Dynamic Quizzes: GI
Children
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?
Vasopressin
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?
-Obtain the client's PT and INR measurements -Administer lactulose 30 mL PO 4 times daily -Obtain daily weight and abdominal girth measurements -Administer a daily multivitamin (Cirrhosis also leads to deficiencies)
A nurse is admitting a client who has cirrhosis. Which of the following prescriptions should the nurse anticipate? (Select all that apply.)
Emesis with a coffee-ground appearance
A nurse is assessing a client who has a bleeding duodenal ulcer. Which of the following findings should the nurse expect?
Hyperactive bowel sounds above the obstruction
A nurse is assessing a client who has a complete intestinal obstruction. Which of the following findings should the nurse expect?
Blumberg's sign (The nurse should expect to find rebound tenderness (Blumberg's sign) in a client who has cholecystitis)
A nurse is assessing a client who has cholecystitis. Which of the following findings should the nurse expect?
Indwelling urinary catheter output of 25 mL/hr
A nurse is assessing a client who is 12 hr postoperative following an open cholecystectomy. Which of the following findings should the nurse report to the provider?
Anorexia
A nurse is assessing a client who is in the early stages of hepatitis A. Which of the following manifestations should the nurse expect?
Rigid abdomen
A nurse is assessing a client who was admitted with a bowel obstruction. The client reports severe abdominal pain. Which of the following findings indicates that a possible bowel perforation has occurred?
Ask the client to empty his bladder before the procedure
A nurse is assisting a provider with performing a paracentesis on a client. Which of the following actions should the nurse take?
Destroys old blood cells (fiy: A client without a spleen has an increased risk of infection and sepsis due to a reduced immune function.)
A nurse is caring for a child who had her spleen removed following a bicycle accident. The child's parent asks the nurse about the role of the spleen in the body. The nurse should explain that the spleen performs which of the following functions?
Prevents excessive pressure on suture lines
A nurse is caring for a client who had a gastric resection to treat adenocarcinoma of the stomach. The client tells the nurse in the PACU that he does not remember why the surgeon said he had to have a tube in his nose. The nurse should explain that the NG tube serves which of the following purposes?
Place the client in the semi-Fowler's position (A client who is receiving PEG tube feedings should be positioned with the head of the bed elevated at least 30° during and after feedings to decrease the risk of aspiration)
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?
Increased serum lipase level
A nurse is caring for a client who has abdominal pain and possible pancreatitis. Which of the following laboratory results should the nurse identify as an indication of pancreatitis?
Amylase
A nurse is caring for a client who has acute pancreatitis. Which of the following serum laboratory values should return to the expected reference range within 72 hr of treatment beginning?
Ensure bowel rest
A nurse is caring for a client who has an acute exacerbation of Crohn's disease. Which of the following actions should the nurse take?
Storing bile
A nurse is caring for a client who has cholelithiasis and will undergo a cholecystectomy. The client states she does not understand how she will be alright without her gallbladder. The nurse should explain to the client that which of the following is the main function of the gallbladder?
"Perhaps we should review your coping mechanisms and talk about other alternatives."
A nurse is caring for a client who has colitis and reported increased exacerbations due to stress at work. Which of the following responses should the nurse make?
Liver transplant
A nurse is caring for a client who has fulminant hepatic failure. Which of the following procedures should the nurse anticipate for this client?
Colonoscopy (helps the provider identify the exact cause and location of bleeding)
A nurse is caring for a client who has gastrointestinal bleeding. The provider suspects a bleeding lesion in the colon. The initial approach to treatment likely will involve which of the following procedures?
"Lying quietly in bed helps slow down the activity in your intestines."
A nurse is caring for a client who has ulcerative colitis. The provider prescribes bed rest with bathroom privileges. When the client asks the nurse why he has to stay in bed, which of the following responses should the nurse provide?
Clear liquids (Water does not contain sugar, which could cause diarrhea due to hyperosmolarity.)
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?
200 mL of bright red drainage from the NG tube
A nurse is caring for a client who is 2 days postoperative following gastric surgery and has an NG tube inserted. Which of the following findings should the nurse report to the provider?
Cover the client's wound with a sterile, moist dressing
A nurse is caring for a client who is 3 days postoperative following abdominal surgery. The client states, "Something just popped when I coughed." Which of the following actions should the nurse take first?
Right shoulder pain
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?
Irrigate the tube with normal saline solution (the nurse should first attempt to irrigate the tube to determine patency)
A nurse is caring for a client who is NPO and has an NG tube to suction. When the client reports nausea, which of the following actions should the nurse take?
The head of the bed is elevated to 20°. (The head of the bed should be elevated to at least 30° (semi-Fowler's position))
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?
Diaphoresis (Because of Hypoglycemia. In addition to diaphoresis, other potential manifestations of hypoglycemia can include weakness, anxiety, confusion, and hunger.)
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?
Prothrombin Time (PT)
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?
To detect an ulceration in the stomach
A nurse is caring for a client who is scheduled to undergo an esophagogastroduodenoscopy (EGD). The nurse should identify that this procedure is for which of the following reasons?
Gamma-glutamyl transferase (GGT)
A nurse is caring for a client with a history of cirrhosis who has been 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?
Alcohol use
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?
-Empty the bag when it is one-third to one-half full -Cut the skin barrier opening a little larger than the ostomy -Wash the peristomal skin with mild soap and water
A nurse is demonstrating colostomy care to a client who has a new colostomy. Which of the following actions should the nurse teach the client to perform? (Select all that apply.)
Increased prothrombin time (Clients who have end-stage liver failure have an inadequate supply of clotting factors and an increased (i.e. prolonged) prothrombin time.)
A nurse is monitoring the laboratory results of a client who has end-stage liver failure. Which of the following results should the nurse expect?
Blood in stool (fiy: guaiac is the same as fecal occult blood test)
A nurse is obtaining a guaiac test from a client. This test is performed to detect which of the following?
Take serial measurements of the abdomen with a tape measure
A nurse is performing a gastrointestinal assessment of a client who has liver cirrhosis with abdominal distention. Which of the following actions should the nurse take to assess for changes in the client's abdominal distention?
"Empty your ostomy pouch when it becomes half full."
A nurse is performing discharge teaching about ostomy care while at home for a client who has a newly placed ileostomy. Which of the following instructions should the nurse include in the teaching?
Decrease the client's fat intake
A nurse is planning care for a client who has cholelithiasis. Which of the following interventions should the nurse include in the plan?
Coughing and deep-breathing exercises
A nurse is planning discharge teaching for a client who is postoperative following a traditional open cholecystectomy. Which of the following learning needs of the client is the nurse's priority?
"A hepatitis B immunization is given to infants and children."
A nurse is preparing a community education program about hepatitis B. Which of the following statements should the nurse include in the teaching?
Foods high in fiber (non-inflammatory)
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?
Roast chicken and white rice (fyi: white rice is not high in fiber according to ATI)
A nurse is providing dietary teaching to a client who has ulcerative colitis. Which of the following food selections by the client indicates an understanding of the teaching?
"Encourage her to eat foods that are high in carbohydrates."
A nurse is providing discharge teaching to the partner of a client who has a new diagnosis of hepatitis A. Which of the following instructions should the nurse include in the teaching?
"A colostomy is from the large intestine, and an ileostomy is from the small intestine."
A nurse is providing preoperative teaching to a client who will undergo surgery to create a temporary colostomy. The client asks the nurse about the difference between colostomies and ileostomies. Which of the following responses should the nurse make?
Eat yogurt with live cultures (bacterial cultures provides dietary probiotics that help maintain and promote bowel function.)
A nurse is providing teaching to a client who has constipation. Which of the following instructions should the nurse include?
"I'll have to consume a soft diet after surgery." (After surgery, the client quickly returns to a regular diet)
A nurse is providing teaching to a client who is scheduled for a sigmoid colon resection with colostomy. Which of the following statements by the client indicates a need for further teaching?
Eat crackers and yogurt regularly (Crackers, toast, and yogurt can help reduce flatus, which contributes to odor.)
A nurse is teaching a client who has a colostomy about ways to reduce flatus and odor. Which of the following strategies should the nurse include?
Destroying liver cells that are later replaced with scar tissue
A nurse is teaching a client who has cirrhosis of the liver and a history of alcohol consumption. The nurse should explain that alcohol can cause liver cirrhosis through which of the following actions?
"This procedure can determine how well the lower part of your esophagus works."
A nurse is teaching a client with Barrett's esophagus who is scheduled to undergo an esophagogastroduodenoscopy (EGD). Which of the following statements should the nurse include in the teaching?
Digesting fats
A nurse is teaching a group of clients about the functions of the liver and gallbladder. Which of the following should the nurse include in the teaching as the purpose of bile?
The client will be placed on mechanical ventilation prior to this procedure.
A nurse is teaching a newly licensed nurse about caring for a client who is scheduled for an esophagogastric balloon tamponade tube to treat bleeding esophageal varices. Which of the following pieces of information should the nurse include in the teaching?
Importance of colonoscopy screening starting at age 50 years old
A nurse is teaching about secondary prevention actions for colorectal cancer for a health fair for adults in the community. Which of the following topics should the nurse include?
Grilled chicken (cirrhosis requires protein to compensate for disease-related weight loss)
A nurse is teaching dietary-modification strategies to a client who has been newly diagnosed with cirrhosis. Which of the following foods should the nurse recommend?