EXAM 4 - GI
The nurse is preparing to perform a patient's abdominal assessment. What examination sequence should the nurse follow? A) Inspection, auscultation, percussion, and palpation B)Inspection, palpation, auscultation, and percussion C)Inspection, percussion, palpation, and auscultation D)Inspection, palpation, percussion, and auscultation
A) Inspection, auscultation, percussion, and palpation
A patient with gastritis required hospital treatment for an exacerbation of symptoms and receives a subsequent diagnosis of pernicious anemia due to malabsorption. When planning the patient's continuing care in the home setting, what assessment question is most relevant? A)"Does anyone in your family have experience at giving injections?" B)"Are you going to be anywhere with strong sunlight in the next few months?" C)"Are you aware of your blood type?" D)"Do any of your family members have training in first aid?"
A)"Does anyone in your family have experience at giving injections?"
A patient comes to the clinic complaining of pain in the epigastric region. What assessment question during the health interview would most help the nurse determine if the patient has a peptic ulcer? A)"Does your pain resolve when you have something to eat?" B)"Do over-the-counter pain medications help your pain?" C)"Does your pain get worse if you get up and do some exercise?" D)"Do you find that your pain is worse when you need to have a bowel movement?"
A)"Does your pain resolve when you have something to eat?"
A triage nurse in the emergency department is assessing a patient who presented with complaints of general malaise. Assessment reveals the presence of jaundice and increased abdominal girth. What assessment question best addresses the possible etiology of this patient's presentation? A)"How many alcoholic drinks do you typically consume in a week?" B)"To the best of your knowledge, are your immunizations up to date?" C)"Have you ever worked in an occupation where you might have been exposed to toxins?" D)"Has anyone in your family ever experienced symptoms similar to yours?"
A)"How many alcoholic drinks do you typically consume in a week?"
A patient presents at the walk-in clinic complaining of recurrent sharp stomach pain that is relieved by eating. The nurse suspects that the patient may have an ulcer. How would the nurse explain the formation and role of acid in the stomach to the patient? A)"Hydrochloric acid is secreted by glands in the stomach in response to the actual or anticipated presence of food." B)"As digestion occurs in the stomach, the stomach combines free hydrogen ions from the food to form acid." C)"The body requires an acidic environment in order to synthesize pancreatic digestive enzymes; the stomach provides this environment." D)"The acidic environment in the stomach exists to buffer the highly alkaline environment in the esophagus."
A)"Hydrochloric acid is secreted by glands in the stomach in response to the actual or anticipated presence of food."
A patient with a diagnosis of peptic ulcer disease has just been prescribed omeprazole (Prilosec). How should the nurse best describe this medication's therapeutic action? A)"This medication will reduce the amount of acid secreted in your stomach." B)"This medication will make the lining of your stomach more resistant to damage." C)"This medication will specifically address the pain that accompanies peptic ulcer disease." D)"This medication will help your stomach lining to repair itself."
A)"This medication will reduce the amount of acid secreted in your stomach."
A patient has been brought to the emergency department with abdominal pain and is subsequently diagnosed with appendicitis. The patient 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? A)"Your appendix doesn't play a major role, so you won't notice any difference after you recovery from surgery." B)"The surgeon will encourage you to limit your fat intake for a few weeks after the surgery, but your body will then begin to compensate." C)"Your body will absorb slightly fewer nutrients from the food you eat, but you won't be aware of this." D)"Your large intestine will adapt over time to the absence of your appendix."
A)"Your appendix doesn't play a major role, so you won't notice any difference after you recovery from surgery."
A nurse is caring for a patient who has been admitted to the hospital with diverticulitis. Which of the following would be appropriate nursing diagnoses for this patient? Select all that apply. A)Acute Pain Related to Increased Peristalsis and GI Inflammation B)Activity Intolerance Related to Generalized Weakness C)Bowel Incontinence Related to Increased Intestinal Peristalsis D)Deficient Fluid Volume Related to Anorexia, Nausea, and Diarrhea E)Impaired Urinary Elimination Related to GI Pressure on the Bladder
A)Acute Pain Related to Increased Peristalsis and GI Inflammation B)Activity Intolerance Related to Generalized Weakness D)Deficient Fluid Volume Related to Anorexia, Nausea, and Diarrhea
A patient's physician has ordered a "liver panel" in response to the patient's development of jaundice. When reviewing the results of this laboratory testing, the nurse should expect to review what blood tests? Select all that apply. A)Alanine aminotransferase (ALT) B)C-reactive protein (CRP) C)Gamma-glutamyl transferase (GGT) D)Aspartate aminotransferase (AST) E)B-type natriuretic peptide (BNP)
A)Alanine aminotransferase (ALT) C)Gamma-glutamyl transferase (GGT) D)Aspartate aminotransferase (AST)
The nurse is providing care for a patient whose inflammatory bowel disease has necessitated hospital treatment. Which of the following would most likely be included in the patient's medication regimen? A)Anticholinergic medications 30 minutes before a meal B)Antiemetics on a PRN basis C)Vitamin B12 injections to prevent pernicious anemia D)Beta adrenergic blockers to reduce bowel motility
A)Anticholinergic medications 30 minutes before a meal
A patient has come to the outpatient radiology department for diagnostic testing. Which of the following diagnostic procedures will allow the care team to evaluate and remove polyps? A)Colonoscopy B)Barium enema C)ERCP D)Upper gastrointestinal fibroscopy
A)Colonoscopy
A patient 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 patient's gastrointestinal function?Select all that apply. A)Decreased motility B)Increased sphincter tone C)Increased enzyme release D)Inhibition of secretions E)Increased peristalsis
A)Decreased motility
A nurse is caring for a patient with cancer of the liver whose condition has required the insertion of a percutaneous biliary drainage system. The nurse's most recent assessment reveals the presence of dark green fluid in the collection container. What is the nurse's best response to this assessment finding? A)Document the presence of normal bile output. B)Irrigate the drainage system with normal saline as ordered. C)Aspirate a sample of the drainage for culture. D)Promptly report this assessment finding to the primary care provider.
A)Document the presence of normal bile output.
A patient has received a diagnosis of gastric cancer and is awaiting a surgical date. During the preoperative period, the patient should adopt what dietary guidelines? A)Eat small, frequent meals with high calorie and vitamin content. B)Eat frequent meals with an equal balance of fat, carbohydrates, and protein. C)Eat frequent, low-fat meals with high protein content. D)Try to maintain the pre-diagnosis pattern of eating
A)Eat small, frequent meals with high calorie and vitamin content.
A patient was treated in the emergency department and critical care unit after ingesting bleach. What possible complication of the resulting gastritis should the nurse recognize? A)Esophageal or pyloric obstruction related to scarring B)Uncontrolled proliferation of H. pylori C)Gastric hyperacidity related to excessive gastrin secretion D)Chronic referred pain in the lower abdomen
A)Esophageal or pyloric obstruction related to scarring
During a health education session, a participant has asked about the hepatitis E virus. What prevention measure should the nurse recommend for preventing infection with this virus? A)Following proper hand-washing techniques B)Avoiding chemicals that are toxic to the liver C)Wearing a condom during sexual contact D)Limiting alcohol intake
A)Following proper hand-washing techniques
A nurse is presenting an educational event to a local community group. When speaking about colorectal cancer, what risk factor should the nurse cite? A)High levels of alcohol consumption B)History of bowel obstruction C)History of diverticulitis D)Longstanding psychosocial stress
A)High levels of alcohol consumption
A nurse educator is teaching a group of recent nursing graduates about their occupational risks for contracting hepatitis B. What preventative measures should the educator promote? Select all that apply. A)Immunization B)Use of standard precautions C)Consumption of a vitamin-rich diet D)Annual vitamin K injections E)Annual vitamin B12 injections
A)Immunization B)Use of standard precaution
A patient is admitted to the medical unit with a diagnosis of intestinal obstruction. When planning this patient's care, which of the following nursing diagnoses should the nurse prioritize? A)Ineffective Tissue Perfusion Related to Bowel Ischemia B)Imbalanced Nutrition: Less Than Body Requirements Related to Impaired Absorption C)Anxiety Related to Bowel Obstruction and Subsequent Hospitalization D)Impaired Skin Integrity Related to Bowel Obstruction
A)Ineffective Tissue Perfusion Related to Bowel Ischemia
A patient presents to the walk-in clinic complaining of vomiting and burning in her mid- epigastria. The nurse knows that in the process of confirming peptic ulcer disease, the physician is likely to order a diagnostic test to detect the presence of what? A)Infection with Helicobacter pylori B)Excessive stomach acid secretion C)An incompetent pyloric sphincter D)A metabolic acid-base imbalance
A)Infection with Helicobacter pylori
A nurse is caring for a patient who is scheduled for a colonoscopy and whose bowel 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? A)Inflammatory bowel disease B)Intestinal polyps C)Diverticulitis D)Colon cancer
A)Inflammatory bowel disease
A 35-year-old male patient presents at the emergency department with symptoms of a small bowel obstruction. In collaboration with the primary care provider, what intervention should the nurse prioritize? A)Insertion of a nasogastric tube B)Insertion of a central venous catheter C)Administration of a mineral oil enema D)Administration of a glycerin suppository and an oral laxative
A)Insertion of a nasogastric tube
A patient has sought care because of recent dark-colored stools. As a result, a fecal occult blood test has been ordered. The nurse should instruct the patient to avoid which of the following prior to collecting a stool sample? A)NSAIDs B)Acetaminophen C)OTC vitamin D supplements D)Fiber supplements
A)NSAIDs
A nurse is providing care for a patient who has a diagnosis of irritable bowel syndrome (IBS). When planning this patient's care, the nurse should collaborate with the patient and prioritize what goal? A)Patient will accurately identify foods that trigger symptoms. B)Patient will demonstrate appropriate care of his ileostomy. C)Patient will demonstrate appropriate use of standard infection control precautions. D)Patient will adhere to recommended guidelines for mobility and activity.
A)Patient will accurately identify foods that trigger symptoms.
An advanced practice nurse is assessing the size and density of a patient's abdominal organs. If the results of palpation are unclear to the nurse, what assessment technique should be implemented? A)Percussion B)Auscultation C)Inspection D)Rectal examination
A)Percussion
A nurse is caring for a patient 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. A)Perforation into the mediastinum B)Development of an esophageal lesion C)Erosion into the great vessels D)Painful swallowing E)Obstruction of the esophagus
A)Perforation into the mediastinum C)Erosion into the great vessels E)Obstruction of the esophagus
Diagnostic imaging and physical assessment have revealed that a patient with peptic ulcer disease has suffered a perforated ulcer. The nurse recognizes that emergencyinterventions must be performed as soon as possible in order to prevent the development of what complication? A)Peritonitis B)Gastritis C)Gastroesophageal reflux D)Acute pancreatitis
A)Peritonitis
A patient is being discharged after a liver transplant and the nurse is performing discharge education. When planning this patient's continuing care, the nurse should prioritize which of the following risk diagnoses? A)Risk for Infection Related to Immunosuppressant Use B)Risk for Injury Related to Decreased Hemostasis C)Risk for Unstable Blood Glucose Related to Impaired Gluconeogenesis D)Risk for Contamination Related to Accumulation of Ammonia
A)Risk for Infection Related to Immunosuppressant Use
A nurse is caring for an 83-year-old patient who is being assessed for recurrent and intractable nausea. What age-related change to the GI system may be a contributor to the patient's health complaint? A)Stomach emptying takes place more slowly. B)The villi and epithelium of the small intestine become thinner. C)The esophageal sphincter becomes incompetent. D)Saliva production decreases.
A)Stomach emptying takes place more slowly.
A patient who experienced an upper GI bleed due to gastritis has had the bleeding controlled and the patient's condition is now stable. For the next several hours, the nurse caring for this patient should assess for what signs and symptoms of recurrence? A)Tachycardia, hypotension, and tachypnea B)Tarry, foul-smelling stools C)Diaphoresis and sudden onset of abdominal pain D)Sudden thirst, unrelieved by oral fluid administration
A)Tachycardia, hypotension, and tachypnea
A patient with gastroesophageal reflux disease (GERD) has a diagnosis of Barrett's esophagus with minor cell changes. Which of the following principles should be integrated into the patient's subsequent care? A)The patient will require an upper endoscopy every 6 months to detect malignant changes. B)Liver enzymes must be checked regularly, as H2 receptor antagonists may cause hepatic damage. C)Small amounts of blood are likely to be present in the stools and are not cause for concern. D)Antacids may be discontinued when symptoms of heartburn subside.
A)The patient will require an upper endoscopy every 6 months to detect malignant changes.
A nurse is preparing to provide care for a patient whose exacerbation of ulcerative colitis has required hospital admission. During an exacerbation of this health problem, the nurse would anticipate that the patient's stools will have what characteristics? A)Watery with blood and mucus B)Hard and black or tarry C)Dry and streaked with blood D)Loose with visible fatty streaks
A)Watery with blood and mucus
A female patient has presented to the emergency department with right upper quadrant pain; the physician has ordered abdominal ultrasound to rule out cholecystitis (gallbladder infection). The patient expresses concern to the nurse about the safety of thisdiagnostic procedure. How should the nurse best respond? A)"Abdominal ultrasound is very safe, but it can't be performed if you're pregnant." B)"Abdominal ultrasound poses no known safety risks of any kind." C)"Current guidelines state that a person can have up to 3 ultrasounds per year." D)"Current guidelines state that a person can have up to 6 ultrasounds per year."
B)"Abdominal ultrasound poses no known safety risks of any kind."
A nurse is caring for a patient with constipation whose primary care provider has recommended senna (Senokot) for the management of this condition. The nurse should provide which of the following education points? A)"Limit your fluid intake temporarily so you don't get diarrhea." B)"Avoid taking the drug on a long-term basis." C)"Make sure to take a multivitamin with each dose." D)"Take this on an empty stomach to ensure maximum effect
B)"Avoid taking the drug on a long-term basis."
A participant in a health fair has asked the nurse about the role of drugs in liver disease. What health promotion teaching has the most potential to prevent drug-induced hepatitis? A)Finish all prescribed courses of antibiotics, regardless of symptom resolution. B)Adhere to dosing recommendations of OTC analgesics. C)Ensure that expired medications are disposed of safely. D)Ensure that pharmacists regularly review drug regimens for potential interactions.
B)Adhere to dosing recommendations of OTC analgesics.
A patient has had an ileostomy created for the treatment of irritable bowel disease and the patient is now preparing for discharge. What should the patient be taught about changing this device in the home setting? A)Apply antibiotic ointment as ordered after cleaning the stoma. B)Apply a skin barrier to the peristomal skin prior to applying the pouch. C)Dispose of the clamp with each bag change. D)Cleanse the area surrounding the stoma with alcohol or chlorhexidine.
B)Apply a skin barrier to the peristomal skin prior to applying the pouch.
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? A)Encourage the patient to take stool softener daily. B)Assess the patient's food and fluid intake. C)Assess the patient's surgical history. D)Encourage the patient to take fiber supplements.
B)Assess the patient's food and fluid intake.
A nurse is providing care for a patient 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. A)Malignant hyperthermia B)Atelectasis C)Pneumonia D)Metabolic imbalances E)Chronic gastritis
B)Atelectasis C)Pneumonia D)Metabolic imbalances
A nurse is caring for a patient with biliary colic and is aware that the patient may experience referred abdominal pain. Where would the nurse most likely expect this patient to experience referred pain? A)Midline near the umbilicus B)Below the right nipple C)Left groin area D)Right lower abdominal quadrant
B)Below the right nipple
A patient admitted with acute diverticulitis has experienced a sudden increase in temperature and complains of a sudden onset of exquisite abdominal tenderness. The nurse's rapid assessment reveals that the patient's abdomen is uncharacteristically rigid on palpation. What is the nurse's best response? A)Administer a Fleet enema as ordered and remain with the patient. B)Contact the primary care provider promptly and report these signs of perforation. C)Position the patient supine and insert an NG tube. D)Page the primary care provider and report that the patient may be obstructed.
B)Contact the primary care provider promptly and report these signs of perforation.
A nurse is providing care for a patient whose recent colostomy has contributed to a nursing diagnosis of Disturbed Body Image Related to Colostomy. What intervention best addresses this diagnosis? A)Encourage the patient to conduct online research into colostomies. B)Engage the patient in the care of the ostomy to the extent that the patient is willing. C)Emphasize the fact that the colostomy was needed to alleviate a much more serious health problem. D)Emphasize the fact that the colostomy is temporary measure and is not permanent.
B)Engage the patient in the care of the ostomy to the extent that the patient is willing.
A nurse is caring for a patient who just has been diagnosed with a peptic ulcer. When teaching the patient about his new diagnosis, how should the nurse best describe a peptic ulcer? A)Inflammation of the lining of the stomach B)Erosion of the lining of the stomach or intestine C)Bleeding from the mucosa in the stomach D)Viral invasion of the stomach wall
B)Erosion of the lining of the stomach or intestine
A patient with a diagnosis of colon cancer is 2 days postoperative following bowel resection and anastomosis. The nurse has planned the patient's care in the knowledge of potential complications. What assessment should the nurse prioritize? A)Close monitoring of temperature B)Frequent abdominal auscultation C)Assessment of hemoglobin, hematocrit, and red blood cell levels D)Palpation of peripheral pulses and leg girth
B)Frequent abdominal auscultation
Anursing student has auscultated a patient's abdomen and noted one or two bowel sounds in a 2- minute period of time. How would you tell the student to document the patient's bowel sounds? A)Normal B)Hypoactive C)Hyperactive D)Paralytic ileus
B)Hypoactive
An adult patient has been diagnosed with diverticular disease after ongoing challenges with constipation. The patient will be treated on an outpatient basis. What components of treatment should the nurse anticipate? Select all that apply. A)Anticholinergic medications B)Increased fiber intake C)Enemas on alternating days D)Reduced fat intake E)Fluid reduction
B)Increased fiber intake D)Reduced fat intake
During a patient's scheduled home visit, an older adult patient 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? A)Regular application of an OTC antibiotic ointment B)Increased fluid and fiber intake C)Daily use of OTC glycerin suppositories D)Use of an NSAID to reduce inflammation
B)Increased fluid and fiber intake
A nurse is assessing a patient who has peptic ulcer disease. The patient requests more information about the typical causes of Helicobacter pylori infection. What would it be appropriate for the nurse to instruct the patient? A)Most affected patients acquired the infection during international travel. B)Infection typically occurs due to ingestion of contaminated food and water. C)Many people possess genetic factors causing a predisposition to H. pylori infection. D)The H. pylori microorganism is endemic in warm, moist climates.
B)Infection typically occurs due to ingestion of contaminated food and water.
Results of a patient barium swallow suggest that the patient has GERD. The nurse is planning health education to address the patient's knowledge of this new diagnosis. Which of the following should the nurse encourage? A)Eating several small meals daily rather than 3 larger meals B)Keeping the head of the bed slightly elevated C)Drinking carbonated mineral water rather than soft drinks D)Avoiding food or fluid intake after 6:00 p.m.
B)Keeping the head of the bed slightly elevated
A nurse is caring for a patient 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. A)Pepsin B)Lipase C)Amylase D)Trypsin E)Ptyalin
B)Lipase C)Amylase D)Trypsin
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 ofreduced pressure associated with GERD? A)Pyloric sphincter B)Lower esophageal sphincter C)Hypopharyngeal sphincter D)Upper esophageal sphincter
B)Lower esophageal sphincter
A patient has been diagnosed with an esophageal diverticulum after undergoing diagnostic imaging. When taking the health history, the nurse should expect the patient to describe what sign or symptom? A)Burning pain on swallowing B)Regurgitation of undigested food C)Symptoms mimicking a heart attack D)Chronic parotid abscesses
B)Regurgitation of undigested food
A nurse caring for a patient with a newly created ileostomy assesses the patient and notes that the patient has had not ostomy output for the past 12 hours. The patient also complains of worsening nausea. What is the nurse's priority action? A)Facilitate a referral to the wound-ostomy-continence (WOC) nurse. B)Report signs and symptoms of obstruction to the physician. C)Encourage the patient to mobilize in order to enhance motility. D)Contact the physician and obtain a swab of the stoma for culture.
B)Report signs and symptoms of obstruction to the physician.
A patient's sigmoidoscopy has been successfully completed and the patient is preparing to return home. Which of the following teaching points should the nurse include in the patient's discharge education? A)The patient should drink at least 2 liters of fluid in the next 12 hours. B)The patient can resume a normal routine immediately. C)The patient should expect fecal urgency for several hours. D)The patient can expect some scant rectal bleeding
B)The patient can resume a normal routine immediately.
A patient 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 patient has a perforated ulcer? A)The patient has abdominal bloating that developed rapidly. B)The patient has a rigid, "boardlike" abdomen that is tender. C)The patient is experiencing intense lower right quadrant pain. D)The patient is experiencing dizziness and confusion with no apparent hemodynamic changes.
B)The patient has a rigid, "boardlike" abdomen that is tender.
A patient has recently received a diagnosis of gastric cancer; the nurse is aware of the importance of assessing the patient's level of anxiety. Which of the following actions is most likely to accomplish this? A)The nurse gauges the patient's response to hypothetical outcomes. B)The patient is encouraged to express fears openly. C)The nurse provides detailed and accurate information about the disease. D)The nurse closely observes the patient's body language.
B)The patient is encouraged to express fears openly.
A patient admitted with inflammatory bowel disease asks the nurse for help with menu selections. What menu selection is most likely the best choice for this patient? A)Spinach B)Tofu C)Multigrain bagel D)Blueberries
B)Tofu
A nurse is caring for a newly admitted patient with a suspected GI bleed. The nurse assesses the patient's stool after a bowel movement and notes it to be a tarry-black color. This finding is suggestive of bleeding from what location? A)Sigmoid Colon B)Upper GI Tract C)Large Intestine D)Anus or rectum
B)Upper GI Tract
A nurse is providing preprocedure education for a patient who will undergo a lower GI tract study the following week. What should the nurse teach the patient about bowel preparation? A)"You'll need to fast for at least 18 hours prior to your test." B)"Starting today, take over-the-counter stool softeners twice daily." C)"You'll need to have enemas the day before the test." D)"For 24 hours before the test, insert a glycerin suppository every 4 hours."
C)"You'll need to have enemas the day before the test."
A patient's colorectal cancer has necessitated a hemicolectomy with the creation of a colostomy. In the 4 days since the surgery, the patient 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? A)Ensure that the patient knows that he or she will be responsible for care after discharge. B)Reassure the patient that many people are fearful after the creation of an ostomy. C)Acknowledge the patient's reluctance and initiate discussion of the factors underlying it. D)Arrange for the patient to be seen by a social worker or spiritual advisor.
C)Acknowledge the patient's reluctance and initiate discussion of the factors underlying it.
A patient'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 patient's signs and symptoms? A)A pattern of distinct exacerbations and remissions B)Severe diarrhea C)An absence of blood in stool D)Involvement of the rectal mucosa
C)An absence of blood in stool
A nurse is providing health promotion education to a patient diagnosed with an esophageal reflux disorder. What practice should the nurse encourage the patient to implement? A)Keep the head of the bed lowered. B)Drinka cup of hot tea before bedtime. C)Avoid carbonated drinks. D)Eat a low-protein diet.
C)Avoid carbonated drinks.
A nurse is working with a patient who has chronic constipation. What should be included in patient teaching to promote normal bowel function? A)Use glycerin suppositories on a regular basis. B)Limit physical activity in order to promote bowel peristalsis. C)Consume high-residue, high-fiber foods. D)Resist the urge to defecate until the urge becomes intense.
C)Consume high-residue, high-fiber foods.
A patient with portal hypertension has been admitted to the medical floor. The nurse should prioritize which of the following assessments related to the manifestations of this health problem? A)Assessment of blood pressure and assessment for headaches and visual changes B)Assessments for signs and symptoms of venous thromboembolism C)Daily weights and abdominal girth measurement D)Blood glucose monitoring q4h
C)Daily weights and abdominal girth measurement
A nurse is assessing a patient'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? A)Irrigate the ostomy to clear a possible obstruction. B)Contact the primary care provider to report this finding. C)Document that the stoma appears healthy and well perfused. D)Document a nursing diagnosis of Impaired Skin Integrity.
C)Document that the stoma appears healthy and well perfused.
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 has the greatest potential to prevent esophageal cancer? A)Promotion of a nutrient-dense, low-fat diet B)Annual screening endoscopy for patients over 50 with a family history of esophageal cancer C)Early diagnosis and treatment of gastroesophageal reflux disease D)Adequate fluid intake and avoidance of spicy foods
C)Early diagnosis and treatment of gastroesophageal reflux disease
An adult patient is scheduled for an upper GI series that will use a barium swallow. What teaching should the nurse include when the patient has completed the test? A)Stool will be yellow for the first 24 hours postprocedure. B)The barium may cause diarrhea for the next 24 hours. C)Fluids must be increased to facilitate the evacuation of the stool. D)Slight anal bleeding may be noted as the barium is passed.
C)Fluids must be increased to facilitate the evacuation of the stool.
A nurse is assessing the abdomen of a patient just admitted to the unit with a suspected GI disease. Inspection reveals several diverse lesions on the patient's abdomen. How should the nurse best interpret this assessment finding? A)Abdominal lesions are usually due to age-related skin changes. B)Integumentary diseases often cause GI disorders. C)GI diseases often produce skin changes. D)The patient needs to be assessed for self-harm.
C)GI diseases often produce skin changes.
A patient who has been experiencing changes in his bowel function is scheduled for a barium enema. What instruction should the nurse provide for postprocedure recovery? A)Remain NPO for 6 hours postprocedure. B)Administer a Fleet enema to cleanse the bowel of the barium. C)Increase fluid intake to evacuate the barium. D)Avoid dairy products for 24 hours postprocedure.
C)Increase fluid intake to evacuate the barium.
A patient is undergoing diagnostic testing for a tumor of the small intestine. What are the most likely symptoms that prompted the patient to first seek care? A)Hematemesis and persistent sensation of fullness B)Abdominal bloating and recurrent constipation C)Intermittent pain and bloody stool D)Unexplained bowel incontinence and fatty stools
C)Intermittent pain and bloody stool
A nurse is providing patient education for a patient with peptic ulcer disease secondary to chronic nonsteroidal anti-inflammatory drug (NSAID) use. The patient has recently been prescribed misoprostol (Cytotec). What would the nurse be most accurate in informing the patient about the drug? A)It reduces the stomach's volume of hydrochloric acid B)It increases the speed of gastric emptying C)It protects the stomach's lining D)It increases lower esophageal sphincter pressure
C)It protects the stomach's lining
Diagnostic testing has revealed that a patient's hepatocellular carcinoma (HCC) is limited to one lobe. The nurse should anticipate that this patient's plan of care will focus on what intervention? A)Cryosurgery B)Liver transplantation C)Lobectomy D)Laser hyperthermia
C)Lobectomy
The nurse is providing health education to a patient scheduled for a colonoscopy. The nurse should explain that she will be placed in what position during this diagnostic test? A)In a knee-chest position (lithotomy position) B)Lying prone with legs drawn toward the chest C)Lying on the left side with legs drawn toward the chest D)In a prone position with two pillows elevating the buttocks
C)Lying on the left side with legs drawn toward the chest
A nurse is performing an admission assessment of a patient with a diagnosis of cirrhosis. What technique should the nurse use to palpate the patient's liver? A)Place hand under the right lower abdominal quadrant and press down lightly with the other hand. B)Place the left hand over the abdomen and behind the left side at the 11th rib. C)Place hand under right lower rib cage and press down lightly with the other hand. D)Hold hand 90 degrees to right side of the abdomen and push down firmly.
C)Place hand under right lower rib cage and press down lightly with the other hand.
A patient who underwent surgery for esophageal cancer is admitted to the critical care unit following postanesthetic recovery. Which of the following should be included in the patient's immediate postoperative plan of care? A)Teaching the patient to self-suction B)Performing chest physiotherapy to promote oxygenation C)Positioning the patient to prevent gastric reflux D)Providing a regular diet as tolerated
C)Positioning the patient to prevent gastric reflux
The nurse is caring for a patient with a duodenal ulcer and is relating the patient's symptoms to the physiologic functions of the small intestine. What do these functions include? Select all that apply. A)Secretion of hydrochloric acid (HCl) B)Reabsorption of water C)Secretion of mucus D)Absorption of nutrients E)Movement of nutrients into the bloodstream
C)Secretion of mucus D)Absorption of nutrients E)Movement of nutrients into the bloodstream
A nurse is completing a health history on a patient whose diagnosis is chronic gastritis. Which of the data should the nurse consider most significantly related to the etiology of the patient's health problem? A)Consumes one or more protein drinks daily. B)Takes over-the-counter antacids frequently throughout the day. C)Smokes one pack of cigarettes daily. D)Reports a history of social drinking on a weekly basis.
C)Smokes one pack of cigarettes daily.
The physiology instructor is discussing the GI system with the pre-nursing class. What should the instructor describe as a major function of the GI tract? A)The breakdown of food particles into cell form for digestion B)The maintenance of fluid and acid-base balance C)The absorption into the bloodstream of nutrient molecules produced by digestion D)The control of absorption and elimination of electrolytes
C)The absorption into the bloodstream of nutrient molecules produced by digestion
A nurse is planning discharge teaching for a 21-year-old patient 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 patient's copingafter discharge? A)The family's ability to take care of the patient's special diet needs B)The family's ability to monitor the patient's changing health status C)The family's ability to provide emotional support D)The family's ability to manage the patient's medication regimen
C)The family's ability to provide emotional support
A nurse is preparing to discharge a patient after recovery from gastric surgery. What is an appropriate discharge outcome for this patient? A)The patient's bowel movements maintain a loose consistency. B)The patient is able to tolerate three large meals a day. C)The patient maintains or gains weight. D)The patient consumes a diet high in calcium.
C)The patient maintains or gains weight.
A patient who has undergone liver transplantation is ready to be discharged home. Which outcome of health education should the nurse prioritize? A)The patient will obtain measurement of drainage from the T-tube. B)The patient will exercise three times a week. C)The patient will take immunosuppressive agents as required. D)The patient will monitor for signs of liver dysfunction.
C)The patient will take immunosuppressive agents as required.
A patient's screening colonoscopy revealed the presence of numerous polyps in the large bowel. What principle should guide the subsequent treatment of this patient's health problem? A)Adherence to a high-fiber diet will help the polyps resolve. B)The patient should be assured that these are a normal, age-related physiologic change. C)The patient's polyps constitute a risk factor for cancer. D)The presence of polyps is associated with an increased risk of bowel obstruction
C)The patient's polyps constitute a risk factor for cancer.
An older adult has a diagnosis of Alzheimer's disease and has recently been experiencingfecal incontinence. However, the nurse has observed no recent change in the character of the patient's stools. What is the nurse's most appropriate intervention? A)Keep a food diary to determine the foods that exacerbate the patient's symptoms. B)Provide the patient with a bland, low-residue diet. C)Toilet the patient on a frequent, scheduled basis. D)Liaise with the primary care provider to obtain an order for loperamide.
C)Toilet the patient on a frequent, scheduled basis.
A patient 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? A)"Drinking beverages after your meal, rather than with your meal, may bring some relief." B)"It's best to avoid dry foods, such as rice and chicken, because they're harder to swallow." C)"Many patients obtain relief by taking over-the-counter antacids 30 minutes before eating." D)"Instead of eating three meals a day, try eating smaller amounts more often."
D)"Instead of eating three meals a day, try eating smaller amounts more often."
A nurse is performing an admission assessment for an 81-year-old patient who generally enjoys good health. When considering normal, age-related changes to hepatic function, the nurse should anticipate what finding? A) Similar liver size and texture as in younger adults B)A nonpalpable liver C)A slightly enlarged liver with palpably hard edges D)A slightly decreased size of the liver
D)A slightly decreased size of the liver
A local public health nurse is informed that a cook in a local restaurant has been diagnosed with hepatitis A. What should the nurse advise individuals to obtain who ate at this restaurant and have never received the hepatitis A vaccine? A)The hepatitis A vaccine B)Albumin infusion C)The hepatitis A and B vaccines D)An immune globulin injection
D)An immune globulin injection
A patient has been diagnosed with peptic ulcer disease and the nurse is reviewing his prescribed medication regimen with him. What is currently the most commonly used drug regimen for peptic ulcers? A)Bismuth salts, antivirals, and histamine-2 (H2) antagonists B)H2 antagonists, antibiotics, and bicarbonate salts C)Bicarbonate salts, antibiotics, and ZES D)Antibiotics, proton pump inhibitors, and bismuth salts
D)Antibiotics, proton pump inhibitors, and bismuth salts
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? A)Development of new hemorrhoids B)Abdominal bloating and flank pain C)Unexplained weight gain D)Change in bowel habits
D)Change in bowel habits
A nurse is performing an abdominal assessment of an older adult patient. When collecting and analyzing data, the nurse should be cognizant of what age-related change in gastrointestinal structure and function? A)Increased gastric motility B)Decreased gastric pH C)Increased gag reflex D)Decreased mucus secretion
D)Decreased mucus secretion
A nurse is caring for a patient with liver failure and is performing an assessment in the knowledge of the patient's increased risk of bleeding. The nurse recognizes that this risk is related to the patient's inability to synthesize prothrombin in the liver. What factor most likely contributes to this loss of function? A)Alterations in glucose metabolism B)Retention of bile salts C)Inadequate production of albumin by hepatocytes D)Inability of the liver to use vitamin K
D)Inability of the liver to use vitamin K
Which of the following is the most plausible nursing diagnosis for a patient whose treatment for colon cancer has necessitated a colonostomy? A)Risk for Unstable Blood Glucose Due to Changes in Digestion and Absorption B)Unilateral Neglect Related to Decreased Physical Mobility C)Risk for Excess Fluid Volume Related to Dietary Changes and Changes In Absorption D)Ineffective Sexuality Patterns Related to Changes in Self-Concept
D)Ineffective Sexuality Patterns Related to Changes in Self-Concept
A nurse is talking with a patient who is scheduled to have a hemicolectomy with the creation of a colostomy. The patient admits to being anxious, and has many questions concerning the surgery, the care of a stoma, and necessary lifestyle changes. Which of the following nursing actions is most appropriate? A)Reassure the patient that the procedure is relatively low risk and that patients are usually successful in adjusting to an ostomy. B)Provide the patient with educational materials that match the patient's learning style. C)Encourage the patient to write down these concerns and questions to bring forward to the surgeon. D)Maintain an open dialogue with the patient and facilitate a referral to the wound- ostomy-continence (WOC) nurse
D)Maintain an open dialogue with the patient and facilitate a referral to the wound- ostomy-continence (WOC) nurse
A patient 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? A)Preventing infection B)Maintaining skin and tissue integrity C)Preventing nausea and vomiting D)Maintaining fluid and electrolyte balance
D)Maintaining fluid and electrolyte balance
A nurse is caring for a patient who has a diagnosis of GI bleed. During shift assessment, the nurse finds the patient to betachycardic and hypotensive, and the patient has an episode of hematemesis while the nurse is in the room. In addition to monitoring the patient's vital signs and level of conscious, what would be a priority nursing action for this patient? A)Place the patient in a prone position. B)Provide the patient with ice water to slow any GI bleeding. C)Prepare for the insertion of an NG tube. D)Notify the physician.
D)Notify the physician.
A nurse is caring for an older adult who has been experiencing severe Clostridium difficile-related diarrhea. When reviewing the patient's most recent laboratory tests, the nurse should prioritize which of the following? A)White blood cell level B)Creatinine level C)Hemoglobin level D)Potassium level
D)Potassium level
A patient's large bowel obstruction has failed to resolve spontaneously and the patient's worsening condition has warranted admission to the medical unit. Which of the following aspects of nursing care is most appropriate for this patient? A)Administering bowel stimulants as ordered B)Administering bulk-forming laxatives as ordered C)Performing deep palpation as ordered to promote peristalsis D)Preparing the patient for surgical bowel resection
D)Preparing the patient for surgical bowel resection
A patient has just been diagnosed with acute gastritis after presenting in distress to the emergency department with abdominal symptoms. What would be the nursing care most needed by the patient at this time? A)Teaching the patient about necessary nutritional modification B)Helping the patient weigh treatment options C)Teaching the patient about the etiology of gastritis D)Providing the patient with physical and emotional support
D)Providing the patient with physical and emotional support
A nurse is caring for a patient hospitalized with an exacerbation of chronic gastritis. What health promotion topic should the nurse emphasize? A)Strategies for maintaining an alkaline gastric environment B)Safe technique for self-suctioning C)Techniques for positioning correctly to promote gastric healing D)Strategies for avoiding irritating foods and beverages
D)Strategies for avoiding irritating foods and beverages
An inpatient has returned to the medical unit after a barium enema. When assessing the patient's subsequent bowel patterns and stools, what finding should the nurse report to the physician? A)Large, wide stools B)Milky white stools C)Three stools during an 8-hour period of time D)Streaks of blood present in the stool
D)Streaks of blood present in the stool
A nurse is admitting a patient diagnosed with late-stage gastric cancer. The patient's family is distraught and angry that she was not diagnosed earlier in the course of her disease. What factor contributes to the fact that gastric cancer is often detected at a later stage? A)Gastric cancer does not cause signs or symptoms until metastasis has occurred. B)Adherence to screening recommendations for gastric cancer is exceptionally low. C)Early symptoms of gastric cancer are usually attributed to constipation. D) D)The early symptoms of gastric cancer are usually not alarming or highly unusual
D)The early symptoms of gastric cancer are usually not alarming or highly unusual
A patient with a recent history of intermittent bleeding is undergoing capsule endoscopyto determine the source of the bleeding. When explaining this diagnostic test to the patient, what advantage should the nurse describe? A)The test allows visualization of the entire peritoneal cavity. B)The test allows for painless biopsy collection. C)The test does not require fasting. D)The test is noninvasive.
D)The test is noninvasive.
