Stomach Disorders Quiz
An older client has had an instance of drug toxicity and asks why this happens, since the client has been on this medication for years at the same dose. What response by the nurse is best? Select one: a. "Your body probably can't tolerate as much medication anymore." b. "Changes in your liver cause drugs to be metabolized differently." c. "Perhaps you don't need as high a dose of the drug as before." d. "Stomach muscles atrophy with age and you digest more slowly."
Decreased liver enzyme activity depresses drug metabolism, which leads to accumulation of drugs-possibly to toxic levels. The other options do not accurately explain this age-related change. The correct answer is: "Changes in your liver cause drugs to be metabolized differently."
A nurse is teaching a client about magnesium hydroxide with aluminum hydroxide (Maalox). What instruction is most appropriate? Select one: a. "Take 1 hour before meals." b. "Aspirin must be avoided." c. "Do not worry about black stools." d. "Report diarrhea to your provider."
Maalox can cause hypermagnesemia, which causes diarrhea, so the client should be taught to report this to the provider. Aspirin is avoided with bismuth sulfate (Pepto-Bismol). Black stools can be caused by Pepto-Bismol. Maalox should be taken after meals. The correct answer is: "Report diarrhea to your provider."
A client scheduled for a percutaneous transhepatic cholangiography (PTC) denies allergies to medication. What action by the nurse is best? Select one: a. Instruct the client on bowel preparation. b. Ensure that the client has a ride home. c. Document this information on the chart. d. Ask the client about shellfish allergies.
PTC uses iodinated dye, so the client should be asked about seafood allergies, specifically to shellfish. Documentation should occur, but this is not the priority. The client will need a ride home afterward if the procedure is done on an outpatient basis. There is no bowel preparation for PTC. The correct answer is: Ask the client about shellfish allergies.
A client is scheduled for a colonoscopy and the nurse has provided instructions on the bowel cleansing regimen. What statement by the client indicates a need for further teaching? Select one: a. "My spouse will be here to drive me home." b. "It's a good thing I love orange and cherry gelatin." c. "I should refrigerate the GoLYTELY before use." d. "I will buy a case of Gatorade before the prep."
The client should be advised to avoid beverages and gelatin that are red, orange, or purple in color as their residue can appear to be blood. The other statements show a good understanding of the preparation for the procedure. The correct answer is: "It's a good thing I love orange and cherry gelatin."
A client has a recurrence of gastric cancer and is in the gastrointestinal clinic crying. What response by the nurse is most appropriate? Select one: a. "Do you have family or friends for support?" b. "Would you like me to refer you to hospice?" c. "I'd like to know what you are feeling now." d. "Well, we knew this would probably happen."
The nurse assesses the client's emotional state with open-ended questions and statements and shows a willingness to listen to the client's concerns. Asking about support people is very limited in nature, and "yes-or-no" questions are not therapeutic. Stating that this was expected dismisses the client's concerns. The client may or may not be ready to hear about hospice, and this is another limited, yes-or-no question. The correct answer is: "I'd like to know what you are feeling now."
A client is being taught about drug therapy for Helicobacter pylori infection. What assessment by the nurse is most important? Select one: a. Family history of H. pylori infection b. Former smoker still using nicotine patches c. Alcohol intake of 1 to 2 drinks per week d. Willingness to adhere to drug therapy
Treatment for this infection involves either triple or quadruple drug therapy, which may make it difficult for clients to remain adherent. The nurse should assess the client's willingness and ability to follow the regimen. The other assessment findings are not as critical. The correct answer is: Willingness to adhere to drug therapy
A nurse assesses clients at a community health center. Which client is at highest risk for the development of colorectal cancer? Select one: a. A 44-year-old with irritable bowel syndrome (IBS) b. A 72-year-old who eats fast food frequently c. A 60-year-old lawyer who works 65 hours per week d. A 37-year-old who drinks eight cups of coffee daily
Colon cancer is rare before the age of 40, but its incidence increases rapidly with advancing age. Fast food tends to be high in fat and low in fiber, increasing the risk for colon cancer. Coffee intake, IBS, and a heavy workload do not increase the risk for colon cancer. The correct answer is: A 72-year-old who eats fast food frequently
After teaching a client who has a femoral hernia, the nurse assesses the client's understanding. Which statement indicates the client needs additional teaching related to the proper use of a truss? Select one: a. "If I have abdominal pain, I'll let my health care provider know right away." b. "I'll put some powder under the truss to avoid skin irritation." c. "The truss will help my hernia because I can't have surgery." d. "I will put on the truss before I go to bed each night."
The client should be instructed to apply the truss before arising, not before going to bed at night. The other statements show an accurate understanding of using a truss. The correct answer is: "I will put on the truss before I go to bed each night."
The nurse is caring for a client with peptic ulcer disease who reports sudden onset of sharp abdominal pain. On palpation, the client's abdomen is tense and rigid. What action takes priority? Select one: a. Notify the health care provider immediately. b. Percuss all four abdominal quadrants. c. Take and document a set of vital signs. d. Administer the prescribed pain medication.
This client has manifestations of a perforated ulcer, which is an emergency. The priority is to get the client medical attention. The nurse can take a set of vital signs while someone else calls the provider. The nurse should not percuss the abdomen or give pain medication since the client may need to sign consent for surgery. The correct answer is: Notify the health care provider immediately.
A nurse prepares a client for a colonoscopy scheduled for tomorrow. The client states, "My doctor told me that the fecal occult blood test was negative for colon cancer. I don't think I need the colonoscopy and would like to cancel it." How should the nurse respond? Select one: a. "I will contact your doctor so that you can discuss your concerns about the procedure." b. "The colonoscopy is required due to the high percentage of false negatives with the blood test." c. "Your doctor should not have given you that information prior to the colonoscopy." d. "A negative fecal occult blood test does not rule out the possibility of colon cancer."
A negative result from a fecal occult blood test does not completely rule out the possibility of colon cancer. To determine whether the client has colon cancer, a colonoscopy should be performed so the entire colon can be visualized and a tissue sample taken for biopsy. The client may want to speak with the provider, but the nurse should address the client's concerns prior to contacting the provider. The correct answer is: "A negative fecal occult blood test does not rule out the possibility of colon cancer."
The nurse working with older clients understands age-related changes in the gastrointestinal system. Which changes does this include? (Select all that apply.) Select one or more: a. Diminished sensation that can lead to constipation b. Decreased hydrochloric acid production c. Pancreatic vessels become calcified d. Increased peristalsis in the large intestine e. Fat not digested as well in older adults
Several age-related changes occur in the gastrointestinal system. These include decreased hydrochloric acid production, diminished nerve function that leads to decreased sensation of the need to pass stool, decreased fat digestion, decreased peristalsis in the large intestine, and calcification of pancreatic vessels. The correct answers are: Decreased hydrochloric acid production, Diminished sensation that can lead to constipation, Fat not digested as well in older adults, Pancreatic vessels become calcified
The nurse knows that a client with prolonged prothrombin time (PT) values (not related to medication) probably has dysfunction in which organ? Select one: a. Stomach b. Spleen c. Kidneys d. Liver
Severe acute or chronic liver damage leads to a prolonged PT secondary to impaired synthesis of clotting proteins. The other organs are not related to this issue. The correct answer is: Liver
The nurse caring for clients with gastrointestinal disorders should understand that which category best describes the mechanism of action of sucralfate (Carafate)? Select one: a. Gastric acid inhibitor b. Proton pump inhibitor c. Histamine receptor blocker d. Mucosal barrier fortifier
Sucralfate is a mucosal barrier fortifier (protector). It is not a gastric acid inhibitor, a histamine receptor blocker, or a proton pump inhibitor. The correct answer is: Mucosal barrier fortifier
A client with peptic ulcer disease is in the emergency department and reports the pain has gotten much worse over the last several days. The client's blood pressure when lying down was 122/80 mm Hg and when standing was 98/52 mm Hg. What action by the nurse is most appropriate? Select one: a. Start a large-bore IV with normal saline. b. Administer ibuprofen (Motrin). c. Tell the client to remain lying down. d. Call the Rapid Response Team.
This client has orthostatic changes to the blood pressure, indicating fluid volume loss. The nurse should start a large-bore IV with isotonic solution. Ibuprofen will exacerbate the ulcer. The Rapid Response Team is not needed at this point. The client should be put on safety precautions, which includes staying in bed, but this is not the priority. The correct answer is: Start a large-bore IV with normal saline.
A client had an upper gastrointestinal hemorrhage and now has a nasogastric (NG) tube. What comfort measure may the nurse delegate to the unlicensed assistive personnel (UAP)? Select one: a. Performing frequent oral care b. Re-positioning the tube every 4 hours c. Lavaging the tube with ice water d. Taking and recording vital signs
Clients with NG tubes need frequent oral care both for comfort and to prevent infection. Lavaging the tube is done by the nurse. Re-positioning the tube, if needed, is also done by the nurse. The UAP can take vital signs, but this is not a comfort measure. The correct answer is: Performing frequent oral care
After teaching a client with irritable bowel syndrome (IBS), a nurse assesses the client's understanding. Which menu selection indicates that the client correctly understands the dietary teaching? Select one: a. Baked tilapia, fresh green beans, cup of coffee with low-fat milk b. Ham sandwich on white bread, cup of applesauce, glass of diet cola c. Broiled chicken with brown rice, steamed broccoli, glass of apple juice d. Grilled cheese sandwich, small banana, cup of hot tea with lemon
lients with IBS are advised to eat a high-fiber diet (30 to 40 g/day), with 8 to 10 cups of liquid daily. Chicken with brown rice, broccoli, and apple juice has the highest fiber content. They should avoid alcohol, caffeine, and other gastric irritants. The correct answer is: Broiled chicken with brown rice, steamed broccoli, glass of apple juice
The student nurse studying stomach disorders learns that the risk factors for acute gastritis include which of the following? (Select all that apply.) Select one or more: a. Caffeine b. Corticosteroids c. Nonsteroidal anti-inflammatory drugs (NSAIDs) d. Fruit juice e. Alcohol
Risk factors for acute gastritis include alcohol, caffeine, corticosteroids, and chronic NSAID use. Fruit juice is not a risk factor, although in some people it does cause distress. The correct answers are: Alcohol, Caffeine, Corticosteroids, Nonsteroidal anti-inflammatory drugs (NSAIDs)
A client has dumping syndrome after a partial gastrectomy. Which action by the nurse would be most helpful? Select one: a. Make the client NPO. b. Increase fluid intake. c. Arrange a dietary consult. d. Limit the client's foods.
The client with dumping syndrome after a gastrectomy has multiple dietary needs. A referral to the registered dietitian will be extremely helpful. Food and fluid intake is complicated and needs planning. The client should not be NPO. The correct answer is: Arrange a dietary consult.
A nurse inserts a nasogastric (NG) tube for an adult client who has a bowel obstruction. Which actions does the nurse perform correctly? (Select all that apply.) Select one or more: a. Instructs the client to extend the neck against the pillow once the NG tube has reached the oropharynx b. Performs hand hygiene and positions the client in high-Fowler's position, with pillows behind the head and shoulders c. Connects the NG tube to intermittent medium suction with an anti-reflux valve on the air vent d. Checks for correct placement by checking the pH of the fluid aspirated from the tube e. Secures the NG tube by taping it to the client's nose and pinning the end to the pillowcase
The client's head should be flexed forward once the NG tube has reached the oropharynx. The NG tube should be secured to the client's gown, not to the pillowcase, because it could become dislodged easily. All the other actions are appropriate. The correct answers are: Performs hand hygiene and positions the client in high-Fowler's position, with pillows behind the head and shoulders, Checks for correct placement by checking the pH of the fluid aspirated from the tube, Connects the NG tube to intermittent medium suction with an anti-reflux valve on the air vent
A client presents to the emergency department reporting severe abdominal pain. On assessment, the nurse finds a bulging, pulsating mass in the abdomen. What action by the nurse is the priority? Select one: a. Auscultate for bowel sounds. b. Palpate the mass and measure its size. c. Notify the provider immediately. d. Order an abdominal flat-plate x-ray.
This observation could indicate an abdominal aortic aneurysm, which could be life threatening and should never be palpated. The nurse notifies the provider at once. An x-ray may be indicated. Auscultation is part of assessment, but the nurse's priority action is to notify the provider. The correct answer is: Notify the provider immediately.