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WorksheetsClinical Scenario-Based Nursing Questions
Total questions: 97
Worksheet time: 49mins
Which action would the nurse include in the plan of care for a patient who is being admitted with a C. difficile infection?
Teach the patient about proper food storage.
Order a diet without dairy products for the patient.
Place the patient in a private room on contact isolation.
Teach the patient about why antibiotics will not be used.
A 74-yr-old male patient tells the nurse that growing old causes constipation, so he has been using a suppository to prevent constipation every morning. Which action would the nurse take first?
Encourage the patient to increase oral fluid intake.
Question the patient about risk factors for constipation.
Suggest that the patient increase intake of high-fiber foods.
Teach the patient that a daily bowel movement is unnecessary.
A patient who has chronic constipation asks the nurse about the use of psyllium (Metamucil). Which information would the nurse provide?
Fiber-containing laxatives may reduce the absorption of fat-soluble vitamins.
Dietary sources of fiber should be eliminated to prevent excessive gas formation.
Use of this type of laxative to prevent constipation does not cause adverse effects.
Large amounts of fluid should be taken to prevent impaction or bowel obstruction.
A 26-yr-old woman is being evaluated for vomiting and abdominal pain. Which question from the nurse will be most useful in determining the cause of the patient's symptoms?
What type of foods do you eat?
Is it possible that you are pregnant?
Can you tell me more about the pain?
What is your usual elimination pattern?
A patient reports gas pains and abdominal distention 2 days after a small bowel resection. Which action would the nurse take?
Administer morphine sulfate.
Encourage the patient to ambulate.
Offer the prescribed promethazine.
Instill a mineral oil retention enema.
A patient with blunt abdominal trauma from a motor vehicle crash undergoes peritoneal lavage. If the lavage returns brown fecal drainage, which action will the nurse plan to take next?
A. Auscultate the bowel sounds.
B. Prepare the patient for surgery.
C. Check the patient's oral temperature.
D. Obtain information about the accident.
A young adult patient is admitted to the hospital for evaluation of right lower quadrant abdominal pain with nausea and vomiting. Which action would the nurse take?
Assist the patient to cough and deep breathe.
Palpate the abdomen for rebound tenderness.
Suggest the patient lie on the side, flexing the right leg.
Encourage the patient to sip clear, noncarbonated liquids.
Which action will the nurse include in the plan of care for a 25-yr-old male patient with a new diagnosis of irritable bowel syndrome (IBS)?
Encourage the patient to express concerns and ask questions about IBS.
Suggest that the patient increase the intake of milk and other dairy products.
Teach the patient to avoid using nonsteroidal antiinflammatory drugs (NSAIDs).
Teach the patient about the use of alosetron (Lotronex) to reduce IBS symptoms.
A patient being admitted with an acute exacerbation of ulcerative colitis reports crampy abdominal pain and passing 15 bloody stools a day. Which intervention would the nurse include in the patient's plan of care?
A. Administer oral metoclopramide.
B. Instruct the patient not to eat or drink.
C. Administer cobalamin (vitamin B12) injections.
D. Teach the patient about total colectomy surgery.
Which nursing action will the nurse include in the plan of care for a patient admitted with an exacerbation of inflammatory bowel disease (IBD)?
Restrict fluid intake.
Monitor stools for blood.
Ambulate six times daily.
Increase dietary fiber intake.
Because anemia or hemorrhage may occur with IBD, stools should be assessed for the presence of blood. The other actions would not be appropriate for the patient with IBD. Dietary fiber may increase gastrointestinal motility and exacerbate the diarrhea, severe fatigue is common with IBD exacerbations, and dehydration may occur. Which prescribed intervention for a patient with chronic short bowel syndrome would the nurse question?
Senna 1 tablet daily
Ferrous sulfate 325 mg daily
Psyllium (Metamucil) 3 times daily
Diphenoxylate with atropine (Lomotil) PRN loose stools
A 22-yr-old female patient with an exacerbation of ulcerative colitis is having 15 to 20 stools daily and has excoriated perianal skin. Which patient behavior indicates that the nurse's teaching about skin integrity has been effective?
A. The patient uses incontinence briefs to contain loose stools.
B. The patient uses witch hazel compresses to soothe irritation.
C. The patient asks for antidiarrheal medication after each stool.
D. The patient cleans the perianal area with soap after each stool.
Which diet choice by the patient with an acute exacerbation of inflammatory bowel disease (IBD) indicates a need for more teaching?
Scrambled eggs
White toast and jam
Oatmeal with cream
Pancakes with syrup
After a total proctocolectomy and permanent ileostomy, the patient tells the nurse, "I cannot manage all this. I don't want to look at the stoma." Which action would the nurse take?
Reassure the patient that ileostomy care will become easier.
Ask the patient about the concerns with stoma management.
Postpone any teaching until the patient adjusts to the ileostomy.
Develop a detailed written list of ostomy care tasks for the patient.
After having frequent diarrhea and a weight loss of 10 lb (4.5 kg) over 2 months, a patient has a new diagnosis of Crohn's disease. What would the nurse plan to teach the patient?
Medication use
Fluid restriction
Enteral nutrition
Activity restrictions
A young woman with Crohn's disease develops a fever and symptoms of a urinary tract infection (UTI) with tan, fecal-smelling urine. Which information will the nurse add to a teaching plan about UTIs for this patient that goes beyond a general teaching plan for UTIs?
Fistulas can form between the bowel and bladder.
Bacteria in the perianal area can enter the urethra.
Drink adequate fluids to maintain normal hydration.
Empty the bladder before and after sexual intercourse.
Which finding is likely in the nurse's assessment of a patient who has a large bowel obstruction?
Referred back pain
Metabolic alkalosis
Projectile vomiting
Abdominal distention
Which screening test would the nurse plan to teach a 45-yr-old male about during an annual wellness exam?
Endoscopy
Colonoscopy
Computerized tomography
Carcinoembryonic antigen (CEA)
The nurse is providing preoperative teaching for a patient scheduled for an abdominal-perineal resection. Which information will the nurse include?
The patient will need to be on bedrest for three days after surgery.
An ileal-anal reservoir will be surgically created in 8 to 12 weeks.
The patient will have a temporary colostomy for 6-12 months.
The site for the stoma will be marked on the abdomen before surgery.
A patient who recently had a colon resection for cancer of the colon asks about the purpose of the carcinoembryonic antigen (CEA) test. Which explanation would the nurse provide?
Identify any metastasis of the cancer.
Monitor for tumor growth after surgery.
Confirm the diagnosis of a specific type of cancer.
Determine the need for postoperative chemotherapy.
A patient had an abdominal-perineal resection for colon cancer. Which action is most important for the nurse to include in the plan of care for the day after surgery?
Teach about a low-residue diet.
Monitor output from the stoma.
Assess the drainage and incision.
Encourage acceptance of the stoma.
A patient is transferred from the recovery room to a surgical unit after a transverse colostomy. The nurse observes the stoma to be deep pink with edema and a small amount of sanguineous drainage. Which action would the nurse take?
Place ice packs around the stoma.
Notify the surgeon about the stoma.
Monitor the stoma every 30 minutes.
Document stoma assessment findings.
Which information will the nurse include in teaching a patient who had a proctocolectomy and ileostomy for ulcerative colitis?
Restrict fluid intake to prevent constant liquid drainage from the stoma.
Use care when eating high-fiber foods to avoid obstruction of the ileum.
Irrigate the ileostomy daily to avoid having to wear a drainage appliance.
Change the pouch every day to prevent leakage of contents onto the skin.
A patient with a new ileostomy asks how much it will drain after the bowel has adapted in a few months. How many cups of drainage per day would the nurse tell the patient to expect?
2
3
4
5
Which action would the nurse plan when admitting a patient with acute diverticulitis plan for initial care?
Administer IV fluids.
Prepare for colonoscopy.
Encourage a high-fiber diet.
Give stool softeners and enemas.
A 40-yr-old male patient has had a herniorrhaphy to repair an incarcerated inguinal hernia. Which patient teaching will the nurse provide before discharge?
Soak in Sitz baths several times each day.
Cough 5 times each hour for the next 48 hours.
Avoid using acetaminophen (Tylenol) for pain.
Apply a scrotal support and ice to reduce swelling.
Which breakfast choice indicates a patient's good understanding of information about a diet for celiac disease?
Wheat toast with butter
Oatmeal with nonfat milk
Bagel with low-fat cream cheese
Corn tortilla with scrambled eggs
After a patient has had a hemorrhoidectomy at an outpatient surgical center, which
instructions will the nurse include in discharge teaching?
A. Maintain a low-residue diet until the area is healed.
B. Avoid using any topical preparations on the surgical area.
C. Take prescribed pain medications before you expect a bowel movement.
D. Delay having a bowel movement for several days until you are well healed
A patient calls the clinic to report a severe diarrhea lasting 4 days. What would the nurse anticipate that the patient will need to do?
Collect a stool specimen.
Prepare for colonoscopy.
Schedule a barium enema.
Have blood cultures drawn.
Which topic would the nurse plan to teach to a patient with Crohn's disease who has megaloblastic anemia?
Iron dextran infusions
Oral ferrous sulfate tablets
Routine blood transfusions
Cobalamin (B12) supplements
The nurse is assessing a patient with abdominal pain. How will the nurse document ecchymosis around the area of umbilicus?
Cullen's sign
Rovsing sign
McBurney's sign
Grey-Turner's sign
A critically ill patient with sepsis is frequently incontinent of watery stools. Which action by the nurse will prevent complications associated with ongoing incontinence?
A. Apply incontinence briefs.
B. Use a fecal management system.
C. Insert a rectal tube with a drainage bag.
D. Assist the patient to a commode frequently
Which question from the nurse would help determine if a patient's abdominal pain might indicate irritable bowel syndrome (IBS)?
Have you been passing a lot of gas?
What foods affect your bowel patterns?
Do you have any abdominal distention?
How long have you had abdominal pain?
A patient in the emergency department has just been diagnosed with peritonitis from a ruptured diverticulum. Which prescribed intervention will the nurse implement first?
Send the patient for a CT scan.
Insert a urinary catheter to drainage.
Infuse metronidazole (Flagyl) 500 mg IV.
Place a nasogastric tube to intermittent low suction.
A patient calls the clinic reporting diarrhea for 24 hours. Which action would the nurse take first?
Inform the patient that testing of blood and stools will be needed.
Suggest that the patient drink clear liquid fluids with electrolytes.
Ask the patient to describe the stools and any associated symptoms.
Advise the patient to use over-the-counter antidiarrheal medication.
A patient is admitted with hypovolemic shock. Which action should the nurse implement first?
Administer IV ketorolac 15 mg for pain relief.
Send a blood sample for a complete blood count (CBC).
Infuse a liter of lactated Ringer's solution over 30 minutes.
Send the patient for an abdominal computed tomography (CT) scan.
Four hours after a bowel resection, a 74-yr-old male patient with a nasogastric tube to suction reports nausea and abdominal distention. Which action would the nurse take first?
A. Auscultate for hypoxic bowel sounds.
B. Notify the patient's health care provider.
C. Check for tube placement and reposition it.
D. Remove the tube and replace it with a new one.
A 19-yr-old woman is brought to the emergency department with a knife handle protruding from her abdomen. Which action would the nurse take during the initial assessment of the patient?
Remove the knife and assess the wound.
Determine the presence of Rovsing sign.
Check for circulation and tissue perfusion.
Insert a urinary catheter and assess for hematuria.
Which activity in the care of a patient with a new colostomy could the nurse delegate to assistive personnel (AP)?
Document the appearance of the stoma.
Place a pouching system over the ostomy.
Drain and measure the output from the ostomy.
Check the skin around the stoma for breakdown.
Which information obtained by the nurse interviewing a patient is most important to communicate to the health care provider?
Blood in the stool.
Mild headache.
Slight fatigue after exercise.
Occasional sneezing.
Which care activity for a patient with a paralytic ileus is appropriate for the registered nurse (RN) to delegate to assistive personnel (AP)?
A. Auscultating for bowel sounds
B. Brushing the teeth and tongue
C. Assessing the nares for irritation
D. Irrigating the nasogastric (NG) tube
After several days of antibiotic therapy for pneumonia, an older hospitalized patient develops watery diarrhea. Which action would the nurse take first?
Notify the health care provider.
Obtain a stool specimen for analysis.
Teach the patient about hand washing.
Place the patient on contact precautions.
Which patient would the nurse assess first after receiving change-of-shift report?
A 40-yr-old patient who has a distended abdomen and tachycardia
A 60-yr-old patient whose ileostomy has drained 800 mL over 8 hours
A 30-yr-old patient with ulcerative colitis who had six liquid stools in 4 hours
A 50-yr-old patient with familial adenomatous polyposis who has occult blood in the stool
A patient with Crohn's disease who is taking infliximab (Remicade) calls the nurse in the outpatient clinic about new symptoms. Which symptom is most important to communicate to the health care provider?
Fever
Nausea
Joint pain
Headache
A 76-yr-old patient with obstipation has a fecal impaction and is incontinent of liquid stool. Which action would the nurse take first?
Administer bulk-forming laxatives.
Assist the patient to sit on the toilet.
Manually remove the hard stool.
Increase the patient's oral fluid intake.
A patient is awaiting surgery for acute peritonitis. Which action will the nurse plan to include in the preoperative care?
Position patient with the knees flexed.
Avoid use of opioids or sedative drugs.
Offer frequent small sips of clear liquids.
Assist patient to breathe deeply and cough.
A 72-yr-old patient with dehydration caused by an exacerbation of ulcerative colitis is receiving 5% dextrose in normal saline at 125 mL/hour. Which assessment finding by the nurse is most important to report to the health care provider?
Skin is dry with tenting and poor turgor.
Patient has not voided for the last 2 hours.
Crackles are heard halfway up the posterior chest.
Patient has had 5 loose stools over the previous 6 hours.
A 19-yr-old patient has familial adenomatous polyposis (FAP). Which action will the nurse in the gastrointestinal clinic include in the plan of care?
Obtain blood samples for DNA analysis.
Schedule the patient for yearly colonoscopy.
Provide preoperative teaching about total colectomy.
Discuss lifestyle modifications to decrease cancer risk.
Which menu choice by the patient with diverticulosis is best for preventing diverticulitis?
Navy bean soup and vegetable salad
Whole grain pasta with tomato sauce
Baked potato with low-fat sour cream
Roast beef sandwich on whole wheat bread
After change-of-shift report, which patient would the nurse assess first?
A. A 40-yr-old male patient with celiac disease who has frequent frothy diarrhea
B. A 30-yr-old female patient with a femoral hernia who has abdominal pain and vomiting
C. A 30-yr-old male patient with ulcerative colitis who has severe perianal skin breakdown
D. A 40-yr-old female patient with a colostomy bag that is pulling away from the adhesive wafer
The nurse is admitting a patient with new-onset steatorrhea. Which question is most important for the nurse to ask?
How much milk do you drink?
Have you had a recent weight loss?
What time of day do your bowels move?
Do you eat meat or other animal products?
Which information will the nurse plan to teach a patient who has lactose intolerance?
Ice cream is relatively low in lactose.
Live-culture yogurt is usually tolerated.
Heating milk will break down the lactose.
Nonfat milk is tolerated better than whole milk.
A 53-year-old male patient with deep partial-thickness burns from a chemical spill in the workplace experiences severe pain followed by nausea during dressing changes. Which action will be most useful in decreasing the patient's nausea?
Keep the patient NPO for 2 hours before and after dressing changes.
Administer the prescribed morphine sulfate before dressing changes.
Encourage the patient to drink carbonated beverages during dressing changes.
Apply cold compresses to the burn area before dressing changes.
Which item should the nurse offer to the patient who is to restart oral intake after being NPO due to nausea and vomiting?
Glass of orange juice
Dish of lemon gelatin
Cup of coffee with cream
Bowl of hot chicken broth
A 38-year old woman receiving chemotherapy for breast cancer develops a Candida albicans oral infection. The nurse will anticipate the need for
hydrogen peroxide rinses.
the use of antiviral agents.
administration of nystatin (Mycostatin) tablets.
referral to a dentist for professional tooth cleaning
Which finding in the mouth of a patient who uses smokeless tobacco is suggestive of oral cancer?
Bleeding during tooth brushing
Painful blisters at the lip border
Red, velvety patches on the buccal mucosa
White, curdlike plaques on the posterior tongue
Which information will the nurse include when teaching adults to decrease the risk for cancers of the tongue and buccal mucosa?
Avoid use of cigarettes and smokeless tobacco.
Use sunscreen when outside even on cloudy days.
Complete antibiotic courses used to treat throat infections.
Use antivirals to treat herpes simplex virus (HSV) infections.
A 46-year-old female with gastroesophageal reflux disease (GERD) is experiencing increasing discomfort. Which patient statement indicates that additional teaching about GERD is needed?
I take antacids between meals and at bedtime each night.
I sleep with the head of the bed elevated on 4-inch blocks.
I eat small meals during the day and have a bedtime snack.
I quit smoking several years ago, but I still chew a lot of gum.
A 68-year-old male patient with a stroke is unconscious and unresponsive to stimuli. After learning that the patient has a history of gastroesophageal reflux disease (GERD), the nurse will plan to do frequent assessments of the patient's
apical pulse.
bowel sounds.
breath sounds.
abdominal girth.
Which statement best describes the action of proton pump inhibitors in the treatment of gastroesophageal reflux disease (GERD)?
reduces gastroesophageal reflux by increasing the rate of gastric emptying.
neutralizes stomach acid and provides relief of symptoms in a few minutes.
coats and protects the lining of the stomach and esophagus from gastric acid.
treats gastroesophageal reflux disease by decreasing stomach acid production.
Which patient choice for a snack 2 hours before bedtime indicates that the nurse's teaching about gastroesophageal reflux disease (GERD) has been effective?
Chocolate pudding
Glass of low-fat milk
Cherry gelatin with fruit
Peanut butter and jelly sandwich
The nurse will anticipate teaching a patient experiencing frequent heartburn about
a barium swallow.
radionuclide tests.
endoscopy procedures.
proton pump inhibitors.
A 58-year-old woman who recently has been diagnosed with esophageal cancer tells the nurse, "I do not feel ready to die yet." Which response by the nurse is most appropriate?
You may have quite a few years still left to live.
Thinking about dying will only make you feel worse.
Having this new diagnosis must be very hard for you.
It is important that you be realistic about your prognosis.
Which information will the nurse include for a patient with newly diagnosed gastroesophageal reflux disease (GERD)?
Peppermint tea may reduce your symptoms.
Keep the head of your bed elevated on blocks.
You should avoid eating between meals to reduce acid secretion.
Vigorous physical activities may increase the incidence of reflux.
Which nursing action should be included in the postoperative plan of care for a patient after a laparoscopic esophagectomy?
Notify the doctor about bloody nasogastric (NG) drainage.
Elevate the head of the bed to at least 30 degrees.
Reposition the NG tube if drainage stops.
Start oral fluids when the patient has active bowel sounds.
When a 72-year-old patient is diagnosed with achalasia, the nurse will teach the patient that
lying down after meals is recommended.
a liquid or blenderized diet will be necessary.
drinking fluids with meals should be avoided.
treatment may include endoscopic procedures.
A 50-year-old man vomiting blood-streaked fluid is admitted to the hospital with acute gastritis. To determine possible risk factors for gastritis, the nurse will ask the patient about:
the amount of saturated fat in the diet.
any family history of gastric or colon cancer.
a history of a large recent weight gain or loss.
use of nonsteroidal antiinflammatory drugs (NSAIDs).
The nurse determines that teaching regarding cobalamin injections has been effective when the patient with chronic atrophic gastritis states which of the following?
The cobalamin injections will prevent gastric inflammation.
The cobalamin injections will prevent me from becoming anemic.
These injections will increase the hydrochloric acid in my stomach.
These injections will decrease my risk for developing stomach cancer.
Which medications will the nurse teach the patient about whose peptic ulcer disease is associated with Helicobacter pylori?
Sucralfate (Carafate), nystatin (Mycostatin), and bismuth (Pepto-Bismol)
Amoxicillin (Amoxil), clarithromycin (Biaxin), and omeprazole (Prilosec)
Famotidine (Pepcid), magnesium hydroxide (Mylanta), and pantoprazole (Protonix)
Metoclopramide (Reglan), bethanechol (Urecholine), and promethazine (Phenergan)
Amoxicillin (Amoxil), clarithromycin (Biaxin), and omeprazole (Prilosec)
Which action should the nurse in the emergency department anticipate for a 23-year-old patient who has had several episodes of bloody diarrhea?
Obtain a stool specimen for culture.
Administer antidiarrheal medication.
Provide teaching about antibiotic therapy.
d. Teach about adverse effects of acetaminophen (Tylenol).
The nurse will anticipate preparing a 71-year-old female patient who is vomiting "coffee-ground" emesis for
endoscopy.
angiography.
barium studies.
gastric analysis.
A 57-year-old man with Escherichia coli O157:H7 food poisoning is admitted to the hospital with bloody diarrhea and dehydration. Which order will the nurse question?
Infuse lactated Ringer's solution at 250 mL/hr.
Monitor blood urea nitrogen and creatinine daily.
Administer loperamide (Imodium) after each stool.
Provide a clear liquid diet and progress diet as tolerated.
Which information will the nurse include when teaching a patient with peptic ulcer disease about the effect of ranitidine (Zantac)?
Ranitidine absorbs the gastric acid.
Ranitidine decreases gastric acid secretion.
Ranitidine constricts the blood vessels near the ulcer.
Ranitidine covers the ulcer with a protective material.
A family member of a 28-year-old patient who has suffered massive abdominal trauma in an automobile accident asks the nurse why the patient is receiving famotidine (Pepcid). The nurse will explain that the medication will:
decrease nausea and vomiting.
inhibit development of stress ulcers.
lower the risk for H. pylori infection.
prevent aspiration of gastric contents.
A 68-year-old patient with a bleeding duodenal ulcer has a nasogastric (NG) tube in place, and the health care provider orders 30 mL of aluminum hydroxide/magnesium hydroxide (Maalox) to be instilled through the tube every hour. To evaluate the effectiveness of this treatment, the nurse:
monitors arterial blood gas values daily.
periodically aspirates and tests gastric pH.
checks each stool for the presence of occult blood.
measures the volume of residual stomach contents.
A 44-year-old man admitted with a peptic ulcer has a nasogastric (NG) tube in place. When the patient develops sudden, severe upper abdominal pain, diaphoresis, and a firm abdomen, which action should the nurse take?
Irrigate the NG tube.
Check the vital signs.
Give the ordered antacid.
Elevate the foot of the bed.
A 50-year-old patient who underwent a gastroduodenostomy (Billroth I) earlier today complains of increasing abdominal pain. The patient has no bowel sounds and 200 mL of bright red nasogastric (NG) drainage in the last hour. The highest priority action by the nurse is to
contact the surgeon.
irrigate the NG tube.
monitor the NG drainage.
administer the prescribed morphine.
Which patient statement indicates that the nurse's teaching following a gastroduodenostomy has been effective?
"Vitamin supplements may prevent anemia."
"Persistent heartburn is common after surgery."
"I will try to drink more liquids with my meals."
"I will need to choose high carbohydrate foods."
At his first postoperative checkup appointment after a gastrojejunostomy (Billroth II), a patient reports that dizziness, weakness, and palpitations occur about 20 minutes after each meal. The nurse will teach the patient to
increase the amount of fluid with meals.
eat foods that are higher in carbohydrates.
lie down for about 30 minutes after eating.
drink sugared fluids or eat candy after meals.
A 62-year-old man patient who requires daily use of a nonsteroidal antiinflammatory drug (NSAID) for the management of severe rheumatoid arthritis has recently developed melena. The nurse will anticipate teaching the patient about
substitution of acetaminophen (Tylenol) for the NSAID.
use of enteric-coated NSAIDs to reduce gastric irritation.
reasons for using corticosteroids to treat the rheumatoid arthritis.
misoprostol (Cytotec) to protect the gastrointestinal (GI) mucosa.
The health care provider prescribes antacids and sucralfate (Carafate) for treatment of a patient's peptic ulcer. The nurse will teach the patient to take
sucralfate at bedtime and antacids before each meal.
sucralfate and antacids together 30 minutes before meals.
antacids 30 minutes before each dose of sucralfate is taken.
antacids after meals and sucralfate 30 minutes before meals.
Which information about dietary management should the nurse include when teaching a patient with peptic ulcer disease (PUD)?
You will need to remain on a bland diet.
Avoid foods that cause pain after you eat them.
High-protein foods are least likely to cause you pain.
You should avoid eating any raw fruits and vegetables.
A 73-year-old patient is diagnosed with stomach cancer after an unintended 20-pound weight loss. Which nursing action will be included in the plan of care?
Refer the patient for hospice services.
Infuse IV fluids through a central line.
Teach the patient about antiemetic therapy.
Offer supplemental feedings between meals.
A 26-year-old patient with a family history of stomach cancer asks the nurse about ways to decrease the risk for developing stomach cancer. The nurse will teach the patient to avoid
emotionally stressful situations.
smoked foods such as ham and bacon.
foods that cause distention or bloating.
chronic use of H2 blocking medications.
The nurse is assessing a patient who had a total gastrectomy 8 hours ago. What information is most important to report to the health care provider?
Absent bowel sounds
Complaints of incisional pain
Temperature 102.1° F (38.9° C)
Scant nasogastric (NG) tube drainage
A 58-year-old patient has just been admitted to the emergency department with nausea and vomiting. Which information requires the most rapid intervention by the nurse?
The patient has been vomiting for 4 days.
The patient takes antacids 8 to 10 times a day.
c. The patient is lethargic and difficult to arouse.
d. The patient has undergone a small intestinal resection.
A 26-year-old woman has been admitted to the emergency department with nausea and vomiting. Which action could the RN delegate to unlicensed assistive personnel (UAP)?
Auscultate the bowel sounds.
Assess for signs of dehydration.
Assist the patient with oral care.
Ask the patient about the nausea.
A 49-year-old man has been admitted with hypotension and dehydration after 3 days of nausea and vomiting. Which order from the health care provider will the nurse implement first?
Insert a nasogastric (NG) tube.
Infuse normal saline at 250 mL/hr.
Administer IV ondansetron (Zofran).
Provide oral care with moistened swabs.
Which patient should the nurse assess first after receiving change-of-shift report?
A patient with nausea who has a dose of metoclopramide (Reglan) due
A patient who is crying after receiving a diagnosis of esophageal cancer
A patient with esophageal varices who has a blood pressure of 92/58 mm Hg
A patient admitted yesterday with gastrointestinal (GI) bleeding who has melena
A patient returned from a laparoscopic Nissen fundoplication for hiatal hernia 4 hours ago. Which assessment finding is most important for the nurse to address immediately?
a. The patient is experiencing intermittent waves of nausea.
b. The patient complains of 7/10 (0 to 10 scale) abdominal pain.
c. The patient has absent breath sounds in the left anterior chest.
d. The patient has hypoactive bowel sounds in all four quadrants.
Which assessment should the nurse perform first for a patient who just vomited bright red blood?
Measuring the quantity of emesis
Palpating the abdomen for distention
Auscultating the chest for breath sounds
Taking the blood pressure (BP) and pulse
The nurse is concerned about blood loss and possible hypovolemic shock in a patient with acute gastrointestinal (GI) bleeding. BP and pulse are the best indicators of these complications. The other information is important to obtain, but BP and pulse rate are the best indicators for assessing intravascular volume. Which order from the health care provider will the nurse implement first for a patient who has vomited 1200 mL of blood?
Give an IV H2 receptor antagonist.
Draw blood for typing and crossmatching.
Administer 1000 mL of lactated Ringer's solution.
Insert a nasogastric (NG) tube and connect to suction.
The nurse is administering IV fluid boluses and nasogastric irrigation to a patient with acute gastrointestinal (GI) bleeding. Which assessment finding is most important for the nurse to communicate to the health care provider?
The bowel sounds are hyperactive in all four quadrants.
The patient's lungs have crackles audible to the midchest.
The nasogastric (NG) suction is returning coffee-ground material.
The patient's blood pressure (BP) has increased to 142/84 mm Hg.
After the nurse has completed teaching a patient with newly diagnosed eosinophilic esophagitis about the management of the disease, which patient action indicates that the teaching has been effective?
Patient orders nonfat milk for each meal.
Patient uses the prescribed corticosteroid inhaler.
Patient schedules an appointment for allergy testing.
Patient takes ibuprofen (Advil) to control throat pain.
An 80-year-old who is hospitalized with peptic ulcer disease develops new-onset auditory hallucinations. Which prescribed medication will the nurse discuss with the health care provider before administration?
Sucralfate (Carafate)
Omeprazole (Prilosec)
Metoclopramide (Reglan)
Aluminum hydroxide (Amphojel)
The nurse and a licensed practical/vocational nurse (LPN/LVN) are working together to care for a patient who had an esophagectomy 2 days ago. Which action by the LPN/LVN requires that the nurse intervene?
The LPN/LVN uses soft swabs to provide for oral care.
The LPN/LVN positions the head of the bed in the flat position.
The LPN/LVN encourages the patient to use pain medications before coughing.
The LPN/LVN includes the enteral feeding volume when calculating intake and output.
After change-of-shift report, which patient should the nurse assess first?
42-year-old who has acute gastritis and ongoing epigastric pain
70-year-old with a hiatal hernia who experiences frequent heartburn
53-year-old who has dumping syndrome after a recent partial gastrectomy
60-year-old with nausea and vomiting who has dry oral mucosa and lethargy
