GI Saunders

The nurse is assisting in planning stress management strategies for the client diagnosed with irritable bowel syndrome. Which suggestion is most appropriate for the nurse to give to the client?

Learn measures such as biofeedback or progressive relaxation

The nurse would include which instruction in a teaching plan for a client who has been diagnosed with peptic ulcer disease?

Learn to use stress reduction techniques.

The nurse is caring for a client within the first 24 hours following a total gastrectomy for gastric cancer. During this time frame, the nurse would focus on which priority intervention?

Maintaining a patent nasogastric (NG) tube

The nurse is caring for a client with a small bowel obstruction. The nurse would notify the surgeon based on which findings noted on the physical assessment?

Muscle guarding on palpation

A client receiving enteral feedings develops abdominal distention and diarrhea shortly after initiation of the feedings. Which is the appropriate intervention for the nurse to implement?

Notify the primary health care provider (PHCP) of the client's signs and symptoms.

The nurse is monitoring a client for the early signs and symptoms of dumping syndrome. Which findings indicate this occurrence?

Sweating and pallor

A postoperative client has regained bowel sounds and is ready to start a clear liquid diet. The nurse is told that the primary health care provider has written a prescription to remove the nasogastric (NG) tube. The nurse assists in the procedure and would ask the client to do which during tube removal?

Take a breath and hold it until the tube is out.

The nurse is reinforcing home care instructions to a client following a gastric resection. The nurse would include which instruction to the client?

Take actions to prevent dumping syndrome.

The nurse is reinforcing instructions to a client about insertion of a Sengstaken-Blakemore tube. Which statement by the client indicates a need for further teaching?

The tube will be inserted through my mouth to my stomach.

The nurse is caring for a client following an esophagogastroduodenoscopy (EGD) done to confirm the diagnosis of esophageal stricture. Which assessment is priority after this procedure to promote client safety?

gag reflex

The nurse is assisting in assessing a client who was in a motor vehicle crash and experienced blunt trauma to the abdomen. The nurse is told that on auscultation of the abdomen, a bruit is heard. Which complication would the nurse suspect?

aortic aneurysm

The nurse is teaching a client with irritable bowel syndrome (IBS) about food items that may exacerbate the condition. The nurse identifies a need for further teaching if the client states which food item is acceptable to consume?

cauliflower

A primary health care provider asks the nurse to obtain a Salem sump tube for gastric intubation. The nurse would correctly select which tube from the unit storage area?

A tube with a larger lumen and an air vent

A client with ulcerative colitis had a new colostomy created 2 days earlier and is beginning to pass malodorous flatus from the stoma. What is the correct interpretation by the nurse?

This is a normal, expected event.

A client that is postgastrectomy being discharged from the hospital tells the nurse, "I hope my stomach problems are over. I need to get back to work right away. I've missed a lot of work, and I may lose my job." Based on the client's statement, the nurse would determine that at this time, it is most appropriate to discuss which topic?

Reducing stressors in life

A licensed practical nurse (LPN) is helping a registered nurse (RN) conduct an abdominal assessment. The LPN would assist the client into which most appropriate position?

Supine with the head raised slightly and the knees slightly flexed

The nurse is collecting data about how well a client diagnosed with a gastrointestinal (GI) disorder is able to absorb food. While doing this, the nurse recalls that absorption is most concerned with which bodily function?

The transfer of digested food molecules from the GI tract into the bloodstream

The client admitted to the hospital with a diagnosis of viral hepatitis is complaining of a loss of appetite. In order to provide adequate nutrition, which action would the nurse encourage the client to take?

Increase intake of fluids.

A nurse organizing care for a client diagnosed with hepatitis plans to meet the client's safety needs by performing which action?

Monitoring prothrombin and partial thromboplastin values

A sexually active 20-year-old client has been diagnosed with viral hepatitis. Which statement made by the client would indicate a need for further teaching?

"I can never drink alcohol again."

A client is seen in the ambulatory care office for a routine examination. Which statement by the client would be most important for the nurse to follow up?

"I just lost a family member to gastrointestinal cancer."

The nurse is reviewing concepts related to irritable bowel syndrome (IBS) with a nursing student. Which statement by the nursing student indicates there is a need for further teaching?

"IBS is characterized by only episodes of diarrhea."

The nurse is collecting data from a client admitted to the hospital with a diagnosis of suspected gastric ulcer and is asking the client questions about pain. Which statement made by the client would the nurse recognize as best supporting the diagnosis of gastric ulcer?

"My pain comes shortly after I eat, maybe a half hour or so later."

A client has had extensive surgery on the gastrointestinal tract and has been started on total parenteral nutrition (TPN). The client tells the nurse, "I think I'm going crazy. I feel like I'm starving, and yet that bag is supposed to be feeding me." Which is the best response from the nurse?

"That is because the empty stomach sends signals to the brain to stimulate hunger."

The nurse reinforces medication instructions to a client with peptic ulcer disease. Which statement by the client indicates the best understanding of the medication therapy?

"The nizatidine will cause me to produce less stomach acid."

Which statement by the spouse of a client with diagnosed end-stage liver failure indicates the need for further teaching by the multidisciplinary team regarding management of the client's pain?

"This opioid will cause very deep sleep, which is what my husband needs."

A licensed practical nurse (LPN) is preparing to assist a registered nurse (RN) with removing a nasogastric (NG) tube from the client. Which interventions would be included in the procedure? Select all that apply.

- Explain the procedure to the client. - Ask the client to take a deep breath and hold. - Pull the tube out in one continuous steady motion. - Remove the device or tape securing the tube from the nose.

A client who has undergone a colostomy several days ago is reluctant to leave the hospital and has not yet looked at the ostomy site. Which measures will most likely promote coping? Select all that apply.

-Ask a member of the local ostomy club to visit with the client before discharge. -Ask the enterostomal nurse specialist to consult with the client before discharge. -Ask the client to begin doing one part of the ostomy care each day and increase tasks daily.

A client has had a partial gastrectomy, and the nurse is reinforcing discharge instructions. The nurse would reinforce instructions to the client about the need for which supplements? Select all that apply.

-Iron supplements -Calcium supplements -Vitamin B12 injections

The nurse is caring for a client that received a new diet prescription from the primary health care provider (PHCP) for nothing-by-mouth (NPO) except ice chips. Which actions would the nurse take to alleviate the effects of dehydration? Select all that apply.

-Observe mucous membranes for drynessisinterest -Provide frequent oral care with moist swabs -Apply lubricant to the lips and oral mucous membranes

The nurse provides information to a client following a gastrectomy who is now diagnosed with pernicious anemia. Which instructions about pernicious anemia would the nurse reinforce to the client? Select all that apply.

-Provide meticulous and frequent oral hygiene. -Use additional lightweight blankets as needed -Check blood serum vitamin B12 levels every 1 to 2 years.

An older client complains of chronic constipation. Which instructions would the nurse reinforce with the client? Select all that apply.

-increase fluids to at least 8 glasses a day -respond in a timely manner to the urge to defecate

The nurse is reviewing a client's medications. The nurse determines which medications increase the client's risk of dehydration? Select all that apply.

-lactulose -spironolactone -polyethylene glycol

The client in an emergency department reports right lower quadrant abdominal pain. After noting a white blood cell count of 16,500 cells/mm3, the nurse should question which prescriptions? Select all that apply.

-milk of magnesia -heat pad to abdomen

A client who has undergone a subtotal gastrectomy is being prepared for discharge. Which considerations concerning ongoing self-management would the nurse reinforce to the client? Select all that apply.

1 3

A client with Crohn's disease has a prescription to begin taking antispasmodic medication. The nurse would schedule the medication so that each dose is taken at which time?

30 minutes before meals

The client is to receive a soapsuds enema. Which is the best position for administering an enema? Refer to figure.

A

The nurse is talking to a nursing student about primary versus secondary peritonitis. The nurse determines that the student understands if the nursing student states which client is at risk for primary peritonitis?

A client with ascites related to cirrhosis

The nurse is reviewing the risk factors for Clostridium difficile (C. difficile) infection with a student nurse. The nurse would determine there is a need for further teaching if the student nurse identifies which clients as being at risk for developing a C. difficile infection? Select all that apply.

A client with coronary artery disease A client receiving total parenteral nutrition

The nurse has been reinforcing dietary teaching for a client diagnosed with gastroesophageal reflux disease (GERD) who has a routine follow-up visit. Which behavior is the best indicator of a successful outcome for this client?

A decrease in sour eructation

The nurse notes that the medical record of a client diagnosed with cirrhosis states that the client has asterixis. To effectively verify this information the nurse would take which action?

Ask the client to extend the arms.

A client with viral hepatitis states to the nurse, "I am so yellow." The nurse would best respond by taking which action?

Assist the client in expressing feelings

The nurse is preparing to administer a soapsuds enema to a client. Into which position would the nurse place the client to administer the enema? Refer to figure.

C

A client has undergone esophagogastroduodenoscopy (EGD). The nurse would place highest priority on which action as part of the client's care plan?

Checking for return of gag reflex

A client with Crohn's disease is scheduled to receive an infusion of infliximab. The nurse assisting with caring for the client would take which action to monitor the effectiveness of treatment?

Checking the frequency and consistency of bowel movements

The nurse is reinforcing medication instructions to a client with peptic ulcer disease. Which represents correct information given by the nurse?

Cimetidine (Tagamet) results in decreased secretion of stomach acid

Which ostomy location would most likely need to be irrigated? Refer to figure.

D

The nurse is reinforcing dietary instructions for a client diagnosed with peptic ulcer disease. Which action would the nurse encourage the client to do?

Eat anything as long as it does not aggravate or cause pain.

The nurse would document that a client diagnosed with a hiatal hernia is implementing effective health maintenance measures after the client reports doing which action?

Eating low-fat or nonfat foods

A client is admitted to a long-term care facility with the diagnosis of weight loss secondary to anorexia. The primary health care provider inserts a nasogastric tube and prescribes a tube feeding of a standard formula feeding to run at 50 mL/hr. The nurse plans care, knowing that which is true regarding enteral feedings?

Enteral feedings require the normal digestive capabilities of the gastrointestinal (GI) tract.

A client with a possible hiatal hernia complains of difficulty swallowing. Which other sign/symptom associated with a hiatal hernia would the nurse recognize?

Heartburn and regurgitation

The nurse is interpreting the laboratory results of a client who has a history of diagnosed chronic ulcerative colitis. The nurse would determine that which result indicates a complication of ulcerative colitis?

Hemoglobin 10.2 g/dL

It has been determined that a client with hepatitis has contracted the infection from contaminated food. Which type of hepatitis is this client most likely experiencing?

Hepatitis A

The client complains of stomach pain 30 minutes to 1 hour after eating. The pain is not relieved by further intake of food, although it is relieved by vomiting, and a gastric ulcer is suspected. The nurse would gather which additional data from the client to support this diagnosis?

History of alcohol use, smoking, and weight loss

The nurse is collecting data on a client with a diagnosis of peptic ulcer disease. Which history would the nurse determine is least likely associated with this disease?

History of the use of acetaminophen for pain and discomfort

A client arrives at the emergency department complaining of severe abdominal pain and is placed on NPO status. During a quick assessment the nurse observes that the client has both Cullen's sign and Grey Turner's sign, and pancreatitis is suspected. The nurse would assist to implement which action first?

Obtain vital signs and draw blood for laboratory analysis.

The nurse is caring for a client with a Sengstaken-Blakemore tube. To effectively prevent ulceration and necrosis of oral and nasal mucosa, the nurse would plan to implement which action?

Provide frequent oral and nasal care on a regular basis

The nurse is caring for a client with a diagnosis of pneumonia and a history of bleeding esophageal varices. Based on this information, the nurse would plan care knowing that which could most result in a potential complication?

Vigorous coughing

A client who is receiving total parenteral nutrition (TPN) complains of a headache. The nurse notes that the client has an increased blood pressure and a bounding pulse. The nurse reports the findings, knowing that these signs/symptoms are indicative of which complication of this therapy?

fluid overload

The nurse is assisting with the insertion of a nasogastric tube into a client. The nurse would place the client in which position for insertion?

high-Fowler's position

A client diagnosed with acute pancreatitis is experiencing severe pain from the disorder. The nurse would instruct the client to avoid which position that could aggravate the pain?

lying flat

The nurse working in the emergency department is assisting with an initial assessment on a client who is complaining of severe upper abdominal pain that spreads throughout the abdomen and radiates to the back and shoulders. The client has tried taking antacids with no relief. On assessment the abdomen is rigid and bowel sounds are absent. Which data in the client's history would the nurse be most concerned about in connection with these assessment findings?

peptic ulcer disease

The nurse has been providing care for a client with a Sengstaken-Blakemore tube. While the tube is inflated the nurse would monitor for which priority sign/symptom?

respiratory distress

A morbidly obese client, 3 days postoperative gastric bypass surgery, comes to the clinic complaining of pain. The nurse suspects that the client has an anastomotic leak requiring hospitalization. The nurse would determine that which findings best validate this suspicion? Select all that apply.

-oliguria -restlessness -abdominal pain -unexplained tachycardia

The nurse is reinforcing discharge instructions to a client with a hiatal hernia. Which considerations would the nurse include in the teaching session? Select all that apply

1,3,4

The nurse is providing education to a client regarding foods that can aggravate the symptoms of gastroesophageal reflux disease (GERD). The nurse identifies a need for further teaching when the client states which foods are acceptable to consume? Select all that apply.

1,3,5

The nurse is collecting data about how well a client diagnosed with a gastrointestinal (GI) disorder is able to digest food. The nurse determines that which processes are involved in the complete digestive process? Select all that apply.

2,4,5,6

The nurse is assigned to care for a client who had a Sengstaken-Blakemore tube inserted when more conservative treatment failed to alleviate the condition. The nurse would most likely suspect that the client has which diagnosis?

Esophageal varices

The nurse is caring for a client with dehydration. The nurse is aware that dehydration is associated with which imbalances?

Extracellular fluid volume deficit and hypernatremia

A client with cirrhosis admitted to the hospital diagnosed with severe jaundice is having diagnostic testing. Because the client has no complaints of fatigue, the client is encouraged to ambulate in the hall to maintain muscle strength. The client paces around the room but will not enter the hall. The nurse would determine which concern is most likely the reason for the client's reluctance to walk in the hall?

Feeling self-conscious about appearance

The nurse is reinforcing dietary instructions for a client diagnosed with peptic ulcer disease. Which statement made by the client indicates a need for further teaching?

I will eat a bland diet only.

The nurse is caring for a client with suspected esophageal stricture. Which statement from the client supports this diagnosis?

I've been having trouble swallowing meat."

The nurse should include which most appropriate information when reinforcing home care instructions for a client who has been diagnosed with peptic ulcer disease?

Learn to use stress reduction techniques.

After a client undergoes a liver biopsy, the nurse places the client in the prescribed right-side lying position. The nurse understands that the purpose of this intervention is to accomplish which?

Limit bleeding from the biopsy site

The client has a prescription for sucralfate 1 g by mouth 4 times daily. The nurse would best schedule the administration of the medication at which time?

One hour before meals and at bedtime

The nurse is caring for a client with a nasogastric (NG) tube and tests the pH of the aspirate to determine correct placement. The test results indicate a pH of 5. The nurse would determine this indicates which information?

Placement of the NG tube is accurate.

The nurse would reinforce instructions to a client that has had a gastrectomy about the signs and symptoms of pernicious anemia, knowing what information?

Regular monthly injections of vitamin B12 will prevent this complication.

A client is admitted to the hospital with a diagnosed bowel obstruction secondary to a recurrent diagnosed malignancy. The primary health care provider plans to insert a Miller-Abbott tube. When the nurse tries to explain the procedure, the client interrupts the nurse and states, "I don't want to hear about that. Just let the doctor do it." Based on the client's statement, which action would the nurse determine is best?

Remain with the client and be silent

A client has undergone subtotal gastrectomy, and the nurse is preparing the client for discharge. Which item would be included when reinforcing instructions to the client about ongoing self-management?

Smaller, more frequent meals should be eaten

The nurse is caring for a client with fatty liver disease who is scheduled for a paracentesis to treat ascites. The client has an indwelling urinary catheter in place to aid in the healing of a sacral pressure injury. The nurse assesses the client and would notify the registered nurse regarding which priority finding?

The client has pink-tinged urine in the indwelling urinary drainage bag.

The nurse is administering a cleansing enema to a client with a fecal impaction. Before administering the enema, the nurse asks the client to assume a modified left lateral recumbent position. The nurse explains that this positioning is preferred because of which reason?

The enema will flow into the bowel easily.

A client is receiving total parenteral nutrition and has been NPO. The primary health care provider (PHCP) prescribed small amounts of clear liquids today. The nurse's priority is to collect data regarding which criterion before giving the client anything by mouth?

The presence of the swallow reflex

The nurse is evaluating the effect of dietary counseling on the client diagnosed with cholecystitis. The nurse determines the client understands the instructions given if the client states that which food item is most appropriate to include in the diet?

Turkey and lettuce sandwich

The nurse is reinforcing discharge instructions to a client who has had a total gastrectomy. The nurse instructs the client about the importance of returning as scheduled to the health care clinic for which priority assessment?

Vitamin B12 and folic acid studies

The nurse is providing dietary instructions to a client with a diagnosis of ulcerative colitis. The client is prescribed to follow a low residue diet during episodes of diarrhea. Which food would the nurse instruct the client to avoid?

Fresh corn on the cob

A licensed practical nurse (LPN) is assisting in the insertion of a nasogastric (NG) tube for an adult client. The LPN helps determine the correct length to insert the tube by performing which measurement?

From the tip of the client's nose to the earlobe and then down to the xiphoid process

The nurse is preparing to administer an enteral feeding through a nasogastric tube. The nurse would place the client in which position during and after the feedings?

Fowler's

The nurse is assessing a client who fell at home and is complaining of abdominal pain. The nurse notes ecchymosis on the client's flanks and documents this as which assessment finding?

Grey Turner's sign

The nurse is participating in a health screening clinic and is preparing materials about colorectal cancer. The nurse would include which risk factor for colorectal cancer in the material?

Personal history of ulcerative colitis or gastrointestinal (GI) polyps

The nurse has assisted the primary health care provider with a liver biopsy, which was done at the bedside. Upon completion of the procedure, the nurse would assist the client into which position?

Right side-lying with a small pillow or towel under the puncture site

The nurse is reviewing the health care record of a client with a diagnosis of chronic pancreatitis. The nurse would determine that which data noted in the record indicate poor absorption of dietary fats?

Steatorrhea

A client had a Miller-Abbott tube inserted 24 hours ago. The nurse is asked to check the client to determine whether the tube is in the appropriate location at this time. Which data finding best indicates adequate location of the tube?

The aspirate from the tube has a pH of 7.45.

The nurse caring for a client diagnosed with acute pancreatitis and has a history of alcoholism is monitoring the client for complications. The nurse determines that which data collected is most likely indicative of paralytic ileus?

Inability to pass flatus

The nurse is caring for a client with a diagnosis of acute appendicitis. Which physical assessment finding consistent with this diagnosis would the nurse expect to be documented in the client's medical record?

Pain at McBurney's point

The nurse is reviewing a chart of a client with irritable bowel syndrome (IBS) that is taking linaclotide. Which item documented in the client's history would prompt the nurse to consult with the registered nurse?

Partial bowel obstruction

The nurse is caring for a client with a diagnosis of acute anal fissure. Which characteristic assessment finding would the nurse expect to note?

Recent constipation

A client diagnosed with a peptic ulcer scheduled for a vagotomy asks the nurse about the purpose of this procedure. The nurse would explain to the client that a vagotomy primarily serves which purpose?

Reduces the stimulation of acid secretions

A client presents to the urgent care center with complaints of abdominal pain. Suddenly the client vomits bright red blood. The nurse would take which immediate action?

Take the client's vital signs.

The nurse who is assisting in the care of a client within the first 24 hours following a total gastrectomy for gastric cancer would avoid which intervention?

Irrigating the nasogastric (NG) tube

The nurse gathers data from a client admitted to the hospital with a diagnosis of gastroesophageal reflux disease (GERD) scheduled for a Nissen fundoplication. Based on an understanding of this disease, the nurse would determine that the client may be most at risk for which complication?

aspiration