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30 Cards in this Set
- Front
- Back
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Rn is assessing a PT following a paracentesis for the treatment of ascites. Which finding indicates the procedure was effective? 1. Presence of a fluid wave 2. Increased HR 3. Equal pre-post procedure weights 4. Decreased SOB |
1. Presence of a fluid wave- this indicates ascites is present 2. Increased HR- this would indicate a complication HR would increase w/ hypovolemia 3. Equal pre-post procedure weights- should differ 4. Decreased SOB- removing fluid will allow for greater chest/lung expansion |
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You are caring for a PT with GERD and has new script for metoclopramide. What adverse effect will you monitor for? 1. Thrombocytopenia 2. Hearing Loss 3. Hypotension 4. Ataxia |
1. Thrombocytopenia- not r/t 2. Hearing Loss- not r/t 3. Hypotension- would be HTN crisis 4. Ataxia- need to watch for EPS extra pyramidal symptoms |
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You are caring for a PT with hepatic cirrhosis. Which lab finding would you report? 1. Albumin 4.0 2. INR 1.5 3. Bili 0.2 4. Ammonia 180 |
1. Albumin 4.0- WNL-norm 3.5-5 2. INR 1.5- WNL norm norm 0.7-1.8 3. Bili 0.2 -WNL norm 0.1-1.0 4. Ammonia 180- increased ammonia can indicate portal systemic encephalopathy Norms- 15-45 |
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You are assessing a PT with peritonitis. Which finding will you expect? 1. Bloody Diarrhea 2. Board like abdomen 3. Periumbilical cyanosis 4. Increased Bowel Sounds |
1. Bloody Diarrhea- would have colorectal cancer 2. Board like abdomen -expected symptom 3. Periumbilical cyanosis- would have subcutaneous intraperitoneal hemorrhage 4. Increased Bowel Sounds- would have diminished bowel sounds with peritonitis |
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You are checking scripts for a PT with campylobacter enteritis. Which script indicates the need for clarification? 1. 0.45 sodium chloride IV 2. Milk of magnesia 3. Ciprofloxacin 4. Potassium |
1. 0.45 sodium chloride IV- Okay limits risk for dehydration 2. Milk of magnesia- this will increase gastrointestinal motility which will place PT at risk for electrolyte imbalance 3. Ciprofloxacin- Good b/c it will treat the bacterial infection 4. Potassium- Good as this will replace electrolytes that may be lost during diarrhea |
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You are checking a PTs lab results who has colorectal cancer. Which finding would you expect with this PT? 1. Negative fecal occult blood test 2. Decreased Carcinoembryonic antigen CEA level 3. Hct 43 4. Hgb 9.1 |
1. Negative fecal occult blood test- would be + r/t intestinal bleeding 2. Decreased Carcinoembryonic antigen CEA level- would expect a high CEA 3. Hct 43- should be decreased r/t intestinal bleeding 4. Hgb 9.1- would be low due to intestinal bleeding |
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You are assessing a PT with cirrhosis. Which is priority for you to report? 1. Spider anginomas 2. Peripheral edema 3. Bloody stools 4. Jaundice |
1. Spider anginomas- expected 2. Peripheral edema- expected 3. Bloody stools- Hemorrhaging is greatest risk and this is an indication of bleeding in the gastrointestinal tract 4. Jaundice- expected |
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You are checking labs of a PT with acute pancreatitis. Which finding will you report? 1. Blood glucose 110 2. Increased serum amylase 3. WBC 9000 4. Decreased Bilirubin |
1. Blood glucose 110-WNL would be elevated with pancreatitis 2. Increased serum amylase- This would be increased du to pancreatic cell injury 3. WBC 9000- WNL would be elevated 4. Decreased Bilirubin- Would be increased due to hepatobiliary obstructive process |
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PT has ulcerative colitis. Which instructions would you include to minimize further risks. Select All? 1. Use progressive relaxation techniques 2. Increased dietary fiber intake 3. Drink 2 240ml glasses of milk per day 4. Arrange activités to allow for daily rest periods 5. Restrict intake of carbonated beverages |
1. Use progressive relaxation techniques- 2. Increased dietary fiber intake- should restrict fiber intake as it can cause diarrhea and cramps 3. Drink 2 240ml glasses of milk per day- dairy is poorly tolerated and should be avoided 4. Arrange activités to allow for daily rest periods 5. Restrict intake of carbonated beverages |
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RN is teaching PT how to prepare for a colonoscopy. Which instructions will the RN include? 1. Begin drinking the prep on the morning of. 2. Drink full liquids for breakfast day of the test. and then NPO 2hr prior to the test 3. Drink clr liquids for 24hr to the test and then NPO for 6 hr prior to the test 4. Drink prep slowly |
1. Begin drinking the prep on the morning of. 2. Drink full liquids for breakfast day of the test. and then NPO 2hr prior to the test 3. Drink clr liquids for 24hr to the test and then NPO for 6 hr prior to the test- should drink clear liquids for 24hr to promote bowel cleansing and be NPO 4-6 hr prior to the test 4. Drink prep slowly |
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You are providing discharge teaching for a PT who has chronic cholecystitis. Which food selection by the PT indicates effective teaching? 1. Unsalted nuts 2. Bologna 3. cheddar cheese 4. Bananas |
1. Unsalted nuts-should avoid high fat foods 2. Bologna-should avoid high fat foods 3. cheddar cheese- should avoid high fat foods 4. Bananas- best option its low fat |
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You are caring for Pt with colorectal cancer who is on chemotherapy. Pt asks why she is having a CEA level drawn what is your best response? 1. CEA determines the current stage of the cancer 2. CEA determines the efficacy of the chemotherapy 3. CEA determines neutrophil count 4. CEA determines if you have + FOBT |
1. CEA determines the current stage of the cancer- 2. CEA determines the efficacy of the chemotherapy 3. CEA determines neutrophil count 4. CEA determines if you have + FOBT |
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Rn is providing discharge teaching for a PT with a new script for his peptic ulcer which medication will inhibit gastric acid secretion? 1. Calcium carbonate 2. Famotidine 3. Aluminum hydroxide 4. Sucralfate |
1. Calcium carbonate- neutralizes gastric acid 2. Famotidine- inhibits gastric acid secretion 3. Aluminum hydroxide- neutralizes gastric acid 4. Sucralfate- mucosal barrier fortifier to create protective coating |
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You are providing teaching for Pt following ileostomy. You should instruct the PT to report? 1. Intolerance to high fiber food 2. Liquid ileostomy output 3. Dark purple stoma 4. Sensation of burning during bowel elimination |
1. Intolerance to high fiber food- may happen 2. Liquid ileostomy output- expected 3. Dark purple stoma- indicates bowel ischemia 4. Sensation of burning during bowel elimination- expected |
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You are providing teaching to a PT with a new colostomy and PT is concerned about flatus and odor which food choice should you recommend? 1. Eggs 2. Fish 3. Yogurt 4. Broccoli |
1. Eggs- increase stool odor 2. Fish- will increase stool odor 3. Yogurt- can PREVENT flatus and stool odor 4. Broccoli- increase flatus and odor |
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PT has hepatic encephalopathy. PT asks if he can have a larger portion of beed for dinner what would be the best response? 1. Beef is too high in fat i can request chicken for you. 2. You need to increase your fluids would you like beef soup. 3. You should limit animal protein can i get you a veggie burger 4. You need to limit calories would you like sugar free gelatin.
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1. Beef is too high in fat i can request chicken for you.- need to reduce animal protein 2. You need to increase your fluids would you like beef soup.- should limit sodium and fluids to limit ascites 3. You should limit animal protein can i get you a veggie burger- Hepatic encephalopathy often requires reduction in animal protein due to increased production of ammonia 4. You need to limit calories would you like sugar free gelatin.- not needed |
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You are providing teaching to a PT with mild diverticulitis which statement indicates understanding? 1. I may experience right lower quadrant pain 2. I will remain active by working in my garden every day 3. I should eat foods that are low in fiber 4. I will use a mild laxative every day |
1. I may experience right lower quadrant pain- would be left lower pains 2. I will remain active by working in my garden every day- should avoid intra abdominal pressure 3. I should eat foods that are low in fiber- should eat this and when inflammation subsides then ca resume normal fiber intake 4. I will use a mild laxative every day- should avoid as it can increase intestinal motility which can exacerbate adverse effects. |
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You are providing teaching to a Pt to prevent dumping syndrome which food choice should he include in his diet? 1. Lactose- reduced milk 2. Eggs 3. Grape Juice 4. Honey |
1. Lactose- reduced milk- should avoid lactose reduced milk as this will increase risk 2. Eggs- should increase intake of protein to decrease risk 3. Grape Juice- sweetened juice can increase risk 4. Honey- should avoid simple sugars as this will increase risk. |
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You are admitting PT with acute pancreatitis. Which action should you take first? 1. insert a NG tube 2. Administer ceftazidime 3. assess current pain level 4. Instruct the PT remain NPO |
1. insert a NG tube 2. Administer ceftazidime 3. assess current pain level -1st action 4. Instruct the PT remain NPO |
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Assessing Pt following a gastrectomy. RN should identify which finding as an indication of acute gastric dilation. 1. Hiccups 2. Elevated BP 3. Bradycardia 4. Left lower quadrant pain |
1. Hiccups-indicates acute gastric dilation should ensure potency of NG tube and notify provider 2. Elevated BP- would be hypotension 3. Bradycardia- would be tachycardic 4. Left lower quadrant pain- would say epigastric pain |
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RN providing teaching for a PT who has gastritis and a new script for famotidine which indicates teaching was effective? 1. I should make sure the water i drink i filtered 2. Should expect immediate pain relief 3. I will drink iced tea with meals and snacks 4. I will monitor my blood pressure regularly |
1. I should make sure the water i drink i filtered- reduces contaminates 2. Should expect immediate pain relief- may take several days for effects 3. I will drink iced tea with meals and snacks- should avoid caffeinated beverages coffee/tea 4. I will monitor my blood pressure regularly - would check glucose levels no need for BP |
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Assessing a PT who has upper gastrointestinal bleeding. Which finding should the RN expect? 1. Hypoactive Bowel sounds 2. Epigastric pain 3. Hypotension 4. Pernicious anemia |
1. Hypoactive Bowel sounds- expected finding 2. Epigastric pain- would be r/t chronic gastritis 3. Hypotension- result of blood loss 4. Pernicious anemia- expected for chronic gastritis |
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Teaching for hep C Pt. which statement indicates understand of teaching? 1. I will avoid alcohol until I'm no longer contagious 2. I will avoid meds containing acetaminophen 3. I will decrease my intake of calories 4. I will need treatment for 3 months.
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1. I will avoid alcohol until I'm no longer contagious- will always carry the risk of transmission 2. I will avoid meds containing acetaminophen- meds containing acetaminophen are very toxic to the liver and will cause damage 3. I will decrease my intake of calories- should eat small frequent meals that are high in carbs and calories 4. I will need treatment for 3 months.- usually need 6mns |
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Assessing Pt with Hep B. Which of the following should the RN expect? 1. Joint pain 2. Obstipation 3. Abdominal distention 4. Periumbilical discoloration |
1. Joint pain- expected finding 2. Obstipation- r/t complete bowel obstruction 3. Abdominal distention- r/t small bowel obstruction 4. Periumbilical discoloration- r/t intraperitoneal bleeding |
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Pt has churns disease which finding would you expect? 1. Fatty diarrheal stools 2. Hyperkalemia 3. Weight gain 4. Sharp epigastric pain
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1. Fatty diarrheal stools- expected 2. Hyperkalemia- would be hypokalemia 3. Weight gain- would be weight loss 4. Sharp epigastric pain- would be right lower quadrant pain |
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Assessing Pt with appendicitis. Which findings would you expect? Select all 1. temp of 101.1 2. WBC 6000 3. Bloody diarrhea 4. N/V 5. Right lower quadrant pain |
1. temp of 101.1- expected 2. WBC 6000- would expect elevated levels 3. Bloody diarrhea- r/t colorectal cancer 4. N/V--expected 5. Right lower quadrant pain- expected |
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Pt has a duodenal ulcer which finding would you expect? 1. PT describes pain as spasms in the right lower quadrant of the stomach 2. PT describes pain as pressure felt in the epigastrium 3. Pt states pain occurs as soon as food enter the stomach 4. Pt states pain occurs 1.5-3 hr after meals and during the night |
1. PT describes pain as spasms in the right lower quadrant of the stomach- not r/t 2. PT describes pain as pressure felt in the epigastrium - would be gastric ulcer 3. Pt states pain occurs as soon as food enter the stomach- not r/t 4. Pt states pain occurs 1.5-3 hr after meals and during the night- usually occurs when stomach is empty and 1.5-3 hr after meals |
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Rn i providing teaching to PT with GERD which statement indicates teaching was effective? 1. I will decrease the amount of carbonated bevargages i drink 2. I will avoid drinking liquids for 30 min after taking antacid tab 3. I will eat a snack before bedtime 4. I will lie down for atlas 30 min after each meal |
1. I will decrease the amount of carbonated beverages i drink- should avoid fatty foods, coffee, cola, tea, chocolate 2. I will avoid drinking liquids for 30 min after taking antacid tab- you should follow antacids with water 3. I will eat a snack before bedtime- should avoid meals before bedtime and have 4-6 small meals per day 4. I will lie down for atlas 30 min after each meal-should sit right after meals for 1-2 hrs |
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Providing teaching for Pt with cirrhosis and Pt has a new script for lactulose. What should you include in the teaching? 1. Notify if bloating occurs 2. Expect to have two or three soft stools per day 3. Restrict carbs in the diet 4. Limit fluid intake to 1000 ml/day |
1. Notify if bloating occurs- adverse effect 2. Expect to have two or three soft stools per day- this med aids in excreting ammonia in the stool 3. Restrict carbs in the diet- should be on a high carb diet 4. Limit fluid intake to 1000 ml/day- should drink 1500-2000mL to prevent dehydration due to frequent stooling |
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RN making a plan of care for a PT with cirrhosis and ascites which intervention should the RN include? 1. Measure abdominal girth daily 2. Administer warfarin same time daily 3. Provide daily intake of 4g Na 4. assess breath sounds Q12hr |
1. Measure abdominal girth daily- greatest indicator of fluid in abdomen 2. Administer warfarin same time daily- should not have due tor risk of bleeding 3. Provide daily intake of 4g Na- should be restricted to 1-2 g Na to reduce ascites 4. assess breath sounds Q12hr- monitor breath sounds every 4-8 due to pulmonary complications |
