GI Disorders

A client reports abdominal pain, fever, and vomiting. The primary health-care provider suspects appendicitis. Which diagnosis will confirm the condition? X-ray of abdomen Physical assessment White blood cell count Computed tomography (CT)

A CT scan is the most common diagnostic test to confirm appendicitis.

Which imaging diagnostic test is preferred for clients who are obese? Fluoroscopy Ultrasound scan Plain radiograph CT scan

A CT scan is the preferred imaging diagnostic test for clients who are obese.

A client is diagnosed with jaundice. The primary health-care provider scheduled the client for a radiographic test of the gallbladder, and the client was instructed to drink an oral radiopaque dye. Which type of test is being performed in this situation? Ultrasound Cholangiogram Cholecystography Endoscopic retrograde cholangiopancreatography

A cholecystography is a radioactive test that requires the oral intake of a radiopaque dye for visualizing the gallbladder. The radiopaque dye is collected in the bladder and is excreted by the liver.

A nurse is discussing postsurgery care techniques for a client with a hernia. Which techniques are appropriate? Select all that apply. Inspect the incision for signs and symptoms of infection and report any concerns to the primary health-care provider. Avoid heavy lifting for several weeks. Promote atelectasis and venous thromboembolism (VTE). Avoid deep breathing and early ambulation. Splint the surgical site with pillows while coughing.

A client that has had hernia repair surgery should inspect the incision for redness, swelling, heat, and drainage, which may indicate infection, and report any abnormalities to the primary health-care provider immediately. A client that has had hernia repair surgery should avoid heavy lifting for several weeks because heavy lifting may place undue pressure and strain on the surgical site. While coughing, a client that has had hernia repair surgery should splint the surgical site with pillows to prevent pressure on the site.

Which is true regarding endoscopic retrograde cholangiopancreatography (ERCP)? A client should not take heart and blood pressure medications the morning of the ERCP procedure. A client who is about to undergo ERCP should not eat or drink anything the night before the procedure. ERCP involves intravenously injecting iodine-containing radiopaque dye. ERCP is not useful in detecting pancreatic cancer or chronic pancreatitis.

A client who is about to undergo an ERCP exam should not eat or drink anything the night before the procedure.

Which body mass index (BMI) value indicates a normal weight? 18 kg/m2 23 kg/m2 27 kg/m2 33 kg/m2

A client with a BMI of 23 kg/m2 is considered to have normal weight.

Which is the typical stool consistency in a client with a sigmoid colostomy? Semi-liquid Formed Semi-liquid to semi-formed Liquid to semi-liquid

A client with a sigmoid colostomy passes formed stools.

Which is a clinical manifestation of cholecystitis? Trousseau's sign Murphy's sign Cullen's sign Grey-Turner's sign

A client with acute cholecystitis will exhibit a positive Murphy's sign, which is pain on palpation of the right upper quadrant upon deep inspiration. To test for the presence of a positive Murphy's sign, the examiner places his or her fingers on the right upper quadrant of the abdomen and then gently presses down while asking the client to take a deep breath. The test result is positive if the client has pain upon deep inspiration.

Which statement made by a nursing student regarding a colonoscopy indicates a need for further learning? "Biopsies can be taken and polyps can be removed during a colonoscopy." "A colonoscopy is the gold standard for colorectal cancer screening." "A colonoscopy involves taking x-ray images after performing a barium enema." "A colonoscopy is an invasive procedure."

A colonoscopy does not involve the use of barium. X-ray images of the intestine are taken after a double-contrast barium enema.

Which process decreases the risk of venous thromboembolism in an obese client who has gone through bariatric surgery? Using incentive spirometry Using sequential compression device Deep breathing exercises Coughing

A sequential compression device decreases the risk of venous thromboembolism in an obese client.

A client who reports pain in the rectal area and blood in stools is diagnosed with hemorrhoids. Which nonpharmacological therapy is most appropriate to alleviate the symptoms? Sitz bath Use of suppositories Rubber band ligation Minimal weight lifting exercise

A sitz bath is a warm bath that covers the hips and buttocks and that may relieve symptoms.

A client is diagnosed with severe peptic ulcers in the gastrointestinal tract. Which surgical procedure is the client most likely to have? Vagotomy Gastrojejunostomy Hepaticojejunostomy Distal pancreatectomy

A vagotomy is a surgical procedure that involves surgical resection of the vagus nerve so that stimulation of gastric acid production in the stomach is decreased and the risk of peptic ulcer formation can be reduced.

Which symptoms are commonly seen in elderly adult clients with diverticulitis? High fever Decreased white blood cell (WBC) count Altered mental status Severe abdominal tenderness

An elderly adult client with diverticulitis may have altered mental status.

Which complication of peptic ulcer disease has the characteristic of epigastric fullness and heaviness after meals? Penetration Perforation Obstruction Gastrointestinal (GI) bleeding

An obstruction is a complication of peptic ulcer disease that has characteristics such as epigastric fullness and heaviness after meals.

A client reports epigastric pain, blood in stools, and a loss of appetite. Which diagnostic test is the primary health-care provider most likely to order so as to determine if the client has Helicobacter pylori infection? Endoscopy Urea breath test Complete blood count Upper gastrointestinal (GI) x-ray

An urea breath test is appropriate to confirm the presence of an H pylori infection.

Which phenomenon involves a rupture where the dissected bowel is reattached in a client during a bariatric surgery? Peritonitis Venous thromboembolism Atelectasis Anastomosis leak

Anastomosis leak is a phenomenon that involves a rupture where the dissected bowel is reattached during a bariatric surgery.

Which type of cells secrete enzymes such as gastric lipase and pepsinogen? Chief cells Enteroendocrine cells Mucous cells Parietal cells

Chief cells secrete enzymes such as gastric lipase and pepsinogen, but they are absent from cardiac and pyloric glands.

In which range of body mass index (BMI) is Class 3 obesity included? Greater than 40 kg/m2 35 to 39.9 kg/m2 30 to 34.9 kg/m2 25 to 29.9 kg/m2

Class 3 obesity or extreme obesity is defined as a BMI of greater than 40 kg/m2.

Which statements are true regarding bariatric surgery? Select all that apply. A roux-en-Y gastric bypass is a restrictive procedure. Bariatric surgical procedures include two techniques. Bariatric surgery is intended for clients with a BMI of >= 40 kg/m2. Malabsorptive procedures are no longer commonly performed Malabsorptive procedures include sleeve gastrectomy and gastric plIcation.

Clients with a BMI of >= 40 kg/m2 undergo bariatric surgery. Malabsorptive procedures account for only two percent of bariatric surgeries. These procedures are no longer commonly performed.

Which surgical technique uses liquid nitrogen to freeze the hemorrhoid? Rubber band ligation Cryosurgery Sclerotherapy Bipolar, infrared, and laser coagulation

Cryosurgery is a surgical technique that uses liquid nitrogen to freeze hemorrhoids.

Which is true regarding a direct inguinal hernia? It is more common in women than in men. The incidence is higher in men. It is known as congenital hernia. It is usually related to obesity or multiparity in women.

Direct inguinal hernias only occur in men.

Which is applicable to a client with diverticulitis? Select all that apply. The client needs gastric compression. The client needs treatment with a sitz bath. The client would require intravenous antibiotics. The client must be prepared for the surgical procedure. The client will require a mesh material to avoid recurrence.

Diverticulitis is the inflammation of diverticula, which are small pouch-like herniations in the colon. Treatment involves inpatient care requiring gastric compression. The client with diverticulitis, depending on the severity, may require outpatient or inpatient treatment by intravenous antibiotics.

A client is diagnosed with acute cholecystitis. Which symptoms can be managed by IV fluids? Select all that apply. Clay-colored stools Increased liver enzymes Imbalanced electrolytes Decreased skin turgor Elevated respiratory rate

Electrolytic imbalances may occur because of dehydration from nausea and vomiting. It can be corrected by IV fluid administration. Skin turgor may be decreased because of dehydration. This can be managed by IV fluid administration.

Which is true regarding the usefulness of the diagnostic test esophageal manometry? It is useful in evaluating esophagitis and monitoring Barrett's esophagitis. It is useful in monitoring gastric pH. It is useful in obtaining a sample of the esophagus for biopsy. It is useful in measuring esophageal motor activity.

Esophageal manometry is the gold standard for the assessment and measurement of esophageal motor activity. This test measures the pressure and action of the esophagus.

In which way are external hemorrhoids diagnosed? Anoscopy Visual inspection Digital examination Sigmoidoscopy

External hemorrhoids are diagnosed by visual inspection.

A client with gastroesophageal reflux disease (GERD) reports heartburn. Which medication treats GERD by increasing gastric emptying? Antacids Prokinetic agents Proton pump inhibitors (PPIs) Histamine receptor antagonists

Gastric emptying is increased with the help of prokinetic drugs.

Which diagnostic test for cholecystitis uses a radioactive tracer to study the production and flow of bile visualizing the liver, gallbladder, bile ducts, and small intestine? Ultrasound Hepatobiliary iminodiacetic acid (HIDA) scan Abdominal x-ray Endoscopic retrograde cholangiopancreatography (ERCP)

HIDA is a nuclear medicine scan that uses a radioactive tracer to study the production and flow of bile visualizing the liver, gallbladder, bile ducts, and small intestine.

Which statement made by a nursing student regarding irritable bowel syndrome (IBS) indicates a need for further learning? "It is also known as spastic colon." "It is characterized by abdominal pain and altered bowel habits where the mucosal lining of the bowel remains unchanged." "It can be diagnosed by the Rome III Diagnostic Criteria for Functional Gastrointestinal Disorders." "IBS-D (diarrhea dominant) causes too much water to be absorbed in the small intestine."

IBS-C (constipation dominant) causes too much water to be absorbed in the small intestine, and IBS-D causes too little water to be absorbed in the small intestine.

Which type of fistula occurs between the two parts of the intestines? Enteroenteral Enterovaginal Enterovesicular Enterocutaneous

In enteroenteral the fistula occurs between intestines.

Which grade, according to the standard grading system, is given to an internal hemorrhoid that prolapses upon defecation but reduces spontaneously? Grade 1 Grade 2 Grade 3 Grade 4

In grade 2 the hemorrhoids prolapse upon defecation but reduce spontaneously.

Which statement made by a nursing student regarding hemorrhoids indicates a need for further learning? "External hemorrhoids lie above the anal sphincter." "Hemorrhoids are varicose veins of the rectum." "Hemorrhoids are a common disorder that affects both men and women." "Hemorrhoids may be caused or precipitated by straining during defecation or prolonged constipation."

Internal hemorrhoids lie above the anal sphincter, and external hemorrhoids lie below the anal sphincter.

Which nursing action taken may lead to further complications in the client with diverticulitis? Administering antibiotics Administering IV fluids Administering opiates Administering laxatives

Laxatives should not be administered because they may increase intestinal motility.

An LPN is discussing dietary suggestions to prevent gallstones with a client? Which statement by the client indicates a need for further discussion? "I should avoid eating ice cream." "I should refrain from heavy alcohol consumption." "I should totally avoid eating lean meat." "I should include fruits and whole grains in my diet."

Lean meat is good for the body because it is low in saturated fats. Red meats contain fat, so the client should avoid eating large quantities of red meat.

While providing home care teaching to a postoperative client who underwent surgery for obesity, the nurse teaches lifting restrictions. Which outcome in the client indicates effective teaching? The client will have a decreased risk for developing hernias. The client will not have a perforation of the new gastric staple. The client will not have obesity hypoventilation syndrome. The client will have minimized pressure of abdominal contents on the thoracic cavity.

Lifting activities may cause hernias. Therefore, instructing the client to restrict lifting will decrease the risk of hernia development.

Which intestinal disorder is diagnosed with the help of Manning criteria? Irritable bowel syndrome Hemorrhoids Appendicitis Colorectal cancer

Manning criteria is a diagnostic tool for diagnosing irritable bowel syndrome.

Which drug is used to prevent mucosal damage in a client with peptic ulcer disease? Sucralfate Misoprostol Vitamin B12 Magnesium sulfate

Misoprostol is used to prevent mucosal damage in clients who are on NSAID therapy. Sucralfate forms a protective barrier that prevents the contact of damaged mucosal lining by the acid.

Which statement by a nursing student regarding medications for the treatment of acute cholecystitis indicates a need for further learning? "Meperidine can be administered for severe pain management in acute cholecystitis." "Morphine is very effective in pain management in acute cholecystitis." "Ibuprofen can be administered to a client with acute cholecystitis for managing pain that is not severe." "Ursodiol can be given for dissolving gallstones in acute cholecystitis."

Morphine is usually contraindicated for pain management in acute cholecystitis as it can cause the Sphincter of Oddi to spasm, which results in pain.

Which drug can be prescribed to manage severe pain in acute cholecystitis? Demerol Morphine Ibuprofen Acetaminophen

Narcotics such as Demerol can be used for severe pain management in acute cholecystitis.

Which are the clinical manifestations observed during dumping syndrome? Select all that apply. Nausea Fever Fatigue Bloating Constipation

Nausea is a clinical manifestation observed during dumping syndrome. Fatigue is a clinical manifestation observed during dumping syndrome. Bloating is a clinical manifestation observed during dumping syndrome.

A client who has undergone bariatric surgery has come for a follow-up visit. Which statements made by the client indicate the development of dumping syndrome? Select All That Apply. "I have frequent urination." "I have had nausea for 3 days." "I have difficulty in breathing." "I have severe abdominal pain." "I have been feeling dizzy this past week."

Nausea is a symptom of dumping syndrome, which is a long-term complication of bariatric surgery. Abdominal pain is a symptom of dumping syndrome. Dizziness is a symptom of dumping syndrome.

Which can increase intraabdominal pressure in a client with a hiatal hernia? Obesity Hemorrhage Laryngeal edema Esophageal strictures

Obesity may increase the intraabdominal pressure in a client with a hiatal hernia and gastroesophageal reflux disease.

A client reports pain in the abdomen and fever. Which other symptoms of the client will help to diagnose the condition as diverticulitis? Select all that apply. Vomiting Tachycardia Blood in stools Elevated red blood cell count Elevated white blood cell count

Tachycardia can accompany fever, which can is a clinical manifestation of diverticulitis. Blood in the stool is a clinical manifestation of diverticulitis. The white blood cells may be elevated because of the presence of infection.

Which point made by a student nurse regarding T-tube or biliary drainage tube indicates a need for discussion? "It is placed into the common bile duct to monitor bile drainage." "It exits the client's abdomen through the mouth." "It is connected to a closed drainage system." "It may stay in place for up to 2 weeks after surgery."

The T-tube or biliary drainage tube exits the client's abdomen through the skin.

Which instruction provided by a student nurse for a client with hemorrhoids may lead to further complications? "Wash the surgical area gently and pat to keep it dry." "Strain in order to have a regular bowel movement." "Apply cold packs and use sitz baths to reduce pain." "Include good sources of fluids and fiber in the diet."

The client should avoid straining to have a bowel movement because it may increase inflammation and pain associated with hemorrhoids.

Which point listed by a nursing student regarding cholecystitis indicates a need for further learning? "It is accompanied by clay colored stool." "It is an inflammation of the gall bladder." "It is associated with left, lower abdominal pain." "It is associated with darkened urine."

The clinical presentation of cholecystitis includes acute right upper quadrant pain.

Which nursing action is most likely to increase the risk of complications while providing postoperative care to a client after an open cholecystectomy? Providing clear liquids once the client passes flatus Introducing pulmonary interventions Monitoring vital signs, pain, neurologic status, and the abdomen Instructing the client to take complete bed rest after discharge

The nurse should encourage the client with open cholecystectomy to walk. The discharge teaching should include activity levels of the client.

Which drug for the treatment of seizures and migraines is also used for obesity because weight loss is a side effect? Phentermine Topiramate Lorcaserin Orlistat

Topiramate is administered for the treatment of seizures and migraines. Weight loss is also a side effect.

A client who is a mother of two children reports pain and bulging in the abdominal region and is diagnosed with a hernia. Which type of hernia is most likely present in the client based on the symptoms and history? Femoral hernia Inguinal hernia Umbilical hernia Incisional hernia

Umbilical hernia occurs frequently in females because of an increase in abdominal pressure and multiparity.

Which type of hernia is seen in infancy? Ventral hernia Femoral hernia Umbilical hernia Direct inguinal hernia

Umbilical hernias can also be congenital, like indirect inguinal hernias. These hernias appear in infancy and close up in the first 12 to 18 months of life.

Which diagnostic test can be used to detect an active infection by Helicobacter pylori? Colonoscopy Urea breath testing White blood cell count Computed tomography (CT) scan

Urea breath testing detects an active H pylori infection.

Which assessment finding is related only to a duodenal ulcer? Blood in the stools Ineffectiveness of antacids Pain that increases on an empty stomach Pain that worsens immediately after eating

With a duodenal ulcer, pain is elevated on an empty stomach and decreases after eating.