Deck 2: Basic Care

Question 1

Which nursing intervention is essential for a client following an upper gastrointestinal endoscopy?

A)Assessment of the pedal pulses
B)Assessment of the gag reflex
C)Monitoring for blood pressure
D)Assessment of the respiratory rate

Answer 1

Assessment of the gag reflex

Question 2

A nurse is caring for a client who was ordered to receive an enema before a colonoscopy. Which of the following is the least important to determine before performing the procedure:

A)Assess whether the client has sphincter control.
B)Assess whether the client can tolerate sitting up.
C)Assess if the client can tolerate a left lateral position.
D)Assess the abdomen.

Answer 2

Assess whether the client can tolerate sitting up.

Question 3

A client with acute pancreatitis is complaining of severe abdominal pain. The nurse should teach the client to avoid which of the following positions to alleviate the pain?

A)Lying supine in the bed
B)Flexing the left leg
C)Sitting up in the bed
D)Leaning forward

Answer 3

Lying supine in the bed

Question 4

The nurse places the client in this position immediately after a percutaneous liver biopsy:

A)Semi-Fowler's position
B)Left-side lying position
C)Right-side lying position
D)Supine position.

Question 5

A client with a perforated bowel is scheduled for emergency surgery. The nurse finds out that the client could not sign the consent form due to sedation induced by the administration of narcotic analgesics. The nurse's most appropriate action is to:

A)Call the client's family to obtain consent, and have it witnessed by two individuals
B)Give the consent herself, and ask two individuals to be the witnesses
C)Send the client to surgery without an informed consent
D)Ask the physician to sign the consent and stand as one of the witnesses