GI questions

A client has just had surgery to create an ileostomy. The nurse assesses the client in the immediate postoperative period for whichmost frequent complication of this type of surgery? 1. Folate deficiency 2. Malabsorption of fat 3. Intestinal obstruction 4. Fluid and electrolyte imbalance

4

A client experiencing chronic dumping syndrome makes the following comments to the nurse. Which one indicates the need for further teaching? 1. "I eat at least three large meals each day." 2. "I eat while lying in a semirecumbent position." 3. "I have eliminated taking liquids with my meals." 4. "I eat a high-protein, low- to moderate-carbohydrate diet."

1

A client 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? 1. This is a normal, expected event. 2. The client is experiencing early signs of ischemic bowel. 3. The client should not have the nasogastric tube removed. 4. This indicates inadequate preoperative bowel preparation.

1

A client is admitted to the hospital with a diagnosis of acute diverticulitis. What should the nurse expect to be prescribed for this client? 1. NPO (nothing by mouth) status 2. Ambulation at least four times daily 3. Cholinergic medications to reduce pain 4. Coughing and deep breathing every 2 hours

1

A client presents to the emergency department with upper gastrointestinal bleeding and is in moderate distress. In planning care, what is the priority nursing action for this client? 1. Assessment of vital signs 2. Completion of abdominal examination 3. Insertion of the prescribed nasogastric tube 4. Thorough investigation of precipitating events

1

The nurse inspects the color of the drainage from a nasogastric tube on a postoperative client approximately 24 hours after gastric surgery. Which finding indicates the need to notify the health care provider? 1. Dark red drainage 2. Dark brown drainage 3. Green-tinged drainage 4. Light yellowish brown drainage

1

The nurse is assessing for stoma prolapse in a client with a colostomy. What should the nurse observe if stoma prolapse occurs? 1. Protruding stoma 2. Sunken and hidden stoma 3. Narrowed and flattened stoma 4. Dark- and bluish-colored stoma

1

The nurse is caring for a client with acute pancreatitis and is monitoring the client for paralytic ileus. Which assessment data would alert the nurse to this occurrence? 1. Inability to pass flatus 2. Loss of anal sphincter control 3. Severe, constant pain with rapid onset 4. Firm, nontender mass palpable at the lower righ

1

The nurse is monitoring a client for the early signs and symptoms of dumping syndrome. Which findings indicate this occurrence? 1. Sweating and pallor 2. Bradycardia and indigestion 3. Double vision and chest pain 4. Abdominal cramping and pain

1

The nurse is preparing to discontinue a client's nasogastric tube. The client is positioned properly, and the tube has been flushed with 15 mL of air to clear secretions. Before removing the tube, the nurse should make which statement to the client? 1. "Take a deep breath when I tell you and hold it while I remove the tube." 2. "Take a deep breath when I tell you and bear down while I remove the tube." 3. "Take a deep breath when I tell you and slowly exhale while I remove the tube." 4. "Take a deep breath when I tell you and breathe normally while I remove the tube."

1

The nurse is reviewing the record of a client with Crohn's disease. Which stool characteristic should the nurse expect to note documented in the client's record? 1. Diarrhea 2. Chronic constipation 3. Constipation alternating with diarrhea 4. Stool constantly oozing from the rectum

1

A client with a new colostomy is concerned about the odor from stool in the ostomy drainage bag. The nurse should teach the client to include which food in the diet to reduce odor? 1. Eggs 2. Yogurt 3. Broccoli 4. Cucumbers

2

The nurse is teaching an older client about measures to prevent constipation. Which statement, if made by the client, indicates that further teaching is necessary about bowel elimination? 1. "I walk 1 to 2 miles every day." 2. "I need to decrease fiber in my diet." 3. "I have a bowel movement every other day." 4. "I drink six to eight glasses of water every day

2

A client receiving a cleansing enema complains of pain and cramping. The nurse should take which corrective action? 1. Discontinue the enema. 2. Reassure the client, and continue the flow.3. Raise the enema bag so that the solution can be completed quickly. 4. Clamp the tubing for 30 seconds, and restart the flow at a slower rate.

3

A client who has undergone gastric surgery has a nasogastric (NG) tube connected to low intermittent suction that is not draining properly. Which action should the nurse take initially? 1. Call the surgeon to report the problem. 2. Reposition the NG tube to the proper location. 3. Check the suction device to make sure it is working. 4. Irrigate the NG tube with saline to remove the obstruction.

3

A nurse is caring for a hospitalized client with a diagnosis of ulcerative colitis. Which finding, if noted on assessment of the client, should the nurse report to the health care provider (HCP)? 1. Hypotension 2. Bloody diarrhea 3. Rebound tenderness 4. A hemoglobin level of 12 mg/dL

3

The nurse has provided home care instructions to a client who had a subtotal gastrectomy. The nurse instructs the client regarding the signs and symptoms associated with dumping syndrome. Which signs and symptoms, if identified by the client, would indicate an understanding of this potential complication after gastrointestinal (GI) surgery? 1. Hiccups and diarrhea 2. Constipation and fever 3. Diaphoresis and diarrhea 4. Fatigue and abdominal pain

3

The nurse is doing an admission assessment on a client with a history of duodenal ulcer. To determine whether the problem is currently active, the nurse should assess the client for which symptom(s) of duodenal ulcer? 1. Weight loss 2. Nausea and vomiting 3. Pain relieved by food intake 4. Pain radiating down the right arm

3

A client with acute ulcerative colitis requests a snack. Which would be the most appropriatesnack for this client? 1. Carrots and ranch dip 2. Whole-grain cereal and milk 3. A cup of popcorn and a cola drink 4. Applesauce and a graham cracker

4

In performing a physical assessment of a client with a diagnosis of ulcerative colitis, the nurse should expect which finding? 1. Hypercalcemia 2. Fibrous stricture 3. Frothy, fatty stools 4. Decreased hemoglobin

4

The nurse is caring for a client with a resolved intestinal obstruction who has a nasogastric tube in place. The client has tolerated the tube being clamped every 2 hours for 1 hour. The health care provider has now prescribed that the nasogastric tube be removed. What is the priority nursing assessment prior to removing the tube? 1. Checking for normal serum electrolyte levels 2. Checking for normal pH of the gastric aspirate 3. Checking for proper nasogastric tube placement 4. Checking for the presence of bowel sounds in all four quadrants

4

A client with a colostomy has a prescription for irrigation of the colostomy. Which solution should the nurse use for the irrigation? 1. Tap water 2. Sterile water 3. Sterile distilled water 4. Sterile lactated Ringer's

1

A client with hiatal hernia chronically experiences heartburn following meals. The nurse should plan to teach the client to avoid which action because it is contraindicated with a hiatal hernia? 1. Lying recumbent following meals 2. Consuming small, frequent, bland meals 3. Raising the head of the bed on 6-inch blocks 4. Taking H2-receptor antagonist medication

1

A nurse is performing colostomy irrigation on a client. During the irrigation, the client begins to complain of abdominal cramps. What is the appropriate nursing action? 1. Stop the irrigation temporarily. 2. Increase the height of the irrigation. 3. Notify the health care provider (HCP). 4. Medicate for pain and resume the irrigation.

1

The nurse has provided dietary instructions to a client with a diagnosis of peptic ulcer disease. Which statement, if made by the client, indicates an understanding of the dietary measures to take? 1. "Baked foods such as chicken or fish are all right to eat." 2. "Citrus fruits and raw vegetables need to be included in my daily diet." 3. "I can drink beer so long as I consume only a moderate amount each day." 4. "I can drink coffee or tea so long as I limit the amount to two cups daily."

1

A client with ulcerative colitis has a prescription to begin a salicylate medication to reduce inflammation. What instruction should the nurse give the client regarding when to take this medication? 1. On arising 2. After meals 3. On an empty stomach 4. 30 minutes before meals

2

After undergoing Billroth I gastric surgery, the client experiences fatigue and complains of numbness and tingling in the feet and difficulties with balance. On the basis of these symptoms, the nurse suspects which postoperative complication? 1. Stroke 2. Pernicious anemia 3. Bacterial meningitis 4. Peripheral arterial disease

2

The nurse is providing instructions to a client with a colostomy about measures to reduce the odor from the colostomy. Which statement, if made by the client, indicates an understanding of these measures? 1. "I should be sure to eat at least one cucumber every day." 2. "Beet greens, parsley, or yogurt will help to control the colostomy odor." 3. "I will need to increase my egg intake and try to eat ½ to 1 egg per day." 4. "Green vegetables such as spinach and broccoli will prevent odor, and I should eat these foods every day."

2

The nurse is performing an admission assessment on a client who has been admitted to the hospital with a diagnosis of suspected gastric ulcer. The nurse is asking the client questions about pain. Which statement, if made by the client, would support the diagnosis of gastric ulcer? 1. "The pain doesn't usually come right after I eat." 2. "The pain gets so bad that it wakes me up at night." 3. "The pain that I get is located on the right side of my chest." 4. "My pain comes shortly after I eat, maybe a half-hour or so later.

4

The nurse obtains an admission history for a client with suspected peptic ulcer disease. Which client factor documented by the nurse would increase the risk for peptic ulcer disease? 1. Recently retired from a job 2. Significant other has a gastric ulcer 3. Occasionally drinks one cup of coffee in the morning 4. Takes nonsteroidal anti-inflammatory drugs (NSAIDs) for osteoarthritis

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