Prep U: Assessment of Digestive & Gastrointestinal Function

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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? - jejunum -duodenum -ileum -cecum

duodenum

Which response is a parasympathetic response in the GI tract? -decreased motility -Increased peristalsis -blood vessel constriction -decreased gastric secretion

increased peristalsis

Which procedure is performed to examine and visualize the lumen of the small bowel? -colonoscopy -panendoscopy -peritoneoscopy -small bowel enteroscopy

small bowel enteroscopy

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? -magnetic resonance imaging - upper GI enteroclysis -abdominal ultrasound -positron emission tomography

upper GI enteroclysis

A client reports having red stools lately. What will the nurse ask during assessment questioning? -Have you been eating spinach?" -"Have you been taking an iron supplement?" -"Have you been drinking grape juice?" -"Have you been eating beets?"

"Have you been eating beets?"

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." - "It detects a protein normally found in the blood." -"It determines functionality of the liver." -"It tells the physician what type of cancer is present."

"It indicates if a cancer is present."

While palpating a client's right upper quadrant (RUQ), the nurse would expect to find which structure? -Sigmoid colon -Liver -Spleen -Appendix

Liver

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 -hypoactive -sluggish -absent

Normal

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 complete blood count including differential -Gastric analysis -Serum antibodies for H. pylori -A sigmoidoscopy

Serum antibodies for H. pylori

A nurse is giving a client barium swallow test. What is the most important assessment a nurse would make to ensure that a client does not retain any barium after a barium swallow? -Observing the color of urine. -Monitoring the volume of urine. -Monitoring the stool passage and its color. -Placing any stool passed in a specific preservative.

Monitoring the stool passage and its color.

Which of the following digestive enzymes aids in the digesting of starch? -Amylase -Trypsin -Lipase -Bile

Amylase

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? -Infection -Rectal fissure -Bowel perforation -Colonic polyp

Bowel perforation

When examining the abdomen of a client with reports of nausea and vomiting, what would the nurse do first? -Palpation -Inspection -Percussion -Auscultation

Inspection

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? - Histamine -Liver enzyme -Intrinsic factor -Hydrochloric acid

Intrinsic factor

After 20 seconds of auscultating for bowel sounds on a client recovering from abdominal surgery, the nurse hears nothing. What should the nurse do based on the assessment findings? -Call the health care provider to report absent bowel sounds. -Return in 1 hour and listen again to confirm findings. -Listen longer for the sounds. -Document that the client is constipated.

Listen longer for the sounds.

Which of the following is an enzyme secreted by the gastric mucosa? -Pepsin -Ptyalin -Bile -Trypsin

Pepsin

The nurse is scheduling gastrointestinal (GI) diagnostic testing for a client. Which GI test should be scheduled first? -Small bowel series -Radiography of the gallbladder -Barium swallow -Barium enema

Radiography of the gallbladder

Specific disease processes and ingestion of certain foods and medications may change the appearance of the stool. If blood is shed in sufficient quantities into the upper gastrointestinal (GI) tract, it produces which change in the stool appearance? -Blood-streaked -Tarry-black -Bright red -Dark brown

Tarry-black

A client receives a local anesthetic to suppress the gag reflex for a diagnostic procedure of the upper GI tract. Which nursing intervention is advised for this patient? -The client should not be given any food and fluids until the gag reflex returns. -The client should be monitored for cramping or abdominal distention. -The client's fluid output should be measured for at least 24 hours after the procedure. -The client should be monitored for any breathing-related disorder or discomforts.

The client should not be given any food and fluids until the gag reflex returns.

The nurse prepares a client for a barium enema. The nurse should place the client on which diet prior to the procedure? -high-fiber diet 1 to 2 days prior -clear liquids day before -soft diet 1 day prior -nothing by mouth (NPO) 2 days prior

clear liquids day before

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? -"There is no need for special preparation before the test." -"I'll take a laxative to clear my bowels before the test." -"I'll avoid eating or drinking anything 6 to 8 hours before the test." -"I'll drink full liquids the day before the test."

"I'll avoid eating or drinking anything 6 to 8 hours before the test."

The nurse is preparing the client for an assessment of the abdomen. What should the nurse complete piror to this assessment? -Prepare for a prostate examination. -Ask the client to empty the bladder. -Dim the lights for privacy. -Assist the client to a Fowler's position.

Ask the client to empty the bladder.

The nurse asks a client to point to where pain is felt. The client asks why this is important. What is the nurse's best response?

"Often the area of pain is referred from another area."

The nurse is caring for a client recovering from an esophagogastroduodenoscopy (EGD). Which of the following client symptoms would require further nursing assessment? -Abdominal distention -Thirst -Sore throat -Drowsiness

Abdominal distention

An older adult client is admitted to an acute care facility for treatment of an acute flare-up of a chronic gastrointestinal condition. In addition to assessing the client for complications of the current illness, the nurse monitors for age-related changes in the gastrointestinal tract. Which age-related change increases the risk of anemia? -Decrease in intestinal flora -increase in bile secretion -Dulling of nerve impulses -Atrophy of the gastric mucosa

Atrophy of the gastric mucosa

Which of the following is considered the gold standard for the diagnosis of liver disease? -Ultrasonography -Cholecystography -Paracentesis -Biopsy

Biopsy

The nurse is to obtain a stool specimen from a client who reported that he is taking iron supplements. The nurse would expect the stool to be which color? -Black -Dark brown -Red -Green

Black

When examining the skin of a client who is dehydrated due to fluid losses from the gastrointestinal tract, which of the following would be most important? -Observing for distended abdominal veins -Checking if the mucous membranes are dry -Examining the sclera if it is yellow -Checking if the skin is discolored

Checking if the mucous membranes are dry

A nurse is preparing a client with Crohn's disease for a barium enema. What should the nurse do the day before the test? -Serve dairy products. -Serve the client his usual diet. -Order a high-fiber diet. -Encourage plenty of fluids.

Encourage plenty of fluids.

A client undergoing a diagnostic examination for gastrointestinal disorder was given polyethylene glycol/electrolyte solution as a part of the test preparation. Which of the following measures should the nurse take once the solution is administered? -Permit the client to drink only clear liquids. -Allow the client to ingest fat-free meal. -Instruct the client to have low-residue meals. -Provide saline gargles to the client.

Permit the client to drink only clear liquids.

Following ingestion of carrots or beets, the nurse would expect which alteration in stool color? -Black -Yellow -Red -Milky white

Red

The nurse is preparing to examine the abdomen of a client who reports a change in bowel pattern. The nurse would place the client in which position? -Left Sim's lateral -Supine with knees flexed -Knee-chest -Lithotomy

Supine with knees flexed

Which nursing instruction is correct to provide the client following a barium enema? -The client will maintain a low residue diet. -Sips of fluid may be increased if tolerated. -The stools may be a white or clay colored. -An enema will be used to clear the bowel.

The stools may be a white or clay colored.

A client is to have an upper GI procedure with barium ingestion and abdominal ultrasonography. While scheduling these diagnostic tests, the nurse must consider which factor? - The upper GI should be scheduled before the ultrasonography. -The client may eat a light meal before either test. -The ultrasonography should be scheduled before the GI procedure. -Both tests need to be done before breakfast.

The ultrasonography should be scheduled before the GI procedure.

The nurse recognizes which change of the gastrointestinal system is an age-related change? - hypertrophy of the small intestine -increased mucus secretion -Increased motility - Weakened gag reflex

weakened gag reflex

When preparing a client for magnetic resonance imaging (MRI) of the abdomen, which statement would indicate the need to notify the health care provider? - "I really don't like to be in small, enclosed spaces." -"I haven't had anything to eat or drink since midnight last night." -"I brought earphones to shut out the loud noise." -"I left all my jewelry and my watch at home."

"I really don't like to be in small, enclosed spaces."

A few hours after eating hot and spicy chicken wings, a client presents with lower chest pain. He wonders if he is having a heart attack. How should the nurse proceed first? - Explain that fatty foods can mimic chest pain. - Further investigate the initial complaint. - Call for an immediate electrocardiogram - Administer an over-the-counter antacid tablet.

Further investigate the initial complaint.

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? -normal -hypoactive -hyperactive -Borborygmi

Hyperactive

The major carbohydrate that tissue cells use as fuel is -fats. -proteins. -chyme. -glucose.

glucose.

The nurse is reviewing the results of a hemoccult test with the client. Which question asked by the nurse is important in screening for the potential of a false-positive result. Select all that apply -"When was the last time that you included red meat in your diet?" -"Are you prescribed regular strength aspirin daily?" -"Can you tell me the amount of alcohol that you drink on an average week?" -"Do you take an iron supplement on a daily basis?" -"Does your diet include a moderate amount of vitamin C?"

-"Are you prescribed regular strength aspirin daily?" -"Can you tell me the amount of alcohol that you drink on an average week?" -"When was the last time that you included red meat in your diet?"

Gastrin has which of the following effects on gastrointestinal (GI) motility? -Relaxation of the colon -Contraction of the ileocecal sphincter -Increased motility of the stomach -Relaxation of gastroesophageal sphincter

Increased motility of the stomach

The nurse is caring for a man who has experienced a spinal cord injury. Throughout his recovery, the client expects to gain control of his bowels. The nurse's best response to this client would be which of the following? -"It is not going to happen. Your nerve cells are too damaged." -"Wearing an undergarment will become more comfortable over time." -"Over time, the nerve fibers will regrow new tracts, and you can have bowel movements again." -"Having a bowel movement is a spinal reflex requiring intact nerve fibers. Yours are not intact."

"Having a bowel movement is a spinal reflex requiring intact nerve fibers. Yours are not intact."

Which of the following is the primary function of the small intestine? -Absorption -Digestion -Secretion -Peristalsis

Absorption

The nurse teaches a client scheduled for a colonoscopy. Which instruction should be included as part of the preparation for the procedure? -Do not void for at least 30 minutes before the test. -Follow the dietary and fluid restrictions and bowel preparation procedures. -Consume at least 3 quarts of water 30 minutes before the test. -Spray or gargle with a local anesthetic.

Follow the dietary and fluid restrictions and bowel preparation procedures.

The nurse is working with clients with digestive tract disorders. Which of the following organs does the nurse realize has effects as an exocrine gland and an endocrine gland? -Gallbladder -Pancreas -Liver -Stomach

Pancreas


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