Common Concepts Final- GI
A common initial symptom of Crohn's disease is? A. Fistula B. Persistant diarrhea C. Rectal bleeding D. Intestinal obstruction
B. Persistant diarrhea
A client with Crohn's Disease understands that this disease can potentially affect what part of the GI tract? A. Mouth B. All of the Above C. Duodenum D. Colon
B. All of the above
Which lifestyle adjustment may a patient have to make to best control GERD? A. Wear snug fitting belts and clothing B. Attain and maintain an ideal body weight. C. Laying down and napping after meals D. Sleep in the trendelenburg position E. Eat only three large meals a day
B. Attain and maintain an ideal body weight.
Which of the following diagnostic tests are the most reliable in detecting colon cancer? A. Sigmoidoscopy B. Colonoscopy C. Barium enema D. Fecal occult blood test (FOBT)
B. Colonoscopy
The physician orders metronidazole (Flagyl) 250mg PO TID for 7 days for a 35 year old client. The nurse teaches the client about the medication. Which of the following statements, if made by the client, would indicate that teaching has been effective and understood? A. "I should NOT drink alcohol while I am taking this medication." B. "I should take this medication between meals to increase absorption." C. "If I experience a metallic taste in my mouth while taking this medication, I should notify the physician." D. "I should avoid strong sunlight while I am taking this medication."
A. "I should NOT drink alcohol while I am taking this medication."
The nurse teaches a client how to prepare for a barium enema. Which statement by the client would indicate a correct understanding of the teaching? A. "I'll cleanse my bowel with laxatives and enemas before the test." B. "I'll stop eating red meat 3 days before the test." C. "I'll drink a contrast medium during and after the test." D. "I'll receive a muscle relaxant during the test."
A. "I'll cleanse my bowel with laxatives and enemas before the test."
A client is scheduled for a colonoscopy, and the nurse is providing pre-procedure instructions. Which of the following statements made by the patient indicates further teaching is required? A. "I'm afraid to have general anesthesia for the procedure." B. "A flexible tube will be inserted into my rectum." C. "I'll be conscious but sedated during the procedure." D. "I'll need to take a laxative and have enemas before the test."
A. "I'm afraid to have general anesthesia for the procedure."
The nurse is monitoring a female patient who is diagnosed with a peptic ulcer. Which of the following assessment findings would most likely indicate perforation secondary to an ulcer? A. A rigid, board-like abdomen B. Diarrhea C.Bradycardia D. Nausea and vomiting
A. A rigid, board-like abdomen
During assessment, the patient verbalizes pain on the right lower quadrant. The nurse knows that the organ(s) affected would be: A. Appendix and cecum B. Sigmoid colon C. Pancreas D. Liver
A. Appendix and cecum
A 58 year old client is admitted to the medical-surgical unit with complaints of gastroesophageal reflux, regurgitation, dysphagia, and belching. The physician suspects hiatal hernia. The client is scheduled for esophagogastroduodenoscopy (EGD). The nurse explains to the patient that an EGD: A. Directly visualizes the esophagus with a flexible fiber-optic endoscope. B. Visualizes the esophagus after a radioactive isotope is injected intravenously. C. Is an esophageal x-ray that is taken while the patient swallows a barium solution. D. Examines gastric fluid that is aspirated with a flexible tube.
A. Directly visualizes the esophagus with a flexible fiber-optic endoscope.
Which of the following factors increase the risk for developing GERD? Select all that apply. Answers: A. History of Diabetes B. Hiatal hernia C. High fiber diet D. Smoking E. Alcohol consumption F. Pregnancy
A. History of Diabetes B. Hiatal hernia D. Smoking E. Alcohol consumption F. Pregnancy
A focused GI assessment begins with a complete history and physical examination. Identify the quadrant of the abdomen to be palpated or percussed for a patient with sigmoid colon pain. A. Left lower B. Right upper C. Left upper D. Right lower
A. Left lower
Which of the following is a preventative measure for diverticular disease? A. Taking bulk forming laxative agents B. Taking routine anticholinergics to reduce bowel spasms C. Excluding whole-grain breads from diet D. Avoiding fresh apples, broccoli, and lettuce
A. Taking bulk forming laxative agents
A patient is admitted to the medical-surgical floor with a diagnosis of diverticulitis. The nurse would expect the patient to exhibit which of the following signs and symptoms associated with diverticulitis? A. Epigastric pain that radiates to the back, hypotension and tachycardia. B. Crampy, left lower quadrant pain and low grade fever. C. Left lower abdominal pain and excessive rectal bleeding. D. Nausea, vomiting, right lower quadrant rebound tenderness and fever.
B. Crampy, left lower quadrant pain and low grade fever.
A 62 year old female presents to the emergency department with complaints of vomiting blood that was described as "coffee ground" appearance, and severe chest pain that woke her in the middle of the night. The nurse suspects? A. Ulcerative colitis B. Peptic Ulcer Disease C. Gastroesophageal Reflux Disease D. Lower GI bleed
B. Peptic Ulcer Disease
A client states "My doctor told me to quit taking aspirin since I've developed this ulcer. But I have to take aspirin to keep my arthritis from hurting. I don't know what to do." Which response on the part of the nurse is most appropriate? A. "Let's worry about treating your ulcer. Your arthritis can wait." B. "Aspirin is one of the medications that makes your ulcer worse. Another medicine can be ordered by the doctor for your arthritis." C. "Continue to take your aspirin for your arthritis. Watch closely for bleeding." D. "The doctor knows what is best for you. Follow the instructions for taking your ulcer medications closely."
B. "Aspirin is one of the medications that makes your ulcer worse. Another medicine can be ordered by the doctor for your arthritis."
The nurse is preparing a patient for a barium enema. The nurse knows that the patient needs further teaching when the patient makes which of the following statements? A. "My stools may appear white for a day or so." B. "The radiologist will give me an enema and take pictures of my colon." C. "I may experience constipation as a result of this barium." D. "I should drink lots of water over the next 8 hrs."
B. "The radiologist will give me an enema and take pictures of my colon."
The client diagnosed with an acute exacerbation of ulcerative colitis, having had multiple bloody diarrheas for the last two days. Which of the following nursing intervention(s) is priority for this patient? A. Provide a low-residue diet. B. Administer intravenous fluids and monitor vital signs frequently. C. Assess vital signs daily. D. Administer antacids orally.
B. Administer intravenous fluids and monitor vital signs frequently.
The doctor prescribes sucralfate (Carafate) to a client diagnosed with a peptic ulcer. The nurse knows that sucralfate is given for which of the following reasons? A. Prevent additional bleeding of gastric ulcers. B. Protect the ulcer's surface by forming a barrier and allowing for the healing of the ulcer. C. Inhibit the action of histamine. D. Inhibit the activity of the acid pump and block the formation of gastric acid.
B. Protect the ulcer's surface by forming a barrier and allowing for the healing of the ulcer.
A 50 year old man is scheduled for a colonoscopy this morning. Last night he had Magnesium Citrate and a soapsuds enema. This morning he passes a medium amount of soft, brown stool. What should the nurse know and report to the physician? A. The patient had something to eat after midnight. B. The bowel prep is incomplete. C. This is an expected finding before this type of surgery. D. This is the last of the stool left in the colon.
B. The bowel prep is incomplete.
The nurse is preparing a client for a flexible sigmoidoscopy. The nurse explains that the difference between a flexible sigmoidoscopy and a colonoscopy is? A. A Flexible sigmoidoscopy is advanced to the length of the cecum, and a colonoscopy is advanced to the sigmoid colon. B. Flexible sigmoidoscopy uses sound waves from an ultrasound to see the lining of the GI walls and a colonoscopy uses a lighted flexible scope to view the GI walls. C. A Flexible sigmoidoscopy is advanced the length of the sigmoid colon, and a colonoscopy is advanced to the cecum. D. Flexible sigmoidoscopy does not have to have a bowel prep and a colonoscopy does
C. A Flexible sigmoidoscopy is advanced the length of the sigmoid colon, and a colonoscopy is advanced to the cecum.
Which of the following clients would not be a candidate for a Capsule Endoscopy? A. A client with Crohn's Disease B. A client with a history of iron deficiency anemia C. A client who complains of dysphagia D. A client with history of blood in the stool
C. A client who complains of dysphagia
A client who is recovering from GI surgery has been advanced from a clear liquid diet to a full liquid diet. The nurse would offer which item to the client on a full liquid diet? A. Ice Cream B. Popsicle C. All of the Above D. Jello E. Coffee
C. All of the Above
A 62 year old male is admitted to the hospital with a diagnosis of diverticulitis. The nurse understands that diverticulitis occurs due to which of the following? A. The appendix ruptured and released bacteria and toxins into the peritoneum B. The mucosal lining was irritated C. Fecal material or bacteria became trapped in the outpouchings of the intestine. D. The outpouching in the intestinal lining perforated
C. Fecal material or bacteria became trapped in the outpouchings of the intestine.
A 42 year old male presents to the ER with complaints of sudden, severe upper abdominal pain with hematemesis. Upon assessment, the nurse notes a rigid, board-like abdomen and absent bowel sounds. Diagnostic tests reveal WBC 18.9 and free air noted on abdominal xray. Vital signs: BP 89/48, HR 140, RR 42, O2 sats 89% and temp 101.6. The nurse suspects? A. Gastritis B. Esophageal varices C. Perforation of bowel D. Appendicitis
C. Perforation of bowel
A client is diagnosed with ulcerative colitis. When assessing this client, which of the following signs and symptoms would the nurse expect to find? A. Oral temperature of 98.9 F B. Hard, rigid abdomen C. Ten bloody stools a day D. Urinary stress incontinence
C. Ten bloody stools a day
The nurse explains to a family that the main physiologic reason for weight loss in a client with Crohn's disease is which of the following? A. The symptom of anorexia prevent the client from eating. B. The "skip lesions" interfere with food passage through the bowel. C. The thickening and congestion of the bowel wall results in malabsorption of nutrients. D. The inflammation of the disease decreases the appetite.
C. The thickening and congestion of the bowel wall results in malabsorption of nutrients.
When the nurse is conducting an initial assessment, which specific data should the nurse obtain from the client who is suspected of having peptic ulcer disease? A. Any known allergies to drugs and enviromental factors B. Medical histories of at least 2 generations. C. Use of non-steroidal anti-inflammatory drugs (NSAIDS) D. History of side effects experienced from all home medications.
C. Use of non-steroidal anti-inflammatory drugs (NSAIDS)
A client asks what the difference is between his gastric ulcer and his friend's duodenal ulcer. The nurse's response should be based on which of the following statements? A. "Antacids such as Maalox are seldom prescribed for clients with duodenal ulcers." B. "Clients with gastric ulcers often gain weight, as food alleviates the pain." C. "Gastric ulcers have an increased association with clients who experience increased psychological pressures." D. "The pain of a duodenal ulcer usually occurs two to four hours after meals."
D. "The pain of a duodenal ulcer usually occurs two to four hours after meals."
A 33 year old male is admitted with a gastric ulcer. The nurse should anticipate the client to have epigastric pain: A. 2-5 hours after a meal. B. at night. C. relieved by ingestion of food. D. 1-2 hours after a meal
D. 1-2 hours after a meal
A 33 year old male is admitted with a gastric ulcer. The nurse should anticipate the client to have epigastric pain: A. relieved by ingestion of food. B. 2-5 hours after a meal C. at night. D. 1-2 hours after a meal.
D. 1-2 hours after a meal.
A client is admitted to the hospital with ulcerative colitis. The nurse should assess the client for which of the following complications of the disease? A. Flatulence B. Thrombocytopenia C. Hiatal hernia D. Anemia
D. Anemia
When assessing the client with a diagnosis of peptic ulcer disease, which physical assessment examination skill should the nurse implement first? A. Percuss the abdominal borders to identify organs B. Assess whether or not the patient has taken NSAIDs C. Palpate the abdominal area for tenderness D. Auscultate the client's bowel sounds in all four quadrants
D. Auscultate the client's bowel sounds in all four quadrants
According to the diagnostic criteria for IBS, IBS is diagnosed when patients present with all of the following symptoms except for? A. Abdominal pain that improves with defecation B. A change in stool appearance C. A change in stool frequency D. Bloody diarrhea
D. Bloody diarrhea
Which statement about diverticular disease is accurate? A. Diverticula are uncomfortable even when not inflamed B. Most diverticula occur in the ascending colon. C. High-fiber diets contribute to diverticula occurrence D. Diverticula form when colonic mucosa herniates through smooth muscle layers
D. Diverticula form when colonic mucosa herniates through smooth muscle layers
The nurse is caring for a client diagnosed with GERD. Which of the following nursing interventions should be implemented? A. Place the client in bed and administer anti-inflammatory medications. B. Have the client remain upright at all times and walk for 30 minutes three times a week C. Instruct the client to maintain a right lateral side lying position and take antacids before meals. D. Elevate the head of the bed 30 degrees and discuss lifestyle modifications with the client.
D. Elevate the head of the bed 30 degrees and discuss lifestyle modifications with the client.
A patient is receiving infliximab for the treatment of Crohn's disease. The nurse knows to monitor for which of the following side effects? A. Thinning hair, nausea, vomiting and diarrhea B. Hyperglycemia, fluid retention, weight gain C. Abdominal cramping and diarrhea D. Fever, chills, itching E. Yellow-orange urine, and photosensitivity
D. Fever, chills, itching
A 41 year old male presents to the clinic with complaints of upper abdominal pain described as gnawing, burning ache that gets better when he eats. He reports one episode of vomiting. What diagnosis does the nurse suspect? A. PUD B. GERD C. Hiatal Hernia D. Gastritis
D. Gastritis
Which of these agents is a major contributing factor in the promotion of peptic ulcer disease? A. Candida albicans B. Streptococcus infection C. Staphylococcus infection D. Helicobacter pylori infection (H-pylori)
D. Helicobacter pylori infection (H-pylori)
The nurse is reviewing the record of a client with Crohn's disease. Which stool characteristic should the nurse expect to find documented in the patient's record? A. Loose, watery alternating with hard, formed B. Soft, constantly leaking from the rectum C. Hard, formed D. Loose, watery
D. Loose, watery
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 the esophagus through an opening in the diaphragm D. Often involves relaxation of the lower esophageal sphincter, allowing stomach content to back up into the esophagus
D. Often involves relaxation of the lower esophageal sphincter, allowing stomach content to back up into the esophagus
Which of the following characteristics of Crohn's disease is accurate? A. Limited to the rectum and colon B. Limited involvement in the layers of the intestinal wall C. Cancer development is common D. Lesions are continuous ulcerative and exudative E. Internal intestine has cobblestone appearance
E. Internal intestine has cobblestone appearance
