Deck 22: Alterations in Gastrointestinal Function

Question 1

A patient is recovering from a colonoscopy with removal of polyps.Which teaching should the nurse provide?

A)"Rectal bleeding can occur up to a year after the polyps are removed."
B)"Rectal bleeding can occur up to 1 month after polyp removal."
C)"Contact the surgeon if any rectal bleeding occurs."
D)"Polyp removal weakens the intestinal wall,so bleeding may occur off and on indefinitely."

Answer 1

"Rectal bleeding can occur up to 1 month after polyp removal."

Question 2

A patient with a massive gastrointestinal bleed is diagnosed with a Mallory-Weiss tear.The nurse would anticipate which patient history?

A)Chronic alcohol ingestion
B)Ingestion of spicy foods
C)Aspirin use
D)20 packs/year smoking history

Answer 2

Chronic alcohol ingestion

Question 3

The conventional transducer method will be used to measure a patient's intra-abdominal pressure.Which interventions will the nurse use in this measurement? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.

A)Connect the transducer to the patient's peripheral intravenous line.
B)Place the head of the patient's bed flat.
C)Inject 20-25 mL of saline into the indwelling urinary catheter port.
D)Calibrate the transducer at the level of the patient's pubis.
E)Obtain the measurement at the beginning of respiration.

Answer 3

Place the head of the patient's bed flat.
Inject 20-25 mL of saline into the indwelling urinary catheter port.
Calibrate the transducer at the level of the patient's pubis.

Question 4

Which assessment finding would the nurse evaluate as most likely occurring due to a lower gastrointestinal bleed?

A)Hematochezia
B)Hematemesis
C)Dark brown guaiac positive stools
D)Melena

Question 5

A patient presents to the emergency department with reports of bloody diarrhea.During assessment,the patient becomes increasingly lethargic.The nurse's emergency interventions are based on which potential patient problems? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.

A)There is insufficient perfusion to the patient's brain.
B)There is impairment of gas exchange at the alveolar level.
C)The patient is at higher risk for infection.
D)The patient is at risk for altered nutrition secondary to anorexia or nothing by mouth (NPO)status.
E)The patient is at risk for confusion.

Question 6

A patient vomiting bright red blood is scheduled for an endoscopy sclerotherapy.The patient asks the nurse what the procedure will do.The nurse would reinforce which teaching?

A)"The area of bleeding can be seen so surgery can be planned to remove it."
B)"A chemical can be injected into the bleeding vessel to stop it from bleeding."
C)"A cold material can be applied to the bleeding area to stop the bleeding."
D)"A laser can be used on the bleeding areas to stop any possibilities of bleeding again."

Question 7

A patient with a history of coronary artery disease is admitted with vomiting,abdominal distention,and hypoactive bowel sounds.Which assessment would provide the nurse with the most accurate information about the patient's fluid volume status?

A)Skin turgor assessment
B)Hourly urine output measurements
C)Daily weights
D)Pulmonary artery catheter

Question 8

A patient is hospitalized with recurrent gastric ulcers.Which education should the nurse provide? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.

A)"You may need to consider treating your chronic headaches with some therapy besides NSAIDs [nonsteroidal anti-inflammatory drugs]."
B)"You should try to avoid eating spicy foods."
C)"It is time for you to seriously consider smoking cessation."
D)"You should contact a personal trainer to get your body in shape."
E)"This antibiotic is different in that you only take it until you are pain free."

Question 9

A patient recovering from thyroid surgery is now experiencing numbness and tingling around the mouth with an increase in irritability.Which additional assessment finding would cause the nurse the most concern?

A)Decreased creatinine and BUN levels
B)Abdominal distention and pain
C)Hyperactive bowel sounds
D)Diarrhea

Question 10

A patient taking nonsteroidal anti-inflammatory drugs (NSAIDs)for osteoarthritis is admitted with acute erosive gastritis caused by alcohol ingestion.Which nursing instruction is indicated?

A)"Limit your alcohol intake to one glass of wine with dinner."
B)"Avoid alcohol use while you are taking NSAIDs."
C)"It is important that we find a different method of controlling pain from your arthritis."
D)"In some people,having a couple of drinks can reduce arthritis pain enough that NSAIDs are not necessary."

Question 11

The nurse is assessing a patient recovering from surgery for abdominal compartment syndrome.Which findings could indicate a life-threatening condition may be developing in this patient? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.

A)Temperature 100.7°F
B)Complaint of dyspnea
C)Poor skin turgor
D)Blood pressure 146/88 mm Hg
E)Complaint of chest pain

Question 12

A patient recovering from an open cholecystectomy 3 days prior has not passed any flatus since surgery.Which finding suggests to the nurse that the patient may be experiencing a life-threatening condition?

A)Anorexia
B)Falling blood pressure
C)Respiratory rate of 24
D)Hypoactive bowel sounds

Question 13

The nurse is providing care to a patient admitted with hematemesis,melena,and abdominal pain.The nurse prioritizes interventions to address which possible patient problem?

A)Anxiety
B)Aspiration
C)Fatigue
D)Pain

Question 14

A trauma patient's intra-abdominal pressure (IAP)measures 26 mm Hg.How would the nurse explain needed treatment to the patient's family?

A)"This pressure reading is normal and will help to get oxygen to the damaged internal organs."
B)"If we reduce the amount of IV fluid he is getting,the IAP will decrease."
C)"We will raise the head of his bed and have him cough more frequently to reduce this pressure."
D)"It is very likely that he will be taken back to surgery to relieve the pressure building in his abdomen."

Question 15

A patient admitted with possible ulcer disease tells the nurse that he has frequent nausea and vomiting and "just can't eat." The nurse would suspect this patient's ulcer to be in which area?

A)Colon
B)Gastric
C)Duodenal
D)Esophageal

Question 16

The nurse is caring for a patient diagnosed with an arteriovenous malformation (AVM)of the ascending colon.The nurse would prepare to implement which intervention?

A)Administration of blood products
B)Administration of cytoprotective medication
C)Administration of H2 receptor blocking medication
D)Administration of antisecretory medication

Question 17

A patient admitted with fatigue,dyspnea,and a hemoglobin level of 8.6 mg/dL tells the nurse that he occasionally has dark,smelly stools but they "go away" in a few days.The nurse would conduct additional assessment for which most common cause of this history?

A)Inability to absorb protein
B)Lower gastrointestinal bleed
C)Chronic gastrointestinal bleed
D)Upper gastrointestinal bleed

Question 18

A patient experiencing massive amounts of bloody diarrhea from the rectum is diagnosed with inflammation of the mucosa and submucosa after a colonoscopy and biopsy.The nurse prepares to provide care for a patient with which condition?

A)Ulcerative colitis
B)Crohn disease
C)Arteriovenous malformation
D)Polyps

Question 19

A patient diagnosed with gastric ulcer is prescribed sucralfate (Carafate).Which patient teaching should the nurse provide? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.

A)"Watch for systemic effects such as hypotension."
B)"Plan to take this medicine for the rest of your life."
C)"Increase your water intake to 8 to 10 glasses per day."
D)"Do not take this medication within 30 minutes of other drugs."
E)"Rest quietly in an upright position for at least 30 minutes after taking this medication."

Question 20

A patient with a history of atrial fibrillation is experiencing a massive gastrointestinal bleed.The patient is prescribed vasopressin.The nurse would be most concerned about the development of which adverse effect?

A)Abdominal cramping
B)Nausea
C)Vertigo
D)Increase in blood pressure