Deck 38: Gastrointestinal System

Question 1

The nursing student is aware that the cause of peptic ulcers is related to:

A)acid/pepsin imbalance
B)erosive gastritis that starts to bleed
C)impaired mucosal defenses
D)high secretion of HCl (hydrochloric acid)

Answer 1

acid/pepsin imbalance

Question 2

A client who has ulcerative colitis has an increased chance of developing which of the following?

A)viral pneumonia
B)colorectal cancer
C)pernicious anemia
D)intestinal obstruction

Answer 2

colorectal cancer

Question 3

Clients who have a history of esophageal varices should avoid which of these?

A)antibiotics
B)antihistamines
C)NSAIDs (nonsteroidal anti-inflammatory drugs)
D)laxatives

Answer 3

NSAIDs (nonsteroidal anti-inflammatory drugs)

Question 4

A client complains of lower right abdominal pain and nausea,and appendicitis is suspected.Which of the following lab reports would assist in confirming the diagnosis?

A)5,000/mm3 WBC (white blood cells);50% neutrophils
B)10,000/mm3 WBC;75% neutrophils
C)15,000/mm3 WBC;85% neutrophils
D)2,000/mm3 WBC;40% neutrophils

Question 5

Clients with diverticulitis will frequently complain of abdominal pain located in which area of the abdomen?

A)generalized
B)left lower side
C)right lower side
D)umbilicus area

Question 6

Which of these factors contributes to a client developing gastritis?

A)exposure to irritating substances such as ibuprofen
B)impaired esophageal sphincter function
C)high-fat diet
D)viral infection

Question 7

Which of these questions is essential to include during the nursing assessment of a client who has digestive system symptoms?

A)whether the client was breast-fed or bottle-fed as an infant
B)whether the client consumes coffee or tea with meals
C)client's knowledge of the food pyramid
D)client's medication history,including over-the-counter drugs

Question 8

A client who has diverticulitis should be instructed to follow which of these prescribed diets when the acute episode is resolved?

A)bland,low residue
B)clear liquids
C)high fiber
D)high protein

Question 9

A client is admitted with diverticulitis of 1 day's duration.Which of these nursing interventions should be included in the client's plan of care?

A)Offer oral fluids frequently.
B)Ambulate ad lib.
C)Keep the client in a private room.
D)Maintain NPO.

Question 10

A client experiences postprandial rapid gastric dumping after a gastrectomy.Which of these approaches should the nurse include in the client's teaching plan?

A)Avoid complex carbohydrates.
B)Eat small meals frequently.
C)Reduce fiber and protein intake.
D)Drink carbonated beverages with meals.

Question 11

Which of these statements about Crohn's disease is TRUE?

A)It affects only the mucosal lining of the bowel.
B)It is treated by colostomy.
C)It can occur anywhere in the small and large intestines.
D)It can produce 15 to 20 liquid stools containing blood daily.

Question 12

When teaching the client with gastritis,the nurse should include which of these instructions?

A)"Avoid eating at bedtime."
B)"Drink as much decaffeinated tea and coffee as you like."
C)"Drink only milk products and antacids until the pain subsides."
D)"Eat anything you want as long as you take your medications on time."

Question 13

An 83-year-old client tells the nurse,"My food doesn't taste as good anymore." Which of these responses by the nurse is correct?

A)"As we age our taste buds decrease.Experiment with various seasonings,but avoid salt."
B)"If your dentures don't fit well,improper chewing could affect your ability to taste food."
C)"Try holding your food in your mouth longer to provide increased taste."
D)"You may find smaller,more frequent meals to be more satisfying."

Question 14

A nurse is caring for a client who has esophageal varices.A difference of how many mmHg in orthostatic blood pressure could indicate a change in fluid volume and possible recurrence of varix bleeding?

A)10
B)20
C)30
D)40

Question 15

When do clients who have gastric ulcers MOST often complain of pain?

A)2 hours before meals
B)1 to 2 hours after eating
C)3 to 4 hours after eating
D)whenever the stomach is empty

Question 16

A client is being treated for bleeding esophageal varices with a Sengstaken-Blakemore tube.Nursing care will include which of these approaches?

A)allowing the client to assume a position of choice
B)emptying the drainage bottle and recording output
C)periodically deflating the balloon
D)providing sips of ice water every 30 to 45 minutes

Question 17

Stress ulcers are the result of which of these factors?

A)acid/pepsin imbalance
B)erosive gastritis that starts to bleed
C)exposure to irritants and impaired mucosal defenses
D)high secretion of HCl

Question 18

A client is admitted with the diagnosis Rule out appendicitis.Which nursing action is MOST important?

A)assessing the client's pain threshold
B)avoiding administering analgesics
C)encouraging the family to visit
D)monitoring laboratory reports

Question 19

A client develops stomatitis as a complication of cancer chemotherapy.Which of these approaches should be included in the client's nursing care?

A)oral care q.d.
B)high-calorie liquid diet
C)diet as tolerated
D)intravenous (IV)morphine

Question 20

A client has a gastrectomy and vagotomy for treatment of peptic ulcer disease.Why was the vagotomy performed?

A)to anastomose the remaining portion of the stomach to the bowel
B)to remove the vagal innervation to the fundus of the stomach
C)to remove the perforated section of the stomach or bowel
D)to prevent further hemorrhage from the site

Question 21

A client who has surgical treatment for peritonitis would be encouraged to do all of the following postoperatively.Which is the MOST important for this client?

A)active exercises of the ankles and knees
B)pulmonary hygiene
C)splinting the abdominal incision with a pillow
D)turning every 2 hours

Question 22

A client who has viral hepatitis should have which dietary modification to allow the liver to heal?

A)restricted caloric intake
B)restricted fluids
C)low carbohydrate
D)low protein

Question 23

Paralytic ileus can develop as the result of:

A)adhesions that obstruct the bowel's lumen
B)interrupted blood flow to a portion of the bowel,which then becomes necrotic
C)interrupted nerve transmission to the bowel with a portion becoming paralyzed
D)a tumor obstructing the bowel's lumen

Question 24

Administration of hepatitis B immunoglobulin (HBIG)is recommended for which group?

A)health care workers
B)people who are homosexual
C)anyone exposed by needle puncture or sexual contact
D)the general public

Question 25

Which of these nursing interventions is MOST important when a client is initially diagnosed with any type of hepatitis?

A)administration of immune globulin
B)restriction of fluid intake
C)bed rest
D)decrease of fat intake

Question 26

The nurse is assessing a client who states having recently noted dark urine and light clay-colored stools.Based on this information,the nurse should inspect the client for which of these signs?

A)accommodation
B)jaundice
C)photophobia
D)pruritus

Question 27

For a client who has viral hepatitis,which of these statements is TRUE?

A)Frequent rest periods are optional.
B)Thorough hand hygiene is essential.
C)Food preparation is unaffected.
D)Donating blood is encouraged.

Question 28

An older adult client tells the nurse about experiencing chronic constipation.The nurse should suggest that the client increase intake of which of these foods?

A)baked potatoes and rice
B)milk and cheese
C)fish and red meat
D)apples and broccoli

Question 29

A client is lifting a box and experiences a sudden pain in the lower right side and upper thigh,with a "bulge" in the groin area.The nurse notes a tight band around the bulge.The client has probably developed which type of hernia?

A)abdominal,reducible
B)femoral,strangulated
C)inguinal,incarcerated
D)umbilical,strangulated

Question 30

A client complains of colicky abdominal pain,nausea,constipation,and bloating.During the nursing assessment,the client vomits fecal material.Which of these conditions should be suspected?

A)abdominal hernia
B)duodenal ulcer
C)intestinal obstruction
D)pancreatitis

Question 31

A postoperative client has been receiving narcotic analgesics every 4 hours for incisional pain for 2 days and has now developed severe constipation.An enema has been prescribed by the health care provider.Client education about preventing constipation should emphasize that enemas and laxatives are not recommended for long-term use,because they can:

A)cause fluid and electrolyte imbalances
B)interrupt normal bowel function
C)remove normal bowel flora and cause infections
D)traumatize the intestinal lining

Question 32

Subjective signs and symptoms of viral hepatitis include which of the following?

A)severe vomiting and diarrhea
B)anxiety and hyperactivity
C)generalized weight gain
D)anorexia and photophobia

Question 33

A client is admitted with a diagnosis of hepatitis B infection.In preparing the client care area,the nurse institutes which type of special preventive measures?

A)enteric precautions
B)respiratory precautions
C)reverse isolation
D)Standard Precautions

Question 34

A client develops peritonitis as a result of a ruptured appendix.The nurse should carefully monitor the client for evidence of which of these complications?

A)hypothermia
B)thrombosis
C)hepatitis
D)paralytic ileus

Question 35

A client has recurrent ascites as a result of cirrhosis.Which of these procedures will the health care provider perform to allow extended control of this fluid buildup?

A)daily administration of aldactone
B)peritoneal venous shunt
C)albumin infusion
D)paracentesis

Question 36

Nursing interventions for clients with intestinal obstruction include all of the following.Which action would be a priority?

A)administering IV fluid and electrolyte replacements as ordered
B)checking weight daily
C)giving oral care frequently
D)monitoring intake and output every shift

Question 37

The client with cirrhosis may develop portal hypertension,which is associated with which of these conditions?

A)clotting disorders
B)esophageal varices
C)hypoglycemia
D)malnutrition

Question 38

A client who has cirrhosis requests a sleeping pill for insomnia.Which of these actions should the nurse take?

A)Administer a placebo.
B)Provide comfort measures to facilitate natural sleep.
C)Request a medication order from his health care provider.
D)Tell the client it is unsafe to take any medications.

Question 39

When a client with cirrhosis is admitted to the hospital,which of the following laboratory results would be expected?

A)albumin: high
B)alkaline phosphatase: low
C)GGT: normal
D)PT,PTT,and clotting times: delayed

Question 40

A client who has cirrhosis becomes very confused and lethargic and exhibits asterixis.These symptoms can indicate the development of what complication?

A)ascites
B)hepatic encephalopathy
C)hypoglycemia
D)portal hypertension

Question 41

When caring for a client who is obese,which of the following are risk factors for increased complications? (Select all that apply. )

A)immobility
B)skin breakdown
C)hypocoagulopathy
D)increased dietary needs
E)difficulty breathing
F)safety

Question 42

A client complains of daily indigestion and heartburn,especially after eating a large meal.A nurse should suspect that the client has which type of hernia?

A)abdominal
B)femoral
C)hiatal
D)umbilical

Question 43

Which of these routine screening tests is recommended for early detection of colorectal cancer?

A)sigmoidoscopy and barium enema
B)fecal occult blood and colonoscopy
C)urinalysis and complete blood count (CBC)
D)blood pressure and diet history

Question 44

Which of these statements about the treatment of cholelithiasis is TRUE?

A)Laparoscopic cholecystectomy is the surgery of choice.
B)Abdominal cholecystectomy is the surgery of choice.
C)Analgesics and antiemetics will control the disease.
D)Activity is encouraged before and after surgery.

Question 45

The nurse is caring for a client diagnosed with gastroesophageal reflux disease (GERD).Which of the following would the nurse expect the health care provider to use to treat this client? (Select all that apply. )

A)NPO diet
B)fundoplication
C)antacids
D)low-fat,low-protein diet
E)proton pump inhibitors