Gastrointestinal

The nurse clarifies that the end product of carbohydrate metabolism is absorbed and put into the blood stream by the:

villi of the small intestine.

The nurse anticipates that the patient who has had a subtotal gastrectomy will need supplemental:

vitamin B12 due to the loss of the intrinsic factor.

The nurse is teaching a client with a newly diagnosed hiatal hernia about measures to prevent recurrence of symptoms. Which statement should be included in the teaching?

"Avoid lying down for an hour after eating."

A client is admitted to the hospital for acute gastritis and ascites secondary to alcoholism and cirrhosis. It is most important for the nurse to assess this client for:

blood in the stool

Crohn's disease _____

can involve both the small and large intetines

A nurse is caring for a client who just had surgery to repair an inguinal hernia. To limit a common complication associated with this surgery, the nurse should:

place a support under the scrotum

Which of the following symptoms may be exhibited by a client with Crohn's disease?

presence of fat in the feces

The nurse points out which of the following as an example of a nonmechanical bowel obstruction?

A paralytic ileus

Which client statement indicates to the nurse that a client who is receiving cyanocobalamin (vitamin B12) therapy for an intrinsic factor deficiency understands the treatment?

"I should have a vitamin B12 injection every month"

A client is admitted to the hospital with a gnawing pain in the mid-epigastric area and black stool for the past week. A diagnosis of chronic duodemal ulcer is made. During the initial nursing assessment, the client makes all of the following statements. Which is most likely related to his admitting diagnosis?

"I take aspirin several times a day for tension headaches"

The home health nurse evaluates a patient being treated for a peptic ulcer with Maalox (antacid) and famotidine (histamine receptor blocker). Which statement made by the patient indicates a need for further instruction?

"I take both those meds at the same time every morning."

The nurse is collecting data from a client admitted to the hospital with a diagnosis of suspected gastric ulcer and is asking the client questions about pain. Which statement made by the client supports the diagnosis of gastric ulcer?

"My pain comes shortly after I eat, maybe a half hour or so later."

The nurse is admitting a client with the diagnosis of appendicitis to the surgical unit. Which questions is it essential to ask?

"When did you last eat"

A 56 -year-old man is admitted to the emergency room with an acute attack of diverticulitis. The patient has a temperature of 102° F, and has an elevated white count. Which assessment would alert the nurse to impending septic shock?

Tachycardia

Before administering an intermittent tube feeding through a nasogastric tube, the nurse checks for gastric residual volume. Which is the best rationale for checking gastric residual volume before administering the tube feeding?

Evaluate absorption of the last feeding

Which of the following are indicators of colorectal cancer? (Select all that apply.)

Excessive flatulence Cachexia Cramps Rectal bleeding

The nurse is reinforcing discharge instructions to a client after a gastrectomy. Which measure should the nurse include in client teaching to help prevent dumping syndrome?

Limit the fluids taken with meals.

A client has severe diarrhea, and the health care provider prescribes intravenous fluids, sodium bicarbonate, and an antidiarrheal medication. Which most frequently prescribed antidiarrheal drug does the nurse expect the health care provider to prescribe?

Loperamide (Imodium)

Why are peptic ulcers a common problem of aging?

Because of overuse of NSAIDs

The nurse assesses jaundice in a newly admitted patient. What is there an excess amount of in the bloodstream that causes jaundice?

Bilirubin

A nurse assesses a client with the diagnosis of an intestinal obstruction in the descending colon. When auscultating the midabdomen, the nurse expects to hear:

Borborygmi

A patient has been diagnosed with diverticulosis as a result of muscle thickening and increased intracolonic pressure. Which of the following recommendations would the nurse give her regarding food choices?

Bran, fruits, and vegetables

Which setting is most appropriate to use when connecting the client's single-lumen NG tube to suction preoperatively?

Low intermittent suction

An older adult client is demonstrating mild confusion after surgical repair of a hernia. What should the nurse do to provide for this client's safety?

activate the position-sensitive bed alarm

The nurse is reviewing the record of a client with Crohn's disease. Which stool characteristic should the nurse expect to see documented in the record?

Diarrhea

What condition is associated with Dumping syndrome?

Following gastric resection or peptic ulcer surgery

The nurse is preparing to administer an enteral feeding through a nasogastric tube. The nurse should place the client in which position during and after the feedings? Sim's

Fowler

What is the preferred diagnostic test for visualizing the biliary tree in a patient with jaundice?

Gallbladder ultrasound

A client with a possible hiatal hernia complains of difficulty swallowing. Which other sign/symptom is associated with a hiatal hernia?

Heartburn and regurgitation

What is the most common form of hepatitis today, which has an incubation period of 10 to 40 days?

Hepatitis A

A food that should be omitted from the diet of a patient with peptic ulcer disease is

black pepper.

A patient is scheduled to undergo T tube cholangiography. Before administration of contrast dye, what allergy should the nurse check the patient for?

Iodine

The nurse instructs the client to follow the label directions when taking medications to relieve occasional pain and discomfort associated with the ulcer. Whyich medication is most appropriate for the client to take based on the medical history and current diagnosis?

Naproxen (Naprosyn)

What type of liver cirrhosis is caused by viral hepatitis, exposure to hepatotoxins (e.g., industrial chemicals), or infection?

Postnecrotic cirrhosis

What is the top priority when managing a patient with a ruptured esophageal varix?

Protection of airway

The nurse is monitoring for stoma prolapse in a client with a colostomy. Which stoma observation should indicate that a prolapse has occurred?

Protruding and swollen

The nurse explains to the patient with Crohn disease that the tube feedings allow for:

Rapid absorption in the upper GI tract

A patient is being discharged after recently suffering through a bout of acute pancreatitis. He is asking for something to eat. The nurse finds each of the following choices in the kitchen. Which would be most appropriate for this patient? (Select all that apply.)

Reduced fat cheese and whole-wheat crackers Grilled chicken and a baked potato

A female patient has been diagnosed with gastroesophageal reflux disease (GERD). The nurse is beginning to teach the patient about lifestyle changes that can be implemented to minimize the symptoms of this disease. Which of the following will the nurse include?

Reducing caffeine and alcohol consumption may alleviate symptoms of the disease.

A client had surgery for a perforated appendix with localized peritonitis. In which position should the nurse place this client?

Semi-fowler

A patient with a large inguinal hernia has abdominal distention and inguinal pain. The nurse recognizes these as indicators of which type of hernia?

Strangulated

A 32-year old female is admitted for hemorrhoidectomy. During the nursing assessment, all of the following factors are elicited. Which one is most likely to hav contributed to the development of hemorrhoids?

The client had four pregnancies

A client has undergone abdominal perineal resection for a bowel tumor. The nurse interprets that the client's colostomy is beginning to function if which of the following signs is noted?

The passage of flatus

Malabsorption can be a major problem with Crohn's disease when what portion of the intestine is involved?

The small intestine

The client who has had an appendectomy and has a Penrose drain in place has recovered from anesthesia. The nurse places her in a semi-sitting position. What is the primary reason for selecting this position?

To promote drainage from the abdominal cavity

What is an imaging technique in which deep structures of the body are visualized by recording reflections or echoes of ultrasonic waves directed into the tissues?

Ultrasonography

A nurse is caring for a client with a diagnosis of chronic gastritis. The nurse anticipates that this client is at risk for which vitamin deficiency?

Vitamin B12

A client had a barium enema. Following the barium enema, the nurse should anticipate an order for which of the following?

a laxative

In designing a teaching plan to present to a group of older adults regarding the assessment and prevention of esophageal cancer, the nurse would include information about the significance of (select all that apply):

cessation of smoking. regular checkups if dysphagia is present. limiting alcohol consumption.

A client with gastroesophageal reflux disease (GERD) should make diet and lifestyle changes. What instructions should the nurse include in the client's discharge teaching?

chew thouroughly while eating slowly

A food that individuals with celiac disease would need to eliminate is

cream of wheat.

The largest glandular organ in the body, which functions as an accessory organ of digestion, is the:

liver.

An 18-year-old is admitted with an acute onset of right lower quadrant pain at McBurney's point. Appendicitis is suspected. For which clinical indicator should the nurse assess the client to determine if the pain is secondary to appendicitis? urinary retention

rebound tenderness

When comparing ulcerative colitis and Crohn's disease, a nurse considers that they are similar yet dissimilar in many ways. What clinical manifestation is common to clients with Crohn's disease and not to clients with ulcerative colitis?

right lower quadrant pain

A nurse is monitoring a client for the early signs and symptoms of dumping syndrome. Which of the following symptoms indicate this occurence?

sweating and pallor

A client develops acute appendicitis. Prior to arrival to the hospital, the client attempted self-care at home. Which self-care measures could potentially lead to rupture of the appendix?

taking a small volume enema

The home health nurse caring for a patient who has dysarthria related to radiation therapy for an oral cancer would recommend that the family provide:

a tablet and pencil as a communication aid.

A patient is undergoing a diagnostic test to rule out carcinoma of the oral cavity. Which of the following symptoms have been associated with the disease? (Select all that apply.)

Difficulty in chewing, swallowing, or speaking Constant earache Toothache Mouth edema Numbness or loss of sensation in part of the mouth Dysphagia

A health care provider places a Miller-Abbott tube in a client who has a bowel obstruction. Six hours later, the nurse measures the length of the tube outside of the nares and notes that the tube has advanced 6 cm since it was first placed. Based on this finding, which action should the nurse take next?

Document the finding in the client's record

Which recommendation is most appropriate for a patient who has had an esophageal dilation related to achalasia?

Drink 10 oz of fluid with each meal

The home health nurse is caring for a patient who has history of frequent bouts of diverticulitis accompanied by increased flatulence, diarrhea, and nausea. Which of the following is the most appropriate suggestion to lessen these symptoms?

Eat a diet high in fiber content

Dumping syndrome after a Billroth II procedure occurs when high-carbohydrate foods are ingested over a period of less than 20 minutes. What would the nurse suggest to reduce the risk of dumping syndrome?

Eating six small daily meals high in protein and fat

What should the nurse include in a teaching plan for a patient with a hiatal hernia to reduce the frequency of heartburn?

Eating small meals

A patient with a ruptured diverticulum in the descending colon has undergone a transverse loop colostomy. The patient is upset and says, "I didn't know it was going to be this awful. I hate this!" Which response made by the nurse would be most helpful?

"This is a temporary solution. It will be closed in 6 weeks."

A client is admitted to an acute care facility with complications of celiac disease. Which question should be helpful initially in obtaining information for the nursing care plan?

"What is your understanding of celiac disease?"

A client with gastroesophageal reflux is to receive metoclopramide (Reglan) 15 mg orally before meals. The concentrated solution contains 10 mg/mL. How much solution should the nurse administer? Record your answer using one decimal place. _______ mL

1.5 mL

The nurse is checking a client for the correct placement of a nasogastric (NG) tube. The nurse aspirates the client's stomach contents and checks its pH level. Which pH value indicates the correct placement of the tube?

3.5

The nurse is caring for a patient diagnosed with alcoholic cirrhosis of the liver. Which of the following orders would you question the RN about before implementing?

Acetaminophen prn pain

Which of the following medications would be the most effective in treating a duodenal ulceration caused by Helicobacter pylori?

Amoxicillin

A client has a PRN prescription for loperamide (hydrochloride (Imodium). The nurse understand that this medication is used for which condition?

An episode of diarrhea

A client who reports a number of GI related symptoms is diagnosed with ulcerative colitis. The nurse explains that ulcerative colitis is

An inflammatory disease of the colon and rectum

A client has a diagnosis of hemorrhoids. Which signs and symptoms does the nurse expect the client to report? (Select all that apply.)

Anal itching Blood in stool rectal pressure pain when defecating

A client with gastroesophageal reflux disease (GERD) is being treated with dietary management. The client states, "I like to have a glass of juice every day." The nurse teaches the client that the most appropriate type of juice to select is:

Apple

Which of the following would be the most helpful nursing intervention to increase the comfort of a patient with appendicitis?

Application of ice bag

The patient has come to the PACU following an ileostomy for the treatment of ulcerative colitis. The patient is conscious and has a nasogastric tube in place and a pouch over the stoma. What should be the nurse's initial action?

Attach NG tube to suction

A client has undergone esophagogastroduodenoscopy (EGD). The nurse places highest priority on which action as part of the client's care plan?

Checking for return of a gag reflex

A male patient complains that he will never adjust to his colostomy. Which is the best action for the nurse in this situation?

Encourage him to express his concern

A client has a history of gastroesophageal reflux disease (GERD). Why should the nurse also monitor the client for clinical manifestations of heart disease?

Esophageal pain may imitate the symptoms of a heart attack.

What is the diagnostic test that involves visualization of the esophagus, stomach, and duodenum via a flexible endoscope?

Esophagogastroduodenoscopy

Because bowel contents from an ileostomy are virtually liquid, what should the nurse include in the plan of care?

Evaluation and assessment of periostomal skin integrity

A nurse is teaching the client about an upcoming colonoscopy procedure. The nurse would include in the instructions that the client will be placed in which of the following positions for th the procedure?

Left Sims' position

A client is diagnosed with gastric cancer, and a subtotal gastrectomy is performed. After surgery the client begins to hemorrhage. What clinical findings support the nurse's conclusion that the client is experiencing hypovolemic shock? (Select all that apply.)

Oliguria Diaphoresis Tachycardia

A client has an order for sucralfate (Carafate) 1 g by mouth four times daily. The nurse writes in the medication record to administer the medication at which of the following times?

One hour before meals and at bedtime

The nurse caring for a patient with a peptic ulcer who has had a nasogastric tube inserted notes bright blood in the tube; the patient complains of pain and has become hypotensive. Which condition should the nurse recognize these as signs of?

Perforation

The nurse is participating in a health screening clinic and is preparing materials about colorectal cancer. The nurse plans to include which risk factor for colorectal cancer in the material?

Personal history of ulcerative colities or GI polyps

A female patient has undergone a needle liver biopsy 15 minutes ago. The nurse enters her room to discover her sitting up in bed reading the newspaper. What is the first action the nurse should take?

Place her on her right side.

A licensed practical nurse (LPN) is preparing to assist a registered nurse (RN) with removing a nasogastric (NG) tube from the client. The LPN should reinforce instructing the client to perform which action?

Take and hold a deep breath.

A health care provider prescribes psyllium (Metamucil) 3.5 g twice a day for constipation. What is most important for the nurse to teach this client?

each dose should be taken with a full glass of water

A client who had surgery for a ruptured appendix develops peritonitis. What clinical findings related to peritonitis should the nurse expect the client to exhibit? (Select all that apply.)

fever severe abdominal pain abdominal muscle rigidity

When an intestinal obstruction is suspected, a client has a nasogastric tube inserted and attached to suction. For what response should the nurse critically assess this client?

fluid deficit

A client retuns from the surgery with an open drain extending from his appendectomy incision. A sterile dressing covers the drain. Which body position is best for the nurse to use for promoting drainage from the wound in the low abdomen?

fowler's

Bowel sound assessment on a patient with an early phase obstruction who has distention, nausea, and visible peristaltic waves would be:

high pitched.

An older client's colonoscopy reveals the presence of extensive diverticulosis. What type of diet should the nurse encourage the client to follow?

high-fiber

Steroid therapy is prescribed for a client with an exacerbation of ulcerative colitis. The nurse evaluates that teaching is effective when the client says, "I should take this medicine:

in the early morning with food

Famotidine (Pepcid) is prescribed for a client with peptic ulcer disease. The client asks the nurse what this medication does. The nurse responds, "It:

inhibits gastric acid secretions

A client has come into the emergency room complaining of colicky abdominal pain, nausea, constipation and bloating. While performing his nursing assessment, he vomits fecal material. You suspect______?

intestinal obstruction

A nurse is caring for a client after a Billroth II procedure. On review of the postoperative prescriptions, which of the following if prescribed would the nurse question and verify?

irrigating the nasogastric (NG) tube

An adult is being treated for a peptic ulcer. The physician has prescribed cimetidine (Tagamet) for which reason?

it blocks the secretion of gastric hydrochloric acid

A client with a history of ulcerative colitis has a large portion of the large intestine removed and the creation of an ileostomy. For which potential life-threatening complication should the nurse assess the client after this surgery?

limited water reabsorption caused by removal of intestine

Becaues of its effect on the small intestines, which of the following associated disorders is the client with Crohn's disease likely exhibit?

malabsorption

The client with appendicities asks the nurse for a laxative to help relieve her constipation. What is primary reason not to give laxative to the patient?

Laxatives could cause a rupture of the appendix.

The nurse is assisting in planning stress management strategies for the client with irritable bowel syndrome. Which suggestion should the nurse give to the client?

Learn measures such as biofeedback or progressive relaxation

A nurse is caring for a postoperative client who has a nasogastric tube attached to low continuous suction. What clinical findings indicate that the client may be experiencing hypokalemia?

muscle weakness and cardiac dysrhythmias

Many people who have gastroesophageal reflux are

obese.

A patient with carcinoma of the esophagus is about to undergo surgery, an esophagogastrectomy, and is very anxious about what to expect immediately after surgery. Which of the following statements would be appropriate to help calm his anxiety?

"When you wake up, we will be monitoring you very closely. We will give you pain medication and do everything we can to keep you as comfortable as possible."

Which activities should the home health nurse suggest to an elderly patient to avoid constipation? (Select all that apply.)

Increasing physical activity Drinking at least 1000 mL fluid Increasing fiber intake

A nurse is preparing to perform an abdominal examiniation. The initital step would be which of the following?

Inspection

What is the most lethal complication of a peptic ulcer?

Perforation

An older adult client who is accustomed to taking enemas periodically to avoid constipation is admitted to a long-term care facility. In addition to medications, the health care provider prescribes bed rest and a regular diet. Which action should be implemented to help prevent the client from developing constipation?

offer a large glass of prune juice with warm water each morning

The nurse takes into consideration that a proton pump inhibitor drug, such as ______________, will completely eradicate gastric acid production.

omeprazole (Prilosec)

You're developing the plan of care for a patient experiencing dumping syndrome after a Billroth II procedure. Which dietary instructions do you include?

omit fluids with meal

A client with diverticulitis has been admitted to the medical unit. The nurse will most likely document which of the following assessment findings in the charting?

pain in the left lower quadrant

A male client who is receiving prolonged steroid therapy complains of always being thirsty and urinating frequently. What is the nurse's best initial action?

perform a finger stick to test the client's blood glucose

Which of the following interventions should be included in the medical management of Crohn's disease to decrease the inflammation

using corticosteroids