Chapter 5 & 6 Exam Flashcards
The nurse clarifies that the end product of carbohydrate metabolism is absorbed and put into the bloodstream by the
Villa of the small intestine
A 56 year old woman is admitted to the emergency room with an acute attack of diverticulitis the patient has a temperature of 102° f and has an elevated white count which assessment would alert the nurse to impending septic shocks
Tachycardia
Because by a contents from an illostomy are virtually liquid what should the nurse include in the plan of care
Evaluation and assessment of periostomal skin integrity
The home health nurse caring for a patient who has dysarthria related to radiation therapy for an oral cancer would recommend that the family provide
A tablet and pencil as a communication aid
Which recommendation is most appropriate for a patient who has had an esophageal dilation related to acalasia
Drink 10 oz of fluid with each meal
A patient who is being evaluated for episodes of hemaremesis and dyspepsia tell the nurse that pain occurs when he eats but pain does not wake in him the nurse recognizes the diagnostic sign of which condition
Peptic ulcer
The nurse anticipates that the patient who has had a subtotal gastrectomy will need supplemental
Vitamin B12 due to the loss of intrinsic Factor
The home health nurse is caring for a patient who has frequent bouts of diverticulitis a company by increased flautance diarrhea and nausea which of the following is the most appropriate suggestion to lessen these symptoms
Eat a diet high in fiber content
The nurse caring for a patient with a peptic ulcer who has had a nasogastric tube inserted notes black blood in the tube the patient complaints of pain and has become hypotensive which condition should the nurse recognize these signs of
Perforation
Dumping syndrome after a billroth ii procedure occurs when high carbohydrate foods are ingested over a period of less than 20 minutes what should the nurse suggest to reduce the risk of dumping syndrome
Eating six Mile meals daily high in fiber and fat
The patient has come to a pacu following an ileostomy for the treatment of ulcerative colitis the patient is conscious and has the Nigel gastric tube in place in a pouch over the stoma what should the nurses initial action be
Attach NG tube to suctioning
The home health nurse evaluates a patient being treated for a peptic ulcer with Riopan (anacid) and famotidine (histamine receptor blockers) which statement made by the patient indicates a need for further instruction
I take both these meds at the same time every morning
What should a nurse do when obtaining a stool specimen to be examined for ova and parasites
Obtain three different stool specimens on subsequent days
The nurse explains to the patient with crohn’s disease that the tube feedings allow for
A rapid absorption in the upper GI tract
A patient with a large inguinal hernia has abdominal distinction and inguinal pain the nurse recognizes that these indicators of which type of hernia
Strangulated
A patient with erupted diverticulum in the descending colon has undergone a transverse loop colostomy the patient is upset and says I didn’t know it was going to be this awful I hate this which response made by the nurse should be most helpful
This is a temporary solution it will be closed in 6 weeks
A mail patient complains that he will never adjust to his colostomy which is the best action for the nurse in this situation
Encourage him to express his concern
And caring for a patient with gastric bleeding who has nasogastric tube in place the nurse should include in the plan of care to ensure that the NG tube is
Kept patten with irrigation
What should the nurse include in the teaching plan for a patient with hiatal hernia to reduce the frequency of heartburn
Eating small meals
The nurse points out which of the following as an example of a non mechanical bowel obstruction
A paralytic ileus
Bowel sounds assessment on a patient with an obstruction who has distention nausea and visible peristaltic waves would be
High pitched
The patient with a peptic ulcer has been placed on regular doses of bismuth salicylate Pepto-Bismol to combat h pylori what color will the drug turn the stool
Gray black
Which of the following should be included in the patient teaching of a patient with a peptic ulcer
Eating six small meals a day
Which of the following will be the most helpful nursing intervention to increase the comfort of a patient with appendicitis
Application of an ice bag
To assist the family with a bow training program to reduce fatal incontinence the nurse would suggest the use of a what at an optimal time to stimulate defecation
Glycerin suppositories
What is the most lethal complication of a peptic ulcer
Perforation
The nurse text into consideration that the proton pump inhibitor drugs such as what will completely eradicate gastric acid production
Omeprazole (Prilosec)
Which of the following is the purpose for antibiotic therapy and the treating of peptic ulcers
It eradictates h pylori
Why are peptic ulcers a common problem of aging
Because of overuse of NSAIDs
The patient with irritable bowel syndrome tells the home health nurse she is going to an acupuncturist for therapy for her condition which of the following would be the best nursing response
It may help but there has been no clinical proof of the effectiveness
The nurse uses a poster to show the process of bowel obstruction from diverticulitis what is the third sequential pathophysiologic event
Pouch protrudes through smooth muscle
Celiac sprue in the adult can lead to systemic problems what is the last pathophysical event of this in order of appearance
Systemic involvement
Which of the following are indicators of colorectal cancer
Excessive flautance Cachexia Cramps Rectal bleeding Anemia
How should the nurse cancel the 34 year old woman who has been prescribed sulfasalazine for Crohn’s disease
Tell her to drink at least 1500 ml of fluid a day
Advise assessing self for rash
Use alternate birth control methods to oral contraception
And designing a teaching plan to present to a group of older adults regarding the prevention of esophageal cancer the nurse went including information about the significance of
Cessation of smoking
Good oral Care
Regular checkups if dysphasia is present
Limiting alcohol consumption
Which activities does the home health nurse suggest in the elderly patient to avoid constipation
Schedule toileting after meals
Taking bulk forming laxatives
Increasing fiber intake
Drinking at least thousand milliliters of fluid
The home health nurse is caring for a patient who has frequent abdominal pain and diarrhea the nurse uses the Rome criteria to direct assessment for irritable bowel syndrome what is included in the Rome criteria
Discomfort at least 3 days a month
Pain relieved by defecation
Onset associated with change in stool consistency or frequency
Flexible sigmoidoscopy should be performed every how many years
Five
The nurse explains that what the chief enzyme of gastric juice is activated by hydrochloric acid to begin digestion of protein
Pepsin
The nurse came for a patient with crohn’s disease will closely monitor the urinary output to ensure that the patient is excreting at least how many milliliters per day
1500
The nurse texting to consideration that long-term use of antibiotics can cause an antibiotic associated pseudomembranous colitis from the organism what
C diff
JJ frequent bats of constipation the nurse examines the bed fast nursing home resident for ulceration of the anus called anal what
Fissure
The nurse clarifies that unconjugated bilibrium which is made up of broken down red cells is
Water insoluble bilibrium that must be converted by the liver
The patient was cirrhosis has an albumin of 2.8 g / DL the nurse is aware that normal is 3.5 g/dl based on these findings what would the nurse expect the patient to exhibit
Edema
What is an essential nursing measure to prevent injury to the patient who has to receive a paracentesis
Have patient void immediately before procedure
What should the nurse expect of a patient with a malabsorption of vitamin k
Increase prothrombin time
A patient was scheduled for a laparoscopic coastectomy but complications developed and he underwent opens coastectomy with a t tube inserted into the common bile duct what is the purpose of the t tube
To keep the duct open and allowed drainage of the bile until edema resolves
The nurse came through a patient who has had an open coastectomy with a t tube will
Position and secure the drainage back at the chest level
Which nursing intervention should be completed immediately after the physician has performed a needle liver biopsy
Keeping the patient on the right side for minimum of 2 hours
Immediately following a liver biopsy the patient becomes just panic the pulse increases to 100 and no breath sounds can be heard on the affected side what should the nurse expect
Pneumothorax
Which patient statement indicates that the patient requires additional teaching about an endoscopic retrograde Choangiopancreatography
Right after the test I want breakfast with black coffee
The narcissistic in the treatment of a patient with ruptured esophageal vertices who has received vasopression IV will carefully assess for
Evidence of cardiac ischemia
What should the nurse point out as a significant advantage of the laparoscopic cholecystectomy
Less invasive procedure
What should the nurse explain is the major purpose of the sengstaken Blake more tube
Control esophageal varices bleeding
The patient’s cirrhosis of the liver has also caused a dilation of the veins of the lower esophagus secondary to portal hypertension resulting in the development of this complication
Esophageal varices
The patient with the rest is has a rising ammonia level and is becoming disoriented the patient waves to the nurse as she enters the room how should the nursing interpret this
As astoraxis
How does the administration of neomycin reduce the production of ammonia
By decreasing the bacteria in the gut
What is the most common procedure for the removal of the gallbladder
Laparoscopic cholecystectomy
What should the nurse do to prepare a patient for an cholecystography
Administer six telepeque tablets 5 minutes apart after the evening meal
Which of the following in the classic symptom of cholecystitis
Right upper abdomen radiating to the back of the right scapula
What should the nurse avoid contamination from to prevent the transmission of hepatitis a
Food or water
What is the most appropriate method used by high risk health workers to prevent hepatitis B
Hepatitis B vaccine
The nurse explains that the use of cyclosporine as an immunosuppressant has been successful in the reduction of rejection of liver transplants because the drug
Does not suppress bone marrow
A male patient states that he returned from a two-week camping trip a few days ago he complains of nausea and anorexia and dark urine what additional information would assist in diagnosing hepatitis a
Recent ingestion of raw fish
When caring for an extreme jaundice patient with cirrhosis what should the nurse include provisions for in the plan of care
Skin care to relieve pruitis
The nurse is aware that an elevated serum amylase is diagnostic of pancreatitis at an early stage as an elevation can be assessed as early as what after the onset of pancreatic disease
2 hours
300 lb patient who has been exposed to hepatitis a is received an injection of immune serum globulin what should the dose be (0.2 ml/kg)
0.9 ml
A family member of a patient ask the nurse about the protein restricted diet order because of advanced liver disease with hepatic encephalopathy what statement by the nurse would be best explained the purpose of this diet
The liver cannot rid the body of ammonia that is made by the breakdown of protein in the digestive system
The nurse would make provisions in the plan of care for a person who has had liver transplant to prevent
Infection
The nurse is aware that the hepatitis a immunization provides immunity in
30 days
What is the challenge in encouraging coughing and deep breathing for a post-operative patient who has had an open cholecystectomy
High placement of incision
Why is it advantageous for a last person to be a liver donor
Because the doner donates only a part of the liver
Which factors are most commonly associated with pancreatitis
Alcoholism and biliary tract disease
The patient with pancreatitis is npo the patient asked the nurse why he is unable to have anything by mouth which of the following is the best response
The pancreas is stimulated whenever you eat or drink and causes pain
Why is morphine contradicted in the patient with pancreatitis
Morphine may cause spasms of the sphincter of Oddi
Which factors may increase the patient’s risk of developing cancer of the pancreas
Cigarette smokers and people with diabetes mellitus
Which assessment would indicate possible gallbladder disease in the older adult
Changes in color of urine or stool
What would the nurse monitoring caring for a patient undergoing a paracentesis
Fluid removal over at least 30 minutes
A patient with a tattoo for an open choecystectomy has resumed oral intake the t tube is clamped 2 hours before meals and unclamp 2 hours after meals to aid in digestion of fat during this time the t tube is clamped the patient complains of abdominal pain and nausea which intervention is most appropriate
Unclamp the tube immediately
The nurse clarifies that deterioration progresses through stages before presenting with liver disease the first stage is destruction what is the last stage
Liver disease
What is the second step in the normal process of protein metabolism
Ammonia produced in the bowel
What are the indications for a liver transplant
Congenital biliary abnormalities
Hepatic malignancy
Chronic hepatitis
Which medical intervention and Management systems control the bleeding of esophageal varices
Stengstaken Blake more tube
Band ligation
Potacaval shut
Dietary teaching for a patient who is treated conservatively for cholecystitis is necessary to keep the patient comfortable which food should be avoided
Peanut butter
Whole milk
Glazed chocolate donuts
Viral hepatitis may be treated at home what should we talk to the patient’s family
Clothes should be laundered separately with hot water
Personal items and drinking glasses should be not shared
Hands need to be thoroughly washed after toileting
The largest aware that the liver synthesizes products essential to health which products are synthesized by the liver
Protein
Albumin
What should the nurse do as part of the preparation for an endoscopic retrograde Choangiopancreatography
Confirm the presence of a consent form
Confirm the presence of a prothrombin time/inr
What is the condition characterized by yellowing of the sclera and the skin
Jaundice
