GI practice exam

An older client has had an instance of drug toxicity and asks why this happens, since the client has been on this medication for years at the same dose. What response by the nurse is best?

"Changes in your liver cause drugs to be metabolized differently."

A client who has had an ileostomy placed in the ascending colon to stop the effects of Crohn's disease. She expresses concern that the effluent collected in the colostomy pouch has remained liquid for 2 weeks after surgery. What is the nurse's best response?

"This is normal for your type of colostomy."

A nurse assesses clients at a community health fair. Which client is at greatest risk for the development of hepatitis B?

A 20-year-old college student who has had several sexual partners

Match the blood component to the appropriate clinical indication.

Platelets B. Thrombocytopenia Packed Red Blood Cells (PRBCs) D. Anemia White Blood Cells (WBCs) or Granulocytes A. Neutropenia Fresh Frozen Plasma (FFP) C. Warfarin (Coumadin) overdose

An emergency room nurse assesses a client with potential liver trauma. Which clinical manifestations should alert the nurse to internal bleeding and hypovolemic shock? (Select all that apply.)

Confusion Tachycardia

The patient who has anorexia and weight loss due to colon cancer is receiving total parenteral nutrition should be observed for symptoms of hyperglycemia, which would include:

Diuresis.

A nurse is reviewing the laboratory findings for a client who has an acute exacerbation of Crohn's disease. Which of the following laboratory findings is indicative of this condition? Select all that apply.

Elevated erythrocyte sedimentation rate (ESR) & C-reactive protein (CRP). Elevated white blood cell count (WBC).

A client who has been taking antibiotics reports severe, watery diarrhea. About which test does the nurse teach the client?

Enzyme-linked immunosorbent assay (ELISA) toxin A+B

Match the following diagnostic tests to the appropriate medical condition.

Esophagogastroduodenoscopy (EGD) A. GERD, peptic ulcer disease Endoscopic Retrograde Cholangiopancreatography (ERCP) C. Cholecystitis, pancreatitis Barium enema B. Diverticulosis/Crohn's disease Paracentesis D. Ascites, abdominal trauma

The nurse understands that the patient with Crohn's disease often has low levels of folic acid and vitamin B12 which results in:

Fatigue

The nurse is caring for a client with ulcerative colitis and severe diarrhea. Which nursing assessment is the highest priority?

Fluids and electrolytes.

A patient is admitted to the hospital with severe diarrhea due to viral gastroenteritis. The nurse understands that the patient is at risk for which of the following complication:

Hypokalemia.

To promote comfort after a colonoscopy, in what position does the nurse place the client?

Left lateral

The student nurse studying the gastrointestinal system understands that chyme refers to what?

Liquefied food ready for digestion

The nurse knows that a client with prolonged prothrombin time (PT) values (not related to medication) probably has dysfunction in which organ?

Liver

A patient with chronic cirrhosis of the liver is admitted with new onset ataxia, cognitive dysfunction, weakness, and stupor. Which of the following dietary management is appropriate for this patient?

Low protein diet.

Match the following medications to the appropriate clinical indication(s) or drug action:

Ranitidine (Zantac) D. Lowers stomach acid by blocking the histamine-2 acid release pathway. Cytotec A. NSAID induced ulcers. Omeprazole (Prilosec) C. Decreases acid secretion by proton pump inhibition. Sulfasalazine (Azulfidine) B. Bowel anti-inflammatory.

A client had a colonoscopy and biopsy yesterday and calls the gastrointestinal clinic to report a spot of bright red blood on the toilet paper today. What response by the nurse is best?

Remind the client that a small amount of bleeding is possible.

The patient with abdominal pain is scheduled for a computed tomography (CT) scan of the abdomen with contrast. Which information on the patient's health record requires further follow-up?

Self-reported allergy to shellfish.

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

Severe, steady right lower quadrant pain

A client is prescribed prednisone following an exacerbation of inflammatory bowel disease (IBD). Which of the following client findings is the highest priority?

The client reports having a sore throat.

The nurse is caring for a client with Crohn's disease and colonic strictures. Which assessment finding indicates to the nurse that a dangerous complication has developed?

The client's abdomen is distended.

The nurse working with clients who have gastrointestinal problems knows that which laboratory values are related to what organ dysfunctions? (Select all that apply.)

a. Ammonia: liver b. Lipase: pancreas

The nurse working in the gastrointestinal clinic sees clients who are anemic. What are common causes for which the nurse assesses in these clients? (Select all that apply.)

a. Inflammatory bowel disease c. Colon cancer d. Diverticulitis e. Peptic ulcer disease

The nurse working with older clients understands age-related changes in the gastrointestinal system. Which changes does this include? (Select all that apply.)

a. Pancreatic vessels become calcified b. Diminished sensation that can lead to constipation d. Decreased hydrochloric acid production e. Fat not digested as well in older adults

A client had an endoscopic retrograde cholangiopancreatography (ERCP). The nurse instructs the client and family about the signs of potential complications, which include what problems? (Select all that apply.)

a. Sepsis c. Pancreatitis d. Perforation e. Cholangitis

The primary nurse wrote, "No heat or warm compress to right abdomen" on the nursing care plan of the patient with confirmed appendicitis. The student nurse understands that this is done to:

prevent increased inflammation and perforation of the appendix.

A patient admitted with a peptic uler is also suffering from osteorithritis for which he takes a variety of over-the-counter medications on a daily basis. Which medication should the nurse instruct the patient to avoid because of its irritating effects on the lining of the gastrointestinal tract?

Naproxen (Aleve).

A client presents to the emergency department reporting severe abdominal pain. On assessment, the nurse finds a bulging, pulsating mass in the abdomen. What action by the nurse is the priority?

Notify the provider immediately.

A client is recovering from an esophagogastroduodenoscopy (EGD) and requests something to drink. What action by the nurse is best?

Assess the client's gag reflex.

A nurse cares for a client who has a Giardia infection. Which medication should the nurse anticipate being prescribed for this client?

Metronidazole (Flagyl)

The nurse is taking care of a patient with acute pancreatitis. For which lab value should the nurse expect to be abnormal?

Amylase.

When assessing the patient with acute appendicitis, the nurse should expect the patient to demonstrate which of the following symptom(s):

Abdominal pain followed by nausea and vomiting.

The client returns to the nursing unit following surgery for a ruptured appendix. The client has an NG tube connected to low suction. An IV of 0.9% sodium chloride is infusing at 100 mL/hr. In providing postoperative care, the nurse should anticipate which of the following nursing actions? Select all that apply.

Assess abdominal dressing. Manage the client's pain. Measure hourly intake and output. Implement risk for falls protocol.

The nurse is receiving a patient from the Emergency Department who has been diagnosed with acute diverticulitis. Which of the following does the nurse anticipate while preparing for the patient's arrival to the med-surg unit? Select all that apply.

Physician orders for IV fluids and antibiotics. The patient has severe, prolonged left lower quadrant abdominal pain requiring pharmacological intervention. The patient has a fever.

A nurse delegates hygiene care for a client who has advanced cirrhosis to an unlicensed nursing personnel (UAP). Which statements should the nurse include when delegating this task to the UAP? (Select all that apply.)

b. "For the client's oral care, use a soft toothbrush." d. "Provide clippers so the client can trim the fingernails." e. "Apply lotion to the client's dry skin areas."

A nurse assesses a client with ulcerative colitis. Which complications are paired correctly with their physiologic processes? (Select all that apply.)

b. Nonmechanical bowel obstruction - Paralysis of colon resulting from colorectal cancer c. Abscess formation - Localized pockets of infection develop in the ulcerated bowel lining d. Lower gastrointestinal bleeding - Erosion of the bowel wall

A nurse assesses a client with peritonitis. Which clinical manifestations should the nurse expect to find? (Select all that apply.)

distended abdomen diminished bowel sounds inability to pass flatus or feces tachycardia decreased urine output secondary to dehydration

After a colonscopy procedure the client is lethargic and difficult to arouse. The priority action(s) for the nurse to perform at this time is to:

Obtain vital signs and assess the client's airway.

A nurse is examining a client reporting right upper quadrant (RUQ) abdominal pain. What technique should the nurse use to assess this client's abdomen?

Palpate the RUQ last.