Free Gastrointestinal Systems practice for ATI Gastrointestinal System Test (ATI RN). Answer 75 nursing exam-style questions with rationales, exam mode, and pro

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Question 1 of 75
Gastrointestinal Systems
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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?

Select the best answer.

Correct Answer: C. Bran

Explanation:

Foods that help to thicken the stool of the client with an ileostomy include pasta, boiled rice, and low-fat cheese. Bran is high in dietary fiber and thus will increase the output of watery stool by increasing propulsion through the bowel. Ileostomy output is liquid. Addition or elimination of various foods can help to thicken or loosen this liquid drainage.

Gastrointestinal Systems
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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:

Select the best answer.

Correct Answer: A. Pork

Explanation:

The client with cirrhosis needs to consume foods high in thiamine. Thiamine is present in a variety of foods of plant and animal origin. Pork products are especially rich in this vitamin. Other good food sources include nuts, whole grain cereals, and legumes. Milk contains vitamins A, D, and B2. Broccoli contains vitamins C, E, and K and folic acid.

Gastrointestinal Systems
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During the first few days of recovery from ostomy surgery for ulcerative colitis, which of the following aspects should be the first priority of client care?

Select the best answer.

Correct Answer: D. Skin care

Explanation:

During the initial recovery period from ostomy surgery, skin care is the first priority to prevent irritation and infection around the stoma site.

Gastrointestinal Systems
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Which of the following symptoms would a client in the early stages of peritonitis exhibit?

Select the best answer.

Correct Answer: B. Abdominal pain and rigidity

Explanation:

In the early stages of peritonitis, the client would exhibit abdominal pain and rigidity due to inflammation.

Gastrointestinal Systems
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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

Select the best answer.

Correct Answer: C. 300 units/L

Explanation:

The normal serum amylase level is 25 to 151 IU/L. With chronic cases of pancreatitis, the rise in serum amylase levels usually does not exceed three times the normal value. In acute pancreatitis, the value may exceed five times the normal value. Options 1 and 2 are within normal limits. Option 3 is an extremely elevated level seen in acute pancreatitis.

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Which of the following associated disorders may a client with ulcerative colitis exhibit?

Select the best answer.

Correct Answer: D. Toxic megacolon

Explanation:

Toxic megacolon is a severe complication that may be exhibited by a client with ulcerative colitis.

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When planning care for a client with ulcerative colitis who is experiencing symptoms, which client care activities can the nurse appropriately delegate to a unlicensed assistant?

Select the best answer.

Correct Answer: D. Maintaining intake and output records

Explanation:

Delegating tasks such as providing skin care, maintaining intake and output records, and obtaining the client's weight are within the scope of practice for an unlicensed assistant. Assessing bowel sounds and evaluating the response to medications require nursing judgment and should not be delegated.

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Which of the following tests can be used to diagnose ulcers?

Select the best answer.

Correct Answer: D. Esophagogastroduodenoscopy (EGD)

Explanation:

Esophagogastroduodenoscopy (EGD) is a diagnostic test that involves visualizing the esophagus, stomach, and duodenum to diagnose ulcers.

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Which of the following symptoms is common with a hiatal hernia?

Select the best answer.

Correct Answer: C. Esophageal reflux

Explanation:

Esophageal reflux is a common symptom of a hiatal hernia because the hernia can cause stomach acid to move back up into the esophagus.

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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?

Select the best answer.

Correct Answer: C. Avoiding coughing

Explanation:

To prevent strain on the surgical site and avoid disruption of tissue integrity, the client should avoid coughing after an umbilical hernia repair.

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

Select the best answer.

Correct Answer: C. Sweating and pallor

Explanation:

Early manifestations of dumping syndrome occur 5 to 30 minutes after eating. Symptoms include vertigo, tachycardia, syncope, sweating, pallor, palpitations, and the desire to lie down.

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The student nurse is participating in colorectal cancer-screening program. Which patient has the fewest risk factors for colon cancer?

Select the best answer.

Correct Answer: C. Herman, a 60 y.o. who follows a low-fat, high-fiber diet

Explanation:

Herman, a 60 y.o. who follows a low-fat, high-fiber diet, has the fewest risk factors for colon cancer.

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Your patient has a GI tract that is functioning, but has the inability to swallow foods. Which is the preferred method of feeding for your patient?

Select the best answer.

Correct Answer: C. NG feeding

Explanation:

NG feeding is the preferred method for patients with a functioning GI tract but an inability to swallow foods.

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Brenda, a 36 y.o. patient is on your floor with acute pancreatitis. Treatment for her includes:

Select the best answer.

Correct Answer: C. Nutritional support with TPN.

Explanation:

Treatment for acute pancreatitis includes nutritional support with TPN.

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The pain of a duodenal ulcer can be distinguished from that of a gastric ulcer by which of the following characteristics?

Select the best answer.

Correct Answer: D. Pain on empty stomach

Explanation:

Pain on an empty stomach is characteristic of a duodenal ulcer, while pain on eating is characteristic of a gastric ulcer.

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

Select the best answer.

Correct Answer: A. Bedrest

Explanation:

Fatigue is a normal response to hepatic cellular damage. During the acute stage, rest is an essential intervention to reduce the metabolic demands on the liver and its blood supply.

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

Select the best answer.

Correct Answer: A. Steatorrhea

Explanation:

Because celiac disease destroys the absorbing surface of the intestine, fat isn't absorbed but is passed in the stool. Steatorrhea is bulky, fatty stools that have a foul odor. Jaundiced sclerae result from elevated bilirubin levels. Clay-colored stools are seen with biliary disease when bile flow is blocked. Celiac disease doesn't cause a widened pulse pressure.

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Which of the following laboratory results would be expected in a client with peritonitis?

Select the best answer.

Correct Answer: D. White blood cell count above 15,000

Explanation:

A white blood cell count above 15,000 is indicative of an infection, such as peritonitis.

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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?

Select the best answer.

Correct Answer: B. Change the dressing.

Explanation:

Serosanguineous drainage with a small amount of bile is expected from the Penrose drain for the first 24 hours. Drainage then decreases, and the drain is removed usually within 48 hours. The nurse does not need to notify the physician. A sterile dressing covers the site and should be changed to prevent infection and skin excoriation.

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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 in which of the following positions?

Select the best answer.

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

Explanation:

The discomfort of reflux is aggravated by positions that compress the abdomen and the stomach. Lying flat on the back (supine) or on the stomach (prone) after a meal can exacerbate symptoms. Similarly, lying on the right side can worsen reflux. The most appropriate position to alleviate discomfort in a client with gastroesophageal reflux disease is lying on the left side with the head of the bed elevated at a 30-degree angle. This position helps prevent the backflow of stomach contents into the esophagus, providing relief to the client.

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A female client complains of gnawing epigastric pain for a few hours after meals. At times, when the pain is severe, vomiting occurs. Specific tests are indicated to rule out:

Select the best answer.

Correct Answer: A. Cancer of the stomach

Explanation:

Specific tests are indicated to rule out cancer of the stomach when a client complains of gnawing epigastric pain and vomiting after meals.

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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?

Select the best answer.

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

Explanation:

During the insertion of a nasogastric tube, if the client experiences difficulty breathing or any respiratory distress, withdraw the tube slightly, stop the tube advancement, and wait until the distress subsides. Options 1 and 4 are unnecessary. Quickly inserting the tube is not an appropriate action because, in this situation, it may be likely that the tube has entered the bronchus.

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Medical management of the client with diverticulitis should include which of the following treatments?

Select the best answer.

Correct Answer: C. Administration of antibiotics

Explanation:

Medical management of diverticulitis typically includes the administration of antibiotics to treat infection and inflammation.

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A client with ulcerative colitis has an order to begin salicylate medication to reduce inflammation. The nurse instructs the client to take the medication:

Select the best answer.

Correct Answer: C. After meals

Explanation:

The correct answer is C: After meals. Salicylate medications for ulcerative colitis should be taken after meals to minimize gastrointestinal irritation and enhance absorption. Taking the medication on an empty stomach (Choice B) may increase the risk of gastrointestinal side effects. Taking it 30 minutes before meals (Choice A) may not provide enough protection for the stomach lining. Taking it on arising (Choice D) is not recommended as it may not coincide with the peak absorption times of the medication.

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The nurse is providing discharge instructions to a client following gastrectomy. Which measure will the nurse instruct the client to follow to assist in preventing dumping syndrome?

Select the best answer.

Correct Answer: B. Limit the fluids taken with meals

Explanation:

To prevent dumping syndrome after a gastrectomy, it is recommended to limit fluids taken with meals to slow down gastric emptying and reduce the symptoms.

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

Select the best answer.

Correct Answer: C. Avoid oral intake except for water on the day of the procedure.

Explanation:

For an oral cholecystogram, the client should eat a fat-free meal the evening before the procedure and avoid oral intake except for water on the day of the procedure. During the test, the client may be given a high-fat meal or drink to stimulate gallbladder emptying. Choice A is incorrect because the client should have a fat-free meal, not a high-fat meal. Choice B is incorrect as strict NPO status is not required. Choice D is incorrect as a high-fat meal is not recommended for breakfast on the day of the procedure.

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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:

Select the best answer.

Correct Answer: D. Maintaining a positive, optimistic outlook.

Explanation:

Convalescence after hepatitis A may take weeks or even months. Boredom and depression are common problems that the client should anticipate. Abdominal pain is not usually a symptom of hepatitis A. Maintaining a regular bowel elimination pattern is not usually a problem with hepatitis. Problems preventing respiratory complications are unlikely. To support healing, activity is strictly limited but bed rest is not prescribed.

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Your patient has a retractable gastric peptic ulcer and has had a gastric vagotomy. Which factor increases as a result of vagotomy?

Select the best answer.

Correct Answer: D. Gastric pH.

Explanation:

After a gastric vagotomy, the gastric pH increases as a result of reduced acid secretion.

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The student nurse is preparing a teaching care plan to help improve nutrition in a patient with achalasia. You include which of the following:

Select the best answer.

Correct Answer: C. Eat meals sitting upright.

Explanation:

Eating meals while sitting upright helps improve swallowing and prevent complications in patients with achalasia.

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You are developing a careplan on Sally, a 67 y.o. patient with hepatic encephalopathy. Which of the following do you include?

Select the best answer.

Correct Answer: A. Administering a lactulose enema as ordered.

Explanation:

Administering a lactulose enema as ordered helps reduce ammonia levels in patients with hepatic encephalopathy.

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A 53 y.o. patient has undergone a partial gastrectomy for adenocarcinoma of the stomach. An NG tube is in place and is connected to low continuous suction. During the immediate postoperative period, you expect the gastric secretions to be which color?

Select the best answer.

Correct Answer: C. Red.

Explanation:

During the immediate postoperative period after a partial gastrectomy, gastric secretions are expected to be red.

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A 40-year-old male client has been hospitalized with peptic ulcer disease. He is being treated with a histamine receptor antagonist (cimetidine), antacids, and diet. The nurse doing discharge planning will teach him that the action of cimetidine is to:

Select the best answer.

Correct Answer: C. Inhibit the production of hydrochloric acid (HCl)

Explanation:

Cimetidine inhibits the production of hydrochloric acid (HCl), which helps to treat peptic ulcer disease.

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

Select the best answer.

Correct Answer: B. Elevated serum bilirubin

Explanation:

Laboratory indicators of hepatitis include elevated liver enzyme levels, elevated serum bilirubin levels, elevated erythrocyte sedimentation rates, and leucopenia. An elevated blood urea nitrogen may indicate renal dysfunction. A hemoglobin level is unrelated to this diagnosis.

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The nurse is performing a colostomy irrigation on a client. During the irrigation, a client begins to complain of abdominal cramps. Which of the following is the most appropriate nursing action?

Select the best answer.

Correct Answer: C. Stop the irrigation temporarily.

Explanation:

If a client experiences abdominal cramps during a colostomy irrigation, it is appropriate to stop the irrigation temporarily to allow the cramps to subside.

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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?

Select the best answer.

Correct Answer: D. I can elevate the head of the bed 4 to 6 inches.

Explanation:

Sleeping with the head of the bed elevated encourages movement of food through the esophagus by gravity. By fostering esophageal acid clearance, gravity helps keep the acidic pepsin and alkaline biliary secretions from contacting the esophagus. Elevating the foot of the bed does not affect clearance of esophageal acid. Sleeping on the stomach with the head turned to the left will not decrease reflux incidence. Sleeping flat without a pillow under the head does not enhance clearance.

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Which of the following conditions can cause a hiatal hernia?

Select the best answer.

Correct Answer: D. Weakness of the diaphragmic muscle

Explanation:

Weakness of the diaphragmic muscle can lead to a hiatal hernia as it allows part of the stomach to push through the diaphragm into the chest cavity.

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Glenda has cholelithiasis (gallstones). You expect her to complain of:

Select the best answer.

Correct Answer: A. Pain in the right upper quadrant, radiating to the shoulder.

Explanation:

Patients with cholelithiasis often complain of pain in the right upper quadrant, radiating to the shoulder.

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Which of the following nursing interventions should be implemented to manage a client with appendicitis?

Select the best answer.

Correct Answer: D. Assessing for symptoms of peritonitis

Explanation:

The correct answer is D: Assessing for symptoms of peritonitis. This intervention is crucial in managing a client with appendicitis because it indicates a possible rupture of the inflamed appendix. Symptoms of peritonitis include severe abdominal pain, fever, nausea, vomiting, and abdominal rigidity. Prompt recognition of these symptoms is essential for timely intervention and surgical management. Choices A, B, and C are incorrect because while assessing for pain is important, assessing for symptoms of peritonitis takes precedence due to the critical nature of appendicitis. Encouraging oral intake of clear fluids and providing discharge teaching are not immediate priorities in the management of a client with acute appendicitis.

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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?

Select the best answer.

Correct Answer: B. Lactase

Explanation:

Lactase is produced in the small intestine and aids in splitting neutral fats into glycerol and fatty acids. Lipase, amylase, and trypsin are produced in the pancreas and aid in the digestion of fats, starches, and proteins, respectively.

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Sharon has cirrhosis of the liver and develops ascites. What intervention is necessary to decrease the excessive accumulation of serous fluid in her peritoneal cavity?

Select the best answer.

Correct Answer: A. Restrict fluids

Explanation:

Restricting fluids is necessary to decrease the excessive accumulation of serous fluid in the peritoneal cavity for a patient with ascites due to cirrhosis.

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

Select the best answer.

Correct Answer: A. Yogurt

Explanation:

Yogurt helps reduce odor in the stool by promoting healthy bacteria in the digestive tract.

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Your patient Maria takes NSAIDS for her degenerative joint disease, has developed peptic ulcer disease. Which drug is useful in preventing NSAID-induced peptic ulcer disease?

Select the best answer.

Correct Answer: C. Misoprostol (Cytotec)

Explanation:

Misoprostol (Cytotec) is useful in preventing NSAID-induced peptic ulcer disease.

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A client being treated for chronic cholecystitis should be given which of the following instructions?

Select the best answer.

Correct Answer: D. Use anticholinergics as prescribed

Explanation:

Using anticholinergics as prescribed can help manage the symptoms of chronic cholecystitis.

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Colon cancer is most closely associated with which of the following conditions?

Select the best answer.

Correct Answer: D. Ulcerative colitis

Explanation:

Ulcerative colitis is a condition closely associated with an increased risk of developing colon cancer due to chronic inflammation of the colon.

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The nurse is doing pre-op 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?

Select the best answer.

Correct Answer: A. I will need to drain the pouch regularly with a catheter.

Explanation:

A Kock pouch is a type of continent ileostomy that requires catheterization to empty the internal reservoir. Understanding the need for regular catheterization indicates the client comprehends the procedure.

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When obtaining a nursing history on a client with a suspected gastric ulcer, which signs and symptoms would the nurse expect to see? Select ONE that does not apply.

Select the best answer.

Correct Answer: B. Relief of epigastric pain after eating

Explanation:

Signs and symptoms of a gastric ulcer include epigastric pain at night, vomiting, and weight loss. Relief of epigastric pain after eating is not typically associated with gastric ulcers.

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Your patient recently had abdominal surgery and tells you that he feels a popping sensation in his incision during a coughing spell, followed by severe pain. You anticipate an evisceration. Which supplies should you take to his room?

Select the best answer.

Correct Answer: D. Sterile saline solution and sterile dressings.

Explanation:

For a suspected evisceration, sterile saline solution and sterile dressings should be taken to the patient's room to cover the wound and keep it moist.

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You have a patient with achalasia (incomplete muscle relaxation of the GI tract, especially sphincter muscles). Which medications do you anticipate to administer?

Select the best answer.

Correct Answer: A. Isosorbide dinitrate (Isordil)

Explanation:

Isosorbide dinitrate (Isordil) is a medication used to relax the muscles of the GI tract in patients with achalasia.

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

Select the best answer.

Correct Answer: A. Profuse vomiting.

Explanation:

Profuse vomiting is the classic sign of small bowel obstruction and rarely occurs with large bowel obstruction. Abdominal discomfort and distention are present in both small and large bowel obstructions, but distention is more common in large bowel obstruction. High-pitched bowel sounds indicate hyperperistalsis, which occurs early in obstruction.

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Leigh Ann is receiving pancrelipase (Viokase) for chronic pancreatitis. Which observation best indicates the treatment is effective?

Select the best answer.

Correct Answer: D. Stools are less fatty and decreased in frequency.

Explanation:

The effectiveness of pancrelipase (Viokase) for chronic pancreatitis is best indicated by stools being less fatty and decreased in frequency.

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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?

Select the best answer.

Correct Answer: C. Emotional support from the family

Explanation:

Emotional support from the family is the main need. A special diet doesn't focus on emotional needs. Role expectations don't address the main issue, but emotional support while the client is fulfilling these roles is important. The family's ability to understand the ups and downs of the illness will help them but not the client.

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Your teaching Anthony how to use his new colostomy. How much skin should remain exposed between the stoma and the ring of the appliance?

Select the best answer.

Correct Answer: A. 1/16"

Explanation:

When teaching a patient how to use a colostomy, only 1/16" of skin should remain exposed between the stoma and the ring of the appliance to prevent skin irritation.

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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?

Select the best answer.

Correct Answer: A. Place a sandbag over the insertion site.

Explanation:

Following this procedure, the nurse monitors the client's vital signs closely for indications of hemorrhage and observes the needle insertion site for bleeding and bile leakage. A sandbag is placed over the insertion site to prevent bleeding. The client is maintained on bedrest, and oral intake is avoided in the immediate postprocedure period in case surgery is necessary to control hemorrhage of bile extravasation.

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You're caring for Betty with liver cirrhosis. Which of the following assessment findings leads you to suspect hepatic encephalopathy in her?

Select the best answer.

Correct Answer: A. Asterixis

Explanation:

Asterixis, a flapping tremor of the hands, is a sign of hepatic encephalopathy.

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You're caring for Carin who has just had ileostomy surgery. During the first 24 hours post-op, how much drainage can you expect from the ileostomy?

Select the best answer.

Correct Answer: C. 1500 ml

Explanation:

During the first 24 hours post-op, you can expect about 1500 ml of drainage from the ileostomy.

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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 on the client's record?

Select the best answer.

Correct Answer: B. Diarrhea

Explanation:

Diarrhea is a common stool characteristic in clients with Crohn's disease due to inflammation of the gastrointestinal tract.

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You're advising a 21 y.o. with a colostomy who reports problems with flatus. What food should you recommend?

Select the best answer.

Correct Answer: D. Yogurt

Explanation:

Yogurt can help reduce problems with flatus in patients with a colostomy.

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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?

Select the best answer.

Correct Answer: C. Leukocytosis with a shift to the left

Explanation:

Laboratory findings do not establish the diagnosis of appendicitis, but often moderate elevation of the white blood cell count (leukocytosis) to 10,000 to 18,000 cells/mm3 occurs with a "shift to the left" (an increased number of immature white blood cells.).

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Which area of the alimentary canal is the most common location for Crohn's disease?

Select the best answer.

Correct Answer: D. Terminal ileum

Explanation:

The terminal ileum is the most common location for Crohn's disease.

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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?

Select the best answer.

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

Explanation:

A tube with a large lumen and an air vent is a Salem sump tube. A tube with a single lumen is called a Levin's tube. A Sengstaken-Blakemore tube is used to control bleeding in the esophagus. A Dobbhoff weighted tube is used for feedings.

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You're doing preoperative teaching with Gertrude who has ulcerative colitis who needs surgery to create an ileoanal reservoir. Which information do you include?

Select the best answer.

Correct Answer: D. The surgery occurs in two stages.

Explanation:

The surgery to create an ileoanal reservoir occurs in two stages.

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Crohn's disease can be described as a chronic relapsing disease. Which of the following areas in the GI system may be involved with this disease?

Select the best answer.

Correct Answer: D. The small intestine and colon; affecting the entire thickness of the bowel

Explanation:

Crohn's disease can affect any part of the gastrointestinal tract from the mouth to the anus, but it commonly affects the small intestine and colon, involving the entire thickness of the bowel wall.

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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?

Select the best answer.

Correct Answer: A. Perforation

Explanation:

The signs and symptoms described in the question are consistent with perforation of the ulcer, which then progresses to peritonitis if the perforation is large enough. The client with intestinal obstruction most likely would complain of abdominal pain, distension, and nausea and vomiting. The client with hemorrhage would be vomiting blood or coffee-ground-like material or would be expelling black, tarry, or bloody stools. Intractability is a term that refers to continued symptoms of a disease process, despite ongoing medical treatment.

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Your teaching Anthony how to use his new colostomy. How much skin should remain exposed between the stoma and the ring of the appliance?

Select the best answer.

Correct Answer: A. 1/16"

Explanation:

When teaching a patient how to use a colostomy, only 1/16" of skin should remain exposed between the stoma and the ring of the appliance to prevent skin irritation.

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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?

Select the best answer.

Correct Answer: A. Place a sandbag over the insertion site.

Explanation:

Following this procedure, the nurse monitors the client's vital signs closely for indications of hemorrhage and observes the needle insertion site for bleeding and bile leakage. A sandbag is placed over the insertion site to prevent bleeding. The client is maintained on bedrest, and oral intake is avoided in the immediate postprocedure period in case surgery is necessary to control hemorrhage of bile extravasation.

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You're caring for Betty with liver cirrhosis. Which of the following assessment findings leads you to suspect hepatic encephalopathy in her?

Select the best answer.

Correct Answer: A. Asterixis

Explanation:

Asterixis, a flapping tremor of the hands, is a sign of hepatic encephalopathy.

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You're caring for Carin who has just had ileostomy surgery. During the first 24 hours post-op, how much drainage can you expect from the ileostomy?

Select the best answer.

Correct Answer: C. 1500 ml

Explanation:

During the first 24 hours post-op, you can expect about 1500 ml of drainage from the ileostomy.

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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 on the client's record?

Select the best answer.

Correct Answer: B. Diarrhea

Explanation:

Diarrhea is a common stool characteristic in clients with Crohn's disease due to inflammation of the gastrointestinal tract.

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You're advising a 21 y.o. with a colostomy who reports problems with flatus. What food should you recommend?

Select the best answer.

Correct Answer: D. Yogurt

Explanation:

Yogurt can help reduce problems with flatus in patients with a colostomy.

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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?

Select the best answer.

Correct Answer: C. Leukocytosis with a shift to the left

Explanation:

Laboratory findings do not establish the diagnosis of appendicitis, but often moderate elevation of the white blood cell count (leukocytosis) to 10,000 to 18,000 cells/mm3 occurs with a 'shift to the left" (an increased number of immature white blood cells.).

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Which area of the alimentary canal is the most common location for Crohn's disease?

Select the best answer.

Correct Answer: D. Terminal ileum

Explanation:

The terminal ileum is the most common location for Crohn's disease.

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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?

Select the best answer.

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

Explanation:

A tube with a large lumen and an air vent is a Salem sump tube. A tube with a single lumen is called a Levin's tube. A Sengstaken-Blakemore tube is used to control bleeding in the esophagus. A Dobbhoff weighted tube is used for feedings.

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You're doing preoperative teaching with Gertrude who has ulcerative colitis who needs surgery to create an ileoanal reservoir. Which information do you include?

Select the best answer.

Correct Answer: D. The surgery occurs in two stages.

Explanation:

The surgery to create an ileoanal reservoir occurs in two stages.

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Crohn's disease can be described as a chronic relapsing disease. Which of the following areas in the GI system may be involved with this disease?

Select the best answer.

Correct Answer: D. The small intestine and colon; affecting the entire thickness of the bowel

Explanation:

Crohn's disease can affect any part of the gastrointestinal tract from the mouth to the anus, but it commonly affects the small intestine and colon, involving the entire thickness of the bowel wall.

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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?

Select the best answer.

Correct Answer: A. Perforation

Explanation:

The signs and symptoms described in the question are consistent with perforation of the ulcer, which then progresses to peritonitis if the perforation is large enough. The client with intestinal obstruction most likely would complain of abdominal pain, distension, and nausea and vomiting. The client with hemorrhage would be vomiting blood or coffee-ground-like material or would be expelling black, tarry, or bloody stools. Intractability is a term that refers to continued symptoms of a disease process, despite ongoing medical treatment.

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