Assessment of the Gastrointestinal System Flashcards
The primary health care provider documents that a client has a bruit over the abdominal aorta. What teaching will the nurse provide for assistive personnel (AP) based on this assessment finding?
a. “Use warm compresses on the client’s abdomen continuously.”
b. “Avoid washing the client’s abdomen too aggressively.”
c. “Apply ice to the client’s abdomen every 4 hours.”
d. “Massage the client’s abdomen to help reduce pain.”
b. “Avoid washing the client’s abdomen too aggressively.”
A client is scheduled for a colonoscopy and the nurse has provided instructions on the bowel cleansing regimen. What statement by the client indicates a need for further teaching?
a. “It’s a good thing I love orange and cherry gelatin.”
b. “My spouse will be here to drive me home.”
c. “I’ll avoid ibuprofen for several days before the test.”
d. “I’ll buy a case of clear Gatorade before the prep.”
a. “It’s a good thing I love orange and cherry gelatin.”
The client would be advised to avoid beverages and gelatin that are red, orange, or purple in color as their residue can appear to be blood.
A client had a colonoscopy and biopsy yesterday and calls the gastrointestinal clinic to report a spot of bright red blood on the toilet paper today. What response by the nurse is appropriate?
a. Ask the client to call back if this happens again today.
b. Instruct the client to go to the emergency department.
c. Remind the client that a small amount of bleeding is possible.
d. Tell the client to come to the clinic this afternoon.
c. Remind the client that a small amount of bleeding is possible.
After a colonoscopy with biopsy, a small amount of bleeding is normal. The nurse would remind the client of this and instruct him or her to go to the emergency department for large amounts of bleeding, severe pain, or dizziness.
An older adult has had an instance of drug toxicity and asks why this happens, since the client has been on this medication for years at the same dose. What response by the nurse is best?
a. “Changes in your liver cause drugs to be metabolized differently.”
b. “Perhaps you don’t need as high a dose of the drug as before.”
c. “Stomach muscles atrophy with age and you digest more slowly.”
d. “Your body probably can’t tolerate as much medication anymore.”
a. “Changes in your liver cause drugs to be metabolized differently.”
Decreased liver enzyme activity depresses drug metabolism, which leads to accumulation of drugs—possibly to toxic levels. The other options do not accurately explain this age-related change.
To promote comfort and the passage of flatus after a colonoscopy, in what position does the nurse place the client?
a. Left lateral
b. Prone
c. Right lateral
d. Supine
a. Left lateral
After colonoscopy, clients have less discomfort and quicker passage of flatus when placed in the left lateral position.
A nurse is assessing a client reporting right upper quadrant (RUQ) abdominal pain. What technique would the nurse use to assess this client’s abdomen?
a. Auscultate after palpating.
b. Avoid any type of palpation.
c. Lightly palpate the RUQ first.
d. Lightly palpate the RUQ last.
a. Auscultate after palpating.
If pain is present in a certain area of the abdomen, that area would be palpated last to keep the client from tensing which could possibly affect the rest of the examination. Auscultation of the abdomen occurs prior to palpation.
The nurse knows that a client with prolonged prothrombin time (PT) values (not related to medication) probably has dysfunction in which organ?
a. Kidneys
b. Liver
c. Spleen
d. Stomach
b. Liver
Severe acute or chronic liver damage leads to a prolonged PT secondary to impaired synthesis of clotting proteins. The other organs are not related to this issue.
A client is recovering from an esophagogastroduodenoscopy (EGD) and requests something to drink. What action by the nurse is appropriate?
a. Allow the client cool liquids only.
b. Assess the client’s gag reflex.
c. Remind the client to remain NPO.
d. Tell the client to wait 4 hours.
b. Assess the client’s gag reflex.
The local anesthetic used during this procedure depresses the client’s gag reflex. After the procedure, the nurse would ensure that the gag reflex is intact before offering food or fluids. The client does not need to be restricted to cool beverages only and is not required to wait 4 hours before oral intake is allowed. Telling the client to remain NPO does not inform the client of when he or she can have fluids, nor does it reflect the client’s readiness for them.
The assistive personnel note that a client had a dark stool. What stool test would the nurse obtain for this client?
a. Culture and sensitivity
b. Parasites and ova
c. Occult blood test
d. Total fat content
c. Occult blood test
Dark stools are typical in clients who have lower GI bleeding. Therefore, an fecal occult blood test would be the most appropriate test as a follow-up
A client had an endoscopic retrograde cholangiopancreatography (ERCP). The nurse teaches the client and family about the signs of potential complications which include what problems? (Select all that apply.)
a. Cholangitis
b. Pancreatitis
c. Perforation
d. Renal lithiasis
e. Sepsis
a. Cholangitis
b. Pancreatitis
c. Perforation
e. Sepsis
Possible complications after an ERCP include cholangitis, pancreatitis, perforation, sepsis, and bleeding. Kidney stones are not a complication of ERCP.
The nurse working with older clients understands age-related changes in the gastrointestinal system. Which changes does this include? (Select all that apply.)
a. Decreased hydrochloric acid production
b. Diminished sensation that can lead to constipation
c. Fat not digested as well in older adults
d. Increased peristalsis in the large intestine
e. Pancreatic vessels become calcified
a. Decreased hydrochloric acid production
b. Diminished sensation that can lead to constipation
c. Fat not digested as well in older adults
e. Pancreatic vessels become calcified
The nurse working with clients who have gastrointestinal problems knows that which laboratory values are related to which organ functions or dysfunctions? (Select all that apply.)
a. Alanine aminotransferase: biliary system
b. Ammonia: liver
c. Amylase: liver
d. Lipase: pancreas
e. Urine urobilinogen: stomach
b. Ammonia: liver
d. Lipase: pancreas
