Deck 32: Gastrointestinal, Hepatobiliary, and Pancreatic Systems Function, Assessment, and Therapeutic Measures

Question 1

A patient receiving tube feedings at 50 mL/hour has a residual volume of 250 mL of undigested tube feeding.What action should the nurse take?

A) Discard aspirated tube feeding, and run tube feeding as ordered by the physician.
B) Report amount of aspirated tube feeding to the RN for consultation with the physician.
C) Return aspirated tube feeding to the patient, and run feeding at a slower rate of 20 mL/hour.
D) Return aspirated tube feeding to the patient, and wait 2 hours before restarting tube feeding at 50 mL/hr.

Answer 1

Report amount of aspirated tube feeding to the RN for consultation with the physician.

Question 2

The nurse is collecting data from a patient who reports right upper abdominal quadrant warmth and tenderness.When the nurse touches the area lightly to assess for warmth and tenderness,what data collection technique is being used?

A) Palpation
B) Inspection
C) Percussion
D) Auscultation

Answer 2

Palpation

Question 3

The nurse is ready to begin a tube feeding via an NG feeding tube for a patient who is comatose.What action should the nurse take before starting the feeding?

A) Listen to bowel sounds.
B) Check the pH of gastric aspirate.
C) Secure the NG tube with additional tape.
D) Irrigate the tube with 10 mL of sterile water.

Answer 3

Check the pH of gastric aspirate.

Question 4

The nurse is auscultating bowel sounds and hears two bowel sounds over 5 minutes.How should the nurse document this finding?

A) Absent bowel sounds
B) Normal bowel sounds
C) Hypoactive bowel sounds
D) Hyperactive bowel sounds

Question 5

A licensed practical nurse (LPN)who typically works on a medical unit has been assigned to cover staffing deficits on a surgical unit.After obtaining report,the nurse realizes that one of the assigned patients is currently receiving parenteral nutrition (PN).Which action should the nurse take?

A) Provide patient care as assigned.
B) Ask another nurse to trade patients for the shift.
C) Notify the supervisor that another nurse will need to be pulled.
D) Notify the charge nurse that an adjustment in the patient assignment is necessary.

Question 6

A patient receiving a tube feeding at 60 mL/hr has a residual of 10 mL.What action should the nurse take?

A) Continue the feeding as ordered.
B) Slow the feeding to 35 mL/hour.
C) Decrease the feeding to 10 mL/hour.
D) Hold the feeding, and notify the physician.

Question 7

The nurse is caring for a patient who is placed on a modified bland diet.Which should be removed before serving the patient's dinner tray?

A) Salt
B) Sugar
C) Pepper
D) Mayonnaise

Question 8

The nurse is preparing to initiate a tube feeding through a patient's nasogastric (NG)tube.Prior to initiating this feeding what should the nurse use to irrigate the tube?

A) Sterile water
B) Normal saline
C) Cranberry juice
D) Carbonated water

Question 9

The nurse is inspecting a patient's oral cavity.What is the most important safety reason for the nurse to inspect for loose teeth when collecting data on the oral cavity of a patient?

A) Loose teeth are unsightly to the patient.
B) Loose teeth can cause dental abscesses.
C) Loose teeth can be aspirated into the airway.
D) Loose teeth can prevent the patient from eating.

Question 10

A patient is being prepared for an upper GI series.Which statement indicates that the patient understands the preparation for this test?

A) "I should eat a soft diet the night before the procedure."
B) "I must not eat or drink for 4 hours after the procedure."
C) "I'll be given a clear liquid diet the night after the procedure."
D) "I can't have anything to eat or drink for 6 to 8 hours before the procedure."

Question 11

The nurse is caring for a patient with cultural dietary needs.Which question should the nurse include in a cultural dietary assessment?

A) "What restaurants do you go to?"
B) "Which foods do you most commonly eat?"
C) "Which unavailable cultural foods do you prefer to eat?"
D) "What foods are available in the country where you lived?"

Question 12

The nurse is reinforcing teaching for a patient who is scheduled for an upper GI series.Which patient statement indicates teaching has been effective?

A) "It is an estimated rectal cholangiopancreatophonography."
B) "It is a scope inserted into the duodenum with dye injection."
C) "It is a sigmoidoscopy with radiography after injection of dye."
D) "It is an x-ray of the esophagus, stomach, and duodenum using barium."

Question 13

A patient receiving 70 mL of tube feeding per hour has a residual amount of 120 mL.What action should the nurse take?

A) Slow the feeding to 35 mL/hr.
B) Continue the feeding as ordered.
C) Increase the feeding to 100 mL/hr.
D) Hold the feeding, and notify the physician.

Question 14

The nurse is reviewing GI function with a patient.Which body structure should the nurse emphasize as accomplishing mechanical digestion in the stomach?

A) Mucosa
B) Gastric glands
C) Smooth muscle layers
D) Striated muscle layers

Question 15

The nurse is caring for a patient whose NG tube,attached to low intermittent suction to decompress a bowel obstruction,is not draining.After checking placement,which action should the nurse take?

A) Advance the NG tube 2 inches.
B) Change the suction setting to high.
C) Reinsert the NG tube in the other nare.
D) Irrigate the NG tube with 30 milliliters of normal saline.

Question 16

The nurse is collecting data from a patient who is scheduled for an ileostomy.Which technique should the nurse use to help identify optimal stoma placement?

A) Palpation
B) Inspection
C) Percussion
D) Auscultation

Question 17

The nurse is ready to begin a tube feeding via a nasogastric feeding tube for a patient who is comatose.Which action should the nurse take?

A) Lay the patient supine.
B) Elevate the head of the bed 10 degrees.
C) Place the patient in high Fowler's position.
D) Place the patient onto the left side with knees flexed.

Question 18

A 30-year-old patient with ulcerative colitis is scheduled for a proctosigmoidoscopy.Which finding should cause the nurse to clarify routine preparation orders with the physician?

A) The patient's age
B) Presence of severe diarrhea
C) Complaints of abdominal cramping
D) Patient's weight is 10% below ideal body weight

Question 19

While providing care for a patient who has recently completed chemotherapy for colorectal cancer,the nurse notes the patient has an elevated carcinoembryonic antigen (CEA)level.How should the nurse interpret this test result?

A) The patient is cured.
B) The patient has a residual or recurrent tumor.
C) The liver has been damaged by chemotherapy.
D) The patient should be placed in protective isolation.

Question 20

The nurse is reinforcing teaching provided to a patient with a peptic ulcer.Which patient statement indicates understanding about the function of hydrochloric acid in gastric juice?

A) Digestion of starch
B) Inactivation of pepsin
C) Destruction of pathogens
D) Maintenance of a pH of 7 to 8

Question 21

The nurse is reinforcing teaching for a patient who is scheduled for an esophagogastroduodenoscopy.Which patient statement indicates understanding of pre-procedure diet instructions?

A) "I may have a full liquid breakfast."
B) "I will not eat or drink 12 hours before the procedure."
C) "I can drink only clear liquids 2 hours before the procedure."
D) "I will have nothing to eat or drink 8 to 12 hours before the procedure."

Question 22

The nurse is assisting with the care of a patient who has PN containing dextrose 50% infusing.The patient asks why the rate keeps being increased.How should the nurse respond to this patient?

A) "It is important to increase the PN whenever your blood sugar is low."
B) "It is important to do this to help reduce bile secretion and prevent heartburn."
C) "By changing the rate, it helps your body increase absorption of the electrolytes."
D) "It is started slowly and increased slowly to allow your pancreas to adjust insulin levels."

Question 23

The nurse is caring for a patient on a full liquid diet.The nurse recognizes that the patient understands teaching if the patient requests which food item?

A) Salad
B) Cheese
C) Milkshake
D) Hamburger

Question 24

The nurse is caring for a patient who has a non-vented nasogastric tube.Which suction setting should the nurse select?

A) Low continuous suction
B) High continuous suction
C) Low intermittent suction
D) High intermittent suction

Question 25

A patient is prescribed PN.For which percentage of dextrose should the nurse prepare the patient to have a central venous catheter placed for this infusion?

A) 5%
B) 8%
C) 10%
D) 12%

Question 26

The nurse is assisting with the care of a patient who has PN infusing.Which data should be the most concerning to the nurse?

A) Heart rate 92 beats/min
B) Respiratory rate 16/min
C) Blood glucose 260 mg/dL
D) Urine output 60 mL in the past hour

Question 27

The nurse is palpating the abdomen of a patient reporting mild abdominal pain in the upper right quadrant.How deep should the nurse depress this patient's abdomen?

A) 1 inch
B) 2 inches
C) 3 inches
D) 4 inches

Question 28

The nurse is reinforcing teaching for a patient who is on a clear liquid diet.Which patient statement(s)indicates correct understanding of the foods that would be appropriate on this diet? (Select all that apply.)

A) Beef broth
B) Grape juice
C) Apple juice
D) Orange gelatin
E) Tea with sugar
F) Vanilla ice cream

Question 29

A patient recovering from GI surgery 4 hours ago is alert and oriented and complains of feeling thirsty.Diet orders read,"clear liquids,advance as tolerated." Which action should the nurse take?

A) Notify the RN.
B) Ask the patient if she has passed any flatus.
C) Allow the patient to take small sips of water.
D) Inform the patient she must remain NPO (nothing by mouth) until she has bowel sounds.

Question 30

The nurse is reinforcing teaching provided to a patient who has a small bowel obstruction.Which processes occur in the small intestine that should be included in this teaching? (Select all that apply.)

A) Production of bile
B) Absorption of water
C) Production of insulin
D) Mechanical digestion of food to chyme
E) Production of enzymes to complete carbohydrate metabolism
F) Production of peptides to complete the digestion of proteins to amino acids

Question 31

The nurse is reinforcing teaching for a patient who has hepatitis.Which functions of the liver should the nurse include in the teaching? (Select all that apply.)

A) Form bilirubin
B) Produce white blood cells
C) Synthesize clotting factors
D) Store sodium and potassium
E) Synthesize essential amino acids
F) Phagocytize worn red blood cells

Question 32

The nurse is preparing a patient for an NG tube insertion.To decrease the patient's anxiety about insertion of a nasogastric tube,what should the nurse do?

A) Administer a narcotic.
B) Administer a sedative.
C) Explain the procedure.
D) Assess the patient's gag reflex.

Question 33

The nurse is contributing to the teaching plan for another nurse's team of patients.Which patients should the nurse expect to be scheduled for an upper GI series? (Select all that apply.)

A) A 45-year-old with a suspected hiatal hernia
B) A 19-year-old with symptoms of appendicitis
C) A 52-year-old with a family history of polyps
D) A 78-year-old who has frank blood in his stool
E) A 65-year-old who is receiving treatment for hemorrhoids
F) A 33-year-old who is experiencing symptoms of pyloric stricture

Question 34

While assessing a patient's abdomen,the nurse notes a yellow-tinge to the skin.How should the nurse document this finding?

A) Striae
B) Jaundice
C) Caput medusae
D) Spider angioma

Question 35

The nurse is caring for a patient who has a permanent gastric feeding tube.What nursing action would be most helpful to prevent aspiration during feedings?

A) Administer careful oral care daily.
B) Check placement of the tube hourly.
C) Elevate head of bed at least 30 degrees.
D) Ask the physician to order daily x-rays.

Question 36

The nurse is participating in a local health fair.Which should the nurse include in a presentation on aging changes associated with the GI system? (Select all that apply.)

A) Decreased peristalsis
B) Increased constipation
C) Decreased sense of taste
D) Increased periodontal disease
E) Decreased risk of colon cancer

Question 37

The nurse is contributing to a patient's plan of care.Which patients should the nurse recommend as benefiting from PN? (Select all that apply.)

A) A patient who has esophageal cancer
B) A patient scheduled for toe amputation
C) A patient who has just had an appendectomy
D) A patient who has been admitted with chest pain
E) A patient with severe burns across the face and chest
F) A patient who has respiratory distress from emphysema

Question 38

The nurse is caring for a patient on a clear liquid diet.The nurse should recognize that the patient requires further teaching if the patient requests which food?

A) Gelatin
B) Beef broth
C) Cranberry juice
D) Coffee with cream

Question 39

A patient's Levin NG tube inserted for decompression of the bowel,which is connected to low intermittent suction,is not draining.The patient reports feeling full,uncomfortable,and nauseous.After verifying tube placement,what action should the nurse take next?

A) Provide an antiemetic.
B) Remove the nasogastric tube.
C) Notify the physician immediately.
D) Gently irrigate tube with normal saline.

Question 40

The nurse is reviewing structures within the hepatobiliary system with a patient with liver disease.Which structures should the nurse identify as being a part of this system? (Select all that apply.)

A) Liver
B) Colon
C) Jejunum
D) Bile duct
E) Esophagus
F) Gallbladder

Question 41

A patient is 5 feet 6 inches tall and weighs 225 pounds.What is this patient's body mass index?

Question 42

The nurse is caring for a patient recovering from an endoscopic retrograde cholangiopancreatography (ERCP).Which findings should the nurse report to the charge nurse immediately? (Select all that apply.)

A) Nausea and vomiting
B) Onset of a fever and chills
C) Urine output 100 mL the last hour
D) Heart rate of 110 beats per minute
E) Increased right upper quadrant pain

Question 43

A patient is diagnosed with liver failure.Which vitamin supplements should the nurse expect to be prescribed for this patient? (Select all that apply.)

A) Vitamin C
B) Vitamin D
C) Vitamin K
D) Vitamin B₆
E) Vitamin B₁₂

Question 44

A patient is upset to learn that an occult blood test of a stool specimen was positive for blood.What should the nurse assess in this patient to determine if the results were falsely positive? (Select all that apply.)

A) Ingestion of fish
B) Use of aspirin or NSAIDs
C) Recent intake of whole milk and cheese
D) Ingestion of red meat three days before the test
E) Recent dental procedure causing bleeding gums

Question 45

The nurse is caring for a patient of Mexican American descent who is experiencing diarrhea.Which foods should the nurse expect the patient to select for the next day's meals? (Select all that apply.)

A) Fish
B) Beef
C) Cheese
D) Chicken
E) Fresh Fruit