Nursing Theory 2: Gastrointestinal

Front

A nurse is reinforcing dietary teaching with a client who has ulcerative colitis. Which of the following food selections by the client indicates an understanding of the teaching? Raw vegetable salad with low-fat dressing, Roasted chicken and white rice, Fresh fruit salad and milk, Peanut butter on whole wheat bread

Back

Roasted chicken and white rice

Answer explanation

Clients who have ulcerative colitis are restricted to a low-fiber diet, which omits whole grains and raw fruits and vegetables. Roasted chicken with white rice is the best choice.

Front

A nurse is reviewing the laboratory results of a client who is taking a medication and notes that the client's blood tests show an elevated level of the enzymes aspartate aminotransferase (AST) and alanine aminotransferase (ALT). The nurse should recognize that these findings are potential indications of which of the following conditions?

Back

Hepatic toxicity

Answer explanation

The nurse should identify that elevated levels of aspartate aminotransferase (AST) and alanine aminotransferase (ALT) are indications the client might be at risk for hepatic toxicity. AST and ALT are enzymes that test liver function. Therefore, this should indicate to the nurse that the medication the client is taking is damaging to the liver. The client should undergo liver function tests, and the nurse should notify the provider of this finding.

Front

A nurse is reinforcing discharge teaching with a client who has a newly placed ileostomy about ostomy care while at home. Which of the following instructions should the nurse include in the teaching? "Empty your ostomy pouch when it gets half full."

Back

"Empty your ostomy pouch when it gets half full."

Answer explanation

The nurse should instruct the client to empty the ostomy pouch when it is a third to half full. This prevents the ostomy from becoming too full of stool or gas and exploding.

Front

A nurse is reinforcing teaching about dietary modifications for a client with newly diagnosed with cirrhosis. Which of the following foods should the nurse recommend? Grilled chicken, Potato soup, Fish sticks, Baked ham

Back

Grilled chicken

Answer explanation

 A client who has cirrhosis requires protein to compensate for the weight loss as a result of the disease. Increasing protein intake from animal or plant sources will also provide more energy.

Front

A nurse is recommending dietary modifications for a client who has GERD. The nurse should suggest eliminating which of the following foods from the client's diet? Oranges and tomatoes, Carrots and bananas, Potatoes and squash, Whole grains and beans

Back

Oranges and tomatoes

Answer explanation

Symptoms of GERD worsen following oral intake of substances that decrease lower esophageal stricture (LES) pressure. These include alcohol, caffeine, nicotine, chocolate, fatty foods, citrus fruits, tomatoes, and peppermint.

Front

What is the difference between colostomies and ileostomies?

Back

A colostomy is from the large intestine and an ileostomy is from the small intestine.

Answer explanation

The name of the ostomy reflects the region the surgeon brings to the surface of the abdominal wall. Therefore, when the colon is the site of surgery, the site is a colostomy (colon + ostomy). When the ileum is the site of surgical intervention, the abdominal stoma is an ileostomy (ileum + ostomy).

Front

A nurse is reinforcing teaching with a client who has diverticulitis about preventing acute attacks. Which of the following foods should the nurse recommend? Foods high in vitamin C, Foods low in fat, Foods high in fiber, Foods low in calories

Back

Foods high in fiber

Answer explanation

The result of long-term, low-fiber eating habits along with increased intracolonic pressure lead to straining during bowel movements, causing the development of diverticula. High-fiber foods help strengthen and maintain active motility of the gastrointestinal tract.

Front

A nurse is caring for a client who is scheduled to undergo a liver biopsy for a suspected malignancy. Which laboratory finding should the nurse monitor prior to the procedure? Options: Prothrombin time, Serum lipase, Bilirubin, Calcium

Back

Prothrombin time

Answer explanation

A major complication following a liver biopsy is hemorrhage. Many clients who have liver disease have clotting defects and are at risk for bleeding. Along with the prothrombin time (PT), activated partial thromboplastin time (aPTT) and platelet count should be monitored. Liver dysfunction reduces the production of blood clotting factors, which leads to an increased incidence of bruising, nosebleeds, bleeding from wounds, and gastrointestinal bleeding. This is due to a deficient absorption of vitamin K from the gastrointestinal tract caused by the inability of liver cells to use vitamin K to make prothrombin.

Front

A nurse is replacing the ostomy appliance for a client whose newly created colostomy is functioning. After removing the pouch, which action should the nurse take first? Options: Measure the stoma, Cover the stoma with gauze, Remove the backing on the skin barrier, Cleanse the stoma and the peristomal skin.

Back

Cleanse the stoma and the peristomal skin.

Answer explanation

The first action the nurse should take is to remove any effluent adhering to the stoma and the peristomal skin to facilitate the assessment of the area.

Front

A nurse is teaching a client about extended-wear skin barriers. Which strategy should the nurse instruct the client to use for maximal adherence? Options: Use an oil-based lotion on the peristomal area., Apply the skin barrier while the skin is slightly moist., Leave the residue from the previous appliance on the skin., Press gently around the barrier for 30 seconds to 1 min.

Back

Press gently around the barrier for 30 seconds to 1 min.

Answer explanation

The nurse should instruct the client to press gently around to barrier for 30 seconds to 1 min because the pressure-sensitive tackifiers and heat-sensitive polymers of the skin barrier require adequate pressure and warmth (from the fingers) to ensure adherence.