GI

The nurse is teaching a client with nonalcoholic fatty liver disease about measures to manage the condition. The nurse determines the client has a need for further teaching if the client makes which statement?

"I should stop taking my cholesterol medication as it puts stress on my liver."

The nurse is providing discharge instructions to a client following hemorrhoidectomy. Which statement, if made by the client, indicates a need for further instruction?

"I should use a doughnut to relieve pressure while sitting down."2

The nurse is talking to a nursing student about primary versus secondary peritonitis. The nurse determines that the student understands if the nursing student states which client is at risk for primary peritonitis?

A client with ascites related to cirrhosis Rationale: Primary peritonitis usually occurs in the client with a disorder associated with underlying ascites. The client with cirrhosis with ascites is at risk for primary peritonitis. Secondary peritonitis is more common and occurs when another condition is the cause. Examples of secondary peritonitis include ruptured appendix, diverticulitis with rupture, severe cholecystitis, receiving peritoneal dialysis treatment, or trauma from knife or gunshot wounds.

A client diagnosed with peptic ulcer disease and scheduled for a pyloroplasty asks the nurse about the procedure. The nurse would base the response on which information?

A pyloroplasty involves an incision and resuturing of the pylorus to relax the muscle and enlarge the opening from the stomach to the duodenum.

A client is admitted to the hospital with a diagnosis of acute pancreatitis. The nurse would plan care knowing that most likely, which problem will occur with this disorder?

Alteration in comfort related to abdominal pain

The nurse is reviewing a client's laboratory results. The nurse notes that which results support a diagnosis of dehydration? Select all that apply.

Increased creatinine Increased hemoglobin Increased serum sodium Decreased estimated glomerular filtration rate (eGFR)

The nurse is caring for a client diagnosed with anal fistula and is monitoring for complications of this problem. Which priority complication would the nurse monitor for while managing care for this client?

Infection

The nurse who is assisting in the care of a client within the first 24 hours following a total gastrectomy for gastric cancer would avoid which intervention?

Irrigating the nasogastric (NG) tube3

A client has been receiving parenteral nutrition at 125 mL/hr for 5 days. On data collection, the nurse notes bilateral crackles and 2+ pedal edema and that the client has gained 3 pounds in 5 days. Which would be appropriate as the initial nursing action?

Notify the registered nurse of the findings.2

The nurse is assisting with admitting a client to the hospital for the treatment of diagnosed dehydration. The client reports nausea, vomiting, diarrhea, and cramping for the past week. The nurse asks the client about medications being taken. The client denies taking prescription medications but states he has been taking some herbs given to him by a cousin. The nurse would alert the registered nurse when the client states he has been taking which herb?

Senna

The nurse is providing care for a client with with ulcerative colitis who underwent the creation of a transverse colostomy. Which observation requires immediate notification of the surgeon?

Stoma has a purple discoloration

A postoperative client has regained bowel sounds and is ready to start a clear liquid diet. The nurse is told that the primary health care provider has written a prescription to remove the nasogastric (NG) tube. The nurse assists in the procedure and would ask the client to do which during tube removal?

Take a breath and hold it until the tube is out.

A client presents to the urgent care center with complaints of abdominal pain. Suddenly the client vomits bright red blood. The nurse would take which immediate action?

Take the client's vital signs.

The nurse is teaching a client with a newly diagnosed hiatal hernia about measures to prevent recurrence of symptoms. Which statement is most appropriate to be included in the teaching?

"Avoid lying down for an hour after eating."

The nurse is reviewing concepts related to irritable bowel syndrome (IBS) with a nursing student. Which statement by the nursing student indicates there is a need for further teaching?

"IBS is characterized by only episodes of diarrhea."3

The nurse is reviewing the prescriptions of a client admitted to the hospital with a diagnosis of acute pancreatitis. Which interventions would the nurse expect to be prescribed? Select all that apply.

Administer antacids, as prescribed. Encourage coughing and deep breathing. Administer anticholinergics, as prescribed.

The nurse is collecting data about how well a client diagnosed with a gastrointestinal (GI) disorder is able to digest food. The nurse determines that which processes are involved in the complete digestive process? Select all that apply.

Chemical Absorption Mechanical Active transport

The nurse is reinforcing dietary instructions for a client diagnosed with peptic ulcer disease. Which action would the nurse encourage the client to do?

Eat anything as long as it does not aggravate or cause pain.4

A client is receiving bolus feedings via a nasogastric tube. The nurse plans to place the client's head of the bed (HOB) in which optimal position once the feeding is completed?

Elevated 30 to 45 degrees with the client in the right lateral position for 60 minutes

A client is admitted to the hospital with a diagnosis of acute viral hepatitis. Which sign/symptom would the nurse expect to observe based on this diagnosis?

Fatigue

A client has a diagnosis of asymptomatic diverticular disease. Which type of diet would the nurse anticipate being prescribed?

High-fiber diet

A client with a diagnosis of acute pancreatitis is experiencing severe pain. After noting an absence of an analgesic prescription on the primary health care provider prescription sheet, the nurse would suggest contacting the primary health care provider to request a prescription for which medication?

Hydromorphone

The nurse is reinforcing dietary instructions for a client diagnosed with peptic ulcer disease. Which statement made by the client indicates a need for further teaching?

I will eat a bland diet only.

The nurse is reviewing the medication record of a client with a diagnosis of acute gastritis. Which medication noted on the client's record would the nurse most likely question?

Ibuprofen

A client has had a partial gastrectomy, and the nurse is reinforcing discharge instructions. The nurse would reinforce instructions to the client about the need for which supplements? Select all that apply.

Iron supplements Calcium supplements Vitamin B12 injections

After a client undergoes a liver biopsy, the nurse places the client in the prescribed right-side lying position. The nurse understands that the purpose of this intervention is to accomplish which?

Limit bleeding from the biopsy site

Atropine sulfate is prescribed for the client diagnosed with gastrointestinal hypermotility, and the nurse reviews the client's record before administering the medication. Which finding, if noted on the client's record, most indicates the need to contact the primary health care provider before administering the medication?

Narrow-angle glaucoma

The nurse is participating in a health screening clinic and is preparing materials about colorectal cancer. The nurse would include which risk factor for colorectal cancer in the material?

Personal history of ulcerative colitis or gastrointestinal (GI) polyps

A client that is postgastrectomy is at high risk for hyperglycemia related to uncontrolled gastric emptying of fluid and food into the small intestine (dumping syndrome). Because of this risk, the nurse would plan to monitor which data?

Postprandial blood glucose readings

The nurse is monitoring for stoma prolapse in a client with a colostomy. Which stoma observation would indicate that a prolapse has occurred?

Protruding and swollen

The nurse is caring for a client with a diagnosis of acute anal fissure. Which characteristic assessment finding would the nurse expect to note?

Recent constipation2

The nurse is reviewing the chart for a client with Clostridium difficile (C. difficile) infection. The nurse would contact the primary health care provider (PHCP) regarding which priority finding?

Serum potassium 2.9 mEq/L (2.9 mmol/L)4

A licensed practical nurse (LPN) is helping a registered nurse (RN) conduct an abdominal assessment. The LPN would assist the client into which most appropriate position?

Supine with the head raised slightly and the knees slightly flexed4

The nurse is reinforcing home care instructions to a client following a gastric resection. The nurse would include which instruction to the client?

Take actions to prevent dumping syndrome.

The nurse is caring for a client with a diagnosis of chronic gastritis. The nurse anticipates that the client is at risk for which vitamin deficiency?

Vitamin B12

A client reports excessive sweating, muscular weakness, diarrhea, and achiness in the bones. The nurse suspects the client is deficient in which vitamin?

Vitamin D3

The nurse is reinforcing discharge instructions to a client who has had a total gastrectomy. The nurse instructs the client about the importance of returning as scheduled to the health care clinic for which priority assessment?

4. Vitamin B12 and folic acid studies

The nurse is teaching a client with irritable bowel syndrome (IBS) about food items that may exacerbate the condition. The nurse identifies a need for further teaching if the client states which food item is acceptable to consume?

Cauliflower

A client is admitted to a long-term care facility with the diagnosis of weight loss secondary to anorexia. The primary health care provider inserts a nasogastric tube and prescribes a tube feeding of a standard formula feeding to run at 50 mL/hr. The nurse plans care, knowing that which is true regarding enteral feedings?

Enteral feedings require the normal digestive capabilities of the gastrointestinal (GI) tract.

A client who is receiving total parenteral nutrition (TPN) complains of a headache. The nurse notes that the client has an increased blood pressure and a bounding pulse. The nurse reports the findings, knowing that these signs/symptoms are indicative of which complication of this therapy?

Fluid overload

The nurse is caring for a client with a history of peptic ulcer disease admitted to the medical-surgical unit with abdominal pain that is worse towards the end of the day. The client tells the nurse that he has had a bowel perforation in the past that healed on its own. Given the client's history, which condition would the nurse suspect?

Gastric outlet obstruction

It has been determined that a client with hepatitis has contracted the infection from contaminated food. Which type of hepatitis is this client most likely experiencing?

Hepatitis A

Which infection control method would the nurse determine to be the priority to include in the plan of care to prevent hepatitis B in a client considered to be at high risk for exposure?

Hepatitis B vaccine

The nurse would include which instruction in a teaching plan for a client who has been diagnosed with peptic ulcer disease?

Learn to use stress reduction techniques.

A client receiving enteral feedings develops abdominal distention and diarrhea shortly after initiation of the feedings. Which is the appropriate intervention for the nurse to implement?

Notify the primary health care provider (PHCP) of the client's signs and symptoms.

The nurse is assessing a client with a suspected Clostridium difficile infection. The nurse notes that which clinical manifestations are consistent with this diagnosis? Select all that apply.

The client's temperature is 101.7°F (38.2°C). The client is having watery bowel movements. The client grimaces while the nurse palpates the abdomen.

The nurse is providing care for a client with a nasogastric tube. Which observation is most appropriate in determining that the tube is correctly placed?

The pH of the aspirate is 5

The nurse observes that a client with a nasogastric tube connected to continuous gastric suction is mouth breathing, has dry mucous membranes, and has a foul breath odor. When planning care, which nursing intervention would be best to maintain the integrity of this client's oral mucosa?

Use diluted mouthwash and water to swab the mouth after brushing teeth.

The nurse understands that the client with a Clostridium difficile (C. difficile) infection is at increased risk for which acid-base imbalance?

Metabolic acidosis

The nurse is monitoring a client for the early signs and symptoms of dumping syndrome. Which indicates this occurrence?

Sweating and pallor

The nurse is collecting data about how well a client diagnosed with a gastrointestinal (GI) disorder is able to absorb food. While doing this, the nurse recalls that absorption is most concerned with which bodily function?

The transfer of digested food molecules from the GI tract into the bloodstream

When reinforcing dietary instructions to a client with irritable bowel syndrome whose primary symptom is alternating constipation and diarrhea, which foods would the nurse tell the client are best to include in the diet for this disorder? Select all that apply.

apples whole-grain bread

A client has been diagnosed with acute gastroenteritis. Which diet would the nurse anticipate to be prescribed for the client?

Low fiber3

A client with ulcerative colitis had a new colostomy created 2 days earlier and is beginning to pass malodorous flatus from the stoma. What is the correct interpretation by the nurse?

This is a normal, expected event.

A client diagnosed with a peptic ulcer scheduled for a vagotomy asks the nurse about the purpose of this procedure. The nurse would explain to the client that a vagotomy primarily serves which purpose?

Reduces the stimulation of acid secretions

The nurse has assisted the primary health care provider with a liver biopsy, which was done at the bedside. Upon completion of the procedure, the nurse would assist the client into which position?

Right side-lying with a small pillow or towel under the puncture site

A client receiving a high cleansing enema complains of pain and cramping. Which corrective action is most appropriate for the nurse to take?

Clamp the tubing for 30 seconds and restart the flow at a slower rate. Submit

The nurse is reviewing the medical record for a client with peritonitis. Which prescription would prompt the nurse to contact the registered nurse to seek clarification from the gastroenterologist?

Clear liquid diet

The nurse is monitoring the intake and output of a client diagnosed with fatty liver disease that is exhibiting ascites. The nurse documents that the client has consumed 4 ounces of apple juice and 8 ounces of coffee with breakfast, 8 ounces of water and 8 ounces of tea with lunch, and 10 ounces of water with dinner. Additionally, the client received two doses of intravenous antibiotics mixed in 50 mL of normal saline. Also noted is 675 mL of urine output documented in the client's chart. What is the client's fluid balance in mL? Fill in the blank.

565 mL

The nurse observes that a client's nasogastric tube has suddenly stopped draining. The tube is connected to suction, the machine is on and functioning, and all connections are snug. After checking placement, the nurse gently flushes the tube with 30 mL of normal saline, but the tube still is not draining. The nurse would conclude which is the problem, and what action would be taken?

Channels of gastric secretions may be bypassing the holes in the tube; turning the client will promote stomach emptying.

A primary health care provider places a Miller-Abbott tube in a client who has a diagnosed bowel obstruction. Six hours later, the nurse measures the length of the tube outside of the nares and notes that the tube has advanced 6 cm since it was first placed. Based on this finding, which action would the nurse take next?

Document the finding in the client's record.4

A client is admitted from the emergency department with a diagnosis of bowel perforation. Which treatment strategies would the nurse anticipate based on this admitting diagnosis? Select all that apply.

Electrocardiogram monitoring Broad-spectrum antibiotic therapy Insertion of an indwelling urinary catheter Fluid replacement with lactated Ringer's solution

A client with a possible hiatal hernia complains of difficulty swallowing. Which other sign/symptom associated with a hiatal hernia would the nurse recognize?

Heartburn and regurgitation

After the deflation of the balloon of a client's Sengstaken-Blakemore tube, the nurse would monitor the client closely for which priority esophageal complication?

Hemorrhage

A client with a diagnosis of viral hepatitis has no appetite, and food makes the client nauseated. The nurse would conclude that which intervention is most appropriate?

Offer small, frequent meals.

The nurse working in the emergency department is assisting with an initial assessment on a client who is complaining of severe upper abdominal pain that spreads throughout the abdomen and radiates to the back and shoulders. The client has tried taking antacids with no relief. On assessment the abdomen is rigid and bowel sounds are absent. Which data in the client's history would the nurse be most concerned about in connection with these assessment findings?

Peptic ulcer disease4

The nurse provides information to a client following a gastrectomy who is now diagnosed with pernicious anemia. Which instructions about pernicious anemia would the nurse reinforce to the client? Select all that apply.

Provide meticulous and frequent oral hygiene. Use additional lightweight blankets as needed. Check blood serum vitamin B12 levels every 1 to 2 years.

The nurse has been providing care for a client with a Sengstaken-Blakemore tube. While the tube is inflated the nurse would monitor for which priority sign/symptom?

Respiratory distress

A client is admitted to an acute care facility with complications of celiac disease. Which question asked by the nurse initially would be most helpful in obtaining information for the nursing care plan?

"What is your understanding of celiac disease?"4

The nurse caring for a client with a diagnosis of cholelithiasis observes for signs of obstruction of the bile ducts. Which assessment findings are indicative of this complication? Select all that apply.

Fever Jaundice Dark, foamy urine Clay-colored stools

The nurse should include which most appropriate information when reinforcing home care instructions for a client who has been diagnosed with peptic ulcer disease?

Learn to use stress reduction techniques.4

The nurse is caring for a client with a diagnosis of acute appendicitis. Which physical assessment finding consistent with this diagnosis would the nurse expect to be documented in the client's medical record?

Pain at McBurney's point4

The nurse has inserted a nasogastric (NG) tube in a client and is checking for the correct placement of an NG tube. Which is the most reliable data to ensure that the end of the tube is in the stomach?

Placement is verified on x-ray.

The nurse is collecting data on a client admitted to the hospital with a diagnosis of hepatitis. The nurse would determine which data indicates the client may have liver damage?

Pruritus

A primary health care provider asks the nurse to obtain a Salem sump tube for gastric intubation for a client with a bowel obstruction. The nurse would select which tube from the unit storage area?

Tube with a lumen and an air vent

A client with a history of gastrointestinal upset has been diagnosed with acute diverticulitis. To aid the client in symptom management, the nurse would most appropriately suggest which diet during the acute phase?

A low-fiber diet

The nurse is collecting assessment data on an assigned client. Which assessment findings support that the client is experiencing dehydration? Select all that apply.

Dark urine Cracked lips Urine output of 20 ml in the past hour

The nurse is caring for a client with a neurogenic bowel due to a lower motor neuron spinal cord injury below T12 resulting in flaccid functionality. Besides triggering or facilitating techniques for defecation, what are some of the strategies the nurse needs to address to reestablish defecation patterns? Select all that apply.

Suppository use Manual disimpaction Consistent toileting schedule

An acutely ill-looking client arrives at the emergency department. The client complains of "the worst pain I ever felt in my belly. I can't get comfortable." The client is quiet but with each movement the client cries out in pain. The nurse suspects the client has peritonitis. Which data would the nurse collect to assist in validating this suspicion? Select all that apply.

Inspect the abdomen for rigidity. Check for the presence of hiccups. Inspect the client's mucous membranes.

The nurse is reinforcing discharge instructions to a client with a hiatal hernia. Which considerations would the nurse include in the teaching session? Select all that apply.

It is advisable to stop smoking cigarettes. Wait at least 1 hour after meals to perform chores. Be sure to elevate the head of the bed during sleep.

The nurse reviewing a client's medical record would recognize which conditions as risk factors for nonalcoholic fatty liver disease (NAFLD)? Select all that apply.

Obesity Diabetes Hyperlipidemia

The nurse is caring for a client that received a new diet prescription from the primary health care provider (PHCP) for nothing-by-mouth (NPO) except ice chips. Which actions would the nurse take to alleviate the effects of dehydration? Select all that apply.

Observe mucous membranes for drynessisinterest Provide frequent oral care with moist swabs Apply lubricant to the lips and oral mucous membranes

A client has undergone subtotal gastrectomy, and the nurse is preparing the client for discharge. Which item would be included when reinforcing instructions to the client about ongoing self-management?

Smaller, more frequent meals should be eaten.2

The nurse is caring for a client with a diagnosis of dehydration. Which laboratory finding, as noted in the client's medical record, supports this diagnosis?

Sodium level of 149 mEq/L (149 mmol/L)

The nurse is reviewing the health care record of a client with a diagnosis of chronic pancreatitis. The nurse would determine that which data noted in the record indicate poor absorption of dietary fats?

Steatorrhea

The nurse is reviewing the primary health care provider's (PHCP'S) prescriptions written for a client admitted with acute pancreatitis. Which PHCP prescription would the nurse verify if noted in the client's chart?

Supine and flat client positioning

The nurse is reviewing the client's medical records for the shift and notes that which clients are at risk for dehydration? Select all that apply.

The client with dementia The client with Clostridium difficile infection The client in acute heart failure exacerbation taking furosemide

A client is receiving total parenteral nutrition and has been NPO. The primary health care provider (PHCP) prescribed small amounts of clear liquids today. The nurse's priority is to collect data regarding which criterion before giving the client anything by mouth?

The presence of the swallow reflex

The nurse has given the client diagnosed with hepatitis instructions about post discharge management during convalescence. The nurse determines a need for further teaching if the client makes which statement?

"I should resume a full activity level within 1 week."

The nurse will be providing postprocedure care to a client who has undergone esophagogastroduodenoscopy (EGD). Based on the procedure done, the nurse would plan to do which action first?

Monitor for return of the gag reflex.

Which statement by the spouse of a client with diagnosed end-stage liver failure indicates the need for further teaching by the multidisciplinary team regarding management of the client's pain?

"This opioid will cause very deep sleep, which is what my husband needs."4

The nurse is collecting data during an assessment on a client. Which of the following assessment findings are typical for a malnourished client? Select all that apply.

Glossitis Cheilosis Bleeding gums

The nurse has assisted with the insertion of a Levin tube for gastrointestinal (GI) decompression in a client with a bowel obstruction. Which settings would the nurse anticipate to be prescribed by the primary health care provider? Select all that apply.

Low Intermittent

A primary health care provider asks the licensed practical nurse (LPN) to reinforce preprocedure instructions to a client who will undergo a barium swallow (esophagography) in a few days. The LPN would include which instruction in this discussion?

Remove all metal and jewelry before the test.

The nurse is evaluating the effect of dietary counseling on the client diagnosed with cholecystitis. The nurse determines the client understands the instructions given if the client states that which food item is most appropriate to include in the diet?

Turkey and lettuce sandwich

A client with Crohns's disease has just had surgery to create an ileostomy. The nurse assesses the client in the postoperative period for which most frequent complication of this type of surgery?

Fluid and electrolyte imbalance

A client who has undergone a colostomy several days ago is reluctant to leave the hospital and has not yet looked at the ostomy site. Which measures will most likely promote coping? Select all that apply.

Ask a member of the local ostomy club to visit with the client before discharge. Ask the enterostomal nurse specialist to consult with the client before discharge. Ask the client to begin doing one part of the ostomy care each day and increase tasks daily.

The nurse would recognize that which type of enema has the highest risk of water intoxication?

Tap water

A primary health care provider is about to perform a paracentesis on a client diagnosed with abdominal ascites. The nurse would assist the client to assume which position?

Upright

A client with Crohn's disease has a prescription to begin taking antispasmodic medication. The nurse would schedule the medication so that each dose is taken at which time?

30 minutes before meals4