Deck 30: Gastrointestinal Disorders and Therapeutic Management

Question 1

Roux-en-Y gastric bypass is

A) a restrictive type of bariatric surgery.
B) a malabsorptive type of bariatric surgery.
C) a combination of restrictive and malabsorption types of bariatric surgery.
D) standard operation for pancreatic cancer.

Answer 1

a combination of restrictive and malabsorption types of bariatric surgery.

Question 2

A nursing priority for a patient with GI hemorrhage is

A) positioning the patient in a high-Fowler position.
B) airway protection.
C) irrigating the nasogastric tube with iced saline.
D) maintaining venous access so that fluids and blood can be administered.

Answer 2

maintaining venous access so that fluids and blood can be administered.

Question 3

The patient at risk for GI hemorrhage should be monitored for which of the following signs and symptoms?

A) Metabolic acidosis and hypovolemia
B) Decreasing hemoglobin and hematocrit
C) Hyperkalemia and hypernatremia
D) Hematemesis and melena

Answer 3

Hematemesis and melena

Question 4

Which of the following disorders is the leading cause of upper GI hemorrhage?

A) Stress ulcers
B) Peptic ulcers
C) Nonspecific erosive gastritis
D) Esophageal varices

Question 5

Esophagectomy is usually performed for

A) cancer of the proximal esophagus and gastroesophageal junction.
B) cancer of the distal esophagus and gastroesophageal junction.
C) cancer of the pancreatic head.
D) varices of the distal esophagus and gastroesophageal junction.

Question 6

A patient with a 10-year history of alcoholism was admitted to the critical care unit with the diagnosis of acute pancreatitis.Based on the diagnosis,the patient

A) is at risk for hypovolemic shock from plasma volume depletion.
B) requires observation for hypoglycemia and hypercalcemia.
C) should be started on enteral feedings after the nasogastric tube is placed.
D) is placed on a fluid restriction to avoid the fluid sequestration.

Question 7

A patient with a 10-year history of alcoholism was admitted to the critical care unit with the diagnosis of acute pancreatitis.The patient is preparing for discharge.Nursing intervention should include

A) diabetes management.
B) alcohol cessation program.
C) frequency of hemoccult testing.
D) frequency of PT and PTT testing.

Question 8

A patient with a 10-year history of alcoholism was admitted to the critical care unit with the diagnosis of acute pancreatitis.The patient is complaining of a pain in the left upper quadrant.Using a 1- to 10-point pain scale,the patient states the current level is at an 8.To properly manage the patient's pain,the priority of nursing interventions is to

A) administer antiemetics around the clock.
B) administer analgesics around the clock.
C) educate the patient and family on lifestyle changes.
D) teach relaxation techniques.

Question 9

Verification of feeding tube placement includes

A) auscultation for position.
B) aspiration of stomach contents.
C) x-ray study for confirmation.
D) gastric pH measurement.

Question 10

Signs and symptoms of an anastomotic leak include

A) pneumonia.
B) subcutaneous emphysema.
C) bleeding.
D) atelectasis.

Question 11

Which classification of medication is used to reduce volume and concentration of gastric secretions?

A) Antacids
B) Histamine2 (H?) antagonists
C) Gastric mucosal agents
D) Gastric proton pump inhibitors

Question 12

To administer sucralfate through a gastric tube it should be

A) crushed and mixed with 10 mL of water.
B) dissolved in 10 mL of water to form a slurry.
C) mixed in 15 mL of water to form a solution.
D) administered as a whole pill with a 35-mL water flush.

Question 13

A patient with a 10-year history of alcoholism was admitted to the critical care unit with the diagnosis of acute pancreatitis.The physiologic alteration that occurs in acute pancreatitis is

A) uncontrolled hypoglycemia caused by an increased release of insulin.
B) loss of storage capacity for senescent red blood cells.
C) premature activation of inactive digestive enzymes, resulting in autodigestion.
D) release of glycogen into the serum, resulting in hyperglycemia.

Question 14

Absorption of Prilosec and Prevacid occurs in the

A) stomach.
B) duodenum.
C) jejunum.
D) cecum.

Question 15

Which of the following can be used as pharmacologic method of treatment in acute variceal hemorrhage?

A) Histamine2 (H?) antagonists
B) Vasopressin
C) Solu-Medrol
D) Antacids

Question 16

Esophagogastric varices are the result of

A) portal hypertension resulting in diversion of blood from a high-pressure area to a low-pressure area.
B) superficial mucosal erosions as a result of increased stress levels.
C) proulcer forces breaking down the mucosal resistance.
D) inflammation and ulceration secondary to nonsteroidal anti-inflammatory drug use.

Question 17

The physician orders gastric lavage to control GI bleeding.The nurse has inserted a large-bore NG tube.What temperature and irrigating fluid would be used to obtain the best results?

A) Warm NS or water
B) Iced NS or water
C) Room temperature NS or water
D) Iced NS only

Question 18

Which of the following nursing interventions after GI surgery would have the highest priority of care?

A) Oxygenation
B) Pain management
C) Circulation
D) Preventing infection

Question 19

Which of the following medications is/are given to help control ammonia levels in a patient with acute liver failure (ALF)?

A) Insulin
B) Vitamin K
C) Lactulose
D) Benzodiazepines

Question 20

A major side effect of vasopressin is

A) constipation.
B) diarrhea.
C) dysrhythmias.
D) bleeding.

Question 21

Which of the following interventions would you expect in the management of hepatic failure?

A) Benzodiazepines for agitation
B) Pulse oximetry and serial arterial blood gas measurements
C) Insulin drip for hyperglycemia and hyperkalemia
D) Monitor electrolyte blood levels
E) Assess for signs of cerebral edema

Question 22

Which of the following are clinical manifestations of pancreatitis?

A) Epigastric and abdominal pain
B) Nausea and vomiting
C) Diaphoresis
D) Jaundice
E) Hyperactive bowel sounds
F) Fever

Question 23

Which of the following is a potential cause for acute liver failure?

A) Ischemia
B) Hepatitis A, B, C, D, E, non-A, non-B, non-C
C) Acetaminophen toxicity
D) Wilson disease
E) Reye syndrome
F) Diabetes

Question 24

A patient has a Salem sump to lower intermittent suction.Nursing interventions include

A) prevention of esophageal erosion and stricture.
B) prevention of dry mouth.
C) prevention of ulceration of the nares.
D) irrigating the tube every 4 hours or as ordered by the health care provider.

Question 25

A patient is admitted with the diagnosis of acute pancreatitis.The nurse expects which of the following laboratory test results to be elevated?

A) Calcium
B) Serum amylase
C) Serum glucose
D) Potassium
E) WBC
F) Serum triglycerides