Gastrointestinal

A patient has been diagnosed with toxic megacolon. Which interventions are appropriate for this patient? Select all that apply.

The nurse is attending the delivery of a full-term neonate whose mother received poor prenatal care. The neonate has cyanosis, increased work of breathing, a barrel chest, and a scaphoid abdomen. The nurse auscultates the patient’s lung fields and notes bowel sounds over the left side of the chest. The nurse suspects which condition in this neonate?

The parents bring a previously toilet trained 3-year-old patient to the clinic reporting regular fecal incontinence. Which assessment is the priority?

Which interventions does the nurse include in the patient’s care plan to decrease the risk for incontinence-associated dermatitis? Select all that apply.

Which intervention is most important to preventing dermatitis in the patient who is incontinent following a recent cervical spinal cord injury?

A patient complains of constipation. Which instruction should the nurse give first?

The nurse is teaching the patient about dietary modifications that enhance bowel regularity. Which food, if selected by the patient, indicate a need for further teaching?

Which characteristic, if found in the patient’s chart, would prompt the nurse to hold the ordered bumetanide and contact the provider?

The nurse calls the provider with this report: “Hi, Dr. Smith, the patient Mrs. Welch is complaining of an 8/10 pain in her lower abdomen. Her abdomen is distended but is soft with positive bowel sounds in all four quadrants. I have tried ambulation, warm compresses, and position changes, to no avail. Could you please come assess her?” Which component of SBAR communication does the nurse need to elaborate for this patient?

The nurse prepares the patient who has been newly prescribed atorvastatin (Lipitor) for which periodic laboratory evaluation prior to the first dose?

The patient reports being hungry prior to the breakfast tray delivery. When the nurse checks on the patient an hour after the tray was delivered, the nurse notes the patient has not eaten any of the food. Which initial nursing action is most appropriate? 

Which assessment prompts the nurse to suspect intussusception in the 10-month-old patient? 

The patient who underwent an upper gastrointestinal radiographic study requires which post-procedure instruction?

Which patient is appropriate to assign to a licensed practical/vocational nurse (LPN/LVN)?

The patient’s stool sample is positive for Entamoeba histolytica. The nurse plans education about which class of medication for this patient?

The nurse is teaching a student nurse about cancer screening guidelines. Which statement by the student nurse indicates the need for further teaching?

Which patient requires the most immediate attention?

The patient with bloody diarrhea and liver abscess is diagnosed with an Entamoeba histolytica infection. The nurse anticipates administering which medication?

The nurse receives report on a 76-year-old patient who is recovering from surgery for creation of an ileal pouch-anal anastomosis. The nurse plans care to prevent which complication that is most specific to this patient?

The patient receiving levothyroxine for hypothyroidism reports treatment failure after the third dose increase. The nurse anticipates the provider to order which test for this patient?

The nurse is planning care for a patient returning from surgery for a colon resection and ileal pouch-anal anastomosis. Which interventions does the nurse employ to prevent surgical site infection? Select all that apply.

The neonate born at 34-weeks estimated gestational age had Apgar scores of 3 and 7 at 1 and 5 minutes, respectively and is taken to the nursery for observation due to a need for continuous positive airway pressure (CPAP). Significant oral secretions are noted and an orogastric tube is unable to be placed because it meets resistance and comes back out the mouth. The nurse suspects which condition?

At a routine ultrasound screening, the pregnant mother is diagnosed with polyhydramnios. This patient’s fetus may have which condition?

The 3-week-old neonate has failed to return to birth weight due to projectile vomiting partially-digested breast milk after most feedings. Upon assessment, an olive-shaped mass is palpated in the upper right abdominal quadrant. The nurse anticipates which diagnosis?

The nurse is the first responder to a 3-year-old male who is with his mother, having recently ingested a large quantity of household cleaner. The patient is unconscious but is hemodynamically stable and breathing. An ambulance has already been called. Which action by the nurse is appropriate?

To which patient does the nurse most likely anticipate administering total parenteral nutrition (TPN)?

The nurse is caring for a patient receiving total parenteral nutrition (TPN). The nurse most closely assesses for which complication in this patient? 

The nurse is most vigilant for signs of which complication in a patient receiving total parenteral nutrition (TPN)?

The patient with chronic malnourishment is started on total parenteral nutrition (TPN). The nurse is vigilant for signs of which complication?

The provider orders that the patient transition to a full liquid diet. Which new item is the patient now allowed to have?

The 33-year-old patient presents to the clinic with signs and symptoms of gastroesophageal reflux disease. The nurse prepares the patient for which test? 

The 50-year-old patient receiving chemotherapy for breast cancer has developed a fungal bloodstream infection. Which intervention is the nurse’s first consideration?

The nurse instructs parents on which type of diet to decrease the risk for lead poisoning in their children? 

The nurse is caring for a 48-year-old female diagnosed with acute kidney injury. Laboratory results reveal that the patient is experiencing mild hyperkalemia. Which independent nursing action is appropriate to manage the patient's hyperkalemia?

The patient who will be travelling out of the country soon is concerned about traveler's diarrhea. How does the nurse counsel the patient? 

The patient with cholestasis complains of significant pruritus. The nurse bases the explanation on which understanding of the pathophysiology behind the patient's pruritus?

The nurse is caring for a patient receiving total parenteral nutrition (TPN). After morning rounds, the nurse notices the rate of TPN infusion is slower than what is ordered for the patient and is three hours behind schedule. There are no nursing notes, and the rate was not mentioned on sign-out. Which initial action is most appropriate?

The nurse receives report on a 24-year-old G1P0 female at 32 weeks estimated gestational age who presents with pre-eclampsia with severe features. The nurse expects the patient to exhibit which symptom? 

The 23-year-old G1P0 patient who is 14 weeks pregnant presents to the emergency department with weakness and lethargy due to intractable nausea and vomiting. The patient has lost approximately 7% of pre-pregnancy weight. The nurse is aware the patient's symptoms are due to excess production of which hormone(s)? Select all that apply.

Which statement is most important for the nurse to include in the teaching of a male patient undergoing treatment for invasive amebiasis?

The patient with severe abdominal pain and distention, elevated white blood cell count, fever, and disorientation is diagnosed with toxic megacolon due to Clostridium difficile infection. Which order for this patient does the nurse question?

The 3-day-old full-term neonate has yet to pass meconium and is experiencing significant abdominal distention. The child is otherwise healthy and is not requiring respiratory support. The nurse learns that Hirschsprung disease is suspected and prepares the patient for which test that will definitively diagnose the condition?

The neonate with suspected Hirschsprung disease is scheduled to undergo testing to definitively diagnose the disorder. Which assessment finding prompts the nurse to request the procedure be postponed?

The nurse is providing preoperative teaching to the parents of a neonate diagnosed with short-segment Hirschsprung disease. Which statement by the patient’s mother indicates an understanding of the education?

Which neonate must be most closely monitored for signs of Hirschsprung disease?

The infant with chronic constipation has undergone a rectal biopsy for diagnosis of Hirschsprung disease. The absence of which type of cell conforms the diagnosis?

The 32-year-old patient presents to the emergency department complaining of difficulty breathing, cough, and chills. Vital signs are notable for a temperature of 38.4°C, heart rate 118 bpm, respiratory rate 24, oxygen saturation 87% on room air, and blood pressure of 98/62 mmHg. Upon assessment, the nurse notes nasal flaring, diminished breath sounds in the right upper lobe, and subcostal retractions. Capillary refill time is 4 seconds. The patient admits waking up in a pool of vomit after binge drinking 3 nights ago. Which orders does the nurse anticipate? Select all that apply.

The nurse is vigilant for which signs of complications in the patient with Zenker diverticulum?

The nurse provides care for the client diagnosed with Barrett's esophagus. Which goals does the nurse establish in the plan of care? Select all that apply.

The family practice nurse is reviewing telephone messages from patients. Which call is to be returned first?