CH 21: Digestive, gastrointestinal, and metabolic function
An older adult client is admitted to an acute care facility for treatment of an acute flare-up of a chronic gastrointestinal condition. In addition to assessing the client for complications of the current illness, the nurse monitors for age-related changes in the gastrointestinal tract. Which age-related change increases the risk of anemia? a) Atrophy of the gastric mucosa B) Decrease in intestinal flora C) Increase in bile secretion D) Dulling of nerve impulses
A) Atrophy of the gastric mucosa
A health care provider plans to send a client home with supplies to complete a hemoccult test on all stools for 3 days. During the client education, the nurse informs the client to avoid which medication while collecting stool for the test? A) ibuprofen B)acetaminophen C)docusate sodium D) ciprofloxacin
A) Ibuprofen Fecal occult blood testing (FOBT) is one of the most commonly performed stool tests. FOBT can be done at the bedside, in the physician's office, or at home. The client is taught to avoid aspirin, red meats, nonsteroidal antiinflammatory agents, and horseradish for 72 hours prior to the examination. Ibuprofen (Advil) is an anti-inflammatory drug and should be avoided with FOBT
When bowel sounds are heard about every 15 seconds, the nurse would record that the bowel sounds are A) normal. B)hypoactive. C)sluggish. D)absent.
A) Normal
Which of the following is an enzyme secreted by the gastric mucosa? A)Pepsin B)Trypsin C)Ptyalin D)Bile
A) Pepsin Pepsin is secreted by the gastric mucosa. Trypsin is secreted by the pancreas. The salivary glands secrete ptyalin. The liver and gallbladder secrete bile.
A client is scheduled to have an endoscopic retrograde cholangiopancreatography. Which structures are visualized during this procedure? A) common bile duct, pancreatic duct, and biliary tree B)common bile duct, portal vein, and gallbladder C)portal vein, pancreatic duct, and biliary tree portal D)vein, gallbladder, and pancreatic duct
A) common bile duct, pancreatic duct, and biliary tree
Swallowing is regulated by which area of the central nervous system (CNS)? a)Medulla oblongata B) Pons C) Cerebellum D) Hypothalamus
A) medulla oblongata Swallowing begins as a voluntary act that is regulated by the swallowing center in the medulla oblongata of the CNS. The act of swallowing requires the innervations of five cranial nerves (CNs), especially CN V, VII, IX, X, and XII. Swallowing is not regulated by the pons, cerebellum, or hypothalamus.
Which diagnostic produces images of the body by detecting the radiation emitted from radioactive substances? A)Positron emission tomography (PET) B) Computed tomography (CT) C)Magnetic resonance imaging (MRI) D) Fibroscopy
A) positron emission tomography PET produces images of the body by detecting the radiation emitted from radioactive substances. CT provides cross-sectional images of abdominal organs and structures. MRI uses magnetic fields and radio waves to produce an image of the area being studied. Fibroscopy of the upper GI tract allows direct visualization of the esophageal, gastric, and duodenal mucosa through a lighted endoscope
The nurse is caring for a geriatric client experiencing diarrhea. When teaching about the site in the body where water and electrolytes are absorbed, the nurse is most correct to instruct on which location? A) The small bowel B)The stomach C) The large bowel D)The cecum
A) the small bowel
A patient with gallbladder disease was being treated for blockage of the common bile duct due to a large gallstone. The nurse recognizes which of the following as an abnormal laboratory result? A) Total bilirubin level of 1.5 mg/dL B)Alkaline phosphatase level of 60 mg/dL C) Albumin level of 4.2 g/dL D) Aspirate aminotransferase level of 25 U/L
A) total bilirubin level of 1.5 mg/dl Gallstones form when the amount of bilirubin or cholesterol is high. As the stones mix with bile, they block the secretion of bile from the gallbladder. The normal total bilirubin level is 0 to 0.9 mg/dL. The other results are within normal ranges.
A patient has come into the radiology department to undergo testing for possible polyps. What diagnostic test may be done to diagnose this type of lesion? A)Gastric analysis B)Barium enema C)Barium swallow D)Gastroscopy
B) Barium enema The purpose of the barium enema is to detect the presence of polyps, tumors, and other lesions of the large intestine and to demonstrate any abnormal anatomy or malfunction of the bowel.
The nurse is answering questions regarding fecal matter for a client who is scheduled for a colon resection. The client is asking questions regarding the composition of the fecal matter and when it becomes a formed mass. The nurse is most correct to state at which location? A) Ileum B) Cecum C) Sigmoid colon D) Duodenum
C) Sigmoid colon Water is reabsorbed by means of diffusion across the intestinal membrane as the contents move through the colon. By the time the mixture reaches the descending and sigmoid colon, the portion of the bowel adjacent to the rectum, it is a formed mass. The ileum and duodenum are located in the small intestine. The cecum is located at the beginning of the large intestine.
An individual has had a snack consisting of half a bagel with cream cheese, lox (smoked salmon), red onions, and capers. Stimulation of the person's gastrointestinal tract has resulted in the secretion of numerous digestive enzymes into the small intestine, including trypsin. What component of this person's snack will be primarily digested by the action of trypsin? a)The bagel b) The lox c)The cream cheese d)The red onions and capers
b)The lox sliced salmon trypsin digest proteins
Cystic fibrosis, a genetic disorder characterized by pulmonary and pancreatic dysfunction, usually appears in young children but can also affect adults. If the pancreas was functioning correctly, where would the bile and pancreatic enzymes enter the GI system? A)duodenum B)jejunum C) ileum D) cecum
A) duodenum The duodenum, which is approximately 10 inches long, is the first region of the small intestine and the site where bile and pancreatic enzymes enter.
During a colonoscopy with moderate sedation, the patient groans with obvious discomfort and begins bleeding from the rectum. The patient is diaphoretic and has an increase in abdominal girth from distention. What complication of this procedure is the nurse aware may be occurring? A) Infection B) Bowel perforation C) Colonic polyp D) Rectal fissure
B) Bowel perforation
A client with diabetes begins to have digestive problems and is told by the physician that they are a complication of the diabetes. Which of the following explanations from the nurse is most accurate? A)The nerve fibers of the intestinal lining are experiencing neuropathy. B)The pancreas secretes digestive enzymes. C)Elevated glucose levels cause bacteria overgrowth in the large intestine. D)Insulin has an adverse effect of constipation.
B)The pancreas secretes digestive enzymes. Explanation: While the pancreas has the well-known function of secreting insulin, it also secretes digestive enzymes. These enzymes include trypsin, amylase, and lipase. If the secretion of these enzymes are affected by a diseased pancreas as foundi with diabetes, the digestive functioning may be impaired.
The nurse is teaching the client about the upcoming endoscopic retrograde cholangiopancreatography (ERCP). Although the nurse instructs on several pertinent points of care, which is emphasized? A)The client will fast prior to the procedure. B) The client will have moderate sedation. C)The client will receive antibiotics before and after the procedure. D) The client will change positions frequently throughout the procedure.
D) The client will change positions frequently throughout the procedure. It is essential that the client understands that cooperation is essential in changing positions throughout the procedure to prevent injury of the gastrointestinal tract. All of the other options are also correct but do not carry a risk for injury if not completed.
