GI FINAL C

9. Which client would the nurse monitor for stomatitis?

- A client undergoing a bone marrow transplant

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

- Back pain

6. Which disorder is the most common functional disorder of the gastrointestinal (GI) tract, causing increased motility of the small or large intestine?

- Irritable bowel syndrome

55. 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?

- Maintains bowel continence - Unlikely to experience bladder dysfunction - Unlikely to experience erectile dysfunction - Unlikely to experience infertility

22. 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.

7. A client has been diagnosed with a functional obstruction of the intestine. Which type of obstructions is the most likely diagnosis?

- Paralytic ileus

17. 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 irrigation.

40. 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.

29. 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

21. 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

10. The nurse is caring for a client diagnosed with Crohn disease who had surgery to create a continent bowel diversion. Which describes this type of surgery?

- The client's own tissues are formed into internal receptacles for stool.

38. 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

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

- Weakness, diaphoresis, diarrhea 90 minutes after eating

44. 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

51. 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 and strenuous exercise. -Avoid constipation. -How to wear a truss

33. 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)

19. 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 foods will help."

23. 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

24. 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

27. 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.

28. 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

26. 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

16. 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.

13. 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

48. The nurse is developing a health promotion program for intestinal health. Which of the following pieces of information should the nurse include in the program?

- The addition of dietary fiber can reduce the risk of diverticulosis.

43. 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."

50. In caring for a client with acute hepatitis B, the client says, "I am so tired of this bed. I don't think I can stay here any longer!" The best response of the nurse is:

- "What activity do you think can you do without getting too tired?"

1. A nurse is caring for a female client diagnosed with anorexia nervosa. What would the nurse observe during the nursing assessment of the client?

- Alopecia

47. A client is admitted with possible liver cancer. Which of the tests below would be the most confirming of this diagnosis?

- Alpha-fetoprotein markers

49. A client visiting an outpatient clinic mentions that she has been having severe indigestion and burning in her chest. The nurse takes a history and learns that she does smoke or consume alcohol. Another dietary consideration to ask about initially would be:

- Amount of caffeine

45. 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.

8. What nursing care measure should the nurse provide for a client who has developed oral canker sores?

- Ask the client to apply a silver nitrate stick, as ordered.

52. 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 reflex - Fetor hepaticus

25. 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

34. 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

5. A client with a family history of ulcerative colitis is to undergo a screening test for early detection of colon cancer. In what group is colon cancer more common?

- Clients who have frequent diarrhea

3. A nurse is caring for a client diagnosed with a duodenal ulcer. What sign and symptom noticed during nursing assessment indicates a potential hemorrhagic complication?

- Coffee ground vomitus

39. 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

54. 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?

- Dehydration - Electrolyte imbalances - Vitamin deficiencies

42. 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 your mouth closed.

35. 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

15. 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

53. 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 beads - Layered tablets

14. 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

2. A nurse is caring for a client being treated for spastic colitis. What signs and symptoms should be reported to the physician for further evaluation?

- Fever

46. A client on the unit with hepatitis B suddenly develops anorexia, vomiting, abdominal pain, progressive jaundice, lethargy, and disorientation. The nurse knows that these indicate which of the following?

- Fulminant hepatitis

4. A morbidly obese client is diagnosed with hepatitis. What intervention should the nurse implement when caring for the client?

- Have the client wear rubber-soled shoes

37. 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

31. 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

30. 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

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

- Measure pH of aspirates

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

- Nonsteroidal anti-inflammatory

32. 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.

41. 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.

36. 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.