GI questions

Which of the following is not an appropriate nursing diagnosis related to appendicitis? 1). Disturbed body image 2). Acute pain 3). Risk for infection r/t rupture 4). Deficient knowledge

Disturbed body image

Which drug class isn't used to treat GERD? 1). Antacids 2). Histamine receptor antagonists 3). Beta blockers 4). Proton pump inhibitors

Beta blockers

What is toxic megacolon (mulitple answers)? 1). A complication of ulcerative colitis 2). Dilation and paralysis of the colon 3). A fistula 4). A risk factor for pancreatitis

A complication of ulcerative colitis Dilation and paralysis of the colon

To verify the placement of a gastric feeding tube, the nurse should perform at least two tests. One test requires instilling air into the tube with a syringe and listening with a stethoscope for air passing into the stomach. Which is another test method? 1). Aspiration of gastric contents and testing for a pH less than 6 2). Instillation of 30 ml of water while listening with a stethoscope 3). Cessation of reflex gagging 4). Ensuring proper measurement of the tube before insertion

Aspiration of gastric contents and testing for a pH less than 6 Rationale: Aspiration of gastric secretions with a pH less than 6 indicates placement in the stomach

A client who underwent abdominal surgery who has a nasogastric (NG) tube in place begins to complain of abdominal pain that he describes as "feeling full and uncomfortable." Which assessment should the nurse perform first? 1). Measure abdominal girth 2). Auscultate bowel sounds 3). Assess patency of the NG tube 4). Assess vital signs

Assess patency of the NG tube Rationale: When an NG tube is no longer patent, stomach contents collect in the stomach giving the client a sensation of fullness

Which item is unneccessary when examing the oral cavity of a patient with candidiasis? 1). Gloves 2). Penlight 3). Gown 4). Tongue blade

Gown

Which diagnostic test would be used first to evaluate a client with upper GI bleeding? 1). Endoscopy 2). Upper GI series 3). Hemoglobin (Hb) levels and hematocrit (HCT) 4). Arteriography

Hemoglobin (Hb) levels and hematocrit (HCT) Rationale: Hemoglobin and hematocrit are typically performed first in clients with upper GI bleeding to evaluate the extent of blood loss. Endoscopy is then performed to directly visualize the upper GI tract and locate the source of bleeding.

Which is the least likely to cause constipation? 1). High fiber intake 2). Being over 75 3). Overuse of laxatives 4). Immobilization

High fiber intake

A client with a recent history of rectal bleeding is being prepared for a colonoscopy. How should the nurse position the client for this test initially? 1). Lying on the right side with legs straight 2). Lying on the left side with knees bent 3). Prone with the torso elevated 4). Bent over with hands touching the floor

Lying on the left side with knees bent Rationale: For a colonoscopy, the nurse initially should position the client on the left side with knees bent to allow proper visualization of the large intestine.

In regards to appendicitis, the location of pain in the lower, right abdominal quadrant is called: 1). Kernig's sign 2). Mc Burney's point 3). Brudzinski's point 4). Schrute's point

Mc Burney's point

When preparing a client, age 50, for surgery to treat appendicitis, the nurse formulates a nursing diagnosis of Risk for infection related to inflammation, perforation, and surgery. What is the rationale for choosing this nursing diagnosis? 1). The appendectomy surgery is very invasive and it puts the client at a risk for infection 2). Obstruction of the appendix reduces arterial flow, leading to ischemia, inflammation, and rupture of the appendix. 3). Infection of the appendix diminishes necrotic arterial blood flow and increases venous drainage 4). The appendix may develop gangrene and rupture, especially in a middle-aged client

Obstruction of the appendix reduces arterial flow, leading to ischemia, inflammation, and rupture of the appendix. Rationale: A client with appendicitis is at risk for infection related to inflammation, perforation, and surgery because obstruction of the appendix causes mucus fluid to build up

Which of the following isn't a complication of peptic ulcer disease? 1). Perforation 2). GI bleeding 3). Pyloric obstruction 4). Pain

Pain Rationale: Pain is a symptom of PUD, not a complication

Which of the following assessment findings suggests early appendicitis? 1). Nausea and vomiting 2). Periumbilical pain 3). Tense positioning 4). Abdominal rigdity

Periumbilical pain Rationale: Periumbilical pain is the initial symptom, followed by nausea and vomiting.

Which of the following are goals of drug therapy in the treatment of PUD (multiple answers)? 1). Provide pain relief 2). Prevent recurrence 3). Heal ulcerations 4). Eradicate H. pylori infection

Provide pain relief Prevent recurrence Heal ulcerations Eradicate H. pylori infection

Which outcome indicates effective client teaching to prevent constipation? 1). The client verbalizes consumption of low-fiber foods 2). The client maintains a sedentary lifestyle 3). The client limits water intake to three glasses per day 4). The client reports engaging in a regular exercise regimen

The client reports engaging in a regular exercise regimen Rationale: A regular exercise regimen promotes peristalsis and contributes to regular bowel elimination patterns. A low-fiber diet, a sedentary lifestyle, and limited water intake would predispose the client to constipation

A client has a newly created colostomy. After participating in counseling with the nurse and receiving support from the spouse, the client decides to change the colostomy pouch unaided. Which behavior suggests that the client is beginning to accept the change in body image? 1). The client asks his wife to leave the room 2). The client closes the eyes when the abdomen is exposed 3). The client avoids talking about the recent surgery 4). The client touches the altered body part

The client touches the altered body part Rationale: By touching the altered body part, the client recognizes the body change and establishes that the change is real. Closing the eyes, not looking at the abdomen when the colostomy is exposed, or avoiding talking about the surgery reflects denial

The graduate nurse and her preceptor are establishing priorities for their morning assessments. Which client should they assess first? 1). The newly admitted client with acute abdominal pain 2). The client who needs an abdominal dressing changed (POD 3) 3). The client receiving continuous tube feedings who needs the tube-feeding residual checked 4). The sleeping client who received pain medication 1 hour ago

The newly admitted client with acute abdominal pain Rationale: The graduate nurse and her preceptor should assess the new admission with acute abdominal pain first because he just arrived on the floor and might be unstable. Next, they should change the abdominal dressing for the postoperative client or measure feeding tube residual in the client with continuous tube feedings.

When assessing a client during a routine checkup, the nurse reviews the history and notes that the client had aphthous stomatitis at the time of the last visit. Aphthous stomatitis is best described as: 1). A canker sore of the oral soft tissues 2). An acute stomach infection 3). Acid indigestion 4). An early sign of peptic ulcer disease

A canker sore of the oral soft tissues Rationale: Aphthous stomatitis refers to a canker sore of the oral soft tissues, including the lips, tongue, and inside of the cheeks.

Which patient is most susceptible for acquiring secondary stomatitis? 1). An AIDs patient suffering from pneumonia 2). An 65 y/o obese female 3). A 45 y/o male suffering from colon cancer 4). A 50 y/o male with CHF

An AIDs patient suffering from pneumonia Rationale: Secondary stomatitis results from infection by oppourtunistic viruses or bacteria. In this case, the patient with AIDs is, likely, the most immunosuppressed.

An elderly client with Alzheimer's disease begins supplemental tube feedings through a gastrostomy tube to provide adequate calorie intake. The nurse should be concerned most with the potential for: 1). Hyperglycemia 2). Fluid volume excess 3). Aspiration 4). Constipation

Aspiration Rationale: Of the choices listed, aspiration is the most serious potential complication of tube feedings. Dehydration — not fluid volume excess — is a concern because of decreased free water intake.

Which task can the nurse delegate to a nursing assistant? 1). Irrigating a nasogastric (NG) tube 2). Assisting a client who had surgery three days ago walk down the hallway 3). Helping a client who just returned from surgery to the bathroom 4). Administering an antacid to a client complaining of heartburn

Assisting a client who had surgery three days ago walk down the hallway Rationale: Because the client had surgery three days ago, the nurse can safely delegate the task of helping the client walk down the hallway.

To prevent gastroesophageal reflux in a client with hiatal hernia, the nurse should provide which discharge instruction? 1). Lie down after meals to promote digestion 2). Avoid coffee and alcoholic beverages 3). Take antacids with meals 4). Limit fluid intake with meals

Avoid coffee and alcoholic beverages Rationale: To prevent reflux of stomach acid into the esophagus, the nurse should advise the client to avoid foods and beverages that increase stomach acid, such as coffee and alcohol

A client is admitted to the health care facility with a diagnosis of a bleeding gastric ulcer. The nurse expects this client's stools to be: 1). Coffee-ground-like 2). Clay-colored 3). Black and tarry 4). Bright red

Black and tarry Rationale: Black, tarry stools are a sign of bleeding high in the GI tract, as from a gastric ulcer, and result from the action of digestive enzymes on the blood.

Which foods should a patient with GERD stay away from (multiple answers)? 1). Burger King double cheeseburger 2). Lettuce 3). Candy canes 4). Chocolate espresso 5). White bread

Burger King double cheeseburger Candy canes Chocolate espresso Rationale: Patients with GERD should avoid peppermint, alcohol, caffeinated beverages, chocolate, tea, and coffee

How are ulcerative colitis and Chron's disease definitively diagnosed? 1). EGD 2). CBC 3). Stool sample 4). Colonoscopy

Colonoscopy

A 72-year-old client seeks help for chronic constipation. This is a common problem for elderly clients due to several factors related to aging. Which is one such factor? 1). Increased intestinal motility 2). Decreased abdominal strength 3). Increased gastric aid production 4). Hyperactive bowel sounds

Decreased abdominal strength Rationale: Decreased abdominal strength, muscle tone of the intestinal wall, and motility all contribute to chronic constipation in the elderly

Which of the following is an inappropriate nursing diagnosis for a client with malignant tumors of the oral cavity? 1). Impaired oral mucous membranes 2). Deficient fluid volume 3). Acute pain 4). Risk for ineffective airway clearance

Deficient fluid volume

Which of the following is not an education tool required prior to an endoscopic procedure? 1). The purpose of the procedure 2). What to expect during the procedure 3). How long the procedure will take 4). Preparation required prior to the surgery

How long the procedure will take Rationale: The length of endoscopies varies and it is also the least important education tool for the patient.

Which of the following has the least important role in terms of peptic ulcer formation? 1). Acid 2). NSAID use 3). Prescence of H. pylori 4). Hypertension

Hypertension

Which of the following is not a common symptom of GERD? 1). Dyspepsia 2). Regurgitation 3). Dysphagia 4). Hyposalivation

Hyposalivation Rationale: Hypersalivation, aka water brash, occurs in response to reflux, not hyposalivation.

While preparing a client for cholecystectomy, the nurse explains that incentive spirometry will be used after surgery primarily to: 1). Increase respiratory effectiveness. 2). Eliminate the need for nasogastric intubation. 3). Improve nutritional status during recovery. 4). Decrease the amount of postoperative analgesia needed

Increase respiratory effectiveness. Rationale: The high abdominal incision used in a cholecystectomy interferes with respirations postoperatively, increasing the risk of atelectasis