NURS 2207 GI Quiz: Questions & Accurate Answers
Which autoantigens are responsible for the development of Crohn disease?
1. Crypt epithelial cells
2. Thyroid cell surface
3. Basement membranes of the lungs
4. Basement membranes of the glomeruli Right Ans - 1. Crypt epithelial
cells
Rationale:
Crypt epithelial cells are considered the autoantigens responsible for Crohn
disease. Thyroid cell surfaces are autoantigens responsible for Hashimoto
thyroiditis. The pulmonary and glomerular basement membranes act as
autoantigens responsible for Goodpasture syndrome.
Parenteral vitamins are prescribed for the client with Crohn disease. The
client asks why the vitamins have to be given intravenously (IV) rather than
by mouth. Which rationales will the nurse provide? Select all that apply. One,
some, or all responses may be correct.
1. "They provide more rapid action results."
2. "They decrease colon irritability."
3. "Oral vitamins are less effective."
4. "Intestinal absorption may be inadequate."
5. "Allergic responses are less likely to occur." Right Ans - ANS: 1, 3, 4
Rationale:
Absorption through the gastrointestinal (GI) tract is impaired, and parenteral
administration goes directly into the intravascular compartment. Disease of
the GI tract hampers absorption. Because the mucosa of the intestinal tract is
damaged, its ability to absorb vitamins taken orally is greatly impaired. IV
,vitamins do not decrease colonic irritability. Route of administration does not
affect allergic response.
While awaiting surgery, a client with a history of Crohn disease is receiving
total parenteral nutrition (TPN) on an outpatient basis. The nurse teaches the
client that TPN helps prepare for surgery by which process?
1. Decreasing fecal bulk
2. Preventing bowel infection
3. Providing stimulation of secretions
4. Maintaining negative nitrogen balance Right Ans - 1. Decreasing fecal
bulk
Rationale:
By decreasing fecal bulk and bowel stimulation, TPN provides rest for the
bowel while the client awaits surgery. TPN does not prevent a bowel infection.
TPN does not stimulate gastrointestinal secretions. TPN promotes positive
nitrogen balance.
A client is admitted to the hospital with a diagnosis of Crohn disease. Which is
important for the nurse to include in the teaching plan for the client?
1. Controlling constipation
2. Meeting nutritional needs
3. Preventing increased weakness
4. Anticipating a sexual alteration Right Ans - 2. Meeting nutritional needs
Rationale:
To avoid gastrointestinal pain and diarrhea, these clients often refuse to eat
and become malnourished. The consumption of a high-calorie, high-protein
diet is advised. Diarrhea, not constipation, is a problem with Crohn disease.
Preventing an increase in weakness is a secondary concern that results from
,malnutrition; correcting the malnutrition will increase strength. Anticipating a
sexual alteration generally is not a problem with Crohn disease.
A client with Crohn disease is admitted to the hospital with a history of
chronic, bloody diarrhea, weight loss, and signs of general malnutrition. The
client has anemia, a low serum albumin level, and signs of negative nitrogen
balance. The nurse concludes that the client's health status is related to which
major deficiency?
1. Ferrous sulfate
2. Protein
3. Ascorbic acid
4. Linoleic acid Right Ans - 2. Protein
Rationale:
Protein deficiency causes a low serum albumin level, which permits fluid
shifts from the intravascular to the interstitial compartment, resulting in
edema. Decreased protein also causes anemia; protein intake must be
increased. Although a deficiency of ferrous sulfate will result in anemia, it will
not cause the other adaptations. Ascorbic acid is unrelated to these
adaptations. Linoleic acid is unrelated to these adaptations.
A client with the diagnosis of Crohn disease tells the nurse, "My partner dates
other people. I believe that behavior has caused an increase in my symptoms."
Which is an appropriate initial nursing response?
1. Help the client explore personal attitudes.
2. Educate the partner about the illness and events that affect the client's
symptoms.
3. Suggest the client should not date the partner to determine if symptoms
change.
4. Schedule the client and the partner for a counseling session. Right Ans -
1. Help the client explore personal attitudes.
, Rationale:
Because emotional stress can influence the progress of Crohn disease, initially
the nurse should help the client explore self-attitudes to aid in better
understanding the feelings engendered by the partner dating others. Initially,
the nurse should help the client explore the situation and the feelings it
engenders rather than involve the partner. The client should make the
decision about continuing to date the partner. Scheduling the client and the
partner for a counseling session is premature; the client is not ready for a joint
counseling session.
A client with severe Crohn disease develops a small bowel obstruction. Which
clinical finding would the nurse expect the client to report?
1. Bloody vomitus
2. Projectile vomiting
3. Bleeding with defecation
4. Pain in the left lower quadrant Right Ans - 2. Projectile vomiting
Rationale:
Nausea and vomiting, accompanied by diffuse abdominal pain, commonly
occur in clients with small bowel obstruction; the vomiting may be projectile
and may contain bile or fecal material. Hematemesis is associated more
closely with peptic ulcer disease. Bleeding with defecation is associated with
hemorrhoids and anal fissures. Pain in the left lower quadrant is associated
with diverticulitis. Pain associated with a small bowel obstruction usually is
more diffuse.
The nurse is assessing a client with Crohn disease who is scheduled for an
upper gastrointestinal series. Which condition would necessitate the
cancellation of the procedure?
1. Hemorrhoids
2. Hyperkalemia
Which autoantigens are responsible for the development of Crohn disease?
1. Crypt epithelial cells
2. Thyroid cell surface
3. Basement membranes of the lungs
4. Basement membranes of the glomeruli Right Ans - 1. Crypt epithelial
cells
Rationale:
Crypt epithelial cells are considered the autoantigens responsible for Crohn
disease. Thyroid cell surfaces are autoantigens responsible for Hashimoto
thyroiditis. The pulmonary and glomerular basement membranes act as
autoantigens responsible for Goodpasture syndrome.
Parenteral vitamins are prescribed for the client with Crohn disease. The
client asks why the vitamins have to be given intravenously (IV) rather than
by mouth. Which rationales will the nurse provide? Select all that apply. One,
some, or all responses may be correct.
1. "They provide more rapid action results."
2. "They decrease colon irritability."
3. "Oral vitamins are less effective."
4. "Intestinal absorption may be inadequate."
5. "Allergic responses are less likely to occur." Right Ans - ANS: 1, 3, 4
Rationale:
Absorption through the gastrointestinal (GI) tract is impaired, and parenteral
administration goes directly into the intravascular compartment. Disease of
the GI tract hampers absorption. Because the mucosa of the intestinal tract is
damaged, its ability to absorb vitamins taken orally is greatly impaired. IV
,vitamins do not decrease colonic irritability. Route of administration does not
affect allergic response.
While awaiting surgery, a client with a history of Crohn disease is receiving
total parenteral nutrition (TPN) on an outpatient basis. The nurse teaches the
client that TPN helps prepare for surgery by which process?
1. Decreasing fecal bulk
2. Preventing bowel infection
3. Providing stimulation of secretions
4. Maintaining negative nitrogen balance Right Ans - 1. Decreasing fecal
bulk
Rationale:
By decreasing fecal bulk and bowel stimulation, TPN provides rest for the
bowel while the client awaits surgery. TPN does not prevent a bowel infection.
TPN does not stimulate gastrointestinal secretions. TPN promotes positive
nitrogen balance.
A client is admitted to the hospital with a diagnosis of Crohn disease. Which is
important for the nurse to include in the teaching plan for the client?
1. Controlling constipation
2. Meeting nutritional needs
3. Preventing increased weakness
4. Anticipating a sexual alteration Right Ans - 2. Meeting nutritional needs
Rationale:
To avoid gastrointestinal pain and diarrhea, these clients often refuse to eat
and become malnourished. The consumption of a high-calorie, high-protein
diet is advised. Diarrhea, not constipation, is a problem with Crohn disease.
Preventing an increase in weakness is a secondary concern that results from
,malnutrition; correcting the malnutrition will increase strength. Anticipating a
sexual alteration generally is not a problem with Crohn disease.
A client with Crohn disease is admitted to the hospital with a history of
chronic, bloody diarrhea, weight loss, and signs of general malnutrition. The
client has anemia, a low serum albumin level, and signs of negative nitrogen
balance. The nurse concludes that the client's health status is related to which
major deficiency?
1. Ferrous sulfate
2. Protein
3. Ascorbic acid
4. Linoleic acid Right Ans - 2. Protein
Rationale:
Protein deficiency causes a low serum albumin level, which permits fluid
shifts from the intravascular to the interstitial compartment, resulting in
edema. Decreased protein also causes anemia; protein intake must be
increased. Although a deficiency of ferrous sulfate will result in anemia, it will
not cause the other adaptations. Ascorbic acid is unrelated to these
adaptations. Linoleic acid is unrelated to these adaptations.
A client with the diagnosis of Crohn disease tells the nurse, "My partner dates
other people. I believe that behavior has caused an increase in my symptoms."
Which is an appropriate initial nursing response?
1. Help the client explore personal attitudes.
2. Educate the partner about the illness and events that affect the client's
symptoms.
3. Suggest the client should not date the partner to determine if symptoms
change.
4. Schedule the client and the partner for a counseling session. Right Ans -
1. Help the client explore personal attitudes.
, Rationale:
Because emotional stress can influence the progress of Crohn disease, initially
the nurse should help the client explore self-attitudes to aid in better
understanding the feelings engendered by the partner dating others. Initially,
the nurse should help the client explore the situation and the feelings it
engenders rather than involve the partner. The client should make the
decision about continuing to date the partner. Scheduling the client and the
partner for a counseling session is premature; the client is not ready for a joint
counseling session.
A client with severe Crohn disease develops a small bowel obstruction. Which
clinical finding would the nurse expect the client to report?
1. Bloody vomitus
2. Projectile vomiting
3. Bleeding with defecation
4. Pain in the left lower quadrant Right Ans - 2. Projectile vomiting
Rationale:
Nausea and vomiting, accompanied by diffuse abdominal pain, commonly
occur in clients with small bowel obstruction; the vomiting may be projectile
and may contain bile or fecal material. Hematemesis is associated more
closely with peptic ulcer disease. Bleeding with defecation is associated with
hemorrhoids and anal fissures. Pain in the left lower quadrant is associated
with diverticulitis. Pain associated with a small bowel obstruction usually is
more diffuse.
The nurse is assessing a client with Crohn disease who is scheduled for an
upper gastrointestinal series. Which condition would necessitate the
cancellation of the procedure?
1. Hemorrhoids
2. Hyperkalemia
