NURS 344 Exam 3 (Week 8)

The gastrointestinal laboratory nurse is learning about small intestine secretions. Which explanation is most accurate? "Ulcers are more likely to occur in the stomach than in the duodenum." "The Brunner glands secrete large amounts of acidic mucus." "An extensive array of mucus-producing glands, called Brunner glands, is concentrated where contents from the stomach and secretions from the liver and pancreas enter the duodenum." "Sympathetic stimulation causes a marked increase in mucus production."

"An extensive array of mucus-producing glands, called Brunner glands, is concentrated where contents from the stomach and secretions from the liver and pancreas enter the duodenum." An extensive array of mucus producing glands, called Brunner glands, is concentrated at the site where the contents of the stomach and secretions from the liver and pancreas enter the duodenum. These glands secrete large amounts of alkaline mucus. Sympathetic stimulation causes a decrease in mucus production, leaving this area more susceptible to irradiation. As a result, ulcers are four times more likely to occur in the duodenum than in the stomach.

A client is scheduled for magnetic resonance imaging (MRI). During the client teaching, what will the nurse discuss? "You must be NPO for the day before the examination." "The examination will take only 15 minutes." "You must remove all jewelry but can wear your wedding ring." "Do you experience any claustrophobia?"

"Do you experience any claustrophobia?"

A client is scheduled for an ultrasound of the abdomen. Which statement indicates that teaching provided to the client to prepare for the test was effective? "I will take medications to reduce gastric acid before the test." "I will take an over-the-counter enema before the test." "I will not eat or drink for 8 to 12 hours before the test." "I will ingest a clear liquid diet for 3 days before the test."

"I will not eat or drink for 8 to 12 hours before the test." Ultrasonography is a noninvasive diagnostic technique in which high-frequency sound waves are passed into internal body structures, and the ultrasonic echoes are recorded on an oscilloscope as they strike tissues of different densities. It is particularly useful in the detection of an enlarged gallbladder or pancreas, or the presence of gallstones, an enlarged ovary, an ectopic pregnancy, or appendicitis. The client should be instructed to fast for 8 to 12 hours before the test to decrease the amount of gas in the bowel. Enemas are not needed before an abdominal ultrasound. A clear liquid diet is not needed before the test. Medications to reduce gastric acid are not required before the test.

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." "There is no need for special preparation before the test." "I'll take a laxative to clear my bowels before the test." "I'll drink full liquids the day before the test."

"I'll avoid eating or drinking anything 6 to 8 hours before the test." The client demonstrates understanding of a barium swallow when stating he or she must refrain from eating or drinking for 6 to 8 hours before the test. No other preparation is needed. Before a lower GI series, the client should eat a low-residue or clear liquid diet for 2 days and take a potent laxative and an oral liquid preparation.

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." "It tells the physician what type of cancer is present." "It determines functionality of the liver." "It detects a protein normally found in the blood."

"It indicates if a cancer is present." The carcinoembryonic antigen (CEA) blood test detects the presence of cancer by identifying the presence of a protein not normally detected in the blood of a healthy person. However, it does not indicate what type of cancer is present nor does it detect the functionality of the liver.

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? "You'll need to restrict your fluid intake for 24 hours after the test." "Make sure to tell your doctor about any allergies to shellfish." "It's important that you take your laxatives as ordered on the day prior to your barium swallow." "Make sure that you don't eat anything after midnight the day before your test."

"Make sure that you don't eat anything after midnight the day before your test." An upper GI series typically requires fasting from the night prior. Shellfish allergies are not relevant, and bowel preparation is not required. Fluid intake should be increased, not restricted, after the 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? "The area may determine the severity of the pain." "Often the area of pain is referred from another area." "If the health care provider massages over the exact painful area, the pain will disappear." "This determines the pain medication to be ordered."

"Often the area of pain is referred from another area." Pain can be a major symptom of disease. The location and distribution of pain can be referred from a different area. If a client points to an area of pain and has other symptoms associated with a certain disease, this is valuable information for treatment.

A student is comparing the two patterns of contractions in the small intestine. Which statement is most accurate? "Segmentation waves function mainly to mix the chyme with the digestive enzymes from the pancreas." "The frequency of segmenting activity decreases after a meal." "Peristaltic movements drive the contents forward and backward." "Peristaltic movements begin in the cecum."

"Segmentation waves function mainly to mix the chyme with the digestive enzymes from the pancreas." There are two patterns of contractions in the small intestine: segmentation and peristaltic contractions. Segmentation waves drive the contents forward and backward. They function mainly to mix the chyme with the digestive enzymes from the pancreas and their frequency increases after a meal. Peristaltic movements begin in the duodenum.

A student is explaining the enteric and autonomic nervous systems in the gastrointestinal (GI) tract. A faculty member knows the student has mastered this information when he or she makes which statement? "Sympathetic innervation controls the extent of mucus secretion by the mucosal glands." "The Meissner plexus is concerned mainly with motility along the length of the gut." The Auerbach plexus is concerned with controlling the secretions, absorption, and contraction of each segment of the intestinal tract." "Sympathetic innervation to the stomach, small intestine, cecum, and ascending and transverse colon occurs through the vagus nerve."

"Sympathetic innervation controls the extent of mucus secretion by the mucosal glands." The sympathetic nervous system exerts several effects on GI function. It controls the extent of mucus secretion by the mucosal glands. Parasympathetic innervation to the stomach, small intestine, cecum, ascending colon, and transverse colon occurs through the vagus nerve. The Meissner or submucosal plexus is mainly concerned with controlling the secretions, absorption, and contractions of each segment of the intestinal tract. The Auerbach or myenteric plexus is concerned mainly with motility along the length of the gut.

A student is studying the esophagus. Which statement made by this student to a faculty member is a correct one? "The smooth muscle layers provide the peristaltic movements needed to move food along the length of the esophagus." "The gastroesophageal sphincter keeps air from entering the esophagus and stomach during breathing." "The upper esophageal sphincter passes through an opening, or hiatus, in the diaphragm." "The lower sphincter, known as the pharyngoesophageal sphincter, lies just above the area where the esophagus joins the stomach."

"The smooth muscle layers provide the peristaltic movements needed to move food along the length of the esophagus." The smooth muscle layers provide the peristaltic movements needed to move food along the length of the esophagus. The pharyngoesophageal sphincter, the upper sphincter, keeps air from entering the esophagus and stomach during breathing. The lower esophageal sphincter passes through an opening, or hiatus, in the diaphragm.

When palpating the abdomen the nurse finds a large pulsating mass. The nurse would suspect this is what? Ascites Abdominal aortic aneurysm Abdominal tumor Inflammation

Abdominal aortic aneurysm Pulsation of the aorta may be increased and lateralized in an abdominal aortic aneurysm. Ascites is collection of fluid in the abdomen. Inflammation and tumors do not pulsate.

The nurse suspects an abdominal aortic aneurysm when what is assessed? Increased femoral pulses Hypertension Abdominal bruit Warm extremities

Abdominal bruit Auscultation of the abdomen would reveal a bruit. The client may exhibit decreased femoral pulses, hypotension and cool extremities.

A 26-year-old sports store manager comes to the clinic with severe right-sided abdominal pain for 12 hours. He began having a stomach ache yesterday with a decreased appetite, but today the pain seems to be just on the lower right side. He has had some nausea and vomiting but no constipation or diarrhea. His last bowel movement was last night and was normal. He has had no fever or chills. He denies any recent illnesses or injuries. His past medical history is unremarkable. He is engaged. He denies any tobacco or drug use and drinks four to six beers per week. His mother has breast cancer and his father has coronary artery disease. On examination he appears ill and is lying on his right side. His temperature is 38.8° and his heart rate is 170. His bowel sounds are decreased, and he has rebound and involuntary guarding at one third of the way between the anterior superior iliac spine and the umbilicus in the right low

Acute appendicitis Appendicitis is common in the young and usually presents with periumbilical pain that localizes to the right lower quadrant in an area known as McBurney's point, described as one third of the way between the anterior superior iliac spine and the umbilicus on the right. Rebound and guarding are common. Remote rebound or Rovsing's sign is also seen commonly when the course of appendicitis is advanced. Bowel movements are usually unaffected.

An emergency department nurse is caring for a teenage client who has severe pain in the umbilical area. Documentation shows that the client exhibits "Rovsing's sign." What medical diagnosis is associated with the assessment finding? Appendicitis Gastroenteritis Liver disease Enlarged spleen

Appendicitis Rovsing's sign is an indicator of appendicitis. It is not a sign of gastroenteritis, liver disease, or an enlarged spleen.

The nurse would assess for positive Blumberg sign how? Having the client breathe deeply Applying and releasing pressure to the abdomen Applying blunt pressure at the costovertebral angle (CVA) Applying blunt pressure that the midclavicular line (MCL)

Applying and releasing pressure to the abdomen Pain that occurs after applying and releasing pressure to the abdomen would be a positive Blumberg sign. Murphy sign occurs when the client holds his breath and there is pain. Blunt pressure at the CVA assesses for kidney pain. Liver span test occurs at the MCL.

The nurse is preparing the client for an assessment of the abdomen. What should the nurse complete prior to this assessment? Dim the lights for privacy. Prepare for a prostate examination. Assist the client to a Fowler's position. Ask the client to empty the bladder.

Ask the client to empty the bladder. The physical examination of the gastrointestinal system includes assessment of the mouth, abdomen, and rectum. It requires good light, full exposure of the abdomen, warm hands with short nails, and a relaxed client with an empty bladder. A full bladder will interfere with inspection and may elicit discomfort with palpation and percussion, thereby altering results.

A client presents complaining of nausea, vomiting, and acute abdominal pain. What is the nurse's first action? Ask about pertinent risk factors. Obtain a 24 hour diet recall. Ask the client when the pain began. Document a detailed health history.

Ask the client when the pain began.

A client has experienced a stroke affecting the reticular formation of the medulla and lower pons. The nurse tells the client's wife that care must be taken with eating to prevent: Gastric atony Duodenal ulcers Steatorrhea Aspiration pneumonia

Aspiration pneumonia Diseases (strokes) that disrupt the brain centers of the reticular formation of the medulla and lower pons disrupt the coordination of swallowing and predispose a person to food and fluid lodging in the trachea and bronchi, which leads to asphyxiation or aspiration pneumonia. The other options are not caused by damage to the brain.

A nurse is teaching a client who suffers from peptic ulcers how to reduce the risk of their recurrence. Which of the following should the nurse recommend? Avoid excessive alcohol intake Avoid eating overcooked foods Avoid taking antacid medications Avoid taking pain medications with food

Avoid excessive alcohol intake The nurse should recommend avoiding excessive alcohol intake, as this is a risk factor associated with peptic ulcer disease. The nurse should also recommend eating foods that have been cooked completely and taking pain medications with food. Antacid medications may relieve peptic ulcers

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. Bile production increases when an individual's fat intake is reduced over several days. Bile is produced in the liver in response to meals that are high in protein. Bile is stored in the gallbladder until it is needed for carbohydrate metabolism.

Bile is produced in the liver but released by the gallbladder when needed for digesting fats. Bile, which is manufactured by the liver, plays a major role in the digestion and absorption of fats in the gastrointestinal tract. It is stored temporarily in the gallbladder until it is needed for digestion, at which time the gallbladder empties and bile enters the intestine.

Which of the following is the most definitive means of assessing for liver disease? Paracentesis Cholecystography Biopsy Ultrasonography

Biopsy Liver biopsy is the most effective means of diagnosing liver disease. Guided liver biopsy can be conducted using laparoscopy, the insertion of a fiberoptic endoscope through a small abdominal incision. Paracentesis is the removal of fluid (ascites) from the peritoneal cavity through a puncture or a small surgical incision through the abdominal wall under sterile conditions. Cholecystography and ultrasonography may be used to detect gallstones. Ultrasonography may also be used to visualize the liver and diagnose conditions such as liver fibrosis; noninvasive techniques such as this can reduce the need for liver biopsy.

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 Red Dark brown Green

Black Ingestion of iron can cause the stool to turn black. Meat protein causes stool to appear dark brown. Ingestion of large amounts of spinach may turn stool green while ingestion of carrots and beets may cause stool to turn red.

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? C-reactive protein (CRP) Coproporphyrin Ceruloplasmin Carcinoembryonic antigen (CEA)

Carcinoembryonic antigen (CEA) CEA is a protein that is normally not detected in the blood of a healthy person; therefore, when detected it indicates that cancer is present. The other cited blood analyses are not associated with cancer.

A nurse explains to an older adult client that production of intrinsic factor in the stomach decreases with aging. The nurse encourages the client to increase intake of which food? Chicken Apples Green leafy vegetables Citrus fruits

Chicken Intrinsic factor is necessary for the absorption of Vitamin B12. Vitamin B12 is contained in meats, dairy products, and eggs. Fruits and vegetables do not contain intrinsic factor.

A student is studying gallbladder function. Which gastrointestinal hormone stimulates contraction of the gallbladder? Ghrelin Cholecystokinin Gastrin Secretin

Cholecystokinin Cholecystokinin, which is secreted in the duodenum and jejunum, stimulates contraction of the gallbladder and secretion of pancreatic enzymes.

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 Upper GI series Small bowel series Computer tomography

Colonoscopy A colonoscopy is a direct visual examination of the entire large intestine. It does not involve the use of a contrast agent. Contrast medium may be used with a small bowel series, computed tomography, and upper GI series.

A college student presents to the health care clinic with reports of no bowel movement for 4 days, bloating, and generalized abdominal discomfort. She states that she has not been eating and drinking correctly and is stressed because she has a final exam in 2 days. A nurse assesses the abdomen and finds positive bowel sounds in all four quadrants and tenderness in the left lower quadrant with a few small, round, firm masses. The Rovsing's sign and Psoas sign are negative. What nursing diagnosis can the nurse confirm for this client? Ineffective Nutrition: Less Than Body Requirements Constipation related to decrease in fluid intake Ineffective Health Maintenance Risk for Fluid Volume Deficit

Constipation related to decrease in fluid intake The nurse can confirm constipation because the major defining characteristics of decreased frequency and abdominal discomfort are present. A few days of altered nutrition does not meet the necessary criteria to confirm Ineffective Nutrition or Risk for Fluid Volume Deficit. Ineffective Health Maintenance cannot be confirmed because there is no evidence that the client lacks the knowledge to eat properly.

A client has been diagnosed with a defect in the pyloric sphincter. How will the nurse explain the likely consequence of a dysfunctional pyloric sphincter? Contents from the small intestine may flow back into the stomach. Intestinal motility will be slowed and you may have constipation. Food may have trouble entering the stomach from the esophagus. Decreased control of defecation could lead to fecal incontinence.

Contents from the small intestine may flow back into the stomach The pyloric sphincter is a muscle that serves as a valve controlling stomach emptying and prevents regurgitation of intestinal contents into the stomach. With dysfunction, the client could have reflux from the small intestine back into the stomach but this will not result in slowing motility. The lower esophageal sphincter controls food entering the stomach. Defecation is controlled by the action of the internal and external anal sphincters.

A client complains of abdominal pain with cramping diarrhea, nausea, vomiting, weight loss, and loss of energy. The nurse should suspect which of the following as the underlying cause? Gastroesophageal reflux Pancreatitis Crohn's disease Gastric ulcer

Crohn's disease Abdominal pain with cramping, diarrhea, nausea, vomiting, weight loss, and lack of energy is often seen in Crohn's disease. Epigastric pain accompanied by tarry stools suggests a gastric or duodenal ulcer. Pancreatitis is worsened with alcohol ingestion. Gastroesophageal reflux is worsened when supine.

Which aspect of gastrointestinal function is performed by the brush border enzymes of the villus structures? Digestion of carbohydrates Vitamin A synthesis Fat metabolism Maintenance of fluid and electrolyte balance

Digestion of carbohydrates Brush border enzymes aid in the digestion of carbohydrates and proteins. They do not metabolize fat or synthesize vitamin A, and they do not directly contribute to fluid and electrolyte balance.

A client with a gastrointestinal condition is prescribed a stool guaiac for fecal occult blood. Which instructions will the nurse provide the client about this test? Select all that apply. Take additional doses of vitamin C supplements before the test. Reduce the amount of nonsteroidal anti-inflammatory drugs taken. Do not take any aspirin for 72 hours before the test. Avoid ingesting red meat for 72 hours before the test. Drink orange juice for 2 days before the test.

Do not take any aspirin for 72 hours before the test. Avoid ingesting red meat for 72 hours before the test. Guaiac based fecal occult blood testing (gFOBT) is one of the most commonly performed stool tests. It can be useful in initial screening for several disorders, although it is used most frequently in early cancer detection programs. The client should be advised to not take aspirin or eat red meat for 72 hours before the test because it could cause a false-positive result. The client should be advised to avoid ingesting anything that contains vitamin C such as orange juice and vitamin C supplements because it could cause a false-negative result. Nonsteroidal anti-inflammatory drugs should be avoided for 72 hours before the test.

The common bile duct opens into which part of the gastrointestinal tract? Cecum Ileum Duodenum Jejunum

Duodenum The duodenum contains the opening for the common bile duct and the main pancreatic duct.

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. Serve the client his usual diet. Serve dairy products. Order a high-fiber diet.

Encourage plenty of fluids. The nurse should encourage plenty of fluids because adequate fluid intake is necessary to avoid dehydration that may be caused by the bowel preparation and to prevent fecal impaction after the procedure. The client may be placed on a low-residue diet 1 to 2 days before the procedure to reduce the contents in the GI tract. Fiber intake is limited in a low-residue diet. Because dairy products leave a residue, they aren't allowed the evening before the test. Clear liquids only are allowed the evening before the test

Mr. Kruger, 84 years old, presents with a smooth lower abdominal mass in the midline, which is minimally tender. There is dullness to percussion up to 6 cm above the symphysis pubis. What does this most likely represent? Tumor in the abdominal wall Hernia Sigmoid mass Enlarged bladder

Enlarged bladder It is possible that this represents a sigmoid colon mass, but this is less likely than an enlarged bladder. Prostatic hypertrophy is very common in this age group and can frequently cause partial urinary obstruction with bladder enlargement. If the mass resolves with catheterization, this is a likely cause. Other forms of urinary obstruction such as neurogenic bladder, urethral stricture, and side effects of drugs can also be contributing to the problem. A hernia would most likely not be dull to percussion. Midline abdominal wall tumors of this size would be unusual but could be discerned by having the client tense his abdominal muscles.

The physiologic rationale for hanging normal saline (0.9% NS) or 5% dextrose in water (D5W) to a client who has been experiencing diarrhea includes: Activation of the ATP channels Activating the pancreatic enzymes of trypsin and elastase Emulsification of fats Facilitating the absorption of osmotically active particles

Facilitating the absorption of osmotically active particles Water absorption from the intestine is linked to absorption of osmotically active particles such as glucose and sodium. It follows that an important consideration in facilitating the transport of water across the intestine (and decreasing diarrhea) after temporary disruption in bowel function is to include sodium and glucose in the fluids that are consumed. None of the other distractors addresses this principle. Activating the pancreatic enzymes of trypsin and elastase is needed for protein digestion and absorption. Emulsification of fats begins in the stomach and continues in the duodenum under the influence of bile from the liver.

The swallowing reflex is an entirely voluntary activity. True False

False Although swallowing is initiated as a voluntary activity, it becomes involuntary as food or fluid reaches the pharynx.

A nurse documents that the client has "steatorrhea." What did the nurse most likely assess? Hard, black stools Incontinence Fatty stools Foul smelling urine

Fatty stools Steatorrhea is the term used to describe fatty stools.

The nurse notes that a client's abdominal skin is pale and taut. What should the nurse suspect is causing this finding? Inflammation of the liver Obstruction of the inferior vena cava Fluid accumulating in the abdominal cavity Bleeding within the abdominal wall

Fluid accumulating in the abdominal cavity Pale taut skin may be seen with ascites which is significant abdominal swelling that indicates fluid accumulation in the abdominal cavity. Jaundice would be present if the liver is inflamed. Purple discoloration at the flank areas indicates bleeding within the abdominal wall. Dilated veins may be seen with obstruction of the inferior vena cava.

Which of the following people need to be vaccinated for hepatitis A and B? Animal care workers Food-service workers Office personnel Truck drivers

Food-service workers Hepatitis A and B immunizations are recommended for all infants; people whose work may expose them to blood, body fluids, or unsanitary conditions (i.e., health care, food services, sex workers); and those traveling to parts of the world where these illnesses are prevalent.

A client is experiencing reflux of stomach contents into the esophagus. The nurse determines that the problem may result from: Pharyngoesophageal sphincter Gastroesophageal sphincter Upper esophageal sphincter Pyloric sphincter

Gastroesophageal sphincter The gastroesophageal sphincter (also called the lower esophageal sphincter) prevents the contents of the stomach from rising into the esophagus. The upper esophageal sphincter (also called the pharyngoesophageal sphincter) keeps air from entering the stomach from the esophagus. The pyloric sphincter controls the rate of stomach emptying.

A student is comparing the actions of the gastrointestinal hormones. Which hormone acts as an appetite-stimulating signal? Glucagon-like peptide 1 (GLP-1) Secretin Gastrin Ghrelin

Ghrelin Ghrelin stimulates secretion of growth hormone and acts as a appetite-stimulating signal from the stomach. GLP-1 decreases appetite. The other options do not have an effect on appetite.

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 Steamed rice with pork and broccoli Grilled chicken on a spinach salad Salmon with cheddar mashed potatoes

Hamburger and French fries Fatty foods delay stomach emptying (bloating) and can cause symptoms of gastrointestinal upset. Fried and deep fried foods contain elevated amounts of fat. The other options have a lower fat content.

A nurse is instructing a client who suffers from peptic ulcer disease about the causes of this condition. Which of the following should the nurse mention as a common bacterial cause? Staphylococcus aureus Helicobacter pylori Streptococcus pyogenes Escherichia coli

Helicobacter pylori

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 Borborygmi Hypoactive

Hyperactive Bowel sounds are assessed using the diaphragm of the stethoscope for high-pitched and gurgling sounds (Gu, Lim, & Moser, 2010). The frequency and character of the sounds are usually heard as clicks and gurgles that occur irregularly and range from 5 to 35 per minute. The terms 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), or absent (no sounds in 3 to 5 minutes) are frequently used in documentation, but these assessments are highly subjective (Li, Wang, & Ma, 2012).

Gastrin has which of the following effects on gastrointestinal (GI) motility? Contraction of the ileocecal sphincter Increased motility of the stomach Relaxation of the colon Relaxation of gastroesophageal sphincter

Increased motility of the stomach Gastrin has the following effects on GI motility: increased motility of the stomach, excitation of the colon, relaxation of ileocecal sphincter, and contraction of the gastroesophageal sphincter

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. Withhold oral medications for 24 hours before the test. Eat a clear liquid breakfast before the test. Avoid products containing aspirin for a week before the test.

Ingest nothing by mouth after midnight. An upper GI fluoroscopy delineates the entire GI tract after the introduction of a contrast agent such as barium. To prepare for the test, the client should be instructed to ingest nothing after midnight before the test. Clear liquids are not permitted the morning of the test. Most oral medications are withheld the morning of the test, but not for 24 hours before. There is no reason to avoid products containing aspirin for a week before the test.

When performing the abdominal assessment for a client, which assessment technique should the nurse perform first? Inspection Percussion Palpation Auscultation

Inspection The appropriate sequence for abdomen assessment is inspection, auscultation, percussion, and palpation. Auscultation is performed after inspection to ensure that the motility of the bowel and bowel sounds are not altered by percussion and palpation.

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? Histamine Liver enzyme Intrinsic factor Hydrochloric acid

Intrinsic factor Vitamin B12 absorption depends on intrinsic factor, which is secreted by parietal cells in the stomach. The vitamin binds with intrinsic factor and is absorbed in the ileum. Hydrochloric acid, histamine, and liver enzymes don't influence vitamin B12 absorption.

Monique is a 33-year-old administrative assistant who has had intermittent lower abdominal pain approximately one week a month for the past year. It is not related to her menses. She notes relief with defecation, and a change in form and frequency of her bowel movements with these episodes. Which of the following is most likely? Inflammatory bowel disease Colon cancer Irritable bowel syndrome Cholecystitis

Irritable bowel syndrome Although colon cancer should be a consideration, these symptoms are intermittent and no note is made of progression. Cholecystitis usually presents with right upper quadrant pain. Inflammatory bowel disease is often associated with fever and hematochezia. Because there is relief with defecation and there are no mentioned structural or biochemical abnormalities, irritable bowel syndrome seems most likely, especially given that she is a young woman. This very common condition can be triggered by certain foods and stress.

Which structure in the gastrointestinal (GI) tract has absorptive function focusing mainly on water resorption? Large intestine Ileum Stomach Small intestine

Large intestine Absorption is the process of moving nutrients and other materials from the external environment in the lumen of the GI tract into the internal environment. The absorptive function of the large intestine focuses mainly on water reabsorption.

A nurse auscultates for bowel sounds on a client admitted for nausea and vomiting and hears no gurgling in the right lower quadrant after 1 minute. What is an appropriate action by the nurse? Assess for findings of dehydration Document the absence of bowel sounds Listen for a total of 5 minutes Palpate for abdominal rigidity

Listen for a total of 5 minutes Bowel sounds normally occur every 5 to 15 seconds. In a client with nausea and vomiting, bowel sounds may be hypoactive. The nurse should listen for a total of 5 minutes to confirm the absence of bowel sounds. Assessing the client for dehydration is necessary but not in relation to the finding of bowel sounds. Palpation should be done after completing auscultation of the abdomen.

The nurse is caring for a geriatric client and notices polypharmacy. Which diagnostic studies are anticipated? Blood chemistry Complete blood count Urinalysis Liver function studies

Liver function studies The liver metabolizes and biotransforms the medications ingested. Geriatric clients who experience polypharmacy or multiple medications have an elevated risk of liver impairment. Routine liver function studies monitor the status of the liver and its ability to metabolize.

Where is the linea alba located? Lower edge of the costal margin Middle of the ventral abdominal wall Anterior-superior iliac spine of the iliac bones Xiphoid process of the sternum

Middle of the ventral abdominal wall Four layers of large, flat muscles form the ventral abdominal wall and are joined at the midline by a tendinous seam, the linea alba. The lower edge of the costal margin and the anterosuperior iliac spine of the iliac bones are landmarks used to divide the abdomen into regions. The abdomen is a large cavity extending from the xiphoid process of the sternum down to the superior margin of the pubic bone.

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? Esophagus Duodenum Mouth Stomach

Mouth Food that contains starch undergoes partial digestion in the mouth when it mixes with the enzyme salivary amylase, which the salivary glands secrete.

A client reports the onset of discomfort and pain in the right upper quadrant of the abdomen after eating. The nurse should assess this finding using which test? Rovsing's Psoas Obturator Murphy's

Murphy's The gallbladder is located in the right upper quadrant of the abdomen. When it is inflamed (cholecystitis), performing the Murphy's sign will cause the client to hold the breath (inspiratory arrest). The Obturator & Psoas tests are to determine if the appendix is inflamed. Rovsing's sign test for rebound tenderness which may indicate peritoneal irritation.

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: Both hands over the left lower quadrant and applying gentle pressure. One hand under the right lower rib cage and press downward with the other hand. One hand under the left lower rib cage and pressing upward toward the midline. The left hand at the level of the umbilicus and the right hand at the base of the diaphragm.

One hand under the right lower rib cage and press downward with the other hand. Refer to Figure 21-8 in the text for an illustration of this procedure. The liver is located under the diaphragm on the right side of the abdominal cavity, extending slightly left from the midline.

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? Liver Gallbladder Pancreas Stomach

Pancreas The pancreas is both an exocrine gland, one that releases secretions into a duct or channel, and an endocrine gland, one that releases substances directly into the bloodstream. The other organs have a variety of functions but do not have a combination function such as the pancreas.

A student is studying the interstitial cells of Cajal found in the smooth muscle tissue of the gastrointestinal tract. The student says that these cells produce slow waves that are increased in amplitude by the: Cranial nerves Parasympathetic nervous system Central nervous system Sympathetic nervous system

Parasympathetic nervous system The amplitude and, to a lesser extent, the frequency of the slow waves, can be modulated by the parasympathetic and sympathetic divisions of the autonomic nervous system. The parasympathetic nervous system increases the amplitude of the slow waves, and the sympathetic system decreases them.

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? Acetylcysteine Glycopyrronium bromide Atropine Pentagastrin

Pentagastrin The gastric acid stimulation test usually is performed in conjunction with gastric analysis. Histamine or pentagastrin is administered subcutaneously to stimulate gastric secretions.

The nurse needs to assess the abdomen of a hospitalized client post gastrointestinal surgery. Place the following assessment steps in order as the nurse enters the client's room. 1Inspect the abdomen. 2Auscultate all four quadrants. 3Palpate for tenderness. 4Perform a general survey of safety hazards. 5Document the findings.

Perform a general survey of safety hazards. Inspect the abdomen. Auscultate all four quadrants. Palpate for tenderness. Document the findings.

Serous fluid is contained in the: Small intestine Stomach Peritoneal cavity Large intestine

Peritoneal cavity Between the visceral and parietal peritoneum is the peritoneal cavity. The peritoneal cavity contains fluid secreted by the serous membranes. This serous fluid forms a moist and slippery surface that prevents friction between the continuously moving abdominal structures. The other options do not contain serous fluid.

Which layer of the digestive tract constitutes the outer wall of the intestine and contains a serous fluid between its two layers? Peritoneum Omentum Mesentery Haustration

Peritoneum The peritoneum is the largest serous membrane and constitutes the outer wall of the intestine, continuous with the mesentery. The greater omentum helps to prevent infection from entering the peritoneal cavity, and protects the intestines from cold. Haustration is the segmental mixing of movements of the large intestine (colon).

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? Provide saline gargles to the client. Permit the client to drink only clear liquids. Instruct the client to have low-residue meals. Allow the client to ingest fat-free meal.

Permit the client to drink only clear liquids. After polyethylene glycol/electrolyte solution is administered, the client should have clear liquids because this ensures watery stools, which are necessary for procedures like a barium enema. Allowing the client to ingest a fat-free meal is used in preparation for oral cholecystography. Instructing the client to have low-residue meals is a pretest procedure for barium enema. A client is offered saline gargles after esophagogastroduodenoscopy.

Select the phase of swallowing that prevents food from entering the nasopharynx when a client is eating. Anal Oral Esophageal Pharyngeal

Pharyngeal Swallowing consists of three phases: an oral, or voluntary, phase; a pharyngeal phase; and an esophageal phase. During the oral phase, the bolus is collected at the back of the mouth, so the tongue can lift the food upward until it touches the posterior wall of the pharynx. At this point, the pharyngeal phase of swallowing is initiated. The soft palate is pulled upward, and the palatopharyngeal folds are pulled together so that food does not enter the nasopharynx. The esophageal phase triggers peristalsis.

How should the nurse perform blunt percussion over the liver? Place left hand on right lower rib cage, strike it with radial side of right fist Place right hand on mid of the rib cage; strike it with ulnar side of left fist Place right hand on mid of the rib cage; strike it with ulnar side of left fist Place left hand on right lower rib cage, strike it with ulnar side of right fist

Place left hand on right lower rib cage, strike it with ulnar side of right fist The correct way of performing blunt percussion is to place left hand on right lower rib cage, strike it with ulnar side of right fist. Placing the hand on the mid of rib cage would not enable the nurse to assess the liver. Placing the right hand on the rib cage and striking with radial side of left hand may not be technically possible.

What precaution should the nurse take when measuring a client's abdominal girth to screen for cardiovascular risk factors? Place the tape measure behind the client and measure at the umbilicus Ask the client to be seated and relaxed when taking the measurement Inform the client that the pen mark on the abdomen should not be washed off Ensure that the client has had a full meal before measuring the abdomen

Place the tape measure behind the client and measure at the umbilicus The nurse should place the tape measure behind the client and measure at the umbilicus. The umbilicus should be the starting point when measuring the abdomen especially when distention is apparent. Abdominal measurement is generally taken in the morning after voiding, not after the client has had a full meal. The ideal position to measure the abdomen is standing not sitting. The nurse informs the client that the pen mark on the abdomen should not be washed out only if the client is being monitored on a regular basis to determine progress of treatment for abdominal distention.

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. Position the client on the right side with the knees up to the chest. Dim the lights to decrease the client's embarrassment. Cleanse gloved fingers with water to allow for easy insertion. Ask the client to bear down for visual inspection. Ask the client to produce a bowel movement after the procedure.

Position the client on the right side with the knees up to the chest. Ask the client to bear down for visual inspection. While examination of the rectum, perineum, and anus may be uncomfortable for the client, it is necessary for a thorough examination. The examiner will position the client on the right side with the knees up. He or she will use a gloved finger lubricated with a water-soluble lubricant for ease of insertion. The health care provider will encourage deep breathing during the procedure and ask the client to bear down while inspecting the anal area. The examination requires appropriate lighting for thorough inspection.

Which diagnostic produces images of the body by detecting the radiation emitted from radioactive substances? Positron emission tomography (PET) Computed tomography (CT) Fibroscopy Magnetic resonance imaging (MRI)

Positron emission tomography (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.

Which statement is true concerning food digestion? Proteins are broken down by carbohydrates. Monosaccharides cannot be absorbed. Pepsin helps to digest food in the small intestine. Protein digestion begins in the stomach.

Protein digestion begins in the stomach. Protein digestion begins in the stomach with the action of pepsin. Pepsin cannot act in the small intestine, as it is broken down by the alkaline pH in the gastro intestinal tract. Proteins do not break down carbohydrates, and monosaccharides can be absorbed.

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. Maintain nothing by mouth until after the test Provide a low-residue breakfast Provide cleansing enemas until clear Administer anti-anxiety medication before the test Give only oral laxatives

Provide cleansing enemas until clear Maintain nothing by mouth until after the test Visualization of the lower GI tract is obtained after rectal installation of barium. The barium enema can be used to detect the presence of polyps, tumors, or other lesions of the large intestine and demonstrate any anatomic abnormalities or malfunctioning of the bowel. The morning of the test, the client should receive cleansing enemas until and clear and be maintained on nothing by mouth status. A low-residue diet would have been provided for 1 to 2 days before the test. Oral laxatives are given the evening before the test. Anti-anxiety medication is not needed or prescribed before this test.

During the abdominal examination, a nurse hyperextends a client's right leg. At this point, the client reports pain in the right lower quadrant. This test is positive for which sign? Rovsing's Murphy's Psoas Obturator

Psoas The obturator sign involves pain in the right lower quadrant as a result of the nurse flexing the client's hip and rotating the leg externally and internally while supporting the client's right knee and ankle. Psoas sign involves pain in the right lower quadrant on hyperextension of the client's right leg and indicates appendicitis. Murphy's sign is for assessment of cholecystitis and is elicited by pressing the fingers at the client's right costal margin and telling the client to inhale. Rovsing's sign involves pain caused by deep palpation in the left lower quadrant.

An anatomy student explains that the funnel-shaped portion of the stomach that connects with the intestine is called which region? Body Fundus Cardiac region Pyloric region

Pyloric region The funnel-shaped portion that connects with the small intestine is called the pyloric region. The small part of the stomach that surrounds the cardiac orifice is called the cardiac region. The dome-shaped region that bulges above the cardiac region is called the fundus, and the middle portion is called the body.

Regurgitation of bile salts and duodenal contents can lead to gastric ulcers. Which structure prevents this from happening? Cardiac orifice Pyloric sphincter Gastroesophageal sphincter Pharyngoesophageal sphincter

Pyloric sphincter The pyloric sphincter prevents the backflow of gastric contents and allows them to flow into the duodenum at a rate commensurate with the ability of the duodenum to accept them. This is important because the regurgitation of bile salts and duodenal contents can lead to gastric ulcers. The esophagus opens into the stomach through an opening called the cardiac orifice. The upper esophageal sphincter is the pharyngoesophageal sphincter; the lower esophageal sphincter is the gastroesophageal sphincter.

When acidic chyme enters the duodenum, it stimulates secretion of which hormone? Glucagon-like peptide 1 (GLP-1) Secretin Ghrelin Gastrin

Secretin When stomach acid in chyme enters the intestine, it stimulates the release of secretin. Secretin inhibits gastrin secretion. Ghrelin is produced by endocrine cells in the fundus of the stomach. GLP-1 is produced in the distal small intestine, and its production is stimulated by a high-carbohydrate meal.

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 A complete blood count including differential A sigmoidoscopy Gastric analysis

Serum antibodies for H. pylori Helicobacter pylori, a bacterium, is believed to be responsible for the majority of peptic ulcers. Blood tests are used to determine whether there are antibodies to H. pylori in the blood. A complete blood count with differential can indicate bleeding and infection associated with a bleeding ulcer. A sigmoidoscopy assesses the lower gastrointestinal tract. Gastric analysis is more common in analyzing gastric fluid in determining problems with the secretory activity of the gastric mucosa.

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? Cecum Duodenum Sigmoid colon Ileum

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.

A client is admitted to the hospital for further evaluation of problems experienced with gastrointestinal digestion and absorption. The nurse anticipates the health care provider will further assess the: Sigmoid colon Small intestine Intestinal lumen Large bowel

Small intestine Digestion and absorption of nutrients take place primarily in the small intestine.

Villi are anatomic features that contribute to the enlarged surface area of the: Large intestine Stomach Small intestine Esophagus

Small intestine The distinguishing characteristic of the small intestine is its large surface area. Anatomic features that contribute to this enlarged surface area are the circular folds that extend into the lumen of the intestine and the villi.

A nurse explains to her client that food is moved along the gastrointestinal (GI) tract with intermittent contractions that mix the food and move it along. These movements are found in which organ? Ileocecal valve Small intestine Upper region of the stomach Internal anal sphincter

Small intestine The movements of the GI tract can be either rhythmic or tonic. Rhythmic movements consist of intermittent contractions that are responsible for mixing and moving food along the digestive tract. They are found in the esophagus, the antrum of the stomach, and the small intestine. Tonic movements are found in the lower esophagus, the upper part of the stomach, the ileocecal valve, and the internal anal sphincter.

A nurse performs percussion beginning along the left midaxillary line and progressing downward until the sound changes from lung resonance to splenic dullness. The client reports tenderness. The nurse recognizes this as an abnormal finding for which organ? Kidney Gall bladder Spleen Liver

Spleen Percussion of the spleen begins in the left midaxillary line and progresses downward until the sound changes from lung resonance to splenic dullness. Percussion for liver tenderness is elicited by placing the left hand flat against the lower rib cage and striking it with the ulnar side of the right fist. The costovertebral angles are located at the twelfth rib posteriorly. Tenderness of the costovertebral angles indicates a kidney problem such as infection (pyelonephritis), renal calculi, or hydronephrosis. The gall bladder is not percussed.

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. Inferior vena cava Inferior mesenteric vein Gastric vein Saphenous vein Splenic vein

Splenic vein Inferior mesenteric vein Gastric vein This portal venous system is composed of five large veins: the superior mesenteric, inferior mesenteric, gastric, splenic, and cystic veins, which eventually form the vena portae that enters the liver. The inferior vena cava is not part of the portal system. The saphenous vein is located in the leg.

A client with a gastrointestinal disorder is having the number and quality of stool monitored by the nursing staff. The nurse notes an abnormal amount of fatty substances in the stool sample. Which term should the nurse use when documenting this assessment finding in the medical record? Lack of emulsification Hematochezia. Meconium present Steatorrhea

Steatorrhea Steatorrhea is the presence of excess fat in feces. Stools may be bulky and difficult to flush, have a pale and oily appearance and can be especially foul-smelling. Hematochezia is defined as bright red blood seen in the toilet either inside of, or surrounding, the stool. Meconium is the first stool of a newborn. Emulsification is the process of breaking down large globules of dietary fat into smaller sizes so that water-soluble digestion enzymes can act on the surface molecules.

The production of chyme occurs in which organ? Esophagus Pancreas Small intestine Stomach

Stomach The chemical breakdown of protein begins in the stomach where food is converted to a creamy mixture called chyme.

Which carbohydrate is matched to its correct enzyme needed for digestion? Starch and alpha dextrinase Lactose and sucrose Sucrose and sucrase Starch and lactase

Sucrose and sucrase Sucrose is a dietary carbohydrate digested by sucrase, an enzyme. This produces the monosaccharides fructose and glucose.

When inspecting the abdomen, which of the following client positions facilitates correct examination technique? Supine with arms at sides or folded across chest Semi-Fowler's with pillows under head and knees Sitting with hands on hips Trendelenburg with hands over head

Supine with arms at sides or folded across chest

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 Knee-chest Lithotomy Left Sim's lateral

Supine with knees flexed When examining the abdomen, the client lies supine with knees flexed. This position assists in relaxing the abdominal muscles. The lithotomy position commonly is used for a female pelvic examination and to examine the rectum. The knee-chest position can be used for a variety of examinations, most commonly the anus and rectum. The left Sim's lateral position may be used to assess the rectum or vagina and to administer an enema.

The nurse is assessing a client with a bladder disorder. Where would the nurse expect the pain to be? Back Perineal Upper abdomen Suprapubic

Suprapubic

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 client had a hamburger for dinner the night before The client regularly takes aspirin The client took an ibuprofen tablet this morning

The client has hemorrhoidal bleeding FOBT should not be performed when there is hemorrhoidal bleeding. In the past, clients were taught to avoid aspirin, red meats, nonsteroidal anti-inflammatory agents, and horseradish for 72 hours prior to the examination. However, these restrictions are no longer advised as the actual effects on testing have not been established.

Which of the following statements provides the most accurate guide to the assessment of the gallbladder? The gallbladder should be percussed and palpated prior to the liver to avoid confusing it with the larger organ. The margins of the gallbladder are obscured by the spleen. Cholecystitis and cholelithiasis are not amenable to diagnosis in the clinical setting. The gallbladder is deep to the liver and cannot normally be distinguished from the liver clinically.

The gallbladder is deep to the liver and cannot normally be distinguished from the liver clinically. Because the gallbladder is deep to the liver, it is normally not amenable to direct examination by auscultation, palpation, or percussion. This does not mean, however, that cholecystitis and cholelithiasis cannot be assessed for a thorough history. The gallbladder and the spleen are not proximate.

A client reports severe pain in the left lower quadrant of 3 days' duration. How should the nurse conduct palpation of the abdomen due to this history? Encourage the client to relax to minimize pain This area should be avoided completely Medicate for pain before beginning the assessment The left lower quadrant is palpated last

The left lower quadrant is palpated last The nurse should avoid touching tender or painful areas until last and reassure the client. The area needs to be assessed for the presence of abnormal findings and should not be avoided. Medicating before palpating may obscure the findings. The client may not be able to relax just by the power of suggestion.

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 red onions and capers The bagel The lox The cream cheese

The lox Trypsin aids in digesting protein, such as fish. Amylase aids in digesting starch, such as the carbohydrates in a bagel. Lipase aids in digesting fats, such as those found in many dairy products.

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. Both tests need to be done before breakfast. The upper GI should be scheduled before the ultrasonography. The client may eat a light meal before either test.

The ultrasonography should be scheduled before the GI procedure. Both an upper GI procedure with barium ingestion and an ultrasonography may be completed on the same day. The ultrasonography test should be completed first, because the barium solution could interfere with the transmission of the sound waves. The ultrasonography test uses sound waves that are passed into internal body structures, and the echoes are recorded as they strike tissues. Fluid in the abdomen prevents transmission of ultrasound.

A nurse is caring for a newly admitted patient with a suspected gastrointestinal (GI) bleed. The nurse assesses the patient's stool after a bowel movement and notes it to be a tarry-black color. The nurse recognizes that the bleeding is likely occurring where? The lower GI tract The upper GI tract The esophagus The anal area

The upper GI tract Blood shed in sufficient quantities in the upper GI tract will produce a tarry-black color (melena). Blood entering the lower portion of the GI tract or passing rapidly through it will appear bright or dark red. Lower rectal or anal bleeding is suspected if there is streaking of blood on the surface of the stool or if blood is noted on toilet tissue

What structure borders the abdominal cavity posteriorly? The midaxillary lines The kidneys The vertebral column The lower rib cage

The vertebral column The abdominal cavity is bordered in the back by the vertebral column and paravertebral muscles and at the sides and front by the lower rib cage and abdominal muscles. The other options are not associated with the abdominal cavity's posterior border.

Which statement is true concerning gastric enterocytes? They secrete enzymes that aid in digestion of proteins. They secrete lubrication for the gastrointestinal tract. They provide binding sites for insulin. They digest enterobacteria.

They secrete enzymes that aid in digestion of proteins. Gastric enterocytes secrete enzymes that aid in the digestion of carbohydrates and proteins.

Which substance is broken down by the emulsification process? Proteins Triglycerides Starch Lactose

Triglycerides The first step in digestion of lipids (triglycerides) is to break down the large globules of dietary fat into smaller sizes, a process called emulsification. Proteins and carbohydrates (lactose and starch) are not broken down by this process.

Biopsy results reveal that a client has a deficient amount of parietal (oxyntic) cells in his stomach. The client asks the nurse to explain what this means. The nurse explains that parietal cells secrete HCl and intrinsic factor, which is needed for absorption of: Vitamin K Vitamin D3 Vitamin A Vitamin B12

Vitamin B12 The oxyntic glands are located on the inside surfaces of the body and fundus of the stomach. They secrete HCl and intrinsic factor, which is needed for vitamin B12 absorption.

While reviewing the colonic absorption and role of flora in the GI system, the instructor will stress that the large intestine contains: a high percentage of acidic secretions that limit bacterial invasion. a complex microbial system that contains hundreds of different species. only a few species of bacterial species, primarily aerobic in nature. a few species of anaerobic bacteria and no aerobic bacteria.

a complex microbial system that contains hundreds of different species. The stomach and small intestine contain only a few species of bacteria, probably because the composition of luminal contents (i.e., acids, bile, pancreatic secretions) kills most ingested microorganisms, and the propulsive movements of these organs impedes their colonization. The large intestine, on the other hand, contains a large and complex microbial ecosystem. It has been estimated that each individual has 300 to 500 different species of intestinal bacteria, with anaerobic bacteria outnumbering aerobic bacteria by a large percentage.

The nurse is planning to assess a client's abdomen. Which assessment technique should the nurse use after inspecting the area? auscultation light palpation deep palpation percussion

auscultation

A client with long-standing digestive problems is found to have a deficiency in pepsinogen. The client likely has dysfunction involving: epithelial cells of gastric pits. chief cells. epithelial cells of the esophagus. crypts of Lieberkühn.

chief cells. The luminal surface and gastric pits of the stomach are lined with mucus-producing epithelial cells, with the parietal and chief cells situated in the bases of the gastric pits. The pepsinogen that is secreted by the chief cells is rapidly converted to pepsin when exposed to the low pH of the gastric juices secreted by the parietal cells. Epithelial cells of the gastric pits produce mucus, and those of the esophagus are ciliated. Crypts of Lieberkühn are specialized cells that produce serous fluid with a pH 6.5 to 7.5 in the intestinal mucosal layer.

The nurse prepares a client for a barium enema. The nurse should place the client on which diet prior to the procedure? high-fiber diet 1 to 2 days prior nothing by mouth (NPO) 2 days prior clear liquids day before soft diet 1 day prior

clear liquids day before The nurse should place the client on clear liquids the evening before the procedure, a low-residue diet 1 to 2 days before the test, and NPO at midnight in preparation for the barium enema.

The nurse plans to assess an adult client's kidneys for tenderness. The nurse should assess the area at the right upper quadrant. external oblique angle. left upper quadrant. costovertebral angle.

costovertebral angle

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? ileum jejunum duodenum cecum

duodenum The duodenum, which is approximately 10 inches long, is the first region of the small intestine and the site where bile and pancreatic enzymes enter

The nurse is assessing a client's abdomen. For which reason should the nurse perform deep palpation? identify abdominal organs detect abdominal tenderness discern muscular resistance complete a surface evaluation

identify abdominal organs Deep palpation is performed to identify abdominal organs. Light palpation is completed to discern muscular resistance, detect abdominal tenderness, and complete a surface evaluation.

The nurse is assessing the abdomen of an adult client and observes a purple discoloration at the flanks. The nurse should refer the client to a physician for possible liver disease. internal bleeding. abdominal distention. Cushing syndrome.

internal bleeding. Purple discoloration at the flanks (Grey-Turner sign) indicates bleeding within the abdominal wall, possibly from trauma to the kidneys, pancreas, or duodenum or from pancreatitis.

While assessing the abdominal sounds of an adult client, the nurse hears high-pitched tinkling sounds throughout the distended abdomen. The nurse should refer the client to a health care provider for possible cirrhosis of the liver. intestinal obstruction. inflamed appendix. gastroenteritis.

intestinal obstruction. Obstruction often presents with high-pitched tinkling sounds above the obstruction, in combination with distended abdomen; abdominal cramping is often present as well. Gastroenteritis may present with hyperactive bowel sounds that include tinkling, rushing, and high-pitched sounds and diarrhea is typical, but a distended abdomen is not typical. Cirrhosis of the liver may present with venous hum.

To palpate the spleen of an adult client, the nurse should begin the abdominal assessment of the client at the left upper quadrant. right upper quadrant. left lower quadrant. right lower quadrant.

left upper quadrant.

The nurse documents that a client's abdomen is scaphoid in shape. Which diagram best describes the client's abdomen?

looks like stomach sunken in A scaphoid abdomen caves in and is usually seen in thin clients. A flat abdomen is not caved in or distended. A rounded abdomen is seen in overweight or obese clients. A distended/protuberant abdomen may be associated with obesity, ascites, or a tumor on an abdominal organ.

When bowel sounds are heard about every 15 seconds, the nurse would record that the bowel sounds are absent. normal. sluggish. hypoactive.

normal. Normal bowel sounds are heard every 5 to 20 seconds. Hypoactive bowel sound is the description given to auscultation of one to two bowel sounds in 2 minutes. Sluggish is not a term a nurse would use to accurately describe bowel sounds. The nurse records that bowel sounds are absent when no sound is heard in 3 to 5 minutes.

The nurse is planning to assess a client's abdomen for rebound tenderness. The nurse should perform this abdominal assessment first. ask the client to assume a side-lying position. palpate deeply while quickly releasing pressure. palpate lightly while slowly releasing pressure.

palpate deeply while quickly releasing pressure. If the client has abdominal pain or tenderness, test for rebound tenderness by palpating deeply at 90 degrees into the abdomen away from the painful or tender area. Then suddenly release pressure. Listen and watch for the client's expression of pain. Ask the client to describe which hurt more—the pressing in or the releasing—and where on the abdomen the pain occurred.

The nurse is assessing the bowel sounds of an adult client. After listening to each quadrant, the nurse determines that bowel sounds are not present. The nurse should refer the client to a physician for possible gastroenteritis. fluid and electrolyte imbalances. aortic aneurysm. paralytic ileus.

paralytic ileus. Absent bowel sounds may be associated with peritonitis or paralytic ileus.

A client is not able to absorb vitamin B12. The nurse determines that the client is deficient in: peptic (chief cells), which secrete pepsinogen. S cells, which secrete secretin. mucous neck cells, which secrete mainly mucus. parietal (oxyntic) cells, which secrete HCl and intrinsic factor.

parietal (oxyntic) cells, which secrete HCl and intrinsic factor Parietal (oxyntic) cells secrete HCl and intrinsic factor, which is needed for vitamin B12 absorption. Mucous neck cells secrete mainly mucus; peptic (chief) cells secrete large quantities of pepsinogen, which is rapidly converted to pepsin. Secretin is secreted by the S cells and inhibits gastric acid secretion.

The nurse assesses an adult male client's abdomen and observes diminished abdominal respiration. The nurse determines that the client should be further assessed for liver disease. intestinal obstruction. peritoneal irritation. umbilical hernia.

peritoneal irritation. Diminished abdominal respiration or change to thoracic breathing in male clients may reflect peritoneal irritation.

To palpate an adult client's appendix, the nurse should begin the abdominal assessment at the client's left lower quadrant. left upper quadrant. right upper quadrant. right lower quadrant.

right lower quadrant.

When palpating the abdomen, the nurse may be able to feel the lower edge of the liver in which quadrant? right upper left lower right lower left upper

right upper

The results of a client's 24-hour stool specimen indicate 20 g or more of fat. The nurse would interpret this as: Clostridioides difficile hyperlipidemia diarrhea steatorrhea

steatorrhea Steatorrhea is the term used to describe fatty stools. It usually indicates that there is 20 g or more of fat in a 24-hour stool sample.

During a lecture about the function of the intestine related to food digestion, the faculty mentions that when the students consume foods high in acid, the intestines will: stimulate the release of glucagon-like peptide 1 to lower blood glucose levels. stimulate pancreatic enzymes to release more insulin. inhibit the release of glucose-dependent insulinotropic peptide to slow gastric emptying. stimulate the release of secretin, which then inhibits release of gastrin.

stimulate the release of secretin, which then inhibits release of gastrin. Secretin, which is secreted by S cells in the mucosa of the duodenum and jejunum, inhibits gastric acid secretion. The entry of an acid chyme into the intestine stimulates the release of secretin, which inhibits the release of gastrin. Several gut-derived hormones have been identified as having what is termed an incretin effect, meaning that they increase insulin release after an oral glucose load. This suggests that gut-derived factors can stimulate insulin secretion after a high-carbohydrate meal. The two hormones that account for about 90% of the incretin effect are glucagon-like peptide 1 (GLP-1) and glucose-dependent insulinotropic peptide (GIP). Because increased levels of GLP-1 and GIP can lower blood glucose levels by augmenting insulin release in a glucose-dependent manner (i.e., at low blood glucose levels) no further insulin is secreted, minimizing the risk of hypoglycemia.

The nurse is assisting the physician in a percutaneous liver biopsy. In assisting with positioning, the nurse should assist the client into a: high Fowler's position. lithotomy position. supine position. dorsal recumbent position.

supine position. The nurse is correct to instruct the client to assume the supine position. Also, the nurse places a rolled towel beneath the right lower ribs.

The client describes a test previously completed to detect a small bowel obstruction prior to admission to the hospital. The client states that the test involved insertion of a tube through the nose and lasted over 6 hours. The nurse determines which test name should be documented? positron emission tomography abdominal ultrasound upper GI enteroclysis magnetic resonance imaging

upper GI enteroclysis Enteroclysis is a double contrast study where a duodenal tube is inserted and 500 to 1000 mL of thin barium sulfate suspension and then methylcellulose is infused. Fluoroscopy is used to visualize the filling of the intestinal loops over a period of up to 6 hours. The test is used for detection of small bowel obstruction and diverticuli. Abdominal ultrasound, magnetic resonance imaging, and positron emission tomography do not involve insertion of a duodenal tube.

During a physical examination of an adult client, the nurse is preparing to auscultate the client's abdomen. The nurse should use the diaphragm of the stethoscope. begin auscultation in the left upper quadrant. palpate the abdomen before auscultation. listen in each quadrant for 15 seconds.

use the diaphragm of the stethoscope. Auscultate for bowel sounds. Use the diaphragm of the stethoscope and make sure that it is warm before you place it on the client's abdomen. Apply light pressure or simply rest the stethoscope on a tender abdomen. Begin in the RLQ and proceed clockwise, covering all quadrants.

The nurse recognizes which change of the GI system is an age-related change? hypertrophy of the small intestine increased mucus secretion increased motility weakened gag reflex

weakened gag reflex A weakened gag reflex is an age-related change of the GI system. There is decreased motility, atrophy of the small intestine, and decreased mucus secretion.