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NR341 Complex Adult Health Exam 10 2024

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NR341 Complex Adult Health Exam 10 2024

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  • January 21, 2025
  • 36
  • 2024/2025
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NR341 Complex Adult Health Exam 10 2024
A client had a routine sigmoidoscopy with a tissue biopsy. What postprocedure complication
would the nurse report to the health care provider?
Gas and flatulence
Excessive bleeding
Nausea and vomiting
Severe rectal pain - Excessive bleeding

The nurse is educating a group of older adults about screening for colorectal cancer. Which
statement by a group member indicates the need for further clarification about these guidelines?
"A barium enema every 5 years is a screening option."
"I will need to have a routine colonoscopy every 5 years."
"My routine flexible sigmoidoscopy every 5 years is OK."
"The 'virtual' colonoscopy every 5 years is acceptable." - "I will need to have a routine
colonoscopy every 5 years."

What is a common gastrointestinal problem that older adults experience more frequently as they
age?
Decreased hydrochloric acid levels
Excess lipase production
Increased liver size
Increased peristalsis - Decreased hydrochloric acid levels

The nurse is assessing an alert client who had abdominal surgery yesterday. What method
provides the most accurate data about resumption of peristalsis in the client?
Asking the client whether he or she has passed flatus (gas) within the previous 12 to 24 hours. (p.
17)
Auscultating bowel sounds in all abdominal quadrants
Counting the number of bowel sounds in each abdominal quadrant over one minute.
Observing the abdomen for symmetry and distention - Asking the client whether he or she has
passed flatus (gas) within the previous 12 to 24 hours. (p. 17)

The nurse is assessing a client who comes to the emergency department with acute abdominal
pain. The nurse notes a bulging, pulsating mass when inspecting the abdomen. Which action by
the nurse is correct?
Auscultate the abdomen to determine the presence of bowel sounds.
Notify the provider about this finding immediately.
Palpate the client's abdomen to determine the outlines of the mass.
Question the client about recent stool habits. - Notify the provider about this finding
immediately.

A client is scheduled for a colonoscopy. What does the nurse tell the client to do before the
procedure is performed?
"Begin a clear liquid diet at least 24 hours before the test."
"Do not eat or drink anything for 12 hours before the test."

,"Give yourself tap water enemas until the fluid returns are clear."
"Be sure to take all currently prescribed medications prior to the procedure." - "Begin a clear
liquid diet at least 24 hours before the test."

The nurse is assessing a client who has come to the emergency department with acute abdominal
pain. The client is very thin and the nurse observes visible peristaltic movements when
inspecting the abdomen. What does the nurse suspect?
Acute diarrhea
Aortic aneurysm
Intestinal obstruction
Pancreatitis - Intestinal obstruction

A client is admitted to the hospital with severe right upper quadrant (RUQ) abdominal pain.
Which assessment technique does the nurse use for this client?
Assesses the abdomen in the following sequence: inspection, palpation, percussion, auscultation
Examines the RUQ of the abdomen last following all other assessment techniques.
Have the client lie in a supine position with legs straight and arms at the sides
Gently palpates any bulging mass and documents findings. - Examines the RUQ of the abdomen
last following all other assessment techniques.

Which client does the charge nurse on the adult medical unit assign to an RN who has floated
from the outpatient gastrointestinal (GI) clinic?
A 38-year-old who needs discharge instructions after having an endoscopic retrograde
cholangiopancreatography (ERCP)
A 40-year-old who needs laxatives administered and effectiveness monitored before a
colonoscopy
A 43-year-old recently admitted with nausea, abdominal pain, and abdominal distention
A 50-year-old with epigastric pain who needs conscious sedation during a scheduled endoscopy
procedure - A 40-year-old who needs laxatives administered and effectiveness monitored before
a colonoscopy

A client arrives at the emergency department with acute abdominal pain in the left lower
quadrant. In which order does the nurse examine and assess the client's abdomen? (left lower
quadrant (LLQ), left upper quadrant (LUQ), right lower quadrant (RLQ), and right upper
quadrant (RUQ))?
LLQ, RLQ, LUQ, RUQ
LUQ, LLQ, RUQ, RLQ
RLQ, LLQ, RUQ, LUQ
RUQ, LUQ, RLQ, LLQ - RUQ, LUQ, RLQ, LLQ

Which substance, produced in the stomach, facilitates the absorption of vitamin B12?
Glucagon
Hydrochloric acid
Intrinsic factor
Pepsinogen - Intrinsic factor

,After a colonoscopy, a client reports severe abdominal pain. The nurse obtains these data:
temperature 100.2°F (37.9°C), pulse 122 beats/min, blood pressure 100/45 mm Hg, respirations
44 breaths/min, and O2 saturation 89%. Which request from the health care provider does the
nurse implement first?
Give cefazolin (Ancef) 500 mg IV.
Infuse normal saline at 200 mL/hr.
Give morphine sulfate 2 mg IV.
Provide oxygen at 6 L/min per nasal cannula. - Provide oxygen at 6 L/min per nasal cannula.

Which client does the charge nurse assign to an experienced LPN/LVN working on the adult
medical unit?
A 32-year-old who needs a nasogastric tube inserted for gastric acid analysis
A 36-year-old who needs teaching about an endoscopic retrograde cholangiopancreatography
A 40-year-old who will need administration of IV midazolam hydrochloride (Versed) during an
upper endoscopy
A 46-year-old who was recently admitted with abdominal cramping and diarrhea of unknown
causes - A 32-year-old who needs a nasogastric tube inserted for gastric acid analysis

While working in the outpatient procedure unit, the RN is assigned to these clients. Which client
does the nurse assess first?
A 51-year-old who recently had an endoscopic retrograde cholangiopancreatography (ERCP)
A 54-year-old who is ready for discharge following a colonoscopy
A 58-year-old who has just arrived for basal gastric secretion and gastric acid stimulation testing
A 60-year-old with questions about an endoscopic ultrasound examination - A 51-year-old who
recently had an endoscopic retrograde cholangiopancreatography (ERCP)

The outpatient clinic nurse is caring for a recovering client who had a colonoscopy. The client
asks for a drink. How does the nurse respond to this request?
"After I hear bowel sounds, you can have a drink."
"Twenty minutes after the procedure was completed, you may have some liquids."
"When you are able to pass flatus (gas), you can have a drink."
"You can have fluids when you get home and are settled." - "When you are able to pass flatus
(gas), you can have a drink."

Which factors place a client at risk for gastrointestinal (GI) problems?
Select all that apply.
Eating a high-fiber diet
Smoking a half-pack of cigarettes per day
Socioeconomic status
Some herbal preparations
Use of nonsteroidal anti-inflammatory drugs (NSAIDs) - Smoking
Socioeconomic status
Some herbal preparations
NSAIDS

, When taking a history for a client with GI problems, which daily client behavior requires further
nursing assessment? (Select all that apply.)

a. Eats multiple servings of vegetables
b. Takes 800 mg of ibuprofen for arthritic pain
c. Walks 30 minutes
d. Chews tobacco
e. Takes senna to assist with bowel movements
f. Listens to music to promote relaxation - B, D, E

The nurse is performing a physical assessment on a client's abdomen. The nurse inspects the
abdomen and finds the abdomen asymmetrical, with a non-pulsating mass in the RUQ. What is
the appropriate priority nursing intervention?

a. Document the findings in the electronic health record.
b. Auscultate for bowel sounds and bruits.
c. Lightly palpate the mass.
d. Notify the health care provider of the findings. - B

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

a. Colonoscopy every 10 years
b. Single sample fecal immunochemical test (FIT).
c. Flexible sigmoidoscopy every 5 years
d. Stool DNA test (sDNA) every 3 years
e. Double contrast barium enema every 5 years
f. Take home yearly guaiac fecal occult blood test (gFOBT) - A, C, D, E, F

The nurse is caring for a client diagnosed with aphthous ulcers. The nurse instructs the client to
avoid which foods?
Select all that apply.
Apples
Bananas
Cheese
Nuts
Potatoes - Cheese
Nuts
Potatoes

The nurse is caring for a postoperative client who had an extensive oral and neck surgery. The
client is now describing throbbing pain in the head. The nurse anticipates that the health care
provider will request which medication for this client?
Diphenhydramine (Benadryl)
Midazolam (Versed) intravenously
Morphine sulfate intravenously

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