GI final exam
The nurse is caring for a client recovering from an esophagogastroduodenoscopy (EGD). Which of the following client symptoms would most require further nursing assessment?
ABDOMINAL DISTENTION
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?
ABDOMINAL SURGERY
When assisting with preparing a client scheduled for a barium swallow, which of the following would be most appropriate to include in the client teaching?
AVOID SMOKING 12-24 HOURS BEFORE TEST
The nurse is instructing a client prior to a colonoscopy. The client states, "Why do I have to drink this disgusting liquid?" The nurse is most correct to verbalize the goal of the oral preparation as which of the following?
TO CLEANSE THE BOWEL TO PROMOTE CLEAR VISUALIZATION OF STRUCTURES
A client is diagnosed with colon cancer, located in the lower third of the rectum.Which of the following would most likely be the surgical treatment option for this client?
ABDOMINOPERINEAL RESECTION
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 INSUFFICIENCY
The nurse is caring for a client who received a Brooke ileostomy five days ago. The nurse, when assessing the ileostomy site, notes that the stoma appears to be extending out from the client's skin by 3/4 inches and bleeds a little when cleaned. What is the nurse's best action at this time?
DOCUMENT THE FINDING NO TREATMENT NECESSARY
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 is this assessment technique commonly referred as?
ROVSING SIGN
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
The nurse is working on a general medical unit. A client is scheduled for an upper gastrointestinal series. Upon returning to the nursing unit, what does the nurse identify as the client goal?
INCREASE IN THE AMOUNT OF FLUIDS
Which of the following symptoms would indicate that a client with chronic pancreatitis has developed secondary diabetes?
INCREASED APPETITE AND THIRST
A client is scheduled to have an endoscopic retrograde cholangiopancreatography. Which of the following statements made by the client indicates a need for further investigation? Select all that apply.
" I usually get hives when I eat shellfish." "The doctor will take a look at my common bile duct, portal vein, and gallbladder."
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 ACCUMULATIONS & VENOUS PRESSURE
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 AGAIN"
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?
"ILL MAKE SURE THERE IS A FAMILIAR NURSE WITH YOU HERE THE FIRST TIME"
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 CONSTIPATION -AVOID HEAVY LIFTING/STRENUOUS ACTIVITY -HOW TO WEAR A TRUSS
The nurse is caring for a geriatric client at a long-term care facility. When administering the client's medications, which age-related changes of the client are anticipated? Select all that apply.
-DECREASED ELASTICITY OF RECTAL WALL -DECREASED MOTILITY IN ESOPHAGUS -WEAK GAG REFLEX
he nurse is caring for a patient who has dumping syndrome from high-carbohydrate foods being administered over a period of fewer than 20 minutes. What is a nursing measure to prevent or minimize the dumping syndrome?
Administer the feeding with the patient in semi-Fowler's position to decrease the effect of gravity on transit time.
The nurse is accompanying the client to the diagnostic imaging unit for a magnetic resonance imaging (MRI). Which action, by the nurse, is most important prior to the test?
CALCULATE DROP PER MINUTE TO INFUSE BY GRAVITY
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
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
A nurse is reinforcing teaching with a client who has a new prescription for aluminum hydroxide to treat heartburn. Which of the following adverse effects of the medication should the nurse include in the teaching?
CONSTIPATION
A nurse is collecting data from a client who is African American has cholecystitis. Which of the following areas should the nurse inspect to monitor for the presence of jaundice?
HARD PALATE
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
A client with dysphagia is scheduled for percutaneous endoscopic gastrostomy (PEG) tube insertion and asks the nurse how the tube will stay in place. What is the nurse's best response?
Internal and external fixation bolsters secure the tube against the stomach wall.
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
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
A nurse is collecting data from a client who has diverticular disease. The nurse should expect the client to report abdominal pain in which of the following locations?
LOWER LEFT QUADRANT
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
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
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
The nurse is evaluating the medication list of a client with acute gastritis. Which medication would create the most concern?
NSAIDS
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 nurse is receiving report from the day shift nurse about a newly admitted patient diagnosed with peptic ulcer disease (PUD). Which of the following symptoms indicate that the patient's condition is worsening?
PROTRACTED VOMITING
A nurse is caring for a client who has cirrhosis of the liver with ascites. Which of following interventions should the nurse take?
RESTRICT FOODS HIGH IN PROTEIN
The nurse is assessing the stool consistency of a client with an transverse colostomy. Which of the following would the nurse expect to find?
SEMILIQUID
The nurse is answering questions regarding fecal matter for a client who is scheduled for a colon resection. The client is asking questions regarding the composition of the fecal matter and when it becomes a formed mass. The nurse is most correct to state at which location?
SIGMOID COLON
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 & SYMPTOMS OF BLEEDING
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
The nurse is caring for a client with volvulus of the bowel. Which of the following statements should the nurse include in the patient education handouts?
THE BOWEL TWISTS & TURNS ITSELF AND OBSTRUCT INTESTINAL LUMEN
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 & COMFORT WHEN PASSING STOOL
The nurse would expect to observe which of the following when assessing a client with cholelithiasis?
URINE THAT APPEARS DARK BROWN
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 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 THE 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 MINUTES AFTER EATING
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 IMBALANCES -VITAMIN DEFICIENCIES
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 -LAYERED TABLETS -SLOW RELEASE BEADS
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 caring for four clients with diarrhea. Which client is most likely to be diagnosed with Crohn disease?
24 YEAR OLD Caucasian eastern European Jewish female
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
The nurse is instructing the client on frequent sensations experienced when a contrast agent is injected into the body during diagnostic studies. Which sensation is most common?
A WARM SENSATION
After assessing a client with peritonitis, the nurse likely would document the client's bowel sounds as?
ABSENT
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?
D. "You may want to consider collection and storing of sperm for later use if you are planning to have children."
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, 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
A client is to undergo surgery for the creation of a continent ileostomy. Which statement by the client indicates successful teaching?
ILL NEED TO LEARN TO EMPTY THE RESERVOIR SEVERAL TIMES A DAY
