Question 1

The nursing student is aware that the cause of peptic ulcers is related to:&#10;A)acid/pepsin imbalance&#10;B)erosive gastritis that starts to bleed&#10;C)impaired mucosal defenses&#10;D)high secretion of HCl (hydrochloric acid)

Accepted Answer

Peptic ulcers are mucosal erosions that occur in the esophagus,stomach,or duodenum as the result of acid/pepsin imbalance.

Question 2

A client who has ulcerative colitis has an increased chance of developing which of the following?&#10;A)viral pneumonia&#10;B)colorectal cancer&#10;C)pernicious anemia&#10;D)intestinal obstruction

Accepted Answer

The lesions in ulcerative colitis (UC)usually occur in the rectal area and sigmoid colon and progress throughout the colon,resulting in symptoms such as cramping,spasms,abdominal pain,and bloody diarrhea;the client is at increased risk for developing colorectal cancer.

Question 3

Clients who have a history of esophageal varices should avoid which of these?&#10;A)antibiotics&#10;B)antihistamines&#10;C)NSAIDs (nonsteroidal anti-inflammatory drugs)&#10;D)laxatives

Accepted Answer

Esophageal varices are enlarged,twisted esophageal veins that are usually associated with chronic liver obstruction such as occurs in cirrhosis;they are asymptomatic until they rupture and hemorrhage.Medical management includes medications prescribed to prevent esophageal irritation,to control bleeding,and to control pain following sclerotherapy.Nursing care focuses on monitoring the client's vital signs and overall condition for evidence of bleeding and alleviating client anxiety.Teaching should include avoiding medications,which will promote bleeding such as NSAIDs,aspirin,and anticoagulants.

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

Accepted Answer

Appendicitis,the most common inflammation of the GI tract,occurs when the vermiform appendix attached to the cecum becomes inflamed,gangrenous,or infected;the appendix may rupture and cause peritonitis from introduction of fecal content into the abdominal cavity.The client experiences right lower quadrant pain,nausea,and anorexia.An elevation in white blood cells (normal 4,500/mm³ to 11,000/mm³)and neutrophils (50% to 75%)will verify the physical symptoms.

Question 5

Clients with diverticulitis will frequently complain of abdominal pain located in which area of the abdomen?&#10;A)generalized&#10;B)left lower side&#10;C)right lower side&#10;D)umbilicus area

Accepted Answer

Diverticulosis is usually asymptomatic;if bleeding or perforation of diverticula occurs or an abscess forms,surgical treatment consists of resection of the affected portion of colon or creation of a colostomy.When a client complains of left lower abdominal pain,constipation,diarrhea,bloating,anorexia,or nausea,diverticulitis is suspected and the client is treated with anti-infectives,analgesics,and colon resection.

Question 6

Which of these factors contributes to a client developing gastritis?&#10;A)exposure to irritating substances such as ibuprofen&#10;B)impaired esophageal sphincter function&#10;C)high-fat diet&#10;D)viral infection

Accepted Answer

Gastritis,inflammation of the stomach mucosa,can occur as the result of exposure to medications,smoking,food allergens,or toxic chemicals or from impaired mucosal defenses.Medical management of the client who has gastritis primarily involves prescription of antacids and histamine receptor antagonists.Nursing care focuses on relieving pain and teaching the client to avoid substances that aggravate gastric irritation and to minimize consumption of foods such as milk,coffee,and cola beverages that increase gastric acid secretions.

Question 7

Which of these questions is essential to include during the nursing assessment of a client who has digestive system symptoms?&#10;A)whether the client was breast-fed or bottle-fed as an infant&#10;B)whether the client consumes coffee or tea with meals&#10;C)client's knowledge of the food pyramid&#10;D)client's medication history,including over-the-counter drugs

Accepted Answer

When a client is experiencing gastrointestinal symptoms,the nurse should obtain data: history of the present complaint,including such aspects as length and frequency of symptoms,when symptoms occur,and factors that aggravate symptoms;the client's medication history,including both prescribed and over-the-counter drugs and the effectiveness of these medications;complete nutritional history,including foods that increase or decrease the symptoms,the effect of meals on symptoms,the appearance of symptoms within a certain time frame following meals,and the amount of fat,fiber,and fluids usually consumed;psychosocial factors,including compliance and noncompliance with health status and the client's typical meal patterns;physical examination,including the client's ability to chew and swallow and abdominal inspection,auscultation,percussion,and palpation;the client's bowel elimination patterns,including frequency,consistency,and quantity of bowel movements;and evaluation of diagnostic data,including reports of the client's laboratory,radiologic,and endoscopic examinations.

Question 8

A client who has diverticulitis should be instructed to follow which of these prescribed diets when the acute episode is resolved?&#10;A)bland,low residue&#10;B)clear liquids&#10;C)high fiber&#10;D)high protein

Accepted Answer

Nursing care of the client who has diverticulosis focuses on preventing diverticulitis;client education includes following a high-fiber diet or taking fiber supplements and stool softeners as prescribed.

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?&#10;A)Offer oral fluids frequently.&#10;B)Ambulate ad lib.&#10;C)Keep the client in a private room.&#10;D)Maintain NPO.

Accepted Answer

Nursing care of the client who has diverticulosis focuses on preventing diverticulitis;client education includes following a high-fiber diet or taking fiber supplements and stool softeners as prescribed.The nurse should monitor the client who has diverticulitis for evidence of infection;if surgery is scheduled,the nurse should allay the client's anxiety about the procedure and maintain NPO status.

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?&#10;A)Avoid complex carbohydrates.&#10;B)Eat small meals frequently.&#10;C)Reduce fiber and protein intake.&#10;D)Drink carbonated beverages with meals.

Accepted Answer

Nursing care focuses on monitoring the client for evidence of bleeding,managing pain,and teaching the client how to manage the condition (e.g. ,avoiding factors that aggravate symptoms such as taking NSAIDs or consuming alcohol),and following the prescribed medication regimen.If the client has a gastrectomy,the nurse should teach the client to observe for development of dumping syndrome as a postoperative complication and encourage clients to eat small,frequent meals.

Question 11

Which of these statements about Crohn's disease is TRUE?&#10;A)It affects only the mucosal lining of the bowel.&#10;B)It is treated by colostomy.&#10;C)It can occur anywhere in the small and large intestines.&#10;D)It can produce 15 to 20 liquid stools containing blood daily.

Accepted Answer

The answer of Which of these statements about Crohn's disease...

Question 12

When teaching the client with gastritis,the nurse should include which of these instructions?&#10;A)&#34;Avoid eating at bedtime.&#34;&#10;B)&#34;Drink as much decaffeinated tea and coffee as you like.&#34;&#10;C)&#34;Drink only milk products and antacids until the pain subsides.&#34;&#10;D)&#34;Eat anything you want as long as you take your medications on time.&#34;

Accepted Answer

The answer of When teaching the client with gastritis,the nurse...

Question 13

An 83-year-old client tells the nurse,&#34;My food doesn't taste as good anymore.&#34; Which of these responses by the nurse is correct?&#10;A)&#34;As we age our taste buds decrease.Experiment with various seasonings,but avoid salt.&#34;&#10;B)&#34;If your dentures don't fit well,improper chewing could affect your ability to taste food.&#34;&#10;C)&#34;Try holding your food in your mouth longer to provide increased taste.&#34;&#10;D)&#34;You may find smaller,more frequent meals to be more satisfying.&#34;

Accepted Answer

The answer of An 83-year-old client tells the nurse,&#34;My food...

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?&#10;A)10&#10;B)20&#10;C)30&#10;D)40

Accepted Answer

The answer of A nurse is caring for a client...

Question 15

When do clients who have gastric ulcers MOST often complain of pain?&#10;A)2 hours before meals&#10;B)1 to 2 hours after eating&#10;C)3 to 4 hours after eating&#10;D)whenever the stomach is empty

Accepted Answer

The answer of When do clients who have gastric ulcers...

Question 16

A client is being treated for bleeding esophageal varices with a Sengstaken-Blakemore tube.Nursing care will include which of these approaches?&#10;A)allowing the client to assume a position of choice&#10;B)emptying the drainage bottle and recording output&#10;C)periodically deflating the balloon&#10;D)providing sips of ice water every 30 to 45 minutes

Accepted Answer

The answer of A client is being treated for bleeding...

Question 17

Stress ulcers are the result of which of these factors?&#10;A)acid/pepsin imbalance&#10;B)erosive gastritis that starts to bleed&#10;C)exposure to irritants and impaired mucosal defenses&#10;D)high secretion of HCl

Accepted Answer

The answer of Stress ulcers are the result of which...

Question 18

A client is admitted with the diagnosis Rule out appendicitis.Which nursing action is MOST important?&#10;A)assessing the client's pain threshold&#10;B)avoiding administering analgesics&#10;C)encouraging the family to visit&#10;D)monitoring laboratory reports

Accepted Answer

The answer of A client is admitted with the diagnosis...

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?&#10;A)oral care q.d.&#10;B)high-calorie liquid diet&#10;C)diet as tolerated&#10;D)intravenous (IV)morphine

Accepted Answer

The answer of A client develops stomatitis as a complication...

Question 20

A client has a gastrectomy and vagotomy for treatment of peptic ulcer disease.Why was the vagotomy performed?&#10;A)to anastomose the remaining portion of the stomach to the bowel&#10;B)to remove the vagal innervation to the fundus of the stomach&#10;C)to remove the perforated section of the stomach or bowel&#10;D)to prevent further hemorrhage from the site

Accepted Answer

The answer of A client has a gastrectomy and vagotomy...

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?&#10;A)active exercises of the ankles and knees&#10;B)pulmonary hygiene&#10;C)splinting the abdominal incision with a pillow&#10;D)turning every 2 hours

Accepted Answer

The answer of A client who has surgical treatment for...

Question 22

A client who has viral hepatitis should have which dietary modification to allow the liver to heal?&#10;A)restricted caloric intake&#10;B)restricted fluids&#10;C)low carbohydrate&#10;D)low protein

Accepted Answer

The answer of A client who has viral hepatitis should...

Question 23

Paralytic ileus can develop as the result of:&#10;A)adhesions that obstruct the bowel's lumen&#10;B)interrupted blood flow to a portion of the bowel,which then becomes necrotic&#10;C)interrupted nerve transmission to the bowel with a portion becoming paralyzed&#10;D)a tumor obstructing the bowel's lumen

Accepted Answer

The answer of Paralytic ileus can develop as the result...

Question 24

Administration of hepatitis B immunoglobulin (HBIG)is recommended for which group?&#10;A)health care workers&#10;B)people who are homosexual&#10;C)anyone exposed by needle puncture or sexual contact&#10;D)the general public

Accepted Answer

The answer of Administration of hepatitis B immunoglobulin (HBIG)is recommended...

Question 25

Which of these nursing interventions is MOST important when a client is initially diagnosed with any type of hepatitis?&#10;A)administration of immune globulin&#10;B)restriction of fluid intake&#10;C)bed rest&#10;D)decrease of fat intake

Accepted Answer

The answer of Which of these nursing interventions is MOST...

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?&#10;A)accommodation&#10;B)jaundice&#10;C)photophobia&#10;D)pruritus

Accepted Answer

The answer of The nurse is assessing a client who...

Question 27

For a client who has viral hepatitis,which of these statements is TRUE?&#10;A)Frequent rest periods are optional.&#10;B)Thorough hand hygiene is essential.&#10;C)Food preparation is unaffected.&#10;D)Donating blood is encouraged.

Accepted Answer

The answer of For a client who has viral hepatitis,which...

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?&#10;A)baked potatoes and rice&#10;B)milk and cheese&#10;C)fish and red meat&#10;D)apples and broccoli

Accepted Answer

The answer of An older adult client tells the nurse...

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

Accepted Answer

The answer of A client is lifting a box and...

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?&#10;A)abdominal hernia&#10;B)duodenal ulcer&#10;C)intestinal obstruction&#10;D)pancreatitis

Accepted Answer

The answer of A client complains of colicky abdominal pain,nausea,constipation,and...

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

Accepted Answer

The answer of A postoperative client has been receiving narcotic...

Question 32

Subjective signs and symptoms of viral hepatitis include which of the following?&#10;A)severe vomiting and diarrhea&#10;B)anxiety and hyperactivity&#10;C)generalized weight gain&#10;D)anorexia and photophobia

Accepted Answer

The answer of Subjective signs and symptoms of viral hepatitis...

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?&#10;A)enteric precautions&#10;B)respiratory precautions&#10;C)reverse isolation&#10;D)Standard Precautions

Accepted Answer

The answer of A client is admitted with a diagnosis...

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?&#10;A)hypothermia&#10;B)thrombosis&#10;C)hepatitis&#10;D)paralytic ileus

Accepted Answer

The answer of A client develops peritonitis as a result...

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?&#10;A)daily administration of aldactone&#10;B)peritoneal venous shunt&#10;C)albumin infusion&#10;D)paracentesis

Accepted Answer

The answer of A client has recurrent ascites as a...

Question 36

Nursing interventions for clients with intestinal obstruction include all of the following.Which action would be a priority?&#10;A)administering IV fluid and electrolyte replacements as ordered&#10;B)checking weight daily&#10;C)giving oral care frequently&#10;D)monitoring intake and output every shift

Accepted Answer

The answer of Nursing interventions for clients with intestinal obstruction...

Question 37

The client with cirrhosis may develop portal hypertension,which is associated with which of these conditions?&#10;A)clotting disorders&#10;B)esophageal varices&#10;C)hypoglycemia&#10;D)malnutrition

Accepted Answer

The answer of The client with cirrhosis may develop portal...

Question 38

A client who has cirrhosis requests a sleeping pill for insomnia.Which of these actions should the nurse take?&#10;A)Administer a placebo.&#10;B)Provide comfort measures to facilitate natural sleep.&#10;C)Request a medication order from his health care provider.&#10;D)Tell the client it is unsafe to take any medications.

Accepted Answer

The answer of A client who has cirrhosis requests a...

Question 39

When a client with cirrhosis is admitted to the hospital,which of the following laboratory results would be expected?&#10;A)albumin: high&#10;B)alkaline phosphatase: low&#10;C)GGT: normal&#10;D)PT,PTT,and clotting times: delayed

Accepted Answer

The answer of When a client with cirrhosis is admitted...

Question 40

A client who has cirrhosis becomes very confused and lethargic and exhibits asterixis.These symptoms can indicate the development of what complication?&#10;A)ascites&#10;B)hepatic encephalopathy&#10;C)hypoglycemia&#10;D)portal hypertension

Accepted Answer

The answer of A client who has cirrhosis becomes very...

Question 41

When caring for a client who is obese,which of the following are risk factors for increased complications? (Select all that apply. )&#10;A)immobility&#10;B)skin breakdown&#10;C)hypocoagulopathy&#10;D)increased dietary needs&#10;E)difficulty breathing&#10;F)safety

Accepted Answer

The answer of When caring for a client who is...

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?&#10;A)abdominal&#10;B)femoral&#10;C)hiatal&#10;D)umbilical

Accepted Answer

The answer of A client complains of daily indigestion and...

Question 43

Which of these routine screening tests is recommended for early detection of colorectal cancer?&#10;A)sigmoidoscopy and barium enema&#10;B)fecal occult blood and colonoscopy&#10;C)urinalysis and complete blood count (CBC)&#10;D)blood pressure and diet history

Accepted Answer

The answer of Which of these routine screening tests is...

Question 44

Which of these statements about the treatment of cholelithiasis is TRUE?&#10;A)Laparoscopic cholecystectomy is the surgery of choice.&#10;B)Abdominal cholecystectomy is the surgery of choice.&#10;C)Analgesics and antiemetics will control the disease.&#10;D)Activity is encouraged before and after surgery.

Accepted Answer

The answer of Which of these statements about the treatment...

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

Accepted Answer

The answer of The nurse is caring for a client...

Deck 38: Gastrointestinal System