GI questions

Which of the following is the most prominent sign of inflammatory bowel disease? a) Intermittent pain b) Abdominal distention c) Increased peristalsis d) Hyperactive bowel sounds

A) Intermittent pain Explanation:The most prominent symptom is intermittent pain that occurs with diarrhea but does not decrease after defecation. Abdominal distention, hyperactive bowel sounds, and increased peristalsis are not the most prominent signs. (less)

Patients with irritable bowel disease (IBD) are at significantly increased risk for which of the following? a) Hypotension b) Deep vein thrombosis c) Osteoporosis d) Pneumonia

C) Osteoporosis Explanation:Patients with IBD also have a significantly increased risk of osteoporotic fractures due to decreased bone mineral density. Patients are not at increased risk of deep vein thrombosis, hypotension, or pneumonia. (less)

The nurse is assessing a client who has a PEG tube in place. On inspection, the nurse observes moist, white patches on the skin below the external retention bolster. What is the nurses action? a) perform skin care and apply antibiotic ointment as prescribed b) apply and anti fungal ointment as prescribed c) irrigate the PEG tube w sterile water d) ask the dietician to reevaluate the clients feeding formula

b) apply and anti fungal ointment as prescribed

After assessing a client with peritonitis, the nurse most likely would document the client's bowel sounds as: a) Mild. b) High-pitched. c) Hyperactive. d) Absent.

d) Absent. Explanation:Since lack of bowel motility typically accompanies peritonitis, bowel sounds are absent. Therefore, the nurse will not observe mild, high-pitched, or hyperactive bowel sounds.

A patient with irritable bowel syndrome has been having more frequent symptoms lately and is not sure what lifestyle changes may have occurred. What suggestion can the nurse provide to identify a trigger for the symptoms? a) Keep a 1- to 2-week symptom and food diary to identify food triggers. b) Document how much fluid is being taken to determine if the patient is overhydrating. c) Discontinue the use of any medication presently being taken to determine if medication is a trigger. d) Begin an exercise regimen and biofeedback to determine if external stress is a trigger.

A) Keep a 1- to 2-week symptom and food diary to identify food triggers. Explanation:The nurse emphasizes and reinforces good dietary habits (e.g., avoidance of food triggers). A good way to identify problem foods is to keep a 1- to 2-week symptom and food diary.

Diet modifications for patient diagnosed with chronic inflammatory bowel disease include which of the following? a) Low residue b) Calorie restriction c) Iron restriction d) Low protein

A) Low residue Explanation:Oral fluids and a low-residue, high-protein, high-calorie diet with supplemental vitamin therapy and iron replacement are prescribed to meet the nutritional needs, reduce inflammation, and control pain and diarrhea. (less)

A nurse is teaching a client who has experienced an episode of acute gastritis. The nurse knows further education is necessary when the client makes which statement? A) "i should feel better in about 24-36 hrs" B) "My appetite should come back tomorrow" C) "I should limit alcohol intake, at least until symptoms subside" D) "Once I can eat again, I should stick w/ bland foods"

B) "My appetite should come back tomorrow"

Which of the following is one of the primary symptoms of irritable bowel syndrome (IBS)? a) Abdominal distention b) Diarrhea c) Bloating d) Pain

B) Diarrhea Explanation: The primary symptoms of IBS include constipation, diarrhea, or a combination of both. Pain, bloating, and abdominal distention often accompany changes in bowel pattern.

A patient with IBD would be encouraged to increase fluids, use vitamins and iron supplements, and follow a diet designed to reduce inflammation. Select the meal choice that would be recommended for a low-residue diet. a) A fruit salad with yogurt b) A peanut butter sandwich and fruit cup c) Broiled chicken with low-fiber pasta d) Salami on whole grain bread and V-8 juice

C) Broiled chicken with low-fiber pasta Explanation:A low-residue, high-protein, and high-calorie diet is recommended to reduce the size and number of stools. Foods to avoid include yogurt, fruit, salami, and peanut butter.

Barbara Allen, a 69-year-old retired cab driver, is undergoing diagnostic testing in the hospital where you practice nursing. She has been experiencing lower GI difficulties that have increased in severity, and her gastroenterologist is concerned that her bowel is not functioning properly. What function of the lower GI tract is most likely to be affected by her disorder? a) Fat digestion b) Protein digestion c) Water and electrolyte absorption d) All options are correct.

C) Water and electrolyte absorption Explanation:Disorders of the lower GI tract usually affect movement of feces toward the anus, absorption of water and electrolytes, and elimination of dietary wastes. Water and electrolyte absorption would most likely be affected. (less)

A nurse caring for a client w/ a small bowel obstruction should plan to implement which nursing intervention first? A) administering pain medication B) Obtaining a blood sample for lab studies C) Preparing to insert a NG tube D) Administering IV fluids

D) Administering IV fluids

A nurse is providing a oral care to a client who is comatose. What action best addresses the client's risk of tooth decay and plaque accumulation? A) Irrigating the mouth using a syringe filled with a bactericidal mouthwash B) Applying a water-soluble gel to the teeth and gums C) wiping the teeth and gums with guaze D) Brushing the client's teeth with a toothbrush and small amount of toothpaste

D) Brushing the client's teeth with a toothbrush and small amount of toothpaste

The nurse is admitting a patient with a diagnosis of diverticulitis and assesses that the patient has a boardlike abdomen, no bowel sounds, and complains of severe abdominal pain. What is the nurse's first action? a) Administer an opioid analgesic. b) Administer a retention enema. c) Start an IV with lactated Ringer's solution. d) Notify the physician.

D) Notify the physician. Explanation:Abdominal pain, a rigid boardlike abdomen, loss of bowel sounds, and signs and symptoms of shock occur with peritonitis. Peritonitis is typically a life-threatening emergency that requires prompt surgical intervention, and typically involves postoperative critical care monitoring due to the risk of sepsis, organ failure, and subsequent infections; thus, the nurse should notify the physician. (less)

A nurse teaches a client homecare nutrition expectations who will undergo bariatric surgery. Which foods will the nurse suggest the client keep on hand at home after surgery? SATA: a) gelatin b) pudding c) fat-free milk d) yogurt e) creamy soups

a) gelatin b) pudding c) fat-free milk

what is a major concern for the nurse when caring for a patient w/ chronic pancreatitis? a) pain b) weight loss c) nausea d) mental status changes

b) weight loss

The nurse observes the physician palpating the abdomen of a client that is suspected of having acute appendicitis. When the abdomen is pressed in the LLQ the client complains of pain on the right side. What does the nurse understand this assessment technique is referred to? A) Referred pain B) Rebound pain C) Rovsing sign D) Cremasteric reflex

C) Rovsing sign

After teaching a group of students about irritable bowel syndrome (IBS) and antidiarrheal agents, the instructor determines that the teaching was effective when the students identify which of the following as an example of an antidiarrheal agent commonly administered for IBS? a) Loperamide b) Dicyclomine c) Peppermint oil d) Lubiprostone

a) Loperamide

A client with GERD comes to the physician's office reporting a burning sensation in the esophagus. The nurse documents that the client is experiencing A) Pyrosis B) Dyspepsia C) Dysphagia D) Odynophagia

a) Pyrosis

The nurse is conducting a gastrointestinal assessment. When the patient complains of the presence of mucus and pus in his stools, the nurse assesses for additional signs/symptoms of which of the following disease/conditions? a) Disorders of the colon b) Small-bowel disease c) Ulcerative colitis d) Intestinal malabsorption

c) Ulcerative colitis Explanation: The presence of mucus and pus in the stools suggests ulcerative colitis. Watery stools are characteristic of small-bowel disease. Loose, semisolid stools are associated more often with disorders of the colon. Voluminous, greasy stools suggest intestinal malabsorption. (less)

which intervention should be included in the plan of care for a client who has undergone a cholecystectomy? a) placing the client on NPO status for 2 days after surgery b) clamping the T tube immediately after surgery c) placing the client in the semi-fowler position immediately after surgery d) assessing the color of the sclera every shift

d) assessing the color of the sclera every shift

Crohn's disease is a condition of malabsorption caused by which of the following pathophysiological processes? a) Inflammation of all layers of intestinal mucosa b) Infectious disease c) Gastric resection d) Disaccharidase deficiency

A) Inflammation of all layers of intestinal mucosa Explanation: Crohn's disease, also known as regional enteritis, can occur anywhere along the GI tract, but most commonly at the distal ileum and in the colon. Infectious disease causes problems such as small bowel bacterial overgrowth leading to malabsorption. Disaccharidase deficiency leads to lactose intolerance. Postoperative malabsorption occurs after gastric or intestinal resection. (less)

A client w/ gastritis required hospital treatment for an exacerbation of symptoms and receives a subsequent diagnosis of pernicious anemia due to malabsorption. When planning the clients continuing care in the home setting, what assessment question is most relevant? A) "does anyone in your family have experience at giving injections?" B) "are you going to be anywhere w/ strong sunlight in the next few months?" C) "are you aware of your blood type?" D) "do any of your family members have training in first aid?"

A) "does anyone in your family have experience at giving injections?"

Common clinical manifestations of Crohn's disease include: a) Abdominal pain and diarrhea. b) Edema and weight gain. c) Obstruction and paralytic ileus. d) Nausea and vomiting.

A) Abdominal pain and diarrhea. Explanation:The onset of symptoms is usually insidious in regional enteritis, with prominent lower right quadrant abdominal pain that is unrelieved by defecation and the presence of diarrhea.

What is the primary nursing diagnosis for a client with a bowel obstruction? a) Deficient fluid volume b) Deficient knowledge c) Acute pain d) Ineffective tissue perfusion

A) Deficient fluid volume Explanation:Feces, fluid, and gas accumulate above a bowel obstruction. Then the absorption of fluids decreases and gastric secretions increase. This process leads to a loss of fluids and electrolytes in circulation. Therefore, Deficient fluid volume is the primary diagnosis. Deficient knowledge, Acute pain, and Ineffective tissue perfusion are applicable but not the primary nursing diagnosis. (less)

A client is being treated for diverticulosis. Which of the following points should the nurse include in this client's teaching plan? Select all that apply. a) Avoid daily exercise; indulge only in mild activity. b) Do not suppress the urge to defecate. c) Use laxatives or enemas at least once a week. d) Drink at least 8 to 10 large glasses of fluid every day.

B) Do not suppress the urge to defecate. D) Drink at least 8 to 10 large glasses of fluid every day. Explanation: Avoid constipation. Do not suppress the urge to defecate. Consume at least 2 L/day (within limits of the client's cardiac and renal reserve) and include foods that are soft but have increased fiber, such as prepared cereals or soft-cooked vegetables, to increase the bulk of the stool and facilitate peristalsis, thereby promoting defecation. Avoid the use of laxatives or enemas except when recommended by the physician. Exercise regularly if the current lifestyle is somewhat inactive. (less)

A client presents to the emergency department with complaints of acute GI distress, bloody diarrhea, weight loss, and fever. Which condition in the family history is most pertinent to the client's current health problem? a) Hypertension b) Ulcerative colitis c) Gastroesophageal reflux disease d) Appendicitis

B) Ulcerative colitis Explanation:A family history of ulcerative colitis, particularly if the relative affected is a first-degree relative, increases the likelihood of the client having ulcerative colitis. Although hypertension has familial tendencies, the client's symptoms aren't related to hypertension. A family history of gastroesophageal reflux disease or appendicitis isn't a significant factor in the client history because these conditions aren't considered familial traits. (less)

A 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) consuming a low-protein, high-fiber diet. b) increasing fluid intake to prevent dehydration. c) wearing an appliance pouch only at bedtime. d) taking only enteric-coated medications.

B) increasing fluid intake to prevent dehydration. Explanation:Because stool forms in the large intestine, an ileostomy typically drains liquid waste. To avoid fluid loss through ileostomy drainage, the nurse should instruct the client to increase fluid intake. The nurse should teach the client to wear a collection appliance at all times because ileostomy drainage is incontinent, to avoid high-fiber foods because they may irritate the intestines, and to avoid enteric-coated medications because the body can't absorb them after an ileostomy. (less)

A nurse caring for a client with small-bowel obstruction should plan to implement which nursing intervention first? a) Preparing to insert a nasogastric (NG) tube b) Obtaining a blood sample for laboratory studies c) Administering I.V. fluids d) Administering pain medication

C) Administering I.V. fluids Explanation:The nurse should first administer I.V. infusions containing normal saline solution and potassium to maintain fluid and electrolyte balance. For the client's comfort and to assist in bowel decompression, the nurse should prepare to insert an NG tube next. A blood sample is then obtained for laboratory studies to help diagnose bowel obstruction and guide treatment. Blood studies usually include a complete blood count, serum electrolyte levels, and blood urea nitrogen level. Pain medication commonly is withheld until obstruction is diagnosed because analgesics can decrease intestinal motility. (less)

A patient diagnosed with IBS is advised to eat a diet that is: a) Sodium-restricted. b) Low in residue. c) High in fiber. d) Restricted to 1,200 calories/day.High in fiber.

C) High in fiber. Explanation:A high-fiber diet is prescribed to control diarrhea and constipation and is recommended for patients with IBS.

A 35-year-old male patient presents at the emergency department with symptoms of a small bowel obstruction. In collaboration with the primary care provider, what intervention should the nurse prioritize? a) Insertion of a central venous catheter b) Administration of a mineral oil enema c) Insertion of a nasogastric tube d) Administration of a glycerin suppository and an oral laxative

C) Insertion of a nasogastric tube Explanation:Decompression of the bowel through a nasogastric tube is necessary for all patients with small bowel obstruction. Peripheral IV access is normally sufficient. Enemas, suppositories, and laxatives are not indicated if an obstruction is present. (less)

A client with inflammatory bowel disease undergoes an ileostomy. On the first day after surgery, the nurse notes that the client's stoma appears dusky. How should the nurse interpret this finding? a) This is a normal finding 1 day after surgery. b) An intestinal obstruction has occurred. c) The ostomy bag should be adjusted. d) Blood supply to the stoma has been interrupted.

D) Blood supply to the stoma has been interrupted. Explanation:An ileostomy stoma forms as the ileum is brought through the abdominal wall to the surface skin, creating an artificial opening for waste elimination. The stoma should appear cherry red, indicating adequate arterial perfusion. A dusky stoma suggests decreased perfusion. The nurse should interpret this finding as an indication that the stoma's blood supply is interuppted, which may lead to tissue damage or necrosis. A dusky stoma isn't a normal finding 1 day after surgery. Adjusting the ostomy bag wouldn't affect stoma color, which depends on blood supply to the area. An intestinal obstruction also wouldn't change stoma color. (less)

A client comes to the clinic complaining of not having a bowel movement in several days, abdominal cramping, and nausea. When the nurse puts the client on the stretcher, he vomits a large amount of fecal material. What should the first action by the nurse be? a) Start an IV of Ringer's lactate. b) Insert an intestinal tube. c) Insert a nasogastric tube. d) Notify the physician.

D) Notify the physician. Explanation: The physician should be notified immediately to examine the client because the client is exhibiting signs of an intestinal obstruction. Starting the IV and inserting a nasogastric tube would be interventions that the physician will order after seeing the client. The nurse does not insert intestinal tubes. (less)

Which of the following will the nurse observe as symptoms of perforation in a client with an intestinal obstruction? Select all that apply. a) Sudden drop in body temperature b) Sudden, sustained abdominal pain c) Intermittent, severe pain d) Abdominal distention

b) Sudden, sustained abdominal pain D) Abdominal distention Explanation:Abdominal distention, fever, and sudden, sustained abdominal pain are the symptoms of perforation in a client with intestinal obstruction.

A home health nurse who sees a client with diverticulitis is evaluating teaching about dietary modifications necessary to prevent future episodes. Which statement by the client indicates effective teaching? a) "I'll incorporate foods rich in omega-3 fatty acids into my diet." b) "I'll increase my intake of protein during exacerbations." c) "I should increase my intake of fresh fruits and vegetables during remissions." d) "I'll snack on nuts, olives, and popcorn during flare-ups."

c) "I should increase my intake of fresh fruits and vegetables during remissions." Explanation: A client with diverticulitis needs to modify fiber intake to effectively manage the disease. During episodes of diverticulitis, he should follow a low-fiber diet to help minimize bulk in the stools. A client with diverticulosis should follow a high-fiber diet. Clients with diverticular disease don't need to modify their intake of protein and omega-3 fatty acids. (less)

A patient is admitted to the hospital after not having had a bowel movement in several days. The nurse observes the patient is having small liquid stools, a grossly distended abdomen, and abdominal cramping. What complication can this patient develop related to this problem? a) Diverticulitis b) Appendicitis c) Bowel perforation d) Rectal fissures

c) Bowel perforation Explanation: Megacolon is a dilated and atonic colon caused by a fecal mass that obstructs the passage of colon contents. Symptoms include constipation, liquid fecal incontinence, and abdominal distention. Megacolon can lead to perforation of the bowel. (less)

Which of the following would a nurse expect to assess in a client with peritonitis? a) hyperactive bowel sounds b) decrease pulse rate c) board-like abdomen d) deep slow respirations

c) board-like abdomen

A client comes to the clinic an informs the nurse that he is there to see the physician for right upper abd discomfort, nausea, and frequent belching especiialy after eating a meal high in fat. What disorder do these symtoms correlate w/? a) hepatitis b) billiary colic c) cholelithiasis d) cholecystitis

c) cholelithiasis

A client w/ liver disease has developed ascites, the nurse is collaborating w/ the client to develop a nutritional plan. The nurse should prioritize which of the following in the clients plan? A) increased potassium intake b) fluid restriction to 2 L per day c) reduction in sodium intake d) high protein, low-fat diet

c) reduction in sodium intake

The nurse cares for a client after an endoscopic examination and prepares the client for discharge. The nurse includes which instruction? a) avoid driving for 24 hours b) continue a clear liquid diet c) resume regular diet d) increase fluid intake

c) resume regular diet

The post-op nurse is attending beginning of shift report and learns that a client who is recovering from bariatric surgery has been experiencing bile reflux. What is the nurse's most appropriate action? a) encourage the client to eat smaller amounts and to eat more slowly b) administer calcium chloride and pancreatic enzymes as prescribed c) prepare the client for an emergency cholecystomy d) administer PPI's as prescribed

d) administer PPI's as prescribed

A nurse is providing follow-up teaching at a clinic visit for a client recovering from gastric resection. The client reports sweating, diarrhea, nausea, palpitations, and the desire to lie down 15 to 30 minutes after meals. Based on the client's assessment, what will the nurse suspect? a) Dehiscence of the surgical wound b) a normal reaction to surgery c) peritonitis d) dumping syndrome

d) dumping syndrome

When planning care for a client with a small-bowel obstruction, the nurse should consider the primary goal to be: a) maintaining body weight. b) reporting pain relief. c) maintaining fluid balance. d) reestablishing a normal bowel pattern.

C) maintaining fluid balance. Explanation:Because a client with a small-bowel obstruction can't tolerate oral intake, fluid volume deficit may occur and can be life-threatening. Therefore, maintaining fluid balance is the primary goal. Pain relief and maintaining body weight don't reflect life-threatening conditions, and the client's normal bowel pattern can be reestablished after fluid volume is stabilized. (less)

A client is admitted to the medical unit w/ a diagnosis of intestinal obstructinon. When planning the clients care, which of the following nursing dx should the nurse prioritize? A) Ineffective tissue perfusion r/t bowel ischemia B) Imbalanced nutrition: less then body requirements r/t impaired absorption C) Anxiety r/t bowel obstruction and subsequent hospitalization C) Impaired skin integrity r/t bowel obstruction

A) Ineffective tissue perfusion r/t bowel ischemia

A client is recently diagnosed with Crohn's disease and is beginning treatment. What first-line treatment does the nurse expect that the client will be placed on to decrease the inflammatory response? a) Ciprofloxacin (Cipro) b) Azathioprine (Imuran) c) Methotrexate (MTX) d) Sulfasalazine (Azulfidine)

D) Sulfasalazine (Azulfidine) Explanation:Considered first-line treatment for inflammatory bowel disease, 5-ASA drugs contain salicy late, which is bonded to a carrying agent that allows the drug to be absorbed in the intestine. These drugs work by decreasing the inflammatory response. MTX or Imuran are used when failure to maintain remission necessitates the use of an immune-modulating agent. Cipro is used as an effective adjunct to treat the disease. (less)

when caring for a client w/ hep B, the nurse should monitor closely for the development of which finding associated w/ a decrease in hepatic function ? a) jaundice b) pruritus of the arms and legs c) fatigue during ambulation d) irritability and drowsiness

d) irritability and drowsiness