Quiz #1: Gastrointestinal System

Introduction Set B
A nurse has auscultated a client's abdomen and noted one or two bowel sounds in a 2-
minute period of time. How should the nurse document the client's bowel sounds? *
Hypoactive
 
A nurse is caring for clients in a stroke rehabilitation facility. Damage to what area of
the brain will most affect a client's ability to swallow? *
Medulla oblongata
 
 
A nurse is providing care for a client with a diagnosis of late-stage Alzheimer disease.
The client has just returned to the medical unit to begin supplemental feedings
through an NG tube. Which of the nurse's assessments addresses this client's most
significant potential complication of feeding? *
0/1

Frequent assessment of the client's abdominal girth

Vigilant monitoring of the frequency and character of bowel movements
Frequent lung auscultation
Assessment for hemorrhage from the nasal insertion site
 
 
A client has returned to the medical unit after a barium enema. When assessing the
client's subsequent bowel patterns and stools, what finding would warrant reporting to
the health care provider? *
Streaks of blood present in the stool
 
 
The nurse is caring for a client who has a nasogastric tube that has been in place for 2
days. Before administering a scheduled feeding, the nurse should *
0/1

perform a focused gastrointestinal assessment.

administer 30 to 45 mL of water to confirm placement.
 
ensure that the client has recently voided.
position the client upright.

 
A client asks the nursing assistant for a bedpan. When the client is finished, the
nursing assistant notifies the nurse that the client has bright red streaking of blood in
the stool. The nurse's assessment should focus on what potential cause? *
Hemorrhoids
 
A client has come to the outpatient radiology department for diagnostic testing that
will allow the care team to evaluate and remove polyps. The nurse should prepare the
client for what procedure? *
Colonoscopy
 
 
The nurse is caring for a client scheduled for a colonoscopy. The nurse should assist
the client into what position during this diagnostic test? *
Lying on the left side with legs drawn toward the chest
 
 
A client has been brought to the emergency department with abdominal pain and is
subsequently diagnosed with appendicitis. The client is scheduled for an
appendectomy but questions the nurse about how his health will be affected by the
absence of an appendix. How should the nurse best respond? *
“Your appendix doesn't play a major role, so you won't notice any difference after your recovery
from surgery.”
 
The nurse is preparing to check for tube placement in the client's stomach as well as
measure the residual volume. What is the main purpose of these nursing actions? *
Prevent aspiration
 
A client's enteral feedings have been determined to be too concentrated based on the
client's development of dumping syndrome. What physiologic phenomenon caused
this client's complication of enteral feeding? *
Entry of large amounts of water into the small intestine because of osmotic pressure
 
A client presents at the ambulatory clinic reporting recurrent sharp stomach pain that
is relieved by eating. The nurse suspects that the client may have an ulcer. How
should the nurse explain the formation and role of acid in the stomach to the client?  *
“Hydrochloric acid is secreted by glands in the stomach in response to the actual or anticipated
presence of food.”
.”

 
The management of the client's gastrostomy is an assessment priority for the home
care nurse. What statement would indicate that the client is managing the tube
correctly? *
“I flush my tube with water before and after each of my medications.”
 
 
A client with dysphagia is scheduled for percutaneous endoscopic gastrostomy (PEG)
tube insertion and asks the nurse how the tube will stay in place. What is the nurse's
best response? *
Internal and external fixation bolsters secure the tube against the stomach wall.
 
The nurse is administering total parenteral nutrition (TPN) to a client who underwent
surgery for gastric cancer. Which of the nurse's assessments most directly addresses
a major complication of TPN? *
Checking the client's capillary blood glucose levels regularly
 
 
A nurse is caring for a client admitted with a suspected malabsorption disorder. The
nurse knows that one of the accessory organs of the digestive system is the pancreas.
What digestive enzymes does the pancreas secrete? Select all that apply. *
Amylase
 
Trypsin
 
Lipase
 
 
A nurse is caring for a client who has an order to discontinue the administration of
parenteral nutrition. What should the nurse do to prevent the occurrence of rebound
hypoglycemia in the client? *
Administer an isotonic dextrose solution for 1 to 2 hours after discontinuing the PN.
 
 
The nurse is providing health education to a client with a gastrointestinal disorder.
What should the nurse describe as a major function of the GI tract? *
0/1

The control of absorption and elimination of electrolytes

The absorption into the bloodstream of nutrient molecules produced by digestion
The breakdown of food particles into cell form for digestion
 
The maintenance of fluid and acid--base balance

 
A nurse is caring for a client who has a gastrointestinal tube in place. Which of the
following are indications for gastrointestinal intubation? Select all that apply. *
0/3

To open sphincters that are closed

 
To administer clotting factors to treat a GI bleed
To remove toxins from the stomach
 
To remove gas from the stomach
 
To diagnose GI motility disorders

 
An adult client is scheduled for an upper GI series that will use a barium swallow.
What teaching should the nurse include when the client has completed the test? *
Fluids must be increased to facilitate the evacuation of the stool.
 
 
A client's new onset of dysphagia has required insertion of an NG tube for feeding; the
nurse has modified the client's care plan accordingly. What intervention should the
nurse include in the client's plan of care? *
Confirm placement of the tube prior to each scheduled feeding.
 
 
The nurse is preparing to perform a client's abdominal assessment. What examination
sequence should the nurse follow? *
Inspection, auscultation, percussion, and palpation

The nurse educator is reviewing the blood supply of the GI tract with a group of
medical nurses. The nurse is explaining the fact that the veins that return blood from
the digestive organs and the spleen form the portal venous system. What large veins
will the nurse list when describing this system? Select all that apply. *
1/1

Gastric vein
 
Inferior mesenteric vein
 
Splenic vein
 
 
A nurse is initiating parenteral nutrition (PN) to a postoperative client who has
developed complications. The nurse should initiate therapy by performing which of the
following actions? *
Initiating the infusion slowly and monitoring the client's fluid and glucose tolerance
 

Gastrointestinal System Part 3 Set B

A nurse is working with a client who has chronic constipation. What should be
included in client teaching to promote normal bowel function? *
Consume high-residue, high-fiber foods.
 
 
A 35-year-old male client presents at the emergency department with symptoms of a
small bowel obstruction. In collaboration with the primary provider, what intervention
should the nurse prioritize? *
Insertion of a nasogastric tube
 
 
A nurse at an outpatient surgery center is caring for a client who had a
hemorrhoidectomy. What discharge education topics should the nurse address with
this client? *
0/1

The need to eat a low-residue, low-fat diet for the next 2 weeks
The correct procedure for taking a sitz bath
The correct technique for keeping the perianal region clean without the use of water
The appropriate use of antibiotics to prevent postoperative infection
 
What type of diarrhea that occurs when water is pulled into the intestine by the
osmotic pressure of unabsorbed particles? *
Osmotic
 
 
A client's health history is suggestive of inflammatory bowel disease. Which of the
following would suggest Crohn's disease, rather that ulcerative colitis, as the cause of
the client's signs and symptoms? *
An absence of blood in stool
 
Involvement of the rectal mucosa

 
A nurse is conducting health screening with a diverse group of clients. Which client
likely has the most risk factors for developing hemorrhoids? *
A pregnant woman at 28 weeks' gestation
 
 
Intussusception is the twisting of the bowel that commonly occurs about a stationary
focus. *
0/1

True
 
False

 
During a client's scheduled home visit, an older adult client has stated to the
community health nurse that she has been experiencing hemorrhoids of increasing
severity in recent months. The nurse should recommend which of the following?  *
0/1

Regular application of an OTC antibiotic ointment

Daily use of OTC glycerin suppositories
Increased fluid and fiber intake
Use of an NSAID to reduce inflammation
 
 
The nurse is assessing a client who had an ileostomy created three days ago for the
treatment of irritable bowel disease. The nurse observes that the client's stoma is
bright red and there are scant amounts of blood on the stoma. What is the nurse's
best action? *
1/1

Document these expected assessment findings

 
 
An older adult has a diagnosis of Alzheimer disease and has recently been
experiencing fecal incontinence. However, the nurse has observed no recent change in
the character of the client's stools. What is the nurse's most appropriate
intervention? *
0/1

Liaise with the primary provider to obtain an order for loperamide.

Keep a food diary to determine the foods that exacerbate the client's symptoms.
Toilet the client on a frequent, scheduled basis.
Provide the client with a bland, low-residue diet.
 
 
"Cobblestone" appearance can be seen in patients with Crohn's Disease. *
True
 
An older adult who resides in an assisted living facility has sought care from the nurse
because of recurrent episodes of constipation. Which of the following actions should
the nurse first perform? *
Assess the client's food and fluid intake.
 
A client's large bowel obstruction has failed to resolve spontaneously and the client's
worsening condition has warranted admission to the medical unit. Which of the
following aspect of nursing care is most appropriate for this client? *
0/1

Administering bowel stimulants as prescribed

Administering bulk-forming laxatives as prescribed
Performing deep palpation as prescribed to promote peristalsis
 
Preparing the client for surgical bowel resection

 
A nurse is caring for a client admitted with symptoms of an anorectal infection;
cultures indicate that the client has a viral infection. The nurse should anticipate the
administration of what drug? *
Acyclovir
 
A 16-year-old presents at the emergency department reporting right lower quadrant
pain and is subsequently diagnosed with appendicitis. When planning this client's
nursing care, the nurse should prioritize what nursing diagnosis? *
Risk for Infection Related to Possible Rupture of Appendix
 
A nurse is providing care for a client whose recent colostomy has contributed to a
nursing diagnosis of Disturbed Body Image Related to Colostomy. What intervention
best addresses this diagnosis? *
Engage the client in dialogue about the implications of having the colostomy.
 
 
A client has been experiencing occasional episodes of constipation and has been
unable to achieve consistent relief by increasing physical activity and improving his
diet. When introducing the client to the use of laxatives, what teaching should the
nurse emphasize? *
0/1

The risk of fecal incontinence

The effect of laxatives on electrolyte levels
 
The risk of becoming laxative-dependent
The underlying causes of constipation
 
A client is admitted to the medical unit with a diagnosis of intestinal obstruction.
When planning this client's care, which of the following nursing diagnoses should the
nurse prioritize? *
Ineffective Tissue Perfusion Related to Bowel Ischemia
 
 
A nurse is planning discharge teaching for a 21-year-old client with a new diagnosis of
ulcerative colitis. When planning family assessment, the nurse should recognize that
which of the following factors will likely have the greatest impact on the client's
coping after discharge? *
The family's ability to provide emotional support
 
 
Volvulus is a condition wherein the bowel is telescoping that would eventually cause
absence of bowel sound. *
False
 
 
A nurse is assessing a client's stoma on postoperative day 3. The nurse notes that the
stoma has a shiny appearance and a bright red color. How should the nurse best
respond to this assessment finding? *
Document that the stoma appears healthy and well perfused.
 
 
A nurse is preparing to provide care for a client whose exacerbation of ulcerative
colitis has required hospital admission. During an exacerbation of this health problem,
the nurse would anticipate that the client's stools will have what characteristics?  *
Watery with blood and mucus
 

Gastrointestinal System Part 2

A client with a diagnosis of peptic ulcer disease has just been prescribed omeprazole.
How should the nurse best describe this medication's therapeutic action? *
“This medication will reduce the amount of acid secreted in your stomach.”
 
 
A nurse is performing health education with a client who has a history of frequent,
serious dental caries. When planning educational interventions, the nurse should
identify a risk for what nursing diagnosis? *
Imbalanced Nutrition: Less Than Body Requirements
 
A client has been diagnosed with an esophageal diverticulum after undergoing
diagnostic imaging. When taking the health history, the nurse should expect the client
to describe what sign or symptom? *
Regurgitation of undigested food
 
 
A nurse is providing health promotion education to a client diagnosed with an
esophageal reflux disorder. What practice should the nurse encourage the client to
implement? *
.
Avoid carbonated drinks.
 
 
A nurse is preparing to discharge a client after recovery from gastric surgery. What is
an appropriate discharge outcome for this client? *
The client maintains or gains weight.
 
A nurse is caring for a client who just has been diagnosed with a peptic ulcer. When
teaching the client about his new diagnosis, how should the nurse best describe it? *
Erosion of the lining of the stomach or intestine
 
 
A client has been diagnosed with peptic ulcer disease and the nurse is reviewing his
prescribed medication regimen with him. What is the client's drug regimen most likely
to consist of? *
Antibiotics, proton pump inhibitors, and bismuth salts
 
An elderly client comes into the emergency department reporting an earache. The
client and has an oral temperature of 37.9° (100.2ºF) and otoscopic assessment of
the ear reveals a pearly gray tympanic membrane with no evidence of discharge or
inflammation. Which action should the triage nurse take next? *
Palpate the client's parotid glands to detect swelling and tenderness.
.

 
A nurse is providing anticipatory guidance to a client who is preparing for a total
gastrectomy. The nurse learns that the client is anxious about numerous aspects of
the surgery. What intervention is most appropriate to alleviate the client's anxiety? *
Facilitate the client's contact with support services.
 
A nurse is caring for a client who has a diagnosis of GI bleed. During shift assessment,
the nurse finds the client to be tachycardic and hypotensive, and the client has an
episode of hematemesis while the nurse is in the room. In addition to monitoring the
client's vital signs and level of conscious, what would be a priority nursing action for
this client? *
Notify the health care provider.
 
 
Diagnostic imaging and physical assessment have revealed that a client with peptic
ulcer disease has suffered a perforated ulcer. The nurse recognizes that emergency
interventions must be performed as soon as possible in order to prevent the
development of what complication? *
Peritonitis
 
A client has experienced symptoms of dumping syndrome following gastric surgery.
To what physiologic phenomenon does the nurse attribute this syndrome? *
0/1

Irritation of the phrenic nerve due to diaphragmatic pressure

Influx of extracellular fluid into the small intestine
Reflux of bile into the distal esophagus
 
Chronic malabsorption of iron and vitamins A and C

 
A client has been diagnosed with achalasia based on his history and diagnostic
imaging results. The nurse should identify what risk diagnosis when planning the
client's care? *
Risk for Aspiration Related to Inhalation of Gastric Contents
 
 
A client has just been diagnosed with acute gastritis after presenting in distress to the
emergency department with abdominal symptoms. Which of the following actions
should the nurse prioritize? *
Providing the client with physical and emotional support
 
 
A client is receiving education about his upcoming Billroth I procedure
(gastroduodenostomy). This client should be informed that he may experience which
of the following adverse effects associated with this procedure? *
Diarrhea and feelings of fullness
 
 
The nurse is admitting a client's whose medication regimen includes regular injections
of vitamin B12. The nurse should question the client about a history of: *
total gastrectomy.
 
A client presents to the clinic reporting vomiting and burning in her mid-epigastria. The
nurse knows that in the process of confirming peptic ulcer disease, the health care
provider is likely to order a diagnostic test to detect the presence of what? *
Infection with Helicobacter pylori
 
 
The nurse's comprehensive assessment of a client includes inspection for signs of
oral cancer. What assessment finding is most characteristic of oral cancer in its early
stages? *
Presence of a painless sore with raised edges
 
A nurse is caring for a client hospitalized with an exacerbation of chronic gastritis.
What health promotion topic should the nurse emphasize? *
Strategies for avoiding irritating foods and beverages
 
 
A client has recently received a diagnosis of gastric cancer; the nurse is aware of the
importance of assessing the client's level of anxiety. Which of the following actions is
most likely to accomplish this? *
The client is encouraged to express fears openly.
 
 
A client has received treatment for oral cancer. The combination of medications and
radiotherapy has resulted in leukopenia. What is the nurse's best response to this
change in health status? *
Ensure that none of the client's visitors have an infection.
 
 
A staff educator is reviewing the causes of gastroesophageal reflux disease (GERD)
with new staff nurses. What area of the GI tract should the educator identify as the
cause of reduced pressure associated with GERD? *
Lower esophageal sphincter
 
 
The school nurse is planning a health fair for a group elementary school students and
dental health is one topic that the nurse plans to address. When teaching the children
about the risk of tooth decay, the nurse should caution them against consuming large
quantities of *
organic fruit juice.
 
 
A nurse is providing oral care to a client who is comatose. What action best addresses
the client's risk of tooth decay and plaque accumulation? *
Brushing the client's teeth with a toothbrush and small amount of toothpaste
 
 
A nurse in an oral surgery practice is working with a client scheduled for removal of an
abscessed tooth. When providing discharge education, the nurse should recommend
what action? *
Use warm saline to rinse the mouth as needed.
 
A client who experienced an upper GI bleed due to gastritis has had the bleeding
controlled and the client's condition is now stable. For the next several hours, the
nurse caring for this client should assess for what signs and symptoms of
recurrence? *
Tachycardia, hypotension, and tachypnea
 
A nurse is completing a health history on a client whose diagnosis is chronic gastritis.
Which of the data should the nurse consider most significantly related to the etiology
of the client's health problem? *
1/1

Smokes one pack of cigarettes daily.

 
 
The nurse is providing care for a client who has recently been diagnosed with chronic
gastritis. What health practice should the nurse address when teaching the client to
limit exacerbations of the disease? *
0/1

Taking multivitamins as prescribed and eating organic foods whenever possible

 
Performing 15 minutes of physical activity at least three times per week
Maintaining a healthy body weight
Avoid taking aspirin to treat pain or fever

 
A client who had a hemiglossectomy earlier in the day is assessed postoperatively,
revealing a patent airway, stable vital signs, and no bleeding or drainage from the
operative site. The nurse notes the client is alert. What is the client's priority need at
this time? *
An effective means of communicating with the nurse
 
 
The nurse is caring for a client who has developed dumping syndrome while
recovering from a gastrectomy. What recommendation should the nurse make to the
client? *
Eat several small meals daily spaced at equal intervals.
 
 
A client comes to the clinic reporting pain in the epigastric region. What statement by
the client suggests the presence of a duodenal ulcer? *
“My pain resolves when I have something to eat.”
 
A nurse is caring for a client who has been admitted for the treatment of advanced
cirrhosis. What assessment should the nurse prioritize in this client's plan of care? *
Assessment for variceal bleeding
  
A 37-year-old male client presents at the emergency department (ED) reporting nausea
and vomiting and severe abdominal pain. The client's abdomen is rigid, and there is
bruising to the client's flank. The client's wife states that he was on a drinking binge
for the past 2 days. The ED nurse should assist in assessing the client for what health
problem? *
Severe pancreatitis with possible peritonitis
 
A client has been newly diagnosed with acute pancreatitis and admitted to the acute
medical unit. How should the nurse most likely explain the pathophysiology of this
client's health problem? *
“The enzymes that your pancreas produces have damaged the pancreas itself.”
 
 
A client has a recent diagnosis of chronic pancreatitis and is undergoing diagnostic
testing to determine pancreatic islet cell function. The nurse should anticipate what
diagnostic test? *
Glucose tolerance test
 
A nurse is creating a care plan for a client with acute pancreatitis. The care plan
includes reduced activity. What rationale for this intervention should be cited in the
care plan? *
1/1

Bed rest lowers the metabolic rate and reduces enzyme production.
 
The nurse's review of a client's most recent laboratory results indicates a bilirubin
level of 3.0 mg/dL (51 mmol/L). The nurse assesses the client for *
jaundice.
 
 
A nurse is caring for a client with gallstones who has been prescribed ursodeoxycholic
acid (UDCA). The client asks how this medicine is going to help his symptoms. The
nurse should be aware of what aspect of this drug's pharmacodynamics? *
It inhibits the synthesis and secretion of cholesterol.

A nurse who provides care in a community clinic assesses a wide range of individuals.
The nurse should identify which of the following clients as having the highest risk for
chronic pancreatitis? *
A 39-year-old man with chronic alcoholism
 
 
A triage nurse in the emergency department is assessing a client who presented with
reports of general malaise. Assessment reveals the presence of jaundice and
increased abdominal girth. What assessment question best addresses the possible
etiology of this client's presentation? *
“How many alcoholic drinks do you typically consume in a week?”
 
 
A client with a cholelithiasis has been scheduled for a laparoscopic cholecystectomy.
Why is laparoscopic cholecystectomy preferred by surgeons over an open
procedure? *
Laparoscopic cholecystectomy poses fewer surgical risks than an open procedure.
 
 
A nurse is caring for a client with hepatic encephalopathy. While making the initial
shift assessment, the nurse notes that the client has a flapping tremor of the hands.
The nurse should document the presence of what sign of liver disease? *
Asterixis
 
A client with ongoing back pain, nausea, and abdominal bloating has been diagnosed
with cholecystitis secondary to gallstones. The nurse should anticipate that the client
will undergo what intervention? *
Laparoscopic cholecystectomy
 
A nurse is providing discharge education to a client who has undergone a
laparoscopic cholecystectomy. During the immediate recovery period, the nurse
should recommend what foods? *
Low-fat foods high in proteins and carbohydrates
 
During a health education session, a participant has asked about the hepatitis E virus.
What prevention measure should the nurse recommend for preventing infection with
this virus? *
Following proper hand-washing techniques
 
A nurse is caring for a client with liver failure and is performing an assessment in the
knowledge of the client's increased risk of bleeding. The nurse recognizes that this
risk is related to the client's inability to synthesize prothrombin in the liver. What factor
most likely contributes to this loss of function? *
Inability of the liver to use vitamin K
 
 
What health promotion teaching should the nurse prioritize to prevent drug-induced
hepatitis? *
Adhere to dosing recommendations of over-the-counter analgesics.
 
 
The nurse is caring for a client who has just returned from the ERCP removal of
gallstones. The nurse should monitor the client for signs of what complications?  *
Bleeding and perforation
 
 
A nurse is caring for a client with cirrhosis secondary to heavy alcohol use. The
nurse's most recent assessment reveals subtle changes in the client's cognition and
behavior. What is the nurse's most appropriate response? *
Report this finding to the primary provider due to the possibility of hepatic encephalopathy.
 
A client presents to the emergency department (ED) complaining of severe right upper
quadrant pain. The client states that his family doctor told him he had gallstones. The
ED nurse should recognize what possible complication of gallstones? *
Gangrene of the gallbladder
 
A student nurse is caring for a client who has a diagnosis of acute pancreatitis and
who is receiving parenteral nutrition. The student should prioritize which of the
following assessments? *
Blood glucose levels
 
A client's abdominal ultrasound indicates cholelithiasis. When the nurse is reviewing
the client's laboratory studies, what finding is most closely associated with this
diagnosis? *
Increased bilirubin
 
A client with portal hypertension has been admitted to the medical floor. The nurse
should prioritize what assessments? *
Daily weights and abdominal girth measurement
 
A nurse is performing an admission assessment of a client with a diagnosis of
cirrhosis. What technique should the nurse use to palpate the client's liver? *
Place hand under right lower rib cage and press down lightly with the other hand.
 
 
A nurse is assisting with serving dinner trays on the unit. Upon receiving the dinner
tray for a client admitted with acute gallbladder inflammation, the nurse will question
which of the following foods on the tray? *
Fried chicken
 
A nurse is assessing a client who has been diagnosed with cholecystitis, and is
experiencing localized abdominal pain. When assessing the characteristics of the
client's pain, the nurse should anticipate that it may radiate to what region? *
Right shoulder