Reference no: EM133483187

Question

1. The nurse caring for a client with cholelithiasis anticipates that the client's laboratory test results will include which of the following?

a. Increased Prothrombin Time (PT)

b. Decreased amylase

c. Increased White Blood Cell (WBC) Count

d. Decreased bilirubin.

2. The nurse will prevent and/or detect which complications when caring for the client with peritonitis?

a. Sepsis and septic shock

b. Portal hypertension

c. Fluid volume overload

3. When assessing a client with cirrhosis, the nurse notes that the client is increasingly confused and lethargic. Which laboratory data will the nurse need to

a. Albumin level

b. Ammonia level

c. Aspartate aminotransferase (AST) level

4. What information would the nurse need to know before administering loperamide (Imodium) to a client?

a. Character and frequency of stool

b. Total oral intake over the last 8 hours.

c. Time of last solid food intake

5. A client with ulcerative colitis is being taught about biological and targeted drug therapies that may help get them into remission. Which of the following responses made by the client indicates a need for additional teaching?

a. I can continue to volunteer at the free health clinic downtown with my church.
b. I must wash my hands after I play with my dog

c. Nausea and vomiting are common side effects of this drug

d. I will avoid large crowds and people who are sick.

6. The nurse should evaluate the results of which of the following laboratory tests for a client who has cirrhosis?

a. Prothrombin time (PT)

b. urinalysis

c. serum lipase

d. serum amylase

7. A client who works in the meat department of a local grocery store has hepatitis D. This means that the client:

a. Contracted the virus through contaminated meat.

b. Also has hepatitis B

c. Recently traveled to a foreign country

d. Had sexual contact with an infected person

8. The evening shift nurse notes hand tremors when a client with cirrhosis is trying to eat dinner. he is oriented to person and place but is easily distracted. These findings may indicate :

a. Hepatic encephalopathy

b. Analgesic toxicity

c. Delayed shock

d. Increased bilirubin

9. The nurse is caring for a client who has ascites, and the health care provider (HCP) prescribes spironolactone (Aldactone). The client asks why this medication. What is the best response by the nurse?

a. This drug will help increase the level of protein in your blood.

b. This medication is a diuretic and will hopefully help move fluid out of your body.

c. This drug will cause an increase in the amount of the hormone aldosterone that your body produces.

d. This drug will help you excrete larger amounts of ammonia.

10. A client with Crohn's disease develops a fever and symptoms of a urinary tract infection (UTI) with tan, fecal-smelling urine. What information will the nurse include when explaining to this client this complication of Crohn's disease?

a. Empty the bladder before and after sexual intercourse

b. Bacteria in the perianal area can enter the urethra.

c. Drink adequate fluids to maintain normal hydration

d. Fistulas can form between the bowel and bladder.

11. . Dietary teaching for a client following a gastric bypass surgery includes information regarding the need to :

a. Avoid sugary foods and limit fluids to prevent dumping syndrome.

b. Maintain a liquid diet indefinitely to prevent damage to the surgical site.

c. consume foods high in complex carbs, protein, and fiber to add bulk to the intestinal contents.

d. gradually increase the amount of food ingested until the client is eating at pre-operative levels

12. After receiving the change of shift report on a set of clients, which on the following clients should the nurse see first?

a. A client with ulcerative colitis who underwent a colostomy placement surgery two days ago with a pulse of 97/min.

b. A client who had surgery to dilate an esophageal stricture yesterday and is ready for their first post- procedure can take oral intake

c. A client with Crohn's disease who had a bowl resection three days ago with a respiratory rate of 32/ min.

d. A client who underwent gastric bypass one day ago and is complaining of abdominal pain 8/10.

13. Which nursing intervention should be completed immediately after the health care provider (HCP) has performed a liver needle biopsy?

a. Keeping the client on their right side for a minimum of 2 hours

b. Keeping the client on their left side for a minimum of 4 hours

c. Taking vital signs every 4 hours

d. Assisting the client to ambulate for the bathroom

14. The nurse is planning care for a client scheduled for esophagogastroduodenoscopy (EGD) and a barium swallow. What will the nursing plan include?

a. Discussing general anesthesia and explaining to the client that he will wake up in the recovery room.

b. Discussing with the client the nasogastric (NG) tube and the importance of gastric drainage for 24 hours after the test.

c. Anticipating that the client will receive a low-residue diet in the evening and then receive nothing by mouth (NPO status) 6 to 12 hours before the test.

d. Explaining to the client that he will receive nothing by mouth (NPO status) for 24 hours after the test to make sure his stomach can tolerate food

15. While caring for a client with cirrhosis and ascites, which of the following assessments would be of most concern to the nurse?

a. The client's serum albumin level is low.

b. The client has right upper quadrant (RUQ) tenderness

c. The client complains of severe fatigue

d. The client's temperature is 102.4 degrees F (38.9 degree C)

16. The nurse is caring for a client with peptic ulcer disease (PUD). the client has a nasogastric (NG) tube is NPO. During an assessment, the nurse notes bright red blood in the NG tube and suction canister. The client is complaining of severe abdominal pain and has become hypotensive. Which condition should the nurse suspect as a result of this assessment?

a. Perforation

b. Appendicitis

c. Gastritis

d. Bowel obstruction

17. A client with nasogastric (NG) tube is receiving a tube feeding and begins vomiting. What actions by the nurse is priority action?

a. Continue the feeding, but reducing the rate by half.

b. Administer and antiemetic

c. Stop the infusion and notify the health care provider (HCP)

d. Immediately check the client's gastric residual volume (GRV)

18. Increasing pressure in the portal-hepatic vein can be evidenced by

a. Jaundice

b. Blood pressure of 88/66

c. Distended veins along the gastrointestinal tract

d. Temperature of 102.0 F

19. The nurse is reviewing the diagnostic testing for a client who was admitted with abdominal pain and possible acute pancreatitis. Which information will be most useful in confirming the diagnosis?

a. The blood alcohol level and albumin are increased.

b. The serum amylase and lipase levels are elevated.

c. Liver enzymes (AST/ALT) levels elevated.

d. The white blood cell (WBC) count and blood glucose are elevated.

20. The nurse preparing to discharge a client with acute hepatitis B instructs the client to avoid

a. nicotine and caffeine

b. Oral decongestants

c. acetaminophen

d. laxatives and stool softeners

21. A client has had an esophagogastroduodenoscopy (EGD) procedure one hour ago. The client is now requesting something to drink. Which action by the registered nurse (RN) is the best?

a. Allow the client cool liquids only.

b. Assess the client's gag reflex.

c. Remind the client to remain NPO.

d. Tell the client to wait 4 hours.

22. A client just returned to the recovery room after gastric bypass surgery. What action by the nurse is the priority?

a. Ensure an adequate airway

b. Assess the surgical incision

c. Initiate intravenous (IV) Fluids

d. Assess the clients pain level

23. A client is recovering from laparoscopic cholecystectomy surgery. The nurse has completed dietary teaching for the client and must assess the client's understanding. Which statement made by the client indicates a correct understanding of the teaching?

a. I will decrease the amount of fatty foods in my diet.

b. I will avoid concentrated sweets and simple carbohydrates.

c. Drinking fluids with my meals will increase bloating.

d. Drinking at least 2 liters of water each day is suggested.

24. Which of the following clinical manifestations occurring in a client with acute pancreatitis will be of most concern to the nurse?

a. Several mid-epigastric pain

b. Absent bowel sounds

c. Blood pressure 84/42 mm Hg

d. Bile colored emesis.

25. A client diagnosed with gastroesophageal reflux disease (GERD) has been prescribed a proton pump inhibitor (PPI) to promote esophageal healing. Which of the following medications would the nurse anticipate teaching the client about?

a. Omeprazole (Prilosec)

b. Ranitidine (Zantac)

c. magnesium hydroxide (Maalox)

d. famotidine (Pepcid)

26. A client with Gastroesophageal Reflux Disease (GERD) has a nasogastric (NG) tube after a Nissen fundoplication (to tighten the LES). The nurse answers the call light and finds the client vomiting bright red blood with the NG tube lying on the floor.

What action should the nurse take?

a. Notify the surgeon.

b. Put on a pair of gloves.

c. Reinsert the NG tube.

d. Take a set of vital signs.

27. When assessing a client's abdomen, the nurse palpates the area directly above the umbilicus. This area is known as the.

A. Iliac area

B. Epigastric area

C. Hypogastric area

D. Suprasternal area