Brunner and Suddarth's Textbook of Medical-surgical
Nursing- Chapter 38, 39, 40, 41, 43,44 Exam Questions
And Answers | Rationales
/. Chapter 38: Assessment of Digestive and Gastrointestinal Function
1. A nurse is caring for a client who is scheduled for a colonoscopy and whose
preparation will include polyethylene glycol electrolyte lavage prior to the procedure.
The presence of what health problem would contraindicate the use of this form of bowel
preparation?
A. Inflammatory bowel disease
B. Intestinal polyps
C. Diverticulitis
D. Colon cancer - Answer-✅A
Rationale: The use of a lavage solution is contraindicated in clients with intestinal
obstruction or inflammatory bowel disease. It can safely be used with clients who have
polyps, colon cancer, or diverticulitis.
PTS: 1 REF: p. 1219
NAT: Client Needs: Physiological Integrity: Reduction of Risk Potential
TOP: Chapter 38: Assessment of Digestive and Gastrointestinal Function
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Understand
/.Multiple Choice
2. A nurse is promoting increased protein intake to enhance a client's wound healing.
What is the enzyme that will initiate the digestion of the protein that the client
consumes?
A. Pepsin
B. Intrinsic factor
C. Lipase
D. Amylase - Answer-✅A
Rationale: The enzyme that initiates the digestion of protein is pepsin. Intrinsic factor
combines with vitamin B12 for absorption by the ileum. Lipase aids in the digestion of
fats and amylase aids in the digestion of starch.
PTS: 1 REF: p. 1210
,NAT: Client Needs: Physiological Integrity: Physiological Adaptation
TOP: Chapter 38: Assessment of Digestive and Gastrointestinal Function
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Understand
/.Multiple Choice
3. A client has been brought to the emergency department with abdominal pain and is
subsequently diagnosed with appendicitis. The client is scheduled for an appendectomy
but questions the nurse about how a person's health is affected by the absence of the
appendix. How should the nurse best respond?
A. "Your appendix doesn't play a major role in health, so you won't notice any difference
after your recovery from surgery."
B. "The surgeon will encourage you to limit your fat intake for a few weeks after the
surgery, but your body will then begin to compensate."
C. "Your body will absorb slightly fewer nutrients from the food you eat, but you won't be
aware of this."
D. "Your small intestine will adapt over time to the absence of your appendix." - Answer-
✅A
Rationale: The appendix is an appendage of the cecum (not the small intestine) that has
little or no physiologic function. Its absence does not affect digestion or absorption.
PTS: 1 REF: p. 1209
NAT: Client Needs: Physiological Integrity: Physiological Adaptation
TOP: Chapter 38: Assessment of Digestive and Gastrointestinal Function
KEY: Integrated Process: Teaching/Learning BLM: Cognitive Level: Apply
/.Multiple Choice
4. An adult client is scheduled for an upper GI series that will use a barium swallow.
What teaching should the nurse include when the client has completed the test?
A. Stool will be yellow for the first 24 hours' postprocedure.
B. The barium may cause diarrhea for the next 24 hours.
C. Fluids must be increased to facilitate the evacuation of the stool.
D. Slight anal bleeding may be noted as the barium is passed. - Answer-✅C
Rationale: Postprocedural client education includes information about increasing fluid
intake; evaluating bowel movements for evacuation of barium; and noting increased
number of bowel movements. The number of bowel movement is noted because
barium, due to its high osmolarity, may draw fluid into the bowel, thus increasing the
intraluminal contents and resulting in greater output. Yellow stool, diarrhea, and anal
bleeding are not expected.
PTS: 1 REF: p. 1219
NAT: Client Needs: Physiological Integrity: Reduction of Risk Potential
TOP: Chapter 38: Assessment of Digestive and Gastrointestinal Function
,KEY: Integrated Process: Teaching/Learning BLM: Cognitive Level: Apply
/.Multiple Choice
5. A nurse is caring for a client with recurrent hematemesis who is scheduled for upper
gastrointestinal fibroscopy. How should the nurse in the radiology department prepare
this client?
A. Insert a nasogastric tube.
B. Administer a micro Fleet enema at least 3 hours before the procedure.
C. Have the client lie in a supine position for the procedure.
D. Apply local anesthetic to the back of the client's throat. - Answer-✅D
Rationale: Preparation includes spraying or gargling with a local anesthetic. A
nasogastric tube or a micro Fleet enema is not required for this procedure. The client
should be positioned in a side-lying position in case of emesis.
PTS: 1 REF: p. 1222
NAT: Client Needs: Physiological Integrity: Reduction of Risk Potential
TOP: Chapter 38: Assessment of Digestive and Gastrointestinal Function
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply
/.Multiple Choice
6. The nurse is caring for a client scheduled for a colonoscopy. The nurse should assist
the client into what position during this diagnostic test?
A. In a knee-chest position (lithotomy position)
B. Lying prone with legs drawn toward the chest
C. Lying on the left side with legs drawn toward the chest
D. In a prone position with two pillows elevating the buttocks - Answer-✅C
Rationale: For best visualization, colonoscopy is performed while the client is lying on
the left side with the legs drawn up toward the chest. A knee-chest position, lying on the
stomach with legs drawn to the chest, and a prone position with two pillows elevating
the legs do not allow for the best visualization.
PTS: 1 REF: p. 1223
NAT: Client Needs: Physiological Integrity: Reduction of Risk Potential
TOP: Chapter 38: Assessment of Digestive and Gastrointestinal Function
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply
/.Multiple Choice
7. A client has sought care because of recent dark-colored stools. As a result, a fecal
occult blood test has been ordered. The nurse should give what instructions to the
client?
A. "Take no NSAIDs within 72 hours of the test."
, B. "Take prescribed medications as usual."
C. "Avoid over-the-counter (OTC) vitamin C supplements."
D. "Do not use fiber supplements before the test." - Answer-✅A
Rationale: In the past, clients were advised to avoid ingesting red meats, aspirin,
nonsteroidal anti-inflammatory drugs, turnips, and horseradish for 72 hours prior to the
study because it was thought that these were associated with false-positive results;
likewise, clients were advised to avoid ingesting vitamin C from supplements or foods
as it was believed that this was associated with false-negative results. However, these
restrictions are no longer advised as their actual effects on test results have not been
established; plus, they unnecessarily restricted client participation in screening.
PTS: 1 REF: p. 1217
NAT: Client Needs: Physiological Integrity: Reduction of Risk Potential
TOP: Chapter 38: Assessment of Digestive and Gastrointestinal Function
KEY: Integrated Process: Teaching/Learning BLM: Cognitive Level: Apply
/.Multiple Choice
8. The nurse is preparing to perform a client's abdominal assessment. What
examination sequence should the nurse follow?
A. Inspection, auscultation, percussion, and palpation
B. Inspection, palpation, auscultation, and percussion
C. Inspection, percussion, palpation, and auscultation
D. Inspection, palpation, percussion, and auscultation - Answer-✅A
Rationale: When performing a focused assessment of the client's abdomen,
auscultation should always precede percussion and palpation because they may alter
bowel sounds. The traditional sequence for all other focused assessments is inspection,
palpation, percussion, and auscultation.
PTS: 1 REF: p. 1215
NAT: Client Needs: Physiological Integrity: Reduction of Risk Potential
TOP: Chapter 38: Assessment of Digestive and Gastrointestinal Function
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply
/.Multiple Choice
9. A client who has been experiencing changes in his bowel function is scheduled for a
barium enema. What instruction should the nurse provide for postprocedure recovery?
A. Remain NPO for 6 hours postprocedure.
B. Administer a Fleet enema to cleanse the bowel of the barium.
C. Increase fluid intake to evacuate the barium.
D. Avoid dairy products for 24 hours' postprocedure. - Answer-✅C
Nursing- Chapter 38, 39, 40, 41, 43,44 Exam Questions
And Answers | Rationales
/. Chapter 38: Assessment of Digestive and Gastrointestinal Function
1. A nurse is caring for a client who is scheduled for a colonoscopy and whose
preparation will include polyethylene glycol electrolyte lavage prior to the procedure.
The presence of what health problem would contraindicate the use of this form of bowel
preparation?
A. Inflammatory bowel disease
B. Intestinal polyps
C. Diverticulitis
D. Colon cancer - Answer-✅A
Rationale: The use of a lavage solution is contraindicated in clients with intestinal
obstruction or inflammatory bowel disease. It can safely be used with clients who have
polyps, colon cancer, or diverticulitis.
PTS: 1 REF: p. 1219
NAT: Client Needs: Physiological Integrity: Reduction of Risk Potential
TOP: Chapter 38: Assessment of Digestive and Gastrointestinal Function
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Understand
/.Multiple Choice
2. A nurse is promoting increased protein intake to enhance a client's wound healing.
What is the enzyme that will initiate the digestion of the protein that the client
consumes?
A. Pepsin
B. Intrinsic factor
C. Lipase
D. Amylase - Answer-✅A
Rationale: The enzyme that initiates the digestion of protein is pepsin. Intrinsic factor
combines with vitamin B12 for absorption by the ileum. Lipase aids in the digestion of
fats and amylase aids in the digestion of starch.
PTS: 1 REF: p. 1210
,NAT: Client Needs: Physiological Integrity: Physiological Adaptation
TOP: Chapter 38: Assessment of Digestive and Gastrointestinal Function
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Understand
/.Multiple Choice
3. A client has been brought to the emergency department with abdominal pain and is
subsequently diagnosed with appendicitis. The client is scheduled for an appendectomy
but questions the nurse about how a person's health is affected by the absence of the
appendix. How should the nurse best respond?
A. "Your appendix doesn't play a major role in health, so you won't notice any difference
after your recovery from surgery."
B. "The surgeon will encourage you to limit your fat intake for a few weeks after the
surgery, but your body will then begin to compensate."
C. "Your body will absorb slightly fewer nutrients from the food you eat, but you won't be
aware of this."
D. "Your small intestine will adapt over time to the absence of your appendix." - Answer-
✅A
Rationale: The appendix is an appendage of the cecum (not the small intestine) that has
little or no physiologic function. Its absence does not affect digestion or absorption.
PTS: 1 REF: p. 1209
NAT: Client Needs: Physiological Integrity: Physiological Adaptation
TOP: Chapter 38: Assessment of Digestive and Gastrointestinal Function
KEY: Integrated Process: Teaching/Learning BLM: Cognitive Level: Apply
/.Multiple Choice
4. An adult client is scheduled for an upper GI series that will use a barium swallow.
What teaching should the nurse include when the client has completed the test?
A. Stool will be yellow for the first 24 hours' postprocedure.
B. The barium may cause diarrhea for the next 24 hours.
C. Fluids must be increased to facilitate the evacuation of the stool.
D. Slight anal bleeding may be noted as the barium is passed. - Answer-✅C
Rationale: Postprocedural client education includes information about increasing fluid
intake; evaluating bowel movements for evacuation of barium; and noting increased
number of bowel movements. The number of bowel movement is noted because
barium, due to its high osmolarity, may draw fluid into the bowel, thus increasing the
intraluminal contents and resulting in greater output. Yellow stool, diarrhea, and anal
bleeding are not expected.
PTS: 1 REF: p. 1219
NAT: Client Needs: Physiological Integrity: Reduction of Risk Potential
TOP: Chapter 38: Assessment of Digestive and Gastrointestinal Function
,KEY: Integrated Process: Teaching/Learning BLM: Cognitive Level: Apply
/.Multiple Choice
5. A nurse is caring for a client with recurrent hematemesis who is scheduled for upper
gastrointestinal fibroscopy. How should the nurse in the radiology department prepare
this client?
A. Insert a nasogastric tube.
B. Administer a micro Fleet enema at least 3 hours before the procedure.
C. Have the client lie in a supine position for the procedure.
D. Apply local anesthetic to the back of the client's throat. - Answer-✅D
Rationale: Preparation includes spraying or gargling with a local anesthetic. A
nasogastric tube or a micro Fleet enema is not required for this procedure. The client
should be positioned in a side-lying position in case of emesis.
PTS: 1 REF: p. 1222
NAT: Client Needs: Physiological Integrity: Reduction of Risk Potential
TOP: Chapter 38: Assessment of Digestive and Gastrointestinal Function
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply
/.Multiple Choice
6. The nurse is caring for a client scheduled for a colonoscopy. The nurse should assist
the client into what position during this diagnostic test?
A. In a knee-chest position (lithotomy position)
B. Lying prone with legs drawn toward the chest
C. Lying on the left side with legs drawn toward the chest
D. In a prone position with two pillows elevating the buttocks - Answer-✅C
Rationale: For best visualization, colonoscopy is performed while the client is lying on
the left side with the legs drawn up toward the chest. A knee-chest position, lying on the
stomach with legs drawn to the chest, and a prone position with two pillows elevating
the legs do not allow for the best visualization.
PTS: 1 REF: p. 1223
NAT: Client Needs: Physiological Integrity: Reduction of Risk Potential
TOP: Chapter 38: Assessment of Digestive and Gastrointestinal Function
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply
/.Multiple Choice
7. A client has sought care because of recent dark-colored stools. As a result, a fecal
occult blood test has been ordered. The nurse should give what instructions to the
client?
A. "Take no NSAIDs within 72 hours of the test."
, B. "Take prescribed medications as usual."
C. "Avoid over-the-counter (OTC) vitamin C supplements."
D. "Do not use fiber supplements before the test." - Answer-✅A
Rationale: In the past, clients were advised to avoid ingesting red meats, aspirin,
nonsteroidal anti-inflammatory drugs, turnips, and horseradish for 72 hours prior to the
study because it was thought that these were associated with false-positive results;
likewise, clients were advised to avoid ingesting vitamin C from supplements or foods
as it was believed that this was associated with false-negative results. However, these
restrictions are no longer advised as their actual effects on test results have not been
established; plus, they unnecessarily restricted client participation in screening.
PTS: 1 REF: p. 1217
NAT: Client Needs: Physiological Integrity: Reduction of Risk Potential
TOP: Chapter 38: Assessment of Digestive and Gastrointestinal Function
KEY: Integrated Process: Teaching/Learning BLM: Cognitive Level: Apply
/.Multiple Choice
8. The nurse is preparing to perform a client's abdominal assessment. What
examination sequence should the nurse follow?
A. Inspection, auscultation, percussion, and palpation
B. Inspection, palpation, auscultation, and percussion
C. Inspection, percussion, palpation, and auscultation
D. Inspection, palpation, percussion, and auscultation - Answer-✅A
Rationale: When performing a focused assessment of the client's abdomen,
auscultation should always precede percussion and palpation because they may alter
bowel sounds. The traditional sequence for all other focused assessments is inspection,
palpation, percussion, and auscultation.
PTS: 1 REF: p. 1215
NAT: Client Needs: Physiological Integrity: Reduction of Risk Potential
TOP: Chapter 38: Assessment of Digestive and Gastrointestinal Function
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply
/.Multiple Choice
9. A client who has been experiencing changes in his bowel function is scheduled for a
barium enema. What instruction should the nurse provide for postprocedure recovery?
A. Remain NPO for 6 hours postprocedure.
B. Administer a Fleet enema to cleanse the bowel of the barium.
C. Increase fluid intake to evacuate the barium.
D. Avoid dairy products for 24 hours' postprocedure. - Answer-✅C
