Digestive and Gastrointestinal Function (CH 43,44,45,46,51)

A patient reports an inflamed salivary gland below the right ear. The nurse documents probable inflammation of which gland? -Sublingual -Buccal -Submandibular -Parotid

parotid

The nurse is caring for a client who has a gastrostomy tube feeding. Upon initiating care, the nurse aspirates the gastrotomy tube for gastric residual volume (GRV) and obtains 200 mL of gastric contents. What is the priority action by the nurse? -Dilute the gastric tube feeding solution with water and continue the feeding. -Place the client in a semi-Fowler's position with the head of the bed at 45 degrees. -Discontinue the infusion. -Remove the aspirated fluid and do not reinstill.

place the client in a semi-fowler's position with the head of the bed at 45 degrees

The nurse is teaching a client with peptic ulcer disease who has been prescribed misoprostol. What information from the nurse would be most accurate about misoprostol? -Decreases mucus production -Works best when taken on an empty stomach -Prevents ulceration in clients taking nonsteroidal anti-inflammatory drugs (NSAIDs) -Increases the speed of gastric emptying

prevents ulceration in clients taking non-steroidal anti-inflammatory drugs

Following ingestion of carrots or beets, the nurse would expect which alteration in stool color? -Red -Milky white -Yellow -Black

Red

Which of the following are characteristics associated with the Zollinger-Ellison syndrome (ZES)? Select all that apply. -Hypocalcemia -Gastrin-secreting tumors of the pancreas -Constipation -Severe peptic ulcers -Extreme gastric hyperacidity

Severe peptic ulcers extreme gastric hyperacidity gastrin-secreting tumors of the pancreas

Which of the following refers to a bacterial or viral infection of the salivary glands? -Parotitis -Sialadenitis -Mumps -Stomatitis

Sialadenitis

Which term is used to describe stone formation in a salivary gland, usually the submandibular gland? -Sialolithiasis -Parotitis -Stomatitis -Sialadenitis

Sialolithiasis

A healthcare provider prescribes a combination of drugs to treat reoccurring peptic ulcer disease, and the client asks the nurse the reason for all the medications. What teaching should the nurse review with the client? -The bismuth salts, antibiotics, and proton pump inhibitors will work together to suppress or eradicate H. pylori. -The proton pump inhibitors, prostaglandin E1 analogs, and bismuth salts will suppress or eradicate H. pylori. -The prostaglandin E1 analogs, antibiotics, and proton pump inhibitors will work together to suppress or eradicate H. pylori. -The antibiotics, prostaglandin E1 analogs, and bismuth salts will work together to suppress or eradicate H. pylori.

- The bismuth salts, antibiotics, and proton pump inhibitors will work together to suppress or eradicate H. pylori

A nurse is performing discharge teaching with a client who had a total gastrectomy. Which statement indicates the need for further teaching? -"I will have to take vitamin B12 shots up to 1 year after surgery." -"I will weight myself each day and record the weight." -"I'm going to visit my pastor weekly for a while." -"I will call my physician if I begin to have abdominal pain."

"I will have to take vitamin B12 shots up to 1 year after surgery"

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 brought earphones to shut out the loud noise." -"I haven't had anything to eat or drink since midnight last night." -"I left all my jewelry and my watch at home." -"I really don't like to be in small, enclosed spaces."

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

The nurse is caring for a client during the postoperative period following radical neck dissection. Which finding should be reported to the physician? -High epigastric pain and/or discomfort -Serous drainage on the dressing -Crackles that clear after coughing -Temperature of 99.0°F (37.2°C)

High epigastric pain and/or discomfort

After teaching a client who has had a Roux-en-Y gastric bypass, which client statement indicates the need for additional teaching? -"I need to drink 8 ounces of water before eating." -"I should pick cereals with less than 2 g of fiber per serving." -"I need to chew my food slowly and thoroughly." -"A total serving should amount to be less than one cup."

I need to drink 8 ounces of water before eating

A client with cancer has a neck dissection and laryngectomy. An intervention that the nurse will do is: -Provide oxygen without humidity through the tracheostomy tube. -Encourage the client to position himself on his side. -Teach the client exercises for the neck and shoulder area to perform 1 day after surgery. -Make a notation on the call light system that the client cannot speak.

Make a notation on the call light system that the client cannot speak

Which medication classification represents a proton (gastric acid) pump inhibitor? -Omeprazole -Famotidine -Metronidazole -Sucralfate

Omperazole

If a client's central venous catheter accidentally becomes disconnected, what should a nurse do first? -Tell the client to take and hold a deep breath. -Apply a dry sterile dressing to the site. -Clamp the catheter. -Call the physician.

clamp the catheter

A client newly diagnosed with diabetes mellitus asks why he needs ketone testing when the disease affects his blood glucose levels. How should the nurse respond? -"Ketones will tell us if your body is using other tissues for energy." -"The spleen releases ketones when your body can't use glucose." -"Ketones help the physician determine how serious your diabetes is." -"Ketones can damage your kidneys and eyes."

ketones will tell us if your body is using other tissues for energy

The nurse in the ED admits a client with suspected gastric outlet obstruction. The client's symptoms include nausea and vomiting. The nurse anticipates that the physician will issue which order? -Nasogastric tube insertion -Stool specimen -Oral contrast -Pelvic x-ray

nasogastric tube insertion

The nurse notes that a client has inflammation of the salivary glands. The nurse documents which finding? -Sialadenitis -Stomatitis -Parotitis -Pyosis

sialadenitis

A client with diabetes mellitus must learn how to self-administer insulin. The physician has ordered 10 units of U-100 regular insulin and 35 units of U-100 isophane insulin suspension (NPH) to be taken before breakfast. When teaching the client how to select and rotate insulin injection sites, the nurse should provide which instruction? -"Inject insulin into healthy tissue with large blood vessels and -nerves." -"Administer insulin into areas of scar tissue or hypertrophy whenever possible." -"Administer insulin into sites above muscles that you plan to exercise heavily later that day." -"Rotate injection sites within the same anatomic region, not among different regions."

"rotate injection sites within the same anatomic region, not among different regions"

Which of the following are functions of saliva? Select all that apply. -Digestion -Protection against harmful bacteria -Metabolism -Lubrication -Elimination

Lubrication protection against harmful bacteria digestion

A client with gastric cancer is scheduled to undergo a Billroth II procedure. The client's spouse asks how much of the client's stomach will be removed. What would be the most accurate response from the nurse? -The amount will depend on the client's weight. -Approximately 75% -Approximately 25% -Approximately 50%

Approximately 75%

A child is brought into the emergency department with vomiting, drowsiness, and blowing respirations. The father reports that the symptoms have been progressing throughout the day. The nurse suspects diabetic ketoacidosis (DKA). Which action should the nurse take first in the management of DKA? -Begin fluid replacements. -Administer prescribed dose of insulin. -Administer bicarbonate to correct acidosis. -Give prescribed antiemetics.

Begin fluid replacements

A client has been receiving radiation therapy to the lungs and now has erythema, edema, and pain of the mouth. What instruction will the nurse give to the client? -Brush and floss daily. -Continue with the usual diet. -Use a hard-bristled toothbrush. -Rinse with an alcohol-based solution.

Brush and floss daily

A nurse inspects the Stensen duct of the parotid gland to determine inflammation and possible obstruction. What area in the oral cavity would the nurse examine? -Buccal mucosa next to the upper molars -Posterior segment of the tongue near the uvula -Roof of the mouth next to the incisors -Dorsum of the tongue

Buccal muscosa next to the upper molars

A nurse is caring for a client receiving parenteral nutrition at home. The client was discharged from the acute care facility 4 days ago. What would the nurse include in the client's plan of care? Select all that apply. -Calorie counts for oral nutrients -Strict bedrest -Daily transparent dressing changes -Intake and output monitoring -Daily weights

Daily weights intake and output monitoring calorie counts for oral nutrients

A client with long-standing type 1 diabetes is admitted to the hospital with unstable angina pectoris. After the client's condition stabilizes, the nurse evaluates the diabetes management regimen. The nurse learns that the client sees the physician every 4 weeks, injects insulin after breakfast and dinner, and measures blood glucose before breakfast and at bedtime. Consequently, the nurse should formulate a nursing diagnosis of: -Defensive coping. -Health-seeking behaviors (diabetes control). -Impaired adjustment. -Deficient knowledge (treatment regimen).

Deficient knowledge (treatment regimin)

A nurse is assessing a client receiving tube feedings and suspects dumping syndrome. What would lead the nurse to suspect this? Select all that apply. -Diarrhea -Decreased bowel sounds -Hypertension -Diaphoresis -Tachycardia

Diarrhea Tachycardia Diaphoresis

Clients with Type O blood are at higher risk for which of the following GI disorders? -Diverticulitis -Esophageal varices -Gastric cancer -Duodenal ulcers

Duodenal ulcers

The nursing student approaches his instructor to discuss the plan of care for his client diagnosed with peptic ulcer disease. The student asks what is the most common site for peptic ulcer formation? The instructor would state which one of the following? -Duodenum -Pylorus -Esophagus -Stomach

Duodenum

A client has been taking famotidine at home. What teaching should the nurse include with the client? -Famotidine will improve the mixing of foods and gastric secretions. -Famotidine will neutralize acid in the stomach. -Famotidine will shorten the time required for digestion in the stomach. -Famotidine will inhibit gastric acid secretions.

Famotidine will inhibit gastric acid secretions

A nurse is assessing a client who is receiving total parenteral nutrition (TPN). Which finding suggests that the client has developed hyperglycemia? -Diaphoresis -Increased urine output -Cheyne-Stokes respirations -Decreased appetite

Increased urine output

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? Histamine Hydrochloric acid Liver enzyme Intrinsic factor

Intrinsic factor

The nurse is describing the action of insulin in the body to a client newly diagnosed with type 1 diabetes. Which of the following would the nurse explain as being the primary action? -It carries glucose into body cells. -It decreases the intestinal absorption of glucose. -It aids in the process of gluconeogenesis. -It stimulates the pancreatic beta cells.

It carries glucose into body cells

The nurse is describing the action of insulin in the body to a client newly diagnosed with type 1 diabetes. Which of the following would the nurse explain as being the primary action? -It stimulates the pancreatic beta cells. -It enhances the transport of glucose across the cell membrane. -It decreases the intestinal absorption of glucose. -It aids in the process of gluconeogenesis.

It enhances the transport of glucose across the cell membrane

The nurse is managing a gastric (Salem) sump tube for a patient who has an intestinal obstruction and will be going to surgery. What interventions should the nurse perform to make sure the tube is functioning properly? -Tape the tube to the head of the bed to avoid dislodgement. -Irrigate only through the vent lumen. -Keep the vent lumen above the patient's waist to prevent gastric content reflux. -Maintain intermittent or continuous suction at a rate greater than 120 mm Hg.

Keep the vent lumen above the patient's waist to prevent gastric content reflux

A client with cancer has a neck dissection and laryngectomy. An intervention that the nurse will do is: -Teach the client exercises for the neck and shoulder area to perform 1 day after surgery. -Encourage the client to position himself on his side. -Provide oxygen without humidity through the tracheostomy tube. -Make a notation on the call light system that the client cannot speak.

Make a notion on the call light system that the client cannot speak

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? -Liver -Stomach -Pancreas -Gallbladder

Pancreas

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 patient? -The client should be monitored for any breathing-related disorder or discomforts. -The client's fluid output should be measured for at least 24 hours after the procedure. -The client should be monitored for cramping or abdominal distention. -The client should not be given any food and fluids until the gag reflex returns.

The client should not be given any food and fluids until the gag reflex returns

A client with a peptic ulcer is diagnosed with Helicobacter pylori infection. The nurse is teaching the client about the medications prescribed, including metronidazole, omeprazole, and clarithromycin. Which statement by the client indicates the best understanding of the medication regimen? -"My ulcer will heal because these medications will kill the bacteria." -"These medications will coat the ulcer and decrease the acid production in my stomach." -"I should take these medications only when I have pain from my ulcer." -"The medications will kill the bacteria and stop the acid production."

The medications will kill the bacteria and stop the acid production

A positive nitrogen balance indicates which condition? -Tissue growth -Burn injury -Fever -Starvation

Tissue growth

A health care provider suspects that a client has peptic ulcer disease. With which diagnostic procedure would the nurse most likely prepare to assist? -Gastric secretion study -Stool antigen test -Endoscopy -Barium study of the upper gastrointestinal tract

endoscopy

The nurse is cautiously assessing a client admitted with peptic ulcer disease because the most common complication that occurs in 10% to 20% of clients is: -Pyloric obstruction -Hemorrhage -Intractable ulcer -Perforation

hemorrhage

A 66-year-old African-American client has recently visited a physician to confirm a diagnosis of gastric cancer. The client has a history of tobacco use and was diagnosed 10 years ago with pernicious anemia. He and his family are shocked about the possibility of cancer because he was asymptomatic prior to recent complaints of pain and multiple gastrointestinal symptoms. On the basis of knowledge of disease progression, the nurse assumes that organs adjacent to the stomach are also affected. Which of the following organs may be affected? Choose all that apply. -Liver -Lungs -Bladder -Pancreas -Duodenum

liver pancreas duodenum

When bowel sounds are heard about every 15 seconds, the nurse would record that the bowel sounds are -sluggish. -hypoactive. -absent. -normal.

normal

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? -Allow the client to ingest fat-free meal. -Instruct the client to have low-residue meals. -Provide saline gargles to the client. -Permit the client to drink only clear liquids.

permit the client to only drink clear liquids

A nurse educator been invited to local seniors center to discuss health-maintaining strategies for older adults. The nurse addresses the subject of diabetes mellitus, its symptoms, and consequences. What should the educator teach the participants about type 1 diabetes? -The participants are unlikely to develop a new onset of type 1 diabetes. -New cases of diabetes are highly uncommon in older adults. -New cases of diabetes will be split roughly evenly between type 1 and type 2. -Type 1 diabetes always develops before the age of 20.

the participants are unlikely to develop a new onset of type 1 diabetes

A patient is receiving continuous tube feedings via a small bore feeding tube. The nurse irrigates the tube after administering medication to maintain patency. Which size syringe would the nurse use? -10-mL -20-mL -30-mL -5-mL

30-mL

A client with human immunodeficiency virus (HIV) comes to the clinic and is experiencing white patches on the lateral border of the tongue. What type of lesions does the nurse document? -Erythroplakia -Nicotine stomatitis -Hairy leukoplakia -Aphthous stomatitis

Hairy leukoplakia

A health care provider suspects that a client has peptic ulcer disease. With which diagnostic procedure would the nurse most likely prepare to assist? -Endoscopy -Stool antigen test -Barium study of the upper gastrointestinal tract -Gastric secretion study

endoscopy

Which medication is classified as a histamine-2 receptor antagonist? -Famotidine -Metronidazole -Esomeprazole -Lansoprazole

famotidine

A nurse is caring for a client with active upper GI bleeding. What is the appropriate diet for this client during the first 24 hours after admission? -Clear liquids -Regular diet -Skim milk -Nothing by mouth

nothing by mouth

The client has returned to the floor following a radical neck dissection. Anesthesia has worn off. What is the nurse's priority action? -Administer morphine for report of pain. -Empty the Jackson-Pratt device (portable drainage device). -Place the client in the Fowler's position. -Provide feeding through the gastrostomy tube.

place the client in the Fowler's position

A nurse practitioner, who is treating a patient with GERD, knows that this type of drug helps treat the symptoms of the disease. The drug classification is: -H2-receptor antagonists. -Antacids -Proton pump inhibitors. -Antispasmodics

proton pump inhibitors

A client with a tentative diagnosis of hyperosmolar hyperglycemic nonketotic syndrome (HHNS) has a history of type 2 diabetes that is being controlled with an oral diabetic agent, tolazamide. Which laboratory test is the most important for confirming this disorder? -Serum potassium level -Serum osmolarity -Serum sodium level -Arterial blood gas (ABG) values

serum osmolarity

Which of the following are characteristics associated with the Zollinger-Ellison syndrome (ZES)? Select all that apply. -Extreme gastric hyperacidity -Gastrin-secreting tumors of the pancreas -Constipation -Hypocalcemia -Severe peptic ulcers

severe peptic ulcers extreme gastric hyperacidity gastrin-secreting tumors of the pancreas

A nurse inspects the Stensen duct of the parotid gland to determine inflammation and possible obstruction. What area in the oral cavity would the nurse examine? -Roof of the mouth next to the incisors -Posterior segment of the tongue near the uvula -Buccal mucosa next to the upper molars -Dorsum of the tongue

Buccal mucosa next to the upper molars

A patient comes to the clinic with the complaint, "I think I have an ulcer." What is a characteristic associated with peptic ulcer pain that the nurse should inquire about? Select all that apply. -Pain that radiates to the shoulder or jaw -Severe gnawing pain that increases in severity as the day progresses -Feeling of emptiness that precedes meals from 1 to 3 hours -Burning sensation localized in the back or mid-epigastrium -Vomiting without associated nausea

-Burning sensation localized in the back or mid-epigastrium -feeling of emptiness that precedes meals from 1 to 3 hours -severe gnawing pain that increases in severity as the day progresses

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? -Large Intestine -Liver -Stomach -Ileum

stomach

A healthcare provider prescribes a combination of drugs to treat reoccurring peptic ulcer disease, and the client asks the nurse the reason for all the medications. What teaching should the nurse review with the client? -The prostaglandin E1 analogs, antibiotics, and proton pump inhibitors will work together to suppress or eradicate H. pylori. -The bismuth salts, antibiotics, and proton pump inhibitors will work together to suppress or eradicate H. pylori. -The antibiotics, prostaglandin E1 analogs, and bismuth salts will work together to suppress or eradicate H. pylori. -The proton pump inhibitors, prostaglandin E1 analogs, and bismuth salts will suppress or eradicate H. pylori.

the bismuth salts, antibiotics, and proton pump inhibitors will work together to suppress or eradicate H. pylori.

A client is recovering from a neck dissection. What volume of serosanguineous secretions would the nurse expect to drain over the first 24 hours? -80 to 120 mL -160 to 200 mL -50 to 75 mL -20 to 40 mL

80-120 mL