Question 1

When preparing a client for gastric analysis, the nurse should plan for
A) antacid administration.
B) fluoroscopic examination.
C) frequent expectoration for samples.
D) nasogastric tube insertion.

Accepted Answer

Gastric analysis is performed to measure secretions of hydrochloric acid and pepsin in the stomach. There are two kinds of gastric analysis: basal cell secretion test and the gastric acid stimulation test. Both examinations require insertion of an NG tube through which samples of gastric secretions can be withdrawn.

Question 2

A client is having an abdominal ultrasound and wonders why the physician did not order a CT scan or MRI. The nurse's best explanation for the choice of procedure is
A) "An ultrasound is far less expensive than CT or MRI."
B) "There is less need for dye contrast and fewer complications."
C) "Ultrasounds can be done more quickly and are best for screening."
D) "You can correlate physical and ultrasound findings during the exam."

Accepted Answer

Ultrasound can enhance physical examination because findings can be correlated with physical structures while the client is on the examining table. Ultrasound is faster and cheaper than CT or MRI, but each test has its own benefits and indications. Ultrasound is not used primarily for screening.

Question 3

For a client taking a histamine H? blocker to reduce clinical manifestations of gastritis, the nurse would clarify that the client is at risk for a possible deficiency of vitamin A) A. B) B₁₂. C) C. D) D.

Accepted Answer

In a possible nutrient interaction, histamine H₂ blockers may cause decreased vitamin B₁₂ absorption. Anti-tuberculosis drugs can also cause interference in the metabolism of vitamin B₁₂.

Question 4

The nurse is assessing a client who describes "stomach discomfort." The most appropriate sequence for conducting the physical examination of the abdomen is
A) auscultation, percussion, palpation, inspection.
B) inspection, auscultation, percussion, palpation.
C) inspection, palpation, percussion, auscultation.
D) palpation, percussion, auscultation, inspection.

Accepted Answer

Assess the abdomen in the following sequence: inspection, auscultation, percussion, and palpation.

Question 5

A nurse is assessing a client who complains of aching abdominal pain. To correctly assess this client, the nurse would
A) defer palpation altogether.
B) give pain medication before starting.
C) palpate the nonpainful areas first.
D) percuss the abdomen before ausculating.

Accepted Answer

The correct sequence of assessments when evaluating a client's abdomen is inspection, auscultation, percussion, and palpation. When palpating, start in any nonpainful areas first. Use light palpation and then move to deeper palpation, being cautious over any painful areas. Giving pain medication may hinder accurate assessments.

Question 6

The nurse conducting a physical assessment on a client with ascorbic acid (vitamin C) deficiency would assess that the clinical manifestation associated with this problem is
A) bumpy or scaly skin.
B) ecchymotic skin lesions.
C) extremity edema.
D) muscle tetany.

Accepted Answer

Evidence of vitamin C (ascorbic acid) deficit includes gingivitis, dry mouth, alopecia, pruritus, and ecchymotic lesions on the skin.

Question 7

A client has the following lab results. Which would alert the nurse to a possible nutrition problem?
A) Albumin 5.0 g/dl
B) Pre-albumin 12 mg/dl
C) Retinol-binding protein 5 mg/dl
D) Transferrin 200 mg/dl

Accepted Answer

Normal pre-albumin levels are 20-40 mg/dl. Even though the other values are normal, since pre-albumin reflects acute changes because of its half-life, the nurse should be concerned that the client is at nutritional risk. The client's transferrin level is at the low end of normal. Transferrin, the other serum protein with a short half-life, would also change rapidly with nutritional changes and its low-normal value in conjunction with the abnormal pre-albumin should confirm the nurse's suspicions.

Question 8

A client who had a barium swallow 4 days earlier calls the nurse in the GI clinic to ask, "Is there anything I can do about my constipation? I have not had a bowel movement since the x-ray, and my stomach is so big that I look pregnant." The most appropriate response for the nurse to make is
A) "Do you normally have more frequent bowel movements?"
B) "Increase fluids in your diet to 10 glasses of water a day."
C) "Take a strong laxative immediately."
D) "You need to be examined in the clinic today."

Accepted Answer

To prevent impactions with barium, the client takes a laxative after the barium test. This client shows manifestations of a barium impaction and needs to be evaluated as soon as possible.

Question 9

Before determining the absence of bowel sounds, the nurse must auscultate the abdomen for
A) 1 minute.
B) 5 minutes.
C) 10 minutes.
D) 20 minutes.

Accepted Answer

To determine the absence of bowel sounds, the nurse must listen a total of 5 minutes, or at least 1 minute per abdominal quadrant.

Question 10

The nurse assessing clients for nutritional status is aware that a client would need a more in-depth analysis when the client complains of frequent nutrition-related manifestations, including (Select all that apply)
A) abdominal pain.
B) changes in weight or appetite.
C) diarrhea.
D) indigestion.
E) nausea and vomiting.

Accepted Answer

These manifestations are frequent complaints that relate to GI function and nutrition and should spur the nurse to conducting a more thorough assessment of GI and nutritional status.

Question 11

The nurse is assessing the abdomen of an obese 67-year-old client who is admitted to the emergency department. The finding noted during the abdominal examination that requires further assessment is
A) flat appearance below the umbilicus.
B) rounded abdominal contour.
C) umbilicus that is concave.
D) visible peristalsis.

Accepted Answer

Normally, peristaltic movements are not visible, although abdominal pulsations may be observed in a very thin client.

Question 12

The amount of calories and protein that a client weighing 185 pounds would require is at least
A) 1575 calories and 53 g of protein.
B) 2394 calories and 62 g of protein.
C) 2520 calories and 67 g of protein.
D) 2743 calories and 73 g of protein.

Accepted Answer

The client weighs $ 84 \mathrm{~kg}(185 \div 2.2=84) $; calories: $ 84 \times 30=2520 $; protein:84 $ \times 0.8=67.2 $.

Question 13

For a client having all the following GI tests, which test should the nurse schedule last?
A) Barium swallow
B) Computed tomography scan
C) Flat plate of abdomen
D) Ultrasound

Accepted Answer

Ultrasound, abdominal scan, and colonoscopy, if indicated, should be performed first, because the barium interferes with these tests.

Question 14

When the nurse measures waist-to-hip ratio and calculates the midarm muscle circumference (MAMC), the nurse is assessing
A) overall muscle strength and density compared to fat stores.
B) proportion and distribution of muscle mass and body fat.
C) reserves of protein and calories stores in the muscle.
D) the size of the body frame related to body weight.

Accepted Answer

These two anthropometric measures are used to assess the proportion and distribution of muscle mass and body fat.

Question 15

A client has been admitted with a diagnosis of primary starvation. The nurse explains to the family that this means the client
A) has a possible problem with the GI tract.
B) has not been eating enough calories and other nutrients.
C) is not eating, absorbing, or using micronutrients.
D) is over-excreting specific nutrients.

Accepted Answer

Primary starvation occurs when adequate nutrition is not delivered to the GI tract because of decreased eating. Secondary starvation is when the GI tract receives enough nutrients, but does not absorb, metabolize, or use them because of a problem with the GI tract itself. Micronutrient malnutrition is what is occurring in option c. Increased excretion of nutrients would be another example of secondary starvation.

Question 16

The nurse administers an anticholinergic drug to a client scheduled for an endoscopy in order to provide
A) decreased secretions.
B) increased peristalsis.
C) muscle relaxation.
D) sedation.

Accepted Answer

Anticholinergic medications may be given to decrease oropharyngeal secretions. They may also help prevent reflex bradycardia.

Question 17

A hospitalized client has lost several pounds in the last week. The nurse reviews the client's lab results understanding that which test is the best indicator of acute nutritional changes?
A) Albumin level
B) Pre-albumin level
C) RBC count
D) Total protein level

Accepted Answer

Serum proteins give accurate nutritional information and include albumin, pre-albumin, retinal-binding protein, and transferrin. Serum proteins with long half-lives (albumin) tend to be global indicators of nutritional status, and proteins with shorter half-lives like pre-albumin and transferrin provide information on acute nutritional status changes.

Question 18

In collecting a 24-hour urine specimen to determine nitrogen balance for a client, the nurse would
A) conduct the urine collection before a 24-hour food record.
B) correct the results by multiplying by 0.13 for clients with renal disease.
C) instruct the client on foods to eat containing specified amounts of protein.
D) start the urine collection at the same time a 24-hour food record starts.

Accepted Answer

To determine nitrogen balance, the nurse will simultaneously record the amount and type of food consumed in a 24-hour period and obtain and 24- hour urine collection for urine urea nitrogen measurement. The start and stop times for the food record and urine collection must be the same. The amount of protein the client eats is not restricted or predetermined. The results are not corrected for clients with renal disease, and analyzing results is not related to the collection procedure.

Quiz 28: Assessment of Nutrition and the Digestive System

When preparing a client for gastric analysis, the nurse should plan for

A client is having an abdominal ultrasound and wonders why the physician did not order a CT scan or MRI. The nurse's best explanation for the choice of procedure is

For a client taking a histamine H? blocker to reduce clinical manifestations of gastritis, the nurse would clarify that the client is at risk for a possible deficiency of vitamin

The nurse is assessing a client who describes "stomach discomfort." The most appropriate sequence for conducting the physical examination of the abdomen is

A nurse is assessing a client who complains of aching abdominal pain. To correctly assess this client, the nurse would

The nurse conducting a physical assessment on a client with ascorbic acid (vitamin C) deficiency would assess that the clinical manifestation associated with this problem is

A client has the following lab results. Which would alert the nurse to a possible nutrition problem?

A client who had a barium swallow 4 days earlier calls the nurse in the GI clinic to ask, "Is there anything I can do about my constipation? I have not had a bowel movement since the x-ray, and my stomach is so big that I look pregnant." The most appropriate response for the nurse to make is

Before determining the absence of bowel sounds, the nurse must auscultate the abdomen for

The nurse assessing clients for nutritional status is aware that a client would need a more in-depth analysis when the client complains of frequent nutrition-related manifestations, including (Select all that apply)

The nurse is assessing the abdomen of an obese 67-year-old client who is admitted to the emergency department. The finding noted during the abdominal examination that requires further assessment is

The amount of calories and protein that a client weighing 185 pounds would require is at least

For a client having all the following GI tests, which test should the nurse schedule last?

When the nurse measures waist-to-hip ratio and calculates the midarm muscle circumference (MAMC) , the nurse is assessing

A client has been admitted with a diagnosis of primary starvation. The nurse explains to the family that this means the client

The nurse administers an anticholinergic drug to a client scheduled for an endoscopy in order to provide

A hospitalized client has lost several pounds in the last week. The nurse reviews the client's lab results understanding that which test is the best indicator of acute nutritional changes?

In collecting a 24-hour urine specimen to determine nitrogen balance for a client, the nurse would