Deck 37: Caring for the Patient With Gastrointestinal Disorders

Question 1

Which acid base and electrolyte complications are commonly associated with prolonged vomiting?.Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Hypokalemia
B) Metabolic alkalosis
C) Metabolic acidosis
D) Hypocalemia
E) Hyponatremia

Answer 1

Hypokalemia
Metabolic alkalosis

Question 2

A 24-year-old patient is admitted for treatment of celiac disease. The nurse would anticipate managing which symptoms?.Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Chronic constipation
B) Flatulence
C) Osteoporosis
D) Peptic ulcer disease (PUD)
E) Chronic hepatitis

Answer 2

Flatulence
Osteoporosis
Chronic hepatitis

Question 3

A patient, 4 weeks post gastric resection surgery, is experiencing cramping, nausea, and diarrhea within 10 minutes after eating. The nurse suspects that the patent is experiencing "dumping syndrome" and suggests which intervention?.Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Increase protein in the diet.
B) Lie down for 30 minutes immediately after eating.
C) Eat frequent, small meals.
D) Reduce the amount of carbohydrates eaten daily.
E) Drink a glass of water prior to each meal.

Answer 3

Increase protein in the diet.
Lie down for 30 minutes immediately after eating.
Eat frequent, small meals.
Reduce the amount of carbohydrates eaten daily.

Question 4

Acyclovir (Zovirax) ointment has been prescribed for a patient with oral herpes lesions. What should the nurse include when instructing the patient regarding this medication?.Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Adverse effects include vomiting and diarrhea.
B) It can reduce the length of the herpes outbreak.
C) It is an antibiotic medication.
D) Repeated usage of the drug will lead to a permanent state of remission.
E) It is most effective when administered intravenously.

Question 5

The nurse is preparing to instruct a patient who is newly diagnosed with gastroesophageal reflux disease (GERD) about dietary considerations. What should the nurse include in these instructions?.Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) "Avoid peppermint."
B) "Meals should be small and more frequent."
C) "Avoid eating within 4 hours of bedtime."
D) "Be sure to eat at least one citrus fruit per day."
E) "Alcohol should be limited to two drinks per day."

Question 6

Which instructions should the nurse provide for a patient diagnosed with gastroesophageal reflux disease (GERD)?.Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Limit last food intake to 4 hours before bedtime.
B) Eat the largest meal of the day at midday.
C) Sleep in a bed with the head elevated 6 to 8 inches.
D) Follow a daily exercise routine.
E) Include a caffeinated beverage with meals.

Question 7

A patient prescribed an antacid is experiencing muscle cramps. What should the nurse do to assist this patient?

A) Notify the health care provider.
B) Review the patient's diet history.
C) Review the patient's elimination patterns.
D) Provide reassurance to the patient.

Question 8

A patient is experiencing manifestations consistent with an oral fungal infection. The patient's health history is unremarkable. Which medication does the nurse anticipate being ordered to manage this condition initially?

A) Nystatin
B) Ciprofloxacin
C) Ampicillin
D) Viscous lidocaine

Question 9

The nurse is providing emotional support to the spouse of a patient recently diagnosed with terminal esophageal cancer. The spouse expresses anger and confusion and questions why the patient did not seek help sooner. Which response by the nurse would be the most appropriate at this time?

A) "Unfortunately, the early symptoms are often vague and not recognized as something serious."
B) "Your spouse was probably afraid of getting bad news."
C) "You will never know."
D) "It is not important to know that right now."

Question 10

The nurse is developing the postoperative plan of care for a patient recovering from surgery for oral cancer. Which nursing diagnosis has the highest priority?

A) Ineffective Airway Clearance
B) Impaired Verbal Communication
C) Body Image Disturbance
D) Risk for Imbalanced Nutrition: More than Body Requirements

Question 11

The physician has ordered metoclopramide (Reglan) 2 mg/kg IVP to be given 30 minutes before the start of chemotherapy. The patient weighs 54 kg. The metoclopramide (Reglan) is dispensed in a 10 mg/10 mL vial. The nurse will administer ________ mL of metoclopramide.

Question 12

A patient with cancer of the rectum is scheduled for surgery and the placement of a permanent ostomy. Which type of ostomy is most likely to be performed on this patient?

A) Ileostomy
B) Double-barrel colostomy
C) Sigmoid colostomy
D) Transverse loop colostomy

Question 13

A patient has been diagnosed with type 1 herpes simplex lesions on the mouth and face. Which statement indicates that the patient understands the information provided by the nurse?

A) "I will have this condition for life."
B) "This was caused by a bacterial infection."
C) "I have come into contact with some type of fungal infection."
D) "An antibiotic will help heal these sores in about 3 days."

Question 14

The nurse learns that an elderly patient with ill-fitting dentures has been using an over-the-counter preparation for a gum sore over the last month. What instruction should the nurse give this patient?

A) Make an appointment to see the physician.
B) Continue to use the preparation.
C) Change the preparation.
D) Stop wearing the dentures.

Question 15

When teaching a patient with fungal stomatitis about performing oral care, the nurse would include which instructions?.Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Avoid tobacco and alcohol.
B) Use saline or sodium bicarbonate rinse after every meal.
C) Drink at least 8 ounces of orange juice daily.
D) Avoid cold beverages.
E) Oral care should be performed with a soft toothbrush.

Question 16

The nurse has identified the goals of "intact skin integrity" and "intact stoma integrity" for a patient with a colostomy. Which evaluation parameters are best suited for these goals?.Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) The stoma is pink and moist.
B) No excoriation is noted on skin surrounding the stoma.
C) The patient shows understanding of importance of preventing fecal leakage.
D) The patient demonstrates ability to apply the collecting appliance properly.
E) The stomal area is free of pain.

Question 17

A patient is suspected of having sprue. Which instruction should the nurse provide this patient about diet?

A) Avoid all milk products.
B) A vegetarian diet is the best treatment for this condition.
C) Gluten products must be eliminated from the diet.
D) All whey products must be eliminated from the diet.

Question 18

The nurse is teaching a patient about the major risk factors for peptic ulcer disease (PUD). Which risk factors should the nurse discuss?.Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Chronic H. pylori infection
B) Use of aspirin and NSAIDs
C) Cigarette smoking
D) Dietary intake of dairy products
E) Stress

Question 19

The nurse is preparing the morning medications for a patient with gastroesophageal reflux disease (GERD). Which nursing intervention would be appropriate regarding this patient's medications?
000.

A) Hold the antacids for at least 2 hours after oral medications are taken.
B) Provide all prescribed medications at 1,
C) Provide the antacids first, and then follow with the oral medications.
D) Provide the antacids only at the hour of sleep.

Question 20

A patient diagnosed with peptic ulcer disease (PUD) asks if surgery will be necessary. How should the nurse respond?

A) "The administration of the appropriate medications makes surgery rarely necessary."
B) "Surgery is required in about 50% of cases."
C) "Surgery has a higher success rate than medication therapy alone."
D) "If you take your medications and follow the prescribed diet, surgery isn't usually needed."

Question 21

The nurse is caring for a patient with a jejunostomy tube. Which statement by the nurse indicates the need for additional information to safely manage the medical intervention?

A) "I will keep the patient on bed rest until the tube can be removed."
B) "It's my habit to irrigate the jejunostomy tube just prior to administering the patient's sleeping medication."
C) "A pH of 5 or less indicates the tube is in the stomach, not the intestine."
D) "I plan to assess the patient's abdomen for distention at regular intervals."

Question 22

The nurse recognizes that a patient diagnosed with celiac disease needs further education regarding the disease process when the patient makes which statement?

A) "It's really difficult to maintain my gluten-free lifestyle."
B) "The only way to truly diagnose this disease is through a biopsy of my small intestine."
C) "The trouble I'm having with the enamel on my teeth is a result of this disease."
D) "I treat myself to a ham and cheese on rye with a light beer once a week."

Question 23

The nurse is reviewing dietary recommendations with a patient recovering from an acute episode of diverticular disease. The nurse identifies which topics for inclusion in the discussion?.Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Incorporating both soluble and insoluble fiber into the daily diet
B) Including raisins in the diet as a good source of iron to offset poor iron absorption
C) Ingesting at least 25 to 30 grams of fiber daily, as recommended for adults
D) Eating oatmeal-based cereals as breakfast and snack foods
E) Avoiding foods such as nuts or strawberries

Question 24

What information should the nurse provide for the patient with a newly created Kock ileostomy (continent ileostomy)?.Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) The stoma will be reversed when the bowels have had the time to heal.
B) Fecal matter will be removed by a catheter inserted through the stoma.
C) A nipple valve was created to control the flow of fecal matter.
D) The stoma should appear pink and moist.
E) The surgery involved manipulating a portion of the terminal ileum.

Question 25

A patient learns that a small bowel obstruction was caused by an appendectomy 5 years ago. How would the nurse explain this development to the patient?

A) "The infection in your appendix should have been treated earlier."
B) "Abdominal surgery sometimes results in adhesion or scarring of tissues that can result in bowel obstruction."
C) "You must have had an undiagnosed femoral hernia at the time of your appendectomy."
D) "The surgeon did not irrigate your abdomen adequately when you had your appendectomy."

Question 26

A patient is being assessed for a possible bowel obstruction. The nurse provides information regarding which diagnostic tests to confirm the presence of an obstruction?.Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Barium swallow
B) A CT scan of the abdomen
C) An abdominal X-ray series
D) Serum osmolality
E) CBC with differential

Question 27

Which nursing action is essential to reduce the patient's risk of developing a postsurgical infection at the site of a permanent colostomy?

A) Change the dressing as ordered by the surgeon.
B) Administer intravenous antibiotics as prescribed.
C) Assesse the patient's understanding of the importance of infection control measures.
D) Instruct the patient in the proper technique for handling hygiene of the colostomy site.

Question 28

A patient with Crohn's disease is demonstrating the nursing diagnosis Imbalanced Nutrition: Less than Body Requirements. What intervention should the nurse include in this patient's plan of care?

A) A low-calorie, high-milk diet
B) A low-calorie, low-residue diet
C) The DASH diet
D) A normal, well-balanced diet

Question 29

The nurse would assess for which risk factor in a patient hospitalized for a strangulated intestinal hernia?

A) Abdominal surgery
B) Hyperlipidemia
C) Intestinal infarctions
D) Family history

Question 30

A patient is hospitalized during an acute exacerbation of symptoms related to Crohn's disease. The nurse shows an understanding of the need for bowel rest by providing which instruction?

A) "Select foods that are high in potassium."
B) "You should eat a soft diet until the diarrhea subsides."
C) "You may find a high-calorie, low-fat, high-fiber diet helpful."
D) "Expect to be started on total parenteral nutrition (TPN)."

Question 31

A patient who has had gastric surgery that affected the effectiveness of the alimentary system will be fed via a gastrostomy tube upon discharge to home. How would the nurse explain the rationale for this intervention?

A) A gastrostomy tube is less invasive than a jejunostomy tube.
B) Gastrostomy tubes are more cost effective than nasogastric feeding.
C) Gastrostomy feeding is less likely to produce side effects than parenteral nutrition.
D) Gastrostomy feeding is more supportive of the specialized diet the patient will require.

Question 32

What information should the nurse provide a patient regarding the patient's newly created permanent ileostomy?

A) An additional surgery will be required in 2 to 3 months.
B) The stoma will initially produce dark green fecal matter.
C) The stoma should not produce any bloody discharge.
D) Because the condition required a gastroduodenostomy (Billroth I), an ileostomy was also necessary.

Question 33

A patient with Crohn's disease is recovering from a bowel resection. What information should the nurse provide?

A) "Surgery has ensured that you will never have another recurrence of the disease."
B) "You need close follow-up because there is a possibility of recurrence in another portion of the bowel."
C) "You may develop ulcerative colitis now that your Crohn's is cured."
D) "The surgery increases your risk of developing an intestinal stricture."

Question 34

A patient who has been diagnosed with a form of gastric carcinoma is concerned about the prospects of her adult children having the disease. Which questions by the nurse shows an understanding of the disease?.Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) "Do any of your children smoke either cigarettes or cigars?"
B) "Have any of your children ever been treated for a stomach ulcer?"
C) "Have your children ever been tested for asthma?"
D) "Are any of your children particularly fond of eating bacon, hot dogs, or luncheon meats?"
E) "Are any of your children exhibiting signs of depression or obsessive compulsive disorder?"