QUESTIONS, EXAM 3 ADULT
HEALTH ADULT HEALTH II EXAM
3 QUESTIONS AND 100% CORRECT
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Chapter 39: Gastrointestinal System - answer-
1. The nurse is performing an assessment of an 80-year-old patient. Which information
obtained by the nurse will be of most concern?
a. Decreased appetite
b. Difficulty chewing food
c. Unintentional weight loss
d. Complaints of indigestion - answer-ANS: C
Unintentional weight loss is not a normal finding in older patients and may indicate a
problem such as cancer or depression. Poor appetite, difficulty in chewing, and
complaints of indigestion are common in older patients. These will need to be
addressed, but are not of as much concern as the weight loss
2. To promote bowel evacuation in a patient with chronic complaints of constipation,
the nurse will suggest that the patient should attempt defecation
a. in the mid-afternoon.
b. after eating breakfast.
c. right after getting up in the morning.
d. immediately before the first daily meal. - answer-ANS: B
,These reflexes are most active after the first daily meal. Arising in the morning, the
anticipation of eating, and physical exercise do not stimulate these reflexes.
3. When a patient has a history of a total gastrectomy, the nurse will monitor for clinical
manifestations of
a. constipation.
b. dehydration.
c. elevated total cholesterol.
d. cobalamin (vitamin B12) deficiency. - answer-ANS: D
The patient with a total gastrectomy does not secrete intrinsic factor, which is needed
for cobalamin (vitamin B12) absorption. Because the stomach absorbs only small
amounts of water and nutrients, the patient is not at higher risk for dehydration,
elevated cholesterol, or constipation.
4. The nurse will monitor a patient who has an obstruction of the common bile duct for
a. melena.
b. steatorrhea.
c. decreased serum cholesterol levels.
d. increased serum indirect bilirubin levels. - answer-ANS: B
A common bile duct obstruction will reduce the absorption of fat in the small intestine,
leading to fatty stools. Gastrointestinal (GI) bleeding is not caused by common bile duct
obstruction. Serum cholesterol levels are increased with biliary obstruction. Direct
bilirubin level is increased with biliary obstruction.
5. During change-of-shift report, the nurse receives the following information about a
patient who is scheduled for a colonoscopy. Which information should be
communicated to the health care provider before sending the patient for the procedure?
a. The patient has a permanent pacemaker to prevent bradycardia.
b. The patient is worried about discomfort during the examination.
c. The patient has had an allergic reaction to shellfish and iodine in the past.
,d. The patient refused to drink the ordered polyethylene glycol (GoLYTELY). - answer-
ANS: D
If the patient has had inadequate bowel preparation, the colon cannot be visualized and
the procedure should be rescheduled. Because contrast solution is not used during
colonoscopy, the iodine allergy is not pertinent. A pacemaker is a contraindication to
magnetic resonance imaging (MRI), but not to colonoscopy. The nurse should instruct
the patient about the sedation used during the examination to decrease the patient's
anxiety about discomfort.
6. When the nurse is obtaining a history from a patient who is admitted with jaundice,
which statement is most indicative of a need for patient teaching?
a. "I used cough syrup several times a day last week."
b. "I take a baby aspirin every day to prevent strokes."
c. "I need to take an antacid for indigestion several times a week"
d. "I use acetaminophen (Tylenol) every 4 hours for chronic pain." - answer-ANS: D
Chronic use of high doses of acetaminophen can be hepatotoxic and may have caused
the patient's jaundice. The other patient statements require further assessment by the
nurse, but do not indicate a need for patient education.
7. To palpate the liver, the nurse
a. places one hand on the patient's back and presses upward and inward with the other
hand below the patient's right costal margin.
b. places one hand on top of the other and uses the upper fingers to apply pressure and
the bottom fingers to feel for the liver edge.
c. presses slowly and firmly over the right costal margin with one hand and withdraws
the fingers quickly after the liver edge is felt.
d. places one hand under the patient's lower ribs and presses the left lower rib cage
forward, palpating below the costal margin with the other hand. - answer-ANS: A
The liver is normally not palpable below the costal margin, the nurse needs to push
inward below the right costal margin while lifting the patient's back slightly with the left
hand. The other methods will not allow palpation of the liver.
, 8. When the nurse is listening to a patient's abdomen, which finding indicates a need for
a focused abdominal assessment?
a. Loud gurgles
b. High-pitched gurgles
c. Absent bowel sounds
d. Frequent clicking sounds - answer-ANS: C
Absent bowel sounds are abnormal and require further assessment by the nurse. The
other sounds may be heard normally.
9. When caring for a patient following a needle biopsy of the liver at the bedside, the
nurse should
a. put pressure on the biopsy site using a sandbag.
b. elevate the head of the bed to facilitate breathing.
c. place the patient on the right side with the bed flat.
d. check the patient's postbiopsy coagulation studies. - answer-ANS: C
After a biopsy, the patient lies on the right side with the bed flat to splint the biopsy site.
Coagulation studies are checked before the biopsy. A sandbag does not exert adequate
pressure to splint the site.
10. Which information obtained by the nurse when admitting a patient who is scheduled
for an ultrasound of the gallbladder indicates that the ultrasound may need to be
rescheduled?
a. The patient has a permanent gastrostomy tube.
b. The patient took a laxative the previous evening.
c. The patient ate a low-fat bagel an hour previously.
d. The patient had a high-fat meal the previous evening. - answer-ANS: C
Food intake can cause the gallbladder to contract and result in a suboptimal study. The
patient should be NPO for 8 to 12 hours before the test. A high-fat meal the previous
evening, laxative use, or a gastrostomy tube will not affect the results of the study.