GI PRACTICE QUESTIONS

A client is scheduled to have a fundoplication. What statement by the client indicates a need to review preoperative teaching?

"After the operation I can eat anything I want."

After teaching a client who is recovering from a colon resection, the nurse assesses the client's understanding. Which statements by the client indicate a correct understanding of the teaching? (Select all that apply.)

"Cutting the flange will help it fit snugly around the stoma to avoid skin breakdown." - "I will use warm water and a soft washcloth to clean around the stoma." - "I might start bicycling and swimming again once my incision has healed."

A nurse teaches a client who has viral gastroenteritis. Which dietary instruction should the nurse include in this client's teaching?

"Drink plenty of fluids to prevent dehydration."

A nurse cares for a client with colon cancer who has a new colostomy. The client states, "I think it would be helpful to talk with someone who has had a similar experience." How should the nurse respond?

"I will make a referral to the United Ostomy Associations of America."

A client with chronic GERD has difficulty swallowing and has been working with a speech-language pathologist. What assessment finding by the nurse indicates that the priority goal for this problem is being met?

Lungs clear after meals and snacks

What GI bleed would make the stool black and tarry?

Upper GI bleed

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."

The nurse has taught a client about lifestyle modifications for gastroesophageal reflux disease (GERD). What statements by the client indicate good understanding of the teaching? (Select all that apply.)

"I sure hate to give up my coffee, but I guess I have to." - "I will eat three small meals and three small snacks a day." - "I just joined a gym, so I hope that helps me lose weight."

Which prescribed action will the nurse implement first for a patient who has vomited 1100 mL of blood

Administer 1 L of lactated Ringer's solution.

A 57-year-old man with Escherichia coli food poisoning is admitted to the hospital with bloody diarrhea and dehydration. Which order will the nurse question?

Administer loperamide (Imodium) after each stool.

A nurse is preparing to administer pantoprazole (Protonix) intravenously. What actions by the nurse are most appropriate? (Select all that apply.)

Administer the drug through a separate IV line, Can be infused with Peripheral IV line, Infuse pantoprazole using an IV pump.

Which action should the nurse in the emergency department take first for a new patient who is vomiting blood?

Check blood pressure and heart rate.

A patient admitted with a peptic ulcer has a nasogastric (NG) tube in place. When the patient develops sudden, severe upper abdominal pain, diaphoresis, and a firm abdomen, which action should the nurse take?

Check the vital signs.

Which patient choice for a snack 2 hours before bedtime indicates that the nurse's teaching about gastroesophageal reflux disease (GERD) has been effective?

Cherry gelatin with fruit

A nurse assesses a client with peritonitis related to a GI perforation. Which clinical manifestations should the nurse expect to find? (Select all that apply.)

Decreased urine output, Inability to pass flatus, Distended abdomen

A nurse cares for a client who has a new colostomy. Which action should the nurse take?

Empty the pouch frequently to remove excess gas collection.

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

The nurse caring for clients with gastrointestinal disorders should understand that which category best describes the mechanism of action of sucralfate (Carafate)?

Mucosal barrier fortifier

The nurse is caring for a client with peptic ulcer disease who reports sudden onset of sharp abdominal pain. On palpation, the client's abdomen is tense and rigid. What action takes priority?

Notify the health care provider immediately.

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 health care provider prescribes antacids and sucralfate (Carafate) for treatment of a patient's peptic ulcer. The nurse will teach the patient to take

antacids after meals and sucralfate 30 minutes before meals.

What does red streaking blood in the stool indicate?

hemorroids

The nurse explaining esomeprazole (Nexium) to a patient with recurring heartburn describes that the medication

treats gastroesophageal reflux disease by decreasing stomach acid production.

A nurse assesses a client with a mechanical bowel obstruction who reports intermittent abdominal pain. An hour later the client reports constant abdominal pain. Which action should the nurse take next?

Assess the client's bowel sounds.

Which medications will the nurse teach the patient about whose peptic ulcer disease is associated with Helicobacter pylori?

Amoxicillin (Amoxil), clarithromycin (Biaxin), and omeprazole (Prilosec)

The nurse is preparing to perform a client's abdominal assessment. What examination sequence should the nurse follow?

Inspection, auscultation, percussion, and palpation

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 nurse assesses a client who has appendicitis. Which clinical manifestation should the nurse expect to find?

Severe, steady right lower quadrant pain

A client with peptic ulcer disease is in the emergency department and reports the pain has gotten much worse over the last several days. The client's blood pressure when lying down was 122/80 mm Hg and when standing was 98/52 mm Hg. What action by the nurse is most appropriate?

Start a large-bore IV with normal saline.

A client has returned to the nursing unit after an open Nissen fundoplication. The client has an indwelling urinary catheter, a nasogastric (NG) tube to low continuous suction, and two IVs. The nurse notes bright red blood in the NG tube. What action should the nurse take first?

Take a full set of vital signs.

A nurse is teaching clients with gastroesophageal reflux disease (GERD) about foods to avoid. Which foods should the nurse include in the teaching? (Select all that apply.)

Tomato sauce, Chocolate, Citrus fruits, Peppermint

A client is being taught about drug therapy for Helicobacter pylori infection. What assessment by the nurse is most important?

Willingness to adhere to drug therapy