GI Review

B

A client is suspected of having hepatitis. Which diagnostic test result will assist in confirming this diagnosis? a) Elevated hemoglobin b) Elevated serum bilirubin level c) Elevated blood urea nitrogen d) Decreased erythrocyte sedimentation rate

C

A congenital malformation in which Intra-abdominal contents herniate through the umbilical cord is called? a) Intussusception b) Atresia c) Omphalocele d) Gastroschisis

B

The nurse is caring for a client postoperatively following the creation of a colostomy. Which nursing diagnosis should be included in the plan of care? a) Sexual dysfunction b) Body image, disturbed c) Fear related to poor prognosis d) Nutrition: more than body requirements, imbalanced

B

The nurse is caring for a client with a diagnosis of chronic gastritis. The nurse monitors the client knowing that this client is at risk for which vitamin deficiency? a) Vitamin A b) Vitamin B12 c) Vitamin C d) Vitamin E

A

The nurse is caring for a neonate with a suspected tracheoesophageal fistula. Nursing care should include which of the following? a) Elevate head but give nothing by mouth b) Elevate head for feedings c) Feed glucose water only d) Avoid suctioning unless the infant is cyanotic

C

When caring for a child with probable appendicitis, the nurse should be alert to recognize which of the following is a sign of perforation. a) Bradycardia b) Anorexia c) Sudden relief from pain d) Decreased abdominal distension

D

Which of the following clinical manifestations would be the most suggestive of acute appendicitis? a) Rebound tenderness b) Bright red or dark red rectal bleeding c) Abdominal pain that is relieved by eating d) Abdominal pain that is most intense at McBurney point

B

Which of the following factors contribute to ulcer formation? a) Smoked and salty foods b) Helicobacter pylori infection c) Increased bicarbonate retention d) Decreased gastrin production

A

Which of the following is characterized by a chronic inflammatory process that may involve any part of the GI tract from mouth to anus? a) Crohn's disease b) Ulcerative colitis c) Meckel diverticulum d) Irritable bowel syndrome

D

While obtaining a nursing history from a pt. with possible cancer of the colon, the nurse asks the pt. about the presence of a) Black tarry stools b) Nausea and vomiting c) Crampy, colicky pain d) Alternating constipation and diarrhea

B

62 yr old diagnosed with esophageal cancer. He tells the nurse that he understands his prognosis is very poor but he is not ready to die yet. The best response by the nurse to the pts. comment is a) What are your plans for the next few years? b) This must be a very difficult time for you to cope with c) You should keep a positive outlook because it will make you feel better d) Everyone I have seen with esophageal cancer has only had a little time left

A

68 yr old with epigastric distress, anorexia and wt loss for 6 mo. Has anemia and ascites, EGD reveals cancer of the stomach. The nurse plans care with knowledge that these findings indicate a) Pt has poor prognosis with any therapy b) Surgical intervention is not indicated for the pt. c) Radiation therapy is the treatment of choice for this pt. d) Pt. has good prognosis with the use of chemotherapy

B

A 4 mo. infant has gastroesophageal reflux but is thriving without other complications. Which of the following should the nurse suggest to minimize reflux a) Place in trendelenburg position after eating b) Thicken formula with rice cereal c) Give continuous nasogastric tube feedings d) Give larger, less frequent feedings.

C

A pt with recurring heartburn tells the nurse that he has used over-the-counter antacids and Pepcid, but the MD has now prescribed Nexium. In teaching the pt. about this med, you explain that this drug a) Reduces the reflux of gastric acid into the esophagus by increasing the rate of gastric emptying b) Coat the stomach and protects the stomach lining and esophagus from the effects of increased gastric acid c) Is used to both diagnose and treat GERD by decreasing stomach acid production d) Provides a quick, but short-lived, relief of symptoms and is an inexpensive means of treating gastroesophageal reflux

B

A pt. develops acute gastritis caused by a nonsteroidal anti-inflammatory drug (NSAID) she uses to treat her arthritis. In teaching the pt. about the effects of these drugs on the stomach's mucosal barrier, the nurse explains that a) NSAIDs stimulate histamine receptors, which increase the release of hydrochloric acid b) NSAIDs inhibit the synthesis of prostaglandins that normally decrease acid secretion in the stomach c) NSAIDs stimulate the parietal cells of the stomach to release pepsin, which is capable of digesting stomach tissue d) The inflammatory response stimulated by prostaglandin release in the stomach is increased with the use of NSAIDs

B

A pt. is being evaluated in the ED for acute lower abd pain with diarrhea and vomiting. During the nursing history, the most helpful question by the nurse to obtain info regarding the pts. condition is a) What do you usually eat? b) Can you tell me about your pain? c) What is your usual elimination pattern? d) When did the diarrhea and vomiting start

B

A pt. recovering from a Bilroth II procedure for the treatment of a duodenal ulcer develops dizziness, weakness, and palpitations with an urge to defecate ~20 min. after eating. To avoid the recurrence of these symptoms the nurse teaches to: a) Increase fluid intake with meals b) Lie down for about 30 min. after each meal c) Drink sugared fluids or eat candy after each meal d) Eat a high-carb, low-fat diet in six small feedings a day

B

A pt. with Crohn's disease develops a fever and symptoms of a UTI. The nurse recognizes that this complication may occur as a result of a) Perianal irritation from frequent diarrhea b) Fistula formation between the bowel and bladder c) Extra intestinal manifestations of the bowel disease d) Impaired immunologic response to infectious microorganisms

D

A pt. with chronic GERD is experiencing increasing discomfort. During the assessment of the patient's current management of the problem, the nurse determines that further teaching is needed when the pt. states a) I use antacids between meals and at bedtime b) I quit smoking several years ago, but I still chew a lot of gum c) I've learned to sleep with the head of the bed elevated on 4-inch blocks d) I try to keep my diet low in fat, and I eat small meals throughout the day and at bedtime

B

After teaching a pt. with an acute exacerbation of ulcerative colitis about recommended dietary modifications, you identify a need for further instruction when the pt. chooses from the menu a) Boiled shrimp b) Ham hocks and beans c) Spaghetti with tomato sauce d) Poached eggs and hash brownse) Waffles and syrup

A

Bulk-forming laxatives: a) Function like dietary fiber b) Act within 2 to 6 hours c) Produce a semifluid stool d) Are used to prepare the bowel for diagnostic procedures

Herniation of a portion of the stomach into the esophagus through an opening in the diaphragm.

Describe a hiatal hernia

B

During initial assessment of pt. with newly diagnosed CA of stomach, it is most important that the nurse obtain info regarding a) The presence of other health problems b) The pts perception of the health problem c) The ability of the family to care for the pt d) Whether the pt. has clinical evidence of metastasis

B

In teaching a pt. with peptic ulcer disease about nutritional management of the disorder, the nurse stresses that the pt. should a) Avoid raw fruits and vegetables b) Avoid foods that cause discomfort c) Eat six small meals a day with bland foods d) Eliminate milk and milk products from diet

D

Info that is most important for the nurse to obtain during the initial assessment of a pt. admitted to the ED with vomiting of bright red blood is a) Current medical problems b) Medications that pt. is taking c) History of prior bleeding episodes d) Vital signs and symptoms of hypovolemia

C

Melena, the passage of black, tarry stools, suggests bleeding from: a) Perianal or rectal area b) Hemorrhoids or anal fissures c) Upper GI tract d) Lower GI tract

C

Pt. has a newly formed ileostomy for the treatment of ulcerative colitis. In teaching about the care of the ileostomy, you inform the pt. she should a) Restrict fluid intake to prevent constant liquid drainage from the stoma b) Change the pouch every day to prevent leakage of contents onto the skin c) Maintain as normal a diet as possible. Avoiding foods that cause gas or diarrhea d) Irrigate the ileostomy daily or every other day to avoid having to wear a drainage appliance.

C

The MD orders IV vasopressin to be administered to a pt. with esophageal bleeding. The outcome that the nurse anticipates for this drug includes a) Sclerosis of the bleeding site b) Increased pH of stomach contents c) Vasoconstriction of bleeding vessels d) Decreased acid production by parietal cells

C

The nurse caring for a client following a Billlroth II procedure. Which postoperative order should the nurse question and verify? a) Leg exercises b) Early ambulation c) Irrigating the nasogastric tube d) Coughing and deep breathing exercises

C

The nurse has given post-procedure instructions to a client who has undergone a colonoscopy. Which statement by the client indicates the need for further teaching? a) "It is normal to feel gassy or bloated after the procedure" b) "The abdominal muscles may be tender from the procedure" c) "It is all right to drive once I've been home for an hour or so" d) "Intake should be light at first and then progress to regular intake"

C

The nurse is doing an admission assessment on a client with a history of duodenal ulcers. To determine whether the problem is currently active, the nurse should assess the client for which symptom(s) of duodenal ulcer. a) Weight loss b) Nausea and vomiting c) Pain relieved by food intake d) Pain radiating down the right arm

A

The nurse is monitoring a client for the early signs and symptoms of dumping syndrome. Which of the following indicates this occurrence? a) Sweating and pallor b) Bradycardia and indigestion c) Double vision and chest pain d) Abdominal cramping and pain) Crying and excessive ice cream

C

The nurse is reviewing the medication record of a client with acute gastritis. Which medication, if noted on the client's record would the nurse question? a) Digoxin b) Furosemide (Lasix) c) Indomethacin (Indocin) d) Propranolol hydrochloride (Inderal)

D

The nurse plans and implements a discharge teaching plan for a pt. following an EGD for treatment of a peptic ulcer. The nurse identifies need for further instruction when the pt. states a) If I do not quit smoking, it is likely that I could develop more ulcers b) I should not take any medications that are not prescribed by doctor c) If I have continuous upper abd pain after eating, I should notify my doctor d) Since my stomach was removed with this surgery I don't have to worry about peptic ulcers anymore

A

The pt. has determined that the client with hepatitis has contracted the infections from contaminated food. The nurse understands that this client is most likely experiencing what type of hepatitis? a) Hepatitis A b) Hepatitis B c) Hepatitis C d) Hepatitis D

B

Understanding the malformation of the last slide, the nurses anticipate each of the following except a) Urgent surgical reduction b) Red jelly-like stools c) NG tube placement d) Antibiotic therapy