Trivia Quiz On Gastrointestinal Health Problems!

1. A client diagnosed with peptic ulcer disease wants to know why he is being given antibiotics. The nurse's best answer would be:

"Antibiotics help calm the stomach and decrease the symptoms."

"Antibiotics decrease dumping syndrome, which can lead to PUD."

"H. pylori is a bacterial cause for PUD and antibiotics will treat the cause."

"The excess acid can be decreased when the stomach is sterile."

Rationale: The bacteria H. pylori has been discovered to be the leading cause of many ulcers and can be treated with success by antibiotics. Options 1, 2, and 4 are unrealistic answers for the action of antibiotics.

Explanation

Rationale: The bacteria H. pylori has been discovered to be the leading cause of many ulcers and can be treated with success by antibiotics. Options 1, 2, and 4 are unrealistic answers for the action of antibiotics.

2. A client states, "My doctor told me to quit taking aspirin since I've developed this ulcer. I have to take aspirin to keep my arthritis from hurting. I don't know what to do." Which response on the part of the nurse is best?

"Let's worry about treating your ulcer—your arthritis will have to wait."

"Aspirin is one of the medications that makes an ulcer worse; another medicine can be ordered by the doctor for your arthritis."

"Go ahead and take the aspirin if it helps, but watch closely for bleeding."

"The doctor knows what is best for you, and you should follow those instructions."

Rationale: Aspirin is one of the nonsteroidal anti-inflammatory drugs (NSAIDs). These drugs are predisposing or contributing factors in the development of an ulcer, because of the effect on prostaglandins. Many of the medications used for arthritis may also irritate an ulcer; therefore, a physician should be consulted.

Explanation

Rationale: Aspirin is one of the nonsteroidal anti-inflammatory drugs (NSAIDs). These drugs are predisposing or contributing factors in the development of an ulcer, because of the effect on prostaglandins. Many of the medications used for arthritis may also irritate an ulcer; therefore, a physician should be consulted.

3. A female client complains of a burning, cramping pain in the top part of the abdomen that becomes worse in the middle of the afternoon and sometimes awakens her at night. She reports that eating something usually helps the pain go away but that the pain is now becoming more intense. Which of the following is the best conclusion for the nurse to draw?

These symptoms are consistent with an ulcer.

The client is probably developing cholelithiasis.

The client probably has indigestion and needs to watch what she eats.

A snack before bed should be recommended.

Rationale: This description of pain is consistent with ulcer pain. The pain is epigastric and is worse when the stomach is empty and is relieved by food. These symptoms are not common with cholelithiasis. Ordinary indigestion does not present with this clinical scenario.

Explanation

Rationale: This description of pain is consistent with ulcer pain. The pain is epigastric and is worse when the stomach is empty and is relieved by food. These symptoms are not common with cholelithiasis. Ordinary indigestion does not present with this clinical scenario.

4. In caring for a client with a hiatal hernia, which of the following should be included in a teaching plan regarding causes?

To avoid heavy lifting

A dietary plan based on soft foods

Its prevalence in young adults

Its prevalence in fair-skinned individuals

Rationale: Heavy lifting is one factor that leads to development of a hiatal hernia. Dietary factors involve limiting fat intake or spicy foods, not restricting the client to soft foods. It is more prevalent in individuals who are middle-aged or older. Fair-skinned individuals are not prone to this condition.

Explanation

Rationale: Heavy lifting is one factor that leads to development of a hiatal hernia. Dietary factors involve limiting fat intake or spicy foods, not restricting the client to soft foods. It is more prevalent in individuals who are middle-aged or older. Fair-skinned individuals are not prone to this condition.

5. A client says to the nurse, "My doctor told me my ulcer may have been caused by bacteria. I thought ulcers were caused by diet and too much stress." Which of the following responses by the nurse is the best?

"If it was caused by bacteria, you would have a fever as a result of the inflammatory process."

"We know that ulcers are communicable. They can be spread easily. Be careful you don't spread it to your children."

"Diet and stress have nothing to do with developing an ulcer."

"Even though the bacteria Heliobacter pylori causes inflammation, other factors may cause increased acid in the stomach."

Rationale: H. pylori causes release of toxins and enzymes that promote inflammation and ulceration. It is not spread from one person to another. Contributing factors are those that increase secretion of acid and pepsin

Explanation

Rationale: H. pylori causes release of toxins and enzymes that promote inflammation and ulceration. It is not spread from one person to another. Contributing factors are those that increase secretion of acid and pepsin

6. A female client complains of a burning, cramping pain in the top part of the abdomen that becomes worse in the middle of the afternoon and sometimes awakens her at night. She reports that eating something usually helps the pain go away but that the pain is now becoming more intense. Which of the following is the best conclusion for the nurse to draw?

These symptoms are consistent with an ulcer.

The client is probably developing cholelithiasis.

The client probably has indigestion and needs to watch what she eats.

A snack before bed should be recommended.

Rationale: This description of pain is consistent with ulcer pain. The pain is epigastric and is worse when the stomach is empty and is relieved by food. These symptoms are not common with cholelithiasis. Ordinary indigestion does not present with this clinical scenario.

Explanation

Rationale: This description of pain is consistent with ulcer pain. The pain is epigastric and is worse when the stomach is empty and is relieved by food. These symptoms are not common with cholelithiasis. Ordinary indigestion does not present with this clinical scenario.

7. A client is being admitted to a hospital unit complaining of severe pain in the lower abdomen and is lying on the bed with his knees flexed. Admission vital signs reveal an oral temperature of 101.2°F. Which of the following would confirm a diagnosis of appendicitis?

The pain is localized at a position halfway between the umbilicus and the right iliac crest.

The client describes the pain as occurring 2 hours after eating.

The pain subsides after eating.

The pain is in the left lower quadrant.

Rationale: Pain over McBurney's point, the point halfway between the umbilicus and the iliac crest, is diagnostic for appendicitis. Assessment for rebound tenderness would also assist in the diagnosis. Options 2 and 3 are common with ulcers; option 4 may suggest ulcerative colitis or diverticulitis.

Explanation

Rationale: Pain over McBurney's point, the point halfway between the umbilicus and the iliac crest, is diagnostic for appendicitis. Assessment for rebound tenderness would also assist in the diagnosis. Options 2 and 3 are common with ulcers; option 4 may suggest ulcerative colitis or diverticulitis.

8. Prior to giving an analgesic for pain to a postoperative client who has a history of peptic ulcer disease (PUD), the nurse should check to see that the agent does not contain which of the following?

An opioid product

Acetaminophen (Tylenol)

Acetylsalicylic acid (aspirin)

Hydrocodone

Rationale: A client with any GI disorder, especially a peptic ulcer, should never receive any aspirin product. Many pain medications contain aspirin and are combinations of an opioid analgesic and a non-opioid analgesic such as aspirin. The nurse administering the pain medication should know what ingredients are in it. Hydrocodone is a schedule III opioid analgesic in agents such as Lortab.

Explanation

Rationale: A client with any GI disorder, especially a peptic ulcer, should never receive any aspirin product. Many pain medications contain aspirin and are combinations of an opioid analgesic and a non-opioid analgesic such as aspirin. The nurse administering the pain medication should know what ingredients are in it. Hydrocodone is a schedule III opioid analgesic in agents such as Lortab.

9. A client is complaining of dyspepsia, frequent belching, and increased salivation. The nurse suspects which of the following?

Peptic ulcer disease (PUD)

Ulcerative colitis

Rolling hiatal hernia

Gastroesophageal reflux disease (GERD)

Rationale: Gastroesophageal reflux disease causes epigastric pain that is usually described as burning; it is accompanied by belching with a sour taste, pain after eating, increased salivation, and flatulence. The symptoms of a sliding hiatal hernia are similar to GERD, but not those of a rolling hernia. Symptoms of PUD are more pronounced and reflective of a full or empty stomach. Ulcerative colitis symptoms are related to pain and bowel movements. Cognitive Level: Application

Explanation

Rationale: Gastroesophageal reflux disease causes epigastric pain that is usually described as burning; it is accompanied by belching with a sour taste, pain after eating, increased salivation, and flatulence. The symptoms of a sliding hiatal hernia are similar to GERD, but not those of a rolling hernia. Symptoms of PUD are more pronounced and reflective of a full or empty stomach. Ulcerative colitis symptoms are related to pain and bowel movements. Cognitive Level: Application

10. A client presents to the clinic with "bad pain" in the middle of the abdomen, vomiting, and "not knowing what is wrong." Palpation reveals rebound tenderness with increased pain halfway between the umbilicus and the top of the pelvis. The client seems to have less pain when lying on the left side and flexing the knees. What is the best conclusion for the nurse to draw?

To make sure the client does not have an impaction, an enema should be given.

Since the client is vomiting, the problem is probably gastroenteritis.

The client should be checked for possible appendicitis.

Since the client has been vomiting, nourishment may help.

Rationale: Lying on the side with legs flexed, pain over McBurney's point, and rebound tenderness are characteristic symptoms of appendicitis. Vomiting frequently accompanies the pain. The client definitely should not have an enema if appendicitis is suspected. If surgery is needed for appendicitis, the client needs to be NPO.

Explanation

Rationale: Lying on the side with legs flexed, pain over McBurney's point, and rebound tenderness are characteristic symptoms of appendicitis. Vomiting frequently accompanies the pain. The client definitely should not have an enema if appendicitis is suspected. If surgery is needed for appendicitis, the client needs to be NPO.

11. An elderly male client is worried about bright red blood in his stool along with feeling tired and worn out. The nurse determines that these symptoms are characteristic of:

Ascending (right-sided) colon cancer.

Descending (left-sided) colon cancer.

Gallbladder disease.

Gastric ulcers.

Rationale: Red blood in the stool is more characteristic of left-sided cancer of the colon. If blood occurs in the stool at all in right-sided cancer of the colon or gastric ulcers, it will be black or tarry. There is no blood in the stool of a client with gallbladder disease. Remember, bright red blood can also occur with hemorrhoids, but this choice was not available.

Explanation

Rationale: Red blood in the stool is more characteristic of left-sided cancer of the colon. If blood occurs in the stool at all in right-sided cancer of the colon or gastric ulcers, it will be black or tarry. There is no blood in the stool of a client with gallbladder disease. Remember, bright red blood can also occur with hemorrhoids, but this choice was not available.

12. Which of the following foods should be avoided in a client with peptic ulcer disease?

Vegetables

Meats

Fruits

Chocolate

Rationale: Caffeine stimulates the acid secretion and can interfere with the function of the lower esophageal sphincter. Chocolate contains caffeine and should be limited along with other drinks and foods with caffeine. Spicy or hot foods, smoking, and alcohol should also be avoided.

Explanation

Rationale: Caffeine stimulates the acid secretion and can interfere with the function of the lower esophageal sphincter. Chocolate contains caffeine and should be limited along with other drinks and foods with caffeine. Spicy or hot foods, smoking, and alcohol should also be avoided.

13. A client is admitted to the unit with a large, distended bowel, acute tenderness upon palpation of the abdomen, fever, rigidity, and absent bowel sounds. After being on the unit, the client's level of consciousness decreases, and he begins to have feculent vomit. The priority therapeutic intervention would be to:

Reduce the fever through antipyretics.

Insert an NG tube to wall suction and monitor the output.

Administer pain medications to relax the client.

Listen to bowel sounds.

Rationale: Inserting an NG tube will decompress the bowel, which will relieve the vomiting and pain and hopefully prevent the client from going into shock. This may be a measure to institute only until surgery can be performed. All of the interventions are appropriate, but vomiting fecal matter can be dangerous (as well as unpleasant) because of the possibility of aspiration, especially with a decreasing level of consciousness.

Explanation

Rationale: Inserting an NG tube will decompress the bowel, which will relieve the vomiting and pain and hopefully prevent the client from going into shock. This may be a measure to institute only until surgery can be performed. All of the interventions are appropriate, but vomiting fecal matter can be dangerous (as well as unpleasant) because of the possibility of aspiration, especially with a decreasing level of consciousness.

14. As opposed to ulcerative colitis, Crohn's disease is characterized by:

Lesions that are limited to the lower colon and rectum

Diarrhea that is self-limiting and easier to control.

Fistulas and fibrotic changes that cause the bowel to become less flexible.

Fewer problems with fluid and electrolyte imbalance.

Rationale: Crohn's disease is characterized by lesions anywhere in the gastrointestinal system. The diarrhea is more liquid and harder to control. The excessive diarrhea frequently causes fluid and electrolyte imbalance. It is often accompanied by fistulas between the colon and other organs or other segments of the bowel. The fibrotic changes cause the colon to be inflexible and thick.

Explanation

Rationale: Crohn's disease is characterized by lesions anywhere in the gastrointestinal system. The diarrhea is more liquid and harder to control. The excessive diarrhea frequently causes fluid and electrolyte imbalance. It is often accompanied by fistulas between the colon and other organs or other segments of the bowel. The fibrotic changes cause the colon to be inflexible and thick.

15. A client with Zollinger-Ellison syndrome thinks she has a rare form of cancer. The nurse explains that this syndrome is characterized by which of the following?

A destruction of the mucus-protecting cells of the stomach that could lead to an ulcer

A condition that causes increased secretion of pepsin and hydrochloric acid

A twisting of the bowel that leads to intestinal obstruction

Crohn's disease, which is an inflammatory bowel disorder

Rationale: Zollinger-Ellison syndrome is a condition usually caused by a gastrin-secreting tumor of the pancreas, stomach, or intestines that leads to the increased secretion of pepsin and hydrochloric acid. This often leads to peptic ulcer disease. Option 1 explains one of the pathologic reasons for peptic ulcer disease; option 3 explains a volvulus obstruction, and another name for Crohn's disease is regional enteritis.

Explanation

Rationale: Zollinger-Ellison syndrome is a condition usually caused by a gastrin-secreting tumor of the pancreas, stomach, or intestines that leads to the increased secretion of pepsin and hydrochloric acid. This often leads to peptic ulcer disease. Option 1 explains one of the pathologic reasons for peptic ulcer disease; option 3 explains a volvulus obstruction, and another name for Crohn's disease is regional enteritis.

16. The nurse is caring for a female client during recuperation following the development of a duodenal ulcer. The client suddenly experiences severe abdominal pain, increased heart rate, increased respiratory rate, and diaphoresis. On palpation, the abdomen is rigid; bowel sounds are faint and diminished. Which of the following nursing actions is appropriate?

Immediately place her in high Fowler's position to facilitate breathing.

Help her walk to the bathroom to get rid of any flatus.

Check to see if she has food allergies and see if she ate anything to which she might be allergic.

Establish IV access and call the doctor to report the assessment data.

Rationale: These are all signs of perforation. If the client is going into shock, it is important to establish IV access before the veins collapse. The doctor will probably schedule emergency surgery. If a client has a possible perforation, she should be in low Fowler's position (option 1) to contain the secretions in the abdomen. Walking (option 2) is not recommended, and food allergies (option 3) are not as likely to be the problem.

Explanation

Rationale: These are all signs of perforation. If the client is going into shock, it is important to establish IV access before the veins collapse. The doctor will probably schedule emergency surgery. If a client has a possible perforation, she should be in low Fowler's position (option 1) to contain the secretions in the abdomen. Walking (option 2) is not recommended, and food allergies (option 3) are not as likely to be the problem.

17. A client who is exhibiting borborygmi, cramping pain, vomiting, and diarrhea has a diagnosis of peptic ulcer disease (PUD) with recent surgical treatment. The client is probably experiencing which of the following?

Dumping syndrome

Complications of the PUD

Perforation of the stomach

Peritonitis

Rationale: Dumping syndrome is the rapid influx of stomach contents into the duodenum or jejunum causing increased peristalsis and dilation of the intestines. Although this occurs primarily after a gastrectomy, the condition can cause an ulcer.

Explanation

Rationale: Dumping syndrome is the rapid influx of stomach contents into the duodenum or jejunum causing increased peristalsis and dilation of the intestines. Although this occurs primarily after a gastrectomy, the condition can cause an ulcer.

18. An elderly client presents with fever, leukocytosis, left lower quadrant pain, and diarrhea alternating with constipation. The nurse concludes that these are frequently seen in clients with:

Appendicitis.

Diverticulitis.

Peptic ulcer disease.

Irritable bowel syndrome.

Rationale: Fever indicates an infection, ruling out options 3 and 4. Appendicitis typically causes pain in the umbilical area or right lower quadrant and is not usually accompanied by diarrhea. Fever and diarrhea accompany diverticulitis.
Cognitive Level: Application

Explanation

Rationale: Fever indicates an infection, ruling out options 3 and 4. Appendicitis typically causes pain in the umbilical area or right lower quadrant and is not usually accompanied by diarrhea. Fever and diarrhea accompany diverticulitis.
Cognitive Level: Application

19. The nurse explains to a family that main physiologic reason for weight loss in a client with Crohn's disease is which of the following?

The symptoms of anorexia prevent the client from eating.

The inflammation of the disease decreases the appetite.

The thickening and congestion of the bowel wall results in malabsorption.

The "skip lesions" interfere with food passage through the bowel.

Rationale: The bowel wall becomes congested, thickens, and sometimes develops fistulas, which can become infected. This leads to malabsorption and deficiency in absorption of folic acid, calcium, and vitamin D. The anorexia can play a role in weight loss, but most clients eat and cannot explain why they have weight loss.

Explanation

Rationale: The bowel wall becomes congested, thickens, and sometimes develops fistulas, which can become infected. This leads to malabsorption and deficiency in absorption of folic acid, calcium, and vitamin D. The anorexia can play a role in weight loss, but most clients eat and cannot explain why they have weight loss.

20. A client who has Crohn's disease and is noncompliant should be cautioned about the risk for which of the following?

Perforation of the bowel

Colorectal cancer

PUD

Ulcerative colitis

Rationale: Clients with Crohn's disease are at risk of developing cancer of the GI tract. A noncompliant client increases that risk and should be educated that Crohn's can be successfully kept under control.

Explanation

Rationale: Clients with Crohn's disease are at risk of developing cancer of the GI tract. A noncompliant client increases that risk and should be educated that Crohn's can be successfully kept under control.