ch 44 GI AQ

A nurse is caring for a patient with diarrhea caused by a Clostridium difficile infection. The patient demands a medication to stop the diarrhea. What would be the best response on the part of the nurse?

"Antidiarrheal medications increase severity of diarrhea."

A nurse is providing education to a patient regarding the importance of normal bacteria in the colon. The patient demonstrates an understanding of the role of normal bacteria by making which statement?

"Bacteria in the colon produce vitamin K to help with clotting."

The nurse is counselling a patient after an upper gastrointestinal study. Which instruction is important after the test?

"Increase your fluid intake."

Which dietary instruction does the nurse give to a patient scheduled for colonoscopy?

"Maintain a clear liquid diet for 1 to 3 days before the procedure."

A patient has developed dumping syndrome after peptic ulcer surgery. Which instructions are given to the patient for management of this disorder?

"Recline for 1 hour after meals." "Increase protein and fat in your diet."

A patient is prescribed lansoprazole(Prevacid) and sucralfate (Carafate) for stomach ulcers caused by gastroesophageal reflux disease (GERD). Which instruction is most important to this patient?

"Take lansoprazole 30 minutes before sucralfate."

A patient who recently had an appendectomy asks the nurse, "Are there any undesirable effects of removing the appendix?" What is an appropriate response by the nurse?

"The appendix has no known digestive function."

Which statement by the student nurse about the function of the hypothalamus indicates effective learning?

"The hypothalamus influences eating habits."

A patient with carcinoma of the esophagus is about to undergo surgery, an esophagogastrectomy, and is very anxious about what to expect immediately after surgery. Which statement would be appropriate to help calm the patient's anxiety?

"When you wake up, we will be monitoring you very closely. We will give you pain medication and do everything we can to keep you as comfortable as possible."

Which patient has a greater chance of developing Barrett's esophagus (esophageal metaplasia)?

A patient with untreated gastroesophageal reflux disease

Which condition is associated with dumping syndrome?

After gastric resection or peptic ulcer surgery

Which of the following medications would be the most effective in treating a duodenal ulceration caused by Helicobacter pylori?

Amoxicillin

A patient complains of soreness in the mouth and difficulty swallowing food. Which objective sign in this patient will indicate oral candidiasis?

Angular cheilitis

Which classes of drugs are used to reduce the symptoms of peptic ulcers?

Antacids Proton pump inhibitors (PPIs)

A nurse is teaching an obese patient with gastroesophageal reflux disease (GERD) measures that should be taken to prevent complications. What instructions should the nurse give?

Avoid smoking cigarettes.

A patient with a positive breath test result has been diagnosed with Helicobacter pylori peptic ulcer disease. The nurse anticipates administering which drugs?

Bismuth

A patient has been diagnosed with diverticulosis as a result of muscle thickening and increased intracolonic pressure. Which recommendation would the nurse give the patient regarding food choices?

Bran, fruits, and vegetables

On examining a patient's mouth, a nurse notes white curd-like lesions surrounded by erythematous mucosa. Which condition should the nurse suspect?

Candidiasis

A nurse is preparing to care for a patient diagnosed with achalasia. The nurse anticipates the patient will undergo which surgical procedure?

Cardiomyotomy

A patient comes to the clinic with complaints of intestinal cramping, diarrhea, and bloating after meals such as pasta and pizza. However, meals consisting of meat, vegetables, and a potato do not cause these symptoms. The nurse anticipates the patient will be diagnosed with which disease?

Celiac disease

An elderly African American reports a change in bowel habits, with rectal bleeding and a sense of incomplete bowel evacuation. What disorder does the nurse suspect in this patient?

Colon cancer

A nurse is caring for patient with cancer of the small intestine that required the removal of the duodenum and jejunum. The nurse knows the patient will have difficulties with which physiologic process?

Digestion

Following a gastrectomy performed for peptic ulcer disease, the patient has recovered and is ready for discharge. What instructions should the nurse include in discharge teaching to prevent dumping syndrome?

Divide meals into six small feedings.

Which condition indicates a need for esophageal manometry?

Dysphagia

The nurse is teaching a patient about the methods of bowel training. Which interventions does the nurse include in the teaching? .

Ensure high fiber intake Encourage exercise

A patient arrives at the clinic complaining of severe heartburn that began 1 month ago and has persisted despite diet change and over-the-counter (OTC) histamine-2 receptor blockers. The nurse knows that medical management of severe gastroesophageal reflux disease (GERD) is vital to prevent which long-term complication?

Esophageal cancer

Which diagnostic test involves visualization of the esophagus, stomach, and duodenum via a flexible endoscope?

Esophagogastroduodenoscopy

A nurse caring for a patient who recently had the gallbladder removed knows the patient will have difficulties digesting large amounts of which type of nutrients?

Fats

Which accessory organs aid in the digestive process?

Gall Bladder

Which assessment finding in a patient with gastritis indicates a need for fluid and blood replacement and nasogastric (NG) lavage?

Gastrointestinal bleeding

Which surgical procedures can be used for the removal of stomach cancer?

Gastrojejunostomy Gastroduodenostomy

Which objective data does the nurse collect while observing for signs of peptic ulcer disease (PUD)?

Hemorrhage Gastric outlet obstruction

A nurse caring for a patient with peptic ulcer disease (PUD) knows to be vigilant for which sign of a life-threatening complication?

Hypotension

A patient complains of heartburn after meals. Which should the nurse suggest first?

Identify and decrease causative foods

A nurse is planning care for a patient who had an upper gastrointestinal study with barium. Which intervention will be most important to prevent complications of this test?

Increase fluid intake

An older adult patient reports constipation to the nurse. What advice should the nurse give to this patient?

Increase your intake of fluids.

A patient is admitted to the hospital because of vomiting that has lasted 3 days despite minimal intake and severe abdominal distention and pain. What should the nurse plan to accomplish first?

Insert a nasojejunal tube and connect it to wall suction

A nurse is caring for a patient with vitamin B 12 deficiency and knows the patient likely has a deficiency of which substance?

Intrinsic factor

When the nurse is interviewing a patient about his health history, which conditions should the nurse include as relevant to the gastrointestinal system?

Lactose intolerance Hemorrhoids Abdominal distension

A patient comes to the clinic complaining of heartburn after meals and is diagnosed with gastroesophageal reflux disease. Which dietary instructions should the nurse include in teaching?

Limit caffeinated foods and drinks

The largest glandular organ in the body, which functions as an accessory organ of digestion, is what?

Liver

A patient who has been diagnosed with gastroesophageal reflux disease (GERD) asks the nurse why, after diet modifications and medications, the patient still has symptoms. The nurse bases the reply on which pathophysiologic change?

Lower esophageal sphincter relaxation

The nurse is analyzing the characteristics of a patient's stool. Which substances indicate an abnormality? .

Mucus

A patient arrives at the clinic complaining of white patches on the tongue and inner cheeks. The patient has a history of diabetes mellitus and chlamydia infection, for which the patient is taking tetracycline. The nurse anticipates the provider will prescribe which medication?

Nystatin (Nystop)

The nurse is called to the room of a patient who is vomiting and notes the vomit has an appearance like coffee grounds. What should the nurse do first?

Obtain patient's vital signs

A nurse is caring for a patient who will undergo a tube gastric analysis in 20 hours. Which medication, if prescribed, would prompt the nurse to hold the medication and speak to the provider?

Oxybutynin (Ditropan)

What is the most lethal complication of a peptic ulcer?

Perforation

A patient is suffering from chronic constipation but has no other symptoms. Which medication would provide the most relief for the patient's constipation?

Polycarbophil

A patient has been diagnosed with gastroesophageal reflux disease (GERD). The nurse is beginning to teach the patient about lifestyle changes that can be implemented to minimize the symptoms of this disease. Which instruction will the nurse include?

Reducing caffeine and alcohol consumption may alleviate symptoms of the disease.

A patient with inflammatory bowel disease (IBD) arrives at the clinic for a yearly examination. The patient states, "I feel wonderful. I haven't had any symptoms in 6 months!" The nurse knows to chart the patient's disease as being at which stage?

Remission

A nurse is providing education to a patient newly diagnosed with celiac disease. Which meal, if chosen by the patient, indicates a need for further instruction regarding the necessary diet for a patient with celiac disease?

Spaghetti with meat sauce and whole-wheat noodles

A 70-year-old patient experiences fecal incontinence. Which gastrointestinal structure involves fecal incontinence?

Sphincter

The nurse suspects that a patient, who complains of diarrhea, has an intestinal infection. Which diagnostic test does the nurse expect the primary health care provider to prescribe?

Stool culture test

Which medications are included in the prescription of a patient who has severe episodes of gastroesophageal reflux disease (GERD)?

Sucralfate (Carafate) Rabeprazole (Aciphex) Esomeprazole (Nexium)

The nurse is interviewing a patient with a duodenal ulcer. Which characteristic of pain is the nurse likely to find?

The pain is dull and burning.

Which event can alter a patient's guaiac test results?

The patient consumed organ meat before the test.

Malabsorption can be a major problem with Crohn disease when what portion of the intestine is involved?

The small intestine

A patient is undergoing diagnostic tests to rule out carcinoma of the oral cavity. Which symptoms have been associated with the disease?

Toothache Constant earache

A patient diagnosed with esophageal cancer has been undergoing radiation therapy. The patient's white blood cell level is increased, oxygen requirements have increased, and lung sounds have decreased. A chest x-ray image shows aspiration pneumonia. The nurse concludes that this is a result of which problem associated with radiation treatment for esophageal cancer?

Tracheoesophageal fistula

A nurse in the clinic is providing education to a female patient with a history of peptic ulcer disease who must take nonsteroidal anti-inflammatory drugs (NSAIDs) for knee pain and inflammation. The patient has been prescribed misoprostol (Cytotec) to prevent NSAID-induced ulcer. What is the most important instruction?

Use a reliable form of contraception

Which signs and symptoms indicate carcinoma of the esophagus?

Weight loss Hemorrhage Odynophagia