Deck 29: Disorders of the Esophagus, Stomach, and Small Intestine

Question 1

On assessing a client with a gastrointestinal disorder, the nurse finds steatorrhea, abdominal distension, and muscle wasting. The health-care provider prescribes corticosteroid therapy for the client. Which instruction does the nurse provide to effectively manage the condition?
1)Reduce alcohol ingestion
2)Reduce coffee consumption
3)Avoid fiber-containing foods
4)Avoid gluten-containing foods

Answer 1

4

Question 2

Which pathophysiological changes are responsible for pain in a client with acute gastritis? Select all that apply.
1)Atrophy of the gastric wall
2)Eradication of prostaglandins by medications
3)Increased blood supply at the inflammatory area
4)Increased pressure within the layers of the stomach
5)Accumulation of white blood cells at the inflammatory area

Answer 2

2, 3, 4

Question 3

A client tells the nurse, "I have had abdominal pain, bloating, visual disturbances, and bone pain for the last 3 to 6 months." On assessment, the nurse finds excessive weight loss and suspects an autoimmune hypersensitivity disorder. Which diagnostic test does the health-care provider recommend for further confirmation?
1)Abdominal computerized tomography (CT) scan
2)Ultrasound abdomen
3)Serology celiac panel
4)Barium contrast x-ray series

Answer 3

3

Question 4

A client is admitted into the emergency room with hematemesis; dark urine; and black, tarry feces. On examination, the nurse finds that the client has weight loss and a distended abdomen. Which condition does the nurse suspect in the client?
1)Hiatal hernia
2)Acute gastritis
3)Pyloric stenosis
4)Esophageal varices

Question 5

The nurse is providing care for a client diagnosed with Helicobacter pylori. Which diagnostic test result is the nurse least likely to expect?
1)Urea breath test
2)Stool antigen test
3)Blood test for antibodies
4)Fasting serum gastrin level

Question 6

The health-care provider prescribes a fasting serum gastrin level test and a magnetic resonance imaging (MRI) scan for symptoms of peptic ulcer. On reviewing the test reports, the nurse finds a diagnosis of hypergastrinemia and a tumor. The nurse administers the prescribed proton pump inhibitors. Which condition does the nurse identify?
1)Dumping syndrome
2)Mallory-Weiss syndrome
3)Zollinger-Ellison syndrome
4)Plummer-Vinson syndrome

Question 7

The nurse is attending a client 3 days postoperative for removal of a section of small bowel because of injury from a strangulated hernia. The nurse is aware the client is now diagnosed with short-bowel syndrome. Which initial postoperative teaching is most important for the nurse to provide?
1)The client will need 12 to 18 months for the body to adapt to the change.
2)The first 3 months will require careful monitoring and nutrition supplements.
3)The body will gradually adapt to the change and eventually function as normal.
4)An extensive regimen of medication therapy requires lifelong compliance.

Question 8

Which gastrointestinal disorder occurs after bariatric surgery involving removal of part of the stomach?
1)Dumping syndrome
2)Mallory-Weiss syndrome
3)Zollinger-Ellison syndrome
4)Plummer-Vinson syndrome

Question 9

The nurse is providing care for a client admitted with abdominal pain, abdominal rigidity, and rebound tenderness. The health-care provider suspects appendicitis and prescribes tests to validate the diagnosis. Which test result indicates a more serious diagnosis?
1)A sudden decrease in the amount of client-reported pain
2)White blood cell (WBCs) count of 10,000 cells/mcL with a high neutrophil count
3)Peritoneal fluid with a neutrophil count of 700 cells/mcL
4)Blood pressure (BP) 130/78 mm Hg, respirations 20/min, pulse 82/min

Question 10

The nurse is assessing a client in the emergency department. The client states, "I have been really sick with an infection and now I have this awful diarrhea." Which type of gastroenteritis does the nurse suspect?
1)Campylobacter
2)Escherichia coli
3)Clostridium difficile
4)Helicobacter pylori

Question 11

Which part of the stomach most commonly harbors Helicobacter pylori?
1)Body
2)Fundus
3)Pylorus
4)Duodenum

Question 12

The nurse finds a note stating, "Reduction of 15% to 20% from the original stomach size" while reviewing the medical record of an obese client. Which surgical procedure does the nurse expect for this client?
1)Gastric bypass
2)Gastric banding
3)Sleeve gastrectomy
4)Biliopancreatic diversion with duodenal switch

Question 13

The nurse concludes that an obese client is manifesting symptoms from a rare type of hernia. Which finding confirms the condition?
1)Belching
2)Acute chest pain
3)Substernal burning
4)Epigastric discomfort

Question 14

The nurse is assessing a client who reports nausea, vomiting, abdominal pain, and discomfort. The nurse finds that the abdomen is firm and peristalsis is visible. The laboratory reports show electrolyte imbalances. Which condition does the nurse anticipate in the client?
1)Hiatal hernia
2)Acute gastritis
3)Pyloric stenosis
4)Peptic ulcer disease

Question 15

A client tells the nurse, "I have intense stomach pain for 3 hours after eating." On assessment the nurse finds abdominal pain and tenderness. The nurse suspects the client has peptic ulcers. Which diagnostic procedure does the nurse expect the health-care provider to prescribe?
1)Ultrasound of the abdomen
2)Blood test for Helicobacter pylori antibodies
3)Fecal occult blood test
4)Computerized tomography (CT) scan

Question 16

Which characteristic feature of dumping syndrome does the nurse recognize in a client after bariatric surgery?
1)Steatorrhea
2)Diaphoresis
3)Colicky cramping
4)Hematemesis

Question 17

The nurse is preparing a client for a laparoscopic fundoplication. Reports on previously performed endoscopy and barium tests are not yet available. On reviewing the medical history, the nurse notes the client complains of dysphagia, substernal burning, and belching. Which condition does the nurse expect to be identified in the client?
1)Hiatal hernia
2)Gastritis
3)Stomach cancer
4)Schatzki ring

Question 18

Which client does the nurse instruct to avoid eating or drinking food items that are hot or spicy?
1)The client with esophagitis
2)The client with esophageal cancer
3)The client with dumping syndrome
4)The client with upper gastrointestinal bleed (UGIB)

Question 19

A client with sudden, excruciating abdominal pain; pale skin; and hematemesis is admitted to the emergency room. On assessment, the client acknowledges an overdose of NSAIDs and a history of substance abuse. The health-care provider instructs the nurse to prepare the client for a gastrojejunostomy procedure. Which condition does the nurse anticipate in the client?
1)Hiatal hernia
2)Acute gastritis
3)Pyloric stenosis
4)Peptic ulcer disease

Question 20

Which client does the nurse expect to be prescribed a tissue biopsy test for confirmation of the disease?
1)The client with peritonitis
2)The client with celiac disease
3)The client with gastroenteritis
4)The client with Zollinger-Ellison syndrome

Question 21

The parent of an adolescent client tells the nurse, "My child complains of a burning sensation in the throat and refuses to eat food." On assessment, the nurse finds the client also has a dry cough. Which teaching does the nurse provide if the client is diagnosed with gastroesophageal reflux disease (GERD)? Select all that apply.
1)Elevate the client's head at 70 degrees for eating
2)Provide small, frequent meals to the client
3)Administer proton pump inhibitors to the client
4)Promote rest or sleep to aid digestion after eating
5)Provide fluids to the client after adding thickening powder

Question 22

The nurse finds that a client coughs frequently while eating and makes repeated attempts to swallow. Based on these findings, the health-care team suspects dysphagia in the client. Which additional findings indicate the client is experiencing aspiration pneumonia? Select all that apply.
1)Elevated temperature
2)Hyperactive bowel sounds
3)Deviated tongue and uvula
4)Drooling of food or liquids
5)Auscultation of crackles in the lungs

Question 23

The laboratory reports of a client with gastritis reveal Helicobacter pylori is the causative organism. Which pathophysiological changes can result from this infection? Select all that apply.
1)Decreased production of pepsin
2)Increased production of gastrin
3)Increased production of intrinsic factor
4)Increased production of prostaglandins
5)Decreased production of HCl acid

Question 24

The health-care provider suspects the presence of esophageal varices in a client diagnosed with cirrhosis of the liver. An ultrasound is prescribed and verifies the suspected condition. Which medications does the health-care provider prescribe to prevent esophageal variceal bleeding? Select all that apply.
1)Octreotide
2)Vasopressin
3)Propranolol
4)Somatostatin
5)Isosorbide mononitrate

Question 25

The client reports nausea, vomiting, abdominal cramping, and diarrhea. On assessment, the nurse finds high-pitched bowel sounds. Which nursing interventions help the client improve the manifestations of the condition? Select all that apply.
1)Administer antibiotics
2)Administer IV fluids
3)Administer frequent, small tube feedings
4)Administer antiemetic medications
5)Administer NSAIDs