Chapter 48: Assessment of the Gastrointestinal System
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? a. "It's a good thing I love orange and cherry gelatin." b. "My spouse will be here to drive me home." c. "I'll avoid ibuprofen for several days before the test." d. "I'll buy a case of clear Gatorade before the prep."
A
An older adult 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? a. "Changes in your liver cause drugs to be metabolized differently." b. "Perhaps you don't need as high a dose of the drug as before." c. "Stomach muscles atrophy with age and you digest more slowly." d. "Your body probably can't tolerate as much medication anymore."
A
To promote comfort and the passage of flatus after a colonoscopy, in what position does the nurse place the client? a. Left lateral b. Prone c. Right lateral d. Supine
A
The nurse working with clients who have gastrointestinal problems knows that which laboratory values are related to which organ functions or dysfunctions?
Ammonia: liver Lipase: pancreas
A client is recovering from an esophagogastroduodenoscopy (EGD) and requests something to drink. What action by the nurse is appropriate? a. Allow the client cool liquids only. b. Assess the client's gag reflex. c. Remind the client to remain NPO. d. Tell the client to wait 4 hours.
B
The nurse knows that a client with prolonged prothrombin time (PT) values (not related to medication) probably has dysfunction in which organ? a. Kidneys b. Liver c. Spleen d. Stomach
B
The primary health care provider documents that a client has a bruit over the abdominal aorta. What teaching will the nurse provide for assistive personnel (AP) based on this assessment finding? a. "Use warm compresses on the client's abdomen continuously." b. "Avoid washing the client's abdomen too aggressively." c. "Apply ice to the client's abdomen every 4 hours." d. "Massage the client's abdomen to help reduce pain."
B
The nurse working with older clients understands age-related changes in the gastrointestinal system. Which changes does this include?
Decreased hydrochloric acid production Diminished sensation that can lead to constipation Fat not digested as well in older adults Pancreatic vessels become calcified
A client had a colonoscopy and biopsy yesterday and calls the gastrointestinal clinic to report a spot of bright red blood on the toilet paper today. What response by the nurse is appropriate? a. Ask the client to call back if this happens again today. b. Instruct the client to go to the emergency department. c. Remind the client that a small amount of bleeding is possible. d. Tell the client to come to the clinic this afternoon.
C
A client is having an esophagogastroduodenoscopy (EGD) and has been given midazolam hydrochloride. The client's respiratory rate is 8 breaths/min. What action by the nurse is appropriate? a. Administer naloxone. b. Call the Rapid Response Team. c. Provide physical stimulation. d. Ventilate with a bag-valve-mask.
C
The assistive personnel note that a client had a dark stool. What stool test would the nurse obtain for this client? a. Culture and sensitivity b. Parasites and ova c. Occult blood test d. Total fat content
C
A client had an endoscopic retrograde cholangiopancreatography (ERCP). The nurse teaches the client and family about the signs of potential complications which include what problems?
Cholangitis Pancreatitis Perforation Sepsis
The nurse is aware of the most recent American Cancer Society Screening Guidelines for colon cancer, which include which accepted testing modalities for people over the age of 50?
Colonoscopy every 10 years Computed tomography (CT) colonography every 5 years Flexible sigmoidoscopy every 5 years
A nurse is assessing a client reporting right upper quadrant (RUQ) abdominal pain. What technique would the nurse use to assess this client's abdomen? a. Auscultate after palpating. b. Avoid any type of palpation. c. Lightly palpate the RUQ first. d. Lightly palpate the RUQ last.
D
The nurse is interviewing a client who reports having abdominal cramping, bloating, and diarrhea after drinking milk or ingesting other dairy products. What health problem does the client most likely have? a. Steatorrhea b. Ulcerative colitis c. Crohn disease d. Lactose intolerance
D
A nurse cares for a client who is recovering from a colonoscopy. Which actions would the nurse take?
Obtain vital signs every 15 to 30 minutes until alert. Assess the client for rectal bleeding and severe pain. Confirm the client has a ride home and plans to rest.