Chapter 5: Care of the Patient with a Gastrointestinal Disorder
MULTIPLE CHOICE
1. The nurse clarifies that the end product of carbohydrate metabolism is absorbed and put into
the blood stream by the:
a. gastric lining of the stomach.
b. villi of the small intestine.
c. bile of the liver in the large intestine.
d. excretion from the cecum.
ANS: B
The inner surface of the small intestine contains millions of tiny, fingerlike projections called
villi, which contain small blood vessels. They are responsible for absorbing the products of
digestion.
DIF: Cognitive Level: Comprehension REF: Page 179 OBJ: 2
TOP: Digestive KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity
2. A 56 -year-old man is admitted to the emergency room with an acute attack of diverticulitis.
The patient has a temperature of 102° F, and has an elevated white count. Which assessment
would alert the nurse to impending septic shock?
a. Chest pain
b. Seizure
c. Tachycardia
d. Massive diarrhea
ANS: C
The patient with diverticulitis who has fever and an elevated white count has an infection that
could lead to septic shock, which will present as tachycardia and hypotension.
DIF: Cognitive Level: Comprehension REF: Page 215 OBJ: 9
TOP: Diverticulitis KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity
3. Because bowel contents from an ileostomy are virtually liquid, what should the nurse include
in the plan of care?
a. Evaluation and assessment of dietary intake of fiber
b. Evaluation and assessment of patient cleanliness
c. Evaluation and assessment of periostomal skin integrity
d. Evaluation and assessment of the adequacy of the collection device
ANS: C
The nurse should assess the periostomal skin for impairment of integrity. The fecal material is
liquid and has a potential for severe skin excoriation from the digestive enzymes.
DIF: Cognitive Level: Application REF: Page 224 OBJ: 8
TOP: Ulcerative colitis KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity
, 4. The home health nurse caring for a patient who has dysarthria related to radiation therapy for
an oral cancer would recommend that the family provide:
a. a tablet and pencil as a communication aid.
b. a TV for diversion.
c. a bell to summon help.
d. a walkie-talkie.
ANS: A
The provision of an alternative method of communicating will lessen the frustration of the
patient who has trouble speaking understandably. The call bell would be helpful also, but
without a way to communicate, the bell is not as essential as a method of communication.
DIF: Cognitive Level: Application REF: Page 187 OBJ: 5
TOP: Cancer of esophagus KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity
5. Which recommendation is most appropriate for a patient who has had an esophageal dilation
related to achalasia?
a. Consume only liquid
b. Avoid fruit juices
c. Drink 10 oz of fluid with each meal
d. Lie down for 30 minutes after each meal
ANS: C
The patient should drink fluid with each meal to increase lower esophageal pressure to push
food into the stomach.
DIF: Cognitive Level: Comprehension REF: Page 191 OBJ: 5
TOP: Esophageal dilation KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity
6. A patient who is being evaluated for episodes of hematemesis and dyspepsia tells the nurse
that pain occurs when he eats, but pain does not waken him. The nurse recognizes a diagnostic
sign of which condition?
a. Duodenal ulcer
b. Gastritis
c. Achalasia
d. Peptic ulcer
ANS: D
A significant subjective data assessment for a peptic ulcer is the patient report that pain is
associated with eating, but not with an empty stomach, because there would be pain with a
duodenal ulcer.
DIF: Cognitive Level: Knowledge REF: Page 193 OBJ: 5
TOP: Peptic ulcer KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity
7. The nurse anticipates that the patient who has had a subtotal gastrectomy will need
supplemental:
a. protein due to the loss of some of the digestive processes.
b. vitamin B12 due to the loss of the intrinsic factor.
MULTIPLE CHOICE
1. The nurse clarifies that the end product of carbohydrate metabolism is absorbed and put into
the blood stream by the:
a. gastric lining of the stomach.
b. villi of the small intestine.
c. bile of the liver in the large intestine.
d. excretion from the cecum.
ANS: B
The inner surface of the small intestine contains millions of tiny, fingerlike projections called
villi, which contain small blood vessels. They are responsible for absorbing the products of
digestion.
DIF: Cognitive Level: Comprehension REF: Page 179 OBJ: 2
TOP: Digestive KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity
2. A 56 -year-old man is admitted to the emergency room with an acute attack of diverticulitis.
The patient has a temperature of 102° F, and has an elevated white count. Which assessment
would alert the nurse to impending septic shock?
a. Chest pain
b. Seizure
c. Tachycardia
d. Massive diarrhea
ANS: C
The patient with diverticulitis who has fever and an elevated white count has an infection that
could lead to septic shock, which will present as tachycardia and hypotension.
DIF: Cognitive Level: Comprehension REF: Page 215 OBJ: 9
TOP: Diverticulitis KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity
3. Because bowel contents from an ileostomy are virtually liquid, what should the nurse include
in the plan of care?
a. Evaluation and assessment of dietary intake of fiber
b. Evaluation and assessment of patient cleanliness
c. Evaluation and assessment of periostomal skin integrity
d. Evaluation and assessment of the adequacy of the collection device
ANS: C
The nurse should assess the periostomal skin for impairment of integrity. The fecal material is
liquid and has a potential for severe skin excoriation from the digestive enzymes.
DIF: Cognitive Level: Application REF: Page 224 OBJ: 8
TOP: Ulcerative colitis KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity
, 4. The home health nurse caring for a patient who has dysarthria related to radiation therapy for
an oral cancer would recommend that the family provide:
a. a tablet and pencil as a communication aid.
b. a TV for diversion.
c. a bell to summon help.
d. a walkie-talkie.
ANS: A
The provision of an alternative method of communicating will lessen the frustration of the
patient who has trouble speaking understandably. The call bell would be helpful also, but
without a way to communicate, the bell is not as essential as a method of communication.
DIF: Cognitive Level: Application REF: Page 187 OBJ: 5
TOP: Cancer of esophagus KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity
5. Which recommendation is most appropriate for a patient who has had an esophageal dilation
related to achalasia?
a. Consume only liquid
b. Avoid fruit juices
c. Drink 10 oz of fluid with each meal
d. Lie down for 30 minutes after each meal
ANS: C
The patient should drink fluid with each meal to increase lower esophageal pressure to push
food into the stomach.
DIF: Cognitive Level: Comprehension REF: Page 191 OBJ: 5
TOP: Esophageal dilation KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity
6. A patient who is being evaluated for episodes of hematemesis and dyspepsia tells the nurse
that pain occurs when he eats, but pain does not waken him. The nurse recognizes a diagnostic
sign of which condition?
a. Duodenal ulcer
b. Gastritis
c. Achalasia
d. Peptic ulcer
ANS: D
A significant subjective data assessment for a peptic ulcer is the patient report that pain is
associated with eating, but not with an empty stomach, because there would be pain with a
duodenal ulcer.
DIF: Cognitive Level: Knowledge REF: Page 193 OBJ: 5
TOP: Peptic ulcer KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity
7. The nurse anticipates that the patient who has had a subtotal gastrectomy will need
supplemental:
a. protein due to the loss of some of the digestive processes.
b. vitamin B12 due to the loss of the intrinsic factor.
