Digestive Exam

The nurse is irrigating a colostomy. The catheter should be advanced into the stoma _______to______ inches.

2;3

If detected early, prior to lymph node involvement, the 5 year survival rate for oral cancer is __________ percent.

60

A client returns to the unit after a neck dissection. The surgeon placed a Jackson--Pratt drain in the wound. When assessing the wound drainage over the first 24 postoperative hours the nurse would notify the physician immediately for what finding?

60 ml of milky or cloudy drainage

A highly reliable blood study used to diagnose appendicitis

CEA

Another name for regional enteritis

Crohn's disease

The nurse is caring for a client scheduled for a colonoscopy. The nurse should assist the client into what position during this diagnostic test?

Lying on the left side with legs drawn toward the chest

The most common site for cancer of the oral cavity is the _______.

Mouth

Digests carbohydrates & helps form fructose

Sucrase

Intravenous nutrition used for inflammatory bowel disease

TPN

Helps convert protein into amino acids

Trypsin

A nurse is caring for a newly admitted client with a suspected GI bleed. The nurse assesses the client's stool after a bowel movement and notes it to be a tarry-black color. This finding is suggestive of bleeding from what location?

Upper Gi tract

straining at stool

Valsalva maneuver

Common clinical manifestations of Crohn's disease are ____________ and ___________.

abdominal pain; diarrhea

A food to avoid with an ileostomy

celery

The most common site for peptic ulcer formation is the

duodenum

The most common site for the presence of diverticulitis is the _____________.

sigmoid

A client with a diagnosis of peptic ulcer disease has just been prescribed omeprazole. How should the nurse best describe this medication's therapeutic action?

this medication will reduce the amount of acid secreted in your stomach"

Moss

triple lumen nasogastric tube that also has a duodenal lumen for postperative feedings

A client with gastritis required hospital treatment for an exacerbation of symptoms and receives a subsequent diagnosis of pernicious anemia due to malabsorption. When planning the client's continuing care in the home setting, what assessment question is most relevant?

"Does anyone in your family have experience at giving injections?"

The management of the client's gastrostomy is an assessment priority for the home care nurse. What statement would indicate that the client is managing the tube correctly?

"I flush my tube with water before and after each of my medications"

A nurse is providing preprocedure education for a client who will undergo a lower GI tract study the following week. What should the nurse teach the client about bowel preparation?

"You'll need to have enemas the day before the test"

A client has been brought to the emergency department with abdominal pain and is subsequently diagnosed with appendicitis. The client is scheduled for an appendectomy but questions the nurse about how his health will be affected by the absence of an appendix. How should the nurse best respond?

"Your appendix doesn't play a major role, so you won't notice any difference after your recovery from surgery"

A nurse is caring for a client with constipation whose primary provider has recommended senna (Senokot) for the management of this condition. The nurse should provide which of the following education points?

"avoid taking the drug on a long-term basis"

A client comes to the clinic reporting pain in the epigastric region. What statement by the client suggests the presence of a duodenal ulcer?

"my pain resolves when when I have something to eat"

The stomach, in which derives it's acidity from hydrochloric acid, has a pH of approximately _______________.

1.0

The recommended dietary intake of fiber is ____________ g/day. This intake, along with 1.5 to 2 L of fluids daily, should prevent constipation that occurs with fewer than __________ bowel movements per week.

25-30; 3

A nasally placed feeding tube is for short term use and should stay in place for no more than ______ weeks before being replaced with a new tube.

4

Peptic ulcers occur with the most frequency in those between the ages of ________ and ___________years.

40;60

It takes _______ hours after eating for food to pass into the terminal ileum. It takes _______ hours for food to reach & distend the rectum.

4;12

Preventitive orhtodontics for malocclusion can start as early as age _________.

5

chemotherapeutic agent used to treat colon cancer

5-FU

A client has come to the clinic complaining of blood in his stool. A FOBT test is performed but is negative. Based on the client's history, the health care provider suggests a colonoscopy, but the client refuses, citing a strong aversion to the invasive nature of the test. What other test might the provider order to check for blood in the stool?

A fecal immunologic test (FIT)

The nurse is caring for a client with a duodenal ulcer and is relating the client's symptoms to the physiologic functions of the small intestine. What do these functions include? Select all that apply.

Absorption of nutrients, movement of nutrients into the bloodstream, secretion of mucus

A client's colorectal cancer has necessitated a hemicolectomy with the creation of a colostomy. In the 4 days since the surgery, the client has been unwilling to look at the ostomy or participate in any aspects of ostomy care. What is the nurse's most appropriate response to this observation?

Acknowledge the client's reluctance and initiate discussion of the factors underlying it

White overgrowth of horny layer of epidermis

Actinic cheilitis

Facilitates the production of dextrins and maltose

Amylase

_______________, which is secreted by the gallbladder, is responsible for fat emulsification.

Bile

Reddend circumscribed lesion that ulcerates and becomes encrusted

Chancre

A nurse is performing an abdominal assessment of an older adult client. When collecting and analyzing data, the nurse should be cognizant of what age-related change in gastrointestinal structure and function?

Decreased mucus secretion

Gastric (Salem) Sump

Double lumen, plastic nasogastric tube about 20 cm in length

The most common bacteria associated with peritonitis

E. coli

A tubular fibrous tract that extends from an opening beside the anus into the anal canal

Fistula

_________________ are of value in diagnosing ZES and achlorhydria, hypochlorhydria, or hyperchlorhydria.

Gastric secretory studies

An emergency department nurse is admitting a 3-year-old brought in after swallowing a piece from a wooden puzzle. The nurse should anticipate the administration of what medication in order to relax the esophagus to facilitate removal of the foreign body?

Glucagon

White patches with rough, hairlike projections usually found on the tongue

Hairy Leukoplakia

A client asks the nursing assistant for a bedpan. When the client is finished, the nursing assistant notifies the nurse that the client has bright red streaking of blood in the stool. The nurse's assessment should focus on what potential cause?

Hemorrhoids

A client presents at the ambulatory clinic reporting recurrent sharp stomach pain that is relieved by eating. The nurse suspects that the client may have an ulcer. How should the nurse explain the formation and role of acid in the stomach to the client?

Hydrochloric acid is secreted by glands

A client who has been experiencing changes in his bowel function is scheduled for a barium enema. What instruction should the nurse provide for postprocedure recovery?

Increase fluid intake to evacuate the barium

The nurse is preparing to perform a client's abdominal assessment. What examination sequence should the nurse follow?

Inspection, auscultation, percussion, and palpation

Helps form galactose

Lactase

The most popular over-the-counter medication purchased in the US.

Laxatives

Hyperkeratotic white patches usually in buccal mucosa

Leukoplakia

Nasoenteric feeding tube about 6 ft. in length

Levin tube

Ulcerated and painful, white papules

Lichen planus

A client has been diagnosed with a small bowel obstruction and has been admitted to the medical unit. The nurse's care should prioritize which of the following outcomes?

Maintaining fluid and electrolyte balance

Glucose is a product of this enzyme's action

Maltase

Dilated and atonic colon caused by fecal mass

Megacolon

_________ or ________ feeding is indicated when the esophagus and stomach need to be bypassed or when the patient is at risk for aspiration.

Nasoduodenal; nasojejunal

A nurse is promoting increased protein intake to enhance a client's wound healing. What is the enzyme that will initiate the digestion of the protein that the client consumes?

Pepsin

Digests protein and helps form polypeptides

Pepsin

The most common complication of colon cancer

Peritonitis

A client has been scheduled for a urea breath test in 1 month's time. What nursing diagnosis most likely prompted this diagnostic test?

Risk for impaired skin integrity related to peptic ulcers

Triple-lumen, rubber nasogastric tube (2 lumens are used to inflate the gastric & esophageal balloons)

Sengstaken Blakemore

Dobbhoff or EnteraFlo

Single lumen, plastic nasogastric tube about 20 cm in length

A nurse is caring for an 83-year-old client who is being assessed for recurrent and intractable nausea. What age-related change to the GI system may be a contributor to the client's health complaint?

Stomach emptying takes place more slowly

A disorder of malabsorption that inactivates pancreatic enzymes is ___________.

Zollinger Ellison Syndrome

A nurse who provides care in an ambulatory clinic integrates basic cancer screening into admission assessments. What client most likely faces the highest immediate risk of oral cancer?

a 65 year old man with alcoholism who smokes

A client has come to the clinic reporting pain just above her umbilicus. When assessing the client, the nurse notes Sister Mary Joseph's nodules. The nurse should refer the client to the primary provider to be assessed for what health problem?

a GI malignancy

A nurse is conducting health screening with a diverse group of clients. Which client likely has the most risk factors for developing hemorrhoids?

a pregnant woman at 28 weeks gestation

A nurse is caring for a client who has been admitted to the hospital with diverticulitis. What would be appropriate nursing diagnoses for this client? Select all that apply.

activity intolerance, acute pain related to increased peristalsis and GI inflammation, deficient fluid volume related to anorexia, nausea, and diarrhea

A nurse is caring for a client admitted with symptoms of an anorectal infection; cultures indicate that the client has a viral infection. The nurse should anticipate the administration of what drug?

acyclovir

The majority of large bowel obstructions are caused by _____________.

adenocaranoid tumors

The three most common causes of small bowel obstruction are ________, _________, and _____________.

adhesions; hernias; neoplasms

A community health nurse is preparing for an initial home visit to a client discharged following a total gastrectomy for treatment of gastric cancer. What would the nurse anticipate that the plan of care is most likely to include?

administration of injections of vitamin B12

A client's health history is suggestive of inflammatory bowel disease. Which of the following would suggest Crohn's disease, rather that ulcerative colitis, as the cause of the client's signs and symptoms?

an absence of blood in stool

A community health nurse serves a diverse population. What individual would likely face the highest risk for parotitis?

an older adult whose medication regimen includes anticholinergic

A client has been diagnosed with peptic ulcer disease and the nurse is reviewing his prescribed medication regimen with him. What is the client's drug regimen most likely to consist of?

antibiotics, proton pump inhibitors, and bismuth salts

The nurse is providing care for a client whose inflammatory bowel disease has necessitated hospital treatment. Which of the following would most likely be included in the client's medication regimen?

antidiarrheal medications 30 minutes before a meal

A common lesion of the mouth that is also referred to as a "canker sore" is:

aphthous stomatitis

The nurse is assessing a client with has a percutaneous endoscopic gastrostomy (PEG) tube in place. On inspection, the nurse observes moist, white patches on the skin below the external retention bolster. What is the nurse's best action?

apply an antifungal ointment as prescribed

An older adult who resides in an assisted living facility has sought care from the nurse because of recurrent episodes of constipation. Which of the following actions should the nurse first perform?

assess the client's food and fluid intake

A radial graft is planned in the treatment of a client's oropharyngeal cancer. In order to ensure that the surgery will be successful, the care team must perform what assessment prior to surgery?

assessing the patency of the ulnar artery

A nurse is providing health promotion education to a client diagnosed with an esophageal reflux disorder. What practice should the nurse encourage the client to implement?

avoid carbonated beverages

A client with a peptic ulcer disease has had metronidazole added to his current medication regimen. What health education related to this medication should the nurse provide?

avoid drinking alcohol while taking the drug

An adult client with a history of dyspepsia has been diagnosed with chronic gastritis. The nurse's health education should include what guidelines? Select all that apply.

avoid non-steroidal anti-inflammatories, avoid drinking alcohl

The nurse is providing care for a client who has recently been diagnosed with chronic gastritis. What health practice should the nurse address when teaching the client to limit exacerbations of the disease?

avoid taking aspirin to treat pain or fever

A nurse is caring for a client who has just had a rigid fixation of a mandibular fracture. When planning the discharge teaching for this client, what would the nurse be sure to include?

avoiding chewing food for the specified number of weeks after surgery

Intestinal rumbling

borborygmus

A nurse is providing oral care to a client who is comatose. What action best addresses the client's risk of tooth decay and plaque accumulation?

brushing the client's teeth with a toothbrush and small amount of toothpaste

Shallow ulcer with a red border & white or yellow center

canker sore

The stomach has four antatomic regions: ________, ____________, __________, and pylorus.

cardia, fundus, body, pylorus

Reflux of food into the esophagus from the stomach is prevented by contraction of the _____________.

cardiac sphincter

Peridontal disease can be linked to a variety of the systemic diseases, such as ____________, ______________, and _______.

cardiovascular disease; diabetes; rheumatoid disease

A nurse is teaching a group of adults about screening and prevention of colorectal cancer. The nurse should describe which of the following as the most common sign of possible colon cancer?

change in bowel habbits

The nurse is administering total parenteral nutrition (TPN) to a client who underwent surgery for gastric cancer. Which of the nurse's assessments most directly addresses a major complication of TPN?

checking the client's capillary blood glucose levels regularly

A nurse is providing care for a client who has a diagnosis of irritable bowel syndrome (IBS). When planning this client's care, the nurse should collaborate with the client and prioritize what goal?

client will accurately identify foods that trigger symptoms

The most common bacteria found in antibiotic associated diarrhea is ______________.

clostridium difficile

A nurse is working with a client who has chronic constipation. What should be included in client teaching to promote normal bowel function?

consume high-residue, high fiber foods

Reddened area or rash associated with itching

contact dermatitis

A nurse is preparing to administer a client's scheduled parenteral nutrition (PN). Upon inspecting the bag, the nurse notices that small amounts of white precipitate are present in the bag. What is the nurse's best action?

contact the pharmacy to obtain a new bag of PN

A client admitted with acute diverticulitis has experienced a sudden increase in temperature and reports a sudden onset of exquisite abdominal tenderness. The nurse's rapid assessment reveals that the client's abdomen is uncharacteristically rigid on palpation. What is the nurse's best response?

contact the primary provider promptly and report these signs of perforation

Another food to avoid for a patient with an ileostomy

corn

Structural changes in the esophagus that occur as the result of age-related changes include: ____________, ___________, and _____________.

decreased motility and emptying; weakened gag reflex; decreased resting pressure of the lower sphincter

A client with gastric cancer has been scheduled for a total gastrectomy. During the pre-operative assessment, the client confides in the nurse that she feels like she will be "mutilated by the surgery." The nurse should plan interventions that address what nursing diagnosis?

deficient knowledge related to risks and expectations of surgery

Prior to a client's scheduled jejunostomy, the nurse is performing the preoperative assessment. What goal should the nurse prioritize during the preoperative assessment?

determining the client's ability to understand and cooperate with the procedure

A client is receiving education about his upcoming Billroth I procedure (gastroduodenostomy). This client should be informed that he may experience which of the following adverse effects associated with this procedure?

diarrhea and feelings of fullness

A client with cystic fibrosis takes pancreatic enzyme replacements on a regular basis. The client's intake of trypsin facilitates what aspect of GI function?

digestion of proteins

A nurse is assessing a client's stoma on postoperative day 3. The nurse notes that the stoma has a shiny appearance and a bright red color. How should the nurse best respond to this assessment finding?

document that the stoma appears healthy and well perfused

The nurse is assessing a client who had an ileostomy created three days ago for the treatment of irritable bowel disease. The nurse observes that the client's stoma is bright red and there are scant amounts of blood on the stoma. What is the nurse's best action?

document these expected assessment findings

A client has been prescribed cimetidine for the treatment of peptic ulcer disease. When providing relevant health education for this client, the nurse should ensure the client is aware of what potential adverse effect?

drug-drug interactions

A nurse is addressing the prevention of esophageal cancer in response to a question posed by a participant in a health promotion workshop. What action should the nurse recommend as having the greatest potential to prevent esophageal cancer?

early diagnosis and treatment of gastroesophageal reflux disease

The nurse is caring for a client who has developed dumping syndrome while recovering from a gastrectomy. What recommendation should the nurse make to the client?

eat several small meals daily spaced at equal intervals

A client has received a diagnosis of gastric cancer and is awaiting a surgical date. During the preoperative period, the client should adopt what dietary guidelines?

eat small, frequent meals with high calorie and vitamin content

Another term for fecal matter

effluent

A nurse is caring for a client who is postoperative from a neck dissection. What would be the most appropriate nursing action to enhance the client's appetite?

encourage the family to bring in the client's favored foods

A nurse is providing care for a client whose recent colostomy has contributed to a nursing diagnosis of Disturbed Body Image Related to Colostomy. What intervention best addresses this diagnosis?

engage the client in dialogue about the implications of having the colostomy

A nurse is caring for a client who has had surgery for oral cancer. When addressing the client's long-term needs, the nurse should prioritize interventions and referrals with what goal?

enhancement of verbal communication

A client has received treatment for oral cancer. The combination of medications and radiotherapy has resulted in leukopenia. What is the nurse's best response to this change in health status?

ensure that none of the client's visitors have an infection

A client's enteral feedings have been determined to be too concentrated based on the client's development of dumping syndrome. What physiologic phenomenon caused this client's complication of enteral feeding?

entry of large amounts of water into the small intestine because of osmotic pressure

A nurse is caring for a client in the late stages of esophageal cancer. The nurse should plan to prevent or address what characteristics of this stage of the disease? Select all that apply.

erosion into the great vessels, obstruction of the esophagus, perforation into the mediastinum

A nurse is caring for a client who just has been diagnosed with a peptic ulcer. When teaching the client about his new diagnosis, how should the nurse best describe it?

erosion of the lining of the stomach or intestine

A client was treated in the emergency department and critical care unit after ingesting bleach. What possible complication of the resulting gastritis should the nurse recognize?

esophageal or pyloric obstruction related to scarring

A nurse has obtained an order to remove a client's NG tube that was placed for feeding. What is the nurse's best initial action?

explain the process clearly to the client

The nurse is caring for a client who is undergoing diagnostic testing for suspected malabsorption. When taking this client's health history and performing the physical assessment, the nurse should recognize what finding as most consistent with this diagnosis?

foul smelling diarrhea that contains fat

A client with a diagnosis of colon cancer is 2 days postoperative following bowel resection and anastomosis. The nurse has planned the client's care in the knowledge of potential complications. What assessment should the nurse prioritize?

frequent abdominal ausculatation

A client has been experiencing disconcerting GI symptoms that have been worsening in severity. Following medical assessment, the client has been diagnosed with lactose intolerance. The nurse should recognize an increased need for what form of health promotion?

frequent screening for osteoporosis

The nurse is caring for a client who is postoperative from having a gastrostomy tube placed. What should the nurse do on a daily basis to prevent skin breakdown?

gently rotate the tube

Painful, inflamed, swollen gums

gingivitis

The major carbohydrate that tissues use for fuel is _________.

glucose

The most common complication of peptic ulcer disease that occurs in 10% to 20% of patients is ___________.

hemorrhage

A nurse is providing care for a client who is postoperative day 2 following gastric surgery. The nurse's assessment should be planned in light of the possibility of what potential complications? Select all that apply.

hemorrhage, pneumonia, atelectasis

_______________, _____________________, _________________, and _____________ are some of the major potential complications of a peptic ulcer.

hemorrhage; perforation; penetration; pyloric obstruction

A clinic client has described recent dark-colored stools and the nurse recognizes the need for fecal occult blood testing (FOBT). What aspect of the client's current health status would contraindicate FOBT?

hemorrhoids

A client is scheduled for the creation of a continent ileostomy. What dietary guidelines should the nurse encourage during the weeks following surgery?

high intake of strained fruits and vegetables

A nurse is presenting an educational event to a local community group. When speaking about colorectal cancer, what risk factor should the nurse cite?

high levels of alcohol consumption

A nurse is creating a care plan for a client who is receiving parenteral nutrition. The client's care plan should include nursing actions relevant to what potential complications? Select all that apply.

hyperglycemia, clotted or displaced catheter, pneumothorax, line sepsis

The use of nonsteroidal anti-inflammatory drugs such as __________ and _______ is a major risk factor for peptic ulcer.

ibuprofen; aspirin

A nurse is caring for a client who is acutely ill and has included vigilant oral care in the client's plan of care. What factor increases this client's risk for dental caries?

inadequate nutrition and decreased saliva production can cause cavities

An adult client has been diagnosed with diverticular disease after ongoing challenges with constipation. The client will be treated on an outpatient basis. What components of treatment should the nurse anticipate? Select all that apply.

increased fiber intake, reduced fat intake

During a client's scheduled home visit, an older adult client has stated to the community health nurse that she has been experiencing hemorrhoids of increasing severity in recent months. The nurse should recommend which of the following?

increased fluid and fiber intake

A medical nurse who is caring for a client being discharged home after a radical neck dissection has collaborated with the home health nurse to develop a plan of care for this client. What is a priority psychosocial outcome for this client?

indicates acceptance of altered appearance and demonstrates positive self-image

A nurse is caring for a client who is receiving parenteral nutrition. When writing this client's plan of care, which of the following nursing diagnoses should be included?

ineffective role performance related to parenteral nutrition

Which of the following is the most plausible nursing diagnosis for a client whose treatment for colon cancer has necessitated a colostomy?

ineffective sexuality patterns related to changes in self concept

A nurse is providing care for a client whose neck dissection surgery involved the use of a graft. When assessing the graft, the nurse should prioritize data related to what nursing diagnosis?

ineffective tissue perfusion

A client is admitted to the medical unit with a diagnosis of intestinal obstruction. When planning this client's care, which of the following nursing diagnoses should the nurse prioritize?

ineffective tissue perfusion related to bowel ischemia

A nurse is assessing a client who has peptic ulcer disease. The client requests more information about the typical causes of Helicobacter pylori infection. What would it be appropriate for the nurse to instruct the client?

infection typically occurs due to ingestion of contaminated food and water

A client presents to the clinic reporting vomiting and burning in her mid-epigastria. The nurse knows that in the process of confirming peptic ulcer disease, the health care provider is likely to order a diagnostic test to detect the presence of what?

infection with Helicobacter pylori

A client has experienced symptoms of dumping syndrome following gastric surgery. To what physiologic phenomenon does the nurse attribute this syndrome?

influx of extracellular fluid into the small intestine

The nurse is caring for a client who has a diagnosis of AIDS. Inspection of the client's mouth reveals the new presence of white lesions on the client's oral mucosa. What is the nurse's most appropriate response?

inform the primary provider of this finding

A nurse is preparing to place a client's prescribed nasogastric tube. What anticipatory guidance should the nurse provide to the client?

insertion is likely to cause some gagging

A 35-year-old male client presents at the emergency department with symptoms of a small bowel obstruction. In collaboration with the primary provider, what intervention should the nurse prioritize?

insertion of a nasogastric tube

A client has been admitted to the hospital after diagnostic imaging revealed the presence of a gastric outlet obstruction (GOO). What is the nurse's priority intervention?

insertion of an NG tube for decompression

A client is undergoing diagnostic testing for a tumor of the small intestine. What are the most likely symptoms that prompted the client to first seek care?

intermittent pain and bloody stool

The two diseases of the colon that are commonly associated with constipation are _____________ and _____________.

irritable bowel syndrome; diverticular disease

A nurse is providing client education for a client with peptic ulcer disease secondary to chronic nonsteroidal anti-inflammatory drug (NSAID) use. The client has recently been prescribed misoprostol. What would the nurse be most accurate in informing the client about the drug?

it protects the stomach's lining

A client receiving tube feedings is experiencing diarrhea. The nurse and the health care provider suspects that the client is experiencing dumping syndrome. What intervention is most appropriate?

keep the client in semi-fowlers position for 1 hour after feedings

Results of a client barium swallow suggest that the client has GERD. The nurse is planning health education to address the client's knowledge of this new diagnosis. Which of the following should the nurse encourage?

keeping the head of the bed partially elevated

When giving an initial tube feeding, the nurse would be looking for _________ around the tube site on the abdomen.

leakage of fluid

A staff educator is reviewing the causes of gastroesophageal reflux disease (GERD) with new staff nurses. What area of the GI tract should the educator identify as the cause of reduced pressure associated with GERD?

lower esophageal sphincter

A nurse is talking with a client who is scheduled to have a hemicolectomy with the creation of a colostomy. The client admits to being anxious, and has many questions concerning the surgery, the care of a stoma, and necessary lifestyle changes. What nursing action is most appropriate?

maintain an open dialogue with the client and facilitate a referral to the wound ostomy continence nurse

A client is recovering in the hospital following gastrectomy. The nurse notes that the client has become increasingly difficult to engage and has had several angry outbursts at staff members in recent days. The nurse's attempts at therapeutic dialogue have been rebuffed. What is the nurse's most appropriate action?

make appropriate referrals to services that provide psychosocial support

A client has a gastrostomy tube that has been placed to drain stomach contents by low intermittent suction. What is the nurse's priority during this aspect of the client's care?

measure and record drainage

A nurse is caring for clients in a stroke rehabilitation facility. Damage to what area of the brain will most affect a client's ability to swallow?

medulla oblongata

Chyme, partially digested food that is mixed with gastic contents, stimulates segmented contractions, which are ___________ & intestinal peristalsis, which is ____________.

mixed waves/churning motion; a movement that propels the contents of the small intestine toward the colon

A client who underwent a gastric resection 3 weeks ago is having her diet progressed on a daily basis. Following her latest meal, the client reports dizziness and palpitations. Inspection reveals that the client is diaphoretic. What is the nurse's best action?

monitor the client closely for further signs of dumping syndrome

Digestion normally begins in the _____.

mouth

A client's physician has determined that for the next 3 to 4 weeks the client will require parenteral nutrition (PN). The nurse should anticipate the placement of what type of venous access device?

nontunneled central catheter

A nurse is caring for a client who has a diagnosis of GI bleed. During shift assessment, the nurse finds the client to be tachycardic and hypotensive, and the client has an episode of hematemesis while the nurse is in the room. In addition to monitoring the client's vital signs and level of conscious, what would be a priority nursing action for this client?

notify the health care provider

An elderly client comes into the emergency department reporting an earache. The client and has an oral temperature of 37.9° (100.2ºF) and otoscopic assessment of the ear reveals a pearly gray tympanic membrane with no evidence of discharge or inflammation. Which action should the triage nurse take next?

palpate the client's parotid glands to detect swelling and tenderness

Mumps, a viral infection affecting children, is usually an inflammation of the _____ gland.

parotid

An advanced practice nurse is assessing the size and density of a client's abdominal organs. If the results of palpation are unclear to the nurse, what assessment technique should be implemented?

percussion

Prokinetic agents can be administered to facilitate _________ movement of the feeding tube into the duodenum.

peristaltic

Diagnostic imaging and physical assessment have revealed that a client with peptic ulcer disease has suffered a perforated ulcer. The nurse recognizes that emergency interventions must be performed as soon as possible in order to prevent the development of what complication?

peritonitis

A client has undergone surgery for oral cancer and has just been extubated in postanesthetic recovery. What nursing action best promotes comfort and facilitates spontaneous breathing for this client?

placing the client in fowler position

A client who underwent surgery for esophageal cancer is admitted to the critical care unit following postanesthetic recovery. What should the nurse include in the client's immediate postoperative plan of care?

positioning the client to prevent gastric reflux

A nurse is caring for an older adult who has been experiencing severe Clostridium difficile-related diarrhea. When reviewing the client's most recent laboratory tests, the nurse should prioritize what finding?

potassium level

A nurse is admitting a client to the postsurgical unit following a gastrostomy. When planning assessments, the nurse should be aware of what potential postoperative complication of a gastrostomy?

premature removal of the G tube

A client's large bowel obstruction has failed to resolve spontaneously and the client's worsening condition has warranted admission to the medical unit. Which of the following aspect of nursing care is most appropriate for this client?

preparing the client for surgical bowel resection

The nurse's comprehensive assessment of a client includes inspection for signs of oral cancer. What assessment finding is most characteristic of oral cancer in its early stages?

presence of a painless sore with raised edges

A client has undergone rigid fixation for the correction of a mandibular fracture suffered in a fight. What area of care should the nurse prioritize when planning this client's discharge education?

promotion of adequate nutrition

A nurse is caring for a client who has undergone neck resection with a radial forearm free flap. The nurse's most recent assessment of the graft reveals that it has a bluish color and that mottling is visible. What is the nurse's most appropriate action?

promptly report these indications of venous congestion

A client has just been diagnosed with acute gastritis after presenting in distress to the emergency department with abdominal symptoms. Which of the following actions should the nurse prioritize?

providing the client with physical and emotional support

The digestion of starches begins in the mouth with the secretion of the enzyme ______________.

ptyalin

Feeding patients through tubes placed beyond the ______ or using _______agents can decrease the frequency of feeding regurgitation.

pylorus; prokinetic

Nasogastric feeding tubes are used for patients who have the ability to _______ and ______ nutrition, fluids, and medications adequately by the gastric route.

receive; process

A client who suffered a stroke had an NG tube inserted to facilitate feeding shortly after admission. The client has since become comatose and the client's family asks the nurse why the physician is recommending the removal of the client's NG tube and the insertion of a gastrostomy tube. What is the nurse's best response?

regurgitation and aspiration are less likely

A client has been diagnosed with an esophageal diverticulum after undergoing diagnostic imaging. When taking the health history, the nurse should expect the client to describe what sign or symptom?

regurgitation of undigested food

A nurse caring for a client with a newly created ileostomy assesses the client and notes that the client has had not ostomy output for the past 12 hours. The client also reports worsening nausea. What is the nurse's priority action?

report signs and symptoms of obstruction to the health care provider

A teenage client with a pilonidal cyst has been brought for care by her mother. The nurse who is contributing to the client's care knows that treatment will be chosen based on what risk?

risk for infection

A 16-year-old presents at the emergency department reporting right lower quadrant pain and is subsequently diagnosed with appendicitis. When planning this client's nursing care, the nurse should prioritize what nursing diagnosis?

risk for infection related to possible rupture of appendix

A hormonal regulatory substance that inhibits stomach contraction and gastric secretions is _________.

secretin

A dressing over the tube outlet and the gastrostomy tube protects the skin around the incision from ______ and ______.

seepage of gastric acid; spillage of feeding

A nurse is completing a health history on a client whose diagnosis is chronic gastritis. Which of the data should the nurse consider most significantly related to the etiology of the client's health problem?

smokes one pack of cigarettes daily

The nurse educator is reviewing the blood supply of the GI tract with a group of medical nurses. The nurse is explaining the fact that the veins that return blood from the digestive organs and the spleen form the portal venous system. What large veins will the nurse list when describing this system? Select all that apply.

splenic vein, inferior mesenteric vein, gastric vein

An ileal outlet on the abdomen

stoma

A nurse is caring for a client hospitalized with an exacerbation of chronic gastritis. What health promotion topic should the nurse emphasize?

strategies for avoiding irritating foods and beverages

A client has returned to the medical unit after a barium enema. When assessing the client's subsequent bowel patterns and stools, what finding would warrant reporting to the health care provider?

streaks of blood present in the stool

The incidence of most dental caries is directly related to an increase in the dietary intake of ________.

sugar

A client who experienced an upper GI bleed due to gastritis has had the bleeding controlled and the client's condition is now stable. For the next several hours, the nurse caring for this client should assess for what signs and symptoms of recurrence?

tachycardia, hypotension, tachypnea

A client with peptic ulcer disease has been prescribed sucralfate. What health education should the nurse provide to this client?

take the medication 2 hours before or after other medications

Painful straining at stool

tenesmus

The nurse is providing health education to a client with a gastrointestinal disorder. What should the nurse describe as a major function of the GI tract?

the absorption into the blood stream of nutrient molecules produced by digestion

A client with a history of peptic ulcer disease has presented to the emergency department (ED) in distress. What assessment finding would lead the ED nurse to suspect that the client has a perforated ulcer?

the client has a rigid, "boardlike" abdomen that is tender

A client has recently received a diagnosis of gastric cancer; the nurse is aware of the importance of assessing the client's level of anxiety. Which of the following actions is most likely to accomplish this?

the client is encouraged to express fears openly

A nurse is preparing to discharge a client after recovery from gastric surgery. What is an appropriate discharge outcome for this client?

the client maintains or gains weight

A medical client's CA 19-9 levels have become available and they are significantly elevated. How should the nurse best interpret this diagnostic finding?

the client may have cancer, but other GI disease must be ruled out

A client with gastroesophageal reflux disease (GERD) has a diagnosis of Barrett esophagus with minor cell changes. What principle should be integrated into the client's subsequent care?

the client will be monitored closely to detect malignant changes

A client's screening colonoscopy revealed the presence of numerous polyps in the large bowel. What principle should guide the subsequent treatment of this client's health problem?

the client's polyps constitute a risk factor for cancer

The nurse is providing care for a client whose peptic ulcer disease will be treated with a Billroth I procedure (gastroduodenostomy). The nurse should address which of the following topics when providing health education? Select all that apply.

the client's vagus nerve may be altered, the procedure carries a risk for dumping syndrome

A nurse at an outpatient surgery center is caring for a client who had a hemorrhoidectomy. What discharge education topics should the nurse address with this client?

the correct procedure for taking a sitz bath

A nurse is admitting a client diagnosed with late-stage gastric cancer. The client's family is distraught and angry that she was not diagnosed earlier in the course of her disease. What factor most likely contributed to the client's late diagnosis?

the early symptoms of gastric cancer are usually not alarming or highly unusual

A nurse is planning discharge teaching for a 21-year-old client with a new diagnosis of ulcerative colitis. When planning family assessment, the nurse should recognize that which of the following factors will likely have the greatest impact on the client's coping after discharge?

the family's ability to provide emotional support

Diagnostic testing of a client with a history of dyspepsia and abdominal pain has resulted in a diagnosis of gastric cancer. The nurse's anticipatory guidance should include what information?

the possibility of surgery, chemotherapy and radiotherapy

A client has been experiencing occasional episodes of constipation and has been unable to achieve consistent relief by increasing physical activity and improving his diet. When introducing the client to the use of laxatives, what teaching should the nurse emphasize?

the risk of becoming laxative dependent

A client with a recent history of intermittent bleeding is undergoing capsule endoscopy to determine the source of the bleeding. When explaining this diagnostic test to the client, what advantage should the nurse describe?

the test is noninvasive

A nurse caring for a client with colorectal cancer is preparing the client for upcoming surgery. The nurse administers cephalexin to the client and explains what rationale?

to reduce intestinal bacteria levels

A nurse is caring for a client who has a gastrointestinal tube in place. Which of the following are indications for gastrointestinal intubation? Select all that apply.

to remove gas from the stomach, to remove toxins from the stomach, to diagnose GI motility disorders

A client admitted with inflammatory bowel disease asks the nurse for help with menu selections. What menu selection is most likely the best choice for this client?

tofu

An older adult has a diagnosis of Alzheimer disease and has recently been experiencing fecal incontinence. However, the nurse has observed no recent change in the character of the client's stools. What is the nurse's most appropriate intervention?

toilet the client on a frequent, scheduled basis

The nurse is admitting a client's whose medication regimen includes regular injections of vitamin B12. The nurse should question the client about a history of:

total gastrectomy

Three pancreatic secretions that contain digestive enzymes are ____________, _________________, and __________.

trypsin, amylase, lipase

_______________ is the preferred diagnostic procedure for peptic ulcers.

upper endoscopy

A nurse is creating a care plan for a client with a nasogastric tube. How should the nurse direct other members of the care team to check correct placement of the tube?

use a combination of at lest two accepted methods for confirming placement

A nurse in an oral surgery practice is working with a client scheduled for removal of an abscessed tooth. When providing discharge education, the nurse should recommend what action?

use warm saline to rinse the mouth as needed

Malabsorption diseases may affect the ability of the digestive system to absorb the major water-soluble ______________.

vitamin B12 `

A client is postoperative day 1 following gastrostomy. The nurse is planning interventions to address the nursing diagnosis of Risk for Infection Related to Presence of Wound and Tube. What intervention is most appropriate?

wash the area around the tube with soap and water daily

A nurse is preparing to provide care for a client whose exacerbation of ulcerative colitis has required hospital admission. During an exacerbation of this health problem, the nurse would anticipate that the client's stools will have what characteristics?

watery with blood and mucus

A nurse is caring for a client with recurrent hematemesis who is scheduled for upper gastrointestinal fibroscopy. How should the nurse in the radiology department prepare this client?

apply local anesthetic to the back of the client's throat

A client's neck dissection surgery resulted in damage to the client's superior laryngeal nerve. What area of assessment should the nurse consequently prioritize?

the client's swallowing ability

The nurse is providing a client with the supplies necessary to perform two hemoccult tests on his stool. What instruction should the nurse give this client?

"mail the paper slides to the clinic once you've collected the samples"

A nurse is assessing the abdomen of a client just admitted to the unit with a suspected GI disease. Inspection reveals several diverse lesions on the client's abdomen. How should the nurse best interpret this assessment finding?

GI diseases often produce skin changes

A nurse is participating in a client's care conference and the team is deciding between parenteral nutrition (PN) and a total nutritional admixture (TNA). What advantages are associated with providing TNA rather than PN?

TNA is less costly than PN

A client has sought care because of recent dark-colored stools. As a result, a fecal occult blood test has been ordered. The nurse should give what instructions to the client?

Take no NSAIDs within 48 hours of the test

A client's sigmoidoscopy has been successfully completed and the client is preparing to return home. What teaching point should the nurse include in the client's discharge education?

The client can resume a normal routine immediately

A nurse is caring for a client who is postoperative day 1 following neck dissection surgery. The nurse is performing an assessment of the client and notes the presence of high-pitched adventitious sounds over the client's trachea on auscultation. The client's oxygen saturation is 90% by pulse oximetry with a respiratory rate of 31 breaths per minute. What is the nurse's most appropriate action?

report this finding promptly to the health care provider and remain with the client

An adult client is scheduled for an upper GI series that will use a barium swallow. What teaching should the nurse include when the client has completed the test?

Fluids must be increased to facilitate the evacuation of the stool

A nurse is caring for a client who has an order to discontinue the administration of parenteral nutrition. What should the nurse do to prevent the occurrence of rebound hypoglycemia in the client?

administer an isotonic dextrose solution for 1-2 hours after discontinuing the PN

A client who had a hemiglossectomy earlier in the day is assessed postoperatively, revealing a patent airway, stable vital signs, and no bleeding or drainage from the operative site. The nurse notes the client is alert. What is the client's priority need at this time?

an effective means of communicating with the nurse

A nurse is assessing a client who has just been admitted to the postsurgical unit following surgical resection for the treatment of oropharyngeal cancer. What assessment should the nurse prioritize?

assess patent airway

A nurse is caring for a client with biliary colic. Where would the nurse most likely expect this client to experience referred pain?

below the right nipple

A nurse is aware of the high incidence of catheter-related bloodstream infections in clients receiving parenteral nutrition. What nursing action has the greatest potential to reduce catheter-related bloodstream infections?

change the dressing no more than weekly

A client has been discharged home on parenteral nutrition (PN). Much of the nurse's discharge education focused on coping. What must a client on PN likely learn to cope with? Select all that apply.

disruptions to mobility , loss of eating as a social behavior, changes in lifestyle

A nurse is providing care for a client with a diagnosis of late-stage Alzheimer disease. The client has just returned to the medical unit to begin supplemental feedings through an NG tube. Which of the nurse's assessments addresses this client's most significant potential complication of feeding?

frequent lung auscultation

A nurse has auscultated a client's abdomen and noted one or two bowel sounds in a 2-minute period of time. How should the nurse document the client's bowel sounds?

hypoactive

A nurse is performing health education with a client who has a history of frequent, serious dental caries. When planning educational interventions, the nurse should identify a risk for what nursing diagnosis?

imbalanced nutrition: less than body requirements

A nurse is caring for a client who is scheduled for a colonoscopy and whose preparation will include polyethylene glycol electrolyte lavage prior to the procedure. The presence of what health problem would contraindicate the use of this form of bowel preparation?

inflammatory bowel disease

A client has been experiencing significant psychosocial stress in recent weeks. The nurse is aware of the hormonal effects of stress, including norepinephrine release. Release of this substance would have what effect on the client's gastrointestinal function? Select all that apply.

inhibition of secretions, increased sphincter tone, decreased motility

A client with cancer of the tongue has had a radical neck dissection. What nursing assessment should the nurse prioritize?

respiratory status and airway clearance

A female client has presented to the emergency department with right upper quadrant pain; the health care provider has ordered abdominal ultrasound to rule out cholecystitis. The client expresses concern to the nurse about the safety of this diagnostic procedure. How should the nurse best respond?

"abdominal ultrasound poses no known safety risks of any kind"

A client seeking care because of recurrent heartburn and regurgitation is subsequently diagnosed with a hiatal hernia. Which of the following should the nurse include in health education?

"instead of eating three meals a day, try eating smaller amounts more often"

The nurse is caring for a client who was admitted to have a low-profile gastrostomy device (LPGD) placed. How soon after the original gastrostomy tube placement can an LPGD be placed?

1 1/2 to 3 months

A nurse is caring for a client admitted with a suspected malabsorption disorder. The nurse knows that one of the accessory organs of the digestive system is the pancreas. What digestive enzymes does the pancreas secrete? Select all that apply.

Amylase, trypsin, lipase

A nurse is initiating parenteral nutrition (PN) to a postoperative client who has developed complications. The nurse should initiate therapy by performing which of the following actions?

initiating the infusion slowly and monitoring the client's fluid and glucose tolerance

A client will be undergoing abdominal computed tomography (CT) with contrast. The nurse has administered IV sodium bicarbonate and oral acetylcysteine (Mucomyst) before the study, as prescribed. What would indicate that these medications have had the desired therapeutic effect?

The client's BUN and creatinine levels are within reference range

A client's NG tube has become clogged after the nurse instilled a medication that was insufficiently crushed. The nurse has attempted to aspirate with a large-bore syringe, with no success. What should the nurse do next?

attach a syringe filled with warm water and attempt an in and out motion of instilling and aspirating

The nurse determines that a client who has undergone skin, tissue, and muscle grafting following a modified radical neck dissection requires suctioning. What is the nurse's priority when suctioning this client?

avoid applying suction on or near the suture line

A critical care nurse is caring for a client diagnosed with acute pancreatitis. The nurse knows that the indications for starting parenteral nutrition (PN) for this client are what?

inability to take in adequate oral food or fluids within 7 days

A client's health decline necessitates the use of total parenteral nutrition. The client has questioned the need for insertion of a central venous catheter, expressing a preference for a "normal IV." The nurse should know that peripheral administration of high-concentration PN formulas is contraindicated because of the risk for what complication?

chemical phlebitis

A client has come to the outpatient radiology department for diagnostic testing that will allow the care team to evaluate and remove polyps. The nurse should prepare the client for what procedure?

colonoscopy

A client's new onset of dysphagia has required insertion of an NG tube for feeding; the nurse has modified the client's care plan accordingly. What intervention should the nurse include in the client's plan of care?

confirm placement of the tube prior to each scheduled feeding

A client with dysphagia is scheduled for percutaneous endoscopic gastrostomy (PEG) tube insertion and asks the nurse how the tube will stay in place. What is the nurse's best response?

internal and external fixation bolsters secure the tube against the stomach wall

A nurse is preparing to administer a client's intravenous fat emulsion simultaneously with parenteral nutrition (PN). What principle should guide the nurse's action?

intravenous fat emulsions may be infused simultaneously with PN through a Y-connector close to the infusion site and should not be filtered

A client is concerned about leakage of gastric contents out of the gastric sump tube the nurse has just inserted. What would the nurse do to prevent reflux gastric contents from coming through the blue vent of a gastric sump tube?

keep the vent lumen above the clinet's waist

A client has been diagnosed with a malignancy of the oral cavity and is undergoing oncologic treatment. The oncologic nurse is aware that the prognosis for recovery from head and neck cancers is often poor because of what characteristic of these malignancies?

metastasis are common and respond poorly to treatment

A client with GERD has undergone diagnostic testing and it has been determined that increasing the pace of gastric emptying may help alleviate symptoms. The nurse should anticipate that the client may be prescribed what drug?

metoclopramide

The school nurse is planning a health fair for a group elementary school students and dental health is one topic that the nurse plans to address. When teaching the children about the risk of tooth decay, the nurse should caution them against consuming large quantities of

organic fruit juice

A client has been brought to the emergency department by EMS after telling a family member that he deliberately took an overdose of NSAIDs a few minutes earlier. If lavage is prescribed, the nurse should prepare to assist with the insertion of what type of tube?

orogastric tube

A client is being assessed for a suspected deficit in intrinsic factor synthesis. What diagnostic or assessment finding is the most likely rationale for this examination of intrinsic factor production?

persistently low hemoglobin

The nurse is caring for a client who has a nasogastric tube that has been in place for 2 days. Before administering a scheduled feeding, the nurse should

position the client upright

Results of a client's preliminary assessment prompted an examination of the client's carcinoembryonic antigen (CEA) levels, which have come back positive. What is the nurse's most appropriate response to this finding?

prepare to meet the client's pyschosocial needs

A nurse is preparing to discharge a client home on parenteral nutrition. What should an effective home care teaching program address? Select all that apply.

preparing the client to troubleshoot for problems, teaching the client and family strict aseptic technique, teaching the client and family how to set up the infusion

The nurse is preparing to check for tube placement in the client's stomach as well as measure the residual volume. What is the main purpose of these nursing actions?

prevent aspiration

A client who has had a radical neck dissection is being prepared for discharge. The discharge plan includes referral to an outpatient rehabilitation center for physical therapy. What should the goals of physical therapy for this client include?

promoting maximum shoulder function

A nurse is caring for a client with a nasogastric tube for feeding. During shift assessment, the nurse auscultates a new onset of bilateral lung crackles and notes a respiratory rate of 30 breaths per minute. The client's oxygen saturation is 89% by pulse oximetry. After ensuring the client's immediate safety, what is the nurse's most appropriate action?

report possible signs of aspiration pneumonia to the primary provider

A client has been diagnosed with achalasia based on his history and diagnostic imaging results. The nurse should identify what risk diagnosis when planning the client's care?

risk for aspiration related to inhalation of gastric contents

A nurse is writing a care plan for a client with a nasogastric tube in place for gastric decompression. Which risk nursing diagnosis is the most appropriate component of the care plan?

risk for impaired skin integrity related to the presence of NG tube

A nurse is caring for a client with a subclavian central line who is receiving parenteral nutrition (PN). In preparing a care plan for this client, what nursing diagnosis should the nurse prioritize?

risk for infection related to the presence of a subclavian catheter