GASTROINTESTINAL SYSTEM
DISORDERS Practice Exam #5 -
QUESTIONS AND CORRECT
ANSWERS WITH RATIONALES
2023/2024
GRADED A+ NEW
1. Question
In a client with diarrhea, which outcome indicates that fluid resuscitation is
successful?
A. The client passes formed stools at regular intervals.
B. The client reports a decrease in stool frequency and liquidity.
C. The client exhibits firm skin turgor.
D. The client no longer experiences perianal burning.
Correct Answer: C. The client exhibits firm skin turgor.
A client with diarrhea has a nursing diagnosis of Deficient fluid volume related to
excessive fluid loss in the stool. Expected outcomes include firm skin turgor, moist
mucous membranes, and urine output of at least 30 ml/hr. Evaluate dehydration by
observing skin turgor over the sternum and inspecting for longitudinal furrows of the
tongue.
Option A: The client also has a nursing diagnosis of diarrhea, with expected outcomes
of passage of formed stools at regular intervals and a decrease in stool frequency and
liquidity. Give antidiarrheal drugs as ordered. Record number and consistency of stools
per day; if desired, use a fecal incontinence collector for accurate measurement of
output.
,Option B: Have patient keep a diary that includes the following: time of day defecation
occurs; usual stimulus for defecation; consistency, amount, and frequency of stool; type
of, amount of, and time food consumed; fluid intake; history of bowel habits and laxative
use; diet; exercise patterns; obstetrical/gynecological, medical, and surgical histories;
medications; alterations in perianal sensations; and present bowel regimen.
Option D: The client is at risk for impaired skin integrity related to irritation from diarrhea;
expected outcomes for this diagnosis include absence of erythema in perianal skin and
mucous membranes and the absence of perianal tenderness or burning. Mild cleansing
of the perianal skin after each bowel movement will prevent excoriation. Barrier creams
can be used to protect the skin.
2. Question
When teaching a community group about measures to prevent colon cancer,
which instruction should the nurse include?
A. “Limit fat intake to 20% to 25% of your total daily calories.”
B. “Include 15 to 20 grams of fiber into your daily diet.”
C. “Get an annual rectal examination after age 35.”
D. “Undergo sigmoidoscopy annually after age 50.”
Correct Answer: A. “Limit fat intake to 20% to 25% of your total daily calories.”
To help prevent colon cancer, fats should account for no more than 20% to 25% of total
daily calories and the diet should include 25 to 30 grams of fiber per day. Long-chain
n-3 fatty acids have been suggested to play a protective role in colorectal cancer
development in laboratory and animal studies, with the mechanism of action
conjectured to be inhibition of the cyclooxygenase-2 (COX-2) enzyme and the
production of arachidonic acid (n-6) derived eicosanoids.
Option B: Many observational studies have reported an inverse association between
dietary fiber and CRC risk, with a relative reduction of up to 40%, although a few large
cohort studies reported small, statistically null associations. A large pooled analysis of
thirteen prospective cohorts suggested that dietary fiber intake was inversely associated
with CRC risk in age-adjusted analyses.
Option C: A digital rectal examination isn’t recommended as a stand-alone test for
colorectal cancer. All new CRC cases should be universally screened for DNA
mismatch repair/microsatellite status, and RAS/BRAF mutational testing when
considering for prognostic and predictive of chemotherapy efficacy. In almost all
patients, a diagnostic or screening colonoscopy is required for tissue biopsy
pathological confirmation of colon carcinoma.
, Option D: For colorectal cancer screening, the American Cancer Society advises clients
over age 50 to have a flexible sigmoidoscopy every 5 years, yearly fecal occult blood
tests, yearly fecal occult blood tests PLUS a flexible sigmoidoscopy every 5 years, a
double-contrast barium enema every 5 years, or a colonoscopy every 10 years.
3. Question
A 30-year old client experiences weight loss, abdominal distention, crampy
abdominal pain, and intermittent diarrhea after the birth of her 2nd child.
Diagnostic tests reveal gluten-induced enteropathy. Which foods must she
eliminate from her diet permanently?
A. Milk and dairy products
B. Protein-containing foods
C. Cereal grains (except rice and corn)
D. Carbohydrates
Correct Answer: C. Cereal grains (except rice and corn)
To manage gluten-induced enteropathy, the client must eliminate gluten, which means
avoiding all cereal grains except for rice and corn. In initial disease management, clients
eat a high-calorie, high-protein diet with mineral and vitamin supplements to help
normalize nutritional status. Gluten is a group of proteins found in certain grains, such
as wheat, rye, and barley.
Option A: Most dairy products are naturally gluten-free. However, those that are flavored
and contain additives should always be double-checked for gluten. Some common
gluten-containing ingredients that may be added to dairy products include thickeners,
malt, and modified food starch.
Option B: Many foods contain protein, including animal and plant-based sources. Most
are naturally gluten-free. However, gluten-containing ingredients, such as soy sauce,
flour, and malt vinegar are often used as fillers or flavorings. They may be added to
sauces, rubs, and marinades that are commonly paired with protein sources.
Option D: Wheat, rye, and barley are the major foods that need to be avoided while
following a gluten-free diet. Gluten is also commonly added to processed foods, such as
canned and boxed items.
4. Question
DISORDERS Practice Exam #5 -
QUESTIONS AND CORRECT
ANSWERS WITH RATIONALES
2023/2024
GRADED A+ NEW
1. Question
In a client with diarrhea, which outcome indicates that fluid resuscitation is
successful?
A. The client passes formed stools at regular intervals.
B. The client reports a decrease in stool frequency and liquidity.
C. The client exhibits firm skin turgor.
D. The client no longer experiences perianal burning.
Correct Answer: C. The client exhibits firm skin turgor.
A client with diarrhea has a nursing diagnosis of Deficient fluid volume related to
excessive fluid loss in the stool. Expected outcomes include firm skin turgor, moist
mucous membranes, and urine output of at least 30 ml/hr. Evaluate dehydration by
observing skin turgor over the sternum and inspecting for longitudinal furrows of the
tongue.
Option A: The client also has a nursing diagnosis of diarrhea, with expected outcomes
of passage of formed stools at regular intervals and a decrease in stool frequency and
liquidity. Give antidiarrheal drugs as ordered. Record number and consistency of stools
per day; if desired, use a fecal incontinence collector for accurate measurement of
output.
,Option B: Have patient keep a diary that includes the following: time of day defecation
occurs; usual stimulus for defecation; consistency, amount, and frequency of stool; type
of, amount of, and time food consumed; fluid intake; history of bowel habits and laxative
use; diet; exercise patterns; obstetrical/gynecological, medical, and surgical histories;
medications; alterations in perianal sensations; and present bowel regimen.
Option D: The client is at risk for impaired skin integrity related to irritation from diarrhea;
expected outcomes for this diagnosis include absence of erythema in perianal skin and
mucous membranes and the absence of perianal tenderness or burning. Mild cleansing
of the perianal skin after each bowel movement will prevent excoriation. Barrier creams
can be used to protect the skin.
2. Question
When teaching a community group about measures to prevent colon cancer,
which instruction should the nurse include?
A. “Limit fat intake to 20% to 25% of your total daily calories.”
B. “Include 15 to 20 grams of fiber into your daily diet.”
C. “Get an annual rectal examination after age 35.”
D. “Undergo sigmoidoscopy annually after age 50.”
Correct Answer: A. “Limit fat intake to 20% to 25% of your total daily calories.”
To help prevent colon cancer, fats should account for no more than 20% to 25% of total
daily calories and the diet should include 25 to 30 grams of fiber per day. Long-chain
n-3 fatty acids have been suggested to play a protective role in colorectal cancer
development in laboratory and animal studies, with the mechanism of action
conjectured to be inhibition of the cyclooxygenase-2 (COX-2) enzyme and the
production of arachidonic acid (n-6) derived eicosanoids.
Option B: Many observational studies have reported an inverse association between
dietary fiber and CRC risk, with a relative reduction of up to 40%, although a few large
cohort studies reported small, statistically null associations. A large pooled analysis of
thirteen prospective cohorts suggested that dietary fiber intake was inversely associated
with CRC risk in age-adjusted analyses.
Option C: A digital rectal examination isn’t recommended as a stand-alone test for
colorectal cancer. All new CRC cases should be universally screened for DNA
mismatch repair/microsatellite status, and RAS/BRAF mutational testing when
considering for prognostic and predictive of chemotherapy efficacy. In almost all
patients, a diagnostic or screening colonoscopy is required for tissue biopsy
pathological confirmation of colon carcinoma.
, Option D: For colorectal cancer screening, the American Cancer Society advises clients
over age 50 to have a flexible sigmoidoscopy every 5 years, yearly fecal occult blood
tests, yearly fecal occult blood tests PLUS a flexible sigmoidoscopy every 5 years, a
double-contrast barium enema every 5 years, or a colonoscopy every 10 years.
3. Question
A 30-year old client experiences weight loss, abdominal distention, crampy
abdominal pain, and intermittent diarrhea after the birth of her 2nd child.
Diagnostic tests reveal gluten-induced enteropathy. Which foods must she
eliminate from her diet permanently?
A. Milk and dairy products
B. Protein-containing foods
C. Cereal grains (except rice and corn)
D. Carbohydrates
Correct Answer: C. Cereal grains (except rice and corn)
To manage gluten-induced enteropathy, the client must eliminate gluten, which means
avoiding all cereal grains except for rice and corn. In initial disease management, clients
eat a high-calorie, high-protein diet with mineral and vitamin supplements to help
normalize nutritional status. Gluten is a group of proteins found in certain grains, such
as wheat, rye, and barley.
Option A: Most dairy products are naturally gluten-free. However, those that are flavored
and contain additives should always be double-checked for gluten. Some common
gluten-containing ingredients that may be added to dairy products include thickeners,
malt, and modified food starch.
Option B: Many foods contain protein, including animal and plant-based sources. Most
are naturally gluten-free. However, gluten-containing ingredients, such as soy sauce,
flour, and malt vinegar are often used as fillers or flavorings. They may be added to
sauces, rubs, and marinades that are commonly paired with protein sources.
Option D: Wheat, rye, and barley are the major foods that need to be avoided while
following a gluten-free diet. Gluten is also commonly added to processed foods, such as
canned and boxed items.
4. Question
