Gastrointestinal

56問 • 1年前

問題一覧

A nurse is planning a community health program about screening for cancer. Which information recommended by the American Cancer Society (ACS) should the nurse include?

Fecal occult blood testing should be performed yearly beginning at age 50 years.

A nurse is teaching an athletic teenager about nutrients that provide the quickest source of energy. Which food selected from a menu indicates to the nurse that the adolescent understands the teaching?

Glass of orange juice

A nurse identifies that the client understands information about vitamin K when the client states, “Vitamin K is:

produced in sufficient amounts by intestinal bacteria, so metabolic needs are met.”

A client describes abdominal discomfort following ingestion of milk. Which enzyme, as a result of a genetic deficiency, should the nurse consider to be the cause of the client’s discomfort?

Lactase

A nurse is caring for a client who is cachectic. What information about the function of adipose tissue in fat metabolism is necessary to better address the needs of this client?

Stores triglycerides for energy reserves

A nurse is teaching a client about the differences between the terms saturated and unsaturated, when used in reference to fats. Which important factor in relation to these types of fats should the nurse include in the teaching?

Density

A nurse is teaching menu planning to a client who has a high triglyceride level. Which nutrient avoided by the client indicates that teaching about foods that are high in fat was understood?

Red meat

A client with a high cholesterol level says to the nurse, “Why can’t the doctor just give me a medication to eliminate all the cholesterol in my body so it isn’t a problem?” Which factor related to why cholesterol is important in the human body should the nurse include in a response to the client’s question?

Cellular membranes

Which statement made by a client after attending a class on nutrition indicates an understanding of the importance of essential amino acids?

“They come from the diet because they cannot be synthesized in the body.”

A nurse provides dietary teaching about a low-sodium diet for a client with hypertension. Which nutrient selected by the client indicates an understanding about foods that are low in natural sodium?

Fruits

Megadoses of vitamin A are taken by a client. Why should the nurse question this practice?

The liver has a great storage capacity for vitamin A, even to toxic amounts.

A nurse is teaching about excellent food sources of vitamin A for a client who is deficient in this vitamin. Which foods should the nurse include in the teaching? Select all that apply.

Cantaloupe, Carrots

A client who recently immigrated to the United States has a chronic vitamin A deficiency. What information about vitamin A should the nurse consider when assessing this client for clinical indicators of this deficiency?

It is a necessary element of rhodopsin, which controls responses to light and dark environments.

A client is to have gastric gavage. In which position should the nurse place the client when the nasogastric tube is being inserted?

High-Fowler

A client with the diagnosis of cancer of the stomach expresses aversion to meals and eats only small amounts. What should the nurse provide?

Small portions more frequently

A health care provider schedules a paracentesis. What should the nurse instruct the client to do to prepare for the procedure?

Empty the bladder before the procedure.

A health care provider orders an upper GI series and a barium enema. The client asks, “Why do I have to have barium for these tests?” The nurse’s best response is “Barium:

gives more contrast to the soft tissue of the alimentary tract, allowing absorption of x-rays.”

A client is scheduled for a sigmoidoscopy. What instruction should the nurse provide the client in preparation for this diagnostic procedure?

Have an enema the morning of the test.

A health care provider orders a sigmoidoscopy for one client and a barium enema for another client. What is a nursing responsibility common to preparing both of these clients for these procedures?

Ensuring an understanding of the procedure

A high-cleansing enema is ordered for a client. What is the maximum height at which the container of fluid should be held by the nurse when administering this enema?

37 cm (15 inches)

During administration of an enema, a client reports having intestinal cramps. What should the nurse do?

Stop the fluid until the cramps subside.

A nurse is evaluating a client’s response to receiving an intermittent gravity flow percutaneous endoscopic gastrostomy (PEG) tube feeding. Which clinical finding indicates that the client is unable to tolerate a continuation of the feeding?

Rise of formula in the tube

A client has a nasogastric feeding tube inserted, and the health care provider orders the prescribed feeding to be instituted immediately. What should the nurse do first?

Obtain an x-ray to verify that the tube is in the stomach.

Three days after admission to the hospital for a brain attack (cerebrovascular accident [CVA]), a client has a nasogastric tube inserted and is receiving continuous tube feedings. What should the nurse do to best evaluate whether the feeding is being absorbed?

Aspirate for a residual volume.

A client is receiving hypertonic tube feedings. What should the nurse consider to be the main reason this client may experience diarrhea?

High osmolarity of the feedings

A health care provider orders intermittent nasogastric tube feeding to supplement a client’s oral nutritional intake. Which hazard associated with a nasogastric tube feeding will be reduced if the nurse administers this feeding over 30 to 60 minutes?

Regurgitation

A client has a fractured mandible that is immobilized with wires. For which life-threatening postoperative problem should the nurse monitor this client?

Vomiting

A client who had an incision and drainage of an oral abscess is to be discharged. For which clinical finding, if it should occur, should the nurse instruct the client to notify the health care provider?

Pain with swelling after one week

A nurse is obtaining a history and performing a physical assessment of a client who has cancer of the tongue. Which clinical findings should the nurse expect to identify? Select all that apply

Leukoplakia, Alterations in taste, Enlarged cervical lymph nodes

A nurse is collecting a health history from a client who has a diagnosis of cancer of the tongue. For which risk factor commonly associated with cancer of the tongue should the nurse assess when collecting the client’s history?

Large consumption of alcohol

A client with gastroesophageal reflux disease reports having difficulty sleeping at night. What should the nurse instruct the client to do?

Elevate the head of the bed on blocks.

A client with gastroesophageal reflux is to receive metoclo- pramide (Reglan) 15 mg orally before meals. The concen- trated solution contains 10 mg/mL. How much solution should the nurse administer? Record your answer using one decimal place.

1.5 ml

A nurse is providing discharge instructions for a client with a diagnosis of gastroesophageal reflux disease (GERD). What should the nurse advise the client to do to limit symp- toms of GERD? Select all that apply

Avoid heavy lifting, Avoid drinking alcohol, Eat small, frequent meals.

A client with gastric ulcer disease asks the nurse why the health care provider has prescribed metronidazole (Flagyl). The nurse explains, “Antibiotics are prescribed to:

treat Helicobacter pylori infection.”

A client with gastroesophageal reflux disease (GERD) should make diet and lifestyle changes. What instructions should the nurse include in the client’s discharge teaching? Select all that apply.

Avoid caffeine-containing products., Chew thoroughly while eating slowly

A client with esophageal cancer is to receive total parenteral nutrition. A right subclavian catheter is inserted. What should the nurse consider is the primary reason why the health care provider ordered a central line?

The large amount of blood helps to dilute the concentrated solution.

A client with inflammatory bowel disease is receiving total parenteral nutrition (TPN) via an infusion pump. What is most important for the nurse to do when administering TPN?

Change the TPN solution bag every 24 hours, even if there is solution left in the bag.

A client has a suspected peptic ulcer in the duodenum. What should the nurse expect the client to report when describing the pain associated with this disease?

A gnawing sensation relieved by food

Famotidine (Pepcid) 20 mg IVPB is prescribed for a client with a duodenal ulcer. The medication is diluted in 50 mil- liliters of 5% dextrose and is to infuse over 15 minutes. At what rate should the infusion control device be set? Record your answer using a whole number.

200 ml/hr

A client is scheduled for a pyloroplasty and vagotomy because of strictures caused by ulcers unresponsive to medical therapy. What information about the purpose of a vagotomy should the nurse include when reviewing the health care provider’s discussion with the client?

Decreases secretions in the stomach

After a subtotal gastrectomy for cancer of the stomach, a client develops dumping syndrome. The client says, “What does it mean when the health care provider said that I am experiencing dumping syndrome?” What information should the nurse include in a response to this question?

Rapid passage of concentrated fluid into the small intestine

An exploratory laparotomy is performed on a client with melena, and gastric cancer is discovered. A partial gastrectomy is performed, and a jejunostomy tube is surgically implanted. A nasogastric tube to suction is in place. What should the nurse expect regarding the client’s nasogastric tube drainage during the first 24 hours after surgery?

Contain some blood and clots

Two hours after a subtotal gastrectomy, the nurse identifies that the drainage from the client’s nasogastric tube is bright red. What should the nurse do first?

Determine that this is an expected finding.

A client is admitted to the surgical unit from the postanesthesia care unit with a Salem sump nasogastric tube that is to be attached to wall suction. Which nursing action should the nurse implement when caring for this client?

Use normal saline to irrigate the tube.

After a partial gastrectomy is performed, a client is returned from the postanesthesia care unit to the surgical unit with an IV solution infusing and a nasogastric tube in place. The nurse identifies that there is no nasogastric drainage for 30 minutes. There is an order for instillation of the nasogastric tube prn. The nurse should instill:

30 mL of normal saline and continue the suction.

A client is admitted to the hospital with a diagnosis of intestinal obstruction. The health care provider orders intestinal suction via a nasoenteric decompression tube. The loss of which constituents associated with intestinal suctioning is most important to consider when caring for this client?

Water and electrolytes

When an intestinal obstruction is suspected, a client has a nasogastric tube inserted and attached to suction. For what response should the nurse critically assess this client?

Fluid deficit

A nurse designs a health teaching program specifically for a client who had a gastrectomy. What should this plan include?

Information about how to limit and prevent dumping syndrome

When caring for a client who is recovering from a gastrectomy, a nurse is concerned about the potential development of pernicious anemia. What should the nurse conclude may be the cause of this complication?

Parietal cells of the stomach secrete the intrinsic factor.

After a subtotal gastrectomy a client is returned to the surgical unit. Which is the best nursing action to prevent pulmonary complications?

Promoting frequent turning and deep breathing to mobilize secretions

An older adult is returned to the surgical unit after having a subtotal gastrectomy. Which dietary modification should the nurse anticipate that the health care provider will most likely order?

Resume small, easily digested feedings gradually.

To help prevent long-term complications associated with gastric bypass surgery, the nurse needs to educate the client. Identify the factors that should be included in the nurse’s teaching plan for this client. Select all that apply

Eat foods rich in calcium., Consume a diet high in protein., Receive vitamin B12 injections routinely.

Six weeks after discharge, a client with a jejunoileal bypass for morbid obesity returns to the outpatient clinic reporting palpitations, abdominal cramps, diarrhea, and dizziness 30 minutes after meals. What complication should the nurse consider that the client is most likely experiencing?

Dumping syndrome

Which statement by a client who is scheduled for bariatric surgery indicates to the nurse that further preoperative teaching is necessary?

“I’m going to have a figure like a model in about a year.”

A nurse is preparing a morbidly obese client for gastric bypass surgery. What should the nurse teach the client to do after surgery?

Take medications in liquid form.

Which clinical indicator should the nurse identify before scheduling a client for an endoscopic retrograde cholangio- pancreatography (ERCP)?

Bilirubin level

M#4 Proteins

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M#4 Proteins