Medsurg Exam 1 PrepU
Cystic fibrosis, a genetic disorder characterized by pulmonary and pancreatic dysfunction, usually appears in young children but can also affect adults. If the pancreas was functioning correctly, where would the bile and pancreatic enzymes enter the GI system?
Duodenum
Which procedure is performed to examine and visualize the lumen of the small bowel?
Small bowel enteroscopy
A nurse cares for a client who is post op from bariatric surgery. Once able, the nurse encourages oral intake for what primary purpose?
Stimulate GI peristalsis
What would the nurse recognize as preventing a client from being able to take a fecal occult blood test (FOBT)?
The client has hemorrhoidal bleeding
A client with obesity is prescribed orlistat for weight loss. The client asks the nurse, "I understand the medication prevents digestion of fat, but what happens if I eat fat?" What is the nurse's best response?
The fat is passed in your stools
A client is to have an upper GI procedure with barium ingestion and abdominal ultrasonography. While scheduling these diagnostic tests, the nurse must consider which factor?
The ultrasonography should be scheduled before the GI procedure
A client with obesity is prescribed lorcaserin for weight loss. The client reports dry mouth. What is the nurse's best response?
This is an expected finding with this medication
The nurse provides care to a menopausal client, who states, "I read a news article that says I am at risk for coronary vascular disease due to inflammation." Which method should the nurse suggest to the client to aid in the prevention of inflammation that can lead to atherosclerosis?
addressing obesity
When caring for a client with an acute exacerbation of a peptic ulcer, the nurse finds the client doubled up in bed with severe pain in the right shoulder. What is the initial appropriate action by the nurse?
assess the client's abdomen and vital signs
The nurse is performing a focused abdominal assessment of a client with a history of bowel obstruction. The nurse has positioned the client appropriately and inspected the client's abdomen carefully. What action should the nurse perform next?
auscultate the client's abdomen
Which of the following clients is at highest risk for peptic ulcer disease?
client with blood type O
The nurse is cautiously assessing a client admitted with peptic ulcer disease. The nurse is aware that which complications occur in 20% to 30% of clients with this diagnosis?
hemorrhage or perforation
A client with gastric ulcers caused by H. pylori is prescribed metronidazole. Which client statement indicates to the nurse that teaching about this medication was effective?
"It might cause a metallic taste in my mouth"
A client with peptic ulcer disease must begin triple medication therapy. For how long will the client follow this regimen?
10-14 days
A client weighs 215 lbs and is 5' 8" tall. The nurse calculate this client's body mass index (BMI) as what?
32.7
Which of the following digestive enzymes aids in the digesting of starch?
Amylase
A client with gastric cancer is scheduled to undergo a Billroth II procedure. The client's spouse asks how much of the client's stomach will be removed. What would be the most accurate response from the nurse?
Approximately 75%
The nurse is to obtain a stool specimen from a client who reported that he is taking iron supplements. The nurse would expect the stool to be which color?
Black
A nurse researcher is reviewing data obtained from a developing nation on nutrition and metabolism issues facing that country. What is the nurse's understanding of the "double-burden" many developing nations now face?
Both undernutrition and obesity
Clients with Type O blood are at higher risk for which of the following GI disorders?
Deodenal ulcers
A client with severe peptic ulcer disease has undergone surgery and is several hours postoperative. During assessment, the nurse notes that the client has developed cool skin, tachycardia, labored breathing, and appears to be confused. Which complication has the client most likely developed?
Hemorrhage
What part of the GI tract begins the digestion of food?
Mouth
Which of the following is an enzyme secreted by the gastric mucosa?
Pepsin
Which diagnostic produces images of the body by detecting the radiation emitted from radioactive substances?
Positron emission tomography (PET)
The nurse cares for a client after an endoscopic examination and prepares the client for discharge. The nurse includes which instruction?
Resume regular diet
Which of the following is the primary function of the small intestine?
absorption
Which of the following is the most definitive means of assessing for liver disease?
biopsy
The nurse recognizes that the client diagnosed with a duodenal ulcer will likely experience
pain 2-3-3 hours after a meal
Which is the most common cause of esophageal varices?
portal hypertension
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 gastic activity and secretions, which need to be minimized to promote recovery.
A client with a gastrointestinal condition asks why the mouth needs to be examined. Which response will the nurse make?
"Changes in the mouth can help explain why your condition is occurring"
When preparing a client for magnetic resonance imaging (MRI) of the abdomen, which statement would indicate the need to notify the health care provider?
"I really don't like to be in small, enclosed spaces."
A client with an H. pylori infection asks why bismuth subsalicylate is prescribed. Which response will the nurse make?
"it aids in the healing of the stomach lining"
A nurse is providing discharge instruction for a client who is postoperative bariatric surgery. What statement will the nurse include when providing teaching aimed at decreasing the risk of gastric ulcers?
Avoid taking non-steroidal anti-inflammatory drugs
During a colonoscopy with moderate sedation, the patient groans with obvious discomfort and begins bleeding from the rectum. The patient is diaphoretic and has an increase in abdominal girth from distention. What complication of this procedure is the nurse aware may be occurring?
Bowel perforation
The nurse prepares a client for a barium enema. The nurse should place the client on which diet prior to the procedure?
Clear liquids day before
The nurse is working with a client who has difficulty controlling blood sugar. The client is classified as overweight. The client does not adhere to a low-calorie diet and forgets to take medications and check blood glucose level. The client's glycohemoglobin is 8.5%. When establishing a goal for the client, what action will the take first?
Collaborates with the client to establish an agreed-upon goal
A nurse is reviewing the medical records of several patients and their risk for health problems. The nurse determines that the patient with which body mass index (BMI) would have the lowest risk?
23
A patient is scheduled for a Billroth I procedure for ulcer management. What does the nurse understand will occur when this procedure is performed?
A partial gastrectomy is performed with anastomosis of the stomach segment to the duodenum
The nurse is caring for a client recovering from an esophagogastroduodenoscopy (EGD). Which of the following client symptoms would require further nursing assessment?
Abdominal distention
A client with newly diagnosed hypertension asks what to do to decrease the risk for related cardiovascular problems. Which risk factor is not modifiable by the client?
Age
An older client underwent a lumpectomy for a breast lesion that was determined to be malignant. Which factors in the client's history may have increased the risk of breast cancer?
All options are correct
A nurse cares for an obese client taking phentermine for weight loss. What client teaching will the nurse include when discussing precautions about the medication?
Do not drink alcohol while taking this medication
A nurse teaches a client who will undergo bariatric surgery the importance of avoiding problematic foods post surgery. Which foods will the nurse suggest the client avoid? Select all that apply.
Doughy breads, overcooked meats, pasta, rice
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?
Dumping syndrome
The nurse is caring for a client who has developed dumping syndrome while recovering from a gastrectomy. What recommendation should the nurse make to the client?
Eat several small meals daily spaced at equal intervals
The nurse is preparing to assess a new client who has class III obesity. In order to provide empathic and holistic care for this client, the nurse should first:
Examine his or her own preconceptions and beliefs about obesity
The nurse is teaching a client about peptic ulcers. The client understands the provided education when stating which of the following?
Hemorrhage and gastritis are the most common complications.
A client with abdominal pain is scheduled for a CT scan of the abdomen with contrast. Which assessment will the nurse complete before transporting the client for the diagnostic test?
History of allergies
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
A nurse is caring for a client who has a history of sleep apnea. The client understands the disease process when he says:
I should become involved in a weight loss program
The nurse instructs a client with a peptic ulcer on modifications to make to their diet. Which statement indicates to the nurse that teaching has been effective?
I will stop drinking decaffeinated coffee
A client is scheduled for an upper gastrointestinal barium study. Which teaching will the nurse provide for the client to prepare for this diagnostic test?
Ingest nothing by mouth after midnight
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.
Ingestion of strong acids, Irritating foods, Overuse of aspirin
A nurse cares for a client who is obese. The health care provider prescribes orlistat in an effort to help client lose weight, along with diet and exercise. When teaching the client about this medication, what will the nurse include?
It binds with enzymes to help prevent digestion of fat
While palpating a client's right upper quadrant (RUQ), the nurse would expect to find which structure?
Liver
A nurse cares for a client who is post op bariatric surgery. Which position will the nurse place the client in order to best promote comfort?
Low fowler's
A client is newly diagnosed with a gastric outlet obstruction. Which topic will the nurse include in client education?
Management of constipation
Which is a true statement regarding gastric cancer?
Most clients are asymptomatic during the early stage of the disease.
Peptic ulcer disease occurs more frequently in people with which blood type?
O
Which medication classification represents a proton (gastric acid) pump inhibitor?
Omeprazole
The nurse is working with clients with digestive tract disorders. Which of the following organs does the nurse realize has effects as an exocrine gland and an endocrine gland?
Pancreas
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?
Peptic ulcers
A client undergoing a diagnostic examination for gastrointestinal disorder was given polyethylene glycol/electrolyte solution as a part of the test preparation. Which of the following measures should the nurse take once the solution is administered?
Permit the client to drink only clear liquids
The nurse is caring for a client with cirrhosis. Which assessment findings indicate that the client has deficient vitamin K absorption caused by this hepatic disease?
Purpura and petechiae
A client who is recovering from bariatric surgery has not had a bowel movement for 48 hours and bowel sounds are absent on auscultation. The nurse has informed the on-call health care provider who has prescribed insertion of a nasogastric tube to low suction. What is the nurse's best action?
Question the order due to the client's recent bariatric surgery
A client recovering from surgery to resect a gastric tumor reports abdominal cramping and diarrhea after eating. Which additional symptoms will the nurse use to determine if the client is experiencing dumping syndrome? Select all that apply.
Report of extreme hunger 3 hours after eating, and sudden onset of extreme shakiness and fatigue
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
The instructor has just finished 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 structure as possibly being affected?
Stomach
A client is recovering at home after surgical removal of a malignant gastric tumor. The client reports feeling weak and fatigued. Which recommendation will the nurse provide the client?
Suggest a home health aide to help with ADLs
The nurse is preparing to examine the abdomen of a client who reports a change in bowel pattern. The nurse would place the client in which position?
Supine with knees flexed
The client describes a test previously completed to detect a small bowel obstruction prior to admission to the hospital. The client states that the test involved insertion of a tube through the nose and lasted over 6 hours. The nurse determines which test name should be documented?
Upper GI enteroclysis
A nurse cares for a female client of childbearing age who will undergo bariatric surgery. When teaching the client about precautions after surgery, which teaching will the nurse include that is specific to this population?
You should avoid pregnancy for at least 18 months after surgery
The nurse determines one or two bowel sounds in 2 minutes should be documented as
hypoactive
An important message for any nurse to communicate is that drug-induced hepatitis is a major cause of acute liver failure. The medication that is the leading cause is:
ibuprofen
A nurse cares for clients with obesity and recognizes that clients with larger waist-to-hip ratios are at greater risk for obesity-related morbidity in comparison to others with smaller waist-to-hip ratios. What findings related to this does the nurse recognize as true? Select all that apply.
individuals with large wast-to-hip ratios have android obesity, individuals with larger waist-to-hip ratios are also referred to as apple-shaped, individuals with larger waist-to-hip ratios have larger visceral fat stores.
A client who is post op from bariatric surgery reports constipation. What is the most likely cause of the client's symptoms?
insufficient water intake
A client is diagnosed with megaloblastic anemia caused by vitamin B12 deficiency. The health care provider begins the client on cyanocobalamin (Betalin-12), 100 mcg I.M. daily. Which substance influences vitamin B12 absorption?
intrinsic factor
Which term describes a gastric secretion that combines with vitamin B12 so that it can be absorbed?
intrinsic factor
A client is being prepared to undergo laboratory and diagnostic testing to confirm the diagnosis of cirrhosis. Which test would the nurse expect to be used to provide definitive confirmation of the disorder?
liver biopsy
A nurse is caring for a client newly diagnosed with hepatitis A. Which statement by the client indicates the need for further teaching?
metabolism of medications
A nurse is giving a client barium swallow test. What is the most important assessment a nurse would make to ensure that a client does not retain any barium after a barium swallow?
monitoring the stool passage and its color
Which of the following is the most successful treatment for gastric cancer?
removal of the tumor
A client with obesity is prescribed orlistat for weight loss. The client asks the nurse, "I understand the medication prevents digestion of fat, but what happens if I eat fat?" What is the nurse's best response?
the fat is passed in your stools
