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WorksheetsCH 45 Care of the Patient With a GI Disorder
Total questions: 43
Worksheet time: 24mins
The nurse clarifies that the end product of food is absorbed and put into the bloodstream by which anatomical feature?
gastric lining of the stomach.
villi of the small intestine.
bile of the liver in the large intestine.
excretion from the cecum.
A 56-year-old man is admitted to the emergency room with an acute attack of diverticulitis. The patient has a temperature of 102°F, and has an elevated white count. Which assessment would alert the nurse to impending septic shock?
Chest pain
Seizure
Tachycardia
Massive diarrhea
Because bowel contents from an ileostomy are virtually liquid, which does the nurse expect to see in the plan of care?
Evaluation and assessment of dietary intake of fiber
Evaluation and assessment of patient cleanliness
Evaluation and assessment of peristomal skin integrity
Evaluation and assessment of the adequacy of the collection device
The home health nurse caring for a patient who has dysarthria related to radiation therapy for an oral cancer would recommend that the family provide which device?
a tablet and pencil as a communication aid.
a TV for diversion.
a bell to summon help.
a walkie-talkie.
Which recommendation is most appropriate for a patient who has had an esophageal dilation related to achalasia?
Consume only liquid.
Avoid fruit juices.
Drink 10 oz of fluid with each meal.
Lie down for 30 minutes after each meal.
A patient who is being evaluated for episodes of hematemesis and dyspepsia tells the nurse that pain occurs when he eats, but pain does not waken him. The nurse recognizes a diagnostic sign of which condition?
Duodenal ulcer
Gastritis
Achalasia
Peptic ulcer
The nurse anticipates that the patient who has had a subtotal gastrectomy will need which type of supplement?
protein due to the loss of some of the digestive processes.
vitamin B12 due to the loss of the loss of the intrinsicfactor.
bulk to prevent constipation.
vitamin A due to the loss of the gastric lining.
The home health nurse is caring for a patient who has frequent bouts of diverticulitis accompanied by increased flatulence, diarrhea, and nausea. Which is the most appropriate suggestion to lessen these symptoms?
Eat a diet high in fiber content.
Increase dietary fat intake.
Exercise to increase intraabdominal pressure.
Take daily laxatives.
The nurse caring for a patient with a peptic ulcer who has had a nasogastric tube inserted notes bright blood in the tube; the patient complains of pain and has become hypotensive. Which condition should the nurse recognize these as signs of?
Hiatal hernia
Gastritis
Perforation
Bowel obstruction
Dumping syndrome after a Billroth II procedure occurs when high-carbohydrate foods are ingested over a period of less than 20 minutes. Which will the nurse suggest to reduce the risk of dumping syndrome?
Eating a high-carbohydrate diet
Drinking 10 oz of fluids with meals
Remaining upright for 2 hours after meals
Eating six small daily meals high in protein and fat
The patient has come to the PACU following an ileostomy for the treatment of ulcerative colitis. The patient is conscious and has a nasogastric tube in place and a pouch over the stoma. What should be the nurse’s initial action?
Turn patient to right side.
Give patient ice chips to moisten mouth.
Attach NG tube to suction.
Irrigate NG tube.
The home health nurse evaluates a patient being treated for a peptic ulcer with an antacid and famotidine (histamine receptor blocker). Which statement made by the patient indicates a need for further instruction?
I know famotidine will not interfere with my Coumadin.
I take the antacid at least 2 hours after any of my other drugs.
Boy! That antacid keeps my stomach happy!
I take both those meds at the same time every morning.
What should a nurse do when obtaining a stool specimen to be examined for ova and parasites?
Use an oil retention enema to facilitate collection.
Refrigerate the specimen immediately.
Obtain three different stool specimens on subsequent days.
Check the specimen for the presence of occult blood.
The nurse explains to the patient with Crohn disease that the tube feedings are placed for which reason?
rapid absorption in the upper GI tract.
decompression of the stomach.
reduction of diarrheic episodes.
a permanent nutritional support.
A patient with a large inguinal hernia has abdominal distention and inguinal pain. The nurse recognizes these as indicators of which type of hernia?
Strangulated
Hiatal
Ventral
Umbilical
For which patient is misoprostol contraindicated?
An older adult
A pregnant female
A patient taking daily aspirin
A patient taking a proton pump inhibitor
A male patient reports that he will never adjust to his colostomy. Which is the best action for the nurse in this situation?
Encourage him to express his concern.
Suggest that he discuss his concerns with his physician.
Counsel him that everything will be all right.
Assure him that his concerns will diminish when he is able to care for his colostomy.
In caring for a patient with gastric bleeding who has a nasogastric (NG) tube in place, the nurse expects to see which intervention for the nasogastric tube included in the plan of care?
clamp for 10 minutes every hour.
keep the patient with irrigation.
frequently reposition to the opposite nostril.
change every 72 hours.
Which will the nurse include when reinforcing the teaching plan for a patient with a hiatal hernia to reduce the frequency of heartburn?
Drinking 10 oz of milk with every meal
Lie down after eating
Panting through mouth when symptoms begin
Eating small meals
The nurse points out which is an example of a nonmechanical bowel obstruction?
A paralytic ileus
Narrowed bowel lumen from an inflammatory process
Tumor of the bowel
Fecal impaction
Bowel sound assessment on a patient with an early bowel obstruction who has distention, nausea, and visible peristaltic waves will demonstrate which type of bowel sound?
loud and clearly audible.
high pitched.
hyperactive.
absent.
The patient with a peptic ulcer has been placed on regular doses of bismuth salicylate to combat Helicobacter pylori. What color will this drug turn the stool?
Gray-black
Dark green
Red-orange
Yellow
Which will the nurse reinforce in the patient teaching of a patient who had a gastrectomy to treat a severely bleeding peptic ulcer?
Introducing irritating foods in minute amounts to desensitize the stomach
Restricting fluid to 1000 mL per day
Eating 6 small meals a day
Drinking alcohol and caffeine in moderation
Which will be the most helpful nursing intervention to increase the comfort of a patient with appendicitis?
Applying of ice bag
Administration of small tap water enema
Warm compress over entire abdomen
Ambulate for short periods in the room
To assist a family with a bowel-training program to reduce fecal incontinence, the nurse would suggest the use of which item at an optimal time to stimulate defecation?
warm bath
a tap water enema
glycerin suppository
large glass of warm lemonade
What is the most lethal complication of a peptic ulcer?
Bleeding
Perforation
Severe pain
Gastric outlet obstruction
The nurse takes into consideration that a proton pump inhibitor drug, such as which drug, will completely eradicate gastric acid production?
omeprazole
misoprostol
sucralfate
olsalazine
Which is the purpose of antibiotic therapy in treating peptic ulcers?
It eradicates H. pylori.
It inhibits gastric acid secretion.
It protects the gastric mucosa.
It neutralizes or reduces the acidity of stomach contents.
Why are peptic ulcers a common problem of aging?
Older adults develop esophageal diverticula
Older adults have a higher incidence of hiatal hernia
Older adults use nonsteroidal anti-inflammatory drugs to treat chronic joint conditions
Older adults have decreased secretion of hydrochloric acid from the parietal cells of the stomach.
The patient with irritable bowel syndrome tells the home health nurse she is going to an acupuncturist for therapy for her condition. Which will be the best nursing response?
Go for it. Alternative medicine does great things.
YIKES! An acupuncturist?
Some people have found relief from nausea and colon muscle spasms.
“You should confirm that the acupuncturist and facility are state licensed.”
During the annual physical examination, the nurse will assess for which risk factor for the development of diverticulosis?
Chronic diarrhea
Excessive fiber intake
Increased intake of refined carbohydrates
Aging related increased elasticity of the colon
Which change in the body leads to poor absorption of nutrients in a patient who has celiac disease?
Development of diverticuli
Anaphylactic reaction to wheat
Destruction of the intestinal villi
Reduced intestinal mucosal output
Which are indicators of colorectal cancer? (Select all that apply.)
Abdominal pain
Cachexia
Cramps
Rectal bleeding
Anemia
The indicators for colorectal cancer are changing bowel habits, abdominal pain, cachexia, cramps, rectal bleeding, and anemia. Which of the following are indicators for colorectal cancer?
Abdominal pain
Cachexia
Cramps
Rectal bleeding
Constipation
How will the nurse counsel the 34-year-old woman who has been prescribed sulfasalazine for Crohn disease?
Expose her to sunlight at least 30 minutes a day for vitamin D synthesis.
Tell her to drink at least 1500 mL of fluid a day.
Advise assessing self for rash.
Use alternate birth control methods to oral contraception.
Take drug on an empty stomach.
In reinforcing a teaching plan to present to a group of older adults regarding the prevention of esophageal cancer, the nurse would include which significant information? (Select all that apply.)
cessation of smoking
frequent monitoring for Barrett’s esophagus
regular checkups if dysphagia is present
limiting alcohol consumption
reduction of consumption of citrus fruits
Which activities should the home health nurse suggest to an older adult patient to avoid constipation?
Schedule toileting after meals
Taking bulk-forming laxatives
Increasing fiber intake
Drinking at least 1000 mL fluid
Taking a daily stool softener
The home health nurse is caring for a patient who has frequent abdominal pain and diarrhea. The nurse uses the Rome Criteria to direct data collection for irritable bowel syndrome. What is included in the Rome Criteria?
Excessive flatulence
Blood in stool
Onset associated with change in stool consistency or frequency
Pain relieved by defecation
Discomfort at least 3 days a month
Flexible sigmoidoscopy should be performed every (a) years.
The nurse explains that (a) , the chief enzyme of gastric juice, is activated by hydrochloric acid to begin digestion of protein.
The nurse caring for a patient with Crohn disease will closely monitor the urinary output to ensure that the patient is excreting at least (a) mL/day.
The nurse takes into consideration that long-term use of antibiotics can cause an antibiotic-associated pseudomembranous colitis from the organism (a) .
Due to frequent bouts of constipation, the nurse examines the bedfast nursing home resident for ulceration of the anus, called anal (a) .
