NCLEX Gastrointestinal review (Saunders questions) Terms in this set (135) After a liver biopsy, the nurse should place the client in which position? A right side-lying position with a small pillow or folded towel under the puncture site The nurse is a

NCLEX Gastrointestinal review (Saunders questions) Terms in this set (135) After a liver biopsy, the nurse should place the client in which position? A right side-lying position with a small pillow or folded towel under the puncture site The nurse is assisting with the insertion of a nasogastric tube into a client. The nurse should place the client in which position for insertion? High-Fowler's position The nurse is checking a client for the correct placement of a nasogastric (NG) tube. The nurse aspirates the client's stomach contents and checks its pH level. Which pH value indicates the correct placement of the tube? 3.5 A licensed practical nurse (LPN) is preparing to assist a registered nurse (RN) with removing a nasogastric (NG) tube from the client. The LPN should reinforce instructing the client to perform which action? Take and hold a deep breath. The nurse is caring for a client with a diagnosis of chronic gastritis. The nurse anticipates that the client is at risk for which vitamin deficiency? Vitamin B12 The nurse is caring for a client after a Billroth II (gastrojejunostomy) procedure. On review of the postoperative prescriptions, which should the nurse clarify? Irrigating the nasogastric (NG) tube The nurse is reinforcing discharge instructions to a client after a gastrectomy. Which measure should the nurse include in Limit the fluids taken with meals. NCLEX Gastrointestinal review (Saunders questions) The nurse is monitoring a client for the early signs and symptoms of dumping syndrome. Which indicates this occurrence? Sweating and pallor The nurse is reviewing the record of a client with Crohn's disease. Which stool characteristic should the nurse expect to see documented in the record Diarrhea The nurse is reviewing the prescriptions of a client admitted to the hospital with a diagnosis of acute pancreatitis. Which interventions should the nurse expect to note? Select all that apply -Administer antacids, as prescribed. -Encourage coughing and deep breathing -Administer anticholinergics, as prescribed It has been determined that a client with hepatitis has contracted the infection from contaminated food. Which type of hepatitis is this client most likely experiencing? Hepatitis A The nurse is reviewing the health care provider's prescriptions written for a client admitted with acute pancreatitis. Which health care provider prescription should the nurse verify if noted in the client's chart? Position the client supine and flat A client with hiatal hernia chronically experiences heartburn after meals. Which should the nurse teach the client to avoid? Lying recumbent after meals The nurse is monitoring for stoma prolapse in a client with a colostomy. Which stoma observation should indicate that a prolapse has occurred? Protruding and swollen Before administering an intermittent tube feeding through a nasogastric tube, the nurse checks for gastric residual volume. Which is the best rationale for checking gastric residual volume before administering the tube feeding? Evaluate absorption of the last feeding. The nurse observes that a client with a nasogastric tube connected to continuous gastric suction is mouth breathing, has dry mucous membranes, and has a foul breath odor. In planning care, which nursing intervention would be best to maintain the integrity of this client's oral mucosa? Use diluted mouthwash and water to rinse the mouth after brushing teeth. A client with acute pancreatitis is experiencing severe pain from the disorder. The nurse tells the client to avoid which position that could aggravate the pain? Lying flat NCLEX Gastrointestinal review (Saunders questions) The nurse is evaluating the effect of dietary counseling on the client with cholecystitis. The nurse determines that the client understands the instructions given if the client states that which food item is acceptable to include in the diet? Turkey and lettuce sandwich A client is admitted to the hospital with acute viral hepatitis. Which sign/symptom should the nurse expect to note based on this diagnosis? Fatigue Which infection control method should be the priority to include in the plan of care to prevent hepatitis B in a client considered to be at high risk for exposure? Hepatitis B vaccine A client is admitted to the hospital with viral hepatitis and is complaining of a loss of appetite. In order to provide adequate nutrition, which action does the nurse encourage the client to take? Increase intake of fluids. The nurse is caring for a client with acute pancreatitis and a history of alcoholism and is monitoring the client for complications. Which data should be indicative of paralytic ileus? Inability to pass flatus A client with viral hepatitis has no appetite, and food makes the client nauseated. Which nursing intervention should be appropriate? Offer small, frequent meals. The nurse is participating in a health screening clinic and is preparing materials about colorectal cancer. The nurse plans to include which risk factor for colorectal cancer in the material? Personal history of ulcerative colitis or gastrointestinal (GI) polyps A client has undergone esophagogastroduodenoscopy (EGD). The nurse places highest priority on which action as part of the client's care plan? Checking for return of a gag reflex The nurse is collecting data from a client admitted to the hospital with a diagnosis of suspected gastric ulcer and is asking the client questions about pain. Which statement made by the client supports the diagnosis of gastric ulcer? "My pain comes shortly after I eat, maybe a half hour or so later." A client has been diagnosed with acute gastroenteritis. Which diet should the nurse anticipate to be prescribed for the client? Low fiber A client has asymptomatic diverticular disease. Which type of diet should the nurse High-fiber diet NCLEX Gastrointestinal review (Saunders questions) The nurse is caring for a client suspected of having appendicitis. Which should the nurse anticipate will be prescribed for this client? No oral intake of liquids or food The nurse has given the client with hepatitis instructions about postdischarge management during convalescence. The nurse determines that the client needs further teaching if the client makes which statement? "I should resume a full activity level within 1 week." The nurse is assigned to care for a client who had a Sengstaken-Blakemore tube inserted when more conservative treatment failed to alleviate the condition. The nurse should suspect that the client has which diagnosis? Esophageal varices The nurse has been caring for a client with a Sengstaken-Blakemore tube. The health care provider arrives on the nursing unit and deflates the esophageal balloon. Following deflation of the balloon, the nurse should monitor the client closely for which? Hematemesis A health care provider places a Miller- Abbott tube in a client who has a bowel obstruction. Six hours later, the nurse measures the length of the tube outside of the nares and notes that the tube has advanced 6 cm since it was first placed. Based on this finding, which action should the nurse take next? Document the finding in the client's record. The nurse is collecting data on a client with a diagnosis of peptic ulcer disease. Which history is least likely associated with this disease? History of the use of acetaminophen (Tylenol) for pain and discomfort A client had a Miller-Abbott tube inserted 24 hours ago. The nurse is asked to check the client to determine whether the tube is in the appropriate location at this time. Which finding would indicate adequate location of the tube? The aspirate from the tube has a pH of 7.45. The nurse is caring for a client with a nasogastric tube. Which observation is most reliable in determining that the tube is correctly placed? The pH of the aspirate is 5. A client is admitted to the hospital with a bowel obstruction secondary to a recurrent malignancy, and the health care provider plans to insert a Miller-Abbott tube. When the nurse tries to explain the procedure, the client interrupts the nurse and states, "I don't want to hear about that. Just let the doctor do it." Based on the client's statement, which is the nurse's best action? Remain with the client and be silent The nurse is assisting in planning stress management strategies for the client with irritable bowel syndrome. Which suggestion should the nurse give to the client? Learn measures such as biofeedback or progressive relaxation A calcium supplement is prescribed for a client with hypoparathyroidism in the management of hypocalcemia. The client arrives at the clinic for a follow-up visit and complains of chronic constipation, and the nurse reinforces instructions to the client about measures to alleviate the constipation. Which comment by the client would indicate a need for further teaching? "I need to add 0.5 ounce of mineral oil to my daily diet." A client who has undergone a colostomy several days ago is reluctant to leave the hospital and has not yet looked at the ostomy site. Which measures are most likely to promote coping? Select all that apply. -Ask a member of the local ostomy club to visit with the client before discharge. - Ask the enterostomal nurse specialist to consult with the client before discharge. - Ask the client to begin doing one part of the ostomy care and increase tasks daily. Which statement by the spouse of a client with end-stage liver failure indicates the need for further teaching by the multidisciplinary team regarding the management of pain? "This opioid will cause very deep sleep, which is what my husband needs." After the deflation of the balloon of a client's Sengstaken-Blakemore tube, the nurse monitors the client closely for which esophageal complication? Hemorrhage The nurse is collecting data on a client admitted to the hospital with hepatitis. Which data indicate that the client may have liver damage? Pruritus The nurse is reviewing the health care provider's prescriptions for a client admitted to the hospital with a diagnosis of liver disease. Which medication prescription should the nurse question? Acetaminophen (Tylenol) A nurse planning care for a client with hepatitis plans to meet the client's safety needs by performing which action? Monitoring prothrombin and partial thromboplastin values The nurse is collecting admission data on the client with hepatitis. Which finding would be a direct result of this client's condition? Drowsiness The nurse is reviewing the health care record of a client with a diagnosis of chronic pancreatitis. Which data noted in the record indicate poor absorption of dietary fats? Steatorrhea A client is admitted to an acute care facility with complications of celiac disease. Which question should be helpful initially in obtaining information for the nursing care plan? "What is your understanding of celiac disease?" A client is seen in the ambulatory care office for a routine examination. Which statement by the client would be important for the nurse to follow up? "I just lost a family member to gastrointestinal cancer." A client with a possible hiatal hernia complains of difficulty swallowing. Which other sign/symptom is associated with a hiatal hernia? Heartburn and regurgitation The nurse is teaching a client with a newly diagnosed hiatal hernia about measures to prevent recurrence of symptoms. Which statement should be included in the teaching? "Avoid lying down for an hour after eating." The nurse documents that a client with a hiatal hernia is implementing effective health maintenance measures after the client reports doing which action? Eating low-fat or nonfat foods Treatment measures have been implemented for a client with bleeding esophageal varices and have been unsuccessful. The health care provider states that a Sengstaken-Blakemore tube will be used to control the resulting hemorrhage. The nurse prepares for insertion via which route? Nasogastric The nurse is caring for a client with a Sengstaken-Blakemore tube. To prevent ulceration and necrosis of oral and nasal mucosa, the nurse should plan to perform which action? Provide frequent oral and nasal care on a regular basis A client complains of stomach pain 30 minutes to 1 hour after eating. The pain is not relieved by further intake of food, although it is relieved by vomiting. A gastric ulcer is suspected. Which data would further support this diagnosis? History of chronic obstructive pulmonary disease with weight loss The nurse should include which information when reinforcing home care instructions for a client who has peptic ulcer disease? Learn to use stress reduction techniques The nurse is reinforcing dietary instructions for a client with peptic ulcer disease. Which action does the nurse encourage the client to do? Eat anything as long as it does not aggravate or cause pain The nurse has been reinforcing dietary teaching for a client with gastroesophageal reflux disease (GERD) who has a routine follow-up visit. Which behavior is the best indicator of a successful outcome for this client? A decrease in sour eructation A client who has undergone a subtotal gastrectomy is being prepared for discharge. Which items concerning ongoing self-management should the nurse reinforce to the client? Select all that apply -Eat smaller and more frequent meals -Drink fluids between meals not with them. The nurse who is reinforcing instructions to a client following gastric resection should include which suggestions? Select all that apply. -Eat small frequent meals. -Take action to prevent dumping syndrome The nurse reinforces instructions to a client following a gastrectomy about the signs and symptoms of pernicious anemia, knowing what information? Regular monthly injections of vitamin B12 will prevent this complication. The nurse who is assisting in the care of a client within the first 24 hours following a total gastrectomy for gastric cancer should avoid which intervention? Irrigating the nasogastric (NG) tube The nurse is collecting data about how well a client with a gastrointestinal (GI) disorder is able to absorb food. While carrying out this function, the nurse recalls that absorption is defined as which? The transfer of digested food molecules from the GI tract into the bloodstream NCLEX Gastrointestinal review (Saunders questions) A health care provider asks the nurse to obtain a Salem Sump tube for gastric intubation. The nurse should correctly select which tube from the unit storage area? A tube with a larger lumen and an air vent The nurse has assisted in the insertion of a Levin tube for gastrointestinal (GI) decompression. The nurse plans to set the suction to which pressure? Low and intermittent A client has had a partial gastrectomy and the nurse is reinforcing discharge instructions. The nurse should tell the client about the need for which? Select all that apply. -Iron supplements -Calcium supplements -Vitamin B12 injections A client in the emergency department reports right lower quadrant abdominal pain. After noting a white blood cell count of 16,500 cells/mm3, the nurse should question which prescriptions? Select all that apply. -Milk of magnesia -Heat pad to the abdomen The nurse is preparing to administer an enteral feeding through a nasogastric tube. The nurse should place the client in which position during and after the feedings? Fowler's The nurse is reinforcing discharge instructions to a client who has had a total gastrectomy. The nurse tells the client about the importance of returning to the health care clinic as scheduled for which priority assessment? Vitamin B12 and folic acid studies The nurse assigned to care for a client with cirrhosis reviews the medical record and notes that the client has difficulty maintaining an effective breathing pattern due to pressure on the diaphragm. The nurse plans care knowing that which client position will best assist in facilitating breathing? Semi-Fowler's A client arrives at the emergency department and complains of severe abdominal pain. The initial diagnosis is acute abdomen, and an x-ray and an abdominal ultrasonogram are prescribed to be obtained immediately. The nurse prepares the client for these diagnostic tests and reviews the health care provider's prescriptions. Which prescription should the Administration of an opioid analgesic NCLEX Gastrointestinal review (Saunders questions) The nurse is caring for a client with a nasogastric (NG) tube and tests the pH of the aspirate to determine correct placement. The nurse notes that the pH is 5. Which information does this indicate? Placement of the NG tube is accurate. A generally healthy 63-year-old man is seen in the health care provider's office for a routine examination. Which statement made by the client is important for the nurse to follow up on? "Everyone in my immediate family has died from gastrointestinal cancer." A client with possible hiatal hernia complains of frequent heartburn and regurgitation. The nurse should gather further information about the presence of which sign or symptom? Difficulty swallowing The nurse is teaching a client who is newly diagnosed with a hiatal hernia about measures to prevent recurrence of symptoms. The nurse should make which accurate statement to the client? "Be sure to sleep with your head elevated in bed." The nurse is reinforcing discharge instructions to a client with a hiatal hernia. Which should the nurse include in the teaching session? Select all that apply. -It is advisable to stop smoking cigarettes -Wait at least 1 hour after meals to perform chores -Be sure to elevate the head of the bed during sleep The nurse is reinforcing instructions to a client about insertion of a Sengstaken- Blakemore tube. Which statement by the client indicates an understanding of the teaching? The tube will be inserted through my nose to my stomach The nurse is assisting in caring for a client with a Sengstaken-Blakemore tube. Which article should the nurse place at the bedside? Scissors A client complains of stomach pain 30 minutes to 1 hour after eating. The pain is not relieved by further intake of food, although it is relieved by vomiting, and a gastric ulcer is suspected. The nurse should gather which additional supportive data from the client for this diagnosis? History of alcohol use, smoking, and weight loss The nurse should include which instruction in a teaching plan for a client who has peptic ulcer disease? Learn to use stress reduction techniques. NCLEX Gastrointestinal review (Saunders questions) The nurse is reinforcing dietary instructions for a client with peptic ulcer disease. Which statement made by the client indicates a need for further teaching? I will eat a bland diet only. A client has undergone subtotal gastrectomy and the nurse is preparing the client for discharge. Which item should be included when reinforcing instructions to the client about ongoing self-management? Smaller, more frequent meals should be eaten The nurse is reinforcing home care instructions to a client following a gastric resection. The nurse should include which instruction? Take actions to prevent dumping syndrome. The nurse provides information to a client following a gastrectomy who is now diagnosed with pernicious anemia. Which instructions about pernicious anemia should the nurse reinforce? Select all that apply. -Provide meticulous and frequent oral hygiene. -Use additional lightweight blankets as needed -Check blood serum vitamin B12 levels every 1 to 2 years. The nurse is caring for a client within the first 24 hours following a total gastrectomy for gastric cancer. During this time frame, on which intervention should the nurse focus? Maintaining a patent nasogastric (NG) tube The nurse is collecting data about how well a client with a gastrointestinal (GI) disorder is able to digest food. Which processes are involved in the complete digestive process? Select all that apply. -Chemical - Absorption -Mechanical -Active transport A licensed practical nurse (LPN) is helping a registered nurse (RN) conduct an abdominal assessment. The LPN assists the client into which position? Supine with the head raised slightly and the knees slightly flexed A health care provider asks the nurse to obtain a Salem Sump tube for gastric intubation. The nurse selects which tube from the unit storage area? Tube with a lumen and an air vent The nurse has assisted with the insertion of a Levin tube for gastrointestinal (GI) decompression. Which settings will the health care provider prescribe? Select all that apply. -Low -Intermittent The nurse is working with a client diagnosed with anorexia nervosa. The nurse plans care, focusing on which as the primary problem? Impaired nutritional status A client has been diagnosed with chronic gastritis and has been told that there is too little intrinsic factor being produced. The nurse tells the client that which therapy will be prescribed to treat the problem? Vitamin B12 injections The nurse is caring for a client in the emergency department who has right lower quadrant abdominal pain. After noting a white blood cell count of 16,500 cells/mm3, the nurse should question which prescription? Milk of magnesia The nurse is performing an abdominal assessment on a client. The nurse interprets that which finding is abnormal and should be reported to the registered nurse (RN) or health care provider? Pulsation between the umbilicus and pubis The nurse is interpreting the laboratory results of a client who has a history of chronic ulcerative colitis. Which result indicates a complication of ulcerative colitis? Hemoglobin 10.2 g/dL A client diagnosed with pernicious anemia asks the nurse what caused the deficiency. The nurse replies that it is likely a result of which condition that is part of the client's health history? Hemigastrectomy The nurse observes that a client's nasogastric tube has suddenly stopped draining. The tube is connected to suction, the machine is on and functioning and all connections are snug. The tube is secured properly and does not appear to have been dislodged. After checking placement, the nurse gently flushes the tube with 30 mL of normal saline, but the tube still is not draining. The nurse analyzes this problem as which? Channels of gastric secretions may be bypassing the holes in the tube; turning the client will promote stomach emptying. The nurse is preparing to administer a soapsuds enema to a client. Into which position does the nurse place the client to administer the enema? Left sims A postgastrectomy client is at high risk for hyperglycemia related to uncontrolled gastric emptying of fluid and food into the small intestine (dumping syndrome). Because of this risk, the nurse plans to monitor which data? Postprandial blood glucose readings The nurse is caring for a client with pneumonia with a history of bleeding esophageal varices. Based on this information, the nurse plans care, knowing that which could result in a potential complication? Vigorous coughing A client is admitted to the hospital with a diagnosis of acute pancreatitis. The nurse plans care, knowing that which problem occurs with this disorder? Alteration in comfort related to abdominal pain