MEDICAL SURGICAL PRACTICE QUESTIONS AND ANSWERS

A nurse is collecting data from a client who has peptic ulcer disease. Which of the following finding is a manifestation of gastrointestinal perforation?

Réponse: ANS: Severe upper abdominal pain. Sudden, severe abdominal pain that radiates to the shoulder is a manifestation of gastrointestinal perforation.

A nurse is reinforcing dietary teaching with a client who tells the nurse she would like to reduce her solid fat intake and increase oil intake in her diet. Which of the following instructions should the nurse include in her teaching?

Réponse: ANS: Use safflower oil instead of butter when baking The client should replace butter with safflower oil when baking to decrease solid fats and increase oil intake.

A nurse is administering a tap water enema to a client. The client reports cramping as the nurse instills the irrigating solution. Which of the following actions should the nurse take to relieve the client’s discomfort?

Réponse: ANS: Lower the height of the solution container If nausea or cramping occurs, the nurse should slow the flow of water, leaving the tube in place. The nurse should then raise the solution container when the cramping has passed.

A nurse is reinforcing teaching with a client how has Cron’s Disease and is experiencing frequent cramping and diarrhea. Which of the following statements should the nurse include in the teaching?

Réponse: ANS: Increase your caloric intake by eating foods high in protein Clients who have Crohn\'s disease are at risk for malnutrition; therefore, they should eat a diet high in protein to help maintain their weight and promote healing and recovery.

A nurse is reinforcing teaching with a client that reports having constipation. Which of the following should the nurse discuss as causes of constipation? (Select all that apply)

Réponse: ANS: Excessive laxative use. Chronic use of laxatives causes the large intestine to lose muscle tone and become less responsive to stimulation by laxatives. Ignoring the urge to defecate. Anything that prevents the client from responding to the urge to defecate and disrupts regular habits can cause possible alterations in bowel habits, such as constipation. Inadequate fluid intake. Reduced fluid intake slows the passage of food through the intestine and can result in hardening of stool.

A nurse is reinforcing teaching for a client who has a duodenal ulcer and a new prescriptions for sucralfate. The client asks the nurse how sucralfate works. Which of the following statements should the nurse take?

Réponse: ANS: This medication adheres to the ulcer and protects it from gastric acid Sucralfate creates a protective coating over the ulcer that lasts about 6 hrs.

A charge nurse is reinforcing teaching with a newly licensed nurse about the common link between ulcerative colitis and Crohn’s disease. Which of the following statements by the newly licensed nurse indicates an understanding of the teaching?

Réponse: ANS: Both illnesses are inflammatory in nature The nurse should reinforce that there are many linking components between ulcerative colitis and Crohn\'s disease, one of them being the inflammatory nature of the illnesses. Other similarities include a genetic component, the chronicity of the illnesses, and the predominant manifestation of both diseases is diarrhea.

A nurse is reinforcing teaching about a high-fiber diet with a client who has constipation. Which of the following statement indicates the client understands the best choice for a high-fiber diet?

Réponse: ANS: My breakfast is ½ cup of bran cereal The client who selects ½ cup of bran cereal is selecting the best source of fiber. A ½ cup of bran cereal contains 8.8 g per serving of fiber; therefore, it is the best food choice for the client.

A nurse is reinforcing teaching with a client who has GERD. Which of the following statements should the nurse include in the teaching?

Réponse: ANS: Avoid wearing constricting clothing The nurse should instruct the client to wear clothing that is comfortably fitting and not restrictive around the middle of the body. This increases the abdominal pressure and reflux.

A nurse is assessing a client who has advanced cirrhosis. Which of the following manifestation should the nurse expect to find?

Réponse: ANS: Spider angioma The nurse should expect to find spider angioma, which indicates portal hypertension, on the client who has advanced cirrhosis.