GI Practice Questions

List 3 categories of medications used in the treatment of peptic ulcer disease?

- Antacids - H2 Receptor Blockers - Mucosal Healing Agents - Proton Pump Inhibitors

In a client with cirrhosis, it is imperative to prevent further bleeding and observe for bleeding tendencies. List six relevant nursing interventions.

- Avoid injections - Use small bore needles for IV insertion - Maintain pressure for 5 minutes on all venipuncture sites - Use electric razor - Use soft bristle toothbrush for mouth - Check stools and emesis for occult blood

What are the common food intolerances for clients with cholelithiasis?

- Fried Foods - Spicy Foods - Fatty Foods

List four groups who have a high risk for contracting hepatitis.

- Homosexual males - IV drug users - Pts with recent ear piercing or tattooing - Health care workers

List the common clinical manifestations of jaundice.

- Scleral icterus (yellow sclera) - Dark urine - Chalky or clay colored stools

What are four interventions for the client with a hiatal hernia?

- Sit upright while eating and for 1 hour after - Eat small frequent meals - Eliminate foods that are problematic

A patient with Hepatitis is extremely confused. The patient is diagnosed with Hepatic Encephalopathy. What lab result would correlate with this mental status change? A. Ammonia 100 mcg/dL B. Bilirubin 7 mg/dL C. ALT 56 U/L D. AST 10 U/L

A. Ammonia 100 mcg/dL

Select all the signs and symptoms associated with Hepatitis? A. Arthralgia B. Bilirubin 1 mg/dL C. Ammonia 15 mcg/dL D. Dark urine E. Vision changes F. Yellowing of the sclera G. Fever H. Loss of appetite

A. Arthralgia D. Dark urine F. Yellowing of the sclera G. Fever H. Loss of appetite

A patient has lab work drawn and it shows a positive HBsAg. What education will you provide to the patient? A. Avoid sexual intercourse or intimacy such as kissing until blood work is negative. B. The patient is now recovered from a previous Hepatitis B infection and is now immune. C. The patient is not a candidate from antiviral or interferon medications. D. The patient is less likely to develop a chronic infection.

A. Avoid sexual intercourse or intimacy such as kissing until blood work is negative.

A patient is admitted with hepatic encephalopathy secondary to cirrhosis. Which meal option selection below should be avoided with this patient? A. Beef tips and broccoli rabe B. Pasta noodles and bread C. Cucumber sandwich with a side of grapes D. Fresh salad with chopped water chestnuts

A. Beef tips and broccoli rabe

You're providing an in-service to new nurse graduates about esophageal varices in patients with cirrhosis. You ask the graduates to list activities that should be avoided by a patient with this condition. Which activities listed are correct: Select all that apply A. Excessive coughing B. Sleeping on the back C. Drinking juice D. Alcohol consumption E. Straining during a bowel movement F. Vomiting

A. Excessive coughing D. Alcohol consumption E. Straining during a bowel movement F. Vomiting

How is Hepatitis E transmitted? A. Fecal-oral B. Percutaneous C. Mucosal D. Body fluids

A. Fecal-oral

Select all the types of viral Hepatitis that have preventive vaccines available in the United States? A. Hepatitis A B. Hepatitis B C. Hepatitis C D. Hepatitis D E. Hepatitis E

A. Hepatitis A B. Hepatitis B

You're providing an in-service on viral hepatitis to a group of healthcare workers. You are teaching them about the types of viral hepatitis that can turn into chronic infections. Which types are known to cause ACUTE infections ONLY? Select all that apply: A. Hepatitis A B. Hepatitis B C. Hepatitis C D. Hepatitis D E. Hepatitis E

A. Hepatitis A E. Hepatitis E

Which statements are INCORRECT regarding the anatomy and physiology of the liver? Select all that apply: A. The liver has 3 lobes and 8 segments. B. The liver produces bile which is released into the small intestine to help digest fats. C. The liver turns urea, a by-product of protein breakdown, into ammonia. D. The liver plays an important role in the coagulation process.

A. The liver has 3 lobes and 8 segments. C. The liver turns urea, a by-product of protein breakdown, into ammonia. The liver has 2 lobes (not 3), and the liver turns ammonia (NOT urea), which is a by-product of protein breakdown, into ammonia. All the other statements are true about liver's anatomy and physiology.

A patient is diagnosed with Hepatitis D. What statement is true about this type of viral Hepatitis? Select all that apply: A. The patient will also have the Hepatitis B virus. B. Hepatitis D is most common in Southern and Eastern Europe, Mediterranean, and Middle East. C. Prevention of Hepatitis D includes handwashing and the Hepatitis D vaccine. D. Hepatitis D is most commonly transmitted via the fecal-oral route.

A. The patient will also have the Hepatitis B virus. B. Hepatitis D is most common in Southern and Eastern Europe, Mediterranean, and Middle East.

Your patient with cirrhosis has severe splenomegaly. As the nurse you will make it priority to monitor the patient for signs and symptoms of? Select all that apply: A. Thrombocytopenia B. Vision changes C. Increased PT/INR D. Leukopenia

A. Thrombocytopenia C. Increased PT/INR D. Leukopenia

A patient was exposed to Hepatitis B recently. Postexposure precautions include vaccination and administration of HBIg (Hepatitis B Immune globulin). HBIg needs to be given as soon as possible, preferably ___________ after exposure to be effective. A. 2 weeks B. 24 hours C. 1 month D. 7 days

B. 24 hours

Which patient below is at MOST risk for developing a complication related to a Hepatitis E infection? A. A 45-year-old male with diabetes. B. A 26-year-old female in the 3rd trimester of pregnancy. C. A 12-year-old female with a ventricle septal defect. D. A 63-year-old male with cardiovascular disease.

B. A 26-year-old female in the 3rd trimester of pregnancy.

Which patients below are at risk for developing complications related to a chronic hepatitis infection, such as cirrhosis, liver cancer, and liver failure? Select all that apply: A. A 55-year-old male with Hepatitis A. B. An infant who contracted Hepatitis B at birth. C. A 32-year-old female with Hepatitis C who reports using IV drugs. D. A 50-year-old male with alcoholism and Hepatitis D. E. A 30-year-old who contracted Hepatitis E.

B. An infant who contracted Hepatitis B at birth. C. A 32-year-old female with Hepatitis C who reports using IV drugs. D. A 50-year-old male with alcoholism and

A patient with late-stage cirrhosis develops portal hypertension. Which of the following options below are complications that can develop from this condition? Select all that apply: A. Increase albumin levels B. Ascites C. Splenomegaly D. Fluid volume deficient E. Esophageal varices

B. Ascites C. Splenomegaly E. Esophageal varices

You are receiving shift report on a patient with cirrhosis. The nurse tells you the patient's bilirubin levels are very high. Based on this, what assessment findings may you expect to find during your head-to-toe assessment? Select all that apply: A. Frothy light-colored urine B. Dark brown urine C. Yellowing of the sclera D. Dark brown stool E. Jaundice of the skin F. Bluish mucous membranes

B. Dark brown urine C. Yellowing of the sclera E. Jaundice of the skin

The physician orders Lactulose 30 mL by mouth per day for a patient with cirrhosis. What findings below demonstrates the medication is working effectively? Select all that apply: A. Decrease albumin levels B. Decrease in Fetor Hepaticus C. Patient is stuporous. D. Decreased ammonia blood level E. Presence of asterixis

B. Decrease in Fetor Hepaticus D. Decreased ammonia blood level

Select all the ways a person can become infected with Hepatitis B: A. Contaminated food/water B. During the birth process C. IV drug use D. Undercooked pork or wild game E. Hemodialysis F. Sexual intercourse

B. During the birth process C. IV drug use E. Hemodialysis F. Sexual intercourse

While providing mouth care to a patient with late-stage cirrhosis, you note a pungent, sweet, musty smell to the breath. This is known as: A. Metallic Hepatico B. Fetor Hepaticus C. Hepaticoacidosis D. Asterixis

B. Fetor Hepaticus

A 36-year-old patient's lab work show anti-HAV and IgG present in the blood. As the nurse you would interpret this blood work as? A. The patient has an active infection of Hepatitis A. B. The patient has recovered from a previous Hepatitis A infection and is now immune to it. C. The patient is in the preicetric phase of viral Hepatitis. D. The patient is in the icteric phase of viral Hepatitis.

B. The patient has recovered from a previous Hepatitis A infection and is now immune to it.

A patient with Hepatitis has a bilirubin of 6 mg/dL. What findings would correlate with this lab result? Select all that apply: A. None because this bilirubin level is normal B. Yellowing of the skin and sclera C. Clay-colored stools D. Bluish discoloration on the flanks of the abdomen E. Dark urine F. Mental status changes

B. Yellowing of the skin and sclera C. Clay-colored stools E. Dark urine

The liver receives blood from two sources. The _____________ is responsible for pumping blood rich in nutrients to the liver. A. hepatic artery B. hepatic portal vein C. mesenteric artery D. hepatic iliac vein

B. hepatic portal vein The liver receives blood from two sources. The hepatic portal vein is responsible for pumping blood rich in nutrients to the liver.

The liver receives it blood supply from two sources. One of these sources is called the _________________, which is a vessel network that delivers blood _____________ in nutrients but ________ in oxygen. A. hepatic artery, low, high B. hepatic portal vein, high, low C. hepatic lobule, high, low D. hepatic vein, low, high

B. hepatic portal vein, high, low

You're providing education to a patient with an active Hepatitis B infection. What will you include in their discharge instructions? Select all that apply: A. "Take acetaminophen as needed for pain." B. "Eat large meals that are spread out through the day." C. "Follow a diet low in fat and high in carbs." D. "Do not share toothbrushes, razors, utensils, drinking cups, or any other type of personal hygiene product." E. "Perform aerobic exercises daily to maintain strength."

C. "Follow a diet low in fat and high in carbs." D. "Do not share toothbrushes, razors, utensils, drinking cups, or any other type of personal hygiene product."

Which of the following is NOT a role of the liver? A. Removing hormones from the body B. Producing bile C. Absorbing water D. Producing albumin

C. Absorbing water

The physician writes an order for the administration of Lactulose. What lab result indicates this medication was successful? A. Bilirubin <1 mg/dL B. ALT 8 U/L C. Ammonia 16 mcg/dL D. AST 10 U/L

C. Ammonia 16 mcg/dL

What is the BEST preventive measure to take to help prevent ALL types of viral Hepatitis? A. Vaccination B. Proper disposal of needles C. Hand hygiene D. Blood and organ donation screening

C. Hand hygiene

During your morning assessment of a patient with cirrhosis, you note the patient is disoriented to person and place. In addition while assessing the upper extremities, the patient's hands demonstrate a flapping motion. What lab result would explain these abnormal assessment findings? A. Decreased magnesium level B. Increased calcium level C. Increased ammonia level D. Increased creatinine level

C. Increased ammonia level

Which of the following is NOT a common source of transmission for Hepatitis A? Select all that apply: A. Water B. Food C. Semen D. Blood

C. Semen D. Blood

A patient is prescribed Peginterferon alfa-2a. The nurse will prepare to administer this medication what route? A. Oral B. Intramuscular C. Subcutaneous D. Intravenous

C. Subcutaneous

A patient with Hepatitis A asks you about the treatment options for this condition. Your response is? A. Antiviral medications B. Interferon C. Supportive care D. Hepatitis A vaccine

C. Supportive care

A patient is diagnosed with Hepatitis A. The patient asks how a person can become infected with this condition. You know the most common route of transmission is? A. Blood B. Percutaneous C. Mucosal D. Fecal-oral

D. Fecal-oral

What is the MOST common transmission route of Hepatitis C? A. Blood transfusion B. Sharps injury C. Long-term dialysis D. IV drug use

D. IV drug use

A 25-year-old patient was exposed to the Hepatitis A virus at a local restaurant one week ago. What education is important to provide to this patient? A. Inform the patient to notify the physician when signs and symptoms of viral Hepatitis start to appear. B. Reassure the patient the chance of acquiring the virus is very low. C. Inform the patient it is very important to obtain the Hepatitis A vaccine immediately to prevent infection. D. Inform the patient to promptly go to the local health department to receive immune globulin.

D. Inform the patient to promptly go to the local health department to receive immune globulin.

________ reside in the liver and help remove bacteria, debris, and old red blood cells. A. Hepatocytes B. Langerhan cells C. Enterocytes D. Kupffer cells

D. Kupffer cells

A patient has completed the Hepatitis B vaccine series. What blood result below would demonstrate the vaccine series was successful at providing immunity to Hepatitis B? A. Positive IgG B. Positive HBsAg C. Positive IgM D. Positive anti-HBs

D. Positive anti-HBs

A 45 year old male has cirrhosis. The patient reports concern about the development of enlarged breast tissue. You explain to the patient that this is happening because? A. The liver cells are removing too much estrogen from the body which causes the testicles to produce excessive amounts of estrogen, and this leads to gynecomastia. B. The liver is producing too much estrogen due to the damage to the liver cells, which causes the level to increase in the body, and this leads to gynecomastia. C. The liver cells are failing to recycle estrogen into testosterone, which leads to gynecomastia. D. The liver cells are failing to remove the hormone estrogen properly from the body, which causes the level to increase in the body, and this leads to gynecomastia.

D. The liver cells are failing to remove the hormone estrogen properly from the body, which causes the level to increase in the body, and this leads to gynecomastia.

What is the main side effect of lactulose, which is used to reduce ammonia levels in clients with cirrhosis?

Diarrhea

Which condition is NOT a known cause of cirrhosis? A. Obesity B. Alcohol consumption C. Blockage of the bile duct D. Hepatitis C E. All are known causes of cirrhosis

E. All are known causes of cirrhosis

What bowel sound disruptions occur with an intestinal obstruction?

Early Obstruction: - High pitched Late Obstruction: - Diminished or absent

How should the nurse administer pancreatic enzymes?

Give with meals or snacks. Powder forms should be mixed with fruit juices.

TRUE or FALSE: A patient with Hepatitis A is contagious about 2 weeks before signs and symptoms appear and 1-3 weeks after the symptoms appear.

TRUE

List symptoms of an upper and lower GI bleed.

Upper GI: - Melena - Hematemesis - Tarry stools Lower GI: - Bloody/ Tarry stools

Which teaching will the nurse include when educating a client who is scheduled to have an esophogastroduodenoscopy (EGD)? Select all that apply. a. "Anesthesia will be used for sedation." b. "The procedure takes about 20-30 min to complete." c. "Informed consent will be needed prior to the procedure." d. "A separate test will be required to obtain any needed biopsies." e. "You will need to refrain from eating for at least 6-8 hours before the EGD."

a. "Anesthesia will be used for sedation." b. "The procedure takes about 20-30 min to complete." d. "A separate test will be required to obtain any needed biopsies." e. "You will need to refrain from eating for at least 6-8 hours before the EGD."

A client is receiving adefovir for management of hepatitis B. What health teaching will the nurse provide for the client about this drug? Select all that apply. a. "Avoid places with crowds and individuals who have infection." b. "Report increased bruising to your doctor because the drug can cause bleeding." c. "Get your lab work done regularly because the drug can affect your kidneys." d. "Be careful and avoid falls because the drug can cause fractures." e. "Follow up with the dietitian to ensure that you adhere to your special diet."

a. "Avoid places with crowds and individuals who have infection." c. "Get your lab work done regularly because the drug can affect your kidneys."

What health teaching will the nurse include to promote gastric health for an adult client? Select all that apply. a. "Stop smoking or using tobacco of any form." b. "Do not drink excessive amounts of alcohol." c. "Consume high-fat foods and decrease carbohydrates." d. "Avoid excessive amounts of pickled or smoked food." e. "Avoid taking large amounts of NSAIDs."

a. "Stop smoking or using tobacco of any form." b. "Do not drink excessive amounts of alcohol." d. "Avoid excessive amounts of pickled or smoked food."

Which intervention should the nurse implement specifically for the client in end-stage liver failure whos is experiencing hepatic encephalopathy? a. Assess the clients neurological status b. Prepare to administer a loop diuretic c. Check the clients stool for blood d. Assess for an abdominal fluid wave

a. Assess the clients neurological status

The nurse cares for a pediatric client in the ambulatory care clinic. The parents report a 24-hoour period of gastrointestinal distress, including vomiting several times and 3 watery stools. Which action does the nurse perform to assist in maintaining nutrition for this client? a. Educate the parents on the signs of dehydration and the slow introduction of fluids to rehydrate the child. b. Offer no advice to the parents other than to suggest parents offer whatever foods the child feels like taking. c. Encourage the parents to offer the child milk products for the vitamins and rehydration. d. Encourage the parents to offer solid foods to improve the nutritional status quickly.

a. Educate the parents on the signs of dehydration and the slow introduction of fluids to rehydrate the child.

A client with peptic ulcer disease vomits undigested food after eating breakfast. The nurse notes abdominal distention. What intervention should the nurse anticipate will be implemented for this client? a. Insert an NG tube b. Insertion of a jejunotomy tube c. Administration of an oral antiemetic d. Administration of H2 receptor antagonists

a. Insert an NG tube

A nurse is caring for a 34-year-old client newly diagnosed with GERD. Which lifestyle change will the nurse suggest? Select all that apply. a. Lose weight if needed. b. Do not eat before bed. c. Elevate the foot of your bed 6-12 inches. d. Avoid pants with a tight waistband or belt. e. Eat fatty foods to minimize ongoing hunger.

a. Lose weight if needed. b. Do not eat before bed. d. Avoid pants with a tight waistband or belt.

The nurse is caring for a client with a complete large bowel obstruction. What assessment findings would the nurse expect? Select all that apply. a. Obstipation b. Dehydration c. Metabolic alkalosis d. Abdominal distention e. Abdominal pain f. Profuse vomiting

a. Obstipation d. Abdominal distention e. Abdominal pain

The nurse is teaching a client undergoing a paracentesis for the treatment of cirrhosis. The client asks about positioning for the procedure. Which description by the nurse would be most appropriate? a. Sitting with the lower extremities well supported b. Side lying with a pillow between the knees c. Prone with the head turned to the left side d. Dorsal recumbent with a pillow at the back of the head

a. Sitting with the lower extremities well supported

The primary health care provider prescribes bismuth subsalicylate for a client as part of treating H. pylori infection. What health teaching will the nurse include for the client about this drug? a. "Do not crush this drug before taking." b. "The drug may cause your tongue and stool to turn black." c. "Take the drug at night only." d. "The drug may cause you to have diarrhea."

b. "The drug may cause your tongue and stool to turn black."

A client is undergoing a colonoscopy procedure. The client has been NPO since midnight and completed the bowel prep. Vitals are within normal limits. The client has mild memory decline and wears hearing aids and glasses. The client lives along and is socially and physically active. Post-procedure, which of the following finding is most concerning to the nurse? Select all that apply. a. Joint pan and stiffness in hips and knees b. Blood pressure 90/60 c. Heart rate 104 d. Vision and hearing deficits e. Mild memory decline f. 1+ radial pulses g. Client age 89

b. Blood pressure 90/60 c. Heart rate 104 f. 1+ radial pulses g. Client age 89

Which interventions should the nurse discuss regarding prevention of an acute exacerbation of diverticulitis? Select all that apply. a. Eat a low-fiber diet b. Drink 2500 ml of water daily c. Avoid eating foods with seeds d. Walk 30 minutes a dat e. Take antacids every 2 hours

b. Drink 2500 ml of water daily c. Avoid eating foods with seeds

The admission assessment for a client with acute gastric bleeding indicates blood pressure 82/40 mm Hg, pulse 124 beats/min, and respiratory rate 26 breaths/min. Which admission request does the nurse implement first? a. Type and crossmatch for 4 units of packed red blood cells. b. Infuse lactated Ringer's solution at 200 mL/hr. c. Give pantoprazole (Protonix) 40 mg IV now and then daily. d. Insert a nasogastric tube and connect to low intermittent suction.

b. Infuse lactated Ringer's solution at 200 mL/hr.

The nurse is assessing the client in end-stage liver failure who is diagnosed with portal hypertension. Which intervention should the nurse include in the plan of care? a. Assess the abdomen for a tympanic wave b. Monitor the clients blood pressure c. Percuss the liver for size and location d. Weigh the client twice a week

b. Monitor the clients blood pressure

The nurse cares for a client with a history of chronic liver disease and cirrhosis of the liver. Lab values reveal rising ammonia levels. Which treatment should the nurse question? a. High-carbohydrate diet b. Protein 100g/day c. Neomycin sulfate d. Potassium supplements

b. Protein 100g/day

Immediately following a colonoscopy, which client behavior will the nurse report to the health care provider? Select all that apply. a. Passing flatus b. Blood pressure 128/80 c. Abdominal guarding d. Change in mental status e. Report of mild abdominal cramping

c. Abdominal guarding d. Change in mental status

During the treatment of the patient with bleeding esophageal varices, it is most important that the nurse: a. Prepare the pt. for immediate portal shunting surgery. b. Perform guaiac testing on all stools to detect occult blood. c. Maintain the patients airway and prevent aspiration of blood. d. Monitor for the cardiac stimulant effects of IV vasopressin and nitroglycerin.

c. Maintain the patients airway and prevent aspiration of blood.

The nurse is caring for a patient with cirrhosis who has hepatic encephalopathy. Which assessment finding should the nurse report to the primary health care provider? a. Fatigue b. Difficulty sleeping c. Seizure d. Disorientation

c. Seizure

The client is diagnosed with ulcerative colitis. Upon assessment, the nurse notes the following findings. Which finding warrants immediate intervention by the nurse? a. 20 bloody stools per day b. oral temperature of 99.8F c. abdomen hard and rigid d. complaints of urinating when coughing

c. abdomen hard and rigid

Which statement by the client who is prescribed to take pancreatic enzyme replacements indicates a need for further teaching by the nurse? a. "I need to take the enzymes at every meal and with snacks." b. "After taking the enzymes, I should drink a glass of water." c. "I should wipe my mouth in case any of the enzyme got on my lips." d. "I should chew each capsule carefully so that it works in my stomach."

d. "I should chew each capsule carefully so that it works in my stomach."

A client is admitted to the hospital with nausea and hematemesis. The nurse is obtaining health history on admission. What will be the most important for the nurse to ask the client? a. Does the client have any family history of GI bleed? b. Has the client had any significant weight gain or loss over the past 2 months? c. What are the characteristics of the clients dietary intake? d. Does the client regularly take any NSAIDs?

d. Does the client regularly take any NSAIDs?

What is the priority nursing care for the patient with Chrons? a. Adequate nutrition and fluid and electrolyte imbalance b. Pain relief c. Health care management d. Management of altered bowel elimination

d. Management of altered bowel elimination

A client admitted to the hospital with a suspected diagnosis of acute pancreatitis is being assessed by the nurse. Which assessment findings would be consistent with acute pancreatitis? Select all that apply. a. Diarrhea b. Black, tarry stools c. Hyperactive bowel sounds d. Gray blue color at the flank e. Abdominal guarding and tenderness f. Left upper quadrant pain with radiation to the back

e. Abdominal guarding and tenderness f. Left upper quadrant pain with radiation to the back