GI passport
A client with acute liver failure exhibits confusion, a declining level of consciousness, and slowed respirations. The nurse finds the client very difficult to arouse. The diagnostic information which best explains the client's behavior is a. subnormal serum glucose and elevated serum ammonia levels. b. subnormal clotting factors and platelet count. c. elevated blood urea nitrogen and creatinine levels and hyperglycemia. d. elevated liver enzymes and low serum protein level.
a. subnormal serum glucose and elevated serum ammonia levels.
Which statement indicates that the client understands the home care of a colostomy? a. "I can anticipate some pain around my stoma when I clean it." b. "I should be able to establish a regular pattern of elimination with my colostomy." c. "I can attach my colostomy pouch directly to my skin as long as it is not irritated." d. "I can expect to see some blood in my stool on occasion."
b. "I should be able to establish a regular pattern of elimination with my colostomy."
Which statement, made by a client with a hiatal hernia, indicates that the client understands the treatment plan? a. "I will need to have my INR/PT every two weeks." b. "I will sit in a chair for several hours after I eat." c. "I will lie down for 15 minutes after I eat." d. "I will lie on my left side at night to decrease reflux."
b. "I will sit in a chair for several hours after I eat."
A client is admitted to the health care facility with abdominal pain, a low-grade fever, abdominal distention, and weight loss. Based on the diagnosis of acute pancreatitis the nurse will provide which explanation for the prescribed interventions? a. "I can offer you ibuprofen for pain with a small sip of water." b. "You are not allowed anything by mouth so that your pancreas can rest." c. "Activity is important, so you will be scheduled for physical therapy." d. "I will be starting antibiotic therapy once the blood cultures are obtained."
b. "You are not allowed anything by mouth so that your pancreas can rest."
A client who underwent abdominal surgery and has a nasogastric (NG) tube in place begins to report of abdominal pain described as "feeling full and uncomfortable." Which assessment should the nurse perform first? a. Auscultate bowel sounds. b. Assess patency of the NG tube. c. Assess vital signs. d. Measure abdominal girth.
b. Assess patency of the NG tube.
The client with a nasogastric (NG) tube has abdominal distention. What should the nurse do first? a. Call the health care provider (HCP). b. Check the function of the suction equipment. c. Irrigate the NG tube. d. Reposition the NG tube.
b. Check the function of the suction equipment.
The nurse is teaching a client with stomatitis about managing oral discomfort. Which instruction is most appropriate? a. drink hot tea at frequent intervals. b. Eat a soft, bland diet. c. Use an electric toothbrush. d. Gargle with an antiseptic mouthwash.
b. Eat a soft, bland diet.
The nurse develops a plan of care for a client with a T-tube. Which nursing intervention should be included? a. Keep the T-tube clamped except during meal times. b. Inspect the skin around the T-tube daily for irritation. c. Maintain the client in a supine position while the T-tube is in place. d. Irrigate the T-tube every 4 hours to maintain patency.
b. Inspect the skin around the T-tube daily for irritation.
A nurse is providing dietary instructions to a client with a history of pancreatitis. Which instructions would be most appropriate? a. Maintain a high-fat, low-carbohydrate diet. b. Maintain a high-carbohydrate, low-fat diet. c. Maintain a low-carbohydrate, low-fat diet. d. Maintain a high-fat, high-carbohydrate diet.
b. Maintain a high-carbohydrate, low-fat diet.
The nurse is teaching a client about managing a hiatal hernia. Which lifestyle modification should the nurse encourage the client with a hiatal hernia to include in activities of daily living? a. balancing activity and rest b. eliminating smoking and alcohol use c. avoiding high-stress situations d. engaging in daily aerobic exercise
b. eliminating smoking and alcohol use
A client has a nasogastric tube inserted at the time of abdominal perineal resection with a permanent colostomy. This tube will most likely be removed when the client demonstrates which finding? a. passage of mucus from the rectum b. passage of flatus and feces from the colostomy c. absence of nausea and vomiting d. absence of stomach drainage for 24 hours
b. passage of flatus and feces from the colostomy
A client admitted for treatment of a gastric ulcer is being prepared for discharge on antacid therapy. Which statement made by the client indicates understanding of discharge teaching? a. "I'll take my antacid in the morning with my other medications." b. "I should not take antacids with magnesium, because I have a heart problem." c. "I'll continue to take my antacid even if I feel better." d. "My antacid will work best if I take it with my meals."
c. "I'll continue to take my antacid even if I feel better."
The client with an intestinal obstruction continues to have acute pain even though the nasoenteric tube is patent and draining. What should the nurse do first? a. Reassure the client that the nasoenteric tube is functioning. b. Administer an opioid as prescribed. c. Assess the client for signs of peritonitis. d. Reposition the client on the left side.
c. Assess the client for signs of peritonitis.
A nurse is caring for a client 24 hours after an abdominal-perineal resection for a bowel tumor. The client's spouse asks if they can bring the client some of their favorite home-cooked Italian minestrone soup. What should the nurse do first? a. Consult the dietician. b. Ask the client if they feel hunger or gas pains. c. Auscultate for bowel sounds. d. Encourage the spouse to bring the soup.
c. Auscultate for bowel sounds.
The nurse is admitting a client with acute appendicitis to the emergency department. The client has abdominal pain of 10 on a pain scale of 1 to 10. The client will be going to surgery as soon as possible. What should the nurse do next? a. Maintain the client in a recumbent position. b. Contact the surgeon to request a prescription for an opioid for the pain. c. Place the client on nothing-by-mouth (NPO) status. d. Apply heat to the abdomen in the area of the pain.
c. Place the client on nothing-by-mouth (NPO) status.
A client with a history of peptic ulcer disease is admitted to the hospital. Initial assessment reveals that the blood pressure is 96/60 mm Hg, with a heart rate of 120 bpm. The client just vomited coffee-ground-like material. Based on these data, what should the nurse do first? a. Place the client in a modified Trendelenburg position. b. Collect data regarding recent client stressors. c. Prepare to insert a nasogastric (NG) tube. d. Administer an antiemetic.
c. Prepare to insert a nasogastric (NG) tube.
A health care provider orders lactulose, 30 ml three times daily, for a client with cirrhosis to treat elevated serum ammonia level. The nurse will know that this medication is effective by which finding? a. The client will have an increase in urine output. b. The client would develop diarrhea. c. The client's level of consciousness (LOC) would improve. d. Abdominal swelling would decrease.
c. The client's level of consciousness (LOC) would improve.
A client has had an incisional cholecystectomy. Which of the following nursing interventions has the highest priority in postoperative care for this client? a. Maintaining a weight-reduction diet. b. Promoting incisional healing. c. Using incentive spirometry every 2 hours while awake. d. Performing leg exercises every shift.
c. Using incentive spirometry every 2 hours while awake.
A nurse is caring for a client with cholelithiasis. Which sign indicates obstructive jaundice? a. straw-colored urine b. reduced hematocrit c. clay-colored stools d. elevated urobilinogen in the urine
c. clay-colored stools
A client with cancer of the stomach had a total gastrectomy 2 days earlier. Which finding indicates the client is ready to try a liquid diet? The client: a. has had a bowel movement. b. is hungry. c. has frequent bowel sounds. d. took pain medication 2 hours ago.
c. has frequent bowel sounds.
When planning care for a client with a small-bowel obstruction, which should the nurse consider to be the primary goal? a. reporting pain relief b. ambulating 4 times per day c. maintaining fluid balance d. maintaining body weight
c. maintaining fluid balance
The nurse is caring for a client with an inguinal hernia. Which position is best for the nurse to assess the client's hernia? a. sitting b. right side-lying c. standing d. left side-lying
c. standing
The nurse is teaching a client with peptic ulcer disease how to take sucralfate. Which statement indicates that the client understands how to take the medication? a. "I should avoid milk products while taking this drug." b. "I should take the sucralfate every evening at bedtime." c. "I should have my hemoglobin checked monthly while taking sucralfate." d. "It's important that I take this drug on an empty stomach."
d. "It's important that I take this drug on an empty stomach."
A client who is recovering from a subtotal gastrectomy experiences dumping syndrome and is to eat six small meals a day. The client asks the nurse, "When will I be able to eat three meals a day again like I used to?" Which response by the nurse is most appropriate? a. "You will be able to tolerate three meals a day before you are discharged." b. "Eating six meals a day is time-consuming, isn't it?" c. "You will have to eat six small meals a day for the rest of your life." d. "Most clients can resume their normal meal patterns in about 6 to 12 months."
d. "Most clients can resume their normal meal patterns in about 6 to 12 months."
The nurse is caring for a client 1 day after having a colectomy. The client is lethargic and difficult to arouse; the temperature is 101.5°F (38.6°C), blood pressure is 92/36 mm Hg (mean arterial pressure [MAP 55 mm Hg]), and heart rate is 114 bpm, with a percutaneous oxygen saturation (SpO2) of 88% on oxygen at 2 L per minute per nasal cannula (previously 94%). A saline lock has been established and is patent. Which prescription should the nurse implement first? a. Obtain stat portable chest x-ray. b. Insert an indwelling urinary catheter. c. Administer vancomycin intravenously. d. Draw blood cultures.
d. Draw blood cultures.
A client with acute appendicitis develops a fever, tachycardia, and hypotension. Based on these findings, the nurse should further assess the client for which complication? a. bowel ischemia b. deficient fluid volume c. intestinal obstruction d. Peritonitis
d. Peritonitis
A client with acute pancreatitis has a blood pressure of 88/40 mm Hg, a heart rate of 128 bpm, respirations of 28 breaths/min, and Grey Turner sign. What prescription should the nurse implement first? a. Position the client on the left side. b. Insert a nasogastric tube. c. Initiate an intake/output record. d. Place an intravenous (IV) line.
d. Place an intravenous (IV) line.
The nurse is planning care for a client who is recently diagnosed with peptic ulcer disease. Which outcome is best for this client? a. The client avoids stressful situations. b. The client exercises 30 minutes daily. c. The client can inject vitamin B12. d. The client reports the absence of epigastric pain.
d. The client reports the absence of epigastric pain.
A nurse is caring for a client who underwent a subtotal gastrectomy. To manage dumping syndrome, the nurse should advise the client to a. restrict fluid intake to 1 qt (1,000 ml)/day. b. drink liquids only with meals. c. not drink liquids 2 hours before meals. d. drink liquids only between meals
d. drink liquids only between meals
The nurse is assessing a client who has cholecystitis caused by gallstones (cholelithiasis). Which finding should the nurse report to the health care provider? a. elevated temperature of 103°F (39.4°C) b. black stools c. decreased white blood cell count d. nausea after ingestion of high-fat foods
d. nausea after ingestion of high-fat foods
A nurse is caring for a client who has had paraplegia for 6 years. The client is admitted with a bleeding peptic ulcer. What would be a priority teaching concern for the nurse? a. repositioning to prevent pressure injuries b. increasing fluid intake c. monitoring for signs of urinary retention d. recommending foods included in a bland diet
d. recommending foods included in a bland diet
Which goal is most important for a client with acute pancreatitis? The client: a. limits alcohol intake to two to three drinks per week. b. regains a normal pattern for bowel movements. c. maintains normal liver function. d. reports minimal abdominal pain.
d. reports minimal abdominal pain.
After undergoing a liver biopsy, a client should be placed in which position? a. Semi-Fowler's position b. supine position c. prone position d. right lateral decubitus position
d. right lateral decubitus position
Which activity should the nurse encourage the client with a peptic ulcer to avoid? a. taking acetaminophen b. eating chocolate c. chewing gum d. smoking cigarettes
d. smoking cigarettes
The nurse is teaching dietary considerations to a client who had a gastric resection. The nurse understands that the instruction has been effective if the client says which statement? a. "I will only have 30 mL of fluid with each meal." b. "I will drink three glasses of milk each day." c. "I will limit protein intake." d. "I will rest for 30 minutes after eating."
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The nurse is instructing a client with diverticulosis about appropriate self-care activities. Which comment(s) by the client would indicate effective teaching? Select all that apply. a. "I should follow a diet that is high in fiber." b. "I should exercise regularly." c. "It is important for me to drink at least 2000 mL of fluid every day." d. "With careful attention to my diet, my diverticulosis can be cured." e. "Using a cathartic laxative weekly is okay to control bowel movements."
a. "I should follow a diet that is high in fiber." b. "I should exercise regularly." c. "It is important for me to drink at least 2000 mL of fluid every day."
The nurse in the emergency department is admitting a client with cholecystitis who is experiencing pain and nausea. Which action should the nurse take first? a. Administer pain medication. b. Tell the client about planned diagnostic tests. c. Administer an oral electrolyte solution. d. Finish obtaining a complete admission history.
a. Administer pain medication.
A client who underwent esophageal hernia repair 4 hours ago has a temperature of 100.4°F (38°C); pulse of 90 bpm; respiration rate of 16 breaths/min; blood pressure of 130/80 mm Hg; and pulse oximeter reading of 91% on room air. What should the nurse do first? a. Assist the client to a sitting position to take deep breaths. b. Notify the surgeon to obtain an antibiotic prescription. c. Obtain a culture of the incision. d. Offer pain medication.
a. Assist the client to a sitting position to take deep breaths.
A client is admitted to the hospital with an exacerbation of chronic gastritis. What recommendation should the nurse make when evaluating the client's nutritional status? a. Consume yogurt with probiotics daily. b. Consume alcohol in moderation. c. Increase fiber in the form of wheat bran. d. Change coffee to decaffeinated only.
a. Consume yogurt with probiotics daily.
A nurse is making a home visit to an older adult client. When asked about bowel elimination, the client tells the nurse that it has been almost a week since the last bowel movement. Fecal impaction is confirmed, and the health care provider orders digital removal. When preparing for the procedure, the nurse would perform which action first? a. Inspect the area for abnormalities. b. Place the client in the lithotomy position. c. Expose the client from the rectum to the lower spine. d. Administer a small-volume saline enema.
a. Inspect the area for abnormalities.
During the evening shift on the day of a client's bowel resection surgery, the nasogastric (NG) tube drains 500 mL of green-brown fluid. What should the nurse do next? a. Record the amount of drainage on the client's chart. b. Call the health care provider. c. Increase the IV infusion rate. d. Irrigate the tube with normal saline solution.
a. Record the amount of drainage on the client's chart.
The nurse is providing dietary instructions to a client who had a cholecystectomy. During the first few weeks after a cholecystectomy, which diet is best for this client? a. a limited intake of fat distributed throughout the day so that there is not an excessive amount in the intestine at any one time. b. at least four servings daily of meat, cheese, and peanut butter to increase protein intake that aids incisional healing. c. ingestion of pancreatic enzymes with meals to replace the normal enzyme secretion that has been surgically altered. d. a decreased intake of fruits, vegetables, whole grains, and nuts, to minimize pressure within the small intestine.
a. a limited intake of fat distributed throughout the day so that there is not an excessive amount in the intestine at any one time.
The nurse is obtaining a health history for an adult with a possible hiatal hernia. Which of the following is a risk factor for this client that would most likely contribute to the development of a hiatal hernia? a. being 5 feet, 3 inches (160 cm) tall and weighing 190 lb (86.2 kg) b. using laxatives frequently c. being 40 years old d. having a sedentary desk job
a. being 5 feet, 3 inches (160 cm) tall and weighing 190 lb (86.2 kg)
A client is admitted to the health care facility with a diagnosis of a bleeding gastric ulcer. What stool appearance will the nurse document as consistent with a gastric ulcer? a. black and tarry b. bright red c. coffee ground-like d. Clay-colored
a. black and tarry
When assessing a client who has been diagnosed with hepatic cirrhosis, the nurse should obtain which information when conducting a focused assessment? Select all that apply. a. current use of alcohol b. mental status c. nutritional status. d. heart sounds e. capillary refill time
a. current use of alcohol b. mental status c. nutritional status.
The nurse is instructing the client with ulcerative colitis about the best diet to maintain nutrition for tissue healing while avoiding foods that will exacerbate ulceration. Which diet would be most appropriate? a. high-protein, low-residue b. low-sodium, high-carbohydrate c. low-fat, high-fiber d. high-calorie, low-protein
a. high-protein, low-residue
Metoclopramide is prescribed as a premedication for a client about to undergo a gastroduodenoscopy. What expected therapeutic effect of this drug should the nurse assess in this client? a. increased gastric emptying b. reduced anxiety c. inhibited respiratory secretions d. increased gastric pH
a. increased gastric emptying
