Gastrointestinal : Medical-Surgical ATI questions

A nurse is teaching a group of clients about the functions of the liver and gallbladder. Which of the following should the nurse include in the teaching as the purpose of bile? A. digesting fats B. producing chyme C. stimulating gastric acid secretion D. Providing energy

A. digesting fats Bile is a product of the liver and aids in the digestion of fats Moderate level

A nurse is planning discharge teaching for a client who is postoperative following a traditional open cholecystectomy. Which of the following learning needs of the client is the nurse's priority? A. dietary recommendations B. incision care C. coughing and deep-breathing exercises D. pain management

C. coughing and deep-breathing exercises The greatest risk to the client is respiratory compromise. Therefore, learning how to perform coughing and deep-breathing exercises to promote lung expansion and secretion removal is the priority. Hard level

A nurse is performing discharge teaching about ostomy care while at home for a client who has a newly placed ileostomy. Which of the following instructions should the nurse include in the teaching? A. "Empty your ostomy pouch when it becomes half full." B. "Place an aspirin in the ostomy pouch to eliminate odor." C. "Change the ostomy appliance every week." D. "Cleanse the site around the stoma with hydrogen peroxide and water."

A. "Empty your ostomy pouch when it becomes half full." The nurse should instruct the client to empty the ostomy pouch when it is 1/3 to 1/2 full. This prevents the ostomy from becoming too full of stool and gas and exploding. Moderate level

A nurse is assisting a provider with performing a paracentesis on a client. Which of the following actions should the nurse take? A. ask the client to empty his bladder before the procedure B. place the client leaning forward over the bedside table for the procedure C. inform the client he will be sedated during the procedure D. instruct the client to fast for 6 hr prior to the procedure

A. ask the client to empty his bladder before the procedure The nurse should ask the client to empty his bladder before the procedure to prevent injury to the bladder. Moderate level

A nurse is developing a plan of care for a client who has GERD. The nurse should plan to monitor the client for which of the following complications? A. aspiration B. infection C. anemia D. weight loss

A. aspiration Aspiration is a common complication of GERD, which results when the esophageal sphincter malfunctions and allows gastric acid and indigested food to back up into the esophagus. This places the client at risk for aspiration. Easy level

A nurse is assessing a client who has a bleeding duodenal ulcer. Which of the following findings should the nurse expect? A. emesis with a coffee-ground appearance B. increased blood pressure C. decreased heart rate D. bright green stools

A. emesis with a coffee-ground appearance The nurse should expect a client who has a bleeding duodenal ulcer to have emesis that resembles coffee-grounds or is bright red in color. Hematemesis indicates upper GI bleeding, occurring at or above the duodenojejunal junction. Easy level

A nurse is teaching dietary-modification strategies to a client who has been newly diagnosed with cirrhosis. Which of the following foods should the nurse recommend? A. grilled chicken B. potato soup C. fish sticks D. baked ham

A. grilled chicken The nurse should identify that a client who has cirrhosis requires protein to compensate for disease-related weight loss. Increasing protein intake from animal or plant sources will also provide the client with more energy. Easy level

A nurse is caring for a client who is NPO and has an NG tube to suction. When the client reports nausea, which of the following actions should the nurse take? A. irrigate the tube with normal saline solution B. provide oral hygiene C. clamp the tube for 30 minutes D. increase the amount of suction

A. irrigate the tube with normal saline solution When a client with an NG tube develops nausea, the nurse should first attempy to irrigate the tube to determine patency. If the tube is not patent, gastric pressure cannot decrease, and the steady or increasing pressure can cause nausea. Hard level

A nurse is recommending dietary modifications for a client who has GERD. The nurse should suggest eliminating which of the following foods from the client's diet? A. oranges and tomatoes B. carrots and bananas C. potatoes and squash D. whole wheat and beans

A. oranges and tomatoes Symptoms of GERD worsen following the oral intake of substances that decrease lower esophageal stricture (LES) pressure. These include alcohol, caffeine, nicotine, chocolate, fatty foods, citrus fruits, tomatoes, and peppermint. Easy level

A nurse is teaching a newly liscensed nurse about caring for a client who is scheduled for an esophagogastric balloon tamponade tube to treat bleeding esophageal varicies. Which of the following pieces of information should the nurse include in the teaching? A. the client will be placed on mechanical ventilation prior to this procedure B. the tube will be inserted into the client's trachea C. the client will receive a bowel preparation with cathartics prior to this prcedure D. the tube allows the application of a ligation band to the bleeding varicies

A. the client will be placed on mechanical ventilation prior to this procedure The client will require intubation and mechanical ventilation prior to this procedure to protect the airway. Hard level

A nurse in a provider's office is assessing a client who has GERD. When documenting the client's history, the nurse should expect the client to report that symptoms worsen with which of the following actions? A. stair-climbing B. bending over C. sitting D. walking

B. bending over Gastroesophageal reflux symptoms are most evident with activities that increase intraabdominal pressure (ex. bending over, straining, lifting, and lying down). Easy level

A nurse is caring for a client who has an indwelling urinary catheter. Which of the following actions should the nurse take? A. place the drainage bag on the client's abdomen when transferring from a bed to cart B. empty the drainage bag when half-full of urine C. rest the drainage bag on the floor when closing the drainage spigot during emptying D. disconnect the drainage bag when obtaining a urine specimen

B. empty the drainage bag when half-full of urine The nurse should empty the drainage bag when half-full of urine. A drainage bag that is too full can place tension on the catheter tubing, resulting in trauma to the urethra and urinary meatus. Easy level

A nurse is caring for a client who is scheduled to undergo a liver biopsy for a suspected malignancy. Which of the following laboratory findings should the nurse monitor prior to the procedure? A. prothrombin time B. serum lipase C. bilirubin D. calcium

A. prothrombin time A major complication following a liver biopsy is hemorrhage. Many clients who have liver disease have clotting defects and are at risk of bleeding. Liver dysfunction causes the production of blood clotting factors to be reduced, which leads to an increased incidence of bruising, nosebleeds, bleeding from wounds, and GI bleeding. Moderate level

A nurse is caring for a client who has celiac disease. Which of the following foods should the nurse remove from the client's meal tray? A. wheat toast B. tapioca pudding C. hard-boiled egg D. mashed potatoes

A. wheat toast Celiac disease is an autoimmune disorder characterized by a permanent intolerance to wheat, barley, and rye. Wheat toast contains gluten and should be removed from the client's tray. Easy level

A nurse is obtaining a guaiac test from a client. This test is performed to detect which of the following? A. fecal material in vomit B. blood in stool C. infestation of parasites D. microorganisms in urine

B. blood in stool A guaiac test detects the prescence of blood in the stool. It is a commonly used point-of-care test for fecal occult blood. Moderate level

A nurse is caring for a client who has a percutaneous endoscopic gastrostomy (PEG) tube and is receiving intermittent feedings. Prior to initiating the feeding, which of the following actions should the nurse take first? A. flush the tube with water B. place the client in the semi-Fowler's position C. cleanse the skin around the tube site D> aspirate the tube for residual contents

B. place the client in the semi-Flowler's position A client who is receiving PEG tube feedings should be positoned with the HOB elevated at least 30 degrees during and after feedings to cecrease the risk of aspiration. Therefore, this is the priority nursing action. Hard level

A nurse is providing dietary teaching to a client who has ulcerative colitis. Which of the following selections by the client indicates an understanding of the teaching? A. raw vegetable salad with low-fat dressing B. roast chicken and white rice C. frest fruit salad and milk D. peanut butter on whole wheat bread

B. roast chicken and white rice Clients who have ulcerative colitis are restricted to a low-fiber diet, which omits whole grains and raw fruits and vegetables. Roast chicken with white rice is the best choice. Moderate level

A nurse is caring for a client who is scheduled to undergo an esophagogastroduodenoscopy (EGD). The nurse should identify that this procedure is for which of the following reasons? A. to visualize polyps in the colon B. to detect an ulceration in the stomach C. to identify an obstruction in the biliary tract D. to determine the prescence of free air in the abdomen

B. to detect an ulceration in the stomach An EGD is used to visualize the esophagus, stomach, and duodenum witha lighted tube to detect a tumor, ulceration, or obstruction. Moderate level

A nurse is caring for a client who is 2 days postoperative following gastric surgery and has an NG tube inserted. Which of the following findings should the nurse report to the provider? A. dryness of the musous membranes B. hypoactive bowel sounds in all quadrants C. 200 mL of bright red draingage from the NG tube D. suction set at continuous low suction

C. 200 mL of bright red draingage from the NG tube The nurse should notify the provider immediately if 200 mL of bright red drainage comes from the NG tube following gastric surgery. Drainage should be either a yellow-green color or clear. Bright red drainage indicated blood loss and can be the result of a disrupted suture line or other internal bleeding. Volume loss from blood is a medical emergency. Easy level

A nurse is planning care for a client who has cholelithiasis. Which of the following interventions should the nurse include in the plan? A. restrict the client's fluid intake B. restrict the client's calcium intake C. decrease the client's fat intake D. decrease the client's potassium intake

C. decrease the client's fat intake The nurse should decrease the client's fat intake to reduce the occurrence of biliary colic. Moderate level

A nurse is assessing a client who was admitted with a bowel obstruction. The client reports severe abdominal pain. Which of the following findings indicates that a possible bowel perforation has occurred? A. elevated blood pressure B. bowel sounds increased in frequency and pitch C. rigid abdomen D. emesis of undigested food

C. rigid abdomen Abdominal tenderness and rigidity indicate a bowel perforation. As fluid escapes into the peritoneal cavity, a reduction in circulating blood volume occurs, lowering blood pressure. Easy level

A nurse is providing postoperative teaching about the management of dumping syndrome to a client who had a partial gastrectomy. Which of the following instructions should the nurse include in teaching? A. "Consume at least 4 oz of fluid with meals." B. "Take a short walk after each meal." C. "Use honey to flavor foods such as cereal." D. "Eat protein with each meal."

D. "Eat protein with each meal." The nurse should instruct the client to eat meals that are high in protein and fat with low to moderate carbohydrate content. Protein should be included in every meal b/c it delays digestion, which helps reduce the manifestations of dumping syndrome. Easy level

A nurse is caring for a client who has colitis and reported increased exacerbations due to stress at work. Which of the following responses should the nurse make? A. "I will contact the social worker so you can discuss career alternatives." B. "Have you thought about discussing the possibility of a part-time assignment with your employer?" C. "Why don't you ask your employer to relieve you of some work until you are stronger?" D. "Perhaps we should review your coping mechanisms and talk about other alternatives."

D. "Perhaps we should review your coping mechanisms and talk about other alternatives." Reviewing coping mechanisms and alternative coping patterns will promote coping skills that can assist the client in reducing stress. Easy level

A nurse is performing a GI assessment of a client who has liver cirrhosis with abdominal distention. Which of the following actions should the nurse take to assess for changes in the client's abdominal distention? A. percuss the abdomen for tympanic sounds B. inspect the contour of the abdominal wall C. instruct the client to report increased abdominal discomfort D. take serial measurements of the abdomen with a tape measure

D. take serial measurements of the abdomen with a tape measure Measuring the abdomen is the most effective way to assess for a change in abdominal distention b/c it provides concrete, objective data that can be compared at various points in time to monitor changes. Moderate level

A nurse enters a client's room and notes smoke coming from a wastebasket in the adjacent bathroom. Which of the following actions should the nurse take first? A close the door to the client's room B. attempt to extinguish the fire C. activate the facility's fire alarm system D. transport the client to an area away from the smoke

D. transport the client to an area away from the smoke The greatest risk to this client is an injury from burns and smoke inhalation; therefore, the nurse should first remove the client from the area. Easy level