GI Exam Practice Questions and Answers 2023

GI Exam Practice Questions and Answers 2023 The nurse cares for a female with a diagnosis of ulcerative colitis. When reviewing the patient's chart, the nurse expects to find which of the following lab values? a) RBC = 4 mil/mm3 b) platelets = 75,000/mm3 c) Hgb = 18.2 g/dL d) WBC = 15,000/mm3 d (WBC = 15,000/mm3) -due to inflammation (ESR will also be elevated) The nurse understands which of these factors is the MOST likely source of hepatitis D? a) Eating infected shellfish b) Overly exerting oneself c) Practicing poor hygiene d) Receiving a blood transfusion d (receiving a blood transfusion) -hepatitis D co-infects with hepatitis B; spread by contact with blood and bodily fluids The nurse identifies which diet BEST meets the nutritional needs of a client diagnosed with cirrhosis? a) High in calories plus vitamin supplements b) High in protein and high in carbohydrates c) High in calcium and low in fat d) High in iron and low in salt b (high protein, high carb) (since many alcoholics are malnourished, a high-protein diet is important; there will be no change in calcium or iron requirements, and only moderate amounts of fat are allowed; cirrhosis accompanied by ascites, sodium may be restricted as well) The nurse obtains a history from a client suspected of having cirrhosis. Which statement, if made by the client to the nurse, should the nurse recognize as MOST directly related to a client's development of cirrhosis? a) "For the past several weeks I have not slept for more than five hours a night." b) "Since my spouse left me five years ago, I have been eating terribly." c) "I have been drinking about a fifth of vodka a day for the last few months." d) "My spouse was a heavy smoker, and I am concerned about second-hand smoke." c (drinking fifth of vodka/day for last few months) alcohol has a toxic effect on the liver, which causes liver inflammation; s/s include N/V, anorexia, weight loss, flatulence, fatigue, headache, ascites, jaundice, and spider angiomas The home care nurse visits a client diagnosed with hepatitis. It is most important for the nurse to intervene if the client makes which statement? a) "I take acetaminophen when I get a headache" b) "I do not drink wine with meals anymore" c) "I keep my fingernails short" d) "I wash my hands before I eat" a (acetaminophen for headache) contraindicated b/c it is hepatotoxic (instruct pt to avoid all meds unless prescribed by HCP) The nurse in the outpatient clinic is counseling a client with a diagnosis of cholecystitis. The nurse determines teaching is successful if the client makes which of the following statements? a) "I really like a lot of cream in my oatmeal." b) "We eat a lot of broiled fish and chicken." c) "I can't wait to eat the chocolate my children gave me." d) "My favorite dish is broccoli with cheese and sauce." b) "We eat a lot of broiled fish and chicken." patients with cholecystitis should eat foods high in protein and low in fat, such as broiled lean meats; cooked fruits, non-gas forming veggies, and bread are also allowed; patients should avoid high fat and gas-forming veggies such as cabbage, onions, broccoli, and cucumbers as these foods may precipitate pain, N/V Which symptoms of liver disease should the nurse expect to see in a client with Laënnec 's cirrhosis? a) Cloudy urine b) Dark urine c) Orange-colored stools d) Tarry stools b) Dark urine normally bilirubin is not excreted in urine; urine with abnormal bilirubin is mahogany-colored and has yellow foam when shaken; clients with cirrhosis may have clay-colored stools due to decreased fecal urobilinogen The nurse cares for a client with a nasogastric tube in place. The client reports discomfort in the back of the throat. Which action by the nurse is BEST? a) Move the tube out 2 inches b) Change feedings to full liquids c) Reinsert tube into other nostril d) Spray with viscous lidocaine solution d) Spray with viscous lidocaine solution viscous lidocaine is a local anesthetic; spraying it on the irritated surface may relieve the discomfort in the back of the client's throat; tube only repositioned if the tube isn't draining after irrigation The school nurse is informed that a sixth grader in the school has been diagnosed with hepatitis A. It is MOST important for the nurse to teach the parents of the classmates to observe the children for which of the following symptoms? a) Fatigue b) Increased appetite c) Tarry stools d) Pallor a) Fatigue symptoms of hepatitis include fatigue, anorexia, RUQ pain, pruritus, jaundice; client will be anorexic, stools will be clay-colored, urine will be tea-colored The nurse cares for a client diagnosed with cholelithiasis. It is MOST important to instruct the client to avoid which of the following foods? SATA a) Apples b) Cabbage c) Lettuce d) Cheese e) Chocolate f) Carrots b) Cabbage d) Cheese e) Chocolate avoid gas-forming vegetables such as onions, broccoli, radishes, beans, foods high in cholesterol/fat, egg yolks, avocado The nurse cares for the client diagnosed with acute cholecystitis. The client states, "My stomach hurts all the way up to my right shoulder. I am nauseated and have vomited twice." Which order should the nurse carry out FIRST? a) Insert nasogastric (NG) tube and attach to intermittent low suction b) Trimethobenzamide 200 mg rectally three times daily c) Morphine 15 mg IM q4h PRN d) Nothing by mouth c) Morphine 15 mg IM q4h PRN address pain to make client more comfortable before performing other orders To prepare a client for a paracentesis, it is essential for the nurse to take which action? a) administer cleansing enema b) premedicate with a narcotic analgesic c) restrict intake of fluids d) instruct client to empty the bladder d (instruct client to empty bladder) -the procedure involves removal of fluid for the client's abdomen through a trocar; the client may have bladder injured by the procedure if is is not empty & small Immediately following a liver biopsy, the nurse places the client in which position? a) on the right side b) on the left side c) prone d) supine a ) on the right side ( important to prevent leakage of fluid or hemorrhage from occurring -- ideal position is to lie directly on the liver with the ribs pushing on the liver - place a pillow under the costal margin) The nurse on the surgical unit cares for several clients with new colostomies. Immediately after surgery, the nurse identifies which of the following stomas is expected? a) A stoma is bluish and dry b) A stoma is beefy-red c) A stoma is gray and small d) A stoma is dark and pulsating b) A stoma is beefy-red immediately following surgery the stoma, which is part of the intestine, is brought out to the abdominal wall and appears beefy-red; it should be moist and protrude about 2 cm from the abdominal wall; it there is no ostomy pouch in place, cover the lumen with petrolatum gauze covered by a dry, sterile dressing The nurse cares for a patient after a traditional cholecystectomy. The nurse should contact the physician if which of the following is observed? a) 800 cc bloody drainage in the first day postop b) The patient frequently complains of abdominal pain during the first 24 hours c) Nasogastric tube connected to intermittent suction the first day postop d) Temperature elevation to 100ºF the evening of the surgery a) 800 mL bloody drainage the first day postop this amount of drainage after a cholecystectomy would indicate hemorrhage; 50 mL is an appropriate amount of drainage -- not unusual for temp to be elevated the evening of surgery (too early to develop a wound infection) The client with alcoholic cirrhosis is at great risk to develop which complication? a) hepatitis B b) pancreatic cancer c) weight gain d) epistaxis d) epistaxis bleeding is common due to decreased formation of coag factors -- GI bleeding is very common! (Hep B is the cause of cirrhosis) The nurse understands that the most common reason for insertion of an NG tube in a post-op client diagnosed with duodenal ulcer includes which reason? a) takes samples of gastric acid b) assess the stomach for bleeding c) decompress the stomach d) permit saline irrigations c (decompress stomach) -prevents distention and pressure on the suture lines post-op The nurse instructs a client about how to increase calories in the diet. The nurse determines teaching is effective if the client makes which statement? a) "I will broil all my meats" b) "I will eat bread with all my meals" c) "I will snack frequently on nuts and dried fruits" d) "I only use low-fat salad dressings" c (snack frequently on nuts & dried fruits) this adds calories (also spread butter and/or cream cheese on rolls and add butter to foods) The nurse reviews the records of a client diagnosed with Laennecs cirrhosis. The nurse expects to find which lab value? a) serum albumin 4.0 g/dL b) Serum asparate aminotransferase (AST, SGOT) 38 units c) Serum alanine amino-transaminase (ALT, SGPT) 600 units d) serum lactate dehydrogenase (LDH) 150 units c) serum ALT 600 units elevation indicates liver damage (normal = 5-35) -normal albumin = 3.5-5 g/dL (decreased in liver disease) -normal AST = 10-40 units (elevated in liver damage) -normal LDH = 100-200 units (elevated in liver disease) The nurse preforms preoperative teaching for a patient scheduled for a colostomy. The nurse explains to the patient that 24 hours after the surgery the colostomy drainage will be which of the following? a) A large amount of bloody output b) A large amount of liquid stool c) Formed stool with water d) A scant amount of bright bloody drainage d) scant amount of bright bloody drainage -small amt of bleeding at stoma is expected (report excessive amounts) The home care nurse visits a client with a diagnosis of ulcerative colitis. The client complains of perineal irritation due to frequent stools. Which suggestion by the nurse is BEST? a) Apply a heat lamp to the perineal area three times per day b) Use protective plastic bed pads c) Clean the perineal area with soap and water after each bowel movement d) Increase roughage in the diet to prevent the frequent stools c) Clean the perineal area with soap and water after each bowel movement keeps the skin free of stool; important to keep perineal area clean and dry; sitz baths; apply petroleum jelly or vitamin A and D ointment; low residue diet recommended The nurse prepares the client for a sigmoidoscopy. The nurse should notify the health care provider if the client makes which statement? a) "I took my BP med with a sip of water this am" b) "I haven't eaten any fruits or veggies since the day before yesterday" c) "I had good results from the tap water enema this morning" d) "I hope that this is easier than the barium enema I had two days ago" d (barium enema two days ago) -barium makes it difficult to visualize the colon; no barium studies for 3 days before a sigmoidoscopy Which finding describes a common complication of Crohn's disease? a) reflux esophagitis b) chronic constipation c) fistulas d) hypothermia c (fistulas) The nurse instructs the client with a sigmoid colostomy how to irrigate the colostomy. Which action does the nurse include in the teaching? a) dilate the stoma gently with gloved finger b) irrigate the colostomy using 30 mL of NS c) continue the irrigations until no stool is returned d) returns should occur 5-10 min after instilling water a (dilate stoma gently with gloved finger) The nurse cares for a patient after an appendectomy. The day after surgery, the patient has severe abdominal pain, a temperature of 101 F, and a rigid abdomen. The nurse suspects that the patient is experiencing which of the following? a) anesthesia intolerance b) abnormal pain tolerance c) infection of the peritoneal sac d) bladder distension c (infection of the peritoneal sac) -peritonitis can be caused by ruptured appendix (s/s = severe abdominal pain, rigid abdomen, decreased bowel sounds, N/V, increased temp, shock, paralytic ileus) --- monitor VS, admin ab'tics and IVs, NG tube to suction, NPO, surgery to correct cause A liver scan is ordered for a client prior to surgery. The nurse understands which description best describes the procedure? a) the client will be strapped to a table & irradiated by a cobalt scanner b) the client will stand in front of a large machine that takes x-rays of the liver c) the client will be asked to lie still while a scanning probe is passed back & forth over the body d) the client's skin will be lubricated with oil & U/S pics will be taken c (probe passes back & forth) The nurse cares for a patient after the physician performed a sigmoid colostomy due to cancer. The nurse instructs the patient about how to care for the stoma. The nurse knows that teaching is successful if the patient makes which of the following statements? a) "I will drape the area and wash the stoma with hexachlorophene soap." b) "I will clean the stoma vigorously with alcohol wipes and pat dry." c) "I will clean around the stoma with soap and water and pat dry." d) "I will drape the area and cleanse the stoma with povidone iodine." c) "I will clean around the stoma with soap and water and pat dry." provides adequate cleaning with limited irritation; observe for skin breakdown; hexachlorophene soap and alcohol wipes are both too drying and povidone iodine will cause irritation to the mucous membranes; moisturizing soaps lubricate the area, interfering with the appliance adhering to the skin