course point unit 7 Flashcards
A client has experienced a stroke affecting the reticular formation of the medulla and lower pons. The nurse tells the client’s wife that care must be taken with eating to prevent:
Aspiration pneumonia
A client takes 650 mg of aspirin every 4 hours daily for reports of joint pain. Which statement should be included in the client’s teaching plan?
“This medication can damage gastric mucosa.“
An anatomy student explains that the funnel-shaped portion of the stomach that connects with the intestine is called which region?
Pyloric region
The physiologic rationale for hanging normal saline (0.9% NS) or 5% dextrose in water (D5W) to a client who has been experiencing diarrhea includes:
Facilitating the absorption of osmotically active particles
Which enzymes adhere to the border of the villus structures to allow access to carbohydrate and protein molecules?
Brush border
A client with long-standing digestive problems is found to have a deficiency in pepsinogen. The client likely has dysfunction involving:
chief cells.
Colonic microorganisms play a role in the synthesis of which vitamin?
K
Which statement would help a nurse best explain an “incretin effect”?
“It is an increase in insulin release after ingestion of food.”
The swallowing reflex is an entirely voluntary activity.
False
Which carbohydrate is matched to its correct enzyme needed for digestion?
Sucrose and sucrase
The gastrointestinal laboratory nurse is learning about small intestine secretions. Which explanation is most accurate?
“An extensive array of mucus-producing glands, called Brunner glands, is concentrated where contents from the stomach and secretions from the liver and pancreas enter the duodenum.”
The nurse is providing medication teaching to a client that includes instructions to take the medication on an empty stomach. The client asks why so many medications are better taken on an empty stomach. Which is the nurse’s best response?
“Many medications rely on an acidic environment for better absorption.”
A student is studying gallbladder function. Which gastrointestinal hormone stimulates contraction of the gallbladder?
Cholecystokinin
Biopsy results reveal that a client has a deficient amount of parietal (oxyntic) cells in his stomach. The client asks the nurse to explain what this means. The nurse explains that parietal cells secrete HCl and intrinsic factor, which is needed for absorption of:
Vitamin B12
A client is not able to absorb vitamin B12. The nurse determines that the client is deficient in:
parietal (oxyntic) cells, which secrete HCl and intrinsic factor.
Serous fluid is contained in the:
Which statement is true concerning gastric enterocytes?
They secrete enzymes that aid in digestion of proteins.
A client is experiencing reflux of stomach contents into the esophagus. The nurse determines that the problem may result from:
Gastroesophageal sphincter
Select the phase of swallowing that prevents food from entering the nasopharynx when a client is eating.
Pharyngeal
The dietitian explains to the client that food is digested and absorbed in the:
Jejunum
Which aspect of gastrointestinal function is performed by the brush border enzymes of the villus structures?
Digestion of carbohydrates
During a lecture about the function of the intestine related to food digestion, the faculty mentions that when the students consume foods high in acid, the intestines will:
stimulate the release of secretin, which then inhibits release of gastrin.
A student is comparing the two patterns of contractions in the small intestine. Which statement is most accurate?
“Segmentation waves function mainly to mix the chyme with the digestive enzymes from the pancreas.”
Which layer of the digestive tract consists of connective tissue and contains nerves, blood vessels, and structures for secreting the digestive juices?
Submucosal
Where in the GI tract is food digested and absorbed?
The jejunum and the ileum
The nurse is caring for a client who lacks an enzyme needed to create monosaccharides. For which manifestation of this disorder does the nurse assess the client?
diarrhea
When discussing pathogens that can invade the gastrointestinal tract, the nurse will likely discuss which type of cell that signals the gastrointestinal immune system to attack pathogens to kill them before they can cause manifestations of an illness?
Cytotoxic T cells
A 2-year-old boy is experiencing recurrent bouts of diarrhea. The volume of fluid that is lost in the stool creates a systemic dehydration. This child has an extracellular fluid deficit because:
water and electrolytes for digestive tract secretions are derived from the extracellular fluid compartment.
The client chews an apple and starts the process of swallowing. As food enters the client’s esophagus, the nurse recognizes that which nerve innervates the sphincter in the lower esophagus?
Vagus nerve
Absorption is a major function of the GI tract. How is absorption accomplished in the GI tract?
Active transport and diffusion
The colon is home to between 300 and 500 different species of bacteria. What is their main metabolic function?
Fermentation of undigestible dietary residue
A rare condition caused by gastrin-secreting tumors most commonly found in the small intestine or pancreas is called:
Zollinger-Ellison syndrome
A nurse administering a client’s medication tells the client that a proton pump inhibitor has been added. When the client asks the purpose of the medication, the nurse responds that it is to prevent:
Stress ulcer
A client is admitted to the hospital with a suspected diagnosis of strangulated bowel. The nurse anticipates the client will need:
surgery to release the bowel.
Crohn disease is recognized by sharply demarcated, granulomatous lesions that are surrounded by normal-appearing mucosal tissue. The nurse recognizes these lesions to be defined by which description?
Cobblestone
The incidence of stomach cancer has significantly decreased in the United States, yet it remains the leading cause of death worldwide. The nurse understands the reason for the high mortality rate in stomach cancer is because of which reason?
Clients have few early symptoms of the disease.
The cause of gastric carcinomas has been influenced by which factors? Select all that apply.
A teenager has been diagnosed with failure to thrive possibly due to malabsorption syndrome. In addition to having diarrhea and bloating, the client more than likely has what hallmark manifestation of malabsorption?
Fatty, yellow-gray, foul-smelling stools
Diarrhea is described as a change in frequency of stool passage to a point where it is excessively frequent. What are the symptoms of non-inflammatory diarrhea? Select all that apply.
Nausea and/or vomiting, Periumbilical cramps, and Nonbloody stools
Which meal choice is most likely to exacerbate an individual’s celiac disease?
Spaghetti with meatballs and garlic bread
A client is admitted with chronic gastritis. The nurse expects which invasive test to be performed to establish the presence of Helicobacter pylori (H. pylori)?
Endoscopic biopsy
A client is admitted with an abrupt onset of referred pain to the epigastric area, with an episode of nausea. On the nurse’s initial assessment, the client is lying still and taking shallow breaths, with a rigid abdomen. Which problem is the client experiencing?
Peritonitis
A client who is diagnosed with Zollinger-Ellison syndrome will exhibit which symptoms?
Diarrhea with fat deposits
Pharmacologic treatment for peptic ulcers has changed over the past several decades. The nurse knows that the goal for pharmacologic treatment is focused on:
Eradicating Helicobacter pylori (H. pylori)
An older adult client has been placed on a broad-spectrum antibiotic for a recurrent urinary tract infection. Which potential problem would the nurse anticipate in this client?
Colonization of Clostridioides difficile
Which client likely faces the greatest risk of a gastrointestinal bleed?
A client who takes aspirin with each meal to control symptoms of osteoarthritis
A health care provider suspects a client has celiac disease after the client reports sickness every time after eating something made with wheat, barley, and/or rye. The provider will further assess the client for which potential manifestations to confirm the diagnosis? Select all that apply.
Iron deficiency, Diarrhea, Abdominal pain
An older adult client presents with loose mucus-filled stools. The nurse suspects the client has Clostridioides difficile. What is a priority assessment for the nurse?
In the balance of secretions in the gastric mucosa by the parietal cells, which ion is produced to buffer the production of hydrochloric acid?
HCO3–
Good hand-washing techniques are important in health care. The nurse knows that bacterial infections can be prevented by good hand washing techniques. Which route of transmission is most common for Clostridioides difficile?
Fecal–oral transmission
A client with quadriplegia adheres to a regular bowel protocol. Which action performed by the client’s caregiver is likely to promote defecation?
Digital stimulation of the client’s rectum
Crohn disease has a distinguishing pattern in the gastrointestinal (GI) tract. The surface has granulomatous lesions surrounded by normal-appearing mucosal tissue. A complication of the pattern includes:
fistula formation
A young client presents reporting diarrhea, fecal urgency, and weight loss. The stool is light-colored and malodorous, and it tends to float and be difficult to flush. The client has also noted tender, red bumps on the shins and reports pain and stiffness in the elbows and knees. Sigmoidoscopy reveals discontinuous, granulomatous lesions; no blood is detected in the stool. Which diagnosis would his care team first suspect?
Crohn disease
Inflammatory bowel disease (IBD) is used to designate two related inflammatory intestinal disorders: Crohn disease and ulcerative colitis. The nurse recognizes the difference between the distribution pattern between Crohn disease and ulcerative colitis. Which pattern describes Crohn’s disease?
Skip lesions
A client with a history of peptic ulcer disease presents to the emergency department with the following symptoms: early satiety, feeling of epigastric fullness and heaviness after meals, weight loss, and vomiting. The nurse suspects that the peptic ulcer has caused which problem?
Obstruction
Caregivers of a toddler report poor oral intake and grimacing when swallowing. The caregivers also describe the toddler as having difficulty with sleep and wheezing being heard when breathing. The nurse focuses initial assessments based on which likely cause of the symptoms?
gastrointestinal reflux disease
Irritable bowel syndrome is thought to be present in 10% to 15% of the population in the United States. What is its hallmark symptom?
Abdominal pain relieved by defecation with a change in consistency or frequency of stools
A client who ate a large meal and then went to weightlifting class states “feeling very uncomfortable” and reports gastric reflux. What is the nurse’s best response to the client?
“There is backward movement of gastric contents into the esophagus that occurs soon after eating.”
Which clinical manifestations would lead the nurse to suspect the postoperative client has developed a mechanical bowel obstruction? Select all that apply.
Increased abdominal distention, Extreme restlessness, High-pitched bowel sounds
A college student goes to the campus health office complaining of diarrhea, lower right abdominal pain, and weight loss. Suspecting Crohn disease, the nurse will assess for which complication associated with this diagnosis?
Urine that has the look and smell of feces
A 40-year-old client tells the nurse that a parent died of gastric cancer and that the client wants to do everything one can do to avoid the disease. Which recommendation should the nurse provide?
Avoid smoked and preserved foods.
A 68-year-old man who has smoked for at least 50 years reports that lately he feels as though food is “getting stuck” in his throat. At first this was a problem just with dry food, but now his morning oatmeal is getting stuck. On questioning, he reports drinking at least five alcoholic beverages nearly every day. His problem is most likely:
squamous cell carcinoma of the esophagus.
A client is admitted with an exacerbation of Crohn disease and has been experiencing a weight loss of 20 pounds in 2 weeks. The client is unable to absorb nutrients from the intestine. The nurse would expect which type of diet to be ordered for this client?
Total parenteral nutrition
A client diagnosed with ulcerative colitis has been experiencing more than six bloody stools daily with evidence of toxicity. The nurse should question which order from the physician?
Colonoscopy
The client who has experienced third-degree burns is susceptible to which specific type of gastrointestinal (GI) ulceration?
Stress
The nurse is reviewing laboratory results of a client who has liver failure. Which finding would place the client at increased risk for bleeding?
Increased prothrombin time
When caring for the client with Laennec cirrhosis, the nurse recognizes which pathophysiologic finding to be an expected etiology of jaundice?
Impaired uptake of bilirubin
A client is diagnosed with choledocholithiasis and acute suppurative cholangitis and is being rushed to surgery to prevent which possible complication?
The accumulation of purulent bile, which can cause sepsis.
The liver has many jobs. One of the most important functions of the liver is to cleanse the portal blood of old and defective blood cells, bacteria in the bloodstream, and any foreign material. Which cells in the liver are capable of removing bacteria and foreign material from the portal blood?
Kupffer cells
A client’s long-standing diagnosis of congenital hemolytic anemia often manifests itself with jaundice. What type of jaundice does this client most likely experience?
Prehepatic
A client with persistent, recurring episodes of epigastric and upper left quadrant pain and anorexia, nausea, vomiting, constipation, and flatulence has been diagnosed with chronic pancreatitis. What is the cause of the symptoms of chronic pancreatitis?
Destruction of both the endocrine and exocrine pancreas
The nurse is caring for a client with advanced liver disease who has ascites. Which treatment will the nurse anticipate being used for the daily management of ascites?
diuretics
When teaching a group of nursing students about the liver, the nurse relates that Kupffer cells function to remove harmful substances or cells from the portal blood and venous sinusoids through which process?
Phagocytosis
Which individual likely faces the highest risk of developing chronic pancreatitis?
A woman who has 6 to 8 alcoholic beverages each evening
The client has right upper quadrant pain caused by acute choledocholithiasis. The health care provider suspects the common bile duct is obstructed, based on which flowing lab value?
Bilirubin 15 mg/dL (256.56 µmol/L) (high)
The liver has many jobs. One of the most important functions of the liver is to cleanse the portal blood of old and defective blood cells, bacteria in the bloodstream, and any foreign material. Which cells in the liver are capable of removing bacteria and foreign material from the portal blood?
Kupffer cells
The nurse is performing a physical assessment of the gastrointestinal tract. In which area does the nurse place the hands for palpation of the liver?
Right upper quadrant
Antibody testing has confirmed that a client is positive for hepatitis A virus (HAV). Which statement does the nurse apply as evidence that the client understands the new diagnosis?
“I don’t know why I didn’t bother to get vaccinated against this.”
The nurse is caring for a client with advanced cirrhosis who had a transjugular intrahepatic portosystemic shunt (TIPS) procedure performed 3 months ago. Which assessment(s) related to the client having a TIPS procedure should the nurse perform? Select all that apply.
Neurologic assessment., Platelet level., & Hemoglobin level.
Given the fact that acute pancreatitis can result in severe, life-threatening complications, the nurse should be assessing the client for which complication?
Acute tubular necrosis
The nurse is caring for the client with hepatocellular carcinoma. What does the nurse recognize is a cause of this disease?
Illness with hepatitis B or C
A client with chronic pancreatitis is experiencing an episode of recurring epigastric pain. The nurse teaches the client to limit which type of meal to avoid further episodes?
fried chicken and french fries
A client has been diagnosed with alcohol-induced liver disease. He admits to the nurse, “I know what the lungs do, and I know what the heart does, but honestly, I have no idea what the liver does in the body.” The nurse should tell the client that the liver:
metabolizes most components of food and also cleans the blood of bacteria and drugs.
Primary biliary cirrhosis is an autoimmune disease that destroys the small intrahepatic bile ducts causing cholestasis. It is insidious in onset and is a progressive disease. What are the earliest symptoms of the disease?
A client newly diagnosed with pancreatic cancer is admitted to begin treatment. Which pain descriptors can be associated with adenocarcinomas of the pancreas?
Dull epigastric pain accompanied by back pain, worse when lying flat and relieved by sitting forward.
A 24-year-old woman undergoing a screening test is found to have elevated levels of AST, ALT, and IgG, but no antibody-specific markers for viral hepatitis. A liver biopsy reveals inflammation and cellular damage. Which treatment is most likely to be effective for her?
Corticosteroids and immunosuppressant drugs
Cholestasis is a condition in which there is a decrease in bile flow through the intrahepatic canaliculi and a reduction in secretion of water, bilirubin, and bile acids by the hepatocytes. Cholestasis can have more than one cause, but in all types of cholestasis, there is:
accumulation of bile pigment in the liver.
The nurse is caring for a client with hepatitis and jaundice. The nurse recognizes that without sufficient circulating bile salts the client will have intolerance to which ingested substance?
Fats
One of the jobs the liver performs is to export triglyceride. When the liver’s capacity to export triglyceride is exceeded, excess fatty acids accumulate in the liver. To what disease do these excess fatty acids contribute?
Nonalcoholic fatty liver disease
A client is prescribed erythromycin for an infection. What manifestations will the nurse recognize that indicate the onset of drug-induced cholestasis?
Jaundice and pruritus
The nurse is caring for a client with asterixis. Which assessment should the nurse make to help a diagnosis of hepatic encephalopathy?
Mental status
A client presents to the emergency department with suspected pancreatitis. Which manifestations would the nurse assess in this client? Select all that apply.
- Fever
- Tenderness
- Tachycardia
- Epigastric pain
A client with no significant past medical history has just been diagnosed with early cirrhotic changes due to an undiagnosed chronic hepatitis C infection. The client asks the nurse about treatment options. Which information should the nurse provide?
“You may be eligible for pangenotypic direct-acting antiviral agents, which are often curative.”
The nurse is caring for a client with liver disease who has edema throughout the body. When reviewing the medical record, the nurse recognizes that which altered diagnostic test is consistent with development of edema?
Decreased albumin
The nurse is teaching a group of nursing students about alcohol-induced liver disease and the cytochrome P450 system (CYP P450). Which of these is correct for the nurse to include in the lesson?
Alcohol consumption enhances susceptibility to effects of drugs and toxins.
When caring for a client with primary biliary cirrhosis, which of these statements by the nurse will best teach the client about the cause of this problem?
There is autoimmune destruction of the bile ducts.
The nurse is caring for a client with a diagnosis of post-hepatic obstruction. Which of these questions will assist the nurse in determining the underlying cause of the obstruction?
“Have you been told you have had gallstones?”
A decrease in the serum level of which substance is suggestive of liver injury?
Albumin
The oncology nurse is teaching a group of nursing students about risk factors for pancreatic cancer. Which factors does the nurse include in the teaching session? Select all that apply.
Chronic pancreatitis, Age over 50 years, cig smoking
Which manifestations will the nurse expect to find in a client with advanced liver failure?
Hematuria, Hyperkalemia, Asterixis
The nurse is teaching a client about surgical treatments available for chronic viral hepatitis. Which of these is appropriate for the nurse to relate?
Liver transplant
The nurse is caring for a college student with infectious mononucleosis. For which reason does the nurse teach the client to abstain from alcohol during the acute phase of the disease?
Alcohol may worsen a mild hepatitis which occurs in the acute phase.
