ATI Med-Surg Test Bank, Infectious Gastrointestinal Disorders Latest 2024/2025

1.In caring for a client diagnosed with a small bowel obstruction, what would the nurse expect to do first? 1. Prepare to put in a nasogastric (NG) tube. 2. Give pain medication. 3.Draw lab work. 4.Start an intravenous (IV) line - 4.Start an intravenous (IV) line Starting an IV to give fluids and electrolytes would be the first step in caring for this client. Although an NG tube will be ordered, fluid balance is more important. Administering pain medication may make the problem worse. Drawing lab work would not be the first intervention needed for this client. 2.The nurse, instructing a client about malabsorption syndrome, should include that food is absorbed in the: . stream. ch. intestine. - intestine. The mouth and stomach are used mostly for digestion. The small intestine is where most of the absorption of food nutrients occurs. Food is not directly absorbed into the bloodstream 3.A client is diagnosed with appendicitis. One of the laboratory tests the nurse would expect to monitor would be: sodium. .2. white blood cell (WBC) count. lobin (Hgb) and hematocrit (Hct). ubin level. - .2. white blood cell (WBC) count. Infection often accompanies the inflammation of the appendix. The nurse would be looking for an elevated WBC count. Serum sodium, hemoglobin, hematocrit, and bilirubin levels are not necessarily indicated in the care of a client diagnosed with appendicitis ATI Med-Surg Test Bank, Infectious Gastrointestinal Disorders Latest 2024/2025 4.When assessing the pain in a client diagnosed with appendicitis, the nurse would expect to assess: me pain with slight palpation anywhere on the abdomen. in the upper back when the right lower quadrant is palpated. pain when the pressure is released in the right lower quadrant. pain when the abdomen is palpated. - ANS: 3 Typically rebound pain is associated with appendicitis. Rebound pain is described as more pain when pressure is released than when pressure is applied. Appendicitis pain is not associated with pain anywhere on the abdomen upon slight palpation. Appendicitis pain is not typically assessed in the upper back. Appendicitis is associated with pain. 5.A client is being evaluated for symptoms associated with diverticular disease. The nurse realizes that the best diagnostic test to be used to aid in this diagnosis would be: ted tomography (CT) scan. m enema. sound. 4.x-ray study. - ANS: 1 A CT scan is the best method of detecting abscesses and complications evidenced in diverticulitis. Barium enema is contraindicated in acute diverticulitis because of the risk of contamination if there is an existing perforation. An ultrasound or x-rays would not adequately diagnose the presence of the disorder. 6.An elderly client has noted blood in her stool for the past few months. Which information in the medical history would strongly suggest colorectal cancer? 1.Increased bouts of vomiting 2.Change in bowel habits 3.Recent infection in the blood 4.Decrease in appetite - ANS: 2 Change in bowel habits is one of the seven danger signals for cancer. Changes in bowel habits and blood in the stool are common signs of colorectal cancer. Vomiting, decreased appetite, or recent blood infection could be symptoms of other health problems, but they are not necessarily colorectal cancer. 7.The nurse is caring for a client diagnosed with irritable bowel syndrome (IBS) who is experiencing diarrhea. What medication would the nurse expect to administer? 1.Loperamide (Imodium) 2.Docusate sodium (Colace) 3.Lorazepam (Ativan) 4.Haloperidol (Haldol) - ANS: 1 Antidiarrheal agents like Imodium can be given prophylactically or symptomatically on an asneeded basis. Docusate sodium (Colace), lorazepam (Ativan), and haloperidon (Haldol) are not indicated to treat this disorder. 8.A client complains of acute gastrointestinal distress. While obtaining a health history, the nurse asks about the family history. Which disorder has a familial basis? 1. Hepatitis 2. Ulcerative colitis 3. Appendicitis 4. Bowel obstructions - ANS: 2 Genetic factors have been identified as susceptibility factors for the development of ulcerative colitis. None of the other choices have a genetic predisposition for developing the disorder. A client diagnosed with appendicitis asks the nurse why this illness occurred. The nurse should respond that the most common cause of appendicitis is: 1. ulcerative colitis. 2. obstruction of the appendix . -fat diet tion. - ANS: 2 An infection may occur with appendicitis, but the most common cause of infection is an obstruction of the appendix. The obstruction could be caused by lymph tissue, a fecalith, a foreign body, or worms. Ulcerative colitis, low-fat diet, or infection does not cause appendicitis. A young client is experiencing acute abdominal pain. The nurse realizes that the most common cause for this type of pain would be: dicitis. 2. biliary tract disease. 3. kidney stones. 4. urinary tract infection. - ANS: 1 The most common cause of acute abdominal pain is appendicitis. Biliary tract disease is the most common disorder in the elderly, causing pain in the right upper quadrant. Kidney stones and urinary tract infections do not necessarily cause abdominal pain. A client experiencing abdominal pain and diarrhea tells the nurse that he used to smoke. Which of the following gastrointestinal disturbances is this client most likely experiencing? 1.Irritable bowel syndrome 2.Crohns disease 3. Acute appendicitis 4. Small bowel obstruction - ANS: 2 Current and former smokers appear to have a greater risk of developing Crohns disease than nonsmokers. Not smoking will not cause irritable bowel syndrome, acute appendicitis, or small bowel obstruction. A client has a history of being treated for ulcerative colitis. The nurse realizes that a life threatening complication of this disorder is: 1. Crohns disease. 2. small bowel obstruction. c ulcer disease. megacolon. - ANS: 4 Toxic megacolon is a life-threatening complication of ulcerative colitis, and it requires immediate surgical intervention. Crohns disease, small bowel obstruction, and peptic ulcer disease are not life threatening complications of ulcerative colitis. The nurse assesses no bowel sounds with occasional splashing sounds over the large intestines. Which of the following do these assessment findings suggest to the nurse? 1. Ulcerative colitis 2. Irritable bowel syndrome 3. Appendicitis 4. Bowel obstruction - ANS: 4 Obstruction can be detected with absent bowel sounds and borborygmi or a splashing sound heard over the large intestine. Absent bowel sounds and borborygmi are not associated with ulcerative colitis, irritable bowel syndrome, or appendicitis. The nurse is instructing a client on diagnostic tests used to screen for colorectal cancer. Which of the following should be included in these instructions? 1.A digital rectal exam should be done annually . 2.A test for fecal occult blood should be done annually. 3.A flexible sigmoidoscopy should be done annually. 4.A colonoscopy should be done every 5 years after age 40. - ANS: 2 The nurse should instruct the client to have a fecal occult blood test done annually. A digital rectal exam is not a recommendation for this disease process. A flexible sigmoidoscopy should be done every 5 years after age 50. A colonoscopy should be done every 10 years after age 50. Before administering an antacid, the nurse should instruct a client that this medication works in the: . ch. intestine. agus. - ANS: 2 Antacids work in the stomach to neutralize stomach acids. They do not work in the esophagus or small intestines. Antacids do not work in the blood. 2.The nurse is assessing a client diagnosed with gastroesophageal reflux disease. Which of the following should be included in this assessment? 1.Degree of mouth burning 2.Difficulty swallowing 3.Presence of pyrosis 4.Painful swallowing - ANS: 3 Mouth burning is not a symptom of gastroesophageal reflux disease. Difficulty swallowing or dysphagia is not associated with gastroesophageal reflux disease. Pain when swallowing is associated with esophagitis, not acid reflux disease. Presence of pyrosis or heartburn should be assessed in this client. 3.During an assessment, the nurse determines a client is at risk for ulcerative stomatitis and gum disease because the client has a history of: 1. alcohol intake. 2. smoking. 3. kissing. g. - ANS: 2 Clients who smoke have seven times the risk of developing gum disease. Alcohol intake increases the risk of throat cancer. Ulcerative stomatitis and gum disease is not associated with kissing or eating. 4.A client is diagnosed with a swallowing disorder. The nurse realizes that which type of diet would be indicated for this client? ? 1.Regular diet 2.Clear liquid diet 3.Mechanical soft diet 4.Low-fat diet - ANS: 3 Some clients may need a pureed diet or mechanical soft diet, especially if their swallowing difficulty is with the oral phase. Some clients may have difficulty swallowing thin liquids and foods that are tough. The client will most likely have difficulty with a regular or low-fat diet. .To support the nutritional needs of a client with dysphagia, the nurse realizes that all of the following are mechanisms to provide enteral feeding EXCEPT: astric tube. taneous endoscopic gastrostomy (PEG) tube. ostomy tube. alimentation. - ANS: 4 Hyperalimentation is associated with parenteral nutrition, not enteral nutrition. The others are forms of administration of nutrients into the gastrointestinal tract. 6.A client is scheduled for diagnostic tests to determine the ability to swallow. Which of the following diagnostic tests will provide the best information regarding this clients status? 1.Pulse oximetry with water 2.Esophageal transit scintigraphy 3.Videofluoroscopy 4.Esophageal manometry - ANS: 3 The gold standard for evaluation of dysphagia is videofluoroscopy or a modified barium swallow. This test demonstrates the swallowing mechanism. The other tests may be prescribed; however, they do not provide as much information as the videofluoroscopy A client, diagnosed with a hiatal hernia, will experience which of the following symptoms most frequently? 1.Nausea 2.Vomiting 3.Diarrhea 4.Heartburn - ANS: 4 With a hiatal hernia, stomach acids reflux into the esophagus, causing pain and irritation that the patient will associate with heartburn. Nausea, vomiting, and diarrhea are not symptoms typically associated with a hiatal hernia. The nurse is instructing a client diagnosed with a hiatal hernia on ways to reduce the symptoms. Which of the following should be included in these instructions? 1.Eat large meals to keep the stomach full. 2.Drink lots of liquids so that the stomach does not have to work so hard. 3.Avoid lying down after meals. 4.Lie down after eating - ANS: 3 Sitting upright or sleeping with the head of the bed elevated helps keep the stomach contents in the stomach. The meal size should be smaller, and meals should be eaten more often so as not to overfill the stomach. A client is diagnosed with burning mouth syndrome. Which of the following interventions should be included in this clients plan of care? 1.Assess the condition of the clients teeth. 2.Collect a saliva specimen for analysis. 3. Tell the client to avoid vitamin supplements. 4. Teach the client how to conduct an oral self-assessment daily. - ANS: 1 Interventions for a client diagnosed with burning mouth syndrome include assessing the condition of the teeth. A saliva specimen is not used to diagnose this disorder. Vitamin supplements do not contribute to this disorder. An oral self- assessment does not need to be completed every day. 10.During an assessment, the nurse learns that a client is inhaling while swallowing food. Which of the following does this assessment finding suggest to the nurse? 1.The client is recovering from a stroke. 2.The client is at risk for aspiration. 3. The client will experience dyspepsia. 4. The client has esophageal reflux disease. - ANS: 2 In clients with dysphagia, inspiration commonly occurs during swallowing. This increases the risk for aspiration. This assessment finding does not indicate that the client is recovering from a stroke. This assessment finding does not indicate that the client will experience dyspepsia or that the client has esophageal reflux disease. A client is experiencing brash water. The nurse realizes this symptom is associated with: 1. oral cancer. 2. gastric ulcers. 3. dysphagia. 4. Barretts esophagus. - ANS: 4 Brash water, or the sensation of the mouth filling with saliva because of acid backflow into the esophagus, is a symptom of Barretts esophagus. Brash water is not associated with oral cancer, gastric ulcers, or dysphagia. .A client has been prescribed Zantac for gastroesophageal reflux disease. The nurse realizes this medication is classified as a: mine H2-receptor antagonist. n pump inhibitor. netic agent. istamine. - ANS: 1 Zantac is a histamine H2-receptor antagonist. This medication is not classified as being a proton pump inhibitor, prokinetic agent, or antihistamine. 13.A client is diagnosed with peptic ulcer disease caused by NSAID use. Which of the following would be indicated for this client? 1.Antibiotic therapy 2.Treatment similar to a client with peptic ulcer disease 3.Preparation for surgery 4.Insertion of a nasogastric tube for gastric lavage - ANS: 2 For clients diagnosed with peptic ulcer disease caused by NSAID use, the anti- inflammatory medication should be discontinued and the client should receive treatment similar to that of peptic ulcer disease. Surgery is not indicated. Antibiotics are not indicated. Gastric lavage is not indicated. A child care worker complains of flu-like symptoms. On further assessment, hepatitis is suspected. The nurse realizes that this individual is at risk for which type of hepatitis? 1.Hepatitis A 2.Hepatitis B 3.Hepatitis C 4.Hepatitis D - ANS: 1 Hepatitis A virus (HAV) is spread through the fecal-oral route. Child care workers are at greater risk because of potentially poor hygiene practices. Child care workers are not at the same risk for contracting hepatitis B, C, or D. An older male is diagnosed with cirrhosis of the liver. The nurse knows that the most likely cause of this problem is: in the military. ling to a foreign country. ing excessive alcohol. g bad food. - ANS: 3 The destruction to the liver from alcohol often progresses from fatty liver to alcoholic hepatitis and culminates in alcoholic cirrhosis. Alcoholic cirrhosis accounts for a great number of individuals diagnosed with this disease. Cirrhosis is not associated with being in the military, traveling to a foreign country, or eating bad food When the liver is seriously damaged, ammonia levels can rise in the body. One of the treatments for this is: istering intravenous (IV) neomycin. g vitamin K. 3. giving lactulose. 4. starting the patient on insulin. - ANS: 3 Lactulose is a laxative that works by pulling water into the stool. It also helps pull ammonia from the blood into the colon for expulsion. IV antibiotics do not reduce serum ammonia levels. Vitamin K controls bleeding, but it does not reduce ammonia levels. Insulin is not used to reduce ammonia levels. A client is scheduled for a liver biopsy. The nurse realizes that the most important sign to assess for is: tion. ing. . a and vomiting. - ANS 2 After a liver biopsy, the client is monitored for bleeding or hemorrhage. Infection and pain are of concern, but they are not the most important signs to be monitored. Nausea and vomiting are not typically associated with a liver biopsy. .The nurse realizes that the organ which is a major site for metastases, harboring and growing cancerous cells that originated in some other part of the body, is the: n. 2. gallbladder. 3. liver. 4. stomach. - ANS: 3 In most developed countries, this secondary type of liver cancer is more common than cancer that originates in the liver itself. The spleen, gallbladder, and stomach are not major sites for metastases. A school age child is placed on a waiting list for a liver transplant. The nurse knows that the most common reason for children to need this type of transplant is because of: osis due to hepatitis C. ry atresia. 3. diabetes. 4. Crohns disease - ANS: 2 Biliary atresia is the most common reason for children to have a liver transplant. Cirrhosis due to hepatitis C is the reason for most adults to have a transplant. Children do not typically need a liver transplant for diabetes or Crohns disease. Because health care workers are at a greater risk of hepatitis B infection, it is recommended that all health care workers: 1. wash their hands often. 2. avoid foreign travel. e vaccinated. bottled water only. - ANS: 3 Because of the risk of blood and body fluid exposure, it is recommended that all health care workers be vaccinated against hepatitis B virus. All health care workers should engage in frequent handwashing, but handwashing is not the primary mechanism to prevent the onset of hepatitis B. Avoiding foreign travel and drinking bottled water only will not reduce the risk of hepatitis B .A client who usually smokes a pack of cigarettes a day tells the nurse that he cannot stand the smell of smoke. The nurse realizes that this client is in which phase of hepatitis? 1. Preicteric 2.Icteric 3.Posticteric 4.Recovery - ANS: 1 In the preicteric phase of hepatitis, some smokers will have an aversion to smoking as a first sign of the disease. Smoking is not affected with the icteric or posticteric phases of the disease. Recovery is not a phase of hepatitis. A female client is surprised to learn that she has been diagnosed with hemochromatosis. Which of the following should the nurse respond to this client? 1.It doesnt affect people until they are in their 50s. 2. I would ask the doctor if hes sure about the diagnosis. 3. Females often do not experience the effects of the disease until menopause. 4.All women have the disorder but not the symptoms. - ANS: 3 Women do not experience the effects of hemochromatosis until menopause when the regular loss of blood stops. This disorder is a genetic disorder and can affect individuals of all ages. The nurse should not doubt the physicians diagnosis. All women do not have this disorder. .A client is diagnosed with liver disease. Which of the following is one impact of this disorder on a clients fluid and electrolyte status? 1.Hyperkalemia 2.Hypercalcemia 3.Hypernatremia 4.Hyponatremia - ANS: 4 Liver disease effects the fluid and electrolyte status by causing ascites, edema, hypokalemia, hypocalcemia, and hyponatremia. Liver disease does not cause hyperkalemia, hypercalcemia, or hypernatremia. The nurse, caring for a client recovering from the placement of a shunt to treat portal hypertension, should assess the client for which of the following complications associated with this surgery? 1.Myocardial infarction 2.Pulmonary emboli 3.Pulmonary edema .Decreased peripheral pulses - ANS: 3 Complications after shunt surgery include the development of pulmonary edema. Myocardial infarction, pulmonary emboli, and decreased peripheral pulses are not complications associated with this type of surgery. A client is diagnosed with macrovesicular fatty liver. Which of the following should the nurse instruct this client? 1.Expect to develop jaundice. 2.Avoid all alcohol. 3. Increase exercise. 4. Treatment includes antibiotic therapy - ANS: 2 The client diagnosed with macrovesicular fatty liver should be instructed to avoid all alcohol. Jaundice is a symptom of microvesicular fatty liver. The client should be instructed to rest. Antibiotic therapy is not indicated for macrovesicular fatty liver. The nurse clarifies that unconjugated bilirubin, which is made up of broken-down red cells, is: a. stored in the gallbladder to make bile. b. water insoluble bilirubin that must be converted by the liver. c. a by-product which is excreted directly into the bowel for excretion. d. necessary for digestion of fats. - ANS: B Unconjugated bilirubin is a water-insoluble product that must be converted in the liver to conjugated bilirubin (water soluble) so that it may be excreted through the bowel. The patient with cirrhosis has an albumin of 2.8 g/dL. The nurse is aware that normal is 3.5 g/dL to 5 g/dL. Based on these findings, what would the nurse expect the patient to exhibit? a. Jaundice b. Edema c. Copious urine output d. Pallor - ANS: B Low serum albumin levels result also from excessive loss of albumin into urine or into third-space volumes, causing ascites or edema. Which nursing intervention should be completed immediately after the physician has performed a needle liver biopsy? a. Assisting to ambulate for the bathroom b. Keeping the patient on the right side for a minimum of 2 hours c. Taking vital signs every 4 hours d. Keeping the patient on the left side for a minimum of 4 hours - ANS: B Keep the patient lying on the right side for minimum of 2 hours to splint the puncture site. It compresses the liver capsule against the chest wall to decrease the risk of hemorrhage or bile leak. Vital signs are taken every 15 minutes for 30 minutes, then every 30 minutes for 2 hours. Immediately following a liver biopsy, the patient becomes dyspneic, the pulse increases to 100, and no breath sounds can be heard on the affected side. What should the nurse suspect? a. Peritonitis b. Pneumothorax C. Hemorrhage of the liver d. Pleural effusion - ANS: B Pneumothorax is a possible complication of paracentesis. The patients head of the bed should be raised slightly, but kept on the right side. Oxygen should be administered and the assessment reported to the charge nurse and documented. The patients cirrhosis of the liver has also caused a dilation of the veins of the lower esophagus secondary to portal hypertension, resulting in the development of the complication of: a. esophageal varices. b. diverticulosis. c. Crohn disease. d. esophageal reflux (GERD). - ANS: A Esophageal varices (a complex of longitudinal, tortuous veins at the lower end of the esophagus) enlarge and become edematous as the result of portal hypertension. The patient with cirrhosis has a rising ammonia level and is becoming disoriented. The patient waves to the nurse as she enters the room. How should the nurse interpret this? a. As an attempt to get the nurses attention b. As asterixis c. As an indication of respiratory obstruction from varices d. As spasticity - ANS: B Asterixis is the flapping tremor seen as the patient deteriorates into ammonia intoxication or hepatic encephalopathy .How does the administration of neomycin (Mycifradin) reduce the production of ammonia? a. By assisting the hepatic cells to regenerate b. By reducing ascites c. By decreasing the bacteria in the gut d. By helping to digest fats and proteins - ANS: C The buildup of ammonia can be prevented with the use of lactulose (Chronulac) and neomycin. Ammonia is produced in the gut by bacterial action. By reducing the bacteria, less ammonia is produced The nurse explains that the use of cyclosporine as an immunosuppressant has been successful in the reduction of rejection of liver transplants because the drug: a. increases the rate of the regeneration of liver cells. b. can overcome complications presented by hepatitis C. c. increases blood supply to transplant. d. does not suppress bone marrow. - ANS: D Cyclosporine is an immunosuppressant that does not cause bone marrow suppression nor does it impede healing. A family member of a patient asks the nurse about the protein-restricted diet ordered because of advanced liver disease with hepatic encephalopathy. What statement by the nurse would best explain the purpose of the diet? a. The liver cannot rid the body of ammonia that is made by the breakdown of protein in the digestive system. b. The liver heals better with a high-carbohydrate diet rather than with a diet high in protein. c. Most people have too much protein in their diets. The amount in this diet is better for liver healing. d. Because of portal hypertension, the blood flows around the liver, and ammonia made from protein collects in the brain, causing hallucinations. - ANS: A The patient with hepatic encephalopathy is on a very low-protein to no-protein diet. The goal of management of hepatic encephalopathy is the reduction of ammonia formation in the intestines. 10.The nurse would make provisions in the plan of care for a person who has had a liver transplant to prevent: a. fluid congestion. b. fatigue. c. infection. d. urinary retention. - ANS: C A critical aspect of nursing care following liver transplantation is monitoring for infection. The major postoperative complications of a liver transplant are rejection and infection .The nurse clarifies that deterioration progresses through stages before presenting with liver disease. Place the stages in order. (Separate letters by a comma and space as follows: A, B, C, D) a. Liver disease b. Inflammation c. Hepatic insufficiency d. Destruction e. Fibrotic regeneration - ANS: D, B, E, C, A Liver deterioration follows a pattern of stages: destruction, inflammation, fibrotic regeneration; hepatic insufficiency then presents as liver disease. What are the indications for a liver transplant? (Select all that apply.) a. Congenital biliary abnormalities b. Hepatic malignancy Chronic hepatitis d. Cirrhosis due to alcoholism e. Gallbladder disease - ANS: A, B, C Indications for liver transplantation include congenital biliary abnormalities, inborn errors of metabolism, hepatic malignancy (confined to the liver), sclerosing cholangitis, and chronic end-stage liver disease. An intravenous pyelogram confirms the presence of a 4-mm renal calculus in the proximal left ureter of a newly admitted patient. Physician orders include meperidine (Demerol) 100 mg IM q4h PRN, strain all urine, and encourage fluids to 4000 mL/day. What should be the nurses highest priority when planning care for this patient? a. Pain related to irritation of a stone b. Anxiety related to unclear outcome of condition c. Ineffective health maintenance related to lack of knowledge about prevention of stones d. Risk for injury related to disorientation - ANS: A Nursing diagnoses directed at pain control are of primary importance at the early stages of care. Opioid medications manage the pain well.