Med Surg Exam 1

The student nurse studying the gastrointestinal system understands that chyme refers to what A Hormones that reduce gastric acidity B Liquefied food ready for digestion C Nutrients after being absorbed D Secretions that help digest food - correct answer B A client scheduled for a percutaneous transhepatic cholangiography (PTC) denies allergies to medication. What action by the nurse is best A Ask the client about shellfish allergies. B Document this information on the chart. C Ensure that the client has a ride home. D Instruct the client on bowel preparation - correct answer A A client is having an esophagogastroduodenoscopy (EGD) and has been given midazolam hydrochloride (Versed). The client's respiratory rate is 8 breaths/min. What action by the nurse is best A Administer naloxone (Narcan). B Call the Rapid Response Team. C Provide physical stimulation. D Ventilate with a bag-valve-mask - correct answer C A client is scheduled for a colonoscopy and the nurse has provided instructions on the bowel cleansing regimen. What statement by the client indicates a need for further teaching A "It's a good thing I love orange and cherry gelatin." B "My spouse will be here to drive me home." C "I should refrigerate the GoLYTELY before use." D "I will buy a case of Gatorade before the prep. - correct answer A An older client has had an instance of drug toxicity and asks why this happens, since the client has been on this medication for years at the same dose. What response by the nurse is best A "Changes in your liver cause drugs to be metabolized differently." B "Perhaps you don't need as high a dose of the drug as before." C "Stomach muscles atrophy with age and you digest more slowly." D "Your body probably can't tolerate as much medication anymore." - correct answer A To promote comfort after a colonoscopy, in what position does the nurse place the client A Left lateral B Prone C Right lateral D Supine - correct answer A A nurse is examining a client reporting right upper quadrant (RUQ) abdominal pain. What technique should the nurse use to assess this client's abdomen A Auscultate after palpating. B Avoid any palpation. C Palpate the RUQ first. D Palpate the RUQ last. - correct answer D The nurse is aware of the 2014 American Cancer Society Screening Guidelines for colon cancer, which include which testing modalities for people over the age of 50 (Select all that apply.) A Colonoscopy every 10 years B Colonoscopy every 5 years C Computed tomography (CT) colonography every 5 years D Double-contrast barium enema every 10 years E Flexible sigmoidoscopy every 10 years - correct answer A C A client had an endoscopic retrograde cholangiopancreatography (ERCP). The nurse instructs the client and family about the signs of potential complications, which include what problems (Select all that apply.) A Cholangitis B Pancreatitis C Perforation D Renal lithiasis E Sepsis - correct answer A B C E The nurse working with older clients understands age-related changes in the gastrointestinal system. Which changes does this include (Select all that apply.) A Decreased hydrochloric acid production B Diminished sensation that can lead to constipation C Fat not digested as well in older adults D Increased peristalsis in the large intestine E Pancreatic vessels become calcified - correct answer A B C E The nurse working in the gastrointestinal clinic sees clients who are anemic. What are common causes for which the nurse assesses in these clients (Select all that apply.) A Colon cancer B Diverticulitis C Inflammatory bowel disease D Peptic ulcer disease E Pernicious anemia - correct answer A B C D The nurse working with clients who have gastrointestinal problems knows that which laboratory values are related to what organ dysfunctions (Select all that apply.) A Alanine aminotransferase: biliary system B Ammonia: liver C Amylase: liver D Lipase: pancreas E Urine urobilinogen: stomach - correct answer B D The nurse is caring for a client with sialadenitis. What comfort measures may the nurse delegate to the unlicensed assistive personnel (UAP) (Select all that apply.) A Applying warm compresses B Massaging salivary glands C Offering fluids every hour D Providing lemon-glycerin swabs E Reminding the client to avoid speaking - correct answer A C A nurse studying cancer knows that job-related risks for developing oral cancer include which occupations (Select all that apply.) A Coal miner B Electrician C Metal worker D Plumber E Textile worker - correct answer A C D E A client has been taught about alginic acid and sodium bicarbonate (Gaviscon). What statement by the client indicates that teaching has been effective A "I can only take this medicine at night." B "I should take this on a full stomach." C "This drug decreases stomach acid." D "This should be taken 1 hour before meals." - correct answer B A client with an esophageal tumor is having extreme difficulty swallowing. For what procedure does the nurse prepare this client A Enteral tube feeding B Esophageal dilation C Nissen fundoplication D Photodynamic therapy - correct answer B A client is scheduled for a traditional esophagogastrostomy. All preoperative teaching has been completed and the client and family show good understanding. What action by the nurse is best A Arrange an intensive care unit tour. B Assess the client's psychosocial status. C Document the teaching and response. D Have the client begin nutritional supplements. - correct answer B A client is 1 day postoperative after having Zenker's diverticula removed. The client has a nasogastric (NG) tube to suction, and for the last 4 hours there has been no drainage. There are no specific care orders for the NG tube in place. What action by the nurse is most appropriate A Document the findings as normal. B Irrigate the NG tube with sterile saline. C Notify the surgeon about this finding. D Remove and reinsert the NG tube - correct answer C A nurse works on the surgical unit. After receiving the hand-off report, which client should the nurse see first A Client who underwent diverticula removal with a pulse of 106/min B Client who had esophageal dilation and is attempting first postprocedure oral intake C Client who had an esophagectomy with a respiratory rate of 32/min D Client who underwent hernia repair, reporting incisional pain of 7/10 - correct answer C The nurse is aware that which factors are related to the development of gastroesophageal reflux disease (GERD) (Select all that apply.) A Delayed gastric emptying B Eating large meals C Hiatal hernia D Obesity E Viral infections - correct answer A B C D The nurse is caring for a client who had an esophagectomy 3 days ago and was extubated yesterday. What actions may the nurse delegate to the unlicensed assistive personnel (UAP) (Select all that apply.) A Assisting with position changes and getting out of bed B Keeping the head of the bed elevated to at least 30 degrees C Reminding the client to use the spirometer every 4 hours D Taking and recording vital signs per hospital protocol E Titrating oxygen based on the client's oxygen saturations - correct answer A B D A client has been discharged to an inpatient rehabilitation center after an esophagogastrectomy. What menu selections by the client at the rehabilitation center indicate a good understanding of dietary instructions (Select all that apply.) A Boost™ supplement B Greek yogurt C Scrambled eggs D Whole milk shake E Whole wheat toast - correct answer A B C D The nurse has taught a client about lifestyle modifications for gastroesophageal reflux disease (GERD). What statements by the client indicate good understanding of the teaching (Select all that apply.) A "I just joined a gym, so I hope that helps me lose weight." B "I sure hate to give up my coffee, but I guess I have to." C "I will eat three small meals and three small snacks a day." D "Sitting upright and not lying down after meals will help." E "Smoking a pipe is not a problem and I don't have to stop." - correct answer A B C D The nurse is working with clients who have esophageal disorders. The nurse should assess the clients for which manifestations (Select all that apply.) A Aphasia B Dysphagia C Eructation D Halitosis E Weight gain - correct answer B C D A nurse is teaching clients with gastroesophageal reflux disease (GERD) about foods to avoid. Which foods should the nurse include in the teaching (Select all that apply.) A Chocolate B Decaffeinated coffee C Citrus fruits D Peppermint E Tomato sauce - correct answer A C D E The nurse is caring for a client with peptic ulcer disease who reports sudden onset of sharp abdominal pain. On palpation, the client's abdomen is tense and rigid. What action takes priority A Administer the prescribed pain medica