Digestive & Gastrointestinal System Disorders | NCLEX Quiz 82

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

Elevated hemoglobin level

Elevated serum bilirubin level

Elevated blood urea nitrogen level

Decreased erythrocyte sedimentation rate

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

Explanation

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

2. A female client being seen in a physician's office has just been scheduled for a barium swallow the next day. The nurse writes down which instruction for the client to follow before the test?

Fast for 8 hours before the test

Eat a regular supper and breakfast

Continue to take all oral medications as scheduled

Monitor own bowel movement pattern for constipation

A barium swallow is an x-ray study that uses a substance called barium for contrast to highlight abnormalities in the gastrointestinal tract. The client should fast for 8 to 12 hours before the test. depending on physician instructions. Most oral medications also are withheld before the test. After the procedure. the nurse must monitor for constipation. which can occur as a result of the presence of barium in the gastrointestinal tract.

Explanation

A barium swallow is an x-ray study that uses a substance called barium for contrast to highlight abnormalities in the gastrointestinal tract. The client should fast for 8 to 12 hours before the test. depending on physician instructions. Most oral medications also are withheld before the test. After the procedure. the nurse must monitor for constipation. which can occur as a result of the presence of barium in the gastrointestinal tract.

3. The nurse is caring for a male client with a diagnosis of chronic gastritis. The nurse monitors the client knowing that this client is at risk for which vitamin deficiency?

Vitamin A

Vitamin B12

Vitamin C

Vitamin E

Chronic gastritis causes deterioration and atrophy of the lining of the stomach. leading to the loss of the function of the parietal cells. The source of the intrinsic factor is lost. which results in the inability to absorb vitamin B12. This leads to the development of pernicious anemia. The client is not at risk for vitamin A. C. or E deficiency.

Explanation

Chronic gastritis causes deterioration and atrophy of the lining of the stomach. leading to the loss of the function of the parietal cells. The source of the intrinsic factor is lost. which results in the inability to absorb vitamin B12. This leads to the development of pernicious anemia. The client is not at risk for vitamin A. C. or E deficiency.

4. A male client with a peptic ulcer is scheduled for a vagotomy and the client asks the nurse about the purpose of this procedure. Which response by the nurse best describes the purpose of a vagotomy?

Halts stress reactions

Heals the gastric mucosa

Reduces the stimulus to acid secretions

Decreases food absorption in the stomach

A vagotomy. or cutting of the vagus nerve. is done to eliminate parasympathetic stimulation of gastric secretion. Options A. B. and D are incorrect descriptions of a vagotomy.

Explanation

A vagotomy. or cutting of the vagus nerve. is done to eliminate parasympathetic stimulation of gastric secretion. Options A. B. and D are incorrect descriptions of a vagotomy.

5. Polyethylene glycol-electrolyte solution (GoLYTELY) is prescribed for the female client scheduled for a colonoscopy. The client begins to experience diarrhea following administration of the solution. What action by the nurse is appropriate?

Start an IV infusion

Administer an enema

Cancel the diagnostic test

Explain that diarrhea is expected

The solution GoLYTELY is a bowel evacuant used to prepare a client for a colonoscopy by cleansing the bowel. The solution is expected to cause a mild diarrhea and will clear the bowel in 4 to 5 hours. Options A. B. and C are inappropriate actions.

Explanation

The solution GoLYTELY is a bowel evacuant used to prepare a client for a colonoscopy by cleansing the bowel. The solution is expected to cause a mild diarrhea and will clear the bowel in 4 to 5 hours. Options A. B. and C are inappropriate actions.

6. The nurse is monitoring a female client with a diagnosis of peptic ulcer. Which assessment findings would most likely indicate perforation of the ulcer?

Bradycardia

Numbness in the legs

Nausea and vomiting

A rigid. board-like abdomen

Perforation of an ulcer is a surgical emergency and is characterized by sudden. sharp. intolerable severe pain beginning in the mid epigastric area and spreading over the abdomen. which becomes rigid and board-like. Nausea and vomiting may occur. Tachycardia may occur as hypovolemic shock develops. Numbness in the legs is not an associated finding.

Explanation

Perforation of an ulcer is a surgical emergency and is characterized by sudden. sharp. intolerable severe pain beginning in the mid epigastric area and spreading over the abdomen. which becomes rigid and board-like. Nausea and vomiting may occur. Tachycardia may occur as hypovolemic shock develops. Numbness in the legs is not an associated finding.

7. The nurse is performing an abdominal assessment and inspects the skin of the abdomen. The nurse performs which assessment technique next?

Palpates the abdomen for size

Palpates the liver at the right rib margin

Listens to bowel sounds in all for quadrants

Percusses the right lower abdominal quadrant

The appropriate sequence for abdominal examination is inspection. auscultation. percussion. and palpation. Auscultation is performed after inspection to ensure that the motility of the bowel and bowel sounds are not altered by percussion or palpation. Therefore. after inspecting the skin on the abdomen. the nurse should listen for bowel sounds.

Explanation

The appropriate sequence for abdominal examination is inspection. auscultation. percussion. and palpation. Auscultation is performed after inspection to ensure that the motility of the bowel and bowel sounds are not altered by percussion or palpation. Therefore. after inspecting the skin on the abdomen. the nurse should listen for bowel sounds.

8. The nurse is assessing a male client 24 hours following a cholecystectomy. The nurse noted that the T-tube has drained 750 mL of green-brown drainage since the surgery. Which nursing intervention is appropriate?

Clamp the T-tube

Irrigate the T-tube

Notify the physician

Document the findings

Following cholecystectomy. drainage from the T-tube is initially bloody and then turns to a greenish-brown color. The drainage is measured as output. The amount of expected drainage will range from 500 to 1000 mL/day. The nurse would document the output.

Explanation

Following cholecystectomy. drainage from the T-tube is initially bloody and then turns to a greenish-brown color. The drainage is measured as output. The amount of expected drainage will range from 500 to 1000 mL/day. The nurse would document the output.

9. The nurse is reviewing the physician's orders written for a male client admitted to the hospital with acute pancreatitis. Which physician order should the nurse question if noted on the client's chart?

NPO status

Nasogastric tube inserted

Morphine sulfate for pain

An anticholinergic medication

Meperidine (Demerol) rather than morphine sulfate is the medication of choice to treat pain because morphine sulfate can cause spasms in the sphincter of Oddi. Options A. B. and D are appropriate interventions for the client with acute pancreatitis.

Explanation

Meperidine (Demerol) rather than morphine sulfate is the medication of choice to treat pain because morphine sulfate can cause spasms in the sphincter of Oddi. Options A. B. and D are appropriate interventions for the client with acute pancreatitis.

10. The nurse is reviewing the medication record of a female client with acute gastritis. Which medication. if noted on the client's record. would the nurse question?

Digoxin (Lanoxin)

Furosemide (Lasix)

Indomethacin (Indocin)

Propranolol hydrochloride (Inderal)

Indomethacin (Indocin) is a nonsteroidal anti-inflammatory drug and can cause ulceration of the esophagus. stomach. or small intestine. Indomethacin is contraindicated in a client with gastrointestinal disorders. Furosemide (Lasix) is a loop diuretic. Digoxin is a cardiac medication. Propranolol (Inderal) is a ك-adrenergic blocker. Furosemide. digoxin. and propranolol are not contraindicated in clients with gastric disorders.

Explanation

Indomethacin (Indocin) is a nonsteroidal anti-inflammatory drug and can cause ulceration of the esophagus. stomach. or small intestine. Indomethacin is contraindicated in a client with gastrointestinal disorders. Furosemide (Lasix) is a loop diuretic. Digoxin is a cardiac medication. Propranolol (Inderal) is a ك-adrenergic blocker. Furosemide. digoxin. and propranolol are not contraindicated in clients with gastric disorders.