More Prep U Questions Flashcards
The presence of mucus and pus in the stools suggests which condition?
a. Small-bowel disease
b. Ulcerative colitis
c. Disorders of the colon
d. Intestinal malabsorption
b. Ulcerative colitis
Explanation:
The presence of mucus and pus in the stools suggests ulcerative colitis. Watery stools are characteristic of small-bowel disease. Loose, semisolid stools are associated more often with disorders of the colon. Voluminous, greasy stools suggest intestinal malabsorption.
A client has received a diagnosis of gastric cancer and is awaiting a surgical date. During the preoperative period, the client should adopt what dietary guidelines?
a. Eat small, frequent meals with high calorie and vitamin content.
b. Eat frequent meals with an equal balance of fat, carbohydrates, and protein.
c. Eat frequent, low-fat meals with high protein content.
d. Try to maintain the pre-diagnosis pattern of eating.
a. Eat small, frequent meals with high calorie and vitamin content.
Explanation:
The nurse encourages the client to eat small, frequent portions of nonirritating foods to decrease gastric irritation. Food supplements should be high in calories, as well as vitamins A and C and iron, to enhance tissue repair.
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The nurse checks residual content before each intermittent tube feeding. When should the client be reassessed?
a. When the residual is about 50 mL
b. When the residual is between 50 and 80 mL
c. When the residual is about 100 mL
d. When the residual is greater than 200 mL
d. When the residual is greater than 200 mL
Explanation:
Although a residual volume of 200 mL or greater is generally considered a cause for concern in clients at high risk for aspiration, feedings do not necessarily need to be withheld in all clients
A client with acute gastritis asks the nurse what might have caused the problem. What is a possible cause of acute gastritis? Select all that apply.
a. Dietary indiscretion
b. Overuse of allergy medicine
c. Alcohol use
d. Drinking fruit juices
e. Radiation therapy
a, c, e
Explanation:
Possible causes of gastritis include dietary indiscretion, overuse of aspirin and other nonsteroidal anti-inflammatory drugs, alcohol use, bile reflux, and radiation therapy. Allergy medicine and fruit juices are not causes of acute gastritis.
The nurse teaches an unlicensed caregiver about bathing clients who are receiving tube feedings. The most significant complication related to continuous tube feedings is the:
a. interruption of GI integrity.
b. disturbance in the sequence of intestinal and hepatic metabolism.
c. potential risk for aspiration.
d. interruption in fat metabolism and lipoprotein synthesis.
c. potential risk for aspiration.
Explanation:
Because the normal swallowing mechanism is bypassed, consideration of the danger of aspiration must be foremost in the mind of the nurse caring for the client receiving continuous tube feedings. Tube feedings preserve GI integrity by intraluminal delivery of nutrients. Tube feedings preserve the normal sequence of intestinal and hepatic metabolism. Tube feedings maintain fat metabolism and lipoprotein synthesis.
Rebleeding may occur from a peptic ulcer and often warrants surgical interventions. Signs of bleeding include which of the following?
a. Mental confusion
b. Bradycardia
c. Bradypnea
d. Hypertension
a. Mental confusion
Explanation:
Signs of bleeding include tachycardia, tachypnea, hypotension, mental confusion, thirst, and oliguria
A nurse is assessing a client and obtains the following findings: abdominal discomfort, mild diarrhea, blood pressure of 100/80 mm Hg, pulse rate of 88 beats/minute, respiratory rate of 20 breaths/minute, temperature 100° F (37.8° C). What diagnosis will the nurse suspect for this client?
a. inflammatory bowel disease (IBD)
b. colorectal cancer
c. diverticulitis
d. liver failure
a. inflammatory bowel disease (IBD)
Explanation:
IBD is a collective term for several GI inflammatory diseases with unknown causes. The most prominent sign of IBD is mild diarrhea, which sometimes is accompanied by fever and abdominal discomfort. Colorectal cancer is usually diagnosed after the client reports of bloody stools; the client will rarely have abdominal discomfort. A client with diverticulitis commonly states they have chronic constipation with occasional diarrhea, nausea, vomiting, and abdominal distention. Jaundice, coagulopathies, edema, and hepatomegaly are common signs of liver failure.
A client comes to the clinic and says, “I think I have an ulcer.” What is a characteristic associated with peptic ulcer pain that the nurse should inquire about? Select all that apply.
a. Burning sensation localized in the back or mid-epigastrium
b. Feeling of emptiness that precedes meals from 1 to 3 hours
c. Severe gnawing pain that increases in severity as the day progresses
d. Pain that radiates to the shoulder or jaw
e. Vomiting without associated nausea
a, b, c
Explanation:
As a rule, the client with an ulcer reports dull, gnawing pain or a burning sensation in the mid-epigastrium or the back. Although vomiting is rare in uncomplicated peptic ulcer, it may be a symptom of a complication of an ulcer.
A nurse is doing a physical assessment on a client with a GI disorder. Which position will the nurse most likely ask the client to assume when performing an abdominal examination?
a. supine with knees flexed slightly
b. supine with legs flat on the exam table
c. side-lying
d. supine with knees flexed
a. supine with knees flexed slightly
Explanation:
The client should lie in a supine position with knees flexed slightly to assist in relaxing the abdominal muscles.
Clients with Type O blood are at higher risk for which of the following GI disorders?
a. Gastric cancer
b. Duodenal ulcers
c. Esophageal varices
d. Diverticulitis
b. Duodenal ulcers
Explanation:
Familial tendency also may be a significant predisposing factor. People with blood type O are more susceptible to peptic ulcers than are those with blood type A, B, or AB. Blood type is not a predisposing factor for gastric cancer, esophageal varices, and diverticulitis.
A client has been diagnosed with chronic gastritis. The nurse knows that which of the following symptoms are indicative of gastritis? Select all that apply.
a. Epigastric fullness
b. Anorexia
c. Sour taste in the mouth
d. Vomiting
e. Abdominal pain
a, b, c
Explanation:
Clinical manifestations of chronic gastritis may include no symptoms or symptoms similar to mild indigestion such as sour taste in the mouth, anorexia (loss of appetite),and epigastric fullness. Abdominal pain and vomiting are usually signs of bacterial or viral infection that cause acute gastritis.
A health care provider prescribes a combination of drugs to treat reoccurring peptic ulcer disease, and the client asks the nurse the reason for all the medications. What teaching should the nurse review with the client?
a. The antibiotics, prostaglandin E1 analogs, and bismuth salts will work together to suppress or eradicate H. pylori.
b. The proton pump inhibitors, prostaglandin E1 analogs, and bismuth salts will suppress or eradicate H. pylori.
c. The bismuth salts, antibiotics, and proton pump inhibitors will work together to suppress or eradicate H. pylori.
d. The prostaglandin E1 analogs, antibiotics, and proton pump inhibitors will work together to suppress or eradicate H. pylori.
c. The bismuth salts, antibiotics, and proton pump inhibitors will work together to suppress or eradicate H. pylori.
Explanation:
The recommended combination of bismuth salts, antibiotics, and proton pump inhibitors will suppress or eradicate H. pylori. Prostaglandin E1 analogs enhance mucosal resistance to injury; they do not suppress or eradicate H. pylori.
The nurse is providing preoperative care for a client with gastric cancer who is having a resection. What is the nursing management priority for this client?
a. Discharge planning
b. Correcting nutritional deficits
c. Preventing deep vein thrombosis (DVT)
d. Teaching about radiation treatment
b. Correcting nutritional deficits
Explanation:
Clients with gastric cancer commonly have nutritional deficits and may have cachexia. Therefore, correcting nutritional deficits is a top priority. Discharge planning before surgery is important, but correcting the nutritional deficits is a higher priority. Radiation therapy hasn’t been proven effective for gastric cancer, and teaching about it preoperatively wouldn’t be appropriate. Preventing DVT isn’t a high priority before surgery, but it assumes greater importance after surgery
A client is having a diagnostic workup for reports of frequent diarrhea, right lower abdominal pain, and weight loss. The nurse is reviewing the results of the barium study and notes the presence of “string sign.” What does the nurse understand that this is significant of?
a. Crohn’s disease
b. Ulcerative colitis
c. Irritable bowel syndrome
d. Diverticulitis
a. Crohn’s disease
Explanation:
The most conclusive diagnostic aid for Crohn’s disease has classically been a barium study of the upper GI tract that shows a “string sign” on an x-ray film of the terminal ileum, indicating the constriction of a segment of intestine.
A client is newly diagnosed with a peptic ulcer. For which medications will the nurse prepare teaching for this client? Select all that apply.
a. Metronidazole
b. Bismuth subsalicylate
c. Warfarin
d. Diphenhydramine
e. Omeprazole
a, b, e
Explanation:
In the past, stress and anxiety were thought to be causes of peptic ulcers, but research has documented that most peptic ulcers result from infection with H. pylori, which may be acquired through ingestion of food and water. Because of this, antibiotics such as metronidazole are used to treat peptic ulcers. Bismuth salts, such as bismuth subsalicylate, potentiate the effects of an antibiotic and also have antacid properties. Proton pump inhibitors, such as omeprazole, reduce the amount of hydrochloric acid produced by stomach cells. Anticoagulants, such as warfarin, and antihistamines, diphenhydramine, are not used to treat peptic ulcer disease.
A nursing student is preparing a teaching plan about peptic ulcer disease. The student knows to include teaching about the percentage of clients with peptic ulcers who experience bleeding. The percentage is
a. Less than 5%
b. 15%
c. 25%
d. Greater than 50%
b. 15%
Explanation:
Fifteen percent of clients with peptic ulcer experience bleeding.
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?
a. Docusate
b. Magnesium hydroxide
c. Bisacodyl
d. Mineral oil
a. Docusate
Explanation:
Docusate (Colace) can be used safely by clients who should avoid straining, such as cardiac clients. Magnesium hydroxide (Milk of Magnesia) is a saline agent. Bisacodyl (Dulcolax) is a stimulant laxative. Mineral oil is a lubricant laxative.
Which is one of the primary symptoms of irritable bowel syndrome (IBS)?
a. Diarrhea
b. Pain
c. Bloating
d. Abdominal distention
a. Diarrhea
Explanation:
The primary symptoms of IBS include constipation, diarrhea, or a combination of both. Pain, bloating, and abdominal distention often accompany changes in bowel pattern.
The nurse auscultates the abdomen to assess bowel sounds and documents five to six sounds heard in less than 30 seconds. How does the nurse document the bowel sounds?
a. Normal
b. Hypoactive
c. Hyperactive
d. Borborygmi
c. Hyperactive
Explanation:
Bowel sounds are assessed using the diaphragm of the stethoscope for high-pitched and gurgling sounds (Gu, Lim, & Moser, 2010). The frequency and character of the sounds are usually heard as clicks and gurgles that occur irregularly and range from 5 to 35 per minute. The terms normal (sounds heard about every 5 to 20 seconds), hypoactive (one or two sounds in 2 minutes), hyperactive (5 to 6 sounds heard in less than 30 seconds), or absent (no sounds in 3 to 5 minutes) are frequently used in documentation, but these assessments are highly subjective (Li, Wang, & Ma, 2012).
A client with an esophageal stricture is about to undergo esophageal dilatation. As the bougies are passed down the esophagus, the nurse should instruct the client to do which action to minimize the vomiting urge?
a. Hold their breath
b. Take long, slow breaths
c. Bear down as if having a bowel movement
d. Pant like a dog
b. Take long, slow breaths
Explanation:
During passage of the bougies used to dilate the esophagus, the client should take long, slow breaths to minimize the vomiting urge. Having the client hold their breath, bear down as if having a bowel movement, or pant like a dog is neither required nor helpful.
A client with a history of pancreatitis seeks medical attention for increasing episodes of abdominal pain. Which assessment finding(s) indicate to the nurse that the client is experiencing chronic pancreatitis? Select all that apply.
a. Anorexia
b. Weight loss
c. Constipation
d. Rectal bleeding
e. Foul-smelling stools
a, b, e
Chronic pancreatitis is characterized by recurring attacks of severe upper abdominal and back pain, accompanied by vomiting. Weight loss is a major problem in chronic pancreatitis. More than 80% of clients experience significant weight loss, which is usually caused by decreased dietary intake secondary to anorexia or fear that eating will precipitate another attack. Malabsorption occurs late in the disease when as little as 10% of pancreatic function remains. As a result, digestion, especially of proteins and fats, is impaired. The stools become frequent, frothy, and foul-smelling because of impaired fat digestion which results in stools with a high-fat content referred to as steatorrhea. Constipation and rectal bleeding are not symptoms associated with chronic pancreatitis.
When bowel sounds are heard about every 15 seconds, the nurse would record that the bowel sounds are
a. normal.
b. hypoactive.
c. sluggish.
d. absent.
a. normal.
Explanation:
Normal bowel sounds are heard every 5 to 20 seconds. Hypoactive bowel sound is the description given to auscultation of one to two bowel sounds in 2 minutes. Sluggish is not a term a nurse would use to accurately describe bowel sounds. The nurse records that bowel sounds are absent when no sound is heard in 3 to 5 minutes.
The nurse knows that the client with cholelithiasis can have a nutritional deficiency. The obstruction of bile flow due to cholelithiasis can interfere with the absorption of
a. Vitamin A
b. Vitamin B6
c. Vitamin B12
d. Vitamin C
a. Vitamin A
Explanation:
Obstruction of bile flow interferes with absorption of the fat-soluble vitamins A, D, E, and K. Clients may exhibit deficiencies of these vitamins if biliary obstruction has been prolonged. Vitamins B6, B12, and C are not fat soluble.
A client has a new order for metoclopramide. The nurse identifies that this medication can be safely administered for which condition?
a. Gastroesophageal reflux disease
b. Peptic ulcer with melena
c. Diverticulitis with perforation
d. Gastritis
a. Gastroesophageal reflux disease
Explanation:
Metoclopramide is a prokinetic agent that accelerates gastric emptying. It is contraindicated with hemorrhage or perforation. It is not used to treat gastritis
Which of the following conditions is most likely to involve a nursing diagnosis of fluid volume deficit?
a. Appendicitis
b. Pancreatitis
c. Cholecystitis
d. Peptic ulcer
b. Pancreatitis
Explanation:
Hypotension is typical and reflects hypovolemia and shock caused by the loss of large amounts of protein-rich fluid into the tissues and peritoneal cavity. The other conditions are less likely to exhibit fluid volume deficit.
