CH 44 - GI ASSESSMENT

A nursing instructor tells the class that review of oral hygiene is an important component during assessment of the gastrointestinal system. One of the students questions this statement. Which of the following explanations from the nurse educator is most appropriate?

"Injury to oral mucosa or tooth decay can lead to difficulty in chewing food."

A client is scheduled for several diagnostic tests to evaluate her gastrointestinal function. After teaching the client about these tests, the nurse determines that the client has understood the teaching when she identifies which test as not requiring the use of a contrast medium?

Colonoscopy

The nurse is assisting the physician with a gastric acid stimulation test for a patient. What medication should the nurse prepare to administer subcutaneously to stimulate gastric secretions?

Pentagastrin Pentagastrin is a synthetic polypeptide that has effects like gastrin when given parenterally. It stimulates the secretion of gastric acid, pepsin, and intrinsic factor,

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?

Permit the client to drink only clear liquids.

A patient tells the nurse that his stool was colored yellow. The nurse assesses for which of the following?

Recent foods ingestedThe nurse should assess for recent foods that the patient ingested, as ingestion of senna can cause the stool to turn yellow. Ingestion of bismuth can turn the stool black and, when occult blood is present, the stool can appear to be tarry black

A client frequently reports constipation. The nurse asks the client about his bowel habits. Which of the following would be the most likely contributing factor related to constipation?

Resisting the urge to defecate several times a day

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?

Sigmoid colon

The nurse is preparing to examine the abdomen of a client complaining of a change in his bowel pattern. The nurse would place the client in which position?

Supine with knees flexed

A nurse is doing a physical assessment on a client with a GI disorder. She is about to assess the client's abdomen. Which position will the nurse most likely ask the client to assume when performing this examination?

Supine with knees flexed slightly

Which patient teaching component is important for the nurse to communicate regarding pain management prior to or during diagnostic testing for a disorder of the GI system?

The patient should inform the test personnel if he or she experiences pressure or cramping during the instillation of test fluids.

Which of the following is an age-related change of the GI system?

Weakened gag reflex

Which of the following is considered the gold standard for the diagnosis of liver disease?

Biopsy

A nurse is assessing a client who complains of abdominal pain, nausea, and diarrhea. When examining the client's abdomen, which sequence should the nurse use?

Inspection, auscultation, percussion, and palpation

Which is the recommended order for performing an abdominal examination?

Inspection, auscultation, percussion, palpation

A client is diagnosed with megaloblastic anemia caused by vitamin B12 deficiency. The physician begins the client on cyanocobalamin (Betalin-12), 100 mcg I.M. daily. Which substance influences vitamin B12 absorption?

Intrinsic factor

Which of the following terms describes a gastric secretion that combines with vitamin B12 so that it can be absorbed?

Intrinsic factor

A client confides in the nurse that she cannot even go to the grocery store anymore because she is frequently passing gas. What may the nurse suggest to this client?

Keep a food diary to monitor what foods may be causing this condition.

The nurse is caring for a client recovering from an esophagogastroduodenoscopy (EGD). Which of the following client symptoms would require further nursing assessment?

Abdominal distention

A 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:

"Has your partner had recent forceful vomiting?"

During Mrs. Feldman's physical assessment, she informs you that her stools have been red lately. Which of the following will the nurse include in her assessment questioning?

"Have you been eating beets?"

The nurse is caring for a man who has experienced a spinal cord injury. Throughout his recovery, the client expects to gain control of his bowels. The nurse's best response to this client would be which of the following?

"Having a bowel movement is a spinal reflex requiring intact nerve fibers. Yours are not intact."

When preparing a client for magnetic resonance imaging (MRI) of the abdomen, which statement would indicate the need to notify the physician?

"I really don't like to be in small, enclosed spaces."

A nurse is teaching a client what to expect following a barium enema. Which client statement indicates a need for further teaching?

"I should limit my fiber intake for 1 to 2 weeks following the procedure."

A home care nurse is caring for a client with complaints of epigastric discomfort who is scheduled for a barium swallow. Which statement by the client indicates an understanding of the test?

"I'll avoid eating or drinking anything 6 to 8 hours before the test."

A patient asks the nurse why the physician ordered the blood test carcinoembryonic antigen (CEA). The nurse answers:

"It indicates if a cancer is present."

The nurse is talking with a client who is scheduled for a computed tomography (CT) colonography. Which client statement would indicate to the nurse that the client needs additional teaching about this procedure?

"My doctor will be able to remove any polyps he finds."

Upon hearing that his small intestine lining has thinned, an elderly client asks, "What can this lead to?" The nurse would most likely respond with which of the following comments?

"You may frequently experience constipation."

A client who had a colonoscopy with removal of a polyp is being prepared for discharge. Which of the following would the nurse include in the discharge instructions?

"You might feel some cramping and gas but these usually go away in about a day."

A client presented with gastrointestinal bleeding 2 days ago and continues to have problems. The physician has ordered a visualization of the small intestine via a capsule endoscopy. Which of the following will the nurse include in the client education about this procedure?

"You will need to swallow a capsule."

Which of the following is the primary function of the small intestine?

Absorption

Suspected ulceration of the stomach necessitates an esophagogastroduodenoscopy. The nurse will implement which of the following for this procedure? Select all that apply.

Administer the ordered sedative before the procedure. Assess for the client's gag reflex after the procedure. Monitor the client's pulse oximetry during and after the procedure.

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?

Black

A nurse is assessing a client who underwent esophagogastroduodenoscopy (EGD) for postoperative complications. Which sign or symptom is a complication of this procedure?

Bloody secretions

The nurse is a preparing a patient for a barium enema. The nurse should place the patient on which of the following prior to the procedure?

Clear liquids day before

A client is scheduled for an esophagogastroduodenoscopy (EGD) to detect lesions in the gastrointestinal tract. The nurse would observe for which of the following while assessing the client during the procedure?

Client's tolerance for pain and discomfort

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?

Duodenum

A nurse is preparing a client with Crohn's disease for a barium enema. What should the nurse do the day before the test?

Encourage plenty of fluids.

Which of the following should be included as part of the preprocedure teaching for a patient scheduled for a proctosigmoidoscopy involving the lower GI structures?

Follow the dietary and fluid restrictions and bowel preparation procedures

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?

Further investigate the initial complaint

Which of the following is the major carbohydrate that tissue cells use as fuel?

Glucose

After 20 seconds of auscultating for bowel sounds on a client recovering from abdominal surgery, the nurse hears nothing. Which of the following should the nurse do based on the assessment findings?

Listen longer for the sounds.

A client calls the nurse into her room and admits to peeking at her chart. She saw that she has borborygmi and is concerned. Which of the following explanations will the nurse give about this term?

Loud, prolonged stomach growling

From the following profiles of clients, which client would be most likely to undergo the diagnostic test of cholecystography?

Mark, suspected of having stones in the gallbladder

Swallowing is regulated by which area of the central nervous system (CNS)?

Medulla oblongata

A client presents to the emergency department, reporting that he has been vomiting every 30 to 40 minutes for the past 8 hours. Frequent vomiting puts this client at risk for which imbalances?

Metabolic alkalosis and hypokalemia

Which of the following would be most important to ensure that a client does not retain any barium after a barium swallow?

Monitoring the stool passage and its color.

What part of the GI tract begins the digestion of food?

Mouth

The nurse is assessing a 50-year-old, dark-skinned African American man and has noted that he appears jaundice. Most likely, the nurse made this observation by assessing which part of his body?

Mucous membranes

Which of the following is an enzyme secreted by the gastric mucosa?

Pepsin

Which of the following is an enzyme that begins the digestion of starches?

Ptyalin

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?

Pyloric sphincter

Following ingestion of carrots or beets, the nurse would expect which alteration in stool color?

Red

A nurse is providing postprocedure instructions for a client who had an esophagogastroduodenoscopy. The nurse should perform which action?

Review the instructions with the person accompanying the client home.

The nurse is providing care to a client who has had a percutaneous liver biopsy. The nurse would monitor the client for which of the following?

Signs and symptoms of bleeding

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?

The ultrasonography should be scheduled before the GI procedure.

The patient is describing to the nurse a test that he underwent to detect a small bowel obstruction prior to admission to the hospital. The patient states that the test involved insertion of a tube through the nose and lasted over 6 hours. The nurse documents the name of the test as which of the following?

Upper GI enteroclysis

When bowel sounds are heard about every 15 seconds, the nurse would record that the bowel sounds are

normal

Which of the following digestive enzymes aids in the digesting of starch?

Amylase

The nurse is working on a general medical unit. A client is scheduled for an upper gastrointestinal series. Upon return to the nursing unit, what does the nurse identify as the client goal?

Increase the amount of fluids

A nurse assesses the abdomen of a newly admitted client. Which finding would necessitate further investigation?

Asymmetrical upper quadrants

A client, age 82, is admitted to an acute care facility for treatment of an acute flare-up of a chronic GI condition. In addition to assessing the client for complications of the current illness, the nurse monitors for age-related changes in the GI tract. Which age-related change increases the risk of anemia?

Atrophy of the gastric mucosa

Gastrin has which of the following effects on gastrointestinal (GI) motility?

Increased motility of the stomach

During assessment of a patient complaining of dyspepsia, the nurse is aware that abdominal pain associated with indigestion is usually which of the following?

Described as cramping or burning Abdominal pain associated with indigestion (dyspepsia) is described as burning, cramping, and bloating. Also, there is abdominal fullness and heartburn. Fatty foods cause the most discomfort, as do coarse vegetables and highly seasoned foods. The pain is in the upper left quadrant.

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?

Hamburger and French fries

The nurse is assessing bowel sounds and hears one to two bowel sounds in 2 minutes. The nurse documents the bowel sounds as being which of the following?

Hypoactive

The nurse preparing a patient for a colostomy is preparing to administer the lavage solution. The nurse stops and notifies the physician when the nurse notes that the patient has which of the following?

Inflammatory bowel disease

Which diagnostic produces images of the body by detecting the radiation emitted from radioactive substances?

Positron emission tomography (PET)

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?

Serum antibodies for H. pylori

Using gastric analysis, the nurse would expect that a patient diagnosed with peptic ulcer would secrete which of the following?

Small amount of acid

After 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 of the following structures as possibly being affected?

Stomach

The nurse is assisting the physician in a percutaneous liver biopsy. In which position would the nurse assist the client to assume?

Supine position