GI System

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.) A. administer antacids, as prescribed. B. encourage coughing and deep breathing. C. administer anticholinergics, as prescribed. D. maintain the client in a supine and flat position. E. encourage small, frequent, high-calorie feedings.

A. administer antacids, as prescribed B. encourage coughing and deep breathing C.administer anticholinergics, as prescribed the client with acute pancreatitis is normally placed on an NPO status to rest the pancreas and suppress GI secretions. because abdominal pain is a prominent symptom of pancreatitis, pain medication will be prescribed. Side-lying position with the head elevated 45 degrees decreases tension on the abdomen and may also help ease the pain

A patient who was admitted with a bowel obstruction is complaining of severe pain. Their abdominal girth has increased by 4 inches in the past hour and the blood pressure is now 80/50 mm Hg. List your actions in priority order. A. Assess breathing. B. Notify the health care provider. C. Position to support blood pressure. D. Ensure IV patency.

A. assess breathing C. position to support blood pressure D. ensure IV patency B. notify the health care provider Increased abdominal pressure can impair the ability of the diaphragm to move and cause problems with breathing. A head of bed flat position with legs elevated would be best for support of blood pressure. However, the patient may not breathe well with the HOB flat so a slight elevation may be necessary. The nurse should anticipate the need for IV fluids and medications so a patient IV is essential. The provider needs to be notified of the change in patient condition.

You are preparing a patient for a liver biopsy. Which nursing interventions should be included? (Select all that apply.) A. Attending to patient's fears and anxiety B. Checking for a signed consent form for the procedure C. Assessing for dehydration and electrolyte imbalance D. Positioning on right side E. Checking coagulation studies for bleeding problems F. Noting any allergy to local anesthetics

A. attending to patient's fears and anxiety B. checking for a signed consent form for the procedure E. checking coagulation studies for bleeding problems F. noting any allergy to local anesthetics Decreasing fears and anxieties promotes psychological well-being related to the upcoming procedure. A signed consent form is necessary for a liver biopsy. Coagulation studies are assessed before a liver biopsy to determine any increased risk of bleeding. Allergy to local anesthetic used during the procedure must be determined pre-test. (3) Assessing for dehydration and electrolyte balance is not indicated for a liver biopsy. (4) The patient should be positioned supine or on the left side for a liver biopsy.

the nurse is assessing the stooling patterns of an assigned patient. The patient reports stools as being clay colored. the nurse knows this may indicate which condition? A. bile is not reaching the intestines. B. the stool contains undigested fat. C. the stool has an excessive amount of bilirubin. D. the patient is experiencing upper gastrointestinal (GI) bleeding.

A. bile is not reaching the intestines The clay-colored stool indicates the bile is not reaching the patient's intestines due to an obstruction in the bile ducts. Intestinal bleeding will present as black or red stools. Stools containing undigested fat will float in the toilet.

which instructions should be given to a patient regarding preventing the spread of hepatitis A? (select all that apply.) A. bleach solutions must be used to clean the bathroom. B. somebody else should be doing the cooking right now. C. no vaccination is available for hepatitis A. D. good hand hygiene reduces the likelihood of passing the virus.

A. bleach solutions must be used to clean the bathroom B. somebody else should be doing the cooking right now D. good hand hygiene reduces the likelihood of passing the virus hepatits A vaccination is available and recommended. the other statements indicate an understanding of the information

A nurse is discussing healthy lifestyle measures with a group of older adults during a senior seminar. What instruction(s) should you include as accurate information? (Select all that apply.) A. Consume sufficient fiber. B. Eat a normal, well-balanced diet. C. Exercise regularly. D. Drink at least three glasses of fluids a day. E. Take laxatives regularly.

A. consume sufficient fiber B. eat a normal, well-balanced diet C. exercise regularly Sufficient fiber, a well-balanced diet, and regular exercise are all good advice. (4) Encourage at least eight glasses of fluid a day, unless there is a medical reason for fluid restriction. (5) Routine use of laxatives should be discouraged to avoid physiologic dependence.

An older adult woman of Puerto Rican descent is admitted for persistent anorexia and dehydration. There are no apparent underlying organic causes for loss of appetite. Which intervention(s) would be culturally appropriate? (Select all that apply.) A. Determine food preferences. B. Encourage family visits. C. Provide small amounts of food and fluid frequently. D. Consider parenteral nutrition. E. Consult a dietitian and speech therapy

A. determine food preferences B. encourage family visits C. provide small amounts of food and fluid frequently Determining food preferences and encouraging family visits are appropriate to meet the cultural needs of the patient. Offering small, frequent amounts of foods and fluids is an appropriate intervention regardless of cultural background. (4) Considering parenteral nutrition is premature if enteral methods are still an option. (5) Consulting a dietician might be appropriate after cultural needs are explored. Consulting speech therapy is appropriate if there are problems with chewing and swallowing.

The patient presents to the clinic complaining of constipation, abdominal pain, and mucous in her stool. The patient states, "I have the same stomach problems my mom had when she was my age. It's always worse after I eat ice cream, so I try to avoid that. I only drink water because I'm on my feet all day. I'm a teacher, so my job can be very stressful at times. I've tried stool softeners and laxatives that help sometimes, but my stomach only feels better after I stool." The nurse suspects irritable bowel syndrome (IBS) due to the patient having which triggers? (Select all that apply.) A. Family history B. Female gender C. Dairy sensitivity D. Stressful lifestyle E. Frequent laxative use F. Lack of caffeine in the diet

A. family history B. female gender C. dairy sensitivity D. stressful lifestyle IBS may be triggered by a familial history. It affects females more than males, and it is related to food sensitivities, stress, and caffeine ingestion. The patient's use of laxatives does not appear to be a trigger for this disease because she is constipated.

a client with hiatal hernia chronically experiences heartburn after meals. which should the nurse teach the client to avoid? A. lying recumbent after meals B. eating small, frequent, bland meals C. raising the head of the bed on 6-inch blocks D. taking histamine receptor antagonist medication, as prescribed

A. lying recumbent after meals hiatal hernia is caused by a protrusion of a portion of the stomach above the diaphragm, where the esophagus usually is positioned. the client generally experiences pain caused by reflux resulting from ingestion of irritating foods, lying flat following meals or at night, and consuming large or fatty meals. relief is obtained by eating small, frequent, and bland meals; histamine antagonists and antacids; and elevation of the thorax after meals and during sleep.

a histamine (H2)-receptor antagonist will be prescribed for a client. the nurse understands that which medications are H2-receptor antagonists? (select all that apply.) A. nizatidine B. panitidine C. famotidine D. cimetidine E. esomeprazole F. lansoprazole

A. nizatidine B. panitidine C. famotidine D. cimetidine H2-receptor antagonists suppress secretion fo gastric acid, alleviate symptoms of heartburn, and assist with preventing complications of peptic ulcer disease. these medications also suppress gastric acid secretions and are used in active ulcer ideas, erosive esophagitis, and pathological hyper secretory conditions.

A patient has been admitted to the hospital with GI bleeding. Which is a priority nursing action for this patient? A. Obtain complete vital signs. B. Administer prescribed medication for pain. C. Administer prescribed antacids every 2 hours. D. Administer prescribed medication for nausea and vomiting.

A. obtain complete vital signs The patient experiencing GI bleeding is at risk for hypovolemic shock. Assessment of vital signs will provide indicators of the patient's condition. The nurse should also plan to administer pain medication, antacids, and antiemetic medications.

When planning care for the patient with acute pancreatitis, the LPN/LVN knows that which intervention is a priority of care? A. Pain control B. Nutritional supplementation C. Observation for mental changes D. Observation for intestinal obstruction

A. pain control The patient with acute pancreatitis presents with pain. The intervention having the highest priority involves management of the pain. Nutritional supplementation and observation for mental changes and intestinal obstruction are appropriate interventions, but not the ones of highest importance.

one goal of nursing care for a patient during the acute phase of pancreatitis is reduction of pain. which nursing interventions help alleviate pain? (Select all that apply.) A. reinforce use of the PCA pump. B. maintain IV fluids as ordered. C. provide a soft diet with additional fluids. D. administer dicyclomine (Bentyl). E. give pancreatic enzymes. F. place the patient in a supine position.

A. reinforce use of the PCA pump B. maintain IV fluids as ordered D. administer dicyclomine (Bentyl) encouraging use of pain medications, maintaining IV fluids, and administering antispasmodics will help alleviate the pain. patient should not be given a bland diet but should remain NPO. pancreatic enzymes are given once oral feeding has resumed. patient is likely to be more comfortable in a knee-chest position

you are caring for a patient who underwent a recent liver transplantation. you reinforce the teaching related to self-care. Which teaching topics are most important to address before discharge? (select all that apply.) A. reporting any kind of pain associated with fever and changes in stool color B. location and meeting time of local support groups C. use of strict hand hygiene in changing dressings D. the lifelong need to take antirejection medications

A. reporting any kind of pain associated with fever and changes in stool color C. use of strict hand hygiene in changing dressing D.the lifelong need to take anti-rejection medications support groups can be helpful after the patient has re-covered from the surgery and can be around others; initially the immunosuppression requires limiting social contracts. the other statements indicate that the patient has understood the instructions and the risk for infection and organ rejection

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? A. monitoring the leukocyte count for 2 days after the infusion B. checking the frequency and consistency of bowel movements C. checking serum liver enzyme levels before and after the infusion D. carrying out a Hematest on gastric fluids after the infusion is completed

B. checking the frequency and consistency of bowel movements the principal manifestations of Crohn's disease are diarrhea and abdominal pain. infliximab is an immunomodulator that reduces the degree of inflammation in the colon, thereby reducing the diarrhea

a patient reports discomfort from flatus after surgery. what action(s) can be suggested by the nurse to help to relieve the flatus buildup? (select all that apply.) A. drink hot coffee B. encourage ambulation C. trendelenburg position D. drink chilled carbonated beverages E. encourage bed rest until the pain subsides

B. encourage ambulation C. trendelenburg position During the postoperative period, patients are at an increased risk for flatus buildup. This is due to analgesics, bowel manipulation, and anesthetic agents. Activities that will aid in the passage of flatus include ambulation and the use of a slight Trendelenburg position. Inactivity and hot and chilled beverages are associated with increased flatus buildup.

The nurse is providing education to a patient with a body mass index (BMI) of 42. The nurse should educate the patient about which conditions for which he is at risk? (Select all that apply.) A. Insomnia B. Hypertension C. Hyperlipidemia D. Hyperthyroidism E. Obstructive sleep apnea F. Type 1 diabetes mellitus

B. hypertension C. hyperlipidemia E. obstructive sleep apnea This patient has a BMI of 42, which is morbidly obese. This patient is at risk for hypertension, hyperlipidemia, type 2 diabetes mellitus (not type 1), and obstructive sleep apnea. Hypothyroidism can contribute to obesity, but obesity does not lead to hyperthyroidism. Insomnia is not directly related to morbid obesity.

A 68-year-old patient complains of mild left lower abdominal pain that is accompanied by frequent diarrhea, slight fever, and rectal bleeding. Which treatment measure should you anticipate? A. Administration of a bulk-forming stool softener B. Increasing fluid intake C. Encouraging solid foods D. Increasing physical activity

B. increasing fluid intake The symptoms of diarrhea and fever suggest the need for increased fluid intake. Rectal bleeding should be further evaluated and reported. These options are not appropriate because all of these actions would increase bowel activity.

the nurse is preparing to perform an abdominal examination. which step should be taken first? A. palpation B. inspection C. percussion D. auscultation

B. inspection the appropriate technique for abdominal examination is inspection, auscultation, percussion, and palpitation

a patient who has GERD for many years is diagnosed with Barrett esophagus. etiologic factors for Barrett esophagus include: A. eating spicy foods and hot peppers on a regular basis. B. long-term gastroesophageal reflux causing mucosal irritation. C. previous history of oral cancer. D. moderate alcohol consumption during adult years.

B. long-term gastroesophageal reflux causing mucosal irritation The irritation of gastric secretions via reflux into the esophagus causes chronic irritation which eventually may cause the cellular changes of Barrett esophagus. (1) Spicy food and hot peppers have not been shown to be a factor in reflux or gastritis unless a person is individually susceptible to that problem. (3) Previous history of cancer is not an etiologic factor for Barrett esophagus. (4) Excessive alcohol consumption over a long period of time is a risk factor for Barrett esophagus. Moderate alcohol use is not considered a risk factor in itself. Smoking combined with alcohol does seem to increase the risk of esophageal cancer.

A patient is receiving continuous enteral feedings. Which intervention will address the most serious problem associated with the feeding therapy? A. Assist the patient to ambulate several times a day. B. Raise the head of the bed. C. Place an emesis basin and tissues within close proximity. D. Offer water, other fluids, or ice chips frequently.

B. raise the head of the bed The most common problem is diarrhea; therefore, observation and skin care are essential. (1) Ambulation is an intervention for constipation, which may occur but is less likely. (3) Vomiting is not expected as long as the patient is tolerating the amount of the feeding. Bolus feedings can cause vomiting, but if vomiting occurs, the physician should be notified so that the amount can be adjusted. (4) Subjective thirst and dryness in the mouth area may occur, but patients who are receiving enteral feedings may also be NPO; therefore, encouraging fluids may not be appropriate. Good oral care should be provided and can help relieve subjective oral dryness.

During a home visit, you provide verbal instructions to a patient with a possible blockage of an ostomy. What would be an appropriate instruction to give? A. Massage the stoma. B. Try different body positions. C. Take a cold bath. D. Begin a high-fiber diet.

B. try different body positions A different body position, such as a knee-chest position, might move the blockage forward. Massage the area around the stoma, not the stoma itself. A warm bath might help. Patient would be switched to a liquid diet; a high-fiber diet could make the problem worse. (See the Patient Teaching box, Measures to Prevent Intestinal Blockage for Ileostomy Patients, for additional information.)

a client with ascites is scheduled for a paracentesis. the nurse is assisting the primary health care provider (PHCP) with performing the procedure. which position should the nurse assist the client into for this procedure? A. flat B. upright C. left side-lying D. right side-lying

B. upright an upright position allows the intestine to float posteriorly and helps prevent intestinal laceration during catheter insertion

if the patient has a history of chronic cholecystitis, which comment is cause for the greatest concern? A. "I have back pain at the level of the shoulder blade." B. "I had nausea after eating a hamburger and fries." C. "I have generalized abdominal pain and fever." D. "I have discomfort in the right upper part of my abdomen."

C. "I have generalized abdominal pain and fever" A chief concern for patients with chronic cholecystitis is infection and rupture of the gallbladder, leading to peritonitis that would be associated with generalized abdominal pain and fever. Referred pain to the back does occur with acute attacks, and pain management is needed. Patient should be reminded that fatty foods can cause nausea. Discomfort in the right upper quadrant is considered a mild symptom of the chronic condition.

you reinforce diet recommendations to a patient with GERD. which patient statement indicates a need for further teaching? A. "I should avoid spicy Italian sauces." B. "clothes should be loose around the waist and abdomen." C. "I need to wait 30 minutes after eating before lying down." D. "I need to consider removing caffeine from my diet."

C. "I need to wait 30 minutes after eating before lying down" Patient should know to wait 3 hours after eating before lying down. The other responses indicate that the patient has understood: (1) Spicy tomato sauces should be avoided. (2) Clothes should be loose around the waist and abdomen. (4) Caffeine should not be consumed

when working with an obese patient who wants to lose weight, which statement would indicate that the teaching has been understood? A. "starting to exercise 2 hours a day is a good beginning for me." B. "eating everything I want except for anything sweet will help me lose weight." C. "a program such as Weight Watchers will help me cut calories and keep on track." D. "over-the-counter diet pills are a good way to jump-start my weight loss."

C. "a program such as weight watchers will help me cut calories and keep on track" Programs such as Weight Watchers, TOPS, and Overeaters Anonymous have shown the greatest success in promoting weight loss that then is maintained. (1) Beginning an exercise program is essential, but starting with 2 hours a day is unrealistic. The patient should consult the physician before starting any exercise program. (2) Cutting total calories is the goal of any weight loss program. Cutting out sweets helps, but only if total calories are cut rather than filling in with other foods. (4) Over-the-counter diet pills have not been shown to promote significant weight loss and they often have many undesirable side effects.

a patient is to collect a specimen for a stool guaiac test. which direction should the patient be given? A. "be sure to use a sterile container to collect the specimen." B. "be sure to take a laxative 2 days prior to collecting the stool." C. "do not eat red meat for at least 3 days before collecting the specimen." D. "do not drink carbonated beverages for 8 hours before collecting the specimen."

C. "do not eat red meat for at least 3 days before collecting the specimen" The stool guaiac test assesses for the presence of blood in the specimen. The patient must have a red meat-free diet for at least 3 days before a stool guaiac test can be considered accurate. Laxative use is not needed prior to collection of the specimen. The container used will be clean but not sterile. Intake of carbonated beverages will not impact the specimen.

a client with a peptic ulcer is diagnosed with a Helicobacter pylori infection. the nurse is reinforcing teaching for the client about the medications prescribed, including clarithromycin, esomeprazole, and amoxicillin. which statement by the client indicates the best understanding of the medication regimen? A. "my ulcer will heal because these medications will kill the bacteria." B. "these medications are only taken when I have pain from my ulcer." C. "the medications will kill the bacteria and stop the acid production." D. "these medications will coat the ulcer and decrease the acid production in my stomach."

C. "the medications will kill the bacteria and stop the acid production" triple therapy for Helicobacter pylori infection usually includes two antibacterial drugs and a proton pump inhibitor. clarithromycin and amoxicillin are antibacterials. esomeprazole is a proton pump inhibitor. these medications will kill the bacteria and decrease acid production.

the client has an as needed prescription for loperamide hydrochloride. for which condition should the nurse administer this medication? A. constipation B. abdominal pain C. an episode of diarrhea D. hematest-positive nasogastric tube drainage

C. an episode of diarrhea loperamide is an antidiarrheal agent. it used to manage acute and also chronic diarrhea in conditions such as inflammatory bowel disease

a patient with acute pancreatitis has a bluish discoloration around the umbilicus. what actions should you take? (place in priority order.) A. place head flat and feet elevated. B. notify health care provider. C. assess vital signs. D. verify patency of IV line.

C. assess vital signs A. place head flat and feet elevated D. verify patency of IV line B. notify health care provider bluish discoloration around the umbilicus for this patient suggests internal bleeding. the nurse would check vital signs first to assess the severity of the bleeding. placing the patient flat with feet elevated will support the blood pressure. patency of the IV is crucial in being able to replace fluids. the provider needs to be notified

You are supervising a nursing student during the care of a patient with a gastrostomy tube. You should intervene if the student: A. aspirates for residual contents before feeding. B. flushes the tube after each feeding. C. changes the tubing and bag every 4 hours. D. cleans and dries the skin around the tube.

C. changes the tubing and bag every 4 hours Tubing and bag are changed every 24 hours, unless there is a special need based on assessment of circumstances. (1) Residual is aspirated before the subsequent feeding. (2) The tube is flushed after each feeding. (4) The skin should be kept clean and dry.

an older client has recently been taking cimetidine. the nurse should monitor the client for which most frequent central nervous system side effect of this medication? A. tremors B. dizziness C. confusion D. hallucinations

C. confusion cimetidine is a histamine 2 (H2)-receptor antagonist. older clients are especially susceptible to the central nervous system side effects of cimetidine. the most frequent of these is confusion

A 30-year-old woman is admitted with complaints of severe nausea and vomiting over the past 2 days. On admission she is hypotensive and extremely weak. What is the priority problem? A. Altered breathing pattern B. Altered activity tolerance C. Deficient fluid volume D. Altered cardiac output

C. deficient fluid volume Deficient fluid volume since symptoms and condition are related to excessive fluid loss. (1) There is nothing in the history that suggests that the patient is having trouble breathing. (2, 4) These are not priority nursing diagnoses. The patient is likely to have activity intolerance and her hypotension suggests a decreased cardiac output, but both problems should readily resolve if the fluid deficit is corrected.

An 82-year-old patient is undergoing bowel preparation for a diagnostic procedure. What are potential complications of the bowel prep? (Select all that apply.) A. Constipation B. Rashes C. Dehydration D. Muscle cramps E. Chest pains F. Hypotension

C. dehydration F. hypotension Dehydration is a possible adverse effect of rigorous bowel preparations. (1, 4) Constipation and chest pain are unlikely to occur because of the bowel preparation. (2) Rash could occur if the patient has an allergy to a component of the fluid but is not the most likely side effect to occur.

a patient is admitted with anorexia, nausea and vomiting, and weight loss. when developing the plan of care, which information is a priority to be obtained? (select all that apply.) A. ability to cook own food B. cultural preferences for food C. dietary history D. pattern of anorexia E. factors that cause vomiting

C. dietary history D. pattern of anorexia E. factors that cause vomiting Dietary history, pattern of anorexia, and factors that cause vomiting are needed to initiate a plan of care. Determining the ability to cook and the cultural preferences for food are not immediately necessary to formulate a nursing care plan for the patient; they may be obtained at a later time.

A decreased secretion of intrinsic factor is a physiologic change associated with the aging process; therefore, you suspect decreased intrinsic factor should assess for which behavior? A. A refusal to eat salty or sweet foods B. A change in stools after eating fatty foods C. Fatigue and activity intolerance D. Difficulties with mastication

C. fatigue and activity intolerance A lack of intrinsic factor may cause pernicious anemia, which can manifest as fatigue and activity intolerance. (1) It is atrophy of taste buds results in a difficulty in distinguishing between salty and sweet flavors. (2) Change in stool quality can be related to many disorders or bodily functions but not to lack of intrinsic factor; however, changes in lipase or bile will change the stool characteristics. (4) Difficulties with mastication can be related to poor dentition or ill-fitting dentures.

you are caring for a patient who underwent radical pancreaticoduodenectomy. which postoperative complication would be the most likely to occur and cause the greatest concern? A. hypoglycemia B. adhesions C. hemorrhage D. anorexia

C. hemorrhage hemorrhage is a possibility with any major abdominal surgery. hyperglycemia is more likely than hypoglycemia. adhesions may develop eventually, but they are not a concern in the immediate postoperative period. anorexia may also occur, but the patient is likely to be NPO and receiving TPN

While a nurse is obtaining a clinical history, a patient with a known history of peptic ulcers suddenly complains of severe upper abdominal pain of increasing intensity that spreads to the shoulders. The abdomen has boardlike rigidity. Which sign(s) and/or symptom(s) signal worsening condition related to the peptic ulcer? (Select all that apply.) A. Slow, deep respirations B. Decreased oxygen saturation C. Increased pulse D. Hot, dry skin E. Belching and flatulence F. Confusion and restlessness

C. increased pulse F. confusion and restlessness An increased pulse is a compensatory measure and the first vital sign change that is expected with pain or bleeding. Restlessness and confusion are early signs of decreased perfusion, in this case related to hemorrhage. (1) Respirations are more likely to increase. (2) Oxygen saturation should not be affected at this point. (4) Hot, dry skin is more associated with infection. (5) Belching and flatulence are more associated with GERD.

the nurse is caring for a client after a billroth II (gastrojejunostomy) procedure. during review of the postoperative prescriptions, which should the nurse clarify? A. leg exercises B. early ambulation C. irrigating the NG tube D. coughing and deep-breathing exercises

C. irrigating the NG tube in a billroth II resection, the proximal remnant of the stomach is anastomosed to the proximal jejunum. potency of the NG tube is critical for preventing the retention of gastric secretions. the nurse, however, should never irrigate or reposition the NG tube after gastric surgery unless specifically prescribed

the nurse reinforces postoperative liver biopsy instructions to a client. which should the nurse tell the client? A. avoid alcohol for 8 hours. B. remain NPO for 24 hours. C. lie on the right side for 2 hours. D. save all stools to be checked for blood.

C. lie on the right side for 2 hours to splint the puncture site, the client is kept on the right side for a minimum of 2 hours

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? A. ambulate after a meal. B. eat high-carbohydrate foods. C. limit the fluids taken with meals. D. sit in a high Fowler's position during meals.

C. limit the fluids taken with meals the client should be instructed to decrease the amount of fluid taken at meals, the client should also be instructed to avoid high-carbohydrate foods, including fluids such as fruit nectars; assume a low-Fowler's position during meals, lie down for 30 minutes after eating to delay gastric emptying and take antispasmodics as prescribed

You are planning care for several patients who had diagnostic testing. Which patient will require the most time for postprocedural care? A. Patient who had an ultrasound B. Patient who had hepatobiliary scintigraphy C. Patient who had a liver biopsy D. Patient who had a Helicobacter pylori antibody test

C. patient who had a liver biopsy Patients who undergo liver biopsy are at risk for postprocedural bleeding or respiratory problems, such as dyspnea, cyanosis, or restlessness, which might indicate pneumothorax. They require frequent vital signs and close observation. (1) Ultrasound is a noninvasive procedure, and routine monitoring is sufficient. (2) Patients who undergo hepatobiliary scintigraphy should be informed that there is little danger of radioactivity; postprocedurally routine monitoring is sufficient. (4) Helicobacter pylori antibody test requires a blood sample, so routine care of a venipuncture site is sufficient.

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? a. NPO status B. an anticholinergic medication C. position the client supine and flat D. prepare to insert a nasogastric tube

C. position the client supine and flat the pain associated with acute pancreatitis is aggravated when the client lies in supine and flat position

A patient has a new colostomy. Which behavior is an early sign of acceptance of the change in body image? A. The patient allows you to empty the colostomy bag. B. The patient refuses to look at the ostomy site. C. The patient holds and examines a new appliance bag. D. The patient continues to ask for a bedpan to have a bowel movement.

C. the patient hold and examines a new appliance bag One of the important goals—related to acceptance—is for the patient to perform self-care of the colostomy. Looking at the stoma and manipulating equipment are early signs of acceptance. Refusing to look at the stoma and passively allowing the nurse to perform the care are signs that the patient is having some difficulties in adjusting to body changes. If the patient continues to use the bedpan, there is either a huge knowledge deficit or significant denial.

an ultrasound of the gallbladder is scheduled for the client with a suspected diagnosis of cholecystitis. which should the nurse explain to the client about this test? A. the test is uncomfortable. B. the test requires that the client be NPO. C. the test requires the client to lie still for short intervals. D. the test is preceded by the administration of oral tablets.

C. the test requires the client to lie still for short intervals ultrasound of the gallbladder is a noninvasive procedure and is frequently used for emergency diagnosis of acute cholecystitis. the client may need to lie still during the procedure for short in travels of time while visualization of the gallbladder is done

For which reason are patients with esophageal varices prone to hemorrhage? A. They have portal hypotension. B. There is poor circulation within the veins. C. They are no longer able to produce vitamin K. D. There is an accumulation of ammonia in the blood.

C. they are no longer able to produce vitamin K Esophageal varices are engorged veins (similar to varicose veins) that line the esophagus. They are the result of portal congestion and hypertension. The congestion can lead to massive bleeding when the vein walls rupture from increased pressure or esophageal irritation. Another factor in hemorrhage is that the liver is no longer able to make vitamin K. Ammonia buildup does not increase the patient's risk for hemorrhage.

A patient develops a paralytic ileus as a complication of peritonitis. Which patient comment suggests a return of peristalsis? A. "I feel thirsty; may I have some water?" B. "I would like to try to walk to the toilet." C. "When will I be allowed to have solid food?" D. "I am sorry to pass gas while you are here."

D. "I am sorry to pass gas while you are here" Reassure the patient that passing gas is a normal healthy sign that peristalsis and gastrointestinal (GI) function are returning to normal. Follow-up by listening for bowel sounds. Subjective thirst is likely to occur because this patient is NPO. Hunger may also occur, but anorexia frequently accompanies GI problems. Ambulating will help to stimulate GI function but is not necessarily a sign that peristalsis has returned. (Patient may have the urge to urinate and therefore would like to ambulate to the toilet.)

You emphasize the importance of eating natural sources of fiber to a patient who has frequent constipation. Which patient statement indicates effective health teaching? A. "I will consider eating more white bread." B. "I will drink fluids only while consuming meals." C. "I will add more milk to my morning cereal." D. "I will eat more fruits and vegetables."

D. "I will eat more fruits and vegetables" Patient has understood that fruits and vegetables are good fiber sources. (1) White bread and dairy products do not supply fiber. (2) Fluid consumption must be spaced throughout the day. If fluids are restricted to mealtimes, it will be very difficult to drink the recommend amount. (3) Adding milk to cereal does not increase the fiber content.

the nurse is caring for a patient who is preparing for discharge after having had an upper GI series. which patient statement demonstrates a need for further discharge instruction? A. "I'll take a laxative." B. "I'll drink lots of water." C. "I can expect my stool to be white for up to 3 days." D. "I will not be able to drink fluids that contain any caffeine."

D. "I will not be able to drink fluids that contain any caffeine" After an upper GI series, the patient does not have any dietary intake restrictions. Caffeine use is not contraindicated. Increased fluids, laxatives, and white stools are included in the education of the patient after an upper GI series.

A patient is suspected of having colon cancer. Which question is most important to ask to see if the patient is at risk? A."Do you eat a lot of wild mushrooms?" B."Do you eat a lot of barbecued foods?" C."Has anyone in your family had rectal polyps?" D."Has anyone in your family had bowel cancer?"

D. "has anyone in your family had bowel cancer?" Colon cancer has a familial link, making this inquiry the most appropriate. Charred meats can increase one's risk for colon cancer. Familial history of rectal polyps and dietary intake of wild mushrooms are less important.

In caring for a patient with an ostomy, which statement is true regarding medication administration? A. Time-release capsules can be given to patients with an ileostomy. B. Enteric-coated tablets are adequately absorbed by patients with ileostomy. C. Glycerin suppositories are readily evacuated in the distal colostomy stoma. D. An antiemetic suppository can be effectively absorbed when inserted in the distal colostomy stoma.

D. an antiseptic suppository can be effectively absorbed when inserted in the distal colostomy stoma A drug that is to be absorbed from the intestine, as for relief of vomiting, should be inserted into the distal stoma, where it will not be expelled. Ileostomy patients should not take time-release capsules and enteric-coated tablets, as there is not enough time for adequate absorption before the medication is expelled through the stoma. Glycerin suppositories will stimulate evacuation if inserted into the proximal stoma, but they will not work if inserted into the distal stoma.

When a patient experiences a severe exacerbation of Crohn disease, the priority pharmacologic treatment would be administration of which class of medication? A. Analgesics B. Antibiotics C. Antidiarrheals D. Corticosteroids

D. corticosteroids Reducing inflammation during severe exacerbation of Crohn disease is the priority. This is accomplished by the administration of corticosteroids. Analgesics, antibiotics, and antidiarrheals may be necessary to treat symptoms, but corticosteroids are the cornerstone of therapy for Crohn disease.

the older adult patient presents to the emergency department complaining of severe vomiting for 3 days. the nurse knows which is the major complication of continuous vomiting? A. weight loss B. cardiac dysrhythmias C. aspiration of vomitus D. dehydration

D. dehydration Older adult patients experiencing continuous vomiting are at particular risk for dehydration. Significant weight loss would not occur immediately; it is a sign of prolonged nutritional deficiency. If the vomiting were to continue, the resulting hypokalemia could result in dysrhythmias

A patient has been diagnosed with gastric cancer. What is associated with increased incidence of this disease? A. Refined sugars B. Dairy products C. Carbonated beverages D. Luncheon meats ("cold cuts")

D. luncheon meats ("cold cuts") Nitrites, found in processed foods such as luncheon meats, have been strongly linked to gastric cancer. Refined sugars, dairy products, and carbonated beverages have not been associated with development of gastric cancer.

the client has an as needed prescription for ondansetron. for which condition should the nurse administer this medication? A. paralytic ileus B. incisional pain C. urinary retention D. nausea and vomiting

D. nausea and vomiting ondansetron is an antiemetic used to treat postoperative nausea and vomiting, as well as nausea and vomiting associated with chemotherapy

The nurse is caring for a patient experiencing stomatitis. Which factor is most likely to have contributed to development of stomatitis? A. Morbid obesity B. Vegetarian diet C. Good oral hygiene D. Nutritional deficiencies

D. nutritional deficiencies Factors likely to have contributed to the development of stomatitis is nutritional deficiencies, trauma from ill-fitting dentures, malocclusions of the teeth, poor oral hygiene, excessive smoking, excessive drinking of alcohol, pathogenic microorganisms, radiation therapy, and drugs used in chemotherapy for malignancies and anticonvulsants. Morbid obesity and intake of a vegetarian diet do not contribute to the development of stomatitis.

the client with a gastric ulcer has a prescription for sucralfate 1 g by mouth four times daily. the nurse should schedule the medication to be administered at which times? A. with meals and at bedtime B. every 6 hours around the clock C. one hour after meals and at bedtime D. one hour before meals and at bedtime

D. one hour before meals and at bedtime sucralfate is a gastric protectant. the medication should be scheduled for administration 1 hour before meals and at bedtime. the medication is timed to allow it to form a protective coating over the ulcer before food intake stimulates gastric acid production and mechanical irritation. The other options are incorrect.

the nurse is monitoring for stoma prolapse in a client with a colostomy. which stoma observation should indicate that a prolapse has occurred? A. dark and bluish B. sunken and hidden C. narrowed and flattened D. protruding and swollen

D. protruding and swollen a prolapsed stoma is one in which bowel protrudes through the stoma, with an elongated and swollen appearance. a stoma retraction is characterized by sinking of the stoma. ischemia of the stoma would be associated with dusky or bluish color. a stoma with a narrowed opening, either at the level of the skin or fascia, is said to be stenosed

an elderly patient reports a loss of interest in eating. the patient's history indicates the patient's spouse died a few months ago. when providing information to the patient, which action by the nurse is likely to be most helpful in increasing the patient's intake? A. having the patient keep a food diary. B. giving the patient a list of high-calorie foods. C. reminding the patient of the importance of eating. D. suggesting to the patient's family members that someone join the patient for meals.

D. suggesting to the patient's family members that someone join the patient for meals Psychosocial factors have a significant impact on one's desire for food. Appetite depends on complex mental processes having to do with memory and mental associations that can be pleasant or extremely unpleasant. Appetite is stimulated by the sight, smell, and thought of food. The physical and social environment in which a person is eating stimulates appetite. It would not be helpful for the nurse to have the patient keep a food diary, to give the patient a list of high-calorie foods, or to remind the patient of the importance of eating.

A common cause of liver toxicity is: A. daily hydrochlorothiazide administration for hypertension. B. regular consumption of a high-fat diet throughout life. C. long-term smoking of a pack of cigarettes per day. D. taking extra-strength acetaminophen at doses of 4500 mg per day.

D. taking extra-strength acetaminophen at doses of 4500 mg per day Excessive amounts of acetaminophen can cause liver toxicity and failure. Patients need to be reminded to check other medications and over-the-counter for acetaminophen while taking the medication. No more than 3000 mg should be taken on a regular basis. (2) Consumption of a high-fat diet may cause gallbladder problems, not liver toxicity. (3) Long-term smoking can damage the lungs, blood vessels, and contribute to the formation of various cancers, but it does not cause liver toxicity.

the nurse is monitoring a client for the early signs and symptoms of dumping syndrome. which indicates this occurrence? A. sweating and pallor B. dry skin and stomach pain C. bradycardia and indigestion D. double vision and chest pain

A. sweating and pallor early manifestations occur 5 to 30 minutes after eating. symptoms include vertigo, tachycardia, syncope, sweating, pallor, palpitations, and the desire to lie down

a magnetic resonance imaging (MRI) test is scheduled. what should be included in the information provided to the patient? A. the test will take approximately 60 minutes. B. the patient will have an intravenous (IV) line started prior to the test. C. solid foods are restricted for 6 to 8 hours prior to the test. D. there is only a limited amount of radiation exposure associated with the test.

A. the test will take approximately 60 minutes

you are caring for a 57-year-old patient with ascites resulting from liver disease. you anticipate that the health care provider will use which therapeutic regimen to reduce portal hypertension? A. vascular shunting of the portal venous systems B. repeated abdominal paracentesis C. diet restrictions and nutrient supplementation D. fluid replacement therapy

A. vascular shunting of the portal venous systems Transjugular intrahepatic portosystemic shunt (TIPS) may be used to decrease pressure between portal and hepatic veins in the liver. Paracentesis is a temporary measure that is used to relieve ascites. Dietary modifications are aimed at symptom control and restoring function. Fluids are likely to be restricted.

a patient with high levels of serum ammonia asks, "why do I have to continue taking lactulose?" what is the best response? A. "It destroys ammonia-producing bacteria in the intestines." B. "It reduces intestinal absorption of ammonia." C. "It corrects vitamin B1 deficiency." D. "It is used in preparation for a diagnostic test."

B. "it reduces intestinal absorption of ammonia" lactulose is used to induce diarrhea and prevent diffusion of ammonia out of the intestinal tract. neomycin is occasionally given orally or by edema to decrease the colonic bacteria. thiamine is given to correct vitamin B1 deficiency. lactulose does induce diarrhea, but it would not be the first choice for bowel preparation

You encourage a patient with IBS to keep a food diary. What is the best nursing response to the patient regarding the importance of keeping the diary? A. "The diary will monitor caloric intake." B. "The diary will help identify foods that cause bloating." C. "The diary will determine food preferences." D. "The diary will reinforce the need for better food choices."

B. "the diary will help identify foods that cause bloating" The purpose of having a patient with irritable bowel syndrome (IBS) keep a food diary is to identify foods that may cause bloating; a diary will help establish a pattern of eating and of symptoms. The other options are also correct and appropriate for different patients with different health conditions. For example, an obese patient may keep a diary to monitor calories or to recognize that there is an overconsumption of high-calorie foods. Keeping a diary for food preferences might be appropriate to identify the favorite foods of an older patient or of someone from a different cultural background.

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? A. vitamin A B. vitamin C C. vitamin E D. vitamin B12

D. vitamin B12 deterioration and atrophy of the lining of the stomach lead to the loss of function of the parietal cell. when the acid secretion decreases, the source of the intrinsic factor is lost, which results in the inability to absorb vitamin B12. this leads to the development of pernicious anemia

a patient questions the use of herbal remedies to manage motion sickness on an upcoming trip. which has been used with success to manage this health complaint? A. ginger B. ginkgo C. ginseng D. goldenrod

A. ginger Ginger has been used for centuries in Asia to combat nausea and vomiting, motion sickness, and dyspepsia. It is available candied, in capsules, fluid extract, and tablets, and tincture or as fresh ginger root that can be grated and used to make tea. Gingko biloba, ginseng, and goldenrod are not used for motion sickness.

You are caring for a patient who is vomiting blood. The health care provider orders a normal saline IV fluid bolus of 500 mL to infuse over 30 minutes. The correct pump setting in mL/h is ________. (Fill in the blank.)

1000 mL/hr or 999 mL/hr Note: Infusion pumps may only allow programming of 999 as the maximum due to digital display. Total volume divided by the total time 500 mL ÷ 0.5 hour = 1000 mL/hr or 500 mL × 60 min/hr ÷ 30 minutes = 1000 mL/hr

Which laboratory values would you use to assess liver function? A. CBC, BUN, creatinine 2. Lipase, amylase, WBC 3. Troponin, CPK, myoglobin 4. ALT, ammonia, INR

4. ALT, ammonia, INR

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? A. diarrhea B. constipation C. bloody stools D. stool constantly oozing from the rectum

A. diarrhea Crohn's disease is characterized by non bloody diarrhea of usually not more than 4 or 5 stools daily. over time, the diarrhea episodes increase in frequency, duration, and severity

Which statement made by a patient might indicate a precipitating factor of acute gastritis? A. "I really like tequila." B. "I never touch alcohol." C. "I just started a new diet." D. "I try to get in a 2-mile walk every day."

A. "I really like tequila" Drinking excessive amounts of alcohol, infection from eating contaminated food, Helicobacter pylori bacteria, and ingestions of aspirin, ibuprofen, corticosteroids, or nonsteroidal anti-inflammatory drugs (NSAIDS) are gastrointestin

a patient has cirrhosis of the liver and ascites. you should question which order? A. bed rest with bathroom privileges B. discontinue furosemide (Lasix) 80 mg C. give 2-g sodium diet D. fluid restriction 1500 mL/24 h

B. discontinue furosemide (lasik) medical treatment includes administration of diuretics, bedrest, sodium, and fluid restriction

The nurse is caring for a patient with ulcerative colitis who recently underwent a colectomy and the creation of an ileal reservoir. How will this patient eliminate stool from his body? A. Continuously into a collection pouch B. With a catheter inserted into the reservoir C. Via his anus, over which he retains control D. Intermittently via the ostomy into a collection pouch

B. with a catheter inserted into the reservoir Patients with ileal reservoirs or Kock pouches are able to empty the reservoir via catheter and not wear a collection pouch. A collection pouch is necessary for traditional ileostomies, with which stool is evacuated continuously rather than intermittently. The patient with an ileoanal anastomosis retains control over the anal sphincter and defecates normally.

A family member tells you, "Dad seems to be having some trouble swallowing lately." What is your priority action? A. Notify the health care provider. B. Consult the speech therapist for advice. C. Initiate aspiration precautions. D. Observe during "practice swallows."

D. observe during "practice swallows" First observe and assess the rise of the larynx during a practice swallow. (1) The provider would be notified if constant choking occurs. (2) This may be appropriate, but it is not the priority action. (3) Aspiration precautions should always be in place for a patient who has trouble swallowing. However, it is essential to assess the patient's swallowing ability in order to determine if he really is having difficulty.

the nurse is reinforcing teaching to a client about an upcoming colonoscopy procedure. the nurse should include in the instructions that the client will be placed in which position for the procedure? A. left Sims' position B. lithotomy position C.knee-chest position D. right Sims' position

A. left sim's position the client is placed in left sim's position for the procedure. this position take the best advantage of the client's anatomy for ease with introducing the colonoscopy

the nurse is caring for an older adult patient who reports continued problems with constipation. what intervention can be implemented to promote timely bowel movements? A. increase fiber intake. B. limit fluid intake to 1500 mL daily. C. administration of an oil retention enema weekly. D. take a mild over-the-counter laxative each evening.

A. increase fiber intake Fiber intake will promote defecation. Fluid intake should be at least 2500 mL daily unless contraindicated by medical conditions. Laxative and enema use should be avoided if possible. Too frequent use of these aids may result in reliance on them to have a bowel movement.

The nurse is reviewing the chart of a patient who recently underwent a total gastrectomy and notes the patient is receiving total parenteral nutrition (TPN). The nurse understands which information about TPN? A. A form of intravenous (IV) feeding B. A type of intestinal decompression C. A new method of tube-feeding a patient with dysphagia D. A method of feeding a patient through a tube inserted through an incision in the stomach

A. a form of intravenous (IV) feeding TPN is indicated when the patient cannot ingest or digest food normally or has a problem with malabsorption. If a patient has continued weight loss and a negative nitrogen balance, TPN is indicated. TPN is essentially a form of IV feeding. However, because the amounts and kinds of nutrients needed for long-term nutritional maintenance usually cannot be handled as well by peripheral veins, the nutrient mix is given into a larger central vein such as the superior vena cava. A Replogle or Salem sump tube is used for GI decompression. Gastrostomy tubes are inserted through an incision in the stomach; enteral feeding is instilled through this tube.

Measures used to teach patients to prevent gastrointestinal ulcers include: A. limiting the amount of routine alcohol consumption. B. refraining from the use of aspirin for a headache. C. taking an H2 inhibitor to decrease stomach acid daily. D. eating hot, spicy food at least once each day.

A. limiting the amount of routine alcohol consumption Drinking excessive alcohol on a consistent basis may cause erosion of the gastric mucosa and predispose to ulcer formation. (2) Taking an occasional aspirin does not predispose to a gastrointestinal (GI) ulcer. (3) Taking an H2 inhibitor on a regular daily basis is not recommended for prevention of an ulcer. (4) Eating hot, spicy food at least once a day is not recommended for ulcer prevention.

What would be included in the recommended diet for patients with IBD? (Select all that apply.) A. Low fat B. High fiber C. High protein D. Low calorie E. Lactose avoidance

A. low fat C. high protein E. lactose avoidance For IBS, the nurse would ensure that the patient received a diet of low-fat, low-fiber foods that have high protein and caloric contents. Small frequent feedings are best. Lactose avoidance helps some patients.

You admit a 23-year-old patient with possible appendicitis. You anticipate which sign(s) and/or symptom(s)? (Select all that apply.) A. Increased red blood cell count B. Abdominal tenderness C. Anorexia and vomiting D. Mild fever E. Dark black stools

B. abdominal tenderness C. anorexia and vomiting D. mild fever Tenderness, nausea, anorexia, and fever are part of the clinical picture for appendicitis. The white blood cell (not the red blood cell) count is likely to be high. Dark, black stool is more associated with GI bleeding than appendicitis.

the client has been taking omeprazole for 4 weeks. the nurse evaluates that the client is receiving the optimal intended effect of the medication if the client reports the absence of which symptom? A. diarrhea B. heartburn C. flatulence D. constipation

B. heartburn omeprazole is a proton pump inhibitor classified as an anti ulcer agent. the intended effect of the medication is relief of pain from gastric irritation, often called "heartburn" by clients

the client has begun medication therapy with pancrelipase. the nurse evaluates that the medication is having the optimal intended benefit if which effect is observed? A. weight loss B. relief of heartburn C. reduction of steatorrhea D. absence of abdominal pain

C. reduction od steatorrhea pancrelipase is a pancreatic enzyme used in clients with pancreatitis as a digestive aid. the medication should reduce the amount of fatty stools (steatorrhea)

The nurse is caring for the patient following abdominal surgery. Which symptom, if demonstrated by the patient, indicates the development of peritonitis? A. Fever B. Projectile vomiting C. Severe abdominal pain D. Anorexia with weight loss

C. severe abdominal pain Peritonitis is an inflammation of the peritoneum. It usually occurs when one of the organs it encloses ruptures or is perforated so that the organ's contents (including bacteria) are spilled into the abdominal cavity. Primary symptoms of peritonitis include nausea and vomiting, and severe abdominal pain and distention. Fever may result later. Projectile vomiting and anorexia are symptoms of many abdominal disorders.

The specific cause of dysphagia can be determined more easily when the LPN/LVN obtains which information about the patient? A. Patient's vital signs, especially rate and depth B. Level of physical activity tolerated by the patient C. Patient's bowel habits and whether laxatives are taken habitually D. Observing conditions under which the patient experiences difficulty swallowing

D. observing conditions under which the patient experiences difficulty swallowing When assessing the patient with dysphagia the nurse should observe carefully the kinds of food the patient can tolerate and the conditions under which difficulties are experienced. Knowing the consistency and temperature of the foods most easily ingested by the patient is helpful. The patient's vital signs, level of tolerated physical activity, and bowel habits are important assessment data but are not related to the patient's dysphagia.

You are caring for a patient who is postoperative after an ileostomy. Which order should you question? A. Strict intake and output recording for 8 hours B. Clear liquid diet C. IV fluids 125 mL/h D. Occlusive dressing over stoma

D. occlusive dressing over stoma A dressing is never placed over an ileal stoma; drainage must be assessed because a decrease in output could signal a blockage, which could lead to a rupture. The other orders are part of the standard postoperative care for an ileostomy patient.

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? A. hepatitis A B. hepatitis B C. hepatitis C D. hepatitis D

A. hepatitis A HAV is transmitted by the fecal-oral route via contaminated food or infected food handlers. HBV,HCV, and HDV are most commonly transmitted via infected blood or bodily fluid

a nurse is taking care of a patient who had a modified radical neck dissection surgery. the patient's spouse asks, "why do you have to apply cold packs and elevate my husband's head?" which response is the most appropriate? A. "these interventions decrease the need for opiates." B. "these interventions reduce neck swelling." C. "these interventions promote faster healing." D. "these interventions reduce the incidence of postoperative fever."

B. "these interventions reduce neck swelling" Application of cold packs is to prevent excessive swelling in the neck that might compress the airway, circulation, and nerves. (1) Cold pack can reduce the need for opiates for some, but this is not the reason for the cold packs. (3) The interventions may or may not promoted quicker healing. (4) These interventions do not reduce the incidence of postoperative fever.

the client who frequently uses nonsteroidal antiinflammatory drugs (NSAIDs) has been taking misoprostol. the nurse determines that this medication is having the intended therapeutic effect if which is noted? A. resolved diarrhea B. relief of epigastric pain C. decreased platelet count D. decreased white blood cell count

B. relief of epigastric pain the client who frequently uses non steroidal anti-inflammatory drugs is prone to gastric mucosal injury. misoprostol os a gastric protectant and is given specifically to prevent this occurrence

A patient reports a history of gastric ulcer. Which sign or symptom indicates the need for a priority action of health care provider notification? A. Epigastric pain that is described as a burning sensation B. Pain that is most severe at bedtime C. Vomit that "looks like coffee grounds" D. Discomfort that comes for several days and then subsides

C. vomit that "looks like coffee grounds" Coffee-ground emesis is a typical appearance of blood that is partially digested; this finding is less acute than bright red blood, but still warrants timely follow-up with the provider. (1) Epigastric pain is a common symptom and is not the priority in this situation. (2) Pain that is more severe at bedtime is treated with antacids. (4) Waxing and waning discomfort is not the priority symptom.

A patient with a sigmoid colostomy is taught to irrigate her colostomy daily to accomplish which goal? A. Prevent infection B. Keep the bowel sterile C. Increase the diameter of the bowel D. Gain control over the time elimination occurs

D. gain control over the time elimination occurs A sigmoid colostomy will usually drain formed stool on a relatively regular schedule. Irrigation of the colostomy gives the patient some control over when elimination takes place. The procedure is done daily or every other day at about the same time and takes close to an hour. The bowel is not sterile. Irrigation does not help prevent infection or increase the diameter of the bowel.

A 56-year-old man is admitted with a diagnosis of gastroesophageal reflux disease (GERD). The nurse anticipates the patient to report gastroesophageal discomfort after which meal? A. Hamburger, peas, and cola B. Turkey, salad, and a glass of red wine C. Chicken in lemon sauce, rice, and fruit juice D. Poached salmon, mashed potatoes, and milk

A. hamburger, peas, and cola Foods with significant fat content (hamburger) and xanthine-containing beverages (tea, cola, coffee) decrease the tone and contractility of the esophageal sphincter, allowing gastric contents to flow back up into the esophagus. Turkey, salad, red wine, chicken, rice, fruit juice, poached salmon, potatoes, and milk are less likely to cause discomfort.

when screening for the presence of risk factors for oral and pharyngeal cancers, which questions would you ask? (select all that apply.) A. how much alcohol do you consume? B. have you had any oral lesions? C. do you have family members who have cancer? D. do you smoke? E. have you been exposed to the hepatitis virus? F. have you vomited blood?

A. how much alcohol do you consume? B. have you had any oral lesions? C. do you have family members who have cancer? D. do you smoke? Use of alcohol, or use of tobacco and a personal history of oral lesions, or a family history of cancer are increased risk factors for oral and pharyngeal cancers. (5) History of hepatitis increases the risk for liver cancer.

Before being discharged to home, a patient who had a laparoscopic cholecystectomy is given instructions regarding pain control. Which patient statements indicate successful teaching? (Select all that apply.) A. "I will stay mobile and change positions frequently." B. "Opioids are the best medication for relieving pain." C. "I will continue my swimming routine for exercise, and this will help my pain." D. "Passing gas will relieve my pain." E. "Pain will become less as the gas in my abdomen is absorbed." F. "I will take NSAIDs for pain control."

A. "I will stay mobile and change positions frequently." B."Opioids are the best medication for relieving pain." D."Passing gas will relieve my pain." Jaundice results as bile backs up into the liver and blood. The surgery and placement of the drain should resolve this problem. The other statements indicate that the patient has understood the instructions. Caring for the drain includes regular empty of the bag so that there is room for additional drainage. Loose-fitting clothes will prevent pressure on the drain site. Stool gets its brown color from bile. As the gastrointestinal system returns to normal function, stools should be brown in color.

A nurse is reviewing signs and symptoms of esophageal cancer with people who are at risk. Which statement indicates that the participants have understood the information? A. "A feeling of fullness in the throat is an early sign." B. "Belching and indigestion are caused by cancerous lesions." C. "Common symptoms are halitosis and dryness of the mouth." D. "Choking or coughing while swallowing liquids is an early sign."

A. "a feeling of fullness in the throat is an early sign" Sensation of fullness in the throat is considered an early sign of esophageal cancer. (2) Belching and indigestion are more associated with a hiatal hernia or gastroesophageal reflux disease (GERD). (3) Dry mouth and halitosis are more associated with stomatitis. (4) Dysphagia with liquids is a late sign.

Patients with ileostomies should be given which instruction? A. "Do not take enteric-coated tablets." B. "Increase your intake of dried fruits." C. "Add more high-fiber foods to your diet." D. "If you notice a blockage, take a laxative."

A. "do not take enteric-coated tablets" Ileostomy patients should not take time-release capsules and enteric-coated tablets, as there is not enough time for adequate absorption before the medication is expelled through the stoma. Dried fruits and high-fiber foods should be avoided. If a blockage is noted, the patient should seek medical attention and never take a laxative.

The nurse is providing discharge education to a patient after a roux-en-Y gastric bypass procedure. Which nutritional supplements must this patient take for the rest of his life? (Select all that apply.) A. Iron B. Calcium C. Folic acid D. Vitamin C E. Vitamin D F. Vitamin B12

A. iron B. calcium C. folic acid F. vitamin B12 After a roux-en-Y gastric bypass procedure, the patient is at risk for iron, calcium, folic acid, and vitamin B12 deficiencies and must take these supplements for life. The patient is not at risk for a vitamin C or D deficiency.

The nurse is reviewing the health history of an assigned patient. Which data in a patient's history might indicate a predisposition to diverticular disease? (Select all that apply.) A. Frequent laxative use B. Low dietary fiber intake C. High dietary fiber intake D. History of passing scant, small stools E. History of chronic diarrhea; vomiting

B. low dietary fiber intake D. history of passing scant, small stools Low-fiber diets and chronic constipation are high-risk factors for development of diverticular disease. Frequent laxative use, high dietary fiber intake, and a history of chronic diarrhea and vomiting may result in other GI disorders, but do not contribute to the development of diverticular disease

One week postoperatively, the LPN/LVN notes that the stoma of a patient who had a colostomy has a purple hue. The nurse's actions are based on which understanding about this finding? A. This is a normal finding. B. There may be too much blood flow. C. There may be an obstruction in blood flow. D. The stoma is healing more quickly than expected.

C. there may be an obstruction in blood flow The stoma is inspected for a normal pink or red color, which indicates adequate blood supply. It should look like healthy mucous membrane such as that inside the mouth. Later, the stoma will shrink in size and may be less highly colored. A deepening of color to a purplish hue may indicate obstruction of blood flow to the stoma.

The nurse is educating a patient who has been recently diagnosed with inflammatory bowel disease about a therapeutic diet. Which meal selection, if made by the patient, indicates an understanding of the teaching? A. Broiled fish with rice and roasted broccoli B. Fried shrimp with french fries and coleslaw C. Whole-grain pasta with marinara sauce and meatballs D. Grilled chicken, mashed potatoes, and strawberry gelatin

D. grilled chicken, mashed potatoes, and strawberry gelatin The patient with inflammatory bowel disease should consume a diet that is high in protein and calories but low in fat and fiber. This includes grilled meat, mashed potatoes, and strawberry gelatin. Roasted broccoli, coleslaw, and whole-grain pasta are high in fiber. Fried shrimp and french fries are high in fat.

A patient has been diagnosed with gastritis. Which medication can the nurse anticipate will be prescribed? A. Aspirin B. Carafate C. Ampicillin D. Ranitidine

D. ranitidine Ranitidine functions as a gastric-acid inhibitor. Carafate may be used in conjunction with cimetidine, but its action is to create a barrier protecting the gastric mucosa from exposure to excess stomach acid. Aspirin and NSAIDs are known gastric irritants, and can result in GI bleeding without an already existing gastritis. Ampicillin is an antibiotic; it is not relevant to the treatment of gastritis.