Medical-Surgical Nursing I Test 6
A patient who had gastric bypass surgery 5 weeks ago calls the office to report feelings of nausea, sweating, and diarrhea shortly after eating meals. What response by the nurse is most appropriate?
"Avoid large meals, limit sweets, and drink small amounts of liquids between meals."
The nurse is obtaining a history of a patient with hepatitis A. Which question is most appropriate for the nurse to ask?
"Do you eat shellfish or oysters often?"
The nurse is discussing bariatric surgery complications with a patient. Which statement indicates that the patient accurately understands the nurse's teaching about common procedural side effects?
"Gallstones are a common occurrence in patients who have bariatric surgery."
A 58-yr-old woman who was recently diagnosed with esophageal cancer tells the nurse, "I do not feel ready to die yet." Which response by the nurse is most appropriate?
"Having this new diagnosis must be very hard for you."
A patient is being prepared for an upper GI series. Which statement indicates that the patient understands the preparation for this test?
"I can't have anything to eat or drink for 6 to 8 hours before the procedure."
The nurse is planning care for a patient who has experienced moderate diarrhea for 3 days. Which collaborative intervention is most important to include in the plan of care?
Limit the patient's diet to clear liquids.
The nurse is caring for a patient with a hiatal hernia. In which position should the nurse expect the patient to report that the symptoms are more acute?
Lying down
The nurse is caring for a patient who complains, "I don't see why I can't have a CT scan instead of the expensive MRI!" Which response is most appropriate for the nurse to make?
"The MRI provides better contrast between normal and pathologic tissue."
The nurse explains that the laparoscopic adjustable gastric banding surgery is best described as which type of bariatric surgery?
Restrictive
Which assessment should the nurse perform first for a patient who just vomited bright red blood?
Taking the blood pressure (BP) and pulse
A patient has just arrived in the recovery area after an upper endoscopy. Which information collected by the nurse is most important to communicate to the health care provider?
The oral temperature is 101.4°F.
The nurse is caring for a patient with a peptic ulcer. The patient also has a history of chronic bronchitis, diabetes, and arthritis. Which component of the patient's history is the most likely contributing factor to the patient's ulcer?
The patient takes ibuprofen daily for arthritis pain.
The nurse will anticipate preparing an older patient who is vomiting "coffee-ground" emesis for
Endoscopy
Which causative agent is the primary cause of Barrett esophagus?
Gastroesophageal reflux disease (GERD)
The nurse is reinforcing teaching for a patient who is scheduled for an upper GI series. Which patient statement indicates teaching has been effective?
"It is an x-ray of the esophagus, stomach, and duodenum after drinking a contrast medium."
Which information will the nurse include for a patient with newly diagnosed gastroesophageal reflux disease (GERD)?
"Keep the head of your bed elevated on blocks."
The nurse is caring for a patient on a gastrointestinal unit. Which patient statement should cause the nurse the most concern?
"Lately, I've had two or three loose, sticky, black stools every day."
A patient with a gastrostomy tube gets a bolus feeding of 200 mL every 4 hours. Before giving the bolus, the nurse aspirates a residual of 100 mL. Which action is most appropriate?
Document the residual and hold the feeding.
The nurse is caring for a patient who has a permanent gastric feeding tube. What nursing action would be most helpful to prevent aspiration during feedings?
Elevate the head of the bed to at least 30 degrees.
A 26-yr-old patient with a family history of stomach cancer asks the nurse about ways to decrease the risk for developing stomach cancer. The nurse will teach the patient to avoid
foods high in nitrites such as bacon.
The nurse is caring for a patient who complains of nausea related to gastric cancer. Which supplement should the nurse suggest?
ginger
After assisting with a needle biopsy of the liver at a patient's bedside, the nurse should
place the patient on the right side with the bed flat.
A patient vomiting blood-streaked fluid is admitted to the hospital with acute gastritis. To determine possible risk factors for gastritis, the nurse will ask the patient about
use of nonsteroidal antiinflammatory drugs (NSAIDs).
The nurse is caring for a patient who is being treated for a gunshot wound to the abdomen. The patient is receiving total parenteral nutrition (TPN), and the physician has prescribed insulin coverage on a sliding scale. The patient reports he has never had diabetes before. What response is best for the nurse to make?
"The TPN you are receiving has high amounts of glucose."
The nurse is reinforcing teaching provided to a patient with dumping syndrome. Which patient statement indicates a correct understanding of this condition?
"There is a rapid entry of food into the jejunum."
The nurse correctly recognizes that esophageal cancer is associated with which risk factor(s)? *(select all that apply.)*
-Cigarette smoking -Heavy alcohol use -Smokeless tobacco
The nurse explains that the older adult is prone to digestive disorders related to which age-related change(s)? *(select all that apply.)*
-Decreased hydrochloric acid -Inadequate chewing -Diminished intestinal motility -Gastroesophageal sphincter incompetence
Which action(s) should the nurse recommend to promote a patient's bowel health? *(select all that apply.)*
-Exercise regularly. -Include adequate bulk in the diet. -Drink adequate water. -Defecate at approximately the same time every day.
The nurse explains to an obese patient that initial medically supervised weight reduction includes which components(s)? *(select all that apply.)*
-General health assessment -Specialized exercise program -Participation in a support group -Stress reduction
Before a nurse can document the presence of diarrhea, which criteria must be met? *(select all that apply.)*
-Multiple liquid or semiliquid stools in a 24-hour period -Hyperactive bowel sounds -Cramping
The nurse is reviewing a student nurse's charting and notes that the student has documented absent bowel sounds. The nurse reminds the student that in order to document absent bowel sounds, one must auscultate each quadrant for what period of time?
5 minutes
After change-of-shift report, which patient should the nurse assess first?
A 60-yr-old patient with nausea and vomiting who has dry mucosa and lethargy
The nurse is caring for a patient who is being treated for extensive burns. The nurse notes the presence of coffee-ground material in the Salem sump catheter. The nurse correctly recognizes which factor as the likely cause?
A physiologic stress ulcer
Which of the following is the purpose of antibiotic therapy in treating peptic ulcers?
A. It eradicates H. pylori
The nurse is caring for a patient who is complaining of postoperative gas pain. What intervention should nurse implement?
Assist the patient with ambulation.
A young adult been admitted to the emergency department with nausea and vomiting. Which action could the LPN delegate to unlicensed assistive personnel (UAP)?
Assist the patient with oral care
In caring for a patient with gastric bleeding who has a nasogastric tube in place, the nurse should include in the plan of care to ensure that the NG tube is:
Kept patent with irrigation
Which classic behavior characterizes bulimia?
Bingeing and purging
A patient admitted with a peptic ulcer has a nasogastric (NG) tube in place. When the patient develops sudden, severe upper abdominal pain, diaphoresis, and a firm abdomen, which action should the nurse take?
Check the vital signs
A patient with a duodenal peptic ulcer vomits old blood. What description should the nurse use to document the appearance of the vomitus?
Coffee-ground particles
The nurse is assessing a patient's bowel sounds. After auscultating each quadrant for 30 seconds, the nurse fails to hear any sounds. How should the nurse document this finding?
Hypoactive bowel sounds
The nurse cautions that constant stress can cause which alteration to the gastrointestinal (GI) system?
Increased digestive juices resulting in a gastric ulcer
The nurse is caring for a patient with suspected dysphagia. Which action is most appropriate for the nurse to take?
Instruct the patient to take practice swallows before the meal.
The nurse is caring for a patient who suddenly begins having large amounts of bright red hematemesis. After the patient is turned onto the side, what should the nurse do?
Obtain the patient's vital signs.
A 58-yr-old patient has just returned to the nursing unit after an esophagogastroduodenoscopy (EGD). Which action by unlicensed assistive personnel (UAP) requires that the nurse intervene?
Offering the patient a pitcher of water
The nurse takes into consideration that a proton pump inhibitor drug, such as ______________, will completely eradicate gastric acid production.
Omeprazole (Prilosec)
The nurse caring for a patient with a peptic ulcer who has had a nasogastric tube inserted notes bright blood in the tube; the patient complains of pain and has become hypotensive. Which condition should the nurse recognize these as signs of?
Perforation
The nurse is caring for a patient who is suspected of having oral cancer. When reviewing the patient's health history, which finding provides supportive data for the diagnosis?
Presence of leukoplakia
A patient with a nasogastric tube connected to suction is NPO (nothing by mouth) and reports a dry mouth and gagging feeling. What action should the nurse take?
Provide oral care
The nurse is caring for a patient on a clear liquid diet. The nurse should recognize that the patient requires further teaching if the patient requests which food?
coffee with cream
