Deck 38: Digestive Tract Disorders

Question 1

The nurse is caring for a patient hemorrhaging from a peptic ulcer when the patient complains of a sharp sudden pain,with a rapidly deteriorating condition.Initially,the nurse should:

A) Roll the patient flat, and assess the vital signs.
B) Notify the charge nurse.
C) Suction the mouth.
D) Prepare for intravenous (IV) infusions.

Answer 1

Roll the patient flat, and assess the vital signs.

Question 2

The nurse explains that the newest endoscopic procedure for examining the small intestine is the:

A) Capsule camera
B) Fiber-optic light probe
C) Rigid lighted tubes
D) Flat plate

Answer 2

Capsule camera

Question 3

An instruction given to a patient with irritable bowel syndrome (IBS)that will lessen discomfort is:

A) Eat only whole grains.
B) Take small bites, and chew well.
C) Include dietary fiber in at least two meals per day.
D) Drink herbal teas and low-calorie cola drinks.

Answer 3

Take small bites, and chew well.

Question 4

The goal for your patient with gastritis who has experienced nausea,vomiting,and diarrhea is to have a return of normal elimination patterns.Which of the following best reflects this goal in a measurable manner?

A) The patient will have fewer stools.
B) Diarrhea will be controlled and not return.
C) The patient will have no more than one stool per day.
D) The patient's bowel pattern will return to normal.

Question 5

After administering promethazine (Phenergan)for nausea,the nurse takes extra precautionary implementations because of the common side effect of antiemetic medications,which is:

A) Check vital signs for erratic blood pressure.
B) Add a blanket to prevent chilling.
C) Provide extra water to combat thirst.
D) Put up side rails to prevent falls.

Question 6

The patient with a hiatal hernia should have a teaching plan to help reduce the complaints of heartburn,regurgitation,and eructation.This would include instruction about:

A) Eating three well-balanced meals.
B) Lying down 1 hour after eating.
C) Sleeping without pillows.
D) Eating nothing for several hours before bedtime.

Question 7

Stool softeners are prescribed to promote normal elimination of feces.The most appropriate way to ensure effectiveness of this type of drug is:

A) Mouth care
B) Ambulation
C) Adequate fluid intake
D) High-fiber diet

Question 8

The patient complains about the placement of the total parenteral nutrition (TPN)line and asks why it cannot be inserted in the arm.The nurse's response is based on the fact that placement in the:

A) Arm would limit patient mobility.
B) Subclavian artery allows for ease in dressing the puncture site.
C) Arm prevents the use of large-bore cannulas.
D) Subclavian artery allows for rapid dilution.

Question 9

Your 34-year-old patient is admitted with severe diarrhea,which has been going on for 2 weeks.The nurse would anticipate the assessments of:

A) Edema of lower legs and feet
B) Hypotension and fatigue
C) Hypertension and hunger
D) Metabolic alkalosis

Question 10

The nurse caring for a patient with a 3-day postoperative bowel resection observes that the suction apparatus is not working and the patient is becoming distended.The initial implementation should be to:

A) Pull tube outward 6 inches.
B) Push tube further in 3 inches.
C) Change the patient's position.
D) Irrigate with 60 ml of normal saline.

Question 11

The set of findings that best indicate that the patient with intestinal obstruction has achieved normal hydration is:

A) Pulse and blood pressure are within the patient's norms, mucous membranes are moist, and fluid intake and output are equal.
B) Pulse rate is strong (at least 60 beats/min), bowel sounds are normal, and a respiratory rate of 22 breaths/min is recorded.
C) Blood pressure is within the patient's norm, the temperature is below normal, and adequate tissue turgor is observed.
D) Mucous membranes are moist, the 24-hour fluid intake is higher than the 24-hour output, and the pulse rate is elevated.

Question 12

The nurse has collected several stool specimens that are to be sent to the laboratory.The nurse should:

A) Immediately take the specimens to the laboratory to be tested for parasites and ova.
B) Take the specimens to the laboratory to be tested for culture and sensitivity, and leave them for later pickup.
C) Take the specimens to the refrigerator to be tested later for parasites and ova.
D) Leave the specimens in a warm place until convenient time to deliver to the laboratory

Question 13

The patient inquires if this newer type of gastric analysis is going to require passage through a nasogastric tube.The nurse replies:

A) "Yes, but just for the instillation of the dye."
B) "No. You take a dye orally, which will be excreted in the urine in approximately 2 hours."
C) "Yes. You will take the dye orally, and then several gastric withdrawals through the tube will show the dye."
D) "Yes. Only one withdrawal will be made through the tube, which will be treated with dye and read in approximately 2 hours."

Question 14

The nurse is preparing to give a tube feeding using a large syringe.Before infusion,the nurse should:

A) Roll the patient flat.
B) Check for a residual formula, and return the patient to his or her stomach.
C) Place the end of the tube in water, and check for bubbles.
D) Flush the tube.

Question 15

After receiving a tube feeding,the patient becomes sweaty and has abdominal distention with diarrhea.The nurse assesses that this response is because of:

A) Expected reaction to the tube feeding
B) Dumping syndrome
C) Gastric reflux syndrome
D) Onset of gastroenteritis

Question 16

The 60-year-old patient who has just been diagnosed with cancer of the stomach says,"I feel blank and numb." The nurse's best response would be:

A) "Shock affects everyone that way."
B) "I'm sure you are considering what you should do now that you have cancer."
C) "Would you like me to bring you a sedative?"
D) "What do you mean when you say 'blank and numb?'"

Question 17

On assessment at an intake examination,the nurse notes a characteristic of an inguinal hernia that should be reported immediately,which is:

A) Hernia of 25 years' duration that can be easily reduced to the abdomen.
B) Hernia of 5 months' duration that can be reduced by an abdominal truss.
C) Hernia of 2 weeks' duration with no bowel movement in 2 days.
D) Hernia of 2 days' duration that cannot be reduced.

Question 18

During an admission assessment,the nurse assesses a risk factor that increases the chances of developing oral cancer; it is:

A) Alcohol consumption
B) Chewing gum
C) Environmental pollution
D) Consumption of a high-fat diet

Question 19

The home health nurse observes the patient with esophageal cancer tilt his head back while eating,which could result in:

A) Narrowing of the esophagus
B) Limiting the types of food that can be consumed
C) Increasing the risk of aspiration
D) Causing a neck injury

Question 20

The nurse caring for a patient with esophageal surgery who has had stents placed in the esophagus instructs the patient how best to avoid regurgitation.The instruction should include:

A) Keep the bed flat.
B) Eat only small meals.
C) Lie on the right side after meals.
D) Drink three glasses of fluid with each meal.

Question 21

The home health nurse suggests dietary changes to an older woman to help prevent constipation,which include:

A) Addition of whole-grain cereal
B) Cessation of laxative use
C) Increase in liquid intake
D) Increase in sugar intake
E) Eating fresh vegetables

Question 22

The assessment of a patient who is receiving a TPN feeding indicates hyperglycemia when which one of the following occurs?

A) Increase of urine output
B) Sudden diarrhea
C) Abdominal distention
D) Tachycardia

Question 23

While the patient is on TPN feedings,the nurse will include in the care plan to:

A) Monitor for hyperglycemia.
B) Assess temperature.
C) Change subclavian dressing with clean procedure.
D) Monitor for hypoglycemia.
E) Assess intake and output.

Question 24

The TPN feeding is running at 20 ml and is an hour behind schedule.The initial intervention would be:

A) Increase the flow rate to 22 ml/hr (10%), and inform the charge nurse.
B) Reposition the patient to the right side, and lower the head of the bed.
C) Dilute the thick feeding formula with 10 ml of sterile water, and inform the charge nurse.
D) Document the event, and inform the charge nurse.

Question 25

The nurse identifies a risk factor in an older man that places him at risk for developing diverticulosis.This risk factor is:

A) Eating a low-fiber diet
B) Chronic diarrhea
C) History of using nonsteroidal antiinflammatory drugs (NSAIDs)
D) Family history of colon cancer

Question 26

The nurse caring for a patient with achalasia can help the patient reduce swallowing difficulty by:

A) Identify foods that cause the problem.
B) Experiment with different eating positions.
C) Elevate the head of the bed at night.
D) Suggest eating more rapidly.
E) Offer small bites of fresh vegetables.

Question 27

Patient teaching to promote self-care for the individual with diverticulosis should include the avoidance of:

A) Peanuts and raspberries
B) Apples and pears
C) Red meat and dairy products
D) Bran and whole grains

Question 28

A need for further teaching is indicated when a patient with an ileostomy as a remedy for ulcerative colitis says:

A) "I will avoid milk products."
B) "I should select food with less dietary fiber."
C) "I'll miss my martini before dinner."
D) "I will be glad when the surgeon closes this ileostomy."

Question 29

The nurse describes a patient as morbidly obese because,with a weight of 387 pounds and a height of 2 meters,the patient's body mass index (BMI)is:

A) 58.4
B) 52.8
C) 43.9
D) 31.6

Question 30

The 92-year-old patient dehydrated from diarrhea exhibits anorexia and has lost 1 pound since yesterday.To help stimulate intake,the nurse would:

A) Moisten the patient's mouth with mouthwash.
B) Put away bedpans and urinals.
C) Leave the patient in privacy during mealtime.
D) Check the fit of the patient's dentures.
E) Offer favorite foods.

Question 31

After abdominal surgery,the patient must cough and take deep breaths.How can the nurse best achieve this with this patient?

A) Withhold analgesics until the patient performs this task.
B) Help the patient splint the incision with a pillow.
C) Explain that pneumonia occurs if deep breathing is not carried out every 4 hours.
D) Ambulate the patient 40 feet to increase his need for oxygen.

Question 32

The nurse includes in the teaching plan information about when and where specific digestion of food takes place:

A) Renin breaks down milk protein in the stomach.
B) Lipase breaks down fats in the stomach.
C) Pepsin begins to break down proteins in the stomach.
D) Liver and pancreatic secretions break down fats in the small bowel.
E) Ptyalin (amylase) breaks down carbohydrates in the colon.