N102 Upper GI Practice Quiz EAQ

An obese client with a hiatal hernia asks the nurse how to prevent esophageal reflux. Which is the nurse's best response? "Lie down after eating." "Eat less food at each meal." "Increase your intake of fat." "Drink more fluid with each meal."

"Eat less food at each meal."

Discharge planning for a client with chronic pancreatitis includes dietary teaching. Which statement indicates to the nurse that the client needs more teaching? "I must eat foods high in calories." "I should avoid alcoholic beverages." "I will eat more often but in smaller amounts." "I can eat foods high in fat now that the acute stage is over."

"I can eat foods high in fat now that the acute stage is over."

A client with a rigid and painful abdomen is diagnosed with a perforated peptic ulcer. A nasogastric tube is inserted, and surgery is scheduled. Before surgery, the nurse should place the client in what position? Sims Flat-lying Semi-Fowler Dorsal recumbent

Semi-Fowler

A nurse is caring for a client with a T-tube after an open cholecystectomy. What specific action should the nurse include in the plan of care? Monitor the color of the stool. Teach ankle pumping exercises. Restrict intake of refined carbohydrates. Compress the drainage container after emptying.

Monitor the color of the stool.

A client experiences occasional right upper quadrant pain attributed to cholecystitis. The nurse is providing discharge instructions, including a list of foods that cause dyspepsia. Which foods should be on the list the nurse provided the client? Nuts and popcorn Meatloaf and baked potato Chocolate and boiled shrimp Fried chicken and buttered corn

Fried chicken and buttered corn

A client is evaluated at a clinic, and the healthcare provider suspects that the client has anemia and a peptic ulcer. To determine if the client has a peptic ulcer, the nurse expects that what diagnostic test will be performed? Barium enema Gastric biopsy Gastric culture Stool examination

Gastric culture A gastric culture enables the healthcare provider to identify the presence of Helicobacter pylori. Two thirds of individuals with gastric or duodenal ulcers are infected with this organism. A barium enema outlines structural changes in the lower gastrointestinal tract; it will not outline the stomach or duodenum. A gastric biopsy is done to identify the presence of malignant cells. A stool examination may identify melena or parasites, but it is not definitive for peptic ulcers.

A nurse teaches a client about limiting the discomfort associated with a hiatal hernia. Which statement from the client indicates teaching by the nurse is effective? "After meals I will take a 10-minute walk." "After meals I will drink 8 oz (240 mL) of water." "After meals I will rest in a sitting position for one hour." "After meals I will lie down in bed for at least 20 minutes."

"After meals I will rest in a sitting position for one hour."

A nurse is obtaining a health history from a client with the diagnosis of peptic ulcer disease. Which client statement provides evidence to support the identification of a possible contributory factor? "My blood type is A positive." "I smoke one pack of cigarettes a day." "I have been overweight most of my life." "My blood pressure has been high lately."

"I smoke one pack of cigarettes a day."

A client returns from surgery after an abdominal cholecystectomy for a gangrenous gallbladder. For which postoperative complication, associated with the location of the surgical site, should the nurse assess the client? Atelectasis Hemorrhage Paralytic ileus Wound infection

Atelectasis Subcostal incisional pain causes the client to splint and avoid deep breathing, which impedes air exchange in the alveoli. The location of the incision does not increase the risk of hemorrhage. Paralytic ileus can be a postoperative problem, but it is unrelated to the site of the incision. The subcostal incision site is not specifically vulnerable to infection.

A nurse is performing the initial history and physical examination of a client with a diagnosis of duodenal ulcer. Which type of pain does the nurse expect the client to describe? Pain that is relieved with eating Pain that is worse with antacids Pain that is relieved with sleep Pain that is worse one hour after eating

Pain that is relieved with eating

A nurse is caring for a client who recently is diagnosed with a gastric ulcer. The nurse expects that the plan of care will include a prescription for which type of diet? Soft diet Low-fat, high-protein liquid diet Hourly feedings of dairy products Regular diet with foods that are tolerated

Regular diet with foods that are tolerated

A client had a laparoscopic cholecystectomy. Postoperatively the client experiences nausea and vomiting and is admitted overnight for observation and hydration. What should the nurse include in the teaching plan when preparing this client for discharge? Select all that apply. a. Wash the puncture sites with strong soap and hot water daily. b. Call the healthcare provider if you have a fever of 100o F (37.8oC) or more for two days. c. Remove the tape-strips over the puncture sites one week after surgery. d. Check the puncture sites daily for redness, tenderness, swelling, heat, or drainage. e. Ease the discomfort from the gas used to insufflate the abdomen during surgery by applying a heating pad to the left shoulder.

b, d, b. Call the healthcare provider if you have a fever of 100o F (37.8oC) or more for two days. d. Check the puncture sites daily for redness, tenderness, swelling, heat, or drainage.

A nurse is caring for a client with cholelithiasis and obstructive jaundice. When assessing this client, the nurse should be alert for which findings that are consistent with these conditions? Select all that apply. a. Ecchymosis b. Yellow sclera c. Dark brown stool d. Straw-colored urine e. Pain in right upper quadrant

a, b, e, a. Ecchymosis b. Yellow sclera e. Pain in right upper quadrant Inadequate bile flow interferes with vitamin K absorption, contributing to ecchymosis, hematuria, and other bleeding. Yellow sclera results from failure of bile to enter the intestines, with subsequent backup into the biliary system and diffusion into the blood. The bilirubin is carried to all body regions, including the skin and mucous membranes. Pain in the right upper quadrant occurs especially after eating foods high in fat and is characteristic of acute cholecystitis and biliary colic. With obstructive jaundice the stool is clay colored, not dark brown; the presence of bile causes stool to be brown. When bile levels in the bloodstream are high, as in obstructive jaundice, there is bile in the urine, causing it to have a dark color.

A client is admitted with a diagnosis of acute pancreatitis. The medical and nursing measures for this client are aimed toward maintaining nutrition, promoting rest, maintaining fluid and electrolytes, and decreasing anxiety. Which interventions should the nurse implement? Select all that apply. a. Provide a low-fat diet b. Administer analgesics c. Teach relaxation exercises d. Encourage walking in the hall e. Monitor cardiac rate and rhythm f. Observe for signs of hypercalcemia

b. Administer analgesics c. Teach relaxation exercises e. Monitor cardiac rate and rhythm

A nurse has provided dietary instructions for a client who is being discharged following a gastroduodenostomy (Billroth I). Which client statement indicates correct understanding of the teaching? "I plan to have a diet of pureed foods for a few days." "I will now resume my regular eating routine and diet." "I need to eat six small meals every day, limiting bulk." "It is important to maintain a diet high in carbohydrates, proteins, and fats."

"I need to eat six small meals every day, limiting bulk."

A client who is diagnosed with a duodenal ulcer asks, "Now that I have an ulcer, what comes next?" What is the nurse's best response? "Most peptic ulcers heal with medical treatment." "Clients with peptic ulcers have pain while eating." "Early surgery is advisable, especially after the first attack." "If ulcers are untreated, cancer of the stomach can develop."

"Most peptic ulcers heal with medical treatment."

A nurse reviews the laboratory results of a client with acute pancreatitis. Which test is most significant in determining the client's response to treatment? Platelet count Amylase level Red blood cell count Erythrocyte sedimentation rate

Amylase level In 90% of clients with acute pancreatitis, the amylase level is elevated up to three times over baseline;

The nurse is caring for a client following a laparoscopic cholecystectomy. Which nursing action is priority? Monitor the abdominal dressing for bleeding Instruct on using patient-controlled analgesia Teach about six-week activity restriction Assess puncture sites for bleeding

Assess puncture sites for bleeding

Optimal discharge teaching with regard to dumping syndrome following gastroduodenostomy should include what information? Encouraging the client to plan for a light walk immediately after meals Encouraging the client to drink adequate fluids with and between meals Instructing the client to follow a high carbohydrate, low fat, low protein diet Assuring the client that symptoms generally resolve within a year of surgery

Assuring the client that symptoms generally resolve within a year of surgery

A client is diagnosed with chronic pancreatitis. Which dietary instruction is most important for the nurse to share with the client? Eat a low-fat, low-protein diet Avoid foods high in carbohydrates Avoid ingesting alcoholic beverages Eat a bland diet with no snacks in between

Avoid ingesting alcoholic beverages

A client is admitted to the hospital with slight jaundice and reports of pain on the left side and back. A diagnosis of acute pancreatitis is made. Which common response to acute pancreatitis should the nurse monitor in the client? Crackles Hypovolemia Gastric reflux Jugular vein distention

Hypovolemia

After an acute episode of upper gastrointestinal (GI) bleeding, a client vomits undigested medications and reports severe epigastric and abdominal pain. The client has absent bowel sounds, rigid abdomen, a pulse rate of 134, and shallow respirations of 32 per minute. The primary healthcare provider has been contacted. What should be the nurse's next priority? Keep the client nothing by mouth (NPO) Teach the client coughing and deep breathing Inquire whether any red or black stools have been noted Place the client in the supine position with the legs elevated

Keep the client nothing by mouth (NPO)

Which is the priority intervention for the dependent client with peptic ulcer disease (PUD) who is vomiting bright red blood? Apply oxygen Place the client in a side-lying position Prepare to administer packed red blood cells Assess the client's pulse and blood pressure

Place the client in a side-lying position Recall the airway, breathing, and circulation (ABCs) of priority care. The client who needs assistance to manage self-care (dependent) should be placed in the side-lying position when vomiting to prevent aspiration.

A client who is obese and has a history of alcohol abuse is admitted to the hospital with the diagnosis of acute pancreatitis. Which is the initial priority expected client outcome in response to therapy at this time? Report decreased pain Insert nasogastric (NG) tube quickly Join Alcoholics Anonymous Lose four pounds (1.8 kilograms) a week

Report decreased pain

A client is discharged the same day after ambulatory surgery for a laparoscopic cholecystectomy. The nurse is providing discharge teaching about how many days the client should wait to engage in certain activities. Place in order the activities from the first to the last in which the client may engage. 1.Showering 2.Driving a car 3.Performing light exercise 4. Lifting objects of more than 10 lb (4.5 kg) 5. Getting out of bed in a chair

5, 3, 1, 2, 4

A client is admitted to the hospital for surgery for a laparoscopic cholecystectomy. To monitor the flow of bile to the gastrointestinal tract, what symptom should the nurse assess? Color of the stool Presence of peristalsis Bleeding at the operative site Presence of cholesterol intolerance

Color of the stool

The nurse is creating a dietary plan for a client with cholecystitis who has been placed on a modified diet. Which will be most appropriate to include in the client's dietary plan? Offer soft-textured foods to reduce the digestive burden Offer low-cholesterol foods to avoid further formation of gallstones Increase protein intake to promote tissue healing and improve energy reserves Decrease fat intake to avoid stimulation of the cholecystokinin mechanism for bile release

Decrease fat intake to avoid stimulation of the cholecystokinin mechanism for bile release

A nurse is caring for a client who just had a gastrectomy. What should the nurse emphasize when teaching the client how to avoid dumping syndrome? Increase activity after eating Drink at least two to three glasses of fluid with each meal Eat small meals with low carbohydrate and moderate fat content Sit in a high-Fowler position for 30 minutes after eating

Eat small meals with low carbohydrate and moderate fat content

A client with an acute attack of cholecystitis has a cholecystectomy with a choledochostomy. The client returns from surgery with a T-tube connected to a drainage bag. What does the nurse conclude is the purpose of the T-tube? Decrease edema Permit drainage of bile Insert antibiotic medication Provide for irrigation of the gallbladder

Permit drainage of bile

A client is admitted with the diagnosis of acute pancreatitis. Which clinical manifestations should a nurse assess in the client? Select all that apply. Jaundice Acute pain Hypertension Hypoglycemia Increased amylase

a. Jaundice b. Acute pain e. Increased amylase

A nurse is teaching a newly admitted client who has acute pancreatitis about dietary restrictions. What should the education include? Use of IV fluids Season foods sparingly Eat small meals frequently Limit coffee to three cups per day

Use of IV fluids Acute pancreatitis requires an NPO status to allow the pancreas to rest. IV fluids are administered. Spicy, seasoned foods stimulate the pancreas and should be avoided, not just sparingly used. S

The nurse is creating a discharge teaching plan for a client who had a subtotal gastrectomy. The nurse should include what instructions about minimizing dumping syndrome? Select all that apply. a. Drink fluids with meals. b. Eat small, frequent meals. c. Lie down for one hour after eating. d. Chew food five times before swallowing. e. Select foods that are low in fiber.

b, c, b. Eat small, frequent meals. c. Lie down for one hour after eating.

A primary healthcare provider diagnoses a client with acute cholecystitis with biliary colic. Which clinical findings should the nurse expect when performing a health history and physical assessment? Select all that apply. a. Diarrhea with black feces b. Intolerance to foods high in fat c. Vomiting of coffee-ground emesis d. Gnawing pain when stomach is empty e. Pain that radiates to the right shoulder

b, e, b. Intolerance to foods high in fat e. Pain that radiates to the right shoulder

A client is admitted to the hospital with Laënnec cirrhosis and chronic pancreatitis. Bile salts (bile acid factor) are prescribed, and the client asks why they are needed. What is the nurse's best response? "They stimulate prothrombin production." "They aid absorption of fat-soluble vitamins." "They promote bilirubin secretion in the urine." "They help the common bile duct contract stronger."

"They aid absorption of fat-soluble vitamins."

A client undergoes an abdominal cholecystectomy with common duct exploration. In the immediate postoperative period, what is the priority nursing action? Irrigating the T-tube every hour Changing the dressing every two hours Encouraging coughing and deep breathing Promoting an adequate fluid and food intake

Encouraging coughing and deep breathing In an abdominal cholecystectomy, the incision is high, causing pain when the client is deep breathing.