Exam threeeeeee :(, ATI Upper GI System Practice Questions, GI Med surg test, GI

A nurse is providing teaching for a client who has gastroesophageal reflux disease (GERD) about ways to manage his condition. Which of the following instructions should the nurse include?

"Eat four small meals each day." The client should avoid eating large meals because of the pressure it places on the stomach. Instead, he should eat four to six small meals per day.

A nurse is caring for a client following the surgical placement of a colostomy. Which of the following statements indicates the client understands the dietary teaching?

"Eating yogurt can help decrease the amount of gas that I have." The client who has a colostomy can include yogurt into his diet to help reduce odors and intestinal gas.

A nurse is teaching a client who has a new prescription for ranitidine to treat peptic ulcer disease. Which of the following statements by the client indicate an understanding of the teaching? (Select all that apply.)

"I can take this medication with or without food." "I will eat five small meals each day"

A nurse is teaching a client who has a new prescription for esomeprazole to manage his GERD. Which of the following statements by the client indicates an understanding of the teaching?

"I have an increased risk of getting pneumonia while taking this medication." The client taking esomeprazole is at a greater risk for developing pneumonia due to an elevation of gastric pH, especially during the first few days of treatment. The nurse should instruct the client about manifestations of a respiratory infection and to report these findings to the provider if they occur.

A nurse is providing teaching to a client who has oral candidiasis and a new prescription for nystatin suspension. Which of the following statements by the client indicates an understanding of the teaching?

"I will store the medication at room temperature." Nystatin oral suspension should be stored at room temperature.

A nurse is caring for a client admitted for an acute exacerbation of ulcerative colitis. The most important nursing goal for this client is to: 1- maintain fluid and electrolyte balance 2- prevent skin breakdown 3- provide emotional support 4- promote physical mobility

1

A nurse is caring for a school-aged child receiving treatment for a systemic disorder with antibiotics, immunosuppressants, and corticosteroids. Both of the child's parents have a smoking history. The client reports soreness of his mouth and refuses to eat. Inspection of his mouth reveals a white, milky plaque. The nurse suspects which of the following conditions? 1- Candidiasis from antibiotic therapy 2- Dermatitis from immunosuppressive therapy 3- Herpex simplex from corticosteroid therapy 4- Squamous cell carcinoma from exposure to second hand smoke

1

A patient is noted to have "cobblestone" appearance of ulcers noted on sigmoidoscopy. The nurse understands that this patient has: 1- IBS 2- Crohn's disease 3- Ulcerative colitis 4- Peptic ulcer disease

2

A nurse is teaching a community education course about the physical complications related to substance use disorder. Which of the following findings should the nurse identify as the primary cause of liver cirrhosis? A. Alcohol B. Caffeine C. Cocaine D. Inhalants

A. Alcohol Chronic alcohol use disorder is one of the primary causes of cirrhosis of the liver.

A nurse is planning care for a client who has cirrhosis and ascites. Which of the following interventions should the nurse include in the plan of care? A. Decrease the client's fluid intake. B. Increase the client's saturated fat intake. C. Increase the client's sodium intake. D. Decrease the client's carbohydrate intake.

A. Decrease the client's fluid intake.

A nurse is reviewing the laboratory results of a client who has liver failure with ascites and is receiving spironolactone. Which of the following findings should the nurse expect? A. Decreased sodium level B. Decreased phosphate level C. Decreased potassium level D. Decreased chloride level

A. Decreased sodium level

A nurse is caring for a client who has liver cirrhosis with ascites, bleeding esophageal varices, and portal hypertension. The nurse recognizes which of the following laboratory findings as indicating the client's gastrointestinal (GI) tract is digesting and absorbing blood? A. Elevated blood urea nitrogen (BUN) B. Elevated HbA1c C. Decreased chloride D. Decreased bilirubin

A. Elevated blood urea nitrogen (BUN)

A nurse is assessing a client who has advanced cirrhosis. Which of the following manifestations should the nurse expect? A. Petechiae B. Hypertension C. Osteoarthritis D. Peripheral ulcers

A. Petechiae

A nurse is planning care for a client who has viral hepatitis. Which of the following actions should the nurse include in the plan of care? A. Provide a high carbohydrate diet. B. Administer acetaminophen for pain. C. Encourage eating three large meals daily. D. Include high protein snacks.

A. Provide a high carbohydrate diet.

A nurse is caring for a client who has cirrhosis and a prothrombin time of 30 seconds. Which of the following medications should the nurse plan to administer? A. Vitamin K B. Heparin C. Warfarin D. Ferrous sulfate

A. Vitamin K

A nurse is caring for a client who is postoperative following abdominal surgery. The nurse discovers a loop of bowel through an opening in the surgical incision. Which of the following actions should the nurse take?

Apply moistened sterile gauze to the site. The nurse should apply moistened sterile gauze to the site to reduce the risk for further injury and infection.

Why are hepatitis and HIV common coinfections? a. They both are caused by a bacterial infection. b. The both have the same mode of transmission. c. They both are spread through the fecal-oral route only. d. Vaccines do not exist for either of these diseases.

B

A patient presents to the ED with jaundice, fatigue, and severe abdominal pain in the right upper quadrant of the abdomen. He has a history of Hepatitis B. What disease process should the nurse suspect? (Select all that apply.) a. Hepatitis E b. Cirrhosis c. Hepatitis D d. Hepatitis A e. Hepatitis C

B and C

A nurse is assessing clients in a health clinic for risk factors for contracting hepatitis. Which of the following clients is at risk for developing hepatitis C? A. A client who eats raw shellfish B. A client who has multiple tattoos C. A client who works in a child care center D. A client who has recently traveled to a underdeveloped country

B. A client who has multiple tattoos

A nurse is preparing to administer a dose of lactulose to a client who has cirrhosis. The client states, "I don't need this medication. I am not constipated." The nurse should explain that in clients who have cirrhosis, lactulose is used to decrease levels of which of the following components in the bloodstream? A. Glucose B. Ammonia C. Potassium D. Bicarbonate

B. Ammonia

A nurse is caring for a client who has esophageal varices and is hypotensive after vomiting 500 mL of blood. Which of the following actions is the nurse's priority? A. Elevate the client's feet. B. Increase the client's IV fluid rate. C. Initiate a dopamine IV infusion for the client. D. Administer a unit of packed RBCs.

B. Increase the client's IV fluid rate.

A nurse is caring for a client who has bleeding esophageal varices and is being treated with a Sengstaken-Blakemore tube. Which of the following actions should the nurse perform? A. Deflate the balloons for 5 min every 2 hr to prevent tissue necrosis. B. Maintain constant observation while the balloons are inflated. C. Suction the tube every 2 hr and as needed to maintain patency. D. Keep the head of the bed flat at all times to prevent the development of shock

B. Maintain constant observation while the balloons are inflated.

A nurse is assessing a client who has cirrhosis. Which of the following is an expected finding for this client? A. Moist skin B. Spider angiomas C. Tarry stools D. Blood in the urine

B. Spider angiomas

A nurse is caring for a client who has cirrhosis and a new prescription for lactulose. Which of the following manifestations indicates an adverse effect of the medication? A. Dry mouth B. Vomiting C. Headache D. Peripheral edema

B. Vomiting

A nurse is caring for a client who has ulcerative colitis and is teaching the client about the common link with Crohn's disease. Which of the following information should the nurse include?

Both are inflammatory The nurse should inform the client that both disease processes are an inflammatory process of the gastrointestinal tract.

A nurse is planning care for a client who has diverticulitis. Which of the following menu selections should the nurse include in the plan?

Both of these items are low in fiber which is advised during the inflammation of diverticulitis. In the presence of diverticulosis, a high-fiber diet is indicated.

A nurse is teaching a client who has stomatitis. Which of the following instructions should the nurse include?

Brush teeth with a soft toothbrush. The client should use a soft toothbrush and gently brush after each meal to reduce mouth irritation and prevent superinfections.

A nurse is teaching a client who has hepatitis A about preventing transmission of the virus. Which of the following strategies should the nurse include in the teaching? A. Avoid eating at fast food restaurants. B. Avoid serving raw foods. C. Practice effective hand hygiene. D. Wear barrier protection during vaginal intercourse.

C. Practice effective hand hygiene.

A nurse is caring for a client who was admitted with bleeding esophageal varices and has an esophagogastric balloon tamponade with a Sengstaken-Blakemore tube to control the bleeding. Which of the following actions should the nurse take? A. Ambulate the client four times per day. B. Encourage the client to consume clear liquids. C. Provide frequent oral and nares care. D. Keep the client in a supine position.

C. Provide frequent oral and nares care.

A nurse is planning care for a client who has end-stage cirrhosis of the liver with encephalopathy. Which of the following interventions should the nurse plan to implement to decrease the client's ammonia level? A. Administer diuretics. B. Restrict the client's intake of fluids. C. Reduce the client's intake of protein. D. Administer vitamin K.

C. Reduce the client's intake of protein.

A nurse is teaching self-management to a client who has hepatitis B. Which of the following Instructions should the nurse include in the teaching? A. You may donate blood 6 months after completing the medication regimen. B. Consume a high-protein diet. C. Rest frequently throughout the day. D. Take acetaminophen every 4 hr, as needed, for discomfort

C. Rest frequently throughout the day.

A nurse is planning care for a client who is postoperative following a liver transplant. and weighs 65 kg. Which of the following actions should the nurse plan to take? A. Keep the client NPO for the first week postoperative. B. Limit caloric content once the client resumes eating. C. Stress the importance of safe food-handling practices. D. Decrease foods high in carbohydrates once the client resumes eating.

C. Stress the importance of safe food-handling practices.

A nurse is teaching a client who has a history of ulcerative colitis and a new diagnosis of anemia. Which of the following manifestations of colitis should the nurse identify as a contributing factor to the development of the anemia?

Chronic blood loss A client with long-standing ulcerative colitis is most likely anemic due to chronic blood loss in small amounts that occurs over time, although the colitis may result in erosion of the intestine and hemorrhage. These clients often report bloody stools and are therefore at increased risk for developing anemia.

A hepatitis B screen is performed on a pregnant client. The results indicate the presence of antigens in the maternal blood. Which of the follow should the nurse anticipate to be prescribed? a. Obtain serum liver function tests. b. Repeat hepatitis B screen in one week. c. Administer antibiotics during pregnancy. d. Administer hepatitis B vaccine and hepatitis B immune globulin to the newborn within 12 hours of birth.

D

A patient is suspected to have a bowel obstruction. The patient is vomiting frequently and complains of colicky abdominal pain. Which of the following would be a priority intervention for this patient? 1- Call radiology to schedule an abdominal X ray 2- Provide patient education on a low fiber diet 3- Administer an enema as ordered 4) Assess bowel sounds and insert an NG tube

D Probably a small bowel obstruction

A nurse is planning care for a client who has hepatitis B. Which of the following interventions should the nurse include in the plan? A. Administer antibiotics. B. Provide a diet high in fat. C. Restrict fluids. D. Encourage short periods of ambulation.

D. Encourage short periods of ambulation.

A nurse is teaching a client about causes of biliary cirrhosis. Which of the following information should the nurse include in the teaching? A. Excessive alcohol consumption B. Hepatitis C C. Hepatotoxic medications D. Obstruction of the bile duct

D. Obstruction of the bile duct

A nurse is admitting a client who has hepatitis C. Which of the following precautions should the nurse implement? A. Droplet B. Contact C. Airborne D. Standard

D. Standard

A nurse is caring for an older adult client who has had surgery for an intestinal obstruction and has an NG tube to wall suction. Which of the following interventions should the nurse include in the client's postoperative plan of care? (Select all that apply.)

Discontinue suction when assessing for peristalsis Irrigate the NG tube with 0.9% sodium chloride irrigation solution Place sequential compression devices on the bilateral lower extremities Reposition the client from side to side every 2 hr

A nurse is developing a plan of care for a client who is postoperative. Which of the following interventions should the nurse include in the plan to prevent pulmonary complications?

Encourage the use of an incentive spirometer Incentive spirometry expands the lungs and promotes gas exchange after surgery which can help prevent pulmonary complications.

A nurse is assessing a client who has peptic ulcer disease. Which of the following findings should the nurse identify as the priority?

Hematemesis When using the urgent vs. non-urgent approach to client care, the nurse should determine that the priority finding is hematemesis, which indicates massive bleeding.

A nurse is reviewing the medical record of a client who has a peptic ulcer. Which of the following findings should the nurse recognize as a risk factor for this condition?

History of NSAID use The nurse should recognize that long-term use of NSAIDs is a risk factor for peptic ulcer disease. NSAIDs break down the mucosal barrier and cause production of prostaglandins to decrease, which results in local gastric mucosal injury.

A nurse is teaching a client who has a hiatal hernia about dietary recommendations. Which of the following client statements indicates an understanding of the teaching? (Select all that apply.)

I will consume less caffeine and fewer spicy foods I will sleep with the head of my bed elevated I will try not to gain weight

A nurse is planning care for a client who is postoperative and at risk for paralytic ileus. Which of the following interventions should the nurse plan to take to promote peristalsis?

Increase ambulation. Decreased bowel motility is an adverse effect of anesthesia. The nurse should encourage the client to ambulate and increase fiber intake as prescribed to promote a return of bowel function and reduce the risk for paralytic ileus.

A nurse is caring for a client who has diverticular disease. When palpating the client's abdomen, in which of the following locations should the nurse expect the client to report abdominal pain?

Lower left quadrant The nurse should expect the client to have abdominal pain in the lower left quadrant of the abdomen. The disease is usually found in the sigmoid colon, where high pressure to move fecal contents from the rectum causes pouch formation.

A nurse is administering a tap water enema to a client who is constipated. During the administration of the enema, the client states he is having abdominal cramps. Which of the following actions should the nurse take to relieve the client's discomfort?

Lower the height of the solution container. If nausea or cramping occurs, the flow of water should momentarily be slowed or stopped by lowering the device or clamping the tubing. This allows the intestinal spasm to pass while leaving the catheter in place. The nurse should then continue administering the enema at a slower rate once the cramping has passed.

A nurse is caring for a client who is postoperative and is at risk for developing venous thromboembolism (VTE). The nurse should instruct the client to avoid which of the following unsafe actions?

Massaging her legs Massaging an extremity that has a blood clot can cause it to detach and become an embolus. The use of sequential compression devices and antiembolic stockings and therapeutic anticoagulation can help prevent this postoperative complication.

A nurse is prioritizing care for two clients at the start of the shift. The first client, who is 1 day postoperative following a partial bowel resection, requires a dressing change, total parental nutrition administration and reports a pain level of 6 on a scale from 0 to 10. The second client, who has a newly inserted percutaneous gastrostomy tube, requires a tube feeding, dressing change, and daily weight. Which of the following nursing actions should the nurse plan to complete first?

Obtain vital signs for both clients. Using the nursing process as an organizing framework, the nurse should obtain vital signs on the two clients to determine if there are any emergent problems.

A nurse is caring for a client who is postoperative following a cholecystectomy and reports pain. Which of the following actions should the nurse take? (Select all that apply.)

Offer the client a back rub. Remind the client to use incisional splinting is. Identify the client's pain level. Change the client's position.

A nurse is preparing to administer three liquid medications to a client who has an NG tube with intermittent suction. Which of the following actions should the nurse take?

Pinch the tube prior to attaching the medication syringe. After detaching the NG tube from the suction tubing, the nurse should pinch or kink the tube to prevent distention from air entering the tube.

A nurse is preparing to insert an NG tube. Place the following steps in the appropriate order. (Move the steps of NG tube placement into the box on the right, placing them in the selected order of performance. Use all the steps.)

Prepare equipment at bedside. Measure the NG tube. Instruct the client to extend the neck backwards. Instruct the client to flex his head forward. Obtain an Xray Secure the tube

A nurse is assessing a client's bowel sounds. At which of the following points in the assessment should the nurse auscultate the client's abdomen?

Prior to percussing the abdomen According to evidence-based practice, the nurse should auscultate the abdomen prior to percussing it to prevent altering the bowel sounds. Both percussion and palpation can stimulate the intestines, increase their motility, and intensify the bowel sounds.

A nurse in a PACU is assessing a client who has a newly created colostomy. Which of the following findings should the nurse report to the provider?

Purplish-colored stoma A stoma that is purplish in color indicates ischemia. The nurse should notify the provider immediately.

A nurse is caring for a client who is being admitted for an acute exacerbation of ulcerative colitis. Which of the following actions should the nurse take first?

Review the client's electrolyte values. The greatest risk to this client is injury from impaired function of cardiac or respiratory muscles; therefore, the first action the nurse should take is to review the client's electrolyte values. The client might have low sodium, potassium, and chloride from frequent diarrhea.

A nurse is providing teaching to a parent of a child who has celiac disease. The nurse should include which of the following food choices for this child?

Rice Because rice is naturally gluten-free, it is an acceptable food choice for a child who has celiac disease.

A nurse is assessing a client who has peritonitis. Which of the following findings should the nurse expect?

Rigid abdomen A rigid, boardlike abdomen is a manifestation of peritonitis.

A nurse is discussing good food choices with a client who is recovering from an exacerbation of inflammatory bowel disease and is to start a low-lactose diet. Which of the following foods is the best choice for the client?

Soy milk Soy milk is the best choice for this client because soy milk is lactose-free.

A nurse is caring for a client who has peptic ulcer disease. The nurse should monitor the client for which of the following findings as an indication of gastrointestinal perforation?

Sudden abdominal pain Classic indications of gastrointestinal perforation include sudden sharp abdominal pain with a rigid abdomen, declining peristalsis, and progression to septicemia and hypovolemic shock.

A nurse is assessing a client who has a colostomy. Which of the following findings should the nurse report to the provider?

The stoma is pale in color. The stoma should be pinkish to cherry red in color, which indicates an adequate blood supply. If the stoma becomes pale, bluish, or dark, the nurse should report this finding to the provider immediately.

A nurse is providing preoperative teaching for a client who will undergo surgery. The nurse explains that the client will wear antiembolism stockings during and after the procedure. When the client asks what the stockings do, which of the following responses should the nurse make?

They improve your circulation to keep blood from pooling in your legs." Antiembolism stockings promote venous return from the legs, thus helping to prevent venous thrombosis, also known as clot formation, and peripheral edema.

A nurse is caring for a client who has Crohn's disease. Which of the following food choices would follow the recommended diet for clients who have Crohn's disease?

Toast with jelly Toast with jelly is an appropriate food choice by the client. It does not contain large amounts of lactose, fat, or fiber.

A nurse is performing gastric lavage on a client using a large-bore NG tube. Which of the following actions should the nurse take?

Withdraw fluid until it is clear. The nurse should continue to instill and withdraw the lavage fluid until it is clear.

A nurse is teaching a client who has a hiatal hernia about dietary recommendations. Which of the following client statements indicates an understanding of the teaching? Select all that apply. a. "I will lie down for one half hour after meals." b. "I will consume less caffeine and fewer spicy foods." c. "I will sleep with the head of my bed elevated." d. "I will try not to gain weight." e. "I will drink less fluid."

b. "I will consume less caffeine and fewer spicy foods." c. "I will sleep with the head of my bed elevated." d. "I will try not to gain weight."

A nurse is caring for a client following an esophagogastroduodenoscopy (EGD) procedure. Which of the following assessments is the nurse's priority? a. Pain b. Nausea c. Gag reflex d. Level of consciousness

c. Gag reflex

A nurse is teaching a client who has a new prescription for sucralfate to treat a gastric ulcer. Which of the following statements by the client indicates an understanding of the teaching? a. "I will take this medication as needed to reduce pain." b. "I will reduce my fluid intake with this medication." c. "I will take this medication with an antacid." d. "I will take this medication 1 hour before meals and at bedtime."

d. "I will take this medication 1 hour before meals and at bedtime."

A nurse is caring for a client who has peptic ulcer disease. The nurse knows the monitor the client for which of the following findings as an indication of the complication of gastrointestinal perforation? 1- hyperactive bowel sounds 2- sudden abdominal pain 3- increased blood pressure 4- bradycardia

2

A nurse is providing teaching to a client who has stomatitis. Which of the following statements by the client indicates a need for further teaching? 1-I will drink liquids through a straw 2- I will season foods with dried spices before cooking 3- I will rinse my mouth with baking soda and water frequently 4- I will eat frozen bananas as a snack

2 Dried spices irritate the mouth further

A nurse is instructing a client who has GERD about positions that can help minimize the effects of reflux during sleep. Which statement indicates to the nurse that the client understands the instructions? 1-I will sleep on my left side 2-I will sleep on my right side 3-I will sleep on my back with my head flat 4-I will sleep on my stomach with my head flat

2 Sleeping on your right side increases peristalsis in the duodenum, so secretions don't go back up into the stomach.

The nurse is providing primary prevention in the community about Hepatitis B. Which statement is accurate patient education? a. The purpose of treatment for chronic Hepatitis B is to prolong life and reduce the chance of liver cancer. b. Hand washing is the most effective means of reducing disease transmission. c. Mother to child transmission of Hepatitis B is only prevented by a vaccine give years prior to pregnancy. d. Hepatitis B is the most common cause of throat cancer.

A

A nurse is caring for a client who is receiving ranitidine HCL (Zantac) for treatment of peptic ulcer disease. Which of the following client statements should indicate to the nurse that treatment has been effective? (Select all that apply) 1-I haven't smoked a cigarette in three days 2- I have been able to sleep through the night 3- I have started eating five or six small meals each day 4- I noticed that I have some dark black stools lately 5- I still occasionally have stomach pain, but I take ibuprofen for it 6- I don't seem to have as much gas after I eat anymore

2 and 6 are correct. PUD wakes pts up at night NO NSAIDs with ulcers!! Eating 5 or 6 small meals each day doesn't have anything to do with Zantac's effectiveness. It's a lifestyle change.

A nurse is teaching a client who has a hiatal hernia about dietary recommendations. Which client statements indicate understanding of these guidelines? (SATA) 1- I will lie down for one half hour after meals 2- I will consume less caffeine and spicy foods 3- I will sleep with the head of my bed elevated 4- I will try not to gain weight 5- I will drink less fluid

2, 3, 4

A client who has GERD reports to the nurse that he has severe heartburn every night. The nurse explores the client's bedtime habits and identifies which of the following as a contributing factor? 1-sleeping on a wedge pillow 2-drinking OJ regularly 3-drinking a couple of glasses of wine in the evening 4-eating dinner early in the evening

3

A client who has experienced an acute episode of gastritis receives home instructions by the nurse. Which of the following should the nurse include in the teaching? 1-limit drinking milk 2-take NSAIDs for pain 3-avoid drinking alcohol 4-limit strenuous exercise

3

A client with a long history of ulcerative colitis has anemia. The nurse should explain to the client that which of the following manifestations of colitis is likely to result in anemia? 1- decreased iron in the client's diet 2- intestinal malabsorption syndrome 3- chronic blood loss 4- intestinal parasites

3

A nurse is caring for a client who is receiving esomeprazole (Nexium) to manage GERD. Which of the following best indicates the desired therapeutic effect? 1-I don't pass gas as often 2-My abdomen is no longer firm 3-I don't have pain in my stomach 4-I have regular bowel movements

3

A nurse is preparing dietary instructions for a client who has episodes of biliary colic from chronic cholecystitis. Which of the following should the nurse include in the teaching plan? 1- An acid-ash diet 2- A high fiber diet 3- A low fat diet 4- A low sodium diet

3

A 56 yo female with a history of osteoporosis has a new diagnosis of GERD. Which medication should be avoided in her treatment regimen? 1- Ranitidine (Zantac) 2- Cimetidine (Tagamet) 3- Omeprazole (Prilosec) 4- Calcium carbonate (Tums)

3 PPIs like omeprazole increase risk of osteoporosis (also, gastric cancer, fractures, pneumonia)

A nurse is admitting an infant who has severe dehydration from acute gastroenteritis. Which of the following findings should the nurse expect?

3% weight loss A weight loss greater than 10% is a manifestation of severe dehydration in an infant.

A nurse is caring for a client who is scheduled for a colonoscopy. The client asks the nurse if there will be a lot of pain during the procedure. Which of the following is an appropriate nursing response? 1-Most clients dislike the prep more than the procedure itself. 2-Don't worry; you'll be sedated and just fine 3-No, you shouldn't feel any pain because your rectum will be anesthetized 4- You'll be sedated for the procedure and may not remember much of the procedure.

4

A client who has diverticulitis is being admitted to a nurse's unit. Which of the following menu selections should a nurse recommend for this client? 1-turkey sandwich with celery sticks 2-sliced ham with green salad 3-pork tenderloin with green peas 4-grilled chicken breast with white rice

4 The other three choices are high fiber, which is bad for diverticulitis pts

A nurse is assisting a group of clients in an outpatient clinic. For which of the following clients should the nurse anticipate scheduling a colonoscopy? 1- 56 yo who had a colonoscopy 6 years ago 2- 34 yo who reports a new onset of constipation 3- 32 yo who has a sister who died of colon cancer 4- 51 yo who is being seen for an annual physical exam

4 The standard for colonoscopies is to start at 50 yo, and have one every 10 years

Which of the following statements indicates further education is needed regarding Hepatitis C? a. "There is a vaccine to prevent Hepatitis C in the United States." b. "Hepatitis C is transmitted via IV drug use and blood." c. " I should avoid sharing personal items such as razors." d. "It is important to avoid alcohol."

A

Which of the following hepatitis are transmitted via the fecal/oral route? (Select all that apply.) a. Hepatitis A b. Hepatitis B c. Hepatitis C d. Hepatitis D e. Hepatitis E

A and E

A nurse is planning care for a client who has cirrhosis of the liver. Which of the following actions should the nurse include in the plan? (Select all that apply.) A. Administer furosemide. B. Administer warfarin. C. Implement a low-sodium diet. D. Measure the client's abdominal girth. E. Encourage weight lifting during physical therapy.

A, C, D

Which statement by the patient indicates that further teaching is needed about Hepatitis A? a. "Washing hands is important after using the bathroom." b. "I might have liver cancer someday because I have this infection." c. "Before I take any over the over the counter medications like Tylenol, I should talk to my provider." d. "I will wash raw fruit and vegetables thoroughly."

B

A patient receives IV promethazine (Phernergan) for persistent nausea and vomiting due to cholecystitis. The nurse understands that this patient is at immediate risk for: 1-Constipation 2- Urinary incontinence 3- Falls 4- Dry eye

C "immediate risk"--Phernergan can cause drowsiness

A nurse is caring for a client with who has hepatitis A. The client asks the nurse how he might have contracted the virus. Which of the following is a question the nurse should ask the client? A. "Have you eaten any fresh water fish lately?" B. "Have you received a blood transfusion recently?" C. "Have you been to a third world country in the past?" D. "Do you take any recreational drugs?

C. "Have you been to a third world country in the past?"

A nurse is teaching a class about preventive care to clients who are at risk for acquiring viral hepatitis. Which of the following information should the nurse include in the presentation? A. Avoid covering sores with bandages. B. Avoid handwashing after eating. C. Avoid foods prepared with tap water. D. Avoid eating meat.

C. Avoid foods prepared with tap water.

A nurse is caring for a client who has cirrhosis and has a prescription for bumetanide. When delivering the client's lunch tray, which of the following items should the nurse identify as contraindicated for the client? A. Baked potato B. Stewed tomatoes C. Ham sandwich D. Milkshake

C. Ham sandwich

A nurse is caring for a child who has acute appendicitis. Which of the following results should the nurse anticipate when reviewing this client's laboratory values?

WBC 17,000/mm3 The expected reference range for a WBC count for a child is 5,000 to 10,000/mm3. A WBC count of 17,000/mm3 is elevated. The nurse should expect to see an elevated WBC count because appendicitis is an acute bacterial infection.

A nurse is reviewing the diagnostic test results of an older adult female client who is preoperative for a knee arthroplasty. The nurse should notify the surgeon of which of the following results?

WBC count 20,000/mm3 This result exceeds the expected reference range for WBC of 5,000 to 10,000/mm3. The client's elevated WBC count indicates infection. The nurse should notify the surgeon.

A nurse is creating a plan of care to maintain the skin integrity of a client who experiences frequent diarrhea due to ulcerative colitis. Which of the following interventions should the nurse include in the plan?

Wipe perianal area with warm water and apply a barrier cream The nurse should instruct the client to wipe the perianal area and apply a barrier cream to decrease skin breakdown when in contact with fecal material.

A nurse is assessing a client who is 48 hr postoperative following abdominal surgery. Which of the following findings should the nurse report to the provider?

Yellow-green drainage on the surgical incision Thick yellow-green drainage is indicative of an infection and should be reported immediately.

A nurse is providing teaching to a client who has peptic ulcer disease and a new prescription for sucralfate tablets. Which of the following information should the nurse provide? a. "An antacid may be taken with the medication if indigestion occurs." b. "Take sucralfate 1 hour before meals." c. "Take the tablets whole." d. "Store sucralfate in the refrigerator."

b. "Take sucralfate 1 hour before meals."

A nurse is providing teaching for a client who has a new diagnosis of gastroesophageal reflux disease (GERD). The client asks about foods he should avoid eating. Which of the following foods should the nurse tell him to avoid? a. Nonfat milk b. Chocolate c. Apples d. Oatmeal

b. Chocolate

A nurse is reviewing the medical record of a client who has a peptic ulcer. Which of the following findings should the nurse recognize as a risk factor for this condition? a. History of bulimia b. History of NSAID use c. Drinks green tea d. Has a glass of wine with dinner each

b. History of NSAID use

A nurse is caring for a client who has peptic ulcer disease. The nurse should monitor the client for which of the following findings as an indication of gastrointestinal perforation? a. Hyperactive bowel sounds b. Sudden abdominal pain c. Increased blood pressure d. Bradycardia

b. Sudden abdominal pain

A nurse is providing teaching for a client who has gastroesophageal reflux disease (GERD) about ways to manage his condition. Which of the following instructions should the nurse include? a. "Sleep on your left side." b. "Drink milk to soothe your stomach." c. "Eat four small meals each day." d. "Wait to go to bed for 1 hour after eating."

c. "Eat four small meals each day."

A nurse is providing teaching for a client who has experienced an acute episode of gastritis. Which of the following instructions should the nurse include in the teaching? a. Limit drinking milk. b. Take NSAIDS for pain. c. Avoid drinking alcohol. d. Limit strenuous exercise.

c. Avoid drinking alcohol.

A nurse is teaching a client who has a prescription of a nasogastric tube (NG) to treat a pyloric obstruction. Which of the following rationales for the use of the nasogastric tube should the nurse include in the teaching? a. Determine the pH of the gastric secretions. b. Supply nutrients via tube feedings. c. Decompress the stomach. d. Administer medications.

c. Decompress the stomach.