Deck 21: Assessing the Gastrointestinal System

Question 1

The healthcare provider determines that a pregnant patient is at risk for having a baby with a weak neurological system. Which foods should the nurse counsel the patient to consume to address this potential problem?

A) potatoes, tomatoes, and sweet potatoes
B) dark green vegetables, lean beef, and eggs
C) liver, legumes, and citrus fruits
D) whole grains, yeast breads, and milk

Answer 1

dark green vegetables, lean beef, and eggs

Question 2

During the admission assessment, the nurse learns that a patient is having her menstrual period. Which ordered tests could be impacted by this finding?

A) small bowel series
B) barium enema
C) stool culture
D) colonoscopy

Answer 2

stool culture

Question 3

A patient tells the nurse about taking large doses of vitamin A for skin health. What should the nurse respond to this patient?

A) "That is a great idea."
B) "That will not benefit your skin. You excrete high doses of vitamin A in your urine."
C) "You should take vitamin C to balance the large dose of A."
D) "Too much vitamin A can be toxic to your body."

Answer 3

"Too much vitamin A can be toxic to your body."

Question 4

The nurse is planning care for a patient scheduled for a barium enema the next morning. What should be included in the plan of care?

A) enemas after the procedure
B) full-liquid diet for 24 hours before the procedure
C) positioning the patient on the right side during the procedure
D) nothing by mouth for 8 hours prior to the procedure

Question 5

A patient is scheduled for a liver biopsy. What should the nurse include in this patient's preprocedure teaching?

A) Abstain from all food and fluids for at least 8 hours prior to the procedure.
B) Consume a low-fat diet 1-3 days prior to the procedure.
C) Complete blood tests prior to the procedure.
D) Restrict activity for 4-6 weeks after the procedure.

Question 6

The nurse is teaching a patient scheduled for a colonoscopy. Which patient statement indicates a need for further teaching?

A) "The procedure will only take about an hour."
B) "It might be quite painful."
C) "I will likely have medications that will make me drowsy during the test."
D) "The physician might take tissue samples for further analysis."

Question 7

The nurse is caring for a patient with multiple skin lesions who reports following a very-low-calorie diet to maintain weight loss. What should the nurse identify as the patient's priority problem?

A) inadequate nutritional intake
B) issues with activity
C) tissue perfusion insufficiency
D) risk for self-harm

Question 8

A patient is recovering from a sigmoidoscopy with removal of a benign polyp. What should the nurse include in this patient's discharge instructions?

A) Contact the primary healthcare provider if experiencing large amounts of flatus.
B) Avoid heavy lifting for 2 weeks after procedure.
C) Report abdominal pain, fever, or chills.
D) Beginning the evening after the procedure, eat foods high in fiber.

Question 9

While conducting an abdominal assessment, the nurse notes dullness on percussion when the patient turns from the supine position to the right side. How should the nurse interpret this finding?

A) The patient is exhibiting normal findings.
B) The patient is exhibiting signs consistent with ascites.
C) The patient is exhibiting signs consistent with a bowel obstruction.
D) The patient is exhibiting signs consistent with hepatomegaly.

Question 10

An 85-year-old patient is concerned about the loss of sensation of the need to defecate. How should the nurse respond?

A) "This is a normal part of aging due to slowed intestinal absorption."
B) "As you age, the rectum loses tone, and there is a reduced sensation of the need to defecate."
C) "Have you had a colonoscopy in the past year to evaluate the condition?"
D) "Reduced vitamin K absorption is associated with this condition."

Question 11

The nurse is teaching a group of older adults about expected changes in dental health related to aging. Which statement by one of the older adults indicates that teaching has been effective?

A) "Tooth enamel is more pliable."
B) "The loss of bone density with aging results in tooth decay and breakage."
C) "Increases in saliva production increase exposure of the tooth's enamel to corrosive agents."
D) "Metabolic changes in aging contribute to dental destruction."

Question 12

The nurse is preparing to assess a patient's gastrointestinal system. What should the nurse say to gain the most information about this patient's elimination pattern?

A) "Are you having any bowel problems?"
B) "Have you had any recent difficulties with your stools?"
C) "Tell me about your usual bowel habits."
D) "Are your bowel movements normal?"

Question 13

When assessing a patient's abdomen, the nurse notes frequent pulsations in the epigastric region. What action should the nurse take?

A) document the findings as hyperactive bowel sounds
B) review the patient's medical records for signs and symptoms of cirrhosis, which may indicate ascites
C) note the time when the patient last voided
D) notify the physician about the findings

Question 14

The nurse is planning the diet for a patient scheduled to have a barium enema in 2 days. What kind of diet should the nurse plan for the next 48 hours?

A) general diet
B) full diet today, clear liquids tomorrow
C) full liquids today, nothing by mouth tomorrow
D) clear liquids both today and tomorrow

Question 15

The nurse determines that a patient's body mass index (BMI) is 22 kg/m². Based on this finding, what should the nurse conclude?

A) BMI should be between 19 and 25 kg/m². The patient's weight is within a healthful range.
B) The patient needs to lose weight for optimum health.
C) The patient is mildly obese.
D) The patient's BMI is below normal.

Question 16

The nurse is preparing to examine a patient's abdomen. In which order should the nurse complete this examination?

A) percussion
B) inspection
C) palpation
D) auscultation
E) non of the above.

Question 17

The nurse is preparing to assess a young adult female with right-upper-quadrant abdominal pain. Which question should the nurse ask when performing this assessment?

A) "Does the pain worsen when you inhale?"
B) "Do you have a history of diabetes?"
C) "When you eat, do you experience any nausea?"
D) "Have your periods been normal?"

Question 18

A 16-year-old patient in an outpatient setting with a body mass index of 35 tells the nurse, "I am going to lose weight by eliminating all fat from my diet." Which action should the nurse take first?

A) Contact the physician.
B) Notify the patient's parents.
C) Refer the patient to a dietitian.
D) Discuss the role of fat in metabolism.

Question 19

A 60-year-old patient who is pale and weak has a hemoglobin level of 9 gm/dL. The patient states, "I eat a healthful diet. Why am I not well?" How should the nurse respond?

A) "You might not be eating as well as you think."
B) "This happens as you get older."
C) "As we age, the amount of iron absorbed by our body decreases."
D) "Menopause is responsible for these changes."

Question 20

A patient with a 2-month history of diarrhea is prescribed a diagnostic test that uses a narrow x-ray beam to provide a 360-degree view of abdominal structures. For which diagnostic test should the nurse prepare the patient?

A) liver biopsy
B) cholecystography
C) gastric emptying study
D) computed tomography

Question 21

The nurse is planning care for a patient with end-stage renal disease who has a moderate daily protein restriction. Which meal choice would be most appropriate for this patient?

A) peanut butter sandwich and apple slices
B) bean soup and spinach salad
C) salmon fillet and asparagus
D) fried rice and fresh strawberries

Question 22

The nurse is teaching a patient about a scheduled small bowel series. Which statement by the patient indicates that further teaching is required?

A) "It is normal to experience constipation for a few days after the procedure."
B) "I will need to increase my fluid intake the first few days after the procedure."
C) "I might have a laxative prescribed after the procedure."
D) "The barium will be inserted through my rectum."

Question 23

The nurse is planning teaching for a patient scheduled for an abdominal ultrasound. How should the nurse instruct the patient to prepare for this test?

A) "Advise the technician if you suspect you are pregnant."
B) "Drink 1 to 2 quarts of water 1 hour before the procedure."
C) "Do not eat anything 8 to 12 hours before the procedure."
D) "Take a laxative the evening before the procedure."

Question 24

The home health nurse is teaching a patient about vitamin requirements. Which statement indicates that the patient requires additional teaching?

A) "I will follow the National Academy of Sciences recommendations for daily intake of vitamins."
B) "I might need more or fewer vitamins than someone else, based on my lifestyle."
C) "Evidence-based practice sometimes changes the recommended amount of a specific vitamin."
D) "Vitamins obtained through food are superior to those obtained through tablets and pills."

Question 25

The nurse is teaching a group of 6-year-olds about the digestive system. Which statements by the children indicate that teaching has been effective?

A) "Grown-ups have 28 teeth."
B) "Spit helps you taste your food."
C) "Food starts breaking down in the stomach."
D) "It's like a tube. Food I need goes in one end. What I don't need comes out the other."
E) "The food moves through the tube in waves, like a snake eating a mouse."

Question 26

The nurse is reviewing data within a patient's health history. Which factor in the history should the nurse recognize as related to the development of familial adenomatous polyposis?

A) The patient eats a diet high in red meat.
B) The patient has never had the recommended screening colonoscopy.
C) The patient's grandfather died of colon cancer.
D) The patient had a basal cell skin cancer removed 2 year ago.

Question 27

The nurse reviews the functions of the gastrointestinal system for a patient with celiac disease. Which statement by the patient indicates that teaching has been effective?

A) "The stomach begins the process of absorbing nutrients."
B) "The stomach turns food into liquid so it can be digested."
C) "The stomach begins the digestion of carbohydrates."
D) "The stomach secretes sulfuric acid."

Question 28

The nurse determines that a patient has a scaphoid abdomen. Which health problem should the nurse suspect the patient is experiencing?

A) type 2 diabetes mellitus
B) Crohn disease
C) malnutrition
D) diverticulosis

Question 29

The nurse is planning a class on nutrition for middle-school students. Which data points should be included in the presentation?

A) Sufficient dietary fats help people absorb vitamins.
B) Cholesterol is needed for proper hormonal function.
C) Fat tissue helps insulate the internal organs.
D) Vitamin K is formed by the action of ultraviolet radiation on the skin.
E) Vitamin D is synthesized by bacteria in the intestine.

Question 30

A patient tells the nurse, "I am going to eat an all-fruit diet. Nothing is more healthful than fruit. Do you think this is a good idea?" How should the nurse respond?

A) "Fruit is natural and a good source of carbohydrates."
B) "Fruit is a good source of carbohydrates but a poor source of fats and protein."
C) "Fruit supplies many important vitamins but is a relatively poor source of minerals."
D) "Incorporating fruit with complete sources of protein and healthful fats provides complete nutrition."
E) "A fruit-based diet will reduce your risk of developing diabetes mellitus."

Question 31

The nurse is conducting an educational session for patients who have a diagnosis of Crohn disease. Fifty patients with the disorder are in attendance. The nurse knows that, statistically, how many of these patients have a form of Crohn disease that is familial in origin?

Question 32

A patient complains of constipation. Which question should the nurse ask to learn more about the problem?

A) "Are you taking any narcotic medication?"
B) "Have you been taking over-the-counter pain relievers?"
C) "Have you been taking over-the-counter sleep aids?"
D) "Are you taking oral contraceptives?"

Question 33

The nurse is preparing to conduct a physical assessment of a patient with obesity. What equipment should the nurse have available for this assessment?

A) scale
B) skinfold calipers
C) calculator
D) glucose meter
E) supplies for blood draw

Question 34

The nurse is assessing a patient who uses chewing tobacco. Which data would be most important for the nurse to obtain?

A) The patient denies shortness of breath.
B) The patient has no leukoplakia.
C) The patient has no glossitis.
D) The patient has no signs of candidiasis.

Question 35

The nurse is preparing to percuss the abdomen of a patient. Which information indicates that the nurse might need assistance with this assessment?

A) The nurse plans to use a systematic approach for the assessment.
B) The nurse anticipates hearing tympany over stool-filled intestines.
C) The nurse anticipates hearing dullness over the liver.
D) The nurse plans to percuss the spleen, liver, and kidneys.

Question 36

The nurse is reviewing data collected from a group of patients. Which patient has a normal waist-to-hip ratio?

A) female patient, waist 29 inches, hips 35 inches
B) female patient, waist 29 inches, hips 36 inches
C) male patient, waist 37 inches, hips 36 inches
D) male patient, waist 40 inches, hips 41 inches

Question 37

The nurse is preparing to assess a patient with a suspected abdominal mass. Which techniques should the nurse use for this assessment?

A) Shine a light source across the abdomen.
B) Inspect by standing beside the patient.
C) Inspect from the patient's right side.
D) Inspect for symmetry and visible peristalsis.
E) Ask the patient to deep-breathe and inspect.

Question 38

A patient reports epigastric abdominal pain, nausea, and vomiting. The serum amylase level is 450 units/dL. For which health problem should the nurse plan care?

A) gastritis
B) malnutrition
C) pancreatitis
D) diverticulitis

Question 39

A patient whose diet consists of processed food from fast-food restaurants has painful lesions at the corners of the mouth. How should the nurse document this finding?

A) glossitis
B) gingivitis
C) cheilosis
D) leukoplakia

Question 40

The nurse is conducting an abdominal assessment. Which finding should the nurse realize is most likely related to a diagnosis of acute diverticulitis?

A) lower-right-quadrant pain
B) lower-left-quadrant pain
C) upper-middle abdominal pain
D) back pain and tenderness

Question 41

The nurse is caring for a patient with liver disease. What nutritional issues should the nurse expect this patient to exhibit?

A) alteration in fat metabolism
B) increase in glucose utilization
C) reduction in fat-soluble vitamins
D) lower amount of bile being stored
E) change in production of red blood cells

Question 42

The nurse notes that a patient's stool specimen is watery and diarrhea-like. Which health problems should the nurse suspect are occurring in this patient?

A) malabsorption
B) antibiotic reaction
C) lactose intolerance
D) irritable bowel syndrome
E) ingestion of spoiled food

Question 43

A patient of Jewish heritage is experiencing body aches and fatigue. The nurse notes that the patient's skin appears pale and yellow-tinged. What nutritional health problem should the nurse suspect is occurring in this patient?

A) Tangier disease
B) hypercholesterolemia
C) Gaucher disease
D) Lynch Syndrome

Question 44

A patient is being evaluated for liver disease. Which laboratory tests should the nurse expect to be conducted for this patient?

A) serum sodium
B) serum potassium
C) alkaline phosphatase
D) alanine aminotransferase
E) aspartate aminotransferase

Question 45

The nurse is instructing a patient newly diagnosed with celiac disease. The nurse knows follow-up is needed when the patient identifies which foods as appropriate choices?

A) spinach salad and corn
B) beefsteak and green beans
C) whole-wheat toast and baked chicken
D) apple slices and tuna salad

Question 46

The nurse is reviewing the contents of a nutritional supplement that a 32-year-old female patient takes each day. Which minerals in this supplement adhere to the recommended daily intake amounts?

A) iron 8 mg
B) zinc 8 mg
C) calcium 1000 mg
D) phosphorus 700 mg
E) magnesium 420 mg