CH 38 Assessment of Digestive and Gastrointestinal Function
The major carbohydrate that tissue cells use as fuel is A) glucose. B) proteins. C) fats. D) chyme.
A
Which neuroregulator increase gastric acid secretion? A) secretin B) acetylcholine C) norepinephrine D) gastrin
B
A client tells the nurse that the stool was colored yellow. The nurse assesses the client for A) pilonidal cyst. B) ingestion of bismuth. C) recent foods ingested. D) occult blood.
C
The nurse is preparing the client for an assessment of the abdomen. What should the nurse complete prior to this assessment? A) Prepare for a prostate examination. B) Assist the client to a Fowler's position. C) Ask the client to empty the bladder. D) Dim the lights for privacy.
C
A client reports a history of bleeding hemorrhoids to the nurse. Which observation supports the client's statement? A) Dark red stool B) Black tarry stool C) Hard, dry stool D) Blood streaks on stool
D
The nurse is assessing a client's rectum, perianal area, and anus. During assessment the nurse notes an anal fissure. Which intervention would the nurse implement? Select all that apply. A) Topical analgesics B) Hemorrhoid cream C) Lateral body positioning D) Sitz bath E) Acetaminophen suppository
A,C, and D
It is important for a nurse to have an understanding of the major digestive enzymes and their actions. Choose the gastric mucosa secretion that plays an important role in the digestion of triglycerides. A) Trypsin B) Steapsin C) Ptyalin D) Amylase
B
The nurse is caring for a client who is having gastrointestinal symptoms. The nurse knows that a scintigraphy is used as a diagnostic tool for what purpose? A) Validate the presence of a tumor. B) Locate the source of internal bleeding. C) Determine areas of gastric inflammation. D) Analyze small bowel obstructions.
B
A client is diagnosed with megaloblastic anemia caused by vitamin B12 deficiency. The health care provider begins the client on cyanocobalamin (Betalin-12), 100 mcg I.M. daily. Which substance influences vitamin B12 absorption? A) Liver enzyme B) Hydrochloric acid C) Intrinsic factor D) Histamine
C
A client is scheduled for an ultrasound of the abdomen. Which statement indicates that teaching provided to the client to prepare for the test was effective? A) "I will take an over-the-counter enema before the test." B) "I will take medications to reduce gastric acid before the test." C) "I will not eat or drink for 8 to 12 hours before the test." D) "I will ingest a clear liquid diet for 3 days before the test."
C
A group of students are studying for an examination on the gastrointestinal (GI) system and are reviewing the structures of the esophagus and stomach. The students demonstrate understanding of the material when they identify which of the following as the opening between the stomach and duodenum? A) Ileocecal valve B) Hypopharyngeal sphincter C) Pyloric sphincter D) Cardiac sphincter
C
A home care nurse is caring for a client with reports of epigastric discomfort who is scheduled for a barium swallow. Which statement by the client indicates an understanding of the test? A) "I'll drink full liquids the day before the test." B) "There is no need for special preparation before the test." C) "I'll avoid eating or drinking anything 6 to 8 hours before the test." D) "I'll take a laxative to clear my bowels before the test."
C
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) Increase in bile secretion B) Decrease in intestinal flora C) Atrophy of the gastric mucosa D) Dulling of nerve impulses
C
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) jejunum B) ileum C) duodenum D) cecum
C
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) Colonic polyp B) Infection C) Bowel perforation D) Rectal fissure
C
The nurse is assessing a client who is stating gastrointestinal upset and a feeling of bloating. Which type of meal would the nurse anticipate causing these types of symptoms? A) Salmon with cheddar mashed potatoes B) Grilled chicken on a spinach salad C) Hamburger and French fries D) Steamed rice with pork and broccoli
C
The nurse is preparing to examine the abdomen of a client who reports a change in bowel pattern. The nurse would place the client in which position? A) Lithotomy B) Knee-chest C) Supine with knees flexed D) Left Sim's lateral
C
What part of the GI tract begins the digestion of food? A) Duodenum B) Esophagus C) Mouth D) Stomach
C
Which response is a parasympathetic response in the GI tract? A) decreased motility B) decreased gastric secretion C) increased peristalsis D) blood vessel constriction
C
While palpating a client's right upper quadrant (RUQ), the nurse would expect to find which structure? A) Appendix B) Sigmoid colon C) Liver D) Spleen
C
A client is scheduled for a flexible sigmoidoscopy. Which preparation will the nurse instruct the client to complete before the procedure? A) Avoid aspirin products a week before the procedure. B) Take oral laxatives for 2 days before the procedure. C) Maintain liquid diet for 3 days before the procedure. D) Administer tap water enemas until liquid from rectum is clear.
D
A client is to have an upper GI procedure with barium ingestion and abdominal ultrasonography. While scheduling these diagnostic tests, the nurse must consider which factor? A) The client may eat a light meal before either test. B) Both tests need to be done before breakfast. C) The upper GI should be scheduled before the ultrasonography. D) The ultrasonography should be scheduled before the GI procedure.
D
A client receives a local anesthetic to suppress the gag reflex for a diagnostic procedure of the upper GI tract. The nurse determines which nursing intervention is advised for this client? A) monitor for cramping or abdominal distention B) measure fluid output for at least 24 hours after the procedure C) monitor for any breathing-related disorder or discomforts D) do not give any food and fluids until the gag reflex returns
D
A client with a gastrointestinal condition asks why the mouth needs to be examined. Which response will the nurse make? A) "It is a body part that is least examined." B) "It is a part of the assessment of every client." C) "Your problem is in your mouth and not your abdomen." D) "Changes in the mouth can help explain why your condition is occurring."
D
A nurse is preparing a client with Crohn's disease for a barium enema. What should the nurse do the day before the test? A) Serve the client his usual diet. B) Serve dairy products. C) Order a high-fiber diet. D) Encourage plenty of fluids.
D
Which of the following is an enzyme secreted by the gastric mucosa? A) Bile B) Ptyalin C) Trypsin D) Pepsin
D
he nurse is assessing the abdomen of the client with an undiagnosed disorder. In which sequence would the nurse conduct the abdominal assessment? Use all options. 1) Auscultation 2) Palpation 3) Inspection 4) Percussion
3, 1, 4, 2
A client is scheduled for several diagnostic tests to evaluate gastrointestinal function. After teaching the client about these tests, the nurse determines that the client has understood the teaching when the client identifies which test as not requiring the use of a contrast medium? A) Colonoscopy B) Computer tomography C) Upper GI series D) Small bowel series
A
A nurse is giving a client barium swallow test. What is the most important assessment a nurse would make to ensure that a client does not retain any barium after a barium swallow? A) Monitoring the stool passage and its color. B) Observing the color of urine. C) Monitoring the volume of urine. D) Placing any stool passed in a specific preservative.
A
The nurse asks a client to point to where pain is felt. The client asks why this is important. What is the nurse's best response? A) "Often the area of pain is referred from another area." B) "If the health care provider massages over the exact painful area, the pain will disappear." C) "This determines the pain medication to be ordered." D) "The area may determine the severity of the pain."
A
The nurse auscultates the abdomen to assess bowel sounds. She documents five to six sounds heard in less than 30 seconds. How does the nurse document the bowel sounds? A) Hyperactive B) Normal C) Hypoactive D) Borborygmi
A
The nurse cares for a client after an endoscopic examination and prepares the client for discharge. The nurse includes which instruction? A) Resume regular diet. B) Avoid driving for 24 hours. C) Continue a clear liquid diet. D) Increase fluid intake.
A
The nurse determines which is a true statement regarding older clients, considering the age-related effects on the gastrointestinal (GI) system? A) They usually have less control of the rectal sphincter. B) They tend to have increased muscle tone and mass. C) They have no awareness of the filling reflex. D) They tend to have higher physiologic reserves to compensate for fluid loss.
A
The nurse is assisting the health care provider with a gastric acid stimulation test for a client. What medication should the nurse prepare to administer subcutaneously to stimulate gastric secretions? A) Pentagastrin B) Acetylcysteine C) Atropine D) Glycopyrronium bromide
A
The nurse is caring for a client with a gastrointestinal condition. For which reason will the nurse question the client being scheduled for a barium enema? A) Frank blood in stool B) Possible rectal tumor C) History of polyps D) Chronic constipation
A
The nurse prepares to administer the lavage solution to a client having a colonoscopy completed. The nurse stops and notifies the physician when noting that the client has which condition? A) inflammatory bowel disease B) pulmonary hypertension C) congestive heart failure D) chronic obstructive pulmonary disease
A
The nurse provides client education to a client about to undergo hydrogen breath testing. The nurse evaluates that the client understands the test when the client makes which statement? A) "I should avoid antibiotics for 1 month before the test." B) "The test will detect the presence of oral cancer." C) "The test will detect the presence of staph." D) "First, I will drink a cherry flavored liquid."
A
Which term describes a gastric secretion that combines with vitamin B12 so that it can be absorbed? A) intrinsic factor B) amylase C) pepsin D) trypsin
A
The nurse is providing instructions to a client scheduled for a gastroscopy. What should the nurse be sure to include in the instructions? Select all that apply. A) After gastroscopy, the client cannot eat or drink until the gag reflex returns (1 to 2 hours). B) The health care provider will be able to determine if there is a presence of bowel disease. C) The client must have bowel cleansing prior to the procedure. D) The client must fast for 8 hours before the examination. E) The throat will be sprayed with a local anesthetic.
A, D, and E
A client asks the nurse why the physician ordered the blood test carcinoembryonic antigen (CEA). The nurse answers: A) "It detects a protein normally found in the blood." B) "It indicates if a cancer is present." C) "It determines functionality of the liver." D) "It tells the physician what type of cancer is present."
B
A client is scheduled for an upper gastrointestinal barium study. Which teaching will the nurse provide for the client to prepare for this diagnostic test? A) Withhold oral medications for 24 hours before the test. B) Ingest nothing by mouth after midnight. C) Avoid products containing aspirin for a week before the test. D) Eat a clear liquid breakfast before the test.
B
A client undergoing a diagnostic examination for gastrointestinal disorder was given polyethylene glycol/electrolyte solution as a part of the test preparation. Which of the following measures should the nurse take once the solution is administered? A) Allow the client to ingest fat-free meal. B) Permit the client to drink only clear liquids. C) Instruct the client to have low-residue meals. D) Provide saline gargles to the client.
B
A client with abdominal pain is scheduled for a CT scan of the abdomen with contrast. Which assessment will the nurse complete before transporting the client for the diagnostic test? A) Last use of an oral laxative B) History of allergies C) Current list of prescribed medications D) Presence of a cochlear implant
B
A few hours after eating hot and spicy chicken wings, a client presents with lower chest pain. He wonders if he is having a heart attack. How should the nurse proceed first? A) Explain that fatty foods can mimic chest pain. B) Further investigate the initial complaint. C) Administer an over-the-counter antacid tablet. D) Call for an immediate electrocardiogram.
B
The client describes a test previously completed to detect a small bowel obstruction prior to admission to the hospital. The client states that the test involved insertion of a tube through the nose and lasted over 6 hours. The nurse determines which test name should be documented? A) positron emission tomography B) upper GI enteroclysis C) abdominal ultrasound D) magnetic resonance imaging
B
The instructor has just finished teaching a group of students about the various organs of the upper gastrointestinal tract and possible disorders. The instructor determines that the teaching was successful when the students identify which structure as possibly being affected? A) Liver B) Stomach C) Ileum D) Large Intestine
B
The nurse inspects a client's tongue. Which finding would the nurse evaluate as an indication of potential oral cancer? A) V formation on dorsum of tongue B) red plaque on undersurface of tongue C) large, vallate papillae on dorsum of tongue D) thin, white coating on dorsum of tongue
B
The nurse is assisting the health care provider with a colonoscopy for a client with rectal bleeding. The health care provider requests the nurse to administer glucagon during the procedure. Why is the nurse administering this medication during the procedure? A) To reduce air accumulation in the colon. B) To relax colonic musculature and reduce spasm. C) To relieve anxiety during the procedure for moderate sedation. D) The client is probably hypoglycemic and requires the glucagon.
B
The nurse prepares a client for a barium enema. The nurse should place the client on which diet prior to the procedure? A) soft diet 1 day prior B) clear liquids day before C) high-fiber diet 1 to 2 days prior D) nothing by mouth (NPO) 2 days prior
B
The nurse recognizes which change of the GI system is an age-related change? A) hypertrophy of the small intestine B) weakened gag reflex C) increased mucus secretion D) increased motility
B
What would the nurse recognize as preventing a client from being able to take a fecal occult blood test (FOBT)? A) The client took an ibuprofen tablet this morning B) The client has hemorrhoidal bleeding C) The client regularly takes aspirin D) The client had a hamburger for dinner the night before
B
When assisting with preparing a client scheduled for a barium swallow, which of the following would be appropriate to include? A) Take three cleansing enemas before the procedure. B) Avoid smoking for at least 12 to 24 hours before the procedure. C) Take vitamin K before the procedure. D) Avoid the intake of red meat before the procedure.
B
When bowel sounds are heard about every 15 seconds, the nurse would record that the bowel sounds are A) sluggish. B) normal. C) absent. D) hypoactive.
B
A nurse is aware that both the sympathetic and parasympathetic portions of the autonomic nervous system affect GI motility. What are the actions of the sympathetic nervous system? Select all that apply. A) Increases secretary activities B) Creates an inhibitory effect on the GI tract C) Causes blood vessel constriction D) Relaxes the sphincters E) Decreases gastric motility
B, C, and E
The nurse is to obtain a stool specimen from a client who reported that he is taking iron supplements. The nurse would expect the stool to be which color? A) Dark brown B) Green C) Black D) Red
C
Which nursing instruction is correct to provide the client following a barium enema? A) An enema will be used to clear the bowel. B) The client will maintain a low residue diet. C) The stools may be a white or clay colored. D) Sips of fluid may be increased if tolerated.
C
Which of the following digestive enzymes aids in the digesting of starch? A) Trypsin B) Lipase C) Amylase D) Bile
C
A client is scheduled to have an endoscopic retrograde cholangiopancreatography. Which structures are visualized during this procedure? A) common bile duct, portal vein, and gallbladder B) portal vein, gallbladder, and pancreatic duct C) portal vein, pancreatic duct, and biliary tree D) common bile duct, pancreatic duct, and biliary tree
D
Swallowing is regulated by which area of the central nervous system (CNS)? A) Pons B) Hypothalamus C) Cerebellum D) Medulla oblongata
D
The nurse is instructing the client who was newly diagnosed with peptic ulcers. Which of the following diagnostic studies would the nurse anticipate reviewing with the client? A) A complete blood count including differential B) A sigmoidoscopy C) Gastric analysis D) Serum antibodies for H. pylori
D
When preparing a client for magnetic resonance imaging (MRI) of the abdomen, which statement would indicate the need to notify the health care provider? A) "I haven't had anything to eat or drink since midnight last night." B) "I brought earphones to shut out the loud noise." C) "I left all my jewelry and my watch at home." D) "I really don't like to be in small, enclosed spaces."
D
Which of the following is the most definitive means of assessing for liver disease? A) Ultrasonography B) Paracentesis C) Cholecystography D) Biopsy
D
Which procedure is performed to examine and visualize the lumen of the small bowel? A) peritoneoscopy B) panendoscopy C) colonoscopy D) small bowel enteroscopy
D
