After teaching a group of students about intestinal obstruction, the instructor determines that the teaching was effective when the students identify which of the following as a cause of a functional obstruction? Abdominal surgery Which of the following instructions should the nurse include in the teaching plan of a client who has undergone colostomy? Chew food well. When inspecting the abdomen of a client with cirrhosis, the nurse observes that the veins over the abdomen are dilated. The nurse documents this finding as which of the following? Caput medusae A client who had a total colectomy with an ileostomy has rectal packing in place to absorb drainage and promote healing. When the client asks how soon the packing will be removed, what is the nurse’s best response? Within 1 week A client who will be having a portion of colon removed and colostomy created informs the nurse that he "will not be attractive any longer." The nurse determines the nursing diagnosis is Altered Body Image Perception related to the stoma and altered bowel elimination. What expected outcome related to this diagnosis will the client have? Client verbalizes what the changes will be and the benefits to future health. A client who is scheduled for an ileostomy surgery says to the nurse, “I’m afraid I won’t be able to look at that stoma.” Which response by the nurse would be most therapeutic? “I’ll make sure there is a familiar nurse here with you the first time.” The nurse is caring for a client with a feeding tube in place who has been prescribed bolus tube feedings. Which consideration(s) should the nurse take into account while administering the client’s plan of care? Select all that apply. The nurse is reviewing an ascending colostomy procedure with a client. Which of the following images would the nurse use in teaching? A client with a history of peptic ulcer disease has presented to the emergency department (ED) in distress. What assessment finding would lead the ED nurse to suspect that the client has a perforated ulcer? The client has a rigid, "board-like" abdomen that is tender. Ursodeoxycholic acid (UDCA) has been used to dissolve small, radiolucent gallstones. Which duration of therapy is required to dissolve the stones? 6 to 12 months A nurse is caring for a client who has undergone neck resection with a radial forearm free flap. The nurse's most recent assessment of the graft reveals that it has a bluish color and that mottling is visible. What is the nurse's most appropriate action? Promptly report these indications of venous congestion. A client weighing 165 lb. (75 kg) is being treated for acute gastritis. Which amount of urine output for 4 hours would indicate an adequate fluid balance if the output should be 1 mL/kg/hour? 300 The nurse is preparing to administer famotidine to a client with gastroesophageal reflux disease. Which safety warning should the nurse consider when administering the medication? to not take maximum dose for more than 2 weeks without medical consultation A client is preparing to have colorectal surgery and will have a colostomy created temporarily in hopes that he may be able to have it reversed in 6 months. The client is very concerned about the care of the colostomy. What preoperative interaction would the client benefit from? Meeting with an enterostomal therapist The nurse has placed a feeding tube for a client with a gastroesophageal disorder. What recommendation(s) should the nurse follow to confirm proper placement of the tube? Select all that apply. A client has been diagnosed with Zenker’s diverticulum. What treatment does the nurse include in the client education? Surgical removal of the diverticulum Which of the following interventions would be appropriate for a client who has undergone surgery for a liver disorder and has started shivering? Cover the client with a light blanket. A client with a colostomy is concerned with the odor that is left on the ostomy appliance and believes it may be caused by some of the medication that they take. What suggestion should the nurse provide to the client to determine if her medication is causing this problem? The client can obtain a list of drugs from an ostomy association or appliance manufacturers. A client with hepatitis who has not responded to medical treatment is scheduled for a liver transplant. Which of the following most likely would be ordered? Tacrolimus The nurse is caring for a client with hypovolemia related to prolonged vomiting and decreased intake of oral fluids. What activity(ies) should the nurse include in the client’s plan of care? Select all that apply. A nurse is reviewing a sigmoid colostomy procedure with a client. Which of the following diagrams would the nurse use in teaching? A client is admitted to the hospital with acute hemorrhage from esophageal varices. What medication should the nurse anticipate administering that will reduce pressure in the portal venous system and control esophageal bleeding? Octreotide The nurse is caring for a client with anorexia and constipation due to reduced bulk in the diet and the use of liquid supplements. Which intervention(s) should the nurse include in the plan of care for the client? Select all that apply. The nurse is teaching the client about the upcoming endoscopic retrograde cholangiopancreatography (ERCP). Although the nurse instructs on several pertinent points of care, which is emphasized? The client will need to be repositioned frequently throughout the procedure in order to prevent injury. The nurse is working on a general medical unit. A client is scheduled for an upper gastrointestinal series. Upon returning to the nursing unit, what does the nurse identify as the client goal? Increase in the amount of fluids The nurse is caring for a geriatric client experiencing diarrhea. When teaching about the site in the body where water and electrolytes are absorbed, the nurse is most correct to instruct on which location? The large intestine A client is seeing the physician for a suspected tumor of the liver. What laboratory study results would indicate that the client may have a primary malignant liver tumor? Elevated alpha-fetoprotein An older adult client presents with a report of 10-lb weight loss over the past month. Which assessment finding is most important in determining the care of this client? History of COPD The nurse is caring for a client following a colonoscopy. During the procedure, two mediumsized polyps were removed. Which nursing assessment in the recovery area is a priority? Vital signs The nurse is assessing a client with suspected cholelithiasis. What can the nurse expect to observe? Urine that appears dark brown A nurse is performing focused assessment on her clients. She expects to hear hypoactive bowel sounds in a client with: paralytic ileus. A male client, age 32 years, was recently married, and he and his wife would like to have children. The client is scheduled to have a total colectomy and is concerned with being able to have children. What is the best answer given by the nurse related to the client’s concern? “You may want to consider collection and storing of sperm for later use if you are planning to have children.” A nurse is reviewing a transverse colostomy procedure with a client. Which of the following diagrams would the nurse use in teaching? A client will be having a total colectomy in 4 days. The client does not have an obstruction. What does the nurse anticipate instructing the client about doing prior to the surgery to prepare the bowel? Instructing the client about dietary restrictions and lavage agents The nurse is scheduling gastrointestinal (GI) diagnostic testing for a client. Which GI test should be scheduled first? Radiography of the gallbladder A client has had surgery to create an ileoanal reservoir. Which instruction would the nurse give to reduce the risk for bowel incontinence? Perform perineal exercises. The nurse is teaching a client with a family history of oral cancer about the early stage of the disease. Which statement(s) should the nurse include in the teaching? Select all that apply. Which of the following interventions would the nurse need to keep in mind when a loop colostomy of a client is to be opened? Prepare the client for the pungent odor before the procedure. A client comes to the clinic to see the health care provider for right upper abdominal discomfort, nausea, and frequent belching especially after eating a meal high in fat. What disorder do these symptoms correlate with? Cholelithiasis The nurse is preparing to irrigate a client's single-barrel colostomy after surgery. The nurse would expect an order from the healthcare provider to irrigate the colostomy on what day after surgery? Fourth or fifth postoperative day A nurse is caring for a client with cardiac disease. The client asks the nurse which medication is best for help with regular bowel movements. What is the best response by the nurse? Docusate A client is recently diagnosed with Crohn’s disease and is beginning treatment. What first-line treatment does the nurse expect that the client will be placed on to decrease the inflammatory response? Sulfasalazine A client is scheduled for an esophagogastroduodenoscopy (EGD) to detect lesions in the gastrointestinal tract. The nurse would observe for which of the following while assessing the client during the procedure? Client's tolerance for pain and discomfort A client has been prescribed cimetidine for the treatment of peptic ulcer disease. When providing relevant health education for this client, the nurse should ensure the client is aware of what potential outcome? Drug-drug interactions A client has developed an anorectal abscess. Which client is likely at risk for the development of this type of abscess? A client with Crohn’s disease The nurse is caring for a client with cirrhosis of the liver. What symptom(s) would indicate to the nurse that the client is experiencing central nervous system effects of the disease? Select all that apply. A client is diagnosed with colon cancer, located in the lower third of the rectum. What does the nurse understand will be the surgical treatment option for this client? Abdominoperineal resection The nurse is caring for a client who is scheduled for a percutaneous liver biopsy. Which diagnostic test is obtained prior? Prothrombin time (PT) The nurse is assessing a client for fecal impaction, and when inserting a lubricated, gloved finger, the stool feels like small rocks. What does the nurse document this finding as? Scybala The nurse is assessing the abdomen of the client with an undiagnosed disorder. In which sequence would the nurse conduct the abdominal assessment? Use all options. Inspection-Auscultation-Percussion-Palpation A client scheduled for a total colectomy has been taking the immunosuppressive agent, azathioprine. When should the client be told to discontinue the medication to prevent negative effects on tissue healing? 1 month before surgery The nurse is reviewing the laboratory test results of a client with Crohn disease. Which of the following would the nurse most likely find? Stool cultures negative for microorganisms or parasite The nurse fills a tube feeding bag with two 8-oz cans of commercially prepared formula. The client is to receive the formula at 80 mL/hour via continuous gastrostomy feeding tube and pump. How many hours will this bag of formula run before becoming empty? Record your answer using a whole number 6 The nurse is managing the care of a client needing gastrointestinal suction and decompression with a Levin tube. Place the steps of initiating suction and decompression in the order the nurse should perform them. Locate the suction source. -Select suction according to health care provider prescription. Insert the gastric decompression tube. -Connect the decompression tube to the suction. The nurse is caring for a client with oral cancer who reports severe mouth sensitivity. The client asks the nurse what might be done about the condition. What should the nurse include in the response? Select all that apply.
