Gastrointestinal System

A nurse is performing discharge teaching about ostomy care while at home for a client who has a newly placed ileostomy. Which of the following instructions should the nurse include in the teaching? a. "Empty your ostomy pouch when it becomes half full." b. "Place an aspirin in the ostomy pouch to eliminate odor." c. "Change the ostomy appliance every week." d. "Cleanse the site around the stoma with hydrogen peroxide and water."

a. "Empty your ostomy pouch when it becomes half full."

A nurse is providing discharge teaching for a client who has peptic ulcer disease and a new prescription for famotidine. Which of the following statements by the client indicates an understanding of the teaching? a. "I should take this medication at bedtime." b. "I should expect this medication to discolor my teeth." c. "I will drink iced tea with my meals and snacks." d. "I will monitor my blood glucose level regularly while taking this medication."

a. "I should take this medication at bedtime."

A nurse is providing discharge teaching for a client who has GERD. Which of the following statements by the client indicates an understanding of the teaching? a. "I will decrease the amount of carbonated beverages I drink." b. "I will avoid drinking liquids for 30 minutes after taking a chewable antacid tablet." c. "I will eat a snack before going to bed." d. "I will lie down for at least 30 minutes after eating each meal."

a. "I will decrease the amount of carbonated beverages I drink."

A nurse is developing a plan of care for a client who has gastroesophageal reflux disease (GERD). The nurse should plan to monitor the client for which of the following complications? a. Aspiration b. Infection c. Anemia d. Weight loss

a. Aspiration

A nurse is teaching a group of clients about the function of the liver and gallbladder. Which of the following should the nurse include in the teaching as a purpose of bile? a. Digesting fats b. Producing chyme c. Stimulating gastric acid secretion d. Providing energy

a. Digesting fats

A nurse is teaching a client who has a colostomy about ways to reduce flatus and odor. Which of the following strategies should the nurse include? a. Eat crackers and yogurt regularly b. Chew minty gum throughout the day c. Drink orange juice every day d. Put an aspirin in the pouch

a. Eat crackers and yogurt regularly

A nurse is caring for a client who has an acute exacerbation of Crohn's disease. Which of the following actions should the nurse take? a. Ensure bowel rest b. Offer sparkling water frequently c. Administer a stool softener d. Offer plan warm tea frequently

a. Ensure bowel rest

A nurse is assessing a client who has Crohn's disease. Which of the following findings should the nurse expect? a. Fatty diarrheal stools b. Hyperkalemia c. Weight gain d. Sharp epigastric pain

a. Fatty diarrheal stools

A nurse is teaching dietary-modification strategies to a client who has been newly diagnosed with cirrhosis. Which of the following foods should the nurse recommend? a. Grilled chicken b. Potato soup c. Fish sticks d. Baked ham

a. Grilled chicken

A nurse is assessing a client who is postoperative following a gastrectomy. The nurse should identify which of the following findings as an indication of abdominal distention? a. Hiccups b. Hypertension c. Bradycardia d. Chest pain

a. Hiccups

A nurse is assessing a client who has acute hepatitis B. Which of the following findings should the nurse expect? a. Joint pain b. Obstipation c. Abdominal distention d. Periumbilical discoloration

a. Joint pain

A nurse is developing a plan of care for a client who has cirrhosis and ascites. Which of the following interventions should the nurse include in the plan? a. Measure the client's abdominal girth daily. b. Check mental status once daily. c. Provide a daily intake of 4 g of sodium for the client. d. Assess the client's breath sounds every 12 hr.

a. Measure the client's abdominal girth daily.

A nurse is assessing a client who has appendicitis. Which of the following findings should the nurse expect? (Select all that apply.) a. Oral temperature 38.4C (101.1F) b. WBC count 6,000/mm3 c. Bloody diarrhea d. Nausea and vomiting e. Right lower quadrant pain

a. Oral temperature 38.4C (101.1F) d. Nausea and vomiting e. Right lower quadrant pain

The nurse is recommending dietary modifications for a client who has GERD. The nurse should suggest eliminating which of the following foods from the client's diet? a. Oranges and tomatoes b. Carrots and bananas c. Potatoes and squash d. Whole wheat and beans

a. Oranges and tomatoes

A nurse is caring for a client who is scheduled to undergo a liver biopsy for a suspected malignancy. Which of the following laboratory findings should the nurse monitor prior to the procedure? a. Prothrombin time b. Serum lipase c. Bilirubin d. Calcium

a. Prothrombin time

A nurse is caring for a client who has ulcerative colitis. The client has had several exacerbations of over the past 3 years. Which of the following instructions should the nurse include in the plan of care to minimize the risk of further exacerbations? (Select all that apply.) a. Use progressive relaxation techniques b. Increase dietary fiber intake c. Drink two 240 mL (8 oz) glasses of milk per day d. Arrange activities to allow for daily rest periods e. Restrict intake of carbonated beverages

a. Use progressive relaxation techniques d. Arrange activities to allow for daily rest periods e. Restrict intake of carbonated beverages

A nurse is caring for a client who has celiac disease. Which of the following foods should the nurse remove from the client's meal tray? a. Wheat toast b. Tapioca pudding c. Hard-boiled eggs d. Mashed potatoes

a. Wheat toast

A nurse is caring for a client who has acute diverticulitis. While the client has active inflammation, the nurse should instruct the client to include which of the following foods in her diet? a. White bread and plain yogurt b. Shredded wheat cereal and blueberries c. Broccoli and kidney beans d. Oatmeal and fresh pears

a. White bread and plain yogurt

A nurse is preparing a community education program about hepatitis B? Which of the following statements should the nurse include in the teaching? a. "A hepatitis B immunization is recommended for those who travel, especially with military personnel." b. "A hepatitis B immunization is given to infants and children." c. "Hepatitis B is acquired by eating foods that are contaminated during handling." d. "Hepatitis B can be prevented by using good personal hygiene habits and proper sanitation."

b. "A hepatitis B immunization is given to infants and children."

A nurse is providing discharge teaching to the partner of a client who has a new diagnosis of hepatitis A. Which of the following instructions should the nurse include in the teaching? a. "During this illness, she may take acetaminophen for fevers and discomforts." b. "Encourage her to eat foods that are high in carbohydrates." c. "The provider will prescribe a medication to help her liver heal faster." d. "Have her perform moderate exercise to restore her strength more quickly."

b. "Encourage her to eat foods that are high in carbohydrates."

A nurse is providing discharge teaching for a client who has chronic hepatitis C. Which of the following statements by the client indicates an understanding of the teaching? a. "I will avoid alcohol until I'm no longer contagious." b. "I will avoid medications that contain acetaminophen." c. "I will decrease my intake of calories." d. "I can donate blood once when I am in remission."

b. "I will avoid medications that contain acetaminophen."

A nurse is caring for a client who has colorectal cancer and is receiving chemotherapy. The client asks the nurse why blood is being drawn for a carcinoembryonic antigen (CEA) level. Which of the following should the nurse make? a. "The CEA determines the current stage of your colon cancer." b. "The CEA determines the efficacy of your chemotherapy." c. "The CEA determines if the neutrophil count is below the expected reference range." d. "The CEA determines if you are experiencing occult bleeding from the gastrointestinal tract."

b. "The CEA determines the efficacy of your chemotherapy."

A nurse is assessing a client who is in the early stages of hepatitis A. Which of the following manifestations should the nurse expect? a. Jaundice b. Anorexia c. Dark urine d. Pale feces

b. Anorexia

A nurse in a provider's office is assessing a client who has GERD. When documenting the client's history, the nurse should expect the client to report that symptoms worsen with which of the following actions? a. Stair-climbing b. Bending over c. Sitting d. Walking

b. Bending over

A nurse is obtaining a guaiac test from a client. This test is performed to detect which of the following? a. Fecal material in vomit b. Blood in stool c. Infestation of parasites d. Microorganisms in the urine

b. Blood in stool

A nurse is assessing a client who has peritonitis. Which of the following findings should the nurse expect? a. Bloody diarrhea b. Board-like abdomen c. Periumbilical cyanosis d. Increased bowel sounds

b. Board-like abdomen

A nurse is teaching a client who has diabetes mellitus about hypoglycemia. Which of the following manifestations should the nurse include? (Select all that apply.) a. Bradycardia b. Diaphoresis c. Deep, rapid respirations d. Palpitations e. Shakiness

b. Diaphoresis d. Palpitations e. Shakiness

A nurse is providing dietary teaching for a client who is postoperative following a gastrectomy. Which of the following foods should the nurse encourage the client to include in their diet to reduce the risk for dumping syndrome? a. Ice cream b. Eggs c. Grape juice d. Honey

b. Eggs

A nurse is demonstrating colostomy care to a client who has a new colostomy. Which of the following actions should the nurse teach the client to perform? (Select all that apply.) a. Use antimicrobial ointment on the peristomal skin b. Empty the bag when it is one-third to one-half full c. Cut the skin barrier opening a little larger than the ostomy d. Wash the peristomal skin with mild soap and water e. Apply the skin barrier while the skin is slightly moist

b. Empty the bag when it is one-third to one-half full c. Cut the skin barrier opening a little larger than the ostomy d. Wash the peristomal skin with mild soap and water

A nurse is caring for a client who has an indwelling urinary catheter. Which of the following actions should the nurse take? a. Place the drainage bag on the client's abdomen when transferring from a bed to cart b. Empty the drainage bag when half-full of urine c. Rest the drainage bag on the floor when closing the spigot during emptying d. Disconnect the drainage bag when obtaining urine specimen

b. Empty the drainage bag when half-full of urine

A nurse is providing teaching for a client who has cirrhosis and a new prescription for lactulose. The nurse should instruct which of the following instructions in the teaching? a. Notify the provider if bloating occurs. b. Expect to have two to three stools per day. c. Restrict carbohydrates in the diet. d. Limit oral fluid intake to 1,000 mL per day of clear liquids.

b. Expect to have two to three stools per day.

A nurse is providing discharge teaching for a client who has a new prescription for medications to treat peptic ulcer disease. The nurse should inform the client that which of the following medications inhibits gastric acid secretions? a. Calcium carbonate b. Famotidine c. Aluminum hydroxide d. Sucralfate

b. Famotidine

A nurse is reviewing the laboratory results of a client who has acute pancreatitis. Which of the following findings should the nurse expect? a. Blood glucose 110 mg/dL b. Increased amylase c. WBC count 9,000/mm3 d. Decreased bilirubin

b. Increased amylase

A nurse is assessing a client who is 12 hr postoperative following an open cholecystectomy. Which of the following findings should the nurse report to the provider? a. Hypoactive bowel sounds b. Indwelling urinary catheter output of 25 mL/hr c. Heart rate of 96/min d. Serous drainage at the surgical incision site

b. Indwelling urinary catheter output of 25 mL/hr

A nurse is planning an in-service training regarding nutrition. Which of the following minerals should the nurse identify as involved in oxygen transportation? a. Zinc b. Iron c. Phosphorus d. Magnesium

b. Iron

A nurse is reviewing the prescription for a client who has Campylobacter enteritis. Which of the following prescriptions should the nurse clarify with the provider? a. 0.45% sodium chloride IV b. Magnesium hydroxide c. Ciprofloxacin d. Potassium

b. Magnesium hydroxide

A nurse is providing dietary teaching to a client who has ulcerative colitis. Which of the following food selections by the client indicates an understanding of the teaching? a. Raw vegetable salad with low-fat dressing b. Roast chicken and white rice c. Fresh fruit salad and milk d. Peanut butter on whole wheat bread

b. Roast chicken and white rice

A nurse is caring for a client who is scheduled to undergo an esophagogastroduodenoscopy (EGD). The nurse should identify that this procedure is for which of the following reasons? a. To visualize polyps in the colon b. To detect an ulceration in the stomach c. To identify an obstruction in the biliary tract d. To determine the presence of free air in the abdomen

b. To detect an ulceration in the stomach

A nurse is providing preoperative teaching to a client who will undergo surgery to create a temporary colostomy. The client asks the nurse about the difference between colostomies and ileostomies. Which of the following responses should the nurse make? a. "A colostomy drains stool, and an ileostomy drains urine." b. "A colostomy is temporary, and an ileostomy is permanent." c. "A colostomy is from the large intestine, and an ileostomy is from the small intestine." d. "An ileostomy requires diet restrictions, while a colostomy does not."

c. "A colostomy is from the large intestine, and an ileostomy is from the small intestine."

A nurse is teaching a client how to prepare for a colonoscopy. Which of the following instructions should the nurse include in the teaching? a. "Refrain from eating or drinking for 2 hr prior to the procedure." b. "Stop taking aspirin the day before the procedure." c. "Drink clear liquids for 24 hr prior to the procedure, and then take nothing by mouth for 6 hr before the procedure." d. "Drink the oral liquid preparation for bowel cleansing slowly the night before the procedure."

c. "Drink clear liquids for 24 hr prior to the procedure, and then take nothing by mouth for 6 hr before the procedure."

A nurse is providing discharge teaching for a client who has mild diverticulitis. Which of the following statements by the client indicates an understanding of the teaching? a. "I may experience right lower quadrant pain." b. "I will remain active by working in my garden every day." c. "I should eat foods that are low in fiber." d. "I will use mild laxative every day."

c. "I should eat foods that are low in fiber."

A nurse is providing dietary teaching for a client who has a new diagnosis of celiac disease. Which of the following statements by the client indicates an understanding of the teaching? a. "I can return to my regular diet when I am free of symptoms." b. "I will need to avoid taking vitamin supplements while on this diet." c. "I will eat beans to ensure I get enough fiber in my diet." d. "I need to avoid drinking liquids with my meals while on this diet."

c. "I will eat beans to ensure I get enough fiber in my diet."

A nurse is providing teaching about nutrients to a client. Which of the following statements should the nurse include? a. "Carbohydrates transport nutrients throughout the body." b. "Fats prevent ketosis." c. "Protein builds up and repairs body tissue." d. "Carbohydrates help regulate body temperature."

c. "Protein builds up and repairs body tissue."

A nurse is caring for a client who is 2 days postoperative following gastric surgery and has an NG tube inserted. Which of the following findings should the nurse report to the provider? a. Dryness of the mucous membranes b. Hypoactive bowel sounds in all quadrants c. 200 mL of bright red drainage from the NG tube d. Suction set at continuous low suction

c. 200 mL of bright red drainage from the NG tube

A nurse is caring for a client who has acute pancreatitis. Which of the following serum laboratory values should return to the expected reference range within 72 hr of treatment beginning? a. Aldolase b. Lipase c. Amylase d. Lactic dehydrogenase

c. Amylase

A nurse is assessing a client who has cirrhosis. Which of the following findings is the priority for the nurse to report to the provider? a. Spider angiomas b. Peripheral edema c. Bloody stools d. Jaundice

c. Bloody stools\

A nurse is providing discharge teaching for a client following an ileostomy. The nurse should instruct the client to report which of the following findings to the provider? a. Intolerance to high-fiber foods b. Liquid ileostomy output c. Dark purple stoma d. Sensation of burning during bowel elimination

c. Dark purple stoma

A nurse is planning care for a client who has cholelithiasis. Which of the following interventions should the nurse include in the plan? a. Restrict the client's fluid intake b. Restrict the client's calcium intake c. Decrease the client's fat intake d. Decrease the client's potassium intake

c. Decrease the client's fat intake

A nurse is caring for a child who had her spleen removed following a bicycle accident. The child's parent asks the nurse about the role of the spleen in the body. The nurse should explain that the spleen performs which of the following functions? a. Maintains fluid balance b. Regulates calcium in the blood c. Destroys old blood cells d. Produces prothrombin

c. Destroys old blood cells

A nurse is caring for a client from the Middle East who has celiac disease. Which of the following actions should the nurse perform regarding the client's diet? a. Provide foods prepared according to kosher dietary laws b. Ask the kitchen to prepare grits to meet the client's dietary need for grains c. Determine the client's dietary preference d. Prepare a diet tray that includes vegetables and barley soup

c. Determine the client's dietary preference

A nurse is providing teaching to a client who has constipation. Which of the following instructions should the nurse include? a. Use bismuth subsalicylate regularly b. Consume a low-fiber diet c. Eat yogurt with live cultures d. Use bisacodyl suppositories regularly

c. Eat yogurt with live cultures

A nurse is assessing a client who has upper gastrointestinal bleeding. Which of the following findings should the nurse expect? a. Bradycardia b. Bounding peripheral pulses c. Hypotension d. Increased hematocrit levels

c. Hypotension

A nurse is admitting a client who has acute pancreatitis. Which of the following actions should the nurse take first? a. Insert a nasogastric tube for the client. b. Administer ceftazidime to the client. c. Identify the client's current level of pain. d. Instruct the client to remain NPO.

c. Identify the client's current level of pain.

A nurse is caring for a client who has abdominal pain and possible pancreatitis. Which of the following laboratory results should the nurse identify as an indication of pancreatitis? a. Decreased white blood cell (WBC) count b. Increase albumin level c. Increased serum lipase level d. Decreased blood glucose level

c. Increased serum lipase level

A nurse is caring for a client who has fulminant hepatic failure. Which of the following procedures should the nurse anticipate for this client? a. Endoscopic sclerotherapy b. Liver lobectomy c. Liver transplant d. Transjugular intrahepatic portal-systemic shunt placement

c. Liver transplant

A nurse is assessing a client who was admitted with a bowel obstruction. The client reports severe abdominal pain. Which of the following findings indicates that a possible bowel perforation has occurred? a. Elevated blood pressure b. Bowel sounds increase in frequency and pitch c. Rigid abdomen d. Emesis of undigested food

c. Rigid abdomen

A nurse is caring for a client who has cholelithiasis and will undergo a cholecystectomy. The client states she does not understand how she will be alright without her gallbladder. The nurse should explain to the client that which of the following is the main function of the gallbladder? a. Producing bile b. Adding digestive enzymes to bile c. Storing bile d. Eliminating bile

c. Storing bile

A nurse in the emergency department is caring for a client who has bleeding esophageal varices. The nurse should anticipate a prescription for which of the following medications? a. Famotidine b. Esomeprazole c. Vasopressin d. Omeprazole

c. Vasopressin

A nurse is providing discharge teaching for a client who has a new colostomy and is concerned about flatus and odor. Which of the following foods should the nurse recommend to the client? a. Eggs b. Fish c. Yogurt d. Broccoli

c. Yogurt

A nurse is providing postoperative teaching about a management of dumping syndrome to a client who had a partial gastrectomy. Which of the following instructions should the nurse include in the teaching? a. "Consume at least 4 oz of fluid with meals." b. "Take a short walk after each meal." c. "Use honey to flavor foods such as cereal." d. "Eat protein with each meal."

d. "Eat protein with each meal."

A nurse is caring for a client who has colitis and reported increased exacerbations due to stress at work. Which of the following responses should the nurse make? a. "I will contact the social worker so you can discuss career alternatives." b. "Have you thought about discussing the possibility of a part-time assignment with your employer?" c. "Why don't you ask your employer to relieve you of some work until you are stronger?" d. "Perhaps we should review your coping mechanisms and talk about other alternatives?"

d. "Perhaps we should review your coping mechanisms and talk about other alternatives?"

A nurse is providing dietary teaching for a client who has chronic pancreatitis. Which of the following food selections by the client indicates an understanding of the teaching? a. 8 oz (0.24 L) whole milk b. One slice of beef bologna c. 1 oz (28.3 g) cheddar d. 1 cup (0.24 L) sliced banana

d. 1 cup (0.24 L) sliced banana

A nurse is completing a history and physical assessment for a client who has chronic pancreatitis. Which of the following findings should the nurse identify as a likely cause of the client's condition? a. High-calorie diet b. Prior gastrointestinal illnesses c. Tobacco use d. Alcohol use

d. Alcohol use

A nurse is reviewing the laboratory results of a client who has hepatic cirrhosis. Which of the following laboratory findings should the nurse report to the provider? a. Albumin 4.0 g/dL b. INR 1.0 c. Direct bilirubin 0.5 mg/dL d. Ammonia 180 mcg/dL

d. Ammonia 180 mcg/dL

A nurse is caring for a client who has GERD and a new prescription for metoclopramide. The nurse should plan to monitor for which of the following adverse effects? a. Thrombocytopenia b. Hearing loss c. Hypersalivation d. Ataxia

d. Ataxia

A nurse is assessing a client who is experiencing perforation of a peptic ulcer. Which of the following manifestations should the nurse expect? a. Increased blood pressure b. Decreased heart rate c. Yellowing of the skin d. Boardlike abdomen

d. Boardlike abdomen

A nurse is caring for a client who is 2 days postoperative following a gastric bypass. The nurse notes that bowel sounds are present. Which of the following foods should the nurse provide at the initial feeding? a. Vanilla pudding b. Apple juice c. Diet ginger ale d. Clear liquids

d. Clear liquids

A nurse is assessing a client immediately following a paracentesis for the treatment of ascites. Which of the following findings indicates the procedure was effective? a. Presence of a fluid wave b. Increased heart rate c. Equal pre- and postprocedure weights d. Decreased shortness of breath

d. Decreased shortness of breath

A nurse is teaching a client who has cirrhosis of the liver and a history of alcohol consumption. The nurse should explain that alcohol can cause liver cirrhosis through which of the following actions? a. Increasing the workload of the liver by releasing stored glycogen b. Causing ulceration of liver tissue that can lead to bleeding c. Dilating veins in the portal circulation d. Destroying liver cells that are later replaced with scar tissue

d. Destroying liver cells that are later replaced with scar tissue

A nurse is caring for a client who is receiving total parenteral nutrition (TPN) therapy and has just returned to the room following physical therapy. The nurse notes that the infusion pump for the client's TPN is turned off. After restarting the infusion pump, the nurse should monitor the client for which of the following findings? a. Hypertension b. Excessive thirst c. Fever d. Diaphoresis

d. Diaphoresis

A nurse is updating the plan of care for a client who has dumping syndrome. Which of the following instructions should the nurse include? a. Consume beverages with meals b. Eat 3 large meals per day c. Include high-fiber foods in the diet d. Eat a source of protein with each meal

d. Eat a source of protein with each meal

A nurse is reviewing the laboratory values of a client who has colorectal cancer. Which of the following findings should the nurse expect? a. Negative fecal occult blood test b. Decreased serum carcinoembryonic antigen (CEA) level c. Hematocrit 43% d. Hemoglobin 9.1 g/dL

d. Hemoglobin 9.1 g/dL

A nurse is teaching about secondary prevention actions for colorectal cancer for a health fair for adults in the community. Which of the following topics should the nurse include? a. Smoking cessation b. Benefits of a diet high in cruciferous vegetables c. New types of ostomy appliances d. Importance of colonoscopy screening starting at age 50 years old

d. Importance of colonoscopy screening starting at age 50 years old

A nurse is monitoring the laboratory results of a client who has end-stage liver failure. Which of the following results should the nurse expect? a. Decreased lactate dehydrogenase b. Increase serum albumin c. Decreased serum ammonia d. Increased prothrombin time

d. Increased prothrombin time

A nurse is planning an in-service training session for a group of nurses regarding the role of enzymes in digestion. Which of the following enzymes plays a role in the digestion of protein? a. Amylase b. Lipase c. Steapsin d. Pepsin

d. Pepsin

A nurse is caring for a client who is postoperative following a laparotomy. The client has an indwelling urinary catheter and a Jackson-Pratt drain in place. Which of the following findings indicates that the client is developing a postoperative complication? a. Pain scale of 5 out of 10 b. Urine output of 65 mL/hr c. 20 mL of bright red drainage from the drain d. Pulse oximetry of 85%

d. Pulse oximetry of 85%

A nurse is performing a gastrointestinal assessment of a client who has liver cirrhosis with abdominal distention. Which of the following actions should the nurse take to assess for changes in the client's abdominal distention? a. Percuss the abdomen for tympanic sounds b. Inspect the contour of the abdominal wall c. Instruct the client to report increased abdominal discomfort d. Take serial measurements of the abdomen with a tape measure

d. Take serial measurements of the abdomen with a tape measure

A nurse is assessing a client who has a duodenal ulcer. Which of the following findings should the nurse expect? a. The client states that the pain is in the upper epigastrium. b. The client is malnourished. c. The client states that ingesting food intensifies the pain. d. The client reports the pain occurs during the night.

d. The client reports the pain occurs during the night.

A nurse enters a client's room and notes smoke coming from a wastebasket in the adjacent bathroom. Which of the following actions should the nurse take first? a. Close the door to the client's room b. Attempt to extinguish the fire c. Activate the facility's fire alarm system d. Transport the client to an area away from the smoke

d. Transport the client to an area away from the smoke

A nurse is providing teaching to the guardian of a child who has celiac disease. Which of the following foods should the nurse instruct the guardian to omit from the child's diet? a. Cornflakes b. Reduced-fat milk c. Canned fruits d. Wheat bread

d. Wheat bread