Nurs 201 - GI

a nurse is providing instructions for a 52 year old client who is scheduled for a colonoscopy. The client reports that he has not had the procedure before and is very anxious about feeling pain during the procedure. Which of the following responses by the nurse is appropriate? "dont worry, most clients dislike the prep more than the procedure itself" "before the examination, your provider will give you a sedative that will make you sleepy" "i know you're anxious, but this procedure is recommended for people your age" "after you have signed the consent form, we can talk more about this"

"before the examination, your provider will give you a sedative that will make you sleepy"

a nurse is caring for an older adult client who reports taking bisacodyl tablets daily. which of the following responses should the nurse take? "irregular bowel movements are an indication of poor intestinal health" "excessive laxative use may cause an electrolyte imbalance" "chronic use of laxatives can lead to a tear in the rectal mucosa" "decrease your intake of foods high in fiber"

"excessive laxative use may cause an electrolyte imbalance"

A nurse is caring for a client who has hep A. The client asks the nurse how he might have contracted the virus. Which of the following is a question the nurse should ask the client? Have you eaten any fresh water fish lately? have you received blood transfusion recently? have you been to a third world country in the past? do you take any recreational drugs?

"have you been to a third world counrty in the past?" - contaminated water and food, shellfish.

a nurse is talking with a client who has cholelithiasis and is about to undergo an oral cholangiogram. Which of the following client statements indicates to the nurse understanding of the procedure? "they are going to examine my gallbladder and ducts" "soon those shock waves will get rid of my gallstones" "ill have a camera put down my throat so they can see my gallbladder" "theyll put medications into my gallbladder to dissolve the stones"

"they are going to examine my gallbladder and ducts" With oral cholangiography, the client receives an iodide-containing contrast agent 10 to 12 hr before the procedure. Then, the examiner can evaluate the gallbladder for filling, contracting, and emptying and can also see the gallstones on the x-rays.

a nurse is planning care for a client who has cirrhosis of the liver. Which of the following actions should the nurse include in the plan? SATA administer furosemide administer warfarin. implement a low-sodium diet. measure the client's abdominal girth. encourage weight lifting during physical therapy.

Administer furosemide, implement a low-sodium diet, measure abdominal girth

A nurse is caring for a client who has liver cirrhosis with ascites, bleeding esophageal varices, and portal hypertension. The nurse recognizes which of the following laboratory findings as indicating the client's GI tract is digesting and absorbing blood? Elevated blood urea nitrogen (BUN) elevated HbA1c decreased chloride decreased bilirubin

Elevated blood urea nitrogen (BUN) -As the body digests blood, BUN rises. An elevated BUN is an indication of GI bleeding.

a nurse is caring for a client who has diverticular disease. When palpating the client's abdomen, in which of the following locations should the nurse expect the client to report abdominal pain? LLQ LUQ RLQ RUQ

LLQ lower left quadrant.

a nurse is assessing clients in a health clinic for risk factors of contracting hepatitis. Which of the following clients is at risk for developing hep c? A client who eats raw shellfish. " " multiple tattoos. " " who works in a childcare center. " " who has recently traveled to a underdeveloped country.

a client who has multiple tattoos. Hepatitis C is transmitted via blood-to-blood contact. The nurse should recognize that improperly maintained tattoo equipment may aid in transmission and could increase the client's risk for contracting hepatitis C.

a nurse is reviewing the lab data of a client who has acute pancreatitis. The nurse should expect to find an elevation of which of the following values? calcium RBC count magnesium amylase

amylase -increase WBC count

a nurse is caring for a client who has ulcerative colitis and is teaching the client about the common link with Crohn's disease. Which of the following information should the nurse include? both are inflammatory. both begin in the rectum. both manifest fistula formation. both require frequent surgery.

both are inflammatory.

a nurse is caring for a client who reports having chronic constipation. which of the following herbal supplements should the nurse recommend? ginseng coenzyme q-10 cranberry juice flaxseeds

flaxseed.

a nurse is teaching self-management to a client who has Hep B. Which of the following instructions should the nurse include in the teaching? you may donate blood 6 months after completing the medication regimen. consume a high-protein diet. rest frequently throughout the day. take acetaminophen every 4 hr, as needed, for discomfort.

rest frequently throughout the day.

a nurse is caring for a client who has just retuned from the PACU after a traditional cholecystectomy. In which of the following positions should the nurse place the client? prone semi-fowlers supported sims dorsal recumbent.

semi-fowlers. -The nurse should expect a prescription to place the client in semi-Fowler's position following a traditional cholecystectomy to facilitate lung expansion as well as coughing and deep breathing. This position will place minimal stress on the abdomen and increase comfort.

a nurse is providing teaching about ileostomy care to a client. Which of the following statements by the client indicates a need for further teaching? "i will empty my pouch when it becomes 1/3 full" "i will be certain to take enteric-coated medications" "i will change my entire pouch system at least weekly" "i will use caution when eating high fiber foods"

"i will be certain to take enteric-coated medications"

a nurse is providing info about pain control for a client who has acute pain following subtotal gastric resection. Which of the following client statements indicates an understanding of pain control? "i will call for pain med before the previous dose wears off" "I will call for pain med. as my pain starts to increase again" "I will wait for you to evaluate my pain before asking for more "I will ask for less medication to avoid addiction"

"i will call for pain med before the previous dose wears off" -The client should call for pain medication before the previous dose of medication wears off or before the pain becomes severe.

a nurse is planning a menu for a client who has folic acid deficiency anemia. Which of the following foods should the nurse include as high in folate? 1/2 cup of asparagus. 1/4 cup of olives 4 slices of roast beef. 1 cup part-skim mozzarella cheese.

1/2 cup of asparagus.

a nurse is caring for a client who has gastrointestinal bleeding. which of the following actions should the nurse take first? assess orthostatic blood pressure. explain the procedure for an upper gastrointestinal series. administer pain medication test the client's emesis for blood.

assess orthostatic blood pressure.

a nurse is planning care for a client who has hep B. Which of the following interventions should the nurse include in the plan? administer antibiotics provide a diet high in fat. restrict fluids. encourage short periods of ambulation.

encourage short periods of ambulation.

a nurse is teaching a client how to do fecal occult blood testing. which of the following statements by the client indicates a need for further teaching? "I will continue my low-dose aspirin therapy regimen." i will refrain from eating raw fruits and veges i will avoid steak and other red meats i will continue taking my Coumadin as prescribed.

"i will continue taking my Coumadin as prescribed" -The client should discontinue anticoagulants for one week prior to this testing. This statement requires clarification.

a nurse is teaching a client about strategies to manage GERD. Which of the following statements should the nurse include? "elevate the head of your bed by 18 inches" "avoid snacking between meals" "limit foods that are high in fiber" "lie on your right side when sleeping"

"lie on your right side when sleeping"

a client who is scheduled for a barium swallow asks the nurse why a laxative is necessary following the procedure. Which of the following responses should the nurse make? "the laxative will prevent the absorption of magnesium" "the laxative helps eliminate the barium" the laxative is a protocol at this facility. the laxative makes the barium turn brown.

"the laxative helps eliminate the barium"

a nurse is teaching a client who is preop for a colectomy. The nurse asks the nurse why he needs a large-bore NG tube. Which of the following statements should the nurse make? "the tube is a routine standard following this type of surgery" "the tube will allow us to provide you with nutrition" "the tube will remove gas and fluid from your stomach" "the tube can be explained to you once you are stable after surgery"

"the tube will remove gas and fluid from your stomach"

a nurse is providing teaching to a client who has a new colostomy. Which of the following information should the nurse include in the teaching? "you can expect fecal output within 24 hours" "you will need to increase your dietary intake of raw vegetables" "you can expect the stoma to be purplish in color for the first week" "you may experience a small amount of bleeding around the stoma"

"you may experience a small amount of bleeding around the stoma"

a nurse is preparing to administer liquid famotidine 20 mg PO every 6 hr for a client who has GERD. Available is famotidine 40 mg/5mL. How many mL should the nurse administer?

2.5 mL

a nurse is teaching a class about preventive care to clients who are at risk for acquiring viral hepatitis. Which of the following information should the nurse include in the presentation? avoid covering sores with bandages. avoid handwashing after eating. avoid foods prepared with tap water. avoid eating meat.

avoid foods prepared with tap water. -To decrease the risk for acquiring viral hepatitis, clients should prepare foods with purified water.

a nurse is preparing dietary instructions for a client who has episodes of biliary colic from chronic cholecystitis. Which of the following instructions should the nurse include in the teaching plan? include food high in starch and proteins include foods high in fiber. avoid foods high in fats. avoid foods high in sodium.

avoid foods high in fat.

a nurse is providing teaching for a client who has a new diagnosis of GERD. The client asks about food he should avoid eating. Which of the following foods should the nurse tell him to avoid. nonfat milk chocolate apples oatmeal

chocolate The client should avoid foods that reduce pressure on the lower esophageal sphincter. These include fatty and fried foods, chocolate, caffeine, alcohol, and carbonated drinks.

a nurse is teaching a client who has a history of ulcerative colitis and a new diagnosis of anemia. Which of the following manifestations of colitis should the nurse identify as a contributing factor to the development of the anemia? dietary iron restrictions. intestinal malabsorption syndrome. chronic blood loss intestinal parasites.

chronic blood loss

a nurse is assessing a client who has an obstruction of the common bile duct resulting from chronic cholecystitis. Which of the following findings should the nurse expect? fatty stools straw-colored urine tenderness in the left upper ab ecchymosis of the extremities.

fatty stools

a nurse is assessing a client who has peptic ulcer disease. which of the following findings should the nurse identify as the priority? epigastric discomfort dyspepsia epigastric discomfort hematemesis.

hematemesis -When using the urgent vs. non-urgent approach to client care, the nurse should determine that the priority finding is hematemesis, which indicates massive bleeding.

a nurse is preparing a client who is scheduled to undergo a paracentesis. Into which of the following positions should the nurse assist the client for this procedure? high-fowlers side-lying leaning forward supine

high-fowlers

a nurse is planning a care for a client who is postoperative and at risk for paralytic ileus. Which of the following interventions should the nurse plan to take to promote peristalsis? increase ambulation. decrease fluid intake. increase protein intake. offer the client the bedpan every 2 hr.

increase ambulation.

a nurse admits a client to the ED who reports N/V that worsens when he lies down. Antacids do not help. The provider suspects acute pancreatitis. Which of the following laboratory test results should the nurse expect to see? decreased WBC. increased serum amylase decreased serum lipase increased serum calcium.

increased serum amylase

a nurse is assessing a client who has advanced cirrhosis. Which of the following manifestations should the nurse expect? petechiae hypertension osteoarthritis peripheral ulcers

petechiae

A nurse is caring for a client who has a history of alcohol use disorder and reports bruising and frequent nosebleeds. The nurse should recognize that this client in manifesting which of the following conditions? Malnutrition Hep A Diabetes. Cirrhosis.

cirrhosis A history of alcohol use disorder increases the client's risk of developing cirrhosis and coagulation defects are a common complication of cirrhosis.

a nurse is teaching a client who has a prescription of a NG to treat a pyloric obstruction. Which of the following rationales for the use of the NG tube should the nurse include in the teaching?

decompress the stomach. -A pyloric obstruction, also called gastric outlet obstruction, is caused by edema, scarring, or spasm, often the result of gastritis or peptic ulcer disease. The nurse should inform the client that because the stomach is dilated and may contain undigested food, it must be decompressed, necessitating the placement of an NG tube.

A nurse is admitting a client who was prescribed antibiotic therapy and now has C.Diff infection. Which of the following actions should the nurse take? disinfect equipment in the client's room daily. place the client in a protective enviro. use alcohol hand sanitizer after completing tasks for the client. have the client wear a mask when out of the room.

disinfect equipment in the client's room daily.

a nurse is providing care for a client who had a laparoscopic cholecystectomy. Which of the following is appropriate nursing action? Place the client in a supine position postop. encourage ambulation once fully awake. offer the client ice cream postoperatively. instruct the client not to lift over 4.5 kg (10lbs)

encourage ambulation once fully awake. -the nurse should instruct the client not to lift more than 2.3 kg (5 lb) following surgery.

a nurse is caring for a client following an esophagogastroduodenoscopy (EGD) procedure. Which of the following assessments is the nurse's priority? pain nausea gag reflex LOC

gag reflex

a nurse is interviewing a client who has acute pancreatitis. Which of the following factors should the nurse anticipate finding in the client's history? gallstones hypolipidemia COPD diabetes mellitus.

gallstones

a nurse is assessing a client who is African American and has jaundice. Which of the following areas is the most reliable for the nurse to inspect the client for jaundice? palms of the hands hard palate conjunctiva back of the neck

hard palate -or oral mucosa.

a nurse is reviewing the provider's prescriptions for a client experiencing a paralytic ileus following an appendectomy. Which of the following actions should the nurse expect to take? adminster an antacid. provide a bulk-forming agent. insert NG tube. apply a truss.

insert nasogastric tube.

a nurse is administering a tap water enema to a client who is constipated. During the administration of the enema, the client states he is having abdominal cramps. Which of the following actions should the nurse take to relieve the client's discomfort? lower the height of the solution container. encourage the client to bear down. allow the client to expel some fluid before continuing. stop the enema and document that that client did not tolerate the procedure.

lower the height of the solution container.

a nurse is teaching a client who is receiving treatment for metastatic colorectal cancer about the adverse effects of bevacizumab with. The nurse should instruct the client to report which of the following findings as an adverse effect of the medication? weight gain. mild hearing loss. temporary loss of smell. nosebleeds.

nosebleeds

A nurse is teaching a client about causes of biliary cirrhosis. Which of the following info should the nurse include in the teaching? excessive alcohol consumption. hepatitis C. hepatotoxic medications obstruction of the bile duct.

obstruction of the bile duct. -Prolonged obstruction of the common bile duct is the most common cause of biliary cirrhosis.

a nurse is assessing a client who is 3 days postoperative following abdominal surgery and notes the absence of bowel sounds, abdominal distention, and the client passing no flatus. Which of the following conditions should the nurse suspect? ulcerative colitis. cholecystitis. paralytic ileus. wound dehiscence.

paralytic ileus A paralytic ileus in a postoperative client is indicated by the absence of bowel sounds, abdominal distention, and the client passing no stool or flatus. It is often caused by bowel handling during surgery and opioid analgesic use.

a nurse is caring for a client who is postoperative following abdominal surgery. Which of the following findings should indicate to the nurse the client's peristalsis is returning? hypoactive bowel sounds in 2 quadrants request for a cup of tea and some toast. passage of flatus abdominal distention.

passage of flatus - & belching

A nurse is assessing a client who has cirrhosis. Which of the following is an expected finding for this client? moist skin spider angiomas tarry stools blood in urine.

spider angiomas Spider angiomas are lesions with a red center and numerous extensions that spread out like a spider web. This is an expected finding for a client who has cirrhosis.

a nurse is caring for a client who has peptic ulcer disease. The nurse should monitor the client for which of the following findings as an indication of gastrointestinal perforation? hyperactive bowel sounds. sudden abdominal pain increased blood pressure bradycardia.

sudden abdominal pain -Classic indications of gastrointestinal perforation include sudden sharp abdominal pain with a rigid abdomen, declining peristalsis, and progression to septicemia and hypovolemic shock.

A client is about to undergo an abdominal paracentesis. In which of the following positions should the nurse place the client? prone supine upright lateral

upright can use folwers position if unable to get out of bed