ATI Gastrointestinal learning system 3.0

A nurse is assessing a client who has advanced cirrhosis. The nurse should identify which of the following findings as indicators of hepatic encephalopathy? (Select all that apply.) A. Anorexia B. Change in orientation C. Asterixis D. Ascites E. Fetor hepaticus

B. Change in orientation C. Asterixis E. Fetor hepaticus

A nurse is completing nutrition teaching for a client who has pancreatitis. Which of the following statements by the client indicates an understanding of the teaching? (Select all that apply.) A. "I plan to eat small, frequent meals." B. "I will eat easy-to-digest foods with limited space." C. "I will use skim milk when cooking." D. "I plan to drink regular cola." E. "I will limit alcohol intake to two drinks per day."

A. "I plan to eat small, frequent meals." B. "I will eat easy-to-digest foods with limited space." C. "I will use skim milk when cooking."

A nurse is reviewing nutrition teaching for a client who has cholecystitis. The nurse should identify that which of the following food choices can trigger cholecystitis? A. Brownie with nuts B. Bowl of mixed fruit C. Grilled turkey D. Baked potato

A. Brownie with nuts

A nurse is caring for a client who has cirrhosis. Which of the following medications can the nurse expect to administer to this client? (Select all that apply.) A. Diuretic B. Beta-blocking agent C. Opioid analgesic D. Lactulose E. Sedative

A. Diuretic B. Beta-blocking agent D. Lactulose

A nurse is teaching a client who has hepatitis B about home care. Which of the following instructions should the nurse include in the teaching? (Select all that apply.) A. Limit physical activity B. Avoid alcohol C. Take acetaminophen for comfort D. Wear a mask when in public places E. Eat small frequent meals

A. Limit physical activity B. Avoid alcohol E. Eat small frequent meals

A nurse is planning care for a client who has a new prescription for TPN. Which of the following interventions should be included in the plan of care? (Select all that apply.) A. Obtain a capillary blood glucose four times daily. B. Administer prescribed medications through a secondary port on the TPN IV tubing. C. Monitor vital signs three times during the 12-hour shift. D. Change the TPN IV tubing every 24 hr. E. Ensure a daily aPTT is obtained.

A. Obtain a capillary blood glucose four times daily. C. Monitor vital signs three times during the 12-hour shift. D. Change the TPN IV tubing every 24 hr.

A nurse is caring for a client who is receiving TPN solution. The current bag of solution was hung 24 hr ago, and 400 mL remains to infuse. Which of the following is the appropriate action for the nurse to take? A. Remove the current bag and hang a new bag. B. Infuse the remaining solution at the current rate and then hang a new bag. C. Increase the infusion rate so the remaining solution is administered within the hour and hang a new bag. D. Remove the current bag and hang a bag of lactated Ringer's.

A. Remove the current bag and hang a new bag.

A nurse is completing preoperative teaching for a client who is scheduled for a laparoscopic cholecystectomy. Which of the following should be included in the teaching? A. "The scope will be passed through your rectum." B. "You might have shoulder pain after surgery." C. "You will have a Jackson-Pratt drain in place after surgery." D. "You should limit how often you walk for 1 to 2 weeks."

B. "You might have shoulder pain after surgery."

A nurse is providing discharge teaching to a client who is postoperative following open cholecystectomy with T-tube placement. Which of the following instructions should the nurse include in the teaching? (Select all that apply.) A. Take baths rather than showers. B. Clamps T-tube for 1 hr before and after meals. C. Keep the drainage system above the level of the abdomen. D. Expect to have the T-tube removed 3 days postoperatively. E. Report brown-green drainage to the provider.

B. Clamps T-tube for 1 hr before and after meals. C. Keep the drainage system above the level of the abdomen.

A nurse is preparing to administer pancrelipase to a client who has pancreatitis. Which of the following actions should the nurse take? A. Instruct the client to chew the medication before swallowing. B. Offer a glass of water following medication administration. C. Administer the medication 30 min before meals. D. Sprinkle the contents on peanut butter.

B. Offer a glass of water following medication administration.

A nurse is caring for a client who has a new diagnosis of hepatitis C. Which of the following laboratory findings should the nurse expect? A. Presence of immunoglobulin G antibodies (IgG) B. Presence of enzyme immunoassay (EIA) C. Aspartate aminotransferase (AST) 35 units/L D. Alanine aminotransferase (ALT) 15 IU/L

B. Presence of enzyme immunoassay (EIA)

A nurse in a clinic is reviewing the laboratory reports of a client who has suspected cholelithiasis. Which of the following is an expected finding? A. Serum amylase 80 units/L B. WBC 9,000/mm3 C. Direct bilirubin 2.1 mg/dL D. Alkaline phosphatase 25 units/L

C. Direct bilirubin 2.1 mg/dL

A nurse is assessing a client who has pancreatitis. Which of the following actions should the nurse take to assess the presence of Cullen's sign? A. Tap lightly at the costovertebral margin on the client's back. B. Palpate the RLQ. C. Inspect the skin around the umbilicus. D. Auscultation the area below the scapula.

C. Inspect the skin around the umbilicus.

A nurse is completing an admission assessment of a client who has pancreatitis. Which of the following findings should the nurse expect? A. Pain in right upper quadrant radiating to right shoulder B. Report of pain being worse when sitting upright C. Pain relieved with defecation D. Epigastric pain radiating to the left shoulder

D. Epigastric pain radiating to the left shoulder

A nurse is completing the admission assessment of a client who has acute pancreatitis. Which of the following findings is the priority to report? A. History of cholelithiasis B. Elevated serum amylase level C. Decrease in bowel sounds upon auscultation D. Hand spasms present when blood pressure is checked

D. Hand spasms present when blood pressure is checked

A nurse on a medical-surgical unit is admitting a client who has hepatitis B with ascites. Which of the following actions should the nurse include in the plan of care? A. Initiate contact precautions. B. Weigh the client weekly. C. Measure abdominal girth 7.5 cm (3 in) above the umbilicus. D. Provide a high-calorie, high-carbohydrate diet.

D. Provide a high-calorie, high-carbohydrate diet.

A nurse is reviewing a new prescription for ursodiol with a client who has cholelithiasis. Which of the following information should the nurse include in the teaching? A. This medication is used to decrease acute biliary pain. B. This medication requires thyroid function monitoring every 6 months. C. This medication is not recommended for clients who have diabetes mellitus. D. This medication dissolves gallstones gradually over a period of up to 2 years.

D. This medication dissolves gallstones gradually over a period of up to 2 years.

A nurse is assessing a client who was admitted with a bowel obstruction. The client reports severe abdominal pain. Which of the following findings should indicate to the nurse that a possible bowel perforation has occurred? a. Elevated blood pressure b. Bowel sounds increased in frequency and pitch c. Rigid abdomen d. Emesis of undigested food

c. Rigid abdomen

A nurse in the emergency department is caring for a client who has bleeding esophageal varices. The nurse should anticipate a prescription for which of the following medications? a. Famotidine b. Esomeprazole c. Vasopressin d. Omeprazole

c. Vasopressin

A community health nurse is planning an educational program about hepatitis A. When preparing the materials, the nurse should identify that which of the following groups is most at risk for developing hepatitis A? a. Children b. Older adults c. Women who are pregnant d. Middle-aged men

a. Children

A nurse is caring for a client who has a history of cirrhosis and is admitted with manifestations of hepatic encephalopathy. The nurse should anticipate a prescription for which of the following laboratory tests to determine the possibility of recent excessive alcohol use? a. Gamma-glutamyl transferase (GGT) b. Alkaline phosphatase (ALP) c. Serum bilirubin d. Alanine aminotransferase (ALT)

a. Gamma-glutamyl transferase (GGT)

A nurse is caring for a client who is scheduled to undergo a liver biopsy for a suspected malignancy. Which of the following laboratory findings should the nurse monitor prior to the procedure? a. Prothrombin time b. Serum lipase c. Bilirubin d. Calcium

a. Prothrombin time

A nurse is caring for a client who is 4 hr postoperative following a laparoscopic cholecystectomy. Which of the following findings should the nurse expect? a. Right shoulder pain b. Urine output 20 mL/hr c. Temperature 38.4° C (101.1° F) d. Oxygen saturation 92%

a. Right shoulder pain

A nurse is caring for a client who has celiac disease. Which of the following foods should the nurse remove from the client's meal tray? a. Wheat toast b. Tapioca pudding c. Hard-boiled egg d. Mashed potatoes

a. Wheat toast

A nurse is preparing a community education program about hepatitis B. Which of the following statements should the nurse include in the teaching? a. "A hepatitis B immunization is recommended for those who travel, especially military personnel." b. "A hepatitis B immunization is given to infants and children." c. "Hepatitis B is acquired by eating foods that are contaminated during handling." d. "Hepatitis B can be prevented by using good personal hygiene habits and proper sanitation."

b. "A hepatitis B immunization is given to infants and children."

A nurse is teaching a client who has Barrett's esophagus and is scheduled to undergo an esophagogastroduodenoscopy (EGD). Which of the following statements should the nurse include in the teaching? a. "This procedure is performed to measure the presence of acid in your esophagus." b. "This procedure can determine how well the lower part of your esophagus works." c. "This procedure is performed while you are under general anesthesia." d. "This procedure can determine if you have colon cancer."

b. "This procedure can determine how well the lower part of your esophagus works."

A nurse is assessing a client who is in the early stages of hepatitis A. Which of the following manifestations should the nurse expect? a. Jaundice b. Anorexia c. Dark urine d. Pale feces

b. Anorexia

A nurse is caring for a client who has a percutaneous endoscopic gastrostomy (PEG) tube and is receiving intermittent feedings. Prior to initiating the feeding, which of the following actions should the nurse take first? a. Flush the tube with water. b. Place the client in semi-Fowler's position. c. Cleanse the skin around the tube site. d. Aspirate the tube for residual contents.

b. Place the client in semi-Fowler's position.

A nurse is caring for a client who is scheduled to undergo an esophagogastroduodenoscopy (EGD). The nurse should identify that this procedure is used to do which of the following? a. To visualize polyps in the colon b. To detect an ulceration in the stomach c. To identify an obstruction in the biliary tract d. To determine the presence of free air in the abdomen

b. To detect an ulceration in the stomach

A nurse is caring for a client who has acute pancreatitis. Which of the following serum laboratory values should the nurse anticipate returning to the expected reference range within 72 hr after treatment begins? a. Aldolase b. Lipase c. Amylase d. Lactic dehydrogenase

c. Amylase

A nurse is providing dietary teaching to a client who has diverticulitis about preventing acute attacks. Which of the following foods should the nurse recommend? a. Foods high in vitamin C b. Foods low in fat c. Foods high in fiber d. Foods low in calories

c. Foods high in fiber

A nurse is caring for a client who has fulminant hepatic failure. Which of the following procedures should the nurse anticipate for this client? a. Endoscopic sclerotherapy b. Liver lobectomy c. Liver transplant d. Transjugular intrahepatic portal-systemic shunt placement

c. Liver transplant

A nurse is assessing a client who is experiencing perforation of a peptic ulcer. Which of the following manifestations should the nurse expect? a. Increased blood pressure b. Decreased heart rate c. Yellowing of the skin d. Boardlike abdomen

d. Boardlike abdomen

A nurse is completing a history and physical assessment for a client who has chronic pancreatitis. Which of the following findings should the nurse identify as a likely cause of the client's condition? a. High-calorie diet b. Prior gastrointestinal illnesses c. Tobacco use d. Alcohol use

d. Alcohol use

A nurse is caring for a client who is 2 days postoperative following a gastric bypass. The nurse notes that bowel sounds are present. Which of the following foods should the nurse provide at the initial feeding? a. Vanilla pudding b. Apple Juice c. Diet ginger ale d. Clear liquids

d. Clear liquids

A nurse is caring for a client who is receiving total parenteral nutrition (TPN) therapy and has just returned to the room following physical therapy. The nurse notes that the infusion pump for the client's TPN is turned off. After restarting the infusion pump, the nurse should monitor the client for which of the following findings? a. Hypertension b. Excessive thirst c. Fever d. Diaphoresis

d. Diaphoresis

A nurse is caring for a client who is dehydrated and is receiving continuous tube feeding through a pump at 75 mL/hr. When the nurse assesses the client at 0800, which of the following findings requires intervention by the nurse? a. A full pitcher of water is sitting on the client's bedside table within the client's reach. b. The disposable feeding bag is from the previous day at 1000 and contains 200 mL of feeding. c. The client is lying on the right side with a visible dependent loop in the feeding tube. d. The head of the bed is elevated 20°.

d. The head of the bed is elevated 20°