GI Review

A few hours after eating hot and spicy chicken wings, a client presents with lower chest pain. He wonders if he is having a heart attack. How should the nurse proceed first? a. Call for an immediate electrocardiogram. b. Explain that fatty foods can mimic chest pain. c. Further investigate the initial complaint. d. Administer an over-the-counter antacid tablet.

c. Further investigate the initial complaint.

Which of the following is an enzyme secreted by the gastric mucosa? a. Trypsin b. Ptyalin c. Pepsin d. Bile

c. Pepsin

The nurse determines a client scheduled to undergo an abdominal ultrasonography should receive which instruction? a. Do not undertake any strenuous exercise for 24 hours before the test. b. Do not consume anything sweet for 24 hours before the test. c. Restrict eating of solid food for 6 to 8 hours before the test. d. Avoid exposure to sunlight for at least 6 to 8 hours before the test.

c. Restrict eating of solid food for 6 to 8 hours before the test.

Which of the following is considered the gold standard for the diagnosis of liver disease? a. Cholecystography b. Ultrasonography c. Paracentesis d. Biopsy

d. Biopsy

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

d. recent foods ingested.

The nurse is caring for a geriatric client and notices polypharmacy. Which diagnostic studies are anticipated? a. Liver function studies b. Urinalysis c. Complete blood count d. Blood chemistry

a. Liver function studies

The nurse is investigating a client's report of pain in the duodenal area. Where should the nurse perform the assessment? a. Epigastric area and consider possible radiation of pain to the right subscapular region b. Hypogastrium in the right or left lower quadrant c. Left lower quadrant d. Periumbilical area, followed by the right lower quadrant

a. Epigastric area and consider possible radiation of pain to the right subscapular region

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

a. increased peristalsis

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

a. normal.

Which procedure is performed to examine and visualize the lumen of the small bowel? a. small bowel enteroscopy b. colonoscopy c. panendoscopy d. peritoneoscopy

a. small bowel enteroscopy

A client with hepatitis B asks the nurse, "Are there any medications to help me get rid of this problem?" Which is the best response by the nurse? "Sedatives can be given to help you relax." "We can give you immune serum globulin." "Vitamin supplements are frequently helpful and hasten recovery." "There are medications to help reduce viral load and liver inflammation."

"There are medications to help reduce viral load and liver inflammation."

A healthcare provider prescribes famotidine and magnesium hydroxide/aluminum hydroxide antacid for a client with a peptic ulcer. The nurse should teach the client to take the antacid at what time?

1 hour before or two hours after famotidine

A client is admitted via the emergency department with the tentative diagnosis of diverticulitis. Which test commonly is prescribed to assess for this problem?

CT scan

anabolism

Constructive metabolism

A client with Crohn disease is admitted to the hospital with abdominal pain, fever, poor skin turgor, and diarrhea, with 10 stools in the past 24 hours. Which signs are evidence that the client most likely is dehydrated? Select all that apply. Moist skin Sunken eyes Decreased apical pulse Dry mucous membranes Increased blood pressure

Dry mucous membranes Sunken eyes

An older client's colonoscopy reveals the presence of extensive diverticulosis. Which type of diet should the nurse encourage the client to follow? Low-fat High-fiber High-protein Low-carbohydrate

High-fiber

The nurse auscultates the abdomen to assess bowel sounds. She documents five to six sounds heard in less than 30 seconds. How does the nurse document the bowel sounds?

Hyperactive

What information from a client's history should the nurse identify as risk factors for the development of colon cancer? Select all that apply. Hemorrhoids Increased age High-fiber diet Ulcerative colitis Low hemoglobin level

Increased Age Ulcerative Colitis

Only vitamins created in the body:

K & D

A client with a history of ulcerative colitis has a large portion of the large intestine removed, and an ileostomy is created. For which potential life-threatening complication should the nurse assess the client after this surgery? Infection caused by the excretion of feces Injury caused by exposed intestinal mucosa Altered bowel elimination caused by the ostomy Limited water reabsorption caused by removal of intestine

Limited water reabsorption caused by removal of intestine

Colorectal cancer Endometrial cancer Ovarian cancer

Lynch Syndrome

Which of the following is an age-related change in the esophagus? a. Increased muscle tone b. Increased motility c. Weakened gag reflex d. Increased emptying

c. Weakened gag reflex

A client undergoing corticosteroid therapy is admitted with a peptic ulcer, osteoporosis, and hypertension. Which medication may have caused this condition?

Methylprednisolone

The nurse cares for a client after an endoscopic examination and prepares the client for discharge. The nurse includes which instruction?

Resume regular diet.

disease of cholesterol transport -characteristic orange-colored tonsils, a very low HDL level, enlarged liver and spleen -because of a mutation in a transport protein, cholesterol cannot properly exit the cell to bind to apo A (forming HDL). This results in a very low HDL level

Tangier disease

Upon hearing that the small intestine lining has thinned, an elderly client asks, "What can this lead to?" What is the best response by the nurse? a. "You may frequently have diarrhea." b. "You may frequently experience constipation." c. "It is the aging process." d. "At times you may see mucus in your stool."

b. "You may frequently experience constipation."

When completing a nutritional assessment of a patient who is admitted for a GI disorder, the nurse notes a recent history of dietary intake. This is based on the knowledge that a portion of digested waste products can remain in the rectum for how many days after a meal is digested? a. 1 day b. 3 days c. 2 days d. 4 days

b. 3 days

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? a. Liver enzyme b. Intrinsic factor c. Histamine d. Hydrochloric acid

b. Intrinsic factor

Swallowing is regulated by which area of the central nervous system (CNS)? a. Cerebellum b. Medulla oblongata c. Hypothalamus d. Pons

b. Medulla oblongata

A home care nurse is caring for a client with reports of epigastric discomfort who is scheduled for a barium swallow. Which statement by the client indicates an understanding of the test? a. "I'll avoid eating or drinking anything 6 to 8 hours before the test." b. "I'll take a laxative to clear my bowels before the test." c. "I'll drink full liquids the day before the test." d. "There is no need for special preparation before the test."

a. "I'll avoid eating or drinking anything 6 to 8 hours before the test."

Blood flow to the GI tract is approximately what percentage of the total cardiac output? a. 20% b. 30% c. 10% d. 40%

a. 20%

Specialized cells in the pancreas that secrete pancreatic juice

acini

Following ingestion of carrots or beets, the nurse would expect which alteration in stool color? a. Black b. Red c. Milky white d. Yellow

b. Red

The nurse prepares a client for a barium enema. The nurse should place the client on which diet prior to the procedure? a. high-fiber diet 1 to 2 days prior b. soft diet 1 day prior c. clear liquids day before d. nothing by mouth (NPO) 2 days prior

c. clear liquids day before

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

c. common bile duct, pancreatic duct, and biliary tree

somatostatin

hormone that inhibits release of growth hormone and insulin

lack of mature erythrocytes caused by inability to absorb vitamin B12 into the bloodstream

pernicious anemia

primary function of the liver

production of bile

Aging brings a decrease in saliva's ability to break down _________.

starches

secretion of pancreatic juice controlled by _________ nerve, secretin, and cholecystokinin

vagus

forcible exhalation against a closed glottis, resulting in increased intrathoracic pressure

valsalva maneuver

Hepatolenticular degeneration. Inborn error of copper metabolism. Hepatic cirrhosis and degenerative changes of basal ganglia. Diffuse atrophy with signal abnormalities involving deep gray matter nuclei and deep white matter.

wilson disease

A client with inflammatory bowel disease is receiving total parenteral nutrition (TPN) via an infusion pump. What is most important for the nurse to do when administering TPN? Change the TPN solution bag every 24 hours, even if there is solution left in the bag. Monitor the client's blood glucose level every 2 hours at the bedside with a glucometer. Instruct the client to breathe shallowly when changing the TPN tubing using sterile techniques. Speed up the rate of the TPN infusion if the amount delivered has fallen behind the prescribed hourly rate

Change the TPN solution bag every 24 hours, even if there is solution left in the bag.

Gastrin has which of the following effects on gastrointestinal (GI) motility? a. Contraction of the ileocecal sphincter b. Relaxation of the colon c. Relaxation of gastroesophageal sphincter d. Increased motility of the stomach

d. Increased motility of the stomach

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? a. Black b. Green c. Dark brown d. Red

a. Black

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? a. Colonoscopy b. Upper GI series c. Computer tomography d. Small bowel series

a. Colonoscopy

The nurse is instructing the client who was newly diagnosed with peptic ulcers. Which of the following diagnostic studies would the nurse anticipate reviewing with the client? a. Serum antibodies for H. pylori b. A sigmoidoscopy c. Gastric analysis d. A complete blood count including differential

a. Serum antibodies for H. pylori

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? a. The ultrasonography should be scheduled before the GI procedure. b. The upper GI should be scheduled before the ultrasonography. c. Both tests need to be done before breakfast. d. The client may eat a light meal before either test.

a. The ultrasonography should be scheduled before the GI procedure.

When describing the role of the pancreas to a client with a pancreatic dysfunction, the nurse would identify which substance as being acted on by pancreatic lipase? a. Triglycerides b. Glucose c. Protein d. Starch

a. Triglycerides

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

b. weakened gag reflex

A client is prescribed ranitidine 150 mg daily to treat peptic ulcer disease (PUD). Which instruction would the nurse give to the client about when to take this medication?

before bedtime

catabolism

breaking down

The nurse is caring for a client recovering from an esophagogastroduodenoscopy (EGD). Which of the following client symptoms would require further nursing assessment? a. Drowsiness b. Thirst c. Abdominal distention d. Sore throat

c. Abdominal distention

Which of the following digestive enzymes aids in the digesting of starch? a. Lipase b. Trypsin c. Amylase d. Bile

c. Amylase

An older adult client is admitted to an acute care facility for treatment of an acute flare-up of a chronic gastrointestinal condition. In addition to assessing the client for complications of the current illness, the nurse monitors for age-related changes in the gastrointestinal tract. Which age-related change increases the risk of anemia? a. Increase in bile secretion b. Dulling of nerve impulses c. Atrophy of the gastric mucosa d. Decrease in intestinal flora

c. Atrophy of the gastric mucosa

The nurse is answering questions regarding fecal matter for a client who is scheduled for a colon resection. The client is asking questions regarding the composition of the fecal matter and when it becomes a formed mass. The nurse is most correct to state at which location? a. Cecum b. Duodenum c. Sigmoid colon d. Ileum

c. Sigmoid colon

After teaching a group of students about the various organs of the upper gastrointestinal tract and possible disorders, the instructor determines that the teaching was successful when the students identify which of the following structures as possibly being affected? a. Ileum b. Large Intestine c. Stomach d. Liver

c. Stomach

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? a. Lithotomy b. Knee-chest c. Supine with knees flexed d. Left Sim's lateral

c. Supine with knees flexed

The nurse is assisting the physician in a percutaneous liver biopsy. In assisting with positioning, the nurse should assist the client into a: a. lithotomy position. b. high Fowler's position. c. supine position. d. dorsal recumbent position.

c. supine position.

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? a. Gallbladder b. Liver c. Stomach d. Pancreas

d. Pancreas

The nurse is caring for a client who is scheduled for a percutaneous liver biopsy. Which diagnostic test is obtained prior? a. Complete blood count (CBC) b. Blood chemistry c. Erythrocyte sedimentation rate (ESR) d. Prothrombin time (PT)

d. Prothrombin time (PT)

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? a. The esophagus b. The lower GI tract c. The anal area d. The upper GI tract

d. The upper GI tract

When gastric analysis testing reveals excess secretion of gastric acid, the nurse recognizes which medical diagnoses is supported? a. pernicious anemia b. chronic atrophic gastritis c. gastric cancer d. duodenal ulcer

d. duodenal ulcer

The major carbohydrate that tissue cells use as fuel is: a. fats. b. proteins. c. chyme. d. glucose.

d. glucose.

Somatomedin C

aka IGF structurally similar to insulin released in response to GH

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

b. Monitoring the stool passage and its color.

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

b. Permit the client to drink only clear liquids.

A client with diabetes begins to have digestive problems and is told by the physician that they are a complication of the diabetes. Which of the following explanations from the nurse is most accurate? a. Elevated glucose levels cause bacteria overgrowth in the large intestine. b. The pancreas secretes digestive enzymes. c. The nerve fibers of the intestinal lining are experiencing neuropathy. d. Insulin has an adverse effect of constipation.

b. The pancreas secretes digestive enzymes.

The nurse is assisting the health care provider with a gastric acid stimulation test for a client. What medication should the nurse prepare to administer subcutaneously to stimulate gastric secretions? a. Glycopyrronium bromide b. Atropine c. Pentagastrin d. Acetylcysteine

c. Pentagastrin

The nurse is caring for a man who has experienced a spinal cord injury. Throughout his recovery, the client expects to gain control of his bowels. The nurse's best response to this client would be which of the following? a. "Over time, the nerve fibers will regrow new tracts, and you can have bowel movements again." b. "Wearing an undergarment will become more comfortable over time." c. "It is not going to happen. Your nerve cells are too damaged." d. "Having a bowel movement is a spinal reflex requiring intact nerve fibers. Yours are not intact."

d. "Having a bowel movement is a spinal reflex requiring intact nerve fibers. Yours are not intact."

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

d. Ask the client to empty the bladder.

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? a. Colonic polyp b. Infection c. Rectal fissure d. Bowel perforation

d. Bowel perforation

Cystic fibrosis, a genetic disorder characterized by pulmonary and pancreatic dysfunction, usually appears in young children but can also affect adults. If the pancreas was functioning correctly, where would the bile and pancreatic enzymes enter the GI system? a. ileum b. jejunum c. duodenum d. cecum

c. duodenum

When assisting with preparing a client scheduled for a barium swallow, what nursing instruction would be appropriate to include? a. Take vitamin K before the procedure. b. Avoid the intake of red meat before the procedure. c. Avoid smoking for at least a day before the procedure. d. Take three cleansing enemas before the procedure.

c. Avoid smoking for at least a day before the procedure.

When examining the skin of a client who is dehydrated due to fluid losses from the gastrointestinal tract, which of the following would be most important? a. Checking if the skin is discolored b. Observing for distended abdominal veins c. Checking if the mucous membranes are dry d. Examining the sclera if it is yellow

c. Checking if the mucous membranes are dry

An adult patient is scheduled for an upper GI series that will use a barium swallow. What teaching should the nurse include when the patient has completed the test? a. The barium may cause diarrhea. b. Stool will be yellow for the first 24 hours postprocedure. c. Fluids must be increased to facilitate the evacuation of the stool. d. This series includes analysis of gastric secretions.

c. Fluids must be increased to facilitate the evacuation of the stool.