Prep U Chapter 21

A client with a gastrointestinal condition asks why the mouth needs to be examined. Which response will the nurse make? "It is a body part that is least examined." "It is a part of the assessment of every client." "Your problem is in your mouth and not your abdomen." "Changes in the mouth can help explain why your condition is occurring."

"Changes in the mouth can help explain why your condition is occurring."

The nurse is caring for a client who reports new onset of diarrhea. Which of the following should the nurse ask this client? Select all that apply. "How long ago did the diarrhea start?" "Does the diarrhea appear to contain mucus?" "Does the diarrhea awaken you at night"? "Are you experiencing severe heartburn with the diarrhea?" "Have you noticed any blood in the diarrhea?"

"How long ago did the diarrhea start?" "Does the diarrhea appear to contain mucus?" "Does the diarrhea awaken you at night"? "Have you noticed any blood in the diarrhea?"

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 haven't had anything to eat or drink since midnight last night." "I really don't like to be in small, enclosed spaces." "I left all my jewelry and my watch at home." "I brought earphones to shut out the loud noise."

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

A client is scheduled for an ultrasound of the abdomen. Which statement indicates that teaching provided to the client to prepare for the test was effective? "I will take an over-the-counter enema before the test." "I will not eat or drink for 8 to 12 hours before the test." "I will ingest a clear liquid diet for 3 days before the test." "I will take medications to reduce gastric acid before the test."

"I will not eat or drink for 8 to 12 hours before the test."

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? "If the health care provider massages over the exact painful area, the pain will disappear." "The area may determine the severity of the pain." "This determines the pain medication to be ordered." "Often the area of pain is referred from another area."

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

The nurse is instructing the client on sensations commonly experienced when a contrast agent is injected into the body during diagnostic studies. Which sensation is most common? Light-headedness A warm sensation Heart palpitations Chills

A warm sensation

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

Absorption

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

Amylase

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

Ask the client to empty the bladder.

A patient has come into the radiology department to undergo testing for possible polyps. What diagnostic test may be done to diagnose this type of lesion? Gastric analysis Barium enema Barium swallow Gastroscopy

Barium enema

The liver performs numerous functions that contribute to homeostasis, including the synthesis of bile. How is bile utilized in the processes of digestion and absorption? Bile is produced in the liver in response to meals that are high in protein. Bile is stored in the gallbladder until it is needed for carbohydrate metabolism. Bile is produced in the liver but released by the gallbladder when needed for digesting fats. Bile production increases when an individual's fat intake is reduced over several days.

Bile is produced in the liver but released by the gallbladder when needed for digesting fats.

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? Dark brown Green Red Black

Black

A client reports a history of bleeding hemorrhoids to the nurse. Which observation supports the client's statement? Hard, dry stool Dark red stool Black tarry stool Blood streaks on stool

Blood streaks on stool

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 Bowel perforation Colonic polyp Rectal fissure

Bowel perforation

A client is scheduled for several diagnostic tests to evaluate gastrointestinal function. After teaching the client about these tests, the nurse determines that the client has understood the teaching when the client identifies which test as not requiring the use of a contrast medium? Small bowel series Computer tomography Colonoscopy Upper GI series

Colonoscopy

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 client? Monitor for any breathing-related disorder or discomforts. Measure fluid output for at least 24 hours after the procedure. Monitor for cramping or abdominal distention. Do not give any food and fluids until the gag reflex returns.

Do not give any food and fluids until the gag reflex returns.

A client with a gastrointestinal condition is prescribed a stool guaiac for fecal occult blood. Which instructions will the nurse provide the client about this test? Select all that apply. Drink orange juice for 2 days before the test. Do not take any aspirin for 72 hours before the test. Avoid ingesting red meat for 72 hours before the test. Take additional doses of vitamin C supplements before the test. Reduce the amount of nonsteroidal anti-inflammatory drugs taken.

Do not take any aspirin for 72 hours before the test. Avoid ingesting red meat for 72 hours before the test.

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 the client his usual diet. Order a high-fiber diet. Encourage plenty of fluids. Serve dairy products.

Encourage plenty of fluids.

The nurse is working in a diagnostic testing unit focusing on gastrointestinal studies. For which testing procedure is the nurse correct to assess the gag reflex before offering fluids? Esophagogastroduodenoscopy Sigmoidoscopy Peritoneoscopy Colonoscopy

Esophagogastroduodenoscopy

The nurse is assessing a client who is stating gastrointestinal upset and a feeling of bloating. Which type of meal would the nurse anticipate causing these types of symptoms? Grilled chicken on a spinach salad Steamed rice with pork and broccoli Hamburger and French fries Salmon with cheddar mashed potatoes

Hamburger and French fries

A client with abdominal pain is scheduled for a CT scan of the abdomen with contrast. Which assessment will the nurse complete before transporting the client for the diagnostic test? History of allergies Presence of a cochlear implant Last use of an oral laxative Current list of prescribed medications

History of allergies

The nurse is working on a general medical unit. A client is scheduled for an upper gastrointestinal series. Upon return to the nursing unit, what does the nurse identify as the client goal? Recover from the general anesthesia Decrease nausea and vomiting Increase the amount of fluids Ambulate independently

Increase the amount of fluids

A client is scheduled for an upper gastrointestinal barium study. Which teaching will the nurse provide for the client to prepare for this diagnostic test? Ingest nothing by mouth after midnight. Eat a clear liquid breakfast before the test. Withhold oral medications for 24 hours before the test. Avoid products containing aspirin for a week before the test.

Ingest nothing by mouth after midnight.

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? Intrinsic factor Hydrochloric acid Histamine Liver enzyme

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? Listen longer for the sounds. Document that the client is constipated. 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.

A client with a recent history of rectal bleeding is being prepared for a colonoscopy. Initially, how should the nurse position the client for this test? Lying on the right side with legs straight Lying on the left side with knees bent Prone with the torso elevated Bent over with hands touching the floor

Lying on the left side with knees bent

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? Placing any stool passed in a specific preservative. Monitoring the stool passage and its color. Observing the color of urine. Monitoring the volume of urine.

Monitoring the stool passage and its color.

What part of the GI tract begins the digestion of food? Mouth Duodenum Esophagus Stomach

Mouth

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 Stomach Liver

Pancreas

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

Pepsin

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? Instruct the client to have low-residue meals. Allow the client to ingest fat-free meal. Permit the client to drink only clear liquids. Provide saline gargles to the client.

Permit the client to drink only clear liquids.

Which diagnostic produces images of the body by detecting the radiation emitted from radioactive substances? Positron emission tomography (PET) Computed tomography (CT) Magnetic resonance imaging (MRI) Fibroscopy

Positron emission tomography (PET)

A client is scheduled for a barium enema later in the day. Which actions will the nurse take to prepare the client on the morning of the test? Select all that apply. Provide a low-residue breakfast Give only oral laxatives Provide cleansing enemas until clear Maintain nothing by mouth until after the test Administer anti-anxiety medication before the test

Provide cleansing enemas until clear Maintain nothing by mouth until after the test

A group of students are studying for an examination on the gastrointestinal (GI) system and are reviewing the structures of the esophagus and stomach. The students demonstrate understanding of the material when they identify which of the following as the opening between the stomach and duodenum? Cardiac sphincter Hypopharyngeal sphincter Ileocecal valve Pyloric sphincter

Pyloric sphincter

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? Supine with knees flexed Knee-chest Lithotomy Left Sim's lateral

Supine with knees flexed

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? Tarry-black Bright red Blood-streaked Dark brown

Tarry-black

The nurse is conducting an abdominal assessment of a patient who is postoperative day 1 following an open cholecystectomy. During auscultation of the patient's abdomen, the nurse has noted that clicks and gurgles are audible approximately every 10 seconds. How should the nurse follow up this assessment finding? The nurse should administer a p.r.n. stool softener. The nurse should contact the patient's care provider. The nurse should assess the patient for paralytic ileus. The nurse should document normoactive bowel sounds.

The nurse should document normoactive bowel sounds.

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? Both tests need to be done before breakfast. The ultrasonography should be scheduled before the GI procedure. 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.

A nurse is caring for a newly admitted patient with a suspected gastrointestinal (GI) bleed. The nurse assesses the patient's stool after a bowel movement and notes it to be a tarry-black color. The nurse recognizes that the bleeding is likely occurring where? The lower GI tract The upper GI tract The esophagus The anal area

The upper GI tract

The nurse determines which is a true statement regarding older clients, considering the age-related effects on the gastrointestinal (GI) system? They tend to have higher physiologic reserves to compensate for fluid loss. They usually have less control of the rectal sphincter. They have no awareness of the filling reflex. They tend to have increased muscle tone and mass.

They usually have less control of the rectal sphincter.

A patient with gallbladder disease was being treated for blockage of the common bile duct due to a large gallstone. The nurse recognizes which of the following as an abnormal laboratory result? Total bilirubin level of 1.5 mg/dL Alkaline phosphatase level of 60 mg/dL Albumin level of 4.2 g/dL Aspirate aminotransferase level of 25 U/L

Total bilirubin level of 1.5 mg/dL

While completing an abdominal assessment, the nurse will use which landmark as the upper boundary for auscultating bowel sounds? Symphysis pubis T12 to L3 vertebrae Xiphoid process Umbilicus

Xiphoid process

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 soft diet 1 day prior nothing by mouth (NPO) 2 days prior clear liquids day before

clear liquids day before

A client is scheduled to have an endoscopic retrograde cholangiopancreatography. Which structures are visualized during this procedure? common bile duct, pancreatic duct, and biliary tree common bile duct, portal vein, and gallbladder portal vein, pancreatic duct, and biliary tree portal vein, gallbladder, and pancreatic duct

common bile duct, pancreatic duct, and biliary tree

The nurse cares for a client after a gastroscopy for which the client received sedation. The nurse should report which finding to the health care provider? loss of gag reflex minor throat pain drowsiness difficulty swallowing

difficulty swallowing

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

glucose.

The nurse determines one or two bowel sounds in 2 minutes should be documented as normal. hyperactive. hypoactive. absent.

hypoactive

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

increased peristalsis

Which term describes a gastric secretion that combines with vitamin B12 so that it can be absorbed? amylase pepsin trypsin intrinsic factor

intrinsic factor

When bowel sounds are heard about every 15 seconds, the nurse would record that the bowel sounds are sluggish. hypoactive. absent. normal.

normal

A client tells the nurse that the stool was colored yellow. The nurse assesses the client for recent foods ingested. occult blood. ingestion of bismuth. pilonidal cyst.

recent foods ingested.

A nurse is teaching a client with malabsorption syndrome about the disorder and its treatment. The client asks which part of the GI tract absorbs food. What is the nurse's best response? stomach small intestine large intestine rectum

small intestine

The nurse recognizes that blood shed in sufficient quantities into the upper GI tract produces which color of stool? bright red tarry black milky white green

tarry black

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

upper GI enteroclysis

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

weakened gag reflex