GI Med surg test

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 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 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 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.

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 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

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

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

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

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 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 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 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