GI Final

The nurse is admitting a client to their room at the hospital and observes that the client's skin and sclera are jaundice. What does the nurse expect the client's total bilirubin levels to be?

3.0 mg/dL

After assessing a client with peritonitis, the nurse likely would document the client's bowel sounds as?

Absent

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

The nurse is caring for a client with cirrhosis of the liver. What symptoms exhibited by the client would indicate to the nurse that he is experiencing central nervous system effects of the disease? Select all that apply.

Asterixis positive babinski fetor hepaticus

A client is being discharged from the outpatient care center after having an inguinal hernia reduced nonsurgically. What can the nurse instruct the client to do to decrease the incidence of recurrence? Select all that apply.

Avoid heavy lifting avoid constipation how to wear a truss

A client is being evaluated for an esophageal tumor. Which nursing assessment finding presents the greatest concern?

Back pain

When inspecting the abdomen of a client with cirrhosis, the nurse observes that the veins over the abdomen are dilated. The nurse documents this finding as which of the following?

Caput medusae

A client informs the nurse that he has been having abdominal pain that is relieved when having a bowel movement. The client states that the physician told him he has irritable bowel syndrome. What does the nurse recognize as characteristic of this disorder?

Chronic constipation with sporadic bouts of diarrhea

Which of the following interventions would be appropriate for a client who has undergone surgery for a liver disorder and has started shivering?

Cover the client with a light blanket

The nurse is preparing a client for a test that involves inserting a thick barium paste into the rectum with radiographs taken as the client expels the barium. What test will the nurse prepare the client for?

Defecography

A client is seeing the physician for a suspected tumor of the liver. What laboratory study results would indicate that the client may have a primary malignant liver tumor?

Elevated alpha-fetoprotein

The nurse is preparing to irrigate a client's single-barrel colostomy after surgery. The nurse would expect an order from the healthcare provider to irrigate the colostomy on what day after surgery?

Fourth or fifth postoperative day

A client has a gastrointestinal tube that enters the stomach through a surgically created opening in the abdominal wall. The nurse documents this as which of the following?

Gastrostomy tube

A client with esophageal cancer has difficulty in swallowing. Which of the following would be appropriate to help the client achieve improved nutrition?

Give high-protein, semi liquid foods

The nurse would instruct a client who has an appendectomy to avoid which of the following?

Heavy lifting

A nurse is preparing a presentation for a local community group about hepatitis. Which of the following would the nurse include?

Hepatitis C increases a persons risk for liver cancer

A client has developed drug-induced hepatitis from a drug reaction to antidepressants. What treatment does the nurse anticipate the client will receive to treat the reaction?

High-dose corticosteroids

An elderly client presents with a complaint of 10-lb weight loss over the past month. Which assessment finding is most important in determining the care of this client?

History of COPD

Which of the following symptoms would indicate that a client with chronic pancreatitis has developed secondary diabetes?

Increased appetite and thirst

The nurse is administering medications to a client that has elevated ammonia due to cirrhosis of the liver. What medication will the nurse give to detoxify ammonium and to act as an osmotic agent?

Lactulose

The client is having a total colectomy with an ileostomy created. What does the nurse explain to the client that the stool consistency will be?

Liquid or mushy

After teaching a group of students about irritable bowel syndrome and antidiarrheal agents, the instructor determines that the teaching was effective when the students identify which of the following as an example of an opiate-related antidiarrheal agent?

Loperamide

Which nursing action provides the most reliable means to assess placement of a client's nasogastric tube, prior to each medication administration?

Measure the PH of aspirates

When performing a physical examination on a client with cirrhosis, a nurse notices that the client's abdomen is enlarged. Which of the following interventions should the nurse consider?

Measure the abdominal girth according to a set routine

A client is preparing to have colorectal surgery and will have a colostomy created temporarily in hopes that he may be able to have it reversed in 6 months. The client is very concerned about the care of the colostomy. What preoperative interaction would the client benefit from?

Meeting with an enterostomal therapist

A client comes to the clinic complaining of not having a bowel movement in several days, abdominal cramping, and nausea. When the nurse puts the client on the stretcher, he vomits a large amount of fecal material. What should the first action by the nurse be?

Notify the physician

A client has a blockage of the passage of bile from a stone in the common bile duct. What type of jaundice does the nurse suspect this client has?

Obstructive jaundice

The nurse is caring for a client with intussusception of the bowel. What does the nurse understand that occurs with this disorder?

One part of the intestine telescopes into another portion of the intestine

A client with a diagnosis of acute appendicitis is awaiting surgical intervention. The nurse listens to bowel sounds and hears none and observes that the abdomen is rigid and boardlike. What complication does the nurse determine may be occurring at this time?

Peritonitis

A client with nausea and vomiting is to receive an antiemetic that inhibits the vomiting center in the brain. Which of the following would the nurse expect the physician to order most likely?

Prochlorperazine

The nurse is following an order to collect a stool specimen from a client who is having diarrhea for ova and parasites. What does the nurse understand may be required when obtaining this specimen?

The nurse may have to obtain several samples

A client with hepatitis who has not responded to medical treatment is scheduled for a liver transplant. Which of the following most likely would be ordered?

Tracolimus

A male client, age 32 years, was recently married, and he and his wife would like to have children. The client is scheduled to have a total colectomy and is concerned with being able to have children. What is the best answer given by the nurse related to the client's concern?

You may want to consider collection and storage of sperm for later use if you are planning to have children

A client has developed an anorectal abscess. Which client is at most risk for the development of this type of abscess?

a client with crohn disease

Which of the following instructions should the nurse include in the teaching plan of a client who has undergone colostomy?

chew food well

A client with severe acute pancreatitis has a glucose level of 750 mg/dL. What does the nurse understand is the cause of this level of hyperglycemia?

imbalance of glucagon, insulin, and somatostatin

A client, who is recovering from bariatric surgery, is returning from the postanesthesia care unit. Which nursing assessment is of greatest concern in the immediate postoperative period for this client?

impaired gas exchange

A client is complaining of problems with constipation. What dietary suggestion can the nurse inform the client may help facilitate the passage of stool?

increase dietary fiber

A client will be having a total colectomy in 4 days. The client does not have an obstruction. What does the nurse anticipate instructing the client about doing prior to the surgery to prepare the bowel?

instructing the client about dietary restrictions and lavage agents

A client is to have a total colectomy and has been on prednisone 3 months ago for the treatment of Crohn's disease. What medication does the nurse anticipate administering in the preoperative phase to prevent adrenal crisis?

intravenous hydrocortisone

A male client will be having an ileoanal anastomosis for the treatment of chronic ulcerative colitis. What is the benefit to this client of having this procedure rather than a total colectomy? Select all that apply.

maintains bowel continence unlikely to experience bladder dysfunction unlikely to experience erectile dysfunction unlikely to experience infertility

Which intervention would be most appropriate for a client who has undergone colostomy surgery?

monitoring the volume of gastric secretions

The nurse is evaluating the medication list of a client with acute gastritis. Which medication would create the most concern?

nonsteroidal anti-inflammatory

A client has had surgery to create an ileoanal reservoir surgery. Which instruction would the nurse give to reduce the risk for bowel incontinence?

perform perineal exercises

The nurse fills a tube feeding bag with two 8-oz cans of commercially prepared formula. The client is to receive the formula at 80 mL/hour via continuous gastrostomy feeding tube and pump. How many hours will this bag of formula run before becoming empty?

6hours

A client is suspected of having cirrhosis of the liver. What diagnostic procedure will the nurse prepare the client for in order to obtain a confirmed diagnosis?

A liver biopsy

The nurse is caring for a young woman who is struggling with weight loss issues, without apparent physical cause. Which is the most likely nursing assessment for this nutritional disorder in which normal body weight is not maintained?

Anorexia nervosa

A client with gallstones tells the nurse, "The doctor has to do something. Isn't there something he can give me to dissolve them?" What medication does the nurse know may help dissolve the gallstones?

Chenodiol

A client, who has occasional gastric symptoms, is receiving teaching on how to prevent gastroesophageal reflux disease (GERD). Which statement indicates the client understands the teaching?

Eliminating bothersome food will help

After teaching a client who has had a Roux-en-Y gastric bypass, which client statement indicates the need for additional teaching?

I need to drink 8oz of water before eating

A client with cirrhosis has portal hypertension, which is causing esophageal varices. What is the goal of the interventions that the nurse will provide?

Reduce fluid accumulation and venous pressure

The nurse is reviewing the laboratory test results of a client with Crohn disease. Which of the following would the nurse most likely find?

Stool cultures negative for microorganisms or parasites

A client is recently diagnosed with Crohn disease and is beginning treatment. What first-line treatment does the nurse expect that the client will be placed on to decrease the inflammatory response?

Sulfasalazine

A client realizes that regular use of laxatives has greatly improved his bowel pattern. However, the nurse cautions this client against the prolonged use of laxatives for which reason?

The client's natural bowel function may become sluggish

The nurse is instructing a client with an ileostomy on appliance use and changing it. What statement made by the client demonstrates the client understands of using a new appliance for the first time?

i will patch test it first on non-irritated skin at the inner aspect of my forearm

A client scheduled for a total colectomy has been taking the immunosuppressive agent, azathioprine. When should the client be told to discontinue the medication to prevent negative effects on tissue healing?

1 month before surgery

The nurse is checking the residual content for a client who is receiving intermittent feedings. Which residual content, if obtained, would lead the nurse to delay the feeding?

120- hold if greater than 100

The nurse is preparing discharge instructions for the client with diverticulosis. When instructing the client to increase dietary fiber, what should the nurse inform the client is the amount that should be taken in daily?

25-35 g

the nurse is caring for four clients with diarrhea. Which client is most likely to be diagnosed with Crohn disease?

A 46 year-old african american male

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 is diagnosed with colon cancer, located in the lower third of the rectum. What does the nurse understand will be the surgical treatment option for this client?

Abdominoperineal resection

In addition to teaching a client with constipation to increase dietary fiber intake to 25 g/day, which of the following would the nurse include as important?

Adding fiber-rich foods to the diet gradually

A client who is scheduled for an ileostomy surgery and been taking corticosteroids is instructed to taper the drug, eventually discontinuing it. The nurse would monitor this client for which of the following?

Adrenal insufficency

A client at a long-term care facility informs the nurse that he is having cramping when trying to have a bowel movement, and all that is coming out is liquid. When the nurse reviews the client's last bowel movement history, it is determined that the client has not had a bowel movement in 7 days. What does the nurse understand is most likely occurring with this client?

Encopresis

What test should the nurse prepare the client for that will locate stones that have collected in the common bile duct?

Endoscopic retrograde cholangiopancreatography (ERCP)

The nurse is discussing care of the client's ileostomy and is instructing the client to avoid certain medications that may pass through without being absorbed. What medications should the nurse instruct the client to avoid? Select all that apply.

Enteric coated products slow-release tablets layered tablets

An elderly client seeks medical attention for a vague complaint of difficulty swallowing. Which of the following assessment findings is most significant as related to this symptom?

Esophageal tumor

A client with esophageal varices is scheduled to undergo injection sclerotherapy. Which of the following client's statements indicate that the teaching was successful?

I might need to have this procedure done again

Which of the following interventions would be most appropriate for a client with a hiatal hernia and nursing diagnosis of Acute Pain related to reflux of gastric secretions?

Inform the client to remain upright for at least two hours after meals

The nurse is providing ostomy care to the client with an ileostomy. What can the nurse use to protect the skin and promote adhesion of the ostomy appliance?

Karaya gum

A client who is recovering from anesthesia following oral surgery for lip cancer is experiencing difficulty breathing deeply and coughing up secretions. Which of the following measures will help ease the client's discomfort?

Keeping the head of the bed elevated

In caring for a client immediately following gastric cancer surgery, which nursing assessment finding would require priority attention?

NG tube set to high continuous suction

A client is scheduled to have a laparoscopic cholecystectomy as an outpatient. The client asks the nurse when he will be able to resume normal activities. What information should the nurse provide?

Normal activities may be resumed in 1 week

The nurse is admitting a client to the acute care facility with abdominal pain related to an umbilical hernia. The nurse is palpating the protrusion, and the client states that it suddenly feels better. What type of hernia does the nurse understand this client has?

Reducible

A client with peptic ulcer disease is scheduled for a partial gastrectomy and vagotomy. The nurse understands the surgery will accomplish which of the following physiologic effects?

Remove source of acid secretion

The nurse observes the physician palpating the abdomen of a client that is suspected of having acute appendicitis. When the abdomen is pressed in the left lower quadrant the client complains of pain on the right side. What does the nurse understand this assessment technique is referred to?

Rovsing sign

A client with Crohn disease informs the nurse that he is allergic to aspirin. What medication ordered for the treatment of Crohn disease does the nurse know is contraindicated when a client is allergic to aspirin?

Sulfasalazine

A client with a colostomy is concerned with the odor that is left on the ostomy appliance and believes it may be caused by some of the medication that they take. What suggestion should the nurse provide to the client to determine if her medication is causing this problem?

The client can obtain a list of drugs from an ostomy association or appliance manufactures

The nurse is reviewing laboratory work that is consistent with a client being positive for hepatitis and in the incubation phase of the illness. What should the nurse be concerned with at this stage of the illness?

The client is infectious

A client tells the nurse, "I am not having normal bowel movements." When differentiating between what are normal and abnormal bowel habits, what indicators are the most important?

The consistency of stool and comfort when passing stool

A client with cirrhosis is complaining to the nurse of itching. The client asks the nurse if the itching is because he has been taking warm baths. What is the best response by the nurse?

The itching is caused by the accumulation of bile salts

A client informs the nurse that he is taking a stimulant laxative in order to be able to have a bowel movement daily. What should the nurse inform the client about the taking a stimulant laxative?

They can be habit forming and will require increasing doses to be effective

The nurse would expect to observe which of the following when assessing a client with cholelithiasis?

Urine that appears dark brown

A female client with chronic hepatitis B has been prescribed recombinant interferon alpha-2b in combination with ribavirin. Which of the following instructions should a nurse provide this client?

Use strict birth control methods

A client with a hernia decides to manage the herniation with a truss. The nurse would emphasize which of the following?

Using cornstarch to absorb moisture in the area

A client has undergone a total gastrectomy for refractory ulcers. The nurse would explain the need for lifelong treatment with which of the following?

Vitamin B12 replacement

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

The nurse is caring for a client in the immediate postoperative phase after having a colostomy created. What type of appliance should the nurse use at this time?

a disposable or temporary appliance should be used

The nurse is assisting the physician with a procedure to remove ascitic fluid from a client with cirrhosis. What procedure does the nurse ensure the client understands will be performed?

abdominal paracentesis

What potentially life-threatening complication can the client have if corticosteroids are abruptly withdrawn or the client has significant stress due to the impending surgical procedure?

adernal crisis

The client expresses fears about looking at the stoma for the first time. What can the nurse inform the client will occur when he first views and touches the stoma?

an assigned staff nurse will be there when the stoma is exposed for view

The nurse is talking with a group of clients that are older than age 50 years about the recognition of colon cancer to access early intervention. What should the nurse inform the clients to report immediately to their primary care provider?

change in bowel habits

A client comes to the clinic and informs the nurse that he is there to see the physician for right upper abdominal discomfort, nausea, and frequent belching especially after eating a meal high in fat. What disorder do these symptoms correlate with?

cholelithiasis

A client with cirrhosis is complaining of severe pruritus related to the accumulation of bile salts. What can be prescribed for the client to relieve the itching?

cholestyramine

When assessing a client with cirrhosis of the liver, which of the following stool characteristics is the client likely to report?

clay-colored or whitish

A client who will be having a portion of colon removed and colostomy created informs the nurse that he "will not be attractive any longer." The nurse determines the nursing diagnosis is Disturbed Body Image related to the stoma and altered bowel elimination. What expected outcome related to this diagnosis will the client have?

client verbalizes what the changes will be and the benefits for future health

A client is having the first stage of an ileoanal anastomosis. What should the nurse inform the client they will experience?

continuous discharge of mucus from the anus

The nurse is caring for a client who has had diarrhea for 3 days. What major problems associated with severe or prolonged diarrhea should the nurse monitor for when caring for this client? Select all that apply.

dehydration, electrolyte imbalance, vitamin deficiencies

A client is scheduled to have a total colectomy due to a colon mass and is also taking prednisone for asthma. The physician has instructed the client to taper down on the prednisone and discontinue. What negative outcome does the nurse know may occur if the client does not adhere to the instructions?

delayed or altered tissue healing

A client with an ileostomy tells the nurse that he is having a lot of problems with the formation of gas. What can the nurse tell the client to help her with this common issue?

eat slowly and chew food well with mouth closed

The nurse is holding a teaching workshop on managing the symptoms of hiatal hernia in the elderly. Which of the following lifestyle modifications should be included in the presentation?

eliminating tobacco use

A client who is scheduled for an ileostomy surgery says to the nurse, "I'm afraid I won't be able to look at that stoma." Which response by the nurse would be most therapeutic?

i'll make sure there is a familiar nurse here with you the first time

A client is to undergo surgery for the creation of a continent ileostomy. Which statement by the client indicates successful teaching?

i'll need to learn how to empty the reservoir several times a day

A client had an open cholecystectomy with a T-tube insertion, and the nurse is measuring the bile drainage every 8 hours. When should the nurse notify the physician?

if more than 500 mL of bile drainage is present in 24 hours

A client is admitted to the hospital with acute hemorrhage from esophageal varices. What medication should the nurse anticipate administering that will reduce pressure in the portal venous system and control esophageal bleeding?

octreotide

After teaching a group of students about intestinal obstruction, the instructor determines that the teaching was effective when the students identify which of the following as a cause of a functional obstruction?

opioid analgesia following abdominal surgery

A client with a history of peptic ulcer disease is admitted for hematemesis associated with gastric bleeding. Which is the most appropriate action of the nurse?

prepare for nasogastric irrigations

When the nurse is teaching the client about attachment of the faceplate around the stoma, what measure will ensure secure attachment of the pouch to the peristomal skin?

press the adhesive faceplate around the stoma for about 30 seconds

A nurse is preparing to administer the prescribed vitamin B12 to a client who has had most of his ileum removed. The nurse understands that this is necessary for which reason?

prevents deficiencies

When interviewing a client with internal hemorrhoids, which of the following would the nurse expect the client to report?

rectal bleeding

The nurse is assessing a client for fecal impaction, and when inserting a lubricated, gloved finger, the stool feels like small rocks. What does the nurse document this finding as?

scybala

The nurse is assessing the stool consistency of a client with an ascending colostomy. Which of the following would the nurse expect to find?

semiliquid

The nurse is asking the client with acute pancreatitis to describe the pain. What pain symptoms does the client describe related to acute pancreatitis?

severe mid-abdominal to upper abdominal pain radiating to both sides and to the back

A client is preparing for discharge to home, following a partial gastrectomy and vagotomy. Which is the best rationale for the client being taught to lie down for 30 minutes after each meal?

slows gastric emptying

The nurse is administering furosemide to promote urinary excretion of excess fluids for a client with cirrhosis. When administering furosemide to this client, what should the nurse closely monitor?

sodium level

A client with an ileostomy who has been discharged from the hospital calls the clinic and asks the nurse if he should take another one of his "potassium pills" because there is a waxy coating on the ileostomy from the pill. What is the best response by the nurse?

some medications like this leave a "ghost'' of the wax matrix coating, but it doesn't mean the drug wasn't absorbed

A client has been discharged from the acute care facility with an ileostomy. The client comes to the clinic for a follow-up visit and informs the nurse that the wound has been draining and they are having abdominal pain and running a fever. What does the nurse suspect is occurring with the client?

the client has developed a wound infection

A client is having a procedure that will remove the entire colon and rectum and will bring the end of the ileum through a separate area on the right lower quadrant of the abdomen. What type of procedure does the nurse understand this client will be having?

total colectomy

The nurse is preparing a client for surgery and observes on the operative permit that the client will be having a double-barrel colostomy. What portion of the large intestine is the nurse aware that this is performed?

transverse

A client is prescribed a magnesium and aluminum hydroxide antacid to treat gastroesophageal reflux disease (GERD). The nurse cautions this client to do which of the following?

watch for possible antacid-related diarrhea

Which of the following assessment findings would be most important for indicating dumping syndrome in a postgastrectomy client?

weakness, diaphoresis, diarrhea 90 mins after eating

A client who had a total colectomy with an ileostomy has rectal packing in place to absorb drainage and promote healing. When does the nurse know that the rectal packing will be removed?

within 1 week