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38 Cards in this Set
- Front
- Back
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A patient's vomitus is dark brown and has a coffee-ground appearance. the nurse recognizes that this emsis is charactristic of:
a. stomach bleeding b. an intestinal obstruction c. bile reflux d. active bleeding of lower esophagus |
a. stomach bleeding
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A patient who has been vomiting for several dasy from an unknown cause is admitted to hospital. the nurse anticipates collaborative care to indlude:
a. oral admin of broth and tea b. admin of paretneral antiemetics c. insertion of NG tube to suction d. IV replacement of fluid and electrolytes |
d. IV replacement of fluid and electrolytes
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Zofran is prescribed for a patient with cancer chemo induced vomiting. The nurse understands this drug:
a. is a derivative of cannabis b. has a strong antihistamine effect that provides sedation and slee c. is used only when othertherapies are ineffective d. relieves vomiting centrally by action in the vomiting center and peripherally by promoting gastric emptying |
d. relieves vomiting centrally by action in the vomiting center and peripherally by promoting gastric emptying
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A patient with oral cancer has a history of heavy smoking, excessive alcohol intake, and personal neglect. During the patient's early postop course the nurse anticpates that the patient may need:
a. oral nutritional supplements b. drug therapy to prevent substance withdrawal symptoms c. less pain mes d. counseling |
b. drug therapy to prevent substance withdrawal symptoms
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the nurse teaches the patient with a hiatal hernia or GERD to control symptoms by:
a. drinking 10-12 oz of water with meals b. spacing six small meals a day c. sleeping wit hthe head of the bed elevated 4-6 inches d. perfrming aily exercises of toe touching |
c. sleeping wit hthe head of the bed elevated 4-6 inches
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A patient is returned to the surgical unit following a laparoscopic fundoplication for repair of hiatal hernia with an IV, NG tube t osuction, and several small abdominal incisions. to prevent disruption of the surgical site, it is most important for the nurse to:
a. monitor for return of perstalsis b. position the patient on the right side c. maintain the patency of the NG tube d. assess abdominal wounds |
c. maintain the patency of the NG tube
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Nursing management of the patient with chronic gastritis includes teaching the patient to:
a. maintain a bland diet with six small meals a day b. take antacids before meals c. use NSAIDS instead of aspirin for pain relief d. eliminate alcohol and caffeine from diet |
a. maintain a bland diet with six small meals a day
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Patient admitted to ER has profuse bright-red hematemesis. During intial care of the patient, the nurse's first priority is to:
a. perform a nursing assessment of patient's status b. establish 2 IV sites c. obtain a thorough health history d. perform a gastric lavage with cool tap water in prep for endoscopic exam |
a. perform a nursing assessment of patient's status
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In teaching patients at risk for upper GI bleeding to prevent bleeding episodes, the nurse stresses that:
a. all stools and vomit must be tested for blood b. the use of over the counter meds of any kind should be avoided c. antacids should be taken with all prescribed meds dd. Cytotec should be used to protect gastric mucosa |
b. the use of over the counter meds of any kind should be avoided
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Management of patient with upper GI bleeding is effective the lab results reveal:
a. decreasing BUN b. normal hematocrit c. urine output of 20 ml hr d. specific gravity of 1.03 |
a. decreasing BUN
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Regardless of precipitating factor, the injury to mucosal cells in PUD is caused by:
a. acid back-diffusion into the mucosa b. ammonia formation in the mucus wall c. breakdown of gastric mucosal barrier d. release of histamine for cells |
a. acid back-diffusion into the mucosa
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Patient with an ulcer of the posterior portion of duodenum experiences:
a. pain that occurs after not eating all day b. back pain that occurs 2-4 hrs after eating c. midepigastric pain unrelieved with antacids d. high epigastric burning relieved with food intake |
b. back pain that occurs 2-4 hrs after eating
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Diagnostic testing is planned fr a patient with suspected peptic ulcer. Most reliable test is:
a. endoscopy b. gastric analysis c. barium swallow d. serologic test for H pylori |
a. endoscopy
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Nurse teaches a patient with newly diagnosed PUD to
a. maintain bland diet b. use alcohol and caffeine in moderation c. eat as normally as possible, eliminating foods that cause pain d. avoid milk and milk products |
c. eat as normally as possible, eliminating foods that cause pain
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Teaching is effective when atient with PUD states:
a. " I should stop all meds if i develop side effects" b. "i should cintinue treatemnt as long as i have pain" c. "i have learned some relaxation strategies that decrease my stress" d. "i can buy whatever antacids are on sale" |
c. "i have learned some relaxation strategies that decrease my stress"
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Patient with history of PUD is hospitalized with symptoms of a perforation. During initial assessment nurse would expect to find:
a. vomit of bright red blood b. projectile vomiting c. sudden, severe upper abdominal pain and shoulder pain d. hyperactive stomach sounds |
c. sudden, severe upper abdominal pain and shoulder pain
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A patient with NG tube develops nausea and increased upper abominal bowel sounds. Appropriate action is to:
a. check the patency of the NG tube b. place client in recumbant position c. assess vital signs d. ecourage deep breathing |
a. check the patency of the NG tube
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Following a Billroth 2 procedure, atient develops dumping syndrome. The nurse explains that the symptoms associated wti h this problem are caused by:
a. distention of smaller stomach by too much food intake b. hyperglycemia caused by uncontrolled gastric emptying into small intestine c. irritation of stomach lining by reflux of bile salts d. movement of fluid into the bowel because concentrated food and fluids move rapidly into the intesting |
d. movement of fluid into the bowel because concentrated food and fluids move rapidly into the intesting
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Nurse determines teaching need when patient with dumping syndrome says
a. "i should eat bread with every meal" b. "i should avoid drinking fluids with meals" c. i should eat small meals about 6x day" d. "i need t olie down for 30-60 min after meals" |
a. "i should eat bread with every meal"
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Patient with cancer of stomach undergoes total gastrecotmy with esophagojejunostomy. Postop the nurse teaches the patient to expect:
a. rapid healing b. ability to return to normal dietary habits c. close follow up for development of ulcers d. lifelong intramuscular or intranasal admin of cobalamin |
d. lifelong intramuscular or intranasal admin of cobalamin
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The preferred immediate treatment for acute episode of constipation is:
a. soapsud enema b. stimulant cthartics c. stool sofenting cathartic d. tap water or hypertonic enemas |
d. tap water or hypertonic enemas
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On 2nd postop day, patient who had exploratory laparotomy complains if abdominal distention and gas pains. Best response to this is:
a. Abdominal distention occurs as a normal response to inflammation and healing b. Gas pains occur when NG tube is not used during surgery c. This is a common complication of abdominl surgery but usualy releived by BM d. This occurs because of bowel immobility caused by anesthesia and manipulation of abdominal contents during surgery |
d. This occurs because of bowel immobility caused by anesthesia and manipulation of abdominal contents during surgery
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Postop patient has nursing diagnosis of pain r/t to immobility, meds, and decreased motility as evidneced by abdominal pain and distention and inability to pass flatus. An apropriate nursing intervention for the patient is to:
a. ambulate patient more frequently b. assess abdomen for bowel sounds c. place patient in high fowlers d. withhold narcotics because they decrease bowel motility |
a. ambulate patient more frequently
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A 22 yr old calls the clinic complaining of N&V and RLQ abdominal pain. The nurse advises the patient to:
a. have the symptoms evaluated by a MD right away b. use a heating pad c. drink at least 2 qts of juice d. take a laxative to empty the bowel before exam at clinic |
a. have the symptoms evaluated by a MD right away
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Patient with a gunshot wound to the abdomen develops a bacterial peritonitis after surgery to repair the bowel. The nurse explains to the patient htat this problem is caused prirmarily by:
a. immobility and loss of perstaliss of the bowel as reuslt of surgery b. penetration of unsteril foreighn bodies into the abdominal cavity c. spillage of bowel contents int othe normally sterile abdominal cavity d. accumulation of blood and fluid in the abdominal cavity as a result of the trauma |
c. spillage of bowel contents int othe normally sterile abdominal cavity
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Patient with ulcerative colitis has a total colectomy with formation of a terminal ileum stoma. an important nursing interention for this patient postop is to:
a. measure the ileosotmy output to determine the status of patient's fluid balance b. change ileostomy q 3-4 hrs c. emphasize that ostomy is temporary d. teach about high fiber diet required to maintain normal ostomy drainage |
a. measure the ileosotmy output to determine the status of patient's fluid balance
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Patient with inflammatory bwel disease has a nursing diagnosis of imbalanced nutrition: less than body requirements r/t decreased nutritional intake and decreased intestinal absorption. Data to support this is:
a. pallor and hair loss b. frequent diarrhea stools c. anorectal excoriation and pain d. hypotension and urine output below 30 ml /hr |
a. pallor and hair loss
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Patient asks nurse if his risks for colon cancer are increased due to a polyp. the best response is:
a. it is very rare for polyps ot become malignant b. individuals with polyps have a 100% lifetime risk of developing colorectal cancer c. all polyps are abnormal and should be removed, but the risk for cancer depends on the type and if malignant changes are present d. all polyps are premalignant and source of most colon cancer. get colonoscpy q 6 months. |
c. all polyps are abnormal and should be removed, but the risk for cancer depends on the type and if malignant changes are present
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Early screening for detection of cancers of the right side of colon in individuals over 50 yrs old should be done q year to include:
a. serum CEA levels b. flexible sigmoidoscopy c. digital rectal exam d. fecal testing for occult blood |
d. fecal testing for occult blood
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A knowledge of factors associated with colorectal cancer guides the nurse when obtaining a nursing history to ask specifically about:
a. usual diet b. history of smoking c. history of alcohol d. environmental exposure to carcinogens |
a. usual die
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Upon examining a patient 8 hrs after formation of a colostomy the nurse would expect to find
a. hypoactive, high pitched bowel sounds b. brickred, puffy stoma that oozes blood c. purplish stoma, shiny and moist d. small amt of liquid fecal drainage from stome |
b. brickred, puffy stoma that oozes blood
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Nurse teaches patient with diverticulosis to
a. use anticholinergic drugs routinely to prevent bowel spasm b. have a nannual colonoscopy to detect malignant changes c. maintain a high fiber diet and use bulk laxatives to increase fecal volume d. exclude whole grains |
c. maintain a high fiber diet and use bulk laxatives to increase fecal volume
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During an acute attack of diverticulitis, the patient is:
a. monitored for signs of peritonitis b. treated with daily med enemas c. prepared for surgery to resect the involved colon d. provided with heathing pad to apply to LLQ |
a. monitored for signs of peritonitis
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When assessing a patient with pancreatitits, nurse would expect to find:
a. hyperactive bowel sounds b. hypertension and tachycardia c. severe midepigastric of LUQ pain d. temp greater than 102º |
c. severe midepigastric of LUQ pain
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Combined with clinical manifestations, the lab finding that is most commonly used to diagnose acute prancreatitis is:
a. increased serum lipase c c. increased urinary amylase d. decreased renal amylase creatine clearance |
c. severe midepigastric of LUQ pain
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Most effective means of suppressing pancreatic secreation during an episode of pancreatitis is the use of:
a. antibiotics b. NPO status c. antispasmotics d. H2R blockers |
b. NPO status
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Patient with pancreatitis has nursing dx of pain r/t distention of pancreas and peritoneal irritation. In addition to effective use of analgesics the nurse should:
a. provide diversional activiies to distract patient b. provide small frequent meals c. position the patient on the side with the head of the bed elevated 45º d. ambulate the patient q 3-4 hours |
c. position the patient on the side with the head of the bed elevated 45º
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the nurse determines tha further discharge instruction is needed whne the patient with acute pancreatititis states:
a. "i should observe for fat in my stools" b. "I must not use alcohol to prevent future attacks" c. "I shouldn't eat salty foods" d. "I will need to continue to monitor my blood glucose levels until my pancreas is healed" |
c. "I shouldn't eat salty foods"
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