Medical-Surgical: Gastrointestinal Practice Quiz and Answers
A community health nurse is planning an educational program about hepatitis A. When preparing the
materials, the nurse should identify that which of the following groups is at risk for developing hepatitis A?
- Children
- Older adults
- Women who are pregnant
- Middle-aged men - ansChildren
Rationale: The nurse should apply the safety and risk reduction priority-setting framework. This framework
assigns priority to the factor or situation posing the greatest safety risk to the client. When there are several
risks to client safety, the one posing the greatest threat is the highest priority. The nurse should use Maslow's
Hierarchy of Needs, the ABC priority-setting framework, or nursing knowledge to identify which risk poses the
greatest threat to the client. The hepatitis A virus can be contracted from the feces, bile, and blood of infected
clients. The usual mode of transmission is the fecal-oral route. Children and young adults are the two groups
most often affected by the hepatitis A virus. Typically, a child or young adult acquires the infection at school,
through poor hygiene, hand-to-mouth contact, or another form of close contact.
A nurse in the emergency department is caring for a client who has bleeding esophageal varices. The nurse
should anticipate a prescription of which of the following medications?
- Famotidine
- Esomeprazole
- Vasopressin
- Omeprazole - ansVasopressin
Rationale: Vasopressin constricts the splanchnic bed and decreases portal pressure. Vasopressin also constricts
the distal esophageal and proximal gastric veins, which reduces inflow into the portal system and is used to
treat bleeding varices.
A nurse is assessing a client who is experiencing perforation of a peptic ulcer. Which of the following
manifestations should the nurse expect?
- Increased blood pressure
, - Decreased heart rate
- Yellowing of the skin
- Boardlike abdomen - ansBoardlike abdomen
Rationale: The nurse should expect the client who is experiencing perforation of a peptic ulcer to exhibit
manifestations of a boardlike abdomen and severe pain in the abdomen or back that radiates to the right
shoulder. Vomiting of blood and shock can occur if the perforation causes hemorrhaging.
A nurse is assessing a client who is in the early stages of hepatitis A. Which of the following manifestations
should the nurse expect?
- Jaundice
- Anorexia
- Dark urine
- Pale feces - ansAnorexia
Rationale: Anorexia is an early manifestation of hepatitis A and is often severe. It is thought to result from the
release of a toxin by the damaged liver or by the failure of the damaged liver cells to detoxify an abnormal
product.
A nurse is assessing a client who was admitted with a bowel obstruction. The client reports severe abdominal
pain. Which of the following findings should indicate ti the nurse that a possible bowel perforation has
occurred?
- Elevated blood pressure
- Bowel sounds increased in frequency and pitch
- Rigid abdomen
- Emesis of undigested food - ansRegid abdomen
Rationale: Abdominal tenderness and rigidity occur with a bowel perforation. As fluid escapes into the
peritoneal cavity, there is a reduction in circulating blood volume and a lowered blood pressure, or
hypotension, results.
A community health nurse is planning an educational program about hepatitis A. When preparing the
materials, the nurse should identify that which of the following groups is at risk for developing hepatitis A?
- Children
- Older adults
- Women who are pregnant
- Middle-aged men - ansChildren
Rationale: The nurse should apply the safety and risk reduction priority-setting framework. This framework
assigns priority to the factor or situation posing the greatest safety risk to the client. When there are several
risks to client safety, the one posing the greatest threat is the highest priority. The nurse should use Maslow's
Hierarchy of Needs, the ABC priority-setting framework, or nursing knowledge to identify which risk poses the
greatest threat to the client. The hepatitis A virus can be contracted from the feces, bile, and blood of infected
clients. The usual mode of transmission is the fecal-oral route. Children and young adults are the two groups
most often affected by the hepatitis A virus. Typically, a child or young adult acquires the infection at school,
through poor hygiene, hand-to-mouth contact, or another form of close contact.
A nurse in the emergency department is caring for a client who has bleeding esophageal varices. The nurse
should anticipate a prescription of which of the following medications?
- Famotidine
- Esomeprazole
- Vasopressin
- Omeprazole - ansVasopressin
Rationale: Vasopressin constricts the splanchnic bed and decreases portal pressure. Vasopressin also constricts
the distal esophageal and proximal gastric veins, which reduces inflow into the portal system and is used to
treat bleeding varices.
A nurse is assessing a client who is experiencing perforation of a peptic ulcer. Which of the following
manifestations should the nurse expect?
- Increased blood pressure
, - Decreased heart rate
- Yellowing of the skin
- Boardlike abdomen - ansBoardlike abdomen
Rationale: The nurse should expect the client who is experiencing perforation of a peptic ulcer to exhibit
manifestations of a boardlike abdomen and severe pain in the abdomen or back that radiates to the right
shoulder. Vomiting of blood and shock can occur if the perforation causes hemorrhaging.
A nurse is assessing a client who is in the early stages of hepatitis A. Which of the following manifestations
should the nurse expect?
- Jaundice
- Anorexia
- Dark urine
- Pale feces - ansAnorexia
Rationale: Anorexia is an early manifestation of hepatitis A and is often severe. It is thought to result from the
release of a toxin by the damaged liver or by the failure of the damaged liver cells to detoxify an abnormal
product.
A nurse is assessing a client who was admitted with a bowel obstruction. The client reports severe abdominal
pain. Which of the following findings should indicate ti the nurse that a possible bowel perforation has
occurred?
- Elevated blood pressure
- Bowel sounds increased in frequency and pitch
- Rigid abdomen
- Emesis of undigested food - ansRegid abdomen
Rationale: Abdominal tenderness and rigidity occur with a bowel perforation. As fluid escapes into the
peritoneal cavity, there is a reduction in circulating blood volume and a lowered blood pressure, or
hypotension, results.
