PNU 133 PrepU Passpoint Gastrointestinal Disorders

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."

A nurse has been asked to obtain a client's signature on an operative consent form. When the nurse approaches the client, who is scheduled for a cholecystectomy later in the day, the client asks the nurse why the procedure is needed. Which response by the nurse is appropriate?

"I will ask the surgeon to come speak to you about the procedure."

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 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."

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 expresses concern that friends will learn about the upcoming surgery and asks the nurse not to share the reason for the surgery. 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 2-year-old child is admitted through the emergency department with a suspected diagnosis of Hirschsprung's disease (aganglionic megacolon). The parent asks about treatment of the disease. What would be an appropriate response from the nurse?

"Initially the child will have a temporary colostomy; later a second operation removes the abnormal part of bowel and reattaches the normal bowel down to the rectum."

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 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."

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

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 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.

A client is admitted to the health care facility with a diagnosis of a bleeding gastric ulcer. The nurse instructs the nursing student to observe this client's stools for which finding?

Black and tarry

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 client with cirrhosis is admitted to the hospital. The nurse observes the client for which sign or symptom that would indicate deterioration of hepatic function?

Difficulty in arousal

The surgeon is discussing surgery with a client diagnosed with colon cancer. The client is visibly shaken over the possibility of a colostomy. Based on the client's response, the surgeon should collaborate with which health team member?

Enterostomal nurse

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.

Which interventions should the nurse perform when gathering data from a child with suspected ingestion of household bleach? Select all that apply.

Obtain a complete set of vital signs. Inspect the mouth and oropharynx. Monitor respiratory status.

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

A nurse is preparing to perform complex abdominal wound care. Which action should the nurse take while performing this task?

Raise the bed to approximately waist level.

A client who is legally blind must undergo a colonoscopy. The nurse is helping the healthcare provider obtain informed consent. When obtaining informed consent from a client who is visually impaired, the nurse should take which step?

Read the consent form to the client and ask if there are any questions.

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

To keep gastric pH at 3.0 to 3.5

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

brace the abdomen with a pillow during coughing.

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 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 primarymode of transmission for hepatitis A?

fecal contamination and oral ingestion

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

A nurse is assigned to care for a client with peptic ulcer disease. Which finding will the nurse report immediately to the health care provider?

heart rate 126 bpm

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.

The nurse is providing care to a client with appendicitis. Which priority nursing intervention should the nurse perform?

monitoring for signs of peritonitis

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

Which client requires immediate nursing intervention? The client who

presents with a rigid, boardlike abdomen.