Upper/Lower GI Evolve Practice Questions
The nurse is caring for a client who is having diarrhea. Which client data would the nurse closely monitor to prevent an adverse outcome A) skin condition B) F&E balance C) food intake D) fluid intake/output
B) F&E balance *** most important to monitor because excess loss of fluid through the multiple loose bowel movements associated with diarrhea lead to alteration in F&E balance
Which pain-related clinical manifestation would the nurse expect in a client who had received a diagnosis of a peptic ulcer? A) The pain intensifies after vomiting stomach contents B) The pain occurs 1-2 hours after having a meal C) The pain increases when ingesting an excess of fatty foods D) The pain begins in the epigastrium and radiates to the abdomen
B) The pain occurs 1-2 hours after having a meal *** pain occurs after the stomach empties; eating stimulates gastric secretions, which act on the gastric mucosa of an empty stomach, causing gnawing pain
The nurse is preparing to assess a client with PUD. Which assessment finding indicates a need for immediate health care provider notification? A) Nausea B) Dyspepsia C) Black stools D) Dull abdominal pain
C) Black stools *** this indicates the presence of blood in the stool and needs to be immediately reported to HCP
The nurse provides teaching for a client with GERD. The nurse should recommend that the client take which action after meals? A) Drink 8 oz (240 mL) of water B) Take a walk for 30 minutes C) Lie down for at least 20 minutes D) Rest in a sitting position for 1 hour
D) Rest in a sitting position for 1 hour ***gravity facilitates digestion and prevents reflux of stomach contents into the esophagus
Famotidine is prescribed for a client with PUD. Which mechanism of action is a characteristic of this medication? A) increases gastric motility B) neutralizes gastric acidity C) facilitates histamine release D) inhibits gastric acid secretion
D) inhibits gastric acid secretion *** famotidine decreases gastric secretion by inhibiting histamine at H2 receptors
The nurse is instructing a client with PUD about the diet that should be followed during the acute phase. Which type of diet would the nurse stress? A) Bland foods B) Regular diet C) Gluten-free foods D) Low-carb foods
A) Bland foods *** a bland, nonirrtating diet is recommended during the acute symptomatic phase; a regular diet would cause discomfort
The nurse is obtaining a health history for a client with a diagnosis of PUD. The nurse identifies a possible contributory risk factor when the client makes which statement? A) 'My blood is type A positive' B) 'I smoke one pack of cigarettes a day' C) 'I have been overweight most of my life' D) 'My blood pressure has been high lately'
B) 'I smoke one pack of cigarettes a day' *** smoking cigarettes increases the acidity of gastrointestinal secretions, which damages the mucosal lining
A client is diagnosed with a peptic ulcer. The nurse instructs the client to contact the health care provider immediately if the client's stool has which appearance? A) Frothy B) Ribbon-shaped C) Pale/clay-colored D) Dark brown/black
D) Dark brown/black *** melena (dark brown/black stools) indicate gastrointestinal bleeding and need to be reported
The 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? A) Inclusion of transmural involvement of the small bowel wall B) Higher occurrence of fistulas and abscesses from changes in the bowel wall C) Pathology beginning proximally with intermittent plaques found along the colon D) Involvement starting distally with rectal bleeding that spreads continuously up the colon
D) Involvement starting distally with rectal bleeding that spreads continuously up the colon
TRUE OR FALSE: the last meal for a patient with GERD should be eaten at least 3 hours before bedtime
TRUE
Which pain description would the nurse expect a client to report when describing pain associated with a suspected duodenal peptic ulcer? A) An ache radiating to McBurney point B) An intermittent, colicky right-flank pain C) A gnawing sensation in the epigastric area D) A generalized abdominal pain intensified by movement
C) A gnawing sensation in the epigastric area ***peptic ulcer pain is usually described as a gnawing sensation and is often caused by H. pylori and NSAIDS
A client with Crohn disease is admitted to the hospital with abdominal pain, fever, poor skin turgor, and having experienced 10 liquid bowel movements in the past 24 hours. The nurse suspects that the client is dehydrated based on which assessment findings? SELECT ALL THAT APPLY. - moist skin - sunken eyes - decreased apical pulse - dry mucous membranes - increases BP
- sunken eyes - dry mucous membranes ***these occur because decreased intracellular/interstitial fluid associated with dehydration
A client has surgery for the creation of a colostomy. Postoperatively, which color would the nurse expect a viable stoma to be? A) Brick red B) Pale pink C) Light gray D) Dark purple
A) Brick red *** this color indicates adequate vascular perfusion while the other colors indicate poor tissue perfusion
The nurse provided education to a client with PUD regarding foods/substances to avoid that would increase the secretion of gastric acid. Which food choice for breakfast selection made by the client indicates a need for further teaching? A) Coffee and toast B) Grapes and cheese C) Apple juice and pancakes D) Cheese and crackers
A) Coffee and toast ***caffeine-containing drinks such as coffee, tea, and soda can increase the production of gastric acid therefore this menu choice indicates a need for further education
A healthcare provider prescribes dietary/medication therapy for a client with a diagnosis of GERD. What is appropriate for the nurse to teach the client about meal management? A) Consume a snack each evening B) Divide food into 4- meals a day C) Eat the last of 3 daily meals by 8:00PM D) Suck on a peppermint candy after each meal
B) Divide food into 4- meals a day *** the volume of food in the stomach should be kept small to limit pressure on the lower esophageal sphincter
A client with the diagnosis of ulcerative colitis has surgery for the creation of an ileostomy. For which potential life-threatening complication would the nurse assess the client postoperatively? A) Wound infection B) Ischemia of the stoma C) Fluid deficit and electrolyte imbalnce D) Excoriation of skin around the stoma
C) Fluid deficit and electrolyte imbalance ***the continuous excretion of liquid feces may deplete the body of F&Es
A client with gastric ulcer disease asks the nurse why the health care provider has prescribed metronidazole. Which purpose would the nurse provide? A) To augment the immune response B) To potentiate the effect of antacids C) To treat H. pylori infection D) To reduce hydrochloric acid secretion
C) To treat H. pylori infection *** approximately 2/3 of clients with PUD are found to have H. pylori infecting the mucosa and interfering with its protective function
The nurse is providing discharge instructions for a client with a diagnosis of gastroesophageal reflux disease (GERD). Which recommendations would the nurse give to the client to limit symptoms of GERD? SELECT ALL THAT APPLY. - Avoid heavy lifting - Lie down after eating - Avoid drinking alcohol - Eat small, frequent meals - Increase fluid intake with meals - Wear an abdominal binder/girdle
- Avoid heavy lifting - Avoid drinking alcohol - Eat small, frequent meal
A client with GERD needs to make dietary/lifestyle changes. Which instructions would the nurse include in the client's discharge teaching? - Encourage the client to quit smoking - Elevate the foot of the bed - Avoid milk/dairy products - Eat 3 large, evenly spaced meals daily - Avoid lying down for 2-3 hours after eating
- Encourage the client to quit smokinig - Avoid lying down for 2-3 hours after eating
A client has a diagnosis of hemorrhoids. Which s/s would the nurse expect the client to report? SELECT ALL THAT APPLY. - flatulence - anal itching - blood in stool - rectal bulging - pain when defecating
- anal itching - blood in stool - rectal bulging - pain when defecating
A client with gastroesophageal reflux disease reports having difficulty sleeping at night. Which instruction should the nurse provide to the client? A) Drink a glass of milk before retiring B) Elevate the head of the bed on blocks C) Eliminate carbs from the diet D) Take antacids such as sodium bicarbonate
B) Elevate the head of the bed on blocks ***elevating the head of the bed on blocks raises the upper torso and minimizes reflux of gastric contents
A client is admitted to the hospital with a diagnosis of peptic ulcer. Which common complication would the nurse assess for in this client? A) Perforation B) Hemorrhage C) Pyloric obstruction D) Esophageal varices
B) Hemorrhage ***because of erosion of blood vessel walls is the most common complication of PUD
The diet prescribed for a client with diverticulosis includes 30 grams of fiber a day. Which breakfast items would the nurse encourage the client to select? A) cream of wheat, milk, and cranberry juice B) Unstrained OJ, pancakes, and bacon C) Oatmeal, sliced bananas, whole-wheat toast, and milk D) Poached eggs on whole-wheat toast, tomato juice, and tea
C) Oatmeal, sliced bananas, whole-wheat toast, and milk *** foods high in fiber = whole wheat, raw fruit/vegetables, and bran cereals (IF WHITE, = LOW FIBER)
TRUE OR FALSE: Alcohol, in addition to peppermints, caffeine, and chocolate, decreases lower esophageal sphincter (LES) pressure, which permits gastric contents to move from the stomach into the esophagus
TRUE
Which rationale explains why the nurse also monitors a client with a history of GERD for clinical manifestations of heart disease? A) Esophageal pain may imitate the symptoms of a heart attack B) GERD may predispose the client to the development of heart disease C) Strenuous exercise may exacerbate reflux problems D) Similar laboratory study changes may occur in both problems
A) Esophageal pain may imitate the symptoms of a heart attack ***clients may interpret symptoms associated with myocardial infarction as esophageal reflux and ignore them
A client with severe Crohn disease develops a small bowel obstruction. Which clinical finding would the nurse expect the client to report? A) Bloody vomitus B) Projectile vomiting C) Bleeding with defecation D) Pain in the left lower quadrant
B) Projectile vomiting *** n/v, accompanied by diffuse abdominal pain, commonly occur in clients with small bowel obstruction; the vomiting may be projectile and may contain bile/fecal material
Which info would be included in the teaching plan for the older adult client with peptic ulcer disease who is taking an antacid and sucralfate? A) Antacids should be taken 30 minutes before a meal. B) Sucralfate should be taken on an empty stomach 1 hour before meals C) Sucralfate is prescribed for the long-term maintenance of PUD D) Sodium bicarbonate is an inexpensive over-the-counter antacid with few adverse effects
B) Sucralfate should be taken on an empty stomach 1 hour before meals
After many years of coping with ulcerative colitis, a client makes the decision to have a colectomy as advised by the HCP. Which is most likely the significant factor that affected the client's decision? A) It is temporary until the colon heals B) Surgical treatment cures ulcerative colitis C) Ulcerative colitis can progress to Crohn disease D) Without surgery, eating table foods is contraindicated
B) Surgical treatment cures ulcerative colitis ***when the diseased bowel is removed, the client's symptoms ceas
An older client's colonoscopy reveals the presence of extensive diverticulosis. Which type of diet would the nurse encourage the client to follow? A) low-fat B) high-fiber C) high protein D) low-carb
B) high-fiber *** a high fiber diet is recommended for diverticulosos; fiber promotes passage of residue through the intestine, thereby preventing constipation
