Deck 4: Digestion

Question 1

During an interview with a client diagnosed with hepatitis B,the nurse obtains the following data: 10 kg weight loss is noted from the client's last visit 4 months ago; review of systems reveals 1)limiting fatigue,2)not well enough for sexual intercourse but doubts if her husband will be willing to use a condom,3)drinks 3-5 mixed drinks weekly socially,4)RUQ pain rated at 6/10,and 5)"constant" pruritus.Prioritize the nursing diagnoses formulated for this client.

A) Imbalanced Nutrition
B) Impaired Skin Integrity
C) Acute Pain
D) Deficient Knowledge

Answer 1

C,D,A,B
Explanation: A) Relieving the pain associated with hepatitis and preventing the spread of infection are priorities of hepatitis management. Interventions related to knowledge deficit will address the potential for spread of the infection to the client's husband, use of alcohol, imbalanced nutrition, and impaired skin integrity.
B) Relieving the pain associated with hepatitis and preventing the spread of infection are priorities of hepatitis management. Interventions related to knowledge deficit will address the potential for spread of the infection to the client's husband, use of alcohol, imbalanced nutrition, and impaired skin integrity.
C) Relieving the pain associated with hepatitis and preventing the spread of infection are priorities of hepatitis management. Interventions related to knowledge deficit will address the potential for spread of the infection to the client's husband, use of alcohol, imbalanced nutrition, and impaired skin integrity.
D) Relieving the pain associated with hepatitis and preventing the spread of infection are priorities of hepatitis management. Interventions related to knowledge deficit will address the potential for spread of the infection to the client's husband, use of alcohol, imbalanced nutrition, and impaired skin integrity.

Question 2

The nurse is providing care for several clients on a medical-surgical unit.The nurse anticipates that the client with which condition may require surgery?

A) Hepatitis
B) Pancreatitis
C) Pyloric stenosis
D) Fecal impaction

Answer 2

Pyloric stenosis

Question 3

A client presents with delayed wound healing.During the physical assessment,which nutrient deficiency does the nurse anticipate based on the data?

A) Protein
B) Digestive enzymes
C) Insulin
D) Carbohydrates

Answer 3

Protein

Question 4

When planning care for a client with chronic hepatitis,which collaborative discipline will be most helpful in treating continued alcohol use?

A) Social worker
B) Primary provider
C) Pharmacist
D) Dietitian

Question 5

The nurse is considering nutritional support for a client experiencing severe side effects of chemotherapy.Which independent and collaborative interventions will best limit the adverse digestive and nutritional effects of chemotherapy?

A) Encourage client to drink 350 ml of clear liquids within 1 hour prior to meals.
B) Position the client flat during intermittent enteral nutrition feedings.
C) Verify that enteral nutrition and total parenteral nutrition (TPN) are never used concurrently.
D) Offer the client music therapy in addition to IV ondansetron.

Question 6

The nurse has implemented a care plan for an adult client with gastroesophegeal reflux disorder (GERD).On the next clinic visit,which statement by the client indicates adherence to the plan of care?

A) "Spandex camisoles are worth heartburn."
B) "I have switched from margaritas to wine."
C) "I've lost 6 pounds because I eat every 3 hours and never before bed."
D) "I take a TUMS with the ranitidine to make it work better."

Question 7

A client presents at the emergency department reporting a burning pain in the chest of a 7 on a 0 to 10 pain scale.Gastroesphogeal reflux disorder (GERD)secondary to hiatal hernia is diagnosed.Based on this data,which is the priority nursing diagnosis?

A) Dysfunctional Gastrointestinal Motility
B) Anxiety
C) Acute Pain
D) Ineffective Health Maintenance

Question 8

What statement made by the client would indicate understanding of discharge teaching for self-care after hospitalization for acute pancreatitis?

A) "I will avoid onions, caffeine, and spices."
B) "I will take the antibiotics for 2 weeks."
C) "I will avoid alcoholic beverages."
D) "I will get immunized prior to my vacation."

Question 9

The multidisciplinary care team is meeting to discuss care for a client who exhibits symptoms of the prodromal phase of hepatitis.Lab results include a positive anti-HAV IgM.The nurse creates an action plan to present to the team.Which interventions are appropriate? Select all that apply.

A) High-fat, low-calorie, and no-alcohol diet teaching
B) Patient education on acceptable pain medication
C) Early treatment with lamivudine
D) Referral to the liver transplant team
E) Family teaching for transmission prevention.

Question 10

A client is diagnosed with viral hepatitis transmitted by the fecal-oral route.Which conditions may be acquired by this mode of transmission?

A) Hepatitis A (HAV) and hepatitis E (HEV)
B) Hepatitis B (HBV) and hepatitis C (HCV)
C) Hepatitis D (HDV)
D) Hepatitis A (HAV), Hepatitis B (HBV), Hepatitis C (HCV), Hepatitis D (HDV), and Hepatitis E (HEV)

Question 11

A client is scheduled for a diagnostic test to determine digestion status.Which test does not require fasting or other preparation?

A) Barium swallow
B) Amylase
C) Endoscopy
D) Lipid panel

Question 12

A client is with a history of gastroesophageal reflux disorder (GERD)presents with metabolic alkalosis.Based on the data reviewed in the client's history,which medication does the nurse suspect contributed to the current diagnosis?

A) Aluminum hydroxide
B) Omeprazole
C) Ranitidine
D) Metoclopramide

Question 13

The nurse is explaining the alteration in normal function to a client recently diagnosed with gastrointestinal reflux disease (GERD).Which etiology contributing to GERD will the nurse include in the teaching session?

A) Transient constriction of the lower esophageal sphincter
B) Decreased pressure within the stomach
C) Incompetent lower esophageal sphincter
D) Prolonged constriction of the upper esophageal sphincter

Question 14

The nurse is providing care to a client diagnosed with celiac disease who experiences frequent diarrhea.Based on this data,the nurse anticipates the client may also experience which associated problems? Select all that apply.

A) Skin breakdown
B) Fluid and electrolyte imbalance
C) Hair loss
D) Lifestyle issues
E) Sexual dysfunction

Question 15

An older adult African-American client with a history of celiac disease presents with abdominal cramps,pain,and diarrhea.The client denies the use alcohol,but states,"my favorite foods are steak,cheese,and ice cream." Based on this data,which condition does the nurse suspect?

A) Acute pancreatitis
B) Appendicitis
C) Lactase deficiency
D) Food poisoning

Question 16

An adult client with a BMI of 39 who smokes 1 pack of cigarettes per day is admitted to the hospital with chest pressure.After myocardial infarction is ruled out,the client is diagnosed with erosive esophagitis through upper GI endoscopy.The client is now refusing all medications and states "I'm not getting hooked on any pills." What would the nurse recommend for the multidisciplinary collaborative plan? Select all that apply.

A) Assess the client's readiness for change in smoking cessation and weight loss.
B) Interview the client and spouse for a 24-hour recall of usual food content, intake, and meal times.
C) Enlist the client's son to elevate the foot of the client's bed at home 6 inches.
D) Offer the client a surgical consult to reduce the necessity of medication.
E) Omit the pharmacist notification of the Multidisciplinary Team meeting about the client.

Question 17

A young adult waiter has been treated for viral hepatitis at a health care clinic.Which client outcome indicates the need for additional intervention? Select all that apply.

A) Body mass index (BMI) changes from 24 to 21.
B) Return demonstration of hand washing is correctly performed.
C) Social Services notified the Health Department of the occurrence.
D) Red scratch marks are noted on the arms and trunk.
E) Client denies abdominal or epigastric pain.

Question 18

The nurse is assigned to a 4-month-old infant with vomiting and diarrhea who is brought to the pediatric clinic.The infant's vital signs are temperature: 37° C,apical HR: 130,R: 40/min.The abdominal assessment reveals a soft,concave abdomen,10 gurgles auscultated in 1 minute in all four quadrants,and tympani to percussion.Which collaborative care action does the nurse anticipate?

A) Check the surgical call schedule and reserve an operating suite.
B) Place the infant NPO for a barium swallow.
C) Prepare a milk-based infant formula to replace fluids.
D) Complete a thorough digestion assessment interview with the mother.

Question 19

Which intervention would best improve diet adherence of an older Hispanic immigrant recently diagnosed with gastroesophageal reflux disorder (GERD)?

A) Scheduling low-fat meal deliveries to the home
B) Providing printed diet information in Spanish
C) Interviewing the client to assess his current diet
D) Giving a list of foods to avoid to the client's wife

Question 20

A school nurse is providing care to a number of school-age children diagnosed with celiac disease.Which interventions are appropriate for the nurse to implement with this group of students? Select all that apply.

A) Teaching about gluten-free food choices
B) Emphasizing low-calorie food selections
C) Implementing a school based prevention program to eliminate the disease process
D) Labeling gluten-free choices in the school lunch program
E) Emphasizing low-fat food selections

Question 21

The nurse is providing care to a pediatric client diagnosed with celiac disease.Which outcomes can be anticipated when the appropriate steps for managing celiac disease have been implemented? Select all that apply.

A) The client is free of abdominal discomfort including bloating, gas, indigestion, nausea, and vomiting.
B) The client is able to maintain normal or routine bowel habits.
C) The client has diarrhea fewer than 3 days weekly.
D) The client is able to maintain adequate nutritional status.
E) The client is able to make appropriate menu choices prior to discharge.

Question 22

The nurse is providing care to an older adult client admitted to the medical unit for acute gastric and left upper abdominal pain radiating to the back.The healthcare provider has diagnosed the client with chronic pancreatitis.Which items are appropriate to include in the discharge teaching for this client? Select all that apply.

A) Encouraging a high-fat diet
B) Eliminating alcoholic beverages
C) Properly administering pancrelipase
D) Monitoring weight every week
E) Taking antacids

Question 23

The nurse is providing care to a client admitted with acute pancreatitis.Which data support the client's diagnosis? Select all that apply.

A) Severe epigastric pain
B) Nausea and vomiting
C) Elevated temperature
D) Hypotension
E) Steatorrhea

Question 24

A new mother brings a male infant,2-weeks-old,to the pediatric clinic for a check-up.The mother is concerned that her infant may be at risk for pyloric stenosis due to her age and because her husband had surgery for the condition when he was an infant.Which responses by the nurse are the most appropriate based on this data?

A) "Your baby has a greater risk for the condition due to a familial history."
B) "Your baby would have an increased risk if the infant was a girl."
C) "Due to your age, your son is at an increased risk for the condition."
D) "As long as your baby has bowel movements there is nothing to worry about."

Question 25

The nurse is providing care to a client who is being admitted to rule out acute pancreatitis.Which item found in the client's history increases the client's risk for this disease process?

A) Systemic lupus
B) Alcoholism
C) Cystic fibrosis
D) Hypertriglyceridemia

Question 26

A school-age child,recently diagnosed with celiac disease,is underweight,vitamin-deficient,anemic,and experiences frequent diarrhea.In addition to removing gluten from his diet,what other recommendations will the nurse provide for this child and family? Select all that apply.

A) Fat restriction
B) A high-carbohydrate diet
C) Vitamin supplements
D) High-calorie diet
E) High protein diet

Question 27

A nurse is caring for an infant post-surgery for pyloric stenosis.Which nursing interventions are appropriate when providing care for this infant? Select all that apply.

A) Administer analgesics, per order.
B) Instruct the parents on proper diapering to avoid pressure over the incision.
C) Encourage swaddling and rocking to facilitate relaxation.
D) Teach the parents to remove the steri-strips during the infant's first bath post-surgery.
E) Monitor temperature once per shift.

Question 28

The nurse is providing care to an older adult client with a history of alcohol abuse who is admitted to the hospital with acute pancreatitis.Which treatment options should the nurse plan for when caring for this client? Select all that apply.

A) Opioid analgesics
B) High-fat diet
C) Total parenteral nutrition
D) Nasogastric tube to suction
E) Pancrealipase administration

Question 29

Parents of a child diagnosed with celiac disease have requested guidance on how to implement an appropriate diet.In addition to a list of foods to include and exclude,which interventions by the nurse are appropriate? Select all that apply.

A) Obtaining a dietary prescription
B) Implementing a recommended exercise program
C) Training on how to read food labels
D) Providing a referral to support groups
E) Encouraging the use of a gluten-free cookbook

Question 30

The nurse is providing care to a 1-month-old infant who is brought to the pediatric clinic for projectile vomiting.Which data collected during the assessment process would support the diagnosis of pyloric stenosis? Select all that apply.

A) Blood-tinged vomit
B) Low-grade fever
C) Persistent hunger
D) Peristaltic wave
E) Consistent weight gain

Question 31

A client diagnosed with chronic pancreatitis,asks if there are any alternative therapies that might help with treating the condition.The nurse teaches the client that which complementary and alternative therapies can be safely used in conjunction with traditional treatment? Select all that apply.

A) Aerobic exercise
B) Low-salt, low-fat vegetarian diet
C) Qigong
D) Magnetic field therapy
E) Herbal kava tea

Question 32

The nurse is providing care to an infant who underwent surgery for pyloric stenosis.Which actions by the nurse will decrease the risk for infection when caring for this infant? Select all that apply.

A) Monitor temperature every hour.
B) Place pressure on the incision.
C) Inspect the incision for redness, swelling, or discharge.
D) Auscultate the lungs to assess for any adventitious sounds.
E) Give the infant a tub bath.

Question 33

A client was discharged after hospitalization for acute pancreatitis with instructions on the use of analgesics,cautions on the importance of avoiding alcohol and smoking,and recommendations for a low-fat diet.Which outcomes would indicate that the client has implemented the recommendations? Select all that apply.

A) The client experiences reduction or elimination of pain.
B) The client is free from alterations in nutritional status.
C) The client remains free from alterations in fluid balance.
D) The client returns to work.
E) The client is free from nausea.