GI

What is one of the major precipitating factors in the development of irritable bowel syndrome (IBS)? A. Stress B. Peptic Ulcers C. GERD D. Helicobacter pylori

A. Stress

Which goal for the clients care should take priority during the first days of hospitalization for an exacerbation of UC? A. Promoting self care and independence B. Managing Diarrhea C. Maintaining adequate nutrition D. Promoting rest and comfort

B

The nurse is caring for a patient preparing to undergo a colonoscopy. She should be prepared to give what drug? A. Laxative B. Diuretic C. Cathartic D. Antihypertensive

C. Cathartic

A client who has a history of Crohns disease is admitted to the hospital with fever, diarrhea, cramping, abdominal pain, and weight loss. The nurse should monitor the client for: A. Hyperalbuminemia B. Thrombocytopenia C. Hypokalemia D. Hypercalcemia

C. Hypokalemia is the most expected finding following diarrhea

Nurses should include which of the following care after an appendectomy: a. Administer a sitz bath b. Limit clients activity to bathroom privileges c. Note the first bowel movement after surgery d. Measure abdominal girth every 2 hours

C. Important indicator that normal peristalsis has returned

3. Upon admission of a client with appendicitis in an emergency room setting, a patient rates pain 10/10 on a scale of 0/10. The client will be going to surgery, the nurse should: a. Contact surgeon to prescribe a narcotic b. Maintain patient in recumbent position c. Place patient on NPO status d. Apply heat to area of pain

C. Primary action is to prevent aspiration during surgery

Peptic ulcers: Emergency symptoms

*Sharp, sudden, persistent, and severe stomach pain *Bloody or black stools *Bloody vomit or vomit that looks like coffee grounds

Peptic ulcers: Symptoms

*dull or burning pain *occurs when stomach is empty- between meals or during the night *may be briefly relieved by eating food or by taking antacids *Comes and goes for several days or weeks (other symptoms include: weight loss, poor appetite, bloating, burping, nausea, vomiting)

What is a peptic ulcer?

A sore on the lining of the stomach or duodenum (beginning of the small intestine). If it is in the stomach it is a peptic ulcer, if it is in the duodenum it is a duodenal ulcer

When doing discharge teaching to a client with chronic cirrhosis, why is it important to put emphasis on bleeding precautions? A. B/c of the cirrhosis, the liver is unable to produce clotting factors B. The low protein diet will result in reduced clotting factors C. The increased production of bile decreases clotting factors D. The required medications reduce clotting factors

A.

With a prolonged episode of vomiting, the patient could be at risk for the development of what problem? A. Acid base disturbances B. Intractable diarrhea C. Esophageal tears D. Hypoventilation

A. Acid base disturbances

A client with cirrhosis of the liver develops ascites. Which of the following orders would the nurse expect? A. Restrict fluid to 1,000mL per day B. Ambulate 100 ft. three times per day C. High sodium diet D. Maalox 30 mL p.o. BID

A. Fluid restriction is the primary treatment for ascites.

The nurse is doing teaching with the family of a client with liver failure. Which of the following foods should the nurse advise them to limit in the clients diet? A. Meats and beans B. Butter and gravies C. Potatoes and pasta D. Cakes and pastries

A. In liver failure, the liver is unable to metabolize protein adequately

Which of the following would be an expected outcome for a client with peptic ulcer disease? The client will: A. Demonstrate appropriate use of analgesics to control pain. B. Explain the rationale for eliminating alcohol from the diet. C. Verbalize the importance of monitoring hemoglobin and hematocrit every 3 months. D. Eliminate engaging in contact sports.

A. Incorrect Analgesics are not used to control ulcer pain; many analgesics are gastric irritants B. Correct Alcohol is a gastric irritant that should be eliminated from the intake of a client with peptic ulcer disease. C. Incorrect The client's hemoglobin and hematocrit typically do not need to be monitored every 3 months, unless GI bleeding is suspected. D. Incorrect The client may maintain an active lifestyle and does not need to eliminate contact sports as long as they are not stress inducing.

An experienced nurse explains to a new nurse that the definitive diagnosis of peptic ulcer disease (PUD) involves: A. A urea breath test B. Upper gastrointestinal endoscopy with biopsy C. Barium contrast studies D. The string test

A. Incorrect--A urea breath test only detects the presence of H. pylori. B. Correct--The gastric mucosa can be visualized with an endoscope. A biopsy is possible to differentiate PUD from other GI disorders and to obtain tissue specimens to identify H. pylori. C. Incorrect--Barium studies do not provide an opportunity for biopsy and H. pylori testing. D. Incorrect--A string test is used to detect presence of H. pylori. (Not commonly used)

Mrs. Smith has had intractable diarrhea for two weeks. The nurse would expect to administer what type of drug for the treatment of this condition? A. Opioids B. Laxatives C. Cathartics D. Bulk forming agents

A. Opioids

The client returning from a colonoscopy has been given a diagnoses of Crohn's disease. The oncoming shift nurse expects to note which of the following manifestations in the client? A. Steatorrhea B. Firm, rigid abdomen C. Constipation D. Enlarged hemorrhoids

A. Steatorrhea

2. A nurse is monitoring a patient who is scheduled for an appendectomy for appendicitis. The patient is scheduled for surgery in 2 hours. The patient starts to complain of increased abdominal pain and starts vomiting. The nurse notes the patients abdomen is distended and decreased bowel sounds. Which is the most appropriate intervention: a. Notify the health care provider b. Administer prescribed pain medication c. Call the surgical team and request they perform surgery ASAP d. Reposition client and apply heat to the abdomen on a warm setting

A. The nurse should suspect peritonitis and call the health care provider

1. When evaluating a male client for complications of acute pancreatitis, the nurse would observe for? a. increased intracranial pressure. b. decreased urine output. c. bradycardia. d. hypertension.

Answer B. Rationale: Acute pancreatitis can cause decreased urine output, which results from the renal failure that sometimes accompanies this condition. Intracranial pressure neither increases nor decreases in a client with pancreatitis. Tachycardia, not bradycardia, usually is associated with pulmonary or hypovolemic complications of pancreatitis. Hypotension can be caused by a hypovolemic complication, but hypertension usually isn't related to acute pancreatitis.

2. What laboratory finding is the primary diagnostic indicator for pancreatitis? a. Elevated blood urea nitrogen (BUN) b. Elevated serum lipase c. Elevated aspartate aminotransferase (AST) d. Increased lactate dehydrogenase (LD)

Answer B. Rationale: Elevation of serum lipase is the most reliable indicator of pancreatitis because this enzyme is produced solely by the pancreas. A client's BUN is typically elevated in relation to renal dysfunction; the AST, in relation to liver dysfunction; and LD, in relation to damaged cardiac muscle.

3. Which condition is most likely to have a nursing diagnosis of fluid volume deficit? a. Appendicitis b. Pancreatitis c. Cholecystitis d. Gastric ulcer

Answer B. Rationale: Hypovolemic shock from fluid shifts is a major factor in acute pancreatitis. The other conditions are less likely to exhibit fluid volume deficit.

When planning care for a client with UC who is experiencing an exacerbation of symptoms, which client care activities can the nurse appropriately delegate to an unlicensed assistant? Select all that apply: A. Assessing the clients bowel sounds B. Providing skin care following bowel movements C. Evaluating the clients response to antidiarrheal medications D. Maintaining intake and output records E. Obtaining the clients weight

B, D, E

The physical assessment of a 55 year old female with end stage cirrhosis reveals a protuberant abdomen with bulging flanks and dullness to the dependent side while lying on the right. The appropriate terminology for documentation of this assessment is what? A. Fluid overload B. Ascites C. Distension

B.

2. Based on the powerpoint , what data would be considered risk factors for gallbladder disease? A. Race, gender, and number of pregnancies B. Age, hormone replacement, and weight C. Hypertension, gender, and race D. Hysterectomy

B. Age, hormone replacement, and weight

What are the two most common conditions of biliary tract disorder? A. Gallstones and associated pancreatitis B. Gallstones and associated cholecystitis C. Gallstones and associated cholelithiasis D. Gallstones and associated cholangitis

B. Gallstones and associated cholecystitis

The client with Crohns disease has concentrated urine. decreased urinary output, dry skin with decreased turgor, hypotension, and weak thready pulses. The nurse should do which of the following first? A. Administer pain medications per order B. Provide parenteral hydration therapy per providers order C. Monitor Vital Signs D. Chart and communicate these symptoms to the nurse coming onto shift

B. Provide parenteral hydrations therapy per providers order

3. The nurse teaches the client with gallbladder disease that a stone in the common bowel duct could cause pancreatitis. Which of the following descriptions of the anatomical positions best describes the relationship between the gallbladder and pancreas? A. Secretions from the pancreas do not mix with bile from the gallbladder. B. Secretions from the pancreas and the gallbladder flow into the common bile duct C. Secretions from the pancreas and the gallbladder flow into the small intestines D. Secretions flow from the pancreas into the common bile duct during meals

B. Secretions from the pancreas and the gallbladder flow into the common bile duct

A client has had an exacerbation of UC with cramping and diarrhea persisting longer than 1 week. The nurse should assess the client for which of the following complications: A. Heart failure B. DVT C. Hypokalemia D. Hypocalcemia

C

Peptic ulcers: Causes

H. Pylori (causes more than half) NSAID's (aspirin/ibuprofen)