GI

Which of the following is are a risk factor for gastric cancer? a. ACHLORHYDRIA b. chronic atrophic gastritis c. H. Pylori infection d. iron deficiency anemia e. PERNICIOUS anemia

A, B, C, E are all risk factors for developing gastric cancer. Iron deficiency anemia is not a risk factor.

What actions by the nurse is are appropriate to promote nutrition in a client who had a partial gastrectomy? a. administer vitamin B12 injections b. asked the Primary Health care provider about folic acid replacement c. educate the client on enteral feedings d. obtain consent for total parenteral nutrition e. provide iron supplements for client

A, B, E after a partial or total gastrectomy, clients are at high risk for anemia due to vitamin B12 deficiency, folic acid deficiency, or iron deficiency. The nurse would provide supplements for all these nutrients. The client does not need enteral feeding or total parenteral nutrition.

the nurse teaches a community group ways to prevent E coli infection. Which statements would the nurse include in this group's teaching? A. Wash your hands after any contact with animals b. it is not necessary to buy a meat thermometer c. stay away from people who are ill with diarrhea d. use separate cutting boards for meat and vegetables e. avoid swimming in backyard pools and using hot tubs

A,D washing hands after contact with animals and using separate cutting boards for meat and other foods will help prevent E coli infection. The other statements are not related to preventing E coli infection

after teaching a client who was prescribed adalimumab for severe ulcerative colitis, the nurse assesses the client's understanding. Which statement made by the client indicates a need for further teaching? A. I will avoid large crowds and people who are sick b. I will take this medication with my breakfast each morning c. nausea and vomiting are common side effects of this drug d. I should wash my hands after I play with my dog

B Adalimumab is an immune modulator that is given via subcutaneous injection. It does not need to be given with food or milk. Nausea and vomiting are two common side effects. It can cause immune suppression, so clients receiving the medication should avoid large crowds and people who are sick, and should practice good hand washing

A client who had a partial gastrectomy 3 days ago begins to experience Vertigo, sweating, and tachycardia about 30 minutes after eating breakfast. What postoperative complication would the nurse suspect? a. pyloric obstruction b. dumping syndrome c. delayed gastric emptying d. pernicious anemia

B dumping syndrome causes autonomic symptoms as food quickly leaves the stomach due to its decreased size after surgery

the nurse plans care for a patient with Crohn's disease who has a heavily draining fistula. Which intervention would be the nurse's priority action? A. Low fiber diet b. skin protection c. antibiotic administration d. intravenous glucocorticoids

B protecting the client's skin is the priority action for a patient who has a heavily draining fistula. Intestinal fluid enzymes are caustic and can cause skin breakdown or fungal infection if the skin is not protected. the plan of care for a client who has Crohn's disease also includes adequate nutrition focused on high calorie, high protein, high vitamin, and low fiber meals, antibiotic administration, and glucocorticoids

The nurse is caring for a client with a long history of peptic ulcer disease. What assessment findings would the nurse anticipate if the client experiences upper gastrointestinal GI bleeding? a. decreased heart rate b. decrease blood pressure c. bounding radial pulse d. dizziness e. hematemesis f. decreased urinary output

B, D, E, F the client who has upper GI bleeding would likely have vomiting that contains blood HEMATEMESIS, and what have signs and symptoms of dehydration such as a decreased blood pressure, dizziness, and or decreased urinary output. The heart rate increases rather than decreases and the pulse is weak rather than bounding in clients who are dehydrated.

the nurse is caring for a client with probable colorectal cancer. What assessment findings would the nurse expect? A. Weight gain b. rectal bleeding c. anemia d. change in stool shape e. electrolyte imbalances f. abdominal discomfort

B,C,D,F the client who has CRC usually experiences unintentional weight loss and rectal bleeding, Either gross or a cult. As a result of bleeding, the client has anemia and fatigue. Electrolyte imbalances are not common, but the client may note that the shape or consistency of stool has changed.

a nurse assesses a patient who has celiac disease. Which signs and symptoms would the nurse expect? A. Weight gain b. anorexia c. Constipation d. anal fistula e. abdominal pain

B,C,E signs and symptoms of celiac disease include weight loss, anorexia, Constipation, and abdominal pain. Anal fistulas are not associated with celiac disease

during an interview, the client tells the nurse that the client has a duodenal ulcer. Which assessment finding would the nurse expect? a. hematemesis b. pain when eating c. melana d. weight loss

C all of the other assessment findings are more commonly seen in clients who have gastric ulcers rather than duodenal ulcers

the nurse reviews the laboratory results for a client who has possible appendicitis. Which laboratory finding would the nurse expect? A. Decrease potassium level b. increase sodium level c. elevated leukocyte count d. decrease thrombocyte count

C appendicitis is an acute inflammatory disorder that frequently results in elevation of leukocytes white blood cells. Serum electrolytes are not affected because the client does not usually have diarrhea. Thrombocyte platelet count is unrelated to this GI disorder.

the nurse teaches the client about how to prevent transmission of gastroenteritis. Which statement by the nurse indicates the need for further teaching? A. I won't let anyone use my dishes or glasses b. I'll wash my hands with antibacterial soap c. I will keep my bathroom extra clean d. I will cook all the meals for my family

D all of these statements are correct except for that the client should not prepare meals for others and to help prevent transmission of gastroenteritis

the nurse is caring for a client with a large bowel obstruction due to fecal impaction. What position would be appropriate for the client while in bed? A. Prone b. supine c. recumbent d. semi Fowler

D having the client in a semi sitting position helps to decrease the pressure caused by abdominal distention and promotes thoracic expansion to facilitate breathing.

A nurse knows that job-related risks for developing oral cancer include which occupations? a. coal miner b. electrician c. metal worker d. plumber e. textile worker

a,c,d,e these occupations produce exposure to polycyclic aromatic hydrocarbons(PAHs) which are known carcinogens.

The nurse is aware of the most recent american cancer society screening guidelines for colon cancer. which include which accepted testing modalities for people over the age of 50? a. colonoscopy every 10 years b. endoscopy every 5 years c. computed tomography CT colonography every 5 years d. double- contrast barium enema every 10 years e. flexible sigmoidoscopy every 5 years

a,c,e

To promote comfort and the passage of flatus after a colonoscopy, in what position does the nurse place the client? a. left lateral b. prone c. right lateral d. supine

a. after colonoscopy clients have less discomfort and quicker passage of flatus when placed in the left lateral position

A client is admitted with a large oral tumor. What assessment by the nurse takes priority? a. airway b. breathing c. circulation d. nutrition

a. airway always takes priority. airway must be assessed first and any problems managed if present.

An older adult has an instance of drug toxicity and asks why this happens, since the client has been on this med for years at the same dose. what response by the nurse is best? a. changes in your liver cause drugs to be metabolized differently b. perhaps you dont need as high a dose of this drug as before c. stomach muscles atrophy with age and you digest more slowly d. your body probably cant tolerate as much mediation anymore

a. decreased liver enzyme activity depresses drug metabolism. which leads to accumulation of drugs - possibly to toxic levels.

The nurse notes that the primary health care provider documented the presence of mucosal erythroplasia in a client. what does the nurse understand that this most likely means for this client? a. early sign of oral cancer b. fungal mouth infection c. inflammation of the gums d. obvious oral tumor

a. mucosal erythroplasia is the earliest sign of oral cancer.

A client is scheduled for a colonoscopy and the nurse has provided instructions on the bowel cleansing regimen. what statement by the client indicates a need for further teaching? a. its a good thing i love orange and cherry gelatin b. my spouse will be here to drive me home c. ill avoid ibuprofen for several days before the test d. ill buy a case of clear gatorade before i prep

a. the client will be advised to avoid beverages and gelatin that are red, orange, or purple in color as their residue can appear to be blood.

the nurse is caring for a client who has frequent gastric pain and dyspepsia which procedure would the nurse expect for the client to make an accurate diagnosis a period a. esophagogastoduodenoscopy (EGD) b. Abdominal arteriogram c. Nuclear medicine scan d. Magnetic resonance imaging MRI

a. the gold standard for diagnosing disorders of the stomach is an EGD which allows direct visualization by the endoscopist into the esophagus stomach and duodenum

A client is recovering from an esophagogastroduodenoscopy (EGD) and requests something to drink. what action by the nurse is appropriate? a. allow the client cool liquids only b. assess the clients gag reflex c. remind the client to remain npo d. tell the client to wait 4 hours

b. after procedure the nurse would ensure the gag reflex is intact before offering food or fluids

The nurse knows that a client with prolonged prothrombin time (PT) values (not related to medication) probably has dysfunction in which organ? a. kidneys b. liver c. spleen d. stomach

b. severe, acute, or chronic liver damage leads to a prolonged pt secondary to impaired synthesis of clotting proteins.

A nurse participates in a community screening event for oral cancer. what client is the highest priority for referral to a primary health care provider? a. client who has poor oral hygiene practices b. client who smokes and drinks daily c. client who tans for an upcoming vacation d. client who occasionally uses illicit drugs

b. smoking and alcohol exposure create a high risk for this client

a client with peptic ulcer disease is in the emergency department and reports gastric pain that has gotten much worse over the last 24 hours the client's blood pressure when lying down is 112/68 mmHG and when standing is 98/52 MmHg what action by the nurse is most appropriate? a. administer a proton pump inhibitor PPI b. call the rapid response team c. start a large bore IV and with normal saline d. tell the patient to remain lying down

c the client has orthostatic changes to the blood pressure indicating fluid volume loss. The nurse would start a large bore IV with isotonic solution. PPI's are not a treatment for an ulcer. The rapid response team is not needed at this point. The client should put be put on safety precautions, which includes staying in bed, but this is not the most appropriate action at this time

A client has an open traditional hiatal hernia repair this morning. what is the nurses priority for client care at this time? a. managing surgical pain b. ambulating the client early c. preventing respiratory complications d. managing the nasogastric tube

c. The client who has traditional surgery (rather than minimally invasive surgery) is at risk for respiratory complications such as atelectasis and pneumonia because he or she has an incision that may prevent the client from taking deep breaths or using an incentive spirometer. therefore, the nurse's priority is to prevent these potentially life threatening respiratory problems.

A client had a colonoscopy and biopsy yesterday and calls the gastrointestinal clinic to report a spot of bright red blood on the toilet paper today. what response by the nurse is appropriate? a. ask client to call back if this happens again today b. instruct client to go to emergency department c. remind the client that a small amount of bleeding is possible d. tell the client to come to the clinic this afternoon

c. after colonoscopy with biopsy a small amount of bleeding is normal. the nurse would remind client of this and instruct him to go to the emergency department for large amounts of bleeding, severe pain, or dizziness

The assistive personnel note that a client had a dark stool. what stool test would the nurse obtain for this client? a. culture and sensitivity b. parasites and ova c. occult blood test d. total fat content

c. dark stools are typical in clients who have lower GI bleeding

A nurse assesses clients at a community Health Center. Which client is at highest risk for developing colorectal cancer? A. A 37 year old who drinks eight cups of coffee a day b. a 44 year old with irritable bowel syndrome IBS c. a 60 year old lawyer who works 65 hours per week d. a 72 year old who eats fast food frequently

d. colon cancer is rare before the age of 40, but its incidence increases rapidly with advancing age. Fast food tends to be high in fat and low in fiber, increasing the risk for colon cancer. Coffee intake, IBS, and a heavy workload do not increase the risk for colon cancer

A nurse is assessing a client reporting RUQ abd pain. what techniques would the nurse use to assess this clients abdomen? a. auscultate after palpating b. avoid any type of paplpation c. lightly palpate the RUQ first d. lightly palpate the RUQ last

d. if pain is present in a certain area of the abd, that area would be palpated last to keep the client from tensing which could possibly affect the rest of the examination.

The nurse is teaching a client about the use of viscous lidocaine for oral pain. what health teaching would the nurse include? a. use the drug every meal to prevent aspiration b. increase your intake of citrus foods to help with healing c. use the drug only at bedtime because you wont be eating d. be sure to check food temp before eating

d. viscous lidocaine has an anesthetic effect in the oral cavity. therefore, to promote client safety, the nurse would want to teach the client to check food temp before eating.

the nurse assesses a client who is hospitalized with an exacerbation of Crohn's disease. Which assessment finding would the nurse expect? A. Positive Murphy sign with rebound tenderness to palpation b. dull, hypoactive bowel sounds in the lower abdominal quadrants c. high pitched rushing bowel sounds in the right lower quadrant d. reports of abdominal cramping that is worse at night

night C the nurse expects high pitched, rushing bowel sounds due to narrowing of the bowel lumen and Crohn's disease. A positive Murphy sign is indicative of gallbladder disease, and rebound tenderness often indicates peritonitis. Dullness in the lower abdominal quadrants and the hypoactive bowel sounds is not commonly found with Crohn's disease. Nightly worsening of abdominal cramping is not consistent with Crohn's disease

A nurse assesses a client who is prescribed alosetron. Which assessment question would the nurse ask this client before starting the drug? A. Have you been experiencing any Constipation? B. Are you eating a diet high in fiber and fluids? C. Do you have a history of high blood pressure? D. What vitamins and supplements are you taking?

A Ischemic colitis is a life threatening complication of alosetron. The nurse would assess the client for Constipation because it places the client at risk for this complication. The other questions do not identify the risk for complications related to the medication.

a nurse reviews the electronic health record of a patient who has Crohn's disease and a draining fistula. Which documentation would alert the nurse to urgently contact the Primary Health care provider for additional prescriptions? A. Serum potassium of 2.6 mEq/L b. client ate 20% of breakfast meal c. white blood cell count of 8200/mm d. clients weight decreased by three pounds

A fistulas placed the patient with Crohn's disease at risk for hypokalemia which can lead to serious dysrhythmias. This potassium level is low and will cause the nurse to intervene. The white blood cell count is normal period the other two findings are abnormal and also warrant intervention but the potassium level takes priority

The nurse assesses a client who has appendicitis. Which assessment finding would the nurse expect? A. Severe, steady right lower quadrant pain b. abdominal pain associated with nausea and vomiting c. marked peristalsis and hyperactive bowel sounds d. abdominal pain that increases with knee flexion

A right lower quadrant pain, specifically at mcburney's point, is characteristic of appendicitis. Usually if nausea and vomiting begin first, the client has gastroenteritis. Marked peristalsis and hyperactive bowel sounds are not indicative of appendicitis. Abdominal pain due to appendicitis decreases with knee flexion.

the nurse teaches a client who has viral gastroenteritis. Which dietary instruction would the nurse include in the health teaching? A. Drink plenty of fluids to prevent dehydration b. you should only drink one liter of fluids daily c. increase your protein intake by drinking more milk d. sips of cola or tea may help to relieve your nausea

A the client should drink plenty of fluids to prevent dehydration. Milk products may not be tolerated. Caffeinated beverages increase intestinal motility and should be avoided

The nurse assesses a patient who is recovering from an ileostomy placement. Which assessment finding would alert the nurse to immediately contact the Primary Health care provider? A. Pale and bluish stoma b. liquid stool c. ostomy pouch intact d. blood tinged output

A the nurse would assess the stoma for color and contact the Primary Health care provider if the stoma is pale, bluish, or dark because these changes indicate possible lack of perfusion. The nurse would expect the client to have an intact ostomy pouch with dark green liquid stool that may contain some blood

A nurse cares for a client who states, my husband is repulsed by my colostomy and refuses to be intimate with me. How would the nurse respond? A. Let's talk to the ostomy nurse to help you and your husband work through this b. you could try to wear longer lingerie that will better hide the ostomy appliance c. you should empty the pouch first so it will be less noticeable for your husband d. if you are not careful, you can hurt the stoma if you engage in sexual activity

A the nurse would collaborate with the ostomy nurse to help the client and her husband work through intimacy issues. The nurse would not minimize the client's concern about her husband with ways to hide the ostomy. The client will not hurt the stoma by engaging in sexual activity

A nurse cares for a client who has a new colostomy. Which action would the nurse take? A. Empty the pouch frequently to remove excess gas collection b. change the ostomy pouch and barrier every morning c. allow the patch to completely fill with stool prior to emptying it d. use surgical tape to secure the pouch and prevent leakage

A the nurse would empty the new ostomy pouch frequently because of excess gas collection, and empty the pouch when it is 1/3 to 1/2 full of stool. The ostomy pouch does not need to be changed every morning. Ostomy barriers would be used to secure and seal the ostomy appliance. Surgical tape would not be used.

A nurse cares for a client who had a colostomy placed in the ascending: two weeks ago. The client states, the stolen my pouch is still liquid. How would the nurse respond? A. The store will always be liquid with this type of colostomy b. eating additional fiber will bulk up your stool and decrease diarrhea c. your store will become firmer over the next couple of weeks d. this is abnormal. I will contact your Primary Health care provider

A the store from an ascending colostomy can be expected to remain liquid because little large bowel is available to reabsorb the liquid from the stool. This finding is not abnormal. Liquid stool from the and ascending colostomy will not become firmer with the addition of fiber to the client's diet or with the passage of time.

A nurse is preparing to administer pantoprazole intravenously to prevent stress ulcers during surgery. What actions by the nurse is are most appropriate? a. administer the drug through a separate IV line b. infuse pantoprazole using an IV pump c. keep the drug in its original brown container d. take vital signs frequently during infusion e. use an inline IV filter when infusing

A, B, E when infusing pantoprazole use a separate IV line, a pump, and an inline filter. A brown wrapper and frequent vital signs are not needed.

a nurse assesses a client with irritable bowel syndrome IBS. Which questions would the nurse include in this client's assessment? A. Which food types cause an exacerbation of symptoms? B. Where is your pain or discomfort and what does it feel like? C. Have you lost a significant amount of weight lately? D. Are your stools soft, watery, and black? E. Do you often experience nausea and vomiting

A,B the nurse would ask the client about factors that may cause exacerbations of symptoms, including food, stress, and anxiety. The nurse would also assess the location, intensity, and quality of the patient's pain or discomfort. Clients who have IBS do not usually lose weight, have nausea and vomiting, or have stools that are black.

The nurse is caring for a client who just had a minimally invasive inguinal hernia repair period which nursing actions would the nurse implement? A. Apply ice to the surgical area for the first 24 hours after surgery b. encourage ambulation with assistance within the first few hours after surgery c. encourage deep breathing after surgery but teach the client to avoid coughing d. assess vital signs frequently for the first few hours after surgery e. teach the client to rest for several days after surgery when at home f. teach the client not to lift more than 10 lbs until allowed by the surgeon

A,B,C,D,E,F all of these nursing actions are appropriate for the client having minimally invasive surgery for inguinal hernia repair

a nurse prepares to discharge a client who is newly diagnosed with the chronic inflammatory bowel disease. Which questions would the nurse ask and preparation for discharge? A. Does your gym provide yoga classes? B. When should you contact your provider? C. What do you plan to eat for dinner? D. Do you have a scale for daily weights? E. How many bathrooms are in your home?

A,B,C,E A home assessment for a client who has a chronic inflammatory bowel disease would include identifying adequacy and availability of bathroom facilities, opportunities for rest and relaxation, and the client's knowledge of dietary therapy, and when to contact the Primary Health care provider. The client does not need to perform daily weights

The nurse assists the wound care ostomy nurse assess a client prior to ostomy surgery. Which assessments would the nurse complete before marking the placement for the ostomy? A. Contour of the abdomen when standing b. location of the clients beltline c. contour of the abdomen when lying d. location of abdominal muscles e. contour of the abdomen when sitting

A,B,C,E before marking the placement for the ostomy, the nurse would consider the contour of the abdomen and lying, sitting, and standing positions, the location of the beltline and possible location in the rectus muscle. The location of abdominal muscles is not considered.

a nurse cares for an older adult who is admitted to the hospital with complications of diverticulitis. Which actions would the nurse include in the client's plan of care? A. Administer pain medications as prescribed b. palpate the abdomen for distention c. assess for sudden changes in mental status d. provide the client with a high fiber diet e. evaluate stools for occult blood

A,B,C,E when caring for an older adult who has diverticulitis, the nurse would administer analgesics as prescribed, palpate the abdomen for distension and tenderness, assess for confusion and sudden changes in mental status, and check stools for occult or frank bleeding. a low fiber residue diet would be approved when symptoms are present in a high fiber diet when inflammation resolves

After teaching a patient who has a permanent ileostomy, a nurse assesses the client's understanding. Which dietary items chosen for dinner indicate that the client needs further teaching? A. Corn b. string beans c. carrots d. wheat rice e. squash

A,B,D clients with an ileostomy should be cautious of high fiber and high cellulose foods including corn, string beans, and rice. Carrots and squash are low fiber items

The nurse assesses a client with ulcerative colitis. Which complications are paired correctly with their physiologic processes? A. Lower gastrointestinal bleeding-erosion of the bowel wall b. Abscess formation-localized pockets of infection develop in the ulcerated bowel lining c. toxic megacolon-transmural inflammation resulting in pyuria and fecaluria d. Fistula-dilation and colonic ilias caused by paralysis of the colon

A,B,D lower GI bleeding can lead to erosion of the bowel wall. Abscesses are localized pockets of infection that develop in the ulcerated bowel lining. Non mechanical bowel obstruction is paralysis of the colon that results from colorectal cancer. When the inflammation is transmural, fistulas can occur between the bowel and bladder resulting in pyuria and fecaluria. Paralysis of the colon causing dilation and subsequent colonic ileus is known as a toxic megacolon

the nurse is caring for a client who is diagnosed with celiac disease and preparing to start NATALIZUMAB. Which health teaching would the nurse include in the teaching? A. Need to have drug administered by a Primary Health care provider b. need to avoid crowds and individuals who have infection c. need to report injection reactions such as redness and swelling d. awareness of a rare but potentially fatal drug complication e. need to report any signs and symptoms of infection immediately

A,B,D,E all of these choices are correct except that the drug is given intravenously. Therefore, there is no need to teach the client to report injection reactions because the client does not self administer the medication subcutaneously. This drug can cause progressive multifocal leukoencephalopathy PML but it is a very rare disorder causing cognitive, sensory, and or motor changes

The nurse is caring for a client with peritonitis. What assessment findings would the nurse expect? A. Nausea and vomiting b. distended rigid abdomen c. abdominal pain d. Bradycardia e. decreased urinary output f. fever

A,C,D,E,F peritonitis is an acute inflammatory disorder. Therefore, the client would likely have all of these signs and symptoms but would have tachycardia rather than bradycardia due to dehydration from fever

A nurse is caring for a client who has been diagnosed with a small bowel obstruction. Which assessment findings would the nurse correlate with this diagnosis? A. Serum potassium of 2.8 mEq/L b. loss of 15 pounds 6.8 kilograms without dieting c. abdominal pain and upper quadrants d. low pitched bowel sounds e. serum sodium of 121 mEq/L

A,C,E small bowel obstructions often lead to severe fluid and electrolyte imbalances. The client is hypokalemic and hyponatremic. Abdominal pain across the upper quadrant is associated with small bowel obstruction. Dramatic weight loss without dieting followed by bowel obstruction leads to the probable development of colon cancer. High pitched sounds may be noted with small bowel obstructions.

The nurse is caring for a client who has perennial surgical wound. Which actions would the nurse take to promote comfort and wound healing? A. Assist the client into a sidelying position b. use a rubber doughnut device when sitting up c. apply warm compresses three to four times a day d. instruct the client to wear boxer shorts e. place an absorbent dressing over the wound

A,C,E the nurse would place an absorbent pad over the wound and apply warm compresses to the wound area. The nurse would also instruct the male client to wear jockey type shorts for support rather than boxers, assume a sideline position in bed, avoid sitting for long periods, and use foam pads or soft pillows whenever in a sitting position. The patient should avoid the use of air rings or rubber donut devices.

A client has dumping syndrome. What menu selections indicate the client understands the correct diet to manage this condition? a. apricots b. coffee cake c. milkshake d. potato soup e. steamed broccoli

A,D canned apricots and potato soup are appropriate selections as they are part of a high protein, high fat, and low to moderate carbohydrate diet. Coffee cake and other sweets must be avoided. Milk products and sweet drinks such as shakes must be avoided. Gas forming foods such as broccoli must be avoided also.

the nurse is caring for a client who has a nasogastric tube NGT. Which actions would the nurse take for client care? A. Assess the proper placement of the tube every four hours per agency policy b. flush the tube with water every hour to ensure patency c. Secure the Ng tube to the client's chin d. disconnect suction when auscultating bowel peristalsis e. monitor the client's skin around the tube site for irritation

A,D,E the nurse would frequently assess for NGT placement, patency, and output every four hours or per agency policy. The nurse would also monitor the skin around the tube for irritation and secure the tube to the client's nose. When auscultating bowel sounds for peristalsis, the nurse would disconnect suction. NGT irrigation may or may not be prescribed if it is prescribed, hourly irrigation is not appropriate.

A client is preparing to have a laparoscopic restorative proctocolectomy with ileo pouch-anal anastomosis (RCA-IPAA). Which preoperative health teaching would the nurse include? A. You will have to wear an appliance for your permanent ileostomy b. you should be able to have better bowel continence after healing occurs c. you will have a large abdominal incision that will require irrigation d. this procedure can be performed under general or regional anesthesia

B A RCA-IPAA Can improve bowel continence although leakage may still occur for some clients. The procedure is a two step process performed under general anesthesia using a laparoscope which does not require an abdominal incision or permanent ileostomy

the nurse is caring for a client who has been prescribed lubiprostone for irritable bowel syndrome IBS-C what health teaching will the nurse include about taking this drug? A. This drug will make you very dry because it will decrease your diarrhea b. be sure to take this drug with food and water to help manage Constipation c. avoid people who have infection as this drug will suppress your immune system d. include high fiber foods in your diet to help produce more solid stools

B LUBIPROSTONE is an oral laxative approved for women who have IBS with Constipation water and food will also help to improve Constipation. The drug is not used for clients who have diarrhea and does not affect the immune system. Although high fiber foods are important for clients who have IBS, this client does not need fiber to help make stools more solid. Instead the fiber will help prevent Constipation.

After teaching a client with irritable bowel syndrome IBS, the nurse assesses the client's understanding. Which menu selection indicates that the client correctly understands the dietary teaching? A. ham sandwich on white bread, cup of apple sauce, carbonated beverage b. broiled chicken with brown rice, steamed broccoli, glass of apple juice c. grilled cheese sandwich, small banana, cup of hot tea with lemon d. baked tilapia, fresh green beans, cup of coffee with low fat milk

B Patients with IBS are advised to eat a high fiber diet. Chicken with brown rice, broccoli, and apple juice has the highest fiber content. Client should avoid alcohol, caffeine, and other gastric irritants.

The nurse is caring for a client who is prescribed sulfasalazine. Question would the nurse ask the client before starting this drug? A. Are you taking vitamin C or B? b. Do you have any allergy to sulfa drugs? C. Can you swallow pills pretty easily? D. Do you have insurance to cover this drug?

B Sulfasalazine Is a sulfa drug given for clients who have ulcerative colitis. However, it should not be given to those who have an allergy to sulfa and sulfa drugs to prevent a hypersensitivity reaction

the nurse is caring for a client who is planning to have a laparoscopic: resection for colorectal cancer tomorrow. Which statement by the client indicates a need for further teaching? A. I should have less pain after the surgery compared to having a large incision b. I will probably be in the hospital for three to four days after surgery c. I will be able to walk around a little on the same day as the surgery d. I will be able to return to work a week or two depending on how I do

B all of these statements are correct about having minimally invasive laparoscopic surgery except that the hospital stay will likely be only one or two days.

the nurse is caring for a client who has a postoperative paralytic ileus following abdominal surgery. What drug is appropriate to manage this non mechanical bowel obstruction? A. alosetron b. alvimopan c. amitriptyline d. amlodipine

B alvimopan is the appropriate drug to promote peristalsis for clients who have a paralytic ileus. The other drugs do not affect intestinal activity.

A client has a nasogastric Ng tube as a result of an upper gastrointestinal GI hemorrhage. What comfort measure would the nurse remind assistive personnel to provide? a. leveraging the tube with ice water b. performing frequent oral care c. repositioning the tube every four hours d. taking and recording vital signs

B clients with Ng tubes need frequent oral care both for comfort and to prevent infection. Leveraging the tube is done by the nurse. Repositioning the tube, if needed, is also done by the nurse. They can take vital signs but this is not a comfort measure

a nurse cares for a client with a new ileostomy. The client states, I don't think my friends will accept me with this ostomy. How would the nurse respond? A. Your friends will be happy that you are alive b. tell me more about your concerns c. a therapist can help you resolve your concerns d. with Time you will accept your new body

B social anxiety and apprehension are common in clients with the new ileostomy. The nurse would encourage the client to discuss concerns by restating them in an open-ended manner. The nurse would not minimize the clients concerns or provide false reassurance

A client is preparing to have a fecal occult blood test capital FOBT. what health teaching would the nurse include prior to the test? A. This test will determine whether you have colorectal cancer b. you need to avoid red meat and NSAIDs for 48 hours before the test c. you don't need to have this test because you can have a virtual colonoscopy d. this test can determine your genetic risk for developing colorectal cancer

B the capital FOBT Training test that is sometimes used to assess for microscopic lower GI bleeding period to help prevent false positive results, the client needs to avoid red meat, vitamin C, and NSAID S. The test is not diagnostic nor does it determine a client's genetic risk for colorectal cancer.

A client has a recurrence of gastric cancer and is crying. What response by the nurse is most appropriate? a. do you have family or friends for support? b. would you tell me what you are feeling now c. well, we knew this would probably happen d. would you like me to refer you to Hospice?

B the nurse assesses the clients emotional state with open-ended questions and statements and shows a willingness to listen to the clients concerns. Asking about support people is very limited in nature, and yes or no questions are not therapeutic. Stating that this was expected dismisses the client's concerns. The client may or may not be ready to hear about Hospice, and that is another limited yes or no question

The nurse is teaching a client who had a descending colostomy 2 days ago about the ostomy stoma. Which changes in the stoma would the nurse teach the client to report to the Primary Health care provider? A. Stool consistency is similar to paste b. stoma becomes dark and dull c. skin around the stoma becomes excoriated d. skin around the stoma becomes protruded e. stoma becomes retracted into the abdomen

B,C,D,E a colostomy placed in the descending: would be expected to have a paste like stool consistency. However, if the stoma becomes retracted or discolored, the client should report those changes to the Primary Health care provider. Skin around the stoma that becomes protruded would suggest the formation of a peristomal hernia, and skin excoriation needs appropriate management. Therefore, both of those skin changes would need to be reported to the Primary Health care provider.

a nurse cares for a patient who has a chronic inflammatory bowel disease. Which actions would the nurse take to prevent skin excoriation? A. Cleanse the perineum with an antibacterial soap b. Use medicated wipes instead of toilet paper c. identify foods that decrease Constipation d. Apply a thin coat of aloe cream to the perineum e. gently pat the perineum dry after cleansing

B,D,E To prevent skin excoriation from frequent bowel movements associated with inflammatory bowel disease, the nurse would encourage good skin care with the mild soap and water and gently patting the area dry after each bowel movement. Using medicated wipes instead of toilet paper and applying a thin coat of aloe cream are appropriate. The client should identify and avoid foods that increase diarrhea. Antibacterial soaps are harsh and should not be used

A nurse assesses a client who has ulcerative colitis and severe diarrhea. Which assessment would the nurse complete first? A. Inspection of oral mucosa b. recent dietary intake c. heart rate and rhythm d. percussion of abdomen

C although the client with severe diarrhea may experience skin irritation and hypovolemia, the client is most at risk for cardiac dysrhythmias secondary to potassium and magnesium loss from severe diarrhea. The client would have her or his electrolyte levels monitored, and electrolyte replacement may be necessary. Oral mucosa inspection, recent dietary intake, and abdominal percussion are important parts of physical assessment but are lower priority for this patient than heart rate and rhythm

after teaching a client who has diverticulitis, a nurse assesses the client's understanding. Which statement made by the client indicates a need for further teaching? A. I will ride my bike or take a long walk at least three times a week b. I must try to include at least 25 grams of fiber in my diet every day c. I will take a laxative nightly at bedtime to avoid becoming constipated d. I should use my legs rather than my back muscles when I lift heavy objects

C laxatives are not recommended for patients with diverticulitis because they can increase pressure in the bowel, causing additional outpouching of the lumen. Exercise and high fiber diet are recommended for clients with diverticulitis because they promote regular bowel function. Using the leg muscles rather than the back for lifting prevents abdominal straining

A nurse cares for a client with colorectal cancer who has a new colostomy. The client states, I think it would be helpful to talk with someone who has had a similar experience. How would the nurse respond? A. I have a good friend with a colostomy who would be willing to talk with you b. the ostomy nurse will be able to answer all of your questions c. I will make a referral to the United ostomy association of America d. you will find that most people with colostomies don't want to talk about them

C nurses need to become familiar with community based resources to better assist clients. The local chapter of the United ostomy associations of America has resources for clients and their families including ostomates specially trained visitors who have ostomies.

the nurse is caring for a client who was diagnosed with a complete small bowel obstruction. For what priority problem is this client most likely at risk? A. Abdominal distention b. nausea c. electrolyte imbalance d. obstipation

C the client who has a small bowel obstruction is at the highest risk for fluid and electrolyte imbalances, especially dehydration and hypokalemia due to profuse vomiting. Nausea, abdominal distention, and obstipation are also usually present, but these problems are not as life threatening as the imbalances in electrolytes.

A client is admitted with a diagnosis of possible strangulated inguinal hernia. For which complication would the nurse monitor? A. Paralytic ileus b. bowel volvulus c. Sepsis d. colitis

C the client who has a strangulated inguinal hernia would likely develop bowel necrosis which can lead to sepsis. The nurse would observe for early signs and symptoms of sepsis, such as fever, tachypnea, and tachycardia. If the client's condition is not promptly managed, bowel perforation, septic shock, and death can result.

a nurse teaches a client who is at risk for colorectal cancer. Which dietary recommendation would the nurse teach the client? A. Eat low fiber and low residual foods b. white rice and bread are easier to digest c. add vegetables such as broccoli and cauliflower to your diet d. food Thai and animal fat help to protect the intestinal mucosa

C the client would be taught to modify his or her diet to decrease animal fat and refined carbohydrates. The client should also increase high fiber foods and brassica vegetables, including broccoli and cauliflower, which helped to protect the intestinal mucosa from colon cancer.

The nurse is teaching a client how to avoid the formation of hemorrhoids. What lifestyle change would the nurse include? A. Avoiding alcohol b. quitting smoking c. decreasing fluid intake d. increasing dietary fiber

C the major cause of hemorrhoid formation is Constipation. Therefore, the nurse teaches the client ways to prevent Constipation, which include increasing dietary fiber, increasing exercise and fluid intake, and avoiding straining when having a stool.

A nurse cares for a young client with a new ileostomy. The client states, I cannot go to prom with an ostomy. How would the nurse respond? A. Sure you can. Purchase a prom dress one size larger to hide the ostomy appliance b. the pouch won't be noticeable if you avoid broccoli and carbonated drinks prior to the prom c. let's talk to the ostomy nurse about options for ostomy supplies and dress styles d. you can remove the pouch from your ostomy appliance when you are at the prom so that it is less noticeable

C the ostomy nurse is a valuable resource for patients, providing suggestions for supplies and methods to manage the ostomy. A larger dress will not necessarily help hide the ostomy appliance. Avoiding broccoli and carbonated drinks does not offer reassurance for the client. Ileostomies have an almost constant liquid, so powder removal during the prom is not feasible

a nurse assessing a client with colorectal cancer auscultates high pitched bowel sounds and notes the presence of visible peristaltic waves. Which action would the nurse take? A. Ask if the client is experiencing pain in the right shoulder b. perform a rectal examination and assess for polyps c. recommend that the client have computed tomography d. administer elective to increase bowel movement activity

C the presence of visible peristaltic waves, accompanied by high pitched or high pitched bowel sounds, is indicative of bowel obstruction caused by the tumor. The nurse would contact the Primary Health care provider with these results and recommend a computed tomography scan for further diagnostic testing period the assessment finding is not associated with right shoulder pain, peritonitis and Cholecystitis are associated with referred pain to the right shoulder. The nurse generalist is not qualified to complete a rectal examination for polyps, and laxatives would not help this client.

The nurse assesses a client who has possible gastritis. Which assessment findings indicate that the client has chronic gastritis? a. anorexia b. dyspepsia c. intolerance of fatty foods d. PERNICIOUS anemia e. nausea and vomiting

C, D intolerance of fatty or spicy foods and pernicious anemia are signs of chronic gastritis. Anorexia and nausea and vomiting can be seen in both conditions. Dyspepsia is seen in acute gastritis.

After teaching a client who is recovering from a colon resection to treat early stage colorectal cancer, the nurse assesses the client's understanding. Which statements by the client indicate understanding of the teaching? A. I must change the ostomy appliance daily and as needed b. I will use warm water and a soft washcloth to clean around the stoma c. I might start bicycling and swimming again once my incision has healed d. I will make sure that I make lifestyle changes to prevent Constipation e. I will be sure to have recommended colonoscopies

C,D,E the client has had a colon resection for early CRC and there is no indication that the client also had a colostomy. Follow up with recommended colonoscopies are essential to monitor for CRC recurrence. Avoiding Constipation will help improve intestinal motility which helps to decrease the risk for CRC recurrence. Exercise and other activities do not need to be restricted after the client has healed.

After teaching a patient with diverticular disease a nurse assesses the client's understanding. Which menu selection indicates the client correctly understood the teaching? A. Roasted chicken with rice pilaf and a cup of coffee with cream b. spaghetti with meat sauce, a fresh fruit cup, and hot tea c. garden salad with a cup of bean soup and a glass of low-fat milk d. baked fish with steamed carrots and a glass of apple juice

D clients who have diverticular disease are prescribed a low residue diet. Whole grains (rice pilaf), uncooked fruits and vegetables( salad fresh fruit cup), and high fiber foods (cup 240mL, of bean soup) would be avoided with a low residue diet. Canned or cooked vegetables are appropriate. Apple juice does not contain fiber and is acceptable for a low residue diet.

The nurse caring for clients with gastrointestinal disorders would recall that omeprazole is a drug in which classification? a. gastric acid inhibitor b. histamine receptor blocker c. mucosal barrier fortifier d. proton pump inhibitor

D omeprazole is a proton pump inhibitor

The nurse assesses a client with gastroenteritis. What risk factors would the nurse consider as the most likely cause of this disorder? A. Consuming too much fruit b. consuming fried or pickled foods c. consuming dairy products d. consuming raw seafood

D raw seafood is often contaminated and unless cooked can would most likely cause gastroenteritis. Any of the other food can also become contaminated if not stored properly or contaminated by workers cooks who contaminate these foods

A nurse cares for a client who has a family history of colorectal cancer. The client states, my father and my brother had colon cancer. What is the chance that I will get cancer? How would the nurse respond? A. If you eat a low fat and low fiber diet, your chances decrease significantly b. you are safe. This is an autosomal dominant disorder that skips generations c. preemptive surgery and chemotherapy will remove cancer cells and prevent cancer d. you should have a colonoscopy more frequently to identify abnormal polyps early

D the nurse would encourage the patient to have frequent colonoscopies to identify abnormal polyps and cancerous cells early.

The nurse is teaching a client who has been treated for acute gastritis what statement by the client indicates a need for further teaching a. I need to cut down on drinking martinis every night b. I should decrease my intake of caffeinated drinks especially coffee c. I will only take ibuprofen once in a while when I really need it d. I can continue smoking cigarettes which is better than chewing tobacco

D to prevent another episode of acute gastritis alcohol caffeinated drinks and NSAIDS should be avoided or kept to a minimum smoking in all forms of tobacco should also be avoided

A client has dumping syndrome after a partial gastrectomy. Which action by the nurse would be appropriate? a. arrange a dietary consult b. increase fluid intake c. limit the clients foods d. make the client NPO

a the client with dumping syndrome after a gastrectomy has multiple dietary needs. A referral to the registered dietitian nutritionist will be extremely helpful. Food and fluid intake is complicated and needs planning period the client should not be NPO

The nurse is teaching a client about risk factors for esophageal cancer. which risk factors would the nurse include? a. alcohol intake b. obesity c. smoking d. lack of fresh fruits and vegetables e. untreated GERD f. use of NSAIDs

a,b,c,d,e

The nurse is teaching a client about the risk of uncontrolled or untreated (GERD). what complications may occur if the GERD is not successfully managed? a. asthma b. laryngitis c. dental caries d. cardiac disease e. cancer

a,b,c,d,e

The nurse is caring for a client diagnosed with probable gastroesophageal reflux disease (GERD) what assessment findings would the nurse expect? a. dyspepsia b. regurgitation c. belching d. coughing e. chest discomfort f. dysphagia

a,b,c,d,e,f all of these signs and symptoms are commonly seen in clients who have GERD

A client had an endoscopic retrograde cholangiopancreatography (ERCP) the nurse teaches the client and family about the signs of potential complications which include what problems? a. cholangitis b. pancreatitis c. perforation d. renal lithiasis e. sepsis

a,b,c,e

The nurse working with older clients understands age-related changes in the gastrointestinal system. which changes does this include? a. decreased hydrochloric acid production b. diminished sensation that can lead to constipation c. fat not digested as well in older adults d. increased peristalsis in the large intestine e. pancreatic vessels become calcified

a,b,c,e

the nurse recalls that the risk factors for acute gastritis include which of the following? a. alcohol b. caffeine c. corticosteroids d. fruit juice e. non steroidal anti-inflammatory drugs (NSAIDs)

a,b,c,e risk factors for acute gastritis include alcohol, caffeine, corticosteroids, and chronic NSAID use. Fruit juice is not a risk factor, although in some people it does cause distress.

A nurse cares for a client who is recovering from a colonoscopy. which actions would the nurse take? a. obtain vs every 15 to 30 minutes until alert b. assess the client for rectal bleeding and severe pain c. administer prescribed pain meds as needed d. monitor the clients serum and urine glucose levels e. confirm the client has a ride home and plans to rest

a,b,e

The nurse is caring for a client with sialadenitis. what comfort measures are appropriate for this client? a. applying warm compresses b. applying ice to salivary glands c. offering fluids every hour d. providing lemon-glycerin swabs e. reminding the patient to avoid speaking

a,c warm compresses and fluids help promote comfort for this client.

The nurse is caring for a client experiencing upper gastrointestinal GI bleeding. What is the priority action for the client's care? a. maintain airway, breathing, and circulation b. monitor vital signs, including orthostatic blood pressures c. draw blood for hemoglobin and hematocrit immediately d. insert a nasogastric Ng tube and connect to intermittent suction

a. the priority action for any client experiencing deterioration or an emergent situation is monitor and maintain airway, breathing, and circulation ABC's. Taking orthostatic blood pressures would not be appropriate, but the nurse would monitor vital signs carefully and draw blood for hemoglobin and hematocrit. And Ng tube would also need to be inserted and connected to gastric suction to rest the GI tract. However, none of these actions take priority over maintaining ABC's

The nurse is teaching a client diagnosed with gastroesophageal reflux disease (GERD) who is planning to have an endoscopic radiofrequency (stretta) procedure. what preprocedure health teaching would the nurse include? a. you will need to be on a liquid diet for the first week after the procedure b. avoid taking any nsaids like ibuprofen for 10 days before the procedure c. contact the primary health care provider after the procedure if you have increased pain d. you will need a nasogastric tube for a few days after the procedure e. you will have a small incision in your stomach area that will have a wound closure

b,c the client having this procedure does not have an incision and will not require a nasogastic tube. the client should should avoid an ngt placement for at least a month after the procedure. a liquid diet is required for only 24 hours after the procedure and then the client should progress to include soft foods like custard and applesauce

The nurse is caring for a client that had an open traditional esophagectomy. which assessment findings would the nurse report immediately to the primary care provider? a. nausea b. wound dehiscence c. fever d. tachycardia e. moderate pain f. fatigue

b,c,d wound dehiscence is a serious, potentially life threatening problem that needs immediate attention of the primary health care provider, typically the surgeon. fever and tachycardia may indicate that the client has a postoperative infection, another serious, potentially life threatening complication

The nurse working with clients who have gastrointestinal problems knows that which lab values are related to which organ functions or dysfunctions? a. alanine aminotransferase-biliary system b. ammonia-liver c. amylase-liver d. lipase-pancreas e. urine urobilinogen-stomach

b,d

The primary healthcare provider documents that a client has a bruit over the abdominal aorta. what teaching will the nurse provide for assistive personnel based on this assessment? a. use warn compresses on clients abdomen continuously. b. avoid washing the client's abdomen too aggressively. c. apply ice to the clients abdomen every 4 hours. d. massage the clients abdomen to help reduce pain.

b. a bruit heard over the abdominal aorta indicates possible stenosis or an aneurysm which should not be palpated or percussed. therefore the ap should wash the clients abdomen very gently

The nurse is caring for a client diagnosed with oral cancer. what is the nurse's priority for client care? a. encourage fluids to liquify the clients secretions b. place the client on aspiration precautions c. remind the client to use an incentive spirometer d. manage the clients pain and inflammation

b. the client who has oral cancer often has difficulty swallowing and is at risk for aspiration and possibly aspiration pneumonia. therefore, the most important nursing action is to place the client on precautions to prevent aspiration.

The nurse is teaching a client diagnosed with stomatitis about special mouth care. Which statement by the client indicates a need for further teaching? a. I need to take out my dentures until my mouth heals. b. I'll try to eat soft foods that arent spicy and acidic. c. I will use a more firm toothbrush to keep my mouth clean. d. I'll be sure to rinse my mouth often with warm salt water.

c. The client who has oral inflammation which causes discomfort. Therefore, all of these actions help to avoid irritation except for needing to use a soft toothbrush or gauze rather than a firm one.

the nurse is caring for a client who has been diagnosed with peptic ulcer disease for which complications would the nurse monitor a. large bowel obstruction b. dyspepsia c. upper gastrointestinal GI bleeding d. gastric cancer

c. peptic ulcer disease PUD can cause gastric mucosal damage or perforation which causes upper GI bleeding. Dyspepsia is a symptom of PUD gastritis and gastric cancer. PUD affects the stomach and/or duodenum not the colon

A client is having an esophagogastroduodenoscopy (EGD) and has been given midazolam hydrochloride. the clients respiratory rate is 8 bpm. what action by the nurse is appropriate? a. administer naloxone b. call the rapid response team c. provide physical stimulation d. ventilate with a bag valve mask

c. provide physical stimulation for shallow is slow respirations after the sedation is given the nurses most appropriate action is to provide a physical stimulation such as a sternal rub and directions to breath deeply

Which of these client assessment findings is typically associated with oral cancer? a. dry sticky oral membranes b. increased appetite c. itchy rash in oral cavity d. painless red or raised lesion

d. a painless red or raised lesion often indicates a diagnosis of oral cancer. the client usually has a decreased appetite and thick secretions. itching is not a common finding associated with oral cancer.

The nurse is interviewing a client who reports having abdominal cramping, bloating, and diarrhea after drinking milk or ingesting other dairy products. What problem does the client most likely have? a. steatorrhea b. ulcerative colitis c. crohn disease d. lactose intolerance

d. lactose intolerance

A client who has peptic ulcer disease is prescribed quadruple drug therapy for HELICOBACTER PYLORI Infection. What health teaching related to bismuth would the nurse include? a. report stool changes to your Primary Health care provider immediately b. do not take aspirin or aspirin products of any kind while on bismuth c. take bismuth about 30 minutes before each meal and at bedtime d. be aware that bismuth can cause frequent vomiting and diarrhea

diarrhea b bismuth is a salicylate drug and causes stool discoloration but not vomiting and diarrhea. It does not have to be taken at a specific time relative to meals. Clients taking bismuth should not take other salicylates such as aspirin or aspirin containing products.