GI quiz !!
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? a) Return of the gag reflex b) Passage of stool c) Intake and output d) signs and symptoms of bleeding
d) signs and symptoms of bleeding
A nurse assesses the stools of a client diagnosed with peptic ulcer disease. Inspection reveals black, tarry stools. The nurse would use which term to document this finding?
melana Melena is the term used to denote black, tarry stools. Hematemesis refers to blood in vomit. Pyrosis is a burning sensation in the esophagus and stomach that moves up to the mouth. Achlorhydria refers to an absence of hydrochloric acid in the stomach.
The nurse recognizes that the client diagnosed with a duodenal ulcer will likely experience
pain 2 to 3 hours after a meal. The client with a gastric ulcer often awakens between 1 and 2 with pain, and ingestion of food brings relief. Vomiting is uncommon in the client with duodenal ulcer. Hemorrhage is less likely in the client with duodenal ulcer than the client with gastric ulcer. The client with a duodenal ulcer may experience weight gain.
A client is prescribed tetracycline to treat peptic ulcer disease. Which instruction would the nurse give the client? "Take the medication with milk." "Be sure to wear sunscreen while taking this medicine." "Do not drive when taking this medication." "Expect a metallic taste when taking this medicine, which is normal."
"Be sure to wear sunscreen while taking this medicine."
A nurse is teaching a client with gastritis about the need to avoid the intake of caffeinated beverages. The client asks why this is so important. Which explanation from the nurse would be most accurate?
"Caffeine stimulates the central nervous system and thus gastric activity and secretions, which need to be minimized to promote recovery." Caffeine is a central nervous system stimulant that increases gastric activity and pepsin secretion. Caffeine is a diuretic that causes decreased fluid volume and potential dehydration. It does not lead to hemorrhage and does not interfere with absorption of vitamin B12.
Endoscopy of a 60-year-old woman has revealed the presence of an esophageal peptic ulcer. The nurse who is providing this woman's care is assessing for risk factors that may have contributed to the development of this disease. What question most directly addresses these risk factors?
"Have you ever been diagnosed with reflux?" Gastroesophageal reflux disease (GERD) is a significant risk factor for peptic ulcer disease. Poor diet, general infections, and dysphagia are less closely associated with etiology of esophageal ulcers.
The nurse determines that teaching for the client with peptic ulcer disease has been effective when the client makes which statement?
"I have learned some relaxation strategies that decrease my stress." The nurse assists the client to identify stressful or exhausting situations. A hectic lifestyle and an irregular schedule may aggravate symptoms and interfere with regular meals taken in relaxed settings along with the regular administration of medications. The client may benefit from regular rest periods during the day, at least during the acute phase of the disease. Biofeedback, hypnosis, behavior modification, massage, or acupuncture may be helpful.
A nursing student is caring for a client with gastritis. Which of the following would the student recognize as a common cause of gastritis? Choose all that apply. Participation in highly competitive sports DASH diet Ingestion of strong acids Irritating foods Overuse of aspirin
-Ingestion of strong acids -Irritating foods -Overuse of aspirin
The nurse is caring for a patient who has been diagnosed with gastritis. To promote fluid balance when treating gastritis, the nurse knows that what minimal daily intake of fluids is required?
1.5 L Daily fluid intake and output are monitored to detect early signs of dehydration (minimal fluid intake of 1.5 L/day, minimal output of 0.5 mL/kg/h).
A client weighs 215 lbs and is 5' 8" tall. What would the nurse calculate this client's body mass index (BMI) as being?
32.7 Using the formula for BMI, the client's weight in pounds (215) is divided by the height in inches squared (68 inches squared) and then multiplied by 703. The result would be 32.7.
A client who is being treated for pyloric obstruction has a nasogastric (NG) tube in place to decompress the stomach. The nurse routinely checks for obstruction which would be indicated by what amount?
450 mL A residual of greater than 400 mL strongly suggests obstruction.
A 32-year-old man who has a body mass index of 32 (morbidly obese) is considering bariatric surgery. In the time leading up to this surgery, which of the following nursing diagnoses will be the primary focus of interventions? A) Knowledge deficit related to the implications of bariatric surgery B) Altered growth and development related to obesity C) Risk for injury related to obesity D) Spiritual distress related to low body image
A) Knowledge deficit related to the implications of bariatric surgery
A client is admitted to the health care facility with a diagnosis of a bleeding gastric ulcer. The nurse expects the client's stools to have which description?
Black and tarry Black, tarry stools are a sign of bleeding high in the GI tract, as from a gastric ulcer, and result from the action of digestive enzymes on the blood. Vomitus associated with upper GI tract bleeding commonly is described as coffee-ground-like. Clay-colored stools are associated with biliary obstruction. Bright red stools indicate lower GI tract bleeding.
Which of the following clients is at highest risk for peptic ulcer disease?
Client with blood type O Clients with blood type O are more susceptible to peptic ulcers than those with blood types A, B, and AB.
A nurse is caring for a patient who has had bariatric surgery and is developing a teaching plan for the patient. Which information is essential for the nurse to include in this teaching?
Eat six small meals daily spaced at equal intervals. Due to decreased stomach capacity, the patient must consume small meals at intervals to meet nutritional requirements while avoiding a feeling of fullness and complications such as dumping syndrome. The patient should not consume fluids with meals. This practice, as well as consumption of foods high in carbohydrates, contributes to the development of dumping syndrome. The patient should maintain a low-calorie diet.
A patient presents to the walk-in clinic complaining of vomiting and burning in his mid-epigastria. The nurse knows that to confirm peptic ulcer disease, the health care provider is likely to order a diagnostic test to detect the presence of what? A. Excessive stomach acid secretion B. Gastric irritation caused by nonsteroidal anti-inflammatory drugs (NSAIDs) C. Inadequate production of pancreatic enzymes D. Infection with Helicobacter pylori
D. Infection with Helicobacter pylori
A nurse is providing follow-up teaching at a clinic visit for a client recovering from gastric resection. The client reports sweating, diarrhea, nausea, palpitations, and the desire to lie down 15 to 30 minutes after meals. Based on the client's assessment, what will the nurse suspect?
Dumping Syndrome Early manifestations of dumping syndrome occur 15 to 30 minutes after eating. Signs and symptoms include vertigo, tachycardia, syncope, sweating, pallor, palpitations, diarrhea, nausea, and the desire to lie down. Dehiscence of the surgical wound is characterized by pain and a pulling or popping feeling at the surgical site. Peritonitis presents with a rigid, boardlike abdomen, tenderness, and fever. The client's signs and symptoms aren't a normal reaction to surgery.
A client who had a Roux-en-Y bypass procedure for morbid obesity ate a chocolate chip cookie after a meal. After ingestion of the cookie, the client reported cramping pains, dizziness, and palpitation. After having a bowel movement, the symptoms resolved. What should the nurse educate the client about regarding this event? Gastric outlet obstruction Bile reflux Dumping syndrome Celiac disease
Dumping syndrome
A patient comes to the bariatric clinic to obtain information about bariatric surgery. The nurse assesses the obese patient knowing that, in addition to meeting the criterion of morbid obesity, a candidate for bariatric surgery must also demonstrate what?
Emotional stability and understanding of required lifestyle changes. Patients seeking bariatric surgery must be evaluated by a psychiatrist, psychologist, or advanced practice mental health nurse to establish that they are free of serious mental disorders and are motivated to comply with lifestyle changes related to eating patterns, dietary choices, and elimination. Obese patients are often unlikely to have a positive body image due to the social stigma associated with obesity. While assessment of knowledge about causes of obesity and its associated risks, as well as insight into the reasons why previous diets have been ineffective are included in the patient's plan of care, these do not predict positive patient outcomes following bariatric surgery. Most obese patients have an impaired body image and alteration in self-esteem. An obese patient with a positive body image would be unlikely to seek this surgery unless she or he was experiencing significant comorbidities.
A critical care nurse is closely monitoring a patient who has recently undergone surgical repair of a bleeding peptic ulcer. The nurse should prioritize assessments of which of the following signs and symptoms of a recurrence of hemorrhage?
Hypotension and tachycardia Rebleeding has multiple manifestations. However, an increase in heart rate and decrease in blood pressure are key signs of a hemorrhage that are present in nearly all patients who are experiencing rebleeding.
Review the following four examples of ideal body weight (IBW), actual weight, and body mass index (BMI). Using three criteria for each example, select the body weight that indicates morbid obesity.
IBW = 145 lbs; weight = 290 lbs; BMI = 31 kg/m2 The criteria for morbid obesity are a body weight that is twice IBW and a BMI that exceeds 30 kg/m2.
Computed tomography of a patient with a sudden onset of severe nausea and vomiting has revealed the presence of a pyloric obstruction. Which of the following interventions is the nurse's priority in the immediate care of this patient?
Insertion of a nasogastric (NG) tube to suction to decompress the stomach In treating the patient with pyloric obstruction, the first consideration is to insert an NG tube to decompress the stomach. Nutrition is not an immediate priority, and neither gastric lavage nor cleansing enemas is indicated.
Which of the following manifestations are associated with a deficiency of vitamin B12? Select all that apply. Lethargy Macrocytic anemia Thrombocytopenia Loss of hair Pernicious anemia
Macrocytic anemia Thrombocytopenia Pernicious anemia
A nurse is teaching a group of middle-aged men about peptic ulcers. When discussing risk factors for peptic ulcers, the nurse should mention:
alcohol abuse and smoking. The nurse should mention that risk factors for peptic (gastric and duodenal) ulcers include alcohol abuse, smoking, and stress. A sedentary lifestyle and a history of hemorrhoids aren't risk factors for peptic ulcers. Chronic renal failure, not acute renal failure, is associated with duodenal ulcers.
The nurse is conducting a community education class on gastritis. The nurse includes that chronic gastritis caused by Helicobacter pylori is implicated in which disease/condition? Systemic infection Peptic ulcers Colostomy Pernicious anemia
Peptic ulcers
A 30-year-old obese female patient who underwent gastric banding 3 days ago is getting ready to go home. Essential postoperative teaching for this patient should include instruction related to the importance of abstaining from what for the next 2 years?
Pregnancy Women of childbearing age who have had bariatric surgery should avoid pregnancy for approximately 2 years until their weight stabilizes, and it is evident that their nutritional needs are being adequately met. Multivitamins are generally recommended for the patient to supplement dietary sources of nutrients. Antidepressants may be taken if clinically indicated. Control-top pantyhose may be uncomfortable postoperatively; however, they are not contraindicated.
A health care provider counsels a client about bariatric surgery and recommends the Roux-en-Y gastric bypass. What is the best response by the nurse to further explain this procedure to the client? Separation of the jejunum with an anastomosis Gastric banding that incorporates a prosthetic device to restrict oral intake Gastroplasty with a vertical band allowing for a pouch with a 15 to 20 mL capacity Biliopancreatic diversion with a duodenal switch
Separation of the jejunum with an anastomosis
Which statement correctly identifies a difference between duodenal and gastric ulcers?
Vomiting is uncommon in clients with duodenal ulcers. Vomiting is uncommon in clients diagnosed with duodenal ulcer. Malignancy is associated with a gastric ulcer. Weight gain may occur with a duodenal ulcer. Duodenal ulcers cause hypersecretion of stomach acid.
A client is recovering from gastric surgery. Toward what goal should the nurse progress the client's enteral intake?
Six small meals daily with 120 mL fluid between meals After the return of bowel sounds and removal of the nasogastric tube, the nurse may give fluids, followed by food in small portions. Foods are gradually added until the client can eat six small meals a day and drink 120 mL of fluid between meals.
