MedSurg Chapter 43

Inspection

When examining the abdomen of a client with complaints of nausea and vomiting, which of the following would the nurse do first?

"It indicates if a cancer is present."

A client asks the nurse why the physician ordered the blood test carcinoembryonic antigen (CEA). The nurse answers:

Intrinsic factor

A client is diagnosed with megaloblastic anemia caused by vitamin B12 deficiency. The physician begins the client on cyanocobalamin (Betalin-12), 100 mcg I.M. daily. Which substance influences vitamin B12 absorption?

recent foods ingested.

A client tells the nurse that the stool was colored yellow. The nurse assesses the client for

Permit the client to drink only clear liquids.

A client undergoing a diagnostic examination for gastrointestinal disorder was given polyethylene glycol/electrolyte solution as a part of the test preparation. Which of the following measures should the nurse take once the solution is administered?

Pyloric Sphincter

A group of students are studying for an examination on the gastrointestinal (GI) system and are reviewing the structures of the esophagus and stomach. The students demonstrate understanding of the material when they identify which of the following as the opening between the stomach and duodenum?

"I'll avoid eating or drinking anything 6 to 8 hours before the test."

A home care nurse is caring for a client with complaints of epigastric discomfort who is scheduled for a barium swallow. Which statement by the client indicates an understanding of the test?

Stomach

After teaching a group of students about the various organs of the upper gastrointestinal tract and possible disorders, the instructor determines that the teaching was successful when the students identify which of the following structures as possibly being affected?

duodenum

Cystic fibrosis, a genetic disorder characterized by pulmonary and pancreatic dysfunction, usually appears in young children but can also affect adults. If the pancreas was functioning correctly, where would the bile and pancreatic enzymes enter the GI system?

Bowel perforation

During a colonoscopy with moderate sedation, the patient groans with obvious discomfort and begins bleeding from the rectum. The patient is diaphoretic and has an increase in abdominal girth from distention. What complication of this procedure is the nurse aware may be occurring?

red

Following ingestion of carrots or beets, the nurse would expect which alteration in stool color?

Increase the amount of fluids

The nurse is working on a general medical unit. A client is scheduled for an upper gastrointestinal series. Upon return to the nursing unit, what does the nurse identify as the client goal?

Pancreas

The nurse is working with clients with digestive tract disorders. Which of the following organs does the nurse realize has effects as an exocrine gland and an endocrine gland?

Increased motility of the stomach

Gastrin has which of the following effects on gastrointestinal (GI) motility?

clear liquids day before

The nurse prepares a client for a barium enema. The nurse should place the client on which diet prior to the procedure?

inflammatory bowel disease

The nurse prepares to administer the lavage solution to a client having a colostomy completed. The nurse stops and notifies the physician when noting that the client has which condition?

weakened gag reflex

The nurse recognizes which change of the gastrointestinal system is an age-related change?

Steapsin

It is important for a nurse to have an understanding of the major digestive enzymes and their actions. Choose the gastric mucosa secretion that plays an important role in the digestion of triglycerides.

metabolism

Lisa Bentley, a 32-year-old teacher, presents to the gastroenterology office where you work. She is known to have a history of Crohn's disease, and you have met with her several times to discuss the various health concerns that she has related to her diagnosis. When talking with the client, the nurse explains that having a GI disorder doesn't mean her problems are limited to the one area that is diseased but might also involve all of the following except ________.

Tarry-black

Specific disease processes and ingestion of certain foods and medications may change the appearance of the stool. If blood is shed in sufficient quantities into the upper gastrointestinal (GI) tract, it produces which change in the stool appearance?

Medulla oblongata

Swallowing is regulated by which area of the central nervous system (CNS)

glucose.

The major carbohydrate that tissue cells use as fuel is

"Often the area of pain is referred from another area."

The nurse asks a client to point to where she feels pain. The client asks why this is important. The nurse's best response would be which of the following?

hypoactive

The nurse assesses bowel sounds and hears one to two bowel sounds in 2 minutes. How should the nurse document the bowel sounds?

Hyperactive

The nurse auscultates the abdomen to assess bowel sounds. She documents five to six sounds heard in less than 30 seconds. How does the nurse document the bowel sounds?

Hamburger and French fries

The nurse is assessing a client who is stating gastrointestinal upset and a feeling of bloating. Which type of meal would the nurse anticipate causing these types of symptoms?

Inspection Auscultation Percussion Palpation

The nurse is assessing the abdomen of the client with an undiagnosed disorder. In which sequence would the nurse conduct the abdominal assessment? Use all options

Prothrombin time (PT)

The nurse is caring for a client who is scheduled for a percutaneous liver biopsy. Which diagnostic test is obtained prior?

"You may frequently experience constipation."

Upon hearing that his small intestine lining has thinned, an elderly client asks, "What can this lead to?" The nurse would most likely respond with which of the following comments?

Avoid smoking for at least 12 to 24 hours before the procedure

When assisting with preparing a client scheduled for a barium swallow, which of the following would be appropriate to include?

Normal

When bowel sounds are heard about every 15 seconds, the nurse would record that the bowel sounds are

3 Days

When completing a nutritional assessment of a patient who is admitted for a GI disorder, the nurse notes a recent history of dietary intake. This is based on the knowledge that a portion of digested waste products can remain in the rectum for how many days after a meal is digested?

Pentagastrin

The nurse is assisting the physician with a gastric acid stimulation test for a patient. What medication should the nurse prepare to administer subcutaneously to stimulate gastric secretions?

The stools may be a white or clay colored.

Which nursing instruction is correct to provide the client following a barium enema?

"Having a bowel movement is a spinal reflex requiring intact nerve fibers. Yours are not intact."

The nurse is caring for a man who has experienced a spinal cord injury. Throughout his recovery, the client expects to gain control of his bowels. The nurse's best response to this client would be which of the following?

Serum antibodies for H. pylori

The nurse is instructing the client who was newly diagnosed with peptic ulcers. Which of the following diagnostic studies would the nurse anticipate reviewing with the client?

Dyspepsia

The nurse is performing an assessment of a patient. During the assessment the patient informs the nurse of some recent "stomach trouble." What does the nurse know is the most common symptom of patients with GI dysfunction?

Supine with knees flexed

The nurse is preparing to examine the abdomen of a client complaining of a change in his bowel pattern. The nurse would place the client in which position?

Esophagus

The nurse is providing community education at the mall. The nurse is instructing on the muscular tube that connects the mouth to the stomach. The nurse outlines this structure on a drawing and labels it with which of the following?

Xiphoid process

While completing an abdominal assessment, the nurse will use which landmark as the upper boundary for auscultating bowel sounds?

Liver

While palpating a client's right upper quadrant (RUQ), the nurse would expect to find which structure?

Atrophy of the gastric mucosa

A client, age 82, is admitted to an acute care facility for treatment of an acute flare-up of a chronic GI condition. In addition to assessing the client for complications of the current illness, the nurse monitors for age-related changes in the GI tract. Which age-related change increases the risk of anemia?

Encourage plenty of fluids

A nurse is preparing a client with Crohn's disease for a barium enema. What should the nurse do the day before the test?

small intestine.

A nurse is teaching a client with malabsorption syndrome about the disorder and its treatment. The client asks which part of the GI tract absorbs food. The nurse tells the client that products of digestion are absorbed mainly in the:

ibuprofen (Advil)

A physician plans to send a client home with supplies to complete a hemoccult test on all stools for 3 days. During the client education, the nurse informs the client to avoid which of the following medications while collecting stool for the test?

Related to the presence of bacteria at the surgical sit

A client is scheduled for bowel resection with anastomosis involving the large intestine. Because of the surgical site, the nurse formulates the nursing diagnosis of Risk for infection. To complete the nursing diagnosis statement, the nurse should add which "related-to" phrase?

common bile duct, pancreatic duct, and biliary tree

A client is scheduled to have an endoscopic retrograde cholangiopancreatography. Which structures are visualized during this procedure?

The ultrasonography should be scheduled before the GI procedure.

A client is to have an upper GI procedure with barium ingestion and abdominal ultrasonography. While scheduling these diagnostic tests, the nurse must consider which factor?

"You will need to swallow a capsule."

A client presented with gastrointestinal bleeding 2 days ago and continues to have problems. The physician has ordered a visualization of the small intestine via a capsule endoscopy. Which of the following will the nurse include in the client education about this procedure?

abdominal distention

The nurse is caring for a client recovering from an esophagogastroduodenoscopy (EGD). Which of the following client symptoms would require further nursing assessment?

The client will change positions frequently throughout the procedure.

The nurse is teaching the client about the upcoming endoscopic retrograde cholangiopancreatography (ERCP). Although the nurse instructs on several pertinent points of care, which is emphasized?

Black

The nurse is to obtain a stool specimen from a client who reported that he is taking iron supplements. The nurse would expect the stool to be which color?

Checking if the mucous membranes are dry

When examining the skin of a client who is dehydrated due to fluid losses from the gastrointestinal tract, which of the following would be most important?

duodenal ulcer

When gastric analysis testing reveals excess secretion of gastric acid, the nurse recognizes which medical diagnoses is supported?

"I really don't like to be in small, enclosed spaces."

When preparing a client for magnetic resonance imaging (MRI) of the abdomen, which statement would indicate the need to notify the physician?.

Positron emission tomography (PET

Which diagnostic produces images of the body by detecting the radiation emitted from radioactive substances?

acetylcholine

Which neuroregulator increase gastric acid secretion?

Amylase

Which of the following digestive enzymes aids in the digesting of starch?

Pepsin

Which of the following is an enzyme secreted by the gastric mucosa?

Biopsy

Which of the following is considered the gold standard for the diagnosis of liver disease?

Absorption

Which of the following is the primary function of the small intestine?

Ask the client to empty his bladder

Which of the following should the nurse complete prior to assessing the abdomen of a 35-year-old man?

Monitoring the stool passage and its color.

Which of the following would be most important to ensure that a client does not retain any barium after a barium swallow?

small bowel enteroscopy

Which procedure is performed to examine and visualize the lumen of the small bowel?

increased peristalsis

Which response is a parasympathetic response in the GI tract?