GI Unit Test

Rebound hypoglycemia is a complication of parental nutrition caused by which of the following? a) Cap missing from the port b) Fluid infusing rapidly c) Glucose intolerance d) Feedings stopped too abruptly

Feedings stopped too abruptly

Which of the following is a protrusion of the intestine through a weakened area in the abdominal wall? a) Tumor b) Adhesion c) Hernia d) Volvulus

Hernia

The type of stool that will be expelled into the ostomy bag by a client who has undergone an surgery for an ileostomy will be a) Liquid b) Filled with mucus c) Bloody d) Soft and semi-formed

Liquid

The nurse is admitting a patient with a diagnosis of diverticulitis and assesses that the patient has a boardlike abdomen, no bowel sounds, and complains of severe abdominal pain. What is the nurse's first action? a) Administer an opioid analgesic. b) Administer a retention enema. c) Notify the physician. d) Start an IV with lactated Ringer's solution.

Notify the physician.

A patient is taking nonsteroidal anti-inflammatory agents for arthritis of the knees and hips. Which of the following diseases is a result of cellular destruction of the gastrointestinal tract from this medication? a) Liver cancer b) Bowel obstruction c) Esophageal cancer d) Peptic ulcer disease

Peptic ulcer disease

A patient with a liver mass is undergoing a percutaneous liver biopsy. What action should the nurse perform when assisting with this procedure? a) Administer at least 1 unit of packed red blood cells as ordered the day before the scheduled procedure. b) Administer 1 unit of albumin 90 minutes before the procedure as ordered. c) Position the patient on the right side with a pillow under the costal margin after the procedure. d) Confirm that the patient's electrolyte levels have been assessed prior to the procedure.

Position the patient on the right side with a pillow under the costal margin after the procedure.

The nurse is concerned about potassium loss when a diuretic is prescribed for a patient with ascites and edema. What diuretic may be ordered that spares potassium and prevents hypokalemia? a) Furosemide (Lasix) b) Spironolactone (Aldactone) c) Bumetanide (Bumex) d) Acetazolamide (Diamox)

Spironolactone (Aldactone)

Which of the following will the nurse observe as symptoms of perforation in a patient with intestinal obstruction? a) Sudden, sustained abdominal pain b) Purulent drainage from the gluteal fold c) Decreased blood pressure d) Decreased urine output

Sudden, sustained abdominal pain

A preoperative client scheduled to have an open cholecystectomy says to the nurse, "The doctor said that after surgery, I will have a tube in my nose that goes into my stomach. Why do I need that?" What most common reason for a client having a nasogastric tube in place after abdominal surgery should the nurse include in a response? a) Decompression b) Gavage c) Instillation d) Lavage

Decompression

Brock Nichols, a four-year-old preschooler, is being seen in the ED where you practice nursing. His mother reports that Brock has been vomiting for three days and is unable to "keep anything down". What poses the greatest danger to Brock? a) Choking on increased salivation b) Anorexia c) Dehydration d) Nausea

Dehydration

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? a) Digestion of proteins b) Maintenance of peristalsis c) Vitamin D synthesis d) Digestion of fats

Digestion of proteins

The nurse may advise a patient to get which of the following after a myocardial infarction to prevent straining during defecation? (Choose one) a) Docusate (Colace) b) Psyllium (Metamucil) c) Lactulose (Cephulac) d) Lubiprostone (Amitiza)

Docusate (Colace)

A client and spouse are visiting the clinic. The client recently experienced a seizure and says she has been having difficulty writing. Before the seizure, the client says that for several weeks she was sleeping late into the day but having restlessness and insomnia at night. The client's husband says that he has noticed the client has been moody and slightly confused. Which of the following problems is most consistent with the client's clinical manifestations? a) Hepatitis C b) Hepatic encephalopathy c) Esophageal varices d) Portal hypertension

Hepatic encephalopathy

When reviewing the history of a client with pancreatic cancer, the nurse would identify which of the following as a possible risk factor? a) One-time exposure to petrochemicals b) Ingestion of caffeinated coffee c) History of pancreatitis d) Ingestion of a low-fat diet

History of pancreatitis

Graphic Option question - Select the correct image. A nurse is reviewing a descending colostomy procedure with a client. Which of the following diagrams would the nurse use in teaching? a) b) c) d)

The image depicts a descending colostomy.

Alice Burton, a 77-year-old retired bookkeeper, is having elimination difficulties and has been admitted to the medical-surgical floor at the hospital where you practice nursing. In your client education regarding her lower GI study that is scheduled, you describe the organs involved and their characteristics. Approximately how long is her duodenum? a) 10 inches b) 15 inches c) 10 feet d) 15 feet

10 inches

The nurse is assisting the physician with a procedure to remove ascitic fluid from a client with cirrhosis. What procedure does the nurse ensure the client understands will be performed? a) Upper endoscopy b) Abdominal CT scan c) Abdominal paracentesis d) Thoracentesis

Abdominal paracentesis

Which of the following sequence should be used to assess the abdomen? a) Inspection, auscultation, percussion, palpation b) Palpation, inspection, percussion, auscultation c) Percussion, auscultation, palpation, inspection d) Auscultation, inspection, percussion, palpation

Inspection, auscultation, percussion, palpation

Which of the following enzymes aids in the digestion of fats? a) Secretin b) Lipase c) Trypsin d) Amylase

Lipase

Choice Multiple question - Select all answer choices that apply. While conducting a physical examination of a client, which of the following skin findings would alert the nurse to the possibility of liver problems? Select all that apply. a) Jaundice b) Aphthous stomatitis c) Cyanosis of the lips d) Ecchymoses e) Petechiae

• Jaundice • Petechiae • Ecchymoses

Choice Multiple question - Select all answer choices that apply. A client has to undergo a colostomy, and the nurse is using a diagram to review the procedure. What type of procedure will the client experience based on the image? a) Sigmoid colostomy b) Descending colostomy c) Transverse colostomy d) Ascending colostomy

• Sigmoid colostomy

A client who has just been diagnosed with hepatitis A asks, "How did I get this disease?" What is the nurse's best response? a) "You must have received an infected blood transfusion." b) "You may have eaten contaminated restaurant food." c) "You could have gotten it by using I.V. drugs." d) "You probably got it by engaging in unprotected sex."

"You may have eaten contaminated restaurant food."

The nurse is confirming placement of a patient's nasogastric (NG) tube using a combination of visual and pH assessment of the aspirate. The nurse determines that the NG tube remains properly placed when the pH of the aspirate is which of the following? a) Unmeasurable b) Alkaline c) Neutral d) Acidic

Acidic

Lactulose (Cephulac) is administered to a patient diagnosed with hepatic encephalopathy to reduce which of the following? a) Ammonia b) Calcium c) Bicarbonate d) Alcohol

Ammonia

A patient with a peptic ulcer disease has had metronidazole (Flagyl) added to his current medication regimen. What health education related to this medication should the nurse provide? a) Take the medication on an empty stomach. b) Take up to one extra dose per day if stomach pain persists. c) Avoid drinking alcohol while taking the drug. d) Take at bedtime to mitigate the effects of drowsiness.

Avoid drinking alcohol while taking the drug

The nurse is assessing a client with a bleeding gastric ulcer. When examining the client's stool, which of the following characteristics would the nurse be most likely to find? a) Clay-like quality b) Green color and texture c) Black and tarry appearance d) Bright red blood in stool

Black and tarry appearance

A longitudinal tear or ulceration in the lining of the anal canal is termed a (an) a) anal fistula. b) anorectal abscess. c) hemorrhoid. d) anal fissure.

anal fissure.

Choice Multiple question - Select all answer choices that apply. A client is being treated for diverticulosis. Which of the following points should the nurse include in this client's teaching plan? Select all that apply. a) Do not suppress the urge to defecate. b) Drink at least 8 to 10 large glasses of fluid every day. c) Use laxatives or enemas at least once a week. d) Avoid daily exercise; indulge only in mild activity.

• Do not suppress the urge to defecate. • Drink at least 8 to 10 large glasses of fluid every day.

A student nurse is caring for a patient who has a diagnosis of acute pancreatitis and who is receiving parenteral nutrition. The student should prioritize which of the following assessments? a) Fluid output b) Blood glucose levels c) BUN and creatinine levels d) Oral intake

Blood glucose levels

When caring for a patient with cirrhosis, which of the following symptoms should the nurse report immediately? a) Change in mental status b) Anorexia and dyspepsia c) Diarrhea or constipation d) Fatigue and weight loss

Change in mental status

A patient reports feeling constipated, yet passes frequent small liquid stools. Which of these actions by the nurse is appropriate? a) Administer an antidiarrheal medication. b) Explain that liquid stools indicate diarrhea. c) Check the patient for a fecal impaction. d) Check the abdomen for rebound tenderness.

Check the patient for a fecal impaction.

A nurse is caring for a client who is scheduled to have a colostomy placed in the transverse section of the large intestine and will contain both a proximal and distal stoma. The client will most likely receive which of the following colostomies? a) Segmental colostomy b) Double-barrel colostomy c) Single-barrel colostomy d) Loop colostomy

Double-barrel colostomy

The nurse is investigating a patient's complaint of pain in the duodenal area. Where should the nurse perform the assessment? a) Periumbilical area, followed by the right lower quadrant b) Hypogastrium in the right or left lower quadrant c) Left lower quadrant d) Epigastric area and consider possible radiation of pain to the right subscapular region

Epigastric area and consider possible radiation of pain to the right subscapular region

Which of the following is a parasympathetic response in the GI tract? a) Decreased motility b) Decreased gastric secretion c) Increased peristalsis d) Blood vessel constriction

Increased peristalsis

Crohn's disease is a condition of malabsorption caused by which of the following pathophysiological processes? a) Gastric resection b) Disaccharidase deficiency c) Infectious disease d) Inflammation of all layers of intestinal mucosa

Inflammation of all layers of intestinal mucosa

Tyrone Freeman is a 49-year-old male being treated for GERD at the gastroenterology office where you work. During his visit, he states that his reflux is much improved, but now, he is having diarrhea. In addition to his prescribed treatment for GERD, he has been taking an antacid. Which of the following components of an antacid might be causing his diarrhea? a) None of the above b) Aluminum c) Calcium d) Magnesium

Magnesium

An elderly homeless client with a lengthy history of alcohol addiction is visiting the health clinic where you work. He has worsening jaundice. After diagnostic testing is complete, the physician returns a diagnosis of cirrhosis. The nurse begins client education about this condition. What would the nurse emphasize as the principal goal of cirrhosis therapy? a) Restoring fat-soluble vitamin absorption b) Preserving liver function c) Curing the illness d) Increasing alcohol toleration

Preserving liver function

A client is admitted to the hospital with an exacerbation of his chronic gastritis. When assessing his nutritional status, the nurse should expect a deficiency in: a) vitamin B12. b) vitamin C. c) vitamin A. d) vitamin B6.

vitamin B12.

A client with cirrhosis is at risk for developing esophageal varices. Which of the following instructions should a nurse provide the client to minimize such risk? a) Use aspirin at least once a day. b) Abstain from drinking alcohol. c) Avoid intake of sodium-rich food. d) Increase intake of potassium-rich food.

Abstain from drinking alcohol.

A client with a feeding tube is to receive medication. The medication supplied is an enteric-coated tablet. Which of the following would be most appropriate? a) Give the tablet as is in its original state. b) Dissolve the tablet in water after crushing it. c) Check with the pharmacist to see of a liquid form is available. d) Sprinkle the contents of the opened tablet into the tube.

Check with the pharmacist to see of a liquid form is available.

A nurse caring for a patient who has had bariatric surgery is developing a teaching plan in anticipation of the patient's discharge. Which of the following is essential to include? a) Choose foods that are high in simple carbohydrates. b) Eat several small meals daily spaced at equal intervals. c) Drink a minimum of 12 ounces of fluid with each meal. d) Sit upright when eating and for 30 minutes afterward.

Eat several small meals daily spaced at equal intervals.

What test should the nurse prepare the client for that will locate stones that have collected in the common bile duct? a) Colonoscopy b) Abdominal x-ray c) Endoscopic retrograde cholangiopancreatography (ERCP) d) Cholecystectomy

Endoscopic retrograde cholangiopancreatography (ERCP)

A client underwent a continent ileostomy 2 months ago. How often should the client's reservoir be emptied? a) Three or four times daily b) At least once every 2 days c) Every 2 to 4 hours d) At least once a day

Every 2 to 4 hours

Which of the following characteristics are risk factors for colorectal cancer? a) Low-fat, low-protein, high-fiber diet b) History of skin cancer c) Familial polyposis d) Being younger than 40 years of age

Familial polyposis

The nurse auscultates the abdomen to assess bowel sounds. She documents five to six sounds heard in less than 30 seconds. How does the nurse document the bowel sounds? a) Normal b) Borborygmi c) Hyperactive d) Hypoactive

Hyperactive

When an appliance is necessary to collect stool from an ostomy, what primarily determines the consistency of the stool that is collected? a) Amount of liquid in the diet b) Intestinal placement of the stoma c) Amount of fiber in the diet d) Last night's dinner

Intestinal placement of the stoma

Diagnostic testing has revealed that a patient's hepatocellular carcinoma (HCC) is limited to one lobe. The nurse should anticipate that this patient's plan of care will focus on what intervention? a) Lobectomy b) Liver transplantation c) Cryosurgery d) Laser hyperthermia

Lobectomy

A patient has sought care because of recent dark-colored stools. As a result, a fecal occult blood test has been ordered. The nurse should instruct the patient to avoid which of the following prior to collecting a stool sample? a) NSAIDs b) Acetaminophen c) Fiber supplements d) OTC vitamin D supplements

NSAIDs

The nurse working in the recovery room is caring for a patient who had a radical neck dissection. The nurse notices that the patient has a coarse, high-pitched sound on inspiration. Which of the following is the appropriate intervention by the nurse? a) Notifying the physician b) Documenting the presence of stridor c) Lowering the head of the bed d) Administering a breathing treatment

Notifying the physician

A client has a blockage of the passage of bile from a stone in the common bile duct. What type of jaundice does the nurse suspect this client has? a) Hemolytic jaundice b) Cirrhosis of the liver c) Obstructive jaundice d) Hepatocellular jaundice

Obstructive jaundice

The nurse is inspecting a client's stoma. Which finding would the nurse need to report to the physician? a) Retraction beneath the skin b) Moist shiny surface c) Bright red color d) Absence of pain sensation

Retraction beneath the skin

A patient comes to the ED with severe abdominal pain, nausea, and vomiting. The physician plans to rule out possible acute pancreatitis. The nurse would expect the diagnosis to be confirmed with which of the following elevated laboratory tests? a) Serum bilirubin b) Serum amylase c) Serum potassium d) Serum calcium

Serum amylase

The nurse is instructing the client who was newly diagnosed with peptic ulcers. Which of the following diagnostic studies would the nurse anticipate reviewing with the client? a) A sigmoidoscopy b) Gastric analysis c) Serum antibodies for H. pylori d) A complete blood count including differential

Serum antibodies for H. pylori

Which of the following is the most common complaint(s) of patients with pancreatitis? a) Tarry-black stools and dark urine b) Increased appetite and weight gain c) Increased and painful urination d) Severe, radiating abdominal pain

Severe, radiating abdominal pain

A client is preparing for discharge to home, following a partial gastrectomy and vagotomy. Which is the best rationale for the client being taught to lie down for 30 minutes after each meal? a) Allows for better absorption of vitamin B12 b) Removes tension on internal suture line c) Provides much needed rest d) Slows gastric emptying

Slows gastric emptying

A nurse educator is teaching a group that specializes in liver disorders. Which of the following is an important education topic regarding ingestion of medications? a) The need to leave daily total doses the same but ingest smaller amounts more often b) The need for increased drug dosages because of disorders c) That medications won't work in clients with liver disorders d) The effect of liver problems on medication metabolism

The effect of liver problems on medication metabolism

Which of the following medications is used to decrease portal pressure, halting bleeding of esophageal varices? a) Nitroglycerin b) Vasopressin (Pitressin) c) Spironolactone (Aldactone) d) Cimetidine (Tagamet)

Vasopressin (Pitressin)

The nurse is assigned to care for a patient 2 days after an appendectomy due to a ruptured appendix with resultant peritonitis. The nurse has just assisted the patient with ambulation to the bedside commode when the patient points to the surgical site and informs the nurse that "something gave way." What does the nurse suspect may have occurred? a) A drain may have become dislodged. b) Infection has developed. c) Wound dehiscence has occurred. d) The surgical wound has begun to bleed.

Wound dehiscence has occurred

A student accepted into a nursing program must begin receiving the hepatitis B series of injections. The student asks when the next two injections should be administered. What is the best response by the instructor? a) "You must have the second one in 1 month and the third in 6 months." b) "You must have the second one in 6 months and the third in 1 year." c) "You must have the second one in 2 weeks and the third in 1 month." d) "You must have the second one in 1 year and the third the following year."

You must have the second one in 1 month and the third in 6 months."

A nurse is assessing the stoma of a patient with an ostomy. What would the nurse assess in a normal, healthy stoma? a) dark red and moist b) pale and oozing c) irritated and bleeding d) purple-blue and dry

dark red and moist