RN targeted medical surgical gastrointestinal online practice 2023

a nurse is caring for a client in an endoscopy suite at a surgical center.

a nurse is assessing the client following the procedure. which of the following findings should the nurse report to the provider?

select all that apply.

throat sensation

voice quality

temperature

oxygen saturation

pain

swallowing ability

bloating

-swallowing ability

-pain

-oxygen saturation

-temperature

a nurse is caring for a client on a medical-surgical unit.

click to highlight the findings that require immediate follow-up. to deselect a finding, click on the finding again.

nurses notes:

drainage from NG is dark brown drainage with small amount of old blood noted.

coughing and hoarse voice after swallowing.

client supports abdomen when coughing.

client reports feeling of abdominal fullness and is unable to belch.

vital signs:

day 9:

oxygen saturation 90% on room air

-coughing and hoarse voice after swallowing.

-oxygen saturation 90% on room air

-client reports feeling of abdominal fullness and is unable to belch.

a nurse is assessing a client who has acute hepatitis B. which of the following findings should the nurse expect?

-joint pain

Joint pain is an expected finding in a client who has acute hepatitis B.

a nurse is admitting a client who has acute pancreatitis. which of the following actions should the nurse take first?

-identify the client's current level of pain

The first action the nurse should take when using the nursing process is to assess the client. Clients who have acute pancreatitis often have severe abdominal pain. By assessing the client's level of pain, the nurse can identify the need for, and implement interventions, to alleviate the client's pain. Therefore, this is the priority action the nurse should take.

a nurse is assessing a client who is postoperative following a gastrectomy. the nurse should identify which of the following findings as an indication of abdominal distension?

-hiccups

Following surgery, hiccups can be caused by irritation of the phrenic nerve, due to abdominal distension. If the hiccups are intractable, the nurse should anticipate a prescription for chlorpromazine. This is because persistent hiccups are distressful to the client and can lead to complications, such as vomiting.

a nurse is providing discharge teaching for a client who has peptic ulcer disease and a new prescription for once daily famotidine. which of the following statements by the client indicates an understanding of the teaching?

-"i should take this medication at bedtime."

The nurse should instruct the client to take the medication at bedtime to inhibit the overnight action of histamine at the H2-receptor site in the stomach.

a nurse is providing dietary teaching for a client who has a new diagnosis of celiac disease. which of the following statements by the client indicates an understanding of the teaching?

-"I will eat beans to ensure I get enough fiber in my diet."

Clients who have celiac disease must maintain a gluten-free diet, which eliminates fiber-rich whole wheat products. Clients should eat beans, nuts, fruits, and vegetables to ensure an adequate intake of fiber.

a nurse is providing dietary teaching for a client who has chronic pancreatitis. which of the following food selections by the client indicates an understading of the teaching?

-8 oz (0.24 L) sliced banana

Foods that are high in fat can cause diarrhea for clients who have pancreatitis. 8 oz (0.24 L), or 1 cup of sliced banana, which contains 0.49 g of fat, is a low-fat food option. Clients who have pancreatitis should consume a high-protein and low-fat diet with an adequate amount of carbohydrates and calories.

a nurse is assessing a client who has appendicitis. which of the following findings should the nurse expect? (Select all that apply.)

oral temperature of 38.4 C (101.1 F)

decreased WBC count

bloody diarrhea

N/V

RLQ pain

-oral temperature of 38.4 C (101.1 F)

-nausea and vomiting

-right lower quadrant pain

a nurse is assessing a client who has peritonitis. which of the following findings should the nurse expect?

-board-like abdomen

A board-like, distended abdomen, accompanied by extreme pain and tenderness, is an expected finding for a client who has peritonitis.

a nurse is caring for a client who has ulcerative colitis. the client has had several exacerbations over the past 3 years. which of the following instructions should the nurse include in the plan of care to minimize the risk of further exacerbations? (Select all that apply.)

use progressive relaxation techniques

increase dietary fiber intake

drink two 8 oz (240 mL) glasses of milk per day

arrange activities to allow for daily rest periods

restrict intake of carbonated beverages

-use progressive relaxation techniques

-arrange activities to allow for daily rest periods

-restrict intake of carbonated beverages

a nurse is assessing a client immediately following a paracentesis for the treatment of ascites. which of the following findings indicates the procedure was effective?

-decreased shortness of breath

Increased abdominal fluid can limit the expansion of the diaphragm and prevent the client from taking a deep breath. After excess peritoneal fluid is removed, the diaphragm will expand more freely. The nurse should identify this finding as an indicator that the procedure was effective.

a nurse is teaching a client how to prepare for a colonoscopy. which of the following instructions should the nurse include in the teaching?

-"Drink clear liquids for 24 hr prior to the procedure, then nothing by mouth for 6 hr before the procedure."

The nurse should instruct the client to drink clear liquids for 24 hr prior to the colonoscopy to promote adequate bowel cleansing.

a nurse is assessing a client who has a duodenal ulcer. which of the following findings should the nurse expect?

-the client reports that pain occurs during the night

Pain associated with a duodenal ulcer occurs when the stomach is empty, which is typically 1.5 to 3 hr after meals and during the night.

a nurse is reviewing the laboratory results of a client who has acute pancreatitis. which of the following findings should the nurse expect?

-increased amylase

Serum amylase levels are increased in a client who has acute pancreatitis, due to pancreatic cell injury.

a nurse is caring for a client who has GERD and a new prescription for metoclopramide. the nurse should plan to monitor for which of the following adverse effects?

-ataxia

The nurse should plan to monitor the client for extrapyramidal symptoms, such as ataxia, and should report any of these findings to the provider.

a nurse is providing dietary teaching for a client who is postoperative following a gastrectomy. which of the following foods should the nurse encourage the client to include in their diet to reduce the risk for dumping syndrome?

-eggs

The nurse should instruct the client to increase dietary intake of protein-containing foods, such as eggs, to decrease the risk for manifestations of dumping syndrome. The client should eat some form of protein at each meal.

a nurse is providing discharge teaching for a client who has a new colostomy pouch and is concerned about flatus and odor. which of the following foods should the nurse recommend to the client?

-yogurt

The nurse should recommend yogurt, crackers, and toast, which can prevent flatus and stool odor.

a nurse is reviewing the prescriptions for a client who has Campylobacter enteritis. which of the following prescriptions should the nurse clarify with the provider?

-magnesium hydroxide

Nausea, vomiting, and diarrhea are manifestations of C. enteritis. The nurse should clarify a prescription for magnesium hydroxide, also known as milk of magnesia, with the provider. This medication increases gastrointestinal motility, which can increase the client's risk for an electrolyte imbalance and contribute to dehydration.

a nurse is providing discharge teaching for a client who has GERD. which of the following statements by the client indicates an understading of the teaching?

-"i will decrease the number of carbonated beverages i drink."

The nurse should instruct the client to limit or eliminate fatty foods, coffee, tea, carbonated beverages, and chocolate from the diet, because they irritate the lining of the stomach.

a nurse is caring for a client who has colorectal cancer and is receiving chemotherapy. the client asks the nurse why blood is being drawn for a carcinoembryonic antigen (CEA) level. which of the following responses should the nurse make?

-"the CEA determines the efficacy of your chemotherapy."

A provider uses the CEA level to determine the efficacy of the chemotherapy. The client's CEA levels will decrease if the chemotherapy is effective.

a nurse is reviewing the laboratory values of a client who has colorectal cancer. which of the following findings should the nurse expect?

-decreased hemoglobin

Decreased hemoglobin is an expected finding in a client who has colorectal cancer, due to occult intestinal bleeding.

a nurse is providing discharge teaching for a client who has mild diverticulitis. which of the following statements by the client indicates an understading of the teaching?

-"i should eat foods that are low in fiber."

The nurse should instruct a client who has diverticulitis to follow a low-fiber diet. When the inflammation subsides, the client should consume foods that are high in fiber.

a nurse is providing teaching for a client who has cirrhosis and a new prescription for lactulose. which of the following instructions should the nurse include in the teaching?

-expect to have 2 to 3 soft stools per day.

The purpose of administering lactulose is to promote the excretion of ammonia in the stool. The nurse should instruct the client to take the medication every day and inform the client that 2 to 3 bowel movements every day is the treatment goal.

a nurse is reviewing the laboratory results of a client who has hepatic cirrhosis. which of the following laboratory findings should the nurse report to the provider?

-increased ammonia level

The nurse should report an increased ammonia level for clients who have hepatic cirrhosis, because it can indicate portal-systemic encephalopathy.

a nurse is providing discharge teaching for a client who has a new prescription for medications to treat peptic ulcer disease. the nurse should inform the client that which of the following medications inhibits gastric acid secretion?

-famotidine

The nurse should inform the client that famotidine is an H2-receptor antagonist that is prescribed for the treatment of peptic ulcer disease to inhibit the secretion of gastric acid.

a nurse is assessing a client who has Crohn's disease. which of the following findings should the nurse expect?

-fatty diarrheal stools

Steatorrhea, or fatty stool, is an expected finding in a client who has Crohn's disease.

a nurse is assessing a client who has upper gastrointestinal bleeding. which of the following findings should the nurse expect?

-hypotension

A client who has upper gastrointestinal bleeding is at risk for hemorrhagic shock. Hypotension is a manifestation of hemorrhagic shock.

a nurse is caring for a client who has a new ileostomy.

click to highlight the day 4 findings that require immediate follow-up. to deselect a finding, click on the finding again.

ileostomy pouch changed

skin around the stoma is inflamed and excoriated

client will not look at stoma

client states they are not interested in learning about stoma care

ileostomy stoma is red

urine output 650 mL/24 hr

weight 78.2 kg (172 lb)

stoma draining moderate brown liquid stool

client placed on a low-residue diet

client reports abdominal cramping, abdomen is distended and firm

-skin around the stoma is inflamed and excoriated

-client will not look at stoma

-client states they are not interested in learning about stoma care

-urine output 650 mL/24 hr

-weight 78.2 kg (172 lb)

-client reports abdominal cramping, abdomen is distended and firm

a nurse in the emergency department (ED) is caring for a male client.

complete the diagram by dragging from the choices below to specify what condition the client is most likely experiencing, 2 actions the nurse should take to address that condition, and 2 parameters the nurse should monitor to assess the client's progress.

actions to take:

-obtain a stool culture

-prepare to insert a NG (nasogastric) tube for the client

-prepare to administer insulin to the client

-prepare to administer a bismuth salt

-place the client on contact precautions

potential condition:

-pancreatitis

-ulcerative colitis

-c. difficile infection

-peptic ulcer disease

parameters to monitor:

-h. pylori level

-blood in stools

-amylase level

-erythrocyte sedimentation rate

-jaundice

actions to take:

-prepare to insert a NG (nasogastric) tube for the client

-prepare to administer insulin to the client

potential condition:

-pancreatitis

parameters to monitor:

-amylase level

-jaundice