NUR 4770-Exam 2: GI Multiple Choice Practice Questions

A 78-year-old patient was admitted to the critical care unit with cirrhosis of the liver. In cirrhosis of the liver, which of the following laboratory values is expected to drop? A. Albumin B. Total bilirubin C. Alkaline phosphatase D. Aspartate aminotransferase

A. Albumin

Signs and symptoms of which condition include nausea, localized right lower quadrant guarding and tenderness after 12 to 24 hours, fever, and an elevated white blood cell count? A. Appendicitis B. Hepatitis C. Cecal volvulus D. Perforated duodenal ulcer

A. Appendicitis

Identify anatomic structures that are found in the left lower quadrant. (Select all that apply.) A. Distended uterus Correct B. Cecum and appendix C. Left ureter Correct D. Portion of the descending colon Correct E. Sigmoid colon Correct

A. Distended uterus C. Left ureter D. Portion of the descending colon E. Sigmoid colon

Identify anatomic structures that are found in the right upper quadrant. (Select all that apply.) A. Duodenum B. Portion of the transverse colon C. Liver D. Stomach E. Cecum

A. Duodenum B. Portion of the transverse colon C. Liver

Which of the following are clinical manifestations of pancreatitis? (Select all that apply.) A. Epigastric and abdominal pain B. Nausea and vomiting C. Diaphoresis D. Jaundice E. Hyperactive bowel sounds F. Fever

A. Epigastric and abdominal pain B. Nausea and vomiting D. Jaundice F. Fever

Which of the following is a potential cause for acute liver failure? (Select all that apply.) A. Ischemia B. Hepatitis A, B, C, D, E, non-A, non-B, non-C C. Acetaminophen toxicity D. Wilson disease E. Reye syndrome F. Diabetes

A. Ischemia B. Hepatitis A, B, C, D, E, non-A, non-B, non-C C. Acetaminophen toxicity D. Wilson disease E. Reye syndrome

Which of the following nursing interventions after GI surgery would have the highest priority of care? A. Oxygenation B. Pain management C. Circulation D. Preventing infection

A. Oxygenation

A client with colon cancer is scheduled to receive radiation therapy prior to surgery. What should the nurse include in the teaching about the use of radiation therapy? A. it helps reduce the size of the tumor B. it eliminates the malignant cells C. it may cure the cancer D. it helps heal the bowel after surgery

A. Radiation therapy is used before surgery to reduce the size of the tumor, making it easier to be resected. Radiation therapy isn't curative, can't eliminate the malignant cells (though it helps to define tumor margins), and could slow postoperative healing.

A patient with a 10-year history of alcoholism was admitted to the critical care unit with the diagnosis of acute pancreatitis. The patient is preparing for discharge. Nursing intervention should include A. diabetes management. B. alcohol cessation program. C. frequency of hemoccult testing. D. frequency of PT and PTT testing.

B. alcohol cessation program.

Esophagectomy is usually performed for A. cancer of the proximal esophagus and gastroesophageal junction. B. cancer of the distal esophagus and gastroesophageal junction. C. cancer of the pancreatic head. D. varices of the distal esophagus and gastroesophageal junction.

B. cancer of the distal esophagus and gastroesophageal junction.

To administer sucralfate through a gastric tube it should be A. crushed and mixed with 10 mL of water. B. dissolved in 10 mL of water to form a slurry. C. mixed in 15 mL of water to form a solution. D. administered as a whole pill with a 35-mL water flush.

B. dissolved in 10 mL of water to form a slurry.

Absorption of Prilosec and Prevacid occurs in the A. stomach. B. duodenum. C. jejunum. D. cecum.

B. duodenum.

Upon auscultation, the nurse hears borborygmi. This is a change in the patient's condition. The nurse suspects the patient maybe experiencing A. a complete ileus. B. early intestinal obstruction. C. abnormality of blood flow. D. peritonitis.

B. early intestinal obstruction.

The patient has just returned from a liver biopsy. The patient should be positioned on the A. left side for 2 hours. B. right side for 2 hours. C. left side for 6 to 8 hours. D. right side for 6 to 8 hours.

B. right side for 2 hours.

Signs and symptoms of an anastomotic leak include A. pneumonia. B. subcutaneous emphysema. C. bleeding. D. atelectasis.

B. subcutaneous emphysema.

The nurse is monitoring a client for the early signs and symptoms of dumping syndrome. Which symptom indicates this occurrence? a.) Abdominal cramping and pain b.) Bradycardia and indigestion c.) Sweating and pallor d.) Double vision and chest pain

Answer: C Early manifestations of dumping syndrome occur 5 to 30 minutes after eating. Symptoms include vertigo, tachycardia, syncope, sweating, pallor, palpitations, and the desire to lie down.

What is the pH of gastric juices prior to being mixed with food? A. 1.0 B. 3.0 C. 5.0 D. 7.0

A. 1.0

Which measure should the nurse focus on for a client with esophageal varicies? A. recognizing hemorrhage B. controlling blood pressure C. encouraging nutritional intake D. teaching the client about varices

A. Recognizing the rupture of esophageal varicies, or hemorrhage, is the focus of nursing care because the client could succumb to this quickly. Controlling blood pressure is also important because it helps reduce the risk of variceal rupture. It's also important to teach the client what foods he should avoid such as spicy foods, and what varicies are.

Identify anatomic structures that are found in the left upper quadrant. (Select all that apply.) A. Stomach Correct B. Spleen Correct C. Portion of the transverse and descending colon Correct D. Head of the pancreas E. Body of the pancreas Correct

A. Stomach B. Spleen C. Portion of the transverse and descending colon E. Body of the pancreas

Which of the following statements are correct regarding epithelial cells of the gastric mucosa? (Select all that apply.) A. They prevent diffusion of hydrogen into the mucosa. B. They secrete bicarbonate to neutralize hydrogen ions. C. They have the ability to increase blood flow to facilitate removal of toxic metabolites. D. They break down prostaglandins.

A. They prevent diffusion of hydrogen into the mucosa. B. They secrete bicarbonate to neutralize hydrogen ions. C. They have the ability to increase blood flow to facilitate removal of toxic metabolites.

Which of the following diagnostic procedures is used to identify gallstones and hepatic abscesses? A. Ultrasonography B. Abdominal radiography C. Angiography D. Liver scan

A. Ultrasonography

Which of the following findings is considered an abnormal gastrointestinal assessment finding? A. Visible peristaltic waves B. Hyper-resonance of the intestine C. High-pitched gurgling sounds in the small intestine D. Dull sounds over the liver and spleen

A. Visible peristaltic waves

The function of bile is mainly to A. emulsify fat globules. B. serve as a reservoir for bilirubin. C. maintain triglyceride levels in the blood. D. aid in detoxification of drugs in the liver.

A. emulsify fat globules.

A patient with a 10-year history of alcoholism was admitted to the critical care unit with the diagnosis of acute pancreatitis. Based on the diagnosis, the patient A. is at risk for hypovolemic shock from plasma volume depletion. B. requires observation for hypoglycemia and hypercalcemia. C. should be started on enteral feedings after the nasogastric tube is placed. D. is placed on a fluid restriction to avoid the fluid sequestration.

A. is at risk for hypovolemic shock from plasma volume depletion.

Inspection of the GI system should include the (Select all that apply.) A. mouth. Correct B. esophagus. C. skin. Correct D. bladder. E. abdomen. Correct

A. mouth. C. skin. E. abdomen.

Potential complications of an endoscopy include (Select all that apply.) A. perforation of the GI tract. Correct B. hemorrhage. Correct C. oversedation. Correct D. constipation. E. aspiration. Correct

A. perforation of the GI tract. B. hemorrhage. C. oversedation. E. aspiration.

Esophagogastric varices are the result of A. portal hypertension resulting in diversion of blood from a high-pressure area to a low-pressure area. B. superficial mucosal erosions as a result of increased stress levels. C. proulcer forces breaking down the mucosal resistance. D. inflammation and ulceration secondary to nonsteroidal anti-inflammatory drug use.

A. portal hypertension resulting in diversion of blood from a high-pressure area to a low-pressure area.

A health care provider has ordered an MRI (magnetic resonance imaging) of the liver. The nurse's first action is to A. prepare the patient psychologically and physically for the procedure. B. monitor the patient's response to the procedure. C. assess the patient after the procedure. D. inform the patient's family of the results.

A. prepare the patient psychologically and physically for the procedure.

The intestinal hormone responsible for stimulating the pancreas to secrete fluid into the duodenum is A. secretin. B. chyme. C. gastrin. D. pepsin.

A. secretin.

The gastrointestinal system plays a vital role in detoxification and elimination of (Select all that apply.) A. viruses. B. chemical toxins. C. drugs. D. bacteria.

A. viruses. B. chemical toxins. C. drugs. D. bacteria.

An important role of saliva is that it A. washes away bacteria. B. provides the body's main source of potassium. C. contains hydrochloric acid for breakdown of protein. D. stimulates the sympathetic nervous system.

A. washes away bacteria.

The nurse is reviewing the record of a client with a diagnosis of cirrhosis and notes that there is documentation of the presence of asterixis. To assess for the presence of this sign, the nurse would do which of the following? a.) Ask the client to extend the arms b.) Assess for the presence of Homans' sign c.) Instruct the client to lean forward d.) Measure the abdominal girth

Answer: A Asterixis is irregular flapping movements of the fingers and wrists when the hands and arms are outstretched, with the palms down, wrists bent up, and fingers spread. Asterixis is the most common and reliable sign that hepatic encephalopathy is developing.

The nurse provides medication instructions to a client with peptic ulcer disease. Which statement, if made by the client, indicates the best understanding of the medication therapy? a.) The Cimetidine (Tagamet) will cause me to produce less stomach acid b.) Sucralfate (Carafate) will change the fluid in my stomach c.) Antacids will coat my stomach d.) Omeprazole (Prilosec) will coat the ulcer and help it heal

Answer: A Cimetidine (Tagamet), a histamine H2 receptor antagonist, will decrease the secretion of gastric acid. Sucralfate promotes healing by coating the ulcer. Antacids neutralize acid in the stomach. Omeprazole inhibits gastric acid secretion.

The client with a new colostomy is concerned about the odor from stool in the ostomy drainage bag. The nurse teaches the client to include which of the following foods in the diet to reduce odor? a.) Yogurt b.) Broccoli c.) Cucumbers d.) Eggs

Answer: A The client should be taught to include deodorizing foods in the diet, such as beet greens, parsley, buttermilk, and yogurt. Spinach also reduces odor but is a gas forming food as well. Broccoli, cucumbers, and eggs are gas forming foods.

The nurse is doing an admission assessment on a client with a history of duodenal ulcer. To determine whether the problem is currently active, the nurse would assess the client for which of the following most frequent symptoms of duodenal ulcer? a.) Pain that is relieved by food intake b.) Pain that radiates down the right arm c.) Nausea and vomiting d.) Weight loss

Answer: A The most frequent symptom of duodenal ulcer is pain that is relived by food intake. These clients generally describe the pain as a burning, heavy, sharp, or hungry pain that often localizes in the mid-epigastric area. The client with duodenal ulcer usually does not experience weight loss or nausea and vomiting. These symptoms are more typical in a client with a gastric ulcer.

The nurse instructs the ileostomy client to do which of the following as part of essential care of the stoma? a.) Cleanse the peristomal skin meticulously b.) Take in high fiber foods such as nuts c.) Massage the area below the stoma d.) Limit fluid intake to prevent diarrhea

Answer: A The peristomal skin must receive meticulous cleansing because the ileostomy drainage has more enzymes and is more caustic to the skin than colostomy drainage. Foods such as nuts and those with seeds will pass through the ileostomy. The client should be taught that these foods will remain indigested. The area below the ileostomy may be massaged if needed if the ileostomy becomes blocked by high fiber foods. Fluid intake should be maintained to at least six to eight glasses of water per day to prevent dehydration.

The nurse is monitoring a client admitted to the hospital with a diagnosis of appendicitis. The client is scheduled for surgery in 2 hours. The client begins to complain of increased abdominal pain and begins to vomit. On assessment the nurse notes that the abdomen is distended and bowel sounds are diminished. Which of the following in the most appropriate nursing intervention? a.) Administer the prescribed pain medication b.) Notify the physician c.) Call and ask the operating room team to perform the surgery as soon as possible d.) Reposition the client and apply a heating pad on the warm setting to the client's abdomen

Answer: B Based on the signs and symptoms presented in the question, the nurse should suspect peritonitis and should notify the physician. Administering pain meds is not an appropriate intervention. Heat should never be applied to the abdomen of a client diagnosed with suspected appendicitis. Scheduling surgical time is not within the scope of nursing practice, although the physician probably would perform the surgery earlier than the prescheduled time.

The nurse is caring a client with a diagnosis of chronic gastritis. The nurse monitors the client, knowing that this client is at risk for which of the following vitamin deficiencies? a.) Vitamin A b.) Vitamin B12 c.) Vitamin C d.) Vitamin E

Answer: B Chronic gastritis causes deterioration and atrophy of the lining of the stomach, leading to the loss of function of the parietal cells. The source of intrinsic factor is lost, which results in the inability to absorb vitamin B12. This leads to the development of pernicious anemia.

The nurse is reviewing the record of a client with Crohn's disease. Which of the following stool characteristics would the nurse expect to note documented in the client's record? a.) Chronic constipation b.) Diarrhea c.) Constipation alternating with diarrhea d.) Stool constantly oozing from the rectum

Answer: B Crohn's disease is characterized by non-bloody diarrhea of usually not more than four to five stools daily. Over time, the diarrhea episodes increase in frequency, duration, and severity. Options A, C, and D are not characteristics of Crohn's disease.

The nurse is assessing a client 24 hours following a cholecystectomy. The nurse notes that the T-tube has drained 750 ml of green brown drainage. Which nursing intervention is most appropriate? a.) Notify the physician b.) Document the findings c.) Irrigate the T-tube d.) Clamp the T-tube

Answer: B Following cholecystectomy, drainage from the T-tube is initially bloody and then turns to green brown. The drainage is measured as output. The amount of expected drainage will range from 500 to 1000 ml per day. The nurse would document the output.

A client is suspected of having hepatitis. Which diagnostic test results will assist in confirming this diagnosis? a.) Decreased ESR b.) Elevated serum bilirubin c.) Elevated hemoglobin d.) Elevated BUN

Answer: B Lab indicates of hepatitis include elevated liver enzyme levels, elevated serum bilirubin levels, elevated ESR, and leucopenia. An elevated BUN may indicate renal dysfunction. Hemoglobin levels are unrelated to this diagnosis.

The nurse is performing an abdominal assessment. The nurse performs which assessment technique first? a.) Auscultation b.) Inspection c.) Palpation d.) Percussion

Answer: B The appropriate sequence for abdominal exams is inspection, auscultation, percussion, and palpation. Auscultation is performed after inspection to ensure that the motility of the bowel and bowel sounds are not altered by percussion or palpation.

The nurse is providing discharge instructions to a client following gastrectomy. Which measure will the nurse instruct the client to follow to assist in preventing during syndrome? a.) Eat high carb foods b.) Limit the fluids taken with meals c.) Ambulate following a meal d.) Sit in a high Fowler's position during meals

Answer: B The nurse should instruct the client to decrease the amount of fluid taken at meals and to avoid high carb foods including fluids such as fruit nectars; to assume a flow Fowler's position during meals to lie down for 30 minutes after eating to delay gastric emptying; and to take anti-spasmotics as prescribed.

The hospitalized client with GERD is complaining of chest discomfort that feels like heartburn following a meal. After administering an ordered antacid, the nurse encourages the client to lie in which of the following positions? a.) Supine with HOB flat b.) On the stomach with the head flat c.) On the left side with the HOB elevated 30 degrees d.) On the right side with the HOB elevated 30 degrees

Answer: C The discomfort of reflux is aggravated by positions that compress the abdomen and the stomach. These include lying flat on the back or on the stomach after a meal or lying on the right side. The left side lying position with the head of the bed elevated is most likely to give relief to the client.

The nurse is assessing for stoma prolapse in a client with a colostomy. The nurse would observe which of the following if stoma prolapse occurred? a.) Sunken and hidden stoma b.) Dark and bluish colored stoma c.) Narrowed and flattened stoma d.) Protruding stoma

Answer: D A prolapsed stoma is one in which the bowel protrudes through the stoma. A stoma retraction is characterized by sinking of the stoma. Ischemia of the stoma would be associated with dusky or bluish color. A stomach with a narrowed opening at the level of the skin or fascia is said to be stenosed.

The client with ascites is scheduled for a paracentesis. The nurse is assisting with the physician in performing the procedure. Which of the following positions will the nurse assist the client to assume for this procedure? a.) Supine b.) Left side lying c.) Right side lying d.) Upright position

Answer: D An upright position allows the intestine to float posteriorly and helps prevent intestinal laceration during catheter insertion.

The nurse is reviewing the lab results in a client with cirrhosis and notes that the ammonia level is elevated. Which of the following diets would the nurse anticipate would most likely be prescribed for this client? a.) High carb b.) Moderate fat c.) High protein d.) Low protein

Answer: D Most of the ammonia in the body is found in the gastrointestinal tract. Protein provided by the diet is transported to the liver by the portal vein. The liver breaks down protein, and this results in the formation of ammonia. If the client has hepatic encephalopathy, a low protein diet would be prescribed.

The nurse is monitoring a client with a diagnosis of peptic ulcer. Which assessment finding would most likely indicate perforation of the ulcer? a.) Bradycardia b.) Numbness in the legs c.) Nausea and vomiting d.) A rigid, board-like abdomen

Answer: D Perforation is a surgical emergency and is characterized by sudden, sharp, intolerable severe pain beginning in the mid-epigastric area and spreading over the abdomen, which becomes rigid and board-like. Nausea and vomiting may occur. Tachycardia may occur as hypovolemic shock develops. Numbness in the legs is not associated finding.

The nurse is caring for a hospitalized client with a diagnosis of ulcerative colitis. Which finding if noted on assessment of the client, would the nurse report to the physician? a.) Bloody diarrhea b.) Hypotension c.) A hemoglobin level of 12 mg/dL d.) Rebound tenderness

Answer: D Rebound tenderness may indicate peritonitis. Bloody diarrhea is expected to occur in ulcerative colitis. Because of the blood loss, the client may be hypotensive and the hemoglobin level may be lower than normal. Signs of peritonitis must be reported to the physician.

The nurse has given post procedure instructions to a client who underwent colonoscopy. The nurse determines that the client needs further instructions if the client stated that? a.) Intake should be light at first and then progress to regular intake b.) It is normal to feel gassy or bloated after the procedure c.) The abdominal muscles may be tender from the procedure d.) It is all right to drive once the client has been home for an hour or so

Answer: D The client should not drive for several hours after discharge because the client would have received sedative meds during the procedure. Important decisions also should be delayed for at least 24 hours for the same reason. The client should resume intake slowly and progress as tolerated. The client may experience gas or abdominal tenderness for a short while after the procedure, and this is normal.

GoLYTELY is prescribed for the client scheduled for a colonoscopy. The client begins to experience diarrhea following administration of the solution. What action by the nurse is most appropriate? a.) Cancel the diagnostic test b.) Start an IV infusion c.) Administer an enema d.) Explain that diarrhea is expected

Answer: D The solution GoLYTELY is a bowel evacuant used to prepare a client for a colonoscopy by cleansing the bowel. The solution is expected to cause a mild diarrhea and will clear the bowel in 4 to 5 hours. Options A, B, and C are inappropriate.

The liver receives nutrient-rich blood from the gut, pancreas, spleen, and stomach from the A. hepatic artery. B. hepatic vein. C. portal vein. D. intralobular veins.

C. portal vein

Which of the following serum laboratory values is increased in acute pancreatitis? A. Bilirubin B. Amylase C. Lactate dehydrogenase D. Ammonia

B. Amylase

An enema is prescribed for a client with suspected appendicitis. Which action should the nurse take? A. Prepare 750mL of irrigating solution warmed to 100o F (37.8 o C) B. Question the physician about the order C. Provide privacy and explain he procedure to the client D. Assist the client to left lateral Sims' position

B. Enemas are contraindicated in an acute abdominal condition of unknown origin as well as after recent colon or rectal surgery or myocardial infarction, so questioning the physician about the order would be the correct thing to do. The other answers are correct only when enema administration is appropriate.

Which laboratory value is reflective of hepatocellular dysfunction? A. Elevated blood glucose level B. High levels of unconjugated bilirubin C. Decreased prothrombin time D. Decreased partial thromboplastin time

B. High levels of unconjugated bilirubin

Which classification of medication is used to reduce volume and concentration of gastric secretions? A. Antacids B. Histamine2 (H2) antagonists C. Gastric mucosal agents D. Gastric proton pump inhibitors

B. Histamine2 (H2) antagonists

Stimulation of the parasympathetic nervous system produces which of the following effects on the gastrointestinal system? A. Decreased peristalsis B. Increased secretion of watery saliva C. Decreased colonic activity D. Increased release of gastrointestinal hormones

B. Increased secretion of watery saliva

A 78-year-old patient was admitted to the critical care unit with cirrhosis of the liver. A hepatobiliary scan is performed to assess the progression of the patient's cirrhosis. Which of the following results is expected? A. Non-visualization B. Little or no uptake C. Increased uptake D. Normal uptake

B. Little or no uptake

Which layer of the large intestine consists of longitudinal and circular muscles? A. Serosa layer B. Muscularis layer C. Submucosa layer D. Mucosa layer

B. Muscularis layer

Which assessment technique is most useful in detecting abdominal pathologic conditions? A. Percussion B. Palpation C. Inspection D. Auscultation

B. Palpation

Which component of gastric juice is necessary for the breakdown of proteins? A. HCl B. Pepsin C. Intrinsic factor D. Potassium

B. Pepsin

Which of the following disorders is the leading cause of upper GI hemorrhage? A. Stress ulcers B. Peptic ulcers C. Nonspecific erosive gastritis D. Esophageal varices

B. Peptic ulcers

Identify anatomic structures that are found in the right lower quadrant. (Select all that apply.) A. Sigmoid colon B. Portion of the ascending colon C. Portion of the descending colon D. Distended bladder E. Enlarged uterus

B. Portion of the ascending colon D. Distended bladder E. Enlarged uterus

Which of the following interventions would you expect in the management of hepatic failure? (Select all that apply.) A. Benzodiazepines for agitation B. Pulse oximetry and serial arterial blood gas measurements C. Insulin drip for hyperglycemia and hyperkalemia D. Monitor electrolyte blood levels E. Assess for signs of cerebral edema

B. Pulse oximetry and serial arterial blood gas measurements D. Monitor electrolyte blood levels E. Assess for signs of cerebral edema

A patient is admitted with the diagnosis of acute pancreatitis. The nurse expects which of the following laboratory test results to be elevated? (Select all that apply.) A. Calcium B. Serum amylase Correct C. Serum glucose Correct D. Potassium E. WBC Correct F. Serum triglycerides Correct

B. Serum amylase C. Serum glucose E. WBC F. Serum triglycerides

Which organ lies obliquely beneath the cardiac sphincter and above the pyloric sphincter? A. Esophagus B. Stomach C. Duodenum D. Ileum

B. Stomach

Which finding would strongly indicate the possibility of cirrhosis? A. Dry skin B. Hepatomegaly C. Peripheral edema D. Pruritus

B. The client with cirrhosis has a lever that is enlarged, fibrotic, and nodular, which makes it palpable. The client may develop dry skin, pruritus, and peripheral edema, but these symptoms may have other causes.

A client with irritable bowel syndrome is being prepared for discharge. Which meal plan should the nurse give the client? A. Low fiber, low fat B. High fiber, low fat C. Low fiber, high fat D. High fiber, high fat

B. The client with irritable bowel syndrome needs to be on a diet that contains at least 25g of fiber per day. Fatty foods should be avoided because they may precipitate symptoms.

The pancreas has both exocrine and endocrine properties. Which of the following are produced by the exocrine function? (Select all that apply.) A. Gastrin B. Trypsin C. Amylase D. Lipase

B. Trypsin C. Amylase D. Lipase

Which of the following can be used as pharmacologic method of treatment in acute variceal hemorrhage? A. Histamine2 (H2) antagonists B. Vasopressin. C. Solu-Medrol D. Antacids

B. Vasopressin.

A patient with a 10-year history of alcoholism was admitted to the critical care unit with the diagnosis of acute pancreatitis. The patient is complaining of a pain in left upper quadrant. Using a 1- to 10-point pain scale, the patient states the current level is at an 8. To properly manage the patient's pain, the priority of nursing interventions is to A. administer antiemetics around the clock. B. administer analgesics around the clock. C. educate the patient and family on lifestyle changes. D. teach relaxation techniques.

B. administer analgesics around the clock.

A 78-year-old patient was admitted to the critical care unit with cirrhosis of the liver. Nursing management of the patient after the liver scan should include A. encouraging her to drink at least 500 mL of fluids after the procedure. B. keeping her flat in bed for 12 hours after the procedure. C. instructing her that she will need to keep flat and still for approximately 60 minutes during the procedure. D. administering cleansing enemas.

C. instructing her that she will need to keep flat and still for approximately 60 minutes during the procedure.

Bacteroides, Lactobacillus, and Clostridium organisms are commonly found in the: A. stomach. B. small intestine. C. large intestine. D. liver.

C. large intestine.

A client with a duodenal ulcer may exibit which finding on assessment? A. Hematemesis B. Malnourishment C. Melena (black tarry feces) D. Pain with eating

C. A client with a duodenal ulcer may have bleeding at the ulcer site which shows up as melena. The other findings are consistent with a gastric ulcer.

Which radiographic test would be used to identify pseudocysts of the pancreas? A. Plain film radiography B. Abdominal ultrasonography C. CT of abdomen D. MRI of the abdomen

C. CT of abdomen

A client with cirrhosis complains that his skin always feels itchy. The nurse recognizes that the itching is a result of which abnormality associated with cirrhosis? A. prolonged prothrombin time B. decreased protein level C. increased bilirubin level D. increased aspirate aminotransferase level

C. High bilirubin levels irritate peripheral nerves, causing an intense itching sensation. Itching isn't a symptom of prolonged prothrombin time, decreased protein levels, or increased aspartate aminotransferase levels.

When assessing the gastrointestinal system, the order of assessment progresses in which of the following? A. Inspection, palpation, percussion, auscultation B. Palpation, percussion, inspection, auscultation C. Inspection, auscultation, percussion, palpation D. Palpation, inspection, auscultation, percussion

C. Inspection, auscultation, percussion, palpation

Which of the following medications is/are given to help control ammonia levels in a patient with acute liver failure (ALF)? A. Insulin B. Vitamin K C. Lactulose D. Benzodiazepines

C. Lactulose

Which test would be used to assess blood vessels and blood flow in the body? A. CT scan B. MRI C. MRA D. MRCP

C. MRA

A client with Chron's disease is experiencing an exacerbation. Which instruction would be a priority in planning his care? A. increasing current weight B. encourage ambulation C. promoting bowel rest D. controlling rectal bleeding

C. Promoting bowel rest is the priority during an acute exacerbation. This is accomplished by decreasing activity and initially putting the client on NPO status. Weight loss may occur, but the priority is bowel rest. Rectal bleeding usually isn't expected in Chron's Disease.

The physician orders gastric lavage to control GI bleeding. The nurse has inserted a large-bore NG tube. What temperature and irrigating fluid would be used to obtain the best results? A. Warm NS or water B. Iced NS or water C. Room temperature NS or water D. Iced NS only

C. Room temperature NS or water

Roux-en-Y gastric bypass is A. a restrictive type of bariatric surgery. B. a malabsorptive type of bariatric surgery. C. a combination of restrictive and malabsorption types of bariatric surgery. D. standard operation for pancreatic cancer.

C. a combination of restrictive and malabsorption types of bariatric surgery.

The role of the liver in response to glycogen is to A. decrease blood sugar levels when insulin production is inadequate. B. synthesize amino acids. C. break down the glycogen to glucose to maintain blood sugar levels. D. produce amino acids.

C. break down the glycogen to glucose to maintain blood sugar levels.

Liver failure may affect the synthesis of fibrinogen, resulting in A. jaundice. B. fluid retention and ascites. C. delayed clotting. D. hepatomegaly.

C. delayed clotting.

A major side effect of vasopressin is A. constipation. B. diarrhea. C. dysrhythmias. D. bleeding.

C. dysrhythmias

The best diagnostic test for the determination of upper gastrointestinal bleeding is A. endoscopic retrograde cholangio-pancreatography (ERCP). B. colonoscopy. C. endoscopy. D. angiography.

C. endoscopy.

When the ileum is distended, the ileogastric reflex inhibits A. gastric absorption. B. absorption in the jejunum. C. gastric motility. D. ileum motility.

C. gastric motility.

The most common location for a male to have a hernia is A. femoral. B. umbilical. C. inguinal. D. abdominal.

C. inguinal.

A patient with a 10-year history of alcoholism was admitted to the critical care unit with the diagnosis of acute pancreatitis. The physiologic alteration that occurs in acute pancreatitis is A. uncontrolled hypoglycemia caused by an increased release of insulin. B. loss of storage capacity for senescent red blood cells. C. premature activation of inactive digestive enzymes, resulting in autodigestion. D. release of glycogen into the serum, resulting in hyperglycemia.

C. premature activation of inactive digestive enzymes, resulting in autodigestion.

Verification of feeding tube placement includes A. auscultation for position. B. aspiration of stomach contents. C. x-ray study for confirmation. D. gastric pH measurement.

C. x-ray study for confirmation.

When assessing the abdomen, how long must the nurse listen to the abdomen to be able to accurately chart that bowel sounds are absent? A. 30 seconds in each quadrant B. 1 minute C. 3 minutes D. 5 minutes

D. 5 minutes

Which lab result would be expected in a client with peritonitis? A. Partial thromboplastin time above 100 seconds B. Hemoglobin level below 10mg/dl C. Potassium level above 5.5mEq/L D. White blood cell count about 15,000

D. Because of infection, the client's WBC count will be elevated. A partial thromboplastin time longer than 100 seconds may suggest disseminated intravascular coagulation, a serious complication of septic shock. A hemoglobin level below 10mg/dl may occur from hemorrhage. A potassium level above 5.5mEq/L may suggest renal failure.

Surgical management of ulcerative colitis may be performed to treat which complication? A. Gastritis B. Bowel herniation C. Bowel outpouching D. Bowel perforation

D. Bowel perforation, obstruction, hemorrhage, and toxic megacolon are common complications of ulcerative colitis that may require surgery. Gastritis and herniation aren't associated with irritable bowel diseases and outpouching of the bowel wall is diverticulosis.

A client with pancreatitis may exhibit Cullen's sign on physical examination. Which symptom best describes Cullen's sign? A. Jaundiced sclera B. Pain that occurs with movement C. Bluish discoloration of the flank area D. Bluish discoloration of the periumbilical area

D. Cullen's sign is bluish discoloration of the periumbilical area from subcutaneous intraperitoneal hemorrhagic pancreatitis. Jaundiced sclera occurs with hepatitis. Pain with movement is a common finding with peritonitis. Turners sign is the bluish discoloration of the left flank area, which can be presented in peritonitis.

A client presents to the emergency department, reporting that he has been vomiting every 30-40 minutes for the past 8 hours. Frequent vomiting puts him at risk for which condition? A. Metabolic acidosis and hyperkalemia B. Metabolic acidosis and hypokalemia C. Metabolic alkalosis and hyperkalemia D. Metabolic alkalosis and hypokalemia

D. Gastric acid contains large amounts of potassium, chloride, and hydrogen ions. Excessive loss of these substances, such as from vomiting can lead to metabolic alkalosis and hypokalemia. It does not cause metabolic acidosis or hyperkalemia.

The patient at risk for GI hemorrhage should be monitored for which of the following signs and symptoms? A. Metabolic acidosis and hypovolemia B. Decreasing hemoglobin and hematocrit C. Hyperkalemia and hypernatremia D. Hematemesis and melena

D. Hematemesis and melena

Which position should the nurse direct a client with appendicitis to assume to help relieve pain? A. Prone B. Sitting C. Supine, stretched out D. Lying with legs drawn up

D. Lying still with the legs drawn up toward the chest helps relieve tension on the abdominal muscles, which helps to reduce the amount of discomfort felt. Lying flat or sitting may increase the amount of pain experienced.

When counseling a client in the ways to prevent cholecystitis, which guideline is most important? A. Eat a low-protein diet B. Eat a low-fat, low-cholesterol diet C. Limit exercise to 10 minutes a day D. Keep weight proportional to height

D. Obesity is a known cause of cholecystitis, and maintaining a recommended weight will help to protect against cholecystitis. Excessive dietary intake of cholesterol is associated with the development of gallstones in many people. Dietary protein isn't implicated in cholecystitis. Liquid protein and low calorie diets (with rapid weight loss of more than 5lbs. per week) are implicated in the cause of some cases of cholecystitis. Regular exercise may help to reduce weight and improve fat metabolism. Reducing stress may reduce bile production, which may also indirectly decrease the chances of developing cholecystitis.

Steatorrhea is determined by which laboratory study? A. Gastric acid stimulation B. Urea breath test C. Culture and sensitivity D. Stool studies

D. Stool studies

If a gastric ulcer perforated, which action should be included in the management of the client? A. Removal of the nasogastric tube B. Antacid administration C. H2-receptor antagonist administration D. Fluid and electrolyte replacement

D. The client should be treated with antibiotics as well as fluid, electrolyte, an blood replacement. NG tube suction should also be performed to prevent further spillage of stomach contents into the perineal cavity. Antacids and H2 receptor antagonists aren't helpful in this situation.

Nursing management of the patient undergoing an angiogram includes A. keeping the patient flat for 24 hours. B. inserting a nasogastric tube before the procedure. C. administering tap water enemas until clear. D. checking the patient's pulse distal to the injection site every 15 minutes.

D. checking the patient's pulse distal to the injection site every 15 minutes.

A patient has a Salem sump to lower intermittent suction. Nursing interventions include A. prevention of esophageal erosion and stricture. B. prevention of dry mouth. C. prevention of ulceration of the nares. D. irrigating the tube every 4 hours or as ordered by the health care provider.

D. irrigating the tube every 4 hours or as ordered by the health care provider.

A nursing priority for a patient with GI hemorrhage is A. positioning the patient in a high-Fowler position. B. airway protection. C. irrigating the nasogastric tube with iced saline. D. maintaining venous access so that fluids and blood can be administered.

D. maintaining venous access so that fluids and blood can be administered.

The innermost layer of the stomach that allows for expansion and secretion of gastric juice is the A. serosa. B. muscularis. C. submucosa. D. mucosa.

D. mucosa.

Food is propelled through the esophagus by A. gravity. B. salivary fluids. C. cardiac sphincter suction. D. peristalsis.

D. peristalsis.

The distal end of the stomach connecting the antrum to the duodenum is known as the A. fundus. B. body. C. cardiac orifice. D. pylorus.

D. pylorus.