GI

The nurse who is assisting in the care of a client within the first 24 hours following a total gastrectomy for gastric cancer should avoid which intervention?

Irrigating the nasogastric (NG) tube

A client has had a partial gastrectomy and the nurse is reinforcing discharge instructions. The nurse should reinforce instructions to the client about the need for which supplements? Select all that apply.

Iron supplements Calcium supplements Vitamin B12 injections

The nurse is caring for a client after a Billroth II (gastrojejunostomy) procedure. During review of the postoperative prescriptions, which should the nurse clarify?

Irrigating the NG tube

The nurse is reinforcing discharge instructions to a client with a hiatal hernia. Which considerations should the nurse include in the teaching session? Select all that apply.

It is advisable to stop smoking cigarettes. Wait at least 1 hour after meals to perform chores. 4. Be sure to elevate the head of the bed during sleep.

The client complains of stomach pain 30 minutes to 1 hour after eating. The pain is not relieved by further intake of food, although it is relieved by vomiting, and a gastric ulcer is suspected. The nurse should gather which additional data from the client to support this diagnosis?

History of alcohol use, smoking, and weight loss

A client complains of stomach pain 30 minutes to 1 hour after eating. The pain is not relieved by further intake of food, although it is relieved by vomiting. A gastric ulcer is suspected. The nurse should determine that which data would further support this diagnosis?

History of chronic obstructive pulmonary disease with weight loss

The nurse is collecting data on a client with a diagnosis of peptic ulcer disease. Which history should the nurse determine is least likely associated with this disease?

History of the use of acetaminophen for pain and discomfort

A client is seen in the ambulatory care office for a routine examination. Which statement by the client should be most important for the nurse to follow up?

I just lost a family member to gastrointestinal cancer."

A calcium supplement is prescribed for a client diagnosed with hypoparathyroidism in the management of hypocalcemia. The client arrives at the clinic for a follow-up visit and complains of chronic constipation, and the nurse reinforces instructions to the client about measures to alleviate the constipation. Which comment by the client would indicate a need for further teaching?

I need to add 0.5 ounce of mineral oil to my daily diet."

The nurse is reinforcing dietary instructions for a client diagnosed with peptic ulcer disease. Which statement made by the client indicates a need for further teaching?

I will eat a bland diet only.

The nurse is working with a client diagnosed with anorexia nervosa. As the nurse plans care, which should be focused on as the primary problem?

Impaired nutritional status

The nurse is reviewing the record of a client with Crohn's disease. Which stool characteristic should the nurse expect to see documented in the record?

Diarrhea

The nurse is caring for a client with a diagnosis of chronic gastritis. The nurse anticipates that the client is at risk for which vitamin deficiency?

Vitamin B12

A generally healthy 63-year-old man is seen in the primary health care provider's office for a routine examination. Which statement made by the client is most important for the nurse to follow up on?

"Everyone in my immediate family has died from gastrointestinal cancer." 4.

Which infection control method should the nurse determine to be the priority to include in the plan of care to prevent hepatitis B in a client considered to be at high risk for exposure?

Hepatitis B vaccine

The nurse is assisting with the insertion of a nasogastric tube into a client. The nurse should place the client in which position for insertion?

High-Fowler's position

The nurse has been reinforcing dietary teaching for a client diagnosed with gastroesophageal reflux disease (GERD) who has a routine follow-up visit. Which behavior is the best indicator of a successful outcome for this client?

A decrease in sour eructation

A primary health care provider asks the nurse to obtain a Salem sump tube for gastric intubation. The nurse should correctly select which tube from the unit storage area?

A tube with a larger lumen and an air vent

The nurse is collecting data about how well a client diagnosed with a gastrointestinal (GI) disorder is able to digest food. The nurse determines that which processes are involved in the complete digestive process? Select all that apply.

Absorption 5.Mechanical 6.Active transport Chemical

The nurse is reviewing the primary health care provider's prescriptions for a client admitted to the hospital with a diagnosis of liver disease. Which medication prescription should the nurse most question

Acetaminophen

The nurse is reviewing the prescriptions of a client admitted to the hospital with a diagnosis of acute pancreatitis. Which interventions should the nurse expect to be prescribed? Select all that apply.

Administer antacids, as prescribed. 2.Encourage coughing and deep breathing. 3.Administer anticholinergics, as prescribed.

The client arrives at an emergency department complaining of severe abdominal pain. The initial diagnosis is acute abdomen, and an x-ray and an abdominal ultrasonogram are prescribed to be obtained immediately. The nurse prepares the client for these diagnostic tests and reviews the primary health care provider's prescriptions. Which prescription should the nurse most likelyquestion if written on the primary health care provider's prescription form?

Administration of an opioid analgesic

A client who has undergone a colostomy several days ago is reluctant to leave the hospital and has not yet looked at the ostomy site. Which measures will most likely promote coping? Select all that apply.

Ask a member of the local ostomy club to visit with the client before discharge. 2.Ask the enterostomal nurse specialist to consult with the client before discharge. Ask the client to begin doing one part of the ostomy care each day and increase tasks daily.

The nurse is teaching a client with a newly diagnosed hiatal hernia about measures to prevent recurrence of symptoms. Which statement is most appropriate to be included in the teaching?

Avoid lying down for an hour after eating."

The nurse is teaching a client who is newly diagnosed with a hiatal hernia about measures to prevent recurrence of symptoms. Which statement should the nurse make to the client for consideration?

Be sure to sleep with your head elevated in bed."

The nurse is preparing to administer a soapsuds enema to a client. Into which position should the nurse place the client to administer the enema? Refer to figure.

C

The nurse observes that a client's nasogastric tube has suddenly stopped draining. The tube is connected to suction, the machine is on and functioning, and all connections are snug. After checking placement, the nurse gently flushes the tube with 30 mL of normal saline, but the tube still is not draining. The nurse should conclude which is the problem and what action should be taken?

Channels of gastric secretions may be bypassing the holes in the tube; turning the client will promote stomach emptying.

A client has a diagnosis of asymptomatic diverticular disease. Which type of diet should the nurse anticipate being prescribed?

High-fiber diet

A client has undergone esophagogastroduodenoscopy (EGD). The nurse should place highest priority on which action as part of the client's care plan?

Checking for return of a gag reflex

A client with Crohn's disease is scheduled to receive an infusion of infliximab. The nurse assisting with caring for the client should take which action to monitor the effectiveness of treatment?

Checking the frequency and consistency of bowel movements

The nurse is assigned to care for a client who had a Sengstaken-Blakemore tube inserted when more conservative treatment failed to alleviate the condition. The nurse should most likelysuspect that the client has which diagnosis?

Esophageal varices

A client with possible hiatal hernia complains of frequent heartburn and regurgitation. The nurse should gather further information about the presence of which sign or symptom?

Difficulty swallowing

A primary health care provider places a Miller-Abbott tube in a client who has a diagnosed bowel obstruction. Six hours later, the nurse measures the length of the tube outside of the nares and notes that the tube has advanced 6 cm since it was first placed. Based on this finding, which action should the nurse take next?

Document the finding in the client's record.

The nurse is collecting admission data on the client with a diagnosis of hepatitis. Which finding should the nurse recognize to be a direct result of this client's condition?

Drowsiness

The nurse is reinforcing dietary instructions for a client diagnosed with peptic ulcer disease. Which action should the nurse encourage the client to do?

Eat anything as long as it does not aggravate or cause pain.

The nurse who is reinforcing instructions to a client who has had a gastric resection should include which considerations? Select all that apply.

Eat small frequent meals. Take action to prevent dumping syndrome

A client who has undergone a subtotal gastrectomy is being prepared for discharge. Which considerations concerning ongoing self-management should the nurse reinforce to the client? Select all that apply.

Eat smaller and more frequent meals. Drink fluids between meals not with them.

The nurse should document that a client diagnosed with a hiatal hernia is implementing effective health maintenance measures after the client reports doing which action?

Eating low-fat or nonfat foods

It has been determined that a client with hepatitis has contracted the infection from contaminated food. Which type of hepatitis is this client most likely experiencing?

Hepatitis A

A licensed practical nurse (LPN) is preparing to assist a registered nurse (RN) with removing a nasogastric (NG) tube from the client. Which interventions should be included in the procedure? Select all that apply.

Explain the procedure to the client. 3. Ask the client to take a deep breath and hold. 4. Pull the tube out in one continuous steady motion. 5. Remove the device or tape securing the tube from the nose.

A client is admitted to the hospital with a diagnosis of acute viral hepatitis. Which sign/symptom should the nurse expect to observe based on this diagnosis?

Fatigue

The nurse is preparing to administer an enteral feeding through a nasogastric tube. The nurse should place the client in which position during and after the feedings?

Fowler's

A client with a possible hiatal hernia complains of difficulty swallowing. Which other sign/symptom associated with a hiatal hernia should the nurse recognize?

Heartburn and regurgitation

The nurse caring for a client diagnosed with acute pancreatitis and has a history of alcoholism is monitoring the client for complications. The nurse determines that which data collected is most likely indicative of paralytic ileus?

Inability to pass flatus

The client admitted to the hospital with a diagnosis of viral hepatitis is complaining of a loss of appetite. In order to provide adequate nutrition, which action should the nurse encourage the client to take?

Increase intake of fluids.

The nurse is assisting in planning stress management strategies for the client diagnosed with irritable bowel syndrome. Which suggestion is most appropriate for the nurse to give to the client?

Learn measures such as biofeedback or progressive relaxation.

The nurse should include which instruction in a teaching plan for a client who has been diagnosed with peptic ulcer disease?

Learn to use stress reduction techniques.

The nurse should include which most appropriate information when reinforcing home care instructions for a client who has been diagnosed with peptic ulcer disease?

Learn to use stress reduction techniques.

After a client undergoes a liver biopsy, the nurse places the client in the prescribed right-side lying position. The nurse understands that the purpose of this intervention is to accomplish which?

Limit bleeding from the biopsy site

The nurse is reinforcing discharge instructions to a client after a gastrectomy. Which measure should the nurse include during client teaching to help prevent dumping syndrome?

Limit the fluids taken with meals.

The nurse has assisted with the insertion of a Levin tube for gastrointestinal (GI) decompression. Which settings should the nurse anticipate to be prescribed by the primary health care provider? Select all that apply.

Low Intermittent

A nurse organizing care for a client diagnosed with hepatitis plans to meet the client's safety needs by performing which action?

Monitoring prothrombin and partial thromboplastin values

The nurse is collecting data from a client admitted to the hospital with a diagnosis of suspected gastric ulcer and is asking the client questions about pain. Which statement made by the client should the nurse recognize as best supporting the diagnosis of gastric ulcer?

My pain comes shortly after I eat, maybe a half hour or so later."

Implemented treatment measures for a client with a diagnosis of bleeding esophageal varices have been unsuccessful. The primary health care provider states that a Sengstaken-Blakemore tube will be used to control the resulting hemorrhage. The nurse should prepare for insertion of this tube via which route?

Nasogastric

The nurse is providing care for a client suspected of having appendicitis. Which priorityintervention should the nurse anticipate will be prescribed for this client?

No oral intake of liquids or food

A client with a diagnosis of viral hepatitis has no appetite, and food makes the client nauseated. The nurse should conclude that which intervention is most appropriate?

Offer small, frequent meals.

The nurse is participating in a health screening clinic and is preparing materials about colorectal cancer. The nurse should include which risk factor for colorectal cancer in the material?

Personal history of ulcerative colitis or gastrointestinal (GI) polyps

The nurse has inserted a nasogastric (NG) tube in a client and is checking for the correct placement of an NG tube. Which is the most reliable data to ensure that the end of the tube is in the stomach?

Placement is verified on x-ray.

The nurse is caring for a client with a nasogastric (NG) tube and tests the pH of the aspirate to determine correct placement. The test results indicate a pH of 5. The nurse should determine this indicates which information?

Placement of the NG tube is accurate.

A client that is postgastrectomy is at high risk for hyperglycemia related to uncontrolled gastric emptying of fluid and food into the small intestine (dumping syndrome). Because of this risk, the nurse should plan to monitor which data?

Postprandial blood glucose readings

The nurse is monitoring for stoma prolapse in a client with a colostomy. Which stoma observation should indicate that a prolapse has occurred?

Protruding and swollen

The nurse is caring for a client with a Sengstaken-Blakemore tube. To effectivelyprevent ulceration and necrosis of oral and nasal mucosa, the nurse should plan to implement which action?

Provide frequent oral and nasal care on a regular basis.

The nurse provides information to a client following a gastrectomy who is now diagnosed with pernicious anemia. Which instructions about pernicious anemia should the nurse reinforce to the client? Select all that apply.

Provide meticulous and frequent oral hygiene. 2.Use additional lightweight blankets as Check blood serum vitamin B12 levels every 1 to 2 years.

The nurse is collecting data on a client admitted to the hospital with a diagnosis of hepatitis. The nurse should determine which data indicates the client may have liver damage?

Pruritus

The nurse is performing an abdominal assessment on a client. The nurse interprets that which finding is abnormal and should be immediately reported?

Pulsation between the umbilicus and pubis

The nurse should reinforce instructions to a client that has had a gastrectomy about the signs and symptoms of pernicious anemia, knowing what information?

Regular monthly injections of vitamin B12 will prevent this complication.

The nurse assigned to care for a client diagnosed with cirrhosis reviews the medical record and notes that the client has difficulty maintaining an effective breathing pattern due to pressure on the diaphragm. The nurse plans care knowing that which client position will best assist in facilitating breathing?

Semi-Fowler's

The nurse is reviewing the health care record of a client with a diagnosis of chronic pancreatitis. The nurse should determine that which data noted in the record indicate poor absorption of dietary fats?

Steatorrhea

The nurse is reviewing the primary health care provider's (PHCP'S) prescriptions written for a client admitted with acute pancreatitis. Which PHCP prescription should the nurse verify if noted in the client's chart?

Supine and flat client positioning

A licensed practical nurse (LPN) is helping a registered nurse (RN) conduct an abdominal assessment. The LPN should assist the client into which most appropriate position?

Supine with the head raised slightly and the knees slightly flexed

The nurse is monitoring a client for the earlysigns and symptoms of dumping syndrome. Which findings indicate this occurrence?

Sweating and pallor

The nurse is monitoring a client for the earlysigns and symptoms of dumping syndrome. Which indicates this occurrence?

Sweating and pallor

The nurse is reinforcing home care instructions to a client following a gastric resection. The nurse should include which instruction to the client?

Take actions to prevent dumping syndrome.

A client had a Miller-Abbott tube inserted 24 hours ago. The nurse is asked to check the client to determine whether the tube is in the appropriate location at this time. Which data finding best indicates adequate location of the tube?

The aspirate from the tube has a pH of 7.45.

The nurse is providing care for a client with a nasogastric tube. Which observation is mostappropriate in determining that the tube is correctly placed?

The pH of the aspirate is 5.

The nurse is collecting data about how well a client diagnosed with a gastrointestinal (GI) disorder is able to absorb food. While doing this, the nurse recalls that absorption is mostconcerned with which bodily function?

The transfer of digested food molecules from the GI tract into the bloodstream

The nurse is reinforcing instructions to a client about insertion of a Sengstaken-Blakemore tube. Which statement by the client indicates a need for further teaching?

The tube will be inserted through my mouth to my stomach.Patterson

Which statement by the spouse of a client with diagnosed end-stage liver failure indicates theneed for further teaching by the multidisciplinary team regarding management of the client's pain?

This opioid will cause very deep sleep, which is what my husband needs."

A primary health care provider asks the nurse to obtain a Salem sump tube for gastric intubation. The nurse should select which tube from the unit storage area?

Tube with a lumen and an air vent

The nurse is evaluating the effect of dietary counseling on the client diagnosed with cholecystitis. The nurse determines the client understands the instructions given if the client states that which food item is most appropriate to include in the diet?

Turkey and lettuce sandwich

The nurse observes that a client with a nasogastric tube connected to continuous gastric suction is mouth breathing, has dry mucous membranes, and has a foul breath odor. When planning care, which nursing intervention would be best to maintain the integrity of this client's oral mucosa?

Use diluted mouthwash and water to swab the mouth after brushing teeth.

The nurse is caring for a client with a diagnosis of pneumonia and a history of bleeding esophageal varices. Based on this information, the nurse should plan care knowing that which could mostresult in a potential complication?

Vigorous coughing

The nurse is reinforcing discharge instructions to a client who has had a total gastrectomy. The nurse instructs the client about the importance of returning as scheduled to the health care clinic for which priority assessment?

Vitamin B12 and folic acid studies

A client diagnosed with chronic gastritis has been told that there is too little intrinsic factor being produced. The nurse should explain to the client that which therapy will be prescribed to treat the problem?

Vitamin B12 injections

A client is admitted to an acute care facility with complications of celiac disease. Which question asked by the nurse initially should be mosthelpful in obtaining information for the nursing care plan?

What is your understanding of celiac disease?"

Before administering an intermittent tube feeding through a nasogastric tube, the nurse checks for gastric residual volume. Which is the bestrationale for checking gastric residual volume before administering the tube feeding?

Evaluate absorption of the last feeding

A client diagnosed with pernicious anemia asks the nurse what caused the deficiency. The nurse replies that it is most likely a result of which condition that is part of the client's health history?

Hemigastrectomy

The nurse is interpreting the laboratory results of a client who has a history of diagnosed chronic ulcerative colitis. The nurse should determine that which result indicates a complication of ulcerative colitis?

Hemoglobin 10.2 g/dL

After the deflation of the balloon of a client's Sengstaken-Blakemore tube, the nurse should monitor the client closely for which priorityesophageal complication?

Hemorrhage

The nurse has given the client diagnosed with hepatitis instructions about post discharge management during convalescence. The nurse determines a need for further teaching if the client makes which statement?

I should resume a full activity level within 1 week."

The nurse has assisted in the insertion of a Levin tube for gastrointestinal (GI) decompression. The nurse should anticipate a prescription to set the suction to which pressure?

Low and intermittent

A client has been diagnosed with acute gastroenteritis. Which diet should the nurse anticipate to be prescribed for the client?

Low fiber

The client diagnosed with acute pancreatitis is experiencing severe pain from the disorder. The nurse should instruct the client to avoid which position that could aggravate the pain?

Lying flat

A client with hiatal hernia chronically experiences heartburn after meals. Which should the nurse teach the client to avoid?

Lying recumbent after meals

The nurse is caring for a client within the first 24 hours following a total gastrectomy for gastric cancer. During this time frame, the nurse should focus on which priority intervention?

Maintaining a patent nasogastric (NG) tube

The nurse is caring for a client in the emergency department who has right lower quadrant abdominal pain. After noting a white blood cell count of 16,500 cells/mm3, the nurse should question which prescription?

Milk of magnesia

The client in an emergency department reports right lower quadrant abdominal pain. After noting a white blood cell count of 16,500 cells/mm3, the nurse should question which prescriptions? Select all that apply.

Milk of magnesia 2.Heat pad to the abdomen

A client has undergone subtotal gastrectomy, and the nurse is preparing the client for discharge. Which item should be included when reinforcing instructions to the client about ongoing self-management?

Smaller, more frequent meals should be eaten.

A client is admitted to the hospital with a diagnosed bowel obstruction secondary to a recurrent diagnosed malignancy. The primary health care provider plans to insert a Miller-Abbott tube. When the nurse tries to explain the procedure, the client interrupts the nurse and states, "I don't want to hear about that. Just let the doctor do it." Based on the client's statement, which action should the nurse determine is best?

Remain with the client and be silent.

The nurse has been providing care for a client with a Sengstaken-Blakemore tube. While the tube is inflated the nurse should monitor for which priority sign/symptom?

Respiratory distress