chapter 45 : Gastrointestinal disorder

Question 1

The nurse clarifies that the end product of food is absorbed and put into the bloodstream by
which anatomical feature?
a. gastric lining of the stomach.
b. villi of the small intestine.
c. bile of the liver in the large intestine.
d. excretion from the cecum.

Answer 1

b. villi of the small intestine.

Question 2

A 56 -year-old man is admitted to the emergency room with an acute attack of diverticulitis.
The patient has a temperature of 102°F, and has an elevated white count. Which assessment
would alert the nurse to impending septic shock?
a. Chest pain
b. Seizure
c. Tachycardia
d. Massive diarrhea

Answer 2

c. Tachycardia

Question 3

Because bowel contents from an ileostomy are virtually liquid, which does the nurse expect
to see in the plan of care?
a. Evaluation and assessment of dietary intake of fiber
b. Evaluation and assessment of patient cleanliness
c. Evaluation and assessment of peristomal skin integrity
d. Evaluation and assessment of the adequacy of the collection device

Answer 3

c. Evaluation and assessment of peristomal skin integrity

Question 4

The home health nurse caring for a patient who has dysarthria related to radiation therapy
for an oral cancer would recommend that the family provide which device?
a. a tablet and pencil as a communication aid.
b. a TV for diversion.
c. a bell to summon help.
d. a walkie-talkie.

Answer 4

a. a tablet and pencil as a communication aid.

Question 5

Which recommendation is most appropriate for a patient who has had an esophageal dilation
related to achalasia?
a. Consume only liquid.
b. Avoid fruit juices.
c. Drink 10 oz of fluid with each meal.
d. Lie down for 30 minutes after each meal.

Answer 5

c. Drink 10 oz of fluid with each meal.

Question 6

A patient who is being evaluated for episodes of hematemesis and dyspepsia tells the nurse
that pain occurs when he eats, but pain does not waken him. The nurse recognizes a
diagnostic sign of which condition?
a. Duodenal ulcer
b. Gastritis
c. Achalasia
d. Peptic ulcer

Answer 6

d. Peptic ulcer

Question 7

The nurse anticipates that the patient who has had a subtotal gastrectomy will need which type of supplement?
a. protein due to the loss of some of the digestive processes.
b. vitamin B12 due to the loss of the intrinsic factor.
c. bulk to prevent constipation.
d. vitamin A due to the loss of the gastric lining.

Answer 7

b. vitamin B12 due to the loss of the intrinsic factor.

Question 8

The home health nurse is caring for a patient who has frequent bouts of diverticulitis accompanied by increased flatulence, diarrhea, and nausea. Which is the most appropriate
suggestion to lessen these symptoms?
a. Eat a diet high in fiber content.
b. Increase dietary fat intake.
c. Exercise to increase intraabdominal pressure.
d. Take daily laxatives.

Answer 8

a. Eat a diet high in fiber content.

Question 9

The nurse caring for a patient with a peptic ulcer who has had a nasogastric tube inserted notes bright blood in the tube; the patient complains of pain and has become hypotensive.
Which condition should the nurse recognize these as signs of?
a. Hiatal hernia
b. Gastritis
c. Perforation
d. Bowel obstruction

Answer 9

c. Perforation

Question 10

Dumping syndrome after a Billroth II procedure occurs when high-carbohydrate foods are ingested over a period of less than 20 minutes. Which will the nurse suggest to reduce the
risk of dumping syndrome?
a. Eating a high-carbohydrate diet
b. Drinking 10 oz of fluids with meals
c. Remaining upright for 2 hours after meals
d. Eating six small daily meals high in protein and fat

Answer 10

d. Eating six small daily meals high in protein and fat

Question 11

The patient has come to the PACU following an ileostomy for the treatment of ulcerative colitis. The patient is conscious and has a nasogastric tube in place and a pouch over the stoma. What should be the nurse’s initial action?
a. Turn patient to right side.
b. Give patient ice chips to moisten mouth.
c. Attach NG tube to suction.
d. Irrigate NG tube.

Answer 11

c. Attach NG tube to suction.

Question 12

The home health nurse evaluates a patient being treated for a peptic ulcer with an antacid and famotidine (histamine receptor blocker). Which statement made by the patient indicates a need for further instruction?
a. “I know famotidine will not interfere with my Coumadin.”
b. “I take the antacid at least 2 hours after any of my other drugs.”
c. “Boy! That antacid keeps my stomach happy!”
d. “I take both those meds at the same time every morning.”

Answer 12

d. “I take both those meds at the same time every morning.”

Question 13

What should a nurse do when obtaining a stool specimen to be examined for ova and parasites?
a. Use an oil retention enema to facilitate collection.
b. Refrigerate the specimen immediately.
c. Obtain three different stool specimens on subsequent days.
d. Check the specimen for the presence of occult blood.

Answer 13

c. Obtain three different stool specimens on subsequent days.

Question 14

The nurse explains to the patient with Crohn disease that the tube feedings are placed for which reason?
a. rapid absorption in the upper GI tract.
b. decompression of the stomach.
c. reduction of diarrheic episodes.
d. a permanent nutritional support.

Answer 14

a. rapid absorption in the upper GI tract.

Question 15

A patient with a large inguinal hernia has abdominal distention and inguinal pain. The nurse recognizes these as indicators of which type of hernia?
a. Strangulated
b. Hiatal
c. Ventral
d. Umbilical

Answer 15

a. Strangulated

Question 16

Analyzing For which patient is misoprostol contraindicated?
a. An older adult
b. A pregnant female
c. A patient taking daily aspirin
d. A patient taking a proton pump inhibitor

Answer 16

b. A pregnant female

Question 17

A male patient reports that he will never adjust to his colostomy. Which is the best action
for the nurse in this situation?
a. Encourage him to express his concern.
b. Suggest that he discuss his concerns with his physician.
c. Counsel him that everything will be all right.
d. Assure him that his concerns will diminish when he is able to care for his
colostomy.

Answer 17

a. Encourage him to express his concern.

Question 18

In caring for a patient with gastric bleeding who has a nasogastric (NG) tube in place, the nurse expects to see which intervention for the nasogastric tube included in the plan ofcare?
a. clampfor 10 minutes every hour.
b. keep the patent with irrigation.
c. frequently reposition to the opposite nostril.
d. change every 72 hours.

Answer 18

b. keep the patent with irrigation.

Question 19

Which will the nurse include when reinforcing the teaching plan for a patient with a hiatal
hernia to reduce the frequency of heartburn?
a. Drinking 10 oz of milk with every meal
b. Lie down after eating
c. Panting through mouth when symptoms begin
d. Eating small meals

Answer 19

d. Eating small meals

Question 20

The nurse points out which is an example of a nonmechanical bowel obstruction?
a. A paralytic ileus
b. Narrowed bowel lumen from an inflammatory process
c. Tumor of the bowel
d. Fecal impaction

Answer 20

a. A paralytic ileus

Question 21

Bowel sound assessment on a patient with an early bowel obstruction who has distention,
nausea, and visible peristaltic waves will demonstrate which type of bowel sound?
a. loud and clearly audible.
b. high pitched.
c. hyperactive.
d. absent.

Answer 21

b. high pitched.

Question 22

The patient with a peptic ulcer has been placed on regular doses of bismuth salicylate to
combat Helicobacter pylori. What color will this drug turn the stool?
a. Gray-black
b. Dark green
c. Red-orange
d. Yellow

Answer 22

a. Gray-black

Question 23

Which will the nurse reinforce in the patient teaching of a patient who had a gastrectomy to
treat a severely bleeding peptic ulcer?
a. Introducing irritating foods in minute amounts to desensitize the stomach
b. Restricting fluid to 1000 mL per day
c. Eating 6 small meals a day
d. Drinking alcohol and caffeine in moderation

Answer 23

c. Eating 6 small meals a day

Question 24

Which will be the most helpful nursing intervention to increase the comfort of a patient with appendicitis?
a. Applying of ice bag
b. Administration of small tap water enema
c. Warm compress over entire abdomen
d. Ambulate for short periods in the room

Answer 24

a. Applying of ice bag

Question 25

To assist a family with a bowel-training program to reduce fecal incontinence, the nurse
would suggest the use of which item at an optimal time to stimulate defecation?
a. warm bath
b. a tap water enema
c. glycerin suppository
d. large glass of warm lemonade

Answer 25

c. glycerin suppository

Question 26

What is the most lethal complication of a peptic ulcer?
a. Bleeding
b. Perforation
c. Severe pain
d. Gastric outlet obstruction

Answer 26

b. Perforation

Question 27

The nurse takes into consideration that a proton pump inhibitor drug, such as which drug,
will completely eradicate gastric acid production?
a. omeprazole
b. misoprostol
c. sucralfate
d. olsalazine

Answer 27

a. omeprazole

Question 28

Which is the purpose of antibiotic therapy in treating peptic ulcers?
a. It eradicates H. pylori.
b. It inhibits gastric acid secretion.
c. It protects the gastric mucosa.
d. It neutralizes or reduces the acidity of stomach contents.

Answer 28

a. It eradicates H. pylori.

Question 29

Why are peptic ulcers a common problem of aging?
a. Older adults develop esophageal diverticula
b. Older adults have a higher incidence of hiatal hernia
c. Older adults use nonsteroidal anti-inflammatory drugs to treat chronic joint conditions
d. Older adults have decreased secretion of hydrochloric acid from the parietal cells
of the stomach.

Answer 29

c. Older adults use nonsteroidal anti-inflammatory drugs to treat chronic joint conditions

Question 30

The patient with irritable bowel syndrome tells the home health nurse she is going to an
acupuncturist for therapy for her condition. Which will be the best nursing response?
a. “Go for it. Alternative medicine does great things.”
b. “YIKES! An acupuncturist?”
c. “Some people have found relief from nausea and colon muscle spasms”.
d. “You should confirm that the acupuncturist and facility are state licensed.”

Answer 30

c. “Some people have found relief from nausea and colon muscle spasms”.

Question 31

During the annual physical examination, the nurse will assess for which risk factor for the
development of diverticulosis?
a. Chronic diarrhea
b. Excessive fiber intake
c. Increased intake of refined carbohydrates
d. Aging related increased elasticity of the colon

Answer 31

c. Increased intake of refined carbohydrates

Question 32

Which change in the body leads to poor absorption of nutrients in a patient who has celiac
disease?
a. Development of diverticuli
b. Anaphylactic reaction to wheat
c. Destruction of the intestinal villi
d. Reduced intestinal mucosal output

Answer 32

c. Destruction of the intestinal villi

Question 33

Flexible sigmoidoscopy should be performed every ? years.

Answer 33

5

Question 34

The nurse explains that, ? the chief enzyme of gastric juice, is activated by
hydrochloric acid to begin digestion of protein.

Answer 34

pepsin

Question 35

The nurse caring for a patient with Crohn disease will closely monitor the urinary output to ensure that the patient is excreting at least ? mL/day.

Answer 35

1500

Question 36

The nurse takes into consideration that long-term use of antibiotics can cause an antibiotic-associated pseudomembranous colitis from the organism ?

Answer 36

Clostridium difficile

Question 37

Due to frequent bouts of constipation, the nurse examines the bedfast nursing home resident for ulceration of the anus, called anal ?

Answer 37

fissure