Chapter 43 Medsurg PREPU

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

amylase

The nurse determines one or two bowel sounds in 2 minutes should be documented as

hypoactive

What part of the GI tract begins the digestion of food?

mouth

When bowel sounds are heard about every 15 seconds, the nurse would record that the bowel sounds are

normal

A client asks the nurse why the physician ordered the blood test carcinoembryonic antigen (CEA). The nurse answers:

"It indicates if a cancer is present."

The nurse is working with clients with digestive tract disorders. Which of the following organs does the nurse realize has effects as an exocrine gland and an endocrine gland?

Pancreas

The nurse is scheduling gastrointestinal (GI) diagnostic testing for a client. Which GI test should be scheduled first?

Radiography of the gallbladder

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.

Specific disease processes and ingestion of certain foods and medications may change the appearance of the stool. If blood is shed in sufficient quantities into the upper gastrointestinal (GI) tract, it produces which change in the stool appearance?

tarry-black

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?

Atrophy of the gastric mucosa

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?

Pentagastrin

A client is scheduled for magnetic resonance imaging (MRI). During the client teaching, what will the nurse discuss?

"Do you experience any claustrophobia?"

The nurse is caring for a man who has experienced a spinal cord injury. Throughout his recovery, the client expects to gain control of his bowels. The nurse's best response to this client would be which of the following?

"Having a bowel movement is a spinal reflex requiring intact nerve fibers. Yours are not intact."

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.

Gastrin has which of the following effects on gastrointestinal (GI) motility?

Increased motility of the stomach

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.

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 nurse is assisting the health care provider with a colonoscopy for a client with rectal bleeding. The health care provider requests the nurse to administer glucagon during the procedure. Why is the nurse administering this medication during the procedure?

To relax colonic musculature and reduce spasm. - glucagon given PRN during colonoscopy

A client tells the nurse that the stool was colored yellow. The nurse assesses the client for

recent foods ingested. (Senna)

Which procedure is performed to examine and visualize the lumen of the small bowel?

small bowel enteroscopy

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?

supine with knees flexed

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

When assisting with preparing a client scheduled for a barium swallow, which of the following would be appropriate to include?

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

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?

Bowel perforation

After 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 of the following structures as possibly being affected?

stomach

Which enzyme aids in the digestion of protein?

trypsin

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?

upper GI enteroclysis

A client presented with gastrointestinal bleeding 2 days ago and continues to have problems. The health care provider has ordered a visualization of the small intestine via a capsule endoscopy. What will the nurse include in the client education about this procedure?

"You will need to swallow a capsule."

Blood flow to the GI tract is approximately what percentage of the total cardiac output?

20%

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?

3 days

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?

Checking if the mucous membranes are dry

The nurse is working in a diagnostic testing unit focusing on gastrointestinal studies. For which testing procedure is the nurse correct to assess the gag reflex before offering fluids?

Esophagogastroduodenoscopy

When preparing a client for magnetic resonance imaging (MRI) of the abdomen, which statement would indicate the need to notify the health care provider?

I really don't like to be in small, enclosed spaces."

A nurse is giving a client barium swallow test. What is the most important assessment a nurse would make to ensure that a client does not retain any barium after a barium swallow?

Monitoring the stool passage and its color.

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?

Permit the client to drink only clear liquids.

The nurse is caring for a client who is scheduled for a percutaneous liver biopsy. Which diagnostic test is obtained prior?

Prothrombin time (PT) - The client must have coagulation studies before the procedure such as a PT or PTT because a major complication after a liver biopsy is bleeding

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?

Serum antibodies for H. pylori - Helicobacter pylori, a bacterium, is believed to be responsible for the majority of peptic ulcers.

The nurse is providing instructions to a client scheduled for a gastroscopy. What should the nurse be sure to include in the instructions? Select all that apply.

The client must fast for 8 hours before the examination. The throat will be sprayed with a local anesthetic. After gastroscopy, the client cannot eat or drink until the gag reflex returns (1 to 2 hours).

Which nursing instruction is correct to provide the client following a barium enema?

The stools may be a white or clay colored.

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 ultrasonography should be scheduled before the GI procedure.

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?

Triglycerides

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?

colonoscopy - Contrast medium may be used with a small bowel series, computed tomography, and upper GI series.

Which of the following is the primary function of the small intestine?

absorption

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?

black

The nurse prepares a client for a barium enema. The nurse should place the client on which diet prior to the procedure?

clear liquids day before

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?

duodenum

The nurse is providing community education at the mall. The nurse is instructing on the muscular tube that connects the mouth to the stomach. The nurse outlines this structure on a drawing and labels it with which of the following?

esophagus

The nurse auscultates the abdomen to assess bowel sounds. She documents five to six sounds heard in less than 30 seconds. How does the nurse document the bowel sounds?

hyperactive

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?

inflammatory bowel disease

Which of the following is an enzyme secreted by the gastric mucosa?

pepsin - Pepsin is secreted by the gastric mucosa. Trypsin is secreted by the pancreas. The salivary glands secrete ptyalin. The liver and gallbladder secrete bile.

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?

pyloric sphincter

Following ingestion of carrots or beets, the nurse would expect which alteration in stool color?

red

The nurse recognizes which change of the GI system is an age-related change?

weakened gag reflex

What is the recommended order for performing an abdominal examination?

inspection, auscultation, percussion, palpation

Which term describes a gastric secretion that combines with vitamin B12 so that it can be absorbed?

intrinsic factor

The nurse determines a client scheduled to undergo an abdominal ultrasonography should receive which instruction?

Restrict eating of solid food for 6 to 8 hours before the test.

A patient is scheduled for a fiberoptic colonoscopy. What does the nurse know that fiberoptic colonoscopy is most frequently used to diagnose?

cancer