MedSurg Test 5
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. What would you like to do?
Which of the following
assessments should the nurse prioritize in the care of a patient who has
recently begun receiving parenteral nutrition (PN)?
- B) Electrolyte levels and
- daily weights
After administering a dose of
promethazine (Phenergan) to a patient with nausea and vomiting, the nurse
explains that which of the following may be experienced as a common temporary
adverse effect of the medication?
The nurse is caring for a
68-year-old patient admitted with abdominal pain, nausea, and vomiting. The
patient has an abdominal mass and a bowel obstruction is suspected. The nurse
auscultating the abdomen listens for which of the following types of bowel sounds
that is consistent with the patient’s clinical picture?
D) High pitched and hyperactive above the area of obstruction
Which of the following tasks can
the RN delegate to the NAP?
- c. Empty drainage devices and
- measure output
All of the following decrease lower
esophageal sphincter pressure except:
d. metoclopramide (Reglan)
Which drug therapy is usually the fastest acting for
relief of constipation?
b. Saline and osmotic solutions
1. The most important reason for
elevating the head of a patient's bed to at least 30 degrees prior to
administration of a tube-feeding is:
- b) to minimize the patient's risk
- for aspiration of gastric contents
. __________ is one of the top five
pathogens contributing to food-borne illnesses acquired in the USA.
3. A 2-year old patient presents in
the ED with rapid radial pulses, mild tenting of the skin at the sternum,
increased respiration rate, and blood pressure within normal limits. The parent
indicates the 2-year old has been vomiting for over 48 hours and is not
"keeping anything down". The nurse knows that it's likely the patient
__________, and calls the doc for orders.
d) is hypovolemic
When planning nutritional intervention for a healthy 83- year old man, the
nurse recognizes that the factor most likely to affect his
nutritional status is
- Living alone on a fixed income
A patient with a history of peptic ulcer disease is hospitalized with symptoms
of perforation. During the initial assessment, the nurse would expect the
patient to report
- sudden, severe upper abdominal pain and shoulder pain
The nurse teaches the patient with Diverticulosis to
- maintain a high-fiber diet and use bulk laxatives to increase fecal volume
The RN can delegate all of the following to the
Evaluate nutritional status of patient receiving enteral feeding
nurse teaches the patient with a hiatal hernia or GERD to control symptoms by
Sleeping with the head of the bed elevated on 4-6-in blocks
preferred immediate treatment for an acute episode of constipation is the
A patient receiving a gastrostomy or
jejunostomy feeding may experience what complications? (select all that apply)
A. Skin irritation
C. Accidental removal of the tube
A 45 year old single mother of 2 comes
to the clinic with complaints of a burning sensation in the upper region of her
abdomen, nausea and vomiting. She states the symptoms started several months
ago, but have been getting worse over the last several weeks, especially after
her pad Thai noodles. She smokes a pack of cigarettes a day, drinks 3-4 cups of
coffee a day to "keep her going," has two glasses of vodka a day to
help her unwind from her day, nurse suspects:
B. Gastric ulcer
A nursing intervention that is
indicated for a male patient following an inguinal herniorrhaphy is
- B. Elevating the scrotum with a
- scrotal support.
of the following procedures can be delegated to LPN?
- Empty drainage devices and measure output
is recovering from sever vomiting and is beginning to tolerate oral intake.
Which of the following food choices would not be most appropriate?
patient is complaining of acute abdominal pain. RN should immediately
a. Obtain vital signs
The nurse is planning to teach the client with gastroesophageal reflux disease
about substances that will increase the lower esophageal sphincter pressure.
Which item should the nurse include on the list?
2. The nurse us monitoring a client with a
diagnosis of peptic ulcer. Which assessment finding would most likely indicate
perforation of the ulcer?
- rigid, board like abdomen
The nurse is reviewing the record of a client with Crohn’s
disease. Which stool characteristic should the nurse expect to note documented
in the client’s record?
1.) A Nurse noticed newly written orders for
insertion of a NG feeding tube in her patient. Once the tube is inserted, what
is the best way to confirm initial placement of the NG tube?
The Dietician is teaching Nutritional therapy to a Postgastrectomy patient.
During the discussion the Dietician understands the patient needs further
teaching when she states:
- “ So…proteins and fats are decreased to help decrease energy for a safe recovery?”
Inflammatory bowel disease (IBD) is best characterized
- Chronic inflammation of the
- GI tract.
A patient is about to be discharged following the insertion of an
enteral feeding device. The LPN is
educating the patient and caregiver regarding the self-care regime they
will need to follow. The RN should…
intervene and educate the patient
A patient who has recently undergone esophageal surgery continues to
have bloody drainage via his NG tube.
The RN should be concerned if it last longer than…
In contrast to diverticulitis, the patient with diverticulosis…
often has no symptoms
2005 Dietary Guidelines for Americans recommends that ________________percent
of total calories should come from carbohydrates.
untreated bacterial peritonitis may occur within _______________hours.
a. 6 to 12
healthy and viable ostomy stoma should appear________________.
b. rose to beefy red
The nurse is taking care of a
critically ill patient on parental nutrition containing fat emulsion.
Which labs may be requested to monitor closely for this patient?
A patient has been consistently
vomiting for 2 days. Upon arrival to the ER labs indicating electrolyte
imbalances are drawn. What would you expect the outcome to be from the loss of
D. Metabolic alkalosis
A 19 year old male enters the ER
with pain in the RLQ with rebound tenderness. You suspect he has appendicitis
and take special consideration to limit the life threatening risk of
A nurse is caring for a patient presenting with
symptoms of peptic ulcer disease and receives an order to draw labs for serum
amylase. The nurse knows this test is used to check for which complication of
- penetration of the pancreas by duodenal ulcer
Why does central parenteral nutrition have to be
given through a large central vein?
- because the solution is hypertonic (1600 mOsm/L)
What are some major roles of the nurse in caring
for a patient with a new ostomy? (select all that apply)
- Emotional support as patient copes with changes in body image.
- Psychologically prepare the patient for the
- changes before surgery.
- Encourage patient to drink plenty of fluids and
- maintain a healthy diet.
- Patient and caregiver teaching about how to care
- for the ostomy and the stoma.
providing a tube feeding to a patient, sterile water should be used to flush
the tube for which of the following patients?
patient is being treated for a gastric ulcer at a ambulatory care clinic. The nurse is educating the patient on post
treatment expectations. The nurse notes
that the patient understands when they state which of the following:
- It could take up to 9 weeks for
- my ulcers to commpletey heal even if I am no longer experiencing pain.
assessing a patient who is in postoperative recovery following a newly placed
colostomy. The nurse notes some mild to
moderate swelling the cause is most likely:
- Normal in the initial post operative period
patient is receiving enteral tube feeding and is at risk for aspiration. Prior to feeding, the action that the nurse
should take first is:
- . Ensure the tube is in the proper location with
- head of bed at least 30°
patient has been recently diagnosed with Peptic Ulcer Disease. The nurse should teach the patient to:
- A. Eat
- as normally as possible, avoiding foods that cause pain
statement is FALSE when teaching a newly diagnosed Irritable Bowel
Syndrome (IBS) patient?
Prolonged use of antibiotics
1. When performing an abdominal
assessment, do the four basic steps in which order?
- B. inspection, auscultation,
- percussion, palpation
2. Your pt. had severe midepigastric
or RUQ pain radiating to the back or referred to the right scapula, belching
that leaves a sour taste in the mouth, and flatulence. She most likely has?
- B. Acute cholecystitis, acute
- cholelithiasis, or choledocholithiasis
3. In a pt. with suspected
appendicitis, which of these interventions are appropriate?
- C. Give I.V. Fluids, give pt.
- nothing by mouth, but give analgesics judiciously; and place him in fowler's
- position to reduce pain.
patient who has dysphagia as a consequence of a stroke is receiving enteral
feedings through a percutaneous endoscopic gastrostomy (PEG). Which of the
following interventions should the nurse integrate into this patient's care?
- flush the tube before and after feedings if the patient's feedings are
patient reports having dry mouth and asks for some liquid to drink.
The nurse reasons that this symptom can most likely be attributed to a common
adverse effect of which of the following medications?
- promethazine (phenergan)
nurse would question the use of which of the following cathartic agents in
a patient with renal insufficiency?
. milk of magnesia
1.) During the bodies pathophysiology of starvation,
what does the body use first?
2.) Which of the 5 restrictive surgeries is
c. gastric banding
3.) These are all common causes of upper
gastrointestinal bleeding EXCEPT
c.excessive alcohol use
nurse is preparing to administer enteral nutrition to her patient. The
patient’s residual volume is 510 ml. Which of the following is the proper
- a) Hold enteral nutrition and
- reassess patient tolerance
teaching a patient recently diagnosed with Peptic Ulcer Disease (PUD) ways to
prevent recurrence or complications of ulcers which of the following should be
- a) Patient should avoid alcohol
caring for a patient with Clostridium difficle
(C. diff) which nursing actions are important to prevent spread of
infection (Select All That Apply)
- a) Wash hands before and after
- contact with each patient
- b) Place patient in a private
- d) Use gown and glove contact
The nurse explains to the patient
with gastroesophageal reflux disease that this disorder
- D often involves the relaxation of
- the lower esophageal sphincter allowing stomach contents to back up into the
A patient with anorexia nervosa
shows signs of malnutrition. During initial refeeding, the nurse carefully
assesses the patient for what abnormal lab value
During the assessment of patient with acute abdominal pain, the nurse should...
measure body temperature because an elevated temperature may indicate an inflammatory or infectious process.
What would you like to do?
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