GI Review Questions

Which of the following positions would permit the best assessment of a client's inguinal hernia? A. standing B. sitting C. left side-lying D. right side-lying

A

What are some tasks that can be delegated to an unlicensed nursing assistant?

Feeding the patient (not dysphagia pts), positioning, helping pt select diet (unless specialty), set up trays, record input and output, oral care, snacks/drinks

The nurse is instructing a client on measures to maintain effective oral health. Which measures does the nurse include in the client's teaching plan? Select all that apply. A. Regular dental checkups B. use of mouthwashes containing alcohol C. Ensuring that dentures are slightly loose fitting D. Managing stress as much as possible E. eating a balanced diet

A, D, E

A barium enema is contraindicated as a diagnostic test for a client with diverticulitis, because a barium enema: A. can perforate an intestinal abscess B. would greatly increase the client's pain C. is of minimal diagnostic value in diverticulitis D. is too lengthy a procedure for the client to tolerate

A

A nurse must provide total parenteral nutrition (TPN) to a client through a triple-lumen central line. To prevent complications of TPN, the nurse should: A. Cover the catheter insertion site with occlusive dressing B. Use clean technique when changing the dressing C. Insert an indwelling urinary catheter D. Keep the client on complete bed rest

A

What does the nurse advise a client diagnosed with irritable bowel syndrome (IBS) to take during periods of constipation? A. bulk-forming laxatives B. Saline laxatives C. Stimulant laxatives D. Stool-softening agents

A

A client has been receiving chemotherapy to treat cancer. Which assessment finding suggests that the client has developed stomatitis? A. White patch with raised edges at the base of the tongue B. Yellow tooth discoloration C. Red, open sores on the oral mucosa D. Rust-colored sputum

C

While working in the outpatient procedure unit, the RN is assigned to these patients. Which patient does the nurse assess first? A. 51 year old who recently had an ERCP B. 54 year old who is ready for discharge following a colonoscopy C. 58 year old who has just arrived for basal gastric secretion and gastric acid stimulation testing D. 60 year old with questions about an endoscopic ultrasound examination

A. ERCP

Which client does the charge nurse assign to experienced LPN working on the adult medical unit? A. 32 year old who needs a NGT inserted for gastric acid analysis B. 36 year old who needs teaching about an ERCP C. 40 year old who will need administration of IV midazolam hydrochloride (Versed) during an upper endoscopy D. 46 year old who was recently admitted with abdominal cramping and diarrhea of unknown cause

A. NGT insertion

A 67 year old male client reports pain in the inguinal area that occurs when he coughs. A bulge that can be pushed pack into the abdomen is found in his inguinal area. What type of hernia does he have? A. Femoral B. Reducible C. Strangulated D. Ventral

B

A client suspected of having irritable bowel syndrome (IBS) is scheduled for a hydrogen breath test. What does the nurse tell the client about this test? A. "During the test, you will drink small amounts of an antacid as directed by the technician" B. "If you have IBS, hydrogen levels may be increased in your breath samples" C. "The test will take between 30 and 45 minutes to complete" D. "You must have nothing to drink (except water) for 24 hours before the test"

B

A nurse is assessing a client who is receiving TPN. Which finding suggests that the client has developed hyperglycemia? A. Kussmaul respirations B. Increased urine output C. Decreased appetite D. Diaphoresis

B

A client who has a history of an inguinal hernia is admitted to the hospital with sudden, severe abdominal pain, vomiting, and abdominal distention. The nurse should assess the client further for which complication? A. peritonitis B. incarcerated hernia C. strangulated hernia D. intestinal perforation

C

The nurse observes that the client's total parenteral nutrition (TPN) solution is infusing too slowly. The nurse calculates that the client has received 300 mL less than was ordered for the day. The nurse should: A. Increase the flow rate to infuse an additional 300 mL over the next hour B. Maintain the flow rate at the current rate and document any discrepancy in the chart C. Assess the infusion system, note the client's condition, and notify the physician D. Discontinue the solution and administer dextrose if 5% water until the infusion problem is resolved

C

The nurse is providing instructions to a client who has a history of stomatitis. Which instructions does the nurse include in the client's teaching plan? A. Encourage the client to eat acidic foods to decrease bacteria B. Mouth care should be performed twice daily C. Rinse the mouth with warm saline or sodium bicarbonate D. Use a medium-bristled toothbrush for oral care

C.

Which substance, produced in the stomach, facilitates the absorption of vitamin B12? A. Glucagon B. Hydrochloric acid C. Intrinsic Factor D. Pepsinogen

C. Intrinsic Factor

A 92 year old male client who is independent and lives alone has an inguinal hernia repair. Which teaching method is the best approach to use for his postoperative and discharge teaching plans? A. Explaining all the instructions to him B. Demonstrating the instructions to him C. Explaining all the instructions to a family member D. Writing the instructions down for him

D

The nurse is teaching a client with stomatitis about mouth care. Which instructions is most appropriate? A. Drink hot tea at frequent intervals B. Gargle with antiseptic mouthwash C. Use an electric toothbrush D. Eat a soft, bland diet

D

When infusing TPN, the nurse should assess the client for which of the following serious complications? A. Essential amino acid deficiency B. Essential fatty acid deficiency C. Hyperglycemia D. infection

D

A client with oral carcinoma has a priority problem of risk for airway blockage related to obstruction by the tumor. At the beginning of the shift, which action will the nurse take first? A. suction the client's oral secretions to clear the airway B. Place the client on humidified oxygen per nasal cannula C. Assist the client to an upright position to facilitate breathing D. Assess the respiratory effort and quantities and types of oral secretions

D.

A client is diagnosed with irritable bowel syndrome (IBS). What factors does the nurse suspect as possible causes of the client's problem? Select all that apply. A. Antihistamines B. Caffeinated drinks C. Stress D. Sleeping pills E. Anxiety

B C E

The nurse is developing a plan of care for a client with Crohn's disease who is receiving TPN. Which of the following interventions should the nurse include? Select all that apply. A. Monitoring vital signs once a shift B. Weighing the client daily C. Changing the central venous line dressing daily D. Monitoring the I.V. infusion rate hourly E. Taping all I.V. tubing connections securely

B D E

A home health nurse who sees a client with diverticulitis is evaluating teaching about dietary modifications necessary to prevent future episodes. Which statement by the client indicates effective teaching? A. "I'll increase my intake of protein during exacerbations" B. "I should increase my intake of fresh fruits and vegetables during remission" C. "I'll snack on nuts, olives, and popcorn during flare ups D. "I'll incorporate foods rich in omega 3 fatty acids into my diet"

B

A male client in a long-term care facility is 2 days postoperative after an open repair of an inguinal hernia. Which nursing action does the RN delegate to unlicensed assistive personnel (UAP)? A. Assessing the client's incision for signs of infection B. Assisting the client to stand to void C. Instructing the client in how to deep-breathe D. Monitoring the client's pain level

B

A client diagnosed with IBS is discharged home with a variety of medications for IBS symptoms. Upon returning to the clinic, the client states, "Most of my symptoms have improved, except for the diarrhea." What does the nurse anticipate will be prescribed for this client? A. Antidiarrheal agent B. Muscarinic receptor antagonist C. Serotonin antagonist D. Tricyclic antidepressant

B

The nurse assesses a client with diverticulitis and suspects peritonitis when which of the following symptoms is noted? A. hyperactive bowel sounds B. rigid abdominal wall C. explosive diarrhea D. excessive flatulence

B

A client is admitted to the hospital with severe right upper quadrant (RUQ) abdominal pain. Which assessment technique does the nurse use for this client? A. Assesses the abdomen in the following sequence: inspection, palpation, percussion, auscultation B. Examine the RUQ of the abdomen last C. Has the client lie in a supine position with legs straight and arms by the sides D. Views the abdomen by looking directly down while standing over

B. Examine the RUQ last

The nurse is assessing a client who comes to the emergency department with acute abdominal pain. The nurse notes a bulging, pulsating mass when inspecting the abdomen. Which action by the nurse is correct? A. Auscultate the abdomen to determine the presence of bowel sounds B. Notify the provider about the finding immediately C. Palpate the client's abdomen to determine the outlines of the mass D. Question the client about recent stool habits

B. Notify the provider about the finding immediately

Which factors place a client at risk for gastrointestinal problems? A. eating a high fiber diet B. smoking a half-pack of cigarettes per day C. socioeconomic status D. some herbal preparations E. use of NSAIDs

BCDE

A client receiving radiation to the head and neck is experiencing stomatitis. The nurse should recommend: A. evaluation by a dentist B. alcohol-based mouth wash rinses C. artificial saliva D. vigorous brushing of teeth after each meal

C

After instructing a client with diverticulitis about appropriate self-care activities, which comment by the client indicates effective teaching? Select all that apply. A. "With careful attention to my diet, my diverticulitis can be cured." B. " Using a cathartic laxative weekly is okay to control bowel movements" C. "I should follow a diet that is high in fiber" D. "It is important for me to drink at least 2,000 mL of fluid every day" E. "I should exercise regularly"

C D E

A client is receiving total parenteral nutrition (TPN). The nurse notices that the bag of TPN solution has been infusing for 24 hours but has 300 mL of solution left. The nurse should: A. Continue the infusion until the remaining 300 ml is infused B. Change the filter on the tubing and continue with the infusion C. Notify the HCP and obtain prescriptions to alter the flow rate of the solution D. Discontinue the current solution, change the tubing and hang a new bag of TPN solution

D -- you can't play catch up and TPN can only hang for 24 hours and then the tubing and bag should be changed