Which area of the abdomen will the nurse palpate to assess for splenomegaly?

What is the most common cause of secondary protein-calorie malnutrition in the United States?
a. The unavailability of foods high in protein
b. Lack of knowledge about nutritional needs
c. Lack of money to purchase high-protein foods
d. Alteration in ingestion, digestion, absorption, or metabolism

What is the most underlying risk factor for metabolic syndrome?
a. age
b. heart disease
c. insulin resistance
d. high cholesterol levels

What does a nurse include when teaching a pt w/ newly dx peptic ulcer disease?
a. maintain a bland, soft, low-residue diet
b. use alcohol & caffeine in moderation & always w/ food
c. midepigastric pain that is unrelieved w/ antacids
d. avoid milk & milk products because they stimulate gastric acid production

Which method is preferred for immediate tx of an acute episode of constipation?
a. an enema
b. increased fluid
c.stool softeners
d. bulk-forming medication

What problem should the nurse assess the patient for if the patient was on prolonged antibiotic therapy?
a. Coagulation problems
b. Elevated serum ammonia levels
c. Impaired absorption of amino acids
d. Increased mucus & bicarbonate secretion

Which patient has the highest risk for poor nutritional balance r/t decreased ingestion?
a. Tuberculosis infection
b. Malabsorption syndrome
c. Draining decubitus ulcers
d. Severe anorexia resulting from radiation therapy

When teaching a pt about weight reduction diets, the nurse teaches the pt that an appropriate single serving of food is
a. a 6 inch bagel
b. 1 cup of chopped vegetables
c. a piece of cheese the size of 3 dice
d. a chicken breast the size of a deck of cards

Which lab findings should the nurse expect in the pt w/ persistent vomiting?
a. decreased pH, increased Na, decreased Hct
b. increased pH, decreased Cl, decreased Hct
c. increased pH, decreased K+, increased Hct
d. decreased pH, decreased K+, increased Hct

The pt has peritonitis, which is a major complication of appendicitis. What tx will the nurse plan to include?
a. peritoneal lavage
b. peritoneal dialysis
c. IV fluid replacement
d. increased oral fluid intake

Which nursing actions are indicated for a liver biopsy? (Select all that apply)
a. Observe for white stools
b. Monitor for rectal bleeding
c. Monitor for internal bleeding
d. Position to right side after test
e. Ensure bowel preparation was done
f. Check coagulation status before test

When teaching an older adult about nutritional needs during aging, what does the nurse emphasize?
a. Need for all nutrients decreases as one ages
b. Fewer calories, but the same or slightly increased amount of protein, are required as one ages
c. Fats, carbs, & protein should be decreased, but vitamin and mineral intake should be increased
d. High-calorie oral supplements should be taken between meals to ensure that recommended nutrient needs are met

Priority Decision: Before selecting a weight reduction plan w/an obese pt, what is most important for the nurse to first assess?
a. pt's motivation to lose weight
b. length ofttimes that the patient has been obese
c. whether financial considerations will affect the pt's choices
d. pt's anthropometric measures of ht, wt, BMI, waist-to-hip ratio, & skin fold thickness

Nursing management of the patient w/ chronic gastritis includes teaching the pt to:
a. take antacids before meals to decrease stomach acidity
b. maintain nonirritating diet w/ 6 small meals a day
c. eliminate alcohol & caffeine from the diet when symptoms occur
d. use nonsteroidal antiinflammatory drugs (NSAIDS) instead of aspirin for minor pain relief

The nurse plans teaching for a pt w/ a colostomy but the pt refuses to look at the nurse or the stoma, stating, "I just can't se myself w/ this thing." What is the best nursing intervention for this pt?
a. encourage pt to share concerns & ask questions
b. refer pt to chaplain to help cope w/ this situation
c. explain that there is nothing the pt can do about it & must care for it
d. tell pt that learning about it will prevent stool leaking & the sounds of flatus.

Checking for the return of the gag reflex & monitoring for LUQ pain, nausea, & vomiting are necessary nursing actions after which diagnostic procedure?
a. ERCP
b. Colonoscopy
c. Barium Swallow
d. Esophagogastroduodenoscopy (EGD)

When considering tube feedings for its w/severe protein-calorie malnutrition, what is an advantage of a gastrostomy tube vs a nasogastric (NG) tube?
a. less irritation to nasal & esophageal mucosa
b. pt experiences sights & smells associated w/eating
c. aspiration resulting from reflux of formulas into esophagus is less common
d. routine checking for placement is not required because gastrostomy tubes do not become displaced

Which statement about obesity is explained by genetics?
a. older obese its have exacerbated changes of aging
b. android body shape & wt gain are influenced by genetics
c. White Americans have a higher incidence of obesity than African Americans
d. men have a harder time losing wt, as they have more muscle mass than women

The nurse is planning to teach the pt w/GERD about foods/beverages that decrease lower esophageal sphincter (LES) pressure. What should be included in the list (Select all that apply)
a. alcohol
b. root beer
c. chocolate
d. citrus fruits
e. fatty foods
f. cola sodas

Priority Decision: What is the most important thing the nurse should do when caring for a pt who has contracted C.diff?
a. clean entire room w/ ammonia
b. feed the pt yogurt w/ probiotics
c. wear gloves & wash hands w/ soap & water
d. teach the family to use alcohol-based hand cleaners

Priority Decision: When caring for a pt who has had majority of the stomach surgically removed, what is important for the nurse to teach the patient?
a. Extra iron will need to be taken to prevent anemia
b. Avoid foods w/lactose to prevent bloating & diarrhea
c. Lifelong supplements of cobalamin (vitamin B12) will be needed
d. Because of the absence of digestive enzymes, protein malnutrition is likely

Priority Decision: Before administering a bolus of intermittent tube feeding to a patient w/a percutaneous endoscopic gastrostomy (PEG), the nurse aspirated 220ml of gastric contents. How should the nurse respond?
a.return aspirate to stomach & recheck vol of aspirate in an hour
b. return aspirate to stomach & continue w/tube feeding as planned
c. discard aspirate to prevent overdistending the stomach when the new feeding is given
d. notify HCP that feedings have been scheduled too frequently to allow for stomach emptying

Priority Decision: The nurse is teaching a moderately obese woman interventions for the management of obesity. (Select all that apply)
a. limit alcohol
b. rest when fatigued
c. determine portion sizes
d. 1800-2200-calorie diet
e. attend overeaters anonymous

Priority Decision: when caring for a pt w/ an acute exacerbation of a peptic ulcer, the nurse finds the pt doubled up in bed w/ shallow, grunting respirations. Which action should the nurse. take first?
a. irrigate the pt's NG tube
b. notify the HCP
c. place pt in high-fowler's position
d. assess pt's abdomen & VS

In instituting a bowel training program for a pt w/fecal incontinence, what should the nurse first plan to do?
a. teach the pt to use a perianal much
b. insert a rectal suppository at the same time every morning
c. place the pt on a bedpan 30 minutes before breakfast
d. assist the pt to the bathroom at the time of pt's normal defecation