CHAPTER 28: GASTROINTESTINAL CLINICAL ASSESSMENT AND DIAGNOSTIC PROCEDURES {Urden: Critical Care Nursing, 9th Edition}

C HAPTER 28: G ASTROINTESTINAL
C LINICAL A SSESSMENT AND D IAGNOSTIC
P ROCEDURES
Urden: Critical Care Nursing, 9th Edition



MULTIPLE CHOICE


1. Preprocedural teaching of a patient undergoing a liver scan sh ould include
which instruction?
a. Drink at least 500 mL of fluids before the procedure.
b. Remain flat in bed for 12 hours after the procedure.
c. Stay flat and still during the procedure.
d. Sedation will be provided during the procedure.



ANS: C



The patient may need to maintain NPO (nothing by mouth) status for 2
to 4 hours before the procedure. Sedation is usuall y not required, but
the patient must be able to lie flat and still for 60 minutes during the
scanning procedure. No special interventions are required after the
procedure.



PTS: 1 DIF: Cognitive Level: Appl ying REF: p. 679
OBJ: Nursing Process Step: Intervention TOP:
Gastrointestinal MSC: NC LEX: Physiologic Integrit y

,2. What is the most common location for a male to have a hernia?
a. Femoral
b. Umbilical
c. Inguinal
d. Abdominal



ANS: C



Strangulated hernia can occur at any age. They are most commonl y
found in the femoral area for women and inguinal area for men.
Symptoms include severe localized pain or, if a bowel is obstructed, a
generalized pain.



PTS: 1 DIF: Cognitive Level: Understanding REF: p.
673 | Table 28 -2 OBJ: Nursing Process Step: Assessment
TOP: Gastrointestinal MSC: NC LEX: Physiologic
Integrit y



3. A patient has been admitted with abdominal pain with right lower
quadrant guarding and tenderness, fever, and an ele vated white blood cell
count. The nurse suspects that the patient has which disorder?
a. Appendicitis
b. Hepatitis
c. Cecal volvulus
d. Perforated duodenal ulcer



ANS: A



Signs and symptoms of appendicitis include anorexia, nausea, and
vomiting; earl y vague epigastri c, periumbilical, or generalized pain

, after 12 to 24 hours; right lower quadrant (RLQ) at McBurney point;
localized R LQ guarding and tenderness after 12 to 24 hours; a white
blood cell count of 10,000/mm or left shift; and low -grade fever. Signs
are highl y variable.



PTS: 1 DIF: Cognitive Level: Understanding REF: p.
673 | Table 28 -2 OBJ: Nursing Process Step: Assessment
TOP: Gastrointestinal MSC: NC LEX: Physiologic
Integrit y



4. The practitioner has ordered a magnetic resonance imaging (MRI) of the
liver. What would the nurse do to prepare the patient for the examination?
a. Explain the patient must lie still during the procedure.
b. Explain the patient may experience deep pressure sensation.
c. Inform the patient that he or she will have to drink contrast.
d. Inform the patient that the procedure will be performed at the
bedside.



ANS: A



The magnetic resonance imaging (MR I) procedure is lengthy and
requires that the patient be transported to the scanner. The patient must
lie motionless in a tight, enclosed space (if a clos ed MR I scanner is
used), and sedation may be necessary. The patient should not
experience any sensations during the procedure. The patient will not
have to drink contrast during the procedure.



PTS: 1 DIF: Cognitive Level: Appl ying REF: p. 679
OBJ: Nursin g Process Step: Assessment TOP:
Gastrointestinal MSC: NC LEX: Physiologic Integrit y