gi disorders

Chronic irritation of the esophageal epithelial cells by gastric acid, as seen in clients with longstanding gastroesophageal reflux disease (GERD), can result in histologic changes. What term best describes this change? A. Atrophy B. Hyperplasia C. Metaplasia D. Hypertrophy

C. Metaplasia

Which laboratory data should the nurse monitor for the client with inflammatory bowel disease who is prescribed sulfasalazine (Azulfidine), a sulfonamide antibiotic? 1.The client's liver function tests. 2.The client's serum potassium level. 3.The client's serum creatinine level. 4.The client's International Normalized Ratio (INR).

3.The client's serum creatinine level.

The nurse is administering 0800 medications. Which medication should the nurse question? 1.Misoprostol (Cytotec), a prostaglandin analog, to a 29-year-old female with an NSAID-produced ulcer. 2.Omeprazole (Prilosec), a proton-pump inhibitor, to a 68-year-old male with a duodenal ulcer. 3.Furosemide (Lasix), a loop diuretic, to a 56-year-old male with a potassium level of 4.2 mEq/L. 4.Acetaminophen (Tylenol), a nonnarcotic analgesic, to an 84-year-old female with a frontal headache.

1.Misoprostol (Cytotec), a prostaglandin analog, to a 29-year-old female with an NSAID-produced ulcer.

The male client who has essential hypertension tells the clinic nurse he is taking the over-the-counter stool softener docusate sodium (Colace). Which priority action should the clinic nurse implement? 1.Determine how often the client has a bowel movement. 2.Discuss the importance of not taking this stool softener. 3.Ask the client what was his last blood pressure reading. 4.Obtain a stool specimen for an occult blood test.

2.Discuss the importance of not taking this stool softener.

The client diagnosed with diverticulitis is requesting pain medication. Which intervention should the medical nurse implement first? 1.Administer the client's pain medication as requested. 2.Check the client's serum sodium and potassium level. 3.Determine when the last pain medication was administered. 4.Assess the client's bowel sounds and abdomen for tenderness.

4.Assess the client's bowel sounds and abdomen for tenderness.

The nurse on a medical unit has received the morning report. Which medication should the nurse administer first? 1. The proton-pump inhibitor pantoprazole (Protonix) to a client on call to surgery. 2. The antacid calcium carbonate (TUMS) to a client complaining of indigestion. 3. The antimicrobial bismusth (Pepto-Bismol) to a client diagnosed with an ulcer. 4. The H2 blocker famotidime (Pepcid) to a client diagnosed with GERD.

1. The proton-pump inhibitor pantoprazole (Protonix) to a client on call to surgery.

The client is prescribed orlistat (Xenical), a lipase inhibitor. Which statement by the client indicates the client requires more teaching? 1."It does not matter what I eat because I will still lose weight." 2."I will limit the amount of fat in my diet to 30%." 3."I may need to take Metamucil daily with the orlistat." 4."I will take a daily multivitamin supplement."

1."It does not matter what I eat because I will still lose weight."

The nurse is transcribing the admitting health-care provider's orders for an elderly client diagnosed with diverticulitis. Which orders would the nurse question? Select all that apply. 1.Administer one bisacodyl (Dulcolax), by mouth, daily. 2.Insert a nasogastric tube to intermittent low suction. 3.Administer morphine 2 mg intravenous push for pain every 4 hours. 4.Infuse D5 0.45 NS intravenously at 100 mL an hour. 5.Administer a Fleet's enema after each bowel movement.

1.Administer one bisacodyl (Dulcolax), by mouth, daily. 5.Administer a Fleet's enema after each bowel movement.

The 62-year-old client suspected of having diverticulosis is scheduled for a colonoscopy and is prescribed sodium biphosphate (Fleet's Phospho-Soda) the night before the procedure. Which priority intervention should the nurse implement prior to the procedure? 1.Assess the client's skin turgor and oral mucosa. 2.Initiate intravenous therapy for the client. 3.Determine if the client has iodine allergies. 4.Monitor the client's bowel movements.

1.Assess the client's skin turgor and oral mucosa.

The client diagnosed with severe ulcerative colitis is prescribed azathioprine (Imuran), an immunosuppressant. Which assessment data concerning the medication warrants immediate intervention by the nurse? 1.Complaints of a sore throat, fever, and chills. 2.Reports of 10-20 loose stools a day. 3.Complaints of abdominal pain and tenderness. 4.Reports of dry mouth and oral mucosa.

1.Complaints of a sore throat, fever, and chills.

The nurse is discussing the problem of constipation with an elderly client. Which information should the nurse discuss with the client concerning laxative abuse? 1.Explain that stimulant laxatives, the chewing gum and chocolate types, are the kind most often abused. 2.Discuss that laxative abuse can occur if the client takes bulk-forming laxatives on a daily basis. 3.Tell the client that taking a Fleet enema daily will help prevent the client from becoming dependent on laxatives. 4.Recommend to the client that eating a high-fiber diet and increasing fluid consumption will ensure the client will not get constipated.

1.Explain that stimulant laxatives, the chewing gum and chocolate types, are the kind most often abused.

The elderly client calls the clinic and is complaining of loose, watery stools. Which interventions should the nurse implement? Select all that apply. 1.Instruct the client to take the antidiarrheal exactly as recommended. 2.Recommend the client drink clear liquids only, such as tea or broth. 3.Determine how long the client has been having the loose, watery stool. 4.Tell the client to go to the emergency department as soon as possible. 5.Ask the client what other medications he or she has taken in the past 24 hours.

1.Instruct the client to take the antidiarrheal exactly as recommended. 2.Recommend the client drink clear liquids only, such as tea or broth. 3.Determine how long the client has been having the loose, watery stool. 5.Ask the client what other medications he or she has taken in the past 24 hours.

The nurse is preparing to administer the proton-pump inhibitor esomeprazole (Nexium). Which intervention should the nurse implement? Select all that apply. 1.Order an infusion pump for the client. 2.Elevate the client's head of the bed. 3.Check the client's ID band with MAR. 4.Check for allergies to cephalosporin. 5.Ask the client his or her date of birth.

2.Elevate the client's head of the bed. 3.Check the client's ID band with MAR. 5.Ask the client his or her date of birth.

The client with inflammatory bowel disease is prescribed the glucocorticoid prednisone. Which interventions should the nurse implement? Select all that apply. 1.Monitor the client's blood glucose level. 2.Discuss the long-term side effects of prednisone. 3.Administer the medication with food. 4.Explain prednisone will be tapered when being discontinued. 5.Tell the client to notify HCP if moon face occurs.

1.Monitor the client's blood glucose level. 2.Discuss the long-term side effects of prednisone. 3.Administer the medication with food. 4.Explain prednisone will be tapered when being discontinued.

The client with a severe acute exacerbation of Crohn's disease is prescribed total parenteral nutrition (TPN). Which interventions should the nurse implement when administering TPN? Select all that apply. 1.Monitor the client's glucose level every 6 hours. 2.Administer the TPN on an intravenous pump. 3.Assess the peripheral intravenous site every 4 hours. 4.Check the TPN according to the five rights prior to administering. 5.Encourage the client to eat all of the food offered at meals.

1.Monitor the client's glucose level every 6 hours. 2.Administer the TPN on an intravenous pump. 4.Check the TPN according to the five rights prior to administering.

The HCP wrote an order for "0.33% dextrose solution IV" for a 6-year-old child diagnosed with gastroenteritis. Which interventions should the nurse implement? Select all that apply. 1.Monitor the serum sodium and potassium levels. 2.Check the fontanels for the hydration status. 3.Discuss the order with the health-care provider. 4.Use a chamber infusion device on the IV pump. 5.Assess the intravenous site every hour.

1.Monitor the serum sodium and potassium levels. 3.Discuss the order with the health-care provider. 4.Use a chamber infusion device on the IV pump. 5.Assess the intravenous site every hour.

The client with inflammatory bowel disease has been on hyperalimentation, total parenteral nutrition (TPN), for 2 weeks. The HCP has written orders to discontinue TPN. Which intervention should the nurse implement? 1.Notify the health-care provider and question the order. 2.Discontinue the TPN and flush the subclavian port. 3.Do not implement the order and talk to the HCP on rounds. 4.Discuss the order with the pharmacist before discontinuing.

1.Notify the health-care provider and question the order.

The adult client recently has been diagnosed with asthma. Which medication is recommended to treat this problem? 1.Omeprazole (Prilosec), a proton-pump inhibitor, daily. 2.Amoxicillin (Amoxil), an antibiotic, twice daily. 3.Loratadine (Claritin), an antihistamine, twice daily. 4.Prednisone, a glucocorticoid, daily.

1.Omeprazole (Prilosec), a proton-pump inhibitor, daily.

The client taking antibiotics calls the clinic and tells the nurse the client has diarrhea. Which interventions should the nurse implement? Select all that apply. 1.Recommend the client take lactobacillus (Bacid), an antidiarrheal agent. 2.Explain diarrhea is a side effect of antibiotics and should be reported to health-care provider. 3.Ask the client if he or she has had any type of bad-tasting or -smelling food. 4.Instruct the client to quit taking the antibiotic for 24 hours, and then start taking again. 5.Tell client to take one diphenoxylate/atropine (Lomotil) after each loose stool up to 8 a day.

1.Recommend the client take lactobacillus (Bacid), an antidiarrheal agent. 2.Explain diarrhea is a side effect of antibiotics and should be reported to health-care provider. 5.Tell client to take one diphenoxylate/atropine (Lomotil) after each loose stool up to 8 a day.

The male client diagnosed with peptic ulcer disease (PUD) has been taking magnesium hydroxide (Milk of Magnesia) for indigestion. The client complains that he has been having diarrhea. Which intervention should the nurse implement? 1.Suggest that the client use magnesium hydroxide with aluminum hydroxide (Mylanta). 2.Encourage the client to discuss the problem with the health-care provider. 3.Tell the client to take loperamide (Imodium), over the counter. 4.Discuss why the client is concerned about experiencing diarrhea.

1.Suggest that the client use magnesium hydroxide with aluminum hydroxide (Mylanta).

The nurse is discharging a client 2 days postoperative hiatal hernia repair. Which discharge instructions should the nurse include? Select all that apply. 1.Take all the prescribed antibiotic. 2.Eat six small meals per day. 3.Use the legs to bend down, not the back. 4.Take esomeprazole (Nexium) twice a day. 5.Use the pain medication when the pain is at 8-10.

1.Take all the prescribed antibiotic. 2.Eat six small meals per day. 3.Use the legs to bend down, not the back.

The client taking orlistat (Xenical), a lipase inhibitor, reports copious frothy diarrhea stools. Which data should the nurse suspect is the cause of the diarrhea? 1.The client has consumed an excessive amount of fats. 2.The client is also taking a lipid-lowering medication. 3.This is a desired effect of the medication. 4.The client has developed a chronic bowel syndrome.

1.The client has consumed an excessive amount of fats.

The client is prescribed the stimulant laxative senna (Senokot) for constipation. The client calls the clinic and reports yellow-green-colored feces. Which intervention should the clinic nurse implement? 1.Have the client come to the clinic immediately. 2.Explain that this is a common side effect of Senokot. 3.Instruct the client to get a stool specimen to bring to the clinic. 4.Determine if the client has eaten any type of yellow or green food.

2.Explain that this is a common side effect of Senokot.

The client complaining of "acid" when lying down at night asks the nurse if there isany medication that might help. Which statement is the nurse's best response? 1. "There are no medications to treat this problem but losing weight will sometimeshelp the symptoms." 2. "There are several over-the-counter and prescription medications available to treatthis. You should discuss this with the HCP." 3. "Have you had any x-rays or other tests to determine if you have cancer or someother serious illness?" 4. "Acid reflux at night can lead to serious complications. You need to have tests doneto determine the cause."

2. "There are several over-the-counter and prescription medications available to treatthis. You should discuss this with the HCP."

The elderly client with diverticulosis is instructed to take the bulk laxative psyllium mucilloid (Metamucil). Which question is most important for the nurse to ask the client? 1."When was your last bowel movement?" 2."Do you have any difficulty swallowing?" 3."How much fiber do you eat daily?" 4."Do you ever notice any abdominal tenderness?"

2."Do you have any difficulty swallowing?"

The client diagnosed with inflammatory bowel disease is prescribed mesalamine (Asacol), an aspirin product, suppositories. Which statement indicates the client understands the medication teaching? 1."I should retain the suppository for at least 15 minutes." 2."The suppository may stain my underwear or clothing." 3."I should store my medication in the refrigerator." 4."I should have a full rectum when applying the suppository."

2."The suppository may stain my underwear or clothing."

The female client calls the clinic complaining of diarrhea and reports that she just came back from vacation in Mexico. Which intervention should the nurse implement first? 1.Instruct the client to take loperamide (Imodium), an antidiarrheal medication. 2.Ask how long the client has had the diarrhea and when she returned from Mexico. 3.Explain that an antibiotic should be prescribed, and that the client needs to see the HCP. 4.Tell the client this is probably traveler's diarrhea and it will run its course.

2.Ask how long the client has had the diarrhea and when she returned from Mexico.

The female client diagnosed with low back pain has been self-medicating with ibuprofen (Motrin), a nonsteroidal anti-inflammatory drug (NSAID), around the clock. The client calls the clinic and tells the nurse that she has been getting dizzy and light-headed. Which intervention should the nurse implement? 1.Tell the client to get up from a sitting or lying position slowly. 2.Have the client come to the clinic for lab work immediately. 3.Suggest the client take the ibuprofen with food or an antacid. 4.Discuss changing to a different nonsteroidal anti-inflammatory medication.

2.Have the client come to the clinic for lab work immediately.

The nurse is discharging a client diagnosed with gastroesophageal reflux disease (GERD). Which information should the nurse include in the teaching? 1.There are no complications of GERD as long as the client takes the medications. 2.Notify the health-care provider if the medication does not resolve the symptoms. 3.Immediately after a meal, lie down for at least 45 minutes. 4.If any discomfort is noted, take an NSAID for the pain.

2.Notify the health-care provider if the medication does not resolve the symptoms.

The 80-year-old client with diverticulosis is prescribed the stool surfactant docusate sodium (Colace). Which assessment data indicate the medication is effective? 1.The client has a bowel movement within 8 hours. 2.The client has soft, brown stools. 3.The client has a soft, non-tender abdomen. 4.The client has bowel sounds in all four quadrants

2.The client has soft, brown stools.

Which side effects would the nurse explain to the male client who is prescribed cimetidine (Tagamet), a histamine2blocker? 1.The medication can cause indigestion and heartburn. 2.The medication can cause impotence and gynecomastia. 3.The medication can cause insomnia and hypervigilance. 4.The medication can cause Zollinger-Ellison syndrome.

2.The medication can cause impotence and gynecomastia.

The home health-care nurse is caring for a male client diagnosed with a hiatal hernia and reflux. Which data indicates the medication therapy is effective? 1.The client takes the antacid 1 hour before and 3 hours after a meal. 2.The client complains of indigestion after eating a large meal. 3.The client states that he did not wake up with heartburn during the night. 4. The client has lost 3 pounds in the past 2 weeks.

3.The client states that he did not wake up with heartburn during the night.

The nurse is working at a senior citizen center. She is giving a lecture on health-promotion activities for the elderly. Which information should the nurse discuss with the group to help prevent constipation? 1.The antispasmodic dicyclomine (Bentyl), taken every morning with the breakfast meals, will help prevent constipation. 2.Eating five to six small meals a day including low-residue foods will help prevent the development of constipation. 3.Taking a daily stool softener along with daily exercise, increased fluids, and a high-fiber diet will help prevent constipation from developing. 4.Elderly clients must have at least one bowel movement a day to prevent the development of constipation.

3.Taking a daily stool softener along with daily exercise, increased fluids, and a high-fiber diet will help prevent constipation from developing.

The client diagnosed with inflammatory bowel disease taking mesalamine (Asacol), an aspirin product, has complaints of nausea, vomiting, and diarrhea. Which intervention should the clinic nurse take? 1.Instruct the client to quit taking the medication immediately. 2.Tell the client to take Prevacid, a proton-pump inhibitor, with the medication. 3.Advise the client to keep taking the medication, but notify the HCP. 4.Explain that these symptoms are expected and will resolve with time.

3.Advise the client to keep taking the medication, but notify the HCP.

Which medication should be the most appropriate medication for the client who is obese who is trying to quit smoking? 1.Orlistat (Xenical), a lipase inhibitor. 2.Sibutramine (Meridia), an appetite suppressant. 3.Bupropion (Zyban), an antidepressant. 4.Olestra (Olean), a fat substitute.

3.Bupropion (Zyban), an antidepressant.

The 72-year-old client is admitted to the medical unit diagnosed with an acute exacerbation of diverticulosis. The health-care provider has prescribed the intravenous antibiotic ceftriaxone (Rocephin). Which intervention should the nurse implement first? 1.Monitor the client's white blood cell count. 2.Assess the client's most recent vital signs. 3.Determine if the client has any known allergies. 4.Send a stool specimen to the laboratory.

3.Determine if the client has any known allergies.

Which information should the nurse discuss with the 75-year-old client diagnosed with diverticulosis who is prescribed methylcellulose (Citrucel), a bulk laxative? 1.Notify the health-care provider if abdominal cramping occurs. 2.Explain that results should be evident within 24 hours. 3.Encourage the client to increase the intake of fluids, especially water. 4.Instruct the client to decrease fiber intake while taking this medication.

3.Encourage the client to increase the intake of fluids, especially water.

The client is diagnosed with a Helicobacter pylori infection and peptic ulcer disease (PUD). Which discharge instructions should the nurse teach? Select all that apply. 1.Discuss placing the head of the bed on blocks to prevent reflux. 2.Teach to never use nonsteroidal anti-inflammatory drugs again. 3.Encourage the client to quit smoking cigarettes. 4.Instruct the client to eat a soft, bland diet. 5.Take the combination of medications for 14 days as directed.

3.Encourage the client to quit smoking cigarettes. 5.Take the combination of medications for 14 days as directed.

The client diagnosed with peptic ulcer disease is admitted to the medical unit with a hemoglobin level of 6.2 g/dL and a hematocrit level of 18%. Which intervention should the nurse prepare to implement first? 1.Obtain an order for an oral proton-pump inhibitor. 2.Instruct the client to save all stools for observation. 3.Initiate an IV with 0.9% NS with an 18-gauge catheter. 4.Place a bedside commode in the client's room.

3.Initiate an IV with 0.9% NS with an 18-gauge catheter.

25. The intensive care nurse is preparing to administer the H2 Receptor blocker ranitidine (Zantac) IVPB to a client with severe burns. Which statement is the scientific rationale for administering this medication? 1.Zantac will prevent an H. pylori infection. 2.The client has a history of ulcer disease. 3.It is for prophylaxis to prevent Curling's ulcer. 4.There is no rationale; the nurse should question the order.

3.It is for prophylaxis to prevent Curling's ulcer.

The child diagnosed with gastroenteritis is scheduled for an endoscopic examination of the stomach and duodenum. Which intervention is priority for the nurse assisting with the procedure? 1.Watch the screen for abnormal data. 2.Hand the physician the instruments. 3.Monitor the child's respiratory status. 4.Clean the instruments between clients.

3.Monitor the child's respiratory status.

Which statement is the scientific rationale for administering a proton-pump inhibitor(PPI) to a client diagnosed with gastrointestinal reflux disease (GERD)? 1.PPI medications neutralize the gastric secretions. 2.PPI medications block H2receptors on the parietal cells. 3.PPI medications inhibit the enzyme that generates gastric acid. 4.PPI medications form a protective barrier against acid and pepsin.

3.PPI medications inhibit the enzyme that generates gastric acid.

The client is prescribed a bulk-forming agent. Which statement best describes the scientific rationale for administering this medication? 1.The medication acts by lubricating the stool and the colon mucosa. 2.Bulk-forming agents irritate the bowel to increase peristalsis. 3.The medication causes more water and fat to be absorbed into the stool. 4.Bulk-forming agents absorb water, which adds size to the fecal mass.

4.Bulk-forming agents absorb water, which adds size to the fecal mass.

The client diagnosed with ulcerative colitis is prescribed mesalamine (Asacol), an aspirin product. Which information should the nurse discuss with the client? 1.Explain to the client that undissolved tablets may be expelled in stool. 2.Discuss the importance of taking the medication on an empty stomach only. 3.Tell the client to avoid drinking any type of carbonated beverages. 4. Instruct the client not to crush, break, or chew the tablets or capsules.

4. Instruct the client not to crush, break, or chew the tablets or capsules.

Which statement is an advantage to administering a histamine 2 blocker rather than an antacid to a client diagnosed with gastroesophageal reflux disease (GERD)? 1.Antacids are more potent than H2blockers in relieving the symptoms of GERD. 2.Histamine2blockers have more side effects than antacids. 3.Histamine2 blockers are less expensive than antacids. 4.Histamine2 blockers require less frequent dosing than antacids.

4.Histamine2 blockers require less frequent dosing than antacids.

The client calls the clinic and reports large amounts of watery stool for the past 3 days. Which intervention should the clinic nurse implement? 1.Instruct the client to take diphenoxylate (Lomotil) after each loose stool. 2.Recommend the client eat some cheese or constipating-type food. 3.Request that the client write down all foods ingested in the past 3 days. 4.Make an appointment for the client to come to the clinic today.

4.Make an appointment for the client to come to the clinic today.

The nurse is administering 0900 medications to a client diagnosed with peptic ulcer disease (PUD). Which medication should the nurse question? 1.Metronidazole (Flagyl), an anti-infective. 2.Bismuth subsalicylate (Pepto Bismol), an antibiotic. 3.Lansoprazole (Prevacid), a proton-pump inhibitor. 4.Sucralfate (Carafate), a mucosal barrier agent.

4.Sucralfate (Carafate), a mucosal barrier agent.

The client with diarrhea is taking diphenoxylate (Lomotil). Which intervention should the nurse discuss with the client? 1.Instruct the client to take one pill after each loose stool until the diarrhea stops. 2.Discuss the need to decrease fluid intake to help decrease loose, watery stool. 3.Explain that the medication should be taken once a day for 1 week. 4.Tell the client not to take more than eight tablets in a 24-hour period.

4.Tell the client not to take more than eight tablets in a 24-hour period.

The client has been on a therapeutic regimen for an H. pylori infection. Which data suggests the medication is not effective? 1.The client states that the midepigastric pain has been relieved. 2.The client's hemoglobin is 15 g/dL and the hematocrit is 44%. 3.The client has gained 3 pounds in 1 week. 4.The client's pulse is 124 and blood pressure is 92/48.

4.The client's pulse is 124 and blood pressure is 92/48.

The client who is obese is participating in an investigational study using metformin (Glucophage), a biguanide antidiabetic medication, for weight loss. Which data should the nurse monitor? 1.The hemoglobin A1C every 2 months. 2.Daily fasting glucose levels. 3.The urine ketones every 2 weeks. 4.The client's weight every month.

4.The client's weight every month.

The child diagnosed with infectious gastroenteritis is prescribed Bactrim, a sulfa antibiotic, 10 mg/kg/day in divided doses twice a day. The child weighs 60 pounds. The medication comes 100 mg/5 mL. How many milliliters will the nurse administer with the morning dose?

6.8 mL per dose. 6.8 mL per dose. The first step is to determine the body weight in kilograms. 60 pounds divided by the 2.2 conversion factor is 27.272, or 27.27 kg. Multiply 27.27 times 10 to find the milligrams, which results in 272.2 or 272 mg of medication each 24 hours. Divide 272 mg by 2 to determine the amount of medication to be administered each dosing time; this equals 136 mg per dose. To set up the algebraic formula:136 x= 100 Then cross multiply:100 x= 680 To solve for x, divide each side of the equation by 100:x =6.8 mL per dose

A client has a chronic left sided abdominal pain and rectal bleeding. The results of the colonoscopy show "herniations of the mucosa and submucosa through the muscularis." Based on this description, the nurse should suspect that the client is experiencing which condition? A. Diverticulosis B. Celiac disease C. Crohn's disease D. Ulcerative colitis

A. Diverticulosis

Digestion begins in the mouth with salivary α-amylase (ptyalin) that initiates the digestion of: A. proteins. B. carbohydrates. C. fats. D. amino acids.

B. carbohydrates.