GI system
A nurse is doing a physical assessment on a client with a GI disorder. Which position will the nurse most likely ask the client to assume when performing an abdominal examination
supine with knees flexed slightly
barium enema preparation
the client should be on clear liquids the evening before the procedure, a low reside diet 1-2 days before the test, and NPO at midnight in preparation for the barium enema
dimenhydrinate
this is an antihistamine that is contraindicated for angle-closure glaucoma
Which of the following asessment findings would be most appropraite for indicating dumping syndrome in a postgastrectomy client
weakness, diaphoresis, and diarrhea 90 minutes after eating
The nurse is inserting a ng tube for a patient with pancreatitis. What intervention can the nurse provide to allow facilitation of the tube insertion
allow the patient to sip water as the tube is being inserted
A nurse is reviewing the lab results of a client who has hepatic cirrhosis. Which of teh followng lav values sould the nurse report toi the provider
ammonia levels
The American Cancer Society recommends routine screening to detect colorectal cancer. Which screening test for colorectal cancer should a nurse recommend?
annual digital examination after age 40
A primary care provider should use caution when prescribing bisacodyl for a patient who has
anorexia nervosa; this is a stimulant laxative that requires caution with patients who have an eating disorder because of teh risk of laxative abuse
A nurse is assessing a client who has an upper GI bleed. Which of the following findings should the nurse expect
hypotension
gastrin function
increased motility of the stomach
endoscopic retrograde cholangiopancreatography
visualizes the biliary structures and the pancreas via the endoscopy ERCP
A nurse is providing discharge teaching for a client who has a new prescription for medications to treat peptic ulcer disease. The nurse should inform the client that which of the following medications inhibits gastric acid secretion
famotidine
A nurse is assessing a client who has crohn's disease. Which of the following findings should the nurse expect
fatty diarrheal stools
A nursing instructor is preparing a class about gastrointestinal intubation. Which of the following would the instructor include as reason for this procedure?
flush ingested toxins from the stomach diagnose gastrointestinal motility disorders flush ingested toxins from the stomach administer nutritional substances decompression
The nurse is to discontinue a nasogastric tube that has been used for decompression . What is the first thing the nurse should do?
flush with 10 mL fo water
The nruse is conucting a community education program on peptic ulcer disease prevention. The nurse includes that the most common cause of peptic ulcer is
gram neg bacteria
A nurse is reviewing the lab results of a client who has acute pancreatitis. Which of the following findings should the nruse expcect
increased amylase due to pancreatic cel injury
A nurse is caring for a patient with a salem sump gastric tube attached to low intermittent suction for decompression. the pateint asks what the blue part of the tibe is for. What will the nruse say
it is a vent that prevents backflow of the secretions ; The blue part of the Salem sump tube vents the larger suction-drainage tube to the atmosphere and, when kept above the patient's waist, prevents reflux of gastric contents through it.
A nurse is assessing a client who has acute Hep B. Which of the following findings should the nurse expect
joint pain
A client with enteritis reports frequent diarrhea. What assessment should the nurse should anticipate?
metabolic acidosis ; bc getting rid of all the mucus
Vomiting results in which of the following acid-base imbalances?
metabolic alkalosis; Vomiting results in loss of hydrochloric acid (HCl) and potassium from the stomach, leading to a reduction of chlorides and potassium in the blood and to metabolic alkalosis.
A client is receiving parenteral nutrition through a PICC line and will be discharged home with PN. the home health nurse evaluates the home setting and would make a recommendation when noticing which circumstance
no land line; cell phone available and taken by family member during working hours
A client is to receive parenteral nutrition for 4 weeks. What type of catheter would the nurse prepare to teach the client about the planned nutrition
nontunneled centrala catheter
The Zollinger-Ellison syndrome (ZES) consists of severe peptic ulcers, extreme gastric hyperacidity, and gastrin-secreting benign or malignant tumors of the pancreas. The nurse recognizes that an agent that is used to decrease bleeding and decrease gastric acid secretions is
ocreotide; For patients with ZES, hypersecretion of acid may be controlled with high doses of H2 receptor antagonists. These clients may require twice the normal dose, and dosages usually need to be increased with prolonged use. Octreotide (Sandostatin), a medication that suppresses gastrin levels, also may be prescribed.
A nurse is assessing a client who has appendicitis. Which of the following findings should the nurse expect
oral temperature of 101.1 nausea and vomiting right lower quadrant pain
A nurse is monitoring a client with peptic ulcer disease. Which assessment finding would most likely indicate perforation of the ulcer
tachycardia hypotension a rigid board-like abdomen ; pain can also radiate to the shoulders
While completing an abdominal assessment, the nurse will use which landmark as the upper boundary for auscultating bowel sounds?
xiphoid process
A nurse is providing discharge teaching for a client who has a new colostomy and is concerned about flatus and stool. Which of the folloeing foods should the nurse recommend to the client
yogurt, crackers, and toast prevnents stool odor
A health care professional is carinf for a patient who is about to begin taking azathiprine to treat inflammatory bowel disease. The health care professional should tell the patient to report which of the following adverse effects
bruising, jaundice, sore throat, nausea
A patient comes to the clinic with the complaint of "I think I have an ulcer" what is a characteristic associated with peptic ulcer pain that the nurse should inquire about
burning sensation localized in the back or med-epigastrium feeling of emptiness that preceds meals from 1-3 hours severe gnawing pain that increases in severeity as the day progresses
A client is readmitted with an exacerbation of celiac disease 2 weeks after discharge. Which statement by the client indicates the need for a dietary consult?
"I didn't eat anything I shouldn't have; I just ate roast beef on rye bread."
Which of the following is the diagnostic of choice if the suspected diagnosis is diverticulitis?
CT
A client admitted for treatment of gastric ulcer is being prepared for dicharge. The client will follow a regimen of antacid therapy. Discharge teaching should inclde
Continue to take antacids even if your symptoms subside." "You may be prescribed H2-receptor antagonists for up to 1 year." taking antacids concomitantly with other drugs should be avoided. For best results antacids should be taken 1 hour before or 2 hours after meals. Antacids will not make the client sleepy.
A nurse cares for a client with interstitial pancreatitis. What client teaching will the nurse include when planning care for the client
inflammation is confined to only the pancreas
A cient has undergone a liver biopsy. After the procedure the nurse should place the client in which positio
on the right side
Health teaching for a patient with GERD is directed toward decreasing lower esophageal sphincter pressure and irritation. The nurse instructs the patient to do which of the following?
-avoid beer, especially in the evening -elevate the head of the bed 6 to 8 inch blocks elevate the upper body on pillows
A nurse is providing teaching for a clien who has chronic pancreatitis. WHich of the following food selections by the client indicates an understandiing of the teaching
2 cup of sliced banana ; foods that are high in fat can cause diarrhea for clients who have pancreatitis!!!! avoid this
gastritis types
Acute gastritis usually develops quickly, whereas chronic gastritis results from prolonged inflammation of the stomach.
Which of the following drugs has protocols that require patients to meet SPECIFIC risk management criteria and sign a treatment agreement before the health care professional can administer the drug
Alosetron (Lotronex) this med treats IBS - Diarrhea because patients can develop constipation and can lead to impaction, bowel obstricution, perforation, and fatal ischemic colitis
A health care professional is caring for a patient who is about to begin taking ranitidine to treat GERD. The health care professional should tell the patient to take certain precautions when taking which of the following over the counter drugs?
Antacids; it can decrease the absorption of ranitidine. The nurse should tell the patient ti allow at least 1 hr between taking ranitidne and taking an antacid.
A nurse is providing discharge teaching for a client who has mild diverticulitis. Which of the follpowing statements by the client indicates an understanding of the teaching
I should eat foods that are low in fiber . when inflmmation subsides, the client can consume foods that are high in fiber
A nurse is providing discharge teaching for a client who has peptic ulcer disease and a new prescriton for famotidine. Which of the following statements by the client indicates an understanding of the teaching
I should take this medication at bedtime
A nurse is admittinga client who has acute pancreatitis. Which of the following actions should the nurse take first
Identify the current level of pain
The nurse in the ED admits a client with suspected gastric outlet obstruction. The client's symptoms include nausea and vomiting. The nurse anticipates that the physician will issue which order?
NG tube insertion to decompress the stomach.
Which diagnostic produces images of the body by detecting the radiation emitted from radioactive substances?
PET; PET produces images of the body by detecting the radiation emitted from radioactive substances. CT provides cross-sectional images of abdominal organs and structures. MRI uses magnetic fields and radio waves to produce an image of the area being studied. Fibroscopy of the upper GI tract allows direct visualization of the esophageal, gastric, and duodenal mucosa through a lighted endoscope.
A client presents to the ED with acute abdominal pain, fever, nausea, and vomiting. During the client's examination, the lower left abdominal quadrant is palpated, causing the client to report pain in the RLQ. This positive sign is referred to as ________ and suggests the client may be experiencing ________.
Rovsing's sign and acute appendicitis
A client tells the nurse, "I am not having normal bowel movements." When differentiating between what are normal and abnormal bowel habits, what indicators are the most important?
The consistency of stool and comfort when passing stool
A patient is receiving a continuous tube feeding. The nurse notes tthat the feeding tube was last irrigated at 2 pm. The nurse would plan to irrigate the tube again at which time
The recommendation is to irrigate the feeding tube of patients receiving continuous tube feedings every 4 to 6 hours. 6-8 pm
An examiner is performing the physical assessment of the rectum, perianal region, and anus. While this examination can be uncomfortable for many clients, health care providers must approach it in a prepared, confident manner. Which of the following considerations will help this examination flow smoothly and efficiently for both provider and client? Select all that apply.
ask the client to bear down for visual inspection position the cllient on the right side with the knees up to the chest
A nurse is caring fotr a client who has GERD and a new prescription of reglan. The nurse should plan toi monitor for which of the following adverse effeccts
ataxia' Extrapyrimidal symptoms because it is a dopamine antagonism
which tube is a nasoenteric feeding tube
dobbhoff
A nurse is assessing a client for GI dysfunction. What is the most common symptom in a client wtih GI dehydration
dyspepsia; Dyspepsia is a condition that usually involves a combination of symptoms: abdominal pain, bloating, distention, nausea, and belching.
The nurse is obtaininga history on a patient who comes to the clinic. What symptom described by the patient is one of the first symptoms associated with esophageal disease
dysphagia
An elderly client seeks medical attention for a vague complaint of difficulty swallowing. Which of the following assessment findings is most significant as related to this symptom
esophageal tumor
A client underwent a continent ileostomy. Within which time frame should the client expect to empty the reservoir?
every 4 to 6 hrs
A health care professional should question the use of diphenoxylate. atropine for a patient who has which of the following disorders?
inflammatory bowel disease; this is an opioid which can cause severe compliaction of toxic megacolon in patients who have inflammatory bowel disease.
The nruse is assisting the health care provuder with a gastric acid stimulation test for a client. What medicaiton should the nurse prepare to administer SQ to stimulate gastric secretion
pentagastrin or histamine
metoclopramide
prokinetic that can cause mild sedation and anticholineric effects including dry mouth.
a patient descirbes a burning sensation in the esophagus, pain when swallowing, and frequent indigestion. What does the nurse suspect that these clinical manifestations indicate
gastroesopahgeal reflux disease
A patient with GERD has a diagnosis of barrett esopahgus and has been admitted to a medical unit. The nurse is writing a care plan for this patient. What information is essential to include
he will need to undergo an upper endoscopy every 6 months to detect malignant changes
The nurse is assessing a client with an ulcer for signs and symptoms of hemorrage. The nurse interupts which condition as a sign or symptom of possible hemorrage
hematemesis
A nurse is reviewing the lav values of a client who has colorectal cancer. Which of the following should the nurse expectr
hgb 9.1
A nurse is assesing a client who is postop following a gastectomy. the nruse should identify which of the following findings as an indication of abdominal distention
hiccups
blood flow to the GI tract
20%
A patient is receiving continuous tube feedings via a small bore feeding tube. The nurse irrigates the tube after administering medication to maintain patency. Which size syringe would the nurse use
30 mL
A nurse is preparing a presentation for a local community group of older adults about colon cancer. What would the nurse include as the primary characteristic associated with this disorder?
A change in bowel habit
A community health nurse is performing a home visit to a 53-year-old patient who requires twice-weekly wound care on her foot. The patient mentions that she is currently having hemorrhoids, a problem that she has not previously experienced. What treatment measure should the nurse recommend to this patient?
A high fiber diet with increased fruit intake
A nurse is providing teachng for a client who has chronic hepatits C. Which of the following statements by the client indicates an understanding of the teaching
I will avoid medications that contain tylenol
A nurse is providing discahrge teaching for a client with GERD. Which of the following statements by the client indicates an understanding of the teaching
I will decrease the amount of carbonated benverages I drink
A nurse is providing dietary teaching for a client who has a new diagnosis of celiac disease. Which of the following statements by the client indicates an understanding of the teaching
I will eat beans to ensure I get enough fiber in my diet
A nurse is performing discharge teaching with a client who had a total gastrectomy. Which statement indicates the need for further teaching
I will have to take v B12 shots for 1 year after surgery
An older adult client in a long-term care facility is concerned about bowel regularity. During a client education session, the nurse reinforces the medically acceptable definition of "regularity." What is the actual measurement of "regular"?
Stool consistency and client comfort
lavage solution
This is used to as a cleaning solution for the bowel to prep for diagnostic tests. the nurse stops administering the lavage solution and notifies the physician when the nurse notes that the client has inflammatory bowel disease. Another contraindication for use of lavage solution is intestinal obstruction.
A primary care provider should use caution when prescribing sulfasalazine for a patient who has
aspirin sentivitity; Any sensitivity to salicylates, sulfonamides, or trimethoprim (Primsol) is a contraindication for the use of sulfasalazine, a 5-aminosalicylate. This is because intestinal bacteria metabolize the drug into 5-aminosalicylic acid, a salicylate. Aspirin is also a salicylate.
When describing abdominal hernias to a group of nursing students, the instructor would identify which type as most common?
inguinal
The nurse is caring for a client who has a gastrostomy tube feeding. Upon initiation of care, the nurse aspirates the gastrostomy tube for gastric residual volume and obtains 200 ml of contents. What is the priority action by the nurse
place the client in a semi-fwolers position with the head of bed at 45
A nurse is caring for a client who has ulcerative colitis. The client has had several exacerbations over the past 3 years. Which of the following isntructuons should the nurse include in the plan of care to minimize the risk of further exacerbations
use progressive relaxation technqiues arrage activities to allow for daily rest periods restrict intake of carbonated beverages; the client should restrict intake of dietary fiber which can cause diarrhea and cramping
celiac axis arteriography
visualizes the liver and the pancreas
Which statement correctly identifies a difference between duodenal and gastric ulcers
vomiting is uncommen with duodebnal ulcers
The nurse recognizes whcih change of the GI system is an age related change
weakened gag reflex
A nurse is reviewing the prescription for a client who has compylobacter enteritis. Which of teh following prescriptions should the nurse clarify with the provider
magnesium hydroxideA m
A nurse is teaching a client how to prepare for a colonoscopy. Which of the following instructions should the nurse include in the teaching
drink clear liquids for 24 hours before the procedure and then take nothing by mouth for 6 hours before the procedure
aphthous stomatitis
refers to a canker sore of the oral soft tissues including the lips, tongue, and inside of the cheek
A nurse is assessing a client who has a duodenal ulcer. Which of the following findings should the nurse expect
The client reports that the pain occurs at night
H2 receptor antagonist
cns effects : lethargy, depression, confusion, seizures.
What is secretin
it is stimulated by the Ph of chyme in the duodenum and stimulates the production of bicarbonate in pancreatic juice
A group of students is reviewing information about oral cancers in preparation for an examination. The students demonstrate a need for additional review when they identify which of the following as a risk factor? You Selected:
Hx of GERD
A nurse practitioner who is treating a patient with GERD knows that this type of drug helps treat the symptoms of the disease. The drug classification
PPIs
A nurse is assessing a client who has peritonitis. Which of the folowing findings should the nurse expect
boardlike abdomen
A health care professional is about to administer ondansetron to a patient who is recieving chemotherapy. Which of the following actions should the health care professional take?
infuse the drug 30 minutes prior to chemotherapy infuse the drug slowly for 15 minutes repeat the dose 4 hr after chemotherapy
A client has a cheesy white plaque in the mouth. The plaque looks like milk curds and can be rubbed off. What is the nurse's best intervention
instruct the client to swish prescribed nystatin solution for 1 minute
what is a cholecystogram
it visualizes the gallbladder and the bile duct
A nurse is developing a plan of care for a client who has cirrhosis and ascities. Which of the following interventions should the nurse include in the plan
measure abdominal girth daily
lubiprostone
med that increases stool count and should not be given with diarrhea
A nurse is caring for a client who has colorectal cancer and is receiving chemotherapy. The client asks why blood is being drawm for a CEA level. What should the nurse say
the CEA determines the effiaccy of your chemotherapy
A health care professional is reviewing the medical record of a patient who is to begin taking ranitide. Which of the following medicaitons interact with it?
ketoconazole; it reduces ket's absorption ebcause they depend on the acidity
A client realizes that regular use of laxatives has greatly improved bowel patterns. However, the nurse cautions this client against the prolonged use of laxatives for which reason?
The client's natural bowel function may become sluggish
After teaching a group of students about intestinal obstruction, the isntructor determines that the teaching was effective when the students identify which of the following as a cause of functional obstruction
abdominal surgery
After assessing a client with peritonitis, how would the nurse most likely document the bowel sounds
absent
While caring for a patient who has had radical neck surgery, the nurse notices an abnormal amount of serosanguineous secretions in the wound suction unit during the first postoperative day. What does the nurse know is an expected amount of drainage in the wound unit? You Selected:
approximately 80 to 120 mL
A client is scheduled to undergo rhinoplasty in the morning, and reports medications used on a daily basis, which the nurse records on the client's chart. Which daily medications have the potential to result in constipation?
laxative; bc of chronic use
A client presented with GI bleeding 2 days ago and continues to have problems. THe health care provider has ordered a visualization of the small intestine via a capsule endoscopy. What will the nurse include in the client education about this procedure
you will need to swallow a capsule' A capsule endoscopy allows for noninvasive visualization of the small intestinal mucosa. The technique consists of the client swallowing a capsule that is embedded with a wireless miniature camera, which is propelled through the intestine by peristalsis. The capsule passes from the rectum in 1 to 2 days.
Which is an accurate statement regarding cancer of the esophagus
chronic irritation of the esophagus is a known risk factor
which ulcer is associated with extensive burn injrut
curling ulcer
To ensure patency of central venous line ports, diluted heparin flushes are used
daily when not in use;
The nurse is providing discharge teaching for a client following an ileostomy. The nurse should instruc the cient to report which of the following findigns to report to the provider
dark purlple stoma
A nruse is assessing a client immediately following a paracentessi for the treatment of ascities. Which of the following findings indicates the procedure was effective
decrease shortness of breath
What is the primary symptom of achalasia?
difficulty swallowing
A health care professional should question the use of metoclopramide for a patient who is taking which of the following drugs
digoxin; also interferes with tetracycline, diazepam
An older adult client is admitted to an acute care facility for treatment of an acute flare-up of a chronic gastrointestinal condition. In addition to assessing the client for complications of the current illness, the nurse monitors for age-related changes in the gastrointestinal tract. Which age-related change increases the risk of anemia?
atrophy of the gastric mucousa ; reduces hydrochloric acid secretion; this, in turn, impairs absorption of iron and vitamin B12, increasing the risk of anemia as a person ages.
A nurse is assessing a client who has cirrhosis. Which of the following findings is the priority for the nurse to report to the provider
bloody stools; this is because hemorrhagic shock due to the risk in esophageal varicies are a great risk
The nurse is performing an abdominal assessment for a patient with diarrhea and auscultates a loud rumbling sound in the left lower quadrant. What will the nurse document this sound as on the nurse's notes?
borboygmus ; rumbling noise caused by the movements of gas through the intestines and is associated with diarrhea
complications of colonsocopy
bowel perforation (rectal bleeding, abdominal pain or distension, fever, focal peritoneal signs)
A njurse is providing dietary teaching for a client who is postoperative following a gastrectomy. Which of the following foods should the nurse encourge the client to include in their diet to reduce the risk of dumping syndrome
eggs; the nurse shou;ld instruct the client to increase the intake of protein containing foods to decrease the risk for manifestations of dumping syndrome.
A nurse is providing teaching for a client who has cirrhosis and a new prescription for lactulose. The nurse should include which of the following instructions in the teaching?
expect to have two to three soft stools per day
A client undergoing a diagnostic examination for gastrointestinal disorder was given polyethylene glycol/electrolyte solution as a part of the test preparation. Which of the following measures should the nurse take once the solution is administered?
permit the client to drink only clear liquids; After polyethylene glycol/electrolyte solution is administered, the client should have clear liquids as this ensures watery stools, which are necessary for procedures like a barium enema.
A client with a disorder of the oral cavity cannot tolerate tooth brush or flossing . Which strategy should the nurse use to assist the client
provide the client with an irrigating solution of baking soda and warm water; using tap water is not enough to promote oral hygiene
Which of the following is the most common symptom of a polyp?
rectal bleeding
A client is admitted to the health care facility with abdominal pain, a low-grade fever, abdominal distention, and weight loss. The physician diagnoses acute pancreatitis. What is the primary goal of nursing care for this client?
relieving abdominal pain
A client being treated for pancreatitis faces the risk of atelectasis. Which of the following interventions would be most important to implement to minimize this risk
reposition the client every 2 hours minimizes the risk of atelectasis
The nurse is instructing the client who was newly diagnosed with peptic ulcers. Which of the following diagnositc studies would the nrse anticipate reviewing with the client
serum H plori antibodies
The nurse is answering questions regarding fecal matter for a client who is scheduled for a colon resection. The client is asking questions regarding the composition of the fecal matter and when it becomes a formed masss. The nurse is most correct to state at which location
sigmoid colon
A client is recovering from gastric surgery. Toward what goal should the nurse progress the client's enteral intake
six small meals daily with 120 mL between meals
select the assessment finding that the nurse should immediately report, post radical neck dissection
stridor; this indicates airway obstruction
A client is recently diagnosed with Crohn's disease and is beginning treatment. What first-line treatment does the nurse expect that the client will be placed on to decrease the inflammatory response?
sulfasalazine; Considered first-line treatment for inflammatory bowel disease, 5-ASA drugs contain salicylate, which is bonded to a carrying agent that allows the drug to be absorbed in the intestine. These drugs work by decreasing the inflammatory response. Methotrexate or azathioprine are used when failure to maintain remission necessitates the use of an immune-modulating agent. Ciprofloxacin is used as an effective adjunct to treat the disease.
The nurse is preparing to examine the abdomen of a flient who reports a change in bowel pattern. The nurse would place the client in which position
supine with knees flexed
