GI- Questions With All Correct Answers
The nurse is monitoring a client admitted to the hospital with a diagnosis of
appendicitis who is scheduled for surgery in 2 hours. The client begins to
complain of increased abdominal pain and begins to vomit. On assessment,
the nurse notes that the abdomen is distended and bowel sounds are
diminished. Which is the most appropriate nursing intervention?
A. Notify the health care provider (HCP).
B. Administer the prescribed pain medication.
C. Call and ask the operating room team to perform surgery as soon as
possible.
D. Reposition the client and apply a heating pad on the warm setting to the
client's abdomen. correct answer -A. Notify the health care provider (HCP).
Rationale:
On the basis of the signs and symptoms presented in the question, the nurse
should suspect peritonitis and notify the HCP. Administering pain medication
is not an appropriate intervention. Heat should never be applied to the
abdomen of a client with suspected appendicitis because of the risk of
rupture. Scheduling surgical time is not within the scope of nursing practice,
although the HCP probably would perform the surgery earlier than the
prescheduled time.
A client has just had a hemorrhoidectomy. Which nursing interventions are
appropriate for this client? Select all that apply.
A. Administer stool softeners as prescribed.
B. Instruct the client to limit fluid intake to avoid urinary retention.
C. Encourage a high-fiber diet to promote bowel movements without
straining.
D. Apply cold packs to the anal-rectal area over the dressing until the packing
is removed.
E. Help the client to a Fowler's position to place pressure on the rectal area
and decrease bleeding. correct answer -A. Administer stool softeners as
prescribed.
C. Encourage a high-fiber diet to promote bowel movements without
straining.
,D. Apply cold packs to the anal-rectal area over the dressing until the packing
is removed.
Rationale:
Nursing interventions after a hemorrhoidectomy are aimed at management of
pain and avoidance of bleeding and incision rupture. Stool softeners and a
high-fiber diet will help the client to avoid straining, thereby reducing the
chances of rupturing the incision. An ice pack will increase comfort and
decrease bleeding. Options 2 and 5 are incorrect interventions.
The nurse is planning to teach a client with gastroesophageal reflux disease
(GERD) about substances to avoid. Which items should the nurse include on
this list? Select all that apply.
A. Coffee
B. Chocolate
C. Peppermint
D. Nonfat milk
E. Fried chicken
F. Scrambled eggs correct answer -A. Coffee
B. Chocolate
C. Peppermint
E. Fried chicken
Rationale:
Foods that decrease lower esophageal sphincter (LES) pressure and irritate
the esophagus will increase reflux and exacerbate the symptoms of GERD and
therefore should be avoided. Aggravating substances include coffee, chocolate,
peppermint, fried or fatty foods, carbonated beverages, and alcohol. Options 4
and 6 do not promote this effect.
A client has undergone esophagogastroduodenoscopy. The nurse should place
highest priority on which item as part of the client's care plan?
1. Monitoring the temperature
2. Monitoring complaints of heartburn
3. Giving warm gargles for a sore throat
4. Assessing for the return of the gag reflex correct answer -4. Assessing
for the return of the gag reflex
,Rationale:
The nurse places highest priority on assessing for return of the gag reflex. This
assessment addresses the client's airway. The nurse also monitors the client's
vital signs and for a sudden increase in temperature, which could indicate
perforation of the gastrointestinal tract. This complication would be
accompanied by other signs as well, such as pain. Monitoring for sore throat
and heartburn are also important; however, the client's airway is the priority.
The nurse is providing dietary teaching for a client with a diagnosis of chronic
gastritis. The nurse instructs the client to include which foods rich in vitamin
B12 in the diet? Select all that apply.
A. Nuts
B. Corn
C. Liver
D. Apples
E. Lentils
F. Bananas correct answer -A. Nuts
C. Liver
E. Lentils
Rationale:
Chronic gastritis causes deterioration and atrophy of the lining of the
stomach, leading to the loss of function of the parietal cells. The source of
intrinsic factor is lost, which results in an inability to absorb vitamin B12,
leading to development of pernicious anemia. Clients must increase their
intake of vitamin B12 by increasing consumption of foods rich in this vitamin,
such as nuts, organ meats, dried beans, citrus fruits, green leafy vegetables,
and yeast.
The nurse is monitoring a client with a diagnosis of peptic ulcer. Which
assessment finding would most likely indicate perforation of the ulcer?
A. Bradycardia
B. Numbness in the legs
C. Nausea and vomiting
D. A rigid, boardlike abdomen correct answer -D. A rigid, boardlike
abdomen
, Rationale:
Perforation of an ulcer is a surgical emergency and is characterized by sudden,
sharp, intolerable severe pain beginning in the mid-epigastric area and
spreading over the abdomen, which becomes rigid and boardlike. Nausea and
vomiting may occur. Tachycardia may occur as hypovolemic shock develops.
Numbness in the legs is not an associated finding.
The nurse is caring for a client following a gastrojejunostomy (Billroth II
procedure). Which postoperative prescription should the nurse question and
verify?
A. Leg exercises
B. Early ambulation
C. Irrigating the nasogastric tube
D. Coughing and deep-breathing exercises correct answer -C. Irrigating the
nasogastric tube
Rationale:
In a gastrojejunostomy (Billroth II procedure), the proximal remnant of the
stomach is anastomosed to the proximal jejunum. Patency of the nasogastric
tube is critical for preventing the retention of gastric secretions. The nurse
should never irrigate or reposition the gastric tube after gastric surgery,
unless specifically prescribed by the health care provider. In this situation, the
nurse should clarify the prescription. Options 1, 2, and 4 are appropriate
postoperative interventions.
The nurse is providing discharge instructions to a client following
gastrectomy and should instruct the client to take which measure to assist in
preventing dumping syndrome?
A. Ambulate following a meal.
B. Eat high-carbohydrate foods.
C. Limit the fluids taken with meals.
D. Sit in a high Fowler's position during meals. correct answer -C. Limit the
fluids taken with meals.
Rationale:
The nurse is monitoring a client admitted to the hospital with a diagnosis of
appendicitis who is scheduled for surgery in 2 hours. The client begins to
complain of increased abdominal pain and begins to vomit. On assessment,
the nurse notes that the abdomen is distended and bowel sounds are
diminished. Which is the most appropriate nursing intervention?
A. Notify the health care provider (HCP).
B. Administer the prescribed pain medication.
C. Call and ask the operating room team to perform surgery as soon as
possible.
D. Reposition the client and apply a heating pad on the warm setting to the
client's abdomen. correct answer -A. Notify the health care provider (HCP).
Rationale:
On the basis of the signs and symptoms presented in the question, the nurse
should suspect peritonitis and notify the HCP. Administering pain medication
is not an appropriate intervention. Heat should never be applied to the
abdomen of a client with suspected appendicitis because of the risk of
rupture. Scheduling surgical time is not within the scope of nursing practice,
although the HCP probably would perform the surgery earlier than the
prescheduled time.
A client has just had a hemorrhoidectomy. Which nursing interventions are
appropriate for this client? Select all that apply.
A. Administer stool softeners as prescribed.
B. Instruct the client to limit fluid intake to avoid urinary retention.
C. Encourage a high-fiber diet to promote bowel movements without
straining.
D. Apply cold packs to the anal-rectal area over the dressing until the packing
is removed.
E. Help the client to a Fowler's position to place pressure on the rectal area
and decrease bleeding. correct answer -A. Administer stool softeners as
prescribed.
C. Encourage a high-fiber diet to promote bowel movements without
straining.
,D. Apply cold packs to the anal-rectal area over the dressing until the packing
is removed.
Rationale:
Nursing interventions after a hemorrhoidectomy are aimed at management of
pain and avoidance of bleeding and incision rupture. Stool softeners and a
high-fiber diet will help the client to avoid straining, thereby reducing the
chances of rupturing the incision. An ice pack will increase comfort and
decrease bleeding. Options 2 and 5 are incorrect interventions.
The nurse is planning to teach a client with gastroesophageal reflux disease
(GERD) about substances to avoid. Which items should the nurse include on
this list? Select all that apply.
A. Coffee
B. Chocolate
C. Peppermint
D. Nonfat milk
E. Fried chicken
F. Scrambled eggs correct answer -A. Coffee
B. Chocolate
C. Peppermint
E. Fried chicken
Rationale:
Foods that decrease lower esophageal sphincter (LES) pressure and irritate
the esophagus will increase reflux and exacerbate the symptoms of GERD and
therefore should be avoided. Aggravating substances include coffee, chocolate,
peppermint, fried or fatty foods, carbonated beverages, and alcohol. Options 4
and 6 do not promote this effect.
A client has undergone esophagogastroduodenoscopy. The nurse should place
highest priority on which item as part of the client's care plan?
1. Monitoring the temperature
2. Monitoring complaints of heartburn
3. Giving warm gargles for a sore throat
4. Assessing for the return of the gag reflex correct answer -4. Assessing
for the return of the gag reflex
,Rationale:
The nurse places highest priority on assessing for return of the gag reflex. This
assessment addresses the client's airway. The nurse also monitors the client's
vital signs and for a sudden increase in temperature, which could indicate
perforation of the gastrointestinal tract. This complication would be
accompanied by other signs as well, such as pain. Monitoring for sore throat
and heartburn are also important; however, the client's airway is the priority.
The nurse is providing dietary teaching for a client with a diagnosis of chronic
gastritis. The nurse instructs the client to include which foods rich in vitamin
B12 in the diet? Select all that apply.
A. Nuts
B. Corn
C. Liver
D. Apples
E. Lentils
F. Bananas correct answer -A. Nuts
C. Liver
E. Lentils
Rationale:
Chronic gastritis causes deterioration and atrophy of the lining of the
stomach, leading to the loss of function of the parietal cells. The source of
intrinsic factor is lost, which results in an inability to absorb vitamin B12,
leading to development of pernicious anemia. Clients must increase their
intake of vitamin B12 by increasing consumption of foods rich in this vitamin,
such as nuts, organ meats, dried beans, citrus fruits, green leafy vegetables,
and yeast.
The nurse is monitoring a client with a diagnosis of peptic ulcer. Which
assessment finding would most likely indicate perforation of the ulcer?
A. Bradycardia
B. Numbness in the legs
C. Nausea and vomiting
D. A rigid, boardlike abdomen correct answer -D. A rigid, boardlike
abdomen
, Rationale:
Perforation of an ulcer is a surgical emergency and is characterized by sudden,
sharp, intolerable severe pain beginning in the mid-epigastric area and
spreading over the abdomen, which becomes rigid and boardlike. Nausea and
vomiting may occur. Tachycardia may occur as hypovolemic shock develops.
Numbness in the legs is not an associated finding.
The nurse is caring for a client following a gastrojejunostomy (Billroth II
procedure). Which postoperative prescription should the nurse question and
verify?
A. Leg exercises
B. Early ambulation
C. Irrigating the nasogastric tube
D. Coughing and deep-breathing exercises correct answer -C. Irrigating the
nasogastric tube
Rationale:
In a gastrojejunostomy (Billroth II procedure), the proximal remnant of the
stomach is anastomosed to the proximal jejunum. Patency of the nasogastric
tube is critical for preventing the retention of gastric secretions. The nurse
should never irrigate or reposition the gastric tube after gastric surgery,
unless specifically prescribed by the health care provider. In this situation, the
nurse should clarify the prescription. Options 1, 2, and 4 are appropriate
postoperative interventions.
The nurse is providing discharge instructions to a client following
gastrectomy and should instruct the client to take which measure to assist in
preventing dumping syndrome?
A. Ambulate following a meal.
B. Eat high-carbohydrate foods.
C. Limit the fluids taken with meals.
D. Sit in a high Fowler's position during meals. correct answer -C. Limit the
fluids taken with meals.
Rationale:
