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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show | Foods that inc. LES will dec. reflux and lessen s/s of GERD. Coffee, Chocolate, Fatty foods, and alcohol dec. LES and aggravate GERD s/s.
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The client has undergone an EGD. The nurse places highest priority on which item as part of the client's care plan? | show 🗑
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show | Address ABC.
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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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show | Early manifestations of dumping syndrome occur 5-30 min after eating. S/s include vertigo, tachycardia, syncope, pallor, sweating, palpitations, and a desire to lie down.
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The nurse is reviewing the record of a client with Crohn's disease. Which stool characteristic should the nurse expect to note documented in the client's record. | show 🗑
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show | Chron's disease is characterized by nonbloody diarrhea of usualy not more than four to five stools daily.
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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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show | Vital signs can indicate amount of blood loss and provide baseline for further treatment. A and C are correct but not priority
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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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show | Lab findings do not establish appy dx, but there is often an inc. in WBC with a left shift (Inc. of immature WBCs)
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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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A client experiencing chronic dumping syndrome makes all of the following comments to the nurse. Which one needs further discussion? | show 🗑
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show | Rapid dumping of gastric contents pulls fluid into intestine. So eliminating fluids is good, low carb-high protein is good, and semirecumbent is good.
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Nurse does admin hx on client with suspected PUD. Which factor documented by nurse increases PUD risk? | show 🗑
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C. Take ibuprophen (motrin) for osteoarthritis | show 🗑
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In performing a physical assessment of a client with a dx of ulcerative colitis, the nurse would expect which of the following findings? | show 🗑
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D. Decreased hemoglobin | show 🗑
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show | A. Carrots and ranch dip
B. Whole-grain cereal and milk
C. A cup of popcorn and cola drink
D. Applesauce and a graham cracker
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D. Applesauce and a graham cracker | show 🗑
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show | A. Citrus fruit and raw vegetables need to be included in my daily diet
B. Beer is ok in moderation
C. Chicken and fish baked are ok
D. Coffee and tea should be limited to two cups daily
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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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show | Psychological or emotional stressors can exacerbate PUD.
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show | A. Maintain NPO status
B. Initiate IV for fluids
C. Apply a cold pack to abdomen
D. Admin 30 mL of MOM (laxative)
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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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A nurse is providing dietary teaching to a client with IBS. Which food stated by client shows an understanding of proper dietary understanding? | show 🗑
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B. Corn | show 🗑
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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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C. LES | show 🗑
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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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A. RLQ | show 🗑
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Pt w/ hx of gastric ulcer has sharp, sudden pain in midepigastric area. Abdomen become board-like and rigid (guarding). Which complication of gastric ulcer is the pt experiencing? | show 🗑
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A. Perforation | show 🗑
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Pt presents to ED with appendicitis. Which prescription would the nurse question? | show 🗑
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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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show | A. N/V
B. A rigid board-like abdomen
C. Bradycardia
D. Numbness in the legs
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B. A rigid board-like abdomen | show 🗑
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show | A. Dry, hard, constipated stool
B. Chalky gray stool
C. Loose, watery stool
D. Blood in the stool
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C. Loose, water stool | show 🗑
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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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B. Ibuprofen (Motrin) | show 🗑
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show | A. NPO status
B. Ambulation QID
C. Cholinergic medications to reduce pain
D. Coughing and deep breathing q2h
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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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