Gastrointestinal

The patient with cystic fibrosis has been ordered to receive pancreatic enzymes. The nurse collaborates with the clinical pharmacist to create which dosing schedule?

The nurse is caring for a 38-year-old G2P1 patient diagnosed with iron-deficiency anemia. The nurse recommends which drink choice to improve absorption of the ordered iron supplements?

The nurse most anticipates administering total parenteral nutrition (TPN) to the patient with which condition?

The nurse assesses which body part to detect jaundice in the patient with dark skin?

​The nurse is supervising the care of the patient prior to a surgical procedure who has been ordered to receive a clear liquid diet. Which food item, if provided to the patient by the unlicensed assistive personnel, prompts the nurse to intervene with further education? 

The nurse is developing a plan of care for a patient who is receiving enteral feedings via gastrostomy tube. Which of the following is the priority nursing diagnosis for the patient?

The nurse is caring for a 30-year-old female patient with ulcerative colitis. The nurse decides to include ‘risk for altered skin integrity related to frequent and loose bowel movement’. Which of the following is most helpful in preventing perianal skin breakdown?

The nurse is caring for a 40-year-old male patient who is experiencing wasting related to HIV infection. In addition to antiretroviral therapy, which intervention is most likely to be helpful?

A 38-year-old unconscious man with a diagnosis of alcohol intoxication is lying on his back in the emergency department. Suddenly he starts vomiting. Which of the following is the best next step?

A 73-year-old man is brought to the emergency department with complaints of profuse watery diarrhea, 7 to 8 times per day over the last three days. Which of the following is the best next step?

The nurse is taking care of a patient who recently received an allogenic stem-cell transplant for acute lymphoblastic leukemia (ALL). The patient abruptly complains of right upper quadrant abdominal pain. Upon assessment, the nurse notes abdominal swelling and yellowing of the sclera and skin. The nurse anticipates the provider will prescribe which treatment?

The nurse is providing discharge teaching for a client who had abdominal surgery and is being discharged with a Jackson-Pratt (JP) drain. Which statements does the nurse include in the teaching? Select all that apply.

The nurse is caring for a client following a diagnostic liver biopsy. Which interventions does the nurse include in the plan of care? Select all that apply.

Which individual is at the highest risk for hepatitis C infection?

The 24-year-old female patient presents to the emergency department with hematemesis. She rarely drinks alcohol and has no known medical conditions. She is afebrile and her laboratory tests are normal, though she has signs of dehydration. The physician diagnoses the patient with Mallory-Weiss Syndrome. The nurse assesses the patient for which conditions?

Chronic peptic ulcers are associated with the presence of which bacterium?

The patient presents to the clinic with rectal bleeding. Which diagnosis is most likely?

The 35-year-old patient presents to the emergency department with nausea, vomiting, and diarrhea for the past week. Vital signs are significant for a heart rate of 135 bpm and a blood pressure of 75/40 mmHg. The nurse anticipates which order?

A client with a history of severe diarrhea presents to the emergency department. Vital signs reveal a respiratory rate of 36 breaths per minute, heart rate 110 bpm, and blood pressure 90/60 mm Hg. Arterial blood gas results include: pH 7.30, PaCO2 29 mm Hg, PaO2 100 mm Hg, and HCO3- 21 mEq/L. How does the nurse interpret these findings?

An alert patient requires a nasogastric (NG) tube for abdominal decompression. The tube is placed to the appropriate depth, but the nurse is unable to hear a rush of air when auscultating over the patient’s stomach and cannot aspirate gastric contents for pH testing. Which of the following is the most appropriate next course of action?

The nurse is inserting a nasogastric (NG) tube into a patient, when the patient begins to cough, wheeze, and have difficulty breathing. Which of the following is the next most appropriate intervention?

The patient complains of severe fatigue and joint pain. Upon assessment, the nurse notes the patient’s skin is bronzed. Which of the following physical assessments is most important?

The patient has been diagnosed with hemochromatosis. Which of the following lab values could be used to monitor for complications of the disease? Select all that apply.

The patient presents with severe fatigue, joint pain, and bronzed skin. Based on these findings, the nurse prepares the patient for which of the following diagnostic test(s)?

A patient with hemochromatosis has just undergone a liver biopsy to assess for cirrhosis. For which complication must the nurse be vigilant in the hours following the procedure?

The nurse is supervising a student nurse in the care of a patient following a percutaneous liver biopsy. The student nurse instructs the patient to lie on his left side following the procedure. Which response by the nurse is most appropriate?

The nurse is reviewing the chart of a patient scheduled to undergo a percutaneous liver biopsy in 2 hours. Which of the following characteristics, if present in the patient’s chart, would prompt the nurse to contact the provider immediately?

The patient with hemochromatosis has a hemoglobin of 8 g/dL. The nurse prepares the patient for which therapy?

The nurse is providing discharge education to a patient with hemochromatosis. Which of the following statements by the patient indicates teaching was effective?

The patient with hemochromatosis has been prescribed deferasirox. Which of the following instructions should the nurse include in discharge teaching?

The patient presents to the emergency department with altered mental status and myoclonic jerking. Although the nurse notes that the patient is flushed and his face is red, his skin and mucous membranes are dry and warm to the touch. The nurse also notes decreased bowel sounds and palpates a distended bladder. Vital signs are significant for a temperature of 39.9°C (103.8°F), heart rate of 122 bpm and a blood pressure of 165/92 mm Hg. The nurse prepares to administer which of the following medications to this patient?

The patient is a 5-year-old boy who presents having ingested an entire bottle of acetaminophen 2 hours ago. The provider has prescribed acetylcysteine 150 mg/kg intravenously in 3ml/kg D5W. The patient weighs 35 pounds. How many grams of acetylcysteine in how many milliliters of D5W does the nurse administer to this patient? Input your answer to the nearest tenth decimal place in this exact format (X.X g in XX.X mL).

The patient is diagnosed with rhabdomyolysis after suffering from heatstroke while running a marathon. Which of the following interventions will be most helpful in preventing acute kidney injury?

A child with acute myelogenous leukemia is scheduled to receive chemotherapy at 0800 on Tuesday. When should the nurse administer the first dose of antiemetic to best prevent chemotherapy-induced nausea and vomiting?

The nurse is assigned to a patient with chronic alcoholism and alcoholic cirrhosis. Examination of the patient is significant for dilated tortuous veins around his umbilicus and internal hemorrhoids. On the morning of his third day of the current admission, the patient acutely begins to vomit up large amounts of blood. Which describes the pathophysiology that most likely caused this event?

The nurse is assigned a 2-year-old patient who has severe periumbilical abdominal pain and hematochezia. On exam, a palpable mass is found in the right upper quadrant. Which of the following diagnostic tests would most likely confirm the diagnosis?

The nurse is assigned to a patient who is suffering from a small bowel obstruction. The patient has a history of multiple abdominal surgeries. Which of the following is the most likely cause of this patient’s small bowel obstruction?

The nurse is caring for a patient scheduled for an endoscopic retrograde cholangiopancreatography (ERCP). Which post-procedure complication occurs most frequently?

A nurse is caring for a young patient who is recovering from a laparoscopic appendectomy following acute appendicitis. 18 hours post-procedure the patient develops a high fever, severe abdominal pain, and nausea. The abdomen is rigid with rebound tenderness and guarding. She is hemodynamically stable. The nurse suspects which complication?

The nurse is caring for a patient with alcoholic liver cirrhosis complicated by abdominal ascites. A diagnostic paracentesis is performed. Shortly after the procedure, the patient becomes hypotensive and quickly loses consciousness. On exam, the patient is pale, peripheral pulses are faint, and extremities are cool to the touch. Which of the following is the most likely etiology of this patient’s condition?

A young patient presents to the ER after consuming a full bottle of acetaminophen about 12 hours ago. She has nausea, vomiting, and malaise. Within hours, she develops right upper quadrant (RUQ) pain. Exam is significant for severe RUQ tenderness and a positive Murphy’s sign. The nurse anticipates administering which medication?

The nurse is caring for a patient with a bleeding gastric ulcer. The patient calls the nurse asking for ibuprofen for a tension headache. Which response by the nurse is most appropriate?

The nurse is educating a patient with a recent esophagectomy how to perform percutaneous endoscopic gastrostomy (PEG) feedings. Which of the following statements is correct regarding PEG feedings?

A hospitalized patient receiving antibiotic therapy develops severe, foul-smelling diarrhea. A stool culture reveals Clostridium difficile. The nurse is aware the patient is at risk for which complications of a C. difficile infection? Select all that apply.

A patient is undergoing continuous gastric decompression due to a bowel obstruction. Which arterial blood gas result indicates the patient is experiencing a complication of gastric decompression?

A patient presents to the emergency department after 4 days of severe diarrhea. Which arterial blood gas result indicates a complication of severe diarrhea?

A patient with type 1 diabetes mellitus has food poisoning and develops vomiting and anorexia. Which statement by the nurse is most important?

An infant is brought to the emergency department with abdominal distention, currant-jelly stools, dark-green emesis, and lethargy. Upon assessment, the nurse notes a palpable sausage-shaped mass in the right upper quadrant. The nurse suspects which condition?

A 22-year-old patient complains of frequent diarrhea, mucous discharge, rectal bleeding, lower abdominal pain, and tenesmus. On endoscopy, inflammation is found only in the descending colon and rectum with no healthy mucosa between the lesions. The nurse begins planning education for the patient about which condition?

A patient hospitalized with ulcerative colitis develops worsening abdominal pain, a fever of 103 °F, heart rate of 132 bpm, and blood pressure of 82/54 mmHg. Her labs are notable for an elevated white blood cell count. What is the nurse’s first action?