Exam 2 GI/GU

A nurse assesses patients at a community health center. Which patient is at highest risk for pancreatic cancer?

50 year old with BRCA2 gene mutation

A nurse assesses patients on the medical-surgical unit. Which patient is at greatest risk for the development of carcinoma of the liver?

66 year old with history of cirrhosis

A nurse is acquainting a group of newly licensed nurses with the role of the various members of the health care team they will encounter on a medical-surgical unit. When she gives examples of the types of tasks certified nursing assistants may perform, which of the following client activities should she include?

Ambulating, bathing, toileting, vitals

A patient is in the family practice clinic. Today the patient weights 186.4 lbs. Six months ago, the patient weighted 211.8 lbs. What action by the nurse is best?

Ask the patient if the weight loss was intentional

A nurse cares for a patient who is hemorrhaging from bleeding esophageal varices and has an esophagogastric tube. What action would the nurse take first?

Assess for airway patency

A nurse assesses a patient who is recovering from an open Whipple procedure. Which action would the nurse perform first?

Assess the patient's endotracheal tube with 40% FiO2

A nurse cares for a patient who is scheduled for a paracentesis. Which intervention would the nurse delegate to unlicensed assistive personnel (UAP)?

Assist patient to void before procedure

A patient is awaiting bariatric surgery in the morning. What action by the nurse is most important?

Begin DVT prophylaxis

A nurse offers pain medication to a client who is postoperative prior to ambulation. The nurse understands that this aspect of care delivery is an example of which of the following ethical principles?

Beneficience

A patient is receiving bolus feedings through a Dobhoff tube. What action by the nurse is most important?

Check tube placement before each feeding

The nurse is caring for a client with gastrointestinal disorders would understand which category best describes the mechanism of action of sucralfate?

Mucosal barrier fortifier

A nurse assesses a patient who is recovering from a Whipple procedure. Which assessment finding alerts the nurse to urgently contact the healthcare provider?

Drainage from a fistula

..... is the most commonly reported symptom associated with PUD.

Dyspepsia

A nurse assesses a patient who has liver disease. Which laboratory findings would the nurse recognize as potentially causing complications of this disorder?

Elevated PT, INR, serum ammonia

A patient just returned to the surgical unit after a gastric bypass. What action by the nurse is the priority?

Ensure an adequate airway

is the inflammation of gastric mucosa.

Gastritis

An older female patient has been prescribed esomeprazole (Nexium) for treatment of chronic gastric ulcers. What teaching is particularly important for this patient?

Increase intake of calcium and Vitamin D

A nurse cares for a patient with hepatic portal-systemic encephalopathy (PSE). The patient is thin and cachectic in appearance, and the family expresses distress that the patient is receiving little dietary protein. How would the nurse respond?

Less protein in the diet will help prevent confusion associated with liver failure

A nurse assesses a patient who has cholecystitis. Which clinical manifestation indicates that the condition is chronic rather than acute?

Light colored stools

A nurse plans care for a patient with acute pancreatitis. Which intervention would the nurse include in this patient's plan of care to reduce discomfort?

Maintain NPO and administer IV fluids

The nurse is caring for a patient with peptic ulcer disease who reports sudden onset of sharp abdominal pain. On palpation, the patient's abdomen is tense and rigid. What action take priority?

Notify healthcare provider immediately

The nurse is caring for a patient with peptic ulcer disease who reports sudden onset of sharp abdominal pain. On palpation, the patient's abdomen is tense and rigid. What action take priority?

Notify the health care provider immediately

The student nurse studying stomach disorders learns that the risk factors for acute gastritis include with of the following?

Nsaids, caffeine, alcohol, corticosteroids

A nurse is explaining the various levels of health care services to a group of newly licensed nurses. Which of the following examples of care or care setting should the nurse classify as tertiary care?

Oncology treatment center, Burn Center, ICU

For which patient would the nurse suggest the provider not prescribe misoprostol (Cytotec)?

Patient taking antacids

A nurse plans care for a patient who has acute pancreatitis and is prescribed nothing by mouth (NPO). With which healthcare team members would the nurse collaborate to provide appropriate nutrition to this patient?

Pharmacist, provider, dietician

A nurse cares for a patient who has cirrhosis of the liver. What action would the nurse take to decrease the presence of ascites?

Provide a low sodium diet

A client has a pyloric obstruction and reports sudden muscle weakness. What action by the nurse takes priority?

Request an Electrocardiogram

After teaching a patient who has a history of cholelithiasis, the nurse assesses the patient's understanding. Which menu selection made by the patient indicates that the patient clearly understands the dietary teaching?

Roasted chicken breast, baked potato with chives, orange juice

An emergency room nurse assesses a patient with potential liver trauma. Which clinical manifestations would alert the nurse to internal bleeding and hypovolemic shock?

Tachycardia, confusion

A patient is being taught about drug therapy for Helicobacter pylori infection. What assessment by the nurse is most important?

Willingness to adhere to drug therapy

If not addressed ..... can result.

autodigestion

A client with peptic ulcer disease is in the emergency department and reports the pain has gotten much worse over the last several days. The patient's blood pressure when lying down was 122/80 mm Hg and when standing was 98/52 mm Hg. What action by the nurse is the most appropriate?

Start a large bore IV with normal saline

A nurse is caring for four patients receiving enteral tube feedings. Which patient should the nurse see first?

Patient with a potassium level of 2.6

A client with a bleeding gastric ulcer is having a nuclear medicine scan. What action by the nurse is most appropriate?

Inform the client a second scan may be needed