NP2 ENDO/GI EXAM WITH !| !| !| !|
ANSWERS
A few months after bariatric surgery, a 62-year-old patient tells
!| !| !| !| !| !| !| !| !| !|
the nurse, "My skin is hanging in folds. I think I need cosmetic
!| !| !| !| !| !| !| !| !| !| !| !| !|
surgery." Which response by the nurse is most appropriate?
!| !| !| !| !| !| !| !|
a. !|
"The skinfolds will gradually disappear once most of the weight
!| !| !| !| !| !| !| !| !| !|
is lost."
!|
!|
b. !|
"Perhaps you would like to talk to a counselor about your body
!| !| !| !| !| !| !| !| !| !| !| !|
image."
c. !|
"Cosmetic surgery is certainly a possibility once your weight has
!| !| !| !| !| !| !| !| !| !|
stabilized."
d. !|
"The important thing is that your weight loss is improving your
!| !| !| !| !| !| !| !| !| !| !|
health." - Correct answer ✔c. !| !| !| !| !|
"Cosmetic surgery is certainly a possibility once your weight has
!| !| !| !| !| !| !| !| !| !|
stabilized."
,Response Feedback: Reconstructive surgery may be used to !| !| !| !| !| !| !| !|
eliminate excess skinfolds after at least a year has passed since
!| !| !| !| !| !| !| !| !| !| !|
the surgery. Skinfolds may not disappear over time, especially
!| !| !| !| !| !| !| !| !|
in older patients. The response, "The important thing is that your
!| !| !| !| !| !| !| !| !| !|
weight loss is improving your health" ignores the patient's
!| !| !| !| !| !| !| !| !| !|
concerns about appearance and implies that the nurse knows
!| !| !| !| !| !| !| !| !|
what is important. Whereas it may be helpful for the patient to
!| !| !| !| !| !| !| !| !| !| !| !|
talk to a counselor, it is more likely to be helpful to know that
!| !| !| !| !| !| !| !| !| !| !| !| !| !|
cosmetic surgery is available. !| !| !|
Which information will the nurse plan to include in discharge
!| !| !| !| !| !| !| !| !| !|
teaching for a patient after gastric bypass surgery?!| !| !| !| !| !| !| !|
a. !|
Choose high-fat foods for at least 30% of intake.
!| !| !| !| !| !| !| !|
!|
b. !|
Avoid drinking fluids with meals. !| !| !| !|
!|
c. !|
Choose foods that are high in fiber to promote bowel function.
!| !| !| !| !| !| !| !| !| !|
!|
d. !|
Development of flabby skin can be prevented by daily exercise. !| !| !| !| !| !| !| !| !| !|
- Correct answer ✔Selected Answer:
!| !| !| !| !|
!| b. !|
Avoid drinking fluids with meals. !| !| !| !|
,Response Feedback: Intake of fluids with meals tends to cause
!| !| !| !| !| !| !| !| !| !|
dumping syndrome and diarrhea. Food choices should be low in
!| !| !| !| !| !| !| !| !| !|
fat and fiber. Exercise does not prevent the development of
!| !| !| !| !| !| !| !| !| !|
flabby skin. !|
During change-of-shift report, the nurse receives the following
!| !| !| !| !| !| !| !|
information about a patient who is scheduled for a colonoscopy.
!| !| !| !| !| !| !| !| !| !|
Which information should be communicated to the health care
!| !| !| !| !| !| !| !| !|
provider before sending the patient for the procedure?
!| !| !| !| !| !| !| !|
a. !|
The patient refused to drink the ordered polyethylene glycol
!| !| !| !| !| !| !| !| !|
(GoLYTELY).
!|
b. !|
The patient has a permanent pacemaker to prevent bradycardia.
!| !| !| !| !| !| !| !|
!|
c. !|
The patient has had an allergic reaction to shellfish and iodine
!| !| !| !| !| !| !| !| !| !| !|
in the past.
!| !|
!|
d. !|
The patient is worried about discomfort during the examination.
!| !| !| !| !| !| !| !| !|
- Correct answer ✔Selected Answer:
!| !| !| !| !|
!| a. !|
The patient refused to drink the ordered polyethylene glycol
!| !| !| !| !| !| !| !| !|
(GoLYTELY).
Response Feedback: If the patient has had inadequate bowel
!| !| !| !| !| !| !| !| !|
preparation, the colon cannot be visualized and the procedure !| !| !| !| !| !| !| !| !|
should be rescheduled. Because contrast solution is not used
!| !| !| !| !| !| !| !| !|
during colonoscopy, the iodine allergy is not pertinent. A
!| !| !| !| !| !| !| !| !|
, pacemaker is a contraindication to magnetic resonance imaging
!| !| !| !| !| !| !| !|
(MRI), but not to colonoscopy. The nurse should instruct the
!| !| !| !| !| !| !| !| !| !|
patient about the sedation used during the examination to
!| !| !| !| !| !| !| !| !|
decrease the patient's anxiety about discomfort.
!| !| !| !| !|
Which action by unlicensed assistive personnel (UAP) when
!| !| !| !| !| !| !| !|
caring for a patient who has just returned to the nursing unit
!| !| !| !| !| !| !| !| !| !| !| !|
after an esophagogastroduodenoscopy (EGD) requires that the
!| !| !| !| !| !| !|
RN intervene?
!| !|
!|
!|
a. !|
Swabbing the patient's mouth with cold water !| !| !| !| !| !|
!|
b. !|
Checking the vital signs every 30 minutes!| !| !| !| !| !|
!|
c. !|
Positioning the patient on the right side !| !| !| !| !| !|
!|
d. !|
Offering the patient a glass of water - Correct answer ✔Selected
!| !| !| !| !| !| !| !| !| !| !|
Answer: d. !| !|
Offering the patient a glass of water
!| !| !| !| !| !|
Response Feedback: Immediately after EGD, the patient will
!| !| !| !| !| !| !| !|
have a decreased gag reflex and is at risk for aspiration.
!| !| !| !| !| !| !| !| !| !| !|
Assessment for return of the gag reflex should be done by the !| !| !| !| !| !| !| !| !| !| !| !|
RN. The other actions by the NAP are appropriate.
!| !| !| !| !| !| !| !|
ANSWERS
A few months after bariatric surgery, a 62-year-old patient tells
!| !| !| !| !| !| !| !| !| !|
the nurse, "My skin is hanging in folds. I think I need cosmetic
!| !| !| !| !| !| !| !| !| !| !| !| !|
surgery." Which response by the nurse is most appropriate?
!| !| !| !| !| !| !| !|
a. !|
"The skinfolds will gradually disappear once most of the weight
!| !| !| !| !| !| !| !| !| !|
is lost."
!|
!|
b. !|
"Perhaps you would like to talk to a counselor about your body
!| !| !| !| !| !| !| !| !| !| !| !|
image."
c. !|
"Cosmetic surgery is certainly a possibility once your weight has
!| !| !| !| !| !| !| !| !| !|
stabilized."
d. !|
"The important thing is that your weight loss is improving your
!| !| !| !| !| !| !| !| !| !| !|
health." - Correct answer ✔c. !| !| !| !| !|
"Cosmetic surgery is certainly a possibility once your weight has
!| !| !| !| !| !| !| !| !| !|
stabilized."
,Response Feedback: Reconstructive surgery may be used to !| !| !| !| !| !| !| !|
eliminate excess skinfolds after at least a year has passed since
!| !| !| !| !| !| !| !| !| !| !|
the surgery. Skinfolds may not disappear over time, especially
!| !| !| !| !| !| !| !| !|
in older patients. The response, "The important thing is that your
!| !| !| !| !| !| !| !| !| !|
weight loss is improving your health" ignores the patient's
!| !| !| !| !| !| !| !| !| !|
concerns about appearance and implies that the nurse knows
!| !| !| !| !| !| !| !| !|
what is important. Whereas it may be helpful for the patient to
!| !| !| !| !| !| !| !| !| !| !| !|
talk to a counselor, it is more likely to be helpful to know that
!| !| !| !| !| !| !| !| !| !| !| !| !| !|
cosmetic surgery is available. !| !| !|
Which information will the nurse plan to include in discharge
!| !| !| !| !| !| !| !| !| !|
teaching for a patient after gastric bypass surgery?!| !| !| !| !| !| !| !|
a. !|
Choose high-fat foods for at least 30% of intake.
!| !| !| !| !| !| !| !|
!|
b. !|
Avoid drinking fluids with meals. !| !| !| !|
!|
c. !|
Choose foods that are high in fiber to promote bowel function.
!| !| !| !| !| !| !| !| !| !|
!|
d. !|
Development of flabby skin can be prevented by daily exercise. !| !| !| !| !| !| !| !| !| !|
- Correct answer ✔Selected Answer:
!| !| !| !| !|
!| b. !|
Avoid drinking fluids with meals. !| !| !| !|
,Response Feedback: Intake of fluids with meals tends to cause
!| !| !| !| !| !| !| !| !| !|
dumping syndrome and diarrhea. Food choices should be low in
!| !| !| !| !| !| !| !| !| !|
fat and fiber. Exercise does not prevent the development of
!| !| !| !| !| !| !| !| !| !|
flabby skin. !|
During change-of-shift report, the nurse receives the following
!| !| !| !| !| !| !| !|
information about a patient who is scheduled for a colonoscopy.
!| !| !| !| !| !| !| !| !| !|
Which information should be communicated to the health care
!| !| !| !| !| !| !| !| !|
provider before sending the patient for the procedure?
!| !| !| !| !| !| !| !|
a. !|
The patient refused to drink the ordered polyethylene glycol
!| !| !| !| !| !| !| !| !|
(GoLYTELY).
!|
b. !|
The patient has a permanent pacemaker to prevent bradycardia.
!| !| !| !| !| !| !| !|
!|
c. !|
The patient has had an allergic reaction to shellfish and iodine
!| !| !| !| !| !| !| !| !| !| !|
in the past.
!| !|
!|
d. !|
The patient is worried about discomfort during the examination.
!| !| !| !| !| !| !| !| !|
- Correct answer ✔Selected Answer:
!| !| !| !| !|
!| a. !|
The patient refused to drink the ordered polyethylene glycol
!| !| !| !| !| !| !| !| !|
(GoLYTELY).
Response Feedback: If the patient has had inadequate bowel
!| !| !| !| !| !| !| !| !|
preparation, the colon cannot be visualized and the procedure !| !| !| !| !| !| !| !| !|
should be rescheduled. Because contrast solution is not used
!| !| !| !| !| !| !| !| !|
during colonoscopy, the iodine allergy is not pertinent. A
!| !| !| !| !| !| !| !| !|
, pacemaker is a contraindication to magnetic resonance imaging
!| !| !| !| !| !| !| !|
(MRI), but not to colonoscopy. The nurse should instruct the
!| !| !| !| !| !| !| !| !| !|
patient about the sedation used during the examination to
!| !| !| !| !| !| !| !| !|
decrease the patient's anxiety about discomfort.
!| !| !| !| !|
Which action by unlicensed assistive personnel (UAP) when
!| !| !| !| !| !| !| !|
caring for a patient who has just returned to the nursing unit
!| !| !| !| !| !| !| !| !| !| !| !|
after an esophagogastroduodenoscopy (EGD) requires that the
!| !| !| !| !| !| !|
RN intervene?
!| !|
!|
!|
a. !|
Swabbing the patient's mouth with cold water !| !| !| !| !| !|
!|
b. !|
Checking the vital signs every 30 minutes!| !| !| !| !| !|
!|
c. !|
Positioning the patient on the right side !| !| !| !| !| !|
!|
d. !|
Offering the patient a glass of water - Correct answer ✔Selected
!| !| !| !| !| !| !| !| !| !| !|
Answer: d. !| !|
Offering the patient a glass of water
!| !| !| !| !| !|
Response Feedback: Immediately after EGD, the patient will
!| !| !| !| !| !| !| !|
have a decreased gag reflex and is at risk for aspiration.
!| !| !| !| !| !| !| !| !| !| !|
Assessment for return of the gag reflex should be done by the !| !| !| !| !| !| !| !| !| !| !| !|
RN. The other actions by the NAP are appropriate.
!| !| !| !| !| !| !| !|