Exam 2 PN1 - Chapter 52 When taking a history for a patient ...

Exam 2 PN1 (NCLEX Questions from the Book & Some Boxes) Chapter 52 When taking a history for a patient with GI problems, which daily client behavior requires further nursing assessment? Select all that apply.

• Eats multiple servings of vegetables
• Takes 800 mg of ibuprofen for arthritic pain
• Walks 30 minutes
• Chews tobacco
• Takes senna to assist with bowel movements
• Listens to music to promote relaxation

Action Alert If a bulging, pulsating mass is present during assessment of the abdomen, do not touch the area because the patient may have an abdominal aortic aneurysm, a life-threatening problem. Notify the primary health care provider of this finding immediately! Peristaltic movements are rarely seen unless the patient is thin and has increased peristalsis. If these movements are observed, note the quadrant of origin and the direction of peristaltic flow. Report this finding to the primary health care provider because it may indicate an intestinal obstruction.The nurse is performing a physical assessment on a client's abdomen. The nurse inspects the abdomen and

finds it asymmetrical, with a nonpulsating mass in the RUQ. What is the priority nursing intervention?

• Document the findings in the electronic health record.
• Auscultate for bowel sounds and bruits.
• Lightly palpate the mass.
• Notify the primary health care provider of the

findings.A nurse is preparing a health teaching session about early detection of colorectal cancer. Which test should the nurse include? Select all that apply.

• Colonoscopy every 10 years
• Single sample fecal immunochemical test (FIT)
• Flexible sigmoidoscopy every 5 years
• Stool DNA test (sDNA) every 3 years
• Double-contrast barium enema every 5 years
• Take-home yearly guaiac fecal occult blood test (gFOBT)

Action Alert The priority for care to promote patient safety after esophagogastroduodenoscopy is to prevent aspiration. Do not

offer fluids or food by mouth until you are sure that the gag reflex is intact! Monitor for signs of perforation, such as pain, bleeding, or fever.Chapter 55 The nurse is performing medication reconciliation for a newly admitted client. The nurse recognizes which drugs contribute to signs and symptoms of gastritis? Select all that apply.

• Aspirin, taken once daily to prevent cardiac concerns
• Naproxen, taken once daily for joint pain associated with

arthritis

• Amoxicillin, taken over a 10-day period for an acute sinus

infection

• Bacitracin ointment (over the counter), applied to minor

scrapes on arms and legs

• Prednisone, tapered over a 14-day period to decrease

inflammation associated with an acute sinus infection When caring for a patient who has just had an upper GI endoscopy, the nurse assesses that the client has developed a temperature of 101.8° F (38.8° C). What is the appropriate nursing intervention?

• Promptly assess the client for potential perforation.
• Ask the nursing assistant to bathe the client with tepid water.
• Administer acetaminophen (Tylenol) to lower the temperature.
• Delegate to an unlicensed assistive personnel (UAP) to retake

the temperature.

The nurse is caring for a client with a bleeding duodenal ulcer who was admitted to the hospital after vomiting bright, red blood. Which condition does the nurse anticipate when the client develops a sudden, sharp pain in the mid-epigastric region and a rigid, board-like abdomen?

• Pancreatitis
• Ulcer perforation
• Small bowel obstruction
• Development of additional ulcers

Which client statement regarding treatment for gastric cancer requires the nurse to intervene immediately?

• “I understand my treatment regimen.”
• “My prognosis is frightening to me and my partner.”
• “Life just doesn't seem to be worth living anymore.”
• “There is a list of community resources stored in my computer

for when I need them.” Chapter 56 A client with rectal bleeding who is preparing to undergo a colonoscopy tells the nurse, “I'm very afraid of having polyps and cancer.” What is the appropriate nursing response?