Test 4/Final Chpt GI Chapters

A nurse is caring for a client hospitalized with an exacerbation of chronic gastritis. What health promotion topic should the nurse emphasize? Techniques for positioning correctly to promote gastric healing Strategies for avoiding irritating foods and beverages Safe technique for self-suctioning Strategies for maintaining an alkaline gastric environment

Strategies for avoiding irritating foods and beverages

A client is admitted with a gastrointestinal bleed. What client symptom may indicate a peptic ulcer perforation to the nurse? Soft abdomen Sudden, severe upper abdominal pain Bradycardia Hypertension

Sudden, severe upper abdominal pain

A client with a peptic ulcer is about to begin a therapeutic regimen that includes a bland diet, antacids, and famotidine. Before the client is discharged, the nurse should provide which instruction? "Avoid aspirin and products that contain aspirin." "Stop taking the drugs when your symptoms subside." "Eat three balanced meals every day." "Increase your intake of fluids containing caffeine."

"Avoid aspirin and products that contain aspirin."

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

"Avoid coffee and alcoholic beverages."

A nurse is teaching a client with gastritis about the need to avoid the intake of caffeinated beverages. The client asks why this is so important. Which explanation from the nurse would be most accurate? "Caffeine can interfere with absorption of vitamin B12, which leads to anemia and further digestive problems." "Caffeine increases the fluid volume in your system, which irritates your digestive organs." "Caffeine stimulates the central nervous system and thus gastric activity and secretions, which need to be minimized to promote recovery." "Caffeine intake can cause tears in your esophagus and intestines, which can lead to hemorrhage."

"Caffeine stimulates the central nervous system and thus gastric activity and secretions, which need to be minimized to promote recovery."

A patient is suspected to have diverticulosis without symptoms of diverticulitis. What diagnostic test does the nurse anticipate educating the patient about prior to scheduling? Colonoscopy CT scan Flexible sigmoidoscopy Barium enema

Colonoscopy

The nurse determines that teaching for the client with peptic ulcer disease has been effective when the client makes which statement? "I should stop all my medications if I develop any side effects." "I have learned some relaxation strategies that decrease my stress." "I should continue my treatment regimen as long as I have pain." "I can buy whatever antacids are on sale because they all have the same effect."

"I have learned some relaxation strategies that decrease my stress."

A client who has occasional gastric symptoms is receiving teaching on how to prevent gastroesophageal reflux disease (GERD). Which statement indicates the client understands the teaching? "I will eliminate bothersome foods from my diet." "I will start taking a nap after meals, when possible." "I will eat two large meals a day instead of three." "I will plan to sleep flat without pillows."

"I will eliminate bothersome foods from my diet."

A client is diagnosed with a hiatal hernia. Which statement indicates effective client teaching about hiatal hernia and its treatment? "I'll eat three large meals every day without any food restrictions." "I'll eat frequent, small, bland meals that are high in fiber." "I'll lie down immediately after a meal." "I'll gradually increase the amount of heavy lifting I do."

"I'll eat frequent, small, bland meals that are high in fiber."

A client comes to the clinic after developing a headache, abdominal pain, nausea, hiccupping, and fatigue about 2 hours ago. The client tells the nurse that the last food was buffalo chicken wings and beer. Which medical condition does the nurse find to be most consistent with the client's presenting problems? Gastric ulcer Acute gastritis Duodenal ulcer Gastric cancer

Acute gastritis

When caring for a client with an acute exacerbation of a peptic ulcer, the nurse finds the client doubled up in bed with severe pain in the right shoulder. What is the initial appropriate action by the nurse? Irrigate the client's NG tube. Place the client in the high-Fowler's position. Notify the health care provider. Assess the client's abdomen and vital signs.

Assess the client's abdomen and vital signs.

The nurse is planning care for a client following an incisional cholecystectomy for cholelithiasis. Which intervention is the highest nursing priority for this client? Assisting the client to ambulate the evening of the operative day Performing range-of-motion (ROM) leg exercises hourly while the client is awake Assisting the client to turn, cough, and deep breathe every 2 hours Teaching the client to choose low-fat foods from the menu

Assisting the client to turn, cough, and deep breathe every 2 hours

The nurse teaches the client with gastroesophageal reflux disease (GERD) which measure to manage the disease? Eat a low-carbohydrate diet Avoid eating or drinking 2 hours before bedtime Elevate the foot of the bed on 6- to 8-inch blocks Wear tight-fitting clothing

Avoid eating or drinking 2 hours before bedtime

The nurse is providing care for a client who has recently been diagnosed with chronic gastritis. What health practice should the nurse address when teaching the client to limit exacerbations of the disease? Performing 15 minutes of physical activity at least three times per week Taking multivitamins as prescribed and eating organic foods whenever possible Maintaining a healthy body weight Avoiding taking aspirin to treat pain or fever

Avoiding taking aspirin to treat pain or fever

A client with peptic ulcer disease has a blood pressure of 88/40 mm Hg, dizziness, and nausea. Which complication will the nurse suspect is occurring with this client? Evidence of ulcer healing Bleeding from the ulcer Allergic response to the medication Medication adverse effects

Bleeding from the ulcer

Which of the following would a nurse expect to assess in a client with peritonitis? Board-like abdomen Hyperactive bowel sounds Deep slow respirations Decreased pulse rate

Board-like abdomen

A client is prescribed a histamine (H2)-receptor antagonist. The nurse understands that this might include which medication(s)? Select all that apply. Esomeprazole Famotidine Nizatidine Lansoprazole Cimetidine

Cimetidine Famotidine Nizatidine

Which is a clinical manifestation of cholelithiasis? Abdominal pain in the upper left quadrant Nonpalpable abdominal mass Clay-colored stools Epigastric distress before a meal

Clay-colored stools

A client with calculi in the gallbladder is said to have Cholecystitis Choledochotomy Cholelithiasis Choledocholithiasis

Cholelithiasis

A client admitted with acute diverticulitis has experienced a sudden increase in temperature and reports a sudden onset of exquisite abdominal tenderness. The nurse's rapid assessment reveals that the client's abdomen is uncharacteristically rigid on palpation. What is the nurse's best response? Administer a Fleet enema as prescribed and remain with the client. Page the primary provider and report that the client may be obstructed. Contact the primary care provider promptly and report these signs of perforation. Position the client supine and insert an NG tube.

Contact the primary care provider promptly and report these signs of perforation

A client is being treated for diverticulosis. Which points should the nurse include in this client's teaching plan? Select all that apply. Drink at least 8 to 10 large glasses of fluid every day. Avoid high-fiber foods Do not suppress the urge to defecate. Use bulk-forming laxatives Encourage an individualized exercise program

Do not suppress the urge to defecate. Use bulk-forming laxatives Encourage an individualized exercise program Drink at least 8 to 10 large glasses of fluid every day.

The nurse is conducting discharge teaching for a client with diverticulosis. Which instruction should the nurse include in the teaching? Avoid unprocessed bran. Use laxatives weekly. Drink 8 to 10 glasses of fluid daily. Avoid daily exercise.

Drink 8 to 10 glasses of fluid daily.

The nurse is teaching a client with gastroesophageal reflux disease (GERD) about how to reduce reflux. What should the nurse include in the teaching? Select all that apply. Instruct the client to eat slowly and chew the food thoroughly. Instruct the client to avoid alcohol or tobacco products. Inform the client to remain upright for at least 2 hours after meals. Encourage the client to eat frequent, small, well-balanced meals. Encourage the client to eat later in the day before bedtime rather than early in the morning.

Encourage the client to eat frequent, small, well-balanced meals. Inform the client to remain upright for at least 2 hours after meals. Instruct the client to avoid alcohol or tobacco products. Instruct the client to eat slowly and chew the food thoroughly.

A nurse is caring for a client who just has been diagnosed with a peptic ulcer. When teaching the client about his new diagnosis, how should the nurse best describe it? Viral invasion of the stomach wall Inflammation of the lining of the stomach Bleeding from the mucosa in the stomach Erosion of the lining of the stomach or intestine

Erosion of the lining of the stomach or intestine

A nurse is assisting with serving dinner trays on the unit. Upon receiving the dinner tray for a client admitted with acute gallbladder inflammation, the nurse will question which of the following foods on the tray? Mashed potatoes Fried chicken Tapioca pudding Dinner roll

Fried chicken

The nurse is caring for a patient who has had an appendectomy. What is the best position for the nurse to maintain the patient in after the surgery? High Fowler's Sims' left lateral Supine with head of bed elevated 15 degrees Prone

High Fowler's

A client presents to the clinic reporting vomiting and burning in the mid-epigastria. The nurse knows that in the process of confirming peptic ulcer disease, the health care provider is likely to order a diagnostic test to detect the presence of what? An incompetent pyloric sphincter Infection with Helicobacter pylori A metabolic acid-base imbalance Excessive stomach acid secretion

Infection with Helicobacter pylori

A nursing student is caring for a client with gastritis. Which of the following would the student recognize as a common cause of gastritis? Choose all that apply. Overuse of aspirin DASH diet Participation in highly competitive sports Irritating foods Ingestion of strong acids

Irritating foods Ingestion of strong acids Overuse of aspirin

Which of the following medications, used in the treatment of GERD, accelerate gastric emptying? Metoclopramide (Reglan) Esomeprazole (Nexium) Nizatidine (Axid) Famotidine (Pepcid)

Metoclopramide (Reglan)

The nurse is admitting a client with a diagnosis of diverticulitis and assesses that the client has a board-like abdomen, no bowel sounds, and reports of severe abdominal pain. What is the nurse's first action? Administer an opioid analgesic. Notify the health care provider. Administer a retention enema. Start an IV with lactated Ringer's solution.

Notify the health care provider.

Peptic ulcer disease occurs more frequently in people with which blood type? B A O AB

O

The nurse is conducting a community education class on gastritis. The nurse includes that chronic gastritis caused by Helicobacter pylori is implicated in which disease/condition? Colostomy Systemic infection Pernicious anemia Peptic ulcers

Peptic ulcers

A patient has been diagnosed with a hiatal hernia. The nurse explains the diagnosis to the patient and his family by telling them that a hernia is a (an): Protrusion of the upper stomach into the lower portion of the thorax. Involution of the esophagus, which causes a severe stricture. Twisting of the duodenum through an opening in the diaphragm. Extension of the esophagus through an opening in the diaphragm.

Protrusion of the upper stomach into the lower portion of the thorax.

A client with gastroesophageal reflux disease (GERD) has a diagnosis of Barrett esophagus with minor cell changes. What principle should be integrated into the client's subsequent care? The client will be monitored closely to detect malignant changes. Antacids may be discontinued when symptoms of heartburn subside. Liver enzymes must be checked regularly, as H2 receptor antagonists may cause hepatic damage. Small amounts of blood are likely to be present in the stools and are not cause for concern.

The client will be monitored closely to detect malignant changes.

The nurse is caring for a client with chronic gastritis. The nurse monitors the client knowing that this client is at risk for which vitamin deficiency? Vitamin B12 Vitamin E Vitamin C Vitamin A

Vitamin B12

A client is admitted to the emergency department with reports right lower quadrant pain. Blood specimens are drawn and sent to the laboratory. Which laboratory finding should be reported to the health care provider immediately? White blood cell (WBC) count 22.8/mm3 Serum sodium 135 mEq/L Serum potassium 4.2 mEq/L Hematocrit 42%

White blood cell (WBC) count 22.8/mm3

A nurse is teaching a group of middle-aged men about peptic ulcers. When discussing risk factors for peptic ulcers, the nurse should mention: a sedentary lifestyle and smoking. alcohol abuse and smoking. alcohol abuse and a history of acute renal failure. a history of hemorrhoids and smoking.

alcohol abuse and smoking.

A preoperative client scheduled to have an open cholecystectomy says to the nurse, "The doctor said that after surgery, I will have a tube in my nose that goes into my stomach. Why do I need that?" What most common reason for a client having a nasogastric tube in place after abdominal surgery should the nurse include in a response? gavage instillation lavage decompression

decompression

A nurse is caring for a client who is undergoing a diagnostic workup for a suspected gastrointestinal problem. The client reports gnawing epigastric pain following meals and heartburn. What would the nurse suspect this client has? appendicitis diverticulitis ulcerative colitis peptic ulcer disease

peptic ulcer disease

A client is admitted from the emergency department with complaints of severe abdominal pain and an elevated white blood cell count. The physician diagnoses appendicitis. The nurse knows the client is at greatest risk for: rupture of the appendix. emotional distress related to the pain. ulceration of the appendix. inflammation of the gallbladder.

rupture of the appendix.

A client seeking care because of recurrent heartburn and regurgitation is subsequently diagnosed with a hiatal hernia. Which of the following should the nurse include in health education? "Instead of eating three meals a day, try eating smaller amounts more often." "Drinking beverages after your meal, rather than with your meal, may bring some relief." "Many clients obtain relief by taking over-the-counter antacids 30 minutes before eating." "It's best to avoid dry foods, such as rice and chicken, because they're harder to swallow."

"Instead of eating three meals a day, try eating smaller amounts more often."

Medical management of a patient with peritonitis includes fluid, electrolyte, and colloid replacement. The nurse knows to prepare the initial, most appropriate intravenous solution. Which of the following is the correct solution? D10W D5W 0.9% NS 0.45% of NS

0.9% NS

A client is scheduled for a cholecystogram for later in the day. What is the nurse's understanding on the diagnostic use of this exam? It visualizes the biliary structures and pancreas via endoscopy. It visualizes the liver and pancreas. It visualizes the gallbladder and bile duct. It shows the sizes of the abdominal organs and detects any masses.

It visualizes the gallbladder and bile duct.

Which of the following is a proton pump inhibitor used in the treatment of gastroesophageal reflux disease (GERD)? Select all that apply. Famotidine (Pepcid) Rabeprazole (AcipHex) Lansoprazole (Prevacid) Esomeprazole (Nexium) Nizatidine (Axid)

Lansoprazole (Prevacid) Rabeprazole (AcipHex) Esomeprazole (Nexium)

A client with a diagnosis of acute appendicitis is awaiting surgical intervention. The nurse listens to bowel sounds and hears none and observes that the abdomen is rigid and board-like. What complication does the nurse determine may be occurring at this time? Accumulation of gas Peritonitis Constipation Paralytic ileus

Peritonitis

Post appendectomy, a nurse should assess the patient for abdominal rigidity and tenderness, fever, loss of bowel sounds, and tachycardia, all clinical signs of: An abscess under the diaphragm. An ileus. A pelvic abscess. Peritonitis

Peritonitis

A nurse is completing a health history on a client whose diagnosis is chronic gastritis. Which of the data should the nurse consider most significantly related to the etiology of the client's health problem? Consumes one or more protein drinks daily. Reports a history of social drinking on a weekly basis. Takes over-the-counter antacids frequently throughout the day. Smokes one pack of cigarettes daily.

Smokes one pack of cigarettes daily.

A nurse practitioner, who is treating a patient with GERD, knows that this type of drug helps treat the symptoms of the disease. The drug classification is: H2-receptor antagonists. Antacids Antispasmodics Proton pump inhibitors.

Proton pump inhibitors.

A nurse is assessing a client who has been diagnosed with cholecystitis, and is experiencing localized abdominal pain. When assessing the characteristics of the client's pain, the nurse should anticipate that it may radiate to what region? Left upper chest Inguinal region Neck or jaw Right shoulder

Right shoulder

A 16-year-old client presents at the emergency department reporting right lower quadrant pain and is subsequently diagnosed with appendicitis. When planning this client's nursing care, the nurse should prioritize what nursing diagnosis? Chronic pain related to appendicitis Imbalanced nutrition: Less than body requirements related to decreased oral intake Constipation related to decreased bowel motility and decreased fluid intake Risk for infection related to possible rupture of appendix

Risk for infection related to possible rupture of appendix

A nursing assessment of a client with peritonitis reveals hypotension, tachycardia, and signs and symptoms of dehydration. What else would the nurse expect to find? jaundice and vomiting severe abdominal pain with direct palpation or rebound tenderness tenderness and pain in the right upper abdominal quadrant rectal bleeding and a change in bowel habits

severe abdominal pain with direct palpation or rebound tenderness

A client with cholelithiasis has a gallstone lodged in the common bile duct. When assessing this client, the nurse expects to note: circumoral pallor. black, tarry stools. light amber urine. yellow sclerae.

yellow sclerae.