Chapter 27: The Gastrointestinal System
deWit: Medical-Surgical Nursing: Concepts & Practice, 3rd Edition
1. The nurse cautions that constant stress can cause which alteration to the gastrointestinal (GI) system?
a. Slowed GI mobility resulting in constipation
b. Reversed peristalsis resulting in projectile vomiting
c. Increased digestive juices resulting in a gastric ulcer
d. Decreased digestive juices resulting in ineffective metabolism
2. The nurse is caring for multiple patients. The nurse determines that which patient has the highest risk
for developing gallstones?
a. A 37-year-old white man of normal weight on long-term corticosteroids for asthma.
b. A 42-year-old African American man of normal weight who has smoked for 25 years.
c. A 46-year-old Indonesian woman who is under normal weight and has recently had radiation
treatments.
d. A 50-year-old obese Mexican American woman who has type 1 diabetes.
.
3. The home health nurse is caring for the patient with tuberculosis who is taking rifampin and isoniazid
(INH). The nurse should carefully monitor the patient for which potential side effect?
a. Gallstones
b. Liver disorders
c. Bleeding ulcers
d. Esophagitis
4. The nurse is obtaining a history of a patient with hepatitis A. Which question is most appropriate for
the nurse to ask?
a. “If using drugs, do you share needles?”
b. “Do you always practice safe sex?”
c. “Have you traveled to Canada in the last month?”
d. “Do you eat shellfish or oysters often?”
5. The nurse is caring for a patient who complains, “I don’t see why I can’t have a CT scan instead of the
expensive MRI!” Which response is most appropriate for the nurse to make?
a. “The MRI provides better contrast between normal and pathologic tissue.”
b. “The MRI requires less analysis and is easier to read.”
c. “The MRI produces a digital image that can be transmitted via e-mail.”
d. “The MRI exposes the patient to less radiation.”
6. The nurse is preparing to administer liquid laxative to a patient in preparation for a colonoscopy.
Which action should the nurse take?
a. Offer a small snack.
b. Take the patient’s temperature.
c. Mix the laxative with orange juice.
d. Chill the laxative and pour it over ice.
,7. The nurse caring for an 80-year-old woman who is undergoing the extensive bowel preparation for a
colonoscopy. The nurse should most closely monitor the patient for which potential complication?
a. Diarrhea
b. Metabolic acidosis
c. Fatigue
d. Dyspnea
8. The nurse is caring for a patient who returns to the floor at lunch time after undergoing an upper GI
(UGI series). Which action is most important for the nurse to perform first?
a. Administer a laxative.
b. Educate the patient about the possibility of white stools.
c. Offer the patient a small snack.
d. Provide oral care.
9. The nurse is assessing a patient’s bowel sounds. After auscultating each quadrant for 30 seconds, the
nurse fails to hear any sounds. How should the nurse document this finding?
a. Absent bowel sounds
b. Hypoactive bowel sounds
c. Active bowel sounds
d. Hyperactive bowel sounds
10. When assessing a patient’s bowel sounds, nurse auscultates loud bowel sounds in each quadrant
every 3 seconds. The nurse understands that these findings could indicate that the patient is
experiencing which condition?
a. Diarrhea
b. Paralytic ileus
c. Vomiting
d. Constipation
11. The nurse is reviewing a student nurse’s charting and notes that the student has documented absent
bowel sounds. The nurse reminds the student that in order to document absent bowel sounds, one must
auscultate each quadrant at what period of time?
a. 30 seconds
b. 1 minute
c. 2 minutes
d. 5 minutes
12. The nurse is percussing a patient’s abdomen and hears a dull thud in the right upper quadrant. This
sound indicates that nurse is percussing over which location?
a. The liver
b. The small intestine
c. The stomach
d. The lungs
13. During a morning assessment, the nurse observes that a patient displays bulging flanks when supine
with the knees flexed. Which action should the nurse take next?
a. Measure the patient’s abdominal girth.
, b. Auscultate each quadrant of the abdomen for 5 minutes.
c. Document the finding.
d. Notify the charge nurse.
14. The nurse is reviewing the laboratory results of an assigned patient. The serum bilirubin is 2.8 mg/dL.
The nurse anticipates that the patient’s urine will display which finding?
a. Dark color
b. Low specific gravity
c. Very scant amount
d. Foul odor
15. The nurse is caring for a patient who is complaining of postoperative gas pain. What intervention
should nurse implement?
a. Assist the patient with ambulation.
b. Apply a cold compress on the abdomen.
c. Offer a cup of coffee or tea.
d. Offer chilled vegetable juice.
16. The nurse is planning care for a patient who has experienced moderate diarrhea for 3 days. Which
collaborative intervention is most important to include in the plan of care?
a. Place the patient on NPO status.
b. Limit the patient’s diet to clear liquids.
c. Administer parenteral nutrition.
d. Restrict the patient’s diet to soft foods only.
17. The nurse is talking with a patient who has been experiencing nausea and vomiting. The patient
indicates an interest in using alternative therapies for the condition. Which product may aid in nausea
management?
a. Ginger
b. Ginseng
c. Chamomile d. Soy
18. The nurse is caring for a patient who has been experiencing severe diarrhea and can now resume
solid foods. The nurse educates the patient about appropriate food choices. Which food choice indicates
that the nurse’s teaching has been successful?
a. Whole-grain rice
b. Wheat toast
c. Applesauce
d. Grapes
19. The nurse is performing preprocedure teaching for a patient scheduled to undergo a liver biopsy.
After listening to the information, the patient states, “I am so scared. I just don’t know if I can do this
procedure.” Which response is best?
a. “The procedure will only last about 15 minutes.”
b. “Most patients say it feels similar to a punch in the shoulder.”
c. “You do not have to have the procedure.”
d. “I understand that you are afraid. Tell me more about your concerns.”
.
deWit: Medical-Surgical Nursing: Concepts & Practice, 3rd Edition
1. The nurse cautions that constant stress can cause which alteration to the gastrointestinal (GI) system?
a. Slowed GI mobility resulting in constipation
b. Reversed peristalsis resulting in projectile vomiting
c. Increased digestive juices resulting in a gastric ulcer
d. Decreased digestive juices resulting in ineffective metabolism
2. The nurse is caring for multiple patients. The nurse determines that which patient has the highest risk
for developing gallstones?
a. A 37-year-old white man of normal weight on long-term corticosteroids for asthma.
b. A 42-year-old African American man of normal weight who has smoked for 25 years.
c. A 46-year-old Indonesian woman who is under normal weight and has recently had radiation
treatments.
d. A 50-year-old obese Mexican American woman who has type 1 diabetes.
.
3. The home health nurse is caring for the patient with tuberculosis who is taking rifampin and isoniazid
(INH). The nurse should carefully monitor the patient for which potential side effect?
a. Gallstones
b. Liver disorders
c. Bleeding ulcers
d. Esophagitis
4. The nurse is obtaining a history of a patient with hepatitis A. Which question is most appropriate for
the nurse to ask?
a. “If using drugs, do you share needles?”
b. “Do you always practice safe sex?”
c. “Have you traveled to Canada in the last month?”
d. “Do you eat shellfish or oysters often?”
5. The nurse is caring for a patient who complains, “I don’t see why I can’t have a CT scan instead of the
expensive MRI!” Which response is most appropriate for the nurse to make?
a. “The MRI provides better contrast between normal and pathologic tissue.”
b. “The MRI requires less analysis and is easier to read.”
c. “The MRI produces a digital image that can be transmitted via e-mail.”
d. “The MRI exposes the patient to less radiation.”
6. The nurse is preparing to administer liquid laxative to a patient in preparation for a colonoscopy.
Which action should the nurse take?
a. Offer a small snack.
b. Take the patient’s temperature.
c. Mix the laxative with orange juice.
d. Chill the laxative and pour it over ice.
,7. The nurse caring for an 80-year-old woman who is undergoing the extensive bowel preparation for a
colonoscopy. The nurse should most closely monitor the patient for which potential complication?
a. Diarrhea
b. Metabolic acidosis
c. Fatigue
d. Dyspnea
8. The nurse is caring for a patient who returns to the floor at lunch time after undergoing an upper GI
(UGI series). Which action is most important for the nurse to perform first?
a. Administer a laxative.
b. Educate the patient about the possibility of white stools.
c. Offer the patient a small snack.
d. Provide oral care.
9. The nurse is assessing a patient’s bowel sounds. After auscultating each quadrant for 30 seconds, the
nurse fails to hear any sounds. How should the nurse document this finding?
a. Absent bowel sounds
b. Hypoactive bowel sounds
c. Active bowel sounds
d. Hyperactive bowel sounds
10. When assessing a patient’s bowel sounds, nurse auscultates loud bowel sounds in each quadrant
every 3 seconds. The nurse understands that these findings could indicate that the patient is
experiencing which condition?
a. Diarrhea
b. Paralytic ileus
c. Vomiting
d. Constipation
11. The nurse is reviewing a student nurse’s charting and notes that the student has documented absent
bowel sounds. The nurse reminds the student that in order to document absent bowel sounds, one must
auscultate each quadrant at what period of time?
a. 30 seconds
b. 1 minute
c. 2 minutes
d. 5 minutes
12. The nurse is percussing a patient’s abdomen and hears a dull thud in the right upper quadrant. This
sound indicates that nurse is percussing over which location?
a. The liver
b. The small intestine
c. The stomach
d. The lungs
13. During a morning assessment, the nurse observes that a patient displays bulging flanks when supine
with the knees flexed. Which action should the nurse take next?
a. Measure the patient’s abdominal girth.
, b. Auscultate each quadrant of the abdomen for 5 minutes.
c. Document the finding.
d. Notify the charge nurse.
14. The nurse is reviewing the laboratory results of an assigned patient. The serum bilirubin is 2.8 mg/dL.
The nurse anticipates that the patient’s urine will display which finding?
a. Dark color
b. Low specific gravity
c. Very scant amount
d. Foul odor
15. The nurse is caring for a patient who is complaining of postoperative gas pain. What intervention
should nurse implement?
a. Assist the patient with ambulation.
b. Apply a cold compress on the abdomen.
c. Offer a cup of coffee or tea.
d. Offer chilled vegetable juice.
16. The nurse is planning care for a patient who has experienced moderate diarrhea for 3 days. Which
collaborative intervention is most important to include in the plan of care?
a. Place the patient on NPO status.
b. Limit the patient’s diet to clear liquids.
c. Administer parenteral nutrition.
d. Restrict the patient’s diet to soft foods only.
17. The nurse is talking with a patient who has been experiencing nausea and vomiting. The patient
indicates an interest in using alternative therapies for the condition. Which product may aid in nausea
management?
a. Ginger
b. Ginseng
c. Chamomile d. Soy
18. The nurse is caring for a patient who has been experiencing severe diarrhea and can now resume
solid foods. The nurse educates the patient about appropriate food choices. Which food choice indicates
that the nurse’s teaching has been successful?
a. Whole-grain rice
b. Wheat toast
c. Applesauce
d. Grapes
19. The nurse is performing preprocedure teaching for a patient scheduled to undergo a liver biopsy.
After listening to the information, the patient states, “I am so scared. I just don’t know if I can do this
procedure.” Which response is best?
a. “The procedure will only last about 15 minutes.”
b. “Most patients say it feels similar to a punch in the shoulder.”
c. “You do not have to have the procedure.”
d. “I understand that you are afraid. Tell me more about your concerns.”
.
