Exam 1

Question 1

A nurse is caring for a patient who is scheduled for a colonoscopy and whose bowel preparation will include polyethylene glycol electrolyte lavage prior to the procedure. The presence of what health problem would contraindicate the use of this form of bowel preparation?

Answer 1

Inflammatory bowel disease

Question 2

A nurse is promoting increased protein intake to enhance a patient’s wound healing. The nurse knows that enzymes are essential in the digestion of nutrients such as protein. What is the enzyme that initiates the digestion of protein?

Answer 2

Pepsin

Question 3

A patient has come to the outpatient radiology department for diagnostic testing. Which of the following diagnostic procedures will allow the care team to evaluate and remove polyps?

Answer 3

Colonoscopy

Question 4

The nurse is providing health education to a patient scheduled for a colonoscopy. The nurse should explain that she will be placed in what position during this diagnostic test?

Answer 4

Lying on the left side with legs drawn toward the chest

Question 5

The nurse is preparing to perform a patient’s abdominal assessment. What examination sequence should the nurse follow?

Answer 5

Inspection, auscultation, percussion, and palpation

Question 6

A nurse is caring for a patient with biliary colic and is aware that the patient may experience referred abdominal pain. Where would the nurse most likely expect this patient to experience referred pain?

Answer 6

Below the right nipple

Question 7

A patient is being assessed for a suspected deficit in intrinsic factor synthesis. What diagnostic or assessment finding is the most likely rationale for this examination of intrinsic factor production?

Answer 7

Persistently low hemoglobin and hematocrit

Question 8

A nurse is providing preprocedure education for a patient who will undergo a lower GI tract study the following week. What should the nurse teach the patient about bowel preparation?

Answer 8

“You’ll need to have enemas the day before the test.”

Question 9

A patient presents at the walk-in clinic complaining of recurrent sharp stomach pain that is relieved by eating. The nurse suspects that the patient may have an ulcer. How would the nurse explain the formation and role of acid in the stomach to the patient?

Answer 9

“Hydrochloric acid is secreted by glands in the stomach in response to the actual or anticipated presence of food.”

Question 10

A clinic patient has described recent dark-colored stools; the nurse recognizes the need for fecal occult blood testing (FOBT). What aspect of the patient’s current health status would contraindicate FOBT?

Answer 10

Hemorrhoids

Question 11

A patient will be undergoing abdominal computed tomography (CT) with contrast. The nurse has administered IV sodium bicarbonate and oral acetylcysteine (Mucomyst) before the study as ordered. What would indicate that these medications have had the desired therapeutic effect?

Answer 11

The patient’s BUN and creatinine levels are within reference range following the CT.

Question 12

A patient has come to the clinic complaining of blood in his stool. A FOBT test is performed but is negative. Based on the patient’s history, the physician suggests a colonoscopy, but the patient refuses, citing a strong aversion to the invasive nature of the test. What other test might the physician order to check for blood in the stool?

Answer 12

A quantitative fecal immunochemical test

Question 13

Probably the most widely used in-office or at-home occult blood test is the Hemoccult II. The patient has come to the clinic because he thinks there is blood in his stool. When you reviewed his medications, you noted he is on antihypertensive drugs and NSAIDs for early arthritic pain. You are sending the patient home with the supplies necessary to perform 2 hemoccult tests on his stool and mail the samples back to the clinic. What instruction would you give this patient?

Answer 13

“Avoid vitamin C for 72 hours before you start the test.”

Question 14

A patient’s sigmoidoscopy has been successfully completed and the patient is preparing to return home. Which of the following teaching points should the nurse include in the patient’s discharge education?

Answer 14

The patient can resume a normal routine immediately.

Question 15

A patient receiving tube feedings is experiencing diarrhea. The nurse and the physician suspect that the patient is experiencing dumping syndrome. What intervention is most appropriate?

Answer 15

Dilute the concentration of the feeding solution.

Question 16

A nurse is admitting a patient to the postsurgical unit following a gastrostomy. When planning assessments, the nurse should be aware of what potential postoperative complication of a gastrostomy?

Answer 16

Premature removal of the G tube

Question 17

A nurse is preparing to administer a patient’s intravenous fat emulsion simultaneously with parenteral nutrition (PN). Which of the following principles should guide the nurse’s action?

Answer 17

Intravenous fat emulsions may be infused simultaneously with PN through a Y-connector close to the infusion site and should not be filtered.

Question 18

A nurse is participating in a patient’s care conference and the team is deciding between parenteral nutrition (PN) and a total nutritional admixture (TNA). What advantages are associated with providing TNA rather than PN?

Answer 18

TNA is less costly than PN.

Question 19

A patient’s physician has determined that for the next 3 to 4 weeks the patient will require parenteral nutrition (PN). The nurse should anticipate the placement of what type of venous access device?

Answer 19

Nontunneled central catheter

Question 20

A patient’s new onset of dysphagia has required insertion of an NG tube for feeding; the nurse has modified the patient’s care plan accordingly. What intervention should the nurse include in the patient’s plan of care?

Answer 20

Confirm placement of the tube prior to each medication administration.

Question 21

A patient’s NG tube has become clogged after the nurse instilled a medication that was insufficiently crushed. The nurse has attempted to aspirate with a large-bore syringe, with no success. What should the nurse do next?

Answer 21

Attach a syringe filled with warm water and attempt an in-and-out motion of instilling and aspirating.

Question 22

A patient is postoperative day 1 following gastrostomy. The nurse is planning interventions to address the nursing diagnosis of Risk for Infection Related to Presence of Wound and Tube. What intervention is most appropriate?

Answer 22

Wash the area around the tube with soap and water daily.

Question 23

A patient has been discharged home on parenteral nutrition (PN). Much of the nurse’s discharge education focused on coping. What must a patient on PN likely learn to cope with? Select all that apply.

Answer 23

Changes in lifestyle, Loss of eating as a social behavior, and Sleep disturbances related to frequent urination during nighttime infusions

Question 24

The nurse is caring for a patient who is postoperative from having a gastrostomy tube placed. What should the nurse do on a daily basis to prevent skin breakdown?

Answer 24

Gently rotate the tube.

Question 25

A nurse is providing oral care to a patient who is comatose. What action best addresses the patient’s risk of tooth decay and plaque accumulation?

Answer 25

Brushing the patient’s teeth with a toothbrush and small amount of toothpaste

Question 26

An elderly patient comes into the emergency department complaining of an earache. The patient and has an oral temperature of 100.2ºF and otoscopic assessment of the ear reveals a pearly gray tympanic membrane with no evidence of discharge or inflammation. Which action should the triage nurse take next?

Answer 26

Palpate the patient’s parotid glands to detect swelling and tenderness.

Question 27

The nurse notes that a patient who has undergone skin, tissue, and muscle grafting following a modified radical neck dissection requires suctioning. What is the most important consideration for the nurse when suctioning this patient?

Answer 27

Avoid applying suction on or near the suture line.

Question 28

The school nurse is planning a health fair for a group of fifth graders and dental health is one topic that the nurse plans to address. What would be most likely to increase the risk of tooth decay?

Answer 28

Organic fruit juice

Question 29

A patient has been diagnosed with an esophageal diverticulum after undergoing diagnostic imaging. When taking the health history, the nurse should expect the patient to describe what sign or symptom?

Answer 29

Regurgitation of undigested food

Question 30

A nurse is caring for a patient who is acutely ill and has included vigilant oral care in the patient’s plan of care. Why are patients who are ill at increased risk for developing dental caries?

Answer 30

Inadequate nutrition and decreased saliva production can cause cavities

Question 31

A nurse is assessing a patient who has just been admitted to the postsurgical unit following surgical resection for the treatment of oropharyngeal cancer. What assessment should the nurse prioritize?

Answer 31

Assess for a patent airway.

Question 32

A nurse is addressing the prevention of esophageal cancer in response to a question posed by a participant in a health promotion workshop. What action has the greatest potential to prevent esophageal cancer?

Answer 32

Early diagnosis and treatment of gastroesophageal reflux disease

Question 33

A nurse is performing health education with a patient who has a history of frequent, serious dental caries. When planning educational interventions, the nurse should identify a risk for what nursing diagnosis?

Answer 33

Imbalanced Nutrition: Less Than Body Requirements

Question 34

A radial graft is planned in the treatment of a patient’s oropharyngeal cancer. In order to ensure that the surgery will be successful, the care team must perform what assessment prior to surgery?

Answer 34

Assessing the patency of the ulnar artery

Question 35

A community health nurse serves a diverse population. What individual would likely face the highest risk for parotitis?

Answer 35

An older adult whose medication regimen includes an anticholinergic

Question 36

A nurse is providing care for a patient whose neck dissection surgery involved the use of a graft. When assessing the graft, the nurse should prioritize data related to what nursing diagnosis?

Answer 36

Ineffective Tissue Perfusion

Question 37

A patient returns to the unit after a neck dissection. The surgeon placed a Jackson Pratt drain in the wound. When assessing the wound drainage over the first 24 postoperative hours the nurse would notify the physician immediately for what?

Answer 37

Spots of drainage on the dressings surrounding the drain

Question 38

A nurse is caring for a patient in the late stages of esophageal cancer. The nurse should plan to prevent or address what characteristics of this stage of the disease? Select all that apply.

Answer 38

Perforation into the mediastinum, Erosion into the great vessels, and Obstruction of the esophagus

Question 39

A nurse is admitting a patient diagnosed with late-stage gastric cancer. The patient’s family is distraught and angry that she was not diagnosed earlier in the course of her disease. What factor contributes to the fact that gastric cancer is often detected at a later stage?

Answer 39

The early symptoms of gastric cancer are usually not alarming or highly unusual.

Question 40

A nurse caring for a patient who has had bariatric surgery is developing a teaching plan in anticipation of the patient’s discharge. Which of the following is essential to include?

Answer 40

Eat several small meals daily spaced at equal intervals.

Question 41

A patient who underwent gastric banding 3 days ago is having her diet progressed on a daily basis. Following her latest meal, the patient complains of dizziness and palpitations. Inspection reveals that the patient is diaphoretic. What is the nurse’s best action?

Answer 41

Monitor the patient closely for further signs of dumping syndrome.

Question 42

A patient is one month postoperative following restrictive bariatric surgery. The patient tells the clinic nurse that he has been having “trouble swallowing” for the past few days. What recommendation should the nurse make?

Answer 42

Eating more slowly and chewing food more thoroughly

Question 43

A patient has experienced symptoms of dumping syndrome following bariatric surgery. To what physiologic phenomenon does the nurse attribute this syndrome?

Answer 43

A sudden release of peptides

Question 44

A patient comes to the bariatric clinic to obtain information about bariatric surgery. The nurse assesses the obese patient knowing that in addition to meeting the criterion of morbid obesity, a candidate for bariatric surgery must also demonstrate what?

Answer 44

Adequate understanding of required lifestyle changes

Question 45

A patient has just been diagnosed with acute gastritis after presenting in distress to the emergency department with abdominal symptoms. What would be the nursing care most needed by the patient at this time?

Answer 45

Providing the patient with physical and emotional support

Question 46

A nurse is providing care for a patient who is postoperative day 2 following gastric surgery. The nurse’s assessment should be planned in light of the possibility of what potential complications? Select all that apply.

Answer 46

Atelectasis, Pneumonia, and Metabolic imbalances

Question 47

A patient is recovering in the hospital following gastrectomy. The nurse notes that the patient has become increasingly difficult to engage and has had several angry outbursts at various staff members in recent days. The nurse’s attempts at therapeutic dialogue have been rebuffed. What is the nurse’s most appropriate action?

Answer 47

Make appropriate referrals to services that provide psychosocial support.

Question 48

A patient has been admitted to the hospital after diagnostic imaging revealed the presence of a gastric outlet obstruction (GOO). What is the nurse’s priority intervention?

Answer 48

Insertion of an NG tube for decompression

Question 49

A patient has been prescribed orlistat (Xenical) for the treatment of obesity. When providing relevant health education for this patient, the nurse should ensure the patient is aware of what potential adverse effect of treatment?

Answer 49

Flatus with oily discharge

Question 50

A patient who is obese has been unable to lose weight successfully using lifestyle modifications and has mentioned the possibility of using weight-loss medications. What should the nurse teach the patient about pharmacologic interventions for the treatment of obesity?

Answer 50

“Medications can be helpful, but few people achieve and maintain their desired weight loss with medications alone.”

Question 51

A patient who is obese is exploring bariatric surgery options and presented to a bariatric clinic for preliminary investigation. The nurse interviews the patient, analyzing and documenting the data. Which of the following nursing diagnoses may be a contraindication for bariatric surgery?

Answer 51

Deficient Knowledge Related to Risks and Expectations of Surgery

Question 52

A patient has recently received a diagnosis of gastric cancer; the nurse is aware of the importance of assessing the patient’s level of anxiety. Which of the following actions is most likely to accomplish this?

Answer 52

The patient is encouraged to express fears openly.

Question 53

A patient has received a diagnosis of gastric cancer and is awaiting a surgical date. During the preoperative period, the patient should adopt what dietary guidelines?

Answer 53

Eat small, frequent meals with high calorie and vitamin content.

Question 54

A nurse is presenting a class at a bariatric clinic about the different types of surgical procedures offered by the clinic. When describing the implications of different types of surgeries, the nurse should address which of the following topics? Select all that apply.

Answer 54

Specific lifestyle changes associated with each procedure, Implications of each procedure for eating habits, and Effects of different surgeries on bowel function

Question 55

A nurse is working with a patient who has chronic constipation. What should be included in patient teaching to promote normal bowel function?

Answer 55

Consume high-residue, high-fiber foods.

Question 56

A nurse is preparing to provide care for a patient whose exacerbation of ulcerative colitis has required hospital admission. During an exacerbation of this health problem, the nurse would anticipate that the patient’s stools will have what characteristics?

Answer 56

Watery with blood and mucus

Question 57

A patient has had an ileostomy created for the treatment of irritable bowel disease and the patient is now preparing for discharge. What should the patient be taught about changing this device in the home setting?

Answer 57

Apply a skin barrier to the peristomal skin prior to applying the pouch.

Question 58

A 35-year-old male patient presents at the emergency department with symptoms of a small bowel obstruction. In collaboration with the primary care provider, what intervention should the nurse prioritize?

Answer 58

Insertion of a nasogastric tube

Question 59

A nurse is presenting an educational event to a local community group. When speaking about colorectal cancer, what risk factor should the nurse cite?

Answer 59

High levels of alcohol consumption

Question 60

A patient’s screening colonoscopy revealed the presence of numerous polyps in the large bowel. What principle should guide the subsequent treatment of this patient’s health problem?

Answer 60

The patient’s polyps constitute a risk factor for cancer.

Question 61

A 16-year-old presents at the emergency department complaining of right lower quadrant pain and is subsequently diagnosed with appendicitis. When planning this patient’s nursing care, the nurse should prioritize what nursing diagnosis?

Answer 61

Risk for Infection Related to Possible Rupture of Appendix

Question 62

A nurse is teaching a group of adults about screening and prevention of colorectal cancer. The nurse should describe which of the following as the most common sign of possible colon cancer?

Answer 62

Change in bowel habits

Question 63

A nurse caring for a patient with a newly created ileostomy assesses the patient and notes that the patient has had not ostomy output for the past 12 hours. The patient also complains of worsening nausea. What is the nurse’s priority action?

Answer 63

Report signs and symptoms of obstruction to the physician.

Question 64

A nurse is working with a patient who is learning to care for a continent ileostomy (Kock pouch). Following the initial period of healing, the nurse is teaching the patient how to independently empty the ileostomy. The nurse should teach the patient to do which of the following actions?

Answer 64

Insert the catheter approximately 5 cm into the pouch.

Question 65

A nurse is providing care for a patient who has a diagnosis of irritable bowel syndrome (IBS). When planning this patient’s care, the nurse should collaborate with the patient and prioritize what goal?

Answer 65

Patient will accurately identify foods that trigger symptoms.

Question 66

A patient’s health history is suggestive of inflammatory bowel disease. Which of the following would suggest Crohn’s disease, rather that ulcerative colitis, as the cause of the patient’s signs and symptoms?

Answer 66

An absence of blood in stool

Question 67

A patient has been experiencing occasional episodes of constipation and has been unable to achieve consistent relief by increasing physical activity and improving his diet. What pharmacologic intervention should the nurse recommend to the patient for ongoing use?

Answer 67

Psyllium hydrophilic mucilloid (Metamucil)

Question 68

A teenage patient with a pilonidal cyst has been brought for care by her mother. The nurse who is contributing to the patient’s care knows that treatment will be chosen based on what risk?

Answer 68

Risk for infection

Question 69

A nurse at an outpatient surgery center is caring for a patient who had a hemorrhoidectomy. What discharge education topics should the nurse address with this patient?

Answer 69

The correct procedure for taking a sitz bath

Question 70

A nurse is caring for a patient with hepatic encephalopathy. While making the initial shift assessment, the nurse notes that the patient has a flapping tremor of the hands. The nurse should document the presence of what sign of liver disease?

Answer 70

Asterixis

Question 71

A patient has been diagnosed with advanced stage breast cancer and will soon begin aggressive treatment. What assessment findings would most strongly suggest that the patient may have developed liver metastases?

Answer 71

Abdominal pain and hepatomegaly

Question 72

A patient is being discharged after a liver transplant and the nurse is performing discharge education. When planning this patient’s continuing care, the nurse should prioritize which of the following risk diagnoses?

Answer 72

Risk for Infection Related to Immunosuppressant Use

Question 73

A nurse is caring for a patient with hepatic encephalopathy. The nurse’s assessment reveals that the patient exhibits episodes of confusion, is difficult to arouse from sleep and has rigid extremities. Based on these clinical findings, the nurse should document what stage of hepatic encephalopathy?

Answer 73

Stage 3

Question 74

A nurse is caring for a patient with a blocked bile duct from a tumor. What manifestation of obstructive jaundice should the nurse anticipate?

Answer 74

Orange and foamy urine

Question 75

A patient with a diagnosis of esophageal varices has undergone endoscopy to gauge the progression of this complication of liver disease. Following the completion of this diagnostic test, what nursing intervention should the nurse perform?

Answer 75

Keep patient NPO until the patient’s gag reflex returns.

Question 76

A patient with a history of injection drug use has been diagnosed with hepatitis C. When collaborating with the care team to plan this patient’s treatment, the nurse should anticipate what intervention?

Answer 76

A regimen of antiviral medications

Question 77

A previously healthy adult’s sudden and precipitous decline in health has been attributed to fulminant hepatic failure, and the patient has been admitted to the intensive care unit. The nurse should be aware that the treatment of choice for this patient is what?

Answer 77

Liver transplantation

Question 78

A patient with liver cancer is being discharged home with a hepatic artery catheter in place. The nurse should be aware that this catheter will facilitate which of the following?

Answer 78

Delivery of a continuous chemotherapeutic dose

Question 79

A nurse is assessing a patient who has been diagnosed with cholecystitis, and is experiencing localized abdominal pain. When assessing the characteristics of the patient’s pain, the nurse should anticipate that it may radiate to what region?

Answer 79

Right shoulder

Question 80

A nurse who provides care in a walk-in clinic assesses a wide range of individuals. The nurse should identify which of the following patients as having the highest risk for chronic pancreatitis?

Answer 80

A 39-year-old man with chronic alcoholism

Question 81

A 37-year-old male patient presents at the emergency department (ED) complaining of nausea and vomiting and severe abdominal pain. The patient’s abdomen is rigid, and there is bruising to the patient’s flank. The patient’s wife states that he was on a drinking binge for the past 2 days. The ED nurse should assist in assessing the patient for what health problem?

Answer 81

Severe pancreatitis with possible peritonitis

Question 82

A patient has been scheduled for an ultrasound of the gallbladder the following morning. What should the nurse do in preparation for this diagnostic study?

Answer 82

Have the patient refrain from food and fluids after midnight.

Question 83

A nurse is caring for a patient who has been scheduled for endoscopic retrograde cholangiopancreatography (ERCP) the following day. When providing anticipatory guidance for this patient, the nurse should describe what aspect of this diagnostic procedure?

Answer 83

The use of moderate sedation

Question 84

An adult patient has been admitted to the medical unit for the treatment of acute pancreatitis. What nursing action should be included in this patient’s plan of care?

Answer 84

Measure the patient’s abdominal girth daily.

Question 85

A patient has a recent diagnosis of chronic pancreatitis and is undergoing diagnostic testing to determine pancreatic islet cell function. The nurse should anticipate what diagnostic test?

Answer 85

Glucose tolerance test

Question 86

A patient has been diagnosed with acute pancreatitis. The nurse is addressing the diagnosis of Acute Pain Related to Pancreatitis. What pharmacologic intervention is most likely to be ordered for this patient?

Answer 86

IV hydromorphone (Dilaudid)

Question 87

A patient with a cholelithiasis has been scheduled for a laparoscopic cholecystectomy. Why is laparoscopic cholecystectomy preferred by surgeons over an open procedure?

Answer 87

Laparoscopic cholecystectomy poses fewer surgical risks than an open procedure.

Question 88

A patient with type 1 diabetes has told the nurse that his most recent urine test for ketones was positive. What is the nurse’s most plausible conclusion based on this assessment finding?

Answer 88

The patient’s insulin levels are inadequate.

Question 89

A nurse is providing health education to an adolescent newly diagnosed with type 1 diabetes mellitus and her family. The nurse teaches the patient and family that which of the following nonpharmacologic measures will decrease the body’s need for insulin?

Answer 89

Exercise

Question 90

A patient has just been diagnosed with type 2 diabetes. The physician has prescribed an oral antidiabetic agent that will inhibit the production of glucose by the liver and thereby aid in the control of blood glucose. What type of oral antidiabetic agent did the physician prescribe for this patient?

Answer 90

A biguanide

Question 91

A school nurse is teaching a group of high school students about risk factors for diabetes. Which of the following actions has the greatest potential to reduce an individual’s risk for developing diabetes?

Answer 91

Lose weight, if obese.

Question 92

A patient with a longstanding diagnosis of type 1 diabetes has a history of poor glycemic control. The nurse recognizes the need to assess the patient for signs and symptoms of peripheral neuropathy. Peripheral neuropathy constitutes a risk for what nursing diagnosis?

Answer 92

Infection

Question 93

A patient has been brought to the emergency department by paramedics after being found unconscious. The patient’s Medic Alert bracelet indicates that the patient has type 1 diabetes and the patient’s blood glucose is 22 mg/dL (1.2 mmol/L). The nurse should anticipate what intervention?

Answer 93

IV administration of 50% dextrose in water

Question 94

A nurse is conducting a class on how to self-manage insulin regimens. A patient asks how long a vial of insulin can be stored at room temperature before it “goes bad.” What would be the nurse’s best answer?

Answer 94

“If you are going to use up the vial within 1 month it can be kept at room temperature.”

Question 95

The most recent blood work of a patient with a longstanding diagnosis of type 1 diabetes has shown the presence of microalbuminuria. What is the nurse’s most appropriate action?

Answer 95

Teach the patient about actions to slow the progression of nephropathy.

Question 96

A patient is prescribed corticosteroid therapy. What would be priority information for the nurse to give the patient who is prescribed long-term corticosteroid therapy?

Answer 96

The patient is at an increased risk for developing infection.

Question 97

The nurse caring for a patient with Cushing syndrome is describing the dexamethasone suppression test scheduled for tomorrow. What does the nurse explain that this test will involve?

Answer 97

Administration of dexamethasone orally at 11 PM, and a plasma cortisol level at 8 AM the next morning

Question 98

The home care nurse is conducting patient teaching with a patient on corticosteroid therapy. To achieve consistency with the body’s natural secretion of cortisol, when would the home care nurse instruct the patient to take his or her corticosteroids?

Answer 98

In the morning between 7 AM and 8 AM

Question 99

A patient presents at the walk-in clinic complaining of diarrhea and vomiting. The patient has a documented history of adrenal insufficiency. Considering the patient’s history and current symptoms, the nurse should anticipate that the patient will be instructed to do which of the following?

Answer 99

Increase his intake of sodium until the GI symptoms improve.

Question 100

A patient with a diagnosis of syndrome of inappropriate antidiuretic hormone secretion (SIADH) is being cared for on the critical care unit. The priority nursing diagnosis for a patient with this condition is what?

Answer 100

Excess fluid volume

Question 101

A patient with suspected adrenal insufficiency has been ordered an adrenocorticotropic hormone (ACTH) stimulation test. Administration of ACTH caused a marked increase in cortisol levels. How should the nurse interpret this finding?

Answer 101

The patient’s pituitary function is compromised.

Question 102

Following an addisonian crisis, a patient’s adrenal function has been gradually regained. The nurse should ensure that the patient knows about the need for supplementary glucocorticoid therapy in which of the following circumstances?

Answer 102

Episodes of high psychosocial stress

Question 103

A patient with pheochromocytoma has been admitted for an adrenalectomy to be performed the following day. To prevent complications, the nurse should anticipate preoperative administration of which of the following?

Answer 103

IV corticosteroids

Question 104

A patient is undergoing testing for suspected adrenocortical insufficiency. The care team should ensure that the patient has been assessed for the most common cause of adrenocortical insufficiency. What is the most common cause of this health problem?

Answer 104

Therapeutic use of corticosteroids

Question 105

A patient on corticosteroid therapy needs to be taught that a course of corticosteroids of 2 weeks’ duration can suppress the adrenal cortex for how long?

Answer 105

Up to 1 year

Question 106

A patient with Cushing syndrome as a result of a pituitary tumor has been admitted for a transsphenoidal hypophysectomy. What would be most important for the nurse to monitor before, during, and after surgery?

Answer 106

Blood glucose

Question 107

The nurse is caring for a patient at risk for an addisonian crisis. For what associated signs and symptoms should the nurse monitor the patient? Select all that apply.

Answer 107

Pallor, Rapid respiratory rate, and Hypotension

Question 108

A patient who has been taking corticosteroids for several months has been experiencing muscle wasting. The patient has asked the nurse for suggestions to address this adverse effect. What should the nurse recommend?

Answer 108

Consumption of a high-protein diet

Question 109

Obesity

Answer 109

• Setting weight-loss goals
• Pharmacology: tricyclic antidepressants
• Spinach has a lot of vitamins and nutrients with few calories
• Nursing management: impaired gas exchange and impaired skin integrity
• Bariatric surgery: determine if client is an appropriate candidate
• RYGB- is a combined restrictive and malabsorptive procedure
• Risk for anastomotic leak: nurse must be astute in recognizing these manifestations and alerting the patient’s primary provider should they occur
• Limit dietary fiber intake due to risk for constipation (bariatric surgery)