Test bank for Brunner and Suddarths Canadian Textbook of
Medical-Surgical Nursing 4th Edition by Mohamed El Hussein;
Joseph Osuji | 9781975108038 | All Chapters with Answers
and Rationals
Chapter 38: Assessment of Digestive and Gastrointestinal Function
1. A nurse is caring for a client who is scheduled for a colonoscopy and whose preparation will include
polyethylene glycol electrolyte lavage prior to the procedure. The presence of what health problem
would contraindicate the use of this form of bowel preparation?
A. Inflammatory bowel disease
B. Intestinal polyps
C. Diverticulitis
D. Colon cancer - ANSWER: A
Rationale: The use of a lavage solution is contraindicated in clients with intestinal obstruction or
inflammatory bowel disease. It can safely be used with clients who have polyps, colon cancer, or
diverticulitis.
PTS: 1 REF: p. 1219
NAT: Client Needs: Physiological Integrity: Reduction of Risk Potential
TOP: Chapter 38: Assessment of Digestive and Gastrointestinal Function
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Understand
Multiple Choice
2. A nurse is promoting increased protein intake to enhance a client's wound healing. What is the
enzyme that will initiate the digestion of the protein that the client consumes?
A. Pepsin
B. Intrinsic factor
C. Lipase
D. Amylase - ANSWER: A
Rationale: The enzyme that initiates the digestion of protein is pepsin. Intrinsic factor combines with
vitamin B12 for absorption by the ileum. Lipase aids in the digestion of fats and amylase aids in the
digestion of starch.
PTS: 1 REF: p. 1210
NAT: Client Needs: Physiological Integrity: Physiological Adaptation
TOP: Chapter 38: Assessment of Digestive and Gastrointestinal Function
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Understand
Multiple Choice
3. A client has been brought to the emergency department with abdominal pain and is subsequently
diagnosed with appendicitis. The client is scheduled for an appendectomy but questions the nurse
about how a person's health is affected by the absence of the appendix. How should the nurse best
respond?
A. "Your appendix doesn't play a major role in health, so you won't notice any difference after your
recovery from surgery."
B. "The surgeon will encourage you to limit your fat intake for a few weeks after the surgery, but your
body will then begin to compensate."
,C. "Your body will absorb slightly fewer nutrients from the food you eat, but you won't be aware of
this."
D. "Your small intestine will adapt over time to the absence of your appendix." - ANSWER: A
Rationale: The appendix is an appendage of the cecum (not the small intestine) that has little or no
physiologic function. Its absence does not affect digestion or absorption.
PTS: 1 REF: p. 1209
NAT: Client Needs: Physiological Integrity: Physiological Adaptation
TOP: Chapter 38: Assessment of Digestive and Gastrointestinal Function
KEY: Integrated Process: Teaching/Learning BLM: Cognitive Level: Apply
Multiple Choice
4. An adult client is scheduled for an upper GI series that will use a barium swallow. What teaching
should the nurse include when the client has completed the test?
A. Stool will be yellow for the first 24 hours' postprocedure.
B. The barium may cause diarrhea for the next 24 hours.
C. Fluids must be increased to facilitate the evacuation of the stool.
D. Slight anal bleeding may be noted as the barium is passed. - ANSWER: C
Rationale: Postprocedural client education includes information about increasing fluid intake;
evaluating bowel movements for evacuation of barium; and noting increased number of bowel
movements. The number of bowel movement is noted because barium, due to its high osmolarity,
may draw fluid into the bowel, thus increasing the intraluminal contents and resulting in greater
output. Yellow stool, diarrhea, and anal bleeding are not expected.
PTS: 1 REF: p. 1219
NAT: Client Needs: Physiological Integrity: Reduction of Risk Potential
TOP: Chapter 38: Assessment of Digestive and Gastrointestinal Function
KEY: Integrated Process: Teaching/Learning BLM: Cognitive Level: Apply
Multiple Choice
5. A nurse is caring for a client with recurrent hematemesis who is scheduled for upper
gastrointestinal fibroscopy. How should the nurse in the radiology department prepare this client?
A. Insert a nasogastric tube.
B. Administer a micro Fleet enema at least 3 hours before the procedure.
C. Have the client lie in a supine position for the procedure.
D. Apply local anesthetic to the back of the client's throat. - ANSWER: D
Rationale: Preparation includes spraying or gargling with a local anesthetic. A nasogastric tube or a
micro Fleet enema is not required for this procedure. The client should be positioned in a side-lying
position in case of emesis.
PTS: 1 REF: p. 1222
NAT: Client Needs: Physiological Integrity: Reduction of Risk Potential
TOP: Chapter 38: Assessment of Digestive and Gastrointestinal Function
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply
Multiple Choice
6. The nurse is caring for a client scheduled for a colonoscopy. The nurse should assist the client into
what position during this diagnostic test?
A. In a knee-chest position (lithotomy position)
B. Lying prone with legs drawn toward the chest
C. Lying on the left side with legs drawn toward the chest
,D. In a prone position with two pillows elevating the buttocks - ANSWER: C
Rationale: For best visualization, colonoscopy is performed while the client is lying on the left side
with the legs drawn up toward the chest. A knee-chest position, lying on the stomach with legs drawn
to the chest, and a prone position with two pillows elevating the legs do not allow for the best
visualization.
PTS: 1 REF: p. 1223
NAT: Client Needs: Physiological Integrity: Reduction of Risk Potential
TOP: Chapter 38: Assessment of Digestive and Gastrointestinal Function
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply
Multiple Choice
7. A client has sought care because of recent dark-colored stools. As a result, a fecal occult blood test
has been ordered. The nurse should give what instructions to the client?
A. "Take no NSAIDs within 72 hours of the test."
B. "Take prescribed medications as usual."
C. "Avoid over-the-counter (OTC) vitamin C supplements."
D. "Do not use fiber supplements before the test." - ANSWER: A
Rationale: In the past, clients were advised to avoid ingesting red meats, aspirin, nonsteroidal anti-
inflammatory drugs, turnips, and horseradish for 72 hours prior to the study because it was thought
that these were associated with false-positive results; likewise, clients were advised to avoid ingesting
vitamin C from supplements or foods as it was believed that this was associated with false-negative
results. However, these restrictions are no longer advised as their actual effects on test results have
not been established; plus, they unnecessarily restricted client participation in screening.
PTS: 1 REF: p. 1217
NAT: Client Needs: Physiological Integrity: Reduction of Risk Potential
TOP: Chapter 38: Assessment of Digestive and Gastrointestinal Function
KEY: Integrated Process: Teaching/Learning BLM: Cognitive Level: Apply
Multiple Choice
8. The nurse is preparing to perform a client's abdominal assessment. What examination sequence
should the nurse follow?
A. Inspection, auscultation, percussion, and palpation
B. Inspection, palpation, auscultation, and percussion
C. Inspection, percussion, palpation, and auscultation
D. Inspection, palpation, percussion, and auscultation - ANSWER: A
Rationale: When performing a focused assessment of the client's abdomen, auscultation should
always precede percussion and palpation because they may alter bowel sounds. The traditional
sequence for all other focused assessments is inspection, palpation, percussion, and auscultation.
PTS: 1 REF: p. 1215
NAT: Client Needs: Physiological Integrity: Reduction of Risk Potential
TOP: Chapter 38: Assessment of Digestive and Gastrointestinal Function
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply
Multiple Choice
9. A client who has been experiencing changes in his bowel function is scheduled for a barium enema.
What instruction should the nurse provide for postprocedure recovery?
A. Remain NPO for 6 hours postprocedure.
B. Administer a Fleet enema to cleanse the bowel of the barium.
C. Increase fluid intake to evacuate the barium.
, D. Avoid dairy products for 24 hours' postprocedure. - ANSWER: C
Rationale: Adequate fluid intake is necessary to rid the GI tract of barium. The client must not remain
NPO after the test and enemas are not used to cleanse the bowel of barium. There is no need to avoid
dairy products.
PTS: 1 REF: p. 1219
NAT: Client Needs: Physiological Integrity: Reduction of Risk Potential
TOP: Chapter 38: Assessment of Digestive and Gastrointestinal Function
KEY: Integrated Process: Teaching/Learning | Integrated Process: Nursing Process
BLM: Cognitive Level: Apply
Multiple Choice
10. A nurse is caring for a newly admitted client with a suspected GI bleed. The nurse assesses the
client's stool after a bowel movement and notes it to be a tarry-black color. This finding is suggestive
of bleeding from what location?
A. Sigmoid colon
B. Upper GI tract
C. Large intestine
D. Anus or rectum - ANSWER: B
Rationale: Blood shed in sufficient quantities in the upper GI tract will produce a tarry-black color
(melena). Blood entering the lower portion of the GI tract or passing rapidly through it will appear
bright or dark red. Lower rectal or anal bleeding is suspected if there is streaking of blood on the
surface of the stool or if blood is noted on toilet tissue.
PTS: 1 REF: p. 1214
NAT: Client Needs: Physiological Integrity: Physiological Adaptation
TOP: Chapter 38: Assessment of Digestive and Gastrointestinal Function
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Analyze
Multiple Choice
11. A nurse has auscultated a client's abdomen and noted one or two bowel sounds in a 2-minute
period of time. How should the nurse document the client's bowel sounds?
A. Normal
B. Hypoactive
C. Hyperactive
D. Paralytic ileus - ANSWER: B
Rationale: Documenting bowel sounds is based on assessment findings. The terms normal (sounds
heard about every 5 to 20 seconds), hypoactive (one or two sounds in 2 minutes), hyperactive (5 to 6
sounds heard in less than 30 seconds), or absent (no sounds in 3 to 5 minutes) are frequently used in
documentation. Paralytic ileus is a medical diagnosis that may cause absent or hypoactive bowel
sounds, but the nurse would not independently document this diagnosis.
PTS: 1 REF: p. 1216
NAT: Client Needs: Physiological Integrity: Reduction of Risk Potential
TOP: Chapter 38: Assessment of Digestive and Gastrointestinal Function
KEY: Integrated Process: Communication and Documentation BLM: Cognitive Level: Apply
Multiple Choice
12. An advanced practice nurse is assessing the size and density of a client's abdominal organs. If the
results of palpation are unclear to the nurse, what assessment technique should be implemented?
A. Percussion
Medical-Surgical Nursing 4th Edition by Mohamed El Hussein;
Joseph Osuji | 9781975108038 | All Chapters with Answers
and Rationals
Chapter 38: Assessment of Digestive and Gastrointestinal Function
1. A nurse is caring for a client who is scheduled for a colonoscopy and whose preparation will include
polyethylene glycol electrolyte lavage prior to the procedure. The presence of what health problem
would contraindicate the use of this form of bowel preparation?
A. Inflammatory bowel disease
B. Intestinal polyps
C. Diverticulitis
D. Colon cancer - ANSWER: A
Rationale: The use of a lavage solution is contraindicated in clients with intestinal obstruction or
inflammatory bowel disease. It can safely be used with clients who have polyps, colon cancer, or
diverticulitis.
PTS: 1 REF: p. 1219
NAT: Client Needs: Physiological Integrity: Reduction of Risk Potential
TOP: Chapter 38: Assessment of Digestive and Gastrointestinal Function
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Understand
Multiple Choice
2. A nurse is promoting increased protein intake to enhance a client's wound healing. What is the
enzyme that will initiate the digestion of the protein that the client consumes?
A. Pepsin
B. Intrinsic factor
C. Lipase
D. Amylase - ANSWER: A
Rationale: The enzyme that initiates the digestion of protein is pepsin. Intrinsic factor combines with
vitamin B12 for absorption by the ileum. Lipase aids in the digestion of fats and amylase aids in the
digestion of starch.
PTS: 1 REF: p. 1210
NAT: Client Needs: Physiological Integrity: Physiological Adaptation
TOP: Chapter 38: Assessment of Digestive and Gastrointestinal Function
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Understand
Multiple Choice
3. A client has been brought to the emergency department with abdominal pain and is subsequently
diagnosed with appendicitis. The client is scheduled for an appendectomy but questions the nurse
about how a person's health is affected by the absence of the appendix. How should the nurse best
respond?
A. "Your appendix doesn't play a major role in health, so you won't notice any difference after your
recovery from surgery."
B. "The surgeon will encourage you to limit your fat intake for a few weeks after the surgery, but your
body will then begin to compensate."
,C. "Your body will absorb slightly fewer nutrients from the food you eat, but you won't be aware of
this."
D. "Your small intestine will adapt over time to the absence of your appendix." - ANSWER: A
Rationale: The appendix is an appendage of the cecum (not the small intestine) that has little or no
physiologic function. Its absence does not affect digestion or absorption.
PTS: 1 REF: p. 1209
NAT: Client Needs: Physiological Integrity: Physiological Adaptation
TOP: Chapter 38: Assessment of Digestive and Gastrointestinal Function
KEY: Integrated Process: Teaching/Learning BLM: Cognitive Level: Apply
Multiple Choice
4. An adult client is scheduled for an upper GI series that will use a barium swallow. What teaching
should the nurse include when the client has completed the test?
A. Stool will be yellow for the first 24 hours' postprocedure.
B. The barium may cause diarrhea for the next 24 hours.
C. Fluids must be increased to facilitate the evacuation of the stool.
D. Slight anal bleeding may be noted as the barium is passed. - ANSWER: C
Rationale: Postprocedural client education includes information about increasing fluid intake;
evaluating bowel movements for evacuation of barium; and noting increased number of bowel
movements. The number of bowel movement is noted because barium, due to its high osmolarity,
may draw fluid into the bowel, thus increasing the intraluminal contents and resulting in greater
output. Yellow stool, diarrhea, and anal bleeding are not expected.
PTS: 1 REF: p. 1219
NAT: Client Needs: Physiological Integrity: Reduction of Risk Potential
TOP: Chapter 38: Assessment of Digestive and Gastrointestinal Function
KEY: Integrated Process: Teaching/Learning BLM: Cognitive Level: Apply
Multiple Choice
5. A nurse is caring for a client with recurrent hematemesis who is scheduled for upper
gastrointestinal fibroscopy. How should the nurse in the radiology department prepare this client?
A. Insert a nasogastric tube.
B. Administer a micro Fleet enema at least 3 hours before the procedure.
C. Have the client lie in a supine position for the procedure.
D. Apply local anesthetic to the back of the client's throat. - ANSWER: D
Rationale: Preparation includes spraying or gargling with a local anesthetic. A nasogastric tube or a
micro Fleet enema is not required for this procedure. The client should be positioned in a side-lying
position in case of emesis.
PTS: 1 REF: p. 1222
NAT: Client Needs: Physiological Integrity: Reduction of Risk Potential
TOP: Chapter 38: Assessment of Digestive and Gastrointestinal Function
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply
Multiple Choice
6. The nurse is caring for a client scheduled for a colonoscopy. The nurse should assist the client into
what position during this diagnostic test?
A. In a knee-chest position (lithotomy position)
B. Lying prone with legs drawn toward the chest
C. Lying on the left side with legs drawn toward the chest
,D. In a prone position with two pillows elevating the buttocks - ANSWER: C
Rationale: For best visualization, colonoscopy is performed while the client is lying on the left side
with the legs drawn up toward the chest. A knee-chest position, lying on the stomach with legs drawn
to the chest, and a prone position with two pillows elevating the legs do not allow for the best
visualization.
PTS: 1 REF: p. 1223
NAT: Client Needs: Physiological Integrity: Reduction of Risk Potential
TOP: Chapter 38: Assessment of Digestive and Gastrointestinal Function
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply
Multiple Choice
7. A client has sought care because of recent dark-colored stools. As a result, a fecal occult blood test
has been ordered. The nurse should give what instructions to the client?
A. "Take no NSAIDs within 72 hours of the test."
B. "Take prescribed medications as usual."
C. "Avoid over-the-counter (OTC) vitamin C supplements."
D. "Do not use fiber supplements before the test." - ANSWER: A
Rationale: In the past, clients were advised to avoid ingesting red meats, aspirin, nonsteroidal anti-
inflammatory drugs, turnips, and horseradish for 72 hours prior to the study because it was thought
that these were associated with false-positive results; likewise, clients were advised to avoid ingesting
vitamin C from supplements or foods as it was believed that this was associated with false-negative
results. However, these restrictions are no longer advised as their actual effects on test results have
not been established; plus, they unnecessarily restricted client participation in screening.
PTS: 1 REF: p. 1217
NAT: Client Needs: Physiological Integrity: Reduction of Risk Potential
TOP: Chapter 38: Assessment of Digestive and Gastrointestinal Function
KEY: Integrated Process: Teaching/Learning BLM: Cognitive Level: Apply
Multiple Choice
8. The nurse is preparing to perform a client's abdominal assessment. What examination sequence
should the nurse follow?
A. Inspection, auscultation, percussion, and palpation
B. Inspection, palpation, auscultation, and percussion
C. Inspection, percussion, palpation, and auscultation
D. Inspection, palpation, percussion, and auscultation - ANSWER: A
Rationale: When performing a focused assessment of the client's abdomen, auscultation should
always precede percussion and palpation because they may alter bowel sounds. The traditional
sequence for all other focused assessments is inspection, palpation, percussion, and auscultation.
PTS: 1 REF: p. 1215
NAT: Client Needs: Physiological Integrity: Reduction of Risk Potential
TOP: Chapter 38: Assessment of Digestive and Gastrointestinal Function
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply
Multiple Choice
9. A client who has been experiencing changes in his bowel function is scheduled for a barium enema.
What instruction should the nurse provide for postprocedure recovery?
A. Remain NPO for 6 hours postprocedure.
B. Administer a Fleet enema to cleanse the bowel of the barium.
C. Increase fluid intake to evacuate the barium.
, D. Avoid dairy products for 24 hours' postprocedure. - ANSWER: C
Rationale: Adequate fluid intake is necessary to rid the GI tract of barium. The client must not remain
NPO after the test and enemas are not used to cleanse the bowel of barium. There is no need to avoid
dairy products.
PTS: 1 REF: p. 1219
NAT: Client Needs: Physiological Integrity: Reduction of Risk Potential
TOP: Chapter 38: Assessment of Digestive and Gastrointestinal Function
KEY: Integrated Process: Teaching/Learning | Integrated Process: Nursing Process
BLM: Cognitive Level: Apply
Multiple Choice
10. A nurse is caring for a newly admitted client with a suspected GI bleed. The nurse assesses the
client's stool after a bowel movement and notes it to be a tarry-black color. This finding is suggestive
of bleeding from what location?
A. Sigmoid colon
B. Upper GI tract
C. Large intestine
D. Anus or rectum - ANSWER: B
Rationale: Blood shed in sufficient quantities in the upper GI tract will produce a tarry-black color
(melena). Blood entering the lower portion of the GI tract or passing rapidly through it will appear
bright or dark red. Lower rectal or anal bleeding is suspected if there is streaking of blood on the
surface of the stool or if blood is noted on toilet tissue.
PTS: 1 REF: p. 1214
NAT: Client Needs: Physiological Integrity: Physiological Adaptation
TOP: Chapter 38: Assessment of Digestive and Gastrointestinal Function
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Analyze
Multiple Choice
11. A nurse has auscultated a client's abdomen and noted one or two bowel sounds in a 2-minute
period of time. How should the nurse document the client's bowel sounds?
A. Normal
B. Hypoactive
C. Hyperactive
D. Paralytic ileus - ANSWER: B
Rationale: Documenting bowel sounds is based on assessment findings. The terms normal (sounds
heard about every 5 to 20 seconds), hypoactive (one or two sounds in 2 minutes), hyperactive (5 to 6
sounds heard in less than 30 seconds), or absent (no sounds in 3 to 5 minutes) are frequently used in
documentation. Paralytic ileus is a medical diagnosis that may cause absent or hypoactive bowel
sounds, but the nurse would not independently document this diagnosis.
PTS: 1 REF: p. 1216
NAT: Client Needs: Physiological Integrity: Reduction of Risk Potential
TOP: Chapter 38: Assessment of Digestive and Gastrointestinal Function
KEY: Integrated Process: Communication and Documentation BLM: Cognitive Level: Apply
Multiple Choice
12. An advanced practice nurse is assessing the size and density of a client's abdominal organs. If the
results of palpation are unclear to the nurse, what assessment technique should be implemented?
A. Percussion
