Gastrointestinal

The nurse is planning care for the patient with severe liver disease who has substantial ascites and peripheral edema. Which interventions are included in the care plan? 

The nurse determines the patient’s nasogastric (NG) tube is not maintaining good flow. Which intervention is appropriate?

The 61-year-old patient with liver cirrhosis reports extreme fatigue on a daily basis. The nurse pursues which intervention?

Which statement does the nurse include in preprocedure teaching for the patient who will undergo abdominal paracentesis?

The nurse is inserting a nasogastric (NG) tube. To ease the process and increase chances for success, which instruction does the nurse give the patient to perform during insertion?

The nurse is caring for the patient who is recovering from an ischemic stroke. The speech therapist recommended all liquids to be thickened to a nectar consistency. The nurse provides which information to the patient about nectar-thick liquid? Select all that apply.

The nurse is caring for the patient with intestinal obstruction who is receiving total parenteral nutrition (TPN). The nurse reviews which lab results to ensure the patient is tolerating the infusion? Select all that apply. 

The pediatric patient is hospitalized for fever, nausea, vomiting, and diarrhea. Capillary refill is >2 seconds. The nurse anticipates an order for which intravenous infusion?

The patient with an ileus is on bed rest after abdominal surgery. A nasogastric tube (NG) is in place because of severe vomiting and significant abdominal distention. Which statement is true regarding management of this patient? 

The patient with advanced liver disease is being evaluated for moderate hematemesis, tachycardia, and hypotension. An esophagogastroduodenoscopy (EGD) confirms the patient has esophageal varices. Which is the priority action by the nurse?

Which type of bowel sounds does the nurse expect to hear when auscultating the abdomen of a patient with watery diarrhea?

The patient with a T4 spinal cord injury has a blood pressure of 160/98 mm Hg. Which interventions does the nurse take? Select all that apply.

The nurse is discharging a patient after fecal disimpaction in the emergency department (ED). Which statement by the patient indicates a need for further teaching?

The nurse advocates for gastric carcinoma screening for the patient with a history of infection with which organism?

The nurse is providing medication instructions for iron supplements to a patient with anemia. Which information is included?

Which nursing interventions are performed for the patient after an uneventful colonoscopy? Select all that apply.

Which comorbidities increase the risk for refeeding syndrome in the chronically ill patient who is started on total parenteral nutrition (TPN)? Select all that apply.

The nurse orders which items for the patient who has been ordered to receive a clear liquid diet? Select all that apply.

The nurse is providing preprocedure education to the family of the child with type 1 diabetes mellitus who must undergo a tonsillectomy. Which information does the nurse include?

The nurse provides which instruction to the patient who will undergo guaiac stool testing?

The charge nurse is planning room assignments during an outbreak of Shiga toxin-producing Escherichia coli (STEC). Due to the influx of patients, only one private room is available. Which patient with STEC must be placed in this private room?

The patient with gastroenteritis is hospitalized for dehydration and stool culture reveals infection with Listeria monocytogenes. Which personal protective equipment does the nurse don prior to entering the room?

The nurse assessing the patient in liver failure documents the patient’s report of pain in which region as an expected finding for this patient?

The 22-year-old woman has selected the Depo-Provera injection as her preferred method of contraception. Which information, if present in the patient’s chart, prompts the nurse to hold the medication and alert the physician?

The nurse receives an alert that a packed red blood cell transfusion has been ordered for the patient who was admitted after a laparoscopic cholecystectomy. Which is the nurse’s initial action?

The patient has hyperlactatemia. Which lab value concerns the nurse the most about the patient’s risk for long-term sequelae?

Following an accidental overdose of acetaminophen, the patient has a lactate level of 5.6 mmol/L. Which compensatory change in the patient will the nurse observe first?

The nurse advocates for a guaiac test to be performed on the patient with which stool?

To which team member does the registered nurse delegate a fecal occult blood test for the patient who requires assistance to ambulate to the restroom?

The patient with chronic obstructive pulmonary disease (COPD) is brought to the post-anesthesia care unit (PACU) after abdominal surgery. Which symptom alerts the nurse to an impending complication?

The nurse is supervising a nursing student performing a comprehensive shift assessment on a patient hospitalized with severe abdominal pain from an unknown cause. Which action, if performed by the nursing student, prompts the nurse to intervene and provide additional teaching?

The triage nurse asks the patient presenting with abdominal pain which question to satisfy the “P” section of the PQRST mnemonic?

The nurse is supervising a student nurse in caring for a postoperative patient at high risk for surgical wound evisceration. The nurse prepares the student to perform which interventions if the wound eviscerates? Select all that apply.

The patient presents with a blood pressure of 135/95 mm Hg and appears jaundiced. She has a history of alcoholism, cirrhosis, and untreated hepatitis C. While the oncoming nurse is receiving report, the patient begins vomiting a large amount of blood. The nurse knows which to be the most likely cause of the patient’s hematemesis?

The patient who is NPO has an order to receive enemas until the intestines are devoid of stool. After 3 enemas, the patient is still passing a moderate amount of loose stool. Which action by the nurse is appropriate?

The patient has returned from abdominal surgery with a gauze dressing. The nurse notes a moderate amount of sanguineous drainage on the dressing. Which action does the nurse take?

The patient underwent colon resection one day ago. The nurse is performing a shift assessment and notes absent bowel sounds after listening for 5 minutes. Which action by the nurse is most appropriate?

Following surgery for a bowel obstruction, the patient has a nasogastric tube in place for gastric decompression. The nurse aspirates fluid from the tube and notes a pH of 2. Which action by the nurse is appropriate?

Two days after an abdominal surgery, the patient develops abdominal distention, tachycardia, fever, and nausea. The provider suspects sepsis. Which order does the nurse implement first?

The nurse is instructing the patient on how to move in bed after an open abdominal surgery. Which statement by the nurse is appropriate?

The patient is 3 hours postop from an open abdominal surgery. Flexion and extension of which joints are most appropriate for this patient to perform to prevent complications of immobility while minimizing the risk of evisceration? Select all that apply.

Following colon resection, the nurse is vigilant for which early symptoms of septic shock? Select all that apply.

The patient is 24-hours-postop from a pelvic reconstruction surgery after fracturing the pelvis in a fall. The patient reports severe abdominal pain and nausea. Upon assessment, the patient’s abdomen is grossly distended and firm. The patient’s skin is diaphoretic and the patient is tachypneic and tachycardic. Pulses and capillary refill time are adequate. During the assessment, the patient vomits a moderate amount of light green liquid. The nurse contacts the provider to report suspicion of which postoperative complication?

The patient has not defecated for 24 hours after an appendectomy. The patient’s abdomen is distended and the patient reports nausea. Upon auscultation, the nurse notes absent bowel sounds after 5 minutes of auscultation. Which action does the nurse take first?

The nurse is called to the intubated patient’s room by the patient's child who reports a large gush of red-tinged fluid from a transverse abdominal wound after the patient coughed. While calling for help, the nurse ensures the patients bed is set to which degree angle?

On day four postop following an open abdominal surgery, the patient develops a cough. During an assessment, the patient coughs, and the wound dehisces. The nurse notes intestinal loops are visible outside of the wound. Which initial intervention by the nurse is appropriate?

In the days following a colon resection and ileostomy creation, which patient action indicates an alteration in body image?

Two days after undergoing surgery for a ruptured appendix, the patient responds to the nurse in only short, clipped statements, becoming visibly frustrated and angry during a routine vital signs check. Which response by the nurse is most appropriate?

The nurse is evaluating discharge teaching for the patient receiving hydrocodone/acetaminophen for the treatment of acute pain due to femur fracture. Which statement by the patient indicates teaching was effective?

What is the main rationale for prescribing hydrocodone with acetaminophen?