GI Adaptive Quizzing

The nurse has provided postoperative teaching to a client who is scheduled for a bilateral herniorrhaphy. Which client statement indicates correct understanding of the teaching?

"I should cough and deep breathe regularly."

A client with ascites has a paracentesis, and 1500 mL of fluid is removed. The nurse recognizes that it is important to monitor the client for what signs of complications that may occur immediately after the procedure? Select all that apply.

Rapid, thready pulse Decreased blood pressure

A nurse is preparing a morbidly obese client for gastric bypass surgery. What should the nurse teach the client to do after surgery?

Take medications in liquid form.

A client is recently diagnosed with an oral cancerous lesion. Which question should the nurse ask when assessing the client's need for instruction in relation to this condition?

"Have you noticed any change in your appetite?"

A client who was admitted to the hospital with metastatic cancer has a temperature of 100.4° F (38° C), a distended abdomen, and abdominal pain. The client asks the nurse, "Do you think that I'm going to have surgery?" How should the nurse respond?

"You seem concerned about having surgery."

A client returns from surgery after an abdominal cholecystectomy for a gangrenous gallbladder. For which postoperative complication, associated with the location of the surgical site, should the nurse assess the client?

Atelectasis

A nurse is providing discharge instructions for a client with a diagnosis of gastroesophageal reflux disease (GERD). What should the nurse advise the client to do to limit symptoms of GERD? Select all that apply.

Avoid heavy lifting. Avoid drinking alcohol. Eat small, frequent meals.

A nurse is caring for a client who just had a gastrectomy. What should the nurse emphasize when teaching the client how to avoid dumping syndrome?

Eat small meals with low carbohydrate and moderate fat content

A client who had surgery for a ruptured appendix develops peritonitis. Which clinical findings related to peritonitis should the nurse expect the client to exhibit? Select all that apply.

Fever Urinary retention Abdominal muscle rigidity

The nurse is providing postoperative care for a client who had an extensive surgical revision of the head of the pancreas. To decrease the risk of hemorrhage at the operative site, what action should the nurse take?

Maintain patency of the nasogastric tube.

A nurse has provided dietary instructions for a client who is being discharged following a gastroduodenostomy (Billroth I). Which client statement indicates correct understanding of the teaching?

"I need to eat six small meals every day, limiting bulk."

A nurse is assessing a client with severe liver disease. Which assessment finding will the nurse expect to observe?

Icterus

A client is scheduled for an abdominal surgery. What is the priority preoperative nursing objective when caring for this client?

Alleviating the client's anxiety

A client had part of the ileum surgically removed. The nurse monitors the client closely for anemia. What is the rationale for the nurse's action?

Cobalamin is absorbed in the ileum.

Following a cholecystectomy to remove a cancerous gallbladder, the client has a T-tube in place. The T-tube drains 300 mL of bile-colored fluid during the first 24 hours after surgery. What should the nurse do?

Consider this an expected response after surgery and record the results.

After taking spironolactone, the client inquires about foods and fluids that contain potassium. Which juice should the nurse recommend?

Cranberry juice

Which should the nurse identify as a risk factor for hyponatremia?

Drainage from a T-tube

A client with cancer of the stomach is admitted to the hospital and scheduled for a subtotal gastrectomy. The nurse is providing preoperative teaching. What should the nurse teach the client to do postoperatively to minimize the complication of dumping syndrome?

Eat 5 or 6 small meals a day.

To help prevent long-term complications associated with gastric bypass surgery, the nurse needs to educate the client. Identify the factors that should be included in the nurse's teaching plan for this client. Select all that apply.

Eat foods rich in calcium. Consume a diet high in protein. Receive cyanocobalamin injections routinely.

A client with the diagnosis of ulcerative colitis has surgery for the creation of an ileostomy. Postoperatively, for which potential life-threatening complication should the nurse assess the client?

Electrolyte imbalances

After surgery to create an ileal conduit, a client awakens and asks for a sip of water. The nurse informs the client that water by mouth cannot be given until what occurs?

Nasogastric suction is discontinued

A client with a diagnosis of stomach cancer expresses a lack of interest in food and consumes only small amounts. What is the best intervention the nurse should offer this client?

Nutritional supplements between meals

The nurse is performing an abdominal assessment on a client. Where on the abdomen should the nurse assess for McBurney point?

Right lower quadrant (RLQ)

An older client with a history of chronic constipation develops acute appendicitis. Prior to arrival at the hospital, the client attempted self-care at home. Which self-care measures could potentially lead to rupture of the appendix?

Self-administering a small volume enema

A nurse is caring for a client with acute pancreatitis. Which elevated laboratory test result is most indicative of acute pancreatitis?

Serum lipase

A client reports pain as a result of a gastric ulcer. What clinical findings is the nurse most likely to identify during an assessment of the client's pain? Select all that apply.

Vomiting relieves pain. Pain is described as gnawing. Pain occurs half an hour after meals.

A client with a history of pancreatitis is scheduled for surgery to excise a pseudocyst of the pancreas. The client asks, "What is a pseudocyst?" Which information should the nurse include in a response to this question?

Walled-off space of pancreatic enzymes and exudate

After a subtotal gastrectomy, a client has a nasogastric (NG) tube to continuous low suction. Three hours after the surgery, the client complains of nausea and abdominal pain. The client's abdomen appears distended. What should the nurse do first?

Instill 30 mL of air into the NG tube

The nurse is caring for a client scheduled to have a percutaneous liver biopsy. Which assessment findings warrant the postponement of the procedure? Select all that apply.

Marked ascites Hemoglobin of less than 9 g/dL (90 mmol/L)

A client is admitted to the hospital for the surgical repair of an incarcerated indirect inguinal hernia. What is the primary preoperative nursing intervention for this client?

Observing the client's bowel movements

Before a male client signs an operative consent for an abdominoperineal resection, the nurse verifies that the client understands that surgery likely will result in which outcome?

Permanent colostomy and impotence

A client with extensive gastric carcinoma is admitted to the hospital for an esophagojejunostomy. What information should the nurse include in the teaching plan when preparing this client for surgery?

Postoperative chest tube

A client appears depressed since the surgical creation of a colostomy five days ago. The nurse determines that there is some movement toward adaptation to the change in body image when the client exhibits which behavior?

Stares at the stoma during dressing changes

During administration of an enema, a client reports having intestinal cramps. What should the nurse do?

Stop the fluid until the cramps subside.

After many years of coping with ulcerative colitis, a client makes the decision to have a colectomy as advised by the primary healthcare provider. Which is most likely the significant factor that impacted on the client's decision?

Surgical treatment cures ulcerative colitis.

A nurse provides dietary teaching about a low-sodium diet for a client with hypertension. Which nutrient selected by the client indicates a correct understanding about foods that are low in natural sodium?

Fruits

The nurse teaches the client about foods to help prevent constipation after pelvic surgery. Which foods selected by the client indicate that the teaching is understood? Select all that apply.

Green vegetables Steamed cabbage Whole grain bread

A client with a long history of alcohol abuse is admitted to the hospital with ascites and jaundice. A diagnosis of hepatic cirrhosis is made. Which is a nursing priority?

Institute fall prevention/safety measures.

A client admitted to the hospital with a small bowel obstruction is to have an intestinal tube inserted. When preparing the client for the procedure, what action should the nurse take?

Instruct the client about techniques for mouth breathing

A client had surgery for a strangulated hernia. One hour after surgery the client's blood pressure drops from 134/80 to 114/76 mm Hg. Assessment reveals that the client does not have postoperative bleeding. What action should the nurse take?

Instruct the client to move both legs.

A client with ascites has been scheduled for a paracentesis. What intervention should the nurse implement immediately before the procedure?

Instruct the client to void

A client has a low hemoglobin level that is attributed to a nutritional deficiency. Which foods should the nurse teach the client to increase in the diet? Select all that apply.

Liver Spinach

A client is scheduled for a barium swallow. How should the nurse prepare the client for this test? Select all that apply.

Ensure that a laxative is prescribed after the test. Instruct to withhold prescribed opioids for one day before the test.

A primary healthcare provider diagnoses a client with acute cholecystitis with biliary colic. Which clinical findings should the nurse expect when performing a health history and physical assessment? Select all that apply.

Intolerance to foods high in fat Pain that radiates to the right shoulder