Prep U 44 (Simple questions)

A nurse is doing a physical assessment on a client with a GI disorder. Which position will the nurse most likely ask the client to assume when performing an abdominal examination? A. supine with knees flexed B. supine with knees flexed slightly C. supine with legs flat on the exam table D. side-lying

A R: The client should lie in a supine position with knees flexed slightly to assist in relaxing the abdominal muscles.

Cancer of the esophagus is most often diagnosed by which of the following? A. Fluoroscopy B. Esophagogastroduodenoscopy (EGD) with biopsy and brushings C. X-ray D. Barium swallow

B R: Currently, diagnosis is confirmed most often by EGD with biopsy and brushings. The biopsy can be used to determine the presence of disease and cell differentiation. X-ray, barium swallow, and fluoroscopy are used in the diagnosis of hiatal hernia.

The nurse is conducting education relating to test preparation for a patient scheduled to undergo an abdominal ultrasonography. The nurse instructs the patient to do which of the following? A. Do not consume anything sweet for 24 hours before the test. B. Avoid exposure to sunlight for at least 6 to 8 hours before the test. C. Do not undertake any strenuous exercise for 24 hours before the test. D. Restrict eating of solid food for 8 to 12 hours before the test.

D

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. Red B. Green C. Dark brown D. Black

D R: Ingestion of iron can cause the stool to turn black. Meat protein causes stool to appear dark brown. Ingestion of large amounts of spinach may turn stool green while ingestion of carrots and beets may cause stool to turn red.

Which of the following is an enzyme secreted by the gastric mucosa? A. Bile B. Ptyalin C. Trypsin D. Pepsin

D R:Pepsin is secreted by the gastric mucosa. Trypsin is secreted by the pancreas. The salivary glands secrete ptyalin. The liver and gallbladder secrete bile.

An examiner is performing the physical assessment of the rectum, perianal region, and anus. While this examination can be uncomfortable for many clients, health care providers must approach it in a prepared, confident manner. Which of the following considerations will help this examination flow smoothly and efficiently for both provider and client? Select all that apply. A. Cleanse gloved fingers with water to allow for easy insertion. B. Position the client on the right side with the knees up to the chest. C. Ask the client to bear down for visual inspection. Dim the lights to decrease the client's embarrassment. D. Ask the client to produce a bowel movement after the procedure.

B, C R: While examination of the rectum, perineum, and anus may be uncomfortable for the client, it is necessary for a thorough examination. The examiner will position the client on the right side with the knees up. He or she will use a gloved finger lubricated with a water-soluble lubricant for ease of insertion. The health care provider will encourage deep breathing during the procedure and ask the client to bear down while inspecting the anal area. The examination requires appropriate lighting for thorough inspection.

When preparing a client for magnetic resonance imaging (MRI) of the abdomen, which statement would indicate the need to notify the physician? A. "I haven't had anything to eat or drink since midnight last night." B. "I brought earphones to shut out the loud noise." C. "I left all my jewelry and my watch at home." D. "I really don't like to be in small, enclosed spaces."

D R: An MRI scanner is a narrow, tunnel-like machine that will enclose the client during the test. Clients who are claustrophobic (fear enclosed spaces) may need sedation because it is imperative that they lie still and not panic during the test. Therefore, the nurse should notify the physician about the client's statement. Typically, the client is NPO for 6 to 8 hours before the test, and he or she must remove any metal objects, credit cards, jewelry, and watch before the test. The machine makes loud repetitive noises while the test is in progress, so earphones may be helpful.

A nurse is teaching a client with malabsorption syndrome about the disorder and its treatment. The client asks which part of the GI tract absorbs food. The nurse tells the client that products of digestion are absorbed mainly in the: A. small intestine. B. stomach. C. large intestine. D. rectum.

A R: The small intestine absorbs products of digestion, completes food digestion, and secretes hormones that help control the secretion of bile, pancreatic juice, and intestinal secretions. The stomach stores, mixes, and liquefies the food bolus into chyme and controls food passage into the duodenum; it doesn't absorb products of digestion. Although the large intestine completes the absorption of water, chloride, and sodium, it plays no part in absorbing food. The rectum is the portion of the large intestine that forms and expels feces from the body; its functions don't include absorption.

The nurse in the ED admits a patient with suspected gastric outlet obstruction. The patient's symptoms include nausea and vomiting. The nurse anticipates that the physician will issue which of the following orders? A. Pelvic x-ray B. Nasogastric (NG) tube insertion C. Oral contrast D. Stool specimen

B R: The nurse anticipates an order for NG tube insertion to decompress the stomach. Pelvic x-ray, oral contrast, and stool specimens are not indicated at this time.

Which diagnostic test is used first to evaluate a client with upper GI bleeding? A. Endoscopy B. Hemoglobin levels and hematocrit (HCT) C. Arteriography D. Upper GI series

B R: Hemoglobin and HCT are typically performed first in clients with upper GI bleeding to evaluate the extent of blood loss. Endoscopy is then performed to directly visualize the upper GI tract and locate the source of bleeding. An upper GI series, or barium study, usually isn't the diagnostic method of choice, especially in a client with acute active bleeding who's vomiting and unstable. An upper GI series is also less accurate than endoscopy. Although an upper GI series might confirm the presence of a lesion, it wouldn't necessarily reveal whether the lesion is bleeding. Arteriography is an invasive study associated with life-threatening complications and wouldn't be used for an initial evaluation.

Which of the following diagnostics is used to identify malignant cells associated with esophageal cancer? A. Magnetic resonance imaging (MRI) B. Positron emission tomography (PET) C. Endoscopic ultrasound D. Computed tomography (CT)

B R:PET specifically assesses the metabolism of the cells being imaged, so that malignant cells can be identified. MRI, CT, and endoscopic ultrasound may also provide useful information.

When examining the abdomen of a client with complaints of nausea and vomiting, which of the following would the nurse do first? A. Auscultation B. Percussion C. Inspection D. Palpation

C R: When assessing the abdomen, the nurse would first inspect or observe the abdomen. This would be followed by auscultation, percussion, and lastly, palpation.

Which of the following is true statement regarding older patients, considering the age-related effects on their GI system? A. They tend to have increased muscle tone and mass. B. They have no awareness of the filling reflex. C. They tend usually to have less control of the rectal sphincter. D. They tend to have higher physiologic reserves to compensate for fluid loss.

C R:Older adults tend to have fewer physiologic reserves to compensate for fluid loss. The older adult usually has less control of the rectal sphincter than a younger adult because of age-related changes in innervations, a diminished awareness of the filling reflex, and decreased muscle tone.

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. Instruct the client to have low-residue meals. B. Allow the client to ingest fat-free meal. C. Provide saline gargles to the client. D. Permit the client to drink only clear liquids.

D R:After polyethylene glycol/electrolyte solution is administered, the client should have clear liquids because this ensures watery stools, which are necessary for procedures like a barium enema. Allowing the client to ingest a fat-free meal is used in preparation for oral cholecystography. Instructing the client to have low-residue meals is a pretest procedure for barium enema. A client is offered saline gargles after esophagogastroduodenoscopy.

A physician suspects that a client has peptic ulcer disease. With which of the following diagnostic procedures would the nurse most likely prepare to assist? A. Stool antigen test B. Endoscopy C. Gastric secretion study D. Barium study of the upper gastrointestinal tract

B R:Barium study of the upper GI tract may show an ulcer; however, endoscopy is the preferred diagnostic procedure because it allows direct visualization of inflammatory changes, ulcers, and lesions. Through endoscopy, a biopsy of the gastric mucosa and of any suspicious lesions can be obtained. Endoscopy may reveal lesions that, because of their size or location, are not evident on x-ray studies. Less invasive diagnostic measures for detecting H. pylori include serologic testing for antibodies against the H. pylori antigen, stool antigen test, and urea breath test.