NUR 240 PrepU Chapter 38: Assessment of Digestive and Gastrointestinal Function
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?
Triglycerides
A client asks the nurse why the physician ordered the blood test carcinoembryonic antigen (CEA). The nurse answers:
"It indicates if a cancer is present."
The nurse asks a client to point to where pain is felt. The client asks why this is important. What is the nurse's best response?
"Often the area of pain is referred from another area."
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?
3 days
The nurse is caring for a client recovering from a colonoscopy. Which assessment finding will the nurse expect in the client after the procedure?
Abdominal cramps
The nurse is caring for a client recovering from an esophagogastroduodenoscopy (EGD). Which of the following client symptoms would require further nursing assessment?
Abdominal distention
Which of the following is the primary function of the small intestine?
Absorption
The nurse is preparing the client for an assessment of the abdomen. What should the nurse complete prior to this assessment?
Ask the client to empty the bladder.
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?
Atrophy of the gastric mucosa
The nurse is performing a focused abdominal assessment of a client with a history of bowel obstruction. The nurse has positioned the client appropriately and inspected the client's abdomen carefully. What action should the nurse perform next?
Auscultate the client's abdomen
When assisting with preparing a client scheduled for a barium swallow, which of the following would be appropriate to include?
Avoid smoking for at least 12 to 24 hours before the procedure.
Which of the following is the most definitive means of assessing for liver disease?
Biopsy
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?
Black
A patient is scheduled for a fiberoptic colonoscopy. What does the nurse know that fiberoptic colonoscopy is most frequently used to diagnose?
Cancer
The nurse prepares a client for a barium enema. The nurse should place the client on which diet prior to the procedure?
clear liquids day before
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?
Pentagastrin
A client is scheduled for an ultrasound of the abdomen. Which statement indicates that teaching provided to the client to prepare for the test was effective?
"I will not eat or drink for 8 to 12 hours before the test."
Which of the following is an enzyme secreted by the gastric mucosa?
Pepsin
A client with abdominal pain is scheduled for a CT scan of the abdomen with contrast. Which assessment will the nurse complete before transporting the client for the diagnostic test?
History of allergies
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
The nurse is working on a general medical unit. A client is scheduled for an upper gastrointestinal series. Upon return to the nursing unit, what does the nurse identify as the client goal?
Increase the amount of fluids
A client is scheduled for an upper gastrointestinal barium study. Which teaching will the nurse provide for the client to prepare for this diagnostic test?
Ingest nothing by mouth after midnight.
The nurse is preparing to examine the abdomen of a client with reports of nausea and vomiting. What action would the nurse perform first?
Inspection
The nurse is assessing the abdomen of the client with an undiagnosed disorder. In which sequence would the nurse conduct the abdominal assessment? Use all options.
Inspection Auscultation Percussion Palpation
A focused GI assessment begins with a complete history and physical examination. Identify the quadrant of the abdomen to be palpated or percussed for a patient with pancreatitis.
Left upper
After 20 seconds of auscultating for bowel sounds on a client recovering from abdominal surgery, the nurse hears nothing. What should the nurse do based on the assessment findings?
Listen longer for the sounds.
Swallowing is regulated by which area of the central nervous system (CNS)?
Medulla oblongata
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?
Monitoring the stool passage and its color.
What part of the GI tract begins the digestion of food?
Mouth
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?
Pancreas
A group of students are studying for an examination on the gastrointestinal (GI) system and are reviewing the structures of the esophagus and stomach. The students demonstrate understanding of the material when they identify which of the following as the opening between the stomach and duodenum?
Pyloric sphincter
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?
Serum antibodies for H. pylori
The instructor has just finished 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 structure as possibly being affected?
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?
Supine with knees flexed
What would the nurse recognize as preventing a client from being able to take a fecal occult blood test (FOBT)?
The client has hemorrhoidal bleeding
The nurse is providing instructions to a client scheduled for a gastroscopy. What should the nurse be sure to include in the instructions? Select all that apply.
The client must fast for 8 hours before the examination. The throat will be sprayed with a local anesthetic. After gastroscopy, the client cannot eat or drink until the gag reflex returns (1 to 2 hours).
The nurse assesses bowel sounds and hears one to two bowel sounds in 2 minutes. How should the nurse document the bowel sounds?
hypoactive
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?
Colonoscopy
The nurse is preparing to educate a group of students on a gastrointestinal assessment. Which common condition will the nurse assess for in the client with gastrointestinal disorder?
Dyspepsia
The nurse is investigating a client's report of pain in the duodenal area. Where should the nurse perform the assessment?
Epigastric area and consider possible radiation of pain to the right subscapular region
A client tells the nurse that the stool was colored yellow. The nurse assesses the client for
recent foods ingested.
When gastric analysis testing reveals excess secretion of gastric acid, the nurse recognizes which medical diagnoses is supported?
duodenal ulcer
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?
duodenum
Which response is a parasympathetic response in the GI tract?
increased peristalsis
The nurse prepares to administer the lavage solution to a client having a colonoscopy completed. The nurse stops and notifies the physician when noting that the client has which condition?
inflammatory bowel disease
The nurse performs an abdominal assessment. The nurse should perform the assessment in which order?
inspection, auscultation, percussion, palpation
Which enzyme aids in the digestion of protein?
trypsin
The nurse recognizes which change of the GI system is an age-related change?
weakened gag reflex
The nurse recognizes which change of the gastrointestinal system is an age-related change?
weakened gag reflex
The nurse is assisting the health care provider with a colonoscopy for a client with rectal bleeding. The health care provider requests the nurse to administer glucagon during the procedure. Why is the nurse administering this medication during the procedure?
To relax colonic musculature and reduce spasm.
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?
The pancreas secretes digestive enzymes.