Chapter 38 HINKLE - GI and Digestive

During a colonoscopy with moderate sedation, the patient groans with obvious discomfort and begins bleeding from the rectum. The patient is diaphoretic and has an increase in abdominal girth from distention. What complication of this procedure is the nurse aware may be occurring? Infection Rectal fissure Bowel perforation Colonic polyp

Bowel perforation

Which diagnostic produces images of the body by detecting the radiation emitted from radioactive substances? Magnetic resonance imaging (MRI) Computed tomography (CT) Fibroscopy Positron emission tomography (PET)

Positron emission tomography (PET)

A client is scheduled for an ultrasound of the abdomen. Which statement indicates that teaching provided to the client to prepare for the test was effective? "I will ingest a clear liquid diet for 3 days before the test." "I will take medications to reduce gastric acid before the test." "I will not eat or drink for 8 to 12 hours before the test." "I will take an over-the-counter enema before the test."

"I will not eat or drink for 8 to 12 hours before the test."

A client with a gastrointestinal condition asks why the mouth needs to be examined. Which response will the nurse make? "It is a part of the assessment of every client." "It is a body part that is least examined." "Changes in the mouth can help explain why your condition is occurring." "Your problem is in your mouth and not your abdomen."

"Changes in the mouth can help explain why your condition is occurring."

A client asks the nurse why the physician ordered the blood test carcinoembryonic antigen (CEA). The nurse answers: "It detects a protein normally found in the blood." "It indicates if a cancer is present." "It determines functionality of the liver." "It tells the physician what type of cancer is present."

"It indicates if a cancer is present."

The nurse is instructing the client who was newly diagnosed with peptic ulcers. Which of the following diagnostic studies would the nurse anticipate reviewing with the client? A sigmoidoscopy Gastric analysis Serum antibodies for H. pylori A complete blood count including differential

Serum antibodies for H. pylori

The nurse is preparing to examine the abdomen of a client who reports a change in bowel pattern. The nurse would place the client in which position? Left Sim's lateral Supine with knees flexed Lithotomy Knee-chest

Supine with knees flexed

bowel sounds

The terms normal (sounds heard about every 5 to 20 seconds), hypoactive (one or two sounds in 2 minutes), hyperactive (5 to 6 sounds heard in less than 30 seconds), or absent (no sounds in 3 to 5 minutes)

The major carbohydrate that tissue cells use as fuel is chyme. glucose. fats. proteins.

glucose

Which of the following digestive enzymes aids in the digesting of starch?

starch

A nurse is aware that both the sympathetic and parasympathetic portions of the autonomic nervous system affect GI motility. What are the actions of the sympathetic nervous system? Select all that apply. Relaxes the sphincters Increases secretary activities Causes blood vessel constriction Creates an inhibitory effect on the GI tract Decreases gastric motility

Causes blood vessel constriction Creates an inhibitory effect on the GI tract Decreases gastric motility

What would the nurse recognize as preventing a client from being able to take a fecal occult blood test (FOBT)? The client has hemorrhoidal bleeding The client regularly takes aspirin The client took an ibuprofen tablet this morning The client had a hamburger for dinner the night before

The client has hemorrhoidal bleeding

When examining the skin of a client who is dehydrated due to fluid losses from the gastrointestinal tract, which of the following would be most important? Observing for distended abdominal veins Checking if the skin is discolored Examining the sclera if it is yellow Checking if the mucous membranes are dry

Checking if the mucous membranes are dry

A client with abdominal pain is scheduled for a CT scan of the abdomen with contrast. Which assessment will the nurse complete before transporting the client for the diagnostic test? Current list of prescribed medications History of allergies Last use of an oral laxative Presence of a cochlear implant

History of allergies

After 20 seconds of auscultating for bowel sounds on a client recovering from abdominal surgery, the nurse hears nothing. What should the nurse do based on the assessment findings? Listen longer for the sounds. Document that the client is constipated. Return in 1 hour and listen again to confirm findings. Call the health care provider to report absent bowel sounds.

Listen longer for the sounds.

A client is scheduled for an upper gastrointestinal barium study. Which teaching will the nurse provide for the client to prepare for this diagnostic test? Withhold oral medications for 24 hours before the test. Ingest nothing by mouth after midnight. Eat a clear liquid breakfast before the test. Avoid products containing aspirin for a week before the test.

Ingest nothing by mouth after midnight.

A client is diagnosed with megaloblastic anemia caused by vitamin B12 deficiency. The health care provider begins the client on cyanocobalamin (Betalin-12), 100 mcg I.M. daily. Which substance influences vitamin B12 absorption? Hydrochloric acid Intrinsic factor Histamine Liver enzyme

Intrinsic factor

The nurse is caring for a client who is having gastrointestinal symptoms. The nurse knows that a scintigraphy is used as a diagnostic tool for what purpose? Locate the source of internal bleeding. Analyze small bowel obstructions. Validate the presence of a tumor. Determine areas of gastric inflammation.

Locate the source of internal bleeding.

A client undergoing a diagnostic examination for gastrointestinal disorder was given polyethylene glycol/electrolyte solution as a part of the test preparation. Which of the following measures should the nurse take once the solution is administered? Instruct the client to have low-residue meals. Permit the client to drink only clear liquids. Allow the client to ingest fat-free meal. Provide saline gargles to the client.

Permit the client to drink only clear liquids.

Cystic fibrosis, a genetic disorder characterized by pulmonary and pancreatic dysfunction, usually appears in young children but can also affect adults. If the pancreas was functioning correctly, where would the bile and pancreatic enzymes enter the GI system? cecum jejunum ileum duodenum

duodenum

Which procedure is performed to examine and visualize the lumen of the small bowel? panendoscopy colonoscopy small bowel enteroscopy peritoneoscopy

small bowel enteroscopy

A nurse is teaching a client with malabsorption syndrome about the disorder and its treatment. The client asks which part of the GI tract absorbs food. What is the nurse's best response? rectum small intestine large intestine stomach

small intestine

A client is scheduled for magnetic resonance imaging (MRI). During the client teaching, what will the nurse discuss? "The examination will take only 15 minutes." "Do you experience any claustrophobia?" "You must be NPO for the day before the examination." "You must remove all jewelry but can wear your wedding ring."

"Do you experience any claustrophobia?"

A home care nurse is caring for a client with reports of epigastric discomfort who is scheduled for a barium swallow. Which statement by the client indicates an understanding of the test? "I'll drink full liquids the day before the test." "I'll avoid eating or drinking anything 6 to 8 hours before the test." "I'll take a laxative to clear my bowels before the test." "There is no need for special preparation before the test."

"I'll avoid eating or drinking anything 6 to 8 hours before the test."

Which of the following is an enzyme secreted by the gastric mucosa? Pepsin Trypsin Ptyalin Bile

Pepsin

Which of the following is the most definitive means of assessing for liver disease? Ultrasonography Cholecystography Paracentesis Biopsy

Biopsy

The nurse asks a client to point to where pain is felt. The client asks why this is important. What is the nurse's best response? "If the health care provider massages over the exact painful area, the pain will disappear." "Often the area of pain is referred from another area." "This determines the pain medication to be ordered." "The area may determine the severity of the pain."

"Often the area of pain is referred from another area."

Gastrin has which of the following effects on gastrointestinal (GI) motility? Increased motility of the stomach Relaxation of the colon Relaxation of gastroesophageal sphincter Contraction of the ileocecal sphincter

Increased motility of the stomach

The nurse is preparing the client for an assessment of the abdomen. What should the nurse complete prior to this assessment? Ask the client to empty the bladder. Assist the client to a Fowler's position. Dim the lights for privacy. Prepare for a prostate examination.

Ask the client to empty the bladder.

The nurse is to obtain a stool specimen from a client who reported that he is taking iron supplements. The nurse would expect the stool to be which color? Dark brown Black Green Red

Black

A nurse is preparing a client with Crohn's disease for a barium enema. What should the nurse do the day before the test? Serve dairy products. Serve the client his usual diet. Encourage plenty of fluids. Order a high-fiber diet.

Encourage plenty of fluids.

The nurse teaches a client scheduled for a colonoscopy. Which instruction should be included as part of the preparation for the procedure? Spray or gargle with a local anesthetic. Follow the dietary and fluid restrictions and bowel preparation procedures. Consume at least 3 quarts of water 30 minutes before the test. Do not void for at least 30 minutes before the test.

Follow the dietary and fluid restrictions and bowel preparation procedures.

The nurse is assisting the health care provider with a gastric acid stimulation test for a client. What medication should the nurse prepare to administer subcutaneously to stimulate gastric secretions? Glycopyrronium bromide Acetylcysteine Pentagastrin Atropine

Pentagastrin

The instructor has just finished teaching a group of students about the various organs of the upper gastrointestinal tract and possible disorders. The instructor determines that the teaching was successful when the students identify which structure as possibly being affected? Large Intestine Liver Ileum Stomach

Stomach

A client with diabetes begins to have digestive problems and is told by the physician that they are a complication of the diabetes. Which of the following explanations from the nurse is most accurate? The pancreas secretes digestive enzymes. Elevated glucose levels cause bacteria overgrowth in the large intestine. The nerve fibers of the intestinal lining are experiencing neuropathy. Insulin has an adverse effect of constipation.

The pancreas secretes digestive enzymes.

Which nursing instruction is correct to provide the client following a barium enema? The client will maintain a low residue diet. An enema will be used to clear the bowel. Sips of fluid may be increased if tolerated. The stools may be a white or clay colored.

The stools may be a white or clay colored.

The nurse prepares to administer the lavage solution to a client having a colonoscopy completed. The nurse stops and notifies the physician when noting that the client has which condition? congestive heart failure pulmonary hypertension chronic obstructive pulmonary disease inflammatory bowel disease

inflammatory bowel disease

A client tells the nurse that the stool was colored yellow. The nurse assesses the client for recent foods ingested. ingestion of bismuth. pilonidal cyst. occult blood.

recent foods ingested.

The nurse is caring for a client scheduled for a diagnostic laparoscopy. The client has questions regarding the use of anesthetic during the procedure. Which response will the nurse provide the client? "What type of anesthetic have you used in the past?" "Let me have the primary health care provider explain this again to you." "Are you worried about pain during the procedure?" "The use of anesthetic will be discussed closer to surgery."

"Let me have the primary health care provider explain this again to you."

A group of students are studying for an examination on the gastrointestinal (GI) system and are reviewing the structures of the esophagus and stomach. The students demonstrate understanding of the material when they identify which of the following as the opening between the stomach and duodenum? Hypopharyngeal sphincter Cardiac sphincter Ileocecal valve Pyloric sphincter

Pyloric sphincter

The nurse is assessing a client's rectum, perianal area, and anus. During assessment the nurse notes an anal fissure. Which intervention would the nurse implement? Select all that apply. Topical analgesics Acetaminophen suppository Sitz bath Lateral body positioning Hemorrhoid cream

Topical analgesics Sitz bath Lateral body positioning

what is a barium swallow

series of radiographs used to examine the gastrointestinal tract for abnormalities

The nurse recognizes which change of the GI system is an age-related change? hypertrophy of the small intestine weakened gag reflex increased mucus secretion increased motility

weakened gag reflex

Gastrin has which of the following effects on gastrointestinal (GI) motility? Contraction of the ileocecal sphincter Relaxation of gastroesophageal sphincter Increased motility of the stomach Relaxation of the colon

Increased motility of the stomach

The nurse prepares a client for a barium enema. The nurse should place the client on which diet prior to the procedure? high-fiber diet 1 to 2 days prior nothing by mouth (NPO) 2 days prior clear liquids day before soft diet 1 day prior

clear liquids day before

When completing a nutritional assessment of a patient who is admitted for a GI disorder, the nurse notes a recent history of dietary intake. This is based on the knowledge that a portion of digested waste products can remain in the rectum for how many days after a meal is digested? 2 days 1 day 3 days 4 days

3 days

A client reports a new onset of diarrhea. For which additional symptoms will the nurse assess this client? Select all that apply. Abdominal pain Vomiting Heartburn Cramping Nausea

Abdominal pain Vomiting Cramping Nausea

A client reports a history of bleeding hemorrhoids to the nurse. Which observation supports the client's statement? Blood streaks on stool Hard, dry stool Black tarry stool Dark red stool

Blood streaks on stool

A client is scheduled for several diagnostic tests to evaluate gastrointestinal function. After teaching the client about these tests, the nurse determines that the client has understood the teaching when the client identifies which test as not requiring the use of a contrast medium? Computer tomography Colonoscopy Small bowel series Upper GI series

Colonoscopy

The client describes a test previously completed to detect a small bowel obstruction prior to admission to the hospital. The client states that the test involved insertion of a tube through the nose and lasted over 6 hours. The nurse determines which test name should be documented? magnetic resonance imaging positron emission tomography upper GI enteroclysis abdominal ultrasound

upper GI enteroclysis

A client is to have an upper GI procedure with barium ingestion and abdominal ultrasonography. While scheduling these diagnostic tests, the nurse must consider which factor? The upper GI should be scheduled before the ultrasonography. Both tests need to be done before breakfast. The client may eat a light meal before either test. The ultrasonography should be scheduled before the GI procedure.

The ultrasonography should be scheduled before the GI procedure.

The nurse is working on a general medical unit. A client is scheduled for an upper gastrointestinal series. Upon returning to the nursing unit, what does the nurse identify as the client goal? Recovery from the general anesthesia Increase in the amount of fluids Ambulates independently Decrease in nausea and vomiting

Increase in the amount of fluids

While palpating a client's right upper quadrant (RUQ), the nurse would expect to find which structure? Spleen Liver Appendix Sigmoid colon

Liver

An older adult client is admitted to an acute care facility for treatment of an acute flare-up of a chronic gastrointestinal condition. In addition to assessing the client for complications of the current illness, the nurse monitors for age-related changes in the gastrointestinal tract. Which age-related change increases the risk of anemia? Increase in bile secretion Dulling of nerve impulses Atrophy of the gastric mucosa Decrease in intestinal flora

Atrophy of the gastric mucosa Atrophy of the gastric mucosa reduces hydrochloric acid secretion; this, in turn, impairs absorption of iron and vitamin B12, increasing the risk of anemia as a person ages. A decrease in hydrochloric acid increases, not decreases, intestinal flora; as a result, the client is at increased risk for infection, not anemia. A reduction, not increase, in bile secretion may lead to malabsorption of fats and fat-soluble vitamins. Dulling of nerve impulses associated with aging increases the risk of constipation, not anemia.

When assisting with preparing a client scheduled for a barium swallow, which of the following would be appropriate to include? Take vitamin K before the procedure. Take three cleansing enemas before the procedure. Avoid smoking for at least 12 to 24 hours before the procedure. Avoid the intake of red meat before the procedure.

Avoid smoking for at least 12 to 24 hours before the procedure.

A client receives a local anesthetic to suppress the gag reflex for a diagnostic procedure of the upper GI tract. Which nursing intervention is advised for this client? Measure fluid output for at least 24 hours after the procedure. Monitor for cramping or abdominal distention. Monitor for any breathing-related disorder or discomforts. Do not give any food and fluids until the gag reflex returns.

Do not give any food and fluids until the gag reflex returns.

Swallowing is regulated by which area of the central nervous system (CNS)? Pons Hypothalamus Medulla oblongata Cerebellum

Medulla oblongata

When describing the role of the pancreas to a client with a pancreatic dysfunction, the nurse would identify which substance as being acted on by pancreatic lipase? Glucose Triglycerides Starch Protein

Triglycerides