NURS 432 GI Review questions with accurate answers
. The nurse is caring for a patient with liver disease. When assessing the
patients laboratory values, the nurse should:
a.
disregard the level of conjugated bilirubin.
b.
assess the indirect serum bilirubin.
c.
call the provider immediately if the direct bilirubin is elevated.
d.
be aware that unconjugated bilirubin is harmless. Ans✓✓✓ ANS: B
Bilirubin enters the circulation bound to albumin and is unconjugated.
This portion of the bilirubin is reflected in the indirect serum bilirubin
level. Accumulation of unconjugated bilirubin is toxic to cells. In the
liver, bilirubin is conjugated with glucuronic acid. Conjugated bilirubin
,is soluble and excreted in bile. Some conjugated bilirubin returns to the
blood and is reflected in the direct serum bilirubin level.
1. The nurse is performing an initial assessment and notes that the client
weighs 186.4 lb (84.7 kg). Six months ago, the client
weighed 211.8 lb (96.2 kg). What action by the nurse is appropriate?
a. Ask the client if the weight loss was intentional.
b. Determine if there are food allergies or intolerances.
c. Perform a comprehensive nutritional assessment.
d. Perform a rapid bedside blood glucose test. Ans✓✓✓ ANS: A
This client has had a 12% weight loss. The nurse first determines if the
weight loss was intentional. If not, then the nurse proceeds
to a comprehensive nutritional assessment. Food intolerances are part of
this assessment. Depending on risk factors and other
findings, a blood glucose test may be warranted.
1. The nurse understands that undernutrition can occur in hospitalized
clients for several reasons. Which of the following factors are
possible reasons for this complication to occur? (Select all that apply.)
a. Cultural food preferences
b. Family bringing snacks
c. Increased need for nutrition
d. Need for NPO status
e. Staff shortages Ans✓✓✓ ANS: A, C, D, E
,Many factors increase the hospitalized client's risk for nutritional
deficits. Cultural food preferences may make hospital food
unpalatable. Ill patients have increased nutritional needs but may be
NPO for testing or treatment, or have a loss of appetite from
their illness. Staff shortages impact clients who need to be fed or assisted
with meals. The family may bring snacks that are either
healthy or unhealthy, so without further information, the nurse cannot
assume that the snacks are leading to undernutrition.
10. A client who had minimally invasive bypass gastric surgery 2 days
ago reports new-onset of severe abdominal pain. What is the
nurse's best action as this time?
a. Listen to the client's bowel sounds.
b. Call the Rapid Response Team.
c. Take the client's vital signs.
d. Contact the primary health care provider. Ans✓✓✓ ANS: C
The client may be experiencing either bleeding or anastomosis leak(s).
Clients having these complications have severe abdominal,
back, or shoulder pain, tachycardia, and hypotension.
11. A client just returned to the surgical unit after an open traditional
gastric bypass. What action by the nurse is the priority?
a. Assess the patient's pain.
b. Check the surgical incision.
c. Ensure an adequate airway.
, d. Program the morphine pump. Ans✓✓✓ ANS: C
All actions are appropriate care measures for this patient; however,
airway is always the priority. Bariatric patients tend to have
short, thick necks that complicate airway management.
12. A client is in the bariatric clinic 1 month after having gastric bypass
surgery. The client is crying and says "I didn't know it would
be this hard to live like this." What approach by the nurse is best?
a. Assess the client's coping and support systems.
b. Inform the client that things will get easier.
c. Re-educate the client on needed dietary changes.
d. Tell the client that lifestyle changes are always hard. Ans✓✓✓ ANS:
A
The nurse would assess this patient's coping styles and support systems
to best provide holistic care. The other options do not
address the patient's distress.
13. A client has been prescribed lorcaserin. What health teaching about
the drug is appropriate for the nurse to provide?
a. "Increase the fiber and water in your diet to prevent diarrhea."
b. "Report any suicidal thoughts to your primary health care provider"
c. "Report dry mouth and decreased sweating."
d. "Do not take antibiotics or nay other anti-infective drugs." Ans✓✓✓
ANS: B
. The nurse is caring for a patient with liver disease. When assessing the
patients laboratory values, the nurse should:
a.
disregard the level of conjugated bilirubin.
b.
assess the indirect serum bilirubin.
c.
call the provider immediately if the direct bilirubin is elevated.
d.
be aware that unconjugated bilirubin is harmless. Ans✓✓✓ ANS: B
Bilirubin enters the circulation bound to albumin and is unconjugated.
This portion of the bilirubin is reflected in the indirect serum bilirubin
level. Accumulation of unconjugated bilirubin is toxic to cells. In the
liver, bilirubin is conjugated with glucuronic acid. Conjugated bilirubin
,is soluble and excreted in bile. Some conjugated bilirubin returns to the
blood and is reflected in the direct serum bilirubin level.
1. The nurse is performing an initial assessment and notes that the client
weighs 186.4 lb (84.7 kg). Six months ago, the client
weighed 211.8 lb (96.2 kg). What action by the nurse is appropriate?
a. Ask the client if the weight loss was intentional.
b. Determine if there are food allergies or intolerances.
c. Perform a comprehensive nutritional assessment.
d. Perform a rapid bedside blood glucose test. Ans✓✓✓ ANS: A
This client has had a 12% weight loss. The nurse first determines if the
weight loss was intentional. If not, then the nurse proceeds
to a comprehensive nutritional assessment. Food intolerances are part of
this assessment. Depending on risk factors and other
findings, a blood glucose test may be warranted.
1. The nurse understands that undernutrition can occur in hospitalized
clients for several reasons. Which of the following factors are
possible reasons for this complication to occur? (Select all that apply.)
a. Cultural food preferences
b. Family bringing snacks
c. Increased need for nutrition
d. Need for NPO status
e. Staff shortages Ans✓✓✓ ANS: A, C, D, E
,Many factors increase the hospitalized client's risk for nutritional
deficits. Cultural food preferences may make hospital food
unpalatable. Ill patients have increased nutritional needs but may be
NPO for testing or treatment, or have a loss of appetite from
their illness. Staff shortages impact clients who need to be fed or assisted
with meals. The family may bring snacks that are either
healthy or unhealthy, so without further information, the nurse cannot
assume that the snacks are leading to undernutrition.
10. A client who had minimally invasive bypass gastric surgery 2 days
ago reports new-onset of severe abdominal pain. What is the
nurse's best action as this time?
a. Listen to the client's bowel sounds.
b. Call the Rapid Response Team.
c. Take the client's vital signs.
d. Contact the primary health care provider. Ans✓✓✓ ANS: C
The client may be experiencing either bleeding or anastomosis leak(s).
Clients having these complications have severe abdominal,
back, or shoulder pain, tachycardia, and hypotension.
11. A client just returned to the surgical unit after an open traditional
gastric bypass. What action by the nurse is the priority?
a. Assess the patient's pain.
b. Check the surgical incision.
c. Ensure an adequate airway.
, d. Program the morphine pump. Ans✓✓✓ ANS: C
All actions are appropriate care measures for this patient; however,
airway is always the priority. Bariatric patients tend to have
short, thick necks that complicate airway management.
12. A client is in the bariatric clinic 1 month after having gastric bypass
surgery. The client is crying and says "I didn't know it would
be this hard to live like this." What approach by the nurse is best?
a. Assess the client's coping and support systems.
b. Inform the client that things will get easier.
c. Re-educate the client on needed dietary changes.
d. Tell the client that lifestyle changes are always hard. Ans✓✓✓ ANS:
A
The nurse would assess this patient's coping styles and support systems
to best provide holistic care. The other options do not
address the patient's distress.
13. A client has been prescribed lorcaserin. What health teaching about
the drug is appropriate for the nurse to provide?
a. "Increase the fiber and water in your diet to prevent diarrhea."
b. "Report any suicidal thoughts to your primary health care provider"
c. "Report dry mouth and decreased sweating."
d. "Do not take antibiotics or nay other anti-infective drugs." Ans✓✓✓
ANS: B
