Brunner and Suddarth's Textbook of Medical-surgical Nursing- Chapter 38, 39, 40, 41, 43,44 Exam Practice Questions and Answers

Brunner and Suddarth's Textbook of Medical-surgical Nursing- Chapter 38, 39, 40, 41, 43,44 Exam Practice Questions and Answers 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 - Ans:-A ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED FIRST PUBLISH OCTOBER 2024 Page 2/265 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 - Ans:-A ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED FIRST PUBLISH OCTOBER 2024 Page 3/265 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." ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED FIRST PUBLISH OCTOBER 2024 Page 4/265 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." - Ans:-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? ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED FIRST PUBLISH OCTOBER 2024 Page 5/265 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. - Ans:-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 ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED FIRST PUBLISH OCTOBER 2024 Page 6/265 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. - Ans:-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 ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED FIRST PUBLISH OCTOBER 2024 Page 7/265 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 - Ans:-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 Funct