GI Questions

A client with liver dysfunction states, "My gums have been bleeding spontaneously." The nurse identifies small hemorrhagic lesions on the client's face. Which vitamin does the nurse conclude the client needs?

vitamin K

A nurse is performing the initial history and physical examination of a client with a diagnosis of duodenal ulcer. Which type of pain does the nurse expect the client to describe?

pain that is relieved with eating

A nurse is caring for a client with chronic inflammation of the bowel. Which most serious complication should the nurse monitor for in this client?

perforation

A nurse is obtaining a health history from a client with the diagnosis of peptic ulcer disease. Which client statement provides evidence to support the identification of a possible contributory factor?

"I smoke one pack of cigarettes a day."

A nurse provides education to a client about how to prevent constipation. The nurse concludes that the teaching is understood when the client makes which statements?

"I should drink at least six glasses of water every day." "I can include bran muffins in my breakfast daily." "I will walk every day as part of my exercise regimen."

A client scheduled for a hemicolectomy because of a small lesion in the colon asks if having a hemicolectomy means "that I have to deal with one of those pouches and have bowel movements into the pouch." Which is the best response by the nurse?

"No, only part of the colon is removed and the rest reattached."

A client expresses a complete lack of interest in food. How should the nurse document this finding in the client's medical record?

Anorexia

The nurse is assessing a client with severe cirrhosis and discovers fetor hepaticus. What did the nurse assess?

Breath

A client is diagnosed with a peptic ulcer. When teaching about peptic ulcers, the nurse instructs the client to report what kind of stools?

Dark brown or black

A nurse is assessing a client for possible malabsorption syndrome. Which stool assessment finding will support this diagnosis?

Fat globules

During change of shift report the night nurse indicates that a client cannot tolerate the prescribed intermittent tube feedings. Which action should the receiving nurse take first?

Gather more data from the night nurse about the technique used

A client who is receiving a 2-gram sodium diet asks for juice. How should the nurse respond?

I suggest you have pear nectar

A nurse is caring for a client with hepatic encephalopathy and ascites. Which elements are important to include in this client's diet? Select all that apply.

Low sodium High vitamins Moderate protein

A nurse is caring for a client on the second day after an abdominoperineal resection. Which finding does the nurse document as normal in the stoma?

Moist, red, and raised above the skin surface

A nurse is caring for a client with a hiatal hernia. Which risk factor should the nurse assess for in this client?

Obesity

A dehydrated older adult is admitted to the hospital from a nursing home. The transfer form documents a history of liquid fecal incontinence. Which intervention by the nurse promotes identification of the cause of this incontinence?

digital rectal exam

A nurse is caring for a client with cholelithiasis and obstructive jaundice. When assessing this client, the nurse should be alert for which findings that are consistent with these conditions? Select all that apply.

ecchymosis yellow sclera Pain in RUQ

What information from a client's history should the nurse identify as risk factors for the development of colon cancer? Select all that apply.

Increased age ulcerative colitis

A nurse is assessing two clients. One client has ulcerative colitis, and the other client has Crohn disease. Which is more likely to be identified in the client with ulcerative colitis than in the client with Crohn disease?

Involvement starting distally with rectal bleeding that spreads continuously up the colon

A nurse is reviewing a list of current medications with a client who has developed gastrointestinal bleeding. Which medication prescription should the nurse discuss with the primary healthcare provider?

ibuprofen NSAIDS can cause GI bleeding

A healthcare provider prescribes an intermittent enteral tube feeding for a client with a nasogastric tube. Place the nursing interventions in the order in which they should be implemented.

1. Verify the healthcare provider's prescription 2. Elevate the head of the bed to at least 30 degrees 3. Check the volume of residual against the parameters prescribed 4. Administer the volume of feeding as per the prescription 5. Administer the volume of feeding as per the prescription

The nurse is instructing the student nurse how to administer percutaneous enterostomal gastrostomy (PEG) tube feeding to a client. What should the nurse tell the student? Select all that apply.

Connect tube feeding bag to client and feeding pump. Flush with warm water before beginning feeding. Check prescription for correct client formula. Set correct rate and initiate pump. Check for diarrhea.

A nurse is assessing a client with severe liver disease. Which assessment finding will the nurse expect to observe?

Icterus

The nurse is taking care of a client with cirrhosis of the liver and ascites. Which lunch is the best choice for a client with this disorder?

Penne pasta, spinach, banana, and decaffeinated iced tea moderate low fat and low sodium

A client with a diagnosis of gastric cancer has a gastric resection with a vagotomy. Which clinical response should alert the nurse that the client is experiencing dumping syndrome?

Reactive hypoglycemia

A client is diagnosed with hepatitis A. The nurse takes the client's history. Which employment history is most likely linked to the development of hepatitis A?

Works at a plumbing business

A client who had surgery for a ruptured appendix develops peritonitis. Which clinical findings related to peritonitis should the nurse expect the client to exhibit? Select all that apply.

fever abdominal muscle rigidity

A primary healthcare provider diagnoses a client with acute cholecystitis with biliary colic. Which clinical findings should the nurse expect when performing a health history and physical assessment? Select all that apply.

intolerance to foods high in fat pain that radiates to the right shoulder

The nurse instructs a client with a new colostomy to avoid foods and drinks that produce a large amount of gas, specifically to avoid the intake of what?

Cabbage

A client is experiencing an exacerbation of ulcerative colitis. A low-residue, high-protein diet and IV fluids with vitamins have been prescribed. When implementing these prescriptions, which goal is the nurse trying to achieve?

Reduce colonic irritation

A nurse is caring for a client who recently is diagnosed with a gastric ulcer. The nurse expects that the plan of care will include a prescription for which type of diet?

Regular diet with foods that are tolerated

A client with ulcerative colitis has experienced frequent severe exacerbations over the past several years. The client is admitted to the hospital with intense pain, severe diarrhea, and cachexia. Which therapeutic course should the nurse expect the primary healthcare provider to explore with this client?

Surgical therapy (colectomy)

Three days after surgery for cancer of the colon, a nurse introduces the client to colostomy care. Which should the nurse teach the client about skin care around the stoma?

Wash the area with soap and water and then apply a protective ointment

A self-help group of clients with irritable bowel syndrome have invited a nurse to present a program on nutrition. Which substance should the nurse teach the clients to minimize in the diet to decrease gastrointestinal (GI) irritability?

cola drinks

A client who has been caring for a colostomy on the left side of the abdomen for several years is admitted to the hospital for an unrelated health problem. Which type of stool should the nurse expect?

moist and formed

After an acute episode of upper gastrointestinal (GI) bleeding, a client vomits undigested medications and reports severe epigastric and abdominal pain. The client has absent bowel sounds, rigid abdomen, a pulse rate of 134, and shallow respirations of 32 per minute. The primary healthcare provider has been contacted. What should be the nurse's next priority?

Keep the client nothing by mouth (NPO)

A client is admitted with a diagnosis of gastric ulcer. Which location is most commonly indicated by the client as being painful when the nurse assesses for the presence of pain?

LUQ

A client with a history of ulcerative colitis is admitted to the hospital because of severe rectal bleeding. The client appears to be angry and demanding. One day the unlicensed assistive personnel (UAP) tells the nurse, "I've had it with that client's demands. I'm not going in that room again." Which response by the nurse is best?

"The client is frightened. Let's think about the best approach we can take."

A client is admitted with a diagnosis of acute pancreatitis. The medical and nursing measures for this client are aimed toward maintaining nutrition, promoting rest, maintaining fluid and electrolytes, and decreasing anxiety. Which interventions should the nurse implement? Select all that apply.

Administer analgesics Teach relaxation exercises Monitor cardiac rate and rhythm

A nurse provides a list of suggested food choices to a client who has peptic ulcer disease. Which foods should be included on the list?

Applesauce, cream of wheat, and apple juic Bland foods that do not irritate the GI mucosa

A nurse is providing discharge instructions to a client diagnosed with cirrhosis and varices. Which information should the nurse include in the teaching session? Select all that apply.

Avoiding aspirin and aspirin-containing products Avoiding acetaminophen and products containing acetaminophen Avoiding coughing, sneezing, and straining to have a bowel movement

A nurse assesses a client with the diagnosis of an intestinal obstruction in the descending colon. When auscultating the midabdomen, what should the nurse expect to hear?

Borborygmi

A nurse is teaching a client about gastroesophageal reflux disease (GERD). Which statement made by the client indicates correct understanding of GERD management?

I will place a 6-inch (15 cm) block under the head of my bed to help with digestion."

A client with an acute episode of ulcerative colitis is admitted to the hospital. Blood studies reveal that the chloride level is low. What should the nurse be prepared to administer?

IV therapy

Six hours after major abdominal surgery, a client reports severe abdominal pain and feeling faint. The nurse identifies a thready, rapid pulse. The nurse checks the medication administration record (MAR) (Physiological Aspects of Care record) and determines that the client can receive another injection of pain medication in an hour. Which is the most appropriate action by the nurse?

Notify healthcare provider The client has symptoms of shock

A client reports pain four hours after a liver biopsy. The nurse identifies that there is leakage of a large amount of bile on the dressing over the biopsy site. What should the nurse do first?

Notify healthcare provider immediately A small amount of bile-colored spotting is expected, but a large amount is excessive and not expected. The healthcare provider should be notified. The client should be on the right side to compress the liver capsule against the chest wall

A client is admitted with a diagnosis of a gastric peptic ulcer. Place an X over the area that the client would indicate is the site of pain associated with this disorder.

Pain associated with a gastric peptic ulcer usually is located slightly left of the midline of the abdomen between the umbilicus and the xiphoid process. It often is described as sharp, burning, or gnawing in nature. Pain associated with a duodenal peptic ulcer usually is located slightly right of the midline of the abdomen between the umbilicus and the xiphoid process.

The nurse assesses a client for the development of pernicious anemia after reviewing the client's history. Which condition did the nurse most likely find in the history?

Partial gastrectomy

A client is diagnosed with acute gastritis secondary to alcoholism and cirrhosis. The client reports frequent nausea, pain that increases after meals, and black, tarry stools. The client recently joined Alcoholics Anonymous. The nurse should give priority to which client history item?

black tarry stools

A client with a history of pancreatitis is scheduled for surgery to excise a pseudocyst of the pancreas. The client asks, "What is a pseudocyst?" Which information should the nurse include in a response to this question?

walled off space of pancreatic enzymes and exudate