MedSurg Review
Quiz yourself by thinking what should be in
each of the black spaces below before clicking
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show | A. Coffee
B. Chocolate
C. Fatty foods.
D. Nonfat milk
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Nonfat milk | show 🗑
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show | A. Monitoring the temp.
B. Monitoring complaints of heartburn
C. Giving warm gargles for a sore throat
D. Assessing for return of gag reflex
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D. Assessing for return of gag reflex | show 🗑
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The nurse is monitoring a client with a dx of peptic ulcer. Which assessment finding would most likely indicate perforation of the ulcer? | show 🗑
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show | Perforation is characterized by sudden, sharp, intolerable pain in the midepigastric area and spreading over the abdomen, which then becomes rigid and board-like.
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show | A. Ambulate following a meal
B. Eat a high carbohydrate diet
C. Limit the fluids taken with meals
D. Sit in a high Fowler's position during meals
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C. Limit fluids taken with meals. | show 🗑
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show | A. Sweating and Pallor
B. Bradycardia and indigestion
C. Double vision and chest pain
D. Abdominal cramping and pain
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A. Sweating and pallor | show 🗑
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show | A. Diarrhea
B. Chronic constipation
C. Constipation alternating with diarrhea
D. Stool constantly oozing from rectum
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A. Diarrhea | show 🗑
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show | A. Weight loss
B. Nausea and vomiting
C. Pain relieved by food intake
D. Pain radiating down the right arm
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show | A common symptom of duodenal ulcer is pain relieved by food Bain is usually burning, heavy, sharp, or 'hungry.' Midepigastric. No weight loss or N/V.
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show | A. thorough investigation of precipitating events.
B. Insertion of a nasogastric tube and Hematest of emesis
C. Complete abdominal examination
D. Assessment of vital signs
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D. Assessment of vital signs | show 🗑
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show | A. Leukopenia w/ a shift to the right
B. Leukocytosis w/ a shift to the right
C. Leukocytosis w/ a shift to the left
D. Leukopenia w/ a shift to the left
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C. Leukocytosis w/ a left shift | show 🗑
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show | A. Risk for aspiration r/t poor gag reflex r/t anesthesia
B. Deficient knowledge r/t postop care
C. Risk for deficient fluid volume r/t hemorrhage
D. Impaired comfort r/t passage of endoscope through throat
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show | EGD is an endoscope going down the throat to the stomach and duodenum. General anesthesia is typically used. ABCs take priority.
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show | A. I eat at least three large meals each day
B. I eat while lying in a semirecumbent position
C. I have eliminated taking liquids with my meals
D. I eat a high-protein, low-to-moderate-carb diet
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A. I eat three large meals a day | show 🗑
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show | A. Recently retired from a job
B. Significant other has a gastric ulcer
C. Takes ibuprophen (Motrin) for osteoarthritis
D. Occasionally drinks onen cup of coffee in the morning
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C. Take ibuprophen (motrin) for osteoarthritis | show 🗑
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show | A. Hypercalcemia
B. Fibrous stricture
C. Frothy, fatty stools
D. Decreased hemoglobin
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D. Decreased hemoglobin | show 🗑
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A client with acute ulcerative colitis requests a snack. Which of hte following would be an appropriate snack for this client? | show 🗑
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show | Diet for UC should be low-fiber. Avoid whole-wheat, nuts, fresh fruits, vegetables, lactose foods, caffeine, pepper, and alcohol.
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A nurse has provided dietary instructions to a client with a dx of PUD. Which statement by the client indicates an understanding of the instruction? | show 🗑
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show | Dietary mods for PUD include spiced foods, alcohol, caffeine, chocolate, and citrus foods.
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A nurse is providingn instructions to a client regarding measures to minimize the risk of dumping syndrome. The nurse says to: | show 🗑
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show | Pts at risk for DS should maintain low Fowler's while eating and lie down for 30 min after eating. Eat more small frequent meals. Dec. fluids with meals. Avoid high carbs.
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show | A. Sleeping 8 to 10 hrs a night
B. Eating 5-6 small meals a day
C. Ability to work at home at times
D. Frequent need to work overtime on short notice
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D. Frequent need to wo rk overtime on short notice | show 🗑
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Client arrives in ED w/ acute RLQ pain. Appendicity suspected. WBC's elevated. Which physician order should the nurse question? | show 🗑
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show | Client would be NPO, IV fluids started, and cold pack used to relieve pain. Laxatives could cause perforation and are contraindicated in appendicitis.
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show | A. Cream of wheat
B. Corn
C. Rice
D. Broiled chicken
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show | Corn is high in fiber, which pts with IBS should have, but is irritating to the bowels.
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A client has been diagnosed with GERD. The nurse plans care knowing client has dysfunction of which part of the digestive system? | show 🗑
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show | The lower esophageal sphincter relaxes too much and gastric contents push up into esophagus.
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A client w/ appendicitis is having an appendectomy. The nurse describes the location of the appendix as being in the: | show 🗑
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show | The appendix is in the RLQ
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show | A. Perforation
B. Obstructionn
C. Hemorrhage
D. Intractability
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A. Perforation | show 🗑
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show | A. Maintain NPO
B. Initiate IV for fluids
C. Maintain semi-fowlers position
D. Apply a heating pad to lower abdomen for comfort
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show | The first three interventions should be done. Heat should never ben applied to abdomen as it increases perfusion to appendix and can cause perforation
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A client has duodenal ulcer as shown by endoscopy. Postop, the nurse should assess most carefully for which s/s? | show 🗑
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show | This is indicative of perforation. Aside**Perforation has similar symptoms irregardless of where it occurs. IE appendix, duodenum, or stomach.
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Client with Crohn's disease has just had a bowel movement. The nurse assess the stool for which of the following characteristics as expected with this disease? | show 🗑
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show | Crohn's involves nonblood diarrhea. 4-5 stools/day.
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Pt hospitalized w/ dx of ulcerative colitis. Which assessment finding would nurse report to the provider? | show 🗑
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show | Rebound tenderness may indicate peritonitis. Bloody diarrhea is normal. Hypotension and low hemoglobin are expected with bloody diarrhea.
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show | A. Nizatidine (Axid)
B. Ibuprofen (Motrin)
C. Sucralfate (Carafate)
D. Omeprazole (Prilosec)
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show | Motrin is an NSAID. These drugs can be irritable to the lining of the GI tract.
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Pt admitted to hospital w/ dx of acute diverticulitis. Which would hte nurse expect to be prescribed for this client? | show 🗑
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A. NPO status | show 🗑
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show | A. Age older than 30 years
B. High-fiber, low-fat diet
C. Distant relative w/ colorectal cancer
D. Persona hx of UC or GI polyps
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D. Personanl hx of UC or GI polyps | show 🗑
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