(Answered) NCLEX-Care of the Patient with a Gastrointestinal Disorder

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(Answered) NCLEX-Care of the Patient with a Gastrointestinal Disorder A client who has undergone a colostomy several days ago is reluctant to leave the hospital and has not yet looked at the ostomy ... site. Which measures are most likely to promote coping? Select all that apply. - Ask a member of the local ostomy club to visit with the client before discharge. - Ask the enterostomal nurse specialist to consult with the client before discharge. - Ask the client to begin doing one part of the ostomy care and increase tasks daily. The nurse is caring for a client after a Billroth II (gastrojejunostomy) procedure. On review of the postoperative prescriptions, which should the nurse clarify? Irrigating the nasogastric (NG) tube The nurse should include which information when reinforcing home care instructions for a client who has peptic ulcer disease? Learn to use stress reduction techniques. The nurse is assigned to care for a client who had a Sengstaken-Blakemore tube inserted when more conservative treatment failed to alleviate the condition. The nurse should suspect that the client has which diagnosis? Esophageal varices A calcium supplement is prescribed for a client with hypoparathyroidism in the management of hypocalcemia. The client arrives at the clinic for a follow-up visit and complains of chronic constipation, and the nurse reinforces instructions to the client about measures to alleviate the constipation. Which comment by the client would indicate a need for further teaching? "I need to add 0.5 ounce of mineral oil to my daily diet." The nurse is evaluating the effect of dietary counseling on the client with cholecystitis. The nurse determines that the client understands the instructions given if the client states that which food item is acceptable to include in the diet? Turkey and lettuce sandwich The nurse is interpreting the laboratory results of a client who has a history of chronic ulcerative colitis. Which result indicates a complication of ulcerative colitis? Hemoglobin 10.2 g/dL A client complains of stomach pain 30 minutes to 1 hour after eating. The pain is not relieved by further intake of food, although it is relieved by vomiting. A gastric ulcer is suspected. Which data would further support this diagnosis? History of chronic obstructive pulmonary disease with weight loss The nurse is reinforcing home care instructions to a client following a gastric resection. The nurse should include which instruction? Take actions to prevent dumping syndrome. A client is admitted to the hospital with a diagnosis of acute pancreatitis. The nurse plans care, knowing that which problem occurs with this disorder? Alteration in comfort related to abdominal pain A postgastrectomy client who is being discharged from the hospital tells the nurse, "I hope my stomach problems are over. I need to get back to work right away. I've missed a lot of work, and I'm really behind. If I don't get my act together, I may lose my job." Based on the client's statement, the nurse determines that at this time, it is appropriate to discuss which topic? Reducing stressors in life A client receiving a high cleansing enema complains of pain and cramping. The nurse should take which corrective action? Clamp the tubing for 30 seconds and restart the flow at a slower rate. The nurse is caring for a client with a resolved intestinal obstruction who has a nasogastric tube in place. The health care provider has now prescribed the nasogastric tube to be discontinued. To determine the client's readiness for discontinuation of the nasogastric tube, which measure should the nurse check? Presence of bowel sounds in all four quadrants A health care provider places a Miller-Abbott tube in a client who has a bowel obstruction. Six hours later, the nurse measures the length of the tube outside of the nares and notes that the tube has advanced 6 cm since it was first placed. Based on this finding, which action should the nurse take next? Document the finding in the client's record. A health care provider asks the nurse to obtain a Salem Sump tube for gastric intubation. The nurse selects which tube from the unit storage area? Tube with a lumen and an air vent The nurse who is assisting in the care of a client within the first 24 hours following a total gastrectomy for gastric cancer should avoid which intervention? Irrigating the nasogastric (NG) tube A client is seen in the ambulatory care office for a routine examination. Which statement by the client would be important for the nurse to follow up? "I just lost a family member to gastrointestinal cancer." The nurse documents that a client with a hiatal hernia is implementing effective health maintenance measures after the client reports doing which action? Eating low-fat or nonfat foods The nurse observes that a client's nasogastric tube has suddenly stopped draining. The tube is connected to suction, the machine is on and functioning and all connections are snug. The tube is secured properly and does not appear to have been dislodged. After checking placement, the nurse gently flushes the tube with 30 mL of normal saline, but the tube still is not draining. The nurse analyzes this problem as which? Channels of gastric secretions may be bypassing the holes in the tube; turning the client will promote stomach emptying. A licensed practical nurse (LPN) is assisting in the insertion of a nasogastric (NG) tube for an adult client. The LPN helps determine the correct length to insert the tube by performing which measurement? From the tip of the client's nose to the earlobe and then down to the top of the sternum The nurse is teaching a client with a newly diagnosed hiatal hernia about measures to prevent recurrence of symptoms. Which statement should be included in the teaching? "Avoid lying down for an hour after eating." The nurse is performing an abdominal assessment on a client. The nurse interprets that which finding is abnormal and should be reported to the registered nurse (RN) or health care provider? Pulsation between the umbilicus and pubis The nurse is getting a client who underwent umbilical hernia repair ready for discharge. The nurse tells the client that it is important to continue to do which action after discharge? Avoid coughing. A client who has undergone a subtotal gastrectomy is being prepared for discharge. Which items concerning ongoing self-management should the nurse reinforce to the client? Select all that apply. - Eat smaller and more frequent meals. - Drink fluids between meals not with them. The nurse is checking a client for the correct placement of a nasogastric (NG) tube. The nurse aspirates the client's stomach contents and checks its pH level. Which pH value indicates the correct placement of the tube? 3.5 The nurse is collecting admission data on the client with hepatitis. Which finding would be a direct result of this client's condition? Drowsiness A client in the emergency department reports right lower quadrant abdominal pain. After noting a white blood cell count of 16,500 cells/mm3, the nurse should question which prescriptions? Select all that apply. - Milk of magnesia - Heat pad to the abdomen The nurse is reinforcing instructions to a client about insertion of a Sengstaken-Blakemore tube. Which statement by the client indicates an understanding of the teaching? The tube will be inserted through my nose to my stomach. The nurse is assisting in planning stress management strategies for the client with irritable bowel syndrome. Which suggestion should the nurse give to the client? Learn measures such as biofeedback or progressive relaxation. A client with viral hepatitis states to the nurse, "I am so yellow." The nurse should take which action? Assist the client in expressing feelings. A client is admitted to an acute care facility with complications of celiac disease. Which question should be helpful initially in obtaining information for the nursing care plan? "What is your understanding of celiac disease?" A client arrives at the emergency department and complains of severe abdominal pain. The initial diagnosis is acute abdomen, and an x-ray and an abdominal ultrasonogram are prescribed to be obtained immediately. The nurse prepares the client for these diagnostic tests and reviews the health care provider's prescriptions. Which prescription should the nurse question if written on the health care provider's prescription form? Administration of an opioid analgesic The nurse is preparing to administer an enteral feeding through a nasogastric tube. The nurse should place the client in which position during and after the feedings? Fowler's A client with Crohn's disease has a prescription to begin taking antispasmodic medication. The nurse should time the medication so that each dose is taken at which time? 30 minutes before meals The nurse is reinforcing dietary instructions for a client with peptic ulcer disease. Which action does the nurse encourage the client to do? Eat anything as long as it does not aggravate or cause pain. A postgastrectomy client is at high risk for hyperglycemia related to uncontrolled gastric emptying of fluid and food into the small intestine (dumping syndrome). Because of this risk, the nurse plans to monitor which data? Postprandial blood glucose readings [Show More]

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