practice questions (exam 4)
state which quadrant each organ is in: -hepatitis -cholecystitis -pancreatitis -diverticulitis -appendicits
-hepatits RUQ -cholecystitis RUQ -pancreatitis LUQ -diverticulitis LLQ -appendicits RLQ
in contrast to diverticulitis, the patient with diverticulosis: a. has rectal bleeding b. often has no symptoms c. has localized cramping pain d. frequently develops peritonitis
b. often has no symptoms -diverticulosis is the formation of abnormal pouches in the bowel wall -diverticulitis is inflammation or infection of these abnormal pouches
which patient will the charge nurse assign to an RN floated to the acute care unit from the surgical ICU: a. patient with kidney stones scheduled for a lithotripsy this morning b. patient who has just undergone surgery for renal stent placement c. newly admitted patient with an acute UTI d. patient with CKD who needs teaching on peritoneal dialysis
b. patient who has just undergone surgery for renal stent placement -RN used to post op -UTI patient newly admitted and would need paperwork done
for which patient is a nurse most concerned about for the risk of developing kidney disease: a. 25-year-old patient who developed a urinary tract infection during pregnancy b. 55-year-old patient with a history of kidney stones c. 63 old patient with type two diabetes d. 79-year-old patient with stress urinary incontinence..
c. 63 old patient with type two diabetes
during an examination of the abdomen the nurse should: a. position the patient in the supine position with the bed flat and the knees straight b. listen for bowel sounds in the epigastrium and all four quadrants for 2 minutes c. describe bowel movement as absent if no sound is heard in a quadrant after 2 minutes d. use the following order of technique: inspection, palpation, percussion, auscultation
b. listen for bowel sounds in the epigastrium and all four quadrants for 2 minutes -want to flex the knees -not considered absent unless not heard for 5 minutes
which statement about peritoneal dialysis would be most important when teaching a patient new to the treatment: a. maintain a daily written record of blood pressure and weight b. maintain aseptic technique to prevent peritonitis c. more liberal protein diet once you complete peritoneal dialysis d. continue regular medical and nursing follow-up visits while performing peritoneal dialysis
b. maintain aseptic technique to prevent peritonitis -peritonitis most severe
patient is scheduled for surgery with general anesthesia in 1 hour and is observed with a moist but empty water glass in his hand. which assessment finding may indicate that the patient drank a glass of water: a. easily heard, loud gurgling in abdomen b. high-pitched, hollow sounds in abdomen c. flat abdomen without movement upon inspection d. tenderness in left upper quadrant upon palpation
a. easily heard, loud gurgling in abdomen
diagnostic testing is planned for a patient with a suspected peptic ulcer. the nurse explains to the patient that the most reliable test to determine the presence and location of an ulcer is: a. endoscopy b. gastric analysis c. barium swallow test d. serologic test for h. pylori
a. endoscopy
the nurse is preparing a patient for a capsule endoscopy. ehat should the nurse ensure is included in the preparation: a. ensure the patient understands the required bowel preparation b. have the patient return to the procedure room for removal of the capsule c. each the patient to maintain a clear liquid diet throughout the procedure d. explain to the patient that conscious sedation will be used during capsule placement
a. ensure the patient understands the required bowel preparation
several patients come to the urgent care with nausea, vomiting, and diarrhea that began 2 hours ago while attending a large family reunion potluck dinner. you ask the patients specifically about foods they ingested containing: a. beef b. meat and milk c. poultry and eggs d. home-preserved vegetables
b. meat and milk
patient with a family history of adenomatous polyposis had a colonoscopy with removal of multiple polyps. after the procedure, which signs and symptoms should the nurse teach the patient to report immediately: a. fever and abdominal pain b. flatulence and liquid stool c. loudly audible bowel sounds d. sleepiness and abdominal cramps
a. fever and abdominal pain -want to observe for signs of rectal bleeding or peritonitis
a 35 y/o patient is admitted to the ED with acute abdominal pain. which medical diagnoses should you consider as possible causes of her pain (select all the apply): a. gastroenteritis b. ectopic pregnancy c. gastrointestinal bleeding d. irritable bowel syndrome e. inflammatory bowel disease
a. gastroenteritis b. ectopic pregnancy c. gastrointestinal bleeding d. irritable bowel syndrome e. inflammatory bowel disease
nurse provides nutritional counseling for a patient kidney disease. the nurse determines teaching has been successful if the patient selects which breakfast menu: a. scrambled eggs, milk, yogurt, and sliced ham b. oatmeal, nondairy creamer, banana, and orange juice c. cottage cheese, peanut butter, white bread, and coffee d. waffle, bacon strips, tomato juice, and canned peaches
b. oatmeal, nondairy creamer, banana, and orange juice
six days after kidney transplant from a deceased donor, a patient develops a temperature of 101.2°F (38.5°C), tenderness at the transplant site, and oliguria. the nurse recognizes that these findings indicate: a. acute rejection, which is not uncommon and is usually reversible b. hyper-acute rejection, which will necessitate removal of the transplanted kidney c. an infection of the kidney, which can be treated with IV antibiotics d. the onset of chronic rejection of the kidney with eventual failure of the kidney
a. acute rejection, which is not uncommon and is usually reversible
nursing management of the patient with acute pancreatitis includes (select all that apply): a. administering pain medication b. checking for signs of hypocalcemia c. providing a diet low in carbohydrates d. giving insulin based on a siding scale e. monitoring for infection particularly respiratory tract infection
a. administering pain medication b. checking for signs of hypocalcemia e. monitoring for infection particularly respiratory tract infection
the nurse is teaching a patient how to prevent renal trauma after an injury that required a left nephrectomy. which points would the nurse include in the teaching plan (select all that apply): a. always wear a seat belt b. avoid contact sports c. practice safe walking habits d. wear protective clothing if you participate in contact sports e. use caution when riding a bicycle f. always avoid use of drugs that may damage the kidney
a. always wear a seat belt b. avoid contact sports c. practice safe walking habits e. use caution when riding a bicycle -drugs that cause damage to the kidney may be needed in life saving treatment
a nurse is working in a outpatient dialysis unit and notices a reddened, skin infection on the right arm of a client. the client share that it was a bug bite but has gotten worse since discharge from the hospital two weeks ago. what action should the nurse take next: a. apply gloves and explore the wound more closely b. encourage the client to apply antibiotic cream and keep it covered c. ask why the client was hospitalized d. culture the wound
a. apply gloves and explore the wound more closely -patient likely has hospital acquired infection, wear gloves because we do not know what disease is -asking the client why they were hospitalized is not pertinent -culturing the wound requires an order
a kidney transplant recipient has had fever, chills, and dysuria over the past 2 days. what is the first action that the nurse should take: a. assess temperature and initiate workup to rule out infection b. reassure the patient that this is common after transplantation c. provide warm covers to the patient and give 1 gram oral acetaminophen d. notify the nephrologist that the patient has manifestations of acute rejection
a. assess temperature and initiate workup to rule out infection -ADPIE, assess first !!!
patient with stage 2 chronic kidney disease is scheduled for an outpatient diagnostic procedure using contrast media. which priority action should the nurse perform: a. assess the patient's hydration status b. insert a urinary catheter for the expected diuresis c. evaluate the patient's lower extremities for edema d. check the patient's urine for the presence of ketones
a. assess the patient's hydration status
the nurse is caring for a patient after bariatric surgery. what should be included in the plan of care (select all that apply): a. assist with early ambulation as needed b. teach the patient to consume liquids with meals c. maintain elevation of the head of bed at 45 degrees d. monitor for vomiting as it is a common complication e. provide a diet high in carbohydrate and fat intake f. assess for incisional pain versus an anastomosis leak
a. assist with early ambulation as needed c. maintain elevation of the head of bed at 45 degrees d. monitor for vomiting as it is a common complication f. assess for incisional pain versus an anastomosis leak -HOB up because of vomiting
the nurse is providing care for a patient after kidney biopsy. which action should the nurse delegate to an experienced assistive personnel (select all that apply): a. check vital signs every four hours for 24 hours b. remind the patient about strict bedrest for 2 to 6 hours c. reposition a patient by logrolling with supporting back roll d. measure and record urine output e. access the dressing site for bleeding and check complete blood count results f. teach the patient to resume normal activities after 24 hours if there's no bleeding
a. check vital signs every four hours for 24 hours b. remind the patient about strict bedrest for 2 to 6 hours c. reposition a patient by logrolling with supporting back roll d. measure and record urine output
jaundiced patient with clay-colored stools, most likely related to: a. decreased bile flow into the intestine b. increased production of urobilinogen c. increased bile and bilirubin in the blood d. increased production of cholecystokinin
a. decreased bile flow into the intestine
an AP reports to the RN that a patient with acute kidney failure had a urine output of 350mL over the past 24 hours after receiving furosemide 40mg IV push. the AP asks the nurse how this can happen. what is the nurse's best response: a. during the oliguric phase of acute kidney failure, patients often do not respond well to either fluid challenges or diuretics b. there must be some sort of error. someone must have failed to record the urine output c. a patient with acute kidney failure retains sodium and water, which counteracts the action of furosemide d. the gradual accumulation of nitrogenous waste products results in the retention of water and sodium
a. during the oliguric phase of acute kidney failure, patients often do not respond well to either fluid challenges or diuretics -gradual accumulation of nitrogenous waste products is a result of the kidney's inability to eliminate
patients with CKD have an increased incidence of CVD related to (select all that apply): a. hypertension b. vascular calcifications c. a genetic predisposition d. hyperinsulinemia causing dyslipidemia e. increased HDL levels
a. hypertension b. vascular calcifications d. hyperinsulinemia causing dyslipidemia -decreased HDL levels
two days after a bowel resection for an abdominal mass, a patient reports gas pains and abdominal distention. the nurse plans care for the patient based on the knowledge that the symptoms are occurring as a result what event: a. impaired peristalsis b. irritation of the bowel c. nasogastric suctioning d. inflammation of the incision site
a. impaired peristalsis
the most appropriate therapy for a patient with acute diarrhea cause by an infection is to: a. increase fluid intake b. administer an antibiotic c. administer an anti-motility drug d. quarantine the patient to pevent spread of virus
a. increase fluid intake
patient with hepatitis a in the acute phase, the nurse plans care for the patient based on the knowledge that: a. itching is a common problem with jaundice in this phase b. the patient is most likely to transmit the disease during the phase c. G.I. symptoms are not as severe and hep as they are in hep b d. extra-hepatic manifestations of glomerulonephritis and poly arthritis are common in this phase
a. itching is a common problem with jaundice in this phase
normal physical assessment finding of the GI system: a. non palpable spleen and liver b. borborygmi (stomach growling) c. liver edge 2 to 4 centimeters below costal margin d. rectum firm with nodular edges
a. non palpable spleen and liver -bowel sounds high pitched not growling -liver 1 to 2 inches -rectum should be smooth with no nodules
nurses can screen patients at risk for developing CKD. those considered to be at increased risk include (select all that apply): a. older black patients b. patients more than 60 years old c. those with a history of pancreatitis d. those with a history of hypertension e. those with a history of type 2 diabetes
a. older black patients b. patients more than 60 years old d. those with a history of hypertension e. those with a history of type 2 diabetes
nurse is caring for a patient who reports abdominal pain and hematemesis. which new assessment finding(s) would indicate the patient's condition is declining: a. pallor and diaphoresis b. reddened peripheral IV site c. guaiac-positive diarrhea stools d. heart rate 90, respiratory rate 20, BP 110/60
a. pallor and diaphoresis
nurse performs a detailed assessment of the abdomen on a patient with a possible bowel obstruction. what are manifestation of obstruction in the large intestine (select all that apply): a. persistent abdominal pain b. marked abdominal distention c. loose/liquid diarrhea d. severe, intermittent pain e. profuse vomiting that relieves abdominal pain
a. persistent abdominal pain b. marked abdominal distention -constipation, vomiting is rare
a patient is admitted to the hospital with CKD. the nurse understands that this condition is characterized by: a. progressive irreversible destruction of the kidneys b. a rapid decrease in urine output with an elevated BUN c. an increasing creatinine clearance with a decrease in urine output d. prostration, somnolence, and confusion with coma and imminent death
a. progressive irreversible destruction of the kidneys -urine output decrease is not rapid
patient with a history of peptic ulcer disease presents to the emergency department with severe abdominal pain and a rigid, board-like abdomen. the health care provider suspects a perforated ulcer. which interventions should the nurse anticipate: a. providing IV fluids and inserting a nasogastric (NG) tube b. dministering oral bicarbonate and testing the patient's gastric pH level c. performing a fecal occult blood test and administering IV calcium gluconate d. starting parenteral nutrition and placing the patient in a high Fowler's position
a. providing IV fluids and inserting a nasogastric (NG) tube
assessment findings suggestive of peritonitis include (select all that apply): a. rebound tenderness b. a soft, distended abdomen c. dull, intermittent abdominal pain d. shallow respirations with bradypnea e. observing that the patient is lying still
a. rebound tenderness e. observing that the patient is lying still
nutritional support and management are essential across the entire continuum of CKD. which statements are true related to nutritional therapy (select all that apply): a. sodium and salt may be restricted in someone with advanced CKD b. fluid is not usually restricted for patient's receiving peritoneal dialysis c. decreased fluid intake and a low potassium diet are part of the diet for a patient receiving hemodialysis d. decreased fluid intake and a low potassium diet are part of the diet for a patient receiving peritoneal dialysis e. decreased fluid intake and a diet in protein-rich foods are part of a diet for a patient receiving hemodialysis
a. sodium and salt may be restricted in someone with advanced CKD b. fluid is not usually restricted for patient's receiving peritoneal dialysis c. decreased fluid intake and a low potassium diet are part of the diet for a patient receiving hemodialysis
an ESRD patient receiving hemodialysis is considering asking a relative to donate a kidney for transplantation. in assisting the patient to make a decision about treatment, the nurse informs the patient that: a. successful transplantation usually provides a better quality of life than that offered by dialysis b. if rejection of the transplanted kidney occurs, no further treatment for the renal failure is available c. the immunosuppressive therapy that is required following transplantation causes fatal malignancies in many patients d. hemodialysis replaces the normal functioning of the kidneys and patients do not have to live with the continual fear of rejection
a. successful transplantation usually provides a better quality of life than that offered by dialysis
which instructions would the nurse include in a teaching plan for a patient with GERD: a. the best time to take an as-needed antacid is 1-3 hours after meals b. a glass of warm milk at bedtime will decrease your discomfort at night c. do not chew gum; the excess saliva will cause you to secrete more acid d. limit your intake of foods high in protein because they take longer to digest
a. the best time to take an as-needed antacid is 1-3 hours after meals
nurse is preparing to insert a nasogastric (NG) tube into a patient with a suspected small intestinal obstruction that is vomiting. the patient asks the nurse why this procedure is necessary. what response by the nurse is most appropriate: a. the tube will help to drain the stomach contents and prevent further vomiting b. the tube will push past the area that is blocked and help to stop the vomiting c. the tube is just a standard procedure before many types of surgery to the abdomen d. the tube will let us measure your stomach contents so we can give you the right IV fluid replacement
a. the tube will help to drain the stomach contents and prevent further vomiting
the nurse is caring for a patient at risk for kidney disease for whom a urinalysis has been ordered. what time will the nurse instruct the assistive personnel as best to collect the sample: a. with first morning void b. before any meal c. at bedtime d. immediately
a. with first morning void
results of a patient's recent endoscopy indicate the presence of peptic ulcer disease (PUD). which teaching point should the nurse provide to the patient based on this new diagnosis: a. would be beneficial for you to stop drinking alcohol b. you'll need to drink at least 2 to 3 glasses of milk daily c. people find that a minced or pureed diet eases their symptoms of PUD d. keep your present diet and minimize symptoms by taking medication
a. would be beneficial for you to stop drinking alcohol
patient with suspected bowel obstruction had a nasogastric tube inserted at 4:00 AM. the nurse shares in the morning report that the day shift staff should check the tube for patency at what times: a. 7:00 AM, 10:00 AM, and 1:00 PM b. 8:00 AM, 12:00 PM, and 4:00 PM c. 9:00 AM and 3:00 PM d. 9:00 AM, 12:00 PM, and 3:00 PM
b. 8:00 AM, 12:00 PM, and 4:00 PM
a patient diagnosed with acute kidney failure had a urine output of 1560mL for the past 8 hours. the new grad nurse asks the RN how a patient with kidney failure can have such a large urine output. what is the RN's best response: a. the patient's kidney failure was caused by hypovolemia, and we have given him the IV fluids to correct the problem b. acute kidney failure patients go through a diuretic phase when their kidneys begin to recover and may put out as much as 10L of urine per day c. with that much urine output, there must have been a mistake on the patient's diagnosis d. an increase in urine output like this is an indicator that the patient is entering the recovery phase of acute kidney failure
b. acute kidney failure patients go through a diuretic phase when their kidneys begin to recover and may put out as much as 10L of urine per day -recovery phase comes after this (d)
nurse caring for a patient with suspected acute cholecystitis would anticipate (select all that apply): a. ordering a low sodium diet b. administration of IV fluids c. monitoring of liver function test d. administration of anti-medics for patients with nausea e. insertion of dwelling catheter to monitor urinary outlet
b. administration of IV fluids c. monitoring of liver function test d. administration of anti-medics for patients with nausea
teaching plan for the patient being discharged following an acute episode of upper GI bleeding includes information concerning the importance of (select all that apply): a. only taking aspirin with milk or bread products b. avoiding taking aspirin and drugs containing aspirin c. taking only drugs prescribed by the health care provider d. taking all drugs 1 hour before mealtime to prevent further bleeding e. limiting alcohol intake to one serving per day
b. avoiding taking aspirin and drugs containing aspirin c. taking only drugs prescribed by the health care provider -eliminate alcohol use
patient has high bilirubin - one cause of this finding is: a. gallbladder is unable to contract to release stored bile b. bilirubin is not being conjugated and excreted into the bile by the liver c. kupffer cells in the liver are unable to remove bilirubin from the blood d. obstruction in the biliary tract preventing flow of bile into the small intestine
b. bilirubin is not being conjugated and excreted into the bile by the liver
the nurse should recognize that the liver performs which functions (select all that apply): a. ile storage b. detoxification c. protein metabolism d. steroid metabolism e. RBC production
b. detoxification c. protein metabolism d. steroid metabolism
nurse is caring for a patient being treated with IV fluid therapy for severe vomiting. as the patient recovers and begins to tolerate oral intake, which food choice would be most appropriate: a. iced tea b. dry toast c. hot coffee d. plain yogurt
b. dry toast -alleviates feeling of nausea
patient with type 2 diabetes and chronic kidney disease has a serum potassium level of 6.8 mEq/L. which finding will the nurse monitor for: a. fatigue b. dysrhythmias c. hypoglycemia d. elevated triglycerides
b. dysrhythmias
the nurse is admitting a 66 year old patient suspected of having a urinary tract infection. which part of the patient's medical history supports the diagnosis: a. patient's wife had a UTI one month ago b. followed for prostate disease for two years c. intermittent catheterization six months ago d. kidney stone removal one year ago
b. followed for prostate disease for two years -prostate disease increases risk -wife's UTI would be concern if we knew they were having intercourse
a patient's daughter calls the clinic and tells the nurse that their 85 y/o mother has been nauseated all day and has vomited twice. before the nurse hangs up and calls the HCP, she should tell the daughter to: a. administer antiemetic drugs and assess her mother's skin turgor b. give her mother sips of water and elevate the head of the bed to prevent aspiration c. offer her mother large quantities of gatorade to decrease the risk for sodium depletion d. give her mother a high-protein liquid supplement to drink to maintain her nutritional needs
b. give her mother sips of water and elevate the head of the bed to prevent aspiration
patient with a history of irritable bowel disease and gastroesophageal reflux disease (GERD) is admitted with a diagnosis of diverticulitis and has received an antacid. the nurse will determine the medication was effective when which symptom has been resolved: a. diarrhea b. heartburn c. constipation d. lower abdominal pain
b. heartburn
the nurse cares for a patient after bariatric surgery. the nurse determines that discharge teaching related to diet is successful if the patient makes which statement: a. fluid intake should be at least 2000 mL/day with meals to avoid dehydration b. high-protein diet that is low in carbohydrates and fat will prevent diarrhea c. food should be high in fiber to prevent constipation from the pain medication d. three meals a day with no snacks between meals will provide optimal nutrition
b. high-protein diet that is low in carbohydrates and fat will prevent diarrhea -fluids and foods high in carbohydrate tend to promote diarrhea and symptoms of the dumping syndrome
what information would have the highest priority for the nurse to include in preoperative teaching for a patient scheduled for an exploratory laparotomy: a. how to care for the wound b. how to deep breathe and cough c. the location and care of drains after surgery d. which medications will be used during surgery
b. how to deep breathe and cough
patient with advanced cirrhosis asks why his abdomen is so swollen. the nurses response is based on the knowledge that: a. lack of clotting factor promotes the collection of blood in the abdominal cavity b. portal hypertension and hypoalbunemia cause a fluid shift into the peritoneal space c. decreased peristalsis in the GI tract, contributes to gas formation, and distention of the bowel d. bile salts in the blood irritate the peritoneal membranes, causing edema in pocketing fluid
b. portal hypertension and hypoalbunemia cause a fluid shift into the peritoneal space
the nurse is reviewing the lab values for a patient with risk for urinary problems, which finding is the most concern to the nurse: a. BUN of 10 mg/mL b. presence of glucose and protein in the urine c. serum creatinine of 0.6 mg/mL d. urinary pH of eight
b. presence of glucose and protein in the urine
a patient undergoes peritoneal dialysis exchanges several times each day.What should the nurse plan to increase in the patient's diet: a. fat b. protein c. calories d. carbohydrates
b. protein
patient has been told that she is elevated liver enzymes caused by nonalcoholic fatty liver disease. the nursing teaching plan should include: a. having genetic testing done b. recommending a heart healthy diet c. the necessity to reduce weight rapidly d. avoiding alcohol until liver enzymes return to normal
b. recommending a heart healthy diet
teaching in relation to home management after a laparoscopic cholecystectomy should include: a. keeping the bandages on the puncture sites for 48 hours b. reporting any bile colored drainage or pus from any incision c. using over-the-counter anti-medics for nausea or vomiting d. emptying and measuring the contents of the bile bag from the t tube every day
b. reporting any bile colored drainage or pus from any incision
nurse is caring for a patient who is in the oliguric phase of acute kidney disease. which action would be appropriate to include in the plan of care: a. provide foods high in potassium b. restrict fluids based on urine output c. monitor output from peritoneal dialysis d. offer high-protein snacks between meals
b. restrict fluids based on urine output
in preparing a patient for a colonoscopy, the nurse explains that: a. a signed permit is not necessary b. sedation may be used during the procedure c. only one cleansing enema is necessary for preparation d. a light meal should be eaten the day before the procedure
b. sedation may be used during the procedure
which nursing intervention is most appropriate in providing care for an adult patient with newly diagnosed adult onset polycystic kidney disease (PKD): a. help the patient cope with the rapid progression of the disease b. suggest genetic counseling resources for the children of the patient c. implement appropriate measures for the patient's deafness and blindness d. expect the patient to have polyuria and poor concentration ability of the kidneys
b. suggest genetic counseling resources for the children of the patient -most common genetic disease -does not have rapid progression
the nurse identifies a risk factor for kidney and bladder cancer in a patient who relates a history of: a. aspirin use b. tobacco use c. chronic alcohol use d. use of artificial sweeteners
b. tobacco use
patient is scheduled for a percutaneous transhepatic cholangiography to restore biliary drainage. the nurse discusses the patient's health history and is most concerned if the patient makes which statement: a. allergic to bee stings b. tongue swells when I eat shrimp c. have had epigastric pain for 2 months d. have a pacemaker because my heart rate was slow
b. tongue swells when I eat shrimp -procedure uses contrast and patients allergic to shellfish and iodine are also allergic to contrast
the nurse teaches the female patient who has frequent UTI's that she should: a. take tub baths with bubble bath b. urinate before and after sexual intercourse c. take prophylactic sulfonamides for the rest of her life d. restrict fluid intake to prevent the need for frequent voiding
b. urinate before and after sexual intercourse
patient with acute hepatitis b is being discharged. the discharge teaching plan should include instructions to: a. avoid alcohol for the first three weeks b. use a condom during sexual intercourse c. have family members get an injection of immunoglobulin d. follow low protein, moderate carbohydrate, moderate fat diet
b. use a condom during sexual intercourse
the nurse is completing a follow-up visit with an 8-year-old child with PKD. which statement by the parent is most concerning: a. "my son seems to drink a lot of water during the day" b. "he doesn't seem to make friends very easily and would rather play alone" c. "his new shoes i just bought last week are already too tight" d. "my spouse is facing a job change, an we expect different insurance soon"
c. "his new shoes i just bought last week are already too tight" -PKD typically follows CKD, and we know edema is a sign of CKD -drinking a lot is not a concern if patient is urinating (we do not know if urinating - do not want to assume he is not)
patient is having an esophagoenterostomy with anastomosis of a segment of the colon to replace the resected portion. what initial postoperative care should the nurse expect when this patient returns to the nursing unit: a. deep breathe, cough, and use spirometer every 4 hours b. maintain an upright position for at least 2 hours after eating c. NG will have bloody drainage and it should not be repositioned d. keep in a supine position to prevent movement of the anastomosis
c. NG will have bloody drainage and it should not be repositioned -semi fowler's to prevent reflux and aspiration of secretions
the pernicious anemia that may accompany gastritis is due to: a. chronic autoimmune destruction of cobalamin stores in the body b. progressive gastric atrophy from chronic breakage in the mucosal barrier and blood loss c. a lack of intrinsic factor normally produced by acid-secreting cells of the gastric mucosa d. hyperchlorhydria from an increase in acid-secreting parietal cells and degradation of RBCs
c. a lack of intrinsic factor normally produced by acid-secreting cells of the gastric mucosa
when caring for the patient with heart failure, the nurse knows that which gastrointestinal process is most dependent on cardiac output and may affect the patient's nutritional status: a. ingestion b. digestion c. absorption d. elimination
c. absorption -cardiac output provides blood flow for absorption
the patient with chronic gastritis is being put on a combination of medications to eradicate h. pylori. which drugs does the nurse know will probably be used: a. antibiotic(s), antacid, and corticosteroid b. antibiotic(s), aspirin, and antiulcer/protectant c. antibiotic(s), proton pump inhibitor, and bismuth d. antibiotic(s) and nonsteroidal antiinflammatory drugs (NSAIDs)
c. antibiotic(s), proton pump inhibitor, and bismuth
nurse is caring for a postoperative patient who has just vomited yellow-green liquid. which action would be an appropriate nursing intervention: a. offer the patient an herbal supplement such as ginseng b. discontinue medications that may cause nausea or vomiting c. apply a cool washcloth to the forehead and provide mouth care d. take the patient for a walk in the hallway to promote peristalsis
c. apply a cool washcloth to the forehead and provide mouth care -do not dc without consent from HCP
patient with abdominal pain is being prepared for surgery to make an incision into the common bile duct to remove stones. what procedure will the nurse prepare the patient for: a. colectomy b. cholecystectomy c. choledocholithotomy d. choledochojejunostomy
c. choledocholithotomy -colectomy: removal of colon -cholecystectomy: removal of gallbladder
patient with a GI problem reports generalized weakness, sweating, palpitations, and dizziness 15 to 30 minutes after eating. what long-term complication does the nurse suspect is occurring: a. malnutrition b. bile reflux gastritis c. dumping syndrome d. postprandial hypoglycemia
c. dumping syndrome
after an exploratory laparotomy, a patient on a clear liquid diet reports severe gas pains and abdominal distention. which action by the nurse is most appropriate: a. return the patient to NPO status b. place cool compresses on the abdomen c. encourage the patient to ambulate as ordered d. administer an as-needed dose of IV morphine sulfate
c. encourage the patient to ambulate as ordered
patient is admitted to the emergency department after a motor vehicle crash with suspected abdominal trauma. what assessment finding by the nurse is of highest priority: a. nausea and vomiting b. hyperactive bowel sounds c. firmly distended abdomen d. abrasions on all extremities
c. firmly distended abdomen
when the nurse is assessing the health perception-health maintenance pattern as related to GI function, an appropriate question to ask is: a. what is your usual bowel elimination pattern b. what percentage of your income is spent on food c. have you traveled to a foreign country in the last year d. do you have diarrhea when you are under a lot stress
c. have you traveled to a foreign country in the last year
patient has a sliding hiatal hernia. what priority nursing intervention will reduce the symptoms of heartburn and dyspepsia: a. keeping the patient NPO b. putting the bed in the trendelenburg position c. having the patient eat 4 to 6 smaller meals each day d. iving various antacids to determine which one works for the patient
c. having the patient eat 4 to 6 smaller meals each day
if a patient is in the diuretic of AKI, the nurse must monitor for which serum electrolyte imbalance: a. hyperkalemia and hyponatremia b. hyperkalemia and hypernatremia c. hypokalemia and hyponatremia d. hypokalemia and hypernatremia
c. hypokalemia and hyponatremia -diuretics get rid of potassium and sodium in the body
patient is recovering in the intensive care unit (ICU) 24 hours after receiving a kidney transplant. what is an expected assessment finding during the earliest stage of recovery: a. hypokalemia b. hyponatremia c. large urine output d. leukocytosis with cloudy urine output
c. large urine output -typical to have diuresis after transplant
to assess the patency of a newly places arteriovenous graft for dialysis, the nurse should (select all that apply): a. irrigate the graft daily with low-dose heparin b. monitor for any increase of BP in the affected arm c. listen with a stethoscope over the graft for presence of a bruit c. palpate the area of the graft to feel a normal thrill e. assess the pulses and neurovascular status distal to the graft
c. listen with a stethoscope over the graft for presence of a bruit c. palpate the area of the graft to feel a normal thrill e. assess the pulses and neurovascular status distal to the graft
patient admitted to the emergency department after a motor vehicle accident. which urinalysis findings would the nurse expect if kidney trauma occurred (select all that apply): a. glucose b. bilirubin c. myoglobinuria d. red blood cells e. white blood cells
c. myoglobinuria d. red blood cells
the nurse is caring for a patient with risk for incomplete bladder emptying. which noninvasive finding best supports the problem: a. patient is able to void additional 100 mL after nurses massages over the bladder b. patient voids additional 350 mL with insertion of an intermittent catheter c. patient has a post void residual of 275 mL documented by bedside bladder scanner d. patient has constant dribbling between voiding
c. patient has a post void residual of 275 mL documented by bedside bladder scanner
patient with an intestinal obstruction has a nasogastric (NG) tube to suction but reports of nausea and abdominal distention. the nurse irrigates the tube as necessary as ordered, but the irrigating fluid does not return. What should be the priority action by the nurse: a. notify the provider b. auscultate for bowel sounds c. reposition the tube and check for placement d. remove the tube and replace it with a new one
c. reposition the tube and check for placement
when caring for a patient with nephrotic syndrome, which food selection indicates the patient understands the dietary teaching provided: a. peanut butter and crackers b. one small grilled pork chop c. salad made of fresh vegetables d. spaghetti with canned spaghetti sauce
c. salad made of fresh vegetables
patient is suspected of having acute pancreatitis after presenting to the emergency department with severe abdominal pain. which laboratory result would indicate the presence of acute pancreatitis: a. gastric pH of 1.4 b. blood glucose of 104 c. serum amylase of 820 U/L d. serum potassium of 3.5 mEq/L
c. serum amylase of 820 U/L
the RN is supervising an LPN, who is providing care for a patient with type two diabetes who is to have a renal computer tomography (CT) scan with contrast tomorrow morning. which instruction would the RN be sure to provide the LPN: a. remind the patient that the purpose of the scan is to measure kidney function b. tell the AP to remove the patient's water pitcher from the bedside at 10 PM c. the patient's metformin should be discontinued 24 hours before the procedure d. keep the patient on bedrest for at least eight hours after returning to the unit
c. the patient's metformin should be discontinued 24 hours before the procedure
after the nurse teaches a patient with gastroesophageal reflux disease (GERD) about recommended dietary modifications, which statement by the patient indicates that the teaching has been effective: a. can have a glass of low-fat milk at bedtime b. will have to eliminate all spicy foods from my diet c. will have to use herbal teas instead of caffeinated drinks d. should keep something in my stomach all the time to neutralize the excess acids
c. will have to use herbal teas instead of caffeinated drinks
patient was involved in a motor vehicle crash and reports an inability to have a bowel movement. what is the best response by the nurse: a. your parasympathetic nervous system is now working to slow the GI tract. b. the circulation in the GI system has been increased, so less waste is removed. c. your sympathetic nervous system was activated, so there is slowing of the GI tract d. you may have bruised your intestines, so no stool will be produced for a few days
c. your sympathetic nervous system was activated, so there is slowing of the GI tract
the nurse is reviewing the home medication list for a patient admitted with suspected hepatic failure. which medication could cause hepatotoxicity: a. digoxin b. nitroglycerin c. ciprofloxacin d. acetaminophen
d. acetaminophen
the problem of constipation related to compression of the intestinal tract has been identified in a patient with CKD. which care action should the nurse assign to a LPN: a. instructing the patient about foods that are high in fiber b. teaching the patient about foods that assist in promoting bowel regularity c. assessing the patient for previous bowel problems and bowel routine d. administering docusate sodium 100mg by mouth twice a day
d. administering docusate sodium 100mg by mouth twice a day
the nurse recommends genetic counseling for the children of a patient with: a. nephrotic syndrome b. chronic pyelonephritis c. malignant nephrosclerosis d. adult-onset polycystic kidney disease
d. adult-onset polycystic kidney disease
the nurse teaches a patient with chronic kidney disease about prevention of complications. What should the nurse include in the teaching plan: a. monitor for proteinuria daily with a urine dipstick b. perform self-catheterization every 4 hours to measure urine c. take calcium-based phosphate binders on an empty stomach d. check weight daily and report a gain of greater than 4 pounds
d. check weight daily and report a gain of greater than 4 pounds
nurse asks a patient scheduled for colectomy to sign the operative permit as directed in the provider's preoperative orders. the patient states that the provider has not explained very well what is involved in the surgical procedure. what is the most appropriate action by the nurse: a. ask family members whether they have discussed the surgical procedure with the provider b. explain the planned surgical procedure as well as possible and have the patient sign the consent form c. have the patient sign the form and state the provider will visit to explain the procedure before surgery d. delay the patient's signature on the consent and notify the provider about the conversation with the patient
d. delay the patient's signature on the consent and notify the provider about the conversation with the patient
when teaching the patient about the diet for diverticular disease, which foods should the nurse recommend: a. white bread, cheese, and green beans b. fresh tomatoes, pears, and corn flakes c. oranges, baked potatoes, and raw carrots d. dried beans, All Bran (100%) cereal, and raspberries
d. dried beans, All Bran (100%) cereal, and raspberries -high fiber diet
patient reports severe pain when the nurse assesses for rebound tenderness. what may this assessment finding indicate: a. hepatic cirrhosis b. hypersplenomegaly c. gallbladder distention d. peritoneal inflammation
d. peritoneal inflammation -appendix
the nurse is teaching the patient and family that peptic ulcers are: a. caused by stressful lifestyle and other acid-producing factors, such as h. pylori b. inherited within families and and reinforced by bacterial spread of staphylococcus aureus in childhood c. promoted by factors that cause over secretion of acid, such as excess dietary fats, smoking, and alcohol use d. promoted by a combination of factors that cause erosion of the gastric mucosa, including certain drugs and h. pylori
d. promoted by a combination of factors that cause erosion of the gastric mucosa, including certain drugs and h. pylori
the nurse is providing care for a 24-year-old female patient admitted to the acute care unit with a diagnosis of cystitis. which intervention should the nurse delegate to the assistive personnel: a. teaching the patient how to secure a clean catch urine sample b. assessing the patient's urine for color, odor and sediment c. reviewing the nursing care plan and adding nursing interventions d. providing the patient with a clean catch urine sample container
d. providing the patient with a clean catch urine sample container
caring for a patient during the oliguric phase of acute kidney injury (AKI), which nursing action is appropriate: a. weigh patient three times weekly b. increase dietary sodium and potassium c. provide a low-protein, high-carbohydrate diet d. restrict fluids according to previous daily loss
d. restrict fluids according to previous daily loss
patient was admitted with epigastric pain because of a gastric ulcer. which patient assessment warrants an urgent change in the nursing plan of care? a. back pain 3 or 4 hours after eating a meal b. chest pain relieved with eating or drinking water c. burning epigastric pain 90 minutes after breakfast d. rigid abdomen and vomiting following indigestion
d. rigid abdomen and vomiting following indigestion
the nurse has delegated collection of a urinalysis specimen to an experienced assistive personnel. for which action should the nurse interviene: a. the AP provides the patient with a specimen cup b. the AP reminds the patient of the need for the specimen c. the assists the patient to the bathroom d. the AP allows the specimen to sit for more than one hour
d. the AP allows the specimen to sit for more than one hour