Final Exam Textbook Info (GI)

a client has dumping syndrome after a partial gastrectomy. which action by the nurse would be most helpful?

arrange a dietary consult

a nurse cares for a client who is prescribed mesalamine (Asacol) for UC. the client states, "I am having trouble swallowing this pill" which action should the nurse take?

ask the HCP to prescribe the med as an enema instead

an ED nurse cares for a client who has been shot in the abdomen & is hemorrhaging heavily. which action should the nurse take first?

assess & maintain a patent airway

an older client has gastric cancer & is scheduled to have a partial gastrectomy. the family doesn't want the client told about her diagnosis. what action by the nurse is best?

assess family concerns & fears

an ED nurse assesses a client after motor vehicle crash & notes ecchymotic areas across the clients lower abdomen. which action should the nurse take first?

assess for abdominal guarding or rigidity

en ED nurse assesses a client after a MVC. the nurse notices a steering wheel mark across the clients chest. which action should the nurse take?

assess the client by gently palpating the abdomen for tenderness

a nurse cares for a client who is hemorrhaging from bleeding esophageal varies & has an esophagogastric tube. which action should the nurse take first?

assess the client for airway patency

a nurse assesses a client w/ 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 clients bowel sounds

a nurse cares for a client who is scheduled for a paracentesis. which intervention should the nurse delegate to an UAP?

assist the client to void before the procedure

a nurse cares for a client who has a Giardia infection. which med should the nurse anticipate being prescribed for this client?

metronidazole (Flagyl)

a nurse assesses a client who is prescribed 5FY chemo IV for the treatment of colon cancer. which assessment findings should alert the nurse to contact the HCP?

WBC of 1500 (leukopenia)

a nurse assesses a client who is prescribed an infusion of vasopressin (Pitressin) for bleeding esophageal varices. which clinical manifestation should alert the nurse to a serious adverse effect?

mid-sternal chest pain SE = angina or MI

the nurse caring for clients w/ GI 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 w/ PUD who reports sudden onset of sharp abdominal pain. on palpation, the clients abdomen is tense & rigid. what action takes priority?

notify HCP immediately manifestations of perforated ulcer (emergency!)

a nurse assesses a client who is recovering from an ileostomy placement. which clinical manifestation should alert the nurse to urgently contact the HCP?

pale & bluish stoma

a client had an upper GI hemorrhage & now has a NG tube. what comfort measure may the nurse delegate to the UAP?

performing frequent oral care

a nurse cares for a client who has cirrhosis of the liver. which action should the nurse take to decrease the presence of ascites?

provide a low sodium diet

a nurse answers a clients call light & finds the client in the bathroom, vomiting large amounts of bright red blood. which action should the nurse take first?

put on a pair of gloves

a nurse is teaching a client about magnesium hydroxide w/ aluminum hydroxide (Maalox). what instruction is most appropriate?

report diarrhea to your provider can cause hypermagnesemia

a client has a pyloric obstruction & reports sudden muscle weakness. what action by the nurse takes priority?

request an ECG can lead to hypokalemia

a nurse cares for a client who has foo poisoning resulting from a Clostridium botulinum infection. which assessment should the nurse complete first?

respiratory rate

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

severe, steady right lower quadrant pain

a nurse plans care for a client w/ Crohns disease who has a heavily draining fistula. which intervention should the nurse indicate as the priority action in this clients POC?

skin protection

a client w/ PUD asks the nurse about taking slippery elm supplements. what response by the nurse is best?

slippery elm is often used for this disorder

a client w/ PUD is in the ED & reports the pain has gotten much worse over the last several days. the clients BP when lying down was 122/80 & when standing was 98/52. what action by the nurse is most appropriate?

start a large bore IV w/ NS

a nurse assesses a client who is hospitalized for botulism. the clients VS are temp: 99.8, HR: 100, RR: 10 & BP: 100/62. which action should the nurse take?

stay w/ the client while another nurse calls the provider

a nurse cares for a client who is recovering from a hemorrhoidectomy. the client states, "I need to have a BM" which action should the nurse take?

stay w/ the client while providing privacy

a nurse teaches a client who is recovering from a colon resection. which statement should the nurse include in this clients POC?

take a stool softener to promote softer stools for ease of defecation

a nurse cares for a client w/ a new ileostomy. the client states "I don't think my friends will accept me w/ this ostomy." how should the nurse respond?

tell me more about your concerns

a nurse cares for a client who had a colostomy placed in the ascending colon 2wks ago. the client states, "the stool in my pouch is still liquid" how should the nurse respond?

the stool will always be liquid w/ this type of colostomy

a nurse cares for a middle-aged male client who has IBS. the client states "I have changed my diet & talk bulk-forming laxatives, but my symptoms haven't gotten better. I heard about a drug called Amitiza, do you think it might help." how should the nurse respond?

unfortunately, lubiprostone (Amitiza) is approved only for use in women

a nurse assesses a client who is recovering from a paracentesis 1hr ago. which assessment finding requires action by the nurse?

urine output via indwelling urinary catheter is 20mL/hr

a nurse teaches a client w/ Hep C who is prescribed ribavirin (Copegus). which statement should the nurse include in this clients discharge education?

use a pill organizer to ensure you take this med as prescribed

a nurse cares for a client w/ Hep C. the client's brother states "I don't want to contract this infection, so I won't go into his hospital room" how should the nurse respond?

viral hepatitis isn't spread through casual contact

a nurse plans care fro a client who is recovering from an inguinal hernia repair. which interventions should the nurse include in this clients POC?

- encouraging ambulation 3x/day - encouraging normal urination - providing ice bags & scrotal support

a nurse working w/ a client who has possible gastritis assesses the clients GI system. which findings indicate a chronic condition as opposed to acute gastritis?

- intolerance of fatty foods - pernicious anemia

after teaching a client w/ a parasitic GI infection, a nurse assesses the clients understanding. which statements made by the client indicate that the client correctly understands the teaching?

- I must take a shower or bathe everyday - I should have my well water tested - I will ask my sexual partner to have a stool test

after teaching a client who is recovering from a colon resection, the nurse assesses the clients understanding. which statements by the client indicate a correct understanding of the teaching?

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

a nurse cares for a client who has been diagnosed w/ a small bowel obstruction. which assessment findings should the nurse correlate w/ this diagnosis?

- K+ = 2.8 - abdominal pain in upper quadrants - Na+ = 121 severe fluid & electrolyte imbalances

the student nurse learns about risk factors for gastric cancer. which factors does this include?

- achlorhydria - chronic atrophic gastritis - H pylori infection - pernicious anemia

a nurse is preparing to administer pantoprazole (proton) IV. what actions by the nurse are most appropriate?

- administer the drug through a separate IV line - infuse Protonix using an IV pump - use an in-line IV filter when infusing

a client who had a partial gastrectomy has several expected nutritional problems. what actions by the nurse are best to promote better nutrition?

- administer vitamin B12 injections - ask the provider about folic acid replacement - provide iron supplements for the client

the student nurse studying stomach disorders learns that the risk factors for acute gastritis include which of the following?

- alcohol - caffeine - corticosteroids - NSAIDs

a client has a GI hemorrhage & is prescribed 2 units of PRBCs. what actions should the nurse perform prior to hanging the blood?

- ask a second nurse to double check the blood - prime the IV tubings w/ NS - take & record a set of VS - teach the client about reaction manifestations

a nurse cares for a client who has an NG tube. which actions should the nurse take?

- assess for proper placement of the tube every 4hrs - disconnect suction when auscultating bowel peristalsis - monitor the clients skin around the tube site for irritation

a client has dumping syndrome. what menu selection indicate the client understands the correct diet to manage this condition?

- canned unsweetened apricots - potato soup high-protein, high-fat, & low-moderate carb diet

a nurse assesses a male client w/ an abdominal hernia. which abdominal hernias are correctly paired w/ their physiologic processes?

- direct inguinal hernia: A peritoneum sac assess through a weak point in the abdominal wall - ventral hernia: results from inadequate healing of an incision - incarcerated hernia: contents of the hernia sac cannot be reduced back into the abdominal cavity

a nurse assesses a client w/ peritonitis. which clinical manifestations should the nurse expect to find?

- distended abdomen - inability to pass flatus - decreased urine output

a nurse assesses a client w/ UC. which complications are paired correctly w/ their physiologic processes?

- lower GI bleeding: erosion of the bowel wall - abscess formation: localized pockets of infection develop in the ulcerated bowel lining - nonmechanical bowel obstruction: paralysis of colon resulting from colorectal cancer

a nurse inserts an NG tube for an adult client who has a bowel obstruction. which actions does the nurse perform correctly?

- performs hand hygiene & positions the client in High-Fowlers position, w/ pillows behind the head & shoulders - checks for correct placement by checking the pH of the fluid aspirated from the tube - connects the NG tube to intermittent medium suction w/ an anti-reflux valve on the air vent

a nurse teaches a community group about food poisoning & gastroenteritis. which statements should the nurse include in this groups teaching?

- rotavirus is more common among infants & younger children - to prevent E. coli infection, don't drink water when swimming - parasitic diseases may not show up for 1-2wks after infection

after teaching a client w/ an anal fissure, a nurse assesses the clients understanding. which client actions indicate that the client correctly understands the teaching?

- taking a warm sitz bath several times each day - using bulk-producing agents to aid elimination - self-administering anti-inflammatory suppositories

a nurse plans care for a client who has chronic diarrhea. which actions should the nurse include in this clients POC?

- using premoistened disposable wipes for perineal care - turning the client from right to left every 2hrs - applying a barrier cream to the skin after cleaning

a nurse teaches a client how to avoid becoming ill w/ Salmonella infection again. which statements should the nurse include in this clients teaching?

- wash leafy veggies carefully before eating or cooking them - wash your hands before & after using the bathroom - be sure meat is cooked to the proper temp - avoid eating eggs that are sunny side up or undercooked

a nurse teaches a community group ways to prevent E. coli infection. which statements should the nurse include in this groups teaching?

- wash your hands after any contact w/ animals - use separate cutting boards for meat & veggies

a nurse assesses a client w/ IBS. which questions should the nurse include in this clients assessment?

- which food types cause an exacerbation of symptoms? - where is your pain & what does it feel like? - do you experience nausea associated w/ defecation?

a nurse assesses a client who has UC & severe diarrhea. which assessment should the nurse complete first?

HR & rhythm

after teaching a client who has been diagnosed w/ Hep A, the nurse assesses the client's understanding. which statement by the client indicates a correct understanding of the teaching?

I may have been exposed when we ate shrimp last weekend contact or ingestion of contaminated water or shellfish

after teaching a client who has alcohol-induced cirrhosis, a nurse assesses the clients understanding. which statement made by the client indicates a need for additional teaching?

I need to avoid protein in my diet

after teaching a client who has plans to travel to a non-industrialized country, the nurse assesses the clients understanding regarding the prevention of viral hepatitis. which statement made by the client indicates a need for additional teaching?

I should eat plenty of fresh fruits & veggies

a nurse obtains a clients health history at a community health clinic. which statement alerts the nurse to provide health teaching to this client?

I take a lot of Tylenol for my arthritis pain

after teaching a client w/ perineal excoriation caused by diarrhea from acute gastroenteritis, a nurse assesses the clients understanding. which statement by the client indicates a need for additional teaching?

I will clean my rectal area thoroughly w/ toiler paper after each stool & then apply aloe vera gel

a nurse cares for a client who has chronic cirrhosis from substance abuse. the client states "all of my family hates me" how should the nurse respond?

I will help you identify a support system

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

I will make a referral to the united stony associations of america

after teaching a client who has a femoral hernia, the nurse assesses the clients understanding. which statement indicates the client needs additional teaching r/t the proper use of a truss?

I will put on the truss before I go to bed each night

after teaching a client who has diverticulitis, a nurse assesses the clients understanding. which statement made by the client indicates a need for additional teaching?

I will take a laxative nightly at bedtime to avoid becoming constipated

after teaching a client who is prescribed adalimumab (Humira) for several UC, the nurse assesses the clients understanding. which statement made by the client indicates a need for additional teaching?

I will take this med w/ my breakfast each morning

a client has a recurrence of gastric cancer & is in the GI clinic crying. what response by the nurse is most appropriate?

I'd like to know what you are feeling now

after teaching a client who was hospitalized for salmonella food poisoning, a nurse assesses the clients understanding. which statement made by the client indicates a need for additional teaching?

I'll take the ciprofloxacin until the diarrhea has resolved

a client is scheduled for a total gastrectomy for gastric cancer. what pre-op lab result should the nurse report to the surgeon immediately?

INR: 4.2 (high)

a nurse reviews the chart of a client who has Crohns disease & a draining fistula. which documentation should alert the nurse to urgently contact the provider for additional prescriptions?

K+ = 2.6

a nurse assesses clients at a community health fair. which client is at greatest risk for the development of Hep B?

a 20yr old college student who has had several sexual partners

a nurse assesses clients on the med-surg unit. which client is at greatest risk for the development of carcinoma of the liver?

a 66yr old who has a history of cirrhosis

a nurse assesses clients at a community health center. which client is at highest risk for the development of colorectal cancer?

a 72 yr old who eats fast food frequently

a nurse prepares a client for a colonoscopy scheduled for tomorrow. the client states, "my doctor told me that the fecal occult blood test was negative for colon cancer. I don't think I need the colonoscopy & would like to cancel it" how should the nurse respond?

a negative fecal occult blood test doesn't rule out the possibility of colon cancer

a nurse cares for an older client who has salmonella food poisoning. the clients VS are HR: 102, BP: 98/55, RR: 22 & O2: 92%... which action should the nurse complete first?

administer IV fluids

a nurse teaches a client who is at risk for colon cancer. which diet recommendation should the nurse teach this client?

add veggies such as broccoli & cauliflower to your new diet

after teaching a client w/ diverticular disease, a nurse assesses the clients understanding. which menu selection made by the client indicates the client correctly understood the teaching?

baked fish w/ steamed carrots & a glass of apple juice low-residue diet

after teaching a client w/ IBS, a nurse assesses the clients understanding. which menu selection indicates that the client correctly understands the dietary teaching?

broiled chicken w/ brown rice, steamed broccoli, glass of apple juice high fiber diet

for which client would the nurse suggest the provider not prescribe misoprostol (Cytotec)?

client who is pregnant

a nurse assessing a client w/ colorectal cancer auscultates high-pitched bowel sounds & notes the presence of visible peristaltic waves. which action should the nurse take?

contact the provider & recommend CT indicative of partial obstruction

a nurse assesses a client who is recovering from a hemorrhoidectomy that was done the day before. the nurse notes that the client has lower abdominal distention accompanied by dullness to percussion over the distended area. which action should the nurse take?

determine when the client has voided

a nurse cares for a client who is prescribed lactulose (Heptalac). the client states "I don't want to take this med because it causes diarrhea" How should the nurse respond?

diarrhea is expected, that's how your body gets rid of ammonia

a nurse assesses a client w/ Crohns disease & colonic strictures. which clinical manifestation should alert the nurse to urgently contact the HCP?

distended abdomen

a nurse teaches a client who has viral gastroenteritis. which diet instruction should the nurse include in this clients teaching?

drink plenty of fluids to prevent dehydration

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 cares for a client newly diagnosed w/ colon cancer who has become withdrawn from family members. which action should the nurse take?

encourage the client to verbalize feelings about the diagnosis

a nurse assesses a client who is prescribed alosetron (Lotronex). which assessment question should the nurse ask this client?

have you been experiencing any constipation? assessing for ischemic colitis (a life-threatening complication of this med)

a nurse assesses a client who is hospitalized w/ an exacerbation of Crohns disease. which clinical manifestation should the nurse expect to find?

high-pitched, rushing bowel sounds in the right lower quadrant

an older female client has been prescribed esomeprazole (Nexium) for treatment of chronic gastric ulcers. what teaching is particularly important for this client?

increase intake of calcium & vitamin D

a client w/ a bleeding gastric ulcer is having a nuclear medicine scan. what action by the nurse is most appropriate?

inform the client a second scan may be needed

a nurse cares for a client w/ hepatopulmonary syndrome who is experiencing dyspnea w/ O2 at 92%. the client states "I don't want to wear the oxygen because it causes my nose to bleed. get out of my room & leave me alone" which action should the nurse take?

instruct the client to sit in an upright position as possible

a nurse cares for a client w/ hepatic portal-systemic encephalopathy. the client is thin & cachet in appearance & the family expresses distress that the client is recovering little dietary protein. how should the nurse respond?

less protein in the diet will help prevent confusion associated w/ liver failure

a nurse cares for a client w/ UC. the client states, "I feel like I am tied to the toilet. this disease is controlling my life." how should the nurse respond?

let's discuss potential factors that increase your symptoms

a nurse cares for a teenage girl w/ a new ileostomy. the client states, "I cannot go to prom w/ an ostomy" how should the nurse respond?

lets talk to the enterostomal therapist about options for ostomy supplies & dress styles

a nurse cares for a client who states, "my husband is repulsed by my colostomy & refuses to be intimate w/ me." how should the nurse respond?

lets talk to the ostomy nurse to help you & your husband work through this

a client is being taught about drug therapy for H pylori infection. what assessment by the nurse is most important?

willingness to adhere to drug therapy

after teaching a client who has a new colostomy, the nurse provides feedback based on the clients ability to complete self-care activities. which statement should the nurse include in this feedback?

you cleaned the stoma well. now you need to practice putting on the appliance

a Telehealth nurse speaks w/ a client who is recovering from a liver transplant 2wks ago. the client states "I am experiencing right flank pain & have a temp of 101F. how should the nurse respond?

you should go to the hospital immediately to have your new liver checked out

a nurse cares for a client who has a family history of colon cancer. the client states "my father & my brother had colon cancer. what is the chance I will get cancer?" how should the nurse respond?

you should have a colonoscopy more frequently to identify abnormal polyps early