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NCLEX ? Small Bowel Obstruction, Ulcerative Colitis and related topics

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Source: Davis Q&A

1. A nurse is performing an initial post op assessment on a client following upper GI surgery. The client has a NG tube to low, intermittent suction. To best assess the client for the presence of bowel sounds, the nurse should:
A. place the stethoscope to the left of the umbilicus.
B. turn off the nasogastric suction.
C. use the bell of the stethoscope.
D. turn the suction on the NG tube to continuous.
Correct: B

2. To assist a client to manage and decrease the sensation of nausea, which nonphamacological intervention should a nurse recommend?
A. Drinking tea made from ginger root.
B. Changing positions quickly when moving.
C. Decreasing food intake.
D. Playing loud rock music.
Correct: A

3. During a hospital admission history, a nurse suspects irritable bowel syndrome when the client states:
A. I am having a lot of bloody stools.
B. I have been vomiting for 2 days.
C. I have lost 10 pounds in the last month.
D. I have noticed mucus in my stool.
Correct: D

4. A nurse is caring for a client diagnosed with Chron's disease, who has undergone a barium enema that demonstrated the presence of strictures in the ileum. Based on this finding, the nurse should monitor the client closely for signs of:
A. peritonitis
B. obstruction
C. malaborsorption.
D. fluid imbalance.
Correct: B

5. While conducting a home visit with a client who had a partial resection of the ileum for Chron's Disease 4 weeks previously, a nurse becomes concerned when the client states:
A. My stools float and seem to have fat in them.
B. I have gaiend 5 pounds since I left the hospital.
C. I am still avoiding milk products.
D. I only have 2 formed stools per day.
Correct: A

6. A nurse is assessing a client who is 24 hours postgastrointestinal hemorrhage. The assessment findings include BUN of 40mg/dl and serum creatinine of 0.8 mg/dl. After reviewing the assessment findings, the nurse should:
A. immediately call the physician to report these results.
B. monitor urine output as this may be a sign of kidney failure.
C. document the findings and continue monitoring the client.
D. encourage the client to limit his dietary intake of protein.
Correct: C

7. A nurse anticipates that the conservative treatment of a client with acute cholecystitis will include:
A. a bland diet.
B.the administration of anitcholinergic medications.
C. placing the client in supine position with the head of the bed flat.
D. administrating laxatives to clear the bowel.
Correct: B

8. A nurse is reviewing the history and physical of a teenager admitted to a hospital with a diagnosis of ulcerative colitis. Based on this diagnosis, which information should the nurse expect to see on this client's medical record?
A. Abdominal pain and bloody diarrhea.
B. Weight gain and elevated blood glucose.
C. Abdominal distention and hypoactive bowel sounds.
D. Heartburn and regurgitation.
Correct: A

9. A 30-year old client is 6 days post-total proctocolectomy with ileostomy creation for ulcerative colitis. During morning report, a nurse is told that the ileostomy is draining large amounts of liquid stool and the client has been reporting dizziness with ambulation. Based on this information, which parameters should the nurse asses immediately? Select all the apply.
A. Pulse rate for the last 24 hours.
B. Urine output.
C. Weight over the last 3 days.
D. Ability to move the lower extremities.
E. Temperature readings for the last 24 hours.
Correct: A, B,C, and D.

10. A RN overhears a LPN talking with a client who is being prepared for a total colectomy with the creation of an ileoanal reservoir for ulcerative colitis. To decrease the client's anxiety, the RN should intervene to clarify the information given by the LPN when the LPN is heard saying:
A. this surgery will prevent you from developing colon cancer.
B. after this surgery you will no longer have ulcerative colitis.
C. when you return from surgery you will not be able to eat solid food for several days.
D. you will have an ileostomy when you return from the surgery.
Correct: D


11.The nurse is reviewing the medication record of a client with acute gastritis. Which medication, if noted on the client’s record, would the nurse question?
A. Digoxin (Lanoxin)
B. Furosemide (Lasix)
C. Indomethacin (Indocin)
D. Propranolol hydrochloride (Inderal)
Correct: C

12. The nurse is assessing a client 24 hours following a cholecystectomy. The nurse noted that the T tube has drained 750 mL of green-brown drainage since the surgery. Which nursing intervention is appropriate?
A. Clamp the T tube
B. Irrigate the T tube
C. Notify the physician
D. Document the findings
Correct: D

13.The nurse is caring for a hospitalized client with a diagnosis of ulcerative colitis. Which finding, if noted on assessment of the client, would the nurse report to the physician?
A. Hypotension
B. Bloody diarrhea
C. Rebound tenderness
D. A hemoglobin level of 12 mg/dL

14. A nurse is preparing to remove a nasogartric tube from a client. The nurse should instruct the client to do which of the following just before the nurse removes the tube?
A. Exhale
B. Inhale and exhale quickly
C. Take and hold a deep breath
D. Perform a Valsalva maneuver
Correct: C

15. The nurse is caring for a male client postoperatively following creation of a colostomy. Which nursing diagnosis should the nurse include in the plan of care?
A. Sexual dysfunction
B. Body image, disturbed
C. Fear related to poor prognosis
D. Nutrition: more than body requirements, imbalanced
Correct: B

S/S of ICP
1. Severe headache
2. Decrease LOC, restlessness, irritability
3. Altered breathing patterns
4. abnormal posturing (decerebrate, decorticate)
5. Seizures

Contraindicated positions for Pt. with ICP
1. Supine
2. HOB lower than 30 degrees
3. Head turned to the side

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