Question 1

A client who has surgical treatment for peritonitis would be encouraged to do all of the following postoperatively.Which is the MOST important for this client?

Accepted Answer

Nursing care of clients who have peritonitis include managing pain,monitoring fluid volume and respiratory status,and providing comfort measures.

Question 2

A client who has viral hepatitis should have which dietary modification to allow the liver to heal?

Accepted Answer

Medical treatment focuses on resting the liver and detecting complications early.Antiemetics and vitamins C,B complex,and K are often prescribed,in addition to dietary modifications such as fat or protein restriction.

Question 3

Paralytic ileus can develop as the result of:

Accepted Answer

Intestinal obstruction (ileus)may occur in the large or small intestine,particularly in the ileum,as the result of mechanical,neurogenic,or vascular factors.Mechanical obstruction can be either partial or complete;possible causes include tumors,fecal impaction,hernia,volvulus,intussusception,or adhesions.

Question 4

Administration of hepatitis B immunoglobulin (HBIG)is recommended for which group?

Accepted Answer

HBIG is recommended to anyone who has the potential for exposure to blood or blood products or those at risk for unprotected sexual contact.

Question 5

Which of these nursing interventions is MOST important when a client is initially diagnosed with any type of hepatitis?

Accepted Answer

Viral infection is the most common cause of hepatitis,and the five known viruses produce similar signs and symptoms but vary in prognosis.Fatigue,anorexia,abdominal pain,generalized muscle aches,fever,jaundice,pruritus,dark amber urine,and clay-colored stools are common manifestations.Medical treatment focuses on resting the liver and detecting complications early.Antiemetics and vitamins C,B complex,and K are often prescribed,in addition to dietary modifications such as fat or protein restriction.

Question 6

The nurse is assessing a client who states having recently noted dark urine and light clay-colored stools.Based on this information,the nurse should inspect the client for which of these signs?

Accepted Answer

Dark urine,light clay-colored stools,and jaundice indicate hepatotoxicity,a sign of cirrhosis.

Question 7

For a client who has viral hepatitis,which of these statements is TRUE?

Accepted Answer

Nursing care focuses on teaching the client about the disease process and its management,with content focused on the specific type of viral infection (i.e. ,A,B,C,D,or E),improving or maintaining nutritional status,and managing fatigue.

Question 8

An older adult client tells the nurse about experiencing chronic constipation.The nurse should suggest that the client increase intake of which of these foods?

Accepted Answer

Dietary methods to reduce chronic constipation include the introduction or increase of foods high in dietary fiber.

Question 9

A client is lifting a box and experiences a sudden pain in the lower right side and upper thigh,with a "bulge" in the groin area.The nurse notes a tight band around the bulge.The client has probably developed which type of hernia?

Accepted Answer

An inguinal hernia occurs in the groin area frequently after activities such as lifting.An incarcerated hernia does not return to the abdominal cavity with rest or manipulation and causes complete bowel obstruction.

Question 10

A client complains of colicky abdominal pain,nausea,constipation,and bloating.During the nursing assessment,the client vomits fecal material.Which of these conditions should be suspected?

Accepted Answer

Common manifestations of ileus include colicky abdominal pain,abdominal distention,nausea,and constipation.

Question 11

A postoperative client has been receiving narcotic analgesics every 4 hours for incisional pain for 2 days and has now developed severe constipation.An enema has been prescribed by the health care provider.Client education about preventing constipation should emphasize that enemas and laxatives are not recommended for long-term use,because they can:

Accepted Answer

Chronic use of narcotic analgesics can interrupt normal bowel function by causing a decrease in peristalsis,thus increasing time for fluid absorption from the feces,resulting in constipation.

Question 12

Subjective signs and symptoms of viral hepatitis include which of the following?

Accepted Answer

Viral infection is the most common cause of hepatitis,and the five known viruses produce similar signs and symptoms but vary in prognosis.Fatigue,anorexia,photophobia,abdominal pain,generalized muscle aches,fever,jaundice,pruritus,dark amber urine,and clay-colored stools are common manifestations.

Question 13

A client is admitted with a diagnosis of hepatitis B infection.In preparing the client care area,the nurse institutes which type of special preventive measures?

Accepted Answer

Nursing care focuses on teaching the client about the disease process and its management,with content focused on the specific type of viral infection (i.e. ,A,B,C,D,or E),improving or maintaining nutritional status,managing fatigue,and maintaining Standard Precautions.

Question 14

A client develops peritonitis as a result of a ruptured appendix.The nurse should carefully monitor the client for evidence of which of these complications?

Accepted Answer

Peritonitis is a life-threatening condition that is evidenced by vomiting,abdominal pain and distention,and absence of bowel sounds.Surgical management includes repairing the cause of peritoneal irritation,decompressing the abdomen,and inserting abdominal drains.Analgesics and antibiotics are prescribed,and the client has no oral intake of food and fluids until bowel sounds return.Nursing care of clients who have peritonitis include managing pain,monitoring fluid volume and respiratory status,monitoring for paralytic ileus,and providing comfort measures.

Question 15

A client has recurrent ascites as a result of cirrhosis.Which of these procedures will the health care provider perform to allow extended control of this fluid buildup?

Accepted Answer

Medical management includes removal of abdominal fluid (paracentesis)and prescription of diuretics;lactulose and antihypertensive medications may also be used.A low-protein diet is also prescribed.Various shunts may be indicated for surgical management of cirrhosis when the client continues to develop ascites after medical treatment or when portal hypertension cannot be controlled with medications.

Question 16

Nursing interventions for clients with intestinal obstruction include all of the following.Which action would be a priority?

Accepted Answer

Nursing care of the client who has an intestinal obstruction includes managing pain and monitoring fluid volume.

Question 17

The client with cirrhosis may develop portal hypertension,which is associated with which of these conditions?

Accepted Answer

Medical management includes removal of abdominal fluid (paracentesis)and prescription of diuretics;lactulose and antihypertensive medications may also be used.A low-protein diet is also prescribed.Various shunts may be indicated for surgical management of cirrhosis when the client continues to develop ascites after medical treatment or when portal hypertension cannot be controlled with medications to prevent the development of esophageal varices.

Question 18

A client who has cirrhosis requests a sleeping pill for insomnia.Which of these actions should the nurse take?

Accepted Answer

Nursing care of clients who have cirrhosis includes monitoring activity tolerance,measuring abdominal girth daily,restricting fluid intake,monitoring skin integrity,encouraging adequate nutritional intake,and providing comfort measures to facilitate natural sleep.

Question 19

When a client with cirrhosis is admitted to the hospital,which of the following laboratory results would be expected?

Accepted Answer

Cirrhosis involves degenerative changes in liver cells and thickening of surrounding tissue,which are caused by alcohol abuse,chronic hepatitis,repeated exposure to toxic substances,or other disease processes.Disruption of liver function creates significant complications such as clotting disorders,malnutrition,and portal hypertension.Manifestations of cirrhosis include fatigue,nausea,anorexia,weakness,indigestion,jaundice,ascites,and petechiae.

Question 20

A client who has cirrhosis becomes very confused and lethargic and exhibits asterixis.These symptoms can indicate the development of what complication?

Accepted Answer

Disruption of liver function creates significant complications such as clotting disorders,malnutrition,and portal hypertension.The buildup of azotemia can lead to the development of hepatic encephalopathy.

Quiz 38: Gastrointestinal System