PNP GI Discorders

When collecting data on a client during a routine checkup, the nursing student reviews the history and notes that the client had aphthous stomatitis at the time of the last visit. The student asks the nurse what is aphthous stomatitis? What is the nurse's best response?

"Aphthous stomatitis is a canker sore of the oral soft tissues."

A client comes to the clinic for a follow-up appointment after diagnostic tests show gastroesophageal reflux disease. What instructions should the nurse reinforce?

"Avoid alcohol and caffeine."

A client with a peptic ulcer is about to begin a therapeutic regimen that includes a bland diet, antacids, and ranitidine. Before the client is discharged, the nurse should provide which instruction?

"Avoid aspirin and products that contain aspirin."

A client with recent onset of epigastric discomfort is scheduled for an upper GI series (barium swallow). When teaching the client how to prepare for the test, which instruction should the nurse provide?

"Avoid eating or drinking anything for 6 to 12 hours before the test."

A nurse reinforces education that has been provided to an older adult about good bowel habits. Which statement indicates that the client understands the information?

"Fifteen minutes of exercise three times a week improves bowel habits."

A patient underwent open abdominal surgery to remove an intestinal mass 5 days previously and calls the clinic reporting cramping abdominal pain, vomiting, and passing no stool or gas. Which response is most appropriate for the nurse to give to this client?

"Go to the emergency department for evaluation."

When reinforcing discharge education for a client with ulcerative colitis, the nurse emphasizes the importance of regular examinations. Which statement by the client indicates an understanding of the instructions?

"I will need to have routine screenings because having ulcerative colitis places me at risk for colon cancer."

A client arrives in the outpatient department for a colonoscopy and states, "I wasn't able to drink all of that stuff. Could only drink 2 cups." What is the best response by the nurse?

"I will notify the health care provider and let him know that you were unable to drink the prep solution."

A client recently diagnosed with colon cancer states, "I am having trouble sleeping because of thoughts of how life will change after surgery." What is the best response by the nurse?

"I will sit and talk with you about how you are feeling."

A client is diagnosed with a hiatal hernia. Which statement indicates effective client teaching about hiatal hernia and its treatment?

"I'll eat frequent, small, bland meals that are high in fiber."

The nurse reinforces home care instructions given to a client with a diagnosis of hiatal hernia. Which statement made by the client indicates an understanding of the instructions?

"I'll sleep with my head elevated about 3 to 4 inches."

A client was hospitalized and treated for acute diverticulitis. The nurse has reinforced discharge education. Which statement by the client indicates that the client understands the discharge instructions?

"I'll take all of my antibiotics."

A client who is about to undergo gastric bypass surgery calls the nurse into the room. The client says she's concerned that friends will learn about her upcoming surgery. She pleads with the nurse to keep her surgery a secret. Which response by the nurse is best?

"I'm not at liberty to discuss your case with anyone except those directly involved in your care unless you authorize me to do so."

A client with colon cancer asks the nurse why radiation therapy is being received before surgery. Which response would be most appropriate?

"It helps reduce the size of the tumor."

The nurse is providing dietary instructions to a client with a history of pancreatitis. Which instruction is correct?

"Maintain a high-carbohydrate, low-fat diet."

A nurse interviewing the parents of a child diagnosed with celiac disease would expect them to report which characteristic?

"Our child has 5 to 6 oily-looking stools a day."

A client who has just been diagnosed with hepatitis A asks, "How could I have gotten this disease?" What is the nurse's best response?

"You may have eaten contaminated restaurant food."

After laparoscopic cholecystectomy, a client reports abdominal pain. The nurse prepares morphine 2 mg. If the label on the morphine reads 10 mg/ml, how many milliliters should the nurse have in the syringe after the correct dose is drawn up? Record your answer using one decimal place.

0.2

A nursing assistant is assisting a nurse with feeding clients. Which client should the nurse assign to the nursing assistant?

A client with bilateral blindness

When providing discharge teaching for the patient after a laparoscopic cholecystectomy, what information should the nurse include?

A low fat diet

After checking the client's chart for possible contraindications, the nurse is administering meperidine, 50 mg I.M., to a client with pain after an appendectomy. The nurse would question which medication if noted on the physician's orders for this client?

A monoamine oxidase (MAO) inhibitor

A nurse is assigned to care for four clients. Which client should a nurse assess first?

A postoperative client who just returned from surgery and is vomiting

A client has just been diagnosed with hepatitis A. During assessment, which signs and/or symptoms would the nurse anticipate to find?

Anorexia, nausea, and vomiting.

The nurse is monitoring a client receiving paregoric to treat diarrhea for drug interactions. Which drugs can produce additive constipation when given with an opium preparation?

Anticholinergic drugs

The LPN is caring for a client who has had a colostomy.Which of the following client behaviors is indicative of a willingness to be involved in self-care following a colostomy?

Asking questions about the equipment being used.

To verify the placement of a gastric feeding tube, the nurse should perform at least two tests. One test requires instilling air into the tube with a syringe and listening with a stethoscope for air passing into the stomach. What is another test method?

Aspiration of gastric contents and testing for a pH less than 6

The nurse is admitting a client with abdominal pain, bloody stools, weakness, and dizziness when the client reports feeling the urge to have a bowel movement. What is the priority action by the nurse?

Assist the client onto the bedpan.

The physician orders morphine for a client who complains of postoperative abdominal pain. The nurse is monitoring the client and will anticipate administering morphine at what time?

Before the pain becomes severe

A client with inflammatory bowel disease undergoes an ileostomy. On the first day after surgery, the nurse notes that the client's dusky-appearing stoma is related to which factor?

Blood supply to the stoma has been interrupted.

A client had a gastroscopy while under local anesthesia. Before resuming the client's oral fluid intake, which action should the nurse take first?

Check for a gag reflex.

The patient with right upper quadrant abdominal pain has an abdominal ultrasound that reveals cholelithiasis. What should the nurse expect to do for this patient?

Control abdominal pain

The nurse is caring for a client in the postoperative period who had an open colon resection. The nurse attempts to change the dressing but observes the protrusion of intestine through the wound. What is the priority nursing action at this time?

Cover the wound with a sterile dressing moistened with normal saline.

A client with a new colostomy asks the nurse how to avoid detachment from the ostomy bag. What is the best response by the nurse?

Empty the bag when it's about half full.

The nurse is caring for a client who is postoperative after abdominal surgery and reporting "gas pains." What action by the nurse can assist the client with alleviating the discomfort associated with gas?

Encourage the client to ambulate.

Polyethylene glycol-electrolyte solution (GoLYTELY) is prescribed for the female client scheduled for a colonoscopy. The client begins to experience diarrhea following administration of the solution. What action by the nurse is appropriate?

Explain that diarrhea is expected

Dr. Smith has determined that the client with hepatitis has contracted the infection from contaminated food. The nurse understands that this client is most likely experiencing what type of hepatitis?

Hepatitis A

The nurse is assessing a client who complains of abdominal pain, nausea, and diarrhea. When examining the client's abdomen, which sequence should the nurse use?

Inspection, auscultation, percussion, and palpation

Which nursing intervention is essential immediately following a gastroduodenoscopy?

Instruct him not to eat or drink.

A nurse approaches a client with an 0800 dose of his scheduled pancreatin. The client states, "I'm not going to take that medicine. It makes me nauseated." What should the nurse do first?

Instruct the client about the benefit of taking the medication.

The nurse is reinforcing education for the parents of a child that has been diagnosed with celiac disease. To help promote a normal life for the child, which intervention should the nurse reinforce for the parents to use?

Introduce the child to a peer with celiac disease.

A client is scheduled to have a cholecystectomy. Which education should the nurse reinforce regarding the use of incentive spirometry? Select all that apply.

It increases alveolar inflation. It will promote lung expansion. It will promote deep breathing.

The nurse should recommend what type of diet for a patient with acute cholecystitis?

Low- fat

Which nursing intervention would be the priority in the immediate postoperative care of a client who has undergone gastric resection?

Monitoring for symptoms of hemorrhage

A client with pancreatitis has been receiving total parenteral nutrition (TPN) for the past week. Which nursing intervention would the nurse use to determine if TPN is providing adequate nutrition?

Monitoring the client's weight every day

A client with abdominal pain secondary to a malignant mass in the colon is receiving fentanyl by transdermal patch. His current patch expires in 48 hours and he reports a pain level of 8 on a 1-to-10 scale. What should a nurse do?

Notify the client's physician.

Risk factors for the development of hiatal hernias are those that lead to increased abdominal pressure. Which of the following complications can cause increased abdominal pressure?

Obesity

A client with left hemiparesis is having difficulty handling eating utensils. A nurse asks the physician to request a consult with which discipline?

Occupational therapy

The nurse should expect to administer which vaccine to the client after a splenectomy?

Pneumovax 23

When caring for a client with acute pancreatitis, the nurse should use which comfort measure?

Positioning the client on the side with the knees flexed

When caring for a client who has had constipation for 4 days, what should be the nurse's primary client care concern?

Promoting defecation

Which nursing intervention is the best way to help reduce the occurrence of poisoning in children?

Provide education to those who care for children.

Which of the following therapies is not included in the medical management of a client with peritonitis?

Regular diet

A client is scheduled for a laparoscopic cholecystectomy under general anesthesia. When the nurse asks the client what procedure the client will be having to compare with the informed consent, the client responds, "The doctor is going to take a piece of my liver out." What action should the nurse take at this time?

Request that the health care provider speak with the client before surgery to clarify the surgical procedure.

Why are antacids administered regularly, rather than as needed, to treat peptic ulcer disease?

To keep gastric pH at 3.0 to 3.5

A client presents to the outpatient center for a gastroscopy that reveals redness and inflammation of the stomach indicating acute gastritis. Which action should be included in the immediate management?

Treat the underlying cause of disease.

A client with viral hepatitis A is being treated in an acute care facility. To prevent spread of the disease, the nurse uses which precaution?

Wear gloves when caring for the client and wash her hands after touching the client.

A female client who has just been diagnosed with hepatitis A asks, "How could I have gotten this disease?" What is the nurse's best response?

You may have eaten contaminated restaurant food.

The nurse is caring for a client with alcohol-related acute pancreatitis. Which intervention is most appropriate to reduce the exacerbation of pain?

abstaining from alcohol

A client who takes famotidine for gastritis asks the home care nurse which medication is best to take for a headache. Which over-the-counter medication should the nurse suggest for this client?

acetaminophen

While obtaining a client's medication history, a nurse learns that the client takes ranitidine as prescribed to treat a peptic ulcer. This client should be cautioned by the nurse to avoid combining ranitidine with a drug from which class because of potential drug interactions?

antacids

A client reports right lower quadrant pain, nausea, vomiting, and a low-grade fever for the past 12 hours. The health care provider documents rebound tenderness, an elevated white blood cell count (WBC), and positive psoas sign. Based on these findings, what would the nurse suspect?

appendicitis

The nurse is caring for a client with an endotracheal tube who receives enteral feedings through a feeding tube. Before each tube feeding, the nurse checks for tube placement in the stomach as well as residual volume. The purpose of the nurse's actions is to avoid:

aspiration

Following a liver transplant a client develops ascites. The nurse should teach the client to:

brace the abdomen with a pillow during coughing.

A client reports excessive flatulence. Which food, reported by the client as consumed regularly, may be responsible for this?

cauliflower

The ingestion of substances containing lead is mostly influenced by which risk factor?

child's age

For a client who must undergo colon surgery, the physician orders preoperative cleansing enemas. The nurse anticipates administration of neomycin to this client to:

decrease the intestinal bacteria count.

A client who can't tolerate oral feedings begins receiving intermittent enteral feedings. When monitoring for evidence of intolerance to these feedings, the nurse must stay alert for:

diaphoresis, vomiting, and diarrhea.

A nurse is collecting data on a client with a history of constipation. Which data, obtained by the nurse, would indicate a risk factor for constipation?

diet high in cheese, lean meats, and pasta

A nurse is planning care for a client diagnosed with acute hepatitis A. What is the primary mode of transmission for hepatitis A?

fecal contamination and oral ingestion

A patient who is receiving treatment for cholelithiasis experiences severe nausea and six episodes of vomiting. The nurse identified that which intervention will be beneficial to the patient?

gastric decompression

A client is suspected of having gastric cancer. The nurse expects to prepare the client for which diagnostic test that will aid in confirming the diagnosis of gastric cancer?

gastroscopy

Several children at a day care center have been infected with hepatitis A virus. Which instruction reinforced by the nurse would reduce the risk of spreading hepatitis A to other children and staff members?

hand washing after diaper changes

The nurse is caring for a client that has taken an overdose of acetaminophen. For which initial complication should the nurse closely monitor the client?

hepatic damage

The nurse is performing an assessment on a client who has developed a paralytic ileus. The nurse expects the client's bowel sounds will be:

hypoactive

A nurse is verifying orders from a health care provider. Which diet will the nurse discuss with child and family related to a new diagnosis of celiac disease?

no-gluten diet

The nurse interviews a client presenting to the clinic with reports of nausea, dark urine, weight loss, and fatigue for the past 2 weeks. Which additional information should the nurse gather from this client related to the presenting symptoms?

number and color of stools

When assisting with development of a postoperative care plan for a client after gastric resection, which would be the priority?

nutritional needs

During the first few days of recovery from ostomy surgery for ulcerative colitis, what should be the priority of client care?

ostomy care

A client has been admitted to the emergency department with severe right upper quadrant pain. Based on the signs and symptoms and laboratory data documented in the chart shown, the nurse would expect the client to have which diagnosis?

pancreatitis

The nurse receives a client at the clinic for follow-up after being treated in the hospital for pancreatitis. When gathering data from the client, which finding should immediately be reported to the health care provider?

shortness of breath with minimal exertion

A client diagnosed with glossitis is prescribed a diet high in folic acid. When assisting with the development of a teaching plan for this client, which food products will the nurse reinforce to fulfill the need for increased folic acid?

spinach

The client with a peptic ulcer is prescribed an antacid. After administering the medication, the nurse assesses the pH of which organ contents to determine effectiveness?

stomach

When caring for a patient following an incisional cholecystectomy for choleslithiasis, the nurse places the highest priority on assisting the patient to:

turn, cough and deep

A nurse is assisting a gastroenterologist in caring for a client with reports of epigastric pain. The nurse is explaining the role of the gastric glands in the fundus and body of the stomach that secrete intrinsic factor and hydrochloric acid. The nurse is correct when stating which of these substances as those needed in the GI tract?. Select all that apply.

vitamin B12 absorption dissolving food fibers killing microorganisms activating the enzyme pepsin

The nurse is reviewing laboratory results for a client with peritonitis. Which results would the nurse expect to observe?

white blood cell (WBC) count above 15,000/μL

.A male client with cholelithiasis has a gallstone lodged in the common bile duct. When assessing this client, the nurse expects to see:

yellow sclera.