NCLEX Gastrointestinal problems Flashcards

Terms Definitions
A patient's vomitus is dark brown and has a coffee-ground appearance. the nurse recognizes that this emsis is charactristic of:

a. stomach bleeding
b. an intestinal obstruction
c. bile reflux
d. active bleeding of lower esophagus
a. stomach bleeding
A patient who has been vomiting for several dasy from an unknown cause is admitted to hospital. the nurse anticipates collaborative care to indlude:

a. oral admin of broth and tea
b. admin of paretneral antiemetics
c. insertion of NG tube to suction
d. I
d. IV replacement of fluid and electrolytes
Zofran is prescribed for a patient with cancer chemo induced vomiting. The nurse understands this drug:

a. is a derivative of cannabis
b. has a strong antihistamine effect that provides sedation and slee
c. is used only when othertherapies are ineffectiv
d. relieves vomiting centrally by action in the vomiting center and peripherally by promoting gastric emptying
A patient with oral cancer has a history of heavy smoking, excessive alcohol intake, and personal neglect. During the patient's early postop course the nurse anticpates that the patient may need:

a. oral nutritional supplements
b. drug therapy to prevent
b. drug therapy to prevent substance withdrawal symptoms
the nurse teaches the patient with a hiatal hernia or GERD to control symptoms by:

a. drinking 10-12 oz of water with meals
b. spacing six small meals a day
c. sleeping wit hthe head of the bed elevated 4-6 inches
d. perfrming aily exercises of toe touch
c. sleeping wit hthe head of the bed elevated 4-6 inches
A patient is returned to the surgical unit following a laparoscopic fundoplication for repair of hiatal hernia with an IV, NG tube t osuction, and several small abdominal incisions. to prevent disruption of the surgical site, it is most important for the
c. maintain the patency of the NG tube
Nursing management of the patient with chronic gastritis includes teaching the patient to:

a. maintain a bland diet with six small meals a day
b. take antacids before meals
c. use NSAIDS instead of aspirin for pain relief
d. eliminate alcohol and caffein
a. maintain a bland diet with six small meals a day
Patient admitted to ER has profuse bright-red hematemesis. During intial care of the patient, the nurse's first priority is to:

a. perform a nursing assessment of patient's status
b. establish 2 IV sites
c. obtain a thorough health history
d. perform a
a. perform a nursing assessment of patient's status
In teaching patients at risk for upper GI bleeding to prevent bleeding episodes, the nurse stresses that:

a. all stools and vomit must be tested for blood
b. the use of over the counter meds of any kind should be avoided
c. antacids should be taken with
b. the use of over the counter meds of any kind should be avoided
Management of patient with upper GI bleeding is effective the lab results reveal:

a. decreasing BUN
b. normal hematocrit
c. urine output of 20 ml hr
d. specific gravity of 1.03
a. decreasing BUN
Regardless of precipitating factor, the injury to mucosal cells in PUD is caused by:

a. acid back-diffusion into the mucosa
b. ammonia formation in the mucus wall
c. breakdown of gastric mucosal barrier
d. release of histamine for cells
a. acid back-diffusion into the mucosa
Patient with an ulcer of the posterior portion of duodenum experiences:

a. pain that occurs after not eating all day
b. back pain that occurs 2-4 hrs after eating
c. midepigastric pain unrelieved with antacids
d. high epigastric burning relieved with foo
b. back pain that occurs 2-4 hrs after eating
Diagnostic testing is planned fr a patient with suspected peptic ulcer. Most reliable test is:

a. endoscopy
b. gastric analysis
c. barium swallow
d. serologic test for H pylori
a. endoscopy
Nurse teaches a patient with newly diagnosed PUD to

a. maintain bland diet
b. use alcohol and caffeine in moderation
c. eat as normally as possible, eliminating foods that cause pain
d. avoid milk and milk products
c. eat as normally as possible, eliminating foods that cause pain
Teaching is effective when atient with PUD states:

a. " I should stop all meds if i develop side effects"
b. "i should cintinue treatemnt as long as i have pain"
c. "i have learned some relaxation strategies that decrease my stre
c. "i have learned some relaxation strategies that decrease my stress"
Patient with history of PUD is hospitalized with symptoms of a perforation. During initial assessment nurse would expect to find:

a. vomit of bright red blood
b. projectile vomiting
c. sudden, severe upper abdominal pain and shoulder pain
d. hyperactive
c. sudden, severe upper abdominal pain and shoulder pain
A patient with NG tube develops nausea and increased upper abominal bowel sounds. Appropriate action is to:

a. check the patency of the NG tube
b. place client in recumbant position
c. assess vital signs
d. ecourage deep breathing
a. check the patency of the NG tube
Following a Billroth 2 procedure, atient develops dumping syndrome. The nurse explains that the symptoms associated wti h this problem are caused by:

a. distention of smaller stomach by too much food intake
b. hyperglycemia caused by uncontrolled gastric
d. movement of fluid into the bowel because concentrated food and fluids move rapidly into the intesting
Nurse determines teaching need when patient with dumping syndrome says

a. "i should eat bread with every meal"
b. "i should avoid drinking fluids with meals"
c. i should eat small meals about 6x day"
d. "i need t olie down f
a. "i should eat bread with every meal"
Patient with cancer of stomach undergoes total gastrecotmy with esophagojejunostomy. Postop the nurse teaches the patient to expect:

a. rapid healing
b. ability to return to normal dietary habits
c. close follow up for development of ulcers
d. lifelong
d. lifelong intramuscular or intranasal admin of cobalamin
The preferred immediate treatment for acute episode of constipation is:

a. soapsud enema
b. stimulant cthartics
c. stool sofenting cathartic
d. tap water or hypertonic enemas
d. tap water or hypertonic enemas
On 2nd postop day, patient who had exploratory laparotomy complains if abdominal distention and gas pains. Best response to this is:

a. Abdominal distention occurs as a normal response to inflammation and healing
b. Gas pains occur when NG tube is not us
d. This occurs because of bowel immobility caused by anesthesia and manipulation of abdominal contents during surgery
Postop patient has nursing diagnosis of pain r/t to immobility, meds, and decreased motility as evidneced by abdominal pain and distention and inability to pass flatus. An apropriate nursing intervention for the patient is to:

a. ambulate patient more fr
a. ambulate patient more frequently
A 22 yr old calls the clinic complaining of N&V and RLQ abdominal pain. The nurse advises the patient to:

a. have the symptoms evaluated by a MD right away
b. use a heating pad
c. drink at least 2 qts of juice
d. take a laxative to empty the bowel be
a. have the symptoms evaluated by a MD right away
Patient with a gunshot wound to the abdomen develops a bacterial peritonitis after surgery to repair the bowel. The nurse explains to the patient htat this problem is caused prirmarily by:

a. immobility and loss of perstaliss of the bowel as reuslt of su
c. spillage of bowel contents int othe normally sterile abdominal cavity
Patient with ulcerative colitis has a total colectomy with formation of a terminal ileum stoma. an important nursing interention for this patient postop is to:

a. measure the ileosotmy output to determine the status of patient's fluid balance
b. change i
a. measure the ileosotmy output to determine the status of patient's fluid balance
Patient with inflammatory bwel disease has a nursing diagnosis of imbalanced nutrition: less than body requirements r/t decreased nutritional intake and decreased intestinal absorption. Data to support this is:

a. pallor and hair loss
b. frequent diarrhe
a. pallor and hair loss
Patient asks nurse if his risks for colon cancer are increased due to a polyp. the best response is:

a. it is very rare for polyps ot become malignant
b. individuals with polyps have a 100% lifetime risk of developing colorectal cancer
c. all polyps are
c. all polyps are abnormal and should be removed, but the risk for cancer depends on the type and if malignant changes are present
Early screening for detection of cancers of the right side of colon in individuals over 50 yrs old should be done q year to include:

a. serum CEA levels
b. flexible sigmoidoscopy
c. digital rectal exam
d. fecal testing for occult blood
d. fecal testing for occult blood
A knowledge of factors associated with colorectal cancer guides the nurse when obtaining a nursing history to ask specifically about:

a. usual diet
b. history of smoking
c. history of alcohol
d. environmental exposure to carcinogens
a. usual die
Upon examining a patient 8 hrs after formation of a colostomy the nurse would expect to find

a. hypoactive, high pitched bowel sounds
b. brickred, puffy stoma that oozes blood
c. purplish stoma, shiny and moist
d. small amt of liquid fecal drainage from
b. brickred, puffy stoma that oozes blood
Nurse teaches patient with diverticulosis to

a. use anticholinergic drugs routinely to prevent bowel spasm
b. have a nannual colonoscopy to detect malignant changes
c. maintain a high fiber diet and use bulk laxatives to increase fecal volume
d. exclude
c. maintain a high fiber diet and use bulk laxatives to increase fecal volume
During an acute attack of diverticulitis, the patient is:

a. monitored for signs of peritonitis
b. treated with daily med enemas
c. prepared for surgery to resect the involved colon
d. provided with heathing pad to apply to LLQ
a. monitored for signs of peritonitis
When assessing a patient with pancreatitits, nurse would expect to find:

a. hyperactive bowel sounds
b. hypertension and tachycardia
c. severe midepigastric of LUQ pain
d. temp greater than 102º
c. severe midepigastric of LUQ pain
Combined with clinical manifestations, the lab finding that is most commonly used to diagnose acute prancreatitis is:

a. increased serum lipase
c
c. increased urinary amylase
d. decreased renal amylase creatine clearance
c. severe midepigastric of LUQ pain
Most effective means of suppressing pancreatic secreation during an episode of pancreatitis is the use of:

a. antibiotics
b. NPO status
c. antispasmotics
d. H2R blockers
b. NPO status
Patient with pancreatitis has nursing dx of pain r/t distention of pancreas and peritoneal irritation. In addition to effective use of analgesics the nurse should:

a. provide diversional activiies to distract patient
b. provide small frequent meals
c. po
c. position the patient on the side with the head of the bed elevated 45º
the nurse determines tha further discharge instruction is needed whne the patient with acute pancreatititis states:

a. "i should observe for fat in my stools"
b. "I must not use alcohol to prevent future attacks"
c. "I shouldn't
c. "I shouldn't eat salty foods"
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