Presentation Questions (Med/Surg)
A severely obese patient has undergone Roux-en-Y gastric bypass surgery. In planning postoperative care, the nurse anticipates that the patient:
may have only liquids orally, and in very limited amounts, during the postoperative period.
The charge nurse is going over a client chart with a newly licensed nurse. She asked her what is the most accurate test to diagnose renal stones?
renal ultrasound
After bariatric surgery, a patient who is being discharged tells the nurse, "I prefer to be independent. I am not interested in any support groups." Which response by the nurse is best?
"Tell me what types of resources you think you might use after this surgery."
A 76 year old female is admitted due to a recent fall. The patient is confused and agitated. The family members report that this is not normal behavior for the patient. They explain that the patient is very active in the community and cares for herself. Based on the information you have gathered about the patient, which physician's order takes priority?
"Collect a urinalysis"
The nurse understands that additional teaching is needed when the patient states which of the following?
"I need to limit my fluid intake to decrease stress on my kidneys"
You're developing a nursing care plan for a patient with a kidney stone. Which of the following nursing interventions will you include in the patient's plan of care?
Strain the urine with every void
Nitrofurantoin (Macrodantin), 75 mg 4 times per day, has been prescribed for a clinet with a lower urinary tract infection. The medication comes in an oral suspension of 25 mg/5mL. How many mL should the nurse administer for each dose?
15 mL
A client asks what causes gallstones to form. Which factor should the nurse explain as being present when these stones are formed?
Abnormal bile composition, Excess cholesterol, Inflammation of the gallbladder, Biliary stasis
A client scheduled for a cholecystectomy asks what caused the gallstones to develop. Which risk factor should the nurse list when responding to this client?
American Indian ethnicity, Family history of gallstones, Obesity, Hyperlipidemia
You're assessing patients during morning rounding. Which patient below is MOST at risk for developing a UTI?
An 87 year old female with Alzheimer's disease who is experiencing bowel incontinence.
The nurse prepares discharge teaching for a client recovering from a cholecystectomy. Which topic should the nurse include in this teaching?
Surgical incision care, Manifestations of postoperative complications, Pain control measures, activity level
The nurse is examining a 15 year old female who is complaining of pain, and frequency and urgency when urinating. After asking the parents to leave the room, which question should the nurse ask first?
Are you sexually active?
The client with gastroesophageal reflux disease (GERD) complains of a chronic cough. The nurse understands that in a client with GERD this symptom may be indicative of which of the following conditions?
Aspiration of gastric contents
Which physical examination should the nurse implement first when assessing the client diagnosed with peptic ulcer disease?
Auscultate the client bowel sounds in all four quadrants
The HCP put in an order for a client to have a cystoscopy. The client is currently being treated for a UTI. Which of the following should the nurse do?
Call the doctor
An 8 year old female was just diagnosed with a UTI. Which medication would you expect the HCP to prescribe?
Cephalexin
A 54 year old client comes into the ED with a tendon rupture and irregular heart rhythm. She states she is on an antibiotic to treat a UTI. Which medication would you suspect she is taking?
Ciprofloxacin
The client in an outpatient clinic is being sent home with a diagnosis of urinary tract infection (UTI). Which instruction should the nurse teach to prevent a reoccurrence of a UTI?
Clean perineum from front to back after a bowel movement, Avoid coffee, teas, sodas and alcoholic beverages
The nurse is teaching the parents of an 18-month-old female toddler with a urinary tract infection (UTI). Which should be included in the teaching to prevent the future risk of UTI?
Cleanse the perineal area front to back.
Which assessment data support to the nurse the client's diagnosis of gastric ulcer?
Complaint of epigastric pain 30-60 minutes after ingesting food
The nurse is caring for a client experiencing urinary retention. Which preventative catheter associated urinary tract infection (CAUTI) measure should the nurse take to protect the client from a urinary tract infection (UTI)?
Consider an alternative to an indwelling catheter
A client with acute cholecystitis is experiencing nausea and vomiting. Which nursing action should the nurse use to address this client's nutritional status?
Counseling regarding low-fat menu choices, Administering antiemetics as prescribed, Assessing height and weight, reviewing serum electrolytes
The nurse will be teaching self-management to patients after gastric bypass surgery. Which information will the nurse plan to include?
Drink fluids between meals but not during meals.
The nurse is caring for a postpartum client. Which intervention is the most important for the nurse to integrate into the plan of care to prevent a urinary tract infection (UTI)?
Empty the bladder completely
A middle aged female client who is obese has been experiencing right upper quadrant abdominal pain for the past several hours. For which risk factors of gallstone development should the nurse assess this client during the health history?
Excess cholesterol, inflammation of the gallbladder, biliary stasis, Abnormal bile composition
The physician orders a urine culture on your patient in room 5505 with a urinary tract infection. In addition, the patient is ordered to start IV Bactrim (Sulfamethoxazole/Trimethoprim). How will you proceed with the following this order?
First, collect the urine culture, and then hang the antibiotic.
A pregnant client of American Indian heritage experiences mild gastric distress and nausea after eating large meals and constant shart abdominal pain. Which additional information should the nurse collect during the interview?
History of chronic diseases, length of time the symptoms last and when they occur, Other symptoms, current diet
The client is discussing treatment for her UTI with the nurse. Which statement made by the client indicates further teaching is needed?
I can stop taking this antibiotic once my pee doesn't burn."
The nurse is teaching a client with cholelithiasis about a new prescription for ursodiol. Which client statement indicates to the nurse that the teaching was successful?
I might have some slight diarrhea or constipation, but that is a normal side effect of the medicine.
The nurse evaluates a client's understanding of discharge teaching following a laparoscopic cholecystectomy. Which client statement indicates teaching has been effective?
I will take my pain medicine on an empty stomach to get the maximum benefit; I will be sure to get up and walk every hour; I will increase the protein in my diet by drinking whole milk
The nurse is teaching a client with cholelithiasis about lifestyle modification. Which statement made by the client indicates that the nurse's teaching has been successful?
I will walk three time a week for 20 minutes each
A nurse is evaluating discharge instructions to a client admitted for urolithiasis. Which of the following statements made by the client indicates to the nurse a need for further instruction?
If I drink at least 2000 mL of fluid per day
The nurse is discharging a client with a health-care facility acquired UTI. Which information should the nurse include in the discharge teaching?
Take all the medications as prescribed.
The nurse is teaching a client ways to prevent UTI's from occurring. The nurse knows that the client needs further teaching when she says:
It is ok if I wear spanx, I can continue douching and using body sprays and powder, I will wipe back to front.
A nurse is assisting with a client who is diagnosed with renal stones. Which medication would the nurse administer to the client who has mild pain?
Ketorolac
The daughter of your client is asking how to prevent cystitis/UTI's for her elderly mother with dementia. Which of the following is the best response?
Making sure she is wiping correctly after using the restroom is very important
A client is experiencing pain and nausea related to biliary colic. Which statement should the nurse make to manage this client's symptoms?
Medication will help with the nausea and vomiting, Intravenous fluids will ensure that you are well hydrated, It's important for you to be comfortable so that you can rest, Pain medication will be prescribed
A client is recovering from a laparoscopic cholecystecotomy. Which nursing action should the nurse use to reduce the client's risk of infection?
Monitor vital signs, including temperature, every 4 hours; Administer antibiotics as prescribed; Coach to take deep breaths every 1-2 hours while awake; Assess the abdomen every 4 hours
A client is experiencing severe upper abdominal pain and jaundice. Which finding on the cholescintigraphy should indicate to the nurse that the client has cholelithiasis?
Obstruction of the cystic duct by a gallstone
A client with acute cholecystitis is experiencing jaundice. Which should the nurse consider as the reason for jaundice?
Obstruction of the cystic duct by a gallstone
The nurse is obtaining a health history from a client who has a sliding hiatal hernia associated with reflux. The nurse should ask the client about the presence of which of the following symptoms?
heartburn
A nurse has admitted a client to the unit for treatment of acute pyelonephritis. Which collaborative intervention does the nurse anticipate initiating as a priority?
Order for a urine specimen for culture and sensitivity
Which problem should the nurse include in the plan of care for the client diagnosed with peptic ulcer disease to observe for physiological complications?
Potential for alteration in gastric emptying
Which is a risk factor for gallbladder disease?
Rapid weight loss
The nurse is preparing health promotion teaching for a client with gallbladder disease. Which topic should the nurse include in the teaching session?
Role of a high-cholesterol diet on gallstone formation, Importance of a low cholesterol diet, Dangers of rapid weight loss, Importance of a high-fiber diet
A client with right upper quadrant abdominal pain asks why so many tests are being scheduled. Which is the reason that the nurse should give to this client?
To identify possible complications, To determine if gallstones are present, To determine the location of gallstones, To diagnose the disorder
A patient is with dementia in a LTC facility has been hitting the call light every 5 minutes. Each time she is changed there is only a tiny amount of urine. Which test would you expect the HCP to order?
UA via intermittent catheter
A client with choleithiasis is not a surgical candidate at this time. Which pharmacologic ereatment should the nurse expect to be prescribed for this client?
Ursodiol, Chenodiol, Antibiotics, Cholestyramine
Which specific data should the nurse obtain from the client who is suspected of having peptic ulcer disease?
Use of nonsteroidal anti-inflammatory drugs (NSAID's)
A client who is morbidly obese is diagnosed with acute cholelithiasis. Which nonpharmacologic therapy should the nurse expect to be prescribed for this client?
Withholding all oral intakes and inserting a nasogastric tube.
The nurse is planning an educational program about development and prevention of gallstones for a community group. Which population should the nurse identify to be most as risk for developing gallstones?
Woman over the age of 40
The nurse is caring for a client diagnosed with a urinary tract infection (UTI). Which assessment finding supports this diagnosis?
abdominal pain, burning sensation during urination, flank pain
The nurse is providing dietary teaching to a client with a history of gallstones. Which diet should the nurse recommend?
high protein, low fat
Which topic is important to include in the home care teaching for a client with a urinary tract infection (UTI)?
adequate fluid consumption, good hygiene methods, proper nutrition
Which of the following factors would most likely contribute to the development of a clients hiatal hernia?
being 5 feet, 3 inches tall and weighing 190 lb
Timothy comes in for a follow up about his kidney stones. The nurse determines he has an understanding of the foods he should avoid when he names which foods:
chocolate, spinach, beets
What is the most common pathogen in acute, uncomplicated pyelonephritis?
e. coli
Which of the following dietary measures would be useful in preventing esophageal reflux?
eating small, frequent meals
The nurse is caring for a client diagnosed with rule out peptic ulcer disease. Which test confirms this diagnosis?
esophagogastroduodenoscopy
A client is admitted to the emergency department for possible acute pyelonephritis. Which manifestation should the nurse consider to be consistent with this disorder?
flank pain, nocturia, urinary frequency
