Test #3 Prepu Questions

A client with obesity is diagnosed with type 2 diabetes. In order to promote weight loss in the client and aid in glucose management, which medication will the nurse anticipate the health care provider ordering?

Metformin Explanation: Metformin (Glucophage) is a diabetes medication that also promotes weight loss. The other medications are diabetes medications; however, these promote weight gain, not weight loss.

The nurse is conducting a community education class on gastritis. The nurse includes that chronic gastritis caused by Helicobacter pylori is implicated in which disease/condition?

Peptic ulcers Chronic gastritis caused by Helicobacter pylori is implicated in the development of peptic ulcers. Chronic gastritis is sometimes associated with autoimmune disease, such as pernicious anemia, but not as a cause of the anemia. Chronic gastritis is not implicated in system infections and/or colostomies.

The nurse is monitoring a client's postoperative course after an appendectomy. The nurse's assessment reveals that the client has vomited, has abdominal tenderness and rigidity, and has tachycardia. The nurse reports to the physician that the client has signs/symptoms of which complication?

Peritonitis

A nurse is inserting a nasogastric tube for feeding a client. Place in order the steps from 1 to 6 for correctly inserting the tube.

Sit the client in an upright position Apply gloves to the nurse's hands Measure the length of the tube that will be inserted Apply water-soluble lubricant to the tip of the tube Tilt the client's nose upward Instruct the client to lower the head and swallow

A client who is postoperative from bariatric surgery is diagnosed with bile reflux after reports of severe epigastric pain and vomiting of bilious material. What statements are true regarding this condition? Select all that apply.

Usually occurs after disruption of the pylorus. Symptoms are usually relieved after pharmacological treatment.

A middle-aged obese female presents to the ED with severe radiating right-sided flank pain, nausea, vomiting, and fever. A likely cause of these symptoms is:

acute cholecystitis Explanation: Gallstones are more frequent in women, particularly women who are middle-aged and obese. With acute cholecystitis, clients usually are very sick with fever, vomiting, tenderness over the liver, and severe pain that may radiate to the back and shoulders. The patient profile and symptoms are suggestive of acute cholecystitis.

What type of feedings should be administered to a client who is at risk of diarrhea due to hypertonic feeding solutions?

continuous Continuous feedings should be administered to a client who is at risk of diarrhea due to hypertonic feeding solutions. Bolus or intermittent feedings cause sudden distention of the small intestine, and cyclic feedings are not advised.

A nurse working in a bariatric clinic assesses various clients with obesity. Which clients will the nurse recognize as meeting the selction criteria for bariatric surgery? Select all that apply.

48-year-old female with BMI 36 k/m2 and uncontrolled type 2 diabetes. 34-year-old male with BMI 30 k/m2 and metabolic syndrome with hypertension.

A nurse cares for a client with obesity who is scheduled to undergo vegal blocking therapy. When teaching the client about the procedure or device, which statements will the nurse include? Select all that apply.

"It is a pacemaker-type device that is implanted under your skin." "A pre-programed pulsating signal is delivered." "Recharge the device two times per week."

A nurse is caring for a patient with a Salem sump gastric tube attached to low intermittent suction for decompression. The patient asks, "What's this blue part of the tube for?" Which response by the nurse would be most appropriate?

"It is a vent that prevents backflow of the secretions."

A client with obesity is prescribed lorcaserin for weight loss. The client reports dry mouth. What is the nurse's best response?

"This is an expected finding with this medication."

A nurse cares for a client with a BMI of 36 kg/m2 and nonalcoholic fatty liver disease. The client asks the nurse if he is a candidate for bariatric surgery. How should the nurse respond to the client?

"Yes, your BMI and chronic condition meets the criteria for bariatric surgery."

A client has recently been diagnosed with gastric cancer. He has a history of tobacco use and was diagnosed 10 years ago with pernicious anemia. He and his family are shocked about the possibility of this diagnosis because he has been asymptomatic prior to recent complaints of pain and multiple gastrointestinal symptoms. On palpation, the nurse notes two signs that confirm metastasis to the liver. Which of the following are signs? Choose all that apply.

- Ascites - Hepatomegaly

A nursing student is caring for a client with gastritis. Which of the following would the student recognize as a common cause of gastritis? Choose all that apply.

- Ingestion of strong acids - Irritating foods - Overuse of aspirin

A nurse cares for a client who is post op from bariatric surgery. What risk factors does the nurse recognize increases the client's risk for developing venous thromboembolism (VTE)? Select all that apply.

Age Higher BMI History of a VTE

A patient is scheduled for a Billroth I procedure for ulcer management. What does the nurse understand will occur when this procedure is performed?

A partial gastrectomy is performed with anastomosis of the stomach segment to the duodenum.

A client reports to the clinic, stating that she rapidly developed headache, abdominal pain, nausea, hiccuping, and fatigue about 2 hours ago. For dinner, she ate buffalo chicken wings and beer. Which of the following medical conditions is most consistent with the client's presenting problems?

Acute gastritis

When preparing a client for a hemorrhoidectomy, the nurse should take which action?

Administer an enema as ordered. When preparing a client for a hemorrhoidectomy, the nurse should administer an enema, as ordered, and record the results. After surgery, the client may require antibiotics and analgesics.

While stripping wax from surfboards, a client accidentally ingested a refrigerated strong base cleaning solution, thinking it was water. The nurse plans to include all the following in the care plan: (Select all that apply.)

Administer medication for report of pain. Insert an intravenous (IV) catheter for administration of IV fluids. Maintain nothing by mouth status. Assess respiratory status every 4 hours and prn.

The nurse is caring for a patient who has dumping syndrome from high carbohydrate foods being administered over a period of less than 20 minutes. What is a nursing measure to prevent or minimize the dumping syndrome?

Administer the feeding with the patient in semi-Fowler's position to decrease transit time influenced by gravity.

A nurse researcher evaluates the epidemiology of obesity among gender and ethnicity of adults in the United States. Which findings correlate with data the nurse researcher finds? Select all that apply.

Among women, the highest prevalence of obesity is among non-Hispanic blacks. Among men, the highest prevalence of obesity is among Hispanics.

A client experienced surgical resection of a tumor of the esophagus. After recovery from the anesthesia, the nurse plans postoperative care to include the following: (Select all that apply.)

Assess lung sounds every 4 hours and prn. Monitor drainage in the closed chest drainage system. Verify rhythm on the cardiac monitoring system.

The nurse is teaching a group of clients with obesity about the risks of disease associated with obesity. Which respiratory conditions or diseases will the nurse include in the teaching, which are associated with obesity? Select all that apply.

Asthma Infection Obstructive sleep apnea

A nurse is preparing to assist a physician with a peripherally inserted central catheter. The nurse demonstrates understanding of this procedure by preparing which insertion site?

Basilic vein Peripherally inserted central catheters are inserted using the basilic or cephalic veins above the antecubital space. The subclavian vein is used for nontunneled central catheters. The jugular vein is used for nontunneled central catheters only as a last resort. The metacarpal vein is used for routine intravenous therapy

Several clinical manifestations are associated with a tumor of the head of the pancreas. Choose all that apply.

Clay-colored stools Dark urine Jaundice

A client has a nasogastric tube for continuous tube feeding. The nurse does all the following every shift to verify placement (select all options that apply):

Compares exposed tube length with original measurement Visually assesses the color of the aspirate Checks the pH of the gastric contents

A nurse is caring for a patient receiving parenteral nutrition at home. The patient was discharged from the acute care facility 4 days ago. Which of the following would the nurse include in the patient's plan of care? Select all that apply.

Daily weights Intake and output monitoring Calorie counts for oral nutrients

A nurse is assessing a patient receiving tube feedings and suspects dumping syndrome. Which of the following would lead the nurse to suspect this? Select all that apply.

Diarrhea Tachycardia Diaphoresis

A client with active schizophrenia has developed acute gastritis after ingesting a strongly alkaline solution during a psychotic episode. Corrosion is extensive. Which of the following emergency treatments might the team working with this client use? Select all that apply.

Diluted lemon juice Diluted vinegar

A client is being treated for diverticulosis. Which points should the nurse include in this client's teaching plan? Select all that apply.

Do not suppress the urge to defecate. Drink at least 8 to 10 large glasses of fluid every day. Use bulk-forming laxatives Encourage an individualized exercise program

A client is scheduled to receive a 25% dextrose solution of parenteral nutrition. The nurse does all of the following. Select all that apply.

Ensures availability of an infusion pump Ensures completion of baseline monitoring of the complete blood count (CBC) and chemistry panel Places a 1.5-micron filter on the tubing

When assessing whether a patient is a candidate for home parenteral nutrition, which of the following would be important to address? Select all that apply.

Family support Telephone access Motivation for learning Health status

While conducting a physical examination of a client, which of the following skin findings would alert the nurse to the possibility of liver problems? Select all that apply.

Jaundice Petechiae Ecchymoses

Gastrostomy feedings are preferred to nasogastric feedings in the comatose patient, because the:

Gastroesophageal sphincter is intact, lessening the possibility of regurgitation.

The nurse is caring for a client who has just returned from the PACU after surgery for peptic ulcer disease. For what potential complications does the nurse know to monitor? Select all that apply.

Hemorrhage Perforation Penetration Pyloric obstruction

A nurse is preparing a presentation for a local community group about hepatitis. Which of the following would the nurse include?

Hepatitis C increases a person's risk for liver cancer. Explanation: Infection with hepatitis C increases the risk of a person developing hepatic (liver) cancer. Hepatitis A is transmitted primarily by the oral-fecal route; hepatitis B is frequently spread by sexual contact and infected blood. Hepatitis E is similar to hepatitis A whereas hepatitis G is similar to hepatitis C.

The nurse is caring for a client receiving chemotherapy. For which mouth conditions associated with HIV infection should the nurse assess? Select all that apply.

Kaposi sarcoma Stomatitis

Place the pathophysiological steps in order of how a client with obesity is at greater risk for venous thromboembolism in comparison to the general population.

Increased adipose tissue Impairment of peripheral blood flow Blood stasis Formation of a thrombus

The client has been taking famotidine (Pepcid) at home. The nurse prepares a teaching plan for the client indicating that the medication acts primarily to achieve which of the following

Inhibit gastric acid secretions.

A nurse cares for a client with a disorder of the endocrine function of the pancreas. Which hormones or enzymes may be impacted by this disorder? Select all that apply.

Insulin Glucagon Somatostatin

Which is a true statement regarding the nursing considerations in administration of metronidazole?

It leaves a metallic taste in the mouth Flagyl leaves a metallic taste in the mouth. It may cause anorexia and should be given with meals to decrease GI upset. Flagyl increases the blood-thinning effects of warfarin (Coumadin).

A nurse is reviewing lab results for a client with an intestinal obstruction, and infection is suspected. Which of the following would be an expected finding?

Leukocytosis; elevated hematocrit; low sodium, potassium, and chloride

The physician orders the insertion of a single lumen nasogastric tube. When gathering the equipment for the insertion, the nurse would select which of the following?

Levin tube A Levin tube is a single lumen nasogastric tube. A Salem sump tube is a double lumen nasogastric tube; a Sengsten-Blakemore tube is a triple lumen nasogastric tube. A Miller-Abbott tube is a double lumen nasoenteric tube.

A client is being prepared to undergo laboratory and diagnostic testing to confirm the diagnosis of cirrhosis. Which test would the nurse expect to be used to provide definitive confirmation of the disorder?

Liver biopsy

Which of the following are functions of saliva? Select all that apply.

Lubrication Protection against harmful bacteria Digestion

The nurse is aware that hemorrhage is a common complication of peptic ulcer disease. Therefore, assessment for indicators of bleeding is an important nursing responsibility. Which of the following are indicators of bleeding? Select all that apply.

Melena Tachypnea Thirst Mental confusion

Rebleeding may occur from a peptic ulcer and often warrants surgical interventions. Signs of bleeding include which of the following?

Mental confusion Signs of bleeding include tachycardia, tachypnea, hypotension, mental confusion, thirst, and oliguria.

A patient has been taking a 10-day course of antibiotics for pneumonia. The patient has been having white patches that look like milk curds in the mouth. What treatment will the nurse educate the patient about?

Nystatin (Mycostatin)

When preparing a client for surgery to treat appendicitis, the nurse formulates a nursing diagnosis of Risk for infection related to inflammation, perforation, and surgery. What is the rationale for choosing this nursing diagnosis?

Obstruction of the appendix reduces arterial flow, leading to ischemia, inflammation, and rupture of the appendix.

A patient complains about an inflamed salivary gland below his right ear. The nurse documents probable inflammation of which gland?

Parotid Explanation: The salivary glands consist of the parotid glands, one on each side of the face below the ear; the submandibular and sublingual glands, both in the floor of the mouth; and the buccal gland, beneath the lips.

A nurse is caring for a client who is undergoing a diagnostic workup for a suspected GI problem. The client reports gnawing epigastric pain following meals and heartburn. The nurse suspects the client has:

Peptic Ulcer Disease Peptic ulcer disease is characterized by dull, gnawing pain in the midepigastrium or the back that worsens with eating. Ulcerative colitis is characterized by exacerbations and remissions of severe bloody diarrhea. Appendicitis is characterized by epigastric or umbilical pain along with nausea, vomiting, and low-grade fever. Pain caused by diverticulitis is in the left lower quadrant and has a moderate onset. It's accompanied by nausea, vomiting, fever, and chills

A client who is postoperative from bariatric surgery reports foul-smelling, fatty stools. What is the nurse's understanding of the primary reason for this finding?

Rapid gastric dumping

A nursing instructor is preparing a class about gastrointestinal intubation. Which of the following would the instructor include as reason for this procedure? Select all that apply.

Remove gas and fluids from the stomach Diagnose gastrointestinal motility disorders Flush ingested toxins from the stomach Administer nutritional substances

A nurse suspects that a patient is developing rebound hypoglycemia secondary to parenteral nutrition being discontinued too rapidly. Which of the following would support the nurse's suspicions? Select all that apply.

Shakiness Tachycardia Weakness Confusion

Which are accurate clinical manifestations associated with hemorrhage? Select all that apply.

Tachycardia, tachypnea, and hypotension

A nurse examines the socioeconomic impact of obesity among Americans. Which statements does the nurse understand is true? Select all that apply.

Those with less education are impacted at a greater prevalence of disease. Those with less income are impacted at a greater prevalence of disease.

The nurse is inserting a nasoenteric tube for a patient with a paralytic ileus. How long does the nurse anticipate the tube will be required? (Select all that apply.)

Until bowel sound is present Until flatus is passed Until peristalsis is resumed

Which of the following is the most common type of diverticulum?

Zenkers

A client has received a diagnosis of portal hypertension. What does portal hypertension treatment aim to reduce? Select all that apply.

fluid accumulation venous pressure

The nurse teaches the client whose surgery will result in a sigmoid colostomy that the feces expelled through the colostomy will be

solid. Explanation: With a sigmoid colostomy, the feces are solid. With a descending colostomy, the feces are semimushy. With a transverse colostomy, the feces are mushy. With an ascending colostomy, the feces are fluid.

Which of the following are characteristics associated with the Zollinger-Ellison syndrome (ZES)? Select all that apply.

• Gastrin-secreting tumors of the pancreas • Extreme gastric hyperacidity • Severe peptic ulcers Explanation: ZES consists of severe peptic ulcers, extreme gastric hyperacidity, and gastrin-secreting benign or malignant tumors of the pancreas. Diarrhea and steatorrhea may be evident. The client may have co-existing parathyroid adenomas or hyperplasia and may therefore exhibit signs of hypercalcemia.

A nurse is educating a community group about coronary artery disease. One member asks about how to avoid coronary artery disease. Which of the following items are considered modifiable risk factors for coronary artery disease? Choose all that apply.

• Hyperlipidemia • Tobacco use • Obesity

Which of the following is a proton pump inhibitor used in the treatment of gastroesophageal reflux disease (GERD)? Select all that apply.

• Lansoprazole (Prevacid) • Rabeprazole (AcipHex) • Esomeprazole (Nexium)

A nurse working in a cardiac health care office notes increased risk of certain cardiac conditions as a result of obesity. Which conditions can be associated with obesity? Select all that apply.

Hypertension Coronary artery disease Heart failure Myocardial infarction

Which of the following is a risk factor for the development of diabetes mellitus? Select all that apply.

Hypertension Obesity Family history Age greater of 45 years or older History of gestational diabetes

The nurse admits a woman who is 8 weeks postpartum. The client presents with reports of severe right upper quadrant pain that radiates to her back. She states she just finished eating Thanksgiving dinner earlier that evening. The nurse suspects gallbladder disease. Statistics show that incidence of gallbladder disease is greater for women who are which of the following? Select all that apply.

Multiparous Obese

A nurse practitioner, who is treating a patient with GERD, knows that responsiveness to this drug classification is validation of the disease. The drug classification is:

Proton pump inhibitors.

A 66-year-old African-American client has recently visited a physician to confirm a diagnosis of gastric cancer. The client has a history of tobacco use and was diagnosed 10 years ago with pernicious anemia. He and his family are shocked about the possibility of cancer because he was asymptomatic prior to recent complaints of pain and multiple gastrointestinal symptoms. On the basis of knowledge of disease progression, the nurse assumes that organs adjacent to the stomach are also affected. Which of the following organs may be affected? Choose all that apply.

- Liver - Pancreas - Duodenum Most gastric cancers are adenocarcinomas; they can occur anywhere in the stomach. The tumor infiltrates the surrounding mucosa, penetrating the wall of the stomach and adjacent organs and structures. The liver, pancreas, esophagus, and duodenum are often already affected at the time of diagnosis. Metastasis through lymph to the peritoneal cavity occurs later in the disease.

A client informs the nurse that he has been having abdominal pain that is relieved when having a bowel movement. The client states that the physician told him he has irritable bowel syndrome. What does the nurse recognize as characteristic of this disorder?

Chronic constipation with sporadic bouts of diarrhea

The nurse is to administer a cyclic feeding through a gastric tube. It is most important for the nurse to

Elevate the head of the bed to 45 degrees.

Health teaching for a patient with GERD is directed toward decreasing lower esophageal sphincter pressure and irritation. The nurse instructs the patient to do which of the following? Select all that apply.

Elevate the upper body on pillows. Avoid beer, especially in the evening. Elevate the head of the bed on 6- to 8-inch blocks.

An older client underwent a lumpectomy for a breast lesion that was determined to be malignant. Which factors in the client's history may have increased the risk of breast cancer?

The risk for breast cancer in women increases with age. Certain factors appear to increase the risk of breast cancer. Being female, being older than 50 years of age, and having a family history of breast cancer are the most common risk factors. Additional factors include obesity, and having no children or having children after 30 years of age.

A nurse teaches a client with obesity about the various medication options for the treatment of obesity. Which medication will the nurse include when teaching the client about the class of medications that stimulate noradrenergic receptors?

Phentermine