Exam 1- 1541

what are the two components what the liver synthesizes?

albumin protein

Which complication of peritonitis would cause a client to be admitted to the intensive care unit. a. Organ failure b. Severe hypotension c. Shock occurring due to septicemia d. Deficient intravascular fluid volume e. Cardiac output failing with a reduction in perfusion of vital organs

all are correct

Which dietary recommendation would be reinforced by the nurse caring for a client with ulcerative colitis to help prevent an exacerbation of the condition? Select all that apply. One, some, or all responses may be correct. a. Decrease alcohol consumption as much as possible. b. Follow the low-residue diet that limits high-fiber foods. c. Avoid concentrated sweets such as juices, candy, and soda. d. Try incorporating more fish such as salmon, mackerel, and herring. e. Consider eating smaller, more frequent meals rather than three large meals.

all are correct

Patient is going to undergo endoscopy of the upper, because pt complained of GERD (heartburn). When the nurse formulate a plan of care, what are involved in the plan of care? SATA 6 answers a. Maintain NPO. b. Informed Consent. Preprocedure IV sedative (midazolam or diprivan). c. Patients pharynx is anesthetized by spraying lidocaine hydrocloride. d. After procedure, not allowed to eat or drink until gag reflex return (can be assessed by tongue blade). e. Assess vital signs & O2, s/s of perforation.

all are correct answers

The nurse is providing discharge instructions to a client who is recovering from an acute case of viral hepatitis. Which statement by the client indicates a need for further teaching? a. " will avoid alcohol." b. "I will eat small, frequent meals." c. " will take acetaminophen for pain rather than aspirin." d. " will eat foods high in carbohydrates and moderate in fats and protein."

b. "I will eat small, frequent meals."

Which instruction would the nurse include in the discharge teaching for a patient with a hepatitis A infection? a. "Avoid sharing razors or toothbrushes." b. "Wash hands carefully after bowel movements." c. "Avoid close contact with other family members." d. "Take acetaminophen every 4 hours if fever persists."

b. "Wash hands carefully after bowel movements."

The nurse anticipates administering which medication to a patient immediately after liver transplantation? a. Lactulose b. Cyclosporine c. Acetaminophen d. Hepatitis B vaccine

b. Cyclosporine

Which instruction would the nurse provide to help prevent leakage of stool when teaching a client with an ascending colon who is using a colostomy appliance? a. Irrigate the colostomy to establish an expected pattern of elimination. b. Empty the appliance when it is approximately one half full of feces. c. Use an antiseptic to clean the peristomal skin before applying the appliance. d. Select an appliance with a pouch opening of at least 5 cm larger than the stoma.

b. Empty the appliance when it is approximately one half full of feces.

Which action would the nurse take first for a patient undergoing a paracentesis for ascites caused by cirrhosis? a. Monitoring for signs of syncope b. Having the patient empty the bladder c. Positioning patient in high-Fowler's position d. Observing the site for bleeding or drainage

b. Having the patient empty the bladder

Which intervention would the nurse perform for a patient who is admitted to the hospital because of vomiting that has lasted 3 days despite minimal intake and severe abdominal distention and pain? a. Administering a laxative to promote bowel evacuation b. Inserting a nasojejunal tube, and connecting it to wall suction c. Providing preoperative education about colostomy formation d. Preparing the patient for surgery to repair the intestinal obstruction

b. Inserting a nasojejunal tube, and connecting it to wall suction

A client with hepatic cirrhosis begins to develop slurred speech, confusion, drowsiness, and a flapping tremor. Which diet would the health care provider prescribe for this client based on the nurse's assessment? a. No protein b. Moderate protein c. High protein d. Strict protein restriction

b. Moderate protein

Which action would the nurse take after assessing abdominal rigidity in a client reporting severe abdominal pain 3 days after a subtotal gastrectomy? a. Assisting the client to ambulate b. Obtaining the client's vital signs c. Administering the prescribed analgesic d. Encouraging the use of spirometry

b. Obtaining the client's vital signs

In which position would the nurse place a patient who had a fine-needle aspiration biopsy (FNAB) of the liver 15 minutes ago? a. On the patient's left side b. On the patient's right side c. Semi-Fowler's position d. Trendelenburg's position

b. On the patient's right side

Which drug does the nurse expect the health care provider to prescribe to treat a chronic hepatitis B infection and decrease the viral load? a. Ribavirin b. Pegylated interferon alfa c. Interferon alfa-2b d. Azathioprine

b. Pegylated interferon alfa

Which nursing action would best prevent pulmonary complications in a client immediately after subtotal gastrectomy? a. Ambulating the client to increase respiratory exchange b. Promoting frequent turning and deep breathing to mobilize secretions c. Maintaining a consistent oxygen flow rate to increase oxygen saturation d. Keeping an artificial airway in place to ensure patency of the client's airway

b. Promoting frequent turning and deep breathing to mobilize secretions

What is lacking in a negative nitrogen balance The nurse concludes that a client with Crohn disease and general malnutrition who has anemia, a low serum albumin level, and signs of negative nitrogen balance is lacking which major substance? a. Iron b. Protein c. Vitamin C d. Linoleic acid

b. Protein

Which outcome is most important for the client to achieve to meet long-range goals associated with adjusting to a new colostomy? a. Mastery of techniques of colostomy care b. Readiness to accept an altered body image and function c. Awareness of available community resources d. Knowledge of the necessary dietary modifications

b. Readiness to accept an altered body image and function

Which action would be considered beneficial in minimizing the risk for contracting hepatitis B? Select all that apply. One, some, or all responses may be correct. a. Preventing constipation b. Screening of blood donors c. Avoiding shellfish in the diet d. Limiting hepatotoxic drug therapy e. Maintaining a monogamous sexual relationship

b. Screening of blood donors e. Maintaining a monogamous sexual relationship

describe the pain of peptic ulcer disease (feeling) pg. 189 (3 answers)

- dull - burning - gnawing

what instructions are to be given to a pt prescribed Mylanta (aluminum hydroxide) and famotidine? pg 190

- famotidine can not be given within 2 hours of antacids (pg 190 adult) - famotidine must be given 1 hour before or 2 hours after antacids are administered (pg 520 pharm)

recommendation for a pt with PUD to reduce risk of dumping syndrome pg 193 (2 answers)

- small frequent meals of soft food - avoid milk

A client with Crohn disease is admitted to the hospital with abdominal pain, fever, poor skin turgor, and diarrhea, with 10 stools in the past 24 hours. Which sign is evidence that the client is probably dehydrated? Select all that apply. One, some, or all responses may be correct. a. Moist skin b. Sunken eyes c. Decreased apical pulse d. Dry mucous membranes e. Increased blood pressure

b. Sunken eyes d. Dry mucous membranes

A client with ulcerative colitis decides to have a colectomy as advised by the primary health care provider. Which is most likely the significant factor that affected the client's decision? a. It is temporary until the colon heals. b. Surgical treatment cures ulcerative colitis. c. Ulcerative colitis can progress to Crohn disease. d. Eating table foods will be easier.

b. Surgical treatment cures ulcerative colitis.

Which action would the nurse do first when counseling a client diagnosed with Crohn disease who thinks that her boyfriend's behavior causes an increase in her symptoms? a. Helping the client explore attitudes about herself b. Educating the client's boyfriend about her illness c. Suggesting that the client not see her boyfriend for a while d. Scheduling the client and her boyfriend for a counseling session

a. Helping the client explore attitudes about herself

pre and post operative pt teaching for ERCP pg 230- 231

before- no food or fluids for 8 hours, signed consent, 1 to 2 hour procedure after- NPO until gag reflex returns

complication of cirrhosis of the liver pg 234

bleeding esophageal varice

Which allergy would the nurse check for before administration of contrast dye in a patient scheduled for a T-tube cholangiography? a. Iodine b. Peanuts c. Silk tape d. Strawberries

a. Iodine

what problem can ulcerative colitis cause? pg 203

bleeding from the ulcerations of the colon ruptured bowel severe bloating

Within the 24 hour placement of colostomy which particular problem is associated with the absence of drainage?

Absence peristalsis

Which intervention would the nurse perform on a client presenting with appendicitis? Select all that apply. One, some, or all responses may be correct. a. Maintain nothing-by-mouth (NPO) status. b. Administer a soap suds enema until clear. c. Administer 30 mL of milk of magnesia 1 hour before surgery. d. Apply moist heat to the right lower abdominal area. e. Hold intravenous antibiotics until surgery is performed

a. Maintain nothing-by-mouth (NPO) status.

Which finding would a nurse expect in a client with rectosigmoid colon cancer admitted for surgery? Select all that apply. One, some, or all responses may be correct. a. Rectal bleeding b. Inability to digest fat c. Change in the shape of stools d. Feeling of abdominal bloating

a. Rectal bleeding c. Change in the shape of stools d. Feeling of abdominal bloating

Food that should be avoid when pt have colostomy or ileostomy

Avoid corn, popcorn, celery, and nuts

Which intervention helps prevent hepatic coma in a client with liver dysfunction? a. Restricting dietary protein b. Preparing for emergency surgery c. Eliminating carbohydrates from the diet d. Giving hypertonic small-volume enemas

a. Restricting dietary protein

Pt with Crohn's disease what evaluation does the nurse observe in order to determine that the aggressive therapy has a positive outcome

body mass index weight control

When a patient has a G tube, how would you teach the patient in doing the feeding?

Check patency check residual

what is Zantac used for?

GERD

what bacteria is associated with peptic ulcer disease?

H pylori

What type of tube after pancreatectomy or duodenal resection

NG tube

Difference between peg tube and NG tube

PEG tube has decreased chance of aspiration

what is prilosec used for?

PUD

A client is admitted to the hospital with signs and symptoms of obstruction of the common bile duct. Which manifestation of biliary obstruction explains why this client would have prolonged bleeding and clotting times? a. Vitamin K is not being absorbed. b. Ionized calcium level is decreased. c. Bilirubin in the plasma is increased. d. Extrinsic factor is not being absorbed.

a. Vitamin K is not being absorbed.

Which statement by the client who recently had a colostomy indicates a need for further teaching? a. "I wanted another child, and now pregnancy is not an option for me." b. "Extra time must be allowed for taking care of my colostomy when traveling." c. "It is good to know that I can swim every day after my incision heals." d. "I'm glad I won't have to buy special clothing and I can wear what I have."

a. "I wanted another child, and now pregnancy is not an option for me."

Which diet would a nurse expect to be prescribed to a client who has hepatic cirrhosis and who is developing slurred speech, confusion, drowsiness, and a flapping tremor with impending hepatic coma? a. 20 g of protein, 2000 calories b. 70 g of protein, 1200 calories c. 80 g of protein, 2500 calories d. 100 g of protein, 1500 calories

a. 20 g of protein, 2000 calories

Which teaching would a nurse include with a client who is learning how to self-administer gastrostomy tube feedings? a. Administering water after the feeding is completed b. Maintaining the supine position during the feeding c. Heating the feeding to slightly above body temperature d. Determining tube placement by instilling water before the feeding

a. Administering water after the feeding is completed

In addition to a proton pump inhibitor, the nurse anticipates the healthcare provider will prescribe another medication from which drug class to eradicate the Helicobacter pylori in a patient being treated for gastritis? a. Antibiotic b. Antiinflammator c. Prostaglandin inhibitor d. Therapeutic nutrients

a. Antibiotic

The nurse recognizes that the client data most likely linked to a diagnosis of hepatitis A is the client's history at which place of employment? a. At a plumbing business b. In a hemodialysis unit at a hospital c. As a dishwasher at a restaurant d. At an occupational arsenic compound business

a. At a plumbing business

Which type of colostomy may allow the client to have bowel continence? a. Descending or sigmoid colostomy b. Ascending or transverse colostomy c. Ascending or descending colostomy d. Transverse or descending colostomy

a. Descending or sigmoid colostomy

Which instruction would the nurse include in discharge teaching for a patient after a gastrectomy to prevent dumping syndrome? a. Divide meals into six small feedings. b. Take fluids along with meals. c. Use concentrated sweets, such as honey, jam, and jelly. d. Reduce protein and fats in the diet.

a. Divide meals into six small feedings.

Which finding related to peritonitis would a nurse expect in a client who had surgery for a ruptured appendix and developed peritonitis? Select all that apply. One, some, or all responses may be correct. a. Fever b. Hyperactivity c. Extreme hunger d. Urinary retention e. Abdominal muscle rigidity

a. Fever e. Abdominal muscle rigidity

Which instruction would the nurse provide the client in preparation for a sigmoidoscopy? a. Have an enema the morning of the test. b. A chalklike substance will have to be swallowed. c. Withhold food for 24 hours before the test. d. A sterile container will be provided for collection of a stool specimen.

a. Have an enema the morning of the test.

Which pain medication ordered by the provider would the nurse question for a patient with cholelithiasis who has severe abdominal pain? a. Morphine b. Ketorolac c. Dicyclomine d. Meperidine

a. morphine

if a pt has stomatitis what will you avoid when taking there vitals?

administering an oral temperature

Which statement by the client with a new colostomy indicates correct understanding of the teaching about irrigation of the colostomy? a. "After it is done healing in a few weeks, I'll begin irrigating it just before going to bed each day." b. "It will need to be irrigated each morning before I can eat any food." c. "I plan to irrigate it in the late morning, the same time I had a bowel movement every day before I had surgery." d. "I can wait to start irrigating it until after I have gotten used to this bag and change in lifestyle."

c. "I plan to irrigate it in the late morning, the same time I had a bowel movement every day before I had surgery."

Which statement by the client indicates understanding of the nurse's teaching regarding the purpose of total parenteral nutrition (TPN) after extensive colon surgery? a. "TPN provides short-term nutrition after surgery." b. "TPN assists in providing supplemental nutrition." c. "TPN provides total nutrition when gastrointestinal (GI) function is questionable." d. "TPN assists people who are unable to eat but have active GI function."

c. "TPN provides total nutrition when gastrointestinal (GI) function is questionable."

Which food choice indicates to the nurse that dietary teaching for a client with an acute exacerbation of colitis was effective? Select all that apply. One, some, or all responses may be correct. a. Orange juice b. Creamed soup c. Jelly sandwich d. Lean roast beef e. Scrambled eggs

c. Jelly sandwich d. Lean roast beef e. Scrambled eggs

A patient is diagnosed with diabetic gastroparesis. Which medication does the nurse recognize as appropriate in treating a patient with diabetic gastroparesis? a. Omeprazole b. Dexlansoprazole c. Metoclopramide d. Famotidine

c. Metoclopramide

How would the nurse expect a client's stoma to appear on the second day after an abdominoperineal resection? a. Dry, pale pink, and flush with the skin b. Moist, skin-colored, and flush with the skin c. Moist, red, and raised above the skin surface d. Dry, purple, and depressed below the skin surface

c. Moist, red, and raised above the skin surface

Which symptom concerns a nurse the most in a patient with late-stage cirrhosis because it puts the patient at risk for a potentially life-threatening complication? a. Pruritus b. Diarrhea c. Nonproductive cough d. Increased abdominal girth

c. Nonproductive cough

A client is admitted to the hospital with jaundice. After numerous diagnostic tests, the health care provider diagnoses the client with cancer of the pancreas. Which is the most likely cause of the client's jaundice? a. Necrosis of the pancreatic parenchyma caused by the neoplasm b. Excessive serum bilirubin caused by red blood cell destruction c. Obstruction of the common bile duct by the pancreatic neoplasm d. Impaired liver function resulting in incomplete bilirubin metabolism

c. Obstruction of the common bile duct by the pancreatic neoplasm

Which lunch selected by the client indicates understanding about the dietary principles associated with viral hepatitis? a. Turkey salad, french fries, and sherbet b. Cottage cheese, mixed fruit salad, and a milkshake c. Salad, sliced chicken sandwich, and gelatin dessert d. A cheeseburger, tortilla chips, and chocolate pudding

c. Salad, sliced chicken sandwich, and gelatin dessert

Which complication of a peptic ulcer is the most lethal? a. Bleeding b. Dyspepsia c. Perforation d. Gastric outlet obstruction

c. perforation

As licensed nurses there is an emergency situation suffering from a shock what will you do?

call HCP

what are you supposed to do if a pt begins to have a sudden change in behavior and they have a T-tube insertion?

clamp it to stop the flow

what is the duct called that is shared between the gallbladder and pancreas?

common bile duct

what could happen if there is ammonia intoxification or hepatic encephalopathy? pg 236

complete brain damage, coma

what is a cause for contracting hepatitis A?

contaminated food

Which is an appropriate response by the nurse when a client with acute pancreatitis and alcoholism asks, "What does drinking alcohol have to do with my diagnosis?" a. "It promotes the formation of calculi in the cystic duct." b. "It stimulates the pancreas to secrete more insulin than it can immediately produce." c. "It alters the composition of enzymes so they are capable of damaging the pancreas." d. "It increases enzyme secretion and pancreatic duct pressure."

d. "It increases enzyme secretion and pancreatic duct pressure."

Which response would a nurse give to a client who asks about the mechanism of famotidine? a. "It increases gastric motility." b. "It neutralizes gastric acidity." c. "It facilitates histamine release." d. "It inhibits gastric acid secretion."

d. "It inhibits gastric acid secretion."

The nurse determines that a client who becomes shaky after an episode of dumping syndrome does so because of which response in the body? a. A second, more extensive rise in glucose b. An overwhelmed insulin-adjusting mechanism c. A distention of the duodenum from an excessive amount of chyme d. An overproduction of insulin that occurs in response to the rise in blood glucose

d. An overproduction of insulin that occurs in response to the rise in blood glucose

Which is a nursing responsibility common to preparing both a sigmoidoscopy and a barium enema? a. Withholding food for several hours b. Giving a laxative the afternoon before c. Administering soapsuds enemas until clear d. Ensuring an understanding of the procedure

d. Ensuring an understanding of the procedure

Which finding is more likely to be identified in a client with ulcerative colitis than in a client with Crohn disease? a. Inclusion of transmural involvement of the small bowel wall b. Correlation with increased malignancy because of malabsorption syndrome c. Pathology beginning proximally with intermittent plaques found along the colon d. Involvement starting distally with rectal bleeding that spreads continuously up the colon

d. Involvement starting distally with rectal bleeding that spreads continuously up the colon

A client with a history of ulcerative colitis has a portion of the large intestine removed, and an ileostomy is created. For which potential life-threatening postoperative complication would the nurse assess in the client? a. Infection caused by the excretion of feces b. Injury caused by exposed intestinal mucosa c. Altered bowel elimination caused by the ostomy d. Limited water reabsorption caused by removal of intestine

d. Limited water reabsorption caused by removal of intestine

Which medications reduce gastric ulcers by inhibiting hydrogen ion pumps? Select all that apply. a. Amoxicillin (Amoxil) b. Cimetidine (Tagamet) c. Misoprostol (Cytotec) d. Pantoprazole (Protonix) e. Dexlansoprazole (Dexilant)

d. Pantoprazole (Protonix) e. Dexlansoprazole (Dexilant)

Which type of tube would the nurse anticipate for a client with bleeding esophageal varices? a. Levin b. Salem sump c. Miller-Abbott d. Sengstaken- Blakemore

d. Sengstaken- Blakemore

Which statement is true regarding sucralfate (Carafate)? a. Sucralfate (Carafate) can induce diarrhea as an adverse effect. b. Sucralfate (Carafate) is a prokinetic agent that is used to treat duodenal ulcers. c. Sucralfate (Carafate) treats ulcers by inhibiting gastric secretions and altering gastric pH. d. Sucralfate (Carafate) is prescribed to patients who cannot tolerate other forms of antiulcer therapy.

d. Sucralfate (Carafate) is prescribed to patients who cannot tolerate other forms of antiulcer therapy.

Which action provides evidence that a family member is effectively managing the care for a homebound client with a percutaneous endoscopic gastrostomy (PEG) tube? a. The empty feeding bag is attached to the tubing. b. The tube is flushed with air after medication is given. c. Replacement of the tube is done on a weekly basis. d. The head of the bed remains elevated after the feeding.

d. The head of the bed remains elevated after the feeding.

The nurse determines that there is some movement toward adaptation to the change in body image when a client who had a colostomy placed 5 days ago takes which action? a. Discusses the necessity of the colostomy b. Requests the nurse to change the dressing c. Looks at the face of the nurse during care d. Views the stoma during dressing changes

d. Views the stoma during dressing changes

what is carafate used for?

duodenal ulcer

what form of medication is avoided when an ileostomy is established?

enteric coated or extended release medications

describe the pain of peptic ulcer disease (location) pg 189

epigastric region

when does pain of peptic ulcer disease appear? pg 189

food intake

how to demonstrate the proper way of removing a colostomy barrier?

gently peel the skin barrier of the skin

what is mylanta used for?

heart burn excessive eating and drinking PUD

how to administer medications safely for a pt with an NG tube?

high fowlers position

how do you prepare your patient for a ERCP? SATA (2)

hold food and fluids for 8 hours prior obtain pt consent

describe the bowel sounds that you can hear when a pt has chronic crohns disease

hyper active due to bowel obstruction

If there is hypovolemia, when checking BP there is

hypotension cardiac output is low

When the pt is discharged home with hemicolectomy with a permanent colostomy how would you determine that the pt understands the pt education?

if they are able to give a demonstration

factors associated with ulcerative colitis

left lower quadrant pain

advantage for laparoscopic choleostectomy pg 246-247

less invasive shorter healing time no scar less pain

what should be prescribed to a patient with cholecystitis and cholelithiasis?

meperidine and ketorolac

Client is admitted with an acute onset of low quadrant pain appendicitis is suspected. Which clinical indicator is associated with appendicitis?

rebound tenderness

When patient has Crohn's disease what important information should the nurse include in patient teaching? pg 208

right lower quadrant pain

If the patient has ileostomy what is most likely to be damaged?

skin integrity

why is tube feeding important when a pt is experiencing malabsorption?

the tube will allow for pt to receive all of the missed nutrients, due to malabsorption