Deck 5: Care of the Patient With a Gastrointestinal Disorder

Question 1

Dumping syndrome after a Billroth II procedure occurs when high-carbohydrate foods are ingested over a period of less than 20 minutes. A nursing measure that will prevent or minimize dumping syndrome is to administer the feeding

A) by bolus to prevent continuous intestinal distention.
B) with large amounts of fluids to maintain hydration.
C) high in carbohydrates and protein.
D) in six small daily meals high in protein and fat.

Answer 1

in six small daily meals high in protein and fat.

Question 2

The patient complains that he will never adjust to his colostomy. In this situation, it would be best for the nurse to

A) encourage him to express his concern.
B) suggest that he discuss his concerns with his physician.
C) counsel him that everything will be all right.
D) explain that his concerns will be dealt with when he is taught how to care for his colostomy.

Answer 2

encourage him to express his concern.

Question 3

A patient with cancer of the esophagus has been receiving radiation therapy. The nurse realizes that this patient should be assessed for

A) aspiration from fistula formation.
B) hemorrhage.
C) incompetence of the suture line.
D) dumping syndrome.

Answer 3

aspiration from fistula formation.

Question 4

A 63-year-old patient is admitted with acute diverticulitis. The most appropriate nursing intervention to lessen this patient's signs and symptoms of increased flatus and chronic constipation alternating with diarrhea, anorexia, and nausea would be to

A) encourage a diet high in fiber content.
B) reduce oral intake to rest the bowel.
C) encourage fluids to prevent dehydration.
D) administer laxatives to prevent secondary constipation.

Question 5

A 56-year-old patient with diverticulitis has been admitted to the medical unit. The nurse will most likely document which assessment in the charting?

A) Chest pain
B) Pain in the upper right quadrant
C) Pain in the left lower quadrant
D) Progressive weight loss

Question 6

A progressive wavelike movement that occurs involuntarily in hollow tubes of the body, especially in the alimentary canal, to propel fluids, gas, and digestive substances forward is called

A) perisclerium.
B) periprostatic.
C) pleurolysis.
D) peristalsis.

Question 7

After barium swallow contrast studies are performed, the nurse should ensure that the patient

A) drinks adequate amounts of water.
B) remains in bed for 6 hours.
C) eats nothing until the gag reflex returns.
D) expels all barium rectally.

Question 8

The patient, age 32, is admitted with possible appendicitis after being evaluated by the physician. It is appropriate for the nurse to administer

A) fluid and electrolyte replacement.
B) heat to decrease discomfort.
C) a cleansing enema.
D) an oral laxative.

Question 9

The nurse determines that a patient has a knowledge deficit regarding her diagnosis of achalasia. The nurse begins patient teaching by explaining that achalasia is

A) a white patch on the mouth or tongue mucosa.
B) caused by frequent ulceration on the lip.
C) caused by excess exposure to sun and wind.
D) caused by the inability of a muscle to relax.

Question 10

The patient, age 32, has ulcerative colitis, and his condition is deteriorating. An ileostomy is scheduled. After the procedure, this patient may be at risk for

A) Activity intolerance.
B) Sexual dysfunction.
C) Disturbed body image.
D) Ineffective thermoregulation.

Question 11

A NANDA-accepted nursing diagnosis that could be written for a patient with an abdominoperineal resection and a permanent colostomy would include

A) Disturbed body image.
B) Ineffective thermoregulation.
C) Ineffective protection.
D) Autonomic dysreflexia.

Question 12

An ileostomy was performed on a patient for the treatment of debilitating ulcerative colitis disease. A problem the nurse should watch for in patients after this surgery is

A) fluid imbalance.
B) sexual activity restriction.
C) skin excoriation.
D) the collecting appliance being bulky and large.

Question 13

The emergency room staff is caring for a patient with an acute inflammatory intestinal disorder who is being observed to rule out appendicitis. Which intervention is contraindicated?

A) Give nothing by mouth until seen by a health care provider
B) Measure intake and output
C) Apply heat to the abdomen
D) Encourage bed rest

Question 14

The end-products of carbohydrate and protein digestion are absorbed by the

A) bloodstream.
B) blood vessels in the villi.
C) lymphatic system.
D) lymph vessels in the villi.

Question 15

The most important nursing intervention to assure the patency of a nasogastric tube (NG) is to:

A) Clamp nasogastric tube 30 minutes twice a day.
B) Monitor NG for patency and irrigate with sterile normal saline PRN as ordered.
C) Cleanse nares at least once each shift; lubricate with a petrolatum ointment.
D) Administer mouth care every 24 hours.

Question 16

Following a gastrectomy, the nurse would anticipate that the patient would need to be assessed for

A) renal failure.
B) vitamin B₁₂ deficiency.
C) obesity complications.
D) continuing his routine diet.

Question 17

A patient has been admitted for diagnostic procedures including an esophagogastroduodenoscopy. The nurse explains to this patient that during this procedure, the physician will

A) use a long, rigid, fiberoptic scope.
B) order NPO status 1 hour before the procedure.
C) view the esophagus, stomach, and upper small intestine.
D) visualize the intestine but cannot remove polyps.

Question 18

A patient had a ruptured diverticulum in his descending colon. He has undergone a transverse loop colostomy. He asks the nurse the purpose of this procedure, and the nurse tells him that it is

A) a temporary colostomy to allow healing of the bowel by diverting feces.
B) to allow for more thorough irrigations.
C) to provide two stomas for fecal elimination.
D) to prevent chronic constipation.

Question 19

A patient, age 84, has a history of a large left inguinal hernia. He is complaining of nausea, vomiting, abdominal distention, and inguinal pain. A serious complication of a hernia in which the blood supply to the tissue becomes occluded is called a(n)

A) strangulated hernia.
B) hiatal hernia.
C) incarcerated hernia.
D) sliding hernia.

Question 20

A patient, age 36, is admitted with diarrhea and dehydration. The physician has ordered several diagnostic studies of the patient's stools. When obtaining a stool specimen to be examined for ova and parasites, the nurse should

A) use an oil retention enema to facilitate collection.
B) refrigerate the specimen immediately.
C) instruct the patient to obtain three different stool specimens on subsequent days.
D) check the specimen for the presence of occult blood.

Question 21

Flexible sigmoidoscopy should be performed every ________ years.

Question 22

Symptoms of GERD (gastroesophageal reflux disease) can be modified or eliminated by which nursing interventions?

A) Eat three large meals daily.
B) Follow a high-protein, high-fat diet.
C) Remain upright for 1 to 2 hours post meals.
D) Eat a snack 1 hour before bedtime.

Question 23

A NANDA-accepted nursing diagnosis that could be written for the patient who is hemorrhaging and in hypovolemic shock from a bleeding peptic ulcer would include

A) Ineffective tissue perfusion (gastrointestinal).
B) Unilateral neglect.
C) Constipation.
D) Disuse syndrome (gastrointestinal).

Question 24

You administered the medication GoLYTELY to a 78-year-old woman in preparation for diagnostic tests. In planning for her care, which would be most appropriate?

A) Side rails up to prevent falling
B) Door closed for privacy
C) Available bedside commode for possible weakness
D) Monitor vital signs

Question 25

A patient was recently diagnosed with colorectal cancer. His wife asks the nurse, "What prevents colon cancer?" The nurse's answer should include which factors? (Select all that apply.)

A) A diet high in fiber
B) Familial predisposition of a cancer-causing gene
C) Regular checkups
D) A diet high in animal fats

Question 26

MATCHING
Match the purpose of nasogastric tubes with its description.

Gavage

A) Internal application of pressure by means of inflated balloon to prevent GI bleeding
B) Irrigation of stomach to remove secretions
C) Relieve abdominal distention
D) Instillation of liquid nutritional supplements into stomach

Question 27

The purpose of antibiotic therapy in treating stomach disorders is that it

A) eradicates H. pylori.
B) inhibits gastric acid secretion.
C) protects the gastric mucosa.
D) neutralizes or reduces the acidity of stomach contents.

Question 28

Peptic ulcers are often common in the aging population. Which medications should be taken with caution to help prevent this problem?

A) Antibiotics
B) Antacids
C) NSAIDs
D) Laxatives

Question 29

The most lethal complication of a peptic ulcer is

A) bleeding.
B) perforation.
C) severe pain.
D) gastric outlet obstruction.

Question 30

A patient is admitted with a diagnosis of Crohn's disease. What nursing interventions would be appropriate when caring for this patient? (Select all that apply.)

A) Daily weight
B) Monitor I & O every shift
C) Fluid restriction
D) Accessibility to bedside commode

Question 31

Colonoscopy should be performed every ________ years.

Question 32

What nursing interventions would be appropriate for inflammatory bowel disease diagnoses of Imbalanced Nutrition: less than body requirements related to bowel hypermotility and decreased absorption?

A) Provide three specific balanced meals a day.
B) Restrict fluid to 1000 mL per day.
C) Provide at least six small frequent meals per day.
D) Allow alcohol and caffeine products.

Question 33

Which nursing intervention would be the highest priority in evaluating a patient with peritonitis from a ruptured appendix?

A) Assessment of severity, location, and duration of pain
B) Assessment of vital signs
C) Preventing wound infection
D) Promoting balanced nutrition

Question 34

Sulfasalazine is the recommended medication for treatment of Crohn's disease. Patient teaching should include:

A) taking medication 2 hours before meals.
B) limiting fluid intake.
C) ensuring adequate hydration to prevent crystallization in kidneys.
D) increased effectiveness of oral contraceptives.

Question 35

Bowel sound assessment is especially important for a postoperative patient who has had abdominal surgery as it can determine the:

A) need for a cathartic.
B) return of peristalsis.
C) presence of singultus.
D) presence of eructation.

Question 36

Constipation is a problem for many older adults. The medical management to prevent constipation includes (Select all that apply):

A) Decreasing physical activity
B) Decreasing fluid intake
C) Nutritional diet high in fiber
D) Increasing fluid intake
E) Increasing daily activity
F) Decreasing strict daily routines

Question 37

MATCHING
Match the purpose of nasogastric tubes with its description.

Compression

A) Internal application of pressure by means of inflated balloon to prevent GI bleeding
B) Irrigation of stomach to remove secretions
C) Relieve abdominal distention
D) Instillation of liquid nutritional supplements into stomach

Question 38

MATCHING
Match the purpose of nasogastric tubes with its description.

Decompression

A) Internal application of pressure by means of inflated balloon to prevent GI bleeding
B) Irrigation of stomach to remove secretions
C) Relieve abdominal distention
D) Instillation of liquid nutritional supplements into stomach

Question 39

MATCHING
Match the purpose of nasogastric tubes with its description.

Lavage

A) Internal application of pressure by means of inflated balloon to prevent GI bleeding
B) Irrigation of stomach to remove secretions
C) Relieve abdominal distention
D) Instillation of liquid nutritional supplements into stomach