Gastrointestinal System and Accessory Structures
The nurse is investigating a client's report of pain in the duodenal area. Where should the nurse perform the assessment?
Epigastric area and consider possible radiation of pain to the right subscapular region
A nurse is caring for a client who is scheduled for a colonoscopy and whose preparation will include polyethylene glycol electrolyte lavage prior to the procedure. The presence of what health problem would contraindicate the use of this form of bowel preparation?
Inflammatory bowel disease
A nurse has auscultated a client's abdomen and noted one or two bowel sounds in a 2-minute period of time. How should the nurse document the client's bowel sounds?
hypoactive
A medical client's CA 19-9 levels have become available and they are significantly elevated. How should the nurse best interpret this diagnostic finding?
it may be cancer, but GI can be ruled out
A nurse is doing a physical assessment on a client with a GI disorder. Which position will the nurse most likely ask the client to assume when performing an abdominal examination?
supine with knees flexed slightly
An adult client is scheduled for an upper GI series that will use a barium swallow. What teaching should the nurse include when the client has completed the test?
Fluids must be increased to facilitate the evacuation of the stool.
The nurse is caring for a client who has a diagnosis of AIDS. Inspection of the client's mouth reveals the new presence of white lesions on the client's oral mucosa. What is the nurse's most appropriate response?
Inform the primary care provider of this finding.
The nurse is caring for a client with a duodenal ulcer and is relating the client's symptoms to the physiologic functions of the small intestine. What do these functions include? Select all that apply.
Secretion of mucus Absorption of nutrients Movement of nutrients into the bloodstream
The nurse determines one or two bowel sounds in 2 minutes should be documented as
hypoactive
Which response is a parasympathetic response in the GI tract?
increased peristalsis
A client reports having red stools lately. What will the nurse ask during assessment questioning?
"Have you been eating beets?"
A client presents at the ambulatory clinic reporting recurrent sharp stomach pain that is relieved by eating. The nurse suspects that the client may have an ulcer. How should the nurse explain the formation and role of acid in the stomach to the client?
"Hydrochloric acid is secreted by glands in the stomach in response to the actual or anticipated presence of food."
A home care nurse is caring for a client with reports of epigastric discomfort who is scheduled for a barium swallow. Which statement by the client indicates an understanding of the test?
"I'll avoid eating or drinking anything 6 to 8 hours before the test."
A client asks the nurse why the physician ordered the blood test carcinoembryonic antigen (CEA). The nurse answers:
"It indicates if a cancer is present."
A client is scheduled to have an upper gastrointestinal series. Which preparations will the client be asked to follow prior to the procedure?
low-residue diet for 2 to 3 days prior; NPO for 8 to 12 hours before
A female client has presented to the emergency department with right upper quadrant pain; the health care provider has ordered abdominal ultrasound to rule out cholecystitis. The client expresses concern to the nurse about the safety of this diagnostic procedure. How should the nurse best respond?
Abdominal ultrasound poses no known safety risks of any kind
A nurse is caring for a client with recurrent hematemesis who is scheduled for upper gastrointestinal fibroscopy. How should the nurse in the radiology department prepare this client?
Apply local anesthetic to the back of the patient's throat.
During a colonoscopy with moderate sedation, the patient groans with obvious discomfort and begins bleeding from the rectum. The patient is diaphoretic and has an increase in abdominal girth from distention. What complication of this procedure is the nurse aware may be occurring?
Bowel perforation
A client comes into the emergency department with reports of abdominal pain. What should the nurse ask first?
Characteristics and duration of pain
The nurse prepares a client for a barium enema. The nurse should place the client on which diet prior to the procedure?
Clear liquids day before
The nurse teaches a client scheduled for a colonoscopy. Which instruction should be included as part of the preparation for the procedure?
Follow the dietary and fluid restrictions and bowel preparation procedures.
A nurse is performing an abdominal assessment of an older adult client. When collecting and analyzing data, the nurse should be cognizant of what age-related change in gastrointestinal structure and function?
Decreased mucus secretion
Which of the following is the primary function of the small intestine?
Digestion
A patient with cystic fibrosis takes pancreatic enzyme replacements on a regular basis. The patient's intake of trypsin facilitates what aspect of GI function?
Digestion of proteins
A nurse is preparing a client with Crohn's disease for a barium enema. What should the nurse do the day before the test?
Encourage plenty of fluids.
A nurse is assessing the abdomen of a client just admitted to the unit with a suspected GI disease. Inspection reveals several diverse lesions on the client's abdomen. How should the nurse best interpret this assessment finding?
GI diseases often produce skin changes.
A client asks the nursing assistant for a bedpan. When the client is finished, the nursing assistant notifies the nurse that the client has bright red streaking of blood in the stool. The nurse's assessment should focus on what potential cause?
Hemorrhoids
A client who has been experiencing changes in his bowel function is scheduled for a barium enema. What instruction should the nurse provide for postprocedure recovery?
Increase fluid intake to evacuate the barium
A client is diagnosed with megaloblastic anemia caused by vitamin B12 deficiency. The health care provider begins the client on cyanocobalamin (Betalin-12), 100 mcg I.M. daily. Which substance influences vitamin B12 absorption?
Intrinsic factor
While palpating a client's right upper quadrant (RUQ), the nurse would expect to find which structure?
Liver
The nurse is caring for a client scheduled for a colonoscopy. The nurse should assist the client into what position during this diagnostic test?
Lying on the left side with legs drawn toward the chest
A nurse is caring for clients in a stroke rehabilitation facility. Damage to what area of the brain will most affect a client's ability to swallow?
Medulla oblongata
A client is being assessed for a suspected deficit in intrinsic factor synthesis. What diagnostic or assessment finding is the most likely rationale for this examination of intrinsic factor production?
Persistently low hemoglobin and hematocrit
A client tells the nurse that the stool was colored yellow. The nurse assesses the client for
Recent foods ingested
An appendectomy surgery involves what quadrant of abdominal?
Right lower quadrant (removal of apendix)
A client has returned to the medical unit after a barium enema. When assessing the client's subsequent bowel patterns and stools, what finding would warrant reporting to the health care provider?
Streaks of blood present in the stool
A client has sought care because of recent dark-colored stools. As a result, a fecal occult blood test has been ordered. The nurse should give what instructions to the client?
Take no NSAIDs within 48 hours of the test
The nurse is providing health education to a client with a gastrointestinal disorder. What should the nurse describe as a major function of the GI tract?
The absorption into the bloodstream of nutrient molecules produced by digestion
A client with a recent history of intermittent bleeding is undergoing capsule endoscopy to determine the source of the bleeding. When explaining this diagnostic test to the client, what advantage should the nurse describe?
The test is noninvasive.
The nurse is assisting the health care provider with a gastric acid stimulation test for a client. What medication should the nurse prepare to administer subcutaneously to stimulate gastric secretions?
To relax colonic musculature and reduce spa
The client describes a test previously completed to detect a small bowel obstruction prior to admission to the hospital. The client states that the test involved insertion of a tube through the nose and lasted over 6 hours. The nurse determines which test name should be documented?
Upper GI enteroclysis
A patient has been brought to the emergency department with abdominal pain and is subsequently diagnosed with appendicitis. The patient is scheduled for an appendectomy but questions the nurse about how his health will be affected by the absence of an appendix. How should the nurse best respond?
Your appendix doesn't play a major role, so you won't notice any difference after you recovery from surgery."
A client who has been in a motor-vehicle collision is comatose and has developed ascites as a result of the accident. The nurse explains the condition to the client's family, and indicates that the primary function of the small intestine is to:
absorb nutrients
Which of the following digestive enzymes aids in the digesting of starch?
amylase
A client has come to the outpatient radiology department for diagnostic testing that will allow the care team to evaluate and remove polyps. The nurse should prepare the client for what procedure?
colonoscopy
When gastric analysis testing reveals excess secretion of gastric acid, the nurse recognizes which medical diagnoses is supported?
duodenal ulcer
Cystic fibrosis, a genetic disorder characterized by pulmonary and pancreatic dysfunction, usually appears in young children but can also affect adults. If the pancreas was functioning correctly, where would the bile and pancreatic enzymes enter the GI system?
duodenum
A clinic client has described recent dark-colored stools and the nurse recognizes the need for fecal occult blood testing (FOBT). What aspect of the client's current health status would contraindicate FOBT?
hemmorhids
What part of the GI tract begins the digestion of food?
mouth
When bowel sounds are heard about every 15 seconds, the nurse would record that the bowel sounds are
normal
A nurse is promoting increased protein intake to enhance a client's wound healing. What is the enzyme that will initiate the digestion of the protein that the client consumes?
pepsin
An advanced practice nurse is assessing the size and density of a client's abdominal organs. If the results of palpation are unclear to the nurse, what assessment technique should be implemented?
percussion
An enzyme that begins the digestion of starches is
ptyalin.
Following ingestion of carrots or beets, the nurse would expect which alteration in stool color?
red
Which procedure is performed to examine and visualize the lumen of the small bowel?
small bowel enteroscopy
A nurse is teaching a client with malabsorption syndrome about the disorder and its treatment. The client asks which part of the GI tract absorbs food. What is the nurse's best response?
small intestine
Which enzyme aids in the digestion of protein?
trypsin
The nurse recognizes which change of the GI system is an age-related change?
weakened gag reflex
A nurse is caring for a newly admitted client with a suspected GI bleed. The nurse assesses the client's stool after a bowel movement and notes it to be a tarry-black color. This finding is suggestive of bleeding from what location?
Upper GI tract
