ATI assessment Gastrointestinal

A nurse is teaching a client how to prepare for a colonoscopy. Which of the following instructions should the nurse include in the teaching?

"Drink clear liquids for 24 hr prior to the procedure, and then take nothing by mouth for 6 hr before the procedure." Reason: The nurse should instruct the client to drink clear liquids for 24 hr prior to the colonoscopy to promote adequate bowel cleansing.

A nurse is providing discharge teaching for a client who has mild diverticulitis. Which of the following statements by the client indicates an understanding of the teaching?

"I should eat foods that are low in fiber." Reason: The nurse should instruct a client who has diverticulitis to follow a low-fiber diet. When the inflammation subsides, the client should consume foods that are high in fiber.

A nurse is providing discharge teaching for a client who has peptic ulcer disease and a new prescription for famotidine. Which of the following statements by the client indicates an understanding of the teaching?

"I should take this medication at bedtime." Reason: The nurse should instruct the client to take the medication at bedtime to inhibit the action of histamine at the H2-receptor site in the stomach.

A nurse is providing discharge teaching for a client who has chronic hepatitis C. Which of the following statements by the client indicates an understanding of the teaching?

"I will avoid medications that contain acetaminophen." Reason: A client who has hepatitis C should avoid medications that contain acetaminophen, which can cause additional liver damage.

A nurse is providing discharge teaching for a client who has GERD. Which of the following statements by the client indicates an understanding of the teaching?

"I will decrease the amount of carbonated beverages I drink." Reason: The nurse should instruct the client to limit or eliminate fatty foods, coffee, tea, carbonated beverages, and chocolate from the diet because they irritate the lining of the stomach.

A nurse is providing dietary teaching for a client who has a new diagnosis of celiac disease. Which of the following statements by the client indicates an understanding of the teaching?

"I will eat beans to ensure I get enough fiber in my diet." Reason: Clients who have celiac disease must maintain a gluten-free diet, which eliminates fiber-rich whole wheat products. Clients should eat beans, nuts, fruits, and vegetables to ensure an adequate intake of fiber.

A nurse is caring for a client who has colorectal cancer and is receiving chemotherapy. The client asks the nurse why blood is being drawn for a carcinoembryonic antigen (CEA) level. Which of the following responses should the nurse make?

"The CEA determines the efficacy of your chemotherapy." Reason: A provider uses the CEA level to determine the efficacy of the chemotherapy. The client's CEA levels will decrease if the chemotherapy is effective.

A nurse is providing dietary teaching for a client who has chronic pancreatitis. Which of the following food selections by the client indicates an understanding of the teaching?

1 cup (0.24 L) sliced banana Reason: Foods that are high in fat can cause diarrhea for clients who have pancreatitis. One cup of sliced banana, which contains 0.49 g of fat, is a low-fat food option. Clients who have pancreatitis should consume a high-protein and low-fat diet with an adequate amount of carbohydrates and calories.

A nurse is reviewing the laboratory results of a client who has hepatic cirrhosis. Which of the following laboratory findings should the nurse report to the provider?

Ammonia 180 mcg/dL Reason: An ammonia level of 180 mcg/dL is above the expected reference range of 10 to 80 mcg/dL. The nurse should report an increased ammonia level because it can indicate portal-systemic encephalopathy.

A nurse is caring for a client who has GERD and a new prescription for metoclopramide. The nurse should plan to monitor for which of the following adverse effects?

Ataxia Reason: The nurse should plan to monitor the client for extrapyramidal symptoms, such as ataxia, and should report any of these findings to the provider.

A nurse is assessing a client who has cirrhosis. Which of the following findings is the priority for the nurse to report to the provider?

Bloody stools Reason: The greatest risk to the client who has cirrhosis of the liver is hemorrhagic shock due to bleeding in the esophageal varices. Therefore, bloody stools is the priority finding to report to the provider.

A nurse is assessing a client who has peritonitis. Which of the following findings should the nurse expect?

Board-like abdomen Reason: A board-like, distended abdomen, accompanied by extreme pain and tenderness, is an expected finding for a client who has peritonitis.

A nurse is providing discharge teaching for a client following an ileostomy. The nurse should instruct the client to report which of the following findings to the provider?

Dark purple stoma Reason: The nurse should instruct the client to contact the provider if the stoma is a dark purple color, which is an indication of bowel ischemia.

A nurse is assessing a client immediately following a paracentesis for the treatment of ascites. Which of the following findings indicates the procedure was effective?

Decreased shortness of breath Reason: Increased abdominal fluid can limit the expansion of the diaphragm and prevent the client from taking a deep breath. After excess peritoneal fluid is removed, the diaphragm will expand more freely. The nurse should identify this finding as an indicator the procedure was effective.

A nurse is providing dietary teaching for a client who is postoperative following a gastrectomy. Which of the following foods should the nurse encourage the client to include in their diet to reduce the risk for dumping syndrome?

Eggs Reason: The nurse should instruct the client to increase dietary intake of protein-containing foods, such as eggs, to decrease the risk for manifestations of dumping syndrome. The client should eat some form of protein at each meal.

A nurse is providing teaching for a client who has cirrhosis and a new prescription for lactulose. The nurse should include which of the following instructions in the teaching?

Expect to have two to three soft stools per day. Reason: The purpose of administering lactulose is to promote the excretion of ammonia in the stool. The nurse should instruct the client to take the medication every day and inform the client that two to three bowel movements every day is the treatment goal.

A nurse is providing discharge teaching for a client who has a new prescription for medications to treat peptic ulcer disease. The nurse should inform the client that which of the following medications inhibits gastric acid secretion?

Famotidine Reason: The nurse should inform the client that famotidine is an H2-receptor antagonist that is prescribed for the treatment of peptic ulcer disease to inhibit the secretion of gastric acid.

A nurse is assessing a client who has Crohn's disease. Which of the following findings should the nurse expect?

Fatty diarrheal stools Reason: Steatorrhea, or fatty stool, is an expected finding in a client who has Crohn's disease.

A nurse is reviewing the laboratory values of a client who has colorectal cancer. Which of the following findings should the nurse expect?

Hemoglobin 9.1 g/dL Reason: A hemoglobin level of 9.1 g/dL is below the expected reference range. Decreased hemoglobin is an expected finding in a client who has colorectal cancer due to occult intestinal bleeding.

A nurse is assessing a client who is postoperative following a gastrectomy. The nurse should identify which of the following findings as an indication of abdominal distension?

Hiccups Reason: Following surgery, hiccups can be caused by irritation of the phrenic nerve due to abdominal distension. If the hiccups are intractable, the nurse should anticipate a prescription for chlorpromazine because persistent hiccups are distressful to the client and can lead to complications, such as vomiting.

A nurse is assessing a client who has upper gastrointestinal bleeding. Which of the following findings should the nurse expect?

Hypotension Reason: A client who has upper gastrointestinal bleeding is at risk for hemorrhagic shock. Hypotension is a manifestation of hemorrhagic shock.

A nurse is admitting a client who has acute pancreatitis. Which of the following actions should the nurse take first?

Identify the client's current level of pain. Reason: The first action the nurse should take when using the nursing process is to assess the client. Clients who have acute pancreatitis often have severe abdominal pain. By assessing the client's level of pain, the nurse can identify the need for and implement interventions to alleviate the client's pain.

A nurse is reviewing the laboratory results of a client who has acute pancreatitis. Which of the following findings should the nurse expect?

Increased amylase Reason: Serum amylase levels are increased in a client who has acute pancreatitis due to pancreatic cell injury.

A nurse is assessing a client who has acute hepatitis B. Which of the following findings should the nurse expect?

Joint pain Reason: Joint pain is an expected finding in a client who has acute hepatitis B.

A nurse is reviewing the prescriptions for a client who has Campylobacter enteritis. Which of the following prescriptions should the nurse clarify with the provider?

Magnesium hydroxide Reason: Nausea, vomiting, and diarrhea are manifestations of enteritis. The nurse should clarify a prescription for magnesium hydroxide, also known as milk of magnesia, with the provider. This medication increases gastrointestinal motility, which can increase the client's risk for an electrolyte imbalance and contribute to dehydration.

A nurse is developing a plan of care for a client who has cirrhosis and ascites. Which of the following interventions should the nurse include in the plan?

Measure the client's abdominal girth daily. Reason: The nurse should measure the client's abdominal girth and weigh the client daily to monitor the amount of fluid accumulation in the abdomen and the effectiveness of treatment measures.

A nurse is assessing a client who has appendicitis. Which of the following findings should the nurse expect? (Select all that apply.)

Oral temperature 38.4° C (101.1° F) is correct. A low-grade temperature is an expected finding in a client who has appendicitis.WBC count 6,000/mm3 is incorrect. A WBC count of 10,000 to 18,000/mm3 is an expected finding in a client who has appendicitis.Bloody diarrhea is incorrect. Bloody diarrhea is an expected finding in a client who has colorectal cancer.Nausea and vomiting is correct. Nausea and vomiting are expected findings in a client who has appendicitis.Right lower quadrant pain is correct. Right lower quadrant pain is an expected finding in a client who has appendicitis.

A nurse is assessing a client who has a duodenal ulcer. Which of the following findings should the nurse expect?

The client reports that pain occurs during the night. Reason: Pain associated with a duodenal ulcer occurs when the stomach is empty, which is typically 1.5 to 3 hr after meals and during the night.

A nurse is caring for a client who has ulcerative colitis. The client has had several exacerbations over the past 3 years. Which of the following instructions should the nurse include in the plan of care to minimize the risk of further exacerbations? (Select all that apply.)

Use progressive relaxation techniques is correct. Progressive relaxation techniques, a form of biofeedback, are recommended to help the client minimize stress, which can precipitate an exacerbation.Increase dietary fiber intake is incorrect. The client should restrict intake of dietary fiber, which can cause diarrhea and cramping.Drink two 240 mL (8 oz) glasses of milk per day is incorrect. Dairy products, such as milk, are poorly tolerated by clients who have ulcerative colitis and should be avoided.Arrange activities to allow for daily rest periods is correct. Daily rest periods decrease stress and reduce intestinal motility.Restrict intake of carbonated beverages is correct. The client should avoid gastrointestinal stimulants, such as carbonated beverages, nuts, peppers, and smoking.

A nurse is providing discharge teaching for a client who has a new colostomy and is concerned about flatus and odor. Which of the following foods should the nurse recommend to the client?

Yogurt Reason: The nurse should recommend yogurt, crackers, and toast, which can prevent flatus and stool odor.