Adult Exam 3 - Chapter 52 Flashcards

The nurse assesses a client who has appendicitis. Which assessment finding would the nurse expect?

A. Severe, steady right lower quadrant pain

B.Abdominal pain associated with nausea and vomiting

C.Marked peristalsis and hyperactive bowel sounds

D.Abdominal pain that increase with knee flexion

The nurse reviews the lab results for a client who has possible appendicitis. Which lab test finding would the nurse expect?

A. Decreased potassium level

B. Increased sodium level

C. Elevated leukocyte count

D. Decreased thrombocyte count

The nurse teaches a client who has viral gastroenteritis. Which dietary instruction would the nurse include in the health teaching?

A. Drink plenty of fluids to prevent dehydration

B. You should only drink 1 L of fluids daily

C. Increase your protein intake by drinking more milk

D. Sips of cola or tea may help to relieve nausea

The nurse assesses a client with gastroenteritis. What factor would the nurse consider as the most likely cause of this disorder?

A. Consuming too much fruit

B. Consuming fried or pickled foods

C. Consuming dairy products

D. Consuming raw seafood

The nurse assess a client who is hospitalized with an exacerbation of Crohn Disease. Which assessment findings would the nurse expect?

A. Positive Murphy sign with rebound tenderness to palpation.

B. Dull, hypoactive bowel sounds in the lower abdominal quadrants

C. High pitched, rushing bowel sounds in the right lower quadrant.

D. Reports of abdominal cramping that is worse at night

After teaching a patient with diverticular disease, a nurse assesses the cleints understanding. Which menu selection indicates the clients correctly understood the teaching?

A. Roasted chicken with rice pilaf and a cup of coffee with cream

B. Spaghetti with meat nausea. fresh fruit cups and hot tea

C. Garden salad with a cup of bean soup and a glass of low fat milk

D. Baked fish with steamed carrots and glass of apple juice

A nurse cares for a young client with anew ileostomy. The client states, I cannot go to prom with an ostomy. How would the nurse respond?

A. Sure you can. Purchase a prom dress one size larger to hide the ostomy appliance.

B. The pouch won't be as noticeable if you avoid broccoli and carbonated drinks prior to the prom.

C.Lets talk to the ostomy nurse about options for ostomy supplies and dress styles

D. You can remove the pouch from your ostomy appliance when you are at the prom so that it is less noticeablee.

The nurse teaches a client about how to prevent transmission of gastroenteritis. Which statement by the nurse indicates a need for further teaching?

A. I won't let anyone use my dishes or glasses

B. Ill wash my hands with antibacterial soap

C. Ill keep my bathroom extra clean

D. Ill cook all the meals for my family

After teaching a client who is prescribed adalimumab for severe ulcerative colitis, the nurse assesses the cleints understanding. Which statement made by the client indicates a need for further teaching?

A. I will avoid large crowds and people who are sick.

B. I will take medication with my breakfast each morning.

C. Nausea and committing are common side effects of this drug.

D. I should wash my hands after I play with my dog.

The nurse is caring for a client who is prescribed sulfasalazine. Which question would the nurse ask the client before starting the drug?

A. Are you taking vitamin C or B?

B. Do you have any allergy to sulfa drugs?

C. Can you swallow pills pretty easily?

D. Do you have insurance to cover this drug?

A nurse assesses a client who has ulcerative colitis and severe diarrhea. Which assessment would the nurse complete first?

A. Inspection of oral mucosa.
B. Recent dietary intake

C.Heart rate and rhythm

D. Percussion of abdomen

A nurse reviews the electronic health records of a client who has Crohn disease and a draining fistula. Which documentation would alert the nurse to urgently contact the primary health care provider for additional prescriptions?

A. Serum potassium of 2.6

B. Client ate 20% of breakfast meal

C. White blood cell count of 8200

D. Client's weight decreased by 3 pounds

A client is preparing to have a laparoscopic restorative proctocolectomy with Cleo pouch - anal anastomosis. Which preoperative health teaching would the nurse include?

A. You will have to wear an appliance for your permanent ileostomy.

B. You should be able to have a better bowel continence after healing occurs.

C. You will have large abdominal incision that will require irrigation.

D. This procedure can be performed under general or regional anesthesia.

After teaching a client who has diverticulitis, a nurse assesses the client's understanding. Which statement made by the client indicates a need for further teaching?

A. Ill ride my bike or tale a long walk at least three times a week.

B. I must try to include at least 25 g of fiber in my diet everyday.

C.I will take a laxative nightly at bedtime to avoid becoming constipated.

D.I should use my legs rather than my back muscles when I lift heavy objects.

The nurse plans care for a client with Chron's disease who has a heavily draining fistula. Which intervention would ne the nurse's priority action?

A. Low fiber diet

B. Skin protection

C. Antibiotic administration

D. aIntravenous glucocorticoids

The nurse assess a patient who is recovering from an ileostomy placement. Which assessment finding would alert the nurse to immediately contact the primary health care provider?

A. Pale and bluish stoma

B. Liquid stool

C. Ostomy pouch intact

D. Blood tinged output

A nurse cares for a client with a new ileostomy. The client states, I don't think my friends will accept me with this ostomy. How would the nurse respond?

A. Your friends will be happy that you are alive

B. Tell me more about your concerns

C. A therapist can help you resolve your concerns

D. With time you will accept your new body.

The nurse teaches a community group ways to prevent Escherichia coli infection. Which statement would the nurse include in this groups teachings? (Select all that apply.)

A. Wash your hands after any contact with animals.

B. It is not necessary to buy a meat thermometer.

C. Stay away from people who are ill with diarrhea

D. Use separate cutting boards for meat and veggies

E. Avoid swimming in the backyard pool and using hot tubs.

The nurse assesses a client with ulcerative colitis. Which complications are paired correctly with their physiologic processing? (Select all that apply.)
A. Lower gastrointestinal bleeding - erosion of the bowel wall

B. Abscess formation - localized pockets of infection develop in the ulcerated bowel lining

C.Toxic megacolon - transmural inflammation resulting in pyuria and fecaluria

D. Nontechnical bowel obstruction - paralysis of colon resulting from colorectal cancer

E. Fistula - dilation and colonic ileus caused by paralysis of the colon

A nurse assess a patient who has celiac disease. Which signs and symptoms would the nurse expect? (Select all that apply.)

A. Weight gain

B. Anorexia

C. Constipation

D. Anal Fistula

E. Abdominal pain

A nurse cares for an older adult who is admitted to the hospital with complications of diverticulitis. Which actions would the nurse include in clients plan of care? (Select all that apply.)

A. Administer pain medications as prescribed.

B. Palpate the abdomen for distention

C. Assess for sudden changes in mental status

D. Provide the client with a high fiber diet

E. Evaluate stools for occult blood.

A nurse prepares to discharge a client who is newly diagnosed with chronic inflammatory bowel disease. Which questions would the nurse ask in preparation for discharge? (Select all that apply.)

A. Does your gym provide yoga class?

B. When should you contact your provider?

C. What do you plan to eat for dinner?

D. Do you have a scale for daily weights?

E. How many bathrooms are in your home?

After teaching a patient who has a permanent ileostomy, a nurse assesses the client's understanding. Which dietary items chosen for dinner indicate that the client needs further teaching? (Select all that apply.)

A. Corn

B. String Beans

C. Carrots

D. Wheat rice

E. Squash

A nurse cares for a patient who has a chronic inflammatory bowel disease. Which actions would the nurse take to prevent skin excoriation? (Select all that apply.)

A. Cleanse the perineum with an antibacterial soap.

B. Use medicated wipes instead of toilet paper

C.Identify foods that decrease constipation

D. Apply a thin coat of aloe cream to the perineum.

E. Gently pat the perineum dry after cleansing.

The nurse is caring for a client who is diagnosed with celiac disease and preparing to start natalizumab. Which health teaching would the nurse include in the teaching? (Select all that apply.)

A. Need to have drug administer by a primary health care provider.

B. Need to avoid crowds and individuals who have infection.

C. Need to report injection reactions such as redness and swelling

D. Awareness of a rare but potentially fatal drug complication.

E. Need to report any signs and symptoms of infection immediately.

The nurse is caring for a client with peritonitis. What assessment findings would the nurse expect? (Select all that apply.)

A. Nausea and vomiting

B. Distended rigid abdomen

C. Abdominal pain

D. Tachycardia

E. Decreased urinary output

F. Fever