nclex GI 2

A client with gastric ulcer disease asks the nurse why the health care provider has prescribed metronidazole (Flagyl). What does the nurse explain?

"Antibiotics are prescribed to treat Helicobacter pylori infection."

A health care provider prescribes an upper gastrointestinal (GI) series and a barium enema. The client asks, "Why do I have to have barium for these tests?" What is the nurse's best response?

"Barium gives more contrast to the soft tissue of the alimentary tract, allowing absorption of x-rays."

A nurse is reviewing preoperative instructions with a client who is scheduled for orthopedic surgery at 8 AM the next day. What does the nurse advise the client to do?

"Consume a light evening meal tonight and then no food or fluids after midnight."

A client is instructed to avoid straining on defecation postoperatively. The nurse evaluates that the related teaching is understood when the client makes which statement?

"I must increase my intake of green vegetables."

A client with a history of ulcerative colitis is admitted to the hospital because of severe rectal bleeding. The client appears to be an angry, demanding person. One day the unlicensed assistive personnel (UAP) tells the nurse, "I've had it with that client's demands. I'm not going in that room again." What is the nurse's best response to this statement?

"The client is frightened. Let's think about the best approach we can take."

A client with hepatitis B asks the nurse, "Are there any medications to help me get rid of this problem?" Which is the best response by the nurse?

"There are medications to help reduce viral load and liver inflammation."

A client is to have gastric lavage following an overdose of acetaminophen (Tylenol). In which position should the nurse place the client when the nasogastric tube is being inserted?

High-Fowler

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

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

A client has a large open abdominal wound. The health care provider's prescription states to cleanse the wound with normal saline, pack the wound with damp gauze, cover with abdominal pads, and secure with Montgomery straps twice a day. What should the nurse do to maintain sterility when changing the dressing?

Cleanse the wound with wet sterile gauze from the center of the wound outward.

A client tells the nurse about recent recurrent episodes of bleeding hemorrhoids. What should the nurse advise the client to do to help prevent future hemorrhoidal episodes?

Consume a high-fiber diet and drink adequate water

Which client is at the highest risk for developing inflammatory bowel disease?

Jewish

A nurse is caring for a client who just had surgery for a parotid tumor. Which nursing intervention is the priority in the immediate postoperative period ?

Keeping the client's respiratory passages patent

A client is admitted to the hospital with a diagnosis of Crohn's disease. What is most important for the nurse to include in the teaching plan for this client?

Meeting nutritional needs

On the second day after an abdominoperineal resection, the nurse anticipates that the colostomy stoma will have what appearance?

Moist, red, and raised above the skin surface

A nurse assists a client who had bariatric surgery to be more mobile. What complication is the nurse attempting to prevent?

Pulmonary embolism

A client with a hiatal hernia comes to the community health clinic to attend a class about nutrition. The client reports frequently waking up at night with heartburn. Which suggestion by the nurse may help to reduce symptoms of heartburn?

Raise the head of the bed on blocks

Morphine via an epidural catheter is prescribed for a client after abdominal surgery. The client asks the nurse why this medicine is necessary. What primary rationale does the nurse give for the administration of an opioid analgesic after abdominal surgery?

Relieves abdominal pain

Megadoses of vitamin A are taken by a client. Why should the nurse question this practice?

The liver has a great storage capacity for vitamin A, even to toxic amounts

A client has decided to become a total vegetarian (vegan) and wishes to plan a diet to ensure adequate protein quality. What should the nurse recommend to the client?

Use a mixture of plant proteins to provide the essential amino acids.

A nurse is caring for a client who is positive for hepatitis A. Which precautions should the nurse take?

Use gloves when removing the client's bedpan.

A nurse is caring for a client with cholelithiasis. Which clinical manifestation does the nurse expect if the client develops obstructive jaundice?

Yellow sclera

An abdominal cholecystectomy is performed on a client with gangrene of the gallbladder. During the first 24 hours postoperatively, when should analgesics be administered?

As prescribed by the health care provider

A client with a recent colostomy expresses concern about the inability to control the passage of gas. What should the nurse teach the client to do?

Avoid foods that in the past caused flatus

A client has surgery for an incarcerated hernia. The health care provider returns the incarcerated tissue to the abdominal cavity and uses a mesh to reinforce the muscle wall. What specific instructions should be included in the discharge instructions?

Avoid lifting heavy items.

A client asks the nurse to review a list of the foods the client has been choosing to combat constipation. Upon review, the nurse identifies that which food item has the least amount of fiber content?

Cream of wheat cereal

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

Encouraging coughing and deep breathing

A client is diagnosed with cancer of the pancreas and is apprehensive and restless. Which nursing action should be included in the plan of care?

Encouraging expression of concerns

A client is scheduled for gastrointestinal surgery. What is the most important nursing action that should be implemented the evening before surgery?

Ensuring the bowel preparation is initiated

A nurse has provided teaching to a client with a newly prescribed proton pump inhibitor (PPI). The nurse determines that the teaching is effective when the client states that the medication is used for the treatment of what?

Gastroesophageal reflux (GERD)

A client is diagnosed as having the hepatitis B virus (HBV). The nurse reviews the client's health history for possible situations in which exposure may have occurred. Which event does the nurse determine is the most likely source of this infection?

Got a small tattoo on the arm 3 months ago

A self-help group of clients with irritable bowel syndrome have invited a nurse to present a program on nutrition. Which substance should the nurse teach the clients to minimize in the diet to decrease gastrointestinal (GI) irritability?

cola drinks

A client with a 20-year history of excessive alcohol use has developed jaundice and ascites and is admitted to the hospital. What is the priority nursing action during the first 48 hours after the client's admission?

monitor vital signs.

A client with early-stage cancer of the esophagus is treated with laser therapy. What type of food should the nurse instruct the client to select when oral intake is permitted?

pureed

An 18-year-old is admitted with an acute onset of right lower quadrant pain at McBurney's point. Appendicitis is suspected. For which clinical indicator should the nurse assess the client to determine if the pain is secondary to appendicitis?

rebound tenderness

A client who is suspected of having salmonellosis asks the nurse how the diagnosis is confirmed. The nurse responds that the medical diagnosis is established with what laboratory test?

stool culture