GI Test Yourself

A 22 yr old calls the clinic complaining of N&V and RLQ abdominal pain. The nurse advises the patient to: a. have the symptoms evaluated by a MD right away b. use a heating pad c. drink at least 2 qts of juice d. take a laxative to empty the bowel before exam at clinic

A

A female client who has just been diagnosed with hepatitis A asks, "How could I have gotten this disease?" What is the nurse's best response? a. "You may have eaten contaminated restaurant food." b. "You could have gotten it by using I.V. drugs." c. "You must have received an infected blood transfusion." d. "You probably got it by engaging in unprotected sex."

A

A knowledge of factors associated with colorectal cancer guides the nurse when obtaining a nursing history to ask specifically about: a. usual diet b. history of smoking c. history of alcohol d. environmental exposure to carcinogens

A

A male client is recovering from an ileostomy that was performed to treat inflammatory bowel disease. During discharge teaching, the nurse should stress the importance of: a. increasing fluid intake to prevent dehydration. b. wearing an appliance pouch only at bedtime. c. consuming a low-protein, high-fiber diet. d. taking only enteric-coated medications.

A

A male client undergoes total gastrectomy. Several hours after surgery, the nurse notes that the client's nasogastric (NG) tube has stopped draining. How should the nurse respond? a. Notify the physician b. Reposition the tube c. Irrigate the tube d. Increase the suction level

A

A male client with cholelithiasis has a gallstone lodged in the common bile duct. When assessing this client, the nurse expects to note: a. yellow sclerae. b. light amber urine. c. circumoral pallor. d. black, tarry stools.

A

A male client with extreme weakness, pallor, weak peripheral pulses, and disorientation is admitted to the emergency department. His wife reports that he has been "spitting up blood." A Mallory-Weiss tear is suspected, and the nurse begins taking a client history from the client's wife. The question by the nurse that demonstrates her understanding of Mallory-Weiss tearing is: a. "Tell me about your husband's alcohol usage." b. "Is your husband being treated for tuberculosis?" c. "Has your husband recently fallen or injured his chest?" d. "Describe spices and condiments your husband uses on food."

A

A patient with NG tube develops nausea and increased upper abominal bowel sounds. Appropriate action is to: a. check the patency of the NG tube b. place client in recumbant position c. assess vital signs d. ecourage deep breathing

A

A patient's vomitus is dark brown and has a coffee-ground appearance. the nurse recognizes that this emsis is charactristic of: a. stomach bleeding b. an intestinal obstruction c. bile reflux d. active bleeding of lower esophagus

A

Diagnostic testing is planned fr a patient with suspected peptic ulcer. Most reliable test is: a. endoscopy b. gastric analysis c. barium swallow d. serologic test for H pylori

A

During an acute attack of diverticulitis, the patient is: a. monitored for signs of peritonitis b. treated with daily med enemas c. prepared for surgery to resect the involved colon d. provided with heathing pad to apply to LLQ

A

Management of patient with upper GI bleeding is effective the lab results reveal: a. decreasing BUN b. normal hematocrit c. urine output of 20 ml hr d. specific gravity of 1.03

A

Nurse determines teaching need when patient with dumping syndrome says a. "i should eat bread with every meal" b. "i should avoid drinking fluids with meals" c. i should eat small meals about 6x day" d. "i need t olie down for 30-60 min after meals"

A

Nursing management of the patient with chronic gastritis includes teaching the patient to: a. maintain a bland diet with six small meals a day b. take antacids before meals c. use NSAIDS instead of aspirin for pain relief d. eliminate alcohol and caffeine from diet

A

Patient admitted to ER has profuse bright-red hematemesis. During intial care of the patient, the nurse's first priority is to: a. perform a nursing assessment of patient's status b. establish 2 IV sites c. obtain a thorough health history d. perform a gastric lavage with cool tap water in prep for endoscopic exam

A

Patient with inflammatory bwel disease has a nursing diagnosis of imbalanced nutrition: less than body requirements r/t decreased nutritional intake and decreased intestinal absorption. Data to support this is: a. pallor and hair loss b. frequent diarrhea stools c. anorectal excoriation and pain d. hypotension and urine output below 30 ml /hr

A

Patient with ulcerative colitis has a total colectomy with formation of a terminal ileum stoma. an important nursing interention for this patient postop is to: a. measure the ileosotmy output to determine the status of patient's fluid balance b. change ileostomy q 3-4 hrs c. emphasize that ostomy is temporary d. teach about high fiber diet required to maintain normal ostomy drainage

A

Regardless of precipitating factor, the injury to mucosal cells in PUD is caused by: a. acid back-diffusion into the mucosa b. ammonia formation in the mucus wall c. breakdown of gastric mucosal barrier d. release of histamine for cells

A

The client with a hiatal hernia chronically experiences heartburn following meals. The nurse planc to teach the client to avoid which action because it is contraindicated with hiatal hernia? A. Lying recumbent following meals B. Taking in small, frequent, bland meals C. Raising the head of the bed on 6-inch blocks D. Taking H2-receptor antagonist medication

A

The nurse is performing an admission assessment on a client diagnosed with gastroesophageal reflux disease (GERD). Which signs and symptoms would indicate GERD? A. Pyrosis, water brash, and flatulence B. Weight loss, dysarthria, and diarrhea C. Decreased abdominal fat, proteinuria, and constipation D. Mid-epigastric pain, positive H. pylori test, and melena

A

When assessing the client with the diagnosis of peptic ulcer disease, which physical examination should the nurse implement first? A. Auscultate the client's bowel sounds in all four quadrants. B. Palpate the abdominal area for tenderness. C. Percuss the abdominal borders to identify organs. D. Assess the tender area progressing to nontender

A

Which assessment data support the client's diagnosis of gastric ulcer?" A. Presence of blood in the client's stool for the past month. B. Complaints of a burning sensation that moves like a wave. C. Sharp pain in the upper abdomen after eating a heavy meal. D. Comparison of complaints of pain with ingestion of food and sleep

A

Which diagnostic test would be used first to evaluate a client with upper GI bleeding? a. Endoscopy b. Upper GI series c. Hemoglobin (Hb) levels and hematocrit (HCT) d. Arteriography

A

Which of the following nursing interventions should the nurse perform for a female client receiving enteral feedings through a gastrostomy tube? a. Change the tube feeding solutions and tubing at least every 24 hours. b. Maintain the head of the bed at a 15-degree elevation continuously. c. Check the gastrostomy tube for position every 2 days. d. Maintain the client on bed rest during the feedings.

A

Which of the following nursing interventions should the nurse perform for a female client receiving enteral feedings through a gastrostomy tube? " A. Change the tube feeding solutions and tubing at least every 24 hours B. Maintain the head of the bed at a 15-degree elevation continuously. C. Check the gastrostomy tube for position every 2 days. D. Maintain the client on bed rest during the feedings

A

While a female client is being prepared for discharge, the nasogastric (NG) feeding tube becomes clogged. To remedy this problem and teach the client's family how to deal with it at home, what should the nurse do? a. Irrigate the tube with cola. b. Advance the tube into the intestine. c. Apply intermittent suction to the tube. d. Withdraw the obstruction with a 30-ml syringe.

A

"The nurse is teaching the patient a client with a peptic ulcer discharge instructions. The client asks the nurse which type of analgesic he may take. Which of the following responses by the nurse would be most accurate? A. Aspirin B. Acetaminophen C. Naproxen D. Ibuprofen

B

A female client with dysphagia is being prepared for discharge. Which outcome indicates that the client is ready for discharge? a. The client doesn't exhibit rectal tenesmus. b. The client is free from esophagitis and achalasia. c. The client reports diminished duodenal inflammation. d. The client has normal gastric structures.

B

A male client has just been diagnosed with hepatitis A. On assessment, the nurse expects to note: a. severe abdominal pain radiating to the shoulder. b. anorexia, nausea, and vomiting. c. eructation and constipation. d. abdominal ascites.

B

A male client has undergone a colon resection. While turning him, wound dehiscence with evisceration occurs. The nurse's first response is to: a. call the physician. b. place saline-soaked sterile dressings on the wound. c. take a blood pressure and pulse. d. pull the dehiscence closed.

B

A male client is recovering from a small-bowel resection. To relieve pain, the physician prescribes meperidine (Demerol), 75 mg I.M. every 4 hours. How soon after administration should meperidine's onset of action occur? a. 5 to 10 minutes b. 15 to 30 minutes c. 30 to 60 minutes d. 2 to 4 hours

B

A male client with a recent history of rectal bleeding is being prepared for a colonoscopy. How should the nurse position the client for this test initially? a. Lying on the right side with legs straight b. Lying on the left side with knees bent c. Prone with the torso elevated d. Bent over with hands touching the floor

B

A male client with pancreatitis complains of pain. The nurse expects the physician to prescribe meperidine (Demerol) instead of morphine to relieve pain because: a. meperidine provides a better, more prolonged analgesic effect. b. morphine may cause spasms of Oddi's sphincter. c. meperidine is less addictive than morphine. d. morphine may cause hepatic dysfunction.

B

A patient with oral cancer has a history of heavy smoking, excessive alcohol intake, and personal neglect. During the patient's early postop course the nurse anticpates that the patient may need: a. oral nutritional supplements b. drug therapy to prevent substance withdrawal symptoms c. less pain meds d. counseling

B

Caffeinated beverages and smoking are risk factors to assess for in the development of what condition? A. Duodenal ulcers B. Peptic ulcers C. Helicobacter pylori D. Esophageal reflux

B

In teaching patients at risk for upper GI bleeding to prevent bleeding episodes, the nurse stresses that: a. all stools and vomit must be tested for blood b. the use of over the counter meds of any kind should be avoided c. antacids should be taken with all prescribed meds d. Cytotec should be used to protect gastric mucosa

B

Most effective means of suppressing pancreatic secreation during an episode of pancreatitis is the use of: a. antibiotics b. NPO status c. antispasmotics d. H2R blockers

B

Patient with an ulcer of the posterior portion of duodenum experiences: a. pain that occurs after not eating all day b. back pain that occurs 2-4 hrs after eating c. midepigastric pain unrelieved with antacids d. high epigastric burning relieved with food intake

B

The nurse is assessing the client diagnosed with chronic gastritis. Which symptom(s) support this diagnosis? A. Rapid onset of midsternal discomfort B. Epigastric pain relieved by eating food C. Dyspepsia and hematemesis D. Nausea and projectile vomiting

B

The nurse is caring for a male client with a diagnosis of chronic gastritis. The nurse monitors the client knowing that this client is at risk for which vitamin deficiency? a. Vitamin A b. Vitamin B12 c. Vitamin C d. Vitamin E

B

The nurse is monitoring a female client receiving paregoric to treat diarrhea for drug interactions. Which drugs can produce additive constipation when given with an opium preparation? a. Antiarrhythmic drugs b. Anticholinergic drugs c. Anticoagulant drugs d. Antihypertensive drugs

B

To prevent gastroesophageal reflux in a male client with hiatal hernia, the nurse should provide which discharge instruction? a. "Lie down after meals to promote digestion." b. "Avoid coffee and alcoholic beverages." c. "Take antacids with meals." d. "Limit fluid intake with meals."

B

Upon examining a patient 8 hrs after formation of a colostomy the nurse would expect to find a. hypoactive, high pitched bowel sounds b. brickred, puffy stoma that oozes blood c. purplish stoma, shiny and moist d. small amt of liquid fecal drainage from stome

B

What laboratory finding is the primary diagnostic indicator for pancreatitis? a. Elevated blood urea nitrogen (BUN) b. Elevated serum lipase c. Elevated aspartate aminotransferase (AST) d. Increased lactate dehydrogenase (LD)

B

What response should a nurse offer to a client who asks why he's having a vagotomy to treat his ulcer? A. To repair a hole in the stomach B. to reduce the ability of the stomach to produce acid C. to prevent the stomach from sliding into the chest D. to remove a potentially malignant lesion in the stomach

B

When evaluating a male client for complications of acute pancreatitis, the nurse would observe for: a. increased intracranial pressure. b. decreased urine output. c. bradycardia. d. hypertension

B

When preparing a male client, age 51, for surgery to treat appendicitis, the nurse formulates a nursing diagnosis of Risk for infection related to inflammation, perforation, and surgery. What is the rationale for choosing this nursing diagnosis? a. Obstruction of the appendix may increase venous drainage and cause the appendix to rupture. b. Obstruction of the appendix reduces arterial flow, leading to ischemia, inflammation, and rupture of the appendix. c. The appendix may develop gangrene and rupture, especially in a middle-aged client. d. Infection of the appendix diminishes necrotic arterial blood flow and increases venous drainage

B

Which condition is most likely to have a nursing diagnosis of fluid volume deficit? a. Appendicitis b. Pancreatitis c. Cholecystitis d. Gastric ulcer

B

"The nurse is planning the care of a client diagnosed with lower esophageal sphincter dysfunction. Which dietary modifications should be included in the plan of care? A. Allow any of the client's favorite foods as long as the amount is limited. B. Have the client perform eructation exercises several times a day. C. Eat four (4) to six (6) small meals a day and limit fluids during mealtimes. D. Encourage the client to consume a glass of red wine with one (1) meal a day

C

"Which of the following types of gastritis is associated with Helicobacter pylori and duodenal ulcers? A. Erosive (hemorrhagic) gastritis B. Fundic gland gastritis (type A) C. Antral gland gastritis (type B) D. Aspiring-induced gastric ulcer

C

A female client with viral hepatitis A is being treated in an acute care facility. Because the client requires enteric precautions, the nurse should: a. place the client in a private room. b. wear a mask when handling the client's bedpan. c. wash the hands after touching the client. d. wear a gown when providing personal care for the client.

C

Gastroesophageal reflux disease (GERD) weakens the lower esophageal sphincter, predisposing older persons to risk for impaired swallowing. In managing the symptoms associated with GERD, the nurse should assign the highest priority to which of the following interventions? A. Decrease daily intake of vegetables and water, and ambulate frequently B. Drink coffee diluted with milk at each meal, and remain in an upright position for 30 minutes. C. Eat small, frequent meals, and remain in an upright position for at least 30 minutes after eating D. Avoid over-the-counter drugs that have antacids in them

C

Mandy, an adolescent girl is admitted to an acute care facility with severe malnutrition. After a thorough examination, the physician diagnoses anorexia nervosa. When developing the plan of care for this client, the nurse is most likely to include which nursing diagnosis? a. Hopelessness b. Powerlessness c. Chronic low self esteem d. Deficient knowledge

C

Nurse teaches a patient with newly diagnosed PUD to a. maintain bland diet b. use alcohol and caffeine in moderation c. eat as normally as possible, eliminating foods that cause pain d. avoid milk and milk products

C

Nurse teaches patient with diverticulosis to a. use anticholinergic drugs routinely to prevent bowel spasm b. have a nannual colonoscopy to detect malignant changes c. maintain a high fiber diet and use bulk laxatives to increase fecal volume d. exclude whole grains

C

Patient asks nurse if his risks for colon cancer are increased due to a polyp. the best response is: a. it is very rare for polyps ot become malignant b. individuals with polyps have a 100% lifetime risk of developing colorectal cancer c. all polyps are abnormal and should be removed, but the risk for cancer depends on the type and if malignant changes are present d. all polyps are premalignant and source of most colon cancer. get colonoscpy q 6 months.

C

Patient with a gunshot wound to the abdomen develops a bacterial peritonitis after surgery to repair the bowel. The nurse explains to the patient htat this problem is caused prirmarily by: a. immobility and loss of perstaliss of the bowel as reuslt of surgery b. penetration of unsteril foreighn bodies into the abdominal cavity c. spillage of bowel contents int othe normally sterile abdominal cavity d. accumulation of blood and fluid in the abdominal cavity as a result of the trauma

C

Patient with history of PUD is hospitalized with symptoms of a perforation. During initial assessment nurse would expect to find: a. vomit of bright red blood b. projectile vomiting c. sudden, severe upper abdominal pain and shoulder pain d. hyperactive stomach sounds

C

Patient with pancreatitis has nursing dx of pain r/t distention of pancreas and peritoneal irritation. In addition to effective use of analgesics the nurse should: a. provide diversional activiies to distract patient b. provide small frequent meals c. position the patient on the side with the head of the bed elevated 45º d. ambulate the patient q 3-4 hours

C

Teaching is effective when atient with PUD states: a. " I should stop all meds if i develop side effects" b. "i should cintinue treatemnt as long as i have pain" c. "i have learned some relaxation strategies that decrease my stress" d. "i can buy whatever antacids are on sale"

C

The nurse is caring for a female client with active upper GI bleeding. What is the appropriate diet for this client during the first 24 hours after admission? a. Regular diet b. Skim milk c. Nothing by mouth d. Clear liquids

C

The nurse is caring for a male client with cirrhosis. Which assessment findings indicate that the client has deficient vitamin K absorption caused by this hepatic disease? a. Dyspnea and fatigue b. Ascites and orthopnea c. Purpura and petechiae d. Gynecomastia and testicular atrophy

C

When assessing a patient with pancreatitits, nurse would expect to find: a. hyperactive bowel sounds b. hypertension and tachycardia c. severe midepigastric of LUQ pain d. temp greater than 102º

C

Which of the following factors can cause hepatitis A? a. Contact with infected blood b. Blood transfusions with infected blood c. Eating contaminated shellfish d. Sexual contact with an infected person

C

the nurse determines tha further discharge instruction is needed whne the patient with acute pancreatititis states: a. "i should observe for fat in my stools" b. "I must not use alcohol to prevent future attacks" c. "I shouldn't eat salty foods" d. "I will need to continue to monitor my blood glucose levels until my pancreas is healed"

C

the nurse teaches the patient with a hiatal hernia or GERD to control symptoms by: a. drinking 10-12 oz of water with meals b. spacing six small meals a day c. sleeping with the head of the bed elevated 4-6 inches d. performing daily exercises of toe touching

C

A female client with hepatitis C develops liver failure and GI hemorrhage. The blood products that would most likely bring about hemostasis in the client are: a. whole blood and albumin. b. platelets and packed red blood cells. c. fresh frozen plasma and whole blood. d. cryoprecipitate and fresh frozen plasma.

D

A patient who has been vomiting for several dasy from an unknown cause is admitted to hospital. the nurse anticipates collaborative care to indlude: a. oral admin of broth and tea b. admin of paretneral antiemetics c. insertion of NG tube to suction d. IV replacement of fluid and electrolytes

D

During preparation for bowel surgery, a male client receives an antibiotic to reduce intestinal bacteria. Antibiotic therapy may interfere with synthesis of which vitamin and may lead to hypoprothrombinemia? a. vitamin A b. vitamin D c. vitamin E d. vitamin K

D

Early screening for detection of cancers of the right side of colon in individuals over 50 yrs old should be done q year to include: a. serum CEA levels b. flexible sigmoidoscopy c. digital rectal exam d. fecal testing for occult blood

D

Following a Billroth 2 procedure, atient develops dumping syndrome. The nurse explains that the symptoms associated wti h this problem are caused by: a. distention of smaller stomach by too much food intake b. hyperglycemia caused by uncontrolled gastric emptying into small intestine c. irritation of stomach lining by reflux of bile salts d. movement of fluid into the bowel because concentrated food and fluids move rapidly into the intesting

D

Nurse Hannah is teaching a group of middle-aged men about peptic ulcers. When discussing risk factors for peptic ulcers, the nurse should mention: a. a sedentary lifestyle and smoking. b. a history of hemorrhoids and smoking. c. alcohol abuse and a history of acute renal failure. d. alcohol abuse and smoking.

D

On 2nd postop day, patient who had exploratory laparotomy complains if abdominal distention and gas pains. Best response to this is: a. Abdominal distention occurs as a normal response to inflammation and healing b. Gas pains occur when NG tube is not used during surgery c. This is a common complication of abdominl surgery but usualy releived by BM d. This occurs because of bowel immobility caused by anesthesia and manipulation of abdominal contents during surgery

D

Patient with cancer of stomach undergoes total gastrecotmy with esophagojejunostomy. Postop the nurse teaches the patient to expect: a. rapid healing b. ability to return to normal dietary habits c. close follow up for development of ulcers d. lifelong intramuscular or intranasal admin of cobalamin

D

The nurse caring for a client with small-bowel obstruction would plan to implement which nursing intervention first? a. Administering pain medication b. Obtaining a blood sample for laboratory studies c. Preparing to insert a nasogastric (NG) tube d. Administering I.V. fluids

D

The nurse explains to the patient with gastroesophageal reflux disease that this disorder: A. results in acid erosion and ulceration of the esophagus caused by frequent vomiting, B. will require surgical wrapping or repair of the pyloric sphincter to control the symptoms, C. is the protrusion of a portion of the stomach into to esophagus through an opening in the diaphragm, D. often involves relaxation of the lower esophageal sphincter, allowing stomach contents to back up into the espophagus

D

The nurse is monitoring a client with a diagnosis of peptic ulcer. Which assessment finding would most likely indicate perforation of the ucler? A. Bradycardia B. Numbness in the legs C. Nausea and vomiting D. A rigid, board-like abdomen

D

The nurse is monitoring a client with a diagnosis of peptic ulcer. Which assessment finding would most likely indicate perforation of the ulcer? A. Bradycardia B. Numbness in the legs C. Nausea and vomiting D. A rigid, board-like abdomen

D

The nurse is planning to teach a client with GERD about substances that will increase the LES pressure.Which item shoud the nurse include on this list. A. Coffee B. Chocolate C. Fatty Foods D. Nonfat MIlk

D

The preferred immediate treatment for acute episode of constipation is: a. soapsud enema b. stimulant cathartics c. stool sofenting cathartic d. tap water or hypertonic enemas

D

While palpating a female client's right upper quadrant (RUQ), the nurse would expect to find which of the following structures? a. Sigmoid colon b. Appendix c. Spleen d. Liver

D