Med Surg 2 Test 1 (3/4/19)

Famotidine

"Take 1 hour before meals"

How far apart to take antacids and other medications?

1 hour

which client finding would be a contraindication for the nurse to administer dicyclomine hydrochloride for IBS? A. bladder scan showing 500 mL urine B. hemoglobin of 11 C. history of cataracts D. reporting frequent diarrhea today

A. bladder scan showing 500ml urine

a nurse is collecting data from a client who has suspected stomach perforation do to a peptic ulcer. Which of the following findings should the nurse expect? Select all that apply. A. rigid abdomen B. tachycardia C. elevated blood pressure D. circumoral cyanosis E. rebound tenderness

A. rigid abdomen B. tachycardia E. rebound tenderness

Psyllium (Metamucil), how is it given?

Antidiarrheal. Decrease diarrhea (bulk-forming); if no BM x3 days, mix in 8oz H2O and give to patient

a nurse is collecting data from a client who is in the early stages of hepatitis A. Which of the following manifestations should the nurse expect? A. Jaundice B. Anorexia C. Dark urine D. Pale feces

B. Anorexia

a nurse is providing care to a client who is 1-day post-operative following a paracentesis. The nurse observes clear pale yellow fluid leaking from the operative site. Which of the following is an appropriate nursing intervention? A. place a clean towel near the drainage site B. apply a dry sterile dressing C. apply direct pressure to the site D. place the client in a Supine position

B. Apply a dry sterile dressing

which appearance of a stoma immediately after colostomy requires that the practical nurse contact the supervising RN immediately? A. Brick red with slight moisture B. Dusky with moderate edema C. Pink with slight oozing of blood D. Rosy with no stool produced

B. Dusky with moderate edema

a nurse is reviewing the serum laboratory data of a client who has an acute exacerbation of Crohn's Disease. Which of the following Laboratory test should the nurse expect to be elevated? Select all that apply. A. Hematocrit B. Erythrocyte sedimentation rate C. WBC D. Folic acid E. Albumin

B. Erythrocyte sedimentation rate C. WBC

a nurse is reinforcing teaching about pernicious anemia with a client who has chronic gastritis. Which of the following information should the nurse include in the teaching? A. pernicious anemia is caused when the cells producing gastric acid are damaged B. expect a monthly injection of vitamin B12 C. plan to take vitamin K supplements D. pernicious anemia is caused by an increased production of intrinsic factor

B. Expect a monthly injection of vitamin B12

a nurse is reinforcing teaching with a client who has Barrett's esophagus and is scheduled to undergo an EGD. Which of the following statements should the nurse include in the teaching? A. this procedure is performed to measure the presence of acid in your esophagus B. this procedure can determine how well the lower part of your esophagus works C. this procedure is performed while you are under general anesthesia D. this procedure can determine if you have colon cancer

B. This procedure can determine how well the lower part of your esophagus works

what are treatment methods for Crohn's disease and ulcerative colitis?

Bowel rest = NPO, TPN Antidiarrheals = imodium, lomotil (no lomotil to children) Increased monitoring for colon cancer (colonoscopy) Crohn's: Monitor WBC, ESR, CRP Ulcerative colitis: Monitor RBC and H&H

a nurse is assisting with the admission of a client who has bleeding esophageal varices. The nurse should anticipate a prescription for which of the following medications? A. Famotidine B. Esomeprazole C. Vasopressin D. Omeprazole

C. Vasopressin

a nurse is caring for a client newly admitted with bleeding esophageal varices. The nurse should anticipate a prescription for which of the following medications? A. propranolol B. metoclopramide C. ranitidine D. vasopressin

D. Vasopressin

what diet should a patient with upper GI bleeding be on? What Med will likely be given?

NPO for 24 hours after bleeding stops; vasopressin into esophagus in the endoscopy room

what is the surgical procedure of choice for Gerda and Barrett's esophagus?

Nissan fundoplication

Omeprazole

PPI; Reduces stomach acid

Amphojel

Tx of GERD and kidney stones; Watch out for constipation; Take 1 hour away from other pills

which statement made by the client demonstrates a correct understanding of the home care of an ascending colostomy? A. I will avoid eating foods such as broccoli and cauliflower B. I will empty the pouch when it is 1/2 full of stool C. I will irrigate the colostomy to promote regular bowel movements D. I will restrict my fluid intake to 2,000 mL of fluid a day

a. I will avoid eating foods such as broccoli and cauliflower

"Plan of care for gastritis"

"I&O, electrolytes, observe stool"

how long should the nurse listen to bowel sounds in each quadrant?

2 minutes

a nurse is collecting data from a client who has chronic pancreatitis. Which of the following findings should the nurse identify as a likely cause of the client's condition? A. High calorie diet B. Prior GI illnesses C. Tobacco use D. Alcohol use

D. Alcohol use

the nurse is preparing to administer a scheduled dose of metoclopramide IV to a client with diabetic gastroparesis. Which clinical finding causes the nerves to question the prescription? A. diarrhea B. frequent burping C. headache D. sucking lip motions

D. sucking lip motions

What to do if pt does not have BM in 3 days?

Laxatives PO, suppository, enema

If the NGT is removed, or the patient vomits, what should the nurse do?

Oral care

what should people with a hiatal hernia not eat?

Peppermint, NSAIDs, chocolate, fat, fried, coffee, spicy, alcohol No HS snack

high fiber foods

Popcorn, apples with skin, bran, whole wheat products, grains, oatmeal, brown rice, beans, carrots

foods that colostomy patient should avoid as they block the intestine/colostomy

Popcorn, celery, stringy meats

what lab tests will be elevated in a patient with an exacerbation of Crohn's Disease?

WBC, ESR, CRP

Docusate

stool softener

what do you do if the patient says they do not want to go to endoscopy?

tell the charge nurse/MD

Nursing actions for patient with NGT to low intermittent suction

Purpose is to decrease gastric distention, measure NGT output in I&O, check bowel sounds with suction off, mouth care every 2 hours, monitor placement, irrigate Q4H, if N/V check if tube is clamped

"Jenny's calories"?

128 carbs 27 fat 12 protein 167 total

how long should a GERD patient wait after eating to go to sleep?

3 hours; no HS snacks

Aspiration must be prevented. Keep HOB ______° at all times

30

a nurse is reinforcing discharge teaching with a client who has IBS. Which of the following instructions should the nurse include? A. avoid foods that trigger exacerbation B. consume 15 to 20 grams of fiber daily C. plan 3 moderate to large meals per day D. limit fluid intake to one L each day

A. Avoid foods that trigger exacerbation

the nurse is assessing a client with an upper GI bleed would expect the clients stool to have which appearance? A. Black tarry B. Bright red bloody C. Light gray "clay colored" D. Small, dry, Rocky-hard masses

A. Black tarry

a client who has been on long-term Omeprazole therapy for GERD is admitted to the hospital for a UTI. The nurse recognizes that this client is at highest risk for which complication due to Omeprazole use? A. C. Diff B. Gait disturbance C. Jaw necrosis D. Tremor

A. C. Diff

a nurse is assisting with the care of a client who has a history of cirrhosis and is admitted with manifestations of hepatic encephalopathy. The nurse should anticipate a prescription for which of the following laboratory tests to determine the possibility of recent excessive alcohol use? A. GGT B. ALP C. Serum bilirubin D. ALT

A. GGT

the nurse is reinforcing teaching about ulcer prevention with a client newly diagnosed with peptic ulcer disease. Which of the following client statements indicate appropriate understanding of the teaching. Select all that apply. A. I need to avoid taking medicine like ibuprofen without a prescription B. I should avoid drinking excess coffee or Cola C. I should enroll in a smoking cessation program D. I should reduce or eliminate my intake of alcoholic beverages E. I will eliminate whole wheat foods, like Breads and cereals, from my diet

A. I need to avoid taking medicine like ibuprofen without a prescription B. I should avoid drinking excess coffee or Cola C. I should enroll in a smoking cessation program D. I should reduce or eliminate my intake of alcoholic beverages

a nurse in a clinic is reinforcing teaching with a client who has ulcerative colitis. Which of the following statements by the client indicates an understanding of the teaching? A. I will plan to limit fiber in my diet B. I will restrict fluid intake during meals C. I will switch to black tea instead of drinking coffee D. I will try to eat three moderate to large meals a day

A. I will plan to limit fiber in my diet

a nurse is caring for a client who is scheduled to undergo a liver biopsy for a suspected malignancy. Which of the following laboratory findings should the nurse monitor prior to the procedure? A. Prothrombin time B. Serum lipase C. Bilirubin D. Calcium

A. Prothrombin time

a nurse is caring for a client who is 4 hours postoperative following a laparoscopic cholecystectomy. Which of the following findings should the nurse expect? A. right shoulder pain B. urine output 20 ml per hour C. temperature 101.1 degrees Fahrenheit D. oxygen saturation 92%

A. Right shoulder pain

a nurse is caring for a client who has celiac disease. Which of the following foods should the nurse remove from the clients meal tray? A. Wheat toast B. Tapioca pudding C. Hard boiled egg D. Mashed potatoes

A. Wheat toast

an older client comes to the Outpatient Clinic for a routine physical examination and health screening. Which findings does the nurse recognize as possible indications of colorectal cancer? Select all that apply. A. abdominal pain B. blood in the stools C. change in bowel habits D. low hemoglobin level E. unexplained weight loss

A. abdominal pain B. blood in the stools C. change in bowel habits D. low hemoglobin level E. unexplained weight loss

the practical nurse is collecting data on a client with acute diverticulitis. Which finding will the nurse report immediately to the registered nurse? A. abdominal pain has progressed to the left upper quadrant B. hemoglobin is 11.2 C. laying on side with knees drawn up to abdomen and trunk flexed D. white blood cell count 12000

A. abdominal pain has progressed to the left upper quadrant

a parent rushes a four-year-old to the emergency department after finding the Child sitting on the kitchen floor holding an empty bottle of aspirin. The parent has no idea how many tablets were left in the container. The child is sniffling and crying quietly. The Practical Nurse anticipates initially assisting with the implementation of which treatment? A. activated charcoal B. gastric lavage C. sodium bicarbonate D. syrup of ipecac

A. activated charcoal

the nurse is reinforcing discharge instructions with a client following a partial gastrectomy. Which of the following instructions should the nurse include to prevent dumping syndrome? Select all that apply. A. add high protein foods to the diet B. consume High carbohydrate meals C. eat small frequent meals D. increase intake of fluids with meals E. lie down after eating

A. add high protein foods to the diet C. eat small frequent meals E. lie down after eating

a nurse is caring for a client who has a new diagnosis of GERD. The nurse should anticipate prescriptions for which of the following medications? Select all that apply. A. antacid B. histamine 2 receptor antagonist C. opioid analgesic D. fiber laxatives E. proton pump inhibitors

A. antacid B. histamine 2 receptor antagonist E. proton pump inhibitors

a client admitted 3 days ago with upper GI bleeding underwent an endoscopic procedure to stop the bleeding. the client is started on a clear liquid diet today. Which foods are appropriate for the nurse to offer the client? Select all that apply. A. apple juice B. Cherry popsicle C. chicken broth D. frozen yogurt E. unsweetened tea F. vanilla ice cream

A. apple juice C. chicken broth E. unsweetened tea

a client diagnosed with cirrhosis is experiencing pruritus. What strategies are appropriate for the nurse to teach the client to promote comfort and Skin Integrity? Select all that apply. A. apply cool moist washcloths to the affected areas B. keep the fingernails trimmed short to minimize skin scratching C. take a hot bath or shower to alleviate itching Sensations D. use Skin protectant or moisturizing cream over unbroken skin E. wear cotton gloves or long-sleeved clothing to avoid scratching

A. apply cool moist washcloths to the affected areas B. keep the fingernails trimmed short to minimize skin scratching D. use Skin protectant or moisturizing cream over unbroken skin E. wear cotton gloves or long-sleeved clothing to avoid scratching

the nurse is reinforcing teaching of proper technique for colostomy irrigation for the home health client. Which client action indicates that further instruction is required? A. attaches an enema set to the irrigation bag, lubricates it, gently inserts it into the stoma, and holds it in place B. Fills irrigation container with 500 to 1000 mL of lukewarm tap water and flushes the irrigation tubing C. hang Loosely irrigation container on a hook at the level of the shoulder approximately 18 to 24 in above the stoma D. slowly opens the roller clamp, allowing the irrigation solution to flow, but clamps the tubing when cramping occurs

A. attaches an enema set to the irrigation bag, lubricates it, gently inserts it into the stoma, and holds it in place

which instructions should the nurse include when reinforcing discharge teaching to a client with peptic ulcer disease do to H. Pylori infection? Select all that apply. A. avoid foods that may cause epigastric distress such as spicy or acidic Foods B. it is best if you refrained from consuming alcoholic products C. report black tarry stools to your healthcare provider immediately D. take your amoxicillin Clarithromycin and omeprazole for the next 14 days E. you may take over the counter drugs such as aspirin if you have mild epigastric pain

A. avoid foods that may cause epigastric distress such as spicy or acidic Foods B. it is best if you refrained from consuming alcoholic products C. report black tarry stools to your healthcare provider immediately D. take your amoxicillin Clarithromycin and omeprazole for the next 14 days

a client receiving tpn reports nausea abdominal pain and excessive thirst. What is the best action for the nurse to take? A. check the client's blood glucose B. check the clients vital signs C. report the findings to the health care provider D. slow down the rate of infusion

A. check the client's blood glucose

a nurse is having difficulty arousing a client following an EGD. Which of the following actions is the nurses priority? A. Check airway B. allow the clients to sleep C. prepare to administer an antidote to the sedative D. evaluate pre-procedure laboratory findings

A. check the clients airway

a nurse is reinforcing teaching with a client about a bowel prep using polyethylene glycol who will undergo a colonoscopy. Which of the following instructions should the nurse reinforce? A. check with the provider about taking current medications during the bowel prep B. consume the usual diet until starting the bowel prep C. expect the bowel prep to act the day after consuming it D. stop the bowel prep as soon as fecal elimination begins

A. check with the provider about taking current medications during the bowel prep

the nurse is reviewing lifestyle and nutritional strategies to help reduce symptoms in a client with newly-diagnosed GERD. Which strategies should the nurse include? Select all that apply. A. choose foods that are low in fat B. do not consume any foods containing Dairy C. eat three large meals a day and minimize snacking D. limit or eliminate the use of alcohol and tobacco E. try to avoid caffeine in Chocolate and Peppermint

A. choose foods that are low in fat D. limit or eliminate the use of alcohol and tobacco E. try to avoid caffeine in Chocolate and Peppermint

a client 4 days post colostomy is preparing to be discharged home. Which findings are concerning and should be further investigated? Select all that apply. A. client states I will need home health to empty the pouch B. client states there is a little gas in the colostomy bag C. no bowel sounds are present in the client reports nausea D. skin surrounding the stoma is red and excoriated E. stoma is red edematous and smaller than the previous day

A. client states I will need home health to empty the pouch C. no bowel sounds are present in the client reports nausea D. skin surrounding the stoma is red and excoriated

during morning rounds the nurse notices that a client who was admitted 3 days ago with hepatic encephalopathy is sleepy and Confused. The client is scheduled for discharge later today. Which interventions are appropriate for the nurse to implement? Select all that apply. A. compare current mental status to previous findings B. encourage the client to ambulate in the hallway C. hold the client's morning dose of lactulose D. monitor the clients ammonia level E. observe the clients hand movements with the arms extended

A. compare current mental status to previous findings D. monitor the clients ammonia level E. observe the clients hand movements with the arms extended

a nurse is contributing to the plan of care for a client who has a small bowel obstruction and a nasogastric tube in place. Which of the following interventions should the nurse recommend for the plan of care? Select all that apply. A. document the NG drainage with the client's output B. irrigate the NG tube every 8 hours C. check bowel sounds D. provide oral hygiene every 2 hours E. monitor NG tube for placement

A. document the NG drainage with the client's output C. check bowel sounds D. provide oral hygiene every 2 hours E. monitor NG tube for placement

a client with a history of diverticular disease is being discharged after an episode of acute diverticulitis. Which instructions should the nurse reinforce to reduce the risk of future episodes? Select all that apply. A. drink plenty of fluids B. exercise regularly C. follow a low fiber diet D. include whole grains fruits and vegetables in the diet E. increase intake of red meat

A. drink plenty of fluids B. exercise regularly D. include whole grains fruits and vegetables in the diet

a nurse is caring for a group of clients. Which of the following client findings should the nurse identify as an indication to recommend enteral feedings? A. dysphagia secondary to Parkinson's disease B. gastric paresis C. short bowel syndrome D. paralytic Ileus

A. dysphagia secondary to Parkinson's disease

a nurse is caring for a client who has a small bowel obstruction from adhesions. Which of the following findings should the nurse expect? Select all that apply. A. emesis greater than 500 mL with a fecal odor B. report of spasmodic abdominal pain C. high pitched bowel sounds D. abdomen flat with rebound tenderness to palpation E. laboratory findings indicating metabolic acidosis

A. emesis greater than 500 mL with a fecal odor B. report of spasmodic abdominal pain C. high pitched bowel sounds

a nurse is assisting with the plan of care for a client who has acute gastritis. Which of the following nursing actions should the nurse recommend for the plan of care? Select all that apply. A. evaluate I&O B. monitor electrolytes C. provide three large meals per day D. administer ibuprofen for pain E. observe stool characteristics

A. evaluate I&O B. monitor electrolytes E. observe stool characteristics

the nurse is reinforcing information to a diabetic client with a new prescription for metoclopramide. Which of the following side effects must be nurse remind me client to report immediately to the health care provider? Select all that apply. A. excess blinking of eyes B. dry mouth C. dull headache D. lip-smacking E. puffing of cheeks

A. excess blinking of eyes D. lip-smacking E. puffing of cheeks

a nurse is completing pre-procedure instructions for a client who will undergo a sigmoidoscopy. Which of the following information should the nurse include? Select all that apply. A. expect more flatulence following the procedure B. consume no fluid or food before the procedure C. you will receive moderate sedation for the procedure D. you will need repositioning throughout the procedure E. limit your fluid intake the day after the procedure

A. expect more flatulence following the procedure B. consume no fluid or food before the procedure

the nurse is teaching about the importance of dietary fiber at a community health fair. Which health benefits of consuming a fiber-rich diet should the nurse include in the teaching plan? Select all that apply. A. helps prevent colorectal cancer B. improves glycemic control C. promotes weight loss D. reduces risk of vascular disease E. regulates bowel movements

A. helps prevent colorectal cancer B. improves glycemic control C. promotes weight loss D. reduces risk of vascular disease E. regulates bowel movements

a nurse is assisting with the plan of care for a client who has a prescription for tpn. Which of the following interventions should the nurse include? Select all that apply. A. measure capillary blood glucose four times daily B. administer medications through a secondary port on the tpn IV tubing C. monitor Vital Signs three times during a 12-hour shift D. change the tpn IV tubing every 24 hours E. obtain a daily aptt

A. measure capillary blood glucose four times daily C. monitor Vital Signs three times during a 12-hour shift D. change the tpn IV tubing every 24 hours

a healthy 50 year old client asks the nurse, what must I do in preparation for my screening colonoscopy? Which instructions should the nurse reinforce to correctly answer the clients? Select all that apply. A. no food or drink is allowed 8 hours prior to the test B. prophylactic antibiotics are taken as prescribed C. smoking must be avoided after midnight D. the day prior to the procedure your diet will be clear liquids E. you will drink polyethylene glycol as directed the day before

A. no food or drink is allowed 8 hours prior to the test D. the day prior to the procedure your diet will be clear liquids E. you will drink polyethylene glycol as directed the day before

a nurse is reinforcing teaching with a client who has a duodenal ulcer and a new prescription for esomeprazole. which of the following information should the nurse include? Select all that apply. A. take the medication 1 hour before a meal B. limit NSAIDs when taking this medication C. expect skin flushing when taking this medication D. increase fiber intake when taking this medication E. chew the medication thoroughly before swallowing

A. take the medication 1 hour before a meal B. limit NSAIDs when taking this medication

H. pylori treatment

Abx, H2 recwptor antagonist (metronidazole, amoxicillin, clarithromycin, tetracycline/ranitidine, famotidine, cimetidine, nizatidine), antacids, PPIs, mucosa protectant (sucralfate, pepto bismol)

Sucralfate

Antiulcer Agent; Coats stomach; "Forms protective barrier around gastric mucosa"

a client tells the nurse of wanting to lose 20 lb in time for the clients daughter's wedding, which is 16 weeks away. How many calories will be client have to eliminate from the diet each day to meet this goal? A. 450 per day B. 625 per day C. 860 per day D. 1000 per day

B. 625 per day

a nurse is reinforcing discharge teaching with a client who has Crohn's disease. Which of the following instructions should the nurse include in the teaching? A. decrease intake of calorie dense foods B. drink canned protein supplements C. increase intake of high fiber foods D. take a bulk forming laxatives daily

B. Drink canned protein supplements

a child with cystic fibrosis is to receive a dose of pancrelipase at 12 pm. The client states that he is not hungry and will not eat his lunch in an hour. Which action is appropriate for the nurse to take? A. administer the prescribed pancrelipase B. holds the pancrelipase until the client eats C. notify the healthcare provider D. skip the dose of the pancrelipase

B. Holds the pancrelipase until they client eats

the nurse is caring for a client with cirrhosis who has hepatic encephalopathy. The client is prescribed lactulose. Which assessment by the nurse will most likely indicate that the medication has achieved the desired therapeutic effect? A. higher potassium level B. improved mental status C. looser stool consistency D. reduced abdominal distension

B. Improved mental status

the nurse is caring for a client with cholelithiasis and acute cholecystitis. The client suddenly vomits 250ml of greenish yellow emesis and reports severe right upper quadrant pain with radiation to the right shoulder. Which intervention would have the highest priority? A. Administer promethazine suppository B. Initiate NPO status C. Insert nasogastric tube set to low suction D. Obtain prescription for pain medication

B. Initiate NPO status

a nurse is collecting data from a client who has gerd. Which of the following findings should the nurse expect? A. absence of saliva B. loss of tooth enamel C. sweet taste in mouth D. absence of eradication

B. Loss of tooth enamel

the nurse is caring for a client who had surgery yesterday. When administering Omeprazole, the client asks what is that for? I don't take it at home. Which reply by the nurse is most appropriate? A. Omeprazole helps prevent nausea by making your stomach empty faster B. Omeprazole helps prevent you from developing an ulcer due to the stress of surgery C. Omeprazole protect you from getting an infection while on antibiotics D. this medication will treat your GERD

B. Omeprazole helps prevent you from developing an ulcer due to the stress of surgery

a nurse is reinforcing teaching with a client who has a hiatal hernia. Which of the following client statements indicates understanding? A. I can take my medications with soda B. peppermint tea will increase my indigestion C. wearing in abdominal binder will limit my symptoms D. I will drink hot chocolate at bedtime to help me sleep

B. Peppermint tea will increase my indigestion

a nurse is caring for a client who has a percutaneous endoscopic gastrostomy tube and is receiving intermittent feedings. Prior to initiating the feeding, which of the following actions should the nurse take first? A. Flush the tube with water B. place the client in semi Fowler's position C. cleanse the skin around the tube site D. I sprayed the D tube prior to each feeding

B. Place the client in semi Fowler's position

a nurse is observing a nursing student reinforce teaching to a client on how to take sucralfate. Which statement made by the student would require intervention by the nurse? A. take this in the morning 1 hour before breakfast B. take this with your other stomach medications C. take your heart medication 2 hours after sucralfate D. you might experience constipation while taking this

B. Take this with your other stomach medications

a nurse is collecting data from an older adult client. The nurse should identify which of the following findings as a manifestation of an obstruction of the large intestine do to a fecal impaction? A. the client reports he had a bowel movement yesterday B. the client is having small frequent liquid stools C. the client is flatulent D. the client indicates he vomited once this morning

B. The client is having small frequent liquid stools

a nurse is reinforcing teaching with a client who has chronic gastritis and is scheduled for a selective vagotomy. Which of the following statements should the nurse include about the purpose of the procedure? A. You will have increased duodenal gastric emptying B. you will have a reduction of gastric acid secretions C. you will have an increase of gastric mucus secretion D. you will have an increased secretion of hydrogen potassium ATPase enzymes

B. You will have a reduction of gastric acid secretions

a nurse is reinforcing teaching with a group of community residents about Hepatitis B. Which of the following statements should the nurse include in the teaching? A. a hepatitis B immunization is recommended for those who travel especially military personnel B. a hepatitis B immunization is given to infants and children C. Hepatitis B is acquired by eating foods that are contaminated during handling D. Hepatitis B can be prevented by using good personal hygiene habits and proper Sanitation

B. a hepatitis B immunization is given to infants and children

the nurse is reviewing prescriptions for the assigned clients. Which prescription should the nurse question? A. allopurinol for a client who developed tumor lysis Syndrome from chemotherapy for acute leukemia B. dicyclomine for a client with a history of IBS Who develops a post-operative paralytic Ileus C. IV morphine for a client after percutaneous nephrolithotripsy who reports the last bowel movement was 2 days ago D. levofloxacin for a client with a UTI who has a history of anaphylaxis to penicillin drugs

B. dicyclomine for a client with a history of IBS Who develops a post-operative paralytic Ileus

the nurse is counseling a client with obesity who is starting a weight reduction diet. The client reports consuming four to five regular Cola beverages daily. Which of the following beverages should the nurse recommend as healthier substitutes? Select all that apply. A. commercial fruit juice B. flavored club soda C. fresh vegetable juice D. Sports beverages E. unsweetened tea

B. flavored club soda C. fresh vegetable juice E. unsweetened tea

the nurse is reinforcing teaching about constipation prevention to a client. Which of the following client statements indicates an appropriate understanding of the teaching? Select all that apply. A. drinking more caffeinated drinks such as tea and soda helps to stimulate the bowel B. having a routine for bowel movements is important but I should not wait if I feel the urge C. I can use in over-the-counter laxative every other day if needed D. I should try to eat more fruits and vegetables every day E. increasing my daily exercise level may help keep my bowel movements regular

B. having a routine for bowel movements is important but I should not wait if I feel the urge D. I should try to eat more fruits and vegetables every day E. increasing my daily exercise level may help keep my bowel movements regular

the nurse admits a post-operative client following weight loss surgery. Which prescription should the nurse question? A. begin a sugar-free, clear liquid diet B. insert nasogastric tube for uncontrolled nausea C. Place client in low Fowler position during meal times D. start morphine via patient-controlled analgesia

B. insert nasogastric tube for uncontrolled nausea

Put the FOBT steps in order A. document the results in the electronic medical record B. obtain supplies wash hands and apply non-sterile gloves C. open the back of the slide and apply to drops of developing solution into the boxes on the slide D. open the slide flap and use the wooden applicator to apply to separate stool samples to the boxes on the slide E. wait 30 to 60 Seconds

B. obtain supplies wash hands and apply non-sterile gloves D. open the slide flap and use the wooden applicator to apply to separate stool samples to the boxes on the slide C. open the back of the slide and apply to drops of developing solution into the boxes on the slide E. wait 30 to 60 seconds A. Document the results in the electronic medical record

the nurse is caring for a client with cirrhosis. Assessment findings include ascites peripheral edema shortness of breath fatigue and generalized discomfort. Which interventions would be appropriate for the nurse to implement to promote the clients Comfort? Select all that apply. A. encourage adequate sodium intake B. place client in semi Fowler position C. Place client in Trendelenburg position D. provide alternating air pressure mattress E. use music to provide a distraction

B. place client in semi Fowler position D. provide alternating air pressure mattress E. use music to provide a distraction

a client with ascites due to cirrhosis has increasing shortness of breath and abdominal pain. The practical nurse is assisting the RN in preparing the client for a paracentesis. Which nursing actions should be implemented prior to the procedure? Select all that apply. A. obtain informed consent for the procedure B. place the client in high Fowler's position C. place the client on NPO status D. request that the client empty the bladder E. take Baseline Vital Signs and weight

B. place the client in high Fowler's position D. request that the client empty the bladder E. take Baseline Vital Signs and weight

an adult diagnosed with celiac disease 3 weeks ago was placed on a gluten-free diet. They client returns for Ambulatory Care follow-up, reports continuation of symptoms, and does not seem to be responding to therapy. Which is the best response by the nurse? A. it should take about six to eight weeks before your symptoms improve B. tell me what you had to eat yesterday C. we will refer you to The dietitian D. you must not be following your diet

B. tell me what you had to eat yesterday

a nurse is caring for a client who is scheduled to undergo an EGD. The nurse should identify that the purpose of this procedure is which of the following? A. To visualize colon polyps B. To detect an ulceration in the stomach C. To identify an obstruction in the biliary duct D. To determine the presence of free air in your abdomen

B. to detect an ulceration in the stomach

a nurse is reviewing the medical record of a client who has a small bowel obstruction. Which of the following findings should the nurse report to the provider? Select all that apply. A. emesis prior to insertion of the nasogastric tube B. urine specific gravity 1.040 C. hematocrit 60% D. serum potassium 3.0 E. WBC 10000

B. urine specific gravity 1.040 C. hematocrit 60% D. serum potassium 3.0

a nurse is caring for a client who has acute pancreatitis. Which of the following serum laboratory values should the nurse anticipate returning to the expected reference range within 72 hours after treatment begins? A. Aldolase B. Lipase C. Amylase D. Lactic dehydrogenase

C. Amylase

a nurse is collecting data from a client who has been taking prednisone following an exacerbation of inflammatory bowel disease. The nurse should identify which of the following findings is the priority? A. client reports difficulty sleeping B. the client's urine is positive for glucose C. client reports having an elevated body temperature D. client reports gaining 4 pounds in the last 6 months

C. Client reports having an elevated body temperature

which group of food selections would be the best choice for a client advancing to a full liquid diet 3 days after bariatric surgery? A. apple juice mashed potatoes chocolate pudding B. chicken broth low fat cheese omelette strawberry ice cream C. creamy wheat cereal Blended cream of chicken soup protein shake D. low-fat vanilla yogurt smooth peanut butter and vegetable juice

C. Creamy wheat cereal Blended cream of chicken soup protein shake

a nurse is reviewing the health record of a client who might have a tumor of the jejunum. The nurse should anticipate a prescription for which of the following tests? Select all that apply. A. serum Alpha fetoprotein B. ERCP C. GI x-ray with contrast D. small bowel capsule endoscopy (M2A) E. colonoscopy

C. GI x-ray with contrast D. small bowel capsule endoscopy (M2A)

a nurse is reinforcing discharge teaching with a client who is post-operative following fundoplication. which of the following statements by the client indicates understanding? A. when the sitting in my lounge chair after a meal I will lower the back of it B. I will try to eat three large meals a day C. I will Elevate the head of my bed on blocks D. when sleeping I will lay on my left side

C. I will Elevate the head of my bed on blocks

a nurse is reinforcing discharge teaching with a client who has an infection due to H pylori. Which of the following statements by the client indicates understanding? A. I will continue my prescription for corticosteroids B. I will schedule a CT scan to monitor my Improvement C. I will take a combination of medications for treatment D. I will have my throat swabbed to re-check for this bacteria

C. I will take a combination of medications for treatment

a nurse is reinforcing teaching with a client who has a new prescription for famotidine. Which of the following statements by the client indicates understanding? A. the medicine coats the lining of my stomach B. the medication should stop be pain right away C. I will take my pill 1 hour before meals D. I will monitor for bleeding from my nose

C. I will take my pill 1 hour before meals

a nurse is assisting with the admission of a client who has fulminant hepatic failure. Which of the following procedures should the nurse expect for the client? A. Endoscopic sclerotherapy B. Liver lobectomy C. Liver transplant D. Transjugular intrahepatic portal-systemic shunt placement

C. Liver transplant

a nurse is reinforcing teaching with a client who has a new prescription for sulfasalazine. Which of the following instructions should the nurse include in the teaching? A. Take the medication 2 hours after eating B. discontinue this medication if your skin turns yellow orange C. notify the provider If you experience a sore throat D. expect your stools to turn black

C. Notify the provider If you experience a sore throat

a nurse is checking a client who was admitted with a bowel obstruction. The client reports severe abdominal pain. Which of the following findings should indicate to the nurse that if possible bowel perforation has occurred? A. Elevated blood pressure B. Bowel sounds increased in frequency and pitch C. Rigid abdomen D. Emesis of undigested food

C. Rigid abdomen

a nurse is reinforcing discharge teaching with a client who has a new prescription for aluminum hydroxide. Which of the following information should the nurse include? A. Take the medication with food B. Monitor for diarrhea C. Wait one hour before taking other oral medications D. maintain a low fiber diet

C. Wait 1 hour before taking other oral medications

a nurse is collecting data from a client who has a gastric ulcer. Which of the following findings should the nurse expect? Select all that apply. A. client reports weight gain B. client states being awakened by pain during the night C. client reports a sensation of bloating D. client states that pain occurs before meals E. client experiences pain upon palpation of the epigastric region

C. client reports a sensation of bloating D. client states that pain occurs before meals E. client experiences pain upon palpation of the epigastric region

a nurse is caring for a client diagnosed with ulcerative colitis and prescribed sulfasalazine. Which instructions should be reinforced at discharge? Select all that apply. A. avoid small frequent meals B. consume a cup of coffee with each meal if desired C. continue medication even after resolution of symptoms D. eat a low residue high-protein high-calorie diet E. increase fluid intake to at least 2000 ml per day

C. continue medication even after resolution of symptoms D. eat a low residue high-protein high-calorie diet E. increase fluid intake to at least 2000 ml per day

the nurse is monitoring a client with appendicitis will expect the client to give which description of the associated abdominal pain? A. a burning sensation in the upper abdomen B. in 8 out of 10 on the left side below the belly button C. excruciating pain in the lower abdomen above the right hip D. intermittent in the abdomen and right shoulder

C. excruciating pain in the lower abdomen above the right hip

a nurse is reinforcing teaching with a client who has diverticulitis about preventing acute attacks. Which of the following foods should the nurse recommend? A. foods high in vitamin C B. foods low in fat C. foods high in fiber D. foods low in calories

C. foods high in fiber

the nurse is reinforcing meal planning teaching to a group of clients with celiac disease. Which meal is appropriate for the nurse to include? A. baked salmon with rice steamed vegetables and dinner roll B. breaded pork chops corn on the and steamed snow peas C. grilled chicken green beans and mashed potatoes D. spaghetti with Italian tomato sauce and meatballs

C. grilled chicken green beans and mashed potatoes

a client has been on long-term therapy with esomeprazole. What is essential for the nurse to ask the client? A. are you drinking plenty of water with the medication? B. are you taking the medication after meals? C. have you had a bone density test recently? D. have you had your blood pressure taken regularly?

C. have you had a bone density test recently?

when monitoring a client with cholelithiasis and acute cholecystitis, which findings might the nurse notes during the health history and physical examination? Select all that apply. A. flank pain radiating to the groin B. ingestion of high protein food before onset of pain C. low-grade fever with chills D. pain at the umbilicus E. right upper quadrant pain radiating to the right shoulder

C. low-grade fever with chills E. right upper quadrant pain radiating to the right shoulder

a client with a 10-year history of major depressive disorder has relapsed and is now hospitalized. The client is currently on phenelzine and weighs 115 pounds but weigh 150 lbs 3 months before admission. Which foods would be best for this client? A. crackers and cheddar cheese B. hard boiled egg with tomatoes C. steamed fish and potatoes D. tortilla chips with avocado dip

C. steamed fish and potatoes

a nurse is reinforcing discharge teaching with a client who is 3 days post-operative following a transverse colostomy. Which of the following should the nurse include in the teaching? A. mucus will be present in stool for 5 to 7 days after surgery B. expect 500 to 1000 ml semi liquid stool after 2 weeks C. stoma should be moist and pink D. empty the ostomy bag when it's 3/4 full

C. stoma should be moist and pink

how are alternative colitis and Crohn's Disease definitively diagnosed? what is the difference between these two?

Colonoscopy Ulcerative colitis: blood, 20x day, typically left sided, ulcers Crohn's Disease: pus/mucusy stool, 5x day, damaged large intestine, can be from mouth to rectum, cobblestone appearance, related to family Hx

a nurse is collecting data from a client who is experiencing perforation of a peptic ulcer. Which of the following manifestations should the nurse expect? A. Decreased heart rate B. Yellowing of the skin C. Increased BP D. Boardlike abdomen

D. Boardlike abdomen

a nurse is caring for a client who is 2 days post-operative following a gastric bypass. The nurse notes that bowel sounds are present. Which of the following foods should the nurse provide at the initial feeding? A. Vanilla pudding B. Apple juice C. Diet ginger ale D. Clear liquids

D. Clear liquids

a nurse is assisting with the care of a client who is receiving tpn therapy and has just returned to the room following Physical Therapy. The nurse notes that the infusion pump for the clients tpn is turned off. After restarting the infusion pump, the nurse should monitor the client for which of the following findings? A. Hypertension B. Excessive thirst C. Fever D. Diaphoresis

D. Diaphoresis

the nurse reinforces teaching to a female client about taking misoprostol to prevent stomach ulcers. Which statement by the client would prompt further instruction? A. I can take this medication with food if it hurts my stomach B. I must use a reliable form of birth control while taking this medication C. I should continue to take my ibuprofen as prescribed D. I will take this medicine with an antacid to decrease stomach upset

D. I will take this medicine with an antacid to decrease stomach upset

the nurse caring for a client with an ileal conduit observes that the stoma appears bluish gray. What is the nurses best action? A. administer an antibacterial agent and assess for additional signs of infection B. document the findings and continue to monitor for changes C. measure the stoma and obtain a larger patching device D. report the findings to the health care provider immediately

D. Report the findings to the health care provider immediately

a nurse is reinforcing teaching with a client who has a new diagnosis of dumping syndrome following gastric surgery. Which of the following information should the nurse include? A. eat 3 moderate size meals a day B. drink at least one glass of water with each meal C. eat a bedtime snack that contains a milk product D. increase protein in the diet

D. increase protein in the diet

the nurse monitors a client who has followed a vegan diet for several years. Which client statement would indicate a possible complication resulting from a vegan diet? A. I have had some visual disturbances while driving at night B. I have had trouble falling asleep over the past few months C. scaly patches of skin are developing on my elbows and knees D. sometimes my hands and feet get a tingling sensation

D. sometimes my hands and feet get a tingling sensation

the nurse is reinforcing education to a client with IBS who is experiencing diarrhea. Which of these mails selected by the client indicates an understanding of diet management? A. beans, yogurt, and a fruit cup B. beef, broccoli, and a glass of wine C. eggs, a bagel, and black coffee D. steak, tomato basil soup, and cornbread

D. steak, tomato basil soup, and cornbread

the nurse is monitoring a client who had an esophagogastroduodenoscopy 2 hours ago. Which finding requires an immediate report to the registered nurse? A. blood pressure drop from 122/88 to 106/72 B. gag reflex has not returned C. sore throat when swallowing D. temperature Spike to 101.2 F

D. temperature Spike to 101.2 F

a nurse is monitoring a client following a paracentesis. Which of the following findings indicates bowel perforation? A. report of upper chest pain B. decreased urine output C. pallor D. temperature elevation

D. temperature elevation

the nurse is caring for a client admitted to the hospital two days ago with acute pancreatitis. Which finding is the most concerning? A. blood glucose levels for the past 24 hours are greater than 250 mg B. client is lying with knees drawn up to the abdomen to alleviate pain C. 5 large liquid stools are yellow and foul-smelling D. temperature is 102.2 F and abdominal pain is increasing

D. temperature is 102.2 F and abdominal pain is increasing

a nurse is caring for a client who is dehydrated and is receiving a continuous tube feeding through a pump at 75 ml per hour. When the nurse checks the client at 0800, which of the following findings requires intervention by the nurse? A. a full pitcher of water sitting on the client's bedside table within the clients reach B. the Disposable feeding bag is from the previous day at 1,000 and contains 200 mL of feeding C. the client is laying on the right side with a visible dependent Loop in the feeding tube D. the head of the bed is elevated in 20 degrees

D. the head of the bed is elevated in 20 degrees

a nurse in a clinic is instructing a client about a fecal occult blood test, which requires mailing three specimens. Which of the following client statements indicates understanding of the instructions? A. I will continue taking my Warfarin while I complete these tests B. I'm glad I don't have to follow any special diet at this time C. this test determines if I have parasites in my bowel D. this is an easy way to screen for colon cancer

D. this is an easy way to screen for colon cancer

why should a patient with a small bowel obstruction get an NGT?

Decrease gastric distention

how is peristomal skin cleansed?

Gentle, warm water, no soap

What bacteria can cause peptic ulcers? S/S perforation from ulcer

H. Pylori; rigid board like abdomen, tachycardia, hypotension, bloating, pain before meals, pain with palpation, increased temperature

Ranitidine

H2 receptor antagonist; decrease stomach acid, do not take within 1 hour of antacids or food

What should drainage look like in: Ileostomy? Colostomy?

Ileostomy: liquid stool Colostomy: formed stool

S&S perforated peptic ulcer

Increased temperature, rigid board like abdomen, N/V, abdominal distention, bleeding, chest/abdominal pain, tachycardia, rebound tenderness, decreased bowel sounds

Nursing actions for Gtube feeding

Irrigate Q4H, keep HOB >30°, when giving meds, give 30mL water before, 10mL with, 10mL between meds, and 30mL after

a client reports that they haven't had a bowel movement in 3 days. The nurse should do what to help the client with GI peristalsis? (meds, food, activities)

MOM, docusate, colace, Metamucil Increase fiber, increased liquids Be active

Preop Appendectomy diet? Should you use a heating pad? Ambulate? Opioids? What happened if pain goes away?

NPO No No Appendix exploded

What OTC pain relievers should patients with duodenal ulcers not take?

NSAIDs, ASA

why would the NGT be draining coffee ground emesis after a gastrectomy?

Perforation

Dumping syndrome

Rapid emptying of gastric contents into small intestines. Client experience ab pain, nausea, vomiting, explosive diarrhea, weakness, dizziness, palpitations & tachycardia. increase fat and protein, small frequent meals, lie down after meal to decrease peristalsis

What does a good Ileostomy stoma look like?

Red, moist, some edema

If a patient has pain in LLQ, what could it be?

Sigmoid colon, ovary, ureter, descending colon

what Behavior suggests that the client is beginning to accept the change in body image with a colostomy?

They are able to look at and touch the stoma and change the pouch

How to tell if NGT is placed properly

Xray, pH 4-6, measure tubing

a community health nurse is planning an educational program about hepatitis A. When preparing the materials the nurse should identify that which of the following groups is most at risk for developing hepatitis A? A. children and young adults B. older adults C. women who are pregnant D. middle-aged men

a. Children and young adults

Gassy/odorous foods that colostomy patient should avoid

beans cabbage broccoli onions cauliflower brussel sprouts

how often should G-tube formula and tubing be changed?

every 24 hours

what is mcburney's point? What disease is it associated with?

it is in the RLQ midway between the umbilicus and top of hip; appendicitis

pain in right upper quadrant, the nurse would expect to find which organs?

liver, gallbladder, kidney

what position should an unconscious patient be placed in to perform mouth care?

on their side, head of bed elevated, facing nurse

the patient with a NGT is complaining of nausea. What could be wrong?

the tubing could be clamped. Check suction

A patient taking GoLYTELY experience has diarrhea following administration of the solution. What does the nurse tell the patient?

this is expected

What should the nurse monitor and record for patients with GI disease?

wait, changes in BM appearance, BM frequency, BM sounds, abdomen soft or firm; if fever and rebound tenderness = peritonitis