GI quiz #1
Which complications with the nurse suspect when a client with peritonitis reports increased pain in the upper left abdominal quadrant and in the left shoulder, especially during inhalation
Localized abscess
Which action is the priority for the nurse to take me to caring for a client with oral cancers?
Maintaining the airway
Which action will the nurse perform when caring for a client with acute appendicitis before surgical management?
Maintaining the client with NPO status Administering IV fluids as prescribed Advising the client to maintain semi Fowler position Giving adequate medication to control the clients pain
What manifestation of esophageal cancer does the nurse recognize when a client describes experiencing dull and steady substernal pain after drinking cold liquids?
Odynophagia
For which reasons will the nurse carefully examine the mouth of an older adult for candidiasis?
Older adults immune system decline with aging increasing the risk for candidiasis
Which priority teaching will the nurse provide an older client with GER de who is prescribed omeprazole for symptom relief?
Older adults taking this drug may be at increased risk for hip fracture because it interferes with calcium absorption
Which findings will the nurse be sure to document after inspecting a clients abdomen during assessment?
Overall asymmetry of the abdomen Discoloration or scarring Abdominal distention in skin folds Location and size of pressure injuries
Which teaching point with the nurse include when instructing a client about preparation for colonoscopy?
"Avoid taking aspirin, NSAIDS or anticoagulants for several days before the test". Do not eat and drink for 3 to 5 hours before the test Drink only clear liquids the day before the colonoscopy An IV will be placed to give medication to help you relax during the procedure
What is the nurses best response when a client asked which diagnostic test will determine if a oral tumor is cancerous?
"Biopsy is the definitive method for diagnosing oral cancer."
Which question will the nurse be sure to ask the client suspected of having leukoplakia?
"Do you smoke, dip, or to tobacco products?"
Which priority teaching with the nurse provide to prevent harm when a client with an oral problem is prescribed viscous lidocaine?
"Lidocaine causes an anesthetic effect so you may not feel burns from hot liquids."
When instructions with the nurse provide to a client with a gastrointestinal problem who is scheduled for an abdominal x-ray?
"Wear a hospital gown and remove any jewelry or belts."
Which postoperative instructions with the nurse provide for a client after laparoscopic Nissen fundoplication (LNF)?
Consume a soft diet for about a week; avoid carbonated beverages, tough foods, and raw vegetables that are difficult to swallow You must not drive for a week after surgery; especially do not drive after taking an opioid pain medication Walk every day but do not do any heavy lifting Report fever above 101°F (38.3°C), nausea, vomiting, or uncontrollable bloating or pain
In collaboration with the registered dietitian nutritionist which nutrients and substances will the nurse instructed client with ulcerative colitis (UC) to avoid to reduce symptoms?
Corn Caffeine Dried fruits Dairy products Pepper base spices
Which action is appropriate for the nurse to take to prevent harm when caring for a client with ulcerative colitis who has undergone a total proctocolectomy with the placement of a permanent ileostomy
Using a skin barrier to prevent excoriation
Which client with symptoms of chronic abdominal pain and frequent bowel movements will the nurse consider at highest risk for diagnosis of ulcerative colitis (UC)
26-year-old white woman or Jewish ancestry who has an identical twin sister with the disorder
What does the nurse expect when a client's parietal cells do not produce enough intrinsic factor?
Development of pernicious anemia
What is the most common symptoms the nurse expect the client was esophageal cancer to report?
Difficulty with swallowing
Which drug will the nurse be sure to question to prevent harm when prescribed for an older adult with gastroenteritis?
Diphenoxylate hydrochloride with atropine sulfate.
Yeah which action by the nurse teach the client to take to prevent the spread of gastroenteritis?
Washing hands well for at least 30 seconds Using easily accessible hand sanitizers Sanitizing all surfaces that may be contaminated
Which interventions with the nurse include when care of a client with peritonitis is focused on restoring fluid volume balance?
Administering IV isotonic fluids in broad spectrum antibiotics Assigning the assistive personnel (AP) to weigh the client daily and record intake and output Providing nasogastric tube (NGT) care and keeping the stomach decompressed Maintained the client on NPO status while the NGT is in place to low suction Assessing whether the client retains fluid used for irrigation by comparing and recording the amount of fluid returned with the amount of fluid iinstilled
Which common signs and symptoms with the nurse expect to find on assessment of a 60-year-old client who has had gastroenteritis for the past two days?
Weight loss Elevated temperature Dry mucous membranes Hypotension Oliguria Poor skin turgor
Which actions with the nurse teacher client with GERD to use to prevent harm?
Do not consume caffeinated or carbonated beverages Avoid peppermint, chocolate, and fried foods Eat slowly and chew food thoroughly Consume 4 to 6 more meals each day Do not eat for three hours before going to bed
What is the nurses best action when assessing a client two hours after abdominal surgery reveals hypoactive bowel sounds?
Documenting the findings and continue to monitor
Which action with the nurse teacher client with severe GERD that causes pain after each meal, last for at least 45 minutes, and worsens when he or she lies down?
Drink fluids right away Take anti-acid as prescribed by the healthcare provider Maintain an upright position for at least an hour after you eat
Which actions with the nurse to the client to avoid to prevent harm after Nissen fundoplication surgery when gas bloat syndrome occurs?
Drinking carbonated beverages Eating gas producing foods Chewing gum Drinking through a straw
Which lunch food selection made by client with diverticulitis indicate to the nurse that the correct understanding of the necessary dietary modifications for management of the problem?
A turkey sandwich on whole wheat bread steamed carrots and while Apple
Which kind is the nurse assess as a highest risk for the development of esophageal cancer?
55-year-old who smokes and is 25 pound overweight
Which surgical client with the nurse recognize as having the highest risk of development of peritonitis?
72 year old having a bowel resection for colon cancer
Which cardinal sign with the nurse expect to assess in a client diagnosed with peritonitis?
Abdominal pain with distention and tenderness
Which of the most common symptoms of gastroesophageal reflux disease (GERD) reported to the nurse by a client?
Dyspepsia Regurgitation
Most accurate diagnostic test will the nurse expect to be ordered for client to verify the diagnosis of GERD?
Ambulatory esophageal pH monitoring
What procedural teaching with the nurse provide for a client scheduled for abdominal CT scan with contrast?
An IV line will be placed for injection of the contrast The CT technician will ask you to hold your breath while images are taken You may feel warm and flushed it may experience a metallic taste with injection If you are claustrophobic you can be given a mild sedative before the procedure
What does the nurse suspect when a client comes into the emergency department (ED) with right lower quadrant cramping pain, nausea, vomiting, and guarding with rigidity of the abdomen?
Appendicitis
What is the most important assessment for a nurse to perform before administering the first dose of sulfasalazine to a client diagnosed with ulcerative colitis?
Asking whether he or she has an allergy to sulfa drugs
Which diagnostic test with the nurse expect the client to undergo to best identify a hiatal hernia?
Barium swallow with fluoroscopy
Which signs and symptoms were the nurse assess when a client is diagnosed with oral cancer?
Bleeding from the mouth Difficulty chewing or swallowing Thick or absent saliva Thickening or lab in cheek
Which drugs will the nurse expect the healthcare provider to prescribe for a client after esophageal trauma?
Broad spectrum antibiotics Corticosteroids Pain medication Viscous lidocaine
For which finding does the nurse alert the healthcare provider immediately after assessing a client abdomen?
Bulging, pulsating mass
Based on the nurses knowledge of gastrointestinal (GI) changes that occur with age, for which disorder in an older client with a nurse vigilantly monitor related to decrease peristalisis?
Constipation with possible impaction
When the nurse collects a clients gastrointestinal (GI) history, which substances are most likely to be a risk factor for peptic ulcer disease or G.I. bleeding?
Caffeine Aspirin Alcohol Ibuprofen
Which oral disorder does the nurse suspect when assessing findings revealed white plaque like lesions that when wiped away show an underlying red and sore surface?
Candidiasis
Which actions will the nurse include with providing care for a client after colonoscopy procedure?
Checking vital signs every 15 to 30 minutes until the client is alert Keeping client and left lateral position to promote passing the Flatus Assessing for signs and symptoms of bowel perforation including severe abdominal pain and guarding Preventing the client from taking anything by mouth and until sedation wears off Keeping the top side rails up until the client is alert
Which cause does the nurse recognize as potential intensional cause for the clients esophageal trauma?
Chemical injury
Which clients with a nurse carefully assess for high risk for oral cavity disorders?
Clients who are homeless or living institutions Clients who are developmentally disabled Client to consume an unhealthy diet Clients who regularly use tobacco or alcohol
For which client assessment findings with the nurse with hold the scheduled monthly dose of prescribe parenteral biologic for management of ulcerative colitis (UC)?
Cough and fever of 102°F (38.9°C)
How does the nurse expect the clients nasogastric (NG) tube drainage to appear immediately after Nissen fundoplication surgery?
Dark brown
Which gastrointestinal (GI) changes will the nurse expect in an older client with a G.I. problem?
Decrease absorbed in of iron and vitamin B 12 Decrease peristalsis or constipation Decreased lipase with decreased fat digestion Decreased drug metabolism with risk of toxicities
Which laboratory assessment findings with the nurse expect in a client who is diagnosed with ulcerative colitis?
Decreasing hemoglobin Decrease potassium Elevated white blood cell (WBC) count Elevated erythrocyte sedimentation rate
Which important information will the nurse include when teaching clients how to maintain healthy oral cavities?
Eat a well-balanced diet and stay hydrated by drinking water If you wear dentures, make sure that they are in a good repair and fit properly Thoroughly brush and floss your teeth (or brush dentures) consistently twice daily See the dentist regularly and have dental problems repaired as soon as possible
Which diagnostic procedure does the nurse expect will be will be ordered by the healthcare provider to view the clients liver, gallbladder, bile ducts, and pancreas for identification of the location of an obstruction?
Endoscopic retrograde cholangiopancreatography
What does the nurse suspect when assessing a client mouth and finding an oral cavity tumor that appears as a red, velvety lesion on the tongue, palate, floor of the mouth, or mandibular mucosa?
Erythroplakia
Which Non-surgical treatment will the nurse expect the client with esophageal cancer to receive for immediate relief of dysphagia?
Esophageal dilation
Which gastrointestinal condition does the nurse suspect a client is at increased risk for when she reports emotional distress about her family situation and whether she will be able to return to work?
Exacerbation of irritable bowel syndrome
Which drug does the nurse expect to administer to a client in order to decrease hydrochloric acid secretion in the stomach?
Famotidine
Which signs and symptoms were the nurse expect to assess when a client is diagnosed with a paraesophageal hernia?
Feeling of fullness (after eating) Breathlessness (after eating) Chest pain that mimics angina
Which disease features with the nurse commonly associated with the client who has Crohndisease (CD) that are rare or absent in the client with ulcerative colitis (UC)?
Fistulas commonly develop Clients have five to six soft, loose non-bloody stools per day The appearance of the affected intestine areas resembles "cobblestone."
The nurse reviews the clients laboratory values and discovers a serum potassium level of 3.1 Meq/L. Which gastrointestinal condition could cause this value?
Gastric suctioning
What type of bowel sounds wILL the nurse expect to auscultate when a client reports having diarrhea for the past two days?
Increased loud and gurgling sounds
For which abdominal laboratory findings with the nurse monitor when providing care for a client with acute pancreatitis?
Increased serum lipase Increased serum amylase
Which laboratory findings with the nurse expect to see in a client who is suspected of having an acute, uncomplicated appendicitis?
Increased white blood cells (W BC) count
Which statement by a client with gastroenteritis due to infection with the norovirus indicates that the nurse's teaching about this illness has been successful?
It is most likely that I got this infectious illness from either contaminated food or water
What is the nurse's first priority when providing care for a client after an esophagogastroduodenoscopy (EGD)?
Keeping the client NPO until the gag reflex returns
What is the nurses priority assessment when a client is giving IV midazolam hydrocholride before a colonoscopy?
Monitoring the rate and depth of respirations
What is the nurses best first action when the stoma of a client who had a permanent ileostomy placed two days ago now has a dark bluish purple appearance?
Notifying the surgeon immediately
Which important information will the nurse include when teaching a client about peritonitis?
Peritonitis is caused by contamination of peritoneal cavity by bacteria or chemicals Respiratory problems associated with peritonitis is related to increase abdominal pressure against the diaphragm Chemical peritonitis is caused by leakage of pancreatic enzymes or gastric acids When the peritoneal cavity is contaminated by bacteria the body begins in inflammatory or reaction walling of a localized area to fight the infection
Which serum laboratory value is most important for the nurse to monitor when caring for an older client with gastroenteritis who has an irregular heart rate and reports "feeling weak?
Potassium
Which important information will the nurse gather with a client reports a change in bowel habits?
Presence of abdominal distention or gas Occurrence of diarrhea or constipation Color and consistency of feces Presence of bloody are tarry stools
For which gastrointestinal diagnostic test does the nurse teach the client to expect mild gas pain, flatulence, in a small amount of bleeding after the procedure if a a biopsy was obtained ?
Proctosigmoidoscopy
About which pancreatic functions will the nurse teach the client with a gastrointestinal (GA) disorder?
Producing glucagon from the endocrine part of the organ Secreting enzymes for digestion from the exocrine part of the organ Producing enzymes that digest carbohydrates, fats, and proteins. Beta cells producing insulin
Which care actions does the nurse expect to perform when caring for a client who had appendectomy with an abscess?
Providing care for wound lines inserted during the surgery Administering IV antibiotics as prescribed by the surgeon Assessing the Nasogastric tube (iNGT) position and drainage Helping the patient out of bed or on the evening of surgery
Which actions will the nurse assigned to the assistive personnel ( AP) who will be helping to care for a client with stomatitis?
Providing oral care every two hours or more if stomatitis is not controlled Encouraging frequent rinsing of the mouth with warm saline, sodium bicarbonate (baking soda) solution, or a combination of these solutions Removing dentures if the client has severe stomatitis or oral pain
Which new onset assessment finding in a client with Crohn disease (CD) indicate to the nurse the possibility of fistula development?
Pyuria with fever
Which action will the nurse instructed client with celiac disease to perform to reduce symptoms?
Reading labels on prepared foods
After esophagectomy for esophageal cancer, what is the nurses priority for clients care?
Respiratory care
In which position with the nurse place the client with peritonitis promote comfort and prevent harm from potential complications?
Semi Fowler
Which non-surgical treatment options for cancer of the esophagus will the nurse discuss with the client?
Swallowing therapy Nutritional therapy Chemoradiation Photodynamic therapy Esophageal dilation
Which assessment finding on the client with peritonitis indicate to the nurse that the probability that the fluid shift into the peritoneal cavity is continuing?
Tachycardia Decreasing your an output Skin tinting over the four head in sternum
To prevent harm from a surgical procedure for peritonitis, which action will the nurse teach a client to avoid?
Taking additional acetaminophen to prevent liver toxicity
When the nurse is providing discharge instructions for a client recovering from peritonitis, which essential findings will the client and family be instructed to report immediately to the primary health care provider?
Unusual or foul smelling drainage Signs of wound dehiscence or ileus Swelling, redness, warmth, or bleeding from the incision site A temperature higher than 101°F (38.3°C) Abdominal pain or board- like stiffness in the abdomen
For what priority information will the nurse asked next after client reports decreased appetite, decreasing nutritional intake, and episodes of nausea over the past two months?
Unusual weight and weight loss
