Med Surg test - GI stuff

Applesauce, cream of wheat, and apple juice (bland foods which do no irritate the gastric mucosa)

A nurse provides a list of suggested food choices to a client who has peptic ulcer disease. Which foods should be included on the list?

"After meals I will rest in a sitting position for one hour."

A nurse teaches a client about limiting the discomfort associated with a hiatal hernia. Which statement from the client indicates teaching by the nurse is effective?

They aid absorption of fat-soluble vitamins.

A client is admitted to the hospital with Laënnec cirrhosis and chronic pancreatitis. Bile salts (bile acid factor) are prescribed, and the client asks why they are needed. What is the nurse's best response?

Every 15 minutes for two hours

A client is admitted to the hospital with a diagnosis of liver disease, and a liver biopsy is prescribed. After the liver biopsy, how often and for how long should the nurse take the client's vital signs?

Replace the client's fluids and electrolytes

A client was diagnosed with ulcerative colitis. Two months after the diagnosis, the client is readmitted for an exacerbation of the illness. The client is weak, thin, and irritable. The client states, "I am now ready for surgery to create an ileostomy." Which nursing intervention will best meet the client's priority need?

Permit drainage of bile

A client with an acute attack of cholecystitis has a cholecystectomy with a choledochostomy. The client returns from surgery with a T-tube connected to a drainage bag. What does the nurse conclude is the purpose of the T-tube?

Electrolyte imbalances

A client with the diagnosis of ulcerative colitis has surgery for the creation of an ileostomy. Postoperatively, for which potential life-threatening complication should the nurse assess the client?

"I need to eat six small meals every day, limiting bulk."

A nurse has provided dietary instructions for a client who is being discharged following a gastroduodenostomy (Billroth I). Which client statement indicates correct understanding of the teaching?

perforation

A nurse is caring for a client with chronic inflammation of the bowel. Which most serious complication should the nurse monitor for in this client?

Large consumption of alcohol

A nurse is collecting a health history from a client who has a diagnosis of cancer of the tongue. Which risk factor commonly associated with cancer of the tongue should the nurse assess when collecting the client's history?

Repairs tissues

A nurse is providing dietary teaching for a client who is receiving a high-protein diet while recovering from an acute episode of colitis. What should the nurse include in the rationale for this diet?

Cherry kool-aid (Red drinks should be avoided to prevent staining of the bowel)

A nurse is providing instructions to a client who is scheduled for a colonoscopy. What drink does the client indicate should be avoided several days before the test if these instructions are understood?

weight loss

A nurse is reviewing the laboratory results of and collecting a health history from a client with a diagnosis of colitis. Which common clinical manifestation of colitis should the nurse expect?

-Maintaining a monogamous sexual relationship -Screening of blood donors

A nurse is teaching a client about prophylactic measures that minimize the risk of contracting hepatitis B. Which actions should be included in this teaching plan?

Scrambled eggs (low fiber and lactose free)

A nurse is teaching a client with an acute exacerbation of ulcerative colitis about the most appropriate diet. Which food selected by the client indicates that the dietary teaching is effective?

Avoid eating red meat before testing

A primary healthcare provider prescribes three stool specimens for occult blood for a client who complains of blood-streaked stools and a 10-pound (4.5 kg) weight loss in one month. To ensure valid test results, what instructions should the nurse give the client?

Keep the client nothing by mouth (NPO)

After an acute episode of upper gastrointestinal (GI) bleeding, a client vomits undigested medications and reports severe epigastric and abdominal pain. The client has absent bowel sounds, rigid abdomen, a pulse rate of 134, and shallow respirations of 32 per minute. The primary healthcare provider has been contacted. What should be the nurse's next priority?

Dark brown or black

A client is diagnosed with a peptic ulcer. When teaching about peptic ulcers, the nurse instructs the client to report what kind of stools?

Reactive hypoglycemia

A client with a diagnosis of gastric cancer has a gastric resection with a vagotomy. Which clinical response should alert the nurse that the client is experiencing dumping syndrome?

Limited water reabsorption caused by removal of intestine

A client with a history of ulcerative colitis has a large portion of the large intestine removed, and an ileostomy is created. For which potential life-threatening complication should the nurse assess the client after this surgery?

semi-fowler

A client with a rigid and painful abdomen is diagnosed with a perforated peptic ulcer. A nasogastric tube is inserted, and surgery is scheduled. Before surgery, the nurse should place the client in what position?

Opioids will be available for postoperative pain

A client with cholelithiasis is scheduled for a lithotripsy. What should the nurse include in the client's teaching plan?

Avoid using analgesics that contain aspirin

A client with chronic gastritis is being treated with medication and diet. What should the nurse teach the client when discussing the therapeutic regimen?

Report signs of bleeding no matter how slight

A client with cirrhosis of the liver has a prolonged prothrombin time and a low platelet count. A regular diet is prescribed. What should the nurse instruct the client to do considering the client's condition?

-Encourage to quit smoking -Avoid caffeine-containing products -Avoid lying down for 2 to 3 hours after eating

A client with gastroesophageal reflux disease (GERD) should make diet and lifestyle changes. Which instructions should the nurse include in the client's discharge teaching?

fat globules (steatorrhea)

A nurse is assessing a client for possible malabsorption syndrome. Which stool assessment finding will support this diagnosis?

Bowel sounds and flatulence indicate the return of intestinal peristalsis

A nurse is caring for a client who had a subtotal gastrectomy. Which assessment finding indicates the client is ready for postoperative oral feedings?

bile

A nurse is caring for a client who is having difficulty digesting fatty foods. To what deficiency does the nurse attribute this difficulty?

Eat small meals with low carbohydrate and moderate fat content

A nurse is caring for a client who just had a gastrectomy. What should the nurse emphasize when teaching the client how to avoid dumping syndrome?

Monitor the color of the stool.

A nurse is caring for a client with a T-tube after an open cholecystectomy. What specific action should the nurse include in the plan of care?

obstruction

A nurse obtains the history of a client with early colon cancer. Which clinical finding does the nurse consider consistent with a diagnosis of cancer of the descending, rather than the ascending, colon?

Instill 30 mL of air into the NG tube

After a subtotal gastrectomy, a client has a nasogastric (NG) tube to continuous low suction. Three hours after the surgery, the client complains of nausea and abdominal pain. The client's abdomen appears distended. What should the nurse do first?

electrolyte imbalance

A client presents with gastric pain, vomiting, dehydration, weakness, lethargy, and shallow respirations. Laboratory results indicate metabolic alkalosis. The diagnosis of gastric ulcer has been made. What is the primary nursing concern?

Absence of gastrointestinal motility; continue to monitor

A client returns from surgery with a permanent colostomy. During the first 24 hours the colostomy does not drain. What does the nurse determine is the probable cause of this response, and what is the treatment?

Encouraging coughing and deep breathing

A client undergoes an abdominal cholecystectomy with common duct exploration. In the immediate postoperative period, what is the priority nursing action?

Metabolic alkalosis

A client arrives in the emergency department with epigastric pain and prolonged vomiting. Assessment findings include rapid and shallow respirations, dry and flushed skin, weakness, and lethargy. Which is the primary nursing concern?

semi-fowler (drain that abdominal cavity)

A client had surgery for a perforated appendix with localized peritonitis. In which position should the nurse place this client?

"I plan to irrigate it in the late morning, the same time I had a bowel movement every day before I had my surgery."

A client has a new colostomy. The nurse has provided teaching related to when the client should irrigate the colostomy. Which client statement indicates correct understanding of the teaching?

A gnawing sensation often caused by H. pylori

A client has a suspected peptic ulcer in the duodenum. What should the nurse expect the client to report when describing the pain associated with this disease?

Individuals who are obese are more prone to this condition than those who are thin

A client has been diagnosed with cholelithiasis. Which fact about cholelithiasis should the nurse recall when assessing this client for risk factors?

Sharp abdominal pain

A client is admitted for repair of bilateral inguinal hernias. Before surgery the nurse assesses the client for indicators that strangulation of the intestine may have occurred. What is an early indicator of strangulation?

Quick passage of hyperosmolar food solution into the small intestine

After a subtotal gastrectomy (Billroth I), a client begins to eat more food in varied forms. After meals, the client experiences a cramping discomfort, a rapid pulse, and waves of weakness, which often are followed by nausea and vomiting. What does the nurse conclude is the cause of this response?

Sudden passage of a hyperosmolar food solution into the small intestine

After a subtotal gastrectomy, a client begins to eat more food in varied forms. After meals the client experiences a cramping discomfort and a rapid pulse with waves of weakness, which often are followed by nausea and vomiting. The nurse concludes that the client is experiencing dumping syndrome, which is caused by what process?

"Eat less food at each meal." (decrease intraabdominal pressure)

An obese client with a hiatal hernia asks the nurse how to prevent esophageal reflux. Which is the nurse's best response?

Oatmeal, sliced bananas, whole wheat toast, and milk

The diet prescribed for a client with diverticulosis includes 30 grams of fiber a day. Which breakfast items should the nurse encourage the client to select?

Rest in a sitting position for one hour

What should the nurse teach the client with gastroesophageal reflux disease to do after meals?

occult blood

A nurse obtains daily stool specimens for a client with chronic bowel inflammation. What does the nurse determine is the reason these stool examinations were prescribed?