Med-Surg GI

A nurse is caring for a client who is two days postop following a gastric bypass. The nurse knows that Paul sounds are present. Which of the following foods should the nurse provide at the initial feeding? A. Vanilla pudding B. Apple juice C. Diet Ginger ale D. Clear liquids

Correct answer: D. Clear liquids Clear liquids such as water or broth can be given for the first oral feedings but should be limited to only 30 mL per feeding. Water does not contain sugar which could cause diarrhea due to hyperosmolarity. A. Vanilla pudding contain sugar which can cause diarrhea. Be. The sugar content of apple juice can cause diarrhea due to hyperosmolarity. C. The client should avoid carbonated beverages because they can just in the stomach causing pressure on the internal sutures or Staples. Pressure can lead to leaking into the peritoneum and result in peritonitis.

A nurse is caring for a client who is scheduled to undergo a liver biopsy for a suspected malignancy. Which of the following lab findings should the nurse monitor prior to the procedure? A. Prothrombin time B. Serum lipase C. Bilirubin D. Calcium

Correct answer: a. Prothrombin time next Correct answer: a. Prothrombin time A major complication following a liver biopsy is hemorrhage. Many clients who have liver disease have clotting defects and are at risk of bleeding. In addition to prothrombin time, activated partial pro thromboplastin time and platelet count should be monitored. B. Serum lipase is monitored to detect pancreatic disease and does not need to be assessed prior to this procedure C. Bilirubin is monitored to detect biliary obstruction and does not need to be assessed prior to this procedure D. Calcium is monitored to detect kidney failure or pancreatitis and does not need to be assessed prior to this procedure

A nurse is teaching a group of clients about the functions of the liver and gallbladder. Which of the following should the nurse include in the teaching as the purpose of bile? A. Digesting fats B. Producing chyme C. Stimulating gastric acid secretions D. Providing energy

A. Digesting fats - CORRECT. Bio as a product of the liver and aids in the digestion of fats. B. Producing chyme - chyme is a semi solid mixture of food and gastric secretions that is formed in the stomach C. Stimulating gastric acid secretions - gastrin is a hormone produced by the stomach mucosa that stimulates the release of gastric secretions during the process of digestion D. Providing energy - I like the gym is stored in the liver and his released in the form of glucose to meet the body's energy needs

A nurse is caring for a client who is two days post op following gastric surgery and has an NG tube inserted. Which of the following findings should the nurse report to the provider? A. Dryness of the mucous membranes B. Hypo active bowel sounds in all quadrants C. 200 mL of bright red drainage from the NG tube D. Suction set a continuous low suction

A. Dryness of the mucous membranes B. Hypoactive bowel sounds in all quadrants C. 200 mL of bright red drainage from the NG tube - CORRECT. The nurse should notify the provider immediately if 200 mL of bright red drainage comes from the NG tube two days following gastric surgery. Drainage should either be yellow green color or clear. Bright red drainage indicates blood loss and can be the result of disrupted suture line or other internal bleeding. Volume loss from blood is a medical emergency and the provider should be immediately notified D. Suction set a continuous low suction

A nurse is caring for a client who has an acute exacerbation of prunes disease. Which of the following actions should the nurse take? A. Ensure bowel rest B. Offer sparkling water frequently C. Administer stool softener D. Offer plane warranty frequently

Correct answer: A. Ensure bowel rest Plan to have an exacerbation of processes usually require NPO status to ensure bowel rest and promote healing and recovery B. Carbonated beverages conversing and exacerbation of chronic disease C. The client with an exacerbation parentheses is already having many students per day. I still softener not worse in the situation. D. Caffeinated beverages and alcohol can worsen and exacerbation of Crohn's disease disease

A nurse is demonstrating colostomy care to a client who has a new colostomy. Which of the following actions should the nurse teach the client form? Select all that apply A. Use anti-microbial appointment on the peristomal skin B. Empty the bag when it is 1/3 to 1/2 full C. Cut the skin barrier opening a little larger than the ostomy D. Wash the peristomal skin with mild soap and water E. Apply the skin barrier while the skin is slightly moist

Correct answer: B, C, D Allowing the bag to become too full can cause leakage. The client should cut an opening that is about 1/16 218 larger than the stoma to avoid applying any constructing pressure to the stoma. The client should avoid moisturizing soap's because Lee Perkins can affect adhesion of the appliance. A. Oil based appointments on the skin disrupt adhesion and anti-microbial's are not necessary unless prescribed by the provider to treat an infection. E. The skin must be dry before applying the skin barrier since the pouch will not adhere to moist skin.

A nurse is assessing a client who is in the early stages of hepatitis A. Which of the following manifestations should the nurse expect? A. Jaundice B. Anorexia C. Dark urine D. Pale feces

Correct answer: B. Anorexia Anorexia is an early manifestation of hepatitis A and is often severe. It is thought to result from the release of a toxin by the damaged liver or by the failure of the damaged liver cells to detoxify an abnormal product. A. Jaundice is a late manifestation of hepatitis A C. Dark urine is a late manifestation of hepatitis A D. Pale feces is a late manifestation of hepatitis A

A nurse is assessing a client who is 12 hours postop following an open cholecystectomy. Which of the following findings should the nurse report to the provider? A. Hypo active bowel sounds Be. Indwelling urinary catheter output of 25 mL per hour C. Heart rate of 96 bpm D. serous drainage at the surgical incision site

Correct answer: B. Indwelling urinary catheter output of 25 mL per hour The nurse to report a urinary output of less than 30 mL per hour to the provider, as this can indicate hypovolemia or renal complication Hey. Hypo active bowel sounds are unexpected findings during the initial postop. Due to decreased peristalsis from the anesthesia an analgesic medications. C. A heart rate of 96 bpm is within the expected range of 60 to 100 bpm. This is an expected findings for a client who is postoperative D. A small to moderate amount of serous drainage at the surgical incision site is an expected finding during the immediate postop period and increase amount of drainage can indicate the possibility of wound dehiscence

A nurse is caring for a client who has ulcerative colitis. The provider prescribes bed rest with bathroom privileges. When the client asked the nurse why he has to stay in bed, which of the following responses should the nurse provide? A. You need to conserve energy at this time B. Lying quietly in bed help slow down the activity in your intestines C. Staying in bed promotes the rest and comfort you need D. Staying in bed will prevent injury and minimalize your fall risk

Correct answer: B. Lying quietly in bed help slow down the activity in your intestines The greatest risk for a client is complications with severe diarrhea such as dehydration, electrolyte in balance, and gastrointestinal bleeding and trauma. Activity restriction can help reduce intestinal peristalsis and diarrhea A. while bed rest does conserve energy, this is not the priority reason for this prescription C. While the rest is promote rest and comfort, this is not a priority reason for this prescription D. While bedrest does help prevent injury, there's another priority reason for this prescription

A nurse is providing dietary teaching to a client who has ulcerative colitis. Which of the following food selections by the client indicates an understanding of the teaching? A. Raw vegetable salad with low-fat dressing B. Roasted chicken and white rice C. Fresh fruit salad and milk D. Peanut butter on whole wheat bread

Correct answer: B. Roasted chicken Clients who have also read colitis or restricted to a low fiber diet, which on that whole grains and raw fruits and vegetables. Roasted chicken with white rice is the best choice. Line clients who have also read colitis or restricted to a low fiber diet, which of that whole grains and raw fruits and vegetables. Roasted chicken with white rice is the best choice. A. Raw vegetables should be avoided because they are high in fiber. C. Raw fruits should be avoided because they are high in fiber. D. Whole grains should be avoided because they are high in fiber.

A nurse is caring for a client who is scheduled to undergo an EGD. The nurse should identify that this procedure is for which of the following reasons? A. To visualize polyps in the colon B. To detect an alteration in the stomach C. To identify an obstruction in the biliary tract D. To determine the presence of free air in the abdomen

Correct answer: B. To detect an alteration in the stomach an EGD is used to visualize the esophagus, stomach, and do a denim with a lighted tube to detect tumor, ulceration, or obstruction. hey. A sigmoidoscopy or barium enema is used to visualize the lower G.I. tract, with polyps found. C. Identifying an obstruction in the biliary tract occurs during ERCP D. The measurement of free air is obtained using fluoroscopy or an x-ray, not an EGD

A nurse is caring for a client who has acute angry a Titus. Which of the following serum lab values should return to the expected reference range within 72 hours of treatment beginning? A. Aldolase B. Lipase C. Amylase D. Lactic dehydrogenase

Correct answer: C. Amylase pancreatitis is the most common diagnosis for market elevations in this lab value. Serum Amylase begins to increase about 3 to 6 hours following the onset of acute pancreatitis. The level peaks in 20 to 30 hours and returns to the expected reference range within 2 to 3 days A. Elevated Aldolase levels are caused by inflammation of the muscles, also known as myositis. Levels are not affected by pancreatic disorders. B. Lipase levels and clients who have pancreatitis increase after a rise serum Amylase and stay elevated for up to 14 days longer than Emily's levels. D. Lactate dehydrogenase increases are typically seen in clients you have anemia, leukemia, or liver damage

A nurse is providing teaching to a client who has constipation. Which of the following instruction should the nurse include? A. Use bismuth subsalicylate regularLy B. Consumer low fiber diet C. Eat yogurt with live cultures D. Use bisacodyl suppositories regularly

Correct answer: C. Eat yogurt with live cultures Yogurt with a bacterial cultures provides dietary probiotics that help maintain and promote bowel function A. Bismuth subsalicylate is an anti-diarrheal agent and will increase constipation B. Increasing fiber gradually can prevent constipation. A low fiber diet is recommended for clients who have diarrhea C. The regular use of stimulant laxative can result in decreased defecation reflexes, causing a reliance on stimulant laxatives for bowel movements. This may eventually cause electrolyte in balance is and colitis

A nurse is caring for a client who has fulminant hepaticfailure. Which of the following procedures should the nurse anticipate for this client? Next A nurse is caring for a client who has four minute apathetic failure. Which of the following procedures should the nurse anticipate for this client? A. Endoscopic sclerotherapy B. Liver lobectomy C. Liver transplant D. Transjugular intrahepatic portal system shunt placement

Correct answer: C. Liver transplant Hepatic failure, most often caused by viral hepatitis, is characterized by the development of hepatic and cephalopathy within weeks of the onset of the disease. Mortality remains high even with treatment modalities such as blood or plasma exchanges, charcoal hemoperfusion, and cortical steroids. Consequently, liver transplantation has become the treatment of choice for these clients. A. Endoscopic sclerotherapy is the injection of a sclerotherapy agent during an endoscopy to target a Soffa Gille varices that are actively bleeding. Next Correct answer: C. Liver transplant Hepatic failure, most often caused by viral hepatitis, is characterized by the development of hepatic and cephalopathy within weeks of the onset of the disease. Mortality remains high even with treatment modalities such as blood or plasma exchanges, charcoal hemoperfusion, and cortical steroids. Consequently, liver transplantation has become the treatment of choice for these clients. A. Endoscopic sclerotherapy is the injection of a sclerotherapy agent during an endoscopy to target a Soffa Gille varices that are actively bleeding. B. A liver lobectomy is used for localized cancer of a lobe of the liver. D. I transjugular intrahepatic portal system shunt is placed a tree esophageal varices threw a stent into the portal vein. The stamp serves as a shunt between the portal circulation and the hepatic vein, thereby reducing portal hypertension. It is not used for hepatic failure

Winners enter the clients room and not smoking coming from the wastebasket in the adjacent room. Which of the following actions should the nurse take first? A. Close the door to the clients room B. Attempt to extinguish the fire C. Activate the facilities fire alarm system D. A transport the client to an area away from the smoke smoke

Correct answer: D. A transport the client to an area away from the smoke next line the greatest risk to the client is an injury from Burns and smoke in halation; therefore the nurses freshman with the client from the area. The acronym race indicates the sequence of the actions and her should take the fire occurs. A. The nurses can find the fire by closing nearby doors and windows reduce the risk of injury to clients and staff however another action is the nurses priority B. The nurse should attempt to extinguish the fire to reduce the risk of injury to clients and staff, however another action is a nurse is priority C. The nurse should activate the fire alarm system to bring responders to the area to extinguish the fire and enact another safety measures, however another action is priority

This is assessing a client who has complete intestinal obstruction. Which of the following findings should the nurse Expect? A. Absence of bowel sounds in all four quadrants B. Passage of blood tinged liquid stool C. Presence of flatus D. Hyper active bowel sounds above the obstruction

Correct answer: D. Hyper active bowel sounds above the obstruction The nurse should expect the client to have hyper active bowel sounds about the obstruction because the intestinal peristalsis above it attempts to push the obstruction through the intestines. A. The nurse should expect an absence of bowel sounds in all four quadrants and a client who has paralytic ileus, rather than a complete intestinal obstruction B. The nurse should expect diarrhea and a client who has a partial intestinal obstruction, a client who has a complete intestinal instruction is unable to Pass stool C. The nurse should not expect a client who has a complete intestinal obstruction to pass Flatus

A nurse is recommending dietary modifications for a client who has Gerd. The nurse or suggest eliminating which of the following foods from the clients diet? A. Oranges and tomatoes B. Carrots and bananas C. Potatoes and squash next D. Whole wheat and beans

Correct answer: a. Oranges and tomatoes symptoms of Gerd worse than following the oral intake of substances that decreased lower esophageal stricture pressure. Correct answer: a. Oranges and tomatoes Symptoms of Gerd worse than following the oral intake of substances that decreased lower esophageal stricture pressure. These include alcohol, Caffeine, nicotine, chocolate, fatty foods, citrus fruits, tomatoes, and peppermint. B. Carrots and bananas do not worsening symptoms C. Potatoes and squash are not worsen symptoms D. Whole wheat and beans do not wear some symptoms