Question 1

A patient is admitted with acute abdominal pain.Which preexisting conditions would prevent this patient from having a nuclear scan to diagnose the cause of the abdominal pain? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.
A)The patient is being treated for congestive heart failure.
B)The patient has severe rheumatoid arthritis.
C)The patient had an appendectomy 6 months ago.
D)The patient has bilateral titanium hip replacements.
E)The patient had a similar scan done last week.

Accepted Answer

D,E

Question 2

A patient is diagnosed with a gastric ulcer located on the antrum.The nurse is aware that the ulcer may also affect the function of which adjacent structure?
A)Sphincter of Oddi
B)Acinus
C)Pyloric sphincter
D)Lower esophageal sphincter

Accepted Answer

The gastric antrum is a section of the stomach located near the pyloric sphincter. A gastric ulcer located on the antrum can cause scarring and inflammation of the surrounding tissue, potentially affecting the function of the pyloric sphincter. The sphincter controls the flow of partially digested food from the stomach into the small intestine. If the function of the pyloric sphincter is impaired, it can lead to delayed gastric emptying and other digestive issues. The other structures listed (Sphincter of Oddi, acinus, and lower esophageal sphincter) are not directly adjacent to the antrum and would not be affected by the ulcer in the same way.

Question 3

A patient is diagnosed with esophageal reflux.The nurse explains to the patient that there is an impairment in which structure?
A)Fundus
B)Duct of Wirsung
C)Cardiac sphincter
D)Antrum

Accepted Answer

The cardiac sphincter is the structure that separates the esophagus from the stomach and regulates the flow of food and stomach acid into the stomach. If it is impaired, stomach acid can flow back into the esophagus, causing esophageal reflux. The fundus is the upper part of the stomach, the duct of Wirsung connects the pancreas to the small intestine, and the antrum is the lower part of the stomach. None of these structures are directly involved in esophageal reflux.

Question 4

The nurse is caring for a patient with an injury to cranial nerve X.Which assessment finding would the nurse attribute to that injury?
A)Rectal bleeding
B)Dry mouth
C)A metallic taste in the mouth
D)Decreased bowel sounds

Accepted Answer

Cranial nerve X, also known as the vagus nerve, innervates the digestive tract and is responsible for controlling gastrointestinal motility. Therefore, a patient with an injury to cranial nerve X may exhibit decreased bowel sounds as a result of impaired digestive function. Rectal bleeding, dry mouth, and a metallic taste in the mouth are not typically associated with an injury to the vagus nerve.

Question 5

A patient is diagnosed with duodenal ulcers caused by a highly acidic gastrointestinal environment.The nurse explains that this condition may be related to deficiency in which hormone?
A)Secretin
B)Lipase
C)Elastase
D)Amylase

Accepted Answer

Secretin is a hormone that stimulates the pancreas to release bicarbonate which neutralizes acid in the duodenum. Deficiency in secretin can lead to a highly acidic gastrointestinal environment and contribute to the development of duodenal ulcers. Lipase, elastase, and amylase are enzymes involved in the digestion of fats, proteins, and carbohydrates respectively, and are not directly related to the development of duodenal ulcers.

Question 6

A patient with a history of tonsillectomy and appendectomy is admitted with a possible infection.The nurse explains that the patient is at higher risk for infection due to which process?
A)Decreased prostaglandin production
B)Impairment of gut-associated lymphoid tissue
C)Increase in mucosa-associated lymphoid tissue
D)Degradation of superficial epithelial cells

Accepted Answer

The gut-associated lymphoid tissue (GALT) plays an important role in the immune response to infections. The removal of the tonsils and appendix, which are both part of the lymphatic system, can impair the function of GALT and increase the risk for infections.

Question 7

A patient is demonstrating hepatic encephalopathy due to buildup of ammonia.The nurse anticipates intervention to support which function of the liver?
A)Protein metabolism
B)Vitamin synthesis
C)Fat metabolism
D)Carbohydrate metabolism

Accepted Answer

Hepatic encephalopathy is caused by the accumulation of ammonia in the blood due to liver dysfunction. The liver plays a crucial role in protein metabolism, including the conversion of ammonia to urea for elimination, which helps to maintain normal ammonia levels in the blood. Therefore, interventions to support protein metabolism are necessary to treat hepatic encephalopathy.

Question 8

The nurse is assessing a patient admitted with acute abdominal pain.Which information would the nurse associate with changes in the gastrointestinal system? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.
A)The patient is taking more of the proton pump inhibitor than is typically indicated for gastroesophageal reflux.
B)The patient reports that his mother was just diagnosed with renal failure.
C)The patient reports an itchy red rash over his thigh that has been present for several weeks.
D)The patient works as an insurance agent.
E)The patient often repeats himself and seems confused at times.

Accepted Answer

The answer of The nurse is assessing a patient admitted...

Question 9

A male patient admitted with a gastrointestinal bleed and a hematocrit level of 40% receives fluid resuscitation.In a few hours,the hematocrit level drops to 32%.How should the nurse evaluate this finding?
A)It is very likely that this patient has underlying renal disease.
B)There must be an undiagnosed second site of bleeding.
C)The patient is experiencing hemodilution caused by fluid resuscitation.
D)Efforts to stop the bleeding have not been successful.

Accepted Answer

The drop in hematocrit level suggests that the patient is experiencing hemodilution caused by fluid resuscitation. As fluid is given, it becomes diluted and thus, hemodilution or a lower hematocrit is observed. It is important for the nurse to continue monitoring the patient's hematocrit levels to ensure they are stable and not dropping too quickly.

Question 10

A patient is scheduled to have sublingual capnometry.How would the nurse explain the purpose of this test?
A)"This test will help us learn about the blood flow to your gastrointestinal organs."
B)"This test will monitor the acidity of your gastric acids."
C)"This test will determine if your pancreas is functioning."
D)"This test will help us determine if you have an infection in your gastrointestinal tract."

Accepted Answer

Sublingual capnometry measures the level of carbon dioxide in the mucous membranes under the tongue, which can reflect systemic blood flow, including to the gastrointestinal organs. It's used to assess perfusion and can indicate issues like shock or sepsis, but it's particularly noted for its ability to reflect blood flow to the gastrointestinal system.

Question 11

A patient is in congestive heart failure due to damage from a myocardial infarction.Which gastrointestinal manifestation would the nurse expect on assessment?
A)Severe stomach cramping
B)Decreased bowel sounds
C)Enlargement of the liver
D)Esophageal reflux

Accepted Answer

Congestive heart failure can cause liver enlargement due to decreased blood flow from the heart to the liver. The other gastrointestinal manifestations listed are not directly related to heart failure.

Question 12

The nurse is planning care for a patient at risk for developing an infection because of an interruption in the intestinal mucosa.Which patient history would the nurse evaluate as most likely to exacerbate this risk?
A)The patient has a history of type 2 diabetes mellitus.
B)The patient was hospitalized 2 months ago for congestive heart failure.
C)The patient was hospitalized for treatment of severe trauma sustained in a motor vehicle accident.
D)The patient has been treated for hypertension for the last 10 years.

Accepted Answer

Patients who have been hospitalized for severe trauma are at a higher risk for developing infections due to the nature of their injuries and the potential for disruption of the intestinal mucosa. Patients with diabetes, hypertension, and a history of congestive heart failure may be more prone to developing infections in general, but they do not necessarily have an increased risk specifically related to mucosal disruption.

Question 13

A patient with liver disease has a decline in his previously elevated urobilinogen levels.The nurse would anticipate further testing for which condition?
A)Overhydration
B)Gastrointestinal bleeding
C)Worsening of the liver failure
D)Protein catabolism

Accepted Answer

A decline in urobilinogen levels in a patient with liver disease could suggest worsening of the liver failure, as the liver is responsible for the conversion of bilirubin into urobilinogen. Other conditions, such as overhydration, gastrointestinal bleeding or protein catabolism, would not necessarily result in a decline in urobilinogen levels.

Question 14

The nurse has completed the focused history for a patient admitted with acute abdominal pain.How should the nurse continue with the assessment?
A)Palpate for abdominal masses or tenderness.
B)Auscultate for bowel sounds.
C)Inspect the abdomen.
D)Percuss for abdominal tones.

Accepted Answer

The correct sequence for an abdominal assessment is inspection, auscultation, percussion, and palpation. After taking the history, the nurse should first inspect the abdomen.

Question 15

A patient is diagnosed with a splenic artery aneurysm.The nurse would assess for dysfunction in which organs? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.
A)Gallbladder
B)Stomach
C)Pancreas
D)Transverse colon
E)Spleen

Accepted Answer

The splenic artery supplies blood to the spleen, pancreas, and the stomach. Therefore, a splenic artery aneurysm could potentially affect the function of these organs due to compromised blood supply. The gallbladder is primarily supplied by the cystic artery, and the transverse colon is supplied by branches of the mesenteric arteries, so they would not be directly affected by a splenic artery aneurysm.

Question 16

A patient will undergo an elastase test for pancreatic function.The nurse will collect which sample?
A)Stool
B)Serum
C)Saliva
D)Urine

Accepted Answer

Elastase is an enzyme produced by the pancreas and secreted into the small intestine. A stool sample is the most appropriate specimen for measuring elastase levels as it reflects the pancreatic function and excretion into the digestive tract. Serum, saliva, and urine samples do not reflect pancreatic elastase levels.

Question 17

A patient was admitted with acute abdominal and back pain.Which test results would the nurse evaluate as indicating additional testing for acute pancreatitis is likely? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.
A)Secretin stimulation test
B)Hematocrit level
C)Hemoglobin level
D)Serum lipase level
E)Amylase

Accepted Answer

Serum lipase and amylase levels are specific tests used to diagnose acute pancreatitis. Elevated levels of these enzymes indicate pancreatic inflammation or damage.

Question 18

A patient has been diagnosed with deficiency of the hormone cholecystokinin (CCK).The nurse would expect this patient to have difficulty digesting which nutrients? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.
A)Fats
B)Proteins
C)Carbohydrates
D)Vitamins
E)Minerals

Accepted Answer

Cholecystokinin (CCK) is a hormone that stimulates the digestion of fats and proteins by facilitating the release of digestive enzymes from the pancreas and bile from the gallbladder. It does not directly affect the digestion of carbohydrates, vitamins, or minerals.

Question 19

A patient tells the nurse that after eating some food that tasted "off" he experienced a severe stomachache.However,after a few hours the discomfort was gone and he felt fine.Which information should the nurse consider when formulating a response to this report?
A)Decreased production of mucous in the duodenum likely propelled the organism through the system in a few hours.
B)The duodenal pH of 4.0 killed the offending organism.
C)The acidic stomach environment likely killed any offending organisms in the ingested food.
D)Chyme blocked the offending organism from attaching to the walls of the GI tract.

Accepted Answer

The acidic stomach environment has a pH of 1.5-3.5, which is a hostile environment for many organisms. It is likely that any offending organism in the ingested food was killed by the acidic environment, allowing the patient to recover within a few hours. The other options are not supported by current knowledge of gastrointestinal physiology.

Question 20

A patient has just received an upper GI series diagnostic test.What nursing intervention is indicated?
A)Keep on bedrest for 6 hours postprocedure.
B)Monitor urine output.
C)Administer the prescribed cathartic.
D)Keep the patient on nothing by mouth (NPO)status.

Accepted Answer

An upper GI series often involves the use of barium contrast, which can cause constipation. Administering a prescribed cathartic (laxative) helps to prevent this by facilitating the elimination of the barium from the body.

Quiz 21: Determinants and Assessment of Gastrointestinal Function

A patient is admitted with acute abdominal pain.Which preexisting conditions would prevent this patient from having a nuclear scan to diagnose the cause of the abdominal pain? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A patient is diagnosed with a gastric ulcer located on the antrum.The nurse is aware that the ulcer may also affect the function of which adjacent structure?

A patient is diagnosed with esophageal reflux.The nurse explains to the patient that there is an impairment in which structure?

The nurse is caring for a patient with an injury to cranial nerve X.Which assessment finding would the nurse attribute to that injury?

A patient is diagnosed with duodenal ulcers caused by a highly acidic gastrointestinal environment.The nurse explains that this condition may be related to deficiency in which hormone?

A patient with a history of tonsillectomy and appendectomy is admitted with a possible infection.The nurse explains that the patient is at higher risk for infection due to which process?

A patient is demonstrating hepatic encephalopathy due to buildup of ammonia.The nurse anticipates intervention to support which function of the liver?

The nurse is assessing a patient admitted with acute abdominal pain.Which information would the nurse associate with changes in the gastrointestinal system? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A male patient admitted with a gastrointestinal bleed and a hematocrit level of 40% receives fluid resuscitation.In a few hours,the hematocrit level drops to 32%.How should the nurse evaluate this finding?

A patient is scheduled to have sublingual capnometry.How would the nurse explain the purpose of this test?

A patient is in congestive heart failure due to damage from a myocardial infarction.Which gastrointestinal manifestation would the nurse expect on assessment?

The nurse is planning care for a patient at risk for developing an infection because of an interruption in the intestinal mucosa.Which patient history would the nurse evaluate as most likely to exacerbate this risk?

A patient with liver disease has a decline in his previously elevated urobilinogen levels.The nurse would anticipate further testing for which condition?

The nurse has completed the focused history for a patient admitted with acute abdominal pain.How should the nurse continue with the assessment?

A patient is diagnosed with a splenic artery aneurysm.The nurse would assess for dysfunction in which organs? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A patient will undergo an elastase test for pancreatic function.The nurse will collect which sample?

A patient was admitted with acute abdominal and back pain.Which test results would the nurse evaluate as indicating additional testing for acute pancreatitis is likely? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A patient has been diagnosed with deficiency of the hormone cholecystokinin (CCK) .The nurse would expect this patient to have difficulty digesting which nutrients? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A patient tells the nurse that after eating some food that tasted "off" he experienced a severe stomachache.However,after a few hours the discomfort was gone and he felt fine.Which information should the nurse consider when formulating a response to this report?

A patient has just received an upper GI series diagnostic test.What nursing intervention is indicated?