Deck 45: Care of the Patient With a Gastrointestinal Disorder

Question 1

The home health nurse caring for a patient who has dysarthria related to radiation therapy for an oral cancer would recommend that the family provide:

A) a tablet and pencil as a communication aid.
B) a TV for diversion.
C) a bell to summon help.
D) a walkie-talkie.

Answer 1

a tablet and pencil as a communication aid.

Question 2

The patient has come to the PACU following an ileostomy for the treatment of ulcerative colitis.The patient is conscious and has a nasogastric tube in place and a pouch over the stoma.What should be the nurse's initial action?

A) Turn patient to right side.
B) Give patient ice chips to moisten mouth.
C) Attach NG tube to suction.
D) Irrigate NG tube.

Answer 2

Attach NG tube to suction.

Question 3

A patient with a large inguinal hernia has abdominal distention and inguinal pain.The nurse recognizes these as indicators of which type of hernia?

A) Strangulated
B) Hiatal
C) Ventral
D) Umbilical

Answer 3

Strangulated

Question 4

The nurse points out which of the following as an example of a nonmechanical bowel obstruction?

A) A paralytic ileus
B) Narrowed bowel lumen from an inflammatory process
C) Tumor of the bowel
D) Fecal impaction

Question 5

What should the nurse include in a teaching plan for a patient with a hiatal hernia to reduce the frequency of heartburn?

A) Drinking 10 oz of milk with every meal
B) Lie down after eating
C) Panting through mouth when symptoms begin
D) Eating small meals

Question 6

Dumping syndrome after a Billroth II procedure occurs when high-carbohydrate foods are ingested over a period of less than 20 minutes.What would the nurse suggest to reduce the risk of dumping syndrome?

A) Eating a high-carbohydrate diet
B) Drinking 10 oz of fluids with meals
C) Remaining upright for 2 hours after meals
D) Eating six small daily meals high in protein and fat

Question 7

Which recommendation is most appropriate for a patient who has had an esophageal dilation related to achalasia?

A) Consume only liquid.
B) Avoid fruit juices.
C) Drink 10 oz of fluid with each meal.
D) Lie down for 30 minutes after each meal.

Question 8

The nurse explains to the patient with Crohn disease that the tube feedings allow for:

A) rapid absorption in the upper GI tract.
B) decompression of the stomach.
C) reduction of diarrheic episodes.
D) a permanent nutritional support.

Question 9

The home health nurse evaluates a patient being treated for a peptic ulcer with Riopan (antacid)and famotidine (histamine receptor blocker).Which statement made by the patient indicates a need for further instruction?

A) "I know famotidine will not interfere with my Coumadin."
B) "I take the Riopan at least 2 hours after any of my other drugs."
C) "Boy! That Riopan keeps my stomach happy!"
D) "I take both those meds at the same time every morning."

Question 10

A 56 -year-old man is admitted to the emergency room with an acute attack of diverticulitis.The patient has a temperature of 102°F,and has an elevated white count.Which assessment would alert the nurse to impending septic shock?

A) Chest pain
B) Seizure
C) Tachycardia
D) Massive diarrhea

Question 11

The home health nurse is caring for a patient who has frequent bouts of diverticulitis accompanied by increased flatulence,diarrhea,and nausea.Which of the following is the most appropriate suggestion to lessen these symptoms?

A) Eat a diet high in fiber content.
B) Increase dietary fat intake.
C) Exercise to increase intraabdominal pressure.
D) Take daily laxatives.

Question 12

The nurse clarifies that the end product of carbohydrate metabolism is absorbed and put into the bloodstream by the:

A) gastric lining of the stomach.
B) villi of the small intestine.
C) bile of the liver in the large intestine.
D) excretion from the cecum.

Question 13

Because bowel contents from an ileostomy are virtually liquid,what should the nurse include in the plan of care?

A) Evaluation and assessment of dietary intake of fiber
B) Evaluation and assessment of patient cleanliness
C) Evaluation and assessment of peristomal skin integrity
D) Evaluation and assessment of the adequacy of the collection device

Question 14

What should a nurse do when obtaining a stool specimen to be examined for ova and parasites?

A) Use an oil retention enema to facilitate collection.
B) Refrigerate the specimen immediately.
C) Obtain three different stool specimens on subsequent days.
D) Check the specimen for the presence of occult blood.

Question 15

The nurse anticipates that the patient who has had a subtotal gastrectomy will need supplemental:

A) protein due to the loss of some of the digestive processes.
B) vitamin B₁₂ due to the loss of the intrinsic factor.
C) bulk to prevent constipation.
D) vitamin A due to the loss of the gastric lining.

Question 16

A patient who is being evaluated for episodes of hematemesis and dyspepsia tells the nurse that pain occurs when he eats,but pain does not waken him.The nurse recognizes a diagnostic sign of which condition?

A) Duodenal ulcer
B) Gastritis
C) Achalasia
D) Peptic ulcer

Question 17

A patient with a ruptured diverticulum in the descending colon has undergone a transverse loop colostomy.The patient is upset and says,"I didn't know it was going to be this awful.I hate this!" Which response made by the nurse would be most helpful?

A) "This is a temporary solution.It will be closed in 6 weeks."
B) "This seems awful now,but you won't have the problems you had before."
C) "If everything goes well the surgeon can close this colostomy in about a year."
D) "With the appropriate pouch and loose clothing,no one will notice a thing."

Question 18

The nurse caring for a patient with a peptic ulcer who has had a nasogastric tube inserted notes bright blood in the tube;the patient complains of pain and has become hypotensive.Which condition should the nurse recognize these as signs of?

A) Hiatal hernia
B) Gastritis
C) Perforation
D) Bowel obstruction

Question 19

A male patient complains that he will never adjust to his colostomy.Which is the best action for the nurse in this situation?

A) Encourage him to express his concern.
B) Suggest that he discuss his concerns with his physician.
C) Counsel him that everything will be all right.
D) Assure him that his concerns will diminish when he is able to care for his colostomy.

Question 20

In caring for a patient with gastric bleeding who has a nasogastric tube in place,the nurse should include in the plan of care to ensure that the NG tube is:

A) clamped for 10 minutes every hour.
B) kept patent with irrigation.
C) frequently repositioned to the opposite nostril.
D) changed every 72 hours.

Question 21

The nurse takes into consideration that a proton pump inhibitor drug,such as ______________,will completely eradicate gastric acid production.

A) omeprazole (Prilosec)
B) ranitidine (Zantac)
C) sucralfate (Carafate)
D) olsalazine (Dipentum)

Question 22

Why are peptic ulcers a common problem of aging?

A) Because of overuse of antibiotics
B) Because of overuse of antacids
C) Because of overuse of NSAIDs
D) Because of overuse of laxatives

Question 23

Flexible sigmoidoscopy should be performed every ________ years.

Question 24

Which of the following is the purpose of antibiotic therapy in treating peptic ulcers?

A) It eradicates H.pylori.
B) It inhibits gastric acid secretion.
C) It protects the gastric mucosa.
D) It neutralizes or reduces the acidity of stomach contents.

Question 25

To assist a family with a bowel-training program to reduce fecal incontinence,the nurse would suggest the use of a ___________ at an optimal time to stimulate defecation.

A) warm bath
B) a tap water enema
C) glycerin suppository
D) large glass of warm lemonade

Question 26

Which of the following would be the most helpful nursing intervention to increase the comfort of a patient with appendicitis?

A) Application of ice bag
B) Administration of small tap water enema
C) Warm compress over entire abdomen
D) Ambulate for short periods in the room

Question 27

Bowel sound assessment on a patient with an obstruction who has distention,nausea,and visible peristaltic waves would be:

A) loud and clearly audible.
B) high pitched.
C) hyperactive.
D) absent.

Question 28

The nurse takes into consideration that long-term use of antibiotics can cause an antibiotic-associated pseudomembranous colitis from the organism ________.

Question 29

Due to frequent bouts of constipation,the nurse examines the bedfast nursing home resident for ulceration of the anus,called anal __________________.

Question 30

The patient with irritable bowel syndrome tells the home health nurse she is going to an acupuncturist for therapy for her condition.Which of the following would be the best nursing response?

A) "Go for it.Alternative medicine does great things."
B) "YIKES! An acupuncturist?"
C) "It may help,but there has been no clinical proof of its effectiveness."
D) "You should confirm that the acupuncturist is licensed."

Question 31

What is the most lethal complication of a peptic ulcer?

A) Bleeding
B) Perforation
C) Severe pain
D) Gastric outlet obstruction

Question 32

The patient with a peptic ulcer has been placed on regular doses of bismuth salicylate (Pepto-Bismol)to combat Helicobacter pylori.What color will this drug turn the stool?

A) Gray-black
B) Dark green
C) Red-orange
D) Yellow

Question 33

The nurse explains that ___________,the chief enzyme of gastric juice,is activated by hydrochloric acid to begin digestion of protein.

Question 34

How should the nurse counsel the 34-year-old woman who has been prescribed sulfasalazine (Azulfidine)for Crohn disease? (Select all that apply. )

A) Expose her to sunlight at least 30 minutes a day for vitamin D synthesis.
B) Tell her to drink at least 1500 mL of fluid a day.
C) Advise assessing self for rash.
D) Use alternate birth control methods to oral contraception.
E) Take drug on an empty stomach.

Question 35

The nurse caring for a patient with Crohn disease will closely monitor the urinary output to ensure that the patient is excreting at least _______ mL/day.

Question 36

Which of the following should be included in the patient teaching of a patient with a peptic ulcer?

A) Introducing irritating foods in minute amounts to desensitize the stomach
B) Restricting fluid to 1000 mL per day
C) Eating 6 small meals a day
D) Drinking alcohol and caffeine in moderation