ATI- GI
A nurse is assessing a client who has upper GI bleeding. Which of the following findings should the nurse expect? a. hypoactive bowel sounds b. epigastric pain c. hypotension d. pernicious anemia
c. hypotension
A nurse is providing discharge teaching for a client who has gastritis and a new prescription for famotidine. Which of the following client statements indicates the teaching was effective? a. "I should make sure the water I drink is filtered." b. "I should expect immediate pain relief starting this therapy." c. "I will drink iced tea with my meals and snacks." d. "I will monitor my blood glucose level regularly while taking this medication."
a. "I should make sure the water I drink is filtered." The RN should instruct the client to make sure foods & water contain no contaminants
A nurse is providing dietary teaching for a client who has a new diagnosis of celiac disease. Which of the following statements by the client indicates an understanding of the teaching? a. "I can return to my regular diet when I am free of symptoms." b. "I will need to avoid taking vitamin supplements while on this diet." c. "I will eat beans to ensure I get enough fiber in my diet." d. "I need to avoid drinking liquids with my meals while on this diet."
C. is the answer a. Celiac disease is an autoimmune disorder that causes changes to the intestinal mucosa, resulting in an intolerance to gluten, which is found in wheat, barley, and rye. The client should continue to avoid eating foods that contain gluten. b. Clients who have celiac disease are at risk for malabsorption of vitamins and minerals; therefore, the client should continue taking vitamin and mineral supplements. c. Clients who have celiac disease must maintain a gluten-free diet which eliminates fiber-rich whole wheat products. Clients should eat beans, nuts, fruits, and vegetables to ensure an adequate intake of fiber. d. Clients who have dumping syndrome should avoid drinking liquids with their meals to slow the movement of food through the intestinal tract. Clients who have celiac disease do not need to refrain from drinking liquids with meals.
A nurse is providing dietary teaching for a client who has chronic pancreatitis. Which of the following food selections by the client indicates an understanding of the teaching? a. 8 oz whole milk b. one slice of beef bologna c. 1 oz cheddar cheese d. 1 cup sliced banana
Foods that are high in fat can cause diarrhea for clients who have pancreatitis. One cup of sliced banana, which contains 0.49 g of fat, is a low-fat food option. Clients who have pancreatitis should consume a high-protein and low-fat diet with an adequate amount of carbohydrates and calories. The nurse should inform the client that high-fat foods, such as whole milk, should be avoided because foods that are high in fat can cause diarrhea. A cup of whole milk contains 7.93 g of fat. The nurse should recommend fat-free milk. The nurse should inform the client that high-fat foods, such as bologna, should be avoided because foods that are high in fat can cause diarrhea. One slice of beef bologna contains 7.84 g of fat. The nurse should inform the client that high-fat foods, such as bologna, should be avoided because foods that are high in fat can cause diarrhea. One slice of beef bologna contains 7.84 g of fat.
A nurse is providing discharge teaching for a client who has GERD. Which of the following client statements indicates the teaching was effective? a. "I will decrease the amount of carbonated beverages I drink" b. "I will avoid drinking liquids for 30 minutes after taking chewable antacid tablet." c. "I will eat a snack before going to bed." d. "I will lie down for at least 30 mins after eating each meal."
a. "I will decrease the amount of carbonated beverages I drink" The RN should instruct the patient to eliminate or limit fatty foods, coffee, cola, tea, carbonated beverages, & chocolate from their diet. b.The nurse should instruct the client to drink a glass of water immediately after taking an antacid tablet. a eat four to six small meals per day and avoid snacking before bed. c The nurse should instruct the client to eat four to six small meals per day and avoid snacking before bed. d. The nurse should instruct the client to sit upright for 1 to 2 hr after meals.
A nurse is assessing a client who has appendicitis. Which of the following findings should the nurse expect? (Select all that apply) a. Oral temp 38.4C (101.1F) b. WBC 6000/mm3 c. bloody diarrhea d. nausea and vomitting e. right lower quadrant pain
a. Oral temp 38.4C (101.1F) d. nausea and vomiting e. right lower quadrant pain Oral temperature 38.4° C (101.1° F) is correct. A low-grade temperature is an expected finding in a client who has appendicitis. WBC 6,000/mm3 is incorrect. A WBC of 10,000 to 18,000/mm3 is an expected finding in a client who has appendicitis. Bloody diarrhea is incorrect. Bloody diarrhea is an expected finding in a client who has colorectal cancer. Nausea and vomiting is correct. Nausea and vomiting are expected findings in a client who has appendicitis. Right lower quadrant pain is correct. Right lower quadrant pain is an expected finding in a client who has appendicitis.
A nurse is assessing a client who has Crohn's disease. Which of the following findings should the nurse expect? a. fatty, diarrheal stools b. hyperkalemia c. wgt gain d. sharp epigastric pain
a. fatty, diarrheal stools Steatorrhea, or fatty stool, is an expected finding in a client who has Crohn's disease. Hypokalemia, weight loss, and abdominal pain in the right lower quadrant is an expected finding in a client who has Crohn's disease.
A nurse is assessing a client who is postoperative following a gastrectomy. The nurse should identify which of the following findings as an indication of acute gastric dilation? a. hiccups b. elevated BP c. bradycardia d. chest pain
a. hiccups RN should ensure patency of NG tube & notify MD. Following surgery, hiccups can be caused by irritation of the phrenic nerve due to abdominal distension. If the hiccups are intractable, the nurse should anticipate a prescription for chlorpromazine because persistent hiccups are distressful to the client and can lead to complications, such as vomiting. b. The nurse should identify hypotension as an indication of abdominal distension. c. The nurse should identify tachycardia as an indication of abdominal distension. d. The nurse should identify abdominal pain as an indication of abdominal distension.
A nurse is assessing a client who has acute Hep B. Which of the following findings should the nurse expect? a. joint pain b. obstipation c. abd distention d. periumbilical discoloration
a. joint pain Joint pain is an expected finding in a client who has acute hepatitis B. b. Obstipation Obstipation, or failure to pass stools, is an expected finding in a client who has a complete bowel obstruction. c Abdominal distention is an expected finding in a client who has a small bowel obstruction d. Periumbilical discoloration is an expected finding in a client who has intraperitoneal bleeding.
A nurse is developing a plan for a client who has cirrhosis and ascites. Which of the following interventions should the nurse include? a. measure abd girth daily b. chest mental status once daily. c. Provide daily intake of 4g of sodium d. Assess breath sounds q12h
a. measure abd girth daily The nurse should measure the client's abdominal girth and weigh the client daily to monitor the amount of fluid accumulation in the abdomen and the effectiveness of treatment measures. b. A client who has cirrhosis is at risk for hepatic encephalopathy. The nurse should assess the client's mental status every 4 to 8 hr. c. A client who has cirrhosis can have edema and ascites. The client who has cirrhosis is usually prescribed a 1 to 2 g sodium-restricted diet to prevent ascites. d.A client who has cirrhosis is at risk for dyspnea due to ascites. The nurse should monitor the client's breath sounds every 4 to 8 hr.
A nurse is caring for a client who has ulcerative colitis. The client has had several exacerbation over the past 3yrs. Which of the following instructions should the nurse include in the plan of care to minimize the risk of further exacerbation's? (select all that apply) a. use progressive relaxation techniques b. increase dietary fiber intake c. drink two 240mL (8oz) glasses of milk per day d. arrange activities to allow for daily rest periods e. restrict intake of carbonated beverages
a. use progressive relaxation techniques d. arrange activities to allow for daily rest periods e. restrict intake of carbonated beverages Use progressive relaxation techniques is correct. Progressive relaxation techniques, a form of biofeedback, are recommended to help the client minimize stress, which can precipitate an exacerbation. Increase dietary fiber intake is incorrect. The client should restrict intake of dietary fiber, which can cause diarrhea and cramping. Drink two 240 mL (8 oz) glasses of milk per day is incorrect. Dairy products, such as milk, are poorly tolerated by clients who have ulcerative colitis and should be avoided. Arrange activities to allow for daily rest periods is correct. Daily rest periods decrease stress and reduce intestinal motility. Restrict intake of carbonated beverages is correct. The client should avoid gastrointestinal stimulants, such as carbonated beverages, nuts, peppers, and smoking.
A nurse is providing discharge for a client who has chronic Hep C. Which of the following statements by the client indicates an understanding of the teaching? a. "I will avoid alcohol until I'm no longer contagious." b. "I will avoid medications containing acetaminophen." c. "I will decrease my intake of calories." d. "I will need treatment for 3 months."
b. "I will avoid medications containing acetaminophen." A client who has hepatitis C should avoid medications that contain acetaminophen, which can cause additional liver damage. a. A client who has hepatitis C should avoid alcohol consumption at all times due to the client's increased risk for cirrhosis. c. A client who has hepatitis C should eat small, frequent meals that are high in carbohydrates and calories. d. Medications used to treat hepatitis include a combination of peginterferon, boceprevir, and ribavirin. A common course of treatment is peginterferon and ribavirin for 4 weeks followed by peginterferon, ribavirin, and boceprevir for 6 to 8 weeks.
A nurse is caring for a client who has colorectal cancer and is receiving chemotherapy. The client asks the nurse why blood is being drawn for carcinoembryonic antigen (CEA) level. Which of the following responses by the nurse is appropriate? a. "the CEA determines the current stage of your colon cancer." b. "the CEA determines the efficacy of your chemotherapy." c. "the CEA determines if the neutrophil count is below the expected reference range." d. "the CEA determines if you are experiencing occult bleeding from the GI tract."
b. "the CEA determines the efficacy of your chemotherapy." the CEA levels will decrease if the chemotherapy is effective. a. A provider uses a colonoscopy to determine the diagnosis of colorectal cancer. b. A provider uses the CEA level to determine the efficacy of the chemotherapy. The client's CEA levels will decrease if the chemotherapy is effective. c. A provider uses a CBC to determine if the neutrophil count is within the expected reference range. d. A provider uses a fecal occult blood test to determine if there is bleeding in the gastrointestinal tract.
A nurse is reviewing the laboratory results of a client who has acute pancreatitis. Which of the following findings should the nurse expect? a. blood glucose 110 mg/dL b. Increased serum amylase c. WBC 9,000/mm3 d. Decreased bilirubin
b. Increased serum amylase d/t the pancreatic cell injury a. A blood glucose level of 110 mg/dL is within the expected reference range. Elevated blood glucose is an expected finding for a client who has acute pancreatitis. b. Serum amylase levels are increased in a client who has acute pancreatitis due to pancreatic cell injury. c. A WBC of 9,000/mm3 is within the expected reference range. An elevated WBC is an expected finding in a client who has acute pancreatitis. d. Increased bilirubin is an expected finding in a client who has acute pancreatitis due to the hepatobiliary obstructive process.
A nurse is assessing a client who has peritonitis. Which of the following findings should the nurse expect? a. bloody diarrhea b. board-like abdomen c. periumbilical cyanosis d. Increased bowel sounds
b. board-like abdomen A board-like, distended abdomen, accompanied by extreme pain and tenderness, is an expected finding in a client who has peritonitis. a.Bloody diarrhea is an expected finding in a client who has colorectal cancer. c. Periumbilical cyanosis is an expected finding in a client who has pancreatitis. d. Diminished bowel sounds is an expected finding in a client who has peritonitis.
A nurse is providing teaching about dietary management to prevent dumping syndrome for a client who is postoperative following a gastrectomy. The nurse should encourage the client to include which of the following foods to his diet? a. lactose-reduced milk b. eggs c. grape juice d. honey
b. eggs The nurse should instruct the client to AVOID eating ice cream, a food that is high in sugar, due to the client's increased risk for manifestations of dumping syndrome. Avoid drinking sweetened fruit juice or honey and other simple sugars due to the client's increased risk for manifestations of dumping syndrome.
A nurse is providing teaching for a client who has cirrhosis and a new prescription of lactulose. The nurse should include which of the following instructions in the teaching? a. notify the provider if bloating occurs b. expect to have 2 to 3 soft stools per day c. restrict carbohydrates in the diet d. limit oral fluid intake to 1,000 mL per day of clear liquids
b. expect to have 2 to 3 soft stools per day The purpose of this medication is to Promote excretion of Ammonia in the stool. Frequent stools are expected in order to achieve the desired outcome. a. The nurse should instruct the client that bloating, flatulence, and belching are adverse effects of lactulose and that it is not necessary to notify the provider about these adverse effects. c. The nurse should instruct the client to follow a diet that is high in carbohydrates and protein because clients who have cirrhosis are at risk for malnutrition. d. Dehydration can result from increased stool frequency. The nurse should instruct the client to maintain an adequate fluid intake to offset the dehydrating effects of the medication.
A nurse is providing discharge teaching for a client who has a new prescription for medications to treat peptic ulcer disease. The nurse should identify that which of the following medications inhibits gastric acid secretion? a. calcium carbonate b. famotidine c. aluminum hydroxide d. sucralfate
b. famotidine The nurse should inform the client that Famotidine is an H2 receptor antagonist that is prescribed for the treatment of PUD to inhibit gastric acid secretion. calcium carbonate is an antacid that neutralizes gastric acid but does not inhibit its secretion. aluminum hydroxide is an antacid that neutralizes gastric acid but does not inhibit its secretion. sucralfate is a mucosal barrier fortifier that forms a protective coating over the ulcer but does not inhibit gastric acid secretion.
A nurse is teaching a client how to prepare for a colonoscopy. Which of the following instructions should the nurse include in the teaching? a. begin drinking the oral liquid preparation for bowel cleansing on the morning of the procedure b. drink full liquids for breakfast the day of the procedure, & then take NPO for 2hr prior to procedure c. drink clear liquids for 24hr prior to the procedure, & then take NPO 6hr prior to procedure d. drink the oral liquid preparation for bowel cleansing slowly
c. drink clear liquids for 24hr prior to the procedure, & then take NPO 6hr prior to procedure a. The nurse should instruct the client to begin drinking the oral liquid preparation the day before the colonoscopy to ensure adequate time for bowel cleansing. b. The nurse should instruct the client to take nothing by mouth except water for 4 to 6 hr prior to the procedure. c The nurse should instruct the client to drink clear liquids for 24 hr prior to the colonoscopy to promote adequate bowel cleansing. Maintaining NPO status for 4 to 6 hr prior to the colonoscopy preserves the bowel's cleansed state. d.The nurse should instruct the client to drink the oral liquid preparation quickly to prevent nausea.
A nurse is reviewing the prescriptions for a client who has Campylobacter enteritis. Which of the following prescriptions should the nurse clarify with the provider? a. 0.45% sodium chloride IV b. milk of magnesia c. ciprofloxacin d. potassium e. Magnesium hydroxide
b. milk of magnesia and e. b. This medication increases GI motility, which can increase the client's risk for electrolyte imbalance and contribute to dehydration. e. Nausea, vomiting, and diarrhea are manifestations of enteritis. The nurse should clarify a prescription for magnesium hydroxide, also known as milk of magnesia, with the provider. This medication increases gastrointestinal motility, which can increase the client's risk for an electrolyte imbalance and contribute to dehydration. a. Nausea, vomiting, and diarrhea are manifestations of enteritis. The nurse should recognize that a prescription for an IV administration of 0.45% sodium chloride, a hypotonic solution, is appropriate to reverse the effects of dehydration. c. The nurse should recognize that a prescription for ciprofloxacin, an antibiotic, is appropriate because Campylobacter enteritis is a bacterial form of gastroenteritis. d. Nausea, vomiting, and diarrhea are manifestations of enteritis, which places the client at risk for hypokalemia. The nurse should recognize that a prescription for potassium is appropriate.
A nurse is providing discharge teaching for an older adult client who has mild diverticulitis. Which of the following client statements indicates an understanding of the teaching? a. "I may experience right lower quadrant pain." b. "I will remain active by working in my garden every day." c. "I should eat foods that are low in fiber." d. "I will use mild laxative every day."
c. "I should eat foods that are LOW in fiber." a. Left lower quadrant pain is an expected finding in a client who has diverticulitis. b The client who has diverticulitis should refrain from any activity that increases intra-abdominal pressure because this can result in the perforation of the diverticula. c. The client who has diverticulitis should refrain from any activity that increases intra-abdominal pressure because this can result in the perforation of the diverticula. d. The client who has diverticulitis should avoid laxatives, which increase intestinal motility and can exacerbate the adverse effects of diverticulitis.
A nurse is caring for a client who has hepatic encephalopathy. The client asks the nurse if she can have a larger portion of beef for dinner. Which of the following responses by the nurse is appropriate? a. "beef is too high fat, but I can request chicken as a substitute" b. "you need to increase your fluid intake. Would you like beef and noodle soup?" c. "you should limit your animal protein intake. Can I get you a veggie burger instead?" d. " you need to limit calories. Would you like some sugar-free gelatin?"
c. "you should limit your animal protein intake. Can I get you a veggie burger instead?" A client with hepatic encephalopathy often requires a temporary reduction in animal protein intake d/t the resulting increased production of ammonia.
A nurse is admitting a client who has acute pancreatitis. Which of the following actions should the nurse take first? a. insert a NG tube b. administer ceftazidime c. Identify the clients current level of pain d. Instruct the client to remain NPO
c. Identify the clients current level of pain c. The first action the nurse should take when using the nursing process is to assess the client. Clients who have acute pancreatitis often have severe abdominal pain. By assessing the client's level of pain, the nurse can identify the need for and implement interventions to alleviate the client's pain. d. Clients who have acute pancreatitis are often placed on NPO status to decrease stress on the pancreas. The nurse should explain this intervention to the client. However, there is another action the nurse should perform first. b. Clients who have acute pancreatitis are at risk for infection. The nurse should administer prescribed antibiotics. However, there is another action the nurse should perform first. a. Clients who have acute pancreatitis are at risk for paralytic ileus and might require gastric decompression. The nurse should insert a nasogastric tube, if needed. However, there is another action the nurse should perform first.
A nurse is assessing a client who has cirrhosis. Which of the following findings is the priority for the nurse to report to the provider? a. Spider angiomas b. peripheral edema c. bloody stools d. jaundice
c. bloody stools a. Spider angiomas are an expected finding for a client who has cirrhosis. Therefore, there is another finding that is the priority for the nurse to report to the provider. b. Peripheral edema is an expected finding for a client who has cirrhosis. Therefore, there is another finding that is the priority for the nurse to report to the provider. c. The greatest risk to the client who has cirrhosis of the liver is hemorrhagic shock due to bleeding in the esophageal varices. Therefore, bloody stools is the priority finding to report to the provider. d. The greatest risk to the client who has cirrhosis of the liver is hemorrhagic shock due to bleeding in the esophageal varices. Therefore, bloody stools is the priority finding to report to the provider.
A nurse is assessing a client who has cirrhosis. Which of the following findings is the priority for the nurse to report to the provider? a. spider angiomas b. peripheral edema c. bloody stools d. jaundice
c. bloody stools at risk for hemorrhaging and indicates GI bleed
A nurse is providing discharge teaching for a client following an ileostomy. The nurse should instruct the client to report which of the following findings to the provider? a. Intolerance of high-fiber foods b. liquid ileostomy output c. dark purple stoma d. sensation of burning during bowel elimination
c. dark purple stoma A dark purple stoma is an indication of bowel ischemia Clients who have an ileostomy often experience intolerance to high-fiber foods. The client might need to eliminate these foods from her diet. However, the client does not need to report this intolerance to the provider. Clients who have an ileostomy are expected to have loose liquid output. The nurse should provide the client with information about how to avoid dehydration due to excessive liquid output, including recommending the consumption of oral replacement solutions. Clients who have an ileostomy are expected to experience a burning sensation during bowel elimination due to decreased absorption of gastric acid in the ileum. The nurse should provide the client with instructions about skin care, such as washing the area around the ostomy with warm soap and water after each bowel movement, drying the area gently, and applying a thin coat of ointment to the area.
A nurse is providing discharge teaching for a client who has a new colostomy and is concerned about flatus and odor. Which of the following foods should the nurse recommend? a. eggs b. fish c. yogurt d. broccoli
c. yogurt The nurse should recommend yogurt, crackers, and toast, which can prevent flatus and stool odor. The nurse should inform the client that eggs, asparagus, and cabbage, fish can contribute to odor when the colostomy pouch is open. The nurse should inform the client that broccoli, beans, and spicy foods can cause flatus.
A nurse is reviewing the laboratory results of a client who has hepatic cirrhosis. Which of the following laboratory findings should the nurse report to the provider? a. Albumin 4.0 g/dL b. INR 1.5 c. Bilirubin 0.2 mg/dL d. Ammonia 180 mcg/dL
d. Ammonia 180 mcg/dL The RN should report an increased serum ammonia level b/c it can indicate port-systemic encephalopathy
A nurse is reviewing the laboratory values of a client who has colorectal cancer. Which of the following findings should the nurse expect? a. negative fecal occult blood test b. decreased serum carcinoembryonic antigen (CEA) level c. Hct 43% d. Hgb 9.1 g/dL
d. Hgb 9.1 g/dL A hemoglobin level of 9.1 g/dL is below the expected reference range. Decreased Hgb is an expected finding in those with colorectal cancer b/c of occult intestinal bleeding. a. A positive fetal occult blood test is an expected finding for a client who has colorectal cancer because colorectal cancer causes bleeding in the gastrointestinal tract. b. An elevated CEA level is an expected finding in a client who has colorectal cancer. c. A hematocrit level of 43% is within the expected reference range. The nurse should expect a decreased hematocrit level in a client who has colorectal cancer due to occult intestinal bleeding.
A nurse is caring for a client who has GERD and new prescription for Metoclopramide. The nurse should plan to monitor for what side effect? a. thrombocytopenia b. hearing loss c. hyper calivation d. ataxia
d. ataxia The RN should monitor for extrapyramidal symptoms, such as ataxia, and should report any positive findings to the provider a. An adverse effect of low-molecular-weight heparins, such as enoxaparin, is thrombocytopenia. However, thrombocytopenia is not an adverse effect of metoclopramide. b.Gentamicin and many other medications are ototoxic. However, metoclopramide does not cause hearing loss. c. An adverse effect of metoclopramide is xerostomia (dry mouth), not hypersalivation.
A nurse is providing discharge teaching for a client who has chronic cholecystitis. Which of the following food selections by the client indicates the teaching was effective? a. unsalted nuts b. bologna c. chedder cheese d. bananas
d. bananas Low-fat food options, such as bananas, are recommended due to the decreased risk for causing manifestations of cholecystitis
A nurse is assessing a client immediately following a paracentesis for the treatment of ascites. Which of the following findings indicates the procedure was effective? a. presence of a fluid wave b. increased heart rate c. equal pre & post procedure weights d. decreased SOB
d. decreased SOB Increased abdominal fluid can limit the expansion of the diaphragm and prevent the client from taking a deep breath. Once excess peritoneal fluid is removed, the diaphragm will expand more freely. The nurse should identify this finding as an indicator the procedure was effective. a. The nurse should identify the presence of a fluid wave as an indication of ascites. This finding does not indicate the procedure was effective. b. The nurse should identify an increased heart rate as an indication of hypovolemia, which is a potential complication of a paracentesis. This finding does not indicate the procedure was effective. c. The nurse should expect the client's postprocedure weight to be less than the preprocedure weight due to the withdrawal of fluid from the peritoneal cavity. This finding does not indicate the procedure was effective.
A nurse is caring for a client who has a duodenal ulcer. Which of the following findings should the nurse expect? a. the client describes the pain as spasms in the upper epigastrium b. the client describes the pain as pressure felt in the epigastrium c. the client states the pain occurs as soon as food enters the stomach d. the client states the pain occurs 1.5-3hrs after meals and during the night
d. the client states the pain occurs 1.5-3hrs after meals and during the night a. Pain associated with a duodenal ulcer is typically located below or to the right of the epigastrium. Typically, the client who has a duodenal ulcer is not malnourished. Typically, the client who has a duodenal ulcer reports that ingesting food diminishes his pain level. d. Pain associated with a duodenal ulcer occurs when the stomach is empty, which is typically 1.5 to 3 hr after meals and during the night.
