GASTROINTESTINAL SYSTEM practice exam

GASTROINTESTINAL SYSTEM Practice Exam

1.        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 of the following signs and symptoms, if identified by the client, indicates an understanding of this potential complication following gastrointestinal surgery?

A.     Hiccups and diarrhea

B.     Fatigue and abdominal pain

C.    Constipation and fever

D.    Diaphoresis and diarrhea

2.        A nurse is providing instructions to a client who will collect a stool specimen for occult blood. The nurse instructs the client to avoid which of the following for 3 days before the collection of the stool specimen?

A.     Milk products

B.     Hard cheese

C.    Turnips

D.    Cottage cheese

3.        Which of the following nursing interventions should have the highest priority during the first hour after the admission of a client with cholecystitis who is experiencing pain, nausea, and vomiting?

A.     Administering pain medication.

B.     Completing the admission history.

C.    Maintaining hydration.

D.    Teaching about planned diagnostic tests.

4.        The client with Crohn’s disease has a nursing diagnosis of Acute Pain. The nurse would teach the client to avoid which of the following in managing this problem?

A.     Lying supine with the legs straight

B.     Massaging the abdomen

C.    Using antispasmodic medication

D.    Using relaxation techniques

5.        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.” The most appropriate response is

A.     “Everything will be alright.”

B.     “I think you should talk more with the doctor about this.”

C.    “I don’t believe that.”

D.    “I’m not sure that I don’t understand. Would you please explain?”

6.        A nurse is reviewing the orders of a client admitted to the hospital with a diagnosis of acute pancreatitis. Select the interventions that the nurse would expect be prescribed for the client.

A.     Small, frequent high calorie feedings.

B.     Meperidine (Demerol) as prescribed for pain.

C.    Maintain the client in a supine and flat position.

D.    Encourage coughing and deep breathing.

E.     Administer antacids as prescribed.

7.        A nurse is performing an assessment on a client with a suspected diagnosis of acute pancreatitis. The nurse assesses the client, knowing that which of the following is a hallmark sign of this disorder?

A.     Severe abdominal pain relieved by vomiting

B.     Severe abdominal pain that is unrelieved by vomiting

C.    Hypothermia

D.    Epigastric pain radiating to the neck area

8.        A 30-year-old woman is admitted to the hospital with complaints of severe abdominal cramping and diarrhea. The nurse evaluates the effectiveness of the patient's intravenous therapy. Which of the following laboratory tests BEST reflects hydration status?

A.     Erythrocyte sedimentation rate.

B.     White blood cell count.

C.    Hematocrit.

D.    Serum glucose.

9.        The nurse provides discharge instructions to a patient with hepatitis B. Which of the following statements, if made by the patient, would indicate the need for further instruction?

A.     "I can never donate blood."

B.     "I can never have unprotected sex."

C.    "I cannot share needles."

D.    "I should avoid drugs and alcohol."

10.     Which nursing measure would be most effective in helping the client cough and deep breathe after a cholecystectomy?

A.     Having the client take rapid, shallow breaths to decrease pain.

B.     Having the client lay on the left side while coughing and deep breathing.

C.    Teaching the client to use a folded blanket or pillow to splint the incision.

D.    Withholding pain medication so the client can be alert enough to follow the nurse's instructions.

11.     A client had an abdominal perineal resection with a colostomy 4 days ago and is ready for discharge. Which of the following would be an appropriate expected outcome at this point?

A.     The client maintains a high-fiber diet.

B.     The client discusses concerns about his sexual functioning.

C.    The client maintains bedrestbed rest.

D.    The client limits fluid intake to 1000 ml/day.

12.     Before administering an intermitted tube feeding through a nasogastric tube, the nurse assesses for gastric residual. The nurse understands that this procedure is important to

A.     Confirm proper nasogastric tube placement.

B.     Observe gastric contents.

C.    Assess fluid and electrolyte status.

D.    Evaluate absorption of the last feeding.

13.     Which of the following expected outcomes would be appropriate for the client who has ulcerative colitis?

A.     The client maintains a daily record of intake and output.

B.     The client verbalizes the importance of small, frequent feedings.

C.    The client uses a heating pad to decrease abdominal cramping.

D.    The client accepts that a colostomy is inevitable at some time in his life.

14.     The home care nurse is visiting a client with a diagnosis of pernicious anemia that developed as a result of gastric surgery. The nurse instructs the client that because the stomach lining produces a decreased amount of intrinsic factor in this disorder, the client will need

A.     Vitamin B12 injections

B.     Vitamin B6 injections

C.    An antibiotic

D.    An antacid

15.     When assessing the client with celiac disease, the nurse can expect to find which of the following?

A.     Steatorrhea

B.     Jaundiced sclerae

C.    Clay-colored stools

D.    Widened pulse pressure

16.     A client with viral hepatitis states, “I am so yellow.” The nurse most appropriately would

A.     Assist the client in expressing feelings.

B.     Do most of the activities of daily living for the client.

C.    Provide information to the client only when the client requests it.

D.    Restrict visitors until the jaundice subsides.

17.     A client has been diagnosed with gastroesophageal reflux disease. The nurse interprets that the client has dysfunction of which of the following parts of the digestive system?

A.     Chief cells of the stomach

B.     Parietal cells of the stomach

C.    Lower esophageal sphincter

D.    Upper esophageal sphincter

18.     The nurse is caring for a client on the first postoperative day following a surgical repair of an abdominal aortic aneurysm. Which nursing diagnosis is the most important for this client?

A.     Risk for infection

B.     Deficient knowledge

C.    Ineffecitve peripheral tissue perfusion

D.    Activity intolerance

19.     The client with cirrhosis has ascites and excess fluid volume. Which measure will the nurse include in the plan of care for this client?

A.     Increase the amount of sodium in the diet.

B.     Limit the amount of fluids consumed.

C.    Encourage frequent ambulation.

D.    Administer magnesium antacids.

20.     The client has had a new colostomy created 2 days earlier. The client is beginning to pass malodorous flatus from the stoma. The nurse interprets that:

A.     This indicates inadequate preoperative bowel preparation.

B.     This is a normal, expected event.

C.    The client is experiencing early signs of ischemic bowel.

D.    The client should not have the nasogastric tube removed.

21.     The nurse is assessing a 71-year-old female client with ulcerative colitis. Which assessment finding related to the family will have the greatest impact on the client's rehabilitation after discharge?

A.     The family's ability to take care of the client's special diet needs

B.     The family's expectation that the client will resume responsibilities and role-related activities

C.    Emotional support from the family

D.    The family's ability to understand the ups and downs of the illness

22.     The nurse is performing an assessment on a client with acute pancreatitis who was admitted to the hospital. Which of the following assessment questions most specifically would elicit information regarding the pain that is associated with acute pancreatitis?

A.     “Does the pain in your abdomen radiate to your groin.”

B.     “Does the pain in your stomach radiate to the back?”

C.    “Does the pain in your stomach radiate to your lower middle abdomen?”

D.    “Does the pain in your lower abdomen radiate to the hip?”

23.     The nurse has given instructions to the client with an ileostomy about foods to eat to thicken the stool. The nurse determines that the client needs further instructions if the client stated to eat which of the following foods to make the stool less watery?

A.     Pasta

B.     Boiled rice

C.    Bran

D.    Low-fat cheese

24.     The nurse is caring for a client with an exacerbation of ulcerative colitis. Which of the following nursing measures should be included in the client's plan of care?

A.     Encourage regular use of antidiarrheal medications.

B.     Incorporate frequent rest periods into the client's schedule.

C.    Have the client maintain a high-fiber diet.

D.    Wear a gown when providing direct client care.

25.     A nurse orientee is preparing to insert a nasogastric tube, and a nurse educator is observing the procedure. Which of the following supplies if obtained by the nurse orientee would indicate a need foe further education regarding this procedure?

A.     Half-inch or one-inch tape

B.     Oil-soluble lubricant

C.    A glass of tap water with a straw

D.    A 50-mL catheter tip syringe

26.     Which of the following expected outcomes would be most appropriate for a client with peptic ulcer disease? The client will:

A.     verbalize absence of epigastric pain.

B.     accept the need to inject himself with vitamin B12 for the rest of his life.

C.    understand the need to increase his exercise activity.

D.    eliminate stress from his life.

27.     A nurse is developing a teaching plan for the client with viral hepatitis. The nurse plans to tell the client which of the following in the teaching session?

A.     Activity should be limited to prevent fatigue

B.     The diet should be low in calories

C.    Meals should be large to conserve energy

D.    Alcohol intake should be limited to 2 oz. per day.

28.     After gastric resection surgery, which of the following signs and symptoms would alert the nurse to the development of a leaking anastomosis?

A.     Pain, fever, and abdominal rigidity.

B.     Diarrhea with fat in the stool.

C.    Palpitations, pallor, and diaphoresis after eating.

D.    Feelings of fullness and nausea after eating.

29.     A home care nurse is visiting a client with a diagnosis of pernicious anemia that developed as a result of gastric surgery. The nurse instructs the client that because the stomach lining produces a decreased amount of intrinsic factor in this disorder, the client will need

A.     Vitamin B12 injections.

B.     Vitamin B6 injections.

C.    An antibiotic.

D.    An antacid.

30.     The nurse assesses the client's understanding of the relationship between body position and gastroesophageal reflux. Which response would indicate that the client understands measures to avoid problems with reflux while sleeping?

A.     "I can elevate the foot of the bed 4 to 6 inches."

B.     "I can sleep on my stomach with my head turned to the left."

C.    "I can sleep on my back without a pillow under my head."

D.    "I can elevate the head of the bed 4 to 6 inches."

31.     A client with ulcerative colitis is diagnosed with a mild case of the disease. The nurse doing dietary teaching gives the client examples of foods to eat that represent which of the following therapeutic diets?

A.     High-fat with milk

B.     High-protein without milk

C.    Low-roughage without milk

D.    Low-roughage with milk

32.     A nurse is inserting a nasogastric tube in an adult client. During the procedure, the client begins to cough and has difficulty breathing. Which of the following is the most appropriate nursing action?

A.     Remove the tube and reinsert when the respiratory distress subsides.

B.     Pull back on the tube and wait until the respiratory distress subsides.

C.    Quickly insert the tube.

D.    Notify the physician immediately.

33.     A client who has had gastrectomy is not producing sufficient intrinsic factor. The nurse interprets that the client has loss the ability to absorb cyanocobalamin (vitamin B12) in the:

A.     Stomach.

B.     Small intestine.

C.    Large intestine.

D.    Colon.

34.     The nurse aspirates 40 mL of undigested formula from the client’s nasogastric tube. Before administering an intermittent tube feeding, the nurse understands that the 40 mL of gastric aspirate should be:

A.     Discarded properly and recorded as output on the client’s intake and output record.

B.     Poured into the nasogastric tube through a syringe with the plunger removed.

C.    Mixed with the formula and poured into the nasogastric tube through a syringe with the plunger removed.

D.    Diluted with water and injected into the nasogastric tube by putting pressure on the plunger.

35.     A nurse is preparing to remove a nasogastric tube from a client. The nurse would instruct the client to do which of the following just before the nurse removes the tube?

A.     To perform Valsalva’s maneuver

B.     To take hold and hold a deep breath

C.    To exhale

D.    To inhale and exhale quickly

36.     The nurse is planning to teach the client with gastroesophageal reflux disease about substances that will increase the lower esophageal sphincter pressure. Which of the following items would the nurse include on this list?

A.     Fatty foods

B.     Nonfat milk

C.    Chocolate

D.    Coffee

37.     Lactulose (Chronulac) is prescribed for a client with a diagnosis of hepatic encephalopathy. The nurse would determine that this medication has had a therapeutic effect if which of following is noted?

A.     Increased red blood cell count

B.     Decreased serum ammonia level

C.    Increased protein level

D.    Decreased white blood cell level

38.     A nurse has been caring for a client with a Sengstaken-Blakemore tube. The physician arrives on the nursing unit and deflates the esophageal balloon. The nurse should monitor the client most closely for which of the following?

A.     Swelling of the abdomen

B.     Bloody diarrhea

C.    Vomiting blood

D.    An elevated temperature and arise in blood pressure

39.     A client is scheduled for an abdominal perineal resection with permanent colostomy. Which of the following measures would most likely be included in the plan for the client's preoperative preparation?

A.     Keep the client NPO for 2 days before surgery.

B.     Administer kanamycin (Kantrex) the night before surgery.

C.    Inform the client that chest tubes will be in place after surgery.

D.    Advise the client to limit activity.

40.     The client with chronic pancreatitis needs information on dietary modification to manage the health problem. The nurse teaches the client to limit which of the following items in the diet?

A.     Carbohydrate

B.     Protein

C.    Fat

D.    Water-soluble vitamins

41.     The nurse is preparing a discharge teaching plan for the client who had an umbilical hernia repair. Which of the following would the nurse include in the plan?

A.     Restricting pain medication

B.     Maintaining bedrest

C.    Avoiding coughing

D.    Irrigating the drain

42.     A client has a nasogastric tube inserted at the time of abdominal perineal resection with permanent colostomy. This tube will most likely be removed when the client demonstrates:

A.     Absence of nausea and vomiting.

B.     Passage of mucus from the rectum.

C.    Passage of flatus and feces from the colostomy.

D.    Absence of stomach drainage for 24 hours.

43.     A nurse is performing an abdominal assessment on a client. The nurse determines that which of the following findings that which of the following findings should be reported to the physician?

A.     Concave, midline umbilicus

B.     Pulsation between the umbilicus and pubis

C.    Bowel sound frequency of 15 sounds per minute

D.    Absence of a bruit

44.     The nurse is doing preoperative teaching with the 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 the surgery if the client makes which of the following statements?

A.     “I will need to drain the pouch regularly with a catheter.”

B.     “I will need to wear a drainage bag for the rest of my life.”

C.    “The drainage from this type of ostomy will be formed.”

D.    “I will be able to pass stool from the rectum eventually.”

45.     A nurse is caring for a client who has just returned from the operating room following the creation of a colostomy. The nurse is assessing the drainage in the pouch attached to the site where the colostomy was formed and notes serosanguineous drainage. Which nursing action is most appropriate based on this assessment?

A.     Notify the physician

B.     Document the amount and characteristics of the drainage

C.    Apply ice to the stoma site

D.    Apply pressure to the site

46.     Cholestyramine resin (Questran Light) is prescribed for the client with an elevated serum cholesterol level. The nurse would instruct the client to take the medication

A.     After meals.

B.     Mixed with fruit juice.

C.    Via rectal suppository.

D.    At least 3 hours before meals.

47.     A client is admitted with a diagnosis of ulcerative colitis. Which of the following symptoms should the nurse expect the client to report when responding to questions about his bowel elimination pattern?

A.     Constipation.

B.     Bloody, diarrheal stools.

C.    Steatorrhea.

D.    Alternating periods of constipation and diarrhea.

48.     The nurse is caring for a client following a Billroth II procedure. On review of the postoperative orders, which of the following if prescribed, should the nurse question and verify?

A.     Irrigating the nasogastric tube

B.     Coughing and deep breathing exercises

C.    Leg exercises

D.    Early ambulation

49.     The nurse is caring for a client who underwent a subtotal gastrectomy. To manage dumping syndrome, the nurse should advise the client to:

A.     restrict fluid intake to 1 qt (1,000 ml)/day.

B.     drink liquids only with meals.

C.    don't drink liquids 2 hours before meals.

D.    drink liquids only between meals.

50.     The nurse is irrigating a client's colostomy when she complains of abdominal cramping after receiving about 100 mL of the irrigating solution. What should the nurse's first response be in this situation?

A.     Stop the flow of solution temporarily.

B.     Reposition the client on to her right side.

C.    Remove the irrigation tube.

D.    Massage the abdomen gently.

51.     A nurse teaches a preoperative client about the nasogastric tube that will be inserted in preparation for surgery. The nurse determines that the client understands when the tube will be removed in the postoperative period when the client states

A.     “When my gastrointestinal system is healed enough.”

B.     “When I can tolerate food without vomiting.”

C.    “When my bowels begin to function again, and I begin to pass gas.”

D.    “When the doctor says so.”

52.     A Penrose drain is in place on the first postoperative day following a cholecystectomy. Serosanguineous drainage is noted on the dressing covering the drain. Which nursing intervention is most appropriate?

A.     Notify the physician.

B.     Change the dressing.

C.    Circle the amount on the dressing with a pen.

D.    Continue to monitor the drainage.

53.     The nurse is monitoring a client for the early signs and symptoms for dumping syndrome. Which symptom indicates this occurrence?

A.     Abdominal cramping and pain

B.     Bradycardia and indigestion

C.    Sweating and pallor

D.    Double vision and chest pain

54.     Which of the following nursing measures would be inappropriate when caring for a client with a Cantor tube?

A.     Injecting 10 mL of air into the tube to facilitate drainage.

B.     Applying a water-soluble lubricant to the client's nares.

C.    Coiling extra tubing on the client's bed.

D.    Irrigating the tube with 50 mL of normal saline solution.

55.     Of the following signs and symptoms of bowel obstruction, which is related primarily to small bowel obstruction rather than large bowel obstruction?

A.     Profuse vomiting.

B.     Cramping abdominal pain.

C.    Abdominal distention.

D.    High-pitched bowel sounds above the obstruction.

56.     A nurse is assigned to a 40-year-old client who has a diagnosis of chronic pancreatitis. The nurse reviews the laboratory result, anticipating a laboratory report that indicates a serum amylase level of:

A.     45 units/L

B.     100 units/L

C.    300 units/L

D.    500 units/L

57.     The client is admitted to the hospital with viral hepatitis, complaining of “no appetite” and “losing my taste for food.” To provide adequate nutrition, the nurse would instruct the client to:

A.     Eat a good supper when anorexia is not as severe.

B.     Eat less often, preferably only three large meals daily.

C.    Increase intake of fluids including juices.

D.    Select foods high in fat.

58.     Which of the following techniques would the nurse use first to determine if a nasogastric tube is positioned in the stomach?

A.     Aspirating with a syringe and observing for the return of gastric contents.

B.     Irrigating with normal saline and observing for the return of solution.

C.    Placing the tube's free end in water and observing for air bubbles.

D.    Instilling air and auscultating over the epigastric area for the presence of the tube.

59.     Vasopressin (Pitressin) therapy is prescribed for a client with a diagnosis of bleeding esophageal varices. The nurse is preparing to administer the medication to the client. Which of the following essential items is needed during the administration of this medication?

A.     A cardiac monitor

B.     An intubation set

C.    A suction setup

D.    A tracheotomy set

60.     When preparing the client with hepatitis A for extended convalescence, the nurse teaches the client about problems that may occur. The nurse knows that the client has understood the teaching when he says that he is most likely to have difficulty:

A.     Controlling abdominal pain.

B.     Maintaining a regular bowel elimination pattern.

C.    Preventing respiratory complications.

D.    Maintaining a positive, optimistic outlook.

61.     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. To assess for the presence of this sign, the nurse would do which of the following?

A.     Ask the client to extend the arms.

B.     Assess for the client the presence of Homans’ sign.

C.    Instruct the client to lean forward.

D.    Measurement the abdominal girth.

62.     A client with a history of gastric ulcer suddenly complains of a sharp-severe pain in the mid epigastric area, which then spreads over the entire abdomen. The client’s abdomen is rigid and board-like to palpation, and the client obtains most comfort from lying in the knee-chest position. The nurse calls the physician immediately suspecting that the client is experiencing which of the following complications of peptic ulcer disease?

A.     Perforation

B.     Obstruction

C.    Hemorrhage

D.    Intractability

63.     The nurse is caring for a client admitted to the hospital with a suspected diagnosis of acute appendicitis. Which of the following laboratory results would the nurse expect to note if the client indeed has appendicitis?

A.     Leukopenia with a shift to the right

B.     Leukocytosis with a shift to the right

C.    Leukocytosis with a shift to the left

D.    Leukopenia with a shift to the left

64.     To prevent gastroesophageal reflux in a client with hiatal hernia, the nurse should provide which discharge instructions?

A.     Lie down after meals to promote digestion.

B.     Avoid coffee and alcoholic beverages.

C.    Take antacids before meals.

D.    Limit fluids with meals.

65.     Which of the following activities should the nurse encourage the client with a peptic ulcer to avoid?

A.     Chewing gum.

B.     Smoking cigarettes.

C.    Eating chocolate.

D.    Taking acetaminophen (Tylenol).

66.     A client returns from surgery with a sigmoid colostomy. An ostomy appliance is attached. The priority nursing diagnosis for daily observation and care is:

A.     Diarrhea related to alteration in bowel elimination.

B.     Impaired skin integrity related to seepage.

C.    Impaired nutrition: More than body requirements related to high-fat diet.

D.    Impaired physical mobility related to surgical procedure.

67.     The nurse provides medication instructions to a client with peptic ulcer disease. Which statement, if made by the client, indicates best understanding of the medication therapy?

A.     “The cimetidine (Tagamet) will cause me to produce less stomach acid.”

B.     “Sucralfate (Carafate) will change the fluid in my stomach.”

C.    “Antacids will coat my stomach.”

D.    “Omeprazole (Prilosec) will coat the ulcer and help it heal.”

68.     A nurse is developing a plan of care for a client who will be returning to a nursing unit following a percutaneous transhephatic cholangiogram. The nurse includes which intervention in the postprocedure plan of care?

A.     Place a sandbag over the insertion site.

B.     Allow the client bathroom privileges only.

C.    Encourage fluid intake.

D.    Allow the client to sit in a chair for meals.

69.     The client with a new colostomy is concerned about the odor from stool from the ostomy drainage bag. The nurse teaches the client to include which of the following foods in the diet to reduce odor?

A.     Yogurt

B.     Broccoli

C.    Cucumbers

D.    Eggs

70.     The nurse has inserted a nasogastric tube to the level of the oropharynx and has repositioned the client’s head in a flexed-forward position. The client has been asked to begin swallowing. The nurse starts slowly to advance the nasogastric tube with each swallow. The client begins to cough, gag, and choke. Which nursing action would least likely result in proper tube insertion and promote client relaxation?

A.     Continuing to advance the tube to the desired distance

B.     Pulling the tube back slightly

C.    Checking the back of the pharynx using a tongue blade and flashlight.

D.    Instructing the client to breathe slowly and take sips of water.

71.     A nurse is giving dietary instructions to a client who has a new colostomy. The nurse encourages the client to eat foods representing which of the following diets for the first 4 to 6 weeks postoperatively?

A.     High-protein

B.     High-carbohydrate

C.    Low-calorie

D.    Low-residue

72.     The nurse is preparing to discontinue a client’s nasogastric tube. The client is positioned properly, and the tube has been flushed with 15 mL of air to clear secretions. Before removing the tube, the nurse makes which statement to the client?

A.     “Take a deep breath when I tell you and breathe normally while I remove the tube.”

B.     “Take a deep breath when I tell you and bear down while I remove the tube.”

C.    “Take a deep breath when I tell you and slowly exhale while I remove the tube.”

D.    “Take a deep breath when I tell you and hold it while I remove the tube.”

73.     The client with a colostomy has an order for irrigation of the colostomy. The nurse uses which solution for the irrigation?

A.     Distilled water

B.     Tap water

C.    Sterile water

D.    Lactated Ringer’s

74.     A client is suspected of having hepatitis. Which diagnostic test results will assist in confirming this diagnosis?

A.     Decreased erythrocyte sedimentation rate

B.     Elevated serum bilirubin

C.    Elevated hemoglobin

D.    Elevated blood urea nitrogen

75.     A nurse is providing the client with biliary obstruction a simple overview of the anatomy of the liver and gallbladder. The nurse tells the client that normally the liver stores bile in the gallbladder, which is connected to the liver by the?

A.     Liver canaliculi

B.     Common bile duct

C.    Cystic duct

D.    Right hepatic duct.

76.     A nurse is reviewing the results of serum laboratory studies drawn on a client who is suspected of having hepatitis. The nurse interprets that an elevation in which of the following studies is the most specific indicator of the disease?

A.     Erythrocyte sedimentation rate

B.     Serum bilirubin

C.    Hemoglobin

D.    Blood urea nitrogen

77.     The nurse develops a plan of care for a client with a T tube. Which one of the following nursing interventions should be included?

A.     Inspect skin around the T tube daily for irritation.

B.     Irrigate the T tube every 4 hours to maintain patency.

C.    Maintain client in a supine position while T tube is in place.

D.    Keep T tube clamped except for during mealtimes.

78.     A client with peptic ulcer is scheduled for a Vagotomy. The client asks the nurse about the purpose of this procedure. The nurse tells the client that the procedure:

A.     Decreases food absorption in the stomach.

B.     Heals the gastric mucosa.

C.    Halts stress reactions.

D.    Reduces the stimulus to acid secretions.

79.     A client is providing instructions to a client who is scheduled for an oral cholecystogram. The nurse tells the client to:

A.     Eat a high-fat meal on the evening before the procedure.

B.     Maintain strict NPO status on the day of the procedure.

C.    Avoid oral except for water on the day of the procedure.

D.    Eat a high-fat meal for breakfast on the day of the procedure.

80.     The nurse is scheduling diagnostic tests for a client. If all of the following diagnostic tests are ordered, which would be performed last?

A.     Gallbladder series

B.     Barium enema

C.    Barium swallow

D.    Oral cholecystogram

81.     A client with liver dysfunction has low serum levels of thrombin. The nurse provides care, anticipating that this client is most at risk of

A.     Dehydration

B.     Malnutrition

C.    Bleeding

D.    Infection

82.     The hospitalized client with gastroesophageal reflux disease is complaining of chest discomfort that feels like heartburn following a meal. After administering an ordered antacid, the nurse encourages the client to lie on which of the following positions?

A.     Supine with the head of bed flat

B.     On the stomach with the head flat

C.    On the left side with the head of bed elevated 30 degrees

D.    On the right side with the head of bed elevated 30 degrees

83.     To accurately assess for jaundice in a patient with dark skin pigmentation, the nurse should examine which body areas?

A.     Nail beds

B.     Skin on back of the hand

C.    Hard palate of the mouth

D.    Soles of the feet

84.     A client is recovering from an ileostomy that was performed to treat inflammatory bowel disease. During discharge teaching for this client, the nurse should stress:

A.     increasing fluid intake to prevent dehydration.

B.     wearing an appliance pouch only at bedtime.

C.    consuming a low-protein, high fiber diet.

D.    taking only enteric-coated medications.

85.     The nurse is reviewing the record of a client with Crohn’s disease. Which of the following stool characteristics would the nurse expect to note documented in the client’s record?

A.     Chronic constipation

B.     Diarrhea

C.    Constipation alternating with diarrhea

D.    Stool constantly oozing from the rectum

86.     A nurse is caring for a client with cirrhosis of the liver. To minimize the effects of the disorder, the nurse teaches the client about foods that are high in thiamine. The nurse determines that the client has best understanding of the dietary measures to follow of the client states an intention to increase intake of:

A.     Pork

B.     Milk

C.    Chicken

D.    Broccoli

87.     The nurse is reviewing the medication record of a client with acute gastritis. Which medication if noted on the client’s record, would the nurse question?

A.     Digoxin (Lanoxin)

B.     Indomethacin (Indocin)

C.    Furosemide (Lasix)

D.    Propranolol hydrochloride (Inderal)

88.     The nurse is evaluating the plan of care for a client with peptic ulcer disease with a nursing diagnosis of Acute Pain. The nurse would determine that the client has not met the expected outcomes if the client states

A.     That pain is relieved with histamine H2 receptor antagonists.

B.     That irritating foods have been eliminated from the diet.

C.    The client is being awakened at 2 AM with heartburn.

D.    The client has absence of pain before meals.

89.     The client being seen in a physician’s office has just been scheduled for a barium swallow the next day. The nurse writes down which of the following instructions for the client to follow before the test?

A.     Fast for 8 hours before the test.

B.     Eat a regular supper and breakfast.

C.    Continue to take all oral medications as scheduled.

D.    Monitor own bowel movement pattern for constipation

90.     The nurse is caring for a client with cirrhosis. Which manifestations indicate deficient vitamin K absorption caused by this liver disease?

A.     Dyspnea and fatigue

B.     Ascites and orthopnea

C.    Purpura and petechiae

D.    Gynecomastia and testicular atrophy

91.     A client is scheduled for oral cholecystography. Which one of the following actions would the nurse plan to implement before the test?

A.     Have the client drink 1000 mL of water.

B.     Ask the client about possible allergies to iodine or shellfish.

C.    Administer an intravenous contrast agent the evening before the test.

D.    Administer tap-water enemas until clear.

92.     A client with liver dysfunction is having difficulty with protein metabolism. The nurse anticipates that the results of which of the following serum laboratory studies will be elevated?

A.     Lactic acid

B.     Ammonia

C.    Albumin

D.    Lactase

93.     A client with viral hepatitis has no appetite, and food makes the client nauseated. Which of the following interventions would be most appropriate?

A.     Explain that high-fat diets usually are tolerated better.

B.     Encourage intake of foods high in protein.

C.    Explain that the majority of calories need to be consumed in the evening hours.

D.    Monitor for fluid and electrolyte imbalance.

94.     The client with ascites is scheduled for a paracentesis. The nurse is assisting the physician in performing the procedure. Which of the following positions will the nurse assist the client to assume for this procedure?

A.     Supine

B.     Left side-lying

C.    Right side-lying

D.    Upright position.

95.     The nurse is caring for a client with a diagnosis of cirrhosis and is monitoring the client for signs of portal hypertension. Which initial sign, if noted in the client, indicates the presence of portal hypertension?

A.     Flat neck veins

B.     Hypotension

C.    Weak pulse

D.    Crackles on auscultation of the lungs

96.     A client is admitted to the hospital with acute viral hepatitis. Which of the following signs or symptoms would the nurse expect to note based on this diagnosis?

A.     Spider angiomas

B.     Fatigue

C.    Pale urine

D.    Weight gain

97.     The nurse is monitoring a client admitted to the hospital with a diagnosis of appendicitis. The client is scheduled for surgery for 2 hours. The client begins to complain of increases abdominal pain and begins to vomit. On assessment the nurse notes that the abdomen distended and bowel sounds are diminished. Which of the following is the most appropriate nursing intervention?

A.     Administer the prescribed pain medication.

B.     Notify the physician.

C.    Call and ask the operating room team to perform the surgery as soon as possible.

D.    Reposition the client and apply a heating pad on warm setting to the client’s abdomen.

98.     A nurse is caring for a client diagnose with pancreatitis. The nurse anticipates that the client would not experience an elevation of which of the following enzymes?

A.     Lipase

B.     Lactase

C.    Amylase

D.    Trypsin

99.     The client is admitted to the hospital for treatment of acute hepatitis B. Which activity order would the nurse expect to be prescribed?

A.     Bedrest

B.     Encourage ambulation

C.    Out of bed in a chair

D.    No activity restrictions

100.  The physician orders a Salem sump tube for gastrointestinal intubation. The nurse prepares for the insertion and obtains which of the following items from the supply room?

A.     A tube with a single lumen that connects to suction

B.     A tube with a large lumen and an air vent

C.    A Sengstaken-Blakemore tube

D.    A Dobbhoff weighted tube

For answers and rationale click the link below:
GASTROINTESTINAL SYSTEM Answers and Rationale

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