MED SURG TEST #3 prep-u questions ch 20

A client has sought care because of recent dark-colored stools. As a result, a fecal occult blood test has been ordered. The nurse should give what instructions to the client?

"Do not take any NSAIDs within 72 hours of the test."

A client is scheduled for magnetic resonance imaging (MRI). During the client teaching, what will the nurse discuss?

"Do you experience any claustrophobia?"

A client reports having red stools lately. What will the nurse ask during assessment questioning?

"Have you been eating beets?"

When preparing a client for magnetic resonance imaging (MRI) of the abdomen, which statement would indicate the need to notify the health care provider?

"I really don't like to be in small, enclosed spaces."

A home care nurse is caring for a client with reports of epigastric discomfort who is scheduled for a barium swallow. Which statement by the client indicates an understanding of the test?

"I'll avoid eating or drinking anything 6 to 8 hours before the test."

A client asks the nurse why the physician ordered the blood test carcinoembryonic antigen (CEA). The nurse answers:

"It indicates if a cancer is present."

The nurse is caring for a client recovering from a colonoscopy. Which assessment finding will the nurse expect in the client after the procedure?

Abdominal cramps

A patient has come into the radiology department to undergo testing for possible polyps. What diagnostic test may be done to diagnose this type of lesion?

Barium enema

The liver performs numerous functions that contribute to homeostasis, including the synthesis of bile. How is bile utilized in the processes of digestion and absorption?

Bile is produced in the liver but released by the gallbladder when needed for digesting fats.

The nurse is to obtain a stool specimen from a client who reported that he is taking iron supplements. The nurse would expect the stool to be which color?

Black

A client reports a history of bleeding hemorrhoids to the nurse. Which observation supports the client's statement?

Blood streaks on stool

During a colonoscopy with moderate sedation, the patient groans with obvious discomfort and begins bleeding from the rectum. The patient is diaphoretic and has an increase in abdominal girth from distention. What complication of this procedure is the nurse aware may be occurring?

Bowel perforation

A client receives a local anesthetic to suppress the gag reflex for a diagnostic procedure of the upper GI tract. Which nursing intervention is advised for this client?

Do not give any food and fluids until the gag reflex returns.

The nurse is preparing to educate a group of students on a gastrointestinal assessment. Which common condition will the nurse assess for in the client with gastrointestinal disorder?

Dyspepsia

A nurse is preparing a client with Crohn's disease for a barium enema. What should the nurse do the day before the test?

Encourage plenty of fluids.

The nurse is investigating a client's report of pain in the duodenal area. Where should the nurse perform the assessment?

Epigastric area and consider possible radiation of pain to the right subscapular region

An adult patient is scheduled for an upper GI series that will use a barium swallow. What teaching should the nurse include when the patient has completed the test?

Fluids must be increased to facilitate the evacuation of the stool.

The nurse is assessing a client who is stating gastrointestinal upset and a feeling of bloating. Which type of meal would the nurse anticipate causing these types of symptoms?

Hamburger and French fries

A client with abdominal pain is scheduled for a CT scan of the abdomen with contrast. Which assessment will the nurse complete before transporting the client for the diagnostic test?

History of allergies A common risk from IV contrast agents is allergic reactions; therefore, the client must be screened for this risk. Any allergies to contrast agents, iodine, or shellfish must be determined before administration of a contrast agent.

The nurse auscultates the abdomen to assess bowel sounds. She documents five to six sounds heard in less than 30 seconds. How does the nurse document the bowel sounds?

Hyperactive -normal (sounds heard about every 5 to 20 seconds), hypoactive (one or two sounds in 2 minutes), hyperactive (5 to 6 sounds heard in less than 30 seconds)

A client is scheduled for an upper gastrointestinal barium study. Which teaching will the nurse provide for the client to prepare for this diagnostic test?

Ingest nothing by mouth after midnight.

A client is diagnosed with megaloblastic anemia caused by vitamin B12 deficiency. The health care provider begins the client on cyanocobalamin (Betalin-12), 100 mcg I.M. daily. Which substance influences vitamin B12 absorption?

Intrinsic factor

After 20 seconds of auscultating for bowel sounds on a client recovering from abdominal surgery, the nurse hears nothing. What should the nurse do based on the assessment findings?

Listen longer for the sounds.

A nurse is giving a client barium swallow test. What is the most important assessment a nurse would make to ensure that a client does not retain any barium after a barium swallow?

Monitoring the stool passage and its color.

A nurse practitioner examined a patient who had been diagnosed with hepatomegaly (enlarged liver) due to accumulated fat deposits in the liver, subsequent to obesity. The nurse would palpate the liver by placing:

One hand under the right lower rib cage and press downward with the other hand.

The nurse is assisting the health care provider with a gastric acid stimulation test for a client. What medication should the nurse prepare to administer subcutaneously to stimulate gastric secretions?

Pentagastrin

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.

The nurse is caring for a client who is scheduled for a percutaneous liver biopsy. Which diagnostic test is obtained prior?

Prothrombin time (PT)

The nurse is scheduling gastrointestinal (GI) diagnostic testing for a client. Which GI test should be scheduled first?

Radiography of the gallbladder Radiography of the gallbladder should be performed before other GI exams in which barium is used because residual barium tends to obscure the images of the gallbladder and its duct. -

The nurse is instructing the client who was newly diagnosed with peptic ulcers. Which of the following diagnostic studies would the nurse anticipate reviewing with the client?

Serum antibodies for H. pylori

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 mass. The nurse is most correct to state at which location?

Sigmoid colon Water is reabsorbed by means of diffusion across the intestinal membrane as the contents move through the colon. By the time the mixture reaches the descending and sigmoid colon, the portion of the bowel adjacent to the rectum, it is a formed mass. The ileum and duodenum are located in the small intestine. The cecum is located at the beginning of the large intestine.

The nurse is caring for a patient who is scheduled for a gastroscopy. What preparation is needed for a gastroscopy?

Spray or gargle the back of the throat with local anesthetic.

The instructor has just finished teaching a group of students about the various organs of the upper gastrointestinal tract and possible disorders. The instructor determines that the teaching was successful when the students identify which structure as possibly being affected?

Stomach

A client has returned to the medical unit after a barium enema. When assessing the client's subsequent bowel patterns and stools, what finding would warrant reporting to the health care provider?

Streaks of blood present in the stool Barium has a high osmolarity and may draw fluid into the bowel, thus increasing the intraluminal contents and resulting in greater output (large stools). The barium will give the stools a milky white appearance, and it is not uncommon for the client to experience an increase in the number of bowel movements. Blood in fecal matter is not an expected finding and the nurse should notify accordingly. -

The nurse is preparing to examine the abdomen of a client who reports a change in bowel pattern. The nurse would place the client in which position?

Supine with knees flexed

What would the nurse recognize as preventing a client from being able to take a fecal occult blood test (FOBT)?

The client has hemorrhoidal bleeding

The nurse is conducting an abdominal assessment of a patient who is postoperative day 1 following an open cholecystectomy. During auscultation of the patient's abdomen, the nurse has noted that clicks and gurgles are audible approximately every 10 seconds. How should the nurse follow up this assessment finding?

The nurse should document normoactive bowel sounds.

Which nursing instruction is correct to provide the client following a barium enema?

The stools may be a white or clay colored.

A client is to have an upper GI procedure with barium ingestion and abdominal ultrasonography. While scheduling these diagnostic tests, the nurse must consider which factor?

The ultrasonography should be scheduled before the GI procedure.

The nurse is assisting the health care provider with a colonoscopy for a client with rectal bleeding. The health care provider requests the nurse to administer glucagon during the procedure. Why is the nurse administering this medication during the procedure?

To relax colonic musculature and reduce spasm.

When describing the role of the pancreas to a client with a pancreatic dysfunction, the nurse would identify which substance as being acted on by pancreatic lipase?

Triglycerides

Which of the following digestive enzymes aids in the digesting of starch?

amylase

The nurse prepares a client for a barium enema. The nurse should place the client on which diet prior to the procedure?

clear liquids day before

A client is scheduled for several diagnostic tests to evaluate gastrointestinal function. After teaching the client about these tests, the nurse determines that the client has understood the teaching when the client identifies which test as not requiring the use of a contrast medium?

colonoscopy

A client is scheduled to have an endoscopic retrograde cholangiopancreatography. Which structures are visualized during this procedure?

common bile duct, pancreatic duct, and biliary tree

Cystic fibrosis, a genetic disorder characterized by pulmonary and pancreatic dysfunction, usually appears in young children but can also affect adults. If the pancreas was functioning correctly, where would the bile and pancreatic enzymes enter the GI system?

duodenum

The major carbohydrate that tissue cells use as fuel is

glucose

Swallowing is regulated by which area of the central nervous system (CNS)?

medulla oblongata

Following ingestion of carrots or beets, the nurse would expect which alteration in stool color?

red

Which procedure is performed to examine and visualize the lumen of the small bowel?

small bowel enteroscopy

The nurse is assisting the physician in a percutaneous liver biopsy. In assisting with positioning, the nurse should assist the client into a:

supine position

Specific disease processes and ingestion of certain foods and medications may change the appearance of the stool. If blood is shed in sufficient quantities into the upper gastrointestinal (GI) tract, it produces which change in the stool appearance?

tarry-black

An individual has had a snack consisting of half a bagel with cream cheese, lox (smoked salmon), red onions, and capers. Stimulation of the person's gastrointestinal tract has resulted in the secretion of numerous digestive enzymes into the small intestine, including trypsin. What component of this person's snack will be primarily digested by the action of trypsin?

the lox

Which enzyme aids in the digestion of protein?

trypsin

The nurse recognizes which change of the gastrointestinal system is an age-related change?

weakened gag reflex

A male patient's present signs and symptoms are suggestive of an incompetent cardiac sphincter, and he has been scheduled for an upper GI series (barium swallow). What pre-procedure teaching should the nurse provide to this patient?

"Make sure that you don't eat anything after midnight the day before your test."

A male patient's present signs and symptoms are suggestive of an incompetent cardiac sphincter, and he has been scheduled for an upper GI series (barium swallow). What preprocedure teaching should the nurse provide to this patient?

"Make sure that you don't eat anything after midnight the day before your test."

The nurse asks a client to point to where pain is felt. The client asks why this is important. What is the nurse's best response?

"Often the area of pain is referred from another area."

A client is scheduled for a barium enema later in the day. Which actions will the nurse take to prepare the client on the morning of the test? Select all that apply. -Provide a low-residue breakfast -Give only oral laxatives -Provide cleansing enemas until clear -Maintain nothing by mouth until after the test -Administer anti-anxiety medication before the test

-Provide cleansing enemas until clear - Maintain nothing by mouth until after the test

The nurse educator is reviewing the blood supply of the GI tract with a group of medical nurses. The nurse is explaining the fact that the veins that return blood from the digestive organs and the spleen form the portal venous system. What large veins will the nurse list when describing this system? Select all that apply. -Splenic vein -Inferior mesenteric vein -Gastric vein -Inferior vena cava -Saphenous vein

-Splenic vein -Inferior mesenteric vein -Gastric vein

When completing a nutritional assessment of a patient who is admitted for a GI disorder, the nurse notes a recent history of dietary intake. This is based on the knowledge that a portion of digested waste products can remain in the rectum for how many days after a meal is digested?

3 days

A 50-year-old male patient with a history of cholelithiasis (gallstones) has presented to the emergency department (ED) with severe upper right quadrant pain. The ED nurse should anticipate the need to facilitate which of the following diagnostic tests?

Abdominal ultrasonography

An elderly patient has developed Clostridium difficile-related diarrhea, a problem that has led to dehydration and hypokalemia. The increased peristalsis that characterizes diarrhea has the potential to cause fluid volume deficit and electrolyte deficits because:

An increase in peristalsis means that the colon cannot absorb the substances that it normally absorbs.

The nurse is preparing the client for an assessment of the abdomen. What should the nurse complete prior to this assessment?

Ask the client to empty the bladder.

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 mucosa

When assisting with preparing a client scheduled for a barium swallow, which of the following would be appropriate to include?

Avoid smoking for at least 12 to 24 hours before the procedure. - The nurse should instruct the client to avoid smoking for at least a day before the procedure of barium swallow because smoking stimulates gastric motility. The client is advised to take vitamin K before a liver biopsy and instructed to take three cleansing enemas before a barium enema. Instruction to avoid red meat would be appropriate for a client who is having a Hemoccult test.

A 56-year-old presented to her nurse practitioner because she had been experiencing unprecedented constipation and the passage of pencil-like stools despite her high fluid and fiber intake. The nurse recognized the need to assess the patient for colorectal cancer and ordered diagnostic evaluations. What component of the patient's blood work would be most indicative of the presence of cancer?

Carcinoembryonic antigen (CEA)

A client comes into the emergency department with reports of abdominal pain. What should the nurse ask first?

Characteristics and duration of pain

The nurse prepares to administer the lavage solution to a client having a colonoscopy completed. The nurse stops and notifies the physician when noting that the client has which condition?

inflammatory. -Another contraindication for use of lavage solution is intestinal obstruction. bowel disease

The nurse is caring for a geriatric client and notices polypharmacy. Which diagnostic studies are anticipated?

liver function studies

The nurse is providing client education about which parts of the body are involved in the digestion of food. What part of the GI tract begins the digestion of food?

mouth

The nurse is working with clients with digestive tract disorders. Which of the following organs does the nurse realize has effects as an exocrine gland and an endocrine gland?

pancreas

Which of the following is an enzyme secreted by the gastric mucosa?

pepsin

A client tells the nurse that the stool was colored yellow. The nurse assesses the client for

recent foods ingested.