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Adult Health-Gastrointestinal, Exams of Nursing

SUNY UlsterNursing

A series of questions and answers related to gastrointestinal health. The questions cover topics such as appendicitis, acute pancreatitis, cholecystitis, viral hepatitis, hemorrhoidectomy, gastroesophageal reflux disease, esophagogastroduodenoscopy, endoscopic retrograde cholangiopancreatography, duodenal ulcer, hiatal hernia, colostomy, ileostomy, and dumping syndrome. The answers provide nursing interventions, expected assessment findings, and client education. useful for nursing students studying adult health and preparing for the NCLEX RN exam.

Typology: Exams

2021/2022

Available from 08/25/2022

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1. The nurse is monitoring a client admitted to the hospital with a diagnosis of appendicitis
who is scheduled for surgery in 2 hours. The client begins to complain of increased
abdominal pain and begins to vomit. On assessment, the nurse notes that the abdomen is
distended and bowel sounds are diminished. Which is the most appropriate nursing
intervention?
1. Notify the health care provider (HCP).
2. Administer the prescribed pain medication.
3. Call and ask the operating room team to perform the surgery as soon as possible.
4. Reposition the client and apply a heating pad on the warm setting to the client's abdomen.
1. Notify the health care provider (HCP)
2. A client has been admitted to the hospital with a diagnosis of acute pancreatitis and the nurse
is assessing the client's pain. What type of pain is consistent with this diagnosis?
1. Burning and aching, located in the left lower quadrant and radiating to the hip
2. Severe and unrelenting, located in the epigastric area and radiating to the back
3. Burning and aching, located in the epigastric area and radiating to the umbilicus
4. Severe and unrelenting, located in the left lower quadrant and radiating to the groin
2. Severe and unrelenting, located in the epigastric area and radiating to the back
3. The nurse is assessing a client who is experiencing an acute episode of cholecystitis. Where
should the nurse anticipate the location of the pain?
1. Right lower quadrant, radiating to the back
2. Right lower quadrant, radiating to the umbilicus
3. Right upper quadrant, radiating to the left scapula and shoulder
4. Right upper quadrant, radiating to the right scapula and shoulder
4. Right upper quadrant, radiating to the right scapula and shoulder
4. A client is admitted to the hospital with viral hepatitis, complaining of "no appetite" and
"losing my taste for food." What instruction should the nurse give the client to provide
adequate nutrition?
1. Select foods high in fat.
2. Increase intake of fluids, including juices.
3. Eat a good supper when anorexia is not as severe.
4. Eat less often, preferably only three large meals daily.
2. Increase intake of fluids, including juices.
5. A client has developed hepatitis A after eating contaminated oysters. The nurse assesses the
client for which expected assessment finding?
1. Malaise
2. Dark stools
3. Weight gain
4. Left upper quadrant discomfort
1. Malaise
Author: nursedaisy98
ID: 256680
Card Set: Adult Health - Gastrointestinal
Updated: 4/20/2014
Tags: NCLEX RN
Description: Gastrointestinal
Show Answers:
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  1. The nurse is monitoring a client admitted to the hospital with a diagnosis of appendicitis who is scheduled for surgery in 2 hours. The client begins to complain of increased abdominal pain and begins to vomit. On assessment, the nurse notes that the abdomen is distended and bowel sounds are diminished. Which is the most appropriate nursing intervention?
    1. Notify the health care provider (HCP).
    2. Administer the prescribed pain medication.
    3. Call and ask the operating room team to perform the surgery as soon as possible.
    4. Reposition the client and apply a heating pad on the warm setting to the client's abdomen.
    5. Notify the health care provider (HCP)
  2. A client has been admitted to the hospital with a diagnosis of acute pancreatitis and the nurse is assessing the client's pain. What type of pain is consistent with this diagnosis?
    1. Burning and aching, located in the left lower quadrant and radiating to the hip
    2. Severe and unrelenting, located in the epigastric area and radiating to the back
    3. Burning and aching, located in the epigastric area and radiating to the umbilicus
    4. Severe and unrelenting, located in the left lower quadrant and radiating to the groin
    5. Severe and unrelenting, located in the epigastric area and radiating to the back
  3. The nurse is assessing a client who is experiencing an acute episode of cholecystitis. Where should the nurse anticipate the location of the pain?
    1. Right lower quadrant, radiating to the back
    2. Right lower quadrant, radiating to the umbilicus
    3. Right upper quadrant, radiating to the left scapula and shoulder
    4. Right upper quadrant, radiating to the right scapula and shoulder
    5. Right upper quadrant, radiating to the right scapula and shoulder
  4. A client is admitted to the hospital with viral hepatitis, complaining of "no appetite" and "losing my taste for food." What instruction should the nurse give the client to provide adequate nutrition?
    1. Select foods high in fat.
    2. Increase intake of fluids, including juices.
    3. Eat a good supper when anorexia is not as severe.
    4. Eat less often, preferably only three large meals daily.
    5. Increase intake of fluids, including juices.
  5. A client has developed hepatitis A after eating contaminated oysters. The nurse assesses the client for which expected assessment finding?
    1. Malaise
    2. Dark stools
    3. Weight gain
    4. Left upper quadrant discomfort
    5. Malaise Author: nursedaisy ID: 256680 Card Set: Adult Health - Gastrointestinal Updated: 4/20/ Tags: NCLEX RN Description: Gastrointestinal Show Answers:
  1. A client has just had a hemorrhoidectomy. Which nursing interventions are appropriate for this client? Select all that apply.
    1. Administer stool softeners as prescribed.
    2. Instruct the client to limit fluid intake to avoid urinary retention.
    3. Instruct the client to avoid activities that will initiate vasovagal responses.
    4. Encourage a high-fiber diet to promote bowel movements without straining.
    5. Apply cold packs to the anal-rectal area over the dressing until the packing is removed.
    6. Help the client to a Fowler's position to place pressure on the rectal area and decrease bleeding. o 1. Administer stool softeners as prescribed. o 4. Encourage a high-fiber diet to promote bowel movements without straining. o 5. Apply cold packs to the anal-rectal area over the dressing until the packing is removed.
  2. The nurse is planning to teach a client with gastroesophageal reflux disease about substances to avoid. Which items should the nurse include on this list? Select all that apply.
    1. Coffee
    2. Chocolate
    3. Peppermint
    4. Nonfat milk
    5. Fried chicken
    6. Scrambled eggs o 1. Coffee o 2. Chocolate o 3. Peppermint o 5. Fried chicken
  3. A client has undergone esophagogastroduodenoscopy. The nurse should place highest priority on which item as part of the client's care plan?
    1. Monitoring the temperature
    2. Monitoring complaints of heartburn
    3. Giving warm gargles for a sore throat
    4. Assessing for the return of the gag reflex
    5. Assessing for the return of the gag reflex
  4. The nurse has taught the client about an upcoming endoscopic retrograde cholangiopancreatography procedure. The nurse determines that the client needs further information if the client makes which statement?
    1. "I know I must sign the consent form."
    2. "I hope the throat spray keeps me from gagging."
    3. "I'm glad I don't have to lie still for this procedure."
    4. "I'm glad some IV medication will be given to relax me."
  1. Eat high-carbohydrate foods.
  2. Limit the fluids taken with meals.
  3. Sit in a high Fowler's position during meals.
  4. Limit the fluids taken with meals.
  5. The nurse is reviewing the prescription for a client admitted to the hospital with a diagnosis of acute pancreatitis. Which interventions would the nurse expect to be prescribed for the client? Select all that apply.
  6. Administer antacids as prescribed.
  7. Encourage coughing and deep breathing.
  8. Administer anticholinergics as prescribed.
  9. Give small, frequent high-calorie feedings.
  10. Maintain the client in a supine and flat position.
  11. Give opioid analgesics as prescribed for pain. o 1. Administer antacids as prescribed. o 2. Encourage coughing and deep breathing. o 3. Administer anticholinergics as prescribed. o 6. Give opioid analgesics as prescribed for pain.
  12. The nurse is reviewing the record of a client with Crohn's disease. Which stool characteristic should the nurse expect to note documented in the client's record?
  13. Diarrhea
  14. Chronic constipation
  15. Constipation alternating with diarrhea
  16. Stool constantly oozing from the rectum
  17. Diarrhea
  18. The nurse is reviewing the record of a client with a diagnosis of cirrhosis and notes that there is documentation of the presence of asterixis. How should the nurse assess for its presence?
  19. Dorsiflex the client's foot.
  20. Measure the abdominal girth.
  21. Ask the client to extend the arms.
  22. Instruct the client to lean forward.
  23. Ask the client to extend the arms.
  24. The nurse is reviewing the laboratory results for a client with cirrhosis and notes that the ammonia level is elevated. Which diet does the nurse anticipate to be prescribed for this client?
  25. Low-protein diet
  26. High-protein diet
  27. Moderate-fat diet
  28. High-carbohydrate diet
  1. Low-protein diet
  2. The nurse is doing an admission assessment on a client with a history of duodenal ulcer. To determine whether the problem is currently active, the nurse should assess the client for which symptom(s) of duodenal ulcer?
  3. Weight loss
  4. Nausea and vomiting
  5. Pain relieved by food intake
  6. Pain radiating down the right arm
  7. Pain relieved by food intake
  8. A client with hiatal hernia chronically experiences heartburn following meals. The nurse should plan to teach the client to avoid which action because it is contraindicated with a hiatal hernia?
  9. Lying recumbent following meals
  10. Consuming small, frequent, bland meals
  11. Raising the head of the bed on 6-inch blocks
  12. Taking H2-receptor antagonist medication
  13. Lying recumbent following meals
  14. The nurse is assessing for stoma prolapse in a client with a colostomy. What should the nurse observe if stoma prolapse occurs?
  15. Protruding stoma
  16. Sunken and hidden stoma
  17. Narrowed and flattened stoma
  18. Dark- and bluish-colored stoma
  19. Protruding stoma
  20. A client had a new colostomy created 2 days earlier and is beginning to pass malodorous flatus from the stoma. What is the correct interpretation by the nurse?
  21. This is a normal, expected event.
  22. The client is experiencing early signs of ischemic bowel.
  23. The client should not have the nasogastric tube removed.
  24. This indicates inadequate preoperative bowel preparation.
  25. This is a normal, expected event.
  26. A client has just had surgery to create an ileostomy. The nurse assesses the client in the immediate postoperative period for whichmost frequent complication of this type of surgery?
  27. Folate deficiency
  28. Malabsorption of fat
  29. Intestinal obstruction
  30. Fluid and electrolyte imbalance
  31. Fluid and electrolyte imbalance
  32. The nurse is doing preoperative teaching with a client who is about to undergo creation of a Kock pouch. The nurse interprets that the client has the best understanding of the nature of
  1. "Take a deep breath when I tell you and breathe normally while I remove the tube."
  2. "Take a deep breath when I tell you and hold it while I remove the tube."
  3. The nurse is caring for a client with a resolved intestinal obstruction who has a nasogastric tube in place. The client has tolerated the tube being clamped every 2 hours for 1 hour. The health care provider has now prescribed that the nasogastric tube be removed. What is the priority nursing assessment prior to removing the tube?
  4. Checking for normal serum electrolyte levels
  5. Checking for normal pH of the gastric aspirate
  6. Checking for proper nasogastric tube placement
  7. Checking for the presence of bowel sounds in all four quadrants
  8. Checking for the presence of bowel sounds in all four quadrants
  9. A sexually active 20-year-old client has developed viral hepatitis. Which client statement indicates the need for further teaching?
  10. "I should avoid drinking alcohol."
  11. "I can go back to work right away."
  12. "My partner should get the vaccine."
  13. "A condom should be used for sexual intercourse."
  14. "I can go back to work right away."
  15. The nurse is caring for a client admitted to the hospital with a suspected diagnosis of acute appendicitis. Which laboratory result should the nurse expect to note if the client does have appendicitis?
  16. Leukopenia with a shift to the left
  17. Leukocytosis with a shift to the left
  18. Leukopenia with a shift to the right
  19. Leukocytosis with a shift to the right
  20. Leukocytosis with a shift to the left
  21. After performing an initial abdominal assessment on a client with a diagnosis of cholelithiasis, the nurse documents that the bowel sounds are normal. Which descriptionbest describes "normal bowel sounds"?
  22. Waves of loud gurgles auscultated in all four quadrants
  23. Low-pitched swishing auscultated in one or two quadrants
  24. Relatively high-pitched clicks or gurgles auscultated in all four quadrants
  25. Very high-pitched loud rushes auscultated especially in one or two quadrants
  26. Relatively high-pitched clicks or gurgles auscultated in all four quadrants
  27. After undergoing Billroth I gastric surgery, the client experiences fatigue and complains of numbness and tingling in the feet and difficulties with balance. On the basis of these symptoms, the nurse suspects which postoperative complication?
  28. Stroke
  29. Pernicious anemia
  30. Bacterial meningitis
  31. Peripheral arterial disease
  1. Pernicious anemia
  2. A client experiencing chronic dumping syndrome makes the following comments to the nurse. Which one indicates the need for further teaching?
  3. "I eat at least three large meals each day."
  4. "I eat while lying in a semirecumbent position."
  5. "I have eliminated taking liquids with my meals."
  6. "I eat a high-protein, low- to moderate-carbohydrate diet."
  7. "I eat at least three large meals each day."
  8. The nurse obtains an admission history for a client with suspected peptic ulcer disease. Which client factor documented by the nurse would increase the risk for peptic ulcer disease?
  9. Recently retired from a job
  10. Significant other has a gastric ulcer
  11. Occasionally drinks one cup of coffee in the morning
  12. Takes nonsteroidal anti-inflammatory drugs (NSAIDs) for osteoarthritis
  13. Takes nonsteroidal anti-inflammatory drugs (NSAIDs) for osteoarthritis
  14. A client who has undergone gastric surgery has a nasogastric (NG) tube connected to low intermittent suction that is not draining properly. Which action should the nurse take initially?
  15. Call the surgeon to report the problem.
  16. Reposition the NG tube to the proper location.
  17. Check the suction device to make sure it is working.
  18. Irrigate the NG tube with saline to remove the obstruction.
  19. Check the suction device to make sure it is working.
  20. In performing a physical assessment of a client with a diagnosis of ulcerative colitis, the nurse should expect which finding?
  21. Hypercalcemia
  22. Fibrous stricture
  23. Frothy, fatty stools
  24. Decreased hemoglobin
  25. Decreased hemoglobin
  26. A client with acute ulcerative colitis requests a snack. Which would be the most appropriatesnack for this client?
  27. Carrots and ranch dip
  28. Whole-grain cereal and milk
  29. A cup of popcorn and a cola drink
  30. Applesauce and a graham cracker
  31. Applesauce and a graham cracker
  32. The nurse is teaching the client with viral hepatitis about the stages of the disease. The nurse should explain to the client that the second stage of this disease is characterized by which specific assessment findings? Select all that apply.
  1. A protrusion of the bowel with an elongated, swollen appearance of the stoma
  2. The nurse is providing instructions to a client with a colostomy about measures to reduce the odor from the colostomy. Which statement, if made by the client, indicates an understanding of these measures?
  3. "I should be sure to eat at least one cucumber every day."
  4. "Beet greens, parsley, or yogurt will help to control the colostomy odor."
  5. "I will need to increase my egg intake and try to eat ½ to 1 egg per day."
  6. "Green vegetables such as spinach and broccoli will prevent odor, and I should eat these foods every day."
  7. "Beet greens, parsley, or yogurt will help to control the colostomy odor."
  8. The nurse has provided dietary instructions to a client with a diagnosis of peptic ulcer disease. Which statement, if made by the client, indicates an understanding of the dietary measures to take?
  9. "Baked foods such as chicken or fish are all right to eat."
  10. "Citrus fruits and raw vegetables need to be included in my daily diet."
  11. "I can drink beer so long as I consume only a moderate amount each day."
  12. "I can drink coffee or tea so long as I limit the amount to two cups daily."
  13. "Baked foods such as chicken or fish are all right to eat."
  14. The nurse has provided home care instructions to a client who had a subtotal gastrectomy. The nurse instructs the client regarding the signs and symptoms associated with dumping syndrome. Which signs and symptoms, if identified by the client, would indicate an understanding of this potential complication after gastrointestinal (GI) surgery?
  15. Hiccups and diarrhea
  16. Constipation and fever
  17. Diaphoresis and diarrhea
  18. Fatigue and abdominal pain
  19. Diaphoresis and diarrhea
  20. The nurse is providing instructions to a client regarding measures to minimize the risk of dumping syndrome. The nurse should make which suggestion to the client?
  21. Maintain a high-carbohydrate diet.
  22. Increase fluid intake, particularly at meal time.
  23. Maintain a low Fowler's position while eating.
  24. Ambulate for at least 30 minutes following each meal.
  25. Maintain a low Fowler's position while eating.
  26. A client with peptic ulcer disease states that stress frequently causes exacerbation of the disease. The nurse determines that which item mentioned by the client is most likely to be responsible for the exacerbation?
  27. Sleeping 8 to 10 hours a night
  28. Ability to work at home periodically
  29. Eating five or six small meals per day
  30. Frequent need to work overtime on short notice
  1. Frequent need to work overtime on short notice
  2. The nurse is giving dietary instructions to a client who has a new colostomy. The nurse should encourage the client to eat foods representing which diet for the first 4 to 6 weeks postoperatively?
  3. Low fiber
  4. Low calorie
  5. High protein
  6. High carbohydrate
  7. Low fiber
  8. A client with viral hepatitis is discussing with the nurse the need to avoid alcohol and states, "I'm not sure I can avoid alcohol." What is the most appropriate nursing response?
  9. "I don't believe that."
  10. "Everything will be all right."
  11. "I'm not sure that I understand. Would you please explain?"
  12. "I think you should talk more with the health care provider (HCP) about this."
  13. "I'm not sure that I understand. Would you please explain?"
  14. A client is hospitalized with a diagnosis of viral hepatitis. To detect any difficulty in coping with this disease, the nurse should ask which question?
  15. "Do you have a fever?"
  16. "Are you losing weight?"
  17. "Have you enjoyed having visitors?"
  18. "Do you rest sometime during the day?"
  19. "Have you enjoyed having visitors?"
  20. A client with viral hepatitis states, "I am so yellow." What is the most appropriate nursing action?
  21. Assist the client in expressing feelings.
  22. Restrict visitors until the jaundice subsides.
  23. Perform most of the activities of daily living for the client.
  24. Provide information to the client only when he or she requests it.
  25. Assist the client in expressing feelings.
  26. A client with viral hepatitis has no appetite, and food makes the client nauseated. Which nursing intervention would be most appropriate?
  27. Encourage foods that are high in protein.
  28. Monitor for fluid and electrolyte imbalance.
  29. Explain that high-fat diets usually are better tolerated.
  30. Explain that most daily calories need to be consumed in the evening hours.
  31. Monitor for fluid and electrolyte imbalance.
  32. A nurse has implemented a bowel maintenance program for an unconscious client. The nurse would evaluate the plan asbest meeting the needs of the client if which method was successful in stimulating a bowel movement?
  33. Fleet enema
  1. Hematemesis
  2. A client in a long-term care facility is being prepared to be discharged to home in 2 days. The client has been eating a regular diet for a week; however, he is still receiving intermittent enteral tube feedings and will need to receive these feedings at home. The client states concern that he will not be able to continue the tube feedings at home. Which nursing response is most appropriate at this time?
  3. "Do you want to stay here in this facility a few more days?"
  4. "Have you discussed your feelings with your health care provider?"
  5. "You need to talk to your health care provider about these findings."
  6. "Tell me more about your concerns with your diet after going home."
  7. "Tell me more about your concerns with your diet after going home."
  8. The nurse is performing an assessment on a client with a suspected diagnosis of acute pancreatitis. The nurse will direct the assessment to look for which as a hallmark sign of this disorder?
  9. Hypothermia
  10. Epigastric pain radiating to the neck area
  11. Severe abdominal pain relieved by vomiting
  12. Severe abdominal pain that is unrelieved by vomiting
  13. Severe abdominal pain that is unrelieved by vomiting
  14. The nurse is reviewing the record of a client admitted to the nursing unit and notes that the client has a history of Laennec's cirrhosis. This type of cirrhosis is most commonly caused by which long-term condition?
  15. Alcohol abuse
  16. Cardiac disease
  17. Exposure to chemicals
  18. Obstruction to biliary ducts
  19. Alcohol abuse
  20. The nurse who is caring for a client with a diagnosis of cirrhosis is monitoring the client for signs of portal hypertension. Which initialsign, if noted in the client, indicates the presence of portal hypertension?
  21. Weak pulse
  22. Hypotension
  23. Flat neck veins
  24. Crackles on auscultation of the lungs
  25. Crackles on auscultation of the lungs
  26. The nurse is developing a plan of care for a client with cirrhosis and ascites. Which nursing actions should be included in the care plan for this client? Select all that apply.
  27. Monitor daily weight.
  28. Measure abdominal girth.
  29. Monitor respiratory status.
  30. Place the client in a supine position.
  31. Assist the client with care as needed.

o 1. Monitor daily weight. o 2. Measure abdominal girth. o 3. Monitor respiratory status. o 5. Assist the client with care as needed.

  1. The nurse is monitoring a client with cirrhosis of the liver for signs of hepatic encephalopathy. Which assessment finding would the nurse note as an early sign of hepatic encephalopathy?
    1. Restlessness
    2. Complaints of fatigue
    3. The presence of asterixis
    4. Decreased serum ammonia levels
    5. The presence of asterixis
  2. A home care nurse is visiting a client with a diagnosis of pernicious anemia that developed as a result of gastric surgery. In teaching the client about this condition, the nurse explains that the stomach lining is producing a decreased amount of intrinsic factor, so the client will need which medication?
    1. An antacid
    2. An antibiotic
    3. Vitamin B 6 injections
    4. Vitamin B 12 injections
    5. Vitamin B 12 injections
  3. A client arrives at the hospital emergency department complaining of acute right lower quadrant abdominal pain, and appendicitis is suspected. Laboratory tests are performed, and the nurse notes that the client's white blood cell (WBC) count is elevated. On the basis of these findings, the nurse would question which health care provider's (HCP) prescriptions documented in the client's medical record?
    1. Apply a cold pack to the abdomen.
    2. Administer 30 mL of milk of magnesia (MOM).
    3. Maintain nothing-by-mouth (nil per os [NPO]) status.
    4. Initiate an intravenous (IV) line for the administration of IV fluids.
    5. Administer 30 mL of milk of magnesia (MOM).
  4. A health care provider (HCP) prescribes a Salem sump tube for gastrointestinal intubation. The nurse prepares for the insertion and obtains which item from the supply room?
    1. A Dobbhoff weighted tube
    2. A Sengstaken-Blakemore tube
    3. A tube with a large lumen and an air vent
    4. A tube with a single lumen that connects to suction
    5. A tube with a large lumen and an air vent
  5. The nurse is preparing to insert a nasogastric (NG) tube as prescribed for the purpose of

o 3. Inguinal or umbilical hernia o 5. Abdominal distention and tenderness

  1. A client has been advanced to a solid diet after undergoing a subtotal gastrectomy. The nurse caring for the client would perform which action to minimize the risk of dumping syndrome?
    1. Remove fluids from the meal tray.
    2. Give the client two large meals per day.
    3. Ask the client to sit up for 1 hour after eating.
    4. Provide concentrated, high-carbohydrate foods.
    5. Remove fluids from the meal tray.
  2. The ambulatory care nurse is providing instructions to a client who is scheduled for a small bowel biopsy. What should the nurse tell the client?
    1. Clear liquids only are allowed on the day of the test.
    2. A signed informed consent form will need to be obtained.
    3. A tube will be inserted through the rectum to obtain the tissue sample.
    4. A full liquid diet will need to be maintained for 48 hours after the procedure.
    5. A signed informed consent form will need to be obtained.
  3. A client has been diagnosed with gastroesophageal reflux disease (GERD). The nurse plans care, knowing that the client has dysfunction of which part of the digestive system?
    1. Chief cells of the stomach
    2. Parietal cells of the stomach
    3. Lower esophageal sphincter (LES)
    4. Upper esophageal sphincter (UES)
    5. Lower esophageal sphincter (LES)
  4. A client is experienced delayed gastric emptying. The nurse plans care, knowing that dysfunction of which structures is responsible for the client's symptoms?
    1. Ileum
    2. Jejunum
    3. Pyloric sphincter
    4. Cardiac sphincter
    5. Pyloric sphincter
  5. A client who has had a gastrectomy is not producing sufficient intrinsic factor. The nurse plans care, knowing that the client has lost the ability to absorb cyanocobalamin (vitamin B 12 ) in which abdominal structure?
    1. Colon
    2. Stomach
    3. Large intestine
    4. Small intestine
    5. Small intestine
  6. A client with a diagnosis of stomach ulcer from gastric hyperacidity asks the nurse why the

acid has not caused an ulcer in the small intestine as well. The nurse responds that the pH of intestinal contents is raised by bicarbonate, which is present in which area of the body?

  1. Bile
  2. Parietal cells
  3. Liver enzymes
  4. Pancreatic juice
  5. Pancreatic juice
  6. A client with appendicitis is scheduled for an appendectomy. The nurse providing preoperative teaching for the client describes the location of the appendix by stating that it is attached to which part of the gastrointestinal system?
  7. Ileum
  8. Cecum
  9. Rectum
  10. Jejunum
  11. Cecum
  12. A nurse is caring for a hospitalized client who has been diagnosed with pancreatitis. The nurse checks the laboratory results form, anticipating that which enzyme will remain normal in the client?
  13. Lipase
  14. Lactase
  15. Trypsin
  16. Amylase
  17. Lactase
  18. A nurse is caring for a group of clients on the surgical nursing unit. The nurse anticipates that the client who underwent which procedure is most likely to have some long-term residual difficulty with absorption of nutrients?
  19. Colectomy
  20. Appendectomy
  21. Ascending colostomy
  22. Small bowel resection
  23. Small bowel resection
  24. A client with spinal cord injury (SCI) is participating in a bowel retraining program. The nurse develops a plan that is based in part on the knowledge that defecation is normally a result of which phenomena?
  25. Sufficiently low water content in the stool
  26. Low intestinal roughage that promotes easier digestion
  27. Constriction of the anal sphincter based on voluntary control
  28. Stimulation of the parasympathetic reflex center at the S1 to S4 level in the spinal cord
  29. Stimulation of the parasympathetic reflex center at the S1 to S4 level in the spinal cord
  30. A client is experiencing blockage of the common bile duct. The nurse anticipates that the client's diet will be altered because the client will experience difficulty digesting which
  1. Cystic duct
  2. Liver canaliculi
  3. Common bile duct
  4. Right hepatic duct
  5. Cystic duct
  6. A client with liver dysfunction exhibits low serum levels of thrombin. The nurse provides care, knowing that this client is most at risk for which complication?
  7. Bleeding
  8. Infection
  9. Dehydration
  10. Malnutrition
  11. Bleeding
  12. A nurse who is caring for an older client is aware that the client is at risk for prolonged medication effects as a result of the normal aging process. The nurse would be most concerned with this effect if the client had a history of disease of which organ?
  13. Liver
  14. Stomach
  15. Pancreas
  16. Gallbladder
  17. Liver
  18. A hospitalized client is diagnosed with pancreatitis. The nurse plans care, knowing that production of which substance will be elevated in blood studies for this client?
  19. Pepsin
  20. Lactase
  21. Amylase
  22. Enterokinase
  23. Amylase
  24. A client with gastric hypersecretion is scheduled for surgery. The nurse teaches the client that the procedure will lessen the stomach's production of acid by altering which structure?
  25. Portal vein
  26. Celiac artery
  27. Vagus nerve
  28. Pyloric valve
  29. Vagus nerve
  30. Lactulose (Chronulac) is prescribed for a hospitalized client with a diagnosis of hepatic encephalopathy. Which assessment finding indicates that the client is responding to this medication therapy as anticipated?
  31. Vomiting occurs.
  32. The fecal pH is acidic.
  33. The client experiences diarrhea.
  34. The client is able to tolerate a full diet.
  1. The fecal pH is acidic.
  2. Cholestyramine resin (Questran Light) is prescribed for a client with an elevated serum cholesterol level. The nurse should instruct the client to take the medication in which way?
  3. After meals
  4. Mixed with fruit juice
  5. Via a rectal suppository
  6. At least 3 hours before meals
  7. Mixed with fruit juice
  8. Pancreatin (Viokase) is prescribed for a client with postgastrectomy syndrome. Which assessment finding would indicate a therapeutic effect of this medication?
  9. The client's appetite improves.
  10. The client experiences weight loss.
  11. Vitamin B 12 deficiency is controlled.
  12. The stool is less fatty and decreases in frequency.
  13. The stool is less fatty and decreases in frequency.
  14. The nurse is evaluating the plan of care for a client with peptic ulcer disease (PUD) who is experiencing acute pain. The nurse determines that the expected outcomes have not been met if the nursing assessment reveals which result?
  15. The client's pain is relieved with histamine-2 receptor antagonists.
  16. The client has eliminated any irritating foods from the diet.
  17. The client frequently is awakened at 2 am with heartburn.
  18. The client reports absence of pain before meals.
  19. The client frequently is awakened at 2 am with heartburn.
  20. A client with a history of gastric ulcer complains of a sudden, sharp, severe pain in the midepigastric area, which then spreads over the entire abdomen. The client's abdomen is rigid and boardlike on palpation, and the client obtains most comfort from lying in the knee- chest position. The nurse calls the health care provider immediately, suspecting that the client is experiencing which complication of peptic ulcer disease?
  21. Perforation
  22. Obstruction
  23. Hemorrhage
  24. Intractability
  25. Perforation
  26. A client is readmitted to the hospital with dehydration after surgery for creation of an ileostomy. The nurse assesses that the client has lost 3 lb of weight, has poor skin turgor, and has concentrated urine. The nurse interprets the client's clinical picture as correlating most closely with recent intake of which medication, which is contraindicated for the ileostomy client?
  27. Folate (folic acid)
  28. Sennosides (Ex-Lax)
  29. Ferrous sulfate (Feosol)
  30. Cyanocobalamin (vitamin B 12 )