Saunders NCLEX Med-Surg Gastrointestinal Patients NCLEX Exam (1 of 3)

Care of Patients with Stomach Disorders Chapter 55, Med Surg 1: Chapter 57 Study guide, NCLEX - Gastrointestinal, GI practice exam, EAQ Ch 58 Care of Patients with Liver Problems Which are pathologic changes associated with acute gastritis? Vascular congestion Severe mucosal damage and ruptured vessels Edema Acute inflammatory cell infiltration Which are possible complications of chronic gastritis? Pernicious anemia Gastric cancer Decreased gastric acid decoration Peptic ulcer disease Which statements about gastritis are accurate? The onset of infection with H. pylori can result in acute gastritis Atrophic gastritis is a form of chronic gastritis that is seen most in older adults Type B chronic gastritis affects the glands in the antrum, but may affect all of the stomach. The nurse is teaching a patient about health promotion and maintenance to prevent gastritis. Which information does the nurse include? "A balanced diet can help prevent gastritis" "If you stop smoking, there is less of a chance that you will develop gastritis" "Yoga has been found to be effective in preventing gastritis" When teaching a patient about pernicious anemia, which statement does the nurse include? Pernicious anemia A patient with chronic gastritis is being admitted. which sign/symptom does the nurse identify as being associated with this patient's condition? "Pernicious anemia results in a deficiency of vitamin B12" A patient comes to the emergency department (ED) reporting rapid onset of epigastric pain with nausea and vomiting. The patient says the pain is worse than any heartburn he has had, and that he has not had an appetite for the past day. what does the nurse suspect this patient has? Acute gastritis Which diagnostic test is the gold standard for diagnosing gastritis? Esophagogasrodudenoscopy The nurse is teaching a patient about ranitidine (Zantac) prescribed for gastritis. Which statement by the patient indicates effective teaching by the nurse? "This drug will block the secretions of my stomach" A patient with acute gastritis is receiving treatment to block and buffer gastric acid secretions to relieve pain Which drugs the nurse identify as an anti-secretory agent (PPI). Omeprazole (Prilosec) The nursing student caring for a patient with a duodenal ulcer is about to administer a PPI. Which statement about this medication is true? "These drugs should not be used for a prolonged period of time because they may contribute to osteoporotic-related fractures. The nurse is teaching a patient being discharged home about taking prescribed medications that include sucralfate (Carafate). Which statement by the patient indicates teaching has been effective? "Sucralfate works to heal my ulcer" Which types of ulcers are included in peptic ulcer diseases? Gastric ulcers Duodenal ulcers Stress ulcers Which type of gastric ulcer does the nurse expect may occur when caring for a patient with extensive burns? Curling's ulcer Which type of NSAID drug is likely to cause mucosal damage to the stomach? Celecoxib The nurse is caring for a patient who vomited coffee-ground blood. Where does the nurse suspect the patient is bleeding? Upper GI system The patient with a gastric ulcer suddenly develops sharp epigastric pain that spreads over the entire abdomen. What complication has the patient most likely developed? Perforation The gastric ulcer patient's abdomen is rigid, tender, and painful. He prefers lying in a knee-chest (fetal) position. What is the nurse's priority action at this time? Notify the health care provider Drug therapy for peptic ulcer disease is implemented for which purposes? Pain relief Eliminate H.pylori infection Heal ulcerations Prevent recurrence Which peptic ulcer disease drug is useful to protect patients against NSAID-induced ulcers? Misoprostol (Cytotec) Which statement about the use of antacids in the treatment of gastric ulcers is true? Avoid using antacids with phenytoin (Dilantin) A patient with peptic ulcer disease is receiving Maalox. Which actions does the nurse take when administering this medication? Give the medication 2 hours after patient's meal Do not give other drugs within 1 to 2 house of antacids Assess the patient for a hx of renal disease before giving Mylanta Assess the patient for a hx of heart failure before giving Maalox The nurse has provided instruction for a patient prescribed sucralfate (Carafate) to treat a gastric ulcer. which statement by the patient indicates that teaching has been effective? "I will take this drug on an empty stomach" An older adult patient is admitted with an upper GI bleed. Which finding does the nurse expect to assess in the patient? Acute confusion A patient develops an active upper GI bleed. Which are the priority actions the nurse takes in caring for this patient? Provide oxygen Start 1 or 2 large-bore IV lines. Prepare to infuse 0.9% NS solution or LR solution Prepare for NG tube insertion When performing an assessment on a patient with an active upper GI bleed, which conditions does the nurse identify as common causes of upper GI bleed? Esophageal cancer Esophageal varicies Duodenal ulcer Gastritis Gastric cancer The student nurse is performing a gastric lavage on a patient with an active upper GI bleed. Which action by the student requires intervention by the supervising nurse? Using ice-cold solution to perform lavage of the stomach Which drug would the health care provider prescribe to treat H. pylori infection? Clarithromycin (Biaxin) The nurse is caring for several patients with gastric and duodenal ulcers. Which differential features of gastric ulcers compared to duodenal ulcers does the nurse identify? Normal secretion or hyposecretion Hematemesis more common then melena The nurse is assessing a patient who has had a total gastrectomy today and notes bright-red blood in the NG and abdominal distention. What does the nurse do next? Inform the surgeon of these findings Which are symptoms of early dumping syndrome? Tachycardia Desire to lie down Syncope Occurs 30 minutes after eating What is the cause of late dumping syndrome? Release of an excessive amount of insulin Which strategies does the nurse expect to implement in the management of dumping syndrome? Provide more frequent smaller meals Eliminate liquids ingested with meals Increase protein and fat in the diet Administer acarbose to decrease carbohydrate absorption. The nurse is caring for a patient who underwent gastric resection. On assessment, the nurse notes that the patient's tongue is smooth, shiny, and appears "beefy." What does the nurse suspect has occurred? Vitamin B 12 deficiency The nurse is teaching a patient with dumping syndrome about diet. Which statement by the patient indicates that teaching has been effective? I will use sugar-free gelatin with caution Which statement about general principles of diet therapy for patients with dumping syndrome is true? Patients with dumping syndrome should have liquids between meals only The nurse is providing discharge teaching for a patient after gastrectomy. Which teaching points will the nurse include to help the patient minimize dumping syndrome? "Eat small frequent meals" "Eliminate alcohol and caffeine from your diet" "Lie flat for a short time after eating" "Take B12 injections as prescribed by your health care provider" The patient comes to the emergency department (ED) with right lower quadrant pain. What does the ED nurse suspect? a. Gastroenteritis b. Ulcerative colitis c. Appendicitis d. Crohn's disease c The nurse is caring for the patient with acute appendicitis. Which interventions will the nurse perform? (Select all that apply.) a. Maintain the patient on NPO status. b. Administer IV fluids as prescribed. c. Apply warm compresses to the right lower abdominal quadrant. d. Maintain the patient in the supine position. e. Administer laxatives. a, b The patient has been diagnosed with acute appendicitis. Based on this diagnosis, which intervention does the nurse perform? a. Start a bowel cleansing program. b. Prepare the patient for surgery. c. Apply a heating pad to the lower abdomen. d. Assess the patient's knowledge about dietary modifications. b The nurse on the surgical unit is expecting to admit the patient who has had an appendectomy with abscess. What does the nurse anticipate care for this patient will include? (Select all that apply.) a. Clear liquids b. Wound drains c. IV antibiotics d. Nonsteroidal antiinflammatory drugs (NSAIDs) for pain control e. Nasogastric (NG) tube care b, c, e Which laboratory finding does the nurse expect may occur with a diagnosis of appendicitis? a. Decreased hematocrit and hemoglobin b. Increased coagulation time c. Decreased potassium d. Increased WBC count d Which statements about peritonitis are true? (Select all that apply.) a. Peritonitis is caused by contamination of the peritoneal cavity by bacteria or chemicals. b. Continuous ambulatory peritoneal dialysis (CAPD) can cause peritonitis. c. White blood cell counts are often decreased with peritonitis. d. Abdominal wall rigidity is a classic finding in patients with peritonitis. e. Chemical peritonitis is caused by leakage of pancreatic enzymes or gastric acids. a, b, d The fluid shift that occurs in peritonitis may result in which of the following? a. Intracellular fluid moving into the peritoneal cavity b. Significant increase in circulatory volume c. Decreased circulatory volume and hypovolemic shock d. Increased bowel motility caused by increased fluid volume c The respiratory problems that may accompany peritonitis are a result of which factor? a. Associated pain interfering with ventilation b. Decreased pressure against the diaphragm c. Fluid shifts to the thoracic cavity d. Decreased oxygen demands related to the infectious process a Which nursing intervention is part of nonsurgical management for a patient with peritonitis? a. Monitor weekly weight and intake and output. b. Insert a nasogastric tube to decompress the stomach. c. Order a breakfast tray when the patient is hungry. d. Administer NSAIDs for pain. b What are the cardinal signs of peritonitis? a. Fever and headache b. Dizziness with nausea and vomiting c. Abdominal pain, distention, and tenderness d. Nausea and loss of appetite c We have an expert-written solution to this problem! Which intervention does the nurse delegate to the unlicensed assistive personnel (UAP) when caring for a postoperative patient with peritonitis? a. Measure intake and output. b. Assess wound drainage. c. Administer IV antibiotics. d. Teach patient about wound care. a The nurse is instructing a patient about home care after an exploratory laparotomy for peritonitis. Which statement by the patient indicates that teaching has been effective? a. "It is normal for the incision site to be warm." b. "I will stop taking the antibiotics if diarrhea develops." c. "I will call the health care provider for a temperature greater than 101° F." d. "I will resume activity with my bowling league this week for exercise." c The patient with gastroenteritis due to infection with the norovirus asks the nurse how this illness occurred. Which statement by the patient indicates correct understanding of the nurse's teaching? a. "I got this infection from being around my grandchildren when they had respiratory illnesses." b. "It is likely that I got this illness from either contaminated water or food." c. "I may have gotten sick when I was travelling last month." d. "It's really important that everything I eat is cooked until it is well done." b Which interventions are useful in preventing spread of gastroenteritis? (Select all that apply.) a. Careful handwashing b. Sanitize all surfaces that may be contaminated c. Prophylactic use of antibiotics d. Easily accessible hand sanitizers e. Test all food preparation employees a, b, d The nurse is assessing a patient with viral gastroenteritis. Which symptom is the nurse most concerned about? a. Orthostatic blood pressure changes b. Poor skin turgor c. Dry mucous membranes d. Rebound tenderness d What is the priority nursing concern for a patient with gastroenteritis? a. Nutrition therapy b. Fluid replacement c. Skin care d. Drug therapy b Which are common manifestations in a 28-year-old patient with dehydration secondary to gastroenteritis? (Select all that apply.) a. Peripheral edema b. Elevated temperature c. Dry mucous membranes d. Hypertension e. Oliguria b ,c, e As part of the routine treatment plan for a patient with bacterial gastroenteritis, which drugs does the nurse anticipate the patient will most likely be prescribed? a. Anticholinergics b. Antiemetics c. Antiperistaltic drugs d. Antibiotics d The nurse is caring for a patient with gastroenteritis who has frequent stools. Which task is best to delegate to the UAP? a. Teach the patient to avoid toilet paper and harsh soaps. b. Instruct the patient on how to take a sitz bath. c. Use a warm washcloth to remove stool from the skin. d. Dry the skin with absorbent cotton. c Which characteristics pertain to Crohn's disease (CD)? (Select all that apply.) a. Begins in the rectum and proceeds in a continuous manner toward the cecum b. Fistulas commonly develop c. Five to six soft, loose stools per day that are nonbloody d. Increased risk of colon cancer e. Some patients experience extraintestinal manifestations such as migratory polyarthritis, ankylosing spondylitis, and erythema nodosum f. Cobblestone appearance of the internal intestine b, c, f A patient is suspected to have ulcerative colitis (UC). Which definitive diagnostic test does the nurse expect the patient to undergo in order to confirm the diagnosis? a. Colonoscopy b. C-reactive protein c. Albumin levels d. Erythrocyte sedimentation rate a A patient is prescribed sulfasalazine (Azulfidine) for the treatment of UC. Which patient statement indicates the patient is experiencing a side effect of this drug? a. "My skin is covered with a rash." b. "My knees hurt." c. "My appetite has increased." d. "I wake up at night sweating sometimes." a Which statement is true about the medical treatment of UC? a. Infliximab (Remicade) is approved as a first-line therapy. b. Immunomodulators are not thought to be effective; however, in combination with steroids, they may offer a synergistic effect. c. When a therapeutic level of glucocorticoids is reached, the dosage of the drug stays the same to maintain the therapeutic effect. d. The method of action for the aminosalicylates is interruption of the pain pathway. b A patient with UC who has had an ileostomy is being discharged home. The nurse has provided discharge teaching. Which statements by the patient indicate the teaching has been effective? (Select all that apply.) a. "I will avoid foods that cause gas." b. "I will call the health care provider if I have a fever over 101° F." c. "I will change the adhesive for the appliance daily." d. "I know the pouch needs emptying when I feel pain in that area." e. "I will call the health care provider if I feel like my heart is beating fast." a, b ,e Which statement is true about drug therapy for CD? a. Budesonide (Entocort EC) is a rapidrelease compound that delivers low local glucocorticoid concentrations to the terminal ileum for patients with CD. b. Methotrexate (Rheumatrex) is contraindicated in the treatment of CD. c. Metronidazole (Flagyl) has been helpful in patients with fistulas and CD. d. Adalimumab (Humira) is a glucocorticoid approved for the treatment of CD c A patient with CD has a fistula. Which assessment finding indicates possible dehydration? a. Weight gain of 2 pounds in one day b. Abdominal pain c. Foul-smelling urine d. Decreased urinary output d In caring for a patient with CD, the nurse observes for which complications? (Select all that apply.) a. Peritonitis b. Small bowel obstruction c. Nutritional and fluid imbalances d. Presence of fistulas e. Appendicitis f. Severe nausea and vomiting a, b, c, d Which surgical procedure involves removal of the colon, rectum, and anus with surgical closure of the anus? a. Restorative proctolectomy with ileo pouch-anal anastomosis (RPC-IPAA) b. Natural orifice transluminal endoscopic surgery (NOTES) c. Sigmoid colostomy d. Total proctocolectomy with a permanent ileostomy d Which type of diet has been implicated in the formation of diverticula? a. High-fat diet b. Low-protein diet c. High-cholesterol diet d. Low-fiber diet d What is the nature of pain associated with diverticulitis? a. Intermittent becoming progressively steady b. Sharp and continuous c. Localized to the right upper quadrant d. Severe and incapacitating a The nurse is assessing an older adult patient with abdominal pain. Assessment findings include generalized abdominal pain with rigidity, nausea and vomiting, elevated temperature (101.2°F), increased heart rate (122/minute) and chills. The patient is also somewhat confused and does not know where he is. What does the nurse suspect with this patient? a. Crohn's disease b. Ulcerative colitis c. Diverticulitis d. Peritonitis d Which drug is often used in older patients for pain management of moderate to severe diverticulitis? a. Ibuprofen (Motrin) b. Acetaminophen (Tylenol) c. Aspirin (Anacin) d. Morphine sulfate (Duramorph) d Which statement about diverticular disease is true? a. Most diverticula occur in the sigmoid colon. b. Diverticula are uncomfortable even when not inflamed. c. High-fiber diets contribute to diverticula occurrence. d. Diverticula form where intestinal wall muscles are weak. a Which is a preventive measure for diverticular disease? a. Excluding whole-grain breads from the diet b. Avoiding fresh apples, broccoli, and lettuce c. Taking bulk agents such as psyllium hydrophilic mucilloid (Metamucil) d. Taking routine anticholinergics to reduce bowel spasms c Which type of stoma will a patient with diverticulitis most likely have postoperatively? a. Ileostomy b. Jejunostomy c. Colostomy d. Cecostomy c Which interventions does the nurse expect to implement when caring for a patient with diverticulitis? (Select all that apply.) a. Laxative and enemas as ordered b. IV fluids to prevent dehydration c. Broad-spectrum antibiotics d. Teach the patient to refrain from lifting or straining e. Keep the patient NPO if symptoms are severe b, c, d, e Which description best defines an anal fissure? a. Perianal tear that can be very painful b. Duct obstruction and infection c. Communicating tract d. Localized area of induration with pus a The nurse is providing teaching for a patient with an anal fissure as a complication of CD. Which statement by the patient indicates the need for further teaching? a. "I will use warm sitz baths." b. "A diet that is low in bulk-producing agents is best for me." c. "Hydrocortisone cream may be helpful to decrease discomfort." d. "Topical antiinflammatory agents will help if I am uncomfortable." b Which statements does the nurse include while providing discharge instructions for a patient with giardiasis? (Select all that apply.) a. "Avoid contact with stool from dogs and beavers." b. "All household and sexual partners should have stool examinations for parasites." c. "Treatment will most likely consist of metronidazole (Flagyl)." d. "The infection can be transmitted to others until the amebicides kill the parasites." e. "Stools are examined 6 days after treatment to assess for eradication." a, b, c, d The ED nurse is assessing a patient admitted with frequent, liquid, foul-smelling stools containing mucus and blood. Assessment findings include temperature 103.8° F, tenesmus, abdominal tenderness, and vomiting. Which additional laboratory tests does the nurse expect to collect? a. Serial stool samples b. Urine culture c. Throat culture d. Sputum culture a After a client undergoes a liver biopsy, the nurse places the client in the prescribed right-side lying position. The nurse understands that the purpose of this intervention is to accomplish which? limit bleeding from the biopsy site Rationale:After a liver biopsy, the client is assisted with assuming a right side-lying position with a small pillow or folded towel under the puncture site for at least 3 hours to apply pressure and limit bleeding from the biopsy site. The liver produces bile that flows through the common bile duct; client discomfort may be decreased; and the liver does store glucose as glycogen, but this is not the purpose of the right side-lying position. 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 Rationale:Before insertion of a nasogastric tube the nurse places the client in a sitting or high-Fowler's position to reduce the risk of pulmonary aspiration if the client should vomit. A pillow may be placed behind the head and shoulders to promote the client's ability to swallow during procedure. Options 1, 2, and 4 do not facilitate the insertion of the tube or prevent aspiration. We have an expert-written solution to this problem! The nurse has inserted a nasogastric (NG) tube in a client and is checking for the correct placement of an NG tube. Which is the most reliable data to ensure that the end of the tube is in the stomach? placement verified on x-ray We have an expert-written solution to this problem! A licensed practical nurse (LPN) is preparing to assist a registered nurse (RN) with removing a nasogastric (NG) tube from the client. Which interventions should be included in the procedure? Select all that apply. explain procedure to client ask patient to take deep breath and hold pull tube out remove device 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 Rationale:Deterioration and atrophy of the lining of the stomach lead to the loss of function of the parietal cells. When the acid secretion decreases, the source of the intrinsic factor is lost, which results in the inability to absorb vitamin B12. This leads to the development of pernicious anemia. Options 1, 2, and 3 are incorrect. We have an expert-written solution to this problem! The nurse is caring for a client after a Billroth II (gastrojejunostomy) procedure. During review of the postoperative prescriptions, which should the nurse clarify? irrigating the NG tube Rationale:In a Billroth II resection, the proximal remnant of the stomach is anastomosed to the proximal jejunum. Patency of the NG tube is critical for preventing the retention of gastric secretions. The nurse, however, should never irrigate or reposition the NG tube after gastric surgery unless specifically prescribed by the PHCP. In this situation, the nurse should clarify the prescription. Options 1, 2, and 4 are appropriate postoperative interventions. The nurse is reinforcing discharge instructions to a client after a gastrectomy. Which measure should the nurse include during client teaching to help prevent dumping syndrome? limit the fluids taken with meals 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 We have an expert-written solution to this problem! 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 be prescribed? Select all that apply. 1,2,3 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? A The nurse is reviewing the primary health care provider's (PHCP'S) prescriptions written for a client admitted with acute pancreatitis. Which PHCP prescription should the nurse verify if noted in the client's chart? 3 We have an expert-written solution to this problem! A client with hiatal hernia chronically experiences heartburn after meals. Which should the nurse teach the client to avoid? 1 The nurse is monitoring for stoma prolapse in a client with a colostomy. Which stoma observation should indicate that a prolapse has occurred? 4 A client with Crohn's disease is scheduled to receive an infusion of infliximab. The nurse assisting with caring for the client should take which action to monitor the effectiveness of treatment? 2 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? 3 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. When planning care, which nursing intervention would be best to maintain the integrity of this client's oral mucosa? 4 The client diagnosed with acute pancreatitis is experiencing severe pain from the disorder. The nurse should instruct the client to avoid which position that could aggravate the pain? 2 We have an expert-written solution to this problem! The nurse is evaluating the effect of dietary counseling on the client diagnosed with cholecystitis. The nurse determines the client understands the instructions given if the client states that which food item is most appropriate to include in the diet? 4 A client is admitted to the hospital with a diagnosis of acute viral hepatitis. Which sign/symptom should the nurse expect to observe based on this diagnosis? 1 Which infection control method should the nurse determine to 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? 1 The client admitted to the hospital with a diagnosis of viral hepatitis is complaining of a loss of appetite. In order to provide adequate nutrition, which action should the nurse encourage the client to take? 2 The nurse caring for a client diagnosed with acute pancreatitis and has a history of alcoholism is monitoring the client for complications. The nurse determines that which data collected is most likely indicative of paralytic ileus? 1 A client with a diagnosis of viral hepatitis has no appetite, and food makes the client nauseated. The nurse should conclude that which intervention is most appropriate? 1 The nurse is participating in a health screening clinic and is preparing materials about colorectal cancer. The nurse should include which risk factor for colorectal cancer in the material? 4 A client has undergone esophagogastroduodenoscopy (EGD). The nurse should place highest priority on which action as part of the client's care plan? 2 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 should the nurse recognize as best supporting the diagnosis of gastric ulcer? 4 A client has been diagnosed with acute gastroenteritis. Which diet should the nurse anticipate to be prescribed for the client? 2 We have an expert-written solution to this problem! A client has a diagnosis of asymptomatic diverticular disease. Which type of diet should the nurse anticipate being prescribed? 2 The nurse is providing care for a client suspected of having appendicitis. Which priority intervention should the nurse anticipate will be prescribed for this client? 4 The nurse has given the client diagnosed with hepatitis instructions about post discharge management during convalescence. The nurse determines a need for further teaching if the client makes which statement? 3 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 most likely suspect that the client has which diagnosis? 4 We have an expert-written solution to this problem! The nurse has been providing care for a client with a Sengstaken-Blakemore tube. While the tube is inflated the nurse should monitor for which priority sign/symptom? 1 A primary health care provider places a Miller-Abbott tube in a client who has a diagnosed 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? 3 The nurse is collecting data on a client with a diagnosis of peptic ulcer disease. Which history should the nurse determine is least likely associated with this disease? 4 We have an expert-written solution to this problem! 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 data finding best indicates adequate location of the tube? 2 The nurse is providing care for a client with a nasogastric tube. Which observation is most appropriate in determining that the tube is correctly placed? 2 We have an expert-written solution to this problem! A client is admitted to the hospital with a diagnosed bowel obstruction secondary to a recurrent diagnosed malignancy. The primary 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 action should the nurse determine is best? 2 The nurse is assisting in planning stress management strategies for the client diagnosed with irritable bowel syndrome. Which suggestion is most appropriate for the nurse to give to the client? 4 We have an expert-written solution to this problem! A calcium supplement is prescribed for a client diagnosed 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? 4 We have an expert-written solution to this problem! 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 will most likely promote coping? Select all that apply. 1,2,5 Which statement by the spouse of a client with diagnosed end-stage liver failure indicates the need for further teaching by the multidisciplinary team regarding management of the client's pain? 3 After the deflation of the balloon of a client's Sengstaken-Blakemore tube, the nurse should monitor the client closely for which priority esophageal complication? 4 The nurse is collecting data on a client admitted to the hospital with a diagnosis of hepatitis. The nurse should determine which data indicates the client may have liver damage? 1 The nurse is reviewing the primary health care provider's prescriptions for a client admitted to the hospital with a diagnosis of liver disease. Which medication prescription should the nurse most question? 4 A nurse organizing care for a client diagnosed with hepatitis plans to meet the client's safety needs by performing which action? 4 The nurse is collecting admission data on the client with a diagnosis of hepatitis. Which finding should the nurse recognize to be a direct result of this client's condition? 2 The nurse is reviewing the health care record of a client with a diagnosis of chronic pancreatitis. The nurse should determine that which data noted in the record indicate poor absorption of dietary fats? 1 We have an expert-written solution to this problem! A client is admitted to an acute care facility with complications of celiac disease. Which question asked by the nurse initially should be most helpful in obtaining information for the nursing care plan? 3 We have an expert-written solution to this problem! A client is seen in the ambulatory care office for a routine examination. Which statement by the client should be most important for the nurse to follow up? 1 A client with a possible hiatal hernia complains of difficulty swallowing. Which other sign/symptom associated with a hiatal hernia should the nurse recognize? 3 The nurse is teaching a client with a newly diagnosed hiatal hernia about measures to prevent recurrence of symptoms. Which statement is most appropriate to be included in the teaching? 2 We have an expert-written solution to this problem! The nurse should document that a client diagnosed with a hiatal hernia is implementing effective health maintenance measures after the client reports doing which action? 1 Implemented treatment measures for a client with a diagnosis of bleeding esophageal varices have been unsuccessful. The primary health care provider states that a Sengstaken-Blakemore tube will be used to control the resulting hemorrhage. The nurse should prepare for insertion of this tube via which route? 2 The nurse is caring for a client with a Sengstaken-Blakemore tube. To effectively prevent ulceration and necrosis of oral and nasal mucosa, the nurse should plan to implement which action? 3 We have an expert-written solution to this problem! 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. The nurse should determine that which data would further support this diagnosis? 4 We have an expert-written solution to this problem! The nurse should include which most appropriate information when reinforcing home care instructions for a client who has been diagnosed with peptic ulcer disease? 3 The nurse is reinforcing dietary instructions for a client diagnosed with peptic ulcer disease. Which action should the nurse encourage the client to do? 3 The nurse has been reinforcing dietary teaching for a client diagnosed 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? 1 A client who has undergone a subtotal gastrectomy is being prepared for discharge. Which considerations concerning ongoing self-management should the nurse reinforce to the client? Select all that apply. 1,3 The nurse who is reinforcing instructions to a client who has had a gastric resection should include which considerations? Select all that apply. 1,3 The nurse should reinforce instructions to a client that has had a gastrectomy about the signs and symptoms of pernicious anemia, knowing what information? 4 We have an expert-written solution to this problem! 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? 2 The nurse is collecting data about how well a client diagnosed with a gastrointestinal (GI) disorder is able to absorb food. While doing this, the nurse recalls that absorption is most concerned with which bodily function? 4 A primary 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? 4 We have an expert-written solution to this problem! The nurse has assisted in the insertion of a Levin tube for gastrointestinal (GI) decompression. The nurse should anticipate a prescription to set the suction to which pressure? 3 A client has had a partial gastrectomy and the nurse is reinforcing discharge instructions. The nurse should reinforce instructions to the client about the need for which supplements? Select all that apply. 2,4,5 The client in an 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. 1,2 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? 3 The nurse is reinforcing discharge instructions to a client who has had a total gastrectomy. The nurse instructs the client about the importance of returning as scheduled to the health care clinic for which priority assessment? 4 We have an expert-written solution to this problem! The nurse assigned to care for a client diagnosed 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? 4 The client arrives at an emergency department complaining 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 primary health care provider's prescriptions. Which prescription should the nurse most likely question if written on the primary health care provider's prescription form? 3 The nurse is caring for a client with a nasogastric (NG) tube and tests the pH of the aspirate to determine correct placement. The test results indicate a pH of 5. The nurse should determine this indicates which information? 2 A generally healthy 63-year-old man is seen in the primary health care provider's office for a routine examination. Which statement made by the client is most important for the nurse to follow up on? 3 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? 2