GI and Gallbladder

A nurse is caring for an older adult client who reports taking bisacodyl tablets daily. Which of the following responses should the nurse make?

"Excessive laxative use may cause an electrolyte imbalance."

A nurse is providing teaching about ileostomy care to a client. Which of the following statements by the client indicates a need for further teaching?

"I will be certain to take enteric-coated medications."

A nurse is providing information about pain control for a client who has acute pain following a subtotal gastric resection. Which of the following client statements indicates an understanding of pain control?

"I will call for pain medication before the previous dose wears off."

A nurse is teaching a client how to do fecal occult blood testing. Which of the following statements by the client indicates a need for further teaching?

"I will continue taking my Coumadin as prescribed."

A client who is scheduled for a barium swallow asks the nurse why a laxative is necessary following the procedure. Which of the following responses should the nurse make?

"The laxative helps eliminate the barium."

A nurse is teaching a client who is preoperative for a colectomy. The client asks the nurse why he needs a large-bore NG tube. Which of the following statements should the nurse make?

"The tube will remove gas and fluid from your stomach."

A nurse is planning care for a client who has cirrhosis of the liver. Which of the following actions should the nurse include in the plan? (Select all that apply.)

-Administer furosemide -Implement a low-sodium diet -Measure the client's abdominal girth

A nurse is planning a menu for a client who has folic acid deficiency anemia. Which of the following foods should the nurse include as high in folate?

1/2 cup of asparagus

A nurse is preparing to administer liquid famotidine 20 mg PO every 6 hr for a client who has GERD. Available is famotidine 40 mg/5 mL. How many mL should the nurse administer? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.)

2.5 ml

A nurse is assessing clients in a health clinic for risk factors for contracting hepatitis. Which of the following clients is at risk for developing hepatitis C?

A client who has multiple tattoos

A nurse is assessing a client who has advanced cirrhosis. Which of the following manifestations should the nurse expect?

A: Petechiae A manifestation of advanced cirrhosis is petechiae due to impaired coagulation from a dysfunctional liver.

A nurse is reviewing the laboratory data of a client who has acute pancreatitis. The nurse should expect to find an elevation of which of following values?

Amylase Ational:Amylase is an enzyme that changes complex sugars into simple sugars that can be used by the body, it is produced by the pantreas and salivary glands and released into the mouth, stomach, and intestines to aid in digestion. The amylase level of a client who has acute pancreatitis usually increases within 12 to 24 hr and can remain elevated for 2 to 3 days.

A nurse is caring for a client who has gastrointestinal bleeding. Which of the following actions should the nurse take first?

Assess orthostatic blood pressure

A nurse is preparing dietary instructions for a client who has episodes of biliary colic from chronic cholecystitis. Which of the following instructions should the nurse include in the teaching plan?

Avoid foods high in fat

A nurse is teaching a class about preventive care to clients who are at risk for acquiring viral hepatitis. Which of the following information should the nurse include in the presentation?

Avoid foods prepared with tap water

A nurse is caring for a client who has ulcerative colitis and is teaching the client about the common link with Crohn's disease. Which of the following information should the nurse include?

Both are inflammatory

A nurse is caring for a client who has a history of alcohol use disorder and reports bruising and frequent nosebleeds. The nurse should recognize that this client in manifesting which of the following conditions?

Cirrhosis The nurse should recognizes this client is displaying manifestations of cirrhosis. A history of alcohol use disorder increases the client's risk of developing cirrhosis and coagulation defects are a common complication of cirrhosis.

A nurse is admitting a client who was prescribed antibiotic therapy and now has a Clostridium difficile infection. Which of the following actions should the nurse take?

Disinfect equipment in the client's room daily

A nurse is caring for a client who has liver cirrhosis with ascites, bleeding esophageal varices, and portal hypertension. The nurse recognizes which of the following laboratory findings as indicating the client's gastrointestinal (Gl) tract is digesting and absorbing blood?

Elevated blood urea nitrogen (BUN)

A nurse is providing care for a client who had a laparoscopic cholecystectomy. Which of the following is an appropriate nursing action?

Encourage ambulation once fully awake

A nurse is assessing a client who has an obstruction of the common bile duct resulting from chronic cholecystitis. Which of the following findings should the nurse expect?

Fatty stools Chronic cholecystitis occurs following several bouts of acute cholecystitis. The repeated episodes of inflammation result in a fibrotic and contracted gallbladder. Because of inflammation in the gallbladder, bile needed to absorb fat and fat-soluble vitamins is unable to enter the bowel, resulting in steatorrhea (fatty stools).

A nurse is assessing a client who is African-American and has jaundice. Which of the following areas is the most reliable for the nurse to inspect the client for jaundice?

Hard palate According to evidence-based practice, inspecting the client's oral mucous membrane and hard palate are the most reliable methods to determine jaundice for a client who is African-American.

A nurse is caring for a client with who has hepatitis A. The client asks the nurse how he might have contracted the virus. Which of the following is a question the nurse should ask the client?

Have you been to a third world country in the past?

A nurse is assessing a client who has peptic ulcer disease. Which of the following findings should the nurse identify as the priority?

Hematemesis When using the urgent vs. non-urgent approach to client care, the nurse should determine that the priority finding is hematemesis, which indicates massive bleeding.

A nurse is preparing a client who is scheduled to undergo a paracentesis. Into which of the following positions should the nurse assist the client for this procedure?

High-Fowler's Sitting upright facilitates pooling of peritoneal fluid for easier drainage.

A nurse is planning care for a client who is postoperative and at risk for paralytic ileus. Which of the following interventions should the nurse plan to take to promote peristalsis?

Increase ambulation. Decreased bowel motility is an adverse effect of anesthesia. The nurse should encourage the client to ambulate and increase fiber intake as prescribed to promote a return of bowel function and reduce the risk for paralytic ileus.

A nurse admits a client to the emergency department who reports nausea and vomiting that worsens when he lies down. Antacids do not help. The provider suspects acute pancreatitis. Which of the following laboratory test results should the nurse expect to see?

Increased serum amylase

A nurse is reviewing the provider's prescriptions for a client experiencing a paralytic ileus following an appendectomy. Which of the following actions should the nurse expect to take?

Insert a nasogastric tube

A nurse is teaching a client about strategies to manage gastrosophageal reflux disease (GERD). Which of the following statements should the nurse include?

Lie on your right side when sleeping

A nurse is administering a tap water enema to a client who is constipated. During the administration of the enema, the client states he is having abdominal cramps. Which of the following actions should the nurse take to relieve the client's discomfort?

Lower the height of the solution container. If nausea or cramping occurs, the flow of water should momentarily be slowed or stopped by lowering the device or clamping the tubing. This allows the intestinal spasm to pass while leaving the catheter in place. The nurse should then continue administering the enema at a slower rate once the cramping has passed.

A nurse is teaching a client about causes of biliary cirrhosis. Which of the following information should the nurse include in the teaching?

Obstruction of the bile duct Prolonged obstruction of the common bile duct is the most common cause of biliary cirrhosis.

A nurse is caring for a client who is postoperative following abdominal surgery. Which of the following findings should indicate to the nurse the client's peristalsis is returning?

Passage of flatus

A nurse is teaching self-management to a client who has hepatitis B. Which of the following Instructions should the nurse include in the teaching?

Rest frequently throughout the day

A nurse is caring for a client who has just returned from the PACU after a traditional cholecystectomy. In which of the following positions should the nurse place the client?

Semi-Fowler's

A nurse is assessing a client who has cirrhosis. Which of the following is an expected finding for this client?

Spider angiomas

A nurse is caring for a client who has peptic ulcer disease. The nurse should monitor the client for which of the following findings as an indication of gastrointestinal perforation?

Sudden abdominal pain

A nurse is talking with a client who has cholelithiasis and is about to undergo an oral cholangiogram. Which of the following client statements indicates to the nurse understanding of the procedure?

They are going to examine my gallbladder and ducts

A nurse is providing instructions for a 52-year-old client who is scheduled for a colonoscopy. The client reports that he has not had the procedure before and is very anxious about feeling pain during the procedure. Which of the following responses by the nurse is appropriate?

before the examination, your provider will give you a sedative that will make you sleepy

A nurse is providing teaching for a client who has a new diagnosis of gastroesophageal reflux disease (GERD). The client asks about foods he should avoid eating. Which of the following foods should the nurse tell him to avoid

chocolate

A nurse is teaching a client who has a history of ulcerative colitis and a new diagnosis of anemia. Which of the following manifestations of colitis should the nurse identify as a contributing factor to the development of the anemia?

chronic blood loss

A nurse is teaching a client who has a prescription of a nasogastric tube (NG) to treat a pyloric obstruction. Which of the following rationales for the use of the nasogastric tube should the nurse include in the teaching?

decompress the stomach

A nurse is planning care for a client who has hepatitis B. Which of the following interventions should the nurse include in the plan?

encourage short periods of ambulation

A nurse is caring for a client who reports having chronic constipation. Which of the following herbal supplements should the nurse recommend?

flaxseed

A nurse is caring for a client following an esophagogastroduodenoscopy (EGD) procedure. Which of the following assessments is the nurse's priority?

gag reflex

A nurse is interviewing a client who has acute pancreatitis. Which of the following factors should the nurse anticipate finding in the client's history?

gallstones

A nurse is caring for a client who has diverticular disease. When palpating the client's abdomen, in which of the following locations should the nurse expect the client to report abdominal pain?

lower left quadrant

A nurse is teaching a client who is receiving treatment for metastatic colorectal cancer about the adverse effects of bevacizumab with. The nurse should instruct the client to report which of the following findings as an adverse effect of the medication?

nosebleeds

A nurse is assessing a client who is 3 days postoperative following abdominal surgery and notes the absence of bowel sounds, abdominal distention, and the client passing no flatus. Which of the following conditions should the nurse suspect?

paralytic ileus

A client is about to undergo an abdominal paracentesis. In which of the following positions should the nurse place the client?

upright

A nurse is providing teaching to a client who has a new colostomy. Which of the following information should the nurse include in the teaching?

you may experience a small amount of bleeding around the stoma