Gastrointestinal Problems (Exam Mode) By Rnpedia.Com

25 Questions | By Rnpedia | Updated: Mar 21, 2022 | Attempts: 2574

Questions

Settings

Feedback

During the Quiz End of Quiz

Play as

Quiz Flashcard

Create your own Quiz

Gastrointestinal Problems (Exam Mode) By Rnpedia.Com - Quiz

Mark the letter of the letter of choice then click on the next button. Score will be posted as soon as the you are done with the quiz. You got 31 minutes to finish the exam. Good luck!

Questions and Answers

1.

In preparing a client for a colonoscopy procedure, which task is most suitable to delegate to the nursing assistant?
- A.
  
  Explain the need for clear liquids 1 – 3 days prior to procedure.
- B.
  
  Reinforce NPO status 8 hours prior to procedure.
- C.
  
  Administer laxatives 1 – 3 days prior to procedure.
- D.
  
  Administer an enema the night before the procedure.
2.

You would be most concerned about which client having an order for TPN (total parental nutrition) fat emulsion?
- A.
  
  A client with gastrointestinal obstruction
- B.
  
  A client with severe anorexia nervosa
- C.
  
  A client with chronic diarrhea and vomiting
- D.
  
  A client with a fractured femur
3.

You are caring for a client with peptic ulcer disease. Which assessment finding is the most serious?
- A.
  
  Projectile vomiting
- B.
  
  Burning sensation 2 hours after eating
- C.
  
  Coffee-grounded emesis
- D.
  
  Board-like abdomen with shoulder pain
4.

You are preparing to administer TPN through a central line. Place the steps for administration in the correct order. a. Use aseptic technique when handling the injection cap. b. Thread the IN tubing through an infusion pump. c. Check the solution for cloudiness or turbidity. d. Connect the tubing to the central line. e. Select the correct tubing and filter. f. Set infusion pump at prescribed rate. _____, _____, _____, _____, _____, _____ * Answer the letter only separated by comma
5.

You are taking an initial history for a client seeking surgical treatment for obesity. Which of the following should be called to the attention of the surgeon before proceeding with additional history or physical assessment?
- A.
  
  Obesity for approximately 5 years
- B.
  
  History of counseling for body dysmorphic disorder
- C.
  
  Failure to reduce weight with other forms of therapy
- D.
  
  Body weight 100% above the ideal for age, gender and height
6.

In educating a client with gastroesophageal reflux disease (GERD), you will teach the client that the drug therapy is a “step-up” approach that depends on the response to the medication. For the drugs listed, what is the anticipated order that the physician will try in the treatment plan? a. Magnesium trisilicate (Gaviscon) and Famotidine (Pepci AC) b. Ranitidine (Zantac) 150 mg c. Pantoprazole (Protonix) _____, _____, _____ * Answer the letter only separated by comma
7.

In caring for a client with GERD, which task would be appropriate to assign to the nursing assistant?
- A.
  
  Share successful strategies for weight reduction.
- B.
  
  Encourage the client to express concerns about lifestyle modification.
- C.
  
  Remind the client not to lie down for 2 – 3 hours after eating.
- D.
  
  Explain the rationale for small frequent meals.
8.

You are preparing to give an enteral feeding through a nasogastric tube. Place the steps in the correct order. a. Assess for bowel sounds. b. Auscultate tube placement and check pH. c. Flush the tube with water. d. Reflush the tube with water. e. Administer the feeding. f. Check for residual volume. _____, _____, _____, _____, _____, _____
9.

Care of which of these clients is most appropriate to assign to the LPN/LVN, under the supervision of an RN?
- A.
  
  A client with oral cancer who is scheduled in the morning for glossectomy
- B.
  
  An obese client returned from surgery following a vertical banded gastroplasty
- C.
  
  A client with anorexia nervosa with muscle weakness and decreased urine output
- D.
  
  A client with intractable nausea and vomiting related to chemotherapy
10.

In planning the post-operative care for a morbidly obese client, how can the expertise of the LPN/LVN best be applied?
- A.
  
  Obtain an oversized blood pressure cuff and a large-size bed.
- B.
  
  Set up a reinforced trapeze bar.
- C.
  
  Assist in the planning of bathing, turning, and ambulation.
- D.
  
  Design alternatives for routine tasks such as daily weights.
11.

A client with proctitis needs a rectal suppository. A senior nursing student assigned to this client tells you that she is afraid to insert the suppository because she has never done it before. What is the most appropriate action in supervising this student?
- A.
  
  You give the medication and report the student to the instructor.
- B.
  
  Ask the student to leave the clinical area for being unprepared.
- C.
  
  Reassign the client to an LPN/LVN.
- D.
  
  Show the student how to insert the suppository and talk to the instructor.
12.

You are teaching the client and family how to do colostomy irrigation. Place the information in the correct order. a. Hang the container at about shoulder height. b. Allow the solution to flow slowly and steadily for 5 – 10 minutes. c. Put 500 – 100 mL of lukewarm water in the container. d. Allow 30 – 45 minutes for evacuation. e. Lubricate the stoma cone and gently insert the tubing tip into the stoma. f. Clean, rinse, and dry skin, and apply a new drainage pouch. _____, _____, _____, _____, _____, _____ * Answer the letter only separated by comma
13.

You are caring for a client with a nasogastric (NG) tube. Which task can be delegated to the experienced nursing assistant?
- A.
  
  Remove the NG tube per physician order.
- B.
  
  Secure the tape if the client accidentally dislodges the tube.
- C.
  
  Disconnect the suction to allow ambulation to the toilet.
- D.
  
  Reconnect the suction after the client has ambulated.
14.

In planning a treatment and prevention program of chronic fecal incontinence for an elderly client, which intervention should you try first?
- A.
  
  Administer a glycerin suppository 15 minutes before evacuation time.
- B.
  
  Insert a rectal tube at specified intervals each day.
- C.
  
  Assist the client to the bedpan or toilet 30 minutes after meals.
- D.
  
  Use incontinence briefs or adult-sized diapers.
15.

A client hospitalized with ulcerative colitis reports 10 – 20 small diarrhea stools per day, with abdominal pain prior to defecation. The client appears depressed and underweight and is uninterested in self-care or suggested therapies. What is the priority nursing diagnosis?
- A.
  
  Diarrhea related to irritated bowel
- B.
  
  Imbalanced Nutrition: Less Than Body Requirements related to nutrient loss
- C.
  
  Acute Pain related to increased GI motility
- D.
  
  Ineffective Therapeutic Regimen related to treatment plan
16.

While transferring a dirty laundry bag, a nursing assistant sustains a puncture would to the finger from a contaminated needle. The unit has several clients with hepatitis and AIDS; the source is unknown. Prioritize the instructions that you, as charge nurse, should give to the assistant. a. Have blood test (s) drawn protocol. b. Complete and file an incident report. c. Perform a thorough aseptic Handwashing. d. Report to the occupational health nurse. e. Follow up for results and counseling. f. Begin prophylactic drug therapy. _____, _____, _____, _____, _____, _____ * Answer the letter only separated by comma
17.

You are caring for an obese post-operative client who underwent surgery for bowel resection. As the client is moving in bed, he states, “Something popped open.” Upon examination you note wound evisceration. Place the following steps in order for handling this complication. a. Cover the intestine with sterile moistened gauze b. Stay calm and stay with the client. c. Monitor the vital signs especially BP and pulse. d. Have a colleague gather supplies and contact the physician. e. Put the client into semi-Fowler’s with knees slightly flexed. f. Prepare the client for surgery as ordered. _____, _____, _____, _____, _____, _____* Answer the letter only separated by comma
18.

You are caring for a post-operative cholecystectomy client. What should be reported immediately to the physician?
- A.
  
  The client cannot void 4 hours post-operatively.
- B.
  
  The client reports shoulder pain.
- C.
  
  The client reports severe RUQ tenderness.
- D.
  
  Output does not equal input for the first few hours.
19.

In caring for a client with acute viral hepatitis, which task should be delegated to the nursing assistant?
- A.
  
  Empty the bedpan while wearing gloves.
- B.
  
  Suggest diversional activities.
- C.
  
  Monitor dietary preferences.
- D.
  
  Reports signs and symptoms of jaundice.
20.

A client with cirrhosis is at risk for developing complications. Which condition is the most serious and potentially life-threatening?
- A.
  
  Esophageal varices
- B.
  
  Ascites
- C.
  
  Peripheral edema
- D.
  
  Asterixis (liver flap)
21.

For clients coming to the ambulatory care GI clinic, which task would be most appropriate to assign to the LPN/LVN?
- A.
  
  Teach a client self-care measures for hemorrhoids.
- B.
  
  Assist the physician in incision and drainage of a pilonidal cyst.
- C.
  
  Evaluate a client’s response to sitz baths for an anorectal abscess.
- D.
  
  Describe the basic pathophysiology of an anal fistula to a client.
22.

A client underwent an exploratory laparotomy 2 days ago. The physician should be called immediately for which physical assessment finding?
- A.
  
  Abdominal distention and rigidity
- B.
  
  NG tube intentionally displaced by client
- C.
  
  Absent or hypoactive bowel sounds
- D.
  
  Nausea and occasional vomiting
23.

As nurse manager, you must select an employee to participate in a hospital committee that will develop client education brochures about common abdominal surgeries and wound care. Who would be the best employee to send to this committee?
- A.
  
  Newly graduated medical-surgical RN
- B.
  
  Experienced medical-surgical RN
- C.
  
  Experienced surgical intensive care unit RN
- D.
  
  Experienced medical-surgical LPN/LVN
24.

A client is admitted through the emergency department for a strangulated intestinal obstruction with perforation. What interventions do you anticipate for this emergency condition? (Choose all that apply.)
- A.
  
  Preparation for surgery
- B.
  
  Barium enema
- C.
  
  NG tube insertion
- D.
  
  Abdominal x-ray
- E.
  
  IV fluids
25.

You must rearrange the room assignment for several clients. Which two clients would best suited to put in the same room?
- A.
  
  A 35-year-old female with copious, intractable diarrhea and vomiting
- B.
  
  A 43-year-old female second day post-operative cholecystectomy
- C.
  
  A 53-year-old female with pain related to alcohol-associated pancreatitis
- D.
  
  A 62-year-old female with colon cancer receiving chemotherapy and radiation