GI
A client with inflammatory bowel disease undergoes an ileostomy. On the first day after surgery, the nurse notes that the client's stoma appears dusky. How should the nurse interpret this finding?
blood supply to the stoma has been interupted
A nurse is assessing a client who underwent esophagogastroduodenoscopy (EGD) for postoperative complications. Which sign or symptom is a complication of this procedure?
bloody secretions
Which type of deficiency results in macrocytic anemia?
folic acid
A nurse is preparing a presentation for a local community group about hepatitis. Which of the following would the nurse include?
hepatitis c increases risk for liver cancer
Which of the following is a parasympathetic response in the GI tract?
increased peristalsis
A client is recovering from an ileostomy that was performed to treat inflammatory bowel disease. During discharge teaching, the nurse should stress the importance of:
increasing fluid intake to prevent dehydration
If a client has abdominal surgery and a portion of the small intestine is removed, the client is at risk for which of the following?
malabsorption syndrome
Vomiting results in which of the following acid-base imbalances?
metabolic alkalosis
Which of the following is considered a bulk-forming laxative?
metamucil
Which of the following would be most important to ensure that a client does not retain any barium after a barium swallow?
monitoring the stool passage and its color
Which of the following is the major cause of morbidity and mortality in patients with acute pancreatitis?
pancreatic necrosis
A client is admitted with a diagnosis of acute appendicitis. When assessing the abdomen, the nurse would expect to find rebound tenderness at which location?
right lower quadrant
Which of the following would be most appropriate for a client who is experiencing biliary colic?
ensure that the client rests
A patient underwent a continent ileostomy 2 months ago. Within which timeframe should the patient's reservoir be emptied?
every 2 to 4 hours
An elderly patient diagnosed with diarrhea is taking digoxin (Lanoxin). Which of the following electrolyte imbalances should the nurse be alert to?
hypokalemia
The nurse is preparing to examine the abdomen of a client complaining of a change in his bowel pattern. The nurse would place the client in which position?
supine with knees flexed
A client ingests a carbohydrate solution as part of hydrogen breath testing. The nurse would need to monitor this client for which of the following?
cramping and abdominal distension
A client is scheduled for magnetic resonance imaging (MRI). During the client teaching, the nurse will discuss which of the following?
do you experience claustrophobia?
Cystic fibrosis, a genetic disorder characterized by pulmonary and pancreatic dysfunction, usually appears in young children but can also affect adults. If the pancreas was functioning correctly, where would the bile and pancreatic enzymes enter the GI system?
duodenum
A client is admitted to the healthcare facility suspected of having acute pancreatitis and undergoes laboratory testing. Which of the following would the nurse expect to find?
elevated urine amylase
Digestive enzymes contribute to the breakdown of foods for the body's use. Stomach contractions mix the food and gastric secretions and, eventually, the chyme moves to the small intestine. Which nutrient actually delays feeling hungry?
fats
Gastrin has which of the following effects on gastrointestinal (GI) motility?
increased motility of the stomach
When bowel sounds are heard about every 15 seconds, the nurse would record that the bowel sounds are
normal
The nurse should assess for an important early indicator of acute pancreatitis, which is a prolonged and elevated level of:
serum lipase
Suspected ulceration of the stomach necessitates an esophagogastroduodenoscopy. The nurse will implement which of the following for this procedure? Select all that apply.
• Administer the ordered sedative before the procedure. • Assess for the client's gag reflex after the procedure. • Monitor the client's pulse oximetry during and after the procedure.
An 87-year-old client in the intensive care unit was admitted with esophageal varices. Which of the following could cause the varices to hemorrhage? Select all that apply.
• Little protective tissue to protect fragile veins • Rough food • Chemical irritation
When preparing a client for surgery to treat appendicitis, the nurse formulates a nursing diagnosis of Risk for infection related to inflammation, perforation, and surgery. What is the rationale for choosing this nursing diagnosis?
Obstruction of the appendix reduces arterial flow, leading to ischemia, inflammation, and rupture of the appendix.
Which diagnostic produces images of the body by detecting the radiation emitted from radioactive substances?
PET scan
A patient scheduled to undergo an abdominal ultrasonography is advised to do which of the following?
Restrict eating of solid food for 6 to 8 hours before the test.
A client with appendicitis is experiencing excruciating abdominal pain. An abdominal X-ray film reveals intraperitoneal air. The nurse should prepare the client for:
surgery
A client is scheduled for several diagnostic tests to evaluate her gastrointestinal function. After teaching the client about these tests, the nurse determines that the client has understood the teaching when she identifies which test as not requiring the use of a contrast medium?
colonoscopy
A nurse is interviewing a client about his past medical history. Which preexisting condition may lead the nurse to suspect that a client has colorectal cancer?
polyps
A client is scheduled for bowel resection with anastomosis involving the large intestine. Because of the surgical site, the nurse formulates the nursing diagnosis of Risk for infection. To complete the nursing diagnosis statement, the nurse should add which "related-to" phrase
related to bacteria at the surgical incision site
The nurse is providing care to a client who has had a percutaneous liver biopsy. The nurse would monitor the client for which of the following?
signs and symptoms of bleeding
Which of the following medications would the nurse expect the physician to order for a client with cirrhosis who develops portal hypertension?
spironolactone
Which of the following is an age-related change of the gastrointestinal system?
weakened gag reflex
Hyperactive bowel sounds are associated with which of the following?
gastroenteritis
A patient has an elevated serum ammonia level and is exhibiting mental status changes. The nurse should suspect which of the following conditions?
hepatic encephalopathy
A nurse is helping to plan a teaching session for a client who will be discharged with a colostomy. Which statement describes a healthy stoma?
"At first, the stoma may bleed slightly when touched."
A client with Crohn's disease is to receive prednisone as part of the treatment plan. Which of the following instructions would be appropriate?
"Avoid contact with other people who might have an infection."
The nurse is caring for a man who has experienced a spinal cord injury. Throughout his recovery, the client expects to gain control of his bowels. The nurse's best response to this client would be which of the following?
"Having a bowel movement is a spinal reflex requiring intact nerve fibers. Yours are not intact."
A nurse is teaching a client what to expect following a barium enema. Which client statement indicates a need for further teaching?
"I should limit my fiber intake for 1 to 2 weeks following the procedure."
Pharmacologic therapy frequently is used to dissolve small gallstones. It takes about how many months of medication with UDCA or CDCA for stones to dissolve?
6 to 12 months
Ursodeoxycholic acid (UDCA) has been used to dissolve small, radiolucent gallstones. Which duration of therapy is required to dissolve the stones?
7 months
A nurse is assisting with a percutaneous liver biopsy. Place the steps involved in care in the correct sequence from first to last.
Ensure that the biopsy equipment is assembled and in order. Help the client assume a supine position. Place a rolled towel beneath the client's right lower ribs. While the physician inserts the needle, instruct the client to take a deep breath and hold it to keep the liver as near to the abdominal wall as possible. Make sure that the specimen container is labeled and delivered to the laboratory.
Which of the following should be included as part of the preprocedure teaching for a patient scheduled for a proctosigmoidoscopy involving the lower GI structures?
Follow the dietary and fluid restrictions and bowel preparation procedures
Which of the following is a function of the stomach? Select all that apply.
Food storage • Secretion of digestive fluids • Propels partially digested food into small intestine
A nurse is applying an ostomy appliance to the ileostomy of a client with ulcerative colitis. Which action is appropriate?
Gently washing the area surrounding the stoma using a facecloth and mild soap
Effie Geitgey, a 93-year-old retired waitress, obsesses about the regularity of her bowel movements (a common obsession among the residents of the long-term care facility where you practice nursing). In your frequent (seems like daily) client education sessions, you reinforce the medically acceptable definition of "regularity". What is the actual measurement of "regular"?
Stool consistency and client comfort are the proper measurements
An elderly client asks the nurse how to treat chronic constipation. What is the best recommendation the nurse can make?
Take a stool softener such as docusate sodium (Colace) daily.
Which of the following is a true statement regarding regional enteritis (Crohn's disease)?
The clusters of ulcers take on a cobblestone appearance.
A nurse is preparing a presentation for a local community group of older adults about colon cancer. Which of the following would the nurse include as the primary characteristic associated with this disorder?
a change in bowel habits
A client with a history of alcohol abuse comes to the emergency department and complains of abdominal pain. Laboratory studies help confirm a diagnosis of acute pancreatitis. The client's vital signs are stable, but the client's pain is worsening and radiating to his back. Which intervention takes priority for this client?
administer morphine IV
A client is diagnosed with megaloblastic anemia caused by vitamin B12 deficiency. The physician begins the client on cyanocobalamin (Betalin-12), 100 mcg I.M. daily. Which substance influences vitamin B12 absorption?
intrinsic factor
Which of the following terms describes a gastric secretion that combines with vitamin B12 so that it can be absorbed?
intrinsic factor
Which of the following is commonly associated with acute episodes of pancreatitis?
long-term use of alcohol
Diet modifications for patient diagnosed with irritable bowel syndrome include which of the following?
low residue
Swallowing is regulated by which area of the central nervous system (CNS)?
medulla oblongata
After teaching a group of students about the various organs of the upper gastrointestinal tract and possible disorders, the instructor determines that the teaching was successful when the students identify which of the following structures as possibly being affected?
stomach
A client with acute liver failure exhibits confusion, a declining level of consciousness, and slowed respirations. The nurse finds him very difficult to arouse. The diagnostic information which best explains the client's behavior is:
subnormal serum glucose and elevated serum ammonia levels.
A client is admitted with increased ascites related to cirrhosis. Which nursing diagnosis should receive top priority?
ineffective breathing pattern
A group of students are studying for an examination on the gastrointestinal (GI) system and are reviewing the structures of the esophagus and stomach. The students demonstrate understanding of the material when they identify which of the following as the opening between the stomach and duodenum?
pyloric sphincter
A client diagnosed with acute pancreatitis is being transferred to another facility. The nurse caring for the client completes the transfer summary, which includes information about the client's drinking history and other assessment findings. Which assessment findings confirm his diagnosis?
recent weight loss and temp elevation
Which of the following is the most common symptom of a polyp?
rectal bleeding
Following ingestion of carrots or beets, the nurse would expect which alteration in stool color?
red
A home care nurse is caring for a client with complaints of epigastric discomfort who is scheduled for a barium swallow. Which statement by the client indicates an understanding of the test?
"I'll avoid eating or drinking anything 6 to 8 hours before the test."
Which of the following conditions is most likely to involve a nursing diagnosis of fluid volume deficit?
pancreatitis
Which diagnostic study is used to detect abnormalities that occur with hepatic coma?
EEG
A physician plans to send a client home with supplies to complete a hemoccult test on all stools for 3 days. During the client education, the nurse informs the client to avoid which of the following medications while collecting stool for the test?
Ibuprofen (Advil)
The nurse assesses a client who is reporting mild abdominal cramping. How will the nurse proceed with assessment of this client?
Inspection, auscultation, percussion, palpation
A nurse is providing postprocedure instructions for a client who had an esophagogastroduodenoscopy. The nurse should perform which action?
Review the instructions with the person accompanying the client home.
Which of the following digestive enzymes aids in the digesting of starch?
amylase
Which client requires immediate nursing intervention? The client who:
presents with a rigid, board-like abdomen
Which of the following should the nurse complete prior to assessing the abdomen of a 35-year-old man?
ask the client to empty his bladder
The nurse is to obtain a stool specimen from a client who reported that he is taking iron supplements. The nurse would expect the stool to be which color?
black
A nursing instructor tells the class that review of oral hygiene is an important component during assessment of the gastrointestinal system. One of the students questions this statement. Which of the following explanations from the nurse educator is most appropriate?
"Injury to oral mucosa or tooth decay can lead to difficulty in chewing food."
The nurse asks a client to point to where she feels pain. The client asks why this is important. The nurse's best response would be which of the following?
"Often the area of pain is referred from another area."
A client who had a colonoscopy with removal of a polyp is being prepared for discharge. Which of the following would the nurse include in the discharge instructions?
"You might feel some cramping and gas but these usually go away in about a day."
A client with anorexia complains of constipation. Which of the following nursing measures would be most effective in helping the client reduce constipation?
assist client to increase dietary fiber
Which patient teaching component is important for the nurse to communicate regarding pain management prior to or during diagnostic testing for a disorder of the GI system?
The patient should inform the test personnel if he or she experiences pressure or cramping during the instillation of test fluids.
A client is to have an upper GI procedure with barium ingestion and abdominal ultrasonography. While scheduling these diagnostic tests, the nurse must consider which factor?
The ultrasonography should be scheduled before the GI procedure.
A client with liver and renal failure has severe ascites. On initial shift rounds, his primary nurse finds his indwelling urinary catheter collection bag too full to store more urine. The nurse empties more than 2,000 ml from the collection bag. One hour later, she finds the collection bag full again. The nurse notifies the physician, who suspects that a bladder rupture is allowing the drainage of peritoneal fluid. The physician orders a urinalysis to be obtained immediately. The presence of which substance is considered abnormal?
albumin
A client has just been diagnosed with hepatitis A. On assessment, the nurse expects to note:
anorexia, nausea vomitting
Which of the following would a nurse expect to assess in a client with peritonitis?
board-like abdomen
A nurse is caring for a client with cirrhosis. The nurse assesses the client at noon and discovers that the client is difficult to arouse and has an elevated serum ammonia level. The nurse should suspect which situation?
the client's hepatic function is decreasing
When describing the role of the pancreas to a client with a pancreatic dysfunction, the nurse would identify which substance as being acted on by pancreatic lipase?
triglycerides
The nurse is assessing a patient for constipation. Which of the following is the first review that the nurse should conduct in order to identify the cause of constipation?
usual pattern of elimination
The nurse knows that the client with cholelithiasis can have a nutritional deficiency. The obstruction of bile flow due to cholelitiasis can interfere with the absorption of
vitamin a
A client with carcinoma of the head of the pancreas is scheduled for surgery. Which of the following should a nurse administer to the client before surgery?
vitamin k
A client undergoing a diagnostic examination for gastrointestinal disorder was given polyethylene glycol/electrolyte solution as a part of the test preparation. Which of the following measures should the nurse take once the solution is administered?
Permit the client to drink only clear liquids.
A nurse is performing focused assessment on her clients. She expects to hear hypoactive bowel sounds in a client with:
paralytic ileus
A client presents with complaints of blood in her stools. Upon inspection, the nurse notes streaks of bright red blood visible on the outer surface of formed stool. Which of the following will the nurse further investigate with this client?
presence or history of hemorrhoids
Which of the following would indicate to the nurse that a client who has received three cleansing enemas in preparation for a barium enema is experiencing dehydration?
signs of dehydration and confusion
Barbara Allen, a 69-year-old retired cab driver, is undergoing diagnostics in the hospital where you practice nursing. She has been experiencing lower GI difficulties and has reached the point where she needs direction. With all the trouble she's been having with her lower bowel, what function being affected most by her disorder?
water and electrolyte absorption
A client with cholelithiasis has a gallstone lodged in the common bile duct. When assessing this client, the nurse expects to note:
yellow sclerae
A client presented with gastrointestinal bleeding 2 days ago and continues to have problems. The physician has ordered a visualization of the small intestine via a capsule endoscopy. Which of the following will the nurse include in the client education about this procedure?
you will need to swallow a capsule
One or two bowel sounds in 2 minutes would be documented as which of the following?
Hypoactive
