Med Surg Exam 10

A client with esophageal varices is scheduled to undergo injection sclerotherapy. Which client statement indicates that the nurse's teaching was successful? "The physician will use a balloon to compress the vessels." "I might need to have this procedure done again." "It seems odd that a rubber band can block off the vessels." "A catheter will be inserted through my belly to fix the vessels."

"I might need to have this procedure done again."

The nurse is preparing a client for magnetic resonance imaging (MRI) of the abdomen. Which statement by the client would indicate the need to notify the physician? "I haven't had anything to eat or drink since midnight last night." "I really don't like to be in small, enclosed spaces." "I left all my jewelry and my watch at home." "I will practice visualization to remain relaxed during the procedure."

"I really don't like to be in small, enclosed spaces."

A client who has occasional gastric symptoms is receiving teaching on how to prevent gastroesophageal reflux disease (GERD). Which statement indicates the client understands the teaching? "I will eat two large meals a day, instead of three." "I will eliminate bothersome foods from my diet." "I will plan to sleep flat without pillows." "I will start taking a nap after meals, when possible."

"I will eliminate bothersome foods from my diet."

The nurse is admitting a client to their room at the hospital and observes that the client's skin and sclera are jaundiced. What does the nurse expect the client's total bilirubin levels to be? 0.2 mg/dL 1.0 mg/dL 2.0 mg/dL 3.0 mg/dL

3.0 mg/dL

The nurse is managing the care of a client needing gastrointestinal suction and 20. The nurse is managing the care of a client needing gastrointestinal suction and decompression with a Levin tube. Place the steps of initiating suction and decompression in the order the nurse should perform them.A. Insert the gastric decompression tube.B. Locate the suction source.C. Connect the decompression tube to the suction.D. Select suction according to health care provider prescription.

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The nurse is instructing the client on sensations commonly experienced when a contrast agent is injected into the body during diagnostic studies. Which sensation is most common? Light-headedness A warm sensation Heart palpitations Chills

A warm sensation

A client is diagnosed with colon cancer, located in the lower third of the rectum. What does the nurse understand will be the surgical treatment option for this client? Colectomy Segmental resection Abdominoperineal resection A low colectomy

Abdominoperineal resection

When inspecting the abdomen of a client with cirrhosis, the nurse observes that the veins over the abdomen are dilated. How does the nurse document this finding? Gynecomastia Cutaneous spider angioma Caput medusae Palmar erythema

Caput medusae

The nurse is preparing to examine the abdomen of a client with reports of nausea and vomiting. What action would the nurse perform first? Palpation Inspection Auscultation Percussion

Inspection

A nurse is preparing to administer the prescribed vitamin B12 to a client who has had most of his ileum removed. The nurse understands that this is necessary for which reason? Prevents thrombosis Prevents deficiencies Aids proper digestion Prevents constipation

Prevents deficiencies

The nurse is preparing to assess the pH of aspirated fluid for a client who has a nasogastric tube in place. Place the following steps in the order the nurse should perform them.A. Obtain a pH test kit.B. Verify that the distal tip of the client's nasogastric tube is in the stomach and has not migrated to the intestine.C. Put on gloves.D. Connect the syringe to the tube.E. Use a new syringe for withdrawing the test specimen.F. Drop a sample of the gastric fluid onto a pH color indicator strip.G. Compare the color on the test strip with the color guide supplied in the test kit and record the findings.H. Instill a small amount of air to clear fluid from the gastric tube just before aspirating.I. Aspirate a small amount of fluid.

?

A nurse is preparing a presentation for a local community group of older adults about colon cancer. What would the nurse include as the primary characteristic associated with this disorder? Abdominal distention Frank blood in the stool A change in bowel habits Abdominal pain

A change in bowel habits

The nurse is caring for a client recovering from an esophagogastroduodenoscopy (EGD). Which of the following client symptoms would require further nursing assessment? Drowsiness Abdominal distention Sore throat Thirst

Abdominal distention

The nurse is assisting the physician with a procedure to remove ascitic fluid from a client with cirrhosis. What procedure does the nurse ensure the client understands will be performed? Thoracentesis Abdominal paracentesis Abdominal CT scan Upper endoscopy

Abdominal paracentesis

The instructor is teaching a group of students about intestinal obstruction. The instructor determines that the teaching was effective when the students identify which of the following as a cause of a functional obstruction? Volvulus Intussusception Tumor Abdominal surgery

Abdominal surgery

What potentially life-threatening complication can the client have if corticosteroids are abruptly withdrawn or the client has significant stress due to the impending surgical procedure? Cushing's disease Myxedema coma Thyroid storm Adrenal crisis

Adrenal crisis

A client who is scheduled for an ileostomy surgery and been taking corticosteroids is instructed to taper the drug, eventually discontinuing it. The nurse would monitor this client for which of the following? Cerebral anoxia Cardiac dysrhythmias Hypothyroidism Adrenal insufficiency

Adrenal insufficiency

When assisting with preparing a client scheduled for a barium swallow, which instruction would be appropriate to include? Avoid smoking for at least 12 to 24 hours before the procedure. Take vitamin K before the procedure. Take three cleansing enemas before the procedure. Avoid the intake of red meat before the procedure.

Avoid smoking for at least 12 to 24 hours before the procedure.

The nurse is talking with a group of clients who are older than age 50 years about the recognition of colon cancer to access early intervention. What should the nurse inform the clients to report immediately to their primary care providers? Change in bowel habits Excess gas Daily bowel movements Abdominal cramping when having a bowel movement

Change in bowel habits

The nurse is examining the skin of a client who is dehydrated due to fluid losses from the gastrointestinal tract. Which would be the most important assessment for the nurse to make? Checking if the skin is discolored Checking if the mucous membranes are dry Examining the sclera if it is yellow Observing for distended abdominal veins

Checking if the mucous membranes are dry

A client with cirrhosis is complaining of severe pruritus related to the accumulation of bile salts. What can be prescribed for the client to relieve the itching? Cholestyramine Kanamycin Lactulose Cyclosporine

Cholestyramine

A client informs the nurse of having abdominal pain that is relieved when having a bowel movement. The health care provider diagnosed the client with irritable bowel syndrome. What does the nurse recognize as characteristic of this disorder? Weight loss due to malabsorption Blood and mucus in the stool Chronic constipation with sporadic bouts of diarrhea Client is awakened from sleep due to abdominal pain.

Chronic constipation with sporadic bouts of diarrhea

A client is scheduled for an esophagogastroduodenoscopy (EGD) to detect lesions in the gastrointestinal tract. The nurse would observe for which of the following while assessing the client during the procedure? Signs of perforation Client's ability to retain the barium Client's tolerance for pain and discomfort Gag reflex

Client's tolerance for pain and discomfort

The nurse is caring for a client about to have the first stage of an ileoanal anastomosis. What should the nurse inform the client they will experience? Solid stool from the anus Very little discharge from the anus Control of the fecal material from the anus Continuous discharge of mucus from the anus

Continuous discharge of mucus from the anus

The nurse is caring for a client who has undergone surgery for a liver disorder and has started shivering. Which intervention would be appropriate? Provide the client with warm fluids. Cover the client with a light blanket. Ensure that the room temperature is below 70° F. Place the client on a hypothermia blanket.

Cover the client with a light blanket.

The nurse is preparing a client for a test that involves inserting a thick barium paste into the rectum with radiographs taken as the client expels the barium. What test will the nurse prepare the client for? Kidneys, ureters, bladder (KUB) Colonic transit studies Defecography Abdominal radiography

Defecography

A client is scheduled to have a total colectomy due to a colon mass and is also taking prednisone for asthma. The physician has instructed the client to taper down on the prednisone and discontinue. What negative outcome does the nurse know may occur if the client does not adhere to the instructions? Liquid stools after surgery Delayed or altered tissue healing Hypertension Increase in blood loss

Delayed or altered tissue healing

The nurse is preparing to administer famotidine to a client with gastroesophageal reflux disease. Which safety warning should the nurse consider when administering the medication? Do not allow client to take maximum dose for more than 2 weeks without medical consultation. Review client's cardiac status and sodium restrictions. Do not give other oral drugs within 1 to 2 hours of administering the medication. Be aware that long-term use may be associated with bone fractures

Do not allow client to take maximum dose for more than 2 weeks without medical consultation.

A client with an ileostomy tells the nurse that he is having a lot of problems with the formation of gas. What can the nurse tell the client to help her with this common issue? Eat slowly and chew food well with mouth closed. Restrict fluids. Administer an enema to clear out the stool. Dilate the stoma.

Eat slowly and chew food well with mouth closed.

The nurse is holding a teaching workshop on managing the symptoms of hiatal hernia in older adults. Which lifestyle modification should be included in the presentation? Eliminating tobacco use Aerobic exercising Avoiding excess stress Providing adequate rest

Eliminating tobacco use

The nurse is caring for a client suspected of having stones that have collected in the common bile duct. What test should the nurse prepare the client for that will locate these stones? Colonoscopy Abdominal x-ray Cholecystectomy Endoscopic retrograde cholangiopancreatography (ERCP)

Endoscopic retrograde cholangiopancreatography (ERCP)

An older adult client seeks medical attention for a report of general difficulty swallowing. Which assessment finding is most significant as related to this symptom? Hiatal hernia Gastroesophageal reflux disease Gastritis Esophageal tumor

Esophageal tumor

A nurse is preparing a presentation for a local community group about hepatitis. Which information would the nurse include? Hepatitis B is transmitted primarily by the oral-fecal route. Hepatitis A is frequently spread by sexual contact. Hepatitis C increases a person's risk for liver cancer. Infection with hepatitis G is similar to hepatitis A.

Hepatitis C increases a person's risk for liver cancer.

An older adult client presents with a complaint of 10-lb weight loss over the past month. Which assessment finding is most important in determining the care of this client? History of seasonal allergies History gallbladder removal History of COPD History of osteoarthritis

History of COPD

A client who is recovering from bariatric surgery is returning from the postanesthesia care unit. Which nursing assessment finding is of greatest concern in the immediate postoperative period for this client? Impaired Gas Exchange Self-Care Deficit Impaired Mobility Diarrhea

Impaired Gas Exchange

The nurse is caring for a client with chronic pancreatitis. Which symptom would indicate the client has developed secondary diabetes? Increased appetite and thirst Vomiting and diarrhea Low blood pressure and pulse Decreased urination and constipation

Increased appetite and thirst

A client who has recovered from anesthesia following oral surgery for lip cancer is experiencing difficulty breathing deeply and coughing up secretions. Which measure will help ease the client's discomfort? Keeping the head of the bed elevated. Positioning the client flat on the abdomen or side. Providing a tracheostomy tray near the bed. Turning the client's head to the side.

Keeping the head of the bed elevated.

A client is preparing to have colorectal surgery and will have a colostomy created temporarily in hopes that he may be able to have it reversed in 6 months. The client is very concerned about the care of the colostomy. What preoperative interaction would the client benefit from? Discussing other options with the surgeon Meeting with an enterostomal therapist Going to a support group with other clients that have colostomies Watching a video about colostomies

Meeting with an enterostomal therapist

Which intervention would be most appropriate for a client who has undergone colostomy surgery? Monitoring vital signs once a day. Taking temperature by rectal route. Monitoring the volume of gastric secretions. Minimizing the client's fluid intake.

Monitoring the volume of gastric secretions.

A client has had surgery to create an ileoanal reservoir. Which instruction would the nurse give to reduce the risk for bowel incontinence? Avoid high-protein food. Take frequent brisk walks. Perform perineal exercises. Perform warm water soaks.

Perform perineal exercises.

A client with a diagnosis of acute appendicitis is awaiting surgical intervention. The nurse listens to bowel sounds and hears none and observes that the abdomen is rigid and board-like. What complication does the nurse determine may be occurring at this time? Constipation Paralytic ileus Peritonitis Accumulation of gas

Peritonitis

The nurse is caring for a client who is scheduled for a percutaneous liver biopsy. Which diagnostic test is obtained prior? Complete blood count (CBC) Prothrombin time (PT) Blood chemistry Erythrocyte sedimentation rate (ESR)

Prothrombin time (PT)

The nurse is interviewing a client with internal hemorrhoids. What would the nurse expect the client to report? Rectal bleeding Pain Itching Soreness

Rectal bleeding

The nurse observes the physician palpating the abdomen of a client that is suspected of having acute appendicitis. When the abdomen is pressed in the left lower quadrant the client complains of pain on the right side. What does the nurse understand this assessment technique is referred to? Referred pain Rebound pain Rovsing sign Cremasteric reflex

Rovsing sign

The nurse is instructing the client who was newly diagnosed with peptic ulcers. Which of the following diagnostic studies would the nurse anticipate reviewing with the client? A complete blood count including differential Serum antibodies for H. pylori A sigmoidoscopy Gastric analysis

Serum antibodies for H. pylori

The nurse is reviewing laboratory work that is consistent with a client being positive for hepatitis and in the incubation phase of the illness. What should the nurse be concerned with at this stage of the illness? The client is infectious. The client may have enlargement of the liver and spleen. The client will have weight loss. The client has jaundice.

The client is infectious.

A client with a hernia decides to manage the herniation with a truss. The nurse would emphasize which of the following? Using laxatives to ensure regular bowel movement Wearing warm, woolen clothes to avoid dryness Applying a sunscreen to prevent exposure to direct sunlight Using cornstarch to absorb moisture in the area

Using cornstarch to absorb moisture in the area

The nurse is caring for a client following a colonoscopy. During the procedure, two medium-sized polyps were removed. Which nursing assessment in the recovery area is a priority? Assessment of level of consciousness Hemoccult test of stool Vital signs Ability to tolerate liquids

Vital signs

Which assessment finding is most indicative of dumping syndrome in a postgastrectomy client? Abdominal distention, elevated temperature, weakness before eating Constipation, rectal bleeding following bowel movements Persistent loose stools, chills, hiccups after eating Weakness, diaphoresis, diarrhea 90 minutes after eating

Weakness, diaphoresis, diarrhea 90 minutes after eating

A client who had a total colectomy with an ileostomy has rectal packing in place to absorb drainage and promote healing. When the client asks how soon the packing will be removed, what is the nurse's best response? Within 24 hours 2 days Within 1 week In 2 weeks

Within 1 week