Page 1 of 19
Med Surg- GASTROINTESTINAL
EXAM 1 GRADED A+ QUESTIONS WITH
CORRECT ANSWERS 2025
What are some nursing interventions related to barium swallow?
Pre-procedure
-Explain procedure (pt education)
-Diet starts with clear liquids and then NPO after midnight- including medications
Post procedure
Laxative may be needed, stool will be gray
Monitor and teach pt., elimination of barium
Increase fluids
If gastrografin used, pt. may have diarrhea
What are the PRE-OP interventions performed for barium enemas?
preop
-explain procedure
-clear liquid diet for lunch and dinner the day before
-drink one glass of water every 8-10 hours on the day before
-strong cathartic- magnesium citrate for X-prep at 2pm on day before
-administer bisocodyl tabs at 7pm the day before
-NPO after midnight
-cleansing enema and/ or dulcolax suppository is given on day of exam at 6am
What are the POST-OP interventions performed for barium enemas?
-explain to pt- may experience gas pains
-assess for abdominal distention/ tenderness
-inspect stool for blood presence
-push fluids
-monitor for barium elimination
-laxative may be ordered to help clear bowel
What is Crohn's disease?
, Page 2 of 19
-Chronic inflammation and ulceration of the mucosal layer of the colon and
rectum with periods of remission and exacerbation
-Common in adolescents and young adults; now frequently seen in older population
(50-80)
-Equal among sexes
What is the pathophysiology of Crohn's disease?
-Inflammation extending through all layers of bowel (transmural)
-Fistulas and abscesses extend into peritoneum
-Lesions are not continuous
(cobblestones appearance)
-Bowel thickens and lumen narrows
-Can occur anywhere including small intestines
What are the s/s of Crohn's disease?
-Abdominal pain and cramping
-Diarrhea (90% of cases)- bloody mucoid stool, dehydration
-Weight loss due to anorexia, N/V, secondary anemia
-Intrabdominal abscess (fever, leukocytosis)
-Rectal bleeding
-Malaise; thin, emaciated (decrease intake, malabsorption, fluid loss
What treatments are available for crohn's disease?
-Inflammation, rest bowel
-Diet and fluid intake
-Low residue/fiber, high protein, high calorie, low fat
-Vitamins and iron
-IV for electrolyte replacement and hydration
-Avoid milk to prevent diarrhea
-Avoid cold foods and smoking-
a. increase intestinal motility- diarrhea and cramping
-TPN (prn)
-Small frequent meals
What medications are used for Crohn's disease?
a. Anxiolytics- reduce any anxiety and to relax smooth muscle.
b. Sedatives
c. Antidiarrheals
, Page 3 of 19
d. Anti-peristaltic- to rest bowel
e. Antibiotics
-Flagyl® (metronidazole)=Infections from fistulas, abscess
f. Corticosteroids
-Prednisone- outpatient
-hydrocontisone (Solu-Cortef®) inpatient
g. Immunomodulators
h. Biological Therapies
i. Anti-inflammatories- sulfa free aminosalicylates, mesalamine
What is a hernia?
a protrusion of internal body organs through the muscular wall
What are some common sites where hernias are found?
1. umbilicus- common in children and obesity
2. groin (inguinal)- more common in males
3. hiatal (epigastric)- opening of diaphragm (where esophagus passes through)
What are common risk factors associated with hernias?
1. lifting heavy objects
2. chronic coughs
3. straining to void or defecating (CONSTIPATION)
4. sneezing
What are the three hernia classifications?
1. REDUCIBLE= protruding organ can e returned to its proper place by pressing on
organ
2. IRREDUCIBLE= protruding organ is tightly wedged outside of the cavity and
cannot be pushed back through the opening
3. STRANGULATED= protruding part is not replaceable and its blood supply is cut
off completely
What are some complications related to hernias?
-"lump" or local swelling at the site especially with umbilical/ inguinal/ femoral
-pain occurs when peritoneum becomes irritated or with incarcerated and
strangulated
-possible intestinal obstruction if intestine becomes blocked by incarcerated hernia
-hiatal hernia: more GI symptoms
a. heart burn
Med Surg- GASTROINTESTINAL
EXAM 1 GRADED A+ QUESTIONS WITH
CORRECT ANSWERS 2025
What are some nursing interventions related to barium swallow?
Pre-procedure
-Explain procedure (pt education)
-Diet starts with clear liquids and then NPO after midnight- including medications
Post procedure
Laxative may be needed, stool will be gray
Monitor and teach pt., elimination of barium
Increase fluids
If gastrografin used, pt. may have diarrhea
What are the PRE-OP interventions performed for barium enemas?
preop
-explain procedure
-clear liquid diet for lunch and dinner the day before
-drink one glass of water every 8-10 hours on the day before
-strong cathartic- magnesium citrate for X-prep at 2pm on day before
-administer bisocodyl tabs at 7pm the day before
-NPO after midnight
-cleansing enema and/ or dulcolax suppository is given on day of exam at 6am
What are the POST-OP interventions performed for barium enemas?
-explain to pt- may experience gas pains
-assess for abdominal distention/ tenderness
-inspect stool for blood presence
-push fluids
-monitor for barium elimination
-laxative may be ordered to help clear bowel
What is Crohn's disease?
, Page 2 of 19
-Chronic inflammation and ulceration of the mucosal layer of the colon and
rectum with periods of remission and exacerbation
-Common in adolescents and young adults; now frequently seen in older population
(50-80)
-Equal among sexes
What is the pathophysiology of Crohn's disease?
-Inflammation extending through all layers of bowel (transmural)
-Fistulas and abscesses extend into peritoneum
-Lesions are not continuous
(cobblestones appearance)
-Bowel thickens and lumen narrows
-Can occur anywhere including small intestines
What are the s/s of Crohn's disease?
-Abdominal pain and cramping
-Diarrhea (90% of cases)- bloody mucoid stool, dehydration
-Weight loss due to anorexia, N/V, secondary anemia
-Intrabdominal abscess (fever, leukocytosis)
-Rectal bleeding
-Malaise; thin, emaciated (decrease intake, malabsorption, fluid loss
What treatments are available for crohn's disease?
-Inflammation, rest bowel
-Diet and fluid intake
-Low residue/fiber, high protein, high calorie, low fat
-Vitamins and iron
-IV for electrolyte replacement and hydration
-Avoid milk to prevent diarrhea
-Avoid cold foods and smoking-
a. increase intestinal motility- diarrhea and cramping
-TPN (prn)
-Small frequent meals
What medications are used for Crohn's disease?
a. Anxiolytics- reduce any anxiety and to relax smooth muscle.
b. Sedatives
c. Antidiarrheals
, Page 3 of 19
d. Anti-peristaltic- to rest bowel
e. Antibiotics
-Flagyl® (metronidazole)=Infections from fistulas, abscess
f. Corticosteroids
-Prednisone- outpatient
-hydrocontisone (Solu-Cortef®) inpatient
g. Immunomodulators
h. Biological Therapies
i. Anti-inflammatories- sulfa free aminosalicylates, mesalamine
What is a hernia?
a protrusion of internal body organs through the muscular wall
What are some common sites where hernias are found?
1. umbilicus- common in children and obesity
2. groin (inguinal)- more common in males
3. hiatal (epigastric)- opening of diaphragm (where esophagus passes through)
What are common risk factors associated with hernias?
1. lifting heavy objects
2. chronic coughs
3. straining to void or defecating (CONSTIPATION)
4. sneezing
What are the three hernia classifications?
1. REDUCIBLE= protruding organ can e returned to its proper place by pressing on
organ
2. IRREDUCIBLE= protruding organ is tightly wedged outside of the cavity and
cannot be pushed back through the opening
3. STRANGULATED= protruding part is not replaceable and its blood supply is cut
off completely
What are some complications related to hernias?
-"lump" or local swelling at the site especially with umbilical/ inguinal/ femoral
-pain occurs when peritoneum becomes irritated or with incarcerated and
strangulated
-possible intestinal obstruction if intestine becomes blocked by incarcerated hernia
-hiatal hernia: more GI symptoms
a. heart burn
