NUR325 Adaptive quiz GI
3
A nurse is caring for a client with chronic inflammation of the bowel. Which most serious complication should the nurse monitor for in this client? 1 Ileus 2 Pain 3 Perforation 4 Obstruction
*1
A nurse is performing the initial history and physical examination of a client with a diagnosis of duodenal ulcer. Which type of pain does the nurse expect the client to describe? 1 Pain that is relieved with eating 2 Pain that is worse with antacids 3 Pain that is relieved with sleep 4 Pain that is worse one hour after eating
1
A client is diagnosed with acute gastritis secondary to alcoholism and cirrhosis. The client reports frequent nausea, pain that increases after meals, and black, tarry stools. The client recently joined Alcoholics Anonymous. The nurse should give priority to which client history item? 1 Black, tarry stools 2 Frequent nausea 3 Joining Alcoholics Anonymous 4 Pain that increases after meals
2
A nurse is providing discharge teaching to a client who had an ileostomy. Which instruction should the nurse emphasize? 1 Informing the client about the ileostomy association 2 Telling the client whom to contact if assistance is needed 3 Encouraging the client to return to the workplace as soon as possible 4 Teaching the client the importance of irrigations to regulate bowel movements
3
A client had a colon resection and formation of a colostomy two days ago. Which color indicates to the nurse the stoma is viable? 1 Blue 2 Gray 3 Brick red 4 Dark purple
2
A client is admitted with a diagnosis of gastric ulcer. Which location is most commonly indicated by the client as being painful when the nurse assesses for the presence of pain? 1 left chest 2 left costal margin 3 right costal margin 4 umbilicus
4
A client is diagnosed with a peptic ulcer. When teaching about peptic ulcers, the nurse instructs the client to report what kind of stools? 1 Frothy 2 Ribbon shaped 3 Pale or clay colored 4 Dark brown or black
3
A nurse is assessing a client for possible malabsorption syndrome. Which stool assessment finding will support this diagnosis? 1 Melena 2 Frank blood 3 Fat globules 4 Currant jelly consistency
3
An 85-year-old client has a three-day history of nausea, vomiting, and diarrhea. The client develops weakness and confusion and is admitted to the hospital. To best monitor the client's rehydration status, what should the nurse assess? 1 Skin turgor 2 Daily weight 3 Urinary output 4 Mucous membranes
*3 . Removal of the fundus of the stomach (gastrectomy) destroys the parietal cells that secrete intrinsic factor (needed to combine with vitamin B12 preliminary to its absorption in the ileum)
The nurse assesses a client for the development of pernicious anemia after reviewing the client's history. Which condition did the nurse most likely find in the history? 1 Acute gastritis 2 Diabetes mellitus 3 Partial gastrectomy 4 Unhealthy dietary habits
3
A client with ulcerative colitis has experienced frequent severe exacerbations over the past several years. The client is admitted to the hospital with intense pain, severe diarrhea, and cachexia. Which therapeutic course should the nurse expect the primary healthcare provider to explore with this client? 1 Intensive psychotherapy 2 Continued medical therapy 3 Surgical therapy (colectomy) 4 Diet therapy (low-residue, high-protein diet)
1
After an acute episode of upper gastrointestinal (GI) bleeding, a client vomits undigested medications and reports severe epigastric and abdominal pain. The client has absent bowel sounds, rigid abdomen, a pulse rate of 134, and shallow respirations of 32 per minute. The primary healthcare provider has been contacted. What should be the nurse's next priority? 1 Keep the client nothing by mouth (NPO) 2 Teach the client coughing and deep breathing 3 Inquire whether any red or black stools have been noted 4 Place the client in the supine position with the legs elevated
2
The nurse is preparing to administer a nasogastric tube feeding to a client via infusion pump. What is the most important assessment the nurse needs to perform before beginning the pump? 1 Checking for the last bowel movement 2 Checking for residual stomach contents 3 Checking to determine time of last medication for nausea 4 Checking to make sure the head of bed is elevated at least 15 degrees
*2
Which is the priority intervention for the dependent client with peptic ulcer disease (PUD) who is vomiting bright red blood? 1 Apply oxygen 2 Place the client in a side-lying position 3 Prepare to administer packed red blood cells 4 Assess the client's pulse and blood pressure
*1 Obesity causes stress on the diaphragmatic musculature, which weakens and allows the stomach to protrude into the thoracic cavity.
A nurse is caring for a client with a hiatal hernia. Which risk factor should the nurse assess for in this client? 1 Obesity 2 Alcoholism 3 Chronic bronchitis 4 Esophageal varices
*2 The semi-Fowler position aids in localizing drainage to the lower abdominal cavity and prevents the spread of infection throughout the abdominal cavity while allowing for lung expansion
A client had surgery for a perforated appendix with localized peritonitis. In which position should the nurse place this client? 1 Sims 2 Semi-Fowler 3 Trendelenburg 4 Dorsal recumbent
ULQ
A client is admitted with a diagnosis of a gastric peptic ulcer. What area that the client would indicate is the site of pain associated with this disorder.
4
A client with a history of ulcerative colitis has a large portion of the large intestine removed, and an ileostomy is created. For which potential life-threatening complication should the nurse assess the client after this surgery? 1 Infection caused by the excretion of feces 2 Injury caused by exposed intestinal mucosa 3 Altered bowel elimination caused by the ostomy 4 Limited water reabsorption caused by removal of intestine
1
A client with a history of ulcerative colitis is admitted to the hospital because of severe rectal bleeding. The client appears to be angry and demanding. One day the unlicensed assistive personnel (UAP) tells the nurse, "I've had it with that client's demands. I'm not going in that room again." Which response by the nurse is best? 1 "The client is frightened. Let's think about the best approach we can take." 2 "You need to try to be patient with the client, who is going through a lot right now." 3 "I'll talk with the client. Maybe I can figure out the best way for us to handle this situation." 4 "Just ignore the client and get on with the rest of your work. Let someone else take a turn."
4
A client with chronic gastritis is being treated with medication and diet. What should the nurse teach the client when discussing the therapeutic regimen? 1 Lie down after eating when possible 2 Take an antacid preparation with meals 3 Limit high-carbohydrate foods in the diet 4 Avoid using analgesics that contain aspirin
2
A nurse assesses a client with the diagnosis of an intestinal obstruction in the descending colon. When auscultating the midabdomen, what should the nurse expect to hear? 1 Tympany 2 Borborygmi 3 Abdominal bruit 4 Pleural friction rub
4
A nurse is assessing two clients. One client has ulcerative colitis, and the other client has Crohn disease. Which is more likely to be identified in the client with ulcerative colitis than in the client with Crohn disease? 1 Inclusion of transmural involvement of the small bowel wall 2 Higher occurrence of fistulas and abscesses from changes in the bowel wall 3 Pathology beginning proximally with intermittent plaques found along the colon 4 Involvement starting distally with rectal bleeding that spreads continuously up the colon
3
A nurse reviews the plan of care for a geriatric client with less than adequate nutritional intake. The nurse should question which prescription? 1 Have client sit in a chair for meals to prevent aspiration of food/liquid into the lungs. 2 Provide six small feedings in 24 hours whenever requested by the client. 3 Give one can of diet supplement at 8:00 AM with breakfast and 4:00 PM prior to evening meal. 4 Encourage the client's family members to bring food from home, especially their favorite dishes.
2
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? 1 It is temporary until the colon heals. 2 Surgical treatment cures ulcerative colitis. 3 Ulcerative colitis can progress to Crohn disease. 4 Without surgery, eating table foods is contraindicated.
2
Three days after surgery for cancer of the colon, a nurse introduces the client to colostomy care. Which should the nurse teach the client about skin care around the stoma? 1 Apply liberal amounts of Vaseline for 3 inches (7.6 centimeters) around the stoma 2 Wash the area with soap and water and then apply a protective ointment 3 Pour saline over the stoma and rub the area to remove hard fecal matter 4 Rinse the area with peroxide before applying fresh gauze bandages
*145
The nurse is caring for a client with peritonitis who had surgery two hours ago due to a ruptured appendix. Which clinical findings should the nurse expect to observe when assessing this client? Select all that apply. 1 Fever 2 Hyperactivity 3 Extreme hunger 4 Urinary retention 5 Abdominal muscle rigidity
*1
Which explanation should the nurse consider when formulating a response to a client's inquiry about intussusception of the bowel? 1 Kinking of the bowel onto itself 2 A band of connective tissue compressing the bowel 3 Telescoping of a proximal loop of bowel into a distal loop 4 A protrusion of an organ or part of an organ through the wall that contains it
125
Which information would the nurse include regarding appliance care and maintenance, when teaching a client with a new colostomy? Select all that apply. 1 Change the ostomy pouch on a routine basis. 2 Replace the ostomy wafer weekly or sooner as needed. 3 Remove the ostomy pouch when showering. 4 Empty the ostomy pouch when three-quarters full of stool or gas. 5 Empty the ostomy pouch before exercise and at bedtime.
