Exam 3 GI questions

A nurse in a provider's office is assessing a client who has GERD. The nurse should expect the client to report which of the following manifestations? (Select all the apply). A. Regurgitation B. Nausea C. Belching D. Heartburn E. Weight loss

A, B, C, D. Rationale: Regurgitation and heartburn are primary manifestations of GERD. Nausea and belching are also common manifestations.

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? A. Digestion fats B. Producing chyme C. Stimulating gastric acid secretion D. Providing energy

A. Bile is a product of the liver and aids in the digestion of fats.

A nurse us developing a plan of care for a client who has gastroesophageal reflux disease (GERD). The nurse should plan to monitor the client for which of the following complications? A. Aspiration B. Infection C. Anemia D. Weight loss

A. Rationale: Aspiration is a common complication of GERD, which results when the esophageal sphincter malfunctions and allows gastric acid and undigested food to back up into the esophagus.

A nurse is assessing a client who has cholecystitis. Which of the following findings should the nurse expect? A. Blumberg's sign B. Ascites C. GI bleeding D. Kehr's sign

A. Rationale: The nurse should expect to find rebound tenderness (Blumberg's sign) in a client who has cholecystitis. This response is an indication of peritoneal inflammation.

A nurse is assessing a client who has a bleeding duodenal ulcer. Which of the following findings should the nurse expect? A. Emesis with a coffee-ground appearance. B. Increased BP C. Decreased HR D. Bright green stools

A. Rationale: The nurse should expect a client who has a bleeding duodenal ulcer to have emesis that resembles coffee-grounds or is bright red in color. Hematemesis indicates upper GI bleeding, occurring at or above the duodenojejunal junction.

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? A. Empty your ostomy pouch when it becomes half full. B. Place an aspirin in the ostomy pouch to eliminate odor. C. Change the ostomy appliance every week. D. Cleanse the site around the stoma with hydrogen peroxide and water.

A. The nurse should instruct the client to empty the ostomy pouch when it is one-third to one-half full. This prevents the ostomy from becoming too full of stool and gas and exploding.

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? 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. Rationale: An EGD is useful in determining the function of the esophageal lining and the extend of inflammation, potential scarring, and strictures.

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 follow? A. "You need to conserve energy at this time." B. "Lying quietly in bed helps slow down the activity in you intestines" C. "Staying in bed promotes rest and comfort you need" D. "Staying in bed will help prevent injury and minimize your fall risk"

B. Rationale: The greatest risk to the client is complications from severe diarrhea such as dehydration, electrolyte imbalances, and GI bleeding and trauma. Activity restriction can help reduce intestinal peristalsis and diarrhea.

A nurse is caring for a client from the Middle East who has celiac disease. Which of the following actions should the nurse perform regarding the client's diet? A. Provide foods prepared according to kosher dietary law. B. Ask the kitchen to prepare grits to meet the client's dietary need for grains. C. Determine the client's dietary preferences. D. Prepare a diet tray that includes vegetables and barley soup.

C. Rationale: While generalizations are often made regarding the traditional eating practices of clients based on their cultural backgrounds, individual food choices can deviate from these generalizations. A nurse should assess the client's dietary habits before planning to meet dietary needs.

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? A. Producing bile B. Adding digestive enzymes to bile C. Storing bile D. Eliminating bile

C. The primary function of the gallbladder is to store bile. Because this organ is only for storage, the client's liver will still produce the bile needed for digestion. Small amounts of bile will continuously enter the duodenum, where it will perform various functions.

A nurse is caring for a client who has acute pancreatitis. Which of the following serum lab values should return to the expected reference range within 72 hr of treatment beginning? A. Aldolase B. Lipase C. Amylase D. Lactic dehydrogenase

C. Rationale: Pancreatitis is the most common diagnosis for marked elevations in serum amylase. Serum amylase begins to increase about 3 to 6 hrs following the onset of acute pancreatitis.

A nurse is planning care for a client who has cholelithiasis. Which of the following interventions should the nurse include in the plan? A. Restrict the client's fluid intake. B. Restrict the client's calcium intake. C. Decrease the client's fat intake. D. Decrease the client's potassium intake.

C. Rationale: The nurse should decrease the client's fat intake to reduce the occurrence of biliary colic.

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. Rationale: Vasopressin constricts the splanchnic bed and decreases portal pressure. Vasopressin also constricts the distal esophageal and proximal gastric veins, which reduces inflow into the portal system and is used to treat bleeding varices.

A nurse is caring for a client who has GI bleeding. The provider suspects a bleeding lesion in the colon. The initial approach to treatment likely will involve which of the following procedures? A. Exploratory laparotomy B. Double-contrast barium enema C. Magnetic resonance imaging D. Colonoscopy

D. Rationale: A colonoscopy requires the insertion of a flexible scope into the rectum. The provider advances the scope carefully until it enters the colon. It can provide direct visualization of the inside of the colon and helps the provider identify the exact cause and location of bleeding.

A nurse is monitoring the lab results of a client who has end-stage liver failure. Which of the following results should the nurse expect? A. Decreased lactate dehydrogenase B. Increased serum albumin C. Decreased serum ammonia D. Increased prothrombin time

D. Rationale: Clients who have end-stage liver failure have an inadequate supply of clotting factors and an increased prothrombin time.

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 GI illnesses C. Tobacco use D. Alcohol use.

D. Rationale: Alcohol consumption is a major cause of chronic pancreatitis in the US. Long-term alcohol use disorder produces hypersecretion of protein in pancreatic secretions, which results in protein plugs and calculi within the pancreatic ducts.

A nurse is planning an in-service training session for a group of nurses regarding the role of enzymes in digestion. Which of the following enzymes plays a role in the digestion of protein? ' A. Amylase B. Lipase C. Steapsin D. Pepsin

D. Rationale: Pepsin is an enzyme secreted by the gastric mucosa that breaks down protein into polypeptides. Other enzymes such as trypsin and aminopeptidase further break down the polypeptides into amino acids, which can be used by the body.

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

B. Rationale: Hepatitis B immunoglobulin is given as part of the standard childhood immunizations.

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 the semi-Fowler's position. C. Cleanse the skin around the tube. D. Aspirate the tube for residual contents.

B. Rationale: The nurse should apply the ABC priority-setting framework, which emphasizes the basic core of human functioning; having an open airway, being able to breath in adequate amounts of oxygen, and circulating oxygen to the body's organs via blood.

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. Rationale: Anorexia is an early manifestation of hepatitis A and is often severe. It is thought to result from the release of a toxin by the damaged liver or by the failure of the damaged liver cells to detoxify an abnormal product.

A nurse is assessing a client who is 12 hr postop following an open cholecystectomy. Which of the following findings should the nurse report to the provider? A. Hypoactive bowel sounds B. Indwelling urinary catheter output of 25 ml/hr. C. Heart rate of 96/ min D. Serous drainage at the surgical incision site.

B. Rationale: The nurse should report a urinary output of less than 30 ml/hr to the provider, as this can indicate hypovolemia or renal complication.