluids." 4. "You should take fat-soluble vitamins." 5. "You need to eliminate your alcohol intake."

1. "You should consume low-fat food." (Clients who have chronic pancreatitis will have a lack of lipase enzyme that helps in the digestion of fatty foods; therefore, the nurse should suggest the client consume low-fat foods) 3. "You should drink plenty of fluids." (Dehydration increases the size of the pancreas; therefore, the nurse should suggest that the client drink plenty of fluids to avoid dehydration) 5. "You need to eliminate your alcohol intake." (Clients with chronic pancreatitis are strongly advised not to smoke or consume alcoholic beverages, even if the pancreatitis is mild or in the early stages)

Which findings can the nurse observe in the laboratory reports of a client after 4 weeks of hepatitis A infection? Select all that apply. 1. A rise in liver enzymes 2. Appearance of immunoglobulin M (IgM) antibodies 3. Appearance of immunoglobulin G (IgG) antibodies 4.Appearance of hepatitis A virus (HAV) in the stool 5. Presence of antimitochondrial antibodies (AMAs)

1. A rise in liver enzymes (The incubation period of HAV is 2 to 4 weeks. After the first 4 weeks, there is a rise in liver enzymes, such as alanine aminotransferases and aspartate aminotransferases) 2. Appearance of immunoglobulin M (IgM) antibodies ( IgM antiHAV antibodies can generally be detected after the first 4 weeks in a client with hepatitis A)

The nurse is caring for a client with glucuronyl transferase enzyme deficiency. The laboratory reports show elevated serum bilirubin levels. Which treatment does the nurse suspect to be effective in the client? Select all that apply. 1. Phenobarbital 2. Phototherapy 3. Paracentesis 4. Deferoxamine 5. Penicillamine

1. Phenobarbital (Glucuronyl transferase enzyme deficiency is associated with Crigler-Najjar syndrome. Glucose transferase enzyme is used to conjugate bilirubin in the liver. Therefore, its deficiency causes increased bilirubin in the blood (hyperbilirubinemia). Phenobarbital is used to decrease the bilirubin levels in the client) 2. Phototherapy (Phototherapy aids in the breakdown and excretion of bilirubin in clients who are diagnosed with Crigler-Najjar syndrome)

The laboratory reports of a client diagnosed with alcoholism show hepatic encephalopathy and portal hypertension. Which nursing interventions will be beneficial for the client? Select all that apply. 1. Provide a low-sodium diet 2. Provide a low-calorie diet 3. Provide a high-protein diet 4. Administer calcium compounds 5. Encourage the use of thiamine supplements

1. Provide a low-sodium diet (The client with portal hypertension will have esophageal varices and ascites. Therefore, a low-sodium diet is important for reducing the fluid accumulation) 3. Provide a high-protein diet (Hepatic encephalopathy develops due to the accumulation of toxic nitrogenous wastes in the brain. High protein in the diet may result in increased production of ammonia and can aggravate hepatic encephalopathy. Therefore, a high-protein diet is given to the client) 5. Encourage the use of thiamine supplements (Thiamine deficiency is common in alcoholic clients with hepatic encephalopathy. Therefore, thiamine supplementation is beneficial to prevent further complications)

Which hormone produced by the intestine triggers the release of pancreatic enzymes? 1. Secretin 2. Somatostatin 3. Insulin 4. Chymotrypsin

1. Secretin (Secretin is a hormone released by the intestine, which helps in stimulating the release of pancreatic enzymes and bile from the bile ducts when food enters into the stomach)

Which complications does the nurse suspect in a client when bile is obstructed from flowing into the intestine? Select all that apply. 1. Steatorrhea 2. Calculus 3. Jaundice 4. Pruritus 5. Autodigestion

1. Steatorrhea (Bile helps in the digestion of fatty foods. Obstruction of bile can cause the indigestion of fatty foods and result in the formation of fat in the stools, called steatorrhea) 3. Jaundice (When bile is obstructed, it flows backward, leading to the accumulation of more bile and resulting in hyperbilirubinemia, which causes jaundice) 4. Pruritus (Obstruction of bile leads to the accumulation of bile salts in the blood, which causes pruritus)

The nurse is attending a pt 3 days p/o for removal of a section of small bowel bc of injury from a strangulated hernia. The nurse is aware the pt is now dx with short-bowel syndrome. Which initial p/o teaching is most important for the nurse to provide? pt will need 12-18 months for the body to adapt to the change. 1st 3 months will require careful monitoring & nutrition supplements. Body will gradually adapt to the change & eventually function as normal.

1st 3 months will require careful monitoring & nutrition supplements. (Initially, the nurse will address the "here and now" of the client's condition. It is important that the client understand the first 3 months (acute phase) will require close monitoring for dehydration; electrolyte imbalance; weight loss; loss of folic acid; and loss of fat-soluble vitamins A, D, E, and K and vitamin B12. Because of loss of absorption function, nutritional supplements are likely to be administered)

Which pathophysiological changes are responsible for pain in a client with acute gastritis? Select all that apply. 1. Atrophy of the gastric wall 2. Eradication of prostaglandins by medications 3. Increased blood supply at the inflammatory area 4. Increased pressure within the layers of the stomach 5. Accumulation of white blood cells at the inflammatory area

2. Eradication of prostaglandins by medications (Medications such as NSAIDs inhibit prostaglandin production and decrease the production of gastric mucus. Pain is produced due to impaired protection and decreased production of gastric mucus) 3. Increased blood supply at the inflammatory area (The increased blood supply at the inflammatory area results in edema of the mucosal layer that results in increased pressure and causes pain) 4. Increased pressure within the layers of the stomach (The erosion of the inner mucosal layer results in increased pressure on the middle muscle layer and outer serous coat that result in severe pain)

The radiographic diagnostic reports for a client show the presence of stones in the common bile duct. Which complications does the nurse expect in the client? Select all that apply. 1. Increase in blood glucose levels 2. Increase in bilirubin levels 3. Increase in bile salts 4. Increase in lipase levels 5. Increase in amylase levels

2. Increase in bilirubin levels (Stones in the common bile duct cause a backup of the bile into the gallbladder and liver; therefore, an increased amount of bile is stored in the liver and gallbladder, which leads to increased levels of bilirubin) 3. Increase in bile salts (Stones in the common bile duct cause a backup of bile into the gallbladder and liver. As a result, more amounts of bile salts will be present in the blood)

Which client does the nurse expect to be prescribed a tissue biopsy test for confirmation of the disease? 1. The client with peritonitis 2. The client with celiac disease 3. The client with gastroenteritis 4. The client with Zollinger-Ellison syndrome

2. The client with celiac disease (The client with celiac disease is ordered a tissue biopsy test to confirm the diagnosis)

The health-care provider suspects the presence of esophageal varices in a client diagnosed with cirrhosis of the liver. An ultrasound is prescribed and verifies the suspected condition. Which medications does the health-care provider prescribe to prevent esophageal variceal bleeding? Select all that apply. 1. Octreotide 2. Vasopressin 3. Propranolol 4. Somatostatin 5. Isosorbide mononitrate

3. Propranolol (Propranolol is an adrenergic beta blocker agent. It decreases blood pressure and thereby reduces portal hypotension, helping to prevent rupture of hemorrhage) 5. Isosorbide mononitrate (Isosorbide mononitrate decreases blood pressure by dilating blood vessels. Therefore, it reduces portal hypotension associated with esophageal varices and helps prevent rupture or hemorrhage)

Arrange the processes occurring in four developmental stages of primary biliary cirrhosis in their correct order. (Enter the number of each step in the proper sequence; do not use commas or spaces.) 1. Destruction of the liver cells, fibrotic tissue taking over hepatic cells, and loss of intralobular bile ducts 2. Progression of inflammation 3. Development of micronodular or macronodular cirrhosis 4. Inflammation of the portal triads and destruction of small and medium bile ducts

4. Inflammation of the portal triads and destruction of small and medium bile ducts 2. Progression of inflammation 1. Destruction of the liver cells, fibrotic tissue taking over hepatic cells, and loss of intralobular bile ducts 3. Development of micronodular or macronodular cirrhosis (The process of primary biliary cirrhosis begins with the inflammation of the portal triads, leading to the destruction of small and medium bile ducts. The progression of the inflammation causes destruction of the liver cells. Then fibrotic tissue takes over hepatic cells, leading to the development of micronodular or macronodular cirrhosis)

The nurse is reviewing Ranson's criteria to assess the severity of pancreatitis in a client. Which findings observed in the client by the nurse within a 48-hour period indicate that the client has chronic pancreatitis? Select all that apply. 1. Glucose of 10 mmol/L 2. White blood cell count of 15,000 mm3 3. Fluid sequestration of 4 L 4. Partial pressure of oxygen of 40 mm Hg 5. Blood urea nitrogen of 1.0 mmol/L

4. Partial pressure of oxygen of 40 mm Hg (Partial pressure of oxygen can be assessed during an initial 48-hour period because it would reflect whether serious complications are present in the client. If the partial pressure of oxygen is less than 60 mm Hg, severe pancreatitis is indicated and the client would require hospitalization) 5. Blood urea nitrogen of 1.0 mmol/L (Blood urea nitrogen can be assessed during an initial 48-hour period because it would reflect whether serious complications are present in the client. If blood urea nitrogen is greater than 0.9 mmol/L, severe pancreatitis is indicated and the client would require hospitalization)

Which client benefits from early endoscopic retrograde cholangiopancreatography (ERCP)? A client with cholelithiasis A client with cholecystitis A client with acute pancreatitis A client with severe gallstone pancreatitis

A client with severe gallstone pancreatitis (Clients who have severe gallstone pancreatitis will benefit mostly from an ERCP procedure. This diagnostic procedure provides accurate visualization of the pancreatic ductal system)

The nurse is providing care for a client with suspected gallbladder disease. Assessment by the nurse reveals jaundice, dark-colored urine, and upper right quadrant abdominal pain. Based on the assessment findings, which is the most likely cause of the client's condition? A gallstone lodged in the cystic duct A gallstone lodged in the common bile duct Multiple gallstones located in the gallbladder Gallstones in the liver from a ruptured gallbladder

A gallstone lodged in the common bile duct (A gallstone can also travel out of the cystic duct and lodge in the common bile duct, which causes backup of bile into the liver and then into the bloodstream, causing jaundice. This is the only option causing jaundice and dark-colored urine)

For which reason does the nurse identify the change of urine color in a client with liver disease? Failure of bilirubin to reach the intestine Accumulation of bilirubin in the bloodstream Accumulation of bile salts in the bloodstream Infiltration of the liver with fat

Accumulation of bilirubin in the bloodstream (The urine is dark in clients with liver disease because of the backup of bilirubin into the bloodstream. Therefore, the nurse suspects that the accumulation of bilirubin in the bloodstream is responsible for a change in the urine color)

The nurse concludes that an obese client is manifesting symptoms from a rare type of hernia. Which finding confirms the condition? Belching Acute chest pain Substernal burning Epigastric discomfort

Acute chest pain (Acute chest pain is a characteristic feature of a paraesophageal hernia, which is a rare type of hernia. The pain occurs due to strangulation of the hernia)

A physical examination of a client elicits the Cullen sign and Grey-Turner sign. Which condition does the nurse suspect in the client? Acute cholecystitis Biliary disorders Acute pancreatitis Emphysematous cholecystitis

Acute pancreatitis (The Cullen sign is a bluish discoloration that is present around the umbilicus, and the Grey-Turner sign is a reddish-brown discoloration that is present along the flanks. The Cullen sign and Grey-Turner sign would be observed during the physical examination of clients who have acute pancreatitis)

The nurse is providing care for a pt in the ER w/ an initial presence of pain in the abdomen. Ass. elicits the presence of rebound pain at McBurney's point, an US is + for an inflamed appendix, & WBCs are moderately elevated. Which prescription does the nurse anticipate from the provider? Initiate NPO status & start an IV infusion Medicate the pt w/ opioids for pain above a level 5 Admin. oral antibiotics & explain continued use at home Present info regarding the risk for developing peritonit

Admin. oral antibiotics & explain continued use at home (Some patients with nonperforated appendicitis can be treated with antibiotics alone. Compared with those who underwent immediate appendectomy, patients treated with antibiotics have lower or similar pain scores, require fewer doses of narcotics, have a quicker return to work, and do not have a higher perforation rate. This is the expected prescription based on the client's presentation)

While assessing a client who has liver dysfunction, the nurse finds the client has shifting abdominal dullness. Which condition does the nurse suspect in the client? Ascites Splenomegaly Spider angiomata Esophageal varices

Ascites (Shifting dullness is a clinical sign that is an indication of fluid buildup in the abdomen (ascites))

While assessing a client with liver cirrhosis, the nurse examines the client for indication of encephalopathy. Which manifestation indicates the development of encephalopathy? Spider angiomata Abdominal ascites Coagulopathy Asterixis

Asterixis (Failure of the liver to remove nitrogenous wastes results in the accumulation of toxins and causes encephalopathy. Hepatic encephalopathy may cause neurologic disturbances, including asterixis, which is characterized by flapping tremors of the hands)

On assessing a client with a gastrointestinal disorder, the nurse finds steatorrhea, abdominal distension, and muscle wasting. The health-care provider prescribes corticosteroid therapy for the client. Which instruction does the nurse provide to effectively manage the condition? Reduce alcohol ingestion Reduce coffee consumption Avoid fiber-containing foods Avoid gluten-containing foods

Avoid gluten-containing foods (Symptoms such as steatorrhea, abdominal distension, and muscle wasting indicate celiac disease. A client with this condition will have effective treatment with corticosteroid therapy. The client's condition is aggravated in the presence of gluten-containing foods. Therefore, the nurse will instruct the client to avoid such foods for effective management of the condition)

The nurse is assessing a client with pain in the right upper quadrant for 4 hours. The client reports the pain is radiating to the upper thoracic region. A laboratory report suggests elevated liver enzymes and serum bilirubin. Which condition does the nurse suspect from the findings? Biliary tract disorder Biliary colic Cholecystitis Acute pancreatitis

Biliary colic (Calculous biliary colic is pain caused by an irritation of the gallbladder in which the pain lasts for several hours. Clients who have calculous biliary colic will exhibit nausea, vomiting, and pain in the right upper quadrant and right flank)

A client tells the nurse, "I have intense stomach pain for 3 hours after eating." On assessment the nurse finds abdominal pain and tenderness. The nurse suspects the client has peptic ulcers. Which diagnostic procedure does the nurse expect the health-care provider to prescribe? Ultrasound of the abdomen Blood test for Helicobacter pylori antibodies Fecal occult blood test Computerized tomography (CT) scan

Blood test for Helicobacter pylori antibodies (Symptoms such as pain in the stomach for 2 to 3 hours after eating and assessment findings such as abdominal pain and tenderness indicate the presence of peptic ulcer disease (PUD). Patients with suspected cases of PUD are tested for the presence of H. pylori; a blood sample is analyzed for the presence of antibodies to H. Pylori. This is the most common method of preliminary diagnosis in PUD)

The nurse is assessing a client with episodic abdominal pain, constipation, and flatulence. Upon physical assessment and review of the laboratory findings, the nurse concludes the client has jaundice and elevated serum amylase. Which condition does the nurse suspect in the client? Cholelithiasis Cholecystitis Acute pancreatitis Chronic pancreatitis

Chronic pancreatitis (Clients who have chronic pancreatitis experience episodic epigastric, upper left quadrant pain; anorexia; constipation; and flatulence. Elevation of serum amylase and lipase occurs with pancreatic inflammation. Pancreatic malfunctioning results in jaundice; therefore, the nurse should suspect that the client has chronic pancreatitis)

A nurse is caring for a client with cholecystitis and diagnosed with pruritus. Which medication does the nurse expect the health-care provider to prescribe for the client? Ursodiol (Actigall) Hydromorphone (Dilaudid) Chenodiol (Chenix) Cholestyramine (Questran)

Cholestyramine (Questran) (Pruritus occurs when bile salts accumulate in the blood. This is caused by the biliary obstruction of the bile in the common bile duct. Cholestyramine (Questran) binds with the bile salts and helps it to be excreted in the feces; therefore, the nurse should expect the health-care provider to prescribe cholestyramine (Questran) for the client who has pruritus)

The nurse is assessing a client in the emergency department. The client states, "I have been really sick with an infection and now I have this awful diarrhea." Which type of gastroenteritis does the nurse suspect? Campylobacter Escherichia coli Clostridium difficile Helicobacter pylori

Clostridium difficile (Recent antibiotic use or hospitalization can predispose the patient to C. difficile infection. The client's statement regarding treatment for what sounds like a serious infection indicates antibiotic therapy. For this reason, the nurse suspects C. difficile)

Upon physical examination, the nurse detects abdominal tenderness, increased bowel sounds accompanied by signs of borborygmi, abdominal distension, and tympany on percussion. Which diagnostic test distinguishes Crohn's disease from ulcerative colitis in the client? Colonoscopy Urinalysis Complete blood count Chest x-ray

Colonoscopy (Colonoscopy is the diagnostic test used to distinguish between Crohn's disease and ulcerative colitis. It determines the underlying pathology in the colon, which is involved in the disorder. Therefore, colonoscopy will help the nurse to distinguish Crohn's disease from ulcerative colitis in the client)

The nurse is reviewing anatomy and physiology with staff nurses. Which structure does the nurse identify as being at risk for choledocholithiasis? Cystic duct Hepatic duct Pancreatic duct Common bile duct

Common bile duct (Choledocholithiasis is the formation of stones in the common bile duct)

Which diagnostic test does the health-care provider order to get the most accurate information related to appendicitis? Urinalysis Abdominal x-ray Abdominal ultrasound Computerized tomography scan

Computerized tomography scan (A computerized tomography scan is used to get the most accurate information related to appendicitis)

Which is a characteristic feature of ulcerative colitis? Presence of cobblestone appearance Continuous areas of inflammation in the large intestine Healthy tissues interrupted by areas of diseased tissue Presence of anal fissure and anal fistula formations

Continuous areas of inflammation in the large intestine (Continuous areas of inflammation in the large intestine are a characteristic feature of ulcerative colitis)

The nurse reviews the colonoscopy report on a client. The nurse concludes that which disorder is diagnosed by the presence of a "cobblestoning" appearance? Volvulus Appendicitis Crohn's disease Ulcerative colitis

Crohn's disease (Cobblestoning is the appearance of multiple round projections from the surface. In Crohn's disease, the bowel mucosa develops granulomas, which appear like cobblestones)

The nurse is reviewing the medical record of a client admitted with severe malabsorption disorder because of pancreatic enzyme deficiency. The nurse is aware of a variety of disorders that can cause the diagnosis. Which pancreatic disorder does the nurse recognize as being genetically related? Cystic fibrosis Celiac disease Crohn's disease Systemic lupus erythematosus

Cystic fibrosis (Severe pancreatic insufficiency occurs in cystic fibrosis, which is a genetically related disease)

Which part of the stomach most commonly harbors Helicobacter pylori? 1. Body 2. Fundus 3. Pylorus 4. Duodenum

Fundus (The fundus is the uppermost portion of the stomach. Usually, the fundus harbors the H. pylori bacterium, which is the most common cause of chronic gastritis.)

Which characteristic feature of dumping syndrome does the nurse recognize in a client after bariatric surgery? Steatorrhea Diaphoresis Colicky cramping Hematemesis

Diaphoresis (Diaphoresis is the excessive production of fluids secreted by sweat glands in the skin. It is a characteristic feature in clients with dumping syndrome)

The nurse is caring for a client with abdominal distention and pain in the right upper quadrant. The nurse suspects a biliary disorder in the client. Which medication does the nurse expect the health-care provider to prescribe for the client to relieve pain? 1. Morphine 2. Codeine 3. Dilaudid 4. NSAIDs

Dilaudid (Narcotic analgesics are preferred to relieve pain in biliary disorders, as they do not cause contraction of muscles. Dilaudid is a narcotic analgesic that helps in relieving pain; therefore, the primary healthcare provider should prescribe Dilaudid to ensure the client's safety)

While reviewing the medical file of a client with cirrhosis, the nurse finds that the client has steatorrhea. Which reason does the nurse identify for this condition in the client? Hyperbilirubinemia Activation of stellate cells Diminished synthesis of bile Nitrogenous waste accumulation in the blood

Diminished synthesis of bile (Bile is produced by the liver and is essential for the digestion of fats. In liver cirrhosis, the production of bile is diminished, leading to the accumulation of undigested fat in the liver, causing steatorrhea)

Which gastrointestinal disorder occurs after bariatric surgery involving removal of part of the stomach? Dumping syndrome Mallory-Weiss syndrome Zollinger-Ellison syndrome Plummer-Vinson syndrome

Dumping syndrome (Dumping syndrome is the gastrointestinal disorder that occurs due to the removal of part of the stomach. It is characterized by epigastric fullness, syncope, palpitations, and hypoglycemia)

A client is admitted into the emergency room with hematemesis; dark urine; and black, tarry feces. On examination, the nurse finds that the client has weight loss and a distended abdomen. Which condition does the nurse suspect in the client? Hiatal hernia Acute gastritis Pyloric stenosis Esophageal varices

Esophageal varices (A client with esophageal varices presents with symptoms of cirrhosis of the liver, such as dark urine, weight loss, and a distended abdomen. The primary clinical symptoms associated with this condition include hematemesis and melena. Hematemesis is the vomiting of blood. Melena is the presence of black, tarry feces)

The nurse is preparing teaching material to present to a community group about the common risk factors for cholecystitis. Which factor does the nurse include for female attendees? Age greater than 40 years High-calorie, high-cholesterol diet Incidence of multiple pregnancies Genetic predisposition

Incidence of multiple pregnancies (The risk related to multiple pregnancy is specifically related to female attendees. Other gender-specific risks include estrogen, oral contraceptives, and pregnancy)

The nurse is reviewing anatomical information about the pancreas. Which conclusion about the function of the pancreas is correct? It is a hollow organ that sits just beneath the liver. It is involved in the digestion of carbohydrates. It produces a bicarbonate as a natural antacid. It stimulates the secretion of cholecystokinin (CCK).

It produces a bicarbonate as a natural antacid. (The pancreas also produces bicarbonate, which is a natural antacid)

The nurse is providing care for a client admitted with an obstruction of the common bile duct. Which additional condition does the nurse associate with the admitting diagnosis? Cholecystitis Pancreatic cancer Jaundice Biliary sludge

Jaundice (An obstruction of the common bile duct leads to a backup of bile into the gallbladder and liver. This results in an increase of bilirubin levels, which leads to jaundice; therefore, jaundice should be suspected in a client who has an obstruction of the common bile duct)

Which diagnostic procedure does the health-care provider use to confirm advanced chronic pancreatitis with exocrine insufficiency in a client? Ultrasound Cholecystogram Fecal chymotrypsin Endoscopic retrograde cholangiopancreatography (ERCP)

Fecal chymotrypsin (Fecal chymotrypsin is used to confirm advanced chronic pancreatitis with exocrine insufficiency in a client)

The nurse is providing care for a client diagnosed with Helicobacter pylori. Which diagnostic test result is the nurse least likely to expect? Urea breath test Stool antigen test Blood test for antibodies Fasting serum gastrin level

Fasting serum gastrin level (Zollinger-Ellison syndrome is a rare disorder that accounts for less than 1% of duodenal or gastric ulcers. It is most commonly caused by a gastrin-secreting tumor (gastrinoma) of the pancreas. The condition does not involve H. pylori)

The laboratory report of a client is provided here. Which condition does the nurse suspect in the client? Serum albumin 4 g/dL Indirect bilirubin 1.5 mg/dL Prothrombin time 14 sec Alkaline phosphatase 100 U/mL Coagulopathy Biliary cirrhosis Hypoalbuminemia Gilbert's disease

Gilbert's disease (he normal range of indirect bilirubin is less than 0.8 mg/dL, but the client has increased indirect bilirubin levels. This increase is seen in clients with Gilbert's disease because of elevated unconjugated bilirubin in the bloodstream)

The nurse is reviewing both the functions and dysfunctions of the pancreas. Which diagnosis related to pancreatic dysfunction is the greatest risk to the client with chronic pancreatitis? Diabetes mellitus Inflammation Gland destruction Insulin insufficiency

Gland destruction (During the inflammatory process, the digestive enzymes attack the pancreatic tissue, which causes autodigestion. In chronic pancreatitis, recurring inflammation occurs, causing gradual destruction of the gland, leaving it nonfunctional, fibrotic, and atrophied. This is the diagnosis that presents the greatest risk to the client because all pancreatic function is lost)

Which part of the gastrointestinal (GI) tract is involved in the production of protective mucus? Goblet cells Submucosal layer Circular muscle layer Columnar epithelial cells

Goblet cells (The goblet cells of the GI tract are involved in the production of mucus, which protects the GI tract from injuries)

Which virus helper function is needed for the replication of hepatitis D virus? Hepatitis A virus (HAV) Hepatitis B virus (HBV) Hepatitis C virus (HCV) Hepatitis E virus (HEV)

Hepatitis B virus (HBV) (HDV is an incomplete defective RNA virus. It uses the enzymes produced by HBV to reproduce. Therefore, HDV uses the helper function of HBV for replication and propagation)

The nurse is preparing a client for a laparoscopic fundoplication. Reports on previously performed endoscopy and barium tests are not yet available. On reviewing the medical history, the nurse notes the client complains of dysphagia, substernal burning, and belching. Which condition does the nurse expect to be identified in the client? Hiatal hernia Gastritis Stomach cancer Schatzki ring

Hiatal hernia (Hiatal hernia is a structural problem, described as part of the stomach protruding into the thoracic cavity through an opening in the diaphragm. Laparoscopic fundoplication is the surgical repair for a hernia when symptoms such as dysphagia and substernal burning do not respond to other treatments)

Which factor is identified as a cause for acute inflammation of the pancreas? Moderate alcohol intake High triglyceride level Influenza antibodies Live virus vaccine

High triglyceride level (An increase in the levels of triglycerides is one of the factors that lead to acute inflammation of the pancreas)

The client's laboratory reports indicate high levels of bilirubin. Which conclusion does the nurse infer from the report? The client has stones in the common bile duct. The client has decreased pancreatic enzymes. The client has stones in the gallbladder. The client has an infection of the pancreas.

The client has stones in the common bile duct. (The presence of gallstones in the common bile duct leads to the obstruction of bile. This obstruction leads to a backup of bile into the gallbladder and liver, which causes a rise in the levels of bilirubin)

After assessing a client with biliary cirrhosis, the nurse identifies the presence of xanthelasmas. Which laboratory test supports the nurse's assessment finding? Endoscopy Lipid levels Bilirubin levels Prothrombin time

Lipid levels (Xanthelasmas are cholesterol deposits around the eyes. These are caused by elevated lipid levels. Therefore, a lipid profile test will help confirm the diagnosis)

The nurse in an intensive care unit (ICU) is providing care for a client diagnosed with encephalopathy due to severe liver disease. Which nonpharmacological treatment is most important for the nurse to initiate? Frequently reorient the client to person, time, and place Monitor routinely for an increase in jaundice Pad side rails and protect from physical injury Encourage frequent, nutritional dietary intake

Pad side rails and protect from physical injury (With encephalopathy, the client will exhibit asterixis, which is wrist flapping that can cause injury. In addition, a decrease in the absorption of fat-soluble vitamins, such as vitamin K, will cause a lack of clotting and lead to bruising and bleeding. The most important nursing intervention is for client safety)

The nurse is providing care for a pt w/ a recent spinal cord injury resulting in paralysis from the midthoracic region downward. The pt is unable to initiate or control bowel function, but states to the nurse, "I am going to get bowel training later." Which factor does the nurse consider in response to the pt? Ability to control the sphincter muscles may return Bowel stimulants will aid in self-management Neural control of the large intestine is likely lost

Neural control of the large intestine is likely lost (Neural control of the large intestine is generally directed by the autonomic nervous system, as well as the nerves that compose the enteric nervous system, which lies entirely in the wall of the gastrointestinal (GI) tract. Paralysis from spinal cord injury interrupts the neural control)

The nurse is using the Ranson's criteria to assess a client's pancreatitis. After 48 hours, which finding validates the client's need to remain hospitalized? White blood cell (WBC) count greater than 16,000 Lactic dehydrogenase greater than 600 U/L Glucose greater than 10 mmol/L Partial pressure of oxygen less than 60 mm Hg

Partial pressure of oxygen less than 60 mm Hg (After 48 hours, partial pressure of oxygen less than 60 mm Hg is indicative of the need to remain hospitalized)

A client with sudden, excruciating abdominal pain; pale skin; and hematemesis is admitted to the emergency room. On assessment, the client acknowledges an overdose of NSAIDs and a history of substance abuse. The health-care provider instructs the nurse to prepare the client for a gastrojejunostomy procedure. Which condition does the nurse anticipate in the client? Hiatal hernia Acute gastritis Pyloric stenosis Peptic ulcer disease

Peptic ulcer disease (Peptic ulcer disease is characterized by sudden, excruciating abdominal pain; pale skin; and hematemesis. A gastrojejunostomy is done, which involves the removal of the lower portion of the stomach and the remaining portion is connected to the jejunum to reduce ulcer-producing properties)

The nurse is providing care for a pt admitted with abdominal pain, abdominal rigidity, and rebound tenderness. The healthcare provider suspects appendicitis & prescribes tests to validate the dx. Which test result indicates a more serious dx? A sudden decrease in the amount of client-reported pain WBCs count of 10,000 cells/mcL with a high neutrophil count Peritoneal fluid with a neutrophil count of 700 cells/mcL Blood pressure (BP) 130/78 mm Hg, respirations 20/min, pulse 82/min

Peritoneal fluid with a neutrophil count of 700 cells/mcL (A sample of peritoneal fluid is withdrawn and analyzed. Peritoneal fluid with a neutrophil count 700 cells/mcL (above 500 cells/mcL) is indicative of peritonitis, which is a more serious diagnosis than the suspected appendicitis)

Which is the largest serous membrane in the body? Peritoneal serosa Submucosal layer Columnar epithelium Circular muscle layer

Peritoneal serosa (Peritoneum is the loosely attached outermost layer of the intestine. It is the largest serous membrane in the body)

The nurse is providing care for an older adult client who presents with abdominal cramping, abdominal distention, and the inability to have a bowel movement. An abdominal x-ray reveals a distended colon, with loops of dilated bowel superior to an obstruction. Which treatment does the nurse expect to be prescribed? Placement of a nasogastric tube Laxatives to stimulate peristalsis Pureed, bland diet as tolerated Enemas until return is clear

Placement of a nasogastric tube (For intestinal decompression, a nasogastric tube is inserted into the stomach to relieve pressure from the obstruction. The dilated loops of bowel superior to the obstruction need to be decompressed)

The nurse finds ursodiol in a client's prescription. Which condition does the nurse suspect in the client? Gilbert's syndrome Alcoholic liver disease Crigler-Najjar syndrome Primary biliary cirrhosis

Primary biliary cirrhosis (Ursodiol helps to move bile out of the liver and intestine. It reduces serum alkaline phosphatase and aminotransferase levels in primary biliary cirrhosis. This is why the nurse suspects primary biliary cirrhosis in the client)

The health-care provider asks a client to lie down facing upwards and flex the right thigh at the hip. The client says, "I cannot do this. This position is hurting my abdomen." Which sign of appendicitis does the nurse recognize in this client? Psoas sign Rovsing sign Obturator sign Rebound tenderness

Psoas sign (The psoas sign can be identified if the client complains of pain upon flexing the right thigh at the hip)

In a pt dx with lg bowel obstruction, an abdominal x-ray is performed, which shows the presence of free air under the diaphragm. After the dx, the nurse initiates prophylactic antibiotic therapy & fluid replacement therapy per the prescriptions of the provider. Which outcome in the pt indicates the effectiveness of the therapy? Pt has normal levels of serum amylase. Pt has a normal count of red blood cells. Pt no longer experiences abdominal cramps. Pt no longer experiences chronic diarrhea.

Pt has normal levels of serum amylase. (In a client with large bowel syndrome, the serum amylase levels are elevated when the client has perforations in the bowel or the organ. In this case, the chest x-ray showed the presence of free air under the diaphragm, which indicates the presence of perforations. Therefore, the presence of normal serum amylase levels indicates effectiveness of therapy)

The nurse is assessing a client who reports nausea, vomiting, abdominal pain, and discomfort. The nurse finds that the abdomen is firm and peristalsis is visible. The laboratory reports show electrolyte imbalances. Which condition does the nurse anticipate in the client? Hiatal hernia Acute gastritis Pyloric stenosis Peptic ulcer disease

Pyloric stenosis (Pyloric stenosis is defined as constriction of the pyloric sphincter, characterized by abdominal pain and distention due to accumulation of fluids. Nausea and vomiting are common symptoms. Electrolyte disturbances are due to vomiting. On palpation of the abdomen, the nurse finds firm and visible peristalsis due to decreased emptying)

A female pt is admitted to the hospital with abdominal pain that originates in the umbilical region & radiates to the right lower quadrant. The provider prescribes a urinalysis. In which manner does this help the health-care provider diagnose the client's condition? Rules out the possibility of calcium stones within the appendix Rules out the possibility of a kidney stone or pyelonephritis Rules out the possibility of ectopic pregnancy Rules out the possibility of a gynecological disorder

Rules out the possibility of a kidney stone or pyelonephritis (Urinalysis will determine the level of urea in urine, which provides information about kidney stones or pyelonephritis. Therefore, the health-care provider can rule out the possibility of kidney stones or pyelonephritis in the client)

The nurse is providing care for a client with renal disease and notices a slight yellowish color of the skin. The client reports recent symptoms of the flu. Which contributing factor does the nurse identify as increasing the client's possibility of hepatitis B? Renal disease is treated with hemodialysis Ethnic background identified as Caucasian Recent travel to Central and Southeast Asia Ingestion of raw or undercooked shellfish

Renal disease is treated with hemodialysis (The treatment of renal disease with hemodialysis increases the risk of the client developing hepatitis B. The client's manifestations support stage 2 hepatitis B)

A client tells the nurse, "I have had abdominal pain, bloating, visual disturbances, and bone pain for the last 3 to 6 months." On assessment, the nurse finds excessive weight loss and suspects an autoimmune hypersensitivity disorder. Which diagnostic test does the health-care provider recommend for further confirmation? Abdominal computerized tomography (CT) scan Ultrasound abdomen Serology celiac panel Barium contrast x-ray series

Serology celiac panel (A serology celiac panel is used to determine an immune reaction to gluten, which confirms the diagnosis of celiac disease. Celiac disease is an autoimmune disorder that occurs from a hypersensitive reaction to gluten)

The nurse suspects hepatic encephalopathy in a client with severe liver dysfunction. Which symptom supports the nurse's suspicion? Stupor Ascites Hematemesis Spider angiomata

Stupor (The accumulation of toxins in the brain results in hepatic encephalopathy and leads to decreased mental function, thus causing stupor. Stupor is the lack of critical cognitive function and decreased level of consciousness (confusion and disorientation))

A client reports fatigue and arthralgia to the nurse. On physical assessment, the nurse finds that the client has hyperpigmentation of the skin. Which laboratory test does the nurse suggest for safe and effective care of the client? Bilirubin levels Serum ferritin levels Ceruloplasmin levels Immunoglobulins level

Serum ferritin levels (Signs and symptoms such as fatigue, arthralgia, and hyperpigmentation of the skin are due to iron overload in clients with hematochromatosis. Clients with hematochromatosis have high iron, serum ferritin, and transferrin levels. So, serum ferritin levels are important to confirm the diagnosis)

A health-care provider suspects the presence of hemorrhoids in a client. Which diagnostic test does the health-care provider prescribe to support the suspected diagnosis? Biopsy Chest x-ray Colonoscopy Sigmoidoscopy

Sigmoidoscopy (Sigmoidoscopy is the insertion of a flexible tube to examine the sigmoid colon. Therefore, the health-care provider will order a sigmoidoscopy to visualize the lower bowel and check for the presence of hemorrhoids)

The nurse finds a note stating, "Reduction of 15% to 20% from the original stomach size" while reviewing the medical record of an obese client. Which surgical procedure does the nurse expect for this client? Gastric bypass Gastric banding Sleeve gastrectomy Biliopancreatic diversion with duodenal switch

Sleeve gastrectomy (Sleeve gastrectomy involves subtotal gastrectomy, in which the stomach size is reduced to about 15% to 20% of its original size)

Which side effect does the nurse expect to observe in a client who is on epinephrine therapy? Gastrocolic reflex Injuries to the gastric epithelium Suppression of the urge to defecate Decreased gastrointestinal secretions

Suppression of the urge to defecate (Epinephrine suppresses the gastrocolic reflex, which is responsible for the propulsion of bowels and initiation of the urge to defecate. Therefore, the client who is on epinephrine therapy will have suppression of the urge to defecate)

A client is brought to the hospital because of severe abdominal pain, nausea, and vomiting. The client reports increased pain in the abdomen and in the epigastric region radiating to the back when lying supine. During physical assessment, the nurse finds the client has fever and hypotension. Which condition does the nurse suspect from these findings? The client has cholelithiasis. The client has cholecystitis. The client has acute pancreatitis. The client has chronic pancreatitis.

The client has acute pancreatitis. (Clients who have acute pancreatitis experience severe abdominal and epigastric pain radiating to the back when lying supine. Nausea and vomiting are also associated with this condition. Acute pancreatitis also results in hypotension, fever, and jaundice in the client; therefore, the nurse should conclude that the client has acute pancreatitis)

The nurse is caring for multiple clients in an acute care setting. Which client does the nurse identify as being at risk for nonalcoholic fatty liver disease (NAFLD)? The client being treated for hepatitis B The client with exposure to isoniazid The client who is a strict vegetarian The client with cell-mediated immunity

The client who is a strict vegetarian (Lack of proteins in the diet leads to a deficiency of amino acids that are needed by the liver for the conversion of fat to phospholipids, lipoproteins, and transportation of fat/cholesterol from the cells. This can cause fat accumulation in the liver, resulting in NAFLD)

Which client does the nurse instruct to avoid eating or drinking food items that are hot or spicy? The client with esophagitis The client with esophageal cancer The client with dumping syndrome The client with upper gastrointestinal bleed (UGIB)

The client with esophagitis (Esophagitis is the inflammation of the esophagus due to reflux of gastric acid. Therefore, the nurse instructs the client with esophagitis to avoid eating or drinking items that have an extreme temperature or spices to prevent reflux of gastric acid)

The nurse finds increased glucose levels in a client with chronic pancreatitis. Which does the nurse interpret from the finding? The client's beta cells are damaged. The client has decreased pancreatic enzymes. The client has high bile salts in the blood. The client's gallbladder was surgically removed.

The client's beta cells are damaged. (Glucose levels increase when there is a damage of insulin-producing cells, which are known as beta cells, in the pancreas. During chronic pancreatitis, the insulin-producing cells may get damaged and result in a rise in glucose levels)

For a client diagnosed with terminal ileal disease, the health-care provider prescribes sulfasalazine. Which outcome in the client indicates the effectiveness of the therapy? The client's gastrointestinal wall is normalized. The client's hematocrit percentage is normal. The client is able to absorb bile acids. The client's urinalysis results show normal values.

The client's gastrointestinal wall is normalized. (Sulfasalazine is a salicylic acid derivative, which is used to reduce gastrointestinal inflammation caused by the immune response. Therefore, a normalized gastrointestinal wall represents the effectiveness of sulfasalazine therapy in a client with terminal ileal disease)

The nurse teaches a group of staff nurses about the dx of IBS. After the teaching session, an attending nurse is asked to determine the presence of lactose intolerance in a client with IBS. Which intervention by the nurse indicates effective learning? The nurse performs a complete blood analysis of the client. The nurse performs a hydrogen breath test on the client. The nurse performs a blood draw for culture and sensitivity. The nurse performs testing on a stool sample for occult blood

The nurse performs a hydrogen breath test on the client. (The hydrogen breath test is used to determine lactose intolerance in a client by determining the amount of hydrogen exhaled. This intervention by the nurse is correct and indicates effective learning)

The nurse is preparing information for a client newly diagnosed with ulcerative colitis. Which information is more likely associated with Crohn's disease than with ulcerative colitis? Only the large intestine is affected. The patient is prone to anal fistula and fissure formation. It predisposes the client to colon cancer. The disease affects only the mucosa and submucosa layers.

The patient is prone to anal fistula and fissure formation. (Clients with ulcerative colitis are not prone to developing anal fistulas or fissures; this manifestation is seen in clients with Crohn's disease)

The health-care provider suggests the hepatitis C virus (HCV) genotyping test to a client with liver disease. Which is the most likely rationale for this testing? To predict prognosis To determine the severity of the disease To predict the likelihood of response and the duration of treatment To detect the presence of antibodies against two or more antigens

To predict the likelihood of response and the duration of treatment (HCV genotyping is a diagnostic test that is performed in a client with liver disease to predict the likelihood of response and duration of treatment)

The client with alcoholic liver disease is experiencing bruising, nosebleed, and hematemesis. Which treatment option does the nurse suspect to be effective in this client? Diuretics Vitamin K Band ligation Phototherapy

Vitamin K (The lack of synthesis of the coagulation factors occurs in the case of liver diseases, resulting in prolonged prothrombin time. Therefore, the client experiences bruising, nosebleed, and hematemesis. The nurse suspects vitamin K to be useful in this client because it helps in the synthesis of the clotting factors)

Which disorder of the large intestine may require laparoscopic surgery to unwind the intestine? Volvulus Appendicitis Hemorrhoids Diverticular disease

Volvulus (Volvulus is the twisting of the large intestine around the point of attachment in the abdomen. Therefore, this disorder of the large intestine requires laparoscopic surgery to unwind the intestine)

The health-care provider prescribes a fasting serum gastrin level test and a magnetic resonance imaging (MRI) scan for symptoms of peptic ulcer. On reviewing the test reports, the nurse finds a diagnosis of hypergastrinemia and a tumor. The nurse administers the prescribed proton pump inhibitors. Which condition does the nurse identify? Dumping syndrome Mallory-Weiss syndrome Zollinger-Ellison syndrome Plummer-Vinson syndrome

Zollinger-Ellison syndrome (Zollinger-Ellison syndrome is characterized by severe symptoms of a peptic ulcer. Proton pump inhibitors are used to inhibit the activity of parietal cells and neutralize HCl acid)