Gastrointestinal

The nurse has received an update from the unlicensed assistive personnel about four patients. Which patient does the nurse assess first?

The patient underwent surgery for creation of a colostomy 2 days ago. Upon assessment, which stoma color prompts the nurse to document the finding and continue with the assessment?

Which medication may be prescribed for the treatment of anorexia and cachexia related to cancer?

The nurse anticipates which laboratory results in the patient with end stage liver disease? Select all that apply.

The nurse is caring for a patient with Guillain-Barré syndrome. The patient has an order for a pureed diet. Which assessment prompts the nurse to clarify the order with the provider?

The registered nurse is observing the licensed practical/vocational nurse (LPN/LVN) administering pantoprazole during morning medication rounds. Which action by the LPN/LVN prompts the nurse to intervene and provide additional education?

The nurse is reviewing the chart of the patient who is scheduled for a laparoscopic cholecystectomy in one hour. Signed consent is found, as well as blood transfusion consent, anesthesia evaluation, blood type, and emergency contacts. The nurse asks the patient, “Do you have any questions about your upcoming gallbladder removal surgery?” The patient replies, “Gallbladder removal? I thought they were just taking out my gallstones. I’ll be glad to get rid of those.” Which response by the nurse is most appropriate?

Which statement does the nurse include in discharge teaching to the parents of the 9-year-old who underwent tonsillectomy and adenoidectomy?

Which is indicated by a positive urea breath test?

Rank these conditions from most (1) to least (4) life-threatening.

Following a scleral buckling procedure, the patient complains of nausea. Which action does the nurse take?

The patient is scheduled to undergo a trabeculectomy for the treatment of refractory glaucoma. The nurse is providing preoperative teaching to the patient. Which statement indicates a need for further teaching?

The patient is admitted to the hospital with acute diverticulitis. Which order does the nurse question?

The patient presents to the clinic complaining of abdominal pain in the left lower quadrant that happens every few days with irregular fecal elimination patterns (constipation alternating with diarrhea). Diverticulosis is suspected. Which test will confirm this diagnosis?

The nurse receives vitals and information about four patients from the unlicensed assistive personnel an hour after shift report. With which patient does the nurse follow up first?

The nurse is caring for the infant hospitalized prior to surgery for intussusception. The nurse anticipates the patient’s stool will have which appearance?

The 6-month-old neonate is brought to the emergency department (ED). The parents state, “She is just so lethargic. Anything she eats, she vomits. Her vomit was normal initially, but now it’s dark green. Also, her stool has turned to a dark red, jelly-like consistency.” The nurse palpates the patient’s abdomen, expecting to make which assessment?

The patient with kidney failure is scheduled to undergo the placement of a peritoneal dialysis catheter. Which instruction does the nurse give the patient?

The nurse is providing discharge teaching to the patient who will be discharged with a peritoneal dialysis catheter. Which statement indicates a need for further teaching?

During assessment of the patient with an ileostomy, the nurse discovers that the opening of the pouch is about 5/8” inch larger than the stoma. This patient is at increased risk for which adverse outcome?

The nurse is providing education to the patient with an ileostomy. Which statement by the patient suggests additional education is needed?

Which interventions does the nurse include in the plan of care for the 2-day-old infant who requires phototherapy for hyperbilirubinemia? Select all that apply.

Which statement by the patient recently diagnosed with Crohn's disease indicates more teaching is needed? 

The parent of the 5-year-old child reports that the child, who was potty trained at 3-years-old, has been stooling in places other than the toilet a couple times per month for 4 months. The nurse uses which term to document this symptom?

The nurse is collecting data from the parents of a seven-year-old boy who often has liquid stool in his underwear. The parents report he developed urinary and stool incontinence at four years of age and this problem started about six months ago. Their son excretes small pellets of stool every night before bed, and the parents wonder if he is soiling his clothing on purpose. Which additional testing does the nurse anticipate at this point?

A ten-year-old patient presents to the emergency department (ED) complaining of abdominal pain. He states, “I poop every day. It sometimes hurts to go and the poop is small, hard pieces. Which response does the nurse anticipate when the child is asked, “How much water do you drink in a day?”

Which evening meal choice is appropriate for this patient? Look at the patient’s chart to make a selection.

The nurse has received an order to insert a nasojejunal tube. The nurse measures the patient as 15 cm from the nose to the tragus and an additional 30 cm to the xiphoid process. What is the total length of tube that should be inserted for this patient?

The patient receiving tube feeding experiences confusion, diaphoresis, pallor, and tremors two hours after receiving a bolus tube feeding. The nurse requests an order for which test?

The patient with a subtotal gastrectomy has been advanced to a regular diet. Which information does the nurse provide the patient? Select all that apply.

Following a major natural disaster, the charge nurse receives instruction from superiors to pair patients as roommates to increase the number of available rooms. The first patient to be paired is a 42-year-old patient with cellulitis who has a 103°C fever and tachycardia. The charge nurse places her in a room with which patient?

Which patient does the nurse advocate to be transferred to the intensive care unit?

The nurse is supervising the student nurse who is making a call to the provider about a patient who is decompensating. The student states, “Hello, Dr. Smith. This is Carly and I’m taking care of Alex Wright in room 433. He is in the hospital after surgery for a ruptured appendix. Over my shift his temperature has increased by 4 degrees and his heart rate is elevated. His blood pressure is decreased from the previous shift as well. Could you please come examine him?” Which additional comments are the priority for the nurse to add? Select all that apply.

The patient is scheduled for a percutaneous liver biopsy at the bedside at 0730. The nurse is reviewing the patient’s chart prior to the procedure. Which initial statement by the nurse is most appropriate? Review the chart to determine the correct answer.

Which food is a priority for the nurse to encourage the patient to eat? Look at the patient’s chart to make a selection.

The nurse is providing post-mortem care to a patient on hospice after being treated for stage 4 colon cancer that metastasized to the bladder. Which action by the nurse is most appropriate?

The nurse is creating a tool to screen for patients who are risk for vitamin A deficiency. The nurse includes which conditions in the screening tool? Select all that apply.

The nurse is planning care for a patient who sustained third degree burns over 42% of the body during an industrial accident the previous day. The patient is intubated, sedated, and chemically paralyzed. Which patient problem is most important for the nurse to address?

The nurse anticipates administering cobalamin and folic acid to the patient presenting with which symptoms? Select all that apply.

The patient with cobalamin deficiency requires prompt and effective treatment to prevent which conditions? Select all that apply.  

The nurse more closely assesses patients with which conditions for signs of pernicious anemia? Select all that apply.  

Which patient characteristic increases the risk for pernicious anemia following a subtotal gastrectomy?  

The patient with a history of colon cancer presents to the emergency department reporting significant abdominal pain, bloating, and vomiting. Which question to garner more information about the emesis is most important?  

In the postoperative period following a Whipple procedure, the nurse includes which interventions in the care plan? 

Four hours after a rectal resection for treatment of rectal cancer, the patient is noted to be pale and diaphoretic. Which assessments are the priority? Select all that apply.  

The nurse is caring for the patient who underwent colon resection and ileostomy creation two days ago. Upon assessment, the nurse notes 40 mL of dark green liquid in the ostomy bag. Which action by the nurse is correct?  

At 48 hours after a bowel resection surgery for colon cancer, the colostomy is noted to be moist and purple. Which additional assessment is most important?  

The patient with severe psoriasis has been prescribed methotrexate. The nurse instructs the patient to schedule which follow-up tests? Select all that apply.   

The patient who has been prescribed methotrexate for the treatment of severe psoriasis has received medication teaching. Which statements indicate the teaching was effective? Select all that apply.

The patient is scheduled for a liver biopsy tomorrow. The nurse has difficulty obtaining blood specimens from the patient and can only send one lab. Which lab test does the nurse choose?