Week 4 Jeopardy: Advanced

Which dietary modification is used for a client diagnosed with acute pancreatitis? A.High-protein diet B.Elimination of coffee C.Low-carbohydrate diet D.High-fat diet

B.Elimination of coffee

A client presents with right lower quadrant pain, temperature of 101°F (38.3°C) and a white blood cell count of 14,000. Which will the nurse prioritize when caring for the client? Select all that apply. A.Administer pain medication as prescribed. B.Prepare the client for surgery. C.Start an intravenous line. D.Begin the administration of antibiotics as prescribed. E.Notify family members of the client's admission.

A.Administer pain medication as prescribed. B.Prepare the client for surgery. C.Start an intravenous line. D.Begin the administration of antibiotics as prescribed.

A client is diagnosed with a peptic ulcer after having an upper endoscopy procedure. Which medication regimen will the nurse educate the client regarding? Select all that apply. A.Bismuth salts B.Antibiotics C.Bicarbonate salts D.Proton pump inhibitors (PPIs) E.Histamine-2 (H2) antagonists F.Antivirals

A.Bismuth salts B.Antibiotics D.Proton pump inhibitors (PPIs)

A nurse cares for a client who is post op open cholecystectomy. Upon assessment, the nurse notes the client's abdomen feels firm to palpation. What is the nurse's priority action? A.Contact the health care provider B.Auscultate the bowel sounds C.Ask the client the last bowel movement date D.Prepare to insert a nasogastric tube to intermittent suction

A.Contact the health care provider

A nurse is aware that both the sympathetic and parasympathetic portions of the autonomic nervous system affect GI motility. What are the actions of the sympathetic nervous system? Select all that apply. A.Decreases gastric motility B.Relaxes the sphincters C.Increases secretary activities D.Causes blood vessel constriction E.Creates an inhibitory effect on the GI tract

A.Decreases gastric motility D.Causes blood vessel constriction E.Creates an inhibitory effect on the GI tract

A client is admitted to the medical unit with a diagnosis of intestinal obstruction. When planning this client's care, which of the following nursing diagnoses should the nurse prioritize? A.Ineffective tissue perfusion related to bowel ischemia B.Imbalanced nutrition: Less than body requirements related to impaired absorption C.Anxiety related to bowel obstruction and subsequent hospitalization D.Impaired skin integrity related to bowel obstruction

A.Ineffective tissue perfusion related to bowel ischemia

A client admitted for treatment of a gastric ulcer is being prepared for discharge. The client will follow a regimen of antacid therapy. Discharge teaching should include which instruction(s)? Choose all that apply. A."Continue to take antacids even if your symptoms subside." B."You may take antacids with other medications." C."Longer treatment durations lead to higher success." D."Be sure to take antacids with meals." E."The antacids will make you sleepy, so do not operate machinery while taking them."

A."Continue to take antacids even if your symptoms subside." C."Longer treatment durations lead to higher success."

A client's assessment and diagnostic testing are suggestive of acute pancreatitis. When the nurse is performing the health interview, what assessment question(s) addresses likely etiologic factors? Select all that apply. A."How many alcoholic drinks do you typically consume in a week?" B."Have you ever been tested for diabetes?" C."Have you ever been diagnosed with gallstones?" D."Would you say that you eat a particularly high-fat diet?" E."Does anyone in your family have cystic fibrosis?"

A."How many alcoholic drinks do you typically consume in a week?" B."Have you ever been tested for diabetes?" C."Have you ever been diagnosed with gallstones?" D."Would you say that you eat a particularly high-fat diet?"

A client is diagnosed with a disorder that affects pancreatic digestive enzymes, and their typsin levels are elevated. The client has jaudice and verbalizes severe abdominal pain. The nurse most likely anticipates which condition? A.Acute pancreatitis B.Choledochostomy C.Steatorrhea D.Cholecysitis

A.Acute pancreatitis

A client who experienced an upper gastrointestinal (GI) bleed due to peptic ulcer disease has had the bleeding controlled and is now in stable condition. Which assessment finding(s) would the nurse identify that indicate recurrence? Select all that apply. A.Tachycardia B.Tarry, foul-smelling stools C.Diaphoresis D.Sudden thirst E.Hypotension F.Tachypnea

A.Tachycardia E.Hypotension F.Tachypnea

The nurse knows that the client with cholelithiasis can have a nutritional deficiency. The obstruction of bile flow due to cholelithiasis can interfere with the absorption of A.Vitamin A B.Vitamin B6 C.Vitamin B12 D.Vitamin C

A.Vitamin A

The nurse is caring for a client with a duodenal ulcer. Which assessment findings indicate to the nurse that the client is experiencing perforation from the ulcer? Select all that apply. A.Vomiting B.Tender and rigid abdomen C.Sudden drop in blood pressure D.Pulsating mass in the left abdominal region E.Abdominal pain referred to the right shoulder

A.Vomiting B.Tender and rigid abdomen C.Sudden drop in blood pressure E.Abdominal pain referred to the right shoulder

A client has been prescribed cimetidine for the treatment of peptic ulcer disease. When providing relevant health education for this client, the nurse should ensure the client is aware of what potential outcome? A.Bowel incontinence B.Drug-drug interactions C.Abdominal pain D.Heat intolerance

B.Drug-drug interactions

A client has had a laparoscopic cholecystectomy. The client is now reporting right shoulder pain. What should the nurse suggest to relieve the pain? A.Aspirin every 4 to 6 hours as prescribed B.Application of heat 15 to 20 minutes each hour C.Application of an ice pack for no more than 15 minutes D.Application of liniment rub to affected area

B.Application of heat 15 to 20 minutes each hour

A client's enteral feedings have been determined to be too concentrated based on the client's development of dumping syndrome. What physiologic phenomenon caused this client's complication of enteral feeding? A.Increased gastric secretion of HCl and gastrin because of high osmolality of feeds B.Entry of large amounts of water into the small intestine because of osmotic pressure C.Mucosal irritation of the stomach and small intestine by the high concentration of the feed D.Acid-base imbalance resulting from the high volume of solutes in the feed

B.Entry of large amounts of water into the small intestine because of osmotic pressure

What is the most common cause of small-bowel obstruction? A.Hernias B.Neoplasms C.Adhesions D.Volvulus

C.Adhesions

A nurse is providing education for a client diagnosed with peptic ulcer disease secondary to chronic nonsteroidal anti-inflammatory drug (NSAID) use. The client has recently been prescribed misoprostol. Which information will the nurse include in client education about the drug? Select all that apply. A.It reduces the stomach's volume of hydrochloric acid B.It increases the speed of gastric emptying C.It protects the stomach's lining D.It increases lower esophageal sphincter pressure E.It should be taken with food

C.It protects the stomach's lining E.It should be taken with food

A client is treated for gastrointestinal problems related to chronic cholecystitis. What pathophysiological process related to cholecystitis does the nurse understand is the reason behind the client's GI problems? A.Contractile spasms of the gallbladder decreases appetite and leads to malnutrition. B.Inflammation of the gallbladder causes pain and impacts gastric motility. C.Reduced or absent bile as a result of obstruction impacts digestion. D.Increased bile as a result of inflammation leads to indigestion.

C.Reduced or absent bile as a result of obstruction impacts digestion.

A client had a laparoscopic cholecystectomy and is being prepared for discharge home. When providing health education, the nurse should prioritize which topic(s)? Select all that apply. A.Management of fluid balance in the home setting B.The need for blood glucose monitoring for the next week C.Signs and symptoms of intra-abdominal complications D.Appropriate use of prescribed pancreatic enzymes E.Management of shoulder pain from gas insufflation.

C.Signs and symptoms of intra-abdominal complications E.Management of shoulder pain from gas insufflation.

A client with a peptic ulcer asks, "How does something that goes into my lungs, like smoking, affect my stomach?" Which response by the nurse is most appropriate? A."Smoking is overall bad for the health." B."Smoking decreases gastric acid secretion." C."Cigarette smoke contains irritants that affects all body organs." D."Smoking reduces the amount of bicarbonate needed to buffer stomach acid."

D."Smoking reduces the amount of bicarbonate needed to buffer stomach acid."

A nurse cares for a client who is post op cholecystectomy due to the development of cholesterol stones. The client asks the nurse, "Why did I develop these stones?" What is the nurse's best response? A."The stones formed from pigments in the bile and are caused by an infection of the biliary tract." B."The stones formed from a component in the bile and are caused by excessive fat in the bloodstream." C."The stones formed from pigments in the bile and are cause by fatty molecules that deposit in the gallbladder." D."The stones formed from a component in the bile and are caused by bile acid and fat abnormalities in the bloodstream."

D."The stones formed from a component in the bile and are caused by bile acid and fat abnormalities in the bloodstream."

After teaching a group of students about intestinal obstruction, the instructor determines that the teaching was effective when the students identify which of the following as a cause of a functional obstruction? A.Volvulus B.Intussusception C.Tumor D.Abdominal surgery

D.Abdominal surgery

A client returns to the outpatient unit after a laparoscopic cholecystectomy. Which signs and symptoms indicate to the nurse the client is experiencing a complication of the surgical procedure? Select all that apply. A.Hyperglycemia B.Pressure wound on the sacrum C.Wound evisceration D.Bile duct injury E.Bile peritonitis

D.Bile duct injury E.Bile peritonitis

The nurse is caring for a client who is suspected to have developed a peptic ulcer hemorrhage. Which action should the nurse include in the plan of care? A.Prepare the client for emergency antrectomy. B.Insert a nasogastric tube to drain stomach contents. C.Assess vital signs every shift. D.Monitor hourly urine output.

D.Monitor hourly urine output.

The nurse observes the physician palpating the abdomen of a client that is suspected of having acute appendicitis. When the abdomen is pressed in the left lower quadrant the client complains of pain on the right side. What does the nurse understand this assessment technique is referred to? •Referred pain •Rebound pain •Rovsing sign •Cremasteric reflex

•Rovsing sign