Ha Exam 3- Gastrointestinal

A patient is scheduled to undergo several diagnostic procedures to evaluate gastrointestinal function. Which test requires informed consent by the patient? -lower GI series -computed tomography (CT) -Upper gastrointestinal (GI) series -Esophagogastroduodenoscopy (EGD)

Esophagogastroduodenoscopy (EGD)

A health care provider has ordered a fecal occult blood test (FOBT) for a patient. What does the nurse instruct the patient to avoid for a few days and during sample collection? Select all that apply -milk -warfarin -vitamin C -red meat -vitamin B12 -Nonsteroidal anti-inflammatory drugs (NSAIDs)

-warfarin -vitamin C -red Meat -Nonsteroidal anti-inflammatory drugs (NSAIDs)

The outpatient clinic nurse is caring for a recovering patient who had a colonoscopy. The patient asks for a drink. How does the nurse respond to this request? -After I hear bowel sounds, you can have a drink -You can have fluids when you get home and are settled -when you are able to pass flatus (gas), you can have a drink -20 minutes after the procedure was completed, you may have some liquids

-when you are able to pass flatus (gas), you can have a drink

The nurse is teaching a patient who is scheduled for esophagogasteodudenoscopy about the procedure. Which statement made by the patient indicates a need for further teaching? -"I will be conscious while the tube is passed during the procedure" -"I should avoid anticoagulants for several days before the procedure" -"I should avoid oral foods and fluids for 6-8 hours before the procedure" -"I should take my medications for hypertension on the morning of the procedure"

"I will be conscious while the tube is passed during the procedure"

A 49-year-old healthy man asks the nurse how often he needs to be screened for colorectal cancer by colonoscopy. Which response by the nurse is best? -"After next year, you should be tested every 3 years" -"You will not need to be tested until you are age 55" -"Your testing needs will be determined by your healthcare provider" -"If you have no family history, you will most likely be tested every 10 years after age 50"

"If you have no family history, you will most likely be tested every 10 years after age 50"

The nurse is using the PQRST mnemonic to evaluate a patient's abdominal pain. Under the "P" this mnemonic, which question would the nurse ask? -"How severe is your pain?" -"Exactly when did your pain first occur?" -"What brings on the pain and what makes it better?" -"On a scale of 0-10, with 10 being the worse, how bad is your pain?"

"What brings on the pain and what makes it better?"

While working in the outpatient procedure unit, the RN is assigned to these patients. Which patient does the nurse assess first? -54-year-old who is ready for discharge following a colonoscopy -60-year-old with questions about an endoscopic ultrasound examination -58-year-old who has just arrived fro basal gastric secretion and gastric acid stimulation testing -51-year-old who recently had an endoscopic retrograde cholangiopancreatography (ERCP)

-51-year-old who recently had an endoscopic retrograde cholangiopancreatography (ERCP)

A patient is admitted to the hospital with severe right upper quadrant (RUQ) abdominal pain. Which assessment technique does the nurse use for the patient? -Examines the RUQ of the abdomen last -Has the patient lie in a supine position with legs straight and arms at the sides -Assesses the abdomen in the following sequence: inspection, palpation, percussion, auscultation -Views the abdomen by looking directly down while standing over the patient's abdominal area

-Examines the RUQ of the abdomen last

The nurse is assessing a patient who comes to the emergency department with acute abdominal pain. The nurse notes a bulging, pulsating mass when inspecting the abdomen. Which action by the nurse is correct? -Question the patient about recent stool habits -Notify the provider of this finding immediately -Palpate the patient's abdomen to determine the outlines of the mass -Auscultate the abdomen to determine the presence of bowel sounds

-Notify the provider of this finding immediately

A patient with gastrointestinal (GI) bleeding is prescribed a small bowel capsule endoscopy. Which statements about this procedure are correct? Select all that apply. -The capsule battery lasts for 8 hours -the capsule is swallowed with a glass of water -the entire small bowel and colon are visualized -The patient can take only water 8-10 hours before the test -the scope is used to follow the capsule to view the intestine -the capsule is a single use device and is excreted naturally

-The capsule battery lasts for 8 hours -the capsule is swallowed with a glass of water -The patient can take only water 8-10 hours before the test -the capsule is a single use device and is excreted naturally

A patient is presorted an esophagogastrodudenoscopy (EGD), which is a visualization of the esophagus, stomach, and duodenum. Which information would the nurse provide to the patient prior to the procedure? Select all that apply. -The entire series will take about an hour -You may have a dry mouth after the exam -You may take your medications on the morning of the exam -if you wear dentures, you may leave them in for the procedure -you must withhold foods and liquids for 6-8 hrs before the test

-You may have a dry mouth after the exam -You may take your medications on the morning of the exam -you must withhold foods and liquids for 6-8 hrs before the test

A patient is prescribed a fecal occult blood test (FOBT). What teaching does the nurse provide got the patient about the test? -Include raw vegetables in salads -consume a healthy diet of raw fruits -avoid vitamin C-rich foods before the test -discontinue anticoagulant therapy 2 days before the test

-avoid vitamin C-rich foods before the test

A patient has just returned from a colonoscopy that did not require a polyectomy or tissue biopsy. What action does the nurse take? -allows the patient to drive home after 6 hours -avoids oral intake until the patient is alert and passes flatus -tells the patient that traces of blood will be seen in the first stool -reminds the patient that abdominal cramping will last for an hour

-avoids oral intake until the patient is alert and passes flatus

What screening tests are recommended to determine the presence of colorectal cancer? Select all that apply -colonoscopy every 10 years -Flexible sigmoidoscopy every 5 years -double-contrast barium enema every 5 years -small bowel capsule endoscopy every 5 years -computed tomography (CT) colonoscopy every 5 years -Endoscopic retrograde cholangiopancreatography (ERCP) every 10 years

-colonoscopy every 10 years -Flexible sigmoidoscopy every 5 years -double-contrast barium enema every 5 years -computed tomography (CT) colonoscopy every 5 years

After abdominal surgery, what are the most reliable methods of assessing a patient for the return of peristalsis? Select all that apply. -report of an appetite -passing flatus within 8 hrs -reporting abdominal pain that "travel" -producing a urinary output of greater than 1000 mL -having a bowel movement within the past 12-24 hrs -having auscultated bowel sounds in all four abdominal areas

-having a bowel movement within the past 12-24 hrs -passing flatus within 8 hrs

A patient is admitted for a barium swallow study. Which actions does the nurse include in preparing the patient for the study? Select all that apply. -instructing the patient on laxative use after the exam -withholding foods and fluids for 24 hours before the test -obtaining IV access for the injection of contrast medium -instructing the patient to drink plenty of fluids after the exam -instructing the patient to take a laxative 4 hours before the exam

-instructing the patient on laxative use after the exam -instructing the patient to drink plenty of fluids after the exam

The nurse is auscultating a patient's abdomen and hears a 'swooshing' sound known as a bruit. What should the nurse's best response be? -notify the health care provider -document the finding as normal -encourage the patient to walk to promote intestinal motility -continue with the assessment by percussing and palpating

-notify the health care provider

A patient is prescribed a gastrointestinal (GI) endoscopic examination. What actions should the endoscopy nurse take after the examination? select all that apply. -raise the siderails of the bed -monitor for signs of perforation -provide the patient with a call light -monitor vital signs every 30 minutes -maintain nothing by mouth (NPO) status until the gage reflex returns

-raise the siderails of the bed -monitor for signs of perforation -monitor vital signs every 30 minutes -maintain nothing by mouth (NPO) status until the gage reflex returns

Which factors place a patient at risk for gastrointestinal (GI) problems? Select all that apply -socioeconomic status -eating a high-fiber diet -some herbal preparations -smoking a half-pack of cigarettes per day -use of non steroidal anti-inflammatory drugs (NSAIDs)

-socioeconomic status -some herbal preparations -smoking a half-pack of cigarettes per day -use of non steroidal anti-inflammatory drugs (NSAIDs)

What does the nurse instruct the patient about barium elimination after a barium enema examination? -take a mild laxative -drink plenty of fluids -report abdominal fullness or pain -observe brown stools after 12 hours -observe that the stool is chalky white

-take a mild laxative -drink plenty of fluids -observe that the stool is chalky white

What age-related physiologic change in the gastrointestinal system may lead to steatorrhea? -decreased hydrochloric acid -decreased lipase production -decreased peristaltic movement -decreased liver weight and mass

decreased lipase production

A 36-year-old patient is admitted to the hospital with a gastrointestinal problem. Which blood serum lab value concerns the nurse? -Albumin 4.2 g/dL -Potassium 3.8 mEq/L -Bilirubin (total) 2.2 mg/dL -Aspartate aminotransferase (AST) 24 units/L

Bilirubin (total) 2.2 mg/dL

A patient reports pain in the right upper quadrant (RUQ) after a high-fat meal. Which organ does the nurse expect to be affected? -Spleen -Stomach -Appendix -Gallbladder

Gallbladder

The clinic nurse is assessing an anemic adult patient. Why is it important for the nurse to advise the patient to seek follow-up care from a health care provider? -The patient may get dizzy and fall -Gastrointestinal bleeding is the mot frequent cause of anemia -The patient needs instructions about how to increase fluid intake -The link between anemia and many skin disorder is quite common

Gastrointestinal bleeding is the mot frequent cause of anemia

the nurse is osculating the abdomen of a patient. What would be a normal finding with this assessment? -Loud gurgling sounds -Bruits or "swishing" sounds -High-pitched irregular gurgles -Diminished or absent sounds

High-pitched irregular gurgles

The nurse is educating a group of older adults about screening for colorectal cancer. Which statement by a group member indicates the need for further clarification about these guidelines? -A barium enema every 5 years is a screening option -the virtual colonoscopy every 5 years is acceptable -I will need to have a routine colonoscopy every 5 years -My routine flexible sigmoidoscopy every 5 years is OK

I will need to have a routine colonoscopy every 5 years

A 32-year-old non diabetic patient is scheduled for an outpatient esophagogastroduodenoscopy (EGD). What does the nurse teach the patient before the procedure? -You can have clear liquids until 1 hours before the procedure -You must take a fleet enema the night before the procedure -Just remain nothing by mouth for 6-8 hours before the procedure -You should avoid taking aspirin, non steroidal anti-inflammatory drugs, or anticoagulants for several days after the test

Just remain nothing by mouth for 6-8 hours before the procedure

While performing an abdominal assessment, where does the nurse expect to find the liver? -Left Lower Quadrant (LLQ) -Left Upper Quadrant (LUQ) -Right lower Quadrant (RLQ) -Right Upper Quadrant (RUQ)

Right Upper Quadrant (RUQ)

The nurse administers midazolam hydrochloride to prepare a patient for an esophagogastroduodenoscopy. What outcome does the nurse expect after the administration of the medication? -The patient will become sedated -The patient's secretions will dry up -the patient's gag reflex will be depressed -the patient's esophagus will facilitate the passage of the tube

The patient will become sedated

The nurse is preparing a patient for sigmoidoscopy. What does the nurse tell the patient about this procedure? -This examination will last for about an hour -Tissue biopsies are not performed during this procedure -You must report any gas pain and flatulence after the procedure -You must consume only a clear liquid diet for 24 hours before the test

You must consume only a clear liquid diet for 24 hours before the test

The nurse is assessing a patient who had abdominal surgery yesterday. What method provides the most accurate data about resumption of peristalsis in the patient? -observing the abdomen for symmetry and distention -Auscultating bowel sounds in all abdominal quadrants -asking the patient whether he or she has passed flatus (gas) -Counting the number of bowel sounds in each abdominal quadrant

asking the patient whether he or she has passed flatus (gas)

A patient is scheduled for a colonoscopy. What does the nurse tell the patient to do before the procedure is performed? -begin a clear liquid diet 12-24 hours before the test -do not drink anything for 12 hours before the test -you will have to drink a contrast liquid 2 hours before the test -give yourself tap water enemas until the fluid returns are normal

begin a clear liquid diet 12-24 hours before the test

The nurse is reviewing a patient's laboratory results and notes elevated levels of serum total bilirubin, conjugated (direct) bilirubin, and urinary urobilinogen. What condition may this indicate? -Ulcerative colitis -biliary obstruction -acute pancreatitis -inflammatory bowel disease

biliary obstruction

A patient is newly diagnosed with irritable bowel syndrome (IBS) reports having 5-6 loose stools daily. What common psychological patient response to this gastrointestinal health problem? -grief -euphoria -acceptance -embarrassment

embarrassment

A patient has a routine sigmoidoscopy with a tissue biopsy. What complication is the nurse looking for in a post procedure assessment? -heavy bleeding -severe rectal pain -excessive diarrhea -nausea and vomiting

heavy bleeding

What is a common gastrointestinal problem that older adults experience more frequently as they age? -increased peristalsis -increased liver enzymes -excess lipase production -decreased hydrochloric acid

decreased hydrochloric acid

A patient is scheduled for a computed tomography (CT) scan of the abdomen. Which statement about this procedure is correct? -the patient lies still and takes deep breaths when asked to do so -if the patient has an allergy to iodine, it must be known if contrast is to be used -the patient is kept nothing by mouth (NPO) 6 hours before the test is contrast is used -all jewelry must be removed during the test, but the patient can wear his or her wedding ring

if the patient has an allergy to iodine, it must be known if contrast is to be used

Which action does the nurse perform first when assessing a patient's abdomen? -inspection -percussion -auscultation -light palpation

inspection

What is the correct sequence of steps for assessing a patient's abdomen? -Palpation, percussion, inspection, auscultation -auscultation, inspection, percussion, palpation -inspection, percussion, palpation, auscultation -inspection, auscultation, percussion, palpation

inspection, auscultation, percussion, palpation

The nurse is assessing a patient who has come to the emergency department with acute abdominal pain. The patient is very thing and the nurse observes visible peristaltic movements when inspecting the abdomen. What does the nurse suspect? -Pancreatitis -Acute diarrhea -aortic aneurysm -intestinal obstruction

intestinal obstruction

Which gastrointestinal secretion influences vitamin B12 absorption? -amylase -pepsinogen -intrinsic factor -chymotrypsin

intrinsic factor

Which substance, produced in the stomach, facilitates the absorption of vitamin B12? -glucagon -pepsinogen -intrinsic factor -hydrochloric acid

intrinsic factor

A patient's lab results show an elevated aspartate aminotransferase (AST) and alanine aminotransferase (ALT). these elevations are consistent with damage to which organ? -liver -stomach -pancreas -gallbladder

liver

In assessing the abdomen, a sound of dullness is expected to be assessed over which organ? -liver -bladder -stomach -intestines

liver

The nurse is assessing the abdomen of a 40-year-old patient who reports acute tenderness and pain I the right upper quadrant (RUQ). What organ does the nurse consider as a plausible origin? -liver -spleen -stomach -sigmoid colon

liver

When palpating the right upper quadrant (RUQ) of the abdomen, what is the nurse assessing? -liver -stomach -appendix -sigmoid colon

liver

When a patient has gastroenteritis, what type of sound is heard during auscultation of the abdomen? -loud, gurgling sounds -swift swishing sounds -high-pitched musical sounds -low-pitched thud-like sounds

loud, gurgling sounds

Which spincter is involved with gastroesophageal reflux disease (GERD) -Pyloric sphincter -Sphincter of Oddi -lower esophageal sphincter (LES) -Upper esophageal sphincter (UES)

lower esophageal sphincter (LES)

A patient's urine test indicates elevated levels of amylase. Which condition may be associated with this laboratory finding? -hepatitis -cirrhosis -diabetes -pancreatitis

pancreatitis

Pernicious anemia is caused by a lack of intrinsic factor, which prevents the absorption of which element? -iron -folic acid -vitamin B6 -vitamin B12

vitamin B12