Question 1

A patient is recovering from a colonoscopy with removal of polyps.Which teaching should the nurse provide?
A)"Rectal bleeding can occur up to a year after the polyps are removed."
B)"Rectal bleeding can occur up to 1 month after polyp removal."
C)"Contact the surgeon if any rectal bleeding occurs."
D)"Polyp removal weakens the intestinal wall,so bleeding may occur off and on indefinitely."

Accepted Answer

Rectal bleeding can occur up to 1 month after polyp removal, so this is the most accurate and relevant information to provide to the patient. Option A is misleading, as rectal bleeding is expected to decrease significantly within a few weeks of polyp removal. Option C is important as the surgeon should be notified if there is significant or ongoing bleeding. Option D is incorrect, as polyp removal does not weaken the intestinal wall, and bleeding should not continue indefinitely.

Question 2

A patient with a massive gastrointestinal bleed is diagnosed with a Mallory-Weiss tear.The nurse would anticipate which patient history?
A)Chronic alcohol ingestion
B)Ingestion of spicy foods
C)Aspirin use
D)20 packs/year smoking history

Accepted Answer

Mallory-Weiss tears are often associated with chronic alcohol ingestion, as the repeated vomiting and retching associated with alcohol abuse can lead to tears in the lining of the esophagus or stomach. Spicy foods and aspirin use are not typically associated with Mallory-Weiss tears, and while smoking can increase the risk of gastrointestinal bleeding, it is not a direct cause of these tears.

Question 3

The conventional transducer method will be used to measure a patient's intra-abdominal pressure.Which interventions will the nurse use in this measurement? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.
A)Connect the transducer to the patient's peripheral intravenous line.
B)Place the head of the patient's bed flat.
C)Inject 20-25 mL of saline into the indwelling urinary catheter port.
D)Calibrate the transducer at the level of the patient's pubis.
E)Obtain the measurement at the beginning of respiration.

Accepted Answer

The head of the bed should be flat to ensure accurate pressure readings. Saline is injected into the urinary catheter to create a fluid column for pressure transmission. The transducer should be calibrated at the level of the pubis to align with the bladder.

Question 4

Which assessment finding would the nurse evaluate as most likely occurring due to a lower gastrointestinal bleed?
A)Hematochezia
B)Hematemesis
C)Dark brown guaiac positive stools
D)Melena

Accepted Answer

Hematochezia, the passage of fresh blood through the anus, typically signifies a lower gastrointestinal bleed.

Question 5

A patient presents to the emergency department with reports of bloody diarrhea.During assessment,the patient becomes increasingly lethargic.The nurse's emergency interventions are based on which potential patient problems? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.
A)There is insufficient perfusion to the patient's brain.
B)There is impairment of gas exchange at the alveolar level.
C)The patient is at higher risk for infection.
D)The patient is at risk for altered nutrition secondary to anorexia or nothing by mouth (NPO)status.
E)The patient is at risk for confusion.

Accepted Answer

The patient's symptoms suggest a critical condition that could lead to insufficient perfusion to the brain (A), indicated by lethargy, and impairment of gas exchange at the alveolar level (B), which could be related to systemic effects of the underlying condition causing bloody diarrhea. The risk for confusion (E) is also increased due to potential alterations in mental status stemming from the primary condition and its effects on the brain's perfusion and oxygenation.

Question 6

A patient vomiting bright red blood is scheduled for an endoscopy sclerotherapy.The patient asks the nurse what the procedure will do.The nurse would reinforce which teaching?
A)"The area of bleeding can be seen so surgery can be planned to remove it."
B)"A chemical can be injected into the bleeding vessel to stop it from bleeding."
C)"A cold material can be applied to the bleeding area to stop the bleeding."
D)"A laser can be used on the bleeding areas to stop any possibilities of bleeding again."

Accepted Answer

Sclerotherapy is a procedure in which a chemical is injected into the bleeding vessel to stop it from bleeding. Option A is incorrect because the procedure does not involve surgery. Option C is incorrect because a cold material does not stop bleeding effectively. Option D is incorrect because lasers are not typically used in sclerotherapy.

Question 7

A patient with a history of coronary artery disease is admitted with vomiting,abdominal distention,and hypoactive bowel sounds.Which assessment would provide the nurse with the most accurate information about the patient's fluid volume status?
A)Skin turgor assessment
B)Hourly urine output measurements
C)Daily weights
D)Pulmonary artery catheter

Accepted Answer

A pulmonary artery catheter provides the most accurate and direct measurement of a patient's fluid volume status by assessing hemodynamic parameters such as cardiac output and pulmonary artery pressures.

Question 8

A patient is hospitalized with recurrent gastric ulcers.Which education should the nurse provide? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.
A)"You may need to consider treating your chronic headaches with some therapy besides NSAIDs [nonsteroidal anti-inflammatory drugs]."
B)"You should try to avoid eating spicy foods."
C)"It is time for you to seriously consider smoking cessation."
D)"You should contact a personal trainer to get your body in shape."
E)"This antibiotic is different in that you only take it until you are pain free."

Accepted Answer

NSAIDs can exacerbate or contribute to the development of gastric ulcers by impairing the stomach's ability to protect itself against gastric acid. Smoking cessation is recommended because smoking can impair the healing of gastric ulcers and potentially contribute to their development.

Question 9

A patient recovering from thyroid surgery is now experiencing numbness and tingling around the mouth with an increase in irritability.Which additional assessment finding would cause the nurse the most concern?
A)Decreased creatinine and BUN levels
B)Abdominal distention and pain
C)Hyperactive bowel sounds
D)Diarrhea

Accepted Answer

Abdominal distention and pain could be a sign of a rare complication called a thyroid storm, which is a life-threatening emergency. The other assessment findings may indicate other complications from surgery or side effects from medication, but they are not as immediately concerning as abdominal pain and distention in this context.

Question 10

A patient taking nonsteroidal anti-inflammatory drugs (NSAIDs)for osteoarthritis is admitted with acute erosive gastritis caused by alcohol ingestion.Which nursing instruction is indicated?
A)"Limit your alcohol intake to one glass of wine with dinner."
B)"Avoid alcohol use while you are taking NSAIDs."
C)"It is important that we find a different method of controlling pain from your arthritis."
D)"In some people,having a couple of drinks can reduce arthritis pain enough that NSAIDs are not necessary."

Accepted Answer

The patient should avoid alcohol use while taking NSAIDs as it can further irritate the stomach lining and increase the risk of gastrointestinal bleeding. It is important to educate the patient on the potential risks and adverse effects of NSAIDs and alcohol use in combination. The other options either do not address the issue or suggest inappropriate alternatives.

Question 11

The nurse is assessing a patient recovering from surgery for abdominal compartment syndrome.Which findings could indicate a life-threatening condition may be developing in this patient? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.
A)Temperature 100.7°F
B)Complaint of dyspnea
C)Poor skin turgor
D)Blood pressure 146/88 mm Hg
E)Complaint of chest pain

Accepted Answer

Dyspnea and chest pain may indicate respiratory distress or cardiac involvement, which could be life-threatening in a patient recovering from abdominal compartment syndrome. The elevated temperature and slightly elevated blood pressure may be related to the patient's surgery and should be monitored, but they do not necessarily indicate a life-threatening condition. Poor skin turgor may be a sign of dehydration, but it is not an immediate concern for a life-threatening condition.

Question 12

A patient recovering from an open cholecystectomy 3 days prior has not passed any flatus since surgery.Which finding suggests to the nurse that the patient may be experiencing a life-threatening condition?
A)Anorexia
B)Falling blood pressure
C)Respiratory rate of 24
D)Hypoactive bowel sounds

Accepted Answer

A lack of flatus alone is not necessarily indicative of a life-threatening condition. However, falling blood pressure may suggest sepsis or hemorrhage, which can be life-threatening post-surgery. Anorexia, increased respiratory rate, and hypoactive bowel sounds are common post-operative findings and, while they may indicate a need for intervention, do not imply a life-threatening condition like falling blood pressure does.

Question 13

The nurse is providing care to a patient admitted with hematemesis,melena,and abdominal pain.The nurse prioritizes interventions to address which possible patient problem?
A)Anxiety
B)Aspiration
C)Fatigue
D)Pain

Accepted Answer

Hematemesis (vomiting blood) and melena (black, tarry stools) indicate gastrointestinal bleeding, which can be life-threatening if it progresses to aspiration (inhaling blood into the lungs). Therefore, prioritizing interventions to prevent aspiration is crucial for this patient. Anxiety, fatigue, and pain can also be addressed, but preventing aspiration takes precedence.

Question 14

A trauma patient's intra-abdominal pressure (IAP)measures 26 mm Hg.How would the nurse explain needed treatment to the patient's family?
A)"This pressure reading is normal and will help to get oxygen to the damaged internal organs."
B)"If we reduce the amount of IV fluid he is getting,the IAP will decrease."
C)"We will raise the head of his bed and have him cough more frequently to reduce this pressure."
D)"It is very likely that he will be taken back to surgery to relieve the pressure building in his abdomen."

Accepted Answer

An IAP reading of 26 mm Hg is considered to be abnormally high and can lead to serious complications such as decreased blood flow to vital organs. The most effective way to relieve this pressure is through surgery. It is important for the nurse to explain this to the patient's family so they understand the seriousness of the situation and can prepare for potential surgery.

Question 15

A patient admitted with possible ulcer disease tells the nurse that he has frequent nausea and vomiting and "just can't eat." The nurse would suspect this patient's ulcer to be in which area?
A)Colon
B)Gastric
C)Duodenal
D)Esophageal

Accepted Answer

Gastric ulcers often cause symptoms such as nausea, vomiting, and a reduced appetite, which can lead to weight loss. These symptoms are more directly related to the stomach (gastric) area, as opposed to ulcers in other locations like the duodenum, esophagus, or colon.

Question 16

The nurse is caring for a patient diagnosed with an arteriovenous malformation (AVM)of the ascending colon.The nurse would prepare to implement which intervention?
A)Administration of blood products
B)Administration of cytoprotective medication
C)Administration of H2 receptor blocking medication
D)Administration of antisecretory medication

Accepted Answer

Arteriovenous malformations (AVMs) can cause bleeding, which may require blood transfusions. Therefore, the nurse would prepare to administer blood products in this case. Cytoprotective medication (B) may be used to prevent or treat gastrointestinal ulcers, but is not specifically indicated for AVMs. H2 receptor blocking medication (C) and antisecretory medication (D) may be used to treat acid-related disorders such as gastroesophageal reflux disease (GERD), but they are not indicated for the treatment of AVMs.

Question 17

A patient admitted with fatigue,dyspnea,and a hemoglobin level of 8.6 mg/dL tells the nurse that he occasionally has dark,smelly stools but they "go away" in a few days.The nurse would conduct additional assessment for which most common cause of this history?
A)Inability to absorb protein
B)Lower gastrointestinal bleed
C)Chronic gastrointestinal bleed
D)Upper gastrointestinal bleed

Accepted Answer

The answer of A patient admitted with fatigue,dyspnea,and a hemoglobin...

Question 18

A patient experiencing massive amounts of bloody diarrhea from the rectum is diagnosed with inflammation of the mucosa and submucosa after a colonoscopy and biopsy.The nurse prepares to provide care for a patient with which condition?
A)Ulcerative colitis
B)Crohn disease
C)Arteriovenous malformation
D)Polyps

Accepted Answer

The symptoms described in the scenario (massive amounts of bloody diarrhea from the rectum, inflammation of the mucosa and submucosa) are consistent with ulcerative colitis, a type of inflammatory bowel disease.

Question 19

A patient diagnosed with gastric ulcer is prescribed sucralfate (Carafate).Which patient teaching should the nurse provide? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.
A)"Watch for systemic effects such as hypotension."
B)"Plan to take this medicine for the rest of your life."
C)"Increase your water intake to 8 to 10 glasses per day."
D)"Do not take this medication within 30 minutes of other drugs."
E)"Rest quietly in an upright position for at least 30 minutes after taking this medication."

Accepted Answer

- Sucralfate (Carafate) can cause constipation, so increasing water intake can help mitigate this side effect.- Sucralfate forms a protective barrier on the ulcer site and can interfere with the absorption of other medications, so it should not be taken within 30 minutes of other drugs.

Question 20

A patient with a history of atrial fibrillation is experiencing a massive gastrointestinal bleed.The patient is prescribed vasopressin.The nurse would be most concerned about the development of which adverse effect?
A)Abdominal cramping
B)Nausea
C)Vertigo
D)Increase in blood pressure

Accepted Answer

Vasopressin is a vasoconstrictor that may cause an increase in blood pressure, which is a concern in patients with a history of atrial fibrillation. A sudden spike in blood pressure may lead to arrhythmias or further bleeding. Abdominal cramping, nausea, and vertigo are potential side effects but are not as significant a concern as an increase in blood pressure in this patient population.

Quiz 22: Alterations in Gastrointestinal Function

A patient is recovering from a colonoscopy with removal of polyps.Which teaching should the nurse provide?

A patient with a massive gastrointestinal bleed is diagnosed with a Mallory-Weiss tear.The nurse would anticipate which patient history?

The conventional transducer method will be used to measure a patient's intra-abdominal pressure.Which interventions will the nurse use in this measurement? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

Which assessment finding would the nurse evaluate as most likely occurring due to a lower gastrointestinal bleed?

A patient vomiting bright red blood is scheduled for an endoscopy sclerotherapy.The patient asks the nurse what the procedure will do.The nurse would reinforce which teaching?

A patient with a history of coronary artery disease is admitted with vomiting,abdominal distention,and hypoactive bowel sounds.Which assessment would provide the nurse with the most accurate information about the patient's fluid volume status?

A patient is hospitalized with recurrent gastric ulcers.Which education should the nurse provide? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A patient recovering from thyroid surgery is now experiencing numbness and tingling around the mouth with an increase in irritability.Which additional assessment finding would cause the nurse the most concern?

A patient taking nonsteroidal anti-inflammatory drugs (NSAIDs) for osteoarthritis is admitted with acute erosive gastritis caused by alcohol ingestion.Which nursing instruction is indicated?

A patient recovering from an open cholecystectomy 3 days prior has not passed any flatus since surgery.Which finding suggests to the nurse that the patient may be experiencing a life-threatening condition?

The nurse is providing care to a patient admitted with hematemesis,melena,and abdominal pain.The nurse prioritizes interventions to address which possible patient problem?

A trauma patient's intra-abdominal pressure (IAP) measures 26 mm Hg.How would the nurse explain needed treatment to the patient's family?

A patient admitted with possible ulcer disease tells the nurse that he has frequent nausea and vomiting and "just can't eat." The nurse would suspect this patient's ulcer to be in which area?

The nurse is caring for a patient diagnosed with an arteriovenous malformation (AVM) of the ascending colon.The nurse would prepare to implement which intervention?

A patient admitted with fatigue,dyspnea,and a hemoglobin level of 8.6 mg/dL tells the nurse that he occasionally has dark,smelly stools but they "go away" in a few days.The nurse would conduct additional assessment for which most common cause of this history?

A patient experiencing massive amounts of bloody diarrhea from the rectum is diagnosed with inflammation of the mucosa and submucosa after a colonoscopy and biopsy.The nurse prepares to provide care for a patient with which condition?

A patient diagnosed with gastric ulcer is prescribed sucralfate (Carafate) .Which patient teaching should the nurse provide? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A patient with a history of atrial fibrillation is experiencing a massive gastrointestinal bleed.The patient is prescribed vasopressin.The nurse would be most concerned about the development of which adverse effect?