Deck 4: Digestion

Question 1

For a 9-month-old infant, which finding is inconsistent with GERD?

A)Weight gain
B)Vomiting
C)Irritability
D)Wheezing

Answer 1

Weight gain

Question 2

A client presents at the emergency department reporting a burning pain in the chest of a 7 on a 0 to 10 pain scale. Gastroesophageal reflux disorder (GERD)secondary to hiatal hernia is diagnosed. Based on this data, which is the priority nursing diagnosis?

A)Dysfunctional Gastrointestinal Motility
B)Anxiety
C)Acute Pain
D)Ineffective Health Maintenance

Answer 2

Acute Pain

Question 3

A client presents with delayed wound healing. During the physical assessment, which nutrient deficiency does the nurse anticipate based on the data?

A)Protein
B)Digestive enzymes
C)Insulin
D)Carbohydrates

Answer 3

Protein

Question 4

The nurse is assigned to a 4-month-old infant with vomiting and diarrhea who is brought to the pediatric clinic. The infant's vital signs are temperature: 37°C, apical HR: 130, R: 40/min. The abdominal assessment reveals a soft, concave abdomen, 10 gurgles auscultated in 1 minute in all four quadrants, and tympani to percussion. Which collaborative care action does the nurse anticipate?

A)Check the surgical call schedule and reserve an operating suite.
B)Place the infant NPO for a barium swallow.
C)Prepare a milk-based infant formula to replace fluids.
D)Complete a thorough digestion assessment interview with the mother.

Question 5

A pediatric client is diagnosed with gastroesophageal reflux disorder (GERD). The nurse is observing a return demonstration of the caregiver preparing and feeding the infant formula. Which observation demonstrates correct procedure for preventing GERD symptoms?

A)Burping the infant after 4 ounces of formula are taken
B)Thinning the formula with water prior to feeding
C)Positioning the infant upright for a minimum of 30 minutes
D)Warming the formula prior to feeding

Question 6

In planning care for a 32-year-old pregnant client with worsening GERD in her second trimester, which teaching would be inappropriate?

A)Eat smaller and more frequent meals.
B)Avoid foods that are known to be triggers for GERD.
C)Proton pump inhibitors (PPIs)are safe to use, with the exception of omeprazole.
D)The use of antacids containing sodium bicarbonate is recommended.

Question 7

The nurse is considering nutritional support for a client experiencing severe side effects of chemotherapy. Which independent and collaborative interventions will best limit the adverse digestive and nutritional effects of chemotherapy?

A)Encourage client to drink 350 mL of clear liquids within 1 hour prior to meals.
B)Position the client flat during intermittent enteral nutrition feedings.
C)Verify that enteral nutrition and total parenteral nutrition (TPN)are never used concurrently.
D)Teach the client relaxation techniques in addition to offering IV ondansetron.

Question 8

An adult client with a BMI of 39 who smokes 1 pack of cigarettes per day is admitted to the hospital with chest pressure. After myocardial infarction is ruled out, the client is diagnosed with erosive esophagitis through upper GI endoscopy. The client now refuses all medications and states, "I'm not getting hooked on any pills." What would the nurse recommend for the multidisciplinary collaborative plan? Select all that apply.

A)Assess the client's readiness for change in smoking cessation and weight loss.
B)Interview the client and spouse for a 24-hour recall of usual food content, intake, and meal times.
C)Enlist the client's son to elevate the foot of the client's bed at home 6 inches.
D)Offer the client a surgical consult to reduce the necessity of medication.
E)Omit the pharmacist notification of the Multidisciplinary Team meeting about the client.

Question 9

A client with a history of gastroesophageal reflux disorder (GERD)presents with metabolic alkalosis. Based on the data reviewed in the client's history, which medication does the nurse suspect contributed to the current diagnosis?

A)Aluminum hydroxide
B)Omeprazole
C)Ranitidine
D)Metoclopramide

Question 10

A client is scheduled for a diagnostic test to determine digestion status. Which test does not require fasting or other preparation?

A)Barium swallow
B)Amylase
C)Endoscopy
D)Lipid panel

Question 11

The nurse is providing care for several clients on a medical-surgical unit. The nurse anticipates that the client with which condition may require surgery?

A)Hepatitis
B)Pancreatitis
C)Pyloric stenosis
D)Malabsorption disorder

Question 12

A client is diagnosed with viral hepatitis transmitted by the fecal-oral route. Which conditions may be acquired by this mode of transmission?

A)Hepatitis A (HAV)and hepatitis E (HEV)
B)Hepatitis B (HBV)and hepatitis C (HCV)
C)Hepatitis D (HDV)
D)Hepatitis A (HAV), hepatitis B (HBV), hepatitis C (HCV), hepatitis D (HDV), and hepatitis E (HEV)

Question 13

What statement made by the client would indicate understanding of discharge teaching for self-care after hospitalization for acute pancreatitis?

A)"I will avoid onions, caffeine, and spices."
B)"I will take the antibiotics for 2 weeks."
C)"I will avoid alcoholic beverages."
D)"I will get immunized prior to my vacation."

Question 14

The nurse has implemented a care plan for an adult client with gastroesophageal reflux disorder (GERD). On the next clinic visit, which statement by the client indicates adherence to the plan of care?

A)"I can wear snug spandex camisoles if I feel comfortable."
B)"I have switched from margaritas to wine."
C)"I've lost 6 pounds because I eat every 3 hours and never before bed."
D)"I take a Tums with the ranitidine to make it work better."

Question 15

The nurse is preparing a presentation to a group of adolescent clients regarding proper nutrition. Which of the following teachings is appropriate for this group?

A)The high metabolism of the typical adolescent lowers nutritional requirements.
B)It is normal for adolescents to consume a lot of calories, but their diet should still be balanced.
C)Roughly half of an adolescent's daily caloric intake should come from fats.
D)The taste preferences of adolescents typically correlate to the nutritional value of what they eat.

Question 16

The nurse is explaining the alteration in normal function to a client recently diagnosed with gastrointestinal reflux disease (GERD). Which etiology contributing to GERD will the nurse include in the teaching session?

A)Transient constriction of the lower esophageal sphincter
B)Decreased pressure within the stomach
C)Incompetent lower esophageal sphincter
D)Prolonged constriction of the upper esophageal sphincter

Question 17

Which clients are at the highest risk of being admitted to the emergency department with severe nausea and vomiting? Select all that apply.

A)A 47-year-old with a 3-hour history of chest pressure
B)A 61-year-old reporting sudden onset of vertigo
C)A 72-year-old with an asthma exacerbation
D)A 23-year-old who sustained a head injury in a fall
E)A 19-year-old who is 6 weeks pregnant

Question 18

The nurse is providing care to several clients in an outpatient clinic. Which client is at high risk of developing gastroesophageal reflux disorder (GERD)?

A)A client who is 6 weeks pregnant
B)A client who is morbidly obese
C)A client who follows a strict vegetarian diet
D)A client who drinks one glass of wine monthly

Question 19

The nurse is caring for a 6-month-old infant with pyloric stenosis. Which of the following statements regarding this client's digestive system is false?

A)The client has voluntary control over swallowing.
B)Enzymes from the client's pancreas are sufficient to aid in digestion.
C)The client has a complete set of primary teeth.
D)The client's tongue is larger than an adult's in comparison to the nasal and oral passages.

Question 20

Which intervention would best improve diet adherence of an older male immigrant recently diagnosed with gastroesophageal reflux disorder (GERD)?

A)Scheduling low-fat meal deliveries to the home
B)Providing printed diet information in his native language
C)Interviewing the client to assess his current diet
D)Giving a list of foods to avoid to the client's wife

Question 21

The nurse is providing care to a client who is being admitted to rule out acute pancreatitis. Which item found in the client's history increases the client's risk for this disease process?

A)Systemic lupus
B)Alcoholism
C)Cystic fibrosis
D)Hypertriglyceridemia

Question 22

A nurse is caring for a client diagnosed with an HBV infection. Which of the following clinical manifestations would indicate that this client had entered the icteric phase?

A)Fatigue
B)Jaundice
C)Loss of appetite
D)Nausea

Question 23

The nurse is explaining hepatitis to a high school health occupations class. The students all volunteer examples of how hepatitis is transmitted. Which student statement indicates the need for further education?

A)"Body piercing or tattoo with infected equipment."
B)"Contaminated food or fluids."
C)"Alcoholism or high doses of acetaminophen."
D)"Bite of an infected mosquito or tick."

Question 24

A school-age child, recently diagnosed with celiac disease, is underweight, vitamin deficient, and anemic and experiences frequent diarrhea. In addition to removing gluten from his diet, what other recommendations will the nurse provide for this child and family? Select all that apply.

A)Fat restriction
B)A high-carbohydrate diet
C)Vitamin supplements
D)High-calorie diet
E)High-protein diet

Question 25

When planning care for a client with chronic hepatitis, which collaborative discipline will be most helpful in treating continued alcohol use?

A)Social worker
B)Primary provider
C)Pharmacist
D)Dietitian

Question 26

The nurse is planning education for an adolescent client recently diagnosed with hepatitis. The client moved back to the parents' home. Which recommendation to the client's parents will best prevent them from acquiring hepatitis B (HBV)?

A)Refuse to donate blood.
B)Avoid contaminated water.
C)Obtain postexposure prophylaxis.
D)Abstain from alcohol.

Question 27

The nurse is providing care to an older adult client admitted to the medical unit for acute gastric and left upper abdominal pain radiating to the back. The healthcare provider has diagnosed the client with chronic pancreatitis. Which items are appropriate to include in the discharge teaching for this client? Select all that apply.

A)Encouraging a high-fat diet
B)Eliminating alcoholic beverages
C)Properly administering pancrelipase
D)Reporting symptoms of infection
E)Taking antacids

Question 28

Which of the following statements best describes the role of gluten in celiac disease?

A)It acts as a toxin damaging the villi of the small intestine.
B)It acts as an immunological body to destroy pathogens.
C)It acts as a virus to cause disease.
D)It acts as a foreign substance that provokes an immune response.

Question 29

During an interview with a 67-year-old client diagnosed with acute hepatitis B, the nurse obtains the following data: 10 kg weight loss is noted from the client's last visit 4 months ago; review of systems reveals (1)limiting fatigue, (2)not well enough for sexual intercourse, (3)drinks 3-5 mixed drinks weekly socially, (4)right upper quadrant (RUQ)pain rated at 6/10, and 5)"constant" pruritus. Which findings indicate that the client's hepatitis may have progressed to a chronic stage? Select all that apply.

A)Fatigue
B)Drinks 3-5 mixed drinks weekly socially
C)RUQ pain rated at 6/10
D)Pruritus

Question 30

An older adult African American client with a history of celiac disease presents with abdominal cramps, pain, and diarrhea. The client denies the use of alcohol, but states, "My favorite foods are steak, cheese, and ice cream." Based on this data, which condition does the nurse suspect?

A)Acute pancreatitis
B)Appendicitis
C)Lactase deficiency
D)Food poisoning

Question 31

Parents of a child diagnosed with celiac disease have requested guidance on how to implement an appropriate diet. In addition to a list of foods to include and exclude, which interventions by the nurse are appropriate? Select all that apply.

A)Obtaining a dietary prescription
B)Implementing a recommended exercise program
C)Training on how to read food labels
D)Providing a referral to support groups
E)Encouraging the use of a gluten-free cookbook

Question 32

A school nurse is providing care to a number of school-age children diagnosed with celiac disease. Which interventions are appropriate for the nurse to implement with this group of students? Select all that apply.

A)Teaching about gluten-free food choices
B)Emphasizing low-calorie food selections
C)Implementing a school-based prevention program to eliminate the disease process
D)Labeling gluten-free choices in the school lunch program
E)Demonstrating coping strategies for living with celiac disease

Question 33

The nurse is providing care to a client diagnosed with celiac disease who experiences frequent diarrhea. Based on this data, the nurse anticipates the client may also experience which associated problems? Select all that apply.

A)Skin breakdown
B)Fluid and electrolyte imbalance
C)Hair loss
D)Lifestyle issues
E)Sexual dysfunction

Question 34

A nurse recommends a gluten-free diet to a client recently diagnosed with celiac disease. The client says that she wants to become pregnant and asks how a gluten-free diet might aid in that. What is not a benefit for this client of a gluten-free diet?

A)A gluten-free diet may lower the risk of infertility.
B)A gluten-free diet may lower the risk of miscarriage.
C)A gluten-free diet may increase the probability that the child's birth weight will be healthy.
D)A gluten-free diet may improve fetal bone development.

Question 35

A home healthcare nurse is providing care to an older adult client who lives alone and has limited financial resources. The client has a history of celiac disease. When planning care for this client, which nursing diagnoses are appropriate? Select all that apply.

A)Risk for Constipation
B)Imbalanced Nutrition: Less than Body Requirements
C)Risk for Imbalanced Fluid Volume
D)Diarrhea
E)Chronic Pain

Question 36

A young adult waiter has been treated for viral hepatitis at a healthcare clinic. Which client outcome indicates the need for additional intervention? Select all that apply.

A)Body mass index (BMI)changes from 24 to 21.
B)Return demonstration of hand washing is correctly performed.
C)Social Services notified the Health Department of the occurrence.
D)Red scratch marks are noted on the arms and trunk.
E)Client denies abdominal or epigastric pain.

Question 37

The multidisciplinary care team is meeting to discuss care for a client who exhibits symptoms of the prodromal phase of hepatitis. Lab results include a positive anti-HAV IgM. The nurse creates an action plan to present to the team. Which interventions are appropriate? Select all that apply.

A)High-fat, low-calorie, and no-alcohol diet teaching
B)Patient education on acceptable pain medication
C)Early treatment with lamivudine
D)Referral to the liver transplant team
E)Family teaching for transmission prevention

Question 38

The nurse is providing care to a pediatric client diagnosed with celiac disease. Which outcomes can be anticipated when the appropriate steps for managing celiac disease have been implemented? Select all that apply.

A)The client is free of abdominal discomfort including bloating, gas, indigestion, nausea, and vomiting.
B)The client is able to maintain normal or routine bowel habits.
C)The client has diarrhea fewer than 3 days weekly.
D)The client is able to maintain adequate nutritional status.
E)The client is able to make appropriate menu choices prior to discharge.

Question 39

The nurse is providing care to a client admitted with acute pancreatitis. Which data support the client's diagnosis? Select all that apply.

A)Severe epigastric pain
B)Nausea and vomiting
C)Elevated temperature
D)Hypotension
E)Steatorrhea

Question 40

A nurse is planning a teaching session for expectant mothers regarding pediatric clients and hepatitis. Regarding hepatitis A, which of the following statements is correct?

A)Infection of the mother is the most common reason hepatitis A spreads to children.
B)A daycare is typically a high-risk environment for the spread of hepatitis A.
C)Children with hepatitis A are commonly asymptomatic.
D)Hepatitis A in children is typically a very serious illness with long-term health effects.

Question 41

What is most characteristic of acute pancreatitis?

A)The pancreas attacks its own tissue.
B)The pancreas becomes distended with fluid.
C)The pancreas ceases to produce enzymes.
D)The pancreas needs to be removed.

Question 42

A nurse is caring for an infant postsurgery for pyloric stenosis. Which nursing interventions are appropriate when providing care for this infant? Select all that apply.

A)Administer analgesics, per order.
B)Instruct the parents on proper diapering to avoid pressure over the incision.
C)Encourage swaddling and rocking to facilitate relaxation.
D)Teach the parents to remove the Steri-Strips during the infant's first bath postsurgery.
E)Monitor temperature once per shift.

Question 43

Which of the following clients is most likely to develop adult pyloric stenosis?

A)11-year-old female client with acute pancreatitis
B)22-year-old male client with acute hepatitis B
C)33-year-old female client with GERD
D)44-year-old male client with gastritis

Question 44

A 28-year-old pregnant client presents with epigastric pain, back pain, anorexia, nausea, vomiting, and jaundice. What diagnostic test should the nurse expect to be performed on this client to determine the presence of gallstones?

A)Ultrasonography
B)Endoscopic retrograde cholangiopancreatography (ERCP)
C)Contrast-enhanced CT scan
D)Percutaneous fine-needle aspiration biopsy

Question 45

A new mother brings a male infant, 2 weeks old, to the pediatric clinic for a checkup. The mother is concerned that the infant may be at risk for pyloric stenosis due to his age and because her husband had surgery for the condition when he was an infant. Which responses by the nurse are the most appropriate based on this data?

A)"Your baby has a greater risk for the condition due to a familial history."
B)"Your baby would have an increased risk if the infant was a girl."
C)"Due to your age, your son is at an increased risk for the condition."
D)"As long as your baby has bowel movements there is nothing to worry about."

Question 46

A nurse is providing care to an infant who underwent a laparoscopic pyloromyotomy. After providing discharge instructions to the infant's caregivers, which statements indicate appropriate understanding? Select all that apply.

A)"I will burp my baby every 1-2 ounces during feedings."
B)"It is important to slide the diaper under my baby when changing the diaper."
C)"I will feed my baby 3 times per day."
D)"I will hold my baby in an upright position for 15 minutes after each feeding."
E)"I will clean the incision site with warm, soapy water twice per day."

Question 47

The nurse is providing care to an infant who underwent surgery for pyloric stenosis. Which actions by the nurse will decrease the risk for infection when caring for this infant? Select all that apply.

A)Monitor temperature every hour.
B)Place pressure on the incision.
C)Inspect the incision for redness, swelling, or discharge.
D)Auscultate the lungs to assess for any adventitious sounds.
E)Give the infant a tub bath.

Question 48

The nurse is caring for an infant who is admitted for possible pyloric stenosis. When assessing the infant, which actions are appropriate? Select all that apply.

A)Observe the infant's abdomen.
B)Auscultate bowel sounds.
C)Provide oral feeding.
D)Palpate the right upper quadrant of the abdomen.
E)Pass a nasogastric tube.

Question 49

The nurse is caring for an infant who is scheduled for surgery for pyloric stenosis. When planning the infant's care, which nursing diagnoses are appropriate? Select all that apply.

A)Deficient Fluid Volume related to inadequate intake and vomiting
B)Hyperbilirubinemia related to poor liver function
C)Sleep Pattern Disturbance related to discomfort and hunger
D)Parental Anxiety related to surgery
E)Imbalanced Nutrition: Less than Body Requirements related to inadequate intake and vomiting

Question 50

A 63-year-old client is diagnosed with chronic pancreatitis. In planning care for this patient, which of the following treatments should the nurse expect to increase the patient's risk for edema?

A)Pancrelipase administration
B)IV fluid administration
C)Nasogastric tube insertion
D)Total parenteral nutrition

Question 51

The nurse is providing care to a 1-month-old infant who is brought to the pediatric clinic for projectile vomiting. Which data collected during the assessment process would support the diagnosis of pyloric stenosis? Select all that apply.

A)Blood-tinged vomit
B)Low-grade fever
C)Persistent hunger
D)Peristaltic wave
E)Consistent weight gain

Question 52

The nurse is providing care to an older adult client with a history of alcohol abuse who is admitted to the hospital with acute pancreatitis. Which treatment options should the nurse plan for when caring for this client? Select all that apply.

A)Opioid analgesics
B)High-fat diet
C)Total parenteral nutrition
D)Nasogastric tube to suction
E)Pancrelipase administration

Question 53

An adult client is admitted to the emergency department with symptoms of acute pancreatitis. Which nursing diagnoses are appropriate for this client? Select all that apply.

A)Acute Pain
B)Impaired Swallowing
C)Deficient Fluid Volume
D)Nausea
E)Imbalanced Nutrition: Less than Body Requirement

Question 54

A client was discharged after hospitalization for acute pancreatitis with instructions on the use of analgesics, cautions on the importance of avoiding alcohol and smoking, and recommendations for a low-fat diet. Which outcomes would indicate that the client has implemented the recommendations? Select all that apply.

A)The client experiences reduction or elimination of pain.
B)The client is free from alterations in nutritional status.
C)The client remains free from alterations in fluid balance.
D)The client returns to work.
E)The client is free from nausea.

Question 55

A 42-year-old male client is diagnosed with adult pyloric stenosis. Which of the following symptoms would the nurse least expect to encounter in this client?

A)Weight loss
B)Upper abdominal pain
C)Increase of appetite
D)Nausea