Nokea
A client with suspected gastric cancer undergoes an endoscopy of the stomach. Which of the following assessments made after the procedure would indicate the development of a potential complication?
- A. The client complains of a sore throat
- B. The client displays signs of sedation
- C. The client experiences a sudden increase in temperature
- D. The client demonstrates a lack of appetite
Correct Answer: C
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
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The nurse instructs the nursing assistant on how to provide oral hygiene for a client who cannot perform this task for himself. Which of the following techniques should the nurse tell the assistant to incorporate into the client's daily care?
- A. Assess the oral cavity each time mouth care is given and record observations
- B. Use a soft toothbrush to brush the client's teeth after each meal
- C. Swab the client's tongue, gums, and lips with a soft foam applicator every 2 hours.
- D. Rinse the client's mouth with mouthwash several times a day.
Correct Answer: C
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
The nurse is monitoring a client admitted to the hospital with a diagnosis of appendicitis. The client is scheduled for surgery for 2 hours. The client begins to complain of increases abdominal pain and begins to vomit. On assessment the nurse notes that the abdomen distended and bowel sounds are diminished. Which of the following is the most appropriate nursing intervention?
- A. Administer the prescribed pain medication.
- B. Notify the physician.
- C. Call and ask the operating room team to perform the surgery as soon as possible.
- D. Reposition the client and apply a heating pad on warm setting to the client's abdomen.
Correct Answer: B
Rationale: Based on the signs and symptoms presented in the question, the nurse should suspect peritonitis and should notify the physician. Administering pain medication is not an appropriate intervention. Heat should never be applied to the abdomen of a client with suspected appendicitis. Scheduling surgical time is not within the scope of nursing practice, although the physician probably would perform the surgery earlier than the prescheduled time.
The nurse is reviewing the record of a client with Crohn's disease. Which of the following stool characteristics would the nurse expect to note documented in the client's record?
- A. Chronic constipation
- B. Diarrhea
- C. Constipation alternating with diarrhea
- D. Stool constantly oozing from the rectum
Correct Answer: B
Rationale: Crohn's disease is characterized by nonbloody diarrhea of usually not more than four to five stools daily. Over time, the diarrhea episodes increase in frequency, duration, and severity. Chronic constipation (Choice A), constipation alternating with diarrhea (Choice C), and stool constantly oozing from the rectum (Choice D) are not characteristics typically associated with Crohn's disease.
A client with viral hepatitis has no appetite, and food makes the client nauseated. Which of the following interventions would be most appropriate?
- A. Explain that high-fat diets usually are tolerated better.
- B. Encourage intake of foods high in protein.
- C. Explain that the majority of calories need to be consumed in the evening hours.
- D. Monitor for fluid and electrolyte imbalance.
Correct Answer: D
Rationale: If nausea occurs and persists, the client will need to be assessed for fluid and electrolyte imbalance. Explaining to the client that the majority of calories should be eaten in the morning hours is important because nausea occurs most often in the afternoon and evening. Clients should select a diet high in calories because energy is required for healing. Protein increases the workload on the liver. Changes in bilirubin interfere with fat absorption, so low-fat diets are tolerated better.
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. Indomethacin (Indocin)
- C. Furosemide (Lasix)
- D. Propranolol hydrochloride (Inderal)
Correct Answer: B
Rationale: Indomethacin (Indocin) is a Nonsteroidal anti-inflammatory drug and can cause ulceration of the esophagus, stomach, duodenum, or small intestine. Indomethacin is contraindicated in a client with gastrointestinal disorders. Furosemide (Lasix) is a loop diuretic. Digoxin is an antidysrhythmic. Propranolol (Inderal) is a B- adrenergic blocker. Furosemide, digoxin, and propranolol are not contraindicated in clients with gastric disorders.