GI EAQ Questions With All Correct Answers
After a subtotal gastrectomy, a client is returned to the surgical unit. Which is
an appropriate nursing action to prevent pulmonary complications?
1
Ambulating the client to increase respiratory exchange
2
Promoting frequent turning and deep breathing to mobilize secretions
3
Maintaining a consistent oxygen flow rate to increase oxygen saturation
4
Keeping a nonrebreather mask in place to ensure adequate oxygenation
correct answer -2 (To promote drainage of different lung regions, clients
should turn every 2 hours. Deep breathing inflates the alveoli and promotes
fluid drainage. During physical effort, individuals with abdominal incisions
often revert to shallow breathing. Oxygen administration is a dependent
function and generally is not required unless there is underlying cardiac or
respiratory disease. There is no indication that a nonrebreather mask is
needed.)
A client is diagnosed with cancer of the stomach and is scheduled for a partial
gastrectomy. Which topic would the nurse include in the postoperative care
teaching?
1
Gastric suction
2
Oxygen therapy
3
Fluid restriction
4
Urinary catheter correct answer -1 (After gastric surgery a nasogastric
tube is in place for drainage of blood and gastric secretions that allow healing
at the site of anastomosis. Oxygen is not required unless the client experiences
a complication necessitating its administration. An intravenous (IV) line to
meet fluid needs and replace gastric losses is given to the average client. A
urinary catheter may or may not be necessary.)
,In the immediate postoperative period after a gastrectomy, a client's
nasogastric tube is draining a light-red liquid. How long should the nurse
expect this type of drainage?
1
1 to 2 hours
2
3 to 4 hours
3
10 to 12 hours
4
24 to 48 hours correct answer -3 (The trauma of surgery results in some
seeping or oozing of blood into the remaining gastric area for 10 to 12 hours
until coagulation takes place. It takes more than 4 hours for the coagulation of
blood to occur after the trauma of surgery. Light-red drainage that occurs 24
to 48 hours after surgery is abnormal and unexpected; the health care
provider should be notified.)
After a client has a total gastrectomy, which necessary treatment does the
nurse plan to include in the discharge teaching?
1
Monthly injections of cyanocobalamin
2
Regular daily use of a stool softener
3
Weekly injections of iron dextran
4
Daily replacement therapy of pancreatic enzymes correct answer -1
(Intrinsic factor is lost with removal of the stomach, and cyanocobalamin is
needed to maintain the hemoglobin level once the client is stabilized;
injections are given monthly for life. Adequate diet, fluid intake, and exercise
should prevent constipation. Weekly injections of iron dextran are not
considered routine. Daily replacement therapy of pancreatic enzymes does
not affect pancreatic enzymes.)
The nurse is creating a discharge teaching plan for a client who had a subtotal
gastrectomy. The nurse would include which instructions about minimizing
dumping syndrome? Select all that apply. One, some, or all responses may be
correct.
1
,Drink fluids with meals.
2
Eat small, frequent meals.
3
Lie down for 1 hour after eating.
4
Chew food five times before swallowing.
5
Select foods that are low in fiber. correct answer -2, 3 (Small, frequent
meals keep the volume within the stomach to a minimum at any one time,
limiting dumping syndrome. Lying down delays emptying of the stomach
contents, which will limit dumping syndrome. Fluids should be taken between
meals to decrease the volume within the stomach at one time. Dumping
syndrome occurs after eating because of the rapid movement of food into the
jejunum without the usual digestive mixing in the stomach and processing in
the duodenum. Chewing a set number of times before swallowing is not
pertinent to solving this problem. High fiber, complex carbohydrates,
moderate fats, and high protein in small, frequent meals are recommended to
prevent dumping syndrome.)
The nurse is caring for a client in the postanesthesia care unit immediately
after the client had a subtotal gastrectomy. The nurse identifies small blood
clots in the client's gastric drainage. Which action would the nurse take?
1
Clamp the tube.
2
Consider this an expected event.
3
Instill the tube with iced normal saline.
4
Notify the health care provider immediately correct answer -2 (Because of
the trauma of surgery, some bleeding can be expected for 4 to 5 hours.
Clamping the tube will cause increased pressure on the gastric sutures from a
buildup of gas and fluid. Iced saline rarely is used because it causes
vasoconstriction, local ischemia, and a reduction in body temperature.
Notifying the client's surgeon of this finding is not necessary; this is an
expected occurrence.)
, After a subtotal gastrectomy, a client has a nasogastric (NG) tube in place for
continuous low suction. Three hours after the surgery, the client experiences
nausea and abdominal pain. The client's abdomen appears distended. Which
action would the nurse take?
1
Instill 30 mL of air into the NG tube.
2
Administer the prescribed pain medication.
3
Inform the client that abdominal pain is common with NG tubes.
4
Notify the health care provider immediately. correct answer -1
(Abdominal distention, nausea, and abdominal pain can be signs of
nasogastric tube blockage. Instilling 30 mL of air may reestablish patency.
Although opioids usually are prescribed postoperatively, they tend to
decrease peristalsis and may increase abdominal distention and nausea. It is
not common for NG tubes to cause abdominal pain. The nurse should evaluate
the cause of the symptoms before notifying the health care provider. If
patency is reestablished, it will most likely relieve the symptoms and
notification of the health care provider will not be necessary.)
After a subtotal gastrectomy, a client demonstrates signs of dumping
syndrome. About 90 minutes after the initial attack, the client reports feeling
shaky. Which would the nurse determine is the cause of the latter effect?
1
A second, more extensive rise in glucose
2
An overwhelmed insulin-adjusting mechanism
3
A distention of the duodenum from an excessive amount of chyme
4
An overproduction of insulin that occurs in response to the rise in blood
glucose correct answer -)4 (The rapid absorption of carbohydrates from
the food mass causes an elevation of blood glucose, and the insulin response
often causes transient hypoglycemic symptoms. The elevation in insulin
usually occurs 90 minutes to 3 hours after eating and is known as late
dumping syndrome. The physiological adaptations related to late dumping
syndrome are caused by an increase in insulin, not glucose. The insulin-
adjusting mechanism is not overwhelmed but responds vigorously, causing
After a subtotal gastrectomy, a client is returned to the surgical unit. Which is
an appropriate nursing action to prevent pulmonary complications?
1
Ambulating the client to increase respiratory exchange
2
Promoting frequent turning and deep breathing to mobilize secretions
3
Maintaining a consistent oxygen flow rate to increase oxygen saturation
4
Keeping a nonrebreather mask in place to ensure adequate oxygenation
correct answer -2 (To promote drainage of different lung regions, clients
should turn every 2 hours. Deep breathing inflates the alveoli and promotes
fluid drainage. During physical effort, individuals with abdominal incisions
often revert to shallow breathing. Oxygen administration is a dependent
function and generally is not required unless there is underlying cardiac or
respiratory disease. There is no indication that a nonrebreather mask is
needed.)
A client is diagnosed with cancer of the stomach and is scheduled for a partial
gastrectomy. Which topic would the nurse include in the postoperative care
teaching?
1
Gastric suction
2
Oxygen therapy
3
Fluid restriction
4
Urinary catheter correct answer -1 (After gastric surgery a nasogastric
tube is in place for drainage of blood and gastric secretions that allow healing
at the site of anastomosis. Oxygen is not required unless the client experiences
a complication necessitating its administration. An intravenous (IV) line to
meet fluid needs and replace gastric losses is given to the average client. A
urinary catheter may or may not be necessary.)
,In the immediate postoperative period after a gastrectomy, a client's
nasogastric tube is draining a light-red liquid. How long should the nurse
expect this type of drainage?
1
1 to 2 hours
2
3 to 4 hours
3
10 to 12 hours
4
24 to 48 hours correct answer -3 (The trauma of surgery results in some
seeping or oozing of blood into the remaining gastric area for 10 to 12 hours
until coagulation takes place. It takes more than 4 hours for the coagulation of
blood to occur after the trauma of surgery. Light-red drainage that occurs 24
to 48 hours after surgery is abnormal and unexpected; the health care
provider should be notified.)
After a client has a total gastrectomy, which necessary treatment does the
nurse plan to include in the discharge teaching?
1
Monthly injections of cyanocobalamin
2
Regular daily use of a stool softener
3
Weekly injections of iron dextran
4
Daily replacement therapy of pancreatic enzymes correct answer -1
(Intrinsic factor is lost with removal of the stomach, and cyanocobalamin is
needed to maintain the hemoglobin level once the client is stabilized;
injections are given monthly for life. Adequate diet, fluid intake, and exercise
should prevent constipation. Weekly injections of iron dextran are not
considered routine. Daily replacement therapy of pancreatic enzymes does
not affect pancreatic enzymes.)
The nurse is creating a discharge teaching plan for a client who had a subtotal
gastrectomy. The nurse would include which instructions about minimizing
dumping syndrome? Select all that apply. One, some, or all responses may be
correct.
1
,Drink fluids with meals.
2
Eat small, frequent meals.
3
Lie down for 1 hour after eating.
4
Chew food five times before swallowing.
5
Select foods that are low in fiber. correct answer -2, 3 (Small, frequent
meals keep the volume within the stomach to a minimum at any one time,
limiting dumping syndrome. Lying down delays emptying of the stomach
contents, which will limit dumping syndrome. Fluids should be taken between
meals to decrease the volume within the stomach at one time. Dumping
syndrome occurs after eating because of the rapid movement of food into the
jejunum without the usual digestive mixing in the stomach and processing in
the duodenum. Chewing a set number of times before swallowing is not
pertinent to solving this problem. High fiber, complex carbohydrates,
moderate fats, and high protein in small, frequent meals are recommended to
prevent dumping syndrome.)
The nurse is caring for a client in the postanesthesia care unit immediately
after the client had a subtotal gastrectomy. The nurse identifies small blood
clots in the client's gastric drainage. Which action would the nurse take?
1
Clamp the tube.
2
Consider this an expected event.
3
Instill the tube with iced normal saline.
4
Notify the health care provider immediately correct answer -2 (Because of
the trauma of surgery, some bleeding can be expected for 4 to 5 hours.
Clamping the tube will cause increased pressure on the gastric sutures from a
buildup of gas and fluid. Iced saline rarely is used because it causes
vasoconstriction, local ischemia, and a reduction in body temperature.
Notifying the client's surgeon of this finding is not necessary; this is an
expected occurrence.)
, After a subtotal gastrectomy, a client has a nasogastric (NG) tube in place for
continuous low suction. Three hours after the surgery, the client experiences
nausea and abdominal pain. The client's abdomen appears distended. Which
action would the nurse take?
1
Instill 30 mL of air into the NG tube.
2
Administer the prescribed pain medication.
3
Inform the client that abdominal pain is common with NG tubes.
4
Notify the health care provider immediately. correct answer -1
(Abdominal distention, nausea, and abdominal pain can be signs of
nasogastric tube blockage. Instilling 30 mL of air may reestablish patency.
Although opioids usually are prescribed postoperatively, they tend to
decrease peristalsis and may increase abdominal distention and nausea. It is
not common for NG tubes to cause abdominal pain. The nurse should evaluate
the cause of the symptoms before notifying the health care provider. If
patency is reestablished, it will most likely relieve the symptoms and
notification of the health care provider will not be necessary.)
After a subtotal gastrectomy, a client demonstrates signs of dumping
syndrome. About 90 minutes after the initial attack, the client reports feeling
shaky. Which would the nurse determine is the cause of the latter effect?
1
A second, more extensive rise in glucose
2
An overwhelmed insulin-adjusting mechanism
3
A distention of the duodenum from an excessive amount of chyme
4
An overproduction of insulin that occurs in response to the rise in blood
glucose correct answer -)4 (The rapid absorption of carbohydrates from
the food mass causes an elevation of blood glucose, and the insulin response
often causes transient hypoglycemic symptoms. The elevation in insulin
usually occurs 90 minutes to 3 hours after eating and is known as late
dumping syndrome. The physiological adaptations related to late dumping
syndrome are caused by an increase in insulin, not glucose. The insulin-
adjusting mechanism is not overwhelmed but responds vigorously, causing
