Adult: GI Diabetes Renal Panc Liver

Question 1

A nurse is reviewing bowel prep using polyethylene glycol with a client scheduled for a colonoscopy. Which of the following instructions should the nurse include?
Check with the provider about taking current medications when consuming bowel prep.
Consume a normal diet until starting the bowel prep.
Expect the bowel prep to not begin acting until the day after all the prep is consumed.
Discontinue the bowel prep once feces start to be expelled.

Answer 1

Check with the provider about taking current medications when consuming bowel prep.

Question 2

A nurse is having difficulty arousing a client following an esophagogastroduodenoscopy (EGD). What is the priority action by the nurse?
Assess the client’s airway.
Allow the client to sleep.
Prepare to administer an antidote to the sedative.
Evaluate preprocedure laboratory findings.

Answer 2

Assess Airway

Question 3

A nurse is teaching a client who has gastroesophageal reflux disease about managing his illness. Which of the following recommendations should the nurse include in the teaching?
Limit fluid intake not related to meals.
Avoid items that can increase gastric acid secretion, like red meat.
Avoid eating within two hours of bedtime.
Season foods with black pepper.

Answer 3

Avoid eating within two hours of bedtime.

Question 4

A nurse is providing instructions for a 40-year-old client who is scheduled for a colonoscopy. The client reports that he has not had the procedure before and is very anxious about it. What response by the nurse is appropriate?
“Stop worrying. It doesn’t help anything.”
“Before the procedure, your provider will give you a sedative that will make you sleepy.”
“I know you’re anxious, but this procedure is recommended for people your age.”
“After you have signed the consent form, we can talk more about this.”

Answer 4

“Before the procedure, your provider will give you a sedative that will make you sleepy.”

Question 5

A nurse is caring for a client who receives intermittent enteral feedings through a nasogastric (NG) tube. Why should the nurse measure the gastric residual before administering a feeding?
To confirm the placement of the NG tube.
To remove gastric acid that might cause dyspepsia.
To determine the client’s electrolyte balance.
To identify delayed gastric emptying.

Answer 5

To identify delayed gastric emptying.

Question 6

What disease is the client diagnosed with GERD at greater risk for developing?
Hiatal hernia.
Gastroenteritis.
Barrett’s esophagus.
Cirrhosis.

Answer 6

Barrett’s Esoph

Question 7

The nurse is preparing a client diagnosed with GERD for surgery. Which information warrants notifying the physician?
The client’s Bernstein esophageal test was positive.
The client’s abdominal X-ray shows a hiatal hernia.
The client’s WBC count is 14,000/mm³.
The client’s hemoglobin is 13.8 g/dl.

Answer 7

The client’s WBC count is 14,000/mm³.

Question 8

A nurse is preparing to administer a dose of lactulose to a client who has cirrhosis. The client states, “I don’t need this medication. I am not constipated.” The nurse should explain that in clients who have cirrhosis, lactulose is used to decrease levels of what component in the bloodstream?
Glucose.
Ammonia.
Potassium.
Bicarbonate.

Answer 8

ammonia

Question 9

A nurse is planning care for a client who has cirrhosis and ascites. Which of the following interventions should the nurse include in the plan of care?
Increase the client’s saturated fat intake.
Decrease the client’s carbohydrate intake.
Increase the client’s sodium intake.
Decrease the client’s fluid intake.

Answer 9

Decrease the client’s fluid intake.

Question 10

A nurse is teaching a community education course about physical complications related to substance use disorder. What should the nurse identify as the primary cause of liver cirrhosis?
Alcohol.
Caffeine.
Cocaine.
Inhalants.

Answer 10

alcohol

Question 11

A nurse is caring for a client who has liver cirrhosis with ascites, bleeding esophageal varices, and portal hypertension. Which of the following laboratory findings indicate the client’s gastrointestinal tract is digesting and absorbing blood?
Elevated blood urea nitrogen (BUN).
Elevated HbA1c.
Decreased chloride.
Decreased bilirubin.

Answer 11

Elevated blood urea nitrogen (BUN).

Question 12

A nurse is caring for a client who has cirrhosis and a new prescription for lactulose. Which of the following manifestations indicates an adverse effect of the medication?
Dry mouth.
Vomiting.
Headache.
Peripheral edema.

Answer 12

vomiting

Question 13

A nurse is planning care for a client who has cirrhosis of the liver. Which of the following actions should the nurse include in the plan?
Administer furosemide.
Administer warfarin.
Implement a low-sodium diet.
Measure the client’s abdominal girth.
Encourage weightlifting during physical therapy.

Answer 13

Administer furosemide.
Implement a low-sodium diet.
Measure the client’s abdominal girth.

Question 14

A nurse expects to find which signs and symptoms in a client experiencing hypoglycemia?
Polydipsia, pallor, and irritability
Polyphagia and flushed, dry skin
Polyuria, headache, and fatigue
Nervousness, diaphoresis, and confusion

Answer 14

Nervousness, diaphoresis, and confusion

Question 15

A diabetic educator is discussing “sick day rules” with a newly diagnosed type 1 diabetic. The educator is aware that the client will require further teaching when the client states what?
“If I cannot eat a meal, I will eat a soft food such as soup, gelatin, or pudding six to eight times a day.”
“I will not take my insulin on the days when I am sick, but I will certainly check my blood sugar every 2 hours.”
“I will call the doctor if my blood sugar is over 300 mg/dL (16.6 mmol/L) or if I have ketones in my urine.”
“I will call the doctor if I am not able to keep liquids in my body due to vomiting or diarrhea.”

Answer 15

“I will not take my insulin on the days when I am sick, but I will certainly check my blood sugar every 2 hours.”

Question 16

A nurse has been asked to speak to a local women’s group about preventing cystitis. Which of the following would the nurse include in the presentation?
Suggestion to take tub baths instead of showers
Need to wear underwear made from synthetic material
Need to urinate after engaging in sexual intercourse
Importance of urinating every 4 to 6 hours while awake

Answer 16

Need to urinate after engaging in sexual intercourse

Question 17

A client who has just been diagnosed with hepatitis A asks, “How did I get this disease?” What is the nurse’s best response?
“You may have eaten contaminated restaurant food.”
“You could have gotten it by using I.V. drugs.”
“You must have received an infected blood transfusion.”
“You probably got it by engaging in unprotected sex.”

Answer 17

“You may have eaten contaminated restaurant food.”

Question 18

A nurse is caring for a client newly diagnosed with hepatitis A. Which statement by the client indicates the need for further teaching?
“I’ll take all my medications as ordered.”
“I’ll be very careful when preparing food for my family.”
“I’ll wash my hands often.”
“How did this happen? I’ve been faithful my entire marriage.”

Answer 18

“How did this happen? I’ve been faithful my entire marriage.”

Question 19

A client and spouse are visiting the clinic. The client recently experienced a seizure and says she has been having difficulty writing. Before the seizure, the client says that for several weeks she was sleeping late into the day but having restlessness and insomnia at night. The client’s husband says that he has noticed the client has been moody and slightly confused. Which of the following problems is most consistent with the client’s clinical manifestations?
Esophageal varices
Portal hypertension
Hepatitis C
Hepatic encephalopathy

Answer 19

Hepatic encephalopathy

Question 20

A nurse is reviewing the history of a client who is suspected of having glomerulonephritis. Which of the following would the nurse consider significant?
Previous episode of acute pyelonephritis
History of osteoporosis
Recent history of streptococcal infection
History of hyperparathyroidism

Answer 20

Recent history of streptococcal infection

Question 21

A post op client reports severe abdominal pain. The nurse cannot auscultate bowel sounds and notes the client’s abdomen is rigid. What is the nurse’s priority action?
Prepare to insert a nasogastric tube.
Call the health care provider.
Re-attempt to auscultate bowel sounds.
Prepare to administer a stool softener.

Answer 21

Call provider

Question 22

A client is admitted with a gastrointestinal bleed. What client symptom may indicate a peptic ulcer perforation to the nurse?
Sudden, severe upper abdominal pain
Hypertension
Soft abdomen
Bradycardia

Answer 22

Sudden, severe upper abdominal pain

Question 23

A patient has presented to the emergency department with signs and symptoms that are characteristic of acute pancreatitis. What assessment question is most likely to relate to the etiology of the problem?
Do you have type 1 diabetes or type 2 diabetes?
Are you a smoker?
Have you ever been diagnosed with hepatitis?
How much alcohol do you typically drink?

Answer 23

D. How much alcohol do you typically drink?
Rationale: Though not every case of acute pancreatitis is due to alcohol abuse, it is among the most frequent causes of the disease. Diabetes, hepatitis, and smoking do not normally contribute to acute pancreatitis.