PrepU 38 Assessment of Digestive and Gastrointestinal Function - PrepU

A client tells the nurse that the stool was colored yellow. The nurse assesses the client for - recent foods ingested. - ingestion of bismuth. - pilonidal cyst. - occult blood.

- recent foods ingested.

A client is scheduled for magnetic resonance imaging (MRI). During the client teaching, what will the nurse discuss? - "Do you experience any claustrophobia?" - "The examination will take only 15 minutes." - "You must remove all jewelry but can wear your wedding ring." - "You must be NPO for the day before the examination."

- "Do you experience any claustrophobia?"

A client reports having red stools lately. What will the nurse ask during assessment questioning? - "Have you been eating spinach?" - "Have you been eating beets?" - "Have you been drinking grape juice?" - "Have you been taking an iron supplement?"

- "Have you been eating beets?"

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? - "Wearing an undergarment will become more comfortable over time." - "Having a bowel movement is a spinal reflex requiring intact nerve fibers. Yours are not intact." - "Over time, the nerve fibers will regrow new tracts, and you can have bowel movements again." - "It is not going to happen. Your nerve cells are too damaged."

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

A client is readmitted with an exacerbation of celiac disease 2 weeks after discharge. Which statement by the client indicates the need for a dietary consult? - "I didn't eat anything I shouldn't have; I just ate roast beef on rye bread." - "I don't understand this; I took the medication the doctor ordered and followed the diet." - "I don't understand why this happened again; I didn't travel out of the country." - "I don't like oatmeal, so it doesn't matter that I can't have it."

- "I didn't eat anything I shouldn't have; I just ate roast beef on rye bread."

A client asks the nurse why the physician ordered the blood test carcinoembryonic antigen (CEA). The nurse answers: - "It tells the physician what type of cancer is present." - "It detects a protein normally found in the blood." - "It indicates if a cancer is present." - "It determines functionality of the liver."

- "It indicates if a cancer is present."

The nurse asks a client to point to where pain is felt. The client asks why this is important. What is the nurse's best response? - "If the health care provider massages over the exact painful area, the pain will disappear." - "This determines the pain medication to be ordered." - "Often the area of pain is referred from another area." - "The area may determine the severity of the pain."

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

The nurse is instructing a client prior to a colonoscopy. The client states, "Why do I have to drink this disgusting liquid?" The nurse is most correct to verbalize the goal of the oral preparation as which of the following? - "To allow ease of passage of the scope through the colon" - "To cleanse the bowel to promote clear visualization of structures" - "To decrease pain associated with fecal matter being pressed against the colon wall" - "To eliminate gas from the internal portion of the colon"

- "To cleanse the bowel to promote clear visualization of structures"

A client presented with gastrointestinal bleeding 2 days ago and continues to have problems. The health care provider has ordered a visualization of the small intestine via a capsule endoscopy. What will the nurse include in the client education about this procedure? - "The health care provider will use a scope called a capsule to view your intestine." - "You will need to swallow a capsule." - "A capsule will be inserted into your rectum." - "An x-ray machine will use a capsule ray to follow your intestinal tract."

- "You will need to swallow a capsule."

Blood flow to the GI tract is approximately what percentage of the total cardiac output? - 20% - 30% - 40% - 10%

- 20%

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? - 3 days - 2 days - 1 day - 4 days

- 3 days

The nurse is caring for a client recovering from an esophagogastroduodenoscopy (EGD). Which of the following client symptoms would require further nursing assessment? - Abdominal distention - Sore throat - Drowsiness - Thirst

- Abdominal distention

Which of the following is the primary function of the small intestine? - Absorption - Digestion - Peristalsis - Secretion

- Absorption

The nurse is performing a focused abdominal assessment of a client with a history of bowel obstruction. The nurse has positioned the client appropriately and inspected the client's abdomen carefully. What action should the nurse perform next? - Palpate the lower two quadrants - Auscultate the client's abdomen - Palpate the upper two quadrants - Perform percussion, if tolerated

- Auscultate the client's abdomen

When assisting with preparing a client scheduled for a barium swallow, which of the following would be appropriate to include? - Avoid smoking for at least 12 to 24 hours before the procedure. - Take vitamin K before the procedure. - Take three cleansing enemas before the procedure. - Avoid the intake of red meat before the procedure.

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

Which of the following is considered the gold standard for the diagnosis of liver disease? - Cholecystography - Paracentesis - Biopsy - Ultrasonography

- Biopsy

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? - Black - Dark brown - Red - Green

- Black

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? - Colonic polyp - Infection - Rectal fissure - Bowel perforation

- Bowel perforation

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? - Observing for distended abdominal veins - Checking if the skin is discolored - Checking if the mucous membranes are dry - Examining the sclera if it is yellow

- Checking if the mucous membranes are dry

A client is scheduled for several diagnostic tests to evaluate gastrointestinal function. After teaching the client about these tests, the nurse determines that the client has understood the teaching when the client identifies which test as not requiring the use of a contrast medium? - Colonoscopy - Computer tomography - Upper GI series - Small bowel series

- Colonoscopy

A nurse is preparing a client with Crohn's disease for a barium enema. What should the nurse do the day before the test? - Serve dairy products. - Serve the client his usual diet. - Order a high-fiber diet. - Encourage plenty of fluids.

- Encourage plenty of fluids.

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? - Hamburger and French fries - Steamed rice with pork and broccoli - Salmon with cheddar mashed potatoes - Grilled chicken on a spinach salad

- Hamburger and French fries

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? - Borborygmi - Normal - Hyperactive - Hypoactive

- Hyperactive

Gastrin has which of the following effects on gastrointestinal (GI) motility? - Relaxation of the colon - Increased motility of the stomach - Relaxation of gastroesophageal sphincter - Contraction of the ileocecal sphincter

- Increased motility of the stomach

A client is recovering from an ileostomy that was performed to treat inflammatory bowel disease. During discharge teaching, what would the nurse stress the importance of? - Increasing fluid intake to prevent dehydration - Taking only enteric-coated medications - Consuming a low-protein, high-fiber diet - Wearing an appliance pouch only at bedtime

- Increasing fluid intake to prevent dehydration

When examining the abdomen of a client with reports of nausea and vomiting, what would the nurse do first? - Percussion - Inspection - Palpation - Auscultation

- Inspection

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. - Percussion - Inspection - Palpation - Auscultation

- Inspection - Auscultation - Percussion - Palpation

A client is diagnosed with megaloblastic anemia caused by vitamin B12 deficiency. The health care provider begins the client on cyanocobalamin (Betalin-12), 100 mcg I.M. daily. Which substance influences vitamin B12 absorption? - Liver enzyme - Hydrochloric acid - Histamine - Intrinsic factor

- Intrinsic factor

While palpating a client's right upper quadrant (RUQ), the nurse would expect to find which structure? - Spleen - Liver - Appendix - Sigmoid colon

- Liver

Swallowing is regulated by which area of the central nervous system (CNS)? - Cerebellum - Pons - Medulla oblongata - Hypothalamus

- Medulla oblongata

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? - Permit the client to drink only clear liquids. - Instruct the client to have low-residue meals. - Provide saline gargles to the client. - Allow the client to ingest fat-free meal.

- Permit the client to drink only clear liquids.

Which diagnostic produces images of the body by detecting the radiation emitted from radioactive substances? - Positron emission tomography (PET) - Computed tomography (CT) - Fibroscopy - Magnetic resonance imaging (MRI)

- Positron emission tomography (PET)

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? - Hypoharyngeal sphincter - Cardiac sphincter - Ileocecal valve - Pyloric sphincter

- Pyloric sphincter

Following ingestion of carrots or beets, the nurse would expect which alteration in stool color? - Black - Yellow - Milky white - Red

- Red

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? - Related to major surgery required by bowel resection - Related to malnutrition secondary to bowel resection with anastomosis - Related to the presence of a nasogastric (NG) tube postoperatively - Related to the presence of bacteria at the surgical site

- Related to the presence of bacteria at the surgical site

The nurse determines a client scheduled to undergo an abdominal ultrasonography should receive which instruction? - Restrict eating of solid food for 6 to 8 hours before the test. - Do not consume anything sweet for 24 hours before the test. - Avoid exposure to sunlight for at least 6 to 8 hours before the test. - Do not undertake any strenuous exercise for 24 hours before the test.

- Restrict eating of solid food for 6 to 8 hours before the test.

The nurse conducts education related to test preparation for a client scheduled to undergo an abdominal ultrasonography. The nurse should give the client which instruction? - Do not undertake any strenuous exercise for 24 hours before the test. - Do not consume anything sweet for 24 hours before the test. - Avoid exposure to sunlight for at least 6 to 8 hours before the test. - Restrict eating of solid food for 8 to 12 hours before the test.

- Restrict eating of solid food for 8 to 12 hours before the test.

When evaluating the function of the GI tract, the nurse needs to understand the role of hormones. Secretin, stimulated by the pH of chyme in the duodenum, is a major GI hormone that does which of the following? - Influences contraction of the esophageal and pyloric sphincters - Stimulates the production of bicarbonate in pancreatic juice - Regulates the secretion of gastric acid - Causes the gallbladder to contract

- Stimulates the production of bicarbonate in pancreatic juice

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? - Ileum - Stomach - Liver - Large Intestine

- Stomach

The nurse is preparing to examine the abdomen of a client who reports a change in bowel pattern. The nurse would place the client in which position? - Lithotomy - Supine with knees flexed - Left Sim's lateral - Knee-chest

- Supine with knees flexed

The nurse is collecting a stool specimen from a patient. What characteristic of the stool indicates to the nurse that the patient may have an upper GI bleed? - Threaded with mucus - Tarry and black - Clay-colored - Greasy and foamy

- Tarry and 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? - Tarry-black - Bright red - Blood-streaked - Dark brown

- Tarry-black

The nurse is caring for a geriatric client experiencing diarrhea. When teaching about the site in the body where water and electrolytes are absorbed, the nurse is most correct to instruct on which location? - The stomach - The large bowel - The small bowel - The cecum

- The small bowel

Which nursing instruction is correct to provide the client following a barium enema? - Sips of fluid may be increased if tolerated. - An enema will be used to clear the bowel. - The client will maintain a low residue diet. - The stools may be a white or clay colored.

- The stools may be a white or clay colored.

When describing the role of the pancreas to a client with a pancreatic dysfunction, the nurse would identify which substance as being acted on by pancreatic lipase? - Protein - Glucose - Starch - Triglycerides

- Triglycerides

A client receives a local anesthetic to suppress the gag reflex for a diagnostic procedure of the upper GI tract. The nurse determines which nursing intervention is advised for this client? - measure fluid output for at least 24 hours after the procedure - monitor for cramping or abdominal distention - do not give any food and fluids until the gag reflex returns - monitor for any breathing-related disorder or discomforts

- do not give any food and fluids until the gag reflex returns

The major carbohydrate that tissue cells use as fuel is - chyme. - glucose. - proteins. - fats.

- glucose.

When preparing a client for magnetic resonance imaging (MRI) of the abdomen, which statement would indicate the need to notify the health care provider? - "I haven't had anything to eat or drink since midnight last night." - "I really don't like to be in small, enclosed spaces." - "I left all my jewelry and my watch at home." - "I brought earphones to shut out the loud noise."

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

The nurse provides client education to a client about to undergo hydrogen breath testing. The nurse evaluates that the client understands the test when the client makes which statement? - "The test will detect the presence of oral cancer." - "I should avoid antibiotics for 1 month before the test." - "First, I will drink a cherry flavored liquid." - "The test will detect the presence of staph."

- "I should avoid antibiotics for 1 month before the test."

A home care nurse is caring for a client with reports of epigastric discomfort who is scheduled for a barium swallow. Which statement by the client indicates an understanding of the test? - "There is no need for special preparation before the test." - "I'll drink full liquids the day before the test." - "I'll take a laxative to clear my bowels before the test." - "I'll avoid eating or drinking anything 6 to 8 hours before the test."

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

Which of the following digestive enzymes aids in the digesting of starch? - Trypsin - Amylase - Bile - Lipase

- Amylase

An older adult client is admitted to an acute care facility for treatment of an acute flare-up of a chronic gastrointestinal condition. In addition to assessing the client for complications of the current illness, the nurse monitors for age-related changes in the gastrointestinal tract. Which age-related change increases the risk of anemia? - Increase in bile secretion - Atrophy of the gastric mucosa - Dulling of nerve impulses - Decrease in intestinal flora

- Atrophy of the gastric mucosa

A client receives a local anesthetic to suppress the gag reflex for a diagnostic procedure of the upper GI tract. Which nursing intervention is advised for this client? - Do not give any food and fluids until the gag reflex returns. - Measure fluid output for at least 24 hours after the procedure. - Monitor for cramping or abdominal distention. - Monitor for any breathing-related disorder or discomforts.

- Do not give any food and fluids until the gag reflex returns.

The nurse teaches a client scheduled for a colonoscopy. Which instruction should be included as part of the preparation for the procedure? - Follow the dietary and fluid restrictions and bowel preparation procedures. - Do not void for at least 30 minutes before the test. - Spray or gargle with a local anesthetic. - Consume at least 3 quarts of water 30 minutes before the test.

- Follow the dietary and fluid restrictions and bowel preparation procedures.

A few hours after eating hot and spicy chicken wings, a client presents with lower chest pain. He wonders if he is having a heart attack. How should the nurse proceed first? - Further investigate the initial complaint. - Call for an immediate electrocardiogram. - Explain that fatty foods can mimic chest pain. - Administer an over-the-counter antacid tablet.

- Further investigate the initial complaint.

After 20 seconds of auscultating for bowel sounds on a client recovering from abdominal surgery, the nurse hears nothing. What should the nurse do based on the assessment findings? - Listen longer for the sounds. - Document that the client is constipated. - Call the health care provider to report absent bowel sounds. - Return in 1 hour and listen again to confirm findings.

- Listen longer for the sounds.

A nurse is giving a client barium swallow test. What is the most important assessment a nurse would make to ensure that a client does not retain any barium after a barium swallow? - Placing any stool passed in a specific preservative. - Observing the color of urine. - Monitoring the volume of urine. - Monitoring the stool passage and its color.

- Monitoring the stool passage and its color.

What part of the GI tract begins the digestion of food? - Mouth - Duodenum - Esophagus - Stomach

- Mouth

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? - Stomach - Liver - Pancreas - Gallbladder

- Pancreas

The nurse is assisting the health care provider with a gastric acid stimulation test for a client. What medication should the nurse prepare to administer subcutaneously to stimulate gastric secretions? - Glycopyrronium bromide - Pentagastrin - Acetylcysteine - Atropine

- Pentagastrin

Which of the following is an enzyme secreted by the gastric mucosa? - Ptyalin - Bile - Trypsin - Pepsin

- Pepsin

The nurse cares for a client after an endoscopic examination and prepares the client for discharge. The nurse includes which instruction? - Avoid driving for 24 hours - Continue a clear liquid diet - Resume regular diet - Increase fluid intake

- Resume regular diet

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? - The ultrasonography should be scheduled before the GI procedure. - Both tests need to be done before breakfast. - The upper GI should be scheduled before the ultrasonography. - The client may eat a light meal before either test.

- The ultrasonography should be scheduled before the GI procedure.

The nurse determines which is a true statement regarding older clients, considering the age-related effects on their GI system? - They tend usually to have less control of the rectal sphincter. - They tend to have higher physiologic reserves to compensate for fluid loss. - They tend to have increased muscle tone and mass. - They have no awareness of the filling reflex.

- They tend usually to have less control of the rectal sphincter.

The nurse is preparing the client for an assessment of the abdomen. What should the nurse complete prior to this assessment? - Dim the lights for privacy. - Prepare for a prostate examination. - Ask the client to empty the bladder. - Assist the client to a Fowler's position.

- Ask the client to empty the bladder.

When bowel sounds are heard about every 15 seconds, the nurse would record that the bowel sounds are - absent. - sluggish. - normal. - hypoactive.

- normal.

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? - Gastric analysis - A complete blood count including differential - Serum antibodies for H. pylori - A sigmoidoscopy

- Serum antibodies for H. pylori

The nurse prepares a client for a barium enema. The nurse should place the client on which diet prior to the procedure? - nothing by mouth (NPO) 2 days prior - clear liquids day before - soft diet 1 day prior - high-fiber diet 1 to 2 days prior

- clear liquids day before

When gastric analysis testing reveals excess secretion of gastric acid, the nurse recognizes which medical diagnoses is supported? - chronic atrophic gastritis - pernicious anemia - duodenal ulcer - gastric cancer

- duodenal ulcer

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? - jejunum - ileum - cecum - duodenum

- duodenum

The nurse determines one or two bowel sounds in 2 minutes should be documented as - hyperactive. - absent. - normal. - hypoactive.

- hypoactive.

A health care provider 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 medication while collecting stool for the test? - ibuprofen - docusate sodium - acetaminophen - ciprofloxacin

- ibuprofen

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? - pulmonary hypertension - congestive heart failure - chronic obstructive pulmonary disease (COPD) - inflammatory bowel disease

- inflammatory bowel disease

The nurse inspects a client's tongue. Which finding would the nurse evaluate as an indication of potential oral cancer? - large, vallate papillae on dorsum of tongue - V formation on dorsum of tongue - red plaque on undersurface of tongue - thin, white coating on dorsum of tongue

- red plaque on undersurface of tongue

Which procedure is performed to examine and visualize the lumen of the small bowel? - small bowel enteroscopy - panendoscopy - peritoneoscopy - colonoscopy

- small bowel enteroscopy

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. What is the nurse's best response? - rectum - large intestine - small intestine - stomach

- small intestine

Which enzyme aids in the digestion of protein? - trypsin - lipase - pepsin - ptyalin

- trypsin

The client describes a test previously completed to detect a small bowel obstruction prior to admission to the hospital. The client states that the test involved insertion of a tube through the nose and lasted over 6 hours. The nurse determines which test name should be documented? - magnetic resonance imaging - positron emission tomography - upper GI enteroclysis - abdominal ultrasound

- upper GI enteroclysis

The nurse recognizes which change of the GI system is an age-related change? - weakened gag reflex - increased mucus secretion - hypertrophy of the small intestine - increased motility

- weakened gag reflex

The nurse recognizes which change of the gastrointestinal system is an age-related change? - increased motility - increased mucus secretion - weakened gag reflex - hypertrophy of the small intestine

- weakened gag reflex