NSG 3800/ NSG3800 Exam 3 V1 – Adult Health II | 2026/2027 Update | Galen | Latest Questions & Verified Answers

NSG 3800/ NSG3800 Exam 3 V1 – Adult Health II | 2026/2027 Update | Galen | Latest Questions & Verified Answers A client receiving tube feedings is experiencing diarrhea. The nurse and the health care provider suspects that the client is experiencing dumping syndrome. What intervention is most appropriate? A) Stop the tube feed and aspirate stomach contents. B) Increase the hourly feed rate so it finishes earlier. C. Keep the client in semi-Fowler position for 1 hour after feedings D) Administer fluid replacement by IV. C. Keep the client in semi-Fowler position for 1 hour after feedings A nurse is admitting a client to the postsurgical unit following a gastrostomy. When planning assessments, the nurse should be aware of what potential postoperative complication of a gastrostomy? A) Premature removal of the G tube B) Bowel perforation C) Constipation D) Development of peptic ulcer disease (PUD) A) Premature removal of the G tube A nurse is providing care for a client with a diagnosis of late-stage Alzheimer disease. The client has just returned to the medical unit to begin supplemental feedings through an NG tube. Which of the nurse's assessments addresses this client's most significant potential complication of feeding? A) Frequent assessment of the client's abdominal girth B) Assessment for hemorrhage from the nasal insertion site C) Frequent lung auscultation D) Vigilant monitoring of the frequency and character of bowel movements C) Frequent lung auscultation The nurse is caring for a client who has a nasogastric tube that has been in place for 2 days. Before administering a scheduled feeding, the nurse should A) ensure that the client has recently voided. B) administer 30 to 45 mL of water to confirm placement. C) position the client upright. D) perform a focused gastrointestinal assessment. C) position the client upright A client's enteral feedings have been determined to be too concentrated based on the client's development of dumping syndrome. What physiologic phenomenon caused this client's complication of enteral feeding? A) Increased gastric secretion of HCl and gastrin because of high osmolality of feeds. B) Entry of large amounts of water into the small intestine because of osmotic pressure C) Mucosal irritation of the stomach and small intestine by the high concentration of the feed D) Acid-base imbalance resulting from the high volume of solutes in the feed B) Entry of large amounts of water into the small intestine because of osmotic pressure A client with dysphagia is scheduled for percutaneous endoscopic gastrostomy (PEG) tube insertion and asks the nurse how the tube will stay in place. What is the nurse's best response? A) Adhesive holds a flange in place against the abdominal skin. B) A stitch holds the tube in place externally. C) The tube is stitched to the abdominal skin externally and the stomach wall internally. D) Internal and external fixation bolsters secure the tube against the stomach wall. D) Internal and external fixation bolsters secure the tube against the stomach wall. A client is postoperative day 1 following gastrostomy. The nurse is planning interventions to address the nursing diagnosis of Risk for Infection Related to Presence of Wound and Tube. What intervention is most appropriate? A) Administer antibiotics via the tube as prescribed. B) Wash the area around the tube with soap and water daily. C) Cleanse the skin within 2 cm of the insertion site with hydrogen peroxide once per shift. D) Irrigate the skin surrounding the insertion site with normal saline before each use. B) Wash the area around the tube with soap and water daily. The nurse is assessing a client with has a percutaneous endoscopic gastrostomy (PEG) tube in place. On inspection, the nurse observes moist, white patches on the skin below the external retention bolster. What is the nurse's best action? A) Perform skin care and apply antibiotic ointment as prescribed B) Apply an antifungal ointment as prescribed C) Irrigate the PEG tube with sterile water D) Ask the dietitian to reevaluate the client's feeding formula B) Apply an antifungal ointment as prescribed The nurse is caring for a client who is postoperative from having a gastrostomy tube placed. What should the nurse do on a daily basis to prevent skin breakdown? A) Verify tube placement. B) Loop adhesive tape around the tube and connect it securely to the abdomen. C) Gently rotate the tube. D) Change the wet-to-dry dressing. C) Gently rotate the tube. A nurse is working with a client who has chronic constipation. What should be included in client teaching to promote normal bowel function? A) Use glycerin suppositories on a regular basis. B) Limit physical activity in order to promote bowel peristalsis. C) Consume high-residue, high-fiber foods. D) Resist the urge to defecate until the urge becomes intense. C) Consume high-residue, high-fiber foods. A nurse is preparing to provide care for a client whose exacerbation of ulcerative colitis has required hospital admission. During an exacerbation of this health problem, the nurse would anticipate that the client's stools will have what characteristics? A) Watery with blood and mucus B) Hard and black or tarry C) Dry and streaked with blood D) Loose with visible fatty streaks A) Watery with blood and mucus A client admitted with acute diverticulitis has experienced a sudden increase in temperature and reports a sudden onset of exquisite abdominal tenderness. The nurse's rapid assessment reveals that the client's abdomen is uncharacteristically rigid on palpation. What is the nurse's best response? A) Administer a Fleet enema as prescribed and remain with the client. B) Contact the primary provider promptly and report these signs of perforation. C) Position the client supine and insert an NG tube. D) Page the primary provider and report that the client may be obstructed. B) Contact the primary provider promptly and report these signs of perforation. A 35-year-old male client presents at the emergency department with symptoms of a small bowel obstruction. In collaboration with the primary provider, what intervention should the nurse prioritize? A) Insertion of a nasogastric tube B) Insertion of a central venous catheter C) Administration of a mineral oil enema D) Administration of a glycerin suppository and an oral laxative A) Insertion of a nasogastric tube A client admitted with inflammatory bowel disease asks the nurse for help with menu selections. What menu selection is most likely the best choice for this client? A) Spinach B) Tofu C) Multigrain bagel D) Blueberries B) Tofu A client is admitted to the medical unit with a diagnosis of intestinal obstruction. When planning this client's care, which of the following nursing diagnoses should the nurse prioritize? A) Ineffective Tissue Perfusion Related to Bowel Ischemia B) Imbalanced Nutrition: Less Than Body Requirements Related to Impaired Absorption C) Anxiety Related to Bowel Obstruction and Subsequent Hospitalization D) Impaired Skin Integrity Related to Bowel Obstruction A) Ineffective Tissue Perfusion Related to Bowel Ischemia A nurse is planning discharge teaching for a 21-year-old client with a new diagnosis of ulcerative colitis. When planning family assessment, the nurse should recognize that which of the following factors will likely have the greatest impact on the client's coping after discharge? A)The family's ability to take care of the client's special diet needs B) The family's ability to monitor the client's changing health status C) The family's ability to provide emotional support D) The family's ability to manage the client's medication regimen C) The family's ability to provide emotional support An older adult who resides in an assisted living facility has sought care from the nurse because of recurrent episodes of constipation. Which of the following actions should the nurse perform first? A) Encourage the client to take stool softener daily. B) Assess the client's food and fluid intake. C) Assess the client's surgical history. D) Encourage the client to take fiber supplements. B) Assess the client's food and fluid intake. A 16-year-old presents at the emergency department reporting right lower quadrant pain and is subsequently diagnosed with appendicitis. When planning this client's nursing care, the nurse should prioritize what nursing diagnosis? A) Imbalanced Nutrition: Less Than Body Requirements Related to Decreased Oral Intake B) Risk for Infection Related to Possible Rupture of Appendix C) Constipation Related to Decreased Bowel Motility and Decreased Fluid Intake D) Chronic Pain Related to Appendicitis B) Risk for Infection Related to Possible Rupture of Appendix A nurse is caring for a client with constipation whose primary provider has recommended senna (Senokot) for the management of this condition. The nurse should provide which of the following education points? A) "Limit your fluid intake temporarily so you don't get diarrhea." B) "Avoid taking the drug on a long-term basis." C) "Make sure to take a multivitamin with each dose." D) "Take this on an empty stomach to ensure maximum effect." B) "Avoid taking the drug on a long-term basis." The nurse is caring for a client who is undergoing diagnostic testing for suspected malabsorption. When taking this client's health history and performing the physical assessment, the nurse should recognize what finding as most consistent with this diagnosis? A) Recurrent constipation coupled with weight loss B) Foul-smelling diarrhea that contains fat C) Fever accompanied by a rigid, tender abdomen D) Bloody bowel movements accompanied by fecal incontinence B) Foul-smelling diarrhea that contains fat A nurse is providing care for a client who has a diagnosis of irritable bowel syndrome (IBS). When planning this client's care, the nurse should collaborate with the client and prioritize what goal? A) Client will accurately identify foods that trigger symptoms. B) Client will demonstrate appropriate care of his ileostomy. C) Client will demonstrate appropriate use of standard infection control precautions. Client will adhere to recommended guidelines for mobility and activity. A) Client will accurately identify foods that trigger symptoms. An older adult has a diagnosis of Alzheimer disease and has recently been experiencing fecal incontinence. However, the nurse has observed no recent change in the character of the client's stools. What is the nurse's most appropriate intervention? A) Keep a food diary to determine the foods that exacerbate the client's symptoms. B) Provide the client with a bland, low-residue diet. C) Toilet the client on a frequent, scheduled basis. D) Liaise with the primary provider to obtain an order for loperamide. C) Toilet the client on a frequent, scheduled basis. An adult client has been diagnosed with diverticular disease after ongoing challenges with constipation. The client will be treated on an outpatient basis. What components of treatment should the nurse anticipate? Select all that apply. A) Anticholinergic medications B) Increased fiber intake C) Enemas on alternating days D) Reduced fat intake E) Fluid reduction B) Increased fiber intake D) Reduced fat intake A client's health history is suggestive of inflammatory bowel disease. Which of the following would suggest Crohn's disease, rather than ulcerative colitis, as the cause of the client's signs and symptoms? A) A pattern of distinct exacerbations and remissions B) Severe diarrhea C) An absence of blood in stool D) Involvement of the rectal mucosa C) An absence of blood in stool A nurse is caring for a client who has been admitted to the hospital with diverticulitis. What would be appropriate nursing diagnoses for this client? Select all that apply. A) Acute Pain Related to Increased Peristalsis and GI Inflammation B) Activity Intolerance Related to Generalized Weakness C) Bowel Incontinence Related to Increased Intestinal Peristalsis D) Deficient Fluid Volume Related to Anorexia, Nausea, and Diarrhea E) Impaired Urinary Elimination Related to GI Pressure on the Bladder A) Acute Pain Related to Increased Peristalsis and GI Inflammation B) Activity Intolerance Related to Generalized Weakness D) Deficient Fluid Volume Related to Anorexia, Nausea, and Diarrhea The nurse is providing care for a client whose inflammatory bowel disease has necessitated hospital treatment. Which of the following would most likely be included in the client's medication regimen? A) Antidiarrheal medications 30 minutes before a meal B) Antiemetics on a PRN basis C) Vitamin Biz injections to prevent pernicious anemia D) Beta adrenergic blockers to reduce bowel motility A) Antidiarrheal medications 30 minutes before a meal A nurse is caring for an older adult who has been experiencing severe Clostridium difficile-related diarrhea. When reviewing the client's most recent laboratory tests, the nurse should prioritize what finding? A) White blood cell level B) Creatinine level C) Hemoglobin level D) Potassium level D. Potassium level A client has been diagnosed with a small bowel obstruction and has been admitted to the medical unit. The nurse's care should prioritize which of the following outcomes? A) Preventing infection B) Maintaining skin and tissue integrity C) Preventing nausea and vomiting D) Maintaining fluid and electrolyte balance D) Maintaining fluid and electrolyte balance A client's large bowel obstruction has failed to resolve spontaneously and the client's worsening condition has warranted admission to the medical unit. Which of the following aspect of nursing care is most appropriate for this client? A) Administering bowel stimulants as prescribed B) Administering bulk-forming laxatives as prescribed C) Performing deep palpation as prescribed to promote peristalsis D) Preparing the client for surgical bowel resection D) Preparing the client for surgical bowel resection A client has been experiencing occasional episodes of constipation and has been unable to achieve consistent relief by increasing physical activity and improving his diet. When introducing the client to the use of laxatives, what teaching should the nurse emphasize? A) The effect of laxatives on electrolyte levels B) The underlying causes of constipation C) The risk of fecal incontinence D) The risk of becoming laxative-dependent D) The risk of becoming laxative-dependent A client's neck dissection surgery resulted in damage to the client's superior laryngeal nerve. What area of assessment should the nurse consequently prioritize? A) The client's swallowing ability B) The client's ability to speak C) The client's management of secretions D) The client's airway patency A. The client's swallowing ability. Rationale: If the superior laryngeal nerve is damaged, the client may have difficulty swallowing liquids and food because of the partial lack of sensation of the glottis. Damage to this particular nerve does not inhibit speech and only indirectly affects management of secretions and airway patency. A staff educator is reviewing the causes of gastroesophageal reflux disease (GERD) with new staff nurses. What area of the GI tract should the educator identify as the cause of reduced pressure associated with GERD? A) Pyloric sphincter B) Lower esophageal sphincter C) Hypopharyngeal sphincter D) Upper esophageal sphincter B) lower esophageal sphincter A nurse is providing health promotion education to a client diagnosed with an esophageal reflux disorder. What practice should the nurse encourage the client to implement? A) Keep the head of the bed lowered. B) Drink a cup of hot tea before bedtime. C) Avoid carbonated drinks. D) Eat a low-protein diet. C) Avoid carbonated drinks A client with gastroesophageal reflux disease (GERD) has been experiencing severe reflux during sleep. Which recommendation by the nurse is most effective to assist the client? A) Losing weight. B) Decreasing caffeine intake. C) Avoiding large meals. D) Raising the head of the bed on blocks. D) Raising the head of the bed on blocks. A client with gastroesophageal reflux disease (GERD) has a diagnosis of Barrett esophagus with minor cell changes. What principle should be integrated into the client's subsequent care? A) The client will be monitored closely to detect malignant changes. B) Liver enzymes must be checked regularly, as H2 receptor antagonists may cause hepatic damage. C) Small amounts of blood are likely to be present in the stools and are not cause for concern. D) Antacids may be discontinued when symptoms of heartburn subside. A) The client will be monitored closely to detect malignant changes. A client with GERD has undergone diagnostic testing and it has been determined that increasing the pace of gastric emptying may help alleviate symptoms. The nurse should anticipate that the client may be prescribed what drug? A) Metoclopramide B) Omeprazole C) Lansoprazole D) Calcium carbonate A. Metoclopramide Rationale: Metoclopramide (Reglan) is useful in promoting gastric motility. Omeprazole and lansoprazole are proton pump inhibitors that reduce gastric acid secretion. Results of a client barium swallow suggest that the client has GERD. The nurse is planning health education to address the client's knowledge of this new diagnosis. Which of the following should the nurse encourage? A) Eating several small meals daily rather than 3 larger meals B) Keeping the head of the bed partially elevated C) Drinking carbonated mineral water rather than soft drinks D) Avoiding food or fluid intake after 6:00 PM. A) Eating several small meals daily rather than 3 larger meals A client seeking care because of recurrent heartburn and regurgitation is subsequently diagnosed with a hiatal hernia. Which of the following should the nurse include in health education? A) "Drinking beverages after your meal, rather than with your meal, may bring some relief." B) "It's best to avoid dry foods, such as rice and chicken, because they're harder to swallow." C) "Many clients obtain relief by taking over-the-counter antacids 30 minutes before eating." D) Instead of eating three meals a day, try eating smaller amounts more often." D) "Instead of eating three meals a day, try eating smaller amounts more often." What is the normal range for Creatinine? M: 0.6-1.2mg/dL F: 0.5-1.1mg/dL What is the normal range for BUN? 10-20 mg/dL What is the normal HCT range? Males: 42-52 Females: 37-47 What is the normal range for RBC? Males: 4.7-6.1 Females: 4.2-5.4 What should you educate a patient on to help promote urinary continence? Perform all pelvic floor muscle exercises as prescribed, everyday. Void Regularly, 5-8 times/day (about q2-3 hours) What are some types of behavior therapy used to assist patients with incontinence? Voiding Dairy, biofeedback, verbal instructions (prompted voiding), PELVIC FLOOR MUSCLES like (KEGELS), and physical therapy/. What is considered adequate fluid intake for one day? 50-60oz (ml), throughout the day know these exercises r/t patient education for incontinence What is urge incontinence? overactive bladder/detrursor instability. sudden urge. frequent urination. What muscle is involved in urge incontinence and what is going on with it? The detrusor muscle. The muscle will squeeze or relax at the wrong times. Where might a lower urinary tract infection occur? Bladder- cystitis Prostate gland- prostatitis Urethra- urethritis A patient is suspected of having sepsis or bacteremia, what is important to assess that may alert the nurse to the involvement of the kidneys? Vitals and LOC! Assessment of vital signs and level of consciousness may alert the nurse to ______ involvement or impending ______, especially in older patients. Kidney Sepsis Penicillins like ampicillin and amoxicillin may be used to treat ____. UTI Pyelonephritis Cephalosporins like cefadroxil may be used to treat ______. UTI Fluoroquinolones that end in "-acin" may be used to treat ____. UTIs and pyelonephritis trimethoprim-sulfamethoxazole AKA bactrim is used as a.... Urinary tract anti-infective Contraindications of trimethoprim-sulfamethoxazole AKA bactrim include... FOLATE DEFICIENCY, fragile x syndrome, and creatinine clearance less than 15ml/min. A patient on trimethoprim-sulfamethoxazole AKA bactrim should report to their HCP if they experience... sore throat, fever, bruising, or a rash. The most common side-effects to trimethoprim-sulfamethoxazole AKA bactrim include... A rash and pruritus How might a geriatric patient react to UTI? Could be asymptomatic to serious. Family members may mention "they are acting different." What is the hallmark sign of a upper UTI? Flank pain & high fever What foods should be avoided to help prevent kidney stones? Foods high in oxalate like strawberries, spinach, rhubarb, tea, peanuts, wheat bran, sodas, and energy drinks, What can you do to help prevent kidney stones r/t nighttime behaviors? Drink two classes of water at bedtime and an additional glass at every awakening to help prevent high urine concentration over night. A patient with kidney stones starts to show signs and symptoms of a UTI. What do you do? Contact HCP. Prophalactic antibiotics will most likely be started. How can you help a patient with kidney stones and the pain their experiencing? Manage their pain with medications. Opioids are preferred (as prescribed) What is the immediate objective of treatment of renal or ureteral colic is to... Relieve the pain until the cause can be eliminated w/ medications like opioids. How can you differentiate nephrotic and nephritic syndromes? Nephrotic Syndrome is defined by severe PROTEINURIA, pronounced oedema, and usually normal blood pressure, whereas Nephritic Syndrome showcases HEMATURIA, hypertension, and moderate glomerular damage. A patient is retaining fluids due to glomerulonephritis. What kind of orders should the nurse place in this situation? Strict Intake and output What is one of the most valuable indicators of fluid retention? Daily Weights What is a clinical manifestation that is specific to kidney injury patients? Periorbital edema What is an indicator of chronic glomerulonephritis? Identification of Antigen-antibody complex from a recent strep infection. What are some signs & symptoms of chronic glomerulonephritis? Hyperkalemia due to decreased potassium excretion, acidosis, catabolism, and excessive intake from food and medications (remember they will have peaked t-waves) Headache, dizziness, GI issues, diminished DTR, pericarditis What can blood disease can develop due to chronic glomerulonephritis? Why? Anemia, due to the decreased production of erythropoietin, which results in decreased erythropoiesis (RBC production) What is normal albumin range? 3.5-5g/dL What is normal phosphorus range? 2.5-4.5 mg/dL What is the normal calcium range? 9-10.5 mg/dL chronic glomerulonephritis can result in decreased ______ and ____ levels. Phosphorus r/t decreased excretion Calcium r/t high phosphorus levels (Ca will bind to phosphorus to compensate for elevated levels) What is nephrotic syndrome? A kidney disorder that causes the body to excrete too much protein in the urine. This results in hypoalbuminia bc the liver can not keep with the the albumin loss. Patients will nephrotic syndrome will have diffuse edema in _________ areas. Dependent areas, like the SACRUM, ankles, and hands. Also periorbital edema What causes prerenal kidney injuries? when the blood supply to the kidneys is compromised or reduced. It is the most common type of ARF occurring in almost 60 to 70 percent of all ARF cases. Think hemmorage, cardiogenic shock, and sepsis What causes intrarenal/renal kidney injuries? conditions that cause direct injury or damage to the kidneys like clots, toxins, infections, drugs, and alcohol What causes postrenal kidney injuries? conditions that cause blockage or obstruction to urine flow like enlarged prostates, kidney stones, tumors, and trauma. What are the four phases of acute kidney injuries? I.O.D.R. (I Ordered Diet Rootbeer) Initiation Period Oliguria Period Diuresis Period Recovery Period What is the initiation phase of an acute kidney injury? What are the markers? How long can it last? The first phase of an AKI. It begins with the initial insult and ends when oliguria develops. It can last from hours to days. What is the oliguria phase of an acute kidney injury? What are the markers? How long can it last? The second phase of an AKI. It begins when urine output is LESS THAN 400ML/DAY. It is accompanied by increased levels of concentration of substance usually excreted by the kidneys like Urea, Creatinine, Uric Acids, potassium, and Magnesium. It lasts 8-14 days depending. What is the normal amount of urine needed to ride the body of normal metabolic waste products? 400mL in 24 hours or 0.5ml/kg/hr What is the diuresis phase of an acute kidney injury? What are the markers? How long can it last? It is the third phase of an AKI. Marked by the gradual increase in urine output, signaling the glomerular filtration is starting to recover. Lab values will begin to stabilize. Renal function may still be abnormal and uremic symptoms may still be present. It can last 7-14 days depending. A patient in the diuresis phase of an AKI must be.... observed closely for dehydration. We do not want uremic symptoms to become worse. What is the recovery phase of an acute kidney injury? What are the markers? How long can it last? The fourth and final phase of an AKI. It signals improvement of renal function, GFR will return to almost normal or the same as before injury. It can take 3 months to a year depending. What can you recommend to help a patient decrease phosphorus? Decrease their dairy intake. A patient with an AKI has increase potassium levels, what do you expect to be ordered to assist in lowering these levels? Cation-exchanging resins like Kayexalate, orally or via retention enemas. how does kayexalate work? It exchanges sodium for potassium in the GI tract removing the potassium. A patient with chronic kidney disease develops periorbital edema. What should the nurse do? Report to PCP. You should always report ________ symptoms to the PCP. WORSENING What types of worsening symptoms would you expect to see in a patient with chronic kidney disease? Nausea, Vomiting, and a change in usual urine output. S/s of hyperkalemia s/s of access problems like clotted fistula or graft, infection Digoxin toxicity causes _______ hyperkalemia What are the signs and symptoms of digoxin toxicity? Very slow or rapid ventricular rhythm, nausea, vomiting, loss of appetite, abdominal distention, vision changes, blurred vision, and mental changes. What is considered the safest choice for dialysis access? Arteriovenous fistula: surgically abnormal connections between arteries and veins How long must a patient wait after receiving an arteriovenous fistula to begin dialysis through the access point? Why? Approximately 2-3 months. The site must heal and mature before usage to prevent potential complications What types of medications might be help prior to dialysis? (or dosages might be modified) Why? Anti-hypertensives because dialysis typically lowers blood pressure. A patient wants to start peritoneal dialysis. What is an important education topic to teach the patient related to dialysate prior to usage? Warm to body temperate to help prevent discomfort and abdominal cramping, and to dilate blood vessels of the peritoneum to increase urea clearance. Do NOT use a microwave to warm the compound or bowl of warm water. A patient is receiving peritoneal dialysis and reports the dialysate is cloudy. What is suspected and what do you do? Peritonitis is suspected. Notify PCP. What is a long term complication of peritoneal dialysis? Increased triglyceride levels. What makes the dailysate flow when a patient is receiving peritoneal dialysis? Gravity pull the fluid through the peritoneal catheter into the peritoneal cavity. A nurse is taking care of a client who has chronic constipation. What should the nurse teach to the client about promoting normal bowel function? a. Use a suppository. b. Limit physical activity c. Consume high residue/ fiber foods ( correct answer) Patient has a new ileostomy and is three days post op for IBD. The nurse notices that the stoma is red and has scant amount of blood. What is the nurses next action ? a. Document - these findings are normal (correct answer) b. Apply a barrier ointment to stoma c. Clean it with soap d. Scrub stoma to get blood off A patient came in the ED and was symptomatic for a small bowel obstruction. What should we do next as the nurse taking care of the patient ? a. Insert NG tube (correct answer) i. Want to decompress the bowel b. Insert IV c. Administer an enema Who is most at risk for developing hemorrhoids? a. Pregnant woman ( correct answer) b. A person who stands for 10 hours a day c. 35 year old male who walks 10,000 steps a day A 20 year old patient is complaining of RLQ pain. When planning care for patient, what would be the priority ? a. Watching for infection because risk of rupture ( correct answer) b. Chronic pain c. Nausea and vomiting Patient has IBD. What should the patient understand about this disease? a. Patient needs to be able to ID foods that trigger symptoms of this disease. (correct) b. Watch for infection c. Try to stay active and exercise with this disease. Patient has been Dx with acute glomelunephritis. What is an expected finding for this disease? a. Decreased serum creatinine b. Decreased calcium c. Hematuria ( correct answer) A client with a GFR of 50mL/min. what stage is this patient in for CKD? a. Stage 1 b. Stage 3 ( correct answer) c. Stage 5 KNOW THE STAGES Patient has AKI. Which complication of labs would you need to admin polystyrene sulfonate? a. Hyperkalemia of 4.0 (correct answer) b. Hypercalcemia c. Hypernatremia PAGE 1568 look at red box What does borborygmus mean? a. Rumbling or gurgling noise made in the intestine (correct answer) b. Urinary stasis c. Belching Patient has an AKI and was from a prerenal cause. Which would it most likely be if it was pre renal? a. Pregnancy b. Reflux c. Burns ( correct answer) d. Renal calculi The patient would need further education if they stated? a. "I go to hemodialysis 2 times a week." (correct answer) b. "I will only need hemodialysis for like for my CKD." c. "hemodialysis I will need a fistula when I get to stage 4." what drug is used to treat stress incontinence? a. pseudophedrine (correct answer) b. tylenol C. HTN meds Patient is in ESKD. You are educating what the client should decrease eating during diet. Select multiple... a. Increased protein b. Decreased protein (correct) c. Decrease sodium (correct) d. Fluid restriction (correct) e. Vitamin C A client has been diagnosed with PKD ( polyscystic kidney disease). What would be correct if the client stated this about there disease? a. My disease is incurable and care will be supportive to my symptoms (correct) b. I will need surgical intervention. c. The cyst will go away after a while Patient has been diagnosed with acute glomelularnephritis. What could have triggered this disease? a. E. coli b. Head cold c. Streptococcal infection (correct) d. Stress Client has a new onset of periorbital edema and sacral edema. What does the client most likely going to be diagnosed with? a. Nephrotic syndrome (correct answer b. Acute glomerular c. Polynephritis The nurse if caring for a client who is in the recovery phase of AKI. The nurse should monitor what during this phase? a. Dehydration b. Electrolytes to return to normal (correct answer) c. Urine output The patient states that they can't make it to the bathroom in time. What type of incontinence is this? a. Functional incontinence b. Urge incontinence (correct) c. Stress incontinence The patient urinates on herself when she coughs. What incontinence does this indicate? a. Stress (correct) b. Iatrogenic c. Functional incontinence A patient has been diagnosed with fecal incontinence. The nurse knows that correct teaching this client would be.... a. Educate patient to Increase water intake b. Teach the client to take bulk forming Metamucil and loperamide 30 min before meals (correct answer) c. Educate client to Eat fatty foods and increase sodium intake. Patient is in a nursing home and has fecal incontinence. The RN is training a newly hired nurse. The newly hired nurse needs to be stopped if she states… a. Educate patient to Increase water intake b. Teach the client to take bulk forming Metamucil and loperamide 30 min before meals (correct answer) c. Educate client to Eat fatty foods and increase sodium intake. Patient is in a nursing home and has fecal incontinence. The RN is training a newly hired nurse. The newly hired nurse needs to be stopped if she states… a. "The patient can wear incontinence briefs all the time" (correct) b. "Patients should on use incontinence briefs for periods of time." c. "the patient should be taking bulk forming medications prior to eating." The newly hired nurse is educating the client on urinary incontinence. What would dbe important to teach. Select all that apply. a. Decrease caffeine, alcohol and sweeteners ( correct) b. Void 5-8x a day (every 2-3 hours) (correct) c. Do not smoke (correct) d. Decrease exercise e. Increase juice consumption Which of the following CM would indicate that the client has Ulcerative colitis. a. Bloody stool (correct) b. Hematuria c. no diarrhea A nurse is taking care of an older client. The patient has had severe diahrrea for several days. What lab would be the most important to look at ? a. WBC b. RBC c. BUN d. Potassium (correct) - bc of electrolyte and risk of being WACKYYYY What should a healed stoma look like? a. Black b. Red and shiny ( correct) c. Gray and pallor What would be a priority if a patient had a small bowel obstruction? MAINTIAN FLUIDS and ELECTROLYTES If we Abruptly stopped Parenteral nutrition what fluid would you want to give to decrease risk of rebound hypoglycemia. a. Isotonic dextrose for 1-2 hours after stopping PN ( correct) b. Hypertonic dextrose c. D5W Patient was diagnosed with gastritis. What finding by the nurse would most significantly trigger this? a. Smokes one pack of cigs a day ( correct) b. Drinking weekly c. Eating lots of protein Patient has peptic ulcer disease because of H. pylori. How did this patient transmit this disease? a. Infection from eating contaminated foods or waters (correct) b. From their dogs c. From people not washing hands after using the restroom what is the diagnostic tool for pyelonephritis ? CT scan or IV pyelogram UTI prevention - NO TUB baths - TAKE showers - decrease caffiene - cranberry juice and vitamin C juice IV pyelogram if on metformin, make them stop for a least 2 DAYS PRIOR Kidney stone causes - foods high in oxylate (spinach, beets, raspberries, rhubarb, wheat bran) Kidney stone diagnostic -PAIN ( lower back = flank pain) - UA -CT Kidney stone Nursing interventions - INCREASE fluidsssss** - moist heat for flank pain - NSAIDS for mild pain - Opioids for Severe pain - AVOID PROTEIN - DRINK fluids every 1-2 hours - avoid activities that lead to hydration (construction workers)** when assessing AV fistula... - will hear a "bruit" = normal finding - 6-8 weeks to mature Peritoneal dialysis nursing considerations - must be room temp for DIALYSATE but never in microwave, blanket warmer, etc. - Must wear mask to access port or change dressing - CHG or soap and water what is considered constipation? 3 BM a week dry/ lumpy/ hard stool GERD s/s - cough - reflux - dyspepsia - regurgitation - dysphagia - esophagitis GERD TX PPI- omeprazole "-ole" Hiatal Hernia post op management if to advance diet slowly from clear liquids to solids***** - must do bowel rest esophageal varices s/s -hematemesis - melena - decreased LOC - S&S of shock (tachy and low BP) IBS triggers - stress -sleep disturbance - certain foods IBS avoid -ETOH - Smoking Peritonitis inflammation of the peritoneum caused by infection of ascitic fluid or perforation Peritonitis S/S - Temp of 100 to 101 is expected - high pulse rate is expected - rebound tenderness - sepsis - altered F/E status Appendicitis s/s - very high WBC count - RLQ pain diverticular disease condition in which bulging pouches (diverticula) in the gastrointestinal (GI) tract push the mucosal lining through the surrounding muscle Diverticular complications - corn/ popcorn can cause fistula / pouches - seeds can also do this (strawberries) -hemorrhage Diverticular Prevention - Take psyllium daily= fiber - rest - fluids 2 liters a day -soft foods ( soft cooked veggies) - avoid trigger foods G- tube cleaned daily and as needed with soap and water or 2% chlorhexidine gluconate according to policy