Alterations - GI
A nurse is preparing to care for a child with a diagnosis of intussusception. The nurse review the child's record and expects to note which symptom of this disorder documented? A. watery diarrhea B. ribbon-like stools C. profuse projectile vomiting D. bright red blood and mucus in stools
D
A female client being seen in a physician's office has just been scheduled for a barium swallow the next day. The nurse writes down which instruction for the client to follow before the test? A. Fast for 8 hours before the test B. eat a regular supper and breakfast C. continue to take all oral medications as scheduled D. monitor own bowel movement pattern for constipation
A
A patient arrives to the clinic for evaluation of epigastric pain. The patient describes the pain to be relieved by food intake. In addition, the patient reports awakening in the middle of the night with a gnawing pain in the stomach. Based on the patient's description this appears to be what type of peptic ulcer? A. duodenal B. gastric C. esophageal D. refractory
A
A patient asks what type of testing is performed to assess for diverticulosis. As the nurse, you know that which test below is used to assess for diverticulosis? A. colonoscopy B. Fleets enema C. bronchoscopy D. Cystoscopy
A
A patient has been diagnosed with achalasia based on his history and diagnostic imaging results. The nurse should identify what risk diagnosis when planning the patients care? A. risk for aspiration related to inhalation of gastric contents B. risk for imbalanced nutrition: less than body requirements related to impaired absorption C. risk for decreased cardiac output related to vasovagal response D. risk for impaired verbal communication related to oral trauma
A
A patient is recovering after having an appendectomy. The patient is 48 hours post-op from surgery and is tolerating full liquids. The physician orders for the patient to try solid foods. What types of foods should the patient incorporate into their diet? A. foods high in fiber B. foods low in fiber C. foods high in carbohydrates D. foods low in protein
A
A patient is recovering from discomfort from a peptic ulcer. the doctor has ordered to advance the patient's diet to solid foods. The patient's lunch tray arrives. Which food should the patient avoid eating? A. Orange B. Milk C. white rice D. banana
A
A patient with GERD has a diagnosis of Barrett's esophagus with minor cell changes. Which of the following principles should be integrated into the patient's subsequent care? A. The patient will require an upper endoscopy every 6 months to detect malignant changes B. Liver enzymes must be checked regularly, as H2 receptor antagonists may cause hepatic damage C. Small amounts of blood are likely to be present in the stools and are not cause for concern D. Antacids may be discontinued when symptoms of heartburn subside
A
A patient with GERD has undergone diagnostic testing and it has been determined that increasing the pace of gastric emptying may help alleviate symptoms. The nurse should anticipate that the patient may be prescribed what drug? A. metoclopramide (reglan) B. omeprazole (prilosec) C. lansoprazole (prevacid) D. famotidine (pepcid)
A
A physician prescribes a Proton pump inhibitor to a patient with a gastric ulcer. Which medication is considered a PPI? A. Pantoprazole B. Famotidine C. Magnesium Hydroxide D. Metronidazole
A
The client is scheduled to have an upper GI series of x-rays. Following the x-rays, the nurse should instruct the client to: A. take a laxative B. follow a clear liquid diet C. administer an enema D. take an antiemetic
A
The client with a hiatal hernia chronically experiences heartburn following meals. The nurse plans to teach the client to avoid which action because it is contraindicated with hiatal hernia? A. Lying recumbent following meals B. Taking in small, frequent, bland meals C. raising the head of the bed on 6 inch blocks D. taking H2 receptor antagonist medication
A
The nurse is obtaining a health history from a client who has a sliding hiatal hernia associated with reflux. The nurse should ask the client about the presence of which of the following symptoms? A. heartburn B. jaundice C. anorexia D. Stomatitis
A
Which statement is INCORRECT about histamine-receptor blockers? A. "H2 blockers block histamine which causes the chief cells to decrease the secretion of HCL" B. "Ranitidine and Famotidine are two types of histamine-receptor blocker medications" C. "Antacids and H2 blockers should not be given together" D. All the statements are CORRECT.
A
You're collecting a patient's medication history that has GERD. Which medication below is NOT typically used to treat GERD? A. Colesevelam "Welchol" B. Omeprazole "Prilosec" C. Metoclopramide "Reglan" D. Ranitidine HCL "Zantac"
A
Your patient is 4 days post-op from an appendectomy. Which assessment finding requires further evaluation? A. The patient reports their last bowel movement was the day before surgery B. The patient reports incisional pain C. The patient coughs and deep breathes while splinting the abdominal incision D. Options A and C
A
A patient reports frequent heartburn twice a week for the past 4 months. What other symptoms reported by the patient may indicate the patient has GERD? Select all that apply A. Bitter taste in mouth B. Dry cough C. Melena D. Difficulty swallowing E. Smooth, red tongue F. Murphy's sign
A, B, D
During a home health visit, you are helping a patient develop a list of foods they should avoid due to GERD. Which items in the patient's pantry should be avoided? Select all that apply A. Hot and spicy pork rinds B. Peppermint patties C. green beans D. Tomato soup E. Chocolate fondue F. Almonds G. Oranges
A, B, D, E, G
Select all the medications a physician may order to treat an h. pylori infection that is causing a peptic ulcer? A. Proton pump inhibitors B. Antacids C. Anticholinergics D. 5-Aminosalicylates E. Antibiotics F. H2 blockers G. Bismuth Subsalicylates
A, E, F, G
A 2 year old is hospitalized with suspected intussusception. Which finding is associated with intussusception? A. ribbon-like stools B. currant jelly stools C. palpable mass over the flank D. projectile vomiting
B
A patient is experiencing an acute episode of diverticulitis. The patient is having abdominal pain, temperature 102.6 F, and elevated WBCs. As the nurse, you know it is important to: A. Encourage intake of high-fiber foods B. Monitor the patient for peritonitis C. Apply a heating pad to the patient's abdomen to help alleviate the pain D. Encourage intake of full liquids
B
A patient with a peptic ulcer is suddenly vomiting dark coffee ground emesis. On assessment of the abdomen you find bloating and an epigastric mass in the abdomen. Which complication may this patient be experiencing? A. obstruction of pylorus B. upper gastrointestinal bleeding C. Perforation D. peritonitis
B
A staff educator is reviewing the causes of GERD with new staff nurses. What area of the GI tract should the educator identify as the cause of the reduced pressure associated with GERD? A. pyloric sphincter B. lower esophageal sphincter C. hypopharyngeal sphincter D. upper esophageal sphincter
B
After dinner time, during hourly rounding, a patient awakes to report they feel like "food is coming up" in the back of their throat and that there is a bitter taste in their mouth. What nursing intervention will you perform next? A. perform deep suctioning B. Assist the patient into the semi-fowler's position C. Keep the patient NPO D. Instruct the patient to avoid milk products
B
After surgery for pyloric stenosis, the nurse could anticipate that the infant will: A. have nasogastric suction for 24 hours B. be fed clear liquids within 6 hours C. remain NPO for 24 to 48 hours D. be fed formula within 4 hours
B
Bethanechol (Urecholine) has been ordered for a client with GERD. The nurse should assess the client for which of the following adverse effects? A. Constipation B. urinary urgency C. hypertension D. dry oral mucosa
B
For Jayvin who is taking antacids, which instruction would be included in the teaching plan? A. "Take the antacids with 8 oz of water." B. "Avoid taking other medications within 2 hours of this one." C. "Continue taking antacids even when pain subsides." D. "weigh yourself daily when taking this medication."
B
Helicobacter pylori can live in the stomach's acidic conditions because it secretes __________ which neutralizes the acid. A. ammonia B. urease C. carbon dioxide D. bicarbonate
B
Most patients with diverticulosis are most likely to have diverticula located in the? A. transverse colon B. Sigmoid colon C. Rectum D. Ascending colon
B
The male client tells the nurse he has been experiencing 'heartburn' at night that awakens him. Which assessment question should the nurse ask? A. How much weight have you gained recently? B. what have you done to alleviate the heartburn? C. do you consume many milk and dairy products? D. have you been around anyone with a stomach virus?
B
The results of a patient's recent endoscopy indicate the presence of peptic ulcer disease. Which of the following teaching points should the nurse provide to the patient in light of his new diagnosis? A. "You'll need to drink at least two to three glasses of milk daily." B. "it would likely be beneficial for you to eliminate drinking alcohol" C. "many people find that a minced or pureed diet eases their symptoms of PUD" D. "your medications should allow you to maintain your present diet while minimizing symptoms"
B
Which of the following assessment findings would the nurse most expect to find in the child who has been diagnosed with having hypertrophic pyloric stenosis? A. currant jelly stools and a palpable, hard mass in the right upper quadrant B. projectile vomiting and hunger soon afterwards C. weight loss and bloody diarrhea D. severe, crampy abdominal pain and lethargy
B
Which of the following factors would most likely contribute to the development of a client's hiatal hernia? A. having a sedentary desk job B. being 5 feet, 3 inches tall and weighing 190 lbs C. using laxatives frequently D. being 4o years old
B
Which of the following lifestyle modifications should the nurse encourage the client with a hiatal hernia to include in activities of daily living? A. daily aerobic exercise B. eliminating smoking and alcohol use C. balancing activity and rest D. avoiding high stress situations
B
You are providing discharge teaching to a patient taking Sucralfate (Carafate). Which statement by the patient demonstrates they understand how to take this medication? A. "I will take this medication at the same time I take Ranitidine" B. "I will always take this medication on an empty stomach" C. "It is best to take this medication with antacids" D. "I will take this medication once a week."
B
You're providing education to a group of nursing students about the care of a patient with appendicitis. Which statement by a nursing student requires re-education about your teaching? A. "After an appendectomy, the patient may have a nasogastric tube to remove stomach fluids and swallowed air." B. "Non-pharmacological techniques for a patient with appendicitis include application of heat to the abdomen and the side-lying position." C. "The nurse should monitor the patient for signs and symptoms of peritonitis which includes increased heart rate, respirations, temperature, abdominal distention, and intense abdominal pain." D. "It is normal for some patients to have shoulder pain after a laparoscopic appendectomy."
B
Your'e educating a group of patients at an outpatient clinic about peptic ulcer formation. Which statement is correct about how peptic ulcers form? A. "An increase in gastric acid is the sole cause of peptic ulcer formation" B. "Peptic ulcers can form when acid penetrates unprotected stomach mucosa. This causes histamine to be released which signals to the parietal cells to release more hydrochloric acid which erodes the stomach lining further" C. "Peptic ulcers form when acid penetrates unprotected stomach mucosa. This causes pepsin to be released which signals to the parietal cells to release more pepsinogen which erodes the stomach lining further." D. "The release of prostaglandins cause the stomach lining to breakdown which allows ulcers to form."
B
a patient is admitted to the hospital with complaints of nausea, vomiting, diarrhea, and severe abdominal pain. Which of the following would immediately alert the nurse that the patient has bleeding from the GI tract? A. complete blood count B. guaiac test C. vital signs D. abdominal girth
B
A patient with chronic peptic ulcer disease underwent a gastric resection 1 month ago and is reporting nausea, bloating, and diarrhea 30 minutes after eating. Select ALL the correct statements on how to educate the patient about decreasing their symptoms A. "It is best to eat 3 large meals a day rather than small frequent meals" B. "After eating a meal lie down for 30 minutes." C. "Eat a diet high in protein, fiber, and low in carbs." D. "Be sure to drink at least 16 oz of milk with meals."
B, C
A patient has developed a duodenal ulcer. As the nurse, you know that which of the following plays a role in peptic ulcer formation. Select all that apply A. Spicy foods B. Helicobacter pylori C. NSAIDs D. Milk E. Zollinger-Ellison Syndrome
B, C, E
Select all the following options that are NOT causes of appendicitis A. Fecalith B. Routine usage of NSAIDs C. Infection due to Helicobacter pylori D. Lymph node enlargement due to viral or bacterial infection E. Diet low in fiber
B, C, E
A patient with a history of diverticulosis is admitted with abdominal pain. The physician suspects diverticulitis. What other findings would correlate with diverticulitis? Select all that apply A. Abdominal pain that is mainly present in the upper right quadrant B. unrelenting cramping type pain C. pain found at McBurney's point D. Blood in stool E. Fever F. Reports of constipation G. Abdominal bloating H. Positive Cullen's sign
B, D, E, F, G
Will is being assessed by Nurse Lucas for possible intussusception; which of the following would be least likely to provide valuable information? A. abdominal palpation B. pain pattern C. family history D. stool inspection
C
A 23 year old patient is admitted with suspected appendicitis. The patient states he is having pain around the umbilicus that extends into the lower part of his abdomen. In addition, he says that the pain is worst on the right lower quadrant. The patient points to his abdomen at a location which is about a one-third distance between the anterior superior iliac spine and umbilicus. This area is known as what? A. Rovsing's point B. Hamman's point C. McBurney's point D. Murphy's point
C
A male client who is recovering from surgery has been advanced from a clear liquid diet to a full liquid diet. The client is looking forward to the diet change because he has been "bored" with the clear liquid diet. The nurse would offer which full liquid item to the client? A. Tea B. gelatin C. custard D. popsicle
C
A male client with a peptic ulcer is scheduled for a vagotomy and the client asks the nurse about the purpose of this procedure. Which response by the nurse best describes the purpose of a vagotomy? A. halts stress reactions B. Heals the gastric mucosa C. reduces the stimulus for acid secretions D. decreases food absorption in the stomach
C
A mother and 7 month old infant present to the pediatric clinic. The infant appears developmentally appropriate and healthy, but the mother tells you that she is exacerbated. She says yesterday her infant had been incessantly crying with vomiting and jelly-like stools. But now is fine. What is the nurses first action? A. determine prenatal status of the mother and child B. prepare the child for immediate surgery C. palpate the stomach for a mass D. administer barium enema
C
A nurse is addressing the prevention of esophageal cancer in response to a question posed by a participant in a health promotion workshop. What action has the greatest potential to prevent esophageal cancer? A. promotion of a nutrient dense, low fat diet B. annual screening endoscopy for patients over 50 with a family history of esophageal cancer C. early diagnosis and treatment of gastroesophageal reflux disease D. adequate fluid intake and avoidance of spicy foods
C
A nurse is providing health promotion to a patient diagnosed with an esophageal reflux disorder. What practice should the nurse encourage the patient to implement? A. keep the head of the bed lowered B. Drink a cup of hot tea before bedtime C. avoid carbonated drinks D. eat a low-protein diet
C
A patient is experiencing an acute episode of diverticulitis. The patient is having abdominal pain, temperature 102.6 F, and elevated WBCs. This patients s/sx are starting to subside. Which of the following food items would be best for the patient to consume? A. oatmeal and bran B. orange juice and eggs C. chicken broth and jello D. salad with chicken
C
A patient is scheduled for an appendectomy at noon. While performing your morning assessment, you note that the patient has a fever of 103.8 F and rates abdominal pain 9 on 1-10. In addition, the abdomen is distended and the patient states, "I was feeling better last night but it seems the pain has become worse." The patient is having tachycardia and tachypnea. Based on the scenario, what do you suspect the patient is experiencing? A. pulmonary embolism B. colon fistulae C. peritonitis D. hemorrhage
C
A patient is taking Bethanechol "Urecholine" for treatment of GERD. This is known as what type of drug? A. Proton-pump inhibitor B. Histamine receptor blocker C. Prokinetic D. Mucosal healing agent
C
A patient with chronic peptic ulcer disease underwent a gastric resection 1 month ago and is reporting nausea, bloating, and diarrhea 30 minutes after eating. What condition is this patient most likely experiencing? A. gastroparesis B. fascia dehiscence C. dumping syndrome D. somgyi effect
C
An 18 year old patient is admitted with appendicitis. Which statement by the patient requires immediate nursing intervention? A. "The pain hurts so much it is making me nauseous" B. "I have no appetite" C. "The pain seems to be gone now." D. "If I position myself on my right side, it makes the pain less intense."
C
GERD weakens the lower esophageal sphincter, predisposing older persons to risk for impaired swallowing. In managing the symptoms associated with GERD, the nurse should assign the highest priority to which of the following interventions? A. Decrease daily intake of vegetables and water, and ambulate frequently B. Drink coffee diluted with milk at each meal, and remain in an upright position for 30 minutes C. Eat small, frequent meals, and remain in an upright position for at least 30 minutes after eating. D. Avoid over the counter drugs that have antacids in them
C
The client has been taking magnesium hydroxide (milk of magnesia) at home in an attempt to control hiatal hernia symptoms. The nurse should assess the client for which of the following conditions most commonly associated with the ongoing use of magnesium-based antacids? A. anorexia B. weight gain C. diarrhea D. constipation
C
The nurse determines that a patient has experienced the beneficial effects of medication therapy with famotidine when which of the following symptoms is relieved? A. nausea B. belching C. epigastric pain D. difficulty swallowing
C
The pathologic disturbance of pyloric stenosis results from: A. edema of pyloric muscle B. ischemia of the pyloric muscle C. hypertrophy of the pyloric muscle D. neoplastic obstruction
C
Which of the following drugs is a histamine blocker and reduces levels of gastric acid? A. Omeprazole (prilosec) B. metoclopramide (reglan) C. cimetidine (tagamet) D. magnesium hydroxide (maalox)
C
Which of the following nursing interventions would most likely promote self-care behaviors in the client with a hiatal hernia? A. introduce the client to other people who are successfully managing their care B. include the client's daughter in the teaching so that she can help implement the plan C. ask the client to identify other situations in which he demonstrated responsibility for himself D. reassure the client that he will be able to implement all aspects of the plan successfully
C
Which question would be most helpful in obtaining a nursing history from the mother of an infant with suspected intussusception? A. is your child eating normally? B. how often has your child been vomiting? C. what do you child's stools look like? D. when did your child last urinate?
C
You're providing discharge teaching to a patient who has hospitalized with diverticulitis. Which statement by the patient requires you to re-educate the patient? A. "It is important I consume a diet high in fiber and keep hydrated to keep my stool soft." B. "The physician prescribed me to take Psyllium everyday which will help prevent constipation." C. "I will be sure to always cook and skin my fruits and vegetables rather than eating them fresh." D. "I will notify my physician if I develop abdominal pain and fever."
C
You're providing nursing education to a group of nursing students about diverticulosis verses diverticulitis. Which statement by the nursing students demonstrate they understand the education provided? A. "Most patients with diverticulitis are asymptomatic." B. "Diverticulosis tends to occur in young women with a family history of diverticulosis" C. "Diverticulitis, if not treated, can lead to abscess formation and peritonitis." D. "Patients with diverticulosis should at all times avoid eating seeds and nuts."
C
Your patient is diagnosed with peptic ulcer disease due to h. pylori. This bacterium has a unique shape which allows it to penetrate the stomach mucosa. You know this bacterium is: A. rod shaped B. spherical shaped C. spiral shaped D. filamentous shaped
C
Your patient, who is presenting with signs and symptoms of GERD, is scheduled to have a test that assesses the function of the esophagus' ability to squeeze food down into the stomach and the closer of the lower esophageal sphincter. The patient asks you, "What is the name of the test I'm having later today?" You tell the patient the name of the test is: A. Lower esophageal gastrointestinal series B. transesophageal echocardiogram C. Esophageal manometry D. Esophageal pH monitoring
C
which clinical manifestation does the nurse expect with acute appendicitis? A. high fever B. nausea and vomiting C. rebound tenderness D. pain relieved with ambulation
C
A 23 year old patient is admitted with suspected appendicitis. The patient states he is having pain around the umbilicus that extends into the lower part of his abdomen. In addition, he says that the pain is worst on the right lower quadrant. What other signs and symptoms are associated with appendicitis? Select all that apply A. Increased red blood cells B. Patient has the desire to be positioned in the prone position to relieve pain C. Umbilical pain that extends in the right lower quadrant D. Abdominal rebound tenderness E. Abdominal flaccidity
C, D
A client with acute appendicitis asks the nurse, "Why don't you give me a heating pad? I think that will help me with my pain." The nurse's response should be based on which reason? A. it increases the need for fluids B. it increases the spread of infection C. it reduces white blood cell count D. it encourages perforation
D
A patient seeking care because of recurrent heartburn and regurgitation is subsequently diagnosed with a hiatal hernia. Which of the following should the nurse include in health education? A. drinking beverages after your meal, rather than with your meal, may bring some relief B. its best to avoid dry foods, such as rice and chicken, because they're harder to swallow C. many patients obtain relief by taking over the counter antacids 30 minutes before eating D. instead of eating three meals a day, try eating smaller amounts more often
D
After providing education to a patient with GERD, you ask the patient to list 4 things they can do to prevent or alleviate signs and symptoms of GERD. Which statement is incorrect? A. "It is best to try to consume small meals throughout the day than eat 3 large ones" B. "I'm disappointed that I will have to limit my intake of peppermint and spearmint because I love eating those types of hard candies." C. "It is important I avoid eating right before bedtime." D. "I will try to lie down after eating a meal to help decrease pressure on the lower esophageal sphincter."
D
In the stomach lining, the parietal cells release _______ and the chief cells release _______ which both play a role in peptic ulcer disease. A. pepsin, hydrochloric acid B. pepsinogen, pepsin C. pepsinogen, gastric acid D. hydrochloric acid, pepsinogen
D
The client with GERD complains of a chronic cough. The nurse understands that in a client with GERD this symptom may be indicative of which of the following conditions? A. Development of laryngeal cancer B. irritation of the esophagus C. esophageal scar tissue formation D. Aspiration of gastric contents
D
The nurse explains to the patient with GERD that this disorder: A. results in acid erosion and ulceration of the esophagus caused by frequent vomiting B. will require surgical wrapping or repair of the pyloric sphincter to control the symptoms C. is the protrusion of a portion of the stomach into the esophagus through an opening in the diaphragm D. often involves relaxation of the lower esophageal sphincter, allowing stomach contents to back up into the esophagus
D
The nurse explains to the patient with gastroesophageal reflux disease that this disorder: A. results in acid erosion and ulceration of the esophagus caused by frequent vomiting, B. will require surgical wrapping or repair of the pyloric sphincter to control the symptoms, C. is the protrusion of a portion of the stomach into to esophagus through an opening in the diaphragm, D. often involves relaxation of the lower esophageal sphincter, allowing stomach contents to back up into the esophagus
D
The nurse is monitoring a female client with a diagnosis of peptic ulcer. Which assessment findings would most likely indicate perforation of the ulcer? A. bradycardia B. Numbness in the legs C. Nausea and vomiting D. a rigid, board-like abdomen
D
The physician order a patient with a duodenal ulcer to take a urea breath test. Which lab value will the test measure to determine if h. pylori is present? A. ammonia B. urea C. hydrochloric acid D. carbon dioxide
D
Which assessment data supports the client's diagnosis of gastric ulcer? A. presence of blood int he clients stool for the past month B. complaints of a burning sensation that moves like a wave C. sharp pain in the upper abdomen after eating a heavy meal D. complaints of epigastric pain 30-60 minutes after ingesting food
D
Which of the following does NOT play a role in the development of GERD? A. Pregnancy B. Hiatal hernia C. usage of anithistamines or calcium channel blockers D. all of the above play a role in GERD
D
True or False: Most patients with chronic diverticulitis require surgery at some point, such as bowel resection. If the healthy bowel cannot be reconnected right away, a permanent colostomy will be created until it can be reconnected.
False
True or False: The appendix is found on the lower left side of the abdomen and is connected to the cecum of the large intestine
False
A patient who underwent surgery for esophageal cancer is admitted to the critical care unit following postanesthetic recovery. Which of the following should be included in the patients immediate postoperative plan of care? A. teaching the patient to self-suction B. performing chest physiotherapy to promote oxygenation C. positioning the patient to prevent gastric reflux D. providing a regular diet as tolerated
c
