UWorld - Gastro

A nurse is caring for a client who developed paralytic ileus after a stroke. The client reports nausea. abdominal discomfort, and distention, bowel sounds are absent Which prescription does the nurse question? a. hydrocodone 5/325 mg 1 tab every 4 hours PRN for moderate pain b. increase continuous IV normal saline rate from 75 to 100 mL/hr c. insert NGT and attach to wall suction d. Ondansetron 4 mg IVP every 4 hours PRN for nausea

A

during the immediate postoperative period after a colostomy, which stoma assessment requires the nurse to contact the HCP immediately? a. brick red with slight moisture b. dusky with moderate edema c. pink with slight oozing of blood d. red with no stool produced

B

the registered nurse is developing a nursing care plan for a client who has just undergone surgery for treatment of ulcerative colitis with the creation of a permanent ileostomy. What is the priority outcome for this client? a. the client with contact the united ostomy association of america b. the client will look at and touch the stoma c. the client will read the materials provided on ostomy care d. the client will verbalize methods to control gas and odor

B

Which prescription should the nurse question when caring for a client hospitalized with acute diverticulitis? a. metronidazole 500 mg IV every 8 hours b. NGT to suction c. NPO d. prepare for barium enema in AM

D

The nurse is caring for a client who had an open appendectomy 24 hours ago. Based on the clients clinical data, which of the health care providers new prescriptions should the nurse clarify? a. advance the client to regular diet b. ambulate 3 times daily postoperative day 1 c. increase IV normal saline rate from 20 mL/hr to 100 mL/hr d. remove indwelling urinary catheter

A

The nurse is caring for a client with liver cirrhosis. Which of the following assessment findings would warrant immediate follow up? a. black, tarry stool b. bright red-streaked stool c. light fray clay-colored stool d. small, dry, rocky stools

A

The nurse is caring for a client with suspected colorectal cancer. Which of the following findings would support a diagnosis of colorectal cancer? SATA a. fatigue b. blood in the stool c. change in bowel habits d. unintentional weight loss e. elevated hemoglobin level

A, B, C, D

which instructions should the nurse include when providing discharge teaching to a client with peptic ulcer disease due to H. pylori infection? SATA a. "avoid foods that may cause epigastric distress such as spicy or acidic foods" b. "it is best if you refrain from consuming alcohol products" c. "report black tarry stools to your HCP immediately" d. "take your amoxicillin, clarithromycin and omeprazole for the next 14 days" e. "you may take OTC drugs such as aspirin if you have mild epigastric p

A, B, C, D

the nurse is teaching a client newly diagnosed with lactose deficiency about dietary management. Which statements by the client indicate a correct understanding of this condition? SATA a. "i can still eat cheese and yogurt as long as they dont make me feel sick" b. "i should take a daily calcium and vitamin D supplement" c. "most dairy products should be eliminated from my diet but ice cream is ok" d. "my lactose enzyme supplement should be taken with meals containing dairy" e. "this means that

A, B, D

the nurse prepares to admit a client with worsening cirrhosis who is on the waiting list for a liver transplant. Based on the clients electronic health record the nurse anticipates which assessment findings? SATA a. ascites b. bruising c. constipation d. itching e. lethargy

A, B, D, E

which nursing intervention would the nurse implement when caring for a client newly diagnosed with acute, viral hepatitis B? SATA a. offer small frequent meals to prevent nausea b. promote rest periods between periods of activity c. provide a diet high in fat and low in carbohydrate d. teach the client not to share razors or toothbrushes with others e. teach the client to abstain from drinking alcohol

A, B, D, E

The nurse is caring for a client who had an endoscopic procedure yesterday to stop upper GI bleeding and who started a clear liquid diet today. Which of the following foods would be appropriate to offer to this client? SATA a. apple juice b. chicken broth c. cranberry juice d. cream of chicken soup e. unsweetened tea f. vanilla ice cream

A, B, E

the nurse is taking a client who is scheduled for a screening colonoscopy. the client asks, "what should I know about this procedure?". Which of the following information should the nurse include? SATA a. "the procedure is not painful, and you will be sedated" b. "your abdomen should feel firm and distended after the procedure" c. "you will need to avoid consuming red liquids prior to the procedure" d. "colonoscopies are performed to screen for colon cancer and colon polyps" e. "you will be give

A, C, D, E

the nurse is reviewing lifestyle and nutritional strategies to help reduce symptoms in a client with newly diagnosed GERD. which strategies should the nurse include? SATA a. choose foods that are low in fat b. do not consume any food containing dairy c. eat three large meals a day and minimize snacking d. limit or eliminate the use of alcohol and tobacco e. try to avoid caffeine, chocolate and peppermint

A, D, E

The nurse is providing nutritional teaching for a client with a new ileostomy. Which foods should the nurse instruct the client to avoid? SATA a. bananas b. broccoli with cheese c. multigrain bagel d. popcorn e. spaghetti with sauce

B, C, D

the nurse has taught the client with ulcerative colitis who is receiving prednisone. Which of the following statements by the client would indicate a correct understanding of the teaching? SATA a. "i should consume a low calorie, low protein diet" b. "i will participate in a smoking cessation program" c. "i should increase my daily fluid intake when I have diarrhea" d. "i will keep a journal to record what i eat and drink during the day" e. "i should avoid taking vitamins and supplements contain

B, C, D

The nurse is teaching a client with ulcerative colitis who has a new prescription for sulfasalazine. Which of the following information should the nurse include? SATA a. "avoid consuming foods high in protein" b. "take vitamin and mineral supplements daily" c. "apply a skin barrier cream for perianal irritation" d. "increase your daily fluid intake to at least 2000 mL" e. "continue taking sulfasalazine after your symptoms resolve"

B, C, D, E

A graduate nurse is caring for a client with acute appendicitis who is awaiting surgery. Which action by the graduate nurse would require the precepting nurse to intervene? a. administers morphine IV PRN for pain b. initiates continuous normal saline IV c. provides a heating pad for abdominal discomfort d. teaches client about prescribed strict NPO status

C

The nurse has taught a client who had a sigmoid colostomy created 3 days ago. Which of the following statements by the client would indicate a correct understanding of the teaching? a. "my stoma should appear dry and dark purple in color" b. "the opening of the pouch should be cut to the same size as my stoma" c. "i may irrigate my colostomy daily in order to regulate the passage of stool" d. "i will use a moisturizing lotion around my stoma before applying a new pouch"

C

The nurse is talking with a client with peptic ulcer disease. Which of the following statements by the client would require immediate follow up? a. "i was nauseous and vomited a small amount after lunch today" b. "after eating, I have pain in the middle of my upper abdomen' c. "for the past few days, I have felt dizzy when I stand up" d. "i feel very full and belch often after eating meals"

C

the nurse admits a client with cirrhosis who has an upper GI bleed from suspected gastroesophageal varcies. Which new prescription should the nurse question? a. administer pantoprazole IV piggyback every 12 hours b. initiate continuous octreotide IV infusion c. insert and maintain a NGT d. maintain NPO status except for PO medications

C

the nurse is caring for a client with ascites who is scheduled for a paracentesis. Which of the following actions should the nurse take? SATA a. explain the risks and benefits of the procedure and obtain informed consent b. encourage the client to ambulate immediately after the procedure c. request that the client empty the bladder before the procedure d. obtain baseline vitals, abdominal girth and weight e. initiate NPO status 12 hours prior to the procedure

C, D

the nurse is caring for a client with cirrhosis who has ascites, peripheral edema, shortness of breath, fatigue and generalized discomfort. which of the following actions should the nurse take? SATA a. assist the client to ambulate in the hallway every shift b. encourage the client to increase sodium intake c. maintain the client in semi-fowler position d. provide an alternating air pressure mattress for the client e. use music to provide a distraction for the client

C, D, E