Both an upper GI procedure with barium ingestion and an

Digestive System Questions ultrasonography may be completed on the same day. The
1. Which of the following is an enzyme secreted by the gastric mucosa? ultrasonography test should be completed first, because the barium
a) Pepsin b) Trypsin c) Bile d) Ptyalin solution could interfere with the transmission of the sound waves. The
Pepsin is secreted by the gastric mucosa. Trypsin is secreted by the ultrasonography test uses sound waves that are passed into internal
pancreas. The salivary glands secrete ptyalin. The liver and body structures, and the echoes are recorded as they strike tissues.
gallbladder secrete bile Fluid in the abdomen prevents transmission of ultrasound.
2. When assisting with preparing a client scheduled for a barium 9. Which of the following would be most important to ensure that a
swallow, which of the following would be appropriate to include? client does not retain any barium after a barium swallow?
a) Take three cleansing enemas before the procedure. a) Observing the color of urine.
b) Take vitamin K before the procedure. b) Placing any stool passed in a specific preservative.
c) Avoid the intake of red meat before the procedure. c) Monitoring the stool passage and its color.
d) Avoid smoking for at least a day before the procedure. d) Monitoring the volume of urine.
The nurse should instruct the client to avoid smoking for at least a day Monitoring stool passage and its color will ensure that the client
before the procedure of barium swallow because smoking stimulates remains barium free following a barium swallow test. The white or
gastric motility. The client is advised to take vitamin K before a liver clay color of the stool would indicate barium retention. The stool
biopsy and instructed to take three cleansing enemas before a barium should be placed in a special preservative if the client undergoes a
enema. Instruction to avoid red meat would be appropriate for a client stool analysis. Observing the color and volume of urine will not
who is having a Hemoccult test. ensure that the client is barium free because barium is not eliminated
3. Which of the following is the primary function of the small intestine? through urine but through stool.
a) Secretion b) Peristalsis c) Absorption d) Digestion 10. A nursing instructor tells the class that review of oral hygiene is an
Absorption is the primary function of the small intestine. Digestion important component during assessment of the gastrointestinal
occurs in the stomach. Peristalsis occurs in the colon. The duodenum system. One of the students questions this statement. Which of the
secretes enzymes. following explanations from the nurse educator is most appropriate?
4. A 24-year-old athlete is admitted to the trauma unit following a a) "Bad breath will encourage ingestion of fatty foods to mask odor."
motor-vehicle collision. The client is comatose and has developed b) "Injury to oral mucosa or tooth decay can lead to difficulty in
ascites as a result of the accident. You are explaining the client's chewing food."
condition to his parents. In your education, what do you indicate is the c) "Decaying teeth secrete toxins that decrease the absorption of
primary function of the small intestine? nutrients."
a) Digest fats b) Digest proteins c) Absorb water d) Absorb nutrients d) "Mouth sores are caused by bacteria that can thin the villi of the
The primary function of the small intestine is to absorb nutrients from small intestine."
the chyme. Poor oral hygiene can result in injury to the oral mucosa, lip, or
5. A home care nurse is caring for a client with complaints of epigastric palate; tooth decay; or loss of teeth. Such problems may lead to
discomfort who is scheduled for a barium swallow. Which statement disruption in the digestive system. The ability to chew food or even
by the client indicates an understanding of the test? swallow may be hindered.
a) "I'll avoid eating or drinking anything 6 to 8 hours before the test." 11. One or two bowel sounds in 2 minutes would be documented as
b) "I'll drink full liquids the day before the test." which of the following?
c) "I'll take a laxative to clear my bowels before the test." a) Hypoactive b) Hyperactive c) Normal d) Absent
d) "There is no need for special preparation before the test." Hypoactive bowel sound is the description given to auscultation of
The client demonstrates understanding of a barium swallow when he one to two bowel sounds in 2 minutes. Normal bowel sounds are
states that he must refrain from eating or drinking for 6 to 8 hours heard every 5 to 20 seconds. Hyperactive bowel sounds occur when 5
before the test. No other preparation is needed. Before a lower GI or 6 sounds are heard in less than 30 seconds. The nurse records that
series, the client should eat a low-residue or clear liquid diet for 2 bowel sounds are absent when no sound is heard in 3 to 5 minutes.
days and take a potent laxative and an oral liquid preparation. 12. A nurse assesses the abdomen of a newly admitted client. Which
6. A nurse is providing postprocedure instructions for a client who had finding would necessitate further investigation?
an esophagogastroduodenoscopy. The nurse should perform which a) Flat appearance below the umbilicus
action? b) Asymmetrical upper quadrants
a) Tell the client there aren't specific instructions for after the c) Striae of lateral abdomen
procedure. d) Rounded contour
b) Tell the client to call back in the morning so she can give him The client lies supine with knees flexed for the abdominal assessment.
instructions over the phone. Upon inspection the nurse notes any skin changes, nodules, lesions,
c) Give instructions to the client immediately before discharge. inflammation, or striae. Lesions are of particular importance and
d) Review the instructions with the person accompanying the client require further investigation, as do irregular contours or asymmetry of
home. the abdomen.
A client who undergoes esophagogastroduodenoscopy receives 13. The hydrogen breath test was developed to evaluate which type of
sedation during the procedure, and his memory becomes impaired. absorption?
Clients tend not to remember instructions provided after the a) Protein b) Vitamin B12 c) Carbohydrate d) Fat
procedure. The nurse's best course of action is to give the instructions The hydrogen breath test that is used to evaluate carbohydrate
to the person who is accompanying the client home. It isn't absorption is performed if carbohydrate malabsorption is suspected.
appropriate for the nurse to tell the client to call back in the morning The hydrogen test does not evaluate fat, protein, or vitamin B12
for instructions. The client needs to be aware at discharge of potential absorption.
complications and signs and symptoms to report to the physician. 14. Gastrin has which of the following effects on gastrointestinal (GI)
7. The nurse is assessing a client following laparoscopy. The client motility?
states that his stomach looks bloated and asks if this is normal. How a) Relaxation of the colon
will the nurse respond? b) Contraction of the ileocecal sphincter
a) "I am not sure about this. Let me get another nurse." c) Increased motility of the stomach
b) "Yes, your abdomen may appear larger as a result of the injection d) Relaxation of gastroesophageal sphincter
of carbon dioxide for visualization." Gastrin has the following effects on GI motility: increased motility of
c) "Do you need to use the restroom? You may have to have a bowel the stomach, excitation of the colon, relaxation of ileocecal sphincter,
movement." and contraction of the gastroesophageal sphincter.
d) "No, this should not occur. I will call the physician right away. 15. Which of the following should be included as part of the preprocedure
During a laparoscopic procedure, a pneumoperitoneum is used to teaching for a patient scheduled for a proctosigmoidoscopy involving
inject carbon dioxide into the peritoneal cavity to separate the the lower GI structures?
intestines from the pelvic organs. Gas (carbon dioxide) is insufflated a) Consume at least three quarts of water 30 minutes before the test
into the peritoneal cavity to create a working space for visualization. b) Follow the dietary and fluid restrictions and bowel preparation
8. A client is to have an upper GI procedure with barium ingestion and procedures
abdominal ultrasonography. While scheduling these diagnostic tests, c) Spray or gargle with a local anesthetic
the nurse must consider which factor? d) Do not void for at least 30 minutes before the test
a) The ultrasonography should be scheduled before the GI procedure. For a patient due to undergo a proctosigmoidoscopy, it is essential
b) The upper GI should be scheduled before the ultrasonography. that the patient follows the dietary and fluid restrictions and bowel
c) The client may eat a light meal before either test. preparation procedures if the examination involves the lower GI
d) Both tests need to be done before breakfast. structures. For the patient undergoing an
esophagogastroduodenoscopy (EGD), it is necessary for the patient to
 spray or gargle with a local anesthetic. The patient is not advised to 23. A client with extreme weakness, pallor, weak peripheral pulses, and
consume three quarts of water and is not advised to void before the disorientation is admitted to the emergency department. His wife
test. These interventions may be essential for tests that involve reports that he has been "spitting up blood." A Mallory-Weiss tear is
ultrasonographic procedures. suspected, and the nurse begins taking a client history from the
16. Which of the following sequence should be used to assess the client's wife. The question by the nurse that demonstrates her
abdomen? understanding of Mallory-Weiss tearing is:
a) Palpation, inspection, percussion, auscultation a) "Is your partner being treated for tuberculosis?"
b) Auscultation, inspection, percussion, palpation b) "Has your partner recently fallen or injured his chest?"
c) Inspection, auscultation, percussion, palpation c) "Has your partner had recent forceful vomiting?"
d) Percussion, auscultation, palpation, inspection d) "What spices and condiments does your spouse use on food?"
Assessment begins with an overall visual inspection of the abdomen A Mallory-Weiss tear is associated with massive bleeding after a tear
followed by auscultation, which always precedes percussion and occurs in the mucous membrane at the junction of the esophagus and
palpation since manipulation of the abdomen may alter the frequency stomach. There is a strong relationship between forceful vomiting,
and intensity of bowel sounds. Inspection allows the nurse to visualize and a Mallory-Weiss tear. The bleeding is coming from the stomach,
the skin, umbilicus, contour, and symmetry of abdomen and any not from the lungs as would be true in some cases of tuberculosis. A
movement or pulsations. Mallory-Weiss tear doesn't occur from chest injuries or falls and isn't
17. Upon review of a client's chart, the nurse notes the client has been associated with eating spicy foods.
receiving antiemetics every 6 to 8 hours. What in this client's history 24. Digestive enzymes contribute to the breakdown of foods for the
may necessitate such frequency? body's use. Stomach contractions mix the food and gastric secretions
a) Pituitary tumor b) Adrenal gland removal 3 days ago and, eventually, the chyme moves to the small intestine. Which
c) Treatment for cancer d) Multiple leg fractures nutrient actually delays feeling hungry?
Antiemetics are used to treat nausea and vomiting. Common causes of a) Fats b) Minerals c) Carbohydrates d) Proteins
nausea and vomiting include visceral afferent stimulation, peritoneal 25. Cystic fibrosis, a genetic disorder characterized by pulmonary and
irritation, infections, radiation or chemotherapy therapy, increased pancreatic dysfunction, usually appears in young children but can also
intracranial pressure, and vestibular disorders. Irritation of the affect adults. If the pancreas was functioning correctly, where would
chemoreceptor trigger zone from cancer treatment can induce nausea the bile and pancreatic enzymes enter the GI system?
and lead to vomiting. a) Cecum b) Jejunum c) Duodenum d) Ileum
18. The nurse asks a client to point to where she feels pain. The client The duodenum, which is approximately 10 inches long, is the first
asks why this is important. The nurse's best response would be which region of the small intestine and the site where bile and pancreatic
of the following? enzymes enter.
a) "This determines the pain medication to be ordered." 26. The nurse is to obtain a stool specimen from a client who reported
b) "The area may determine the severity of the pain." that he is taking iron supplements. The nurse would expect the stool
c) "If the doctor massages over the exact painful area, the pain will to be which color?
disappear." a) Red b) Black c) Dark brown d) Green
d) "Often the area of pain is referred from another area." Ingestion of iron can cause the stool to turn black. Meat protein
Pain can be a major symptom of disease. The location and distribution causes stool to appear dark brown. Ingestion of large amounts of
of pain can be referred from a different area. If a client points to an spinach may turn stool green while ingestion of carrots and beets may
area of pain and has other symptoms associated with a certain disease, cause stool to turn red.
this is valuable information for treatment. 27. The nurse is preparing to examine the abdomen of a client
19. A client is diagnosed with megaloblastic anemia caused by vitamin complaining of a change in his bowel pattern. The nurse would place
B12 deficiency. The physician begins the client on cyanocobalamin the client in which position?
(Betalin-12), 100 mcg I.M. daily. Which substance influences vitamin a) Lithotomy b) Knee-chest
B12 absorption? c) Supine with knees flexed d) Left Sim's lateral
a) Intrinsic factor b) Histamine When examining the abdomen, the client lies supine with his knees
c) Liver enzyme d) Hydrochloric acid flexed. This position assists in relaxing the abdominal muscles. The
Vitamin B12 absorption depends on intrinsic factor, which is secreted lithotomy position commonly is used for a female pelvic examination
by parietal cells in the stomach. The vitamin binds with intrinsic and to examine the rectum. The knee-chest position can be used for a
factor and is absorbed in the ileum. Hydrochloric acid, histamine, and variety of examinations, most commonly the anus and rectum. The
liver enzymes don't influence vitamin B12 absorption. left Sim's lateral position may be used to assess the rectum or vagina
20. Which of the following digestive enzymes aids in the digesting of and to administer an enema.
starch? 28. A client recently started a new medication to treat a suspected ulcer.
a) Bile b) Trypsin c) Amylase d) Lipase Digestive She asks the nurse how this medicine is helping. Which of the
Enzymes secreted by the pancreas include trypsin, which aids in following would be the best response by the nurse regarding anti-
digesting protein; amylase, which aids in digesting starch; and lipase, ulcerative medications?
which aids in digesting fats. Bile is secreted by the liver and is not a) "This medication helps to digest food more slowly, allowing acid to
considered a digestive enzyme. attach to the food particles."
21. A few hours after eating hot and spicy chicken wings, a client b) "This medication reduces the acid secretion in your stomach."
presents with lower chest pain. He wonders if he is having a heart c) "The medication is allowing the acid to be eliminated more quickly
attack. How should the nurse proceed first? in the stool."
a) Further investigate the initial complaint. d) "This medication acts to reduce the volume of acid and foods that
b) Explain that fatty foods can mimic chest pain. can enter the small intestine."
c) Administer an over-the-counter antacid tablet. The stomach secretes a highly acidic fluid in response to food. The
d) Call for an immediate electrocardiogram. acid is derived from hydrochloric acid, which is secreted by the
While fatty foods can cause discomfort similar to chest pain, the nurse glands of the stomach. Ulcer medications inhibit acid secretion in the
must fully assess all the client's symptoms. Investigation of chief stomach or inhibit the action of histamine at the receptor sites.
complaint begins with a complete history. The underlying cause of 29. A client is scheduled for several diagnostic tests to evaluate her
pain influences the characteristics, duration, pattern, location, and gastrointestinal function. After teaching the client about these tests,
distribution of pain. the nurse determines that the client has understood the teaching when
22. A client undergoing a diagnostic examination for gastrointestinal she identifies which test as not requiring the use of a contrast
disorder was given polyethylene glycol/electrolyte solution as a part of medium?
the test preparation. Which of the following measures should the a) Small bowel series b) Colonoscopy
nurse take once the solution is administered? c) Upper GI series d) Computer tomography A
a) Allow the client to ingest fat-free meal. Colonoscopy is a direct visual examination of the entire large
b) Instruct the client to have low-residue meals. intestine. It does not involve the use of a contrast agent. Contrast
c) Provide saline gargles to the client. medium may be used with a small bowel series, computed
d) Permit the client to drink only clear liquids. tomography, and upper GI series.
After polyethylene glycol/electrolyte solution is administered, the 30. Which of the following should the nurse advise a client due to
client should have clear liquids as this ensures watery stools, which undergo a diagnostic test for a disorder of the GI system, to ensure
are necessary for procedures like a barium enema. Allowing the client that the client experiences none or minimal discomfort?
to ingest a fat-free meal is used in preparation for oral a) The client should not expel gas and test fluids from the bowel when
cholecystography. Instructing the client to have low-residue meals is a he or she experiences the urge during the procedure
pretest procedure for barium enema. A client is offered saline gargles b) The client should take a sedative before the procedure to avoid the
after esophagogastroduodenoscopy. possibility of experiencing any discomfort
 c) The client should lie down in a supine position for at least three which can lead to metabolic alkalosis and hypokalemia. Excessive
hours before the test to reduce any discomfort during the test vomiting doesn't cause metabolic acidosis or hyperkalemia.
d) The client should inform the test personnel if he or she experiences 36. If a client has abdominal surgery and a portion of the small intestine is
pressure or cramping during the instillation of test fluids removed, the client is at risk for which of the following?
To ensure that a client who is to undergo a diagnostic test for a a) Cirrhosis b) Gastric ulcers
disorder of the gastrointestinal system experiences none or minimal c) Constipation d) Malabsorption syndrome
discomfort during the test, the client should be instructed to inform Absorption is the primary function of the small intestine. Vitamins
the test personnel if the client experiences pressure or cramping and minerals are absorbed essentially unchanged. Nutrients are
during the instillation of test fluids. The test personnel can slow the absorbed at specific locations in the small intestine.
instillation or take other measures to relieve discomfort. 37. When describing the role of the pancreas to a client with a pancreatic
31. A client has recently obtained a set of dentures. Which of the dysfunction, the nurse would identify which substance as being acted
following will the nurse do during a complete physical examination? on by pancreatic lipase?
a) Remove the plates and rinse under hot water to remove bacteria. a) Protein b) Glucose c) Triglycerides d) Starch
b) Brush the dentures before examining the oral cavity. Pancreatic lipase acts on lipids, especially triglycerides. Salivary
c) Remove the plates to visualize the oral cavity. amylase and pancreatic amylase act on starch. Pepsin and
d) Have the client rinse with warm salt water before assessing the oral hydrochloric acid in the stomach and trypsin from the pancreas act on
cavity. proteins. Insulin acts on glucose.
A complete physical examination includes an assessment of the 38. Select all answer choices that apply.
mouth. It is necessary to remove the dentures to allow good An examiner is performing the physical assessment of the rectum,
visualization of the entire oral cavity. perianal region, and anus. While this examination can be
32. A client is scheduled for bowel resection with anastomosis involving uncomfortable for many clients, health care providers must approach
the large intestine. Because of the surgical site, the nurse formulates it in a prepared, confident manner. Which of the following
the nursing diagnosis of Risk for infection. To complete the nursing considerations will help this examination flow smoothly and
diagnosis statement, the nurse should add which "related-to" phrase? efficiently for both provider and client? Select all that apply.
a) Related to the presence of bacteria at the surgical site a) Position the client on the right side with the knees up to the chest.
b) Related to malnutrition secondary to bowel resection with b) Dim the lights to decrease the client's embarrassment.
anastomosis c) Cleanse gloved fingers with water to allow for easy insertion.
c) Related to major surgery required by bowel resection d) Ask the client to produce a bowel movement after the procedure.
d) Related to the presence of a nasogastric (NG) tube postoperatively e) Ask the client to bear down for visual inspection.
The nurse should add "Related to the presence of bacteria at the While examination of the rectum, perineum, and anus may be
surgical site" to the diagnosis of Risk for infection. The large intestine uncomfortable for the client, it is necessary for a thorough
normally contains bacteria because its alkaline environment permits examination. The examiner will position the client on the right side
growth of organisms that putrefy and break down remaining proteins with the knees up. He or she will use a gloved finger lubricated with a
and indigestible residue. These organisms include Escherichia coli, water-soluble lubricant for ease of insertion. The health care provider
Aerobacter aerogenes, Clostridium perfringens, and Lactobacillus. will encourage deep breathing during the procedure and ask the client
Although bowel resection with anastomosis is considered major to bear down while inspecting the anal area. The examination requires
surgery, it poses no greater risk of infection than any other type of appropriate lighting for thorough inspection.
major surgery. Malnutrition seldom follows bowel resection with 39. The nurse is caring for a man who has experienced a spinal cord
anastomosis because nutritional absorption (except for some water, injury. Throughout his recovery, the client expects to gain control of
sodium, and chloride) is completed in the small intestine. An NG tube his bowels. The nurse's best response to this client would be which of
is placed through a natural opening, not a wound, and therefore the following?
doesn't increase the client's risk of infection. a) "Over time, the nerve fibers will regrow new tracts, and you can
33. A client with diabetes begins to have digestive problems and is told have bowel movements again."
by the physician that they are a complication of the diabetes. Which b) "It is not going to happen. Your nerve cells are too damaged."
of the following explanations from the nurse is most accurate? c) "Wearing an undergarment will become more comfortable over
a) The pancreas secretes digestive enzymes. time."
b) Elevated glucose levels cause bacteria overgrowth in the large d) "Having a bowel movement is a spinal reflex requiring intact nerve
intestine. fibers. Yours are not intact."
c) The nerve fibers of the intestinal lining are experiencing The act of defecation is a spinal reflex involving the parasympathetic
neuropathy. nerve fibers. Normally, the external anal sphincter is maintained in a
d) Insulin has an adverse effect of constipation. state of tonic contraction. With a spinal cord injury, the client no
While the pancreas has the well-known function of secreting insulin, longer has this nervous system control and is often incontinent.
it also secretes digestive enzymes. These enzymes include trypsin, 40. Which information about an 80-year-old man at the senior center is of
amylase, and lipase. If the secretion of these enzymes are affected by most concern to the nurse?
a diseased pancreas as found in with diabetes, the digestive a. Decreased appetite b. Unintended weight loss
functioning may be impaired. c. Difficulty chewing food d. Complaints of indigestion
34. A client who had a colonoscopy with removal of a polyp is being 41. When caring for a patient with a history of a total gastrectomy, the
prepared for discharge. Which of the following would the nurse nurse will monitor for
include in the discharge instructions? a. constipation. b. dehydration. c. elevated total serum cholesterol.
a) "You might experience some nausea and vomiting for a day or so. d. cobalamin (vitamin B12) deficiency.
This is normal." 42. The nurse will plan to monitor a patient with an obstructed common
b) "Call your physician if there is even slight bleeding with your first bile duct for
bowel movement." a. melena. b. steatorrhea (fat in feces).
c) "You might feel some cramping and gas but these usually go away c. decreased serum cholesterol levels.
in about a day." d. increased serum indirect bilirubin levels.
d) "Be sure to eat high fiber foods when you get home to help you A common bile duct obstruction will reduce the absorption of fat in
move your bowels." the small intestine, leading to fatty stools.
After a colonoscopy, a client may experience mild cramping and 43. The nurse receives the following information about a 51-year-old
flatulence which usually resolve within n 24 hours. If the client has a woman who is scheduled for a colonoscopy. Which information
small growth or polyp removed, there may be a slight amount of should be communicated to the health care provider before sending
bleeding that resolves on its own. The client should notify his the patient for the procedure?
physician if he experiences nausea, vomiting, fever, or excessive a. The patient has a permanent pacemaker to prevent bradycardia.
bleeding. The client also should avoid high-fat and high-fiber foods b. The patient is worried about discomfort during the examination.
for at least 24 hours after the procedure. c. The patient has had an allergic reaction to shellfish and iodine in
35. A client presents to the emergency department, reporting that he has the past.
been vomiting every 30 to 40 minutes for the past 8 hours. Frequent d. The patient refused to drink the ordered polyethylene glycol
vomiting puts this client at risk for which imbalances? (GoLYTELY).
a) Metabolic alkalosis and hyperkalemia 44. Which statement to the nurse from a patient with jaundice indicates a
b) Metabolic acidosis and hypokalemia need for teaching?
c) Metabolic alkalosis and hypokalemia a. "I used cough syrup several times a day last week."
d) Metabolic acidosis and hyperkalemia b. "I take a baby aspirin every day to prevent strokes."
Gastric acid contains large amounts of potassium, chloride, and c. "I use acetaminophen (Tylenol) every 4 hours for back pain."
hydrogen ions. Excessive vomiting causes loss of these substances, d. "I need to take an antacid for indigestion several times a week"
45. Which finding by the nurse during abdominal auscultation indicates a 57. The specific cause of dysphagia can be determined more easily when
need for a focused abdominal assessment? the LPN/LVN obtains which information about the patient?
a. Loud gurgles b. High-pitched gurgles A. Patient's vital signs, especially rate and depth
c. Absent bowel sounds d. Frequent clicking sounds B. Level of physical activity tolerated by the patient
46. A 42-year-old woman is admitted to the outpatient testing area for an C. Patient's bowel habits and whether laxatives are taken habitually
ultrasound of the gallbladder. Which information obtained by the D. Observing conditions under which the patient experiences
nurse indicates that the ultrasound may need to be rescheduled? difficulty swallowing
a. The patient took a laxative the previous evening. 58. The nurse is reviewing the chart of a patient who recently underwent
b. The patient had a high-fat meal the previous evening. a total gastrectomy and notes the patient is receiving total parenteral
c. The patient has a permanent gastrostomy tube in place. nutrition (TPN). The nurse understands which information about
d. The patient ate a low-fat bagel 4 hours ago for breakfast. TPN?
47. The nurse is assessing an alert and independent 78-year-old woman A. A form of intravenous (IV) feeding
for malnutrition risk. The most appropriate initial question is which of B. A type of intestinal decompression
the following? C. A new method of tube-feeding a patient with dysphagia
a. "How do you get to the store to buy your food?" D. A method of feeding a patient through a tube inserted through an
b. "Can you tell me the food that you ate yesterday?" incision in the stomach
c. "Do you have any difficulty in preparing or eating food?" 59. The nurse is providing discharge education to a patient after a roux-
d. "Are you taking any medications that alter your taste for food?" en-Y gastric bypass procedure. Which nutritional supplements must
48. A 54-year-old man has just arrived in the recovery area after an upper this patient take for the rest of his life? (Select all that apply.)
endoscopy. Which information collected by the nurse is most A. Iron B. Calcium C. Folic acid
important to communicate to the health care provider? D. Vitamin C E. Vitamin D F. Vitamin B12
a. The patient is very drowsy. 60. Patients with ileostomies should be given which instruction?
b. The patient reports a sore throat. A."Do not take enteric-coated tablets."
c. The oral temperature is 101.6° F. B. "Increase your intake of dried fruits."
d. The apical pulse is 104 beats/minute. C. "Add more high-fiber foods to your diet."
49. A 30-year-old man is being admitted to the hospital for elective knee D. "If you notice a blockage, take a laxative."
surgery. Which assessment finding is most important to report to the 61. A patient with a sigmoid colostomy is taught to irrigate her colostomy
health care provider? daily to accomplish which goal?
a. Tympany on percussion of the abdomen A. Prevent infection B. Keep the bowel sterile
b. Liver edge 3 cm below the costal margin C. Increase the diameter of the bowel
c. Bowel sounds of 20/minute in each quadrant D. Gain control over the time elimination occurs
d. Aortic pulsations visible in the epigastric area 62. One week postoperatively, the LPN/LVN notes that the stoma of a
50. A 58-year-old woman has just returned to the nursing unit after an patient who had a colostomy has a purple hue. The nurse's actions are
esophagogastroduodenoscopy (EGD). Which action by unlicensed based on which understanding about this finding?
assistive personnel (UAP) requires that the registered nurse (RN) A. This is a normal finding.
intervene? B. There may be too much blood flow.
a. Offering the patient a drink of water C. There may be an obstruction in blood flow.
b. Positioning the patient on the right side D. The stoma is healing more quickly than expected.
c. Checking the vital signs every 30 minutes 63. When a patient experiences a severe exacerbation of Crohn disease,
d. Swabbing the patient's mouth with cold water the priority pharmacologic treatment would be administration of
51. While interviewing a 30-year-old man, the nurse learns that the which class of medication?
patient has a family history of familial adenomatous polyposis (FAP). A. Analgesics B. Antibiotics C. Antidiarrheals D. Corticosteroids
The nurse will plan to assess the patient's knowledge about 64. The nurse is caring for the patient following abdominal surgery.
a. preventing noninfectious hepatitis. Which symptom, if demonstrated by the patient, indicates the
b. treating inflammatory bowel disease. development of peritonitis?
c. risk for developing colorectal cancer. A. Fever B. Projectile vomiting
d. using antacids and proton pump inhibitors. C. Severe abdominal pain D. Anorexia with weight loss
65. The nurse is caring for a patient with ulcerative colitis who recently
https://quizlet.com/270681913/gi-digestive-and-metabolic-nclex-flash- underwent a colectomy and the creation of an ileal reservoir. How
cards/ will this patient eliminate stool from his body?
A. Continuously into a collection pouch
52. The nurse is caring for an older adult patient who reports continued B. With a catheter inserted into the reservoir
problems with constipation. What intervention can be implemented to C. Via his anus, over which he retains control
promote timely bowel movements? D. Intermittently via the ostomy into a collection pouch
A. Increase fiber intake. 66. The nurse is reviewing the health history of an assigned patient.
B. Limit fluid intake to 1500 mL daily. Which data in a patient's history might indicate a predisposition to
C. Administration of an oil retention enema weekly. diverticular disease? (Select all that apply.)
D. Take a mild over-the-counter laxative each evening. A. Frequent laxative use B. Low dietary fiber intake
53. The nurse is assessing the stooling patterns of an assigned patient. C. High dietary fiber intake
The patient reports stools as being clay colored. The nurse knows this D. History of passing scant, small stools
may indicate which condition? E. History of chronic diarrhea; vomiting
A.Bile is not reaching the intestines. 67. For which reason are patients with esophageal varices prone to
B. The stool contains undigested fat. hemorrhage?
C. The stool has an excessive amount of bilirubin. A. They have portal hypotension.
D. The patient is experiencing upper gastrointestinal (GI) bleeding. B. There is poor circulation within the veins.
54. A patient is to collect a specimen for a stool guaiac test. Which C. They are no longer able to produce vitamin K.
direction should the patient be given? D. There is an accumulation of ammonia in the blood
A. "Be sure to use a sterile container to collect the specimen." 68. When planning care for the patient with acute pancreatitis, the
B. "Be sure to take a laxative 2 days prior to collecting the stool." LPN/LVN knows that which intervention is a priority of care?
C. "Do not eat red meat for at least 3 days before collecting the A. Pain control B. Nutritional supplementation
specimen." C. Observation for mental changes
D. "Do not drink carbonated beverages for 8 hours before collecting D. Observation for intestinal obstruction
the specimen." 69. What are the three most common symptoms of cancer of the
55. A patient is admitted with anorexia, nausea and vomiting, and weight pancreas?
loss. When developing the plan of care, which information is a A. Dark urine, jaundice, and weight loss
priority to be obtained? (Select all that apply.) B. Jaundice, abdominal distention, and edema
A. Ability to cook own food B. Cultural preferences for food C. Dark stools, food intolerance, and weight loss
C. Dietary history D. Pattern of anorexia D. Pruritus, right upper quadrant pain, and weight gain
E. Factors that cause vomiting 70. The patient in the clinic has recently been diagnosed with viral
56. A patient has been diagnosed with gastritis. Which medication can the hepatitis. The nurse anticipates that which test will be used to predict
nurse anticipate will be prescribed? the virus's response to therapy?
A. Aspirin B. Carafate A. Genotype assay B. Molecular assay
C. Ampicillin D. Ranitidine C. Western blot test D. Enzyme immunoassay