Gastrointestinal Assignment

As part of a newly admitted patient's admission assessment, the nurse is questioning the patient about risk factors for liver disease. Which of the following questions most directly addresses these risk factors?

A. "What do you do for a living?" B. "How much alcohol do you typically drink?" C. "Do you have any chronic illnesses that your care team is not aware of?" D. "Do you know if your immunizations are up to date?" CORRECT ANSWER: B. "How much alcohol do you typically drink?"

The nurse is conducting a patient teaching with a patient who has just been prescribed lansoprazole (Prevacid). What statement would indicate that the patient correctly understands the action of this medication?

A. "The medication inhibits acid secretions." B. "The medication is an analgesic." C. "The medication will repair my ulcer." D. "The medication is an antibiotic." CORRECT ANSWER: A. "The medication inhibits acid secretions."

After relocating to new community, a 60-year-old man has presented for care to a nurse practitioner. During the nurse's initial health assessment, the man states that he has had a diagnosis of gastroesophageal reflux disease (GERD) for several years. The nurse should anticipate that a medication reconciliation is likely to reveal that the man has been prescribed:

A. A bisphosphonate B. A proton pump inhibitor (PPI) C. A calcium channel blocker D. A nitrate CORRECT ANSWER: B. A proton pump inhibitor (PPI)

The nurse is caring for a patient who is postoperative day 3 following bowel resection and the creation of a colostomy. While changing the dressing, the nurse notes the stoma is dusky in color. How should the nurse interpret this assessment finding?

A. Circulation to the stoma is compromised. B. The stoma is blocked. C. The patient's oxygen saturation may be low. D. This is a normal color postoperatively. CORRECT ANSWER: A. Circulation to the stoma is compromised.

A patient with a new ileostomy is preparing to go home. What should the patient be taught about changing his ileostomy?

A. Cleanse the area surrounding the stoma with alcohol. B. Apply moisturizing lotion after cleaning the stoma. C. Apply a skin barrier to the peristomal skin prior to applying the pouch. D. Dispose of the clamp with each bag change. CORRECT ANSWER: C. Apply a skin barrier to the peristomal skin prior to applying the pouch.

A nurse is caring for a patient who has had bariatric surgery and is developing a teaching plan for the patient. Which information is essential for the nurse to include in this teaching?

A. Eat six small meals daily spaced at equal intervals. B. Limit calories to no more than 3,000 daily. C. Choose foods high in simple carbohydrates. D. Drink a minimum of 90 mL (3 oz) of fluid with each meal. CORRECT ANSWER: A. Eat six small meals daily spaced at equal intervals.

A patient diagnosed with esophageal reflux disorder has been admitted to the floor. When planning teaching for this patient what should the nurse advise the patient to do?

A. Keep the head of the bed lowered. B. Drink a carbonated drink after meals. C. Avoid carbonated drinks. D. Drink a cup of hot tea before bedtime. CORRECT ANSWER: C. Avoid carbonated drinks.

The nurse is preparing to perform an abdominal assessment of a newly admitted patient. When performing an abdominal assessment, what examination sequence should the nurse follow?

A. Inspection, percussion, palpation, and auscultation B. Inspection, auscultation, percussion, and palpation C. Inspection, palpation, percussion, and auscultation D. Inspection, auscultation, palpation, and percussion CORRECT ANSWER: D. Inspection, auscultation, palpation, and percussion

A 75-year-old male patient presents at the emergency department with symptoms of a small bowel obstruction. An emergency room nurse is obtaining assessment data from this patient. What assessment finding is characteristic of a small bowel obstruction?

A. Mucus in the stool B. Nausea and vomiting C. Decrease in urine production D. Mucosal edema CORRECT ANSWER: B. Nausea and vomiting

The nurse is checking placement of a nasogastric (NG) tube that has been in place for 2 days. The tube is draining green aspirate. What does this color of aspirate indicate?

A. The tube is the intestine. B. The tube is in the esophagus. C. The tube is in the pleural space. D. The tube is in the stomach. CORRECT ANSWER: D. The tube is in the stomach.

Endoscopy of a 60-year-old woman has revealed the presence of an esophageal peptic ulcer. The nurse who is providing this woman's care is assessing for risk factors that may have contributed to the development of this disease. What question most directly addresses these risk factors?

A. "Do you consider yourself to have a healthy diet?" B. "Have you ever been diagnosed with reflux?" C. "Do you ever find it difficult to swallow certain foods?" D. "Have you been prone to infections over the past few years?" CORRECT ANSWER: B. "Have you ever been diagnosed with reflux?"

Serologic testing of a middle-aged woman with a recent history of severe flu-like symptoms has just resulted in a diagnosis of hepatitis A. Which of the following assessment questions should the nurse prioritize when discussing this diagnosis with the patient?

A. "Have you ever used recreational drugs?" B. "Are you currently in a monogamous sexual relationship?" C. "Which restaurants have you eaten in over the past few weeks?" D. "How would describe your typical diet? CORRECT ANSWER: C. "Which restaurants have you eaten in over the past few weeks?"

The nurse is providing care for a patient whose cancer has metastasized to her small intestine. What does the small intestine do? Select all that apply.

A. Absorption B. Secretion C. Movement of nutrients into the blood stream. D. Reabsorption of water to maintain blood pressure E. Creation of human waste products CORRECT ANSWERS: A. Absorption B. Secretion C. Movement of nutrients into the blood stream.

A 37-year-old male patient presents at the emergency department complaining of nausea and vomiting and severe abdominal pain. While the nurse is assessing the patient, the patient's wife informs the nurse that the patient ingested 24 ounces of vodka last evening. The patient's abdomen is rigid, and there is bruising to the patient's flank. What is the patient exhibiting signs of?

A. Acute appendicitis B. Acute cholecystitis C. Obstruction of the bowel D. Pancreatitis with possible peritonitis CORRECT ANSWER: D. Pancreatitis with possible peritonitis

The nurse is caring for a patient who has a gallstone blocking his bile duct. When the nurse assesses the patient's laboratory studies, what would be an expected finding?

A. Decreased cholesterol level B. Increased bilirubin level in the blood C. Increased blood urea nitrogen (BUN) level D. Decreased serum alkaline phosphatase level CORRECT ANSWER: B. Increased bilirubin level in the blood

The nurse is caring for a 77-year-old patient diagnosed with Crohn's disease. What would be especially important to monitor this patient for?

A. Dehydration B. Pain C. Fatigue D. Fluid overload CORRECT ANSWER: a. Dehydration

A patient comes to the clinic complaining of pain in the epigastric region. The nurse suspects that the patient's pain is related to a peptic ulcer when the patient states the pain is relieved by what?

A. Eating B. Suppressing emesis C. Having a bowel movement D. Drinking milk CORRECT ANSWER: A. eating

A patient presents to the walk-in clinic complaining of vomiting and burning in his mid-epigastria. The nurse knows that to confirm peptic ulcer disease, the health care provider is likely to order a diagnostic test to detect the presence of what?

A. Gastric irritation caused by nonsteroidal anti-inflammatory drugs (NSAIDs) B. Inadequate production of pancreatic enzymes C. Excessive stomach acid secretion D. Infection with Helicobacter pylori CORRECT ANSWER: D. Infection with Helicobacter pylori

The nurse is aware that many of the diseases of the lower gastrointestinal tract can be identified by the characteristics of the patient's stool. What would voluminous, greasy stools suggest?

A. Intestinal malabsorption B. Small bowel obstruction C. Inflammatory colitis D. Colon cancer CORRECT ANSWER: A. Intestinal malabsorption

The critical care nurse is caring for a patient with cirrhosis. What is a priority nursing function when caring for a patient with cirrhosis?

A. Monitoring the patient's oral intake B. Monitoring the patient for signs of hypervolemia C. Monitoring the patient's social support network D. Monitoring the patient's mental status CORRECT ANSWER: D. Monitoring the patient's mental status

A 16-year-old girl presents at the emergency department complaining of right lower quadrant pain and is diagnosed with appendicitis. When assessing this patient, what signs or symptoms should the nurse expect to find?

A. Rigid abdomen, Levine's sign, pain relief leaning forward B. Right lower quadrant pain, Chvostek's sign, muscle guarding C. Rebound tenderness, McBurney's sign, low-grade fever D. Periumbilical pain, Trousseau's sign, pain relief with pressure CORRECT ANSWER: C. Rebound tenderness, McBurney's sign, low-grade fever

A 50-year-old woman has a long history of hospital admissions related to alcohol abuse and consequent liver failure. During this present admission, the patient has been diagnosed with hepatic encephalopathy and prescribed lactulose (Cephulac). During morning report, the nurse learns that the previous nurse withheld the patient's latest dose of lactulose because the patient had two loose bowel movements during the shift. How should the nurse interpret the previous nurse's action?

A.The previous nurse acted correctly because loose bowel movements present a threat to the patient's fluid and electrolyte balance. B.The previous nurse should have administered the lactulose because it is necessary to remove excess ammonia. C.The previous nurse should have obtained an order for a stool softener to replace the scheduled lactulose. D.The previous nurse should have administered a partial dose of the lactulose in spite of the patient's bowel movements. CORRECT ANSWER: B.The previous nurse should have administered the lactulose because it is necessary to remove excess ammonia.

The nursing educator is teaching a group of nurses about constipation and the elderly. What recommendation for this population should a nurse can make about treating chronic constipation?

A. Administer a tap water enema weekly. B. Take a mild laxative, such as magnesium citrate, when necessary. C. Take a stool softener, such as docusate sodium (Colace), daily. D. Administer a phospho-soda (Fleet) enema when necessary. CORRECT ANSWER: C. Take a stool softener, such as docusate sodium (Colace), daily.

A patient asks the home health nurse from what the distressing symptoms of dumping syndrome result. What physiological occurrence should the nurse explain?

A. Chronic malabsorption of iron and vitamins A and C B. Osmotic transport of extracellular fluid into the gastrointestinal tract C. Reflux of bile into the distal esophagus D. Irritation of the phrenic nerve due to diaphragmatic pressure CORRECT ANSWER: B. Osmotic transport of extracellular fluid into the gastrointestinal tract

A 59-year-old woman with a recent history of heartburn, regurgitation, and occasional dysphagia has been diagnosed with a sliding hiatal hernia following an upper GI series. The nurse is providing patient education about the management of this health problem. What should the nurse suggest as a management strategy to this patient?

A. Remaining upright for at least 1 hour following each meal B. Minimizing her intake of highly spiced foods and dairy products C. Drinking one to two glasses of water before and after each meal D. Abstaining from alcohol CORRECT ANSWER: A. Remaining upright for at least 1 hour following each meal

The nurse is caring for a patient admitted with symptoms of an anorectal infection. Cultures obtained from a rectal swab indicate that the patient has a viral infection. What medication will the nurse anticipate the health care provider to order for this anorectal infection?

A. Acyclovir (Zovirax) B. Metronidazole (Flagyl) C. Penicillin (Penicillin G) D. Doxycycline (Vibramycin) CORRECT ANSWER: A. Acyclovir (Zovirax)

A patient with portal hypertension has been admitted to the medical floor. What will the nurse assess for related to portal hypertension?

A. Bowel obstruction B. Ascites C. Vitamin A deficiency D. Hepatic encephalopathy CORRECT ANSWER: B. Ascites

A 33-year-old male patient with a history of IV heroin and cocaine use has been admitted to the medical unit for the treatment of endocarditis. The nurse should recognize that this patient is also likely to test positive for which of the following hepatitis viruses?

A. Hepatitis D B. Hepatitis A C. Hepatitis C D. Hepatitis B CORRECT ANSWER: C. Hepatitis C

A 49-year-old man with a history of heavy alcohol use and liver cirrhosis has been admitted to the hospital's medical unit due to an exacerbation of his health problems that has resulted in massive ascites. The nurse should be prepared to implement which of the following interventions in an effort to resolve the patient's ascites?

A. Low-protein diet and administration of IV albumin B. High Fowler's positioning and fluid restriction C. Peritoneal massage and administration of hypertonic IV solutions D. Low-sodium diet and administration of diuretics CORRECT ANSWER: D. Low-sodium diet and administration of diuretics

The nurse is preparing to place a nasogastric (NG) tube in one of his patients. What is the process for determining the length of an NG tube to be placed in the stomach?

A. Place distal tip to nose, then ear tip and end of xiphoid process. B. Insert the tube into nose until tube fills with secretions. C. Obtain an order from the health care provider for the number of inches to insert the tube. D. Instruct the patient to lie prone and measure tip of nose to umbilical area. CORRECT ANSWER: A. Place distal tip to nose, then ear tip and end of xiphoid process.