NRS 3025 Midterm Questions
An older patient diagnosed with bacterial gastroenteritis reports abdominal cramping, diarrhea, nausea and vomiting, and fatigue for the past 24 hours. The nurse should monitor the patient for what priority assessment? A. Dehydration B. Hypokalemia C. Hypernatremia D. Perineal skin breakdown
A In older adults, dehydration occurs with viral and bacterial gastroenteritis and may require hospitalization. Electrolyte imbalances are also common, especially hypokalemia and hypernatremia. The aging skin is also at risk of compromise from frequent exposure to enzymes in the stool.
What is the nursing priority in the management of a patient with an active upper GI bleed? A. Obtain vital signs. B. Apply oxygen by nasal cannula. C. Type and crossmatch the patient for blood products. D. Notify the physician.
A Vital signs are needed to evaluate the severity of the patient's bleed and hypovolemic status. Oxygen will assist with delivery of oxygen to the tissues. A type and crossmatch is not the immediate priority. Assessment data such as the patient's vital signs are needed before contacting the physician.
What priority laboratory analysis should the nurse review when caring for a patient with Crohn's disease? A. C-reactive protein B. Serum albumin C. Hemoglobin D. Potassium
C Crohn's disease presents as transmural inflammation that causes a thickened bowel wall, strictures, and deep ulcerations that result in severe diarrhea and malabsorption of vital nutrients. Anemia is common, usually from iron deficiency or malabsorption issues. C-reactive protein may be monitored as a marker of inflammation, albumin to assess nutritional status, and potassium related to losses from diarrhea.
A 68-year-old patient with a history of arthritis and hypertension is admitted reporting progressive epigastric cramping, dyspepsia, nausea, and dark, sticky stools for 3 days. Which order will the nurse question? A. IV fluids, normal saline at 125 ml/hr B. Guaiac stool sample 2 C. Naproxen (Naprosyn) 500 mg twice daily D. Stool sample for bacterial testing
C Long-term NSAID use creates a high risk for acute gastritis. Naproxen is an NSAID that may be used to treat arthritis. Other risk factors for acute gastritis include alcohol, caffeine, and corticosteroids. IV fluids may or may not be needed to replace any fluids or blood lost from the patient's gastritis. Stool guaiac is nonspecific but may be ordered to confirm blood in the stool, and a stool sample may be used to test for the presence of H Pylori infection. However, it is not as accurate as blood or breath tests.
Which patient statement alerts the nurse to perform a thorough GI history and focused assessment? "I don't like the taste of spicy foods." "I got dentures four years ago." "I experience occasional constipation." "I take ibuprofen three times daily for arthritis."
D Large amounts of aspirin or other nonsteroidal antiinflammatory drugs (NSAIDs) such as ibuprofen can predispose the patient to peptic ulcer disease and GI bleeding
A 23-year-old female patient reports having red, raised lesions at the base of her tongue and on the inside of her mouth for the past 3 weeks. What priority assessment question should the nurse ask? A. "Do you smoke cigarettes?" B. "What type of work do you do?" C. "Have you seen a dentist recently?" D. "Do you have a history of human papillomavirus?
D. It is now confirmed that in younger age groups, including those who have never used tobacco products, mouth lesions can be caused by human papillomavirus (HPV). HPV, particularly version 16, has been shown to be sexually transmitted between partners and is conclusively implicated in the increasing incidence of young, nonsmoking oral cancer patients.
