GI Clinical Practice Questions (Med Surg)

A male client with cholelithiasis has a gallstone lodged in the common bile duct. When assessing this client, the nurse should note: a. yellow sclera b. light amber urine c. circumoral pallor d. black, tarry stools

A

The graduate nurse and her preceptor are establishing priorities for their morning assessments. Which client should they assess first? 1. The newly admitted client with acute abdominal pain 2. The client who underwent surgery three days ago and who now requires a dressing change 3. The client receiving continuous tube feedings who needs the tube-feeding residual checked 4. The sleeping client who received pain medication 1 hour ago

A

Which condition is most likely to have a nursing diagnosis of fluid volume deficit? a. appendicitis b. pancreatitis c. cholecystitis d. gastric ulcer

B

Which of the following has the least important role in terms of peptic ulcer formation? a. acid b. NSAID use c. presence of H. pylori d. hypertension

D

Which foods should a patient with GERD stay away from. Select all that apply: a. Burger King double cheeseburger b. lettuce c. candy canes d. chocolate espresso e: white bread

ACD - should avoid peppermint, alcohol, caffeinated beverages, chocolate, tea, and coffee

A male client has just been diagnosed with hepatitis A. On assessment, the nurse expects to note: a. severe abdominal pain radiating to the shoulder b. anorexia, nausea, and vomiting c. eructation and constipation d. abdominal ascites

B

A female client who has just been diagnosed with hepatitis A asks, "How could I have gotten this disease?" What is the nurse's best response? "A. "You may have eaten contaminated restaurant food." b. "You could have gotten it by using I.V. drugs." c. "You must have received an infected blood transfusion." d. "You probably got it by engaging in unprotected sex.""

A

A male client undergoes total gastrectomy. Several hours after surgery, the nurse notes that the nasogastric (NG) tube has stopped draining. How should the nurse respond? a. Notify the physician b. Reposition the tube c. Irrigate the tube d. Increase the suction level

A

A female client with dysphagia is being prepared for discharge. Which outcome indicates that the client is ready for discharge? a. the client doesn't exhibit rectal tenesmus b. the client is free from esophagitis and achalasia c. the client reports diminished duodenal inflammation d. the client has normal gastric structures

B

A male client has undergone a colon resection. While turning him, wound dehiscence with evisceration occurs. The nurse's first response is to: a. call the physician b. place saline-soaked sterile dressings on the wound c. take a blood pressure and pulse d. pull the dehiscence closed

B

A male client is recovering from a small-bowel resection. To relieve pain, the physician prescribes meperidine (Demerol), 75 mg I.M. every 4 hours. How soon after administration should meperidine onset of action occur? a. 5 to 10 minutes b. 15 to 30 minutes c. 30 to 60 minutes d. 2 to 4 hours

B

A male client with a recent history of rectal bleeding is being prepared for a colonoscopy. How should the nurse position the client for this test initially? a. lying on the right side with legs straight b. lying on the left side with knees bent c. prone with the torso elevated d. bent over with hands touching the floor

B

A male client with pancreatitis complains of pain. The nurse expects the physician to prescribe meperidine (Demerol) instead of morphine to relieve pain because: a. meperidine provides a better, more prolonged analgesic effect. b. morphine may cause spasms of Oddi's sphincter. c. meperidine is less addictive than morphine. d. morphine may cause hepatic dysfunction.

B

To prevent gastroesophageal reflux in a client with hiatal hernia, the nurse should provide which discharge instruction? a) "Lie down after meals to promote digestion." b) "Avoid coffee and alcoholic beverages." c) "Limit fluid intake with meals." d) "Take antacids with meals."

B

To prevent gastroesophageal reflux in a male client with hiatal hernia, the nurse should provide which discharge instruction? a. "Lie down after meals to promote digestion." b. "Avoid coffee and alcoholic beverages." c. "Take antacids with meals." d. "Limit fluid intake with meals."

B

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. increase lactate dehydrogenase (LD)

B

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

B

When preparing a male client, age 51, for surgery to treat appendicitis, the nurse formulates a nursing diagnosis of Risk for infection related to inflammation, perforation, and surgery. What is the rationale for choosing this nursing diagnosis? a. Obstruction of the appendix may increase venous drainage and cause the appendix to rupture. b. Obstruction of the appendix reduces arterial flow, leading to ischemia, inflammation, and rupture of the appendix. c. The appendix may develop gangrene and rupture, especially in a middle-aged client. d. Infection of the appendix diminishes necrotic arterial blood flow and increases venous drainage."

B

Which diagnostic test is used first to evaluate a client with upper GI bleeding? a) Hemoglobin levels and hematocrit (HCT) b) Endoscopy c) Arteriography d) Upper GI series

B

Mandy, an adolescent girl is admitted to an acute care facility with severe malnutrition. After a thorough examination, the physician diagnoses anorexia nervosa. When developing the plan of care for this client, the nurse is most likely to include which nursing diagnosis? a. Hopelessness b. Powerlessness c. Chronic low self esteem d. Deficient knowledge

C

The nurse is caring for a male client with cirrhosis. Which assessment findings indicate that the client has deficient vitamin K absorption caused by this hepatic disease? a. dyspnea and fatigue b. ascites and orthopnea c. purpura and petechiae d. gynecomastia and testicular atrophy

C

Which of the following is not a common symptom of GERD? a. dyspepsia b. regurgitation c. dysphagia d. hyposalivation

D

While palpating a female client's right upper quadrant (RUQ), the nurse would expect to find which of the following structures? a. Sigmoid colon b. Appendix c. spleen d. liver

D

A male client is recovering from an ileostomy that was performed to treat inflammatory bowel disease. During discharge teaching, the nurse should stress the importance of: a. increasing fluid intake to prevent dehydration b. wearing an appliance pouch only at nighttime c. consuming a low-protein, high-fiber diet d. taking only enteric-coated medications

A

A male client with extreme weakness, pallor, weak peripheral pulses, and disorientation is admitted to the emergency department. His wife reports that he has been 'spitting up blood.' A Mallory-Weiss tear is suspected, and the nurse begins taking a client history from the client's wife. The question by the nurse that demonstrates her understanding of Mallory-Weiss tearing is: a. "Tell me about your husband's alcohol usage" b. "Is your husband being treated for tuberculosis?" c. "Has your husband recently fallen or injured his chest?" d. "Describe spices and condiments your husband uses on food."

A

When assessing a client during a routine checkup, the nurse reviews the history and notes that the client had aphthous stomatitis at the time of the last visit. Aphthous stomatitis is best described as: a. a canker sore of the oral soft tissue b. an acute stomach infection c. acid indigestion d. an early sign of peptic ulcer disease

A

Which of the following nursing interventions should the nurse perform for a female client receiving enteral feedings through a gastrostomy tube? a. change the tube feeding solutions and tubing at least every 24 hours b. maintain the head of the bed at a 15-degree elevation continuously c. check the gastrostomy tube for position every 2 days d. maintain the client on bed rest during the feedings

A

Which patient is most susceptible for acquiring secondary stomatitis? a. an AIDs patient suffering from pneumonia b. an 65 y/o obese female c. a 45 y/o male suffering from colon cancer d. a 50 y/o male with CHF

A

While a female client is being prepared for discharge, the nasogastric (NG) feeding tube becomes clogged. To remedy this problem and teach the client's family how to deal with it at home, what should the nurse do? a. Irrigate the tube with cola. b. Advance the tube into the intestine. c. Apply intermittent suction to the tube. d. Withdraw the obstruction with a 30-ml syringe.

A

The nurse is monitoring a female client receiving paregoric to treat diarrhea for drug interactions. Which drugs can produce additive constipation when given with an opium preparation? a. antiarrhythmic drugs b. anticholinergic drugs c. anticoagulant drugs d. antihypertensive drugs

B

Which of the following is an inappropriate nursing diagnosis for a client with malignant tumors of the oral cavity? A) impaired oral mucous membranes B) deficient fluid volume C) acute pain D) risk for ineffective airway clearance

B

A female client with viral hepatitis A is being treated in an acute care facility. Because the client requires enteric precautions, the nurse should: a. place the client in a private room b. wear a mask when handling the client's bedpan c. wash the hands after touching the client d. wear a gown when providing personal care for the client

C

The nurse is caring for a female client with active upper GI bleeding. What is the appropriate diet for this client during the first 24 hrs after admission? a. regular diet b. skim milk c. NPO d. clear liquids

C

Which drug class isn't used to treat GERD? a. antacids b. histamine receptor antagonists c. beta blockers d. proton pump inhibitors

C

Which item is unnecessary when examining the oral cavity of a patient with candidiasis? a. gloves b. penlight c. gown d. tongue blade

C

Which of the following factors can cause hepatitis A? a. contact with infected blood b. blood transfusions with infected blood c. eating contaminated shellfish d. sexual contact with an infected person

C

A female client with hepatitis C develops liver failure and GI hemorrhage. The blood products that would most likely bring about hemostasis in the client are: a. whole blood and albumin b. platelets and packed red blood cells c. fresh frozen plasma and whole blood d. cryoprecipitate and fresh frozen plasma

D

During preparation for bowel surgery, a male client receives an antibiotic to reduce intestinal bacteria. Antibiotic therapy may interfere with synthesis of which vitamin and may lead to hypoprothrombinemia? a. vitamin A b. vitamin D c. vitamin E d. vitamin K

D

Nurse Hannah is teaching a group of middle-aged men about peptic ulcers. When discussing risk factors for peptic ulcers, the nurse should mention: a. a sedentary lifestyle and smoking. b. a history of hemorrhoids and smoking. c. alcohol abuse and a history of acute renal failure. d. alcohol abuse and smoking.

D

The nurse caring for a client with small-bowel obstruction would plan to implement which nursing intervention first? a. administering pain medication b. obtaining a blood sample for laboratory studies c. preparing to insert a nasogastric (NG) tube d. administering I.V. fluids

D