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Nurse Berlinda is assigned to a 41-year-old client who has a diagnosis of chronic pancreatitis. The nurse reviews the laboratory result, anticipating a laboratory report that indicates a serum amylase level of:

  • 500 units/L (correct)
  • 45 units/L
  • 100 units/L
  • 300 units/L
  • A male client who is recovering from surgery has been advanced from a clear liquid diet to a full liquid diet. The client is looking forward to the diet change because he has been “bored” with the clear liquid diet. The nurse would offer which full liquid item to the client?

  • Gelatin
  • Tea
  • Custard (correct)
  • Popsicle
  • Nurse Juvy is caring for a client with cirrhosis of the liver. To minimize the effects of the disorder, the nurse teaches the client about foods that are high in thiamine. The nurse determines that the client has the best understanding of the dietary measures to follow if the client states an intention to increase the intake of:

  • Chicken
  • Pork (correct)
  • Milk
  • Broccoli
  • Nurse Oliver checks for residual before administering a bolus tube feeding to a client with a nasogastric tube and obtains a residual amount of 150 mL. What is the appropriate action for the nurse to take?

    <p>Discard the residual amount and proceed with administering the feeding</p> Signup and view all the answers

    A nurse is inserting a nasogastric tube in an adult male client. During the procedure, the client begins to cough and has difficulty breathing. Which of the following is the appropriate nursing action?

    <p>Pull back on the tube and wait until the respiratory distress subsides</p> Signup and view all the answers

    Nurse Ryan is assessing for correct placement of a nasogastric tube. The nurse aspirates the stomach contents and checks the contents for pH. The nurse verifies correct tube placement if which pH value is noted?

    <p>3.5</p> Signup and view all the answers

    A nurse is preparing to remove a nasogastric tube from a female client. The nurse should instruct the client to do which of the following just before the nurse removes the tube?

    <p>Exhale</p> Signup and view all the answers

    Nurse Joy is preparing to administer medication through a nasogastric tube that is connected to suction. To administer the medication, the nurse would:

    <p>Clamp the nasogastric tube for 30 minutes following administration of the medication</p> Signup and view all the answers

    A nurse is preparing to care for a female client with esophageal varices who just had a Sengstaken-Blakemore tube inserted. The nurse gathers supplies, knowing that which of the following items must be kept at the bedside at all times?

    <p>An obturator</p> Signup and view all the answers

    Dr. Smith has determined that the client with hepatitis has contracted the infection from contaminated food. The nurse understands that this client is most likely experiencing what type of hepatitis?

    <p>Hepatitis A</p> Signup and view all the answers

    A client is suspected of having hepatitis. Which diagnostic test result will assist in confirming this diagnosis?

    <p>Elevated serum bilirubin level</p> Signup and view all the answers

    The nurse is reviewing the physician's orders written for a male client admitted to the hospital with acute pancreatitis. Which physician order should the nurse question if noted on the client's chart?

    <p>An anticholinergic medication</p> Signup and view all the answers

    A female client being seen in a physician's office has just been scheduled for a barium swallow the next day. The nurse writes down which instruction for the client to follow before the test?

    <p>Fast for 8 hours before the test</p> Signup and view all the answers

    The nurse is performing an abdominal assessment and inspects the skin of the abdomen. The nurse performs which assessment technique next?

    <p>Listens to bowel sounds in all four quadrants</p> Signup and view all the answers

    Polyethylene glycol-electrolyte solution (GoLYTELY) is prescribed for the female client scheduled for a colonoscopy. The client begins to experience diarrhea following the administration of the solution. What action by the nurse is appropriate?

    <p>Explain that diarrhea is expected</p> Signup and view all the answers

    The nurse is caring for a male client with a diagnosis of chronic gastritis. The nurse monitors the client knowing that this client is at risk for which vitamin deficiency?

    <p>Vitamin B12</p> Signup and view all the answers

    The nurse is reviewing the medication record of a female client with acute gastritis. Which medication, if noted on the client's record, would the nurse question?

    <p>Indomethacin (Indocin)</p> Signup and view all the answers

    The nurse is assessing a male client 24 hours following a cholecystectomy. The nurse noted that the T-tube has drained 750 mL of green-brown drainage since the surgery. Which nursing intervention is appropriate?

    <p>Document the findings</p> Signup and view all the answers

    The nurse is monitoring a female client with a diagnosis of peptic ulcer. Which assessment findings would most likely indicate perforation of the ulcer?

    <p>A rigid, board-like abdomen</p> Signup and view all the answers

    A male client with a peptic ulcer is scheduled for a vagotomy and the client asks the nurse about the purpose of this procedure. Which response by the nurse best describes the purpose of a vagotomy?

    <p>Reduces the stimulus to acid secretions</p> Signup and view all the answers

    The nurse is caring for a female client following a Billroth II procedure. Which postoperative order should the nurse question and verify?

    <p>Irrigating the nasogastric tube</p> Signup and view all the answers

    The nurse is providing discharge instructions to a male client following gastrectomy and instructs the client to take which measure to assist in preventing dumping syndrome?

    <p>Sit in a high-Fowler's position during meals</p> Signup and view all the answers

    The nurse is monitoring a female client for the early signs and symptoms of dumping syndrome. Which of the following indicate this occurrence?

    <p>Sweating and pallor</p> Signup and view all the answers

    The nurse is preparing a discharge teaching plan for the male client who had umbilical hernia repair. What should the nurse include in the plan?

    <p>Avoiding coughing</p> Signup and view all the answers

    The nurse is instructing the male client who has an inguinal hernia repair how to reduce postoperative swelling following the procedure. What should the nurse tell the client?

    <p>Elevate the scrotum</p> Signup and view all the answers

    The nurse is caring for a hospitalized female client with a diagnosis of ulcerative colitis. Which finding, if noted on assessment of the client, would the nurse report to the physician?

    <p>Bloody diarrhea</p> Signup and view all the answers

    The nurse is caring for a male client postoperatively following the creation of a colostomy. Which nursing diagnosis should the nurse include in the plan of care?

    <p>Body image, disturbed</p> Signup and view all the answers

    The nurse is reviewing the record of a female client with Crohn's disease. Which stool characteristics should the nurse expect to note documented in the client's record?

    <p>Diarrhea</p> Signup and view all the answers

    The nurse is performing colostomy irrigation on a male client. During the irrigation, the client begins to complain of abdominal cramps. What is the appropriate nursing action?

    <p>Stop the irrigation temporarily</p> Signup and view all the answers

    The nurse is teaching a female client how to perform a colostomy irrigation. To enhance the effectiveness of the irrigation and fecal returns, what measure should the nurse instruct the client to do?

    <p>Increase fluid intake</p> Signup and view all the answers

    For a client in hepatic coma, which outcome would be the most appropriate?

    <p>The client is oriented to time, place, and person.</p> Signup and view all the answers

    Jordin is a client with jaundice who is experiencing pruritus. Which nursing intervention would be included in the care plan for the client?

    <p>Keeping the client's fingernails short and smooth</p> Signup and view all the answers

    Marie, a 51-year-old woman, is diagnosed with cholecystitis. Which diet, when selected by the client, indicates that the nurse's teaching has been successful?

    <p>Low-fat, high-carbohydrate meals</p> Signup and view all the answers

    The hospital administrator had undergone percutaneous transhepatic cholangiography. Which assessment finding indicates complication after the operation?

    <p>Fever and chills</p> Signup and view all the answers

    When planning home care for a client with hepatitis A, which preventive measure should be emphasized to protect the client's family?

    <p>Using good sanitation with dishes and shared bathrooms</p> Signup and view all the answers

    For Jayvin who is taking antacids, which instruction would be included in the teaching plan?

    <p>Avoid taking other medications within 2 hours of this one</p> Signup and view all the answers

    Which clinical manifestation would the nurse expect a client diagnosed with acute cholecystitis to exhibit?

    <p>Nausea, vomiting, and anorexia</p> Signup and view all the answers

    Pierre, who is diagnosed with acute pancreatitis, is under the care of Nurse Bryan. Which intervention should the nurse include in the care plan for the client?

    <p>Dietary plan of a low-fat diet and increased fluid intake to 2,000 ml/day</p> Signup and view all the answers

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