Adult Health Exam 3-GI
Which statement by the client might indicate a precipitating factor of acute gastritis? A. "I really enjoy tequila" B. "I just started a new diet" C. "I try to walk 2 miles everyday D. "I never drink alcohol"
A
The nurse is teaching a class on diverticulosis. Which interventions should the nurse discuss when teaching ways to prevent an acute exacerbation of diverticulitis? Select all that apply. A. Eat a high-fiber diet B. Increase fluid intake C. Elevate the HOB after eating D. Walk 30 minutes a day E. Take an antacid every 2 hours
A, B, D
A client diagnosed as having an exacerbation of colitis. Which clinical findings would the nurse expect? Select all that apply. A. Fatigue B. Diarrhea C. Weight gain D. Spitting up blood E. Abdominal cramps
A, B, E
A client who had surgery for a perforated bowel develops peritonitis. What clinical findings related to peritonitis should the nurse expect the client to exhibit? Select all that apply. A. Fever B. Hyperactivity C. Extreme hunger D. Urinary retention E. Abdominal muscle rigidity
A, D, E
The nurse is caring for a client 1 day post-op sigmoid resection notes a moderate amount of dark, reddish-brown drainage on the midline abdominal incision. Which intervention should the nurse implement first? A. Mark the drainage on the dressing with the time and date B. Change the dressing immediately using sterile technique C. Notify the HCP immediately D. Reinforce the dressing with a sterile gauze pad
A
The nurse is caring for a client diagnosed with rule out peptic ulcer disease. Which test confirms this diagnosis? A. Esophagogastroduodenoscropy (EGD) B. Magnetic resonance imaging (MRI) C. Occult blood test D. Gastric acid stimulation test
A
Which clinical manifestation should the nurse expect to find in a client diagnosed with ulcerative colitis? A. Twenty bloody stools a day B. Oral temperature of 102F C. Hard, rigid abdoment D. Urinary stress incontinence
A
Which oral medication should the nurse question before administering to the client diagnosed with peptic ulcer disease? A. Celecoxib B. Omeprazole C. Metronidazole D. Acetaminophen
A
Which physical examination should the nurse implement first when assessing the client diagnosed with peptic ulcer disease? A. Auscultate bowel sounds in all 4 quadrants B. Palpate the abdominal area for tenderness C. Percuss the abdominal borders to identify organs D. Assess the tender area progressing to nontender
A
After a partial gastrectomy is performed, a client is returned to the surgical unit with IV fluids running and an NG tube. After 30 minutes the nurse identifies that there has been no NG drainage for 30 minutes. There is an order for irrigation of the NG tube PRN. The nurse should: A. Instill 30mL of NS and continue to suction B. Instill 30mL of air and clamp off the suction for 1 hour C. Instill 30mL of saline and increase the pressure of suction D. Instill 30mL of distilled water and disconnect the suction for 30 minutes
A
The client diagnosed with IBD is prescribed total parental nutrition (TPN). Which intervention should the nurse implement? A. Check the client's glucose level B. Administer an oral hypoglycemic C. Assess the peripheral IV site D. Monitor the client's oral food intake
A
The client diagnosed with a cute diverticulitis has a NG tube draining green liquid bile. Which intervention should the nurse implement? A. Document the findings as normal B. Assess the client's bowel sounds C. Determine the client's last bowel movement D. Insert the NG tube at least 2 more inches
A
The client diagnosed with acute diverticulitis is reporting severe abdominal pain. On assessment, the nurse finds a hard, rigid abdomen and temp of 102F. Which intervention should the nurse implement? A. Notify the HCP B. Prepare to administer a sodium phosphate enema C. Administer an antipyretic suppository D. Continue to monitor the patient closely
A
The client is diagnosed with Crohn's disease. Which statement by the client supports this diagnosis? A. "My pain is on the right lower side of my abdomen" B. "I have bright red blood in my stool all of the time" C. "I have episodes of diarrhea and constipation" D. "My abdomen is hard and rigid, and I have a fever"
A
The client is diagnosed with Salmonella infection secondary to eating some slightly cooked hamburger meat. Which clinical manifestations should the nurse expect the client to report? A. Abdominal cramping, nausea, vomiting B. Neuromuscular paralysis and dysphagia C. Gross amounts of explosive bloody diarrhea D. Frequent "rice-water stools" with no fecal odor
A
A nurse is teaching a client recovering from an acute exacerbation of colitis about the most appropriate diet. Which food/beverage selected by the client indicates that dietary teaching is effective? A. Peanuts B. Scrambled eggs C. Vanilla milkshake D. Coca-cola
B
The charge nurse has just received the shift report. Which client should the nurse see first? A. The client diagnosed with Crohn's disease who, on the previous shift, had 2 semi-formed stools B. The elderly client admitted from another facility, reporting constipation C. The client diagnosed with AIDS had a 200mL diarrhea stool and has elastic skin tissue turgor D. The client diagnosed with hemorrhoids having spots of bright red blood on the toilet seat
B
The client diagnosed with IBD has a serum potassium level of 3.4 mEq/L. Which action should the nurse implement first? A. Notify the HCP B. Assess the client for muscle weakness C. Request telemetry for the client D. Prepare to administer potassium IV
B
The client diagnosed with UC has an ileostomy. Which statement indicates the client needs more teaching concerning the ileostomy? A. "My stoma should be pink and moist" B. "I will irrigate my ileostomy every morning" C. "If I get a red, bumping, itchy rash, I will call my HCP" D. "I will change my pouch if it starts leaking"
B
The client is admitted to the medical floor with acute diverticulitis. Which collaborative intervention should the nurse anticipate the HCP ordering? A. Administer total parental nutrition (TPN) B. Maintain NPO and NG tube C. Maintain on a high-fiber diet and increase fluids D. Obtain consent for abdominal surgery
B
The client is diagnosed with an acute exacerbation of ulcerative colitis (UC). Which intervention should the nurse implement? A. Provide a low-residue diet B. Rest the client's bowel C. Assess the vital signs daily D. Administer antacids orally
B
The client reports unhappiness with the HCP to the nurse. Which intervention should the nurse implement next? A. Call the HCP and suggest a talk with the client B. Determine what about the HCP is bothering the client C. Notify the nursing supervisor to arrange a new HCP to take over D. Explain the client cannot request another HCP until after discharge
B
The client with a history of peptic ulcer disease is admitted into the ICU with frank gastric bleeding. Which priority intervention should the nurse implement? A. Maintain a strict record of intake and output B. Insert a NG tube and begin saline leverage C. Assist the client with keeping a detailed calorie count D. Provide a quiet environment to promote rest
B
The client with a new colostomy is being discharged. Which statement made by the client indicates the need for further teaching? A. "If I notice any skin breakdown, I will call the HCP" B. "I should drink only liquids until the colostomy starts to work" C. "I should not take a tub bath until the HCP okays it" D. "I should not drive or lift more than 5 pounds"
B
The female client came to the clinic reporting abdominal cramping and at least 10 episodes of diarrhea every day for the last 2 days. The client just returned from a trip in Mexico. Which intervention should the nurse implement? A. Instruct the client to take a cathartic laxative daily B. Tell the client to take an oral glucose electrolyte solution C. Discuss the need to increase protein in the diet D. Explain the client should weigh herself daily
B
The nurse is caring for a patient with a bleeding gastric ulcer. Which is the appropriate diet for this patient 24 hours after admission? A. Regular diet B. Nothing by mouth (NPO) C. Clear liquid D. Full liquid
B
The nurse is preparing to administer the initial dose of an amino-glycoside antibiotic to the client diagnosed with acute diverticulitis. Which intervention should the nurse implement? A. Obtain a serum trough level B. Ask about drug allergies C. Monitor the peak level D. Assess the vital signs
B
Which assessment data indicate to the nurse the client's gastric ulcer has perforated? A. Reports of sudden, sharp pain in the back B. Rigid, boardlike abdomen with rebound tenderness C. Frequent, clay-colored, liquid stool D. Reports of vague abdominal pain in the right upper quadrant
B
Which expected outcome should the nurse include for a client diagnosed with peptic ulcer disease? A. The client's pain is controlled with the use of NSAIDs B. The client maintains lifestyle modifications C. The client has no clinical manifestations of hemoptysis D. The client takes antacids with each meal
B
Which specific data should the nurse obtain from the client suspected of having peptic ulcer disease? A. History of side effects experienced from all medications B. Use of NSAIDs C. Any known allergies to drugs and environmental factors D. Medical histories of at least 3 generations
B
The client diagnosed with gastroenteritis is being discharged from the ED. Which interventions should the nurse include in the discharge teaching? Select all that apply. A. If diarrhea persists for more than 96 hrs, contact the HCP B. Instruct the client to wash hands thoroughly before handling any type of food C. Explain the importance of decreasing steroids gradually as instructed D. Discuss how to collect all stool samples for the next 24 hours E. Tell the client to drink clear liquids or electrolyte solutions
B, E
The occupational health nurse is preparing a presentation to a group of factory workers about preventing colon cancer. Which information should be included in the presentation? Select all that apply. A. Wear a high-filtration mask when around chemicals B. Eat several servings of cruciferous vegetables daily C. Take multivitamins everyday D. Do not engage in high-risk sexual behaviors E. Avoid smoking and tobacco use
B, E
The client diagnosed with Crohn's disease is crying and tells the nurse, "I can't take it anymore. I never know when I will get sick and end up here in the hospital." Which statement is the nurse's best response? A. "I understand how frustrating this must be for you" B. "You must keep thinking about the good things in your life" C. "I can see you are very upset. I'll sit down and we can talk" D. "Are you contemplating committing suicide?"
C
The client diagnosed with UC is prescribed a low-residue diet during exacerbations. Which meal selection indicates the client understands the diet teaching? A. Grilled hamburger on a wheat bun and fried potatoes B. A chicken salad sandwich and lettuce and tomato salad C. Roast pork, white rice, and plain custard D. Fried fish, whole grain pasta, and fruit salad
C
The client diagnosed with type 2 diabetes is prescribed predisone for an acute exacerbation of IBD. Which intervention should the nurse discuss with the client? A. Take this medication on an empty stomach B. Notify the HCP if experiencing a moon face C. Take the steroid medication as prescribed D. Notify the HCP if the blood glucose is over 160
C
The client is admitted to the medical unit with a diagnosis of acute diverticulitis. Which HCP's order should the nurse question? A. Insert an NG tube B. Start an IV with D5W at 125mL/hr C. Put the client on a clear liquid diet D. Place the client on bedrest with bathroom privileges
C
The client is diagnosed with an acute exacerbation of IBD. Which priority intervention should the nurse implement? A. Weight the client daily and document in the client's EHR B. Teach coping strategies such as dietary modifications C. Record the frequency, amount, and color of stools D. Monitor the client's oral fluid intake every shift
C
The client presents with a complete blockage of the large intestine from a tumor. Which HCP's order would the nurse question? A. Obtain consent for a colonoscopy and biopsy B. Start an IV of 0.9% saline at 125mL/hr C. Administer 3L of polyethylene glycol D. Give tap water enemas until it is clear
C
The nurse has been assigned to care for a client diagnosed with peptic ulcer disease. Which assessment data require further intervention? A. Bowel sounds auscultated 15 times in 1 minute B. Belching after eating a heavy and fatty meal late at night C. A decrease in systolic BP of 20mmHg from lying to sitting D. A decreased frequency of distress located in the epigastric region
C
The nurse has received the a.m. shift report. Which client should the nurse assess first? A. The 44 y/o client diagnosed with peptic ulcer disease reporting acute epigastric pain B. The 74 y/o client diagnosed with acute gastroenteritis and 4 diarrhea stools during the night C. The 65 y/o client diagnosed with IBD, tented skin turgor, and dry mucous membranes D. The 15 y/o client diagnosed with food poisoning who vomited several times during the night shift
C
The nurse is admitting a client to a medical floor with a diagnosis of adenocarcinoma of the rectosignmoid colon. Which assessment data support this diagnosis? A. The client reports up to 20 bloody stools per day B. The client has a feeling of fullness after a heavy meal C. The client has diarrhea alternating with constipation D. The client reports right lower quadrant pain
C
The nurse is discussing the therapeutic diet for the client diagnosed with diverticulosis. Which meal indicates the client understands the discharge teaching? A. Fried fish, mashed potatoes, and iced tea B. Ham sandwich, applesauce, and whole milk C. Chicken salad on whole-wheat bread and water D. Lettuce, tomato, and cucumber salad and coffee
C
The nurse is working in an outpatient clinic. Which client is most likely to have a diagnosis of diverticulitis? A. A 60 y/o male with a sedentary lifestyle B. A 72 y/o female with multiple childbirths C. A 63 y/o female with hemorrhoids D. A 40 y/o male with a family of history of diverticulosis
C
You are preparing to educate a group at the community center about peptic ulcers. When discussing risk factors, you should mention? A. Alcohol use and history of acute renal failure B. History of hemorrhoids and diabetes C. Alcohol abuse and smoking D. Sedentary lifestyle and smoking
C
The nurse is caring for a client diagnosed with hemorrhaging duodenal ulcer. Which collaborative interventions should the nurse implement? Select all that apply. A. Perform a complete pain assessment B. Asses the client's vital signs frequently C. Administer a proton pump inhibitor intravenously D. Obtain permission and administer blood products E. Monitor the intake of a soft, bland diet
C, D
A client is admitted to the hospital with the diagnosis of intestinal obstruction. The HCP orders intestinal suction via an NG tube. The loss of which constituents associated with NG suctioning is most important to consider with this client? A. Protein Enzymes B. Carbohydrates C. Vitamins and Minerals D. Water and Electrolytes
D
The client diagnosed with IBD is prescribed sulfasalazine. Which statement best describes the rationale for administering this medication? A. It is administered rectally to hep decrease colon inflammation B. This medication slows GI motility and reduces diarrhea C. This medication kills the bacteria causing the exacerbation D. It acts topically on the colon mucosa to decrease inflammation
D
The client diagnosed with diverticulitis is reporting severe pain in the left lower quadrant and has an oral temp of 100.6F. Which intervention should the nurse implement first? A. Notify the HCP B. Document the findings in the EHR C. Administer an oral antipyretic D. Assess the client's abdomen
D
The client had an abdominal perineal resection and is being discharged. Which discharge information should the nurse teach? A. The stoma should be a white, blue, or purple color B. Limit ambulation to precent the pouch from coming off C. Take pain medication when the pain level is at an 8 D. Empty the pouch when it is 1/3 to 1/2 full
D
The client has been experiencing difficulty and straining when expelling feces. Which intervention should the nurse discuss with the client? A. Explain some blood in the stool will be normal for the client B. Instruct the client in manual removal of the feces C. Encourage the client to use a cathartic laxative on a daily basis D. Place the client on a high-fiber diet
D
The client is 2 hours post colonoscopy. Which assessment data warrant immediate intervention by the nurse? A. The client has a soft, nontender abdomen B. The client has a loose, watery stool C. The client has hyperactive bowel sounds D. The client's pulse is 104 and BP is 98/60
D
The nurse has administered an antibiotic, a proton pump inhibitor, and bismuth subsalicylate for peptic ulcer disease secondary to H. pylori. Which data would indicate to the nurse the medications are effective? A. A decrease in alcohol intake B. Maintaining a bland diet C. A return to previous activities D. A decrease in gastric distress
D
The nurse is teaching the client diagnosed with diverticulitis. Which instruction should the nurse include in the teaching session? A. Discuss the importance of drinking 1,000mL of water daily B. Instruct the client to exercise at least 3x a week C. Teach the client about eating a low-residue diet D. Explain the need to have regular bowel movements
D
The nurse writes a psychosocial problem of "risk for altered sexual functioning related to the new colostomy." Which intervention should the nurse implement? A. Tell the patient there should be no intimacy for at least 3 months B. Ensure the client and significant other are able to change the ostomy pouch C. Demonstrate with charts possible sexual positions for the client to assume D. Teach the client to protect the pouch from becoming dislodged during sex
D
Which assessment data support the client's diagnosis of gastric ulcer to the nurse? A. Presence of blood in the client's stool for the past month B. Reports of a burning sensation moving like a wave C. Sharp pain in the upper abdomen after eating a heavy meal D. Reports of epigastric pain shortly after ingesting food
D
Which data should the nurse expect to assess in the client diagnosed with acute gastroenteritis? A. Decreased gurgling sounds on auscultation of the abdominal wall B. A hard, firm, edematous abdomen on palpation C. Frequent, small melena-type liquid bowel movements D. Bowel assessment reveals loud, rushing bowel sounds
D
Which problems should the nurse include in the plan of care for the client diagnosed with peptic ulcer disease to observe for physiological complications? A. Alteration in bowel elimination patterns B. Knowledge deficit in the causes of ulcers C. Inability to cope with changing family roles D. Potential for alteration in gastric emptying
D