Gastro

The parents of a 4-year-old ask th nurse how to manage their child's constipation. Select the nurse's best response "Add 2 ounces of apple or pear juice to the child's diet." "Be sure your child eats a lot of fresh fruit such as apples and bananas." "Encourage your child to drink more fluids." "Decrease bulky foods such as whole-grain breads and brown rice."

"Encourage your child to drink more fluids." Increasing fluid consumption helps to decrease the hardness of the stool.

The nurse completes teaching the parents of the 3-month-old who had a surgical correction for pyloric stenosis. Which statement by the parents indicates teaching has been effective? We should use a special infant feeding device so our baby doesn't get so much air." "We should handle our baby as little as possible right after giving the baby a bottle." "Increasing the formula amount with feedings will help expand our baby's stomach." "Our baby should be positioned on the right side when put back to bed after a feeding."

"Our baby should be positioned on the right side when put back to bed after a feeding."

The infant is hospitalized with infectious gastroenteritis and dehydration. The nurse determines that the NA caring for the infant understands the necessary precautions when the NA makes which statements? Select all that apply. "I should put on gloves when I am holding the infant." "I should wear a gown and gloves to change the infant's diapers." "I should keep the door to the infant's room closed most of the time." "I should perform hand hygiene each time I change the infant's diaper." "I should keep the infant in the room unless instructed otherwise.

: "I should wear a gown and gloves to change the infant's diapers." "I should perform hand hygiene each time I change the infant's diaper." "I should keep the infant in the room unless instructed otherwise." 2 - Because organisms causing gastroenteritis are eliminated in the feces, contact precautions should be used. 4- Hand hygiene is included in standard precautions and should be performed before and after contact. 5- The infant's movement outside the room is limited to only what is absolutely necessary. Incorrect- 1- If soiling or contact with infected surfaces or items is unlikely, neither gown nor gloves are needed. 3- The door is closed for airborne precautions , gastroenteritis is not airborne

A nurse who provides care in an ambulatory clinic integrates basic cancer screening into admission assessments. What client most likely faces the highest immediate risk of oral cancer? A 65-year-old man with alcoholism who smokes A 45-year-old woman who has type 1 diabetes and who wears dentures A 32-year-old man who is obese and uses smokeless tobacco A 57-year-od man with GERD and dental caries

A 65-year-old man with alcoholism who smokes Oral cancers are often associated with the use of alcohol and tobacco, which when used together have a synergistic carcinogenic effect. Most cases of oral cancers occur in people over the age of 60 and a disproportionate number of cases occur in men. Diabetes, dentures, dental caries, and GERD are not risk factors for oral cancer.

Which foods should be offered to a child with hepatitis? A tuna sandwich on whole wheat bread and a cup of skim milk. Clear liquids, such as broth, and Jell-O A hamburger, French fries and a diet soda. A peanut butter sandwich and a milkshake.

A tuna sandwich on whole wheat bread and a cup of skim milk.

You are the nurse caring for a child with Meckel's diverticulum. Which of the following manifestations would you expect to find? Select all that apply. Abdominal pain Fever Mucus and blood in stools Vomiting Rapid shallow breathing

Abdominal pain Mucus and blood in stools

The nurse is caring for a child diagnosed with celiac disease. The parent is describing the number, consistency, appearance, and size of the child's stools. Which changes in the child's stools should prompt the nurse to conclude that the child's ability to absorb nutrients is improving? Disappearance of current jelly stools Reduction of ribbonlike stools Absence of large, bulky, greasy stools Absence of liquid green stools

Absence of large, bulky, greasy stools When gluten is ingested in celiac disease, changes occur in the intestinal mucosa or villi that prevent the absorption of foods into the bloodstream and affect the ability to absorb fat. Stools are large, bulky, and greasy, indicating steatorrhea. An absence of steatorrhea indicates that the child'3s ability to absorb nutrients is improving.

A child is scheduled for a lower endoscopy. What would the nurse include in the child's plan of care in preparation for this test? Explaining about the need to ingest barium Establishing an intravenous access for radionuclide administration Administering the prescribed bowel cleansing regimen Withholding prescribed proton pump inhibitors for 5 days befor

Administering the prescribed bowel cleansing regimen

A client's health history is suggestive of inflammatory bowel disease. Which of the following would suggest Crohn's disease, rather that ulcerative colitis, as the cause of the client's signs and symptoms? A pattern of distinct exacerbations and remissions Severe diarrhea An absence of blood in stool Involvement of the rectal mucosa

An absence of blood in stool

A client's NG tube has become clogged after the nurse instilled a medication that was insufficiently crushed. The nurse has attempted to aspirate with a large-bore syringe, with no success. What should the nurse do next? Withdraw the NG tube 2 inches (5 cm) and reattempt aspiration. Attach a syringe filled with warm water and attempt an in-and-out motion of instilling and aspirating. Withdraw the NG tube slightly and attempt to dislodge by flicking the tube with the fingers. Remove the NG tube promptly and obtain an order for reinsertion from the primary provider.

Attach a syringe filled with warm water and attempt an in-and-out motion of instilling and aspirating. Warm water irrigation is one of the methods that can be used to declog a feeding tube. Removal is not warranted at this early stage and a flicking motion is unlikely to have an effect. The tube should not be withdrawn, even a few centimeters.

An adult client with a history of dyspepsia has been diagnosed with chronic gastritis. The nurse's health education should include what guidelines? Select all that apply. Avoid drinking alcohol Adopt a low-residue diet Avoid non=steroidal anti-inflammatories Take calcium gluconate as prescribed Prepare for the possibility of surgery

Avoid non=steroidal anti-inflammatories Avoid drinking alcohol

The nurse is providing care for a client who has recently been diagnosed with chronic gastritis. What health practice should the nurse address when teaching the client to limit exacerbations of the disease? Performing 15 minutes of physical activity at least three times per week Avoid taking aspirin to treat pain or fever Taking multivitamins as prescribed and eating organic foods whenever possible Maintaining a healthy body weight

Avoid taking aspirin to treat pain or fever Aspirin and other NSAIDs are implicated in chronic gastritis because of their irritating effect on the gastric mucosa. Organic foods and vitamins confer no protection. Exercise and a healthy body weight are beneficial to overall health but do not prevent gastritis.

The 5-year-old child who has been diagnosed with peritonitis secondary to a ruptured appendix has abdominal pain and nausea, even though an NG tube is in place. When pulling back the covers. The nurse notes that the child's abdomen is distended. What action should the nurse take first? Telephone the health care provider to report the child's symptoms. Check the NG tubing for movement of fluid to the collection container. Finish the abdominal assessment and then check the child's vital signs. Administer an antiemetic medication such as droperidol if prescribed.

Check the NG tubing for movement of fluid to the collection container.

A nurse is completing an assessment of a client who has a gastric ulcer. Which of the following findings should the nurse expect? Select all the apply Client reports pain relieved by eating Client reports pain often occurs at night Client reports a sensation of bloating Client states that pain occurs 30 min to 1 hr after a meal Client experiences pain upon palpation of the epigastric regio

Client reports a sensation of bloating Client states that pain occurs 30 min to 1 hr after a meal Client experiences pain upon palpation of the epigastric region

A nurse is creating a care plan for a client who is receiving parenteral nutrition. The client's care plan should include nursing actions relevant to what potential complications? Select all that apply. Dumping syndrome Clotted or displaced catheter Pneumothorax Hyperglycemia Line sepsis

Clotted or displaced catheter Pneumothorax Hyperglycemia Line sepsis

A nurse is working with a client who has chronic constipation. What should be included in client teaching to promote normal bowel function? Use glycerin suppositories on a regular basis. Limit physical activity in order to promote bowel peristalsis. Consume high-residue, high-fiber foods. Resist the urge to defecate until the urge becomes intense.

Consume high-residue, high-fiber foods. Goals for the client include restoring or maintaining a regular pattern of elimination by responding to the urge to defecate, ensuring adequate intake of fluids and high-fiber foods, learning about methods to avoid constipation, relieving anxiety about bowel elimination patterns, and avoiding complications. Ongoing use of pharmacologic aids should not be promoted, due to the risk of dependence. Increased mobility helps to maintain a regular pattern of elimination. The urge to defecate should be heeded.

A client admitted with acute diverticulitis has experienced a sudden increase in temperature and reports a sudden onset of exquisite abdominal tenderness. The nurse's rapid assessment reveals that the client's abdomen is uncharacteristically rigid on palpation. What is the nurse's best response? Administer a Fleet enema as prescribed and remain with the client. Contact the primary provider promptly and report these signs of perforation. Position the client supine and insert an NG tube. Page the primary provider and report that the client may be obstructed.

Contact the primary provider promptly and report these signs of perforation. The client's change in status is suggestive of perforation, which is a surgical emergency. Obstruction does not have this presentation involving fever and abdominal rigidity. An enema would be strongly contraindicated. An order is needed for NG insertion and repositioning is not a priority.

The nurse is assessing a client who had an ileostomy created three days ago for the treatment of irritable bowel disease. The nurse observes that the client's stoma is bright red and there are scant amounts of blood on the stoma. What is the nurse's best action? Contact the care provider to have the client's hemoglobin and hematocrit measured Document these expected assessment findings Apply barrier ointment to the stoma as prescribed Cleanse the stoma with alcohol or chlorhexidine.

Document these expected assessment findings Redness and slight bleeding are expected, so no further intervention or assessment is likely necessary.

A nurse is caring for a client who just has been diagnosed with a peptic ulcer. When teaching the client about his new diagnosis, how should the nurse best describe it? Inflammation of the lining of the stomach Erosion of the lining of the stomach or intestine Bleeding from the mucosa in the stomach Viral invasion of the stomach wall

Erosion of the lining of the stomach or intestine A peptic ulcer is erosion of the lining of the stomach or intestine. Peptic ulcers are often accompanied by bleeding and inflammation, but these are not the definitive characteristics.

The nurse is caring for a client who is undergoing diagnostic testing for suspected malabsorption. When taking this client's health history and performing the physical assessment, the nurse should recognize what finding as most consistent with this diagnosis? Recurrent constipation coupled with weight loss Foul-smelling diarrhea that contains fat Fever accompanied by a rigid, tender abdomen Bloody bowel movements accompanied by fecal incontinence

Foul-smelling diarrhea that contains fat

The management of the client's gastrostomy is an assessment priority for the home care nurse. What statement would indicate that the client is managing the tube correctly? I clean my stoma twice a day with alcohol. The only time I flush my tube is when I'm putting in medications. I flush my tube with water before and after each of my medications. I try to stay still most of the time to avoid dislodging my tube

I flush my tube with water before and after each of my medications. Frequent flushing is needed to prevent occlusion, and should not just be limited to times of medication administration. Alcohol will irritate skin surrounding the insertion site and activity should be maintained as much as possible.

The nurse is providing teaching to the parents of an infant with an umbilical hernia. Which should be included in the plan of care? f the hernia has not resolved on it's own by the age of 12 months, surgery is generally recommended. If the hernia appears to be more swollen or tender, seek medical attention immediately. To help the hernia resolve, place a pressure dressing over the area gently. If the hernia is repaired surgically, there is a strong likelihood that is will return.

If the hernia appears to be more swollen or tender, seek medical attention immediately.

A 10-year-old is being evaluated for possible appendicitis and complains of nausea and sharp abdominal pain in the right lower quadrant. An abdominal ultrasound is scheduled, and a blood count has been obtained. The child vomits, finds the pain relieved , and calls the nurse. Which should be the nurse's next action? Cancel the ultrasound and obtain an order for oral ondansetron (Zofran) Cancel the ultrasound and prepare to administer an intravenous bolus. Prepare for the probable discharge of the client. Immediately notify the health-care provider of the child's status.

Immediately notify the health-care provider of the child's status. The HCP should be notified immediately, because a sudden change or loss of pain often indicates a perforated appendix.

The nurse is caring for the infant with Hirschsprung's disease. Which statement by the parent indicates understanding of the treatment for Hirschsprung's disease? Increased pH and increased bicarbonate Decreased pH and decreased bicarbonate Increased pH and decreased bicrbonate Decreased pH and increased bicarbonate

Increased pH and increased bicarbonate An infant with pyloric stenosis often has been vomiting for 1-2 weeks, resulting in metabolic alkalosis as evidenced by an increase in both serum pH and bicarbonate

A nurse is assessing a client who has peptic ulcer disease. The client requests more information about the typical causes of Helicobacter pylori infection. What would it be appropriate for the nurse to instruct the client? Most affected clients acquired the infection during international travel. Infection typically occurs due to ingestion of contaminated food and water. Many people possess genetic factors causing a predisposition to H. pylori infection. The H. pylori microorganism is endemic in warm, moist climates.

Infection typically occurs due to ingestion of contaminated food and water. Most peptic ulcers result from infection with the gram-negative bacteria H. pylori, which may be acquired through ingestion of food and water. The organism is endemic to many areas, not only warm, moist climates. Genetic factors have not been identified.

A client seeking care because of recurrent heartburn and regurgitation is subsequently diagnosed with a hiatal hernia. Which of the following should the nurse include in health education? Drinking beverages after your meal, rather than with your meal, may bring some relief. It's best to avoid dry foods, such as rice and chicken, because they're harder to swallow. Many clients obtain relief by taking over-the-counter antacids 30 minutes before eating. Instead of eating three meals a day, try eating smaller amounts more often.

Instead of eating three meals a day, try eating smaller amounts more often. Management for a hiatal hernia includes frequent, small feedings that can pass easily through the esophagus. Avoiding beverages and particular foods or taking OTC antacids are not noted to be beneficial.

A client receiving tube feedings is experiencing diarrhea. The nurse and the health care provider suspects that the client is experiencing dumping syndrome. What intervention is most appropriate? Stop the tube feed and aspirate stomach contents. Increase the hourly feed rate so it finishes earlier. Keep the client in semi-Fowler position for 1 hour after feedings Administer fluid replacement by IV.

Keep the client in semi-Fowler position for 1 hour after feedings

Results of a client barium swallow suggest that the client has GERD. The nurse is planning health education to address the client's knowledge of this new diagnosis. Which of the following should the nurse encourage? Eating several small meals daily rather than 3 larger meals Keeping the head of the bed partially elevated Drinking carbonated mineral water rather than soft drinks Avoiding food or fluid intake after 6:00 PM.

Keeping the head of the bed partially elevated

A nurse is completing an assessment of a client who has GERD. Which of the following is an expected finding? Absence of saliva Loss of tooth enamel Sweet taste in the mouth Absence of eructation

Loss of tooth enamel

A staff educator is reviewing the causes of gastroesophageal reflux disease (GERD) with new staff nurses. What area of the GI tract should the educator identify as the cause of reduced pressure associated with GERD? Upper esophageal sphincter Lower esophageal sphincter Pyloric sphincter Hypopharyngeal sphincter

Lower esophageal sphincter The lower esophageal sphincter, also called the gastroesophageal sphincter or cardiac sphincter, is located at the junction of the esophagus and the stomach. An incompetent lower esophageal sphincter allows reflux (backward flow) of gastric contents. The upper esophageal sphincter and the hypopharyngeal sphincter are synonymous and are not responsible for the manifestations of GERD. The pyloric sphincter exists between the stomach and the duodenum.

A client has been diagnosed with a small bowel obstruction and has been admitted to the medical unit. The nurse's care should prioritize which of the following outcomes? Preventing infection Maintaining skin and tissue integrity Maintaining fluid and electrolyte balance Preventing nausea and vomiting

Maintaining fluid and electrolyte balance All of the listed focuses of care are important for the client with a small bowel obstruction. However, the client's risk of fluid and electrolyte imbalances is an immediate threat to safety, and is a priority in nursing assessment and interventions.

A client who underwent a gastric resection 3 weeks ago is having her diet progressed on a daily basis. Following her latest meal, the client reports dizziness and palpitations. Inspection reveals that the client is diaphoretic. What is the nurse's best action? insert a nasogastric tube promptly. Reposition the client supine. Monitor the client closely for further signs of dumping syndrome. Assess the client for signs and symptoms of aspiration

Monitor the client closely for further signs of dumping syndrome. The client's symptoms are characteristic of dumping syndrome, which results in a sensation of fullness, weakness, faintness, dizziness, palpitations, diaphoresis, cramping pains, and diarrhea. Aspiration is a less likely cause for the client's symptoms. Supine positioning will likely exacerbate the symptoms and insertion of an NG tube is contraindicated due to the nature of the client's surgery.

A client comes to the clinic reporting pain in the epigastric region. What statement by the client suggests the presence of a duodenal ulcer? My pain resolves when I have something to eat. The pain really interferes with my quality of life. I know that my father and my grandfather both had ulcers. I seem to have bowel movements more often than I usually do.

My pain resolves when I have something to eat. Pain relief after eating is associated with duodenal ulcers. This type of ulcer is not associated with family history or increased frequency of bowel movements. All types of ulcers can affect the client's quality of life.

The nurse is preparing the 4-month-old diagnosed with intussusception for surgery when the infant passes a normal brown stool. What is the nurse's most important action? Palpate the infant's abdomen Notify the health care provider Document the character of the stool Check the stool for presence of blood

Notify the health care provider The HCP should be notified because the passage of normal brown stool may indicate reduction of the intussusception, and the course of treatment may be altered and surgery canceled.

The nurse is planning care for the infant newly hospitalized with intussusception. Which problem should the nurse establish as the priority? Pain related to abnormal abdominal peristalsis Risk for deficit fluid volume related to bowel obstruction Altered nutrition, less than body requirements, related to vomitng Risk for altered skin integrity related to bloody stools

Pain related to abnormal abdominal peristalsis

You are the nurse teaching a parent of an infant about gastrointestinal reflux disease. Which of the following should you include in the teaching? Select all that apply. Offer frequent feedings Thickened formula Use a bottle with a one-way valve. Position baby upright after feedings. Use a wide-based nipple for feedings

Position baby upright after feedings. Offer frequent feedings Thickened formula

The nurse is preparing to check for tube placement in the client's stomach as well as measure the residual volume. What is the main purpose of these nursing actions? Prevent diarrhea Prevent gastric ulcers Prevent aspiration Prevent abdominal distention

Prevent aspiration Protecting the client from aspirating is essential because aspiration can cause pneumonia, a potentially life-threatening disorder. Gastric ulcers are not a common complication of tube feeding in clients with ET tubes. Abdominal distention and diarrhea can both be associated with tube feeding, but prevention of these problems is not the primary rationale for confirming placement.

The nurse is admitting a 5-week-old infant for a laparoscopic correction of pyloric stenosis. Which information should the nurse expect when asking the parents about the infant's symptoms? Select all that apply. Projectile vomiting Bile-colored emesis Sweet-smelling vomitus Weight loss Absence of tears

Projectile vomiting Weight loss

A nurse is completing a health history on a client whose diagnosis is chronic gastritis. Which of the data should the nurse consider most significantly related to the etiology of the client's health problem? Consumes one or more protein drinks daily Takes over-the-counter antacids frequently throughout the day Smokes one pack of cigarettes daily Reports a history of social drinking on a weekly basis

Smokes one pack of cigarettes daily

The nurse is caring for a 4-month-old who has just had an isolated cleft-lip repaired. Select the best position for the child in the immediate post-operative period. Right side-lying Left side-lying Supine Prone

Supine The supine position is preferred because there is decreased risk of the infant rubbing the suture line.

A client has sought care because of recent dark-colored stools. As a result, a fecal occult blood test has been ordered. The nurse should give what instructions to the client? Take no NSAIDs within 48 hours of the test Take prescribed medications as usual Avoid over-the-counter (OTC) vitamin C supplements Do not use fiber supplements before the test

Take no NSAIDs within 48 hours of the test In the past, patients were advised to avoid ingesting red meats, aspirin, nonsteroidal anti-inflammatory drugs, turnips, and horseradish for 72 hours prior to the study because it was thought that these were associated with false-positive results; likewise, patients were advised to avoid ingesting vitamin C from supplements or foods as it was believed that this was associated with false-negative results. However, these restrictions are no longer advised as their actual effects on test results have not been established; plus, they unnecessarily restricted patient participation in screening.

A client with a history of peptic ulcer disease has presented to the emergency department (ED) in distress. What assessment finding would lead the ED nurse to suspect that the client has a perforated ulcer? The client has abdominal bloating that developed rapidly. The client has a rigid, boardlike abdomen that is tender. The client is experiencing intense lower right quadrant pain The client is experiencing dizziness and confusion with no apparent hemodynamic changes

The client has a rigid, boardlike abdomen that is tender. An extremely tender and rigid (boardlike) abdomen is suggestive of a perforated ulcer. None of the other listed signs and symptoms is suggestive of a perforated ulcer.

A client's screening colonoscopy revealed the presence of numerous polyps in the large bowel. What principle should guide the subsequent treatment of this client's health problem? Adherence to a high-fiber diet will help the polyps resolve. The client should be assured that these are a normal, age-related physiologic change. The client's polyps constitute a risk factor for cancer. The presence of polyps is associated with an increased risk of bowel obstructio

The client's polyps constitute a risk factor for cancer. Although most polyps do not develop into invasive neoplasms, they must be identified and followed closely. They are very common, but are not classified as a normal, age-related physiologic change. Diet will not help them resolve and they do not typically lead to obstructions.

The school nurse is working with a 10-year-old girl with recurrent abdominal pain. The girl's teacher has been less than understanding about the frequent absences and trips to the nurse's office. How should the nurse respond? Be patient; she is trying some new medication. The pain she is having is real. The family is working toward improvement. Please do not add to this family's stress.

The pain she is having is real. It is important to educate the teacher that this recurrent abdominal pain is a true pain that the child feels and it is not in her mind. Telling the teacher not to add to the family's stress or that the family is working toward improvement does not teach. The nurse must have the permission of the family to discuss the girl's medication.

A nurse is caring for a client who has a gastrointestinal tube in place. Which of the following are indications for gastrointestinal intubation? Select all that apply. To remove gas from the stomach To administer clotting factors to treat a GI bleed To remove toxins from the stomach To open sphincters that are closed To diagnose GI motility disorders

To remove gas from the stomach To diagnose GI motility disorders To remove toxins from the stomach

The experienced nurse is observing the new nurse caring for the 11-month-old child who is 12 hours postoperative from cleft palate repair. Which nursing action requires the experienced nurse to intervene? Uses a suction catheter to remove oral secretions Cautions the NA against giving toast or hard foods Removes an elbow restraint to check the skin and IV Administers a prn prescribed analgesic intravenously

Uses a suction catheter to remove oral secretions 1- Placing a suction catheter in the child's mouth can disrupt the suture line and cause bleeding or injury.

The public health nurse is caring for the 10-year-old with hepatitis A. The nurse is instructing the parents to avoid giving their child any medications that are not prescribed. Which is the nurse's rationale for this instruction? OTC medications are not sufficient to control the pain associated with hepatitis A. The medication of choice is antibiotics, and the child will be on those only while hospitalized. Usual drug doses may become dangerous due to the liver's inability to detoxify and excrete them. The foods provided will contain all of the natural substances the child will need for recovery.

Usual drug doses may become dangerous due to the liver's inability to detoxify and excrete them. The function of the liver is altered due to liver damage in hepatitis, and medications cannot be metabolized and detoxified by the liver and excreted from the body. The parents should not give any medications that are not prescribed.

A nurse is preparing to provide care for a client whose exacerbation of ulcerative colitis has required hospital admission. During an exacerbation of this health problem, the nurse would anticipate that the client's stools will have what characteristics? Watery with blood and mucus Hard and black or tarry Dry and streaked with blood Loose with visible fatty streaks

Watery with blood and mucus