Targeted Med Surge Gastrointestinal Questions and Answers with Explanations Graded A+ 2023

1. A nurse is assessing a client who has peritonitis. Which of the following should the nurse expect? A. Bloody diarrhea B. Board-like abdomen C. Periumbilical cyanosis D. Increased bowel sounds - B. Board-like abdomen A board-like, distended abdomen, accompanied by extreme pain and tenderness, is an expected finding in a client who has peritonitis. 2. A nurse is caring for a client who has colorectal cancer and is receiving chemotherapy. The client asks the nurse why his blood is being drawn for a carcinoembryonic antigen (CEA) level. Which of the following responses should the nurse make? A. "The CEA determines the current stage of your colon cancer" B. "The CEA determines the efficacy of your chemotherapy" C. "The CEA determines if the neutrophil count is below the expected reference range" D. "The CEA determines if you are experiencing occult bleeding from the GI tract" - B. "The CEA determines the efficacy of your chemotherapy" A provider uses the CEA level to determine the efficacy of the chemotherapy. The client's CEA levels will decrease if the chemotherapy is effective. 3. A nurse is assessing a client who has appendicitis. Which of the following should the nurse expect? (select all that apply) A. Oral temperature 38.4 (101.1) B. WBC 6000 C. Bloody diarrhea D. Nausea and vomiting E. RLQ pain - A. Oral temperature 38.4 (101.1) D. Nausea and vomiting E. RLQ pain Oral temperature 38.4° C (101.1° F) is correct. A low-grade temperature is an expected finding in a client who has appendicitis. WBC 6,000/mm3 is incorrect. A WBC of 10,000 to 18,000/mm3 is an expected finding in a client who has appendicitis. Bloody diarrhea is incorrect. Bloody diarrhea is an expected finding in a client who has colorectal cancer. Nausea and vomiting is correct. Nausea and vomiting are expected findings in a client who has appendicitis. Right lower quadrant pain is correct. Right lower quadrant pain is an expected finding in a client who has appendicitis. 4. A nurse is providing dietary teaching for a client who is postoperative following a gastrectomy. Which of the following foods should the nurse encourage the client to include in her diet to prevent dumping syndrome? A. Ice cream B. Eggs C. Grape juice D. Honey - B. Eggs The nurse should instruct the client to increase dietary intake of protein-containing foods, such as eggs, to decrease the risk for manifestations of dumping syndrome. The client should eat some form of protein at each meal. high sugar causes dumping 5. A nurse is providing teaching for a client who has cirrhosis and a new prescription for lactulose. The nurse should include which of the following instructions in the teaching? A. Notify the provider if bloating occurs B. Expect to have 2-3 soft stools per day C. Restrict carbs D. Limit oral intake to 1000mL/day of clear liquids - B. Expect to have 2-3 soft stools per day The purpose of administering lactulose is to promote the excretion of ammonia in the stool. The nurse should instruct the client to take the medication every day and inform the client that two to three bowel movements every day is the treatment goal. 6. A nurse is teaching a client how to prepare for a colonoscopy. Which of the following instructions should the nurse include in the teaching? A. Begin drinking the oral liquid prep for bowel cleansing on the morning of the procedure B. Drink full liquids for breakfast the day of the procedure, and then take nothing PO for 2 hr before the procedure C. Drink clear liquids for 24 hr prior to the procedure, and then NPO for 6 hr before the procedure. D. Drink the oral liquid prep for bowel cleansing slowly - C. Drink clear liquids for 24 hr prior to the procedure, and then NPO for 6 hr before the procedure. The nurse should instruct the client to drink clear liquids for 24 hr prior to the colonoscopy to promote adequate bowel cleansing. Maintaining NPO status for 4 to 6 hr prior to the colonoscopy preserves the bowel's cleansed state. 7. A nurse is assessing a client who has Crohn's disease. Which of the following findings should the nurse expect? A. Fatty diarrheal stools B. Hyperkalemia C. Weight gain D. Sharp epigastric pain - A. Fatty diarrheal stools Steatorrhea, or fatty stool, is an expected finding in a client who has Crohn's disease. 8. A nurse is providing dietary teaching for a client who has a new diagnosis of celiac disease. Which of the following statements by the client indicates an understanding of the teaching? A. "I can return to my regular diet when i am free of symptoms" B. "I will need to avoid taking vitamin supplements while on this diet" C. "I will eat beans to ensure I get enough fiber in my diet." D. "I need to avoid drinking liquids with my meals while on this diet" - C. "I will eat beans to ensure I get enough fiber in my diet." Clients who have celiac disease must maintain a gluten-free diet which eliminates fiber-rich whole wheat products. Clients should eat beans, nuts, fruits, and vegetables to ensure an adequate intake of fiber 9. A nurse is providing discharge teaching for a client who has peptic ulcer disease and a new prescription for famotidine. Which of the following statements by the client indicates an understanding of the teaching? A. "I should take this medication at bedtime" B. "I should expect this medication to discolor my stools" C. "I will drink iced tea with my meals and snacks" D. "I will monitor my blood glucose level regularly while taking this medication" - A. "I should take this medication at bedtime" The nurse should instruct the client to take the medication at bedtime to inhibit the action of histamine at the H2-receptor site in the stomach. 10. A nurse is reviewing the laboratory results of a client who has hepatic cirrhosis. Which of the following findings should the nurse report to the provider? A. Albumin 4.0 g/dL B. INR 1.0 C. Direct bilirubin 0.5 mg/dL D. Ammonia 180 mcg/dL - D. Ammonia 180 mcg/dL An ammonia level of 180 mcg/dL is above the expected reference range of 10 to 80 mcg/dL. The nurse should report an increased ammonia level because it can indicate portal-systemic encephalopathy.