Chapter 13: Abdomen and Gastrointestinal System Wilson: Health Assessment for Nursing Practice, 6th Edition

Chapter 13: Abdomen and Gastrointestinal System Wilson: Health Assessment for Nursing Practice, 6th Edition MULTIPLE CHOICE 1. A patient tells the nurse, “I’ve been having pain in my belly for several days that gets worse after eating.” Which datum from the symptom analysis is consistent with the nurse’s suspicion of peptic ulcer disease? a. Gnawing epigastric pain radiates to the back or shoulder that worsens after eating. b. Sharp midepigastric pain radiates to the jaw. c. Intermittent cramping pain in the left lower quadrant is relieved by defecation. d. Colicky pain is felt near the umbilicus with vomiting and constipation. ANS: A Gnawing epigastric pain that radiates to the back or shoulder and worsens after eating is a symptom that is consistent with peptic ulcer disease. Sharp midepigastric pain that radiates to the jaw is not a symptom of peptic ulcer disease. Intermittent cramping pain in the left lower quadrant relieved by defecation is a symptom of diverticular disease rather than peptic ulcer disease. Colicky pain felt near the umbilicus with vomiting and constipation is a symptom of an intestinal obstruction rather than peptic ulcer disease. DIF: Cognitive Level: Apply REF: p. 251 | p. 267 TOP: Nursing Process: Assessment MSC: NCLEX Patient Needs: Physiologic Integrity: Physiologic Adaptation: Alteration in Body Systems 2. During an assessment for abdominal pain, a patient reports a colicky abdominal pain and pain in the right shoulder that gets worse after eating fried foods. What question does the nurse ask to confirm the suspicion of cholelithiasis? a. “Have you noticed any swelling in your ankles or feet at the end of the day?” b. “Have you noticed a change in the color of your urine or stools?” c. “Have you vomited up any blood in the last 24 hours?” d. “Have you experienced fever, chills, or sweating?” ANS: B Gallstones can obstruct the flow of bile to the gastrointestinal tract making urine darker and stools lighter in color. The question “Have you noticed any swelling in your ankles or feet at the end of the day?” is related to fluid retention, which may be asked if the patient has renal or heart failure. The question “Have you vomited up any blood in the last 24 hours?” applies if the patient has peptic ulcer disease or esophageal varices. The question “Have you experienced fever, chills, or sweating?” applies if the patient has gastroenteritis or a urinary tract infection. DIF: Cognitive Level: Analyze REF: p. 251 | p. 268 TOP: Nursing Process: Assessment MSC: NCLEX Patient Needs: Physiologic Integrity: Reduction of Risk Potential: System Specific Assessments