UNIT 5- GI

Which priority teaching will the nurse provide to prevent harm when a client with an oral problem is prescribed viscous lidocaine? A. "Lidocaine causes an anesthetic effect so you may not feel burns from hot liquids." B. "You should avoid drinking either cool or cold liquids which can damage the tongue." C. "When you take viscous lidocaine, you should swish it around your mouth then spit it out." D. "Viscous lidocaine will decrease the pain in your mouth when you use it regularly."

A. "Lidocaine causes an anesthetic effect so you may not feel burns from hot liquids."

What instructions will the nurse provide to a client with a gastrointestinal problem who is scheduled for an abdominal x-ray? A. "Wear a hospital gown and remove any jewelry or belts." B. "You will have nothing to eat or drink until after the procedure." C. "A nasogastric tube will be placed to decompress your stomach." D. "You will receive a laxative to clear stool out of your bowel."

A. "Wear a hospital gown and remove any jewelry or belts."

What is the nurse's best response when a client asks which kind of stool to expect from a colostomy in the descending colon? A. "Your stool will be solid and similar to what you expelled from your rectum." B. "It will be very watery and similar to diarrhea stool." C. "You should expect your stool to be somewhat thin and gelatin-like." D. "Most likely your stool will have the consistency of paste and be thick."

A. "Your stool will be solid and similar to what you expelled from your rectum."

Which client with symptoms of chronic abdominal pain and frequent bowel movements will the nurse consider at highest risk for a diagnosis of ulcerative colitis (UC)? A. 26-year-old white woman of Jewish ancestry who has an identical twin sister with the disorder B. 40-year-old black man who has just returned home from a business trip to southeast Asia C. 50-year-old Latino man with liver cirrhosis whose uncle died of colon cancer D. 65-year-old obese Asian woman who has chronic inflammatory cystitis

A. 26-year-old white woman of Jewish ancestry who has an identical twin sister with the disorder

When the nurse is teaching a client about bowel obstructions, which conditions will be described as mechanical bowel obstructions? Select all that apply. A. Adhesions B. Paralytic ileus C. Tumors D. Functional obstruction E. Crohn disease F. Absent peristalsis

A. Adhesions C. Tumors E. Crohn disease

Which neuromuscular assessment change indicates to the nurse that a client who has late-stage liver cirrhosis now has encephalopathy? A. Asterixis B. Positive Chvostek sign C. Increased deep tendon reflex responses D. Decreased deep tendon reflex responses

A. Asterixis

Which advantages of minimally invasive surgery (MIS) laparoscopic cholecystectomy will the nurse reinforce to a client after the surgeon has provided information for informed consent? Select all that apply. A. Bile duct injuries are rare. B. Complications are uncommon. C. Postoperative pain is less severe. D. Mortality is about equal to that of traditional cholecystectomy. E. IV antibiotics are not needed because infection does not occur. F. Depending on the nature of the job, some clients can return to work within 1 to 2 weeks.

A. Bile duct injuries are rare. B. Complications are uncommon. C. Postoperative pain is less severe. F. Depending on the nature of the job, some clients can return to work within 1 to 2 weeks.

Which signs and symptoms does the nurse expect to assess when a client experiences an upper GI bleed? Select all that apply. A. Decreased blood pressure B. Decreased heart rate C. Dizziness or light-headedness D. Melena (tarry or dark sticky) stools E. Weak peripheral pulses F. Increased hemoglobin and hematocrit levels

A. Decreased blood pressure C. Dizziness or light-headedness D. Melena (tarry or dark sticky) stools E. Weak peripheral pulses

Which symptoms in a client with cirrhosis and encephalopathy indicate to the nurse that the prescribed lactulose therapy is effective? Select all that apply. A. Decreased confusion B. Increased urine output C. Musty odor to the breath D. Two to three soft stools daily E. Lower serum bilirubin levels F. Lower serum ammonia levels

A. Decreased confusion D. Two to three soft stools daily F. Lower serum ammonia levels

Which drug does the nurse expect to administer to a client in order to decrease hydrochloric acid secretion in the stomach? A. Famotidine B. Gaviscon C. Mylanta D. Antibiotic

A. Famotidine

For clients with which types of hepatitis will the nurse teach about prevention of infection spread through the oral-fecal contamination route? Select all that apply. A. Hepatitis A (HAV) B. Hepatitis B (HBV) C. Hepatitis C (HCV) D. Hepatitis D (HDV) E. Hepatitis E (HEV) F. Toxic hepatitis

A. Hepatitis A (HAV) E. Hepatitis E (HEV)

What is the nurse's priority action when caring for a client with acute cholecystitis who now has severe abdominal pain, diaphoresis, heart rate of 118 beats/min, BP 95/70, respirations 32 breaths/min, and temperature 101°F (38.3°C)? A. Initiating the Rapid Response Team B. Assisting the client to a semi-Fowler position C. Administering the prescribed opioid analgesic D. Auscultating the client's abdomen in all four quadrants

A. Initiating the Rapid Response Team

A nurse is completing discharge teaching with a client who has irritable bowel syndrome. Which of the following instructions should the nurse include? A. Keep a food diary to identify triggers to exacerbation B. Consume 15 to 20 g of fiber daily C. Plan 3 moderate to large meals per day D. Limit fluid intake to 1 L each day

A. Keep a food diary to identify triggers to exacerbation

Which findings will the nurse be sure to document after inspecting a client's abdomen during assessment? Select all that apply. A. Overall asymmetry of the abdomen B. Size of percussed abdominal organs C. Discoloration or scarring D. Abdominal distention and skin folds E. High-pitched musical sounds F. Location and size of pressure injuries

A. Overall asymmetry of the abdomen C. Discoloration or scarring D. Abdominal distention and skin folds

Which actions will the nurse take to manage a client's dumping syndrome? Select all that apply. A. Providing smaller, more frequent meals B. Eliminating ingestion of fluids with meals C. Providing a high-carbohydrate diet D. Administering acarbose as prescribed E. Increasing fat and protein in the diet F. Administering subcutaneous octreotide three times a day before meals

A. Providing smaller, more frequent meals B. Eliminating ingestion of fluids with meals D. Administering acarbose as prescribed E. Increasing fat and protein in the diet F. Administering subcutaneous octreotide three times a day before meals

In which position will the nurse place a client with peritonitis to promote comfort and prevent harm from potential complications? A. Semi-Fowler B. Left side-lying with knees to chest C. Right side-lying with knees to chest D. Supine flat with hips and knees flexed

A. Semi-Fowler

Which finding does the nurse understand is an early pathologic manifestation when a client is diagnosed with acute gastritis? A. Thickened, reddened mucous membrane with prominent rugae B. Patchy, diffuse inflammation C. H. pylori infection D. Thin, atrophied wall and lining of the stomach

A. Thickened, reddened mucous membrane with prominent rugae

Which actions will the nurse teach a client to take to prevent the spread of gastroenteritis? Select all that apply. A. Washing hands well for at least 30 seconds B. Using easily accessible hand sanitizers C. Taking broad-spectrum antibiotics prophylactically D. Testing all food preparation employees E. Sanitizing all surfaces that may be contaminated F. Properly preparing food and beverages

A. Washing hands well for at least 30 seconds B. Using easily accessible hand sanitizers E. Sanitizing all surfaces that may be contaminated

Which common signs and symptoms will the nurse expect to find on assessment of a 60-year-old client who has had gastroenteritis for the past 2 days? Select all that apply. A. Weight loss B. Elevated temperature C. Dry mucous membranes D. Hypotension E. Oliguria F. Poor skin turgor

A. Weight loss B. Elevated temperature C. Dry mucous membranes D. Hypotension E. Oliguria F. Poor skin turgor DOUBLE CHECK ANSWER

Which location of a tumor in the colon does the nurse suspect when a client presents with passage of red blood via the rectum? A. Transverse colon B. Ascending colon C. Descending colon D. Rectosigmoid colon

B. Ascending colon

A nurse is assessing a client who has advanced cirrhosis. The nurse should identify which of the following findings as indicators of hepatic encephalopathy? (select all that apply) A. Anorexia B. Change in orientation C. Asterixis D. Ascites E. Fetor hepaticus

B. Change in orientation C. Asterixis E. Fetor hepaticus

Which laboratory assessment findings will the nurse expect in a client who is diagnosed with ulcerative colitis? Select all that apply. A. Increased albumin B. Decreased hemoglobin C. Increased sodium D. Decreased potassium E. Elevated white blood cell (WBC) count F. Elevated erythrocyte sedimentation rate

B. Decreased hemoglobin D. Decreased potassium E. Elevated white blood cell (WBC) count F. Elevated erythrocyte sedimentation rate

Which signs and symptoms does the nurse expect to assess when a client has early gastric cancer? Select all that apply. A. Nausea and vomiting B. Feeling of fullness C. Weakness and fatigue D. Epigastric, back, or retrosternal pain E. Palpable gastric mass F. Abdominal discomfort initially relieved with antacids

B. Feeling of fullness D. Epigastric, back, or retrosternal pain F. Abdominal discomfort initially relieved with antacids

Which signs and symptoms will the nurse expect to assess when a client is diagnosed with a paraesophageal hernia? Select all that apply. A. Regurgitation B. Feeling of fullness (after eating) C. Dyspepsia D. Breathlessness (after eating) E. Dysphagia F. Chest pain that mimics angina

B. Feeling of fullness (after eating) D. Breathlessness (after eating) F. Chest pain that mimics angina

Which action is the priority for the nurse to take when caring for clients with oral cancers? A. Providing pain control B. Maintaining the airway C. Promoting tissue integrity D. Enhancing nutrition

B. Maintaining the airway

Which nursing assessment has the highest priority for the nurse to perform on a client admitted in severe pain with acute pancreatitis? A. Asking the client to rate the level of pain B. Measuring heart rate, blood pressure, and oxygen saturation C. Auscultating bowel sounds in all four abdominal quadrants D. Determining the amount of alcoholic beverages the client consumes daily

B. Measuring heart rate, blood pressure, and oxygen saturation

Which drugs will the nurse expect to give a client with acute gastritis that are antisecretory agents? Select all that apply. A. Famotidine B. Omeprazole C. Sucralfate D. Pantoprazole E. Nizatidine F. Calcium carbonate

B. Omeprazole D. Pantoprazole

A nurse is teaching a client who has a hiatal hernia. Which of the following client statements indicate an understanding of the teaching? A. I can take my medications with soda B. Peppermint tea will increase my indigestion C. Wearing an abdominal binder will limit my manifestations D. I will drink hot chocolate at bedtime to help me sleep E. I can lift weights as a way to exercise

B. Peppermint tea will increase my indigestion

Which complication does the nurse suspect when a client with PUD suddenly develops sharp epigastric pain that spreads over the entire abdomen? A. Gastric erosion B. Perforation C. Hemorrhage D. Gastric cancer

B. Perforation

How will the nurse interpret a client's laboratory finding of the presence of immunoglobulin G antibodies directed against hepatitis A (HAV)? A. Active, infectious HAV is present. B. Permanent immunity to HAV is present. C. This is the client's first infection to HAV. D. The risk for infection if exposed to HAV is high.

B. Permanent immunity to HAV is present.

What type of hernia does the nurse suspect when assessing a client and discovering these findings: abdominal pain, nausea, vomiting, pain, heart rate 118 beats/min, and temperature 101°F (38.3°C)? A. Incisional B. Strangulated C. Incarcerated D. Umbilical

B. Strangulated

Which most accurate diagnostic test will the nurse expect to be ordered for a client to verify the diagnosis of GERD? A. Esophagogastroduodenoscopy (EGD) B. Esophageal manometry C. Ambulatory esophageal pH monitoring D. Motility testing

C. Ambulatory esophageal pH monitoring

What does the nurse suspect when a client comes into the emergency department (ED) with right lower quadrant cramping pain, nausea, vomiting, and guarding with rigidity of the abdomen? A. Gastroenteritis B. Ulcerative colitis C. Appendicitis D. Crohn disease

C. Appendicitis

Which are the most common symptoms of gastroesophageal reflux disease (GERD) reported to the nurse by a client? Select all that apply. A. Eructation B. Water brash C. Dyspepsia D. Regurgitation E. Odynophagia F. Flatulence

C. Dyspepsia D. Regurgitation

What type of bowel sounds will the nurse expect to auscultate when a client reports having diarrhea for the past 2 days? A. Decreased or diminished sounds B. Increased sounds in the left lower quadrant only C. Increased loud and gurgling sounds D. Decreased sounds in the right upper quadrant only

C. Increased loud and gurgling sounds

Which laboratory finding will the nurse expect to see in a client who is suspected of having an acute, uncomplicated appendicitis? A. Decreased serum potassium level B. Increased international normalized ratio (INR) C. Increased white blood cell (WBC) count D. Decreased erythrocyte sedimentation rate

C. Increased white blood cell (WBC) count

The nurse is doing an admission assessment on a client with a history of duodenal ulcer. To determine whether the problem is currently active, the nurse should assess the client for which manifestation of duodenal ulcer? A. Weight loss B. Nausea and vomiting C. Pain relieved by food intake D. Pain radiating down the right arm

C. Pain relieved by food intake

What does the nurse suspect has occurred when a client with a bowel obstruction starts passing flatus and has a small bowel movement? A. Blockage is complete. B. Peritonitis has occurred. C. Peristalsis has returned. D. Client is rehydrated.

C. Peristalsis has returned.

Which serum laboratory value is most important for the nurse to monitor when caring for an older client with gastroenteritis who has an irregular heart rate and reports "feeling weak?" A. Albumin B. Sodium C. Potassium D. Leukocyte count

C. Potassium

Which statement indicates to the nurse that a client who is experiencing frequent episodes of "indigestion" and flatulence may have cholecystitis?A. "My stools are sometimes very dark and tarry looking." B. "Sometimes at night I have bad-tasting fluid in my mouth." C. "Usually about a half hour after I eat, I become sweaty and nauseated." D. "My right arm and shoulder always seem to hurt after I eat fried foods."

D. "My right arm and shoulder always seem to hurt after I eat fried foods."

Which client will the nurse recognize as having the highest risk for pancreatic cancer? A. 27-year-old man who is underweight and has opioid use disorder B. 35-year-old woman who is overweight and uses oral contraceptives C. 50-year-old woman who has ductal breast cancer and receiving radiotherapy D. 60-year old man who smokes two packs of cigarettes daily and has liver cirrhosis

D. 60-year old man who smokes two packs of cigarettes daily and has liver cirrhosis

Which cause does the nurse recognize as a potential intentional cause for a client's esophageal trauma? A. Nasogastric (NG) tube placement B. Esophageal ulcers C. Struck by a foreign object D. Chemical injury

D. Chemical injury

For which client assessment finding will the nurse withhold the scheduled monthly dose of a prescribed parenteral biologic for management of ulcerative colitis (UC)? A. 5 lb (2.3 kg) weight gain B. Increased number of diarrhea stools per day C. Presence of occult blood in today's stool sample D. Cough and fever of 102°F (38.9°C)

D. Cough and fever of 102°F (38.9°C)

What does the nurse expect when a client's parietal cells do not produce enough intrinsic factor? A. Reflux of GI contents B. Poor regulation of metabolism C. Buildup of harmful substances D. Development of pernicious anemia

D. Development of pernicious anemia

Which drug will the nurse be sure to question to prevent harm when prescribed for an older adult with gastroenteritis? A. Azithromycin B. Protective skin barrier cream C. Ciprofloxacin D. Diphenoxylate hydrochloride with atropine sulfate

D. Diphenoxylate hydrochloride with atropine sulfate

What manifestation of esophageal cancer does the nurse recognize when a client describes experiencing a dull and steady substernal pain after drinking cold liquids? A. Angina B. Aspiration C. Dysphagia D. Odynophagia

D. Odynophagia

Which nursing care action will the nurse assign to the assistive personnel (AP)when caring for a client with a bowel obstruction? A. Discussing surgical procedures with the client B. Checking the client's abdomen for distention C. Assessing the client's level of discomfort D. Providing mouth care every 2 hours as needed

D. Providing mouth care every 2 hours as needed

From where does the nurse suspect a client with PUD is bleeding when massive coffee-ground emesis occurs? A. Colon B. Rectum C. Small intestine D. Upper GI system

D. Upper GI system

Which question will the nurse be sure to ask a client suspected of having leukoplakia? A. "Do you smoke, dip, or chew tobacco products?" B. "How much alcohol do you drink each day?" C. "Do you consume many of fast food meals?" D. "How often do you have dental checkups?"

A. "Do you smoke, dip, or chew tobacco products?"

For which finding does the nurse alert the health care provider immediately after assessing a client's abdomen? A. Bulging, pulsating mass B. Borborygmus C. Unintentional weight loss D. Reflux with dyspepsia

A. Bulging, pulsating mass

What is the nurse's best first action when a client with a gastric ulcer is found lying in the knee-chest (fetal) position with a rigid, tender, and painful abdomen? A. Notify the primary health care provider. B. Administer opioid pain medication. C. Reposition the client supine. D. Measure the abdominal circumference.

A. Notify the primary health care provider.

Which common factors will the nurse recognize as contributing to or worsening of hepatic encephalopathy in clients with liver cirrhosis? Select all that apply. A. Anorexia B. Infection C. Opioids D. Diarrhea E. GI bleeding F. High-protein diet G. Diabetes mellitus H. Chronic confusion

B. Infection C. Opioids E. GI bleeding F. High-protein diet

Which serum electrolyte value in a client with early-stage ascites from chronic liver disease who is taking spironolactone will the nurse report immediately to the primary health care provider? A. Sodium 133 mEq/L (mmol/L) B. Potassium 6.4 mEq/L (mmol/L) C. Chloride 101 mEq/L (mmol/L) D. Calcium 8.9 mg/dL (2.2 mmol/L)

B. Potassium 6.4 mEq/L (mmol/L)

Which new-onset assessment finding in a client with Crohn disease (CD) indicates to the nurse the possibility of fistula development? A. Anorexia B. Pyuria with fever C. Smooth, beefy red tongue D. Decreased serum albumin

B. Pyuria with fever

Which client will the nurse recognize as having the most risk factors for cholelithiasis? A. 25-year-old white female athlete who is 10 lb (4.5 kg) underweight and had an appendicitis 2 months ago B. 35-year-old African-American male who is 10 lb (4.5 kg) overweight and is hypertensive C. 50-year-old Mexican-American female who has three children and takes hormone replacement therapy D. 60-year-old Asian-American male who had coronary artery bypass graft surgery 4 weeks ago

C. 50-year-old Mexican-American female who has three children and takes hormone replacement therapy

Which client does the nurse assess as at highest risk for development of esophageal cancer? A. 45-year-old on a high-fiber diet B. 50-year-old with a sedentary lifestyle C. 55-year-old who smokes and is 25 lb overweight D. 60-year-old who is prescribed famotidine for reflux

C. 55-year-old who smokes and is 25 lb overweight

Which diagnostic test will the nurse prepare a client for to confirm the diagnosis of colorectal cancer (CRC)? A. Fecal occult blood test (FOBT) B. Carcinoembryonic antigen (CEA) C. Colonoscopy with biopsy D. CT-guided virtual colonoscopy

C. Colonoscopy with biopsy

Which electrolyte imbalance will the nurse assess for most frequently in a client who is receiving total parenteral nutrition with a solution that contains both glucose and insulin A. Hypocholremia B. Hypercholremia C. Hypokalemia D. Hyperkalemia

C. Hypokalemia

What is the nurse's best first action when a client who just had a liver transplant develops oozing around two IV sites as well as has some new bruising? A. Applying pressure to the IV sites B. Checking the client's platelet levels C. Notifying the surgeon immediately D. Documenting the findings as the only action

C. Notifying the surgeon immediately

Which action will the nurse instruct a client with celiac disease to perform to reduce symptoms? A. Limiting caffeine B. Drinking more liquids C. Reading labels on prepared foods D. Avoiding raw fruits and vegetables

C. Reading labels on prepared foods

Which surgical client will the nurse recognize as having the highest risk for development of peritonitis? A. 35-year-old having a laparoscopic appendectomy B. 45-year-old having a vaginal hysterectomy C. 60-year-old having a traditional cholecystectomy for cholelithiasis D. 72-year-old having a bowel resection for colon cancer

D. 72-year-old having a bowel resection for colon cancer

What instruction will the nurse provide to a client to prepare him or her to undergo ultrasonography of the right upper abdominal quadrant to diagnose gallstones? A. Do not eat or drink for at least 6 hours before the test. B. Shower with an antibacterial soap the morning before the test. C. Be sure to have someone come with you who can drive you home. D. A small instrument will be rolled over your upper abdomen and there will be no pain.

D. A small instrument will be rolled over your upper abdomen and there will be no pain.

Which teaching points will the nurse include when instructing a client about preparation for a colonoscopy? Select all that apply. A. "Avoid taking aspirin, NSAIDs, or anticoagulants for several days before the test." B. "Drink lots of red, orange, or purple beverages the day before the test." C. "Do not eat or drink for 4 to 5 hours before the test." D. "After the bowel-cleansing solutions, you may develop constipation for 1 to 2 days." E. "Drink only clear liquids the day before the colonoscopy." F. "An IV will be placed to give medication to help you relax during the procedure."

A. "Avoid taking aspirin, NSAIDs, or anticoagulants for several days before the test." C. "Do not eat or drink for 4 to 5 hours before the test." E. "Drink only clear liquids the day before the colonoscopy."

Which actions will the nurse teach a client with severe GERD that causes pain after each meal, lasts for at least 45 minutes, and worsens when he or she lies down? Select all that apply. A. "Drink fluids right away." B. "When you lie down, try lying on your side." C. "Take an antacid as prescribed by the health care provider." D. "Eat something bland such as a slice of white bread." E. "Maintain an upright position for at least an hour after you eat." F. "Try pressing over your abdomen to mobilize the food in your stomach."

A. "Drink fluids right away." C. "Take an antacid as prescribed by the health care provider." E. "Maintain an upright position for at least an hour after you eat."

What priority teaching points will the nurse include when teaching a group of older adults about prevention of fecal impaction? Select all that apply. A. "Eat high-fiber foods including raw fruits and vegetables." B. "Consume adequate fluids, especially water." C. "Use a laxative daily as needed to foster bowel regularity." D. "Walking every day is an excellent exercise for promoting intestinal motility." E. "Use natural foods to stimulate peristalsis, such as warm beverages and prune juice." F. "Avoid bulk-forming products to ease bowel elimination."

A. "Eat high-fiber foods including raw fruits and vegetables." B. "Consume adequate fluids, especially water." D. "Walking every day is an excellent exercise for promoting intestinal motility." E. "Use natural foods to stimulate peristalsis, such as warm beverages and prune juice."

Which priority teaching will the nurse provide to an older client with GERD who is prescribed omeprazole for symptom relief? A. "Older adults taking this drug may be at increased risk for hip fracture because it interferes with calcium absorption." B. "Because of this drug's side effect of decreasing potassium, you may be prescribed a potassium supplement." C. "This drug causes sodium retention, so you may be prescribed a dietary sodium restriction." D. "A pacemaker may be necessary because this drug changes magnesium levels which can lead to life-threatening dysrhythmias."

A. "Older adults taking this drug may be at increased risk for hip fracture because it interferes with calcium absorption."

Which alternative or complimentary therapies will the nurse teach a client may be helpful in managing irritable bowel syndrome (IBS)? Select all that apply. A. "Probiotics can help decrease bacteria and IBS symptoms." B. "Ginkgo can be used for abdominal discomfort and to expel gas." C. "Meditation may help decrease stress and help eliminate IBS symptoms." D. "Regular exercise will help decrease stress and lead to regular bowel movements." E. "Peppermint oil has been used to expel gas and relax spastic intestinal muscles." F. "Hydrotherapy may help decrease IBS symptoms."

A. "Probiotics can help decrease bacteria and IBS symptoms." C. "Meditation may help decrease stress and help eliminate IBS symptoms." D. "Regular exercise will help decrease stress and lead to regular bowel movements." E. "Peppermint oil has been used to expel gas and relax spastic intestinal muscles."

Which clients will the nurse expect to be prescribed total enteral nutrition to help attain or maintain an adequate nutrition status? Select all that apply A. 28 year old who remains comatose 10 days after a head injury B. 38 year old with esophageal strictures and an intestinal blockage C. 48 year old who eats all meals but remains 22 lb underweight D. 58 year old who has lung cancer and cachexia E. 68 year old with no teeth or dentures F. 78 year old who cannot swallow after a stroke

A. 28 year old who remains comatose 10 days after a head injury C. 48 year old who eats all meals but remains 22 lb underweight D. 58 year old who has lung cancer and cachexia F. 78 year old who cannot swallow after a stroke

For which client will the nurse expect extracorporeal shock wave lithotripsy as treatment for gallstones to be contraindicated? A. 30 year old who is 70 inches tall and weighs 375 lb B. 35 year old who has cholesterol bases stones C. 45 year old who has shellfish allergy and uses hormone replacement therapy D. 55 year old who has bilateral total knee replacements.

A. 30 year old who is 70 inches tall and weighs 375 lb

For which client will the nurse expect extracorporeal shock wave lithotripsy (ESWL) as treatment for gallstones to be contraindicated? A. 30-year-old who is 70 inches (1.75 m) tall and weighs 325 lb (147.2 kg) B. 35-year-old who has cholesterol-based stones C. 45-year-old who has a shellfish allergy and uses hormone replacement therapy D. 55-year-old who has bilateral total knee replacements

A. 30-year-old who is 70 inches (1.75 m) tall and weighs 325 lb (147.2 kg)

Which client will the nurse recognize as having the greatest risk for nonacoholic fatty liver disease (NAFLD)? A. 45-year-old Latino man who is 30 lb (13.9 kg) overweight and has type 2 diabetes B. 50-year-old white woman who drinks one glass of wine daily and has breast cancer C. 60-year-old black woman who is hypertensive and takes a diuretic daily D. 70-year-old Asian man who has gastroesophageal reflux disease (GERD)

A. 45-year-old Latino man who is 30 lb (13.9 kg) overweight and has type 2 diabetes

Which lunch food selection made by a client with diverticulosis indicates to the nurse the correct understanding of the necessary dietary modifications for management of the problem? A. A turkey sandwich on whole wheat bread, steamed carrots, and a raw apple B. Roasted chicken, potato salad, and a glass of milk C. Chicken salad sandwich on white bread, creamed soup, and hot tea D. Fried shrimp, lettuce and tomato salad, and a dinner roll

A. A turkey sandwich on whole wheat bread, steamed carrots, and a raw apple

Which interventions will the nurse include when care of a client with peritonitis is focused on restoring fluid volume balance? Select all that apply. A. Administering IV isotonic fluids and broad-spectrum antibiotics B. Assigning the assistive personnel (AP) to weigh the client daily and record intake and output C. Providing nasogastric tube (NGT) care and keeping the stomach decompressed D. Administering opioid pain medications as prescribed by the primary health care provider E. Maintaining the client on NPO status while the NGT is in place to low suction F. Assessing whether the client retains fluid used for irrigation by comparing and recording the amount of fluid returned with the amount of fluid instilled

A. Administering IV isotonic fluids and broad-spectrum antibiotics B. Assigning the assistive personnel (AP) to weigh the client daily and record intake and output C. Providing nasogastric tube (NGT) care and keeping the stomach decompressed E. Maintaining the client on NPO status while the NGT is in place to low suction F. Assessing whether the client retains fluid used for irrigation by comparing and recording the amount of fluid returned with the amount of fluid instilled

Which priority actions will the nurse take to manage a client's active upper GI bleeding? Select all that apply. A. Administering oxygen B. Starting two large-bore IV lines C. Infusing 0.9% normal saline solution as prescribed D. Collecting a urine sample for urinalysis E. Inserting a nasogastric tube (NGT)F. Monitoring serum electrolytes

A. Administering oxygen B. Starting two large-bore IV lines C. Infusing 0.9% normal saline solution as prescribed E. Inserting a nasogastric tube (NGT)F. Monitoring serum electrolytes

Which are the major risk factors for development of colorectal cancer that the nurse will be sure to ask about when taking a client's history? Select all that apply. A. Age older than 50 years B. Personal or family history of cancer C. History of intestinal blockage D. Crohn disease E. Ulcerative colitis F. Duodenal ulcers

A. Age older than 50 years B. Personal or family history of cancer D. Crohn disease E. Ulcerative colitis

Which serum laboratory values will the nurse expect to be elevated in a client who has acute pancreatitis? Select all that apply. A. Amylase B. Bilirubin C. Calcium D. Lipase E. Magnesium F. Glucose

A. Amylase B. Bilirubin D. Lipase F. Glucose

Which signs or symptoms will the nurse assess for in a client who is suspected of having cholecystitis? Select all that apply. A. Anorexia B. Jaundice C. Ascites D. Steatorrhea E. Eructation F. Rebound tenderness

A. Anorexia B. Jaundice D. Steatorrhea E. Eructation F. Rebound tenderness

A nurse is caring for a client who has a new diagnosis of GERD. The nurse should expect prescriptions for which of the following medications? Select all that apply. A. Antacids B. Histamine2 receptor antagonists C. Opioid analgesics D. Fiber laxatives E. Proton pump inhibitors

A. Antacids B. Histamine2 receptor antagonists E. Proton pump inhibitors

Which new-onset assessment findings in a client with Laennec cirrhosis indicates to the nurse that the client may be starting to have delirium tremens (DTs) from alcohol withdrawal? Select all that apply. A. Anxiety B. Tachycardia C. Hypotension D. Hypertension E. Cool, clammy skin F. Psychotic behavior

A. Anxiety B. Tachycardia D. Hypertension F. Psychotic behavior

Which action will the nurse take first when an 80-year-old client with acute pancreatitis has no breath sounds in the left lower lung lobe? A. Apply oxygen. B. Assess the breath sounds on the right. C. Notify the primary health care provider. D. Document the finding as the only action.

A. Apply oxygen.

Which assessment findings will the nurse expect in a client with late-stage liver cirrhosis whose total serum albumin level is low? Select all that apply. A. Ascites B. Hypotension C. Hyperkalemia D. Hyponatremia E. Dependent edema F. Decreased serum ammonia levels

A. Ascites B. Hypotension D. Hyponatremia E. Dependent edema

Which precaution is most important for the nurse to instruct clients with hepatitis C (HCV) who are receiving drug therapy with any second-generation protease inhibitor? A. Avoid crowds and people who are ill. B. Do not touch these drugs with your bare hands. C. Alternate periods of activity with periods of rest. D. Be sure to take vitamin K supplements with this drug.

A. Avoid crowds and people who are ill.

A client is receiving adefovir for management of hepatitis B. What health teaching will the nurse provide for the client about this drug? Select all that apply. A. Avoid places with crowds and individuals who have infection B. Report increased bruising to your doctor because the drug can cause bleeding C. Get your lab work done regularly because the drug can affect your kidneys D. Be careful and avoid falls because the drug can cause fractures E. Follow up with the dietitian to ensure that you adhere to your special diet

A. Avoid places with crowds and individuals who have infection C. Get your lab work done regularly because the drug can affect your kidneys

Which precaution is most important for the nurse to instruct a client with cirrhosis and his or her family about continuing care in the home? A. Avoid taking acetaminophen or drinking alcohol. B. Maintain one-floor living to prevent excessive fatigue. C. Use cool baths to reduce the sensation of itching. D. Report any change in cognition to the health care provider.

A. Avoid taking acetaminophen or drinking alcohol.

Which signs and symptoms will the nurse assess when a client is diagnosed with oral cancer? Select all that apply. A. Bleeding from the mouth B. Painful oral lesions that are red, raised, or eroded C. Difficulty chewing or swallowing D. Unplanned weight gain E. Thick or absent saliva F. Thickening or lump in cheek

A. Bleeding from the mouth C. Difficulty chewing or swallowing E. Thick or absent saliva F. Thickening or lump in cheek

When providing discharge teaching, for which symptoms will the nurse teach a client with peptic ulcer disease (PUD) to seek immediate medical attention? Select all that apply. A. Bloody or black stools B. Dyspepsia or reflux C. Bloody vomit or vomit that looks like coffee grounds D. Odynophagia with nausea E. Sharp, sudden, persistent, and severe epigastric or abdominal pain F. Loss of appetite with dysphagia

A. Bloody or black stools C. Bloody vomit or vomit that looks like coffee grounds E. Sharp, sudden, persistent, and severe epigastric or abdominal pain

Which drugs will the nurse expect the health care provider to prescribe for a client after esophageal trauma? Select all that apply. A. Broad-spectrum antibiotics B. Loop diuretics C. Corticosteroids D. Antacids E. Pain medications F. Viscous lidocaine

A. Broad-spectrum antibiotics C. Corticosteroids E. Pain medications F. Viscous lidocaine

When the nurse collects a client's gastrointestinal (GI) history, which substances are most likely to be risk factors for peptic ulcer disease or GI bleeding? Select all that apply. A. Caffeine B. Furosemide C. Aspirin D. Desmopressin E. Alcohol F. Ibuprofen

A. Caffeine C. Aspirin E. Alcohol

Which actions will the nurse take to prevent harm when caring for a client receiving continuous enteral tube feeding? Select all that apply. A. Checking the residual volume at least every 6 hours B. Changing the feeding bag and tubing every 12 hours C. Keeping the head of the bed elevated at least 30 degrees D. Using clean technique when changing the feeding system E. Discarding unused open enteral products after 24 hours F. Warming the enteral products before infusion

A. Checking the residual volume at least every 6 hours C. Keeping the head of the bed elevated at least 30 degrees D. Using clean technique when changing the feeding system E. Discarding unused open enteral products after 24 hours

Which actions will the nurse include when providing care for a client after a colonoscopy procedure? Select all that apply. A. Checking vital signs every 15 to 30 minutes until the client is alert B. Keeping client in left lateral position to promote passing of flatus C. Assessing for signs and symptoms of bowel perforation, including severe abdominal pain and guarding D. Preventing the client from taking anything by mouth until sedation wears offE. Keeping the top side rails up until the client is alert F. Holding the client 6 to 8 hours before allowing him or her to drive home

A. Checking vital signs every 15 to 30 minutes until the client is alert B. Keeping client in left lateral position to promote passing of flatus C. Assessing for signs and symptoms of bowel perforation, including severe abdominal pain and guarding D. Preventing the client from taking anything by mouth until sedation wears offE. Keeping the top side rails up until the client is alert

Which clients will the nurse carefully assess for high risk of oral cavity disorders? Select all that apply. A. Clients who are homeless or live in institutions B. Clients with sexually transmitted infection C. Clients who are developmentally disabled D. Clients who consume an unhealthy diet E. Clients who work in coal mines F. Clients who regularly use tobacco or alcohol

A. Clients who are homeless or live in institutions C. Clients who are developmentally disabled D. Clients who consume an unhealthy diet F. Clients who regularly use tobacco or alcohol

The nurse is planning to teach a client with GERD about substances to avoid. Which items should the nurse include on this list? Select all that apply. A. Coffee B. Chocolate C. Peppermint D. Nonfat milk E. Fried chicken F. Scrambled eggs

A. Coffee B. Chocolate C. Peppermint E. Fried chicken

Which condition will the nurse most likely suspect as the cause of a client's symptoms of obstipation and failure to pass flatus? A. Complete obstruction B. Partial obstruction C. Colorectal cancer D. Singultus

A. Complete obstruction

Which postoperative instructions will the nurse provide for a client after laparoscopic Nissen fundoplication (LNF)? Select all that apply. A. Consume a soft diet for about a week; avoid carbonated beverages, tough foods, and raw vegetables that are difficult to swallow. B. You will no longer need to take antireflux medications after your surgery is over. C. You must not drive for a week after surgery; especially do not drive after taking an opioid pain medication. D. Walk every day but do not do any heavy lifting. E. Remove the small dressings and closure strips 2 days after surgery and then you may shower. F. Report fever above 101°F (38.3°C), nausea, vomiting, or uncontrollable bloating or pain.

A. Consume a soft diet for about a week; avoid carbonated beverages, tough foods, and raw vegetables that are difficult to swallow. C. You must not drive for a week after surgery; especially do not drive after taking an opioid pain medication. D. Walk every day but do not do any heavy lifting. F. Report fever above 101°F (38.3°C), nausea, vomiting, or uncontrollable bloating or pain.

Which dietary change suggestions will the nurse make to a client to decrease the risk of colorectal cancer (CRC)? Select all that apply. A. Decrease fat intake B. Increase fiber foods C. Decrease proteins D. Decrease refined carbohydrates E. Increase brassica vegetables F. Increase intake of red meat

A. Decrease fat intake B. Increase fiber foods D. Decrease refined carbohydrates E. Increase brassica vegetables

What is the most common symptom the nurse expects clients with esophageal cancer to report? A. Difficulty with swallowing B. Shortness of breath C. Reflux especially at night D. Productive cough

A. Difficulty with swallowing

A nurse is caring for a client who has cirrhosis. Which of the following medications can the nurse expect to administer to this client? (select all that apply) A. Diuretic B. Beta blocking agent C. Opioid analgesic D. Lactulose E. sedative

A. Diuretic B. Beta blocking agent D. Lactulose

Which actions will the nurse teach a client with GERD to use to prevent harm? Select all that apply. A. Do not consume caffeinated or carbonated beverages. B. Avoid peppermint, chocolate, and fried foods. C. Eat slowly and chew food thoroughly. D. Consume four to six small meals each day. E. Do not eat for 3 hours before going to bed. F. Sleep on your side to prevent regurgitation.

A. Do not consume caffeinated or carbonated beverages. B. Avoid peppermint, chocolate, and fried foods. C. Eat slowly and chew food thoroughly. D. Consume four to six small meals each day. E. Do not eat for 3 hours before going to bed.

Which actions and precautions will the nurse educate a client with chronic pancreatitis about when starting pancreatic enzyme replacement therapy (PERT)? Select all that apply. A. Do not crush or chew the capsules. B. Take these drugs with all meals and snacks. C. Sit in an upright position for at least 30 minutes after taking the drug. D. Wear sunscreen and protective clothing outdoors to prevent severe sunburn. E. Check your stools for amount and presence of fat to assess whether the drugs are working. F. If you are too nauseated to eat or to take the drug, go to an emergency department for an injectable form of the drug.

A. Do not crush or chew the capsules. B. Take these drugs with all meals and snacks.

What is the nurse's best action when assessment of a client 2 hours after abdominal surgery reveals hypoactive bowel sounds? A. Documenting the finding and continue to monitor B. Notifying the surgeon immediately C. Putting a nasogastric (NG) tube in place D. Obtaining an immediate abdominal x-ray

A. Documenting the finding and continue to monitor

Which actions will the nurse teach a client to avoid to prevent harm after Nissen fundoplication surgery when gas bloat syndrome occurs? Select all that apply. A. Drinking carbonated beverages B. Passing flatus or belching C. Eating gas-producing foods D. Chewing gum E. Drinking through a straw F. Changing positions frequently

A. Drinking carbonated beverages C. Eating gas-producing foods D. Chewing gum E. Drinking through a straw

A client who had the Stretta procedure to treat severe GERD is being discharged. Which client statement requires further nursing teaching? Select all that apply. A. Dysphagia after this procedure is normal B. It's important to stop my proton pump inhibitor C. I will not take NSAIDs and aspirin for at least 10 days D. I might cough up some blood following this procedure E. Today I will drink clear liquids and tomorrow I can eat soft food

A. Dysphagia after this procedure is normal B. It's important to stop my proton pump inhibitor D. I might cough up some blood following this procedure

What priority teaching points will the nurse include when instructing a client and family about how to prevent gastritis? Select all that apply. A. Eat a well-balanced diet and exercise regularly. B. Do not take large doses of aspirin, other NSAIDs (e.g., ibuprofen), and corticosteroids. C. Decrease the amount of smoking and/or use of other forms of tobacco. D. Manage stress levels using complementary and integrative therapies such as relaxation and meditation techniques. E. Use over-the-counter (OTC) proton pump inhibitors if you experience symptoms of esophageal reflux. F. Protect yourself against exposure to toxic substances in the workplace such as lead and nickel.

A. Eat a well-balanced diet and exercise regularly. B. Do not take large doses of aspirin, other NSAIDs (e.g., ibuprofen), and corticosteroids. D. Manage stress levels using complementary and integrative therapies such as relaxation and meditation techniques. F. Protect yourself against exposure to toxic substances in the workplace such as lead and nickel.

Which potential causes will the nurse be sure to ask about when taking a history from an older client suspected of having a mechanical obstruction? Select all that apply. A. Fecal impaction B. Strictures from previous radiation therapy C. Fibrosis related to endometriosis D. Recent bowel surgery E. Benign tumor F. Diverticulitis

A. Fecal impaction B. Strictures from previous radiation therapy C. Fibrosis related to endometriosis E. Benign tumor F. Diverticulitis

How will the nurse know that the drug alvimopan, given to a client with postoperative ileus, is working and providing its intended action? A. Gastrointestinal (GI) motility is increased. B. The client has a large, formed bowel movement. C. Indications of infection are gone. D. Nausea and vomiting are no longer present.

A. Gastrointestinal (GI) motility is increased.

The nurse provides instructions to a client about measures to treat inflammatory bowel syndrome. Which statement by the client indicates a need for further teaching? A. I need to limit my intake of dietary fiber B. I need to drink plenty, at least 8 to 10 cups daily C. I need to eat regular meals and chew my food well D. I will take the prescribed medications because they will regulate my bowel patterns

A. I need to limit my intake of dietary fiber

Which client statement regarding diet and nutrition after a total gastrectomy requires further teaching by the nurse? A. I should stay sitting up for an hour after I eat B. I will avoid liquids with my meals C. I need to eat small frequent meals D. I need to stay away from concentrated sweets

A. I should stay sitting up for an hour after I eat

What will the nurse recognize as the cause of splenomegaly in a client who has cirrhosis? A. Increased pressure in the portal vein causing backflow of blood into the spleen B. The loss of cellular regulation in the liver spreading to the spleen and causing extensive scarring C. Chronic inflammation and infection increasing the spleen's maturation and release of white blood cells D. Direct destruction of spleen cells from alcohol or other toxins causing replacement with scar tissue formation

A. Increased pressure in the portal vein causing backflow of blood into the spleen

Which signs and symptoms will the nurse expect to see in a client who is diagnosed with advanced pancreatic cancer? Select all that apply. A. Light-colored urine and dark-colored stools B. Anorexia and weight loss C. Splenomegaly D. Ascites E. Leg or calf pain F. Weakness and fatigue

A. Light-colored urine and dark-colored stools B. Anorexia and weight loss C. Splenomegaly D. Ascites E. Leg or calf pain F. Weakness and fatigue

A nurse is teaching a client who has hepatitis B about home care. Which of the following instructions should the nurse include in the teaching? (Select all that apply) A. Limit physical activity B. Avoid alcohol C. Take acetaminophen for comfort D. Wear a mask when in public places E. Eat small frequent meals

A. Limit physical activity B. Avoid alcohol E. Eat small frequent meals

A nurse is caring for a 24 year old client newly diagnosed with GERD. Which lifestyle change will the nurse suggest? Select all that apply. A. Lose weight if needed B. Do not eat before bed C. Elevate the foot of your bed by 6-12 inches D. Avoid pants with a tight waistband or belt E. Eat fatty foods to minimize ongoing hunger

A. Lose weight if needed B. Do not eat before bed D. Avoid pants with a tight waistband or belt

A client with hiatal hernia chronically experiences heartburn following meals. The nurse should plan to teach the client to avoid which action because it is contraindicated with a hiatal hernia? A. Lying recumbent following meals B. Consuming small, frequent, bland meals C. Taking h2 receptor antagonist medication D. Raising the HOB on 6 inch blocks

A. Lying recumbent following meals

Which actions will the nurse perform when caring for a client with acute appendicitis before surgical management? Select all that apply. A. Maintaining the client on NPO status B. Administering IV fluids as prescribed C. Providing laxatives and enemas to clear the bowel D. Advising the client to maintain semi-Fowler position E. Giving adequate medications to control the client's pain F. Applying hot compresses to the right lower quadrant

A. Maintaining the client on NPO status B. Administering IV fluids as prescribed D. Advising the client to maintain semi-Fowler position E. Giving adequate medications to control the client's pain

Which actions will the nurse take to help relieve the severe pain in a client with acute pancreatitis? Select all that apply. A. Maintaining the client on NPO status B. Administering oral NSAIDs around the clock C. Inserting a nasogastric (NG) tube to low suction D. Providing opioids by patient-controlled analgesia E. Administering pancreatic enzyme replacement therapy F. Assisting the client to a side-lying position with knees drawn up to the chest

A. Maintaining the client on NPO status D. Providing opioids by patient-controlled analgesia F. Assisting the client to a side-lying position with knees drawn up to the chest

Which actions are appropriate for the nurse to perform to prevent harm in a client with cirrhosis and ascites who has just undergone an esophagogastroduodenoscopy (EGD)? Select all that apply. A. Measuring oxygen saturation B. Checking for leakage from the site C. Assessing for return of the gag reflex D. Monitoring heart rate and blood pressure E. Auscultating bowel sounds in all four quadrants F. Comparing weight with that obtained before the procedure

A. Measuring oxygen saturation C. Assessing for return of the gag reflex D. Monitoring heart rate and blood pressure

Which actions will the nurse take when caring for a client after bariatric surgery to prevent harm from complications? Select all that apply. A. Monitoring oxygen saturation B. Applying an abdominal binder C. Placing the client in semi-Fowler position D. Applying sequential compression stockings E. Assessing skinfolds for redness and excoriation F. Maintaining the client on bedrest for 24 to 48 hours

A. Monitoring oxygen saturation B. Applying an abdominal binder C. Placing the client in semi-Fowler position D. Applying sequential compression stockings E. Assessing skinfolds for redness and excoriation

What is the nurse's priority assessment when a client is given IV midazolam hydrochloride before a colonoscopy? A. Monitoring the rate and depth of respirations B. Auscultating for bowel sounds in all four quadrants C. Monitoring the client for cardiac dysrhythmias D. Suctioning secretions as needed to prevent aspiration

A. Monitoring the rate and depth of respirations

What is the nurse's best first action when the stoma of a client who had a permanent ileostomy placed 2 days ago now has a dark bluish-purple appearance? A. Notifying the surgeon immediately B. Applying oxygen by nasal cannula C. Placing the client in a high-Fowler position D. Documenting the finding as the only action

A. Notifying the surgeon immediately

Which clients will the nurse suggest to be immunized against hepatitis B (HBV)? Select all that apply. A. People who have unprotected sex with more than one partner B. Men who have sex with men C. Any client scheduled for a surgical procedure D. Firefighters E. Health care providers F. Clients prescribed immunosuppressant drugs

A. People who have unprotected sex with more than one partner B. Men who have sex with men D. Firefighters E. Health care providers F. Clients prescribed immunosuppressant drugs

Which important information will the nurse include when teaching a client about peritonitis? Select all that apply. A. Peritonitis is caused by contamination of the peritoneal cavity by bacteria or chemicals. B. Respiratory problems associated with peritonitis are related to increased abdominal pressure against the diaphragm. C. White blood cell counts are often decreased when a client is diagnosed with peritonitis. D. Chemical peritonitis is caused by leakage of pancreatic enzymes or gastric acids. E. Fairly common causes of peritonitis include invasive tumors and continuous ambulatory peritoneal dialysis (CAPD). F. When the peritoneal cavity is contaminated by bacteria, the body begins an inflammatory reaction, walling off a localized area to fight the infection.

A. Peritonitis is caused by contamination of the peritoneal cavity by bacteria or chemicals. B. Respiratory problems associated with peritonitis are related to increased abdominal pressure against the diaphragm. D. Chemical peritonitis is caused by leakage of pancreatic enzymes or gastric acids. F. When the peritoneal cavity is contaminated by bacteria, the body begins an inflammatory reaction, walling off a localized area to fight the infection.

Which important information will the nurse gather when a client reports a change in bowel habits? Select all that apply. A. Presence of abdominal distention or gas B. Intentional weight gain C. Occurrence of diarrhea or constipation D. Color and consistency of feces E. Occurrence of heartburn or reflux F. Presence of bloody or tarry stools

A. Presence of abdominal distention or gas C. Occurrence of diarrhea or constipation F. Presence of bloody or tarry stools

Which care actions does the nurse expect to perform when caring for a client who had an appendectomy with an abscess? Select all that apply. A. Providing care for wound drains inserted during the surgery B. Administering IV antibiotics as prescribed by the surgeon C. Providing the client with a clear liquid diet D. Assessing the nasogastric tube (NGT) position and drainage E. Providing nonsteroidal anti-inflammatory drugs (NSAIDs) for pain control F. Helping the patient out of bed on the evening of surgery

A. Providing care for wound drains inserted during the surgery B. Administering IV antibiotics as prescribed by the surgeon D. Assessing the nasogastric tube (NGT) position and drainage F. Helping the patient out of bed on the evening of surgery

Which actions will the nurse assign to the assistive personnel (AP) who will be helping to care for a client with stomatitis? Select all that apply. A. Providing oral care every 2 hours or more if stomatitis is not controlled B. Teaching the client to use a soft toothbrush or gauze, and to avoid commercial mouthwashes and lemon-glycerin swabs which can irritate mucosa C. Encouraging frequent rinsing of the mouth with warm saline, sodium bicarbonate (baking soda) solution, or a combination of these solutions D. Applying topical analgesics or anesthetics as prescribed by the primary health care provider and documenting effectiveness E. Instructing the client on how to select soft, bland, and nonacidic foods F. Removing dentures if the client has severe stomatitis or oral pain

A. Providing oral care every 2 hours or more if stomatitis is not controlled C. Encouraging frequent rinsing of the mouth with warm saline, sodium bicarbonate (baking soda) solution, or a combination of these solutions F. Removing dentures if the client has severe stomatitis or oral pain

Which signs and symptoms will the nurse expect to find on assessment of a client with chronic liver disease who has an elevated serum bilirubin level? Select all that apply. A. Pruritus B. Icterus C. Hypertension D. Jaundice E. Pale, clay-colored stools F. Dark, coffee-colored urine

A. Pruritus B. Icterus D. Jaundice E. Pale, clay-colored stools F. Dark, coffee-colored urine

Which signs and symptoms will the nurse expect to find on assessment of a client who is admitted with obstructive jaundice? Select all that apply. A. Pruritus B. Hypertension C. Pale, clay-colored stools D. Dark, coffee-colored urine E. Pink discoloration of sclera F. Bright red bleeding from the gums

A. Pruritus C. Pale, clay-colored stools D. Dark, coffee-colored urine

A client has postcholecystectomy syndrome (PCS) with persistent abdominal pain accompanied by vomiting for several weeks after removal of the gallbladder. Which possible causes or complications will the nurse remain alert for in this client? Select all that apply. A. Pseudocyst B. Common bile duct leak C. Dumping syndrome D. Diverticular compression E. Ductal stricture or obstruction F. Sphincter of Oddi dysfunction G. Primary sclerosis cholangitis H. Retained or new gallstones

A. Pseudocyst B. Common bile duct leak D. Diverticular compression E. Ductal stricture or obstruction F. Sphincter of Oddi dysfunction G. Primary sclerosis cholangitis H. Retained or new gallstones

A nurse in the emergency department is completing an assessment of a client who has suspected stomach perforation due 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

In which position will the nurse place a client after an open Whipple procedure for treatment of pancreatic cancer? A. Semi-Fowler position to reduce tension on the suture line B. Prone position to prevent acute respiratory distress syndrome C. Left lateral Sims' position with knees drawn up to the chest to reduce pain D. Right lateral Sims' position with knees drawn up to the chest to reduce pain

A. Semi-Fowler position to reduce tension on the suture line

Which simple, noninvasive tests will the nurse expect to be ordered to detect H. pylori in a client with PUD? Select all that apply. A. Serologic testing for antibodies B. Abdominal ultrasound C. Urea breath test D. Computerized tomography scan E. Stool antigen test F. Magnetic resonance imaging

A. Serologic testing for antibodies C. Urea breath test E. Stool antigen test

Which potential causes will the nurse monitor for when a client is suspected of having irritable bowel syndrome? Select all that apply. A. Stress B. Caffeinated beverages C. Sugary deserts D. Anxiety E. Red meats F. Dairy products

A. Stress B. Caffeinated beverages D. Anxiety F. Dairy products

Which nonsurgical treatment options for cancer of the esophagus will the nurse discuss with the client? Select all that apply. A. Swallowing therapy B. Smoking cessation programs C. Nutritional therapy D. Chemoradiation E. Photodynamic therapy F. Esophageal dilation

A. Swallowing therapy D. Chemoradiation E. Photodynamic therapy F. Esophageal dilation

The nurse is monitoring for the early signs and symptoms of dumping syndrome. Which findings indicate this occurrence? A. Sweating and pallor B. Bradycardia and indigestion C. Double vision and chest pain D. Abdominal cramping and pain

A. Sweating and pallor

To prevent harm after a surgical procedure for peritonitis, which action will the nurse teach a client to avoid? A. Taking additional acetaminophen to prevent liver toxicity B. Lifting for at least 6 months after an open surgical procedure C. Resuming normal activities for at least 3 to 4 days after the procedure D. Using stool softeners and laxatives to prevent diarrhea

A. Taking additional acetaminophen to prevent liver toxicity

Which risk factors will the nurse assess for when taking a history of a client suspected of having gastritis? Select all that apply. A. Use of alcohol B. Excessive caffeine intake C. Smoking cigarettes D. Life stressors E. Prescribed steroids F. Ingestion of corrosive substances

A. Use of alcohol B. Excessive caffeine intake C. Smoking cigarettes D. Life stressors E. Prescribed steroids F. Ingestion of corrosive substances

Which actions are most effective for nurses and other health care workers to prevent occupational transmission of viral hepatitis? Select all that apply. A. Washing hands before and after contact with all clients B. Using needleless systems for parenteral therapy C. Using Standard Precautions with all clients regardless of age or sexual orientation D. Obtaining an immunoglobulin injection after exposure to hepatitis A E. Being fully vaccinated with the hepatitis B vaccine F. Wearing gloves during direct contact with all clients

A. Washing hands before and after contact with all clients B. Using needleless systems for parenteral therapy C. Using Standard Precautions with all clients regardless of age or sexual orientation D. Obtaining an immunoglobulin injection after exposure to hepatitis A E. Being fully vaccinated with the hepatitis B vaccine

Which priority points will the nurse include when providing discharge teaching for a client who had a minimally invasive inguinal hernia repair (MIIHR)? Select all that apply. A. "Limit your oral fluid intake to between 1000 and 1200 mL per day." B. "Avoid strenuous activity for several days before returning to work and normal activities." C. "Take your prescribed stool softener regularly to prevent the occurrence of constipation." D. "You will need to learn how to insert a straight urinary catheter for the first week after your surgery." E. "Observe your incisions and report any signs of infection to your surgeon immediately." F. "This procedure is fairly painless so you will not need a prescription for pain medications."

B. "Avoid strenuous activity for several days before returning to work and normal activities." C. "Take your prescribed stool softener regularly to prevent the occurrence of constipation." E. "Observe your incisions and report any signs of infection to your surgeon immediately."

Which statement by a client with gastroenteritis due to infection with the norovirus indicates that the nurse's teaching about this illness has been successful? A. "I got this infection from being around my grandchildren when they had respiratory illnesses." B. "It is most likely that I got this infectious illness from either contaminated food or water." C. "I may have gotten sick when I was travelling last month to Florida." D. "It's really important that I don't go to restaurants for at least a month after I am well."

B. "It is most likely that I got this infectious illness from either contaminated food or water."

Which clients will the nurse recognize as having a higher risk for development of acute pancreatitis? Select all that apply. A. 26-year-old woman who is a marathon runner B. 34-year-old man with Stage II HIV disease C. 40-year-old woman who has had cholelithiasis for 3 years D. 56-year-old man who drinks alcohol heavily and is underweight E. 62-year-old woman with gastroesophageal reflux disease F. 70-year-old man who has type 2 diabetes

B. 34-year-old man with Stage II HIV disease C. 40-year-old woman who has had cholelithiasis for 3 years D. 56-year-old man who drinks alcohol heavily and is underweight

Which client's previous health history will the nurse most associate with a risk for developing postnecrotic cirrhosis of the liver? A. 28-year-old woman who had gallstones 1 year ago and has recently lost 20 lb (9 kg) on a low-calorie, low-fat diet B. 45-year-old man with hepatitis C infection and chronic use of acetaminophen C. 50-year-old man who has many years of excessive alcohol consumption D. 55-year-old woman who has chronic biliary obstruction

B. 45-year-old man with hepatitis C infection and chronic use of acetaminophen

For which client with gastric cancer does the nurse expect that minimal invasive surgery (MIS) plus radiation therapy or chemotherapy may be curative? A. 45-year-old with advanced disease B. 50-year-old with early disease C. 60-year-old with liver metastases D. 65-year-old with invasion of the stomach muscle

B. 50-year-old with early disease

Which drugs will the nurse expect to administer to a client with PUD, caused by an H. pylori infection, who is prescribed PPI-triple therapy? A. A proton pump inhibitor, two antibiotics, and bismuth B. A proton pump inhibitor and two antibiotics C. An opioid drug, proton pump inhibitor, and an antibiotic D. An H2 histamine blocker, an antibiotic, and a proton pump inhibitor

B. A proton pump inhibitor and two antibiotics

Which assessment findings will the nurse expect to find when a client is experiencing early mechanical small bowel obstruction? Select all that apply. A. Absence of bowel sounds B. Abdominal distention C. Visible peristaltic waves D. High-pitched bowel sounds E. Abdominal rigidity F. Cramping

B. Abdominal distention C. Visible peristaltic waves D. High-pitched bowel sounds F. Cramping

What procedural teaching will the nurse provide for a client scheduled for an abdominal CT scan with contrast? Select all that apply. A. The test will take about 30 to 45 minutes. B. An IV line will be placed for injection of the contrast. C. You may experience loud and gurgling sounds from your belly. D. The CT technician may ask you to hold your breath while images are taken. E. You may feel warm and flushed, and may experience a metallic taste with the injection. F. If you are claustrophobic, you can be given a mild sedative before the procedure.

B. An IV line will be placed for injection of the contrast. D. The CT technician may ask you to hold your breath while images are taken. E. You may feel warm and flushed, and may experience a metallic taste with the injection.

What is the most important assessment for the nurse to perform before administering the first dose of sulfasalazine to a client diagnosed with ulcerative colitis? A. Obtaining an accurate weight B. Asking whether he or she has an allergy to sulfa drugs C. Measuring heart and respiratory rate and blood pressure D. Determining the number of times the client has had a stool today

B. Asking whether he or she has an allergy to sulfa drugs

The nurse is caring for a client with peritonitis from a perforated appendix. Which abdominal assessment finding will the nurse most likely expect? A. Soft abdomen B. Board like abdomen C. Slightly distended abdomen D. Absent bowel sounds

B. Board like abdomen

Which oral disorder does the nurse suspect when assessment findings reveal white plaquelike lesions that when wiped away show an underlying red and sore surface? A Leukoplakia B. Candidiasis C. Erythroplakia D. Kaposi's sarcoma

B. Candidiasis

Which assessment is the priority for the nurse to make in the immediate postoperative period for a client after bariatric surgery? A. Asking the client to rate his or her pain B. Checking oxygen saturation and respiratory effort C. Examining the wound for indications of infection or dehiscence D. Monitoring skinfold areas for cleanliness and indications of breakdown

B. Checking oxygen saturation and respiratory effort

What is the next best action for the nurse to take after assessing a client who returned to the care unit with a colostomy by minimally invasive surgery (MIS) that is covered by a petrolatum gauze dressing under a dry sterile dressing? A. Reinforcing the dressing and leave it in place until the surgeon changes it the next morning B. Collaborating with the certified wound, ostomy, continence nurse (CWOCN) to place a pouch system as soon as possible C. Teaching the client how to use the patient-controlled anesthesia (PCA) machine to control his or her pain D. Notifying the surgeon that the colostomy stoma is pink, moist, slightly edematous, and protrudes 2 cm from the abdominal wall

B. Collaborating with the certified wound, ostomy, continence nurse (CWOCN) to place a pouch system as soon as possible

Based on the nurse's knowledge of gastrointestinal (GI) changes that occur with age, for which disorder in an older client will the nurse vigilantly monitor related to decreased peristalsis? A. Loss of appetite for favorite foods B. Constipation with possible impaction C. Vomiting that occurs after eating D. Indigestion related to consuming spicy foods

B. Constipation with possible impaction

In collaboration with the registered dietitian nutritionist, which nutrients and substances will the nurse instruct a client with ulcerative colitis (UC) to avoid to reduce symptoms? Select all that apply. A. Eggs B. Corn C. Caffeine D. Vitamin C E. Dried fruits F. Carbohydrates G. Dairy products H. Pepper-based spices

B. Corn C. Caffeine E. Dried fruits G. Dairy products H. Pepper-based spices

How does the nurse expect a client's nasogastric (NG) tube drainage to appear immediately after Nissen fundoplication surgery? A. Bright red mixed with brown B. Dark brown C. Yellowish to green D. Green to clear

B. Dark brown

Which gastrointestinal (GI) changes will the nurse expect in an older client with a GI problem? Select all that apply. A. Increased hydrochloric acid secretion B. Decreased absorption of iron and vitamin B12 C. Decreased peristalsis with constipation D. Increased cholesterol synthesis E. Decreased lipase with decreased fat digestion F. Decreased drug metabolism with risk of toxicities

B. Decreased absorption of iron and vitamin B12 C. Decreased peristalsis with constipation E. Decreased lipase with decreased fat digestion F. Decreased drug metabolism with risk of toxicities

What complication does the nurse suspect when a client who had a gastrectomy develops tachycardia, syncope, and a desire to lie down 30 minutes after eating? A. Fluid overload B. Early dumping syndrome C. Late dumping syndrome D. Vitamin B12 deficiency

B. Early dumping syndrome

Which important information will the nurse include when teaching clients how to maintain healthy oral cavities? Select all that apply. A. Perform a monthly self-examination of the mouth looking for changes. B. Eat a well-balanced diet and stay hydrated by drinking water. C. If you wear dentures, make sure that they are in good repair and fit properly. D. Thoroughly brush and floss your teeth (or brush dentures) consistently twice daily. E. Use mouthwashes that contain alcohol to destroy organisms that live in the mouth. F. See the dentist regularly and have dental problems repaired as soon as possible.

B. Eat a well-balanced diet and stay hydrated by drinking water. C. If you wear dentures, make sure that they are in good repair and fit properly. D. Thoroughly brush and floss your teeth (or brush dentures) consistently twice daily. F. See the dentist regularly and have dental problems repaired as soon as possible.

Which activities are most important for the nurse to teach a client with esophageal varices to prevent harm from bleeding or hemorrhage? Select all that apply. A. Avoid alcoholic beverages. B. Eat soft foods and cool liquids. C. Do not engage in strenuous exercise or heavy lifting. D. Try to eat six smaller meals daily instead of three larger ones. E. Be sure to keep your mouth open when sneezing or coughing. F. Cross your legs only at the ankles when sitting, rather than the knees.

B. Eat soft foods and cool liquids. C. Do not engage in strenuous exercise or heavy lifting.

Which nonsurgical treatment will the nurse expect the client with esophageal cancer to receive for immediate relief of dysphagia? A. Photodynamic therapy B. Esophageal dilation C. Radiation therapy D. Swallowing therapy

B. Esophageal dilation

Which gastrointestinal condition does the nurse suspect a client is at increased risk for, when she reports emotional distress about her family situation and whether she will be able to return to work? A. Hiatal hernia B. Exacerbation of irritable bowel syndrome C. Nausea accompanied by vomiting and diarrhea D. Esophageal ulcers

B. Exacerbation of irritable bowel syndrome

Which disease features will the nurse commonly associate with a client who has Crohn disease (CD) that are rare or absent in a client with ulcerative colitis (UC)? Select all that apply. A. The problem first appears in the rectum and proceeds in a continuous manner toward the cecum. B. Fistulas commonly develop. C. Clients have five to six soft, loose, nonbloody stools per day. D. There is a greatly increased risk for colon cancer. E. Many clients have one or more extraintestinal problems such as arthritis, ankylosing spondylitis, and erythema nodosum. F. The appearance of the affected intestine areas resemble "cobblestone."

B. Fistulas commonly develop. C. Clients have five to six soft, loose, nonbloody stools per day. F. The appearance of the affected intestine areas resemble "cobblestone."

The nurse reviews a client's laboratory values and discovers a serum potassium level of 3.1 mEq/L. Which gastrointestinal condition could cause this value? A. Malabsorption B. Gastric suctioning C. Acute pancreatitis D. Liver disease

B. Gastric suctioning

Which types of ulcers does the nurse teach a client about when discussing peptic ulcer disease (PUD)? Select all that apply. A. Pressure ulcers B. Gastric ulcers C. Duodenal ulcers D. Stress ulcers E. Esophageal ulcers F. Colon ulcers

B. Gastric ulcers C. Duodenal ulcers D. Stress ulcers

For which abnormal laboratory findings will the nurse monitor when providing care for a client with acute pancreatitis? Select all that apply. A. Increased prothrombin time B. Increased serum lipase C. Increased unconjugated bilirubin D. Increased aspartate transaminase E. Increased serum amylase F. Increased serum ammonia

B. Increased serum lipase E. Increased serum amylase

Which action will the nurse take to prevent harm when a client's total parenteral nutrition bag has only 20 mL left in it and the next bag will not be delivered for at least 1 hour A. Capping the TPN line until the next TPN solution is available B. Infusing 10% dextrose/water until the TPN solution is available C. Preparing to treat the client for hypoglycemia D. Notifying the primary health care provider

B. Infusing 10% dextrose/water until the TPN solution is available

Which actions will the nurse include when providing care for a client with a nasogastric tube (NGT) in place? Select all that apply. A. Assessing for NGT placement every 8 hours B. Keeping the client in a semi-Fowler position C. If the NGT is repositioned, confirming placement with an x-ray D. Instructing the client that feeling nausea is due to the NGT placement E. Monitoring the contents and drainage from the NGT F. Irrigating the NGT with 30 mL of normal saline as prescribed

B. Keeping the client in a semi-Fowler position C. If the NGT is repositioned, confirming placement with an x-ray E. Monitoring the contents and drainage from the NGT F. Irrigating the NGT with 30 mL of normal saline as prescribed

A nurse completing an assessment of a client who has GERD. Which of the following is an expected finding? A. Absence of saliva B. Painful swallowing C. Sweet taste in mouth D. Absence of eructation

B. Painful swallowing

Which complication in a client with acute necrotizing pancreatitis who develops a temperature spike to 104°F (40°C) will the nurse suspect? A. Pancreatic pseudocyst B. Pancreatic abscess C. Chronic pancreatitis D. Pancreatic cancer

B. Pancreatic abscess

Which condition or symptom does the nurse associate with a client who has chronic gastritis? A. Hematemesis B. Pernicious anemia C. Dyspepsia D. Epigastric burning

B. Pernicious anemia

Which food will the nurse recommend a client avoid when he or she reports fear of stomach cancer? A. Foods that cause reflux B. Pickled or processed foods C. Large, heavy meals D. Spicy foods that cause gas

B. Pickled or processed foods

Which fluid and electrolyte balance assessment action will the nurse perform most often for a client with pancreatic cancer after surgery with a traditional Whipple procedure? A. Using a reflex hammer to check deep tendon reflexes B. Pinching up skin over the sternum and checking for tenting C. Applying a blood pressure cuff and assessing for a Trousseau sign D. Asking the client whether he or she has noticed tingling or numbness around the mouth

B. Pinching up skin over the sternum and checking for tenting

1. About which pancreatic functions will the nurse teach a client with a gastrointestinal (GI) disorder? Select all that apply. A. Breaking down amino acids B. Producing glucagon from the endocrine part of the organ C. Detoxifying potentially harmful compounds D. Secreting enzymes for digestion from the exocrine part of the organ E. Producing enzymes that digest carbohydrates, fats, and proteins F. Beta cells producing insulin

B. Producing glucagon from the endocrine part of the organ D. Secreting enzymes for digestion from the exocrine part of the organ E. Producing enzymes that digest carbohydrates, fats, and proteins

Which are the most common symptoms of colorectal cancer that clients are likely to report to nurses? A. Constipation and fatigue B. Rectal bleeding and change in stool consistency C. Weight loss and abdominal fullness D. Abdominal pain and diarrhea

B. Rectal bleeding and change in stool consistency

Which assessment findings on a client with peritonitis indicate to the nurse the probability that the fluid shift into the peritoneal cavity is continuing? Select all that apply. A. Weight loss B. Tachycardia C. Hypertension D. Decreasing urine output E. Hyperactive bowel sounds F. Skin tenting over the forehead and sternum

B. Tachycardia D. Decreasing urine output F. Skin tenting over the forehead and sternum

For which reasons will the nurse insert a large-bore nasogastric tube (NGT) in a client with active upper GI bleeding or possible obstruction? Select all that apply. A. To provide nutritional supplements B. To determine the presence or absence of blood in the stomach C. To assess the rate of bleeding D. To administer medications E. To prevent gastric dilation F. To administer gastric lavage

B. To determine the presence or absence of blood in the stomach C. To assess the rate of bleeding E. To prevent gastric dilation F. To administer gastric lavage

When the nurse is providing discharge instructions for a client recovering from peritonitis, which essential findings will the client and family be instructed to report immediately to the primary health care provider? Select all that apply. A. Completion of broad-spectrum antibiotics as prescribed B. Unusual or foul-smelling drainage C. Signs of wound dehiscence or ileus D. Swelling, redness, warmth, or bleeding from the incision site E. A temperature higher than 101°F (38.3°C) F. Abdominal pain or board-like stiffness in the abdomen

B. Unusual or foul-smelling drainage C. Signs of wound dehiscence or ileus D. Swelling, redness, warmth, or bleeding from the incision site E. A temperature higher than 101°F (38.3°C) F. Abdominal pain or board-like stiffness in the abdomen

Which action is appropriate for the nurse to take to prevent harm when caring for a client with ulcerative colitis who has undergone a total proctocolectomy with placement of a permanent ileostomy? A. Irrigating the ileostomy to maintain patency B. Using a skin barrier to prevent excoriation C. Monitoring the client for nausea due to decreased intestinal motility D. Giving small, frequent feedings to compensate for malnutrition from short-gut syndrome

B. Using a skin barrier to prevent excoriation

What advice will the nurse give when a client expresses concern about gas and odor from a colostomy? A. "Place an aspirin in the colostomy bag once a day to help eliminate gas." B. "Empty the bag often, especially when it is about half full." C. "Adding a breath mint to the pouch can help to eliminate odors." D. "Cutting a small hole in the top of the bag will allow for the release of excess gas."

C. "Adding a breath mint to the pouch can help to eliminate odors."

Which statements about eating habits and diet therapy indicate to the nurse that the client recovering from acute pancreatitis understands the recommendations made in collaboration with the registered dietitian nutritionist? Select all that apply. A. "Now I can go back to my usual three meals a day." B. "Replacing carbohydrates with protein will speed my recovery." C. "Although they do not contain fat, I will avoid chocolate and caffeine." D. "If vomiting or diarrhea occur, I will call my primary health care provider." E. "I can't wait to have some good, spicy Mexican food after all this hospital food." F. "I am planning on joining Alcoholics Anonymous and giving up drinking altogether."

C. "Although they do not contain fat, I will avoid chocolate and caffeine." D. "If vomiting or diarrhea occur, I will call my primary health care provider." E. "I can't wait to have some good, spicy Mexican food after all this hospital food."

Which priority teaching will the nurse provide to a client who is prescribed bismuth for peptic ulcer disease (PUD)? A. "Take this drug with an aspirin." B. "You may experience dyspepsia between doses." C. "Bismuth may cause your tongue and stool to appear black." D. "Be sure to take this drug before each meal and snack."

C. "Bismuth may cause your tongue and stool to appear black."

Which statement by a client indicates to the nurse that teaching about the action of sucralfate has been successful? A. "The main side effect of sucralfate is diarrhea." B. "I will take my sucralfate with each meal." C. "Sucralfate will work to heal my ulcer." D. "I will take my sucralfate with my antacid."

C. "Sucralfate will work to heal my ulcer."

What is the nurse's best response to a client who fears he may have been exposed to hepatitis A while attending a banquet last week after which three restaurant workers were diagnosed with hepatitis A? A. "Which types of food did you eat at the banquet?" B. "If you have no symptoms at this time, you are probably safe." C. "You can receive an immunoglobulin injection to prevent the infection." D. "Contact your primary health care provider about receiving the hepatitis A vaccine."

C. "You can receive an immunoglobulin injection to prevent the infection."

Which is the most effective action for the nurse to take to assess adequate bowel function in a client with acute pancreatitis who is at risk for the development of paralytic (adynamic) ileus? A. Observing contents of the nasogastric drainage B. Listening for bowel sounds in all four abdominal quadrants C. Asking the client if he or she has passed flatus or had a stool D. Interpreting the report of a CT scan of the abdomen with contrast medium

C. Asking the client if he or she has passed flatus or had a stool

Which actions will the nurse perform when preparing a client for paracentesis? Select all that apply. A. Obtaining informed consent B. Maintaining the client on NPO status C. Asking the client to void before the procedure D. Placing the client in the flat supine position E. Weighing the client before the procedure F. Assessing the respiratory rate and blood pressure

C. Asking the client to void before the procedure E. Weighing the client before the procedure F. Assessing the respiratory rate and blood pressure

What is the nurse's priority action when a client with ascites reports increased abdominal pain and chills? A. Applying oxygen and making the client NPO B. Notifying the primary health care provider immediately C. Assessing for abdominal rigidity and taking the client's temperature D. Applying a heating blanket and raising the head of the bed to a 45-degree angle

C. Assessing for abdominal rigidity and taking the client's temperature

A client has a new diagnosis of irritable bowel syndrome with diarrhea. What health teaching by the nurse is appropriate for this client? A. Take a stool softener every day to ease defecation B. Avoid high fiber foods in your diet C. Avoid dairy products and caffeinated beverages D. Ask your primary health care provider for an antidepressant

C. Avoid dairy products and caffeinated beverages

A nurse is completing an assessment of a client who has a gastric ulcer. Which of the following findings should the nurse expect (select all that apply) A. A client reports pain relieved by eating B. Client states that pain often occurs at night C. Client reports sensation of bloating D. Client states that pain occurs 30 min to 1 hr after a meal E. Client experiences pain upon palpation of the epigastric region

C. Client reports sensation of bloating D. Client states that pain occurs 30 min to 1 hr after a meal E. Client experiences pain upon palpation of the epigastric region

What liver problem does the nurse suspect in a client whose liver is hard with a nodular texture and the hepatic enzymes remain normal? A. Prenecrotic inflammation B. Postnecrotic inflammation C. Compensated cirrhosis D. Decompensated cirrhosis

C. Compensated cirrhosis

Which diagnostic procedure does the nurse expect will be ordered by the health care provider to view a client's liver, gallbladder, bile ducts, and pancreas for identification of the location of an obstruction? A. Upper gastrointestinal radiographic series B. Percutaneous transhepatic cholangiography C. Endoscopic retrograde cholangiopancreatography D. Esophagogastroduodenoscopy

C. Endoscopic retrograde cholangiopancreatography

What does the nurse suspect when assessing a client's mouth and finding an oral cavity tumor that appears as a red, velvety lesion on the tongue, palate, floor of the mouth, or mandibular mucosa? A. Kaposi's sarcoma B. Basal cell carcinoma C. Erythroplakia D. Leukoplakia

C. Erythroplakia

Which diagnostic test does the nurse expect will be ordered for a client with suspected gastritis? A. Computed tomography (CT) scan B. Upper gastrointestinal (GI) series C. Esophagogastroduodenoscopy (EGD) D. Barium swallow

C. Esophagogastroduodenoscopy (EGD)

Which change in electrolyte values will the nurse expect in a client with acute pancreatitis who reports numbness around the mouth and leg muscle twitching? A. Hyponatremia B. Hypokalemia C. Hypocalcemia D. Hypochloremia

C. Hypocalcemia

A nurse is completing discharge teaching with a client who is postoperative following fundoplication. Which of the following statements by the client indicates understanding of the teaching? A. When sitting in my lunge 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. I will avoid eating within 1 hour before bedtime

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

What is the nurse's first priority when providing care for a client after an esophagogastroduodenoscopy (EGD)? A. Monitoring the client's vital signs every 15 minutes B. Auscultating the client's breath sounds for crackles C. Keeping the client NPO until the gag reflex returns D. Recording accurate intake and output

C. Keeping the client NPO until the gag reflex returns

Which complication will the nurse suspect when a client with peritonitis reports increased pain in the upper left abdominal quadrant and in the left shoulder, especially during inhalation? A. Sepsis B. Pneumonia C. Localized abscess D. Bacterial hepatitis

C. Localized abscess

What action will the nurse take when, 12 hours after a traditional cholecystectomy, a client's Jackson-Pratt (JP) drain shows serosanguineous drainage stained with bile? A. Placing the client to the left lateral Sims' position B. Clamping the drain intermittently for 30 minutes every hour C. Measuring the drainage and documenting the findings D. Disconnecting the suction device and gently irrigating the drain with sterile saline

C. Measuring the drainage and documenting the findings

A client had a colectomy with creation of an ileo-anal pouch and temporary ileostomy yesterday morning. The nurse assesses the ostomy and its functioning. Which assessment finding will the nurse report to the primary health care provider? A. Client's report of abdominal pain of 3 on a 0 to 10 pain intensity scale B. Slight abdominal distention C. No drainage from the ileostomy D. Serosanguinous effluent from the drain

C. No drainage from the ileostomy

For which reason will the nurse carefully examine the mouth of an older adult for candidiasis? A. Older clients are more likely to wear dentures which increases the risk for candidiasis. B. Older adults on fixed incomes consume fewer fresh vegetables and fruits. C. Older adults' immune systems decline with aging increasing their risk for candidiasis. D. Older clients are less likely to see a dentist and have healthy oral hygiene.

C. Older adults' immune systems decline with aging increasing their risk for candidiasis.

After esophagectomy for esophageal cancer, what is the nurse's priority for client care? A. Wound care B. Nutrition management C. Respiratory care D. Hydration status

C. Respiratory care

The nurse is caring for a patient with cirrhosis who has hepatic encephalopathy. Which assessment finding should the nurse report to the primary health care provider? A. Fatigue B. Difficulty sleeping C. Seizure D. Disorientation

C. Seizure

What priority teaching will the nurse provide to prevent harm when a client with gastritis reports taking ibuprofen regularly for discomfort related to arthritis? A. "Do not take ibuprofen more than twice a day." B. "Ibuprofen can interfere with the action of the drugs you take for gastritis." C. "This drug is excellent for pain relief related to arthritis." D. "Avoid taking ibuprofen because it can cause gastritis."

D. "Avoid taking ibuprofen because it can cause gastritis."

What is the nurse's best response when a client asks which diagnostic test will determine if an oral tumor is cancerous? A. "MRI is the only test that you will need at this time." B. "No single test will make the diagnosis on its own." C. "Aqueous toluidine blue will be absorbed by malignancies." D. "Biopsy is the definitive method for diagnosing oral cancer."

D. "Biopsy is the definitive method for diagnosing oral cancer."

Which cardinal signs will the nurse expect to assess in a client diagnosed with peritonitis? A. Fever with headache and confusion B. Dizziness with nausea and vomiting C. Loss of appetite with nausea and weight loss D. Abdominal pain with distention and tenderness

D. Abdominal pain with distention and tenderness

A client has undergone esophagogastroduodensocopy. The nurse should place highest priority on which item as part of the client's care plan? A. Monitoring the temperature B. Monitoring complaints of heartburn C. Giving warm gargles for a sore throat D. Assessing for the return of the gag reflex

D. Assessing for the return of the gag reflex

What does the nurse suspect when assessment of a client after gastric resection reveals a tongue that is smooth, shiny, and appears "beefy"? A. Inadequate nutrition B. Hypovolemia C. Anemia D. Atrophic glossitis

D. Atrophic glossitis

Which diagnostic test will the nurse expect the client to undergo to best identify a hiatal hernia? A. Esophagogastroduodenoscopy (EGD) B. 24-hour ambulatory pH monitoring C. Esophageal manometry D. Barium swallow with fluoroscopy

D. Barium swallow with fluoroscopy

Which problem does the nurse suspect in a client who is 4 weeks postoperative from gastric bypass surgery and reports that after a meal her heart races, she is nauseated, and has abdominal cramping with diarrhea? A. Hyperglycemia B. Intestinal obstruction C. Possible peritonitis D. Dumping syndrome

D. Dumping syndrome

A nurse is teaching a client who has a new diagnosis of dumping syndrome following gastric surgery. Which of the following information should the nurse include in the teaching? A. Eat 3 moderate sized 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

What action does the nurse expect to occur after administration of the drug linaclotide to a client with irritable bowel syndrome (IBS)? A. Control of symptoms of diarrhea B. Elimination of pain associated with bowel movement C. Reduction of anxiety and stress D. Increased fluid in the intestines to promote bowel elimination

D. Increased fluid in the intestines to promote bowel elimination

Which acid-base imbalance does the nurse expect when a client experiences a bowel obstruction high in the small intestine? A. Respiratory acidosis B. Respiratory alkalosis C. Metabolic acidosis D. Metabolic alkalosis

D. Metabolic alkalosis

What is the nurse's best first action when assessment findings on a client after gastric bypass surgery reveal increased back pain, restlessness, heart rate of 126 beats/min, and a urine output of only 15 mL for the past 2 hours? A. Increasing the IV infusion rate B. Inserting a fresh nasogastric tube C. Listening for bowel sounds in all abdominal quadrants D. Notifying the surgeon or Rapid Response team immediately

D. Notifying the surgeon or Rapid Response team immediately

For which gastrointestinal diagnostic test does the nurse teach a client to expect mild gas pain, flatulence, and a small amount of bleeding after the procedure if a biopsy was obtained? A. Endoscopic retrograde cholangiopancreatography B. Esophagogastroduodenoscopy C. Barium swallow D. Proctosigmoidoscopy

D. Proctosigmoidoscopy

A nurse on a medical-surgical unit is admitting a client who has hepatitis B with ascites. Which of the following actions should the nurse include in the plan of care? A. Initiate contact precautions B. Weight the client weekly C. Measure abdominal girth at the base of the ribcage D. Provide a high-calorie, high-carbohydrate diet.

D. Provide a high-calorie, high-carbohydrate diet.

Which complication does the nurse suspect when a client in a starvation state receiving enteral feedings has shallow respirations, weakness, acute confusion, and oozing from the IV site? A. Sepsis B. Aspiration C. Hypoglycemia D. Refeeding syndrome

D. Refeeding syndrome

What is the nurse's best action to prevent harm for a client who is receiving enteral feeding by NG tube when stomach contents cannot be aspirated and the client is coughing continuously? A. Notify the primary health care provider to request an order for a chest x-ray B. Use piston style syringe and gentle pressure to instill 30 mL of water C. Reposition the client on his or her right side and apply oxygen D. Remove the tube

D. Remove the tube

For what priority information will the nurse ask next after a client reports decreased appetite, decreased nutritional intake, and episodes of nausea over the past 2 months? A. Usual bowel pattern B. Baseline blood pressure C. Preferred favorite foods D. Usual weight and weight loss

D. Usual weight and weight loss

Which essential nutrient will the nurse expect to be deficient in a client who has liver cirrhosis and ascites? A. Sodium B. Potassium C. Vitamin C D. Vitamin K

D. Vitamin K

Which assessment technique will the nurse use to most accurately determine increasing ascites in a client with advanced liver cirrhosis and portal hypertension? A. Interpreting the serum albumin value B. Measuring the client's abdominal girth C. Testing stool for the presence of occult blood D. Weighing the client daily at the same time of the day

D. Weighing the client daily at the same time of the day