Chapter 27: The Gastrointestinal System |DeWit: Medical-Surgical Nursing: Concepts & Practice, 3rd Edition

MULTIPLE CHOICE 1. The nurse cautions that constant stress can cause which alteration to the gastrointestinal (GI) system? a. Slowed GI mobility resulting in constipation b. Reversed peristalsis resulting in projectile vomiting c. Increased digestive juices resulting in a gastric ulcer d. Decreased digestive juices resulting in ineffective metabolism ANS: C Stress increases the gastric secretions, which irritate and finally ulcerate the gastric mucosal lining. PTS:1 DIF: Cognitive Level: Comprehension REF: 627 OBJ:2 (theory) TOP: Stress: Gastric Ulcer KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance 2. The nurse is caring for multiple patients. The nurse determines that which patient has the highest risk for developing gallstones? a. A 37-year-old white man of normal weight on long-term corticosteroids for asthma. b. A 42-year-old African American man of normal weight who has smoked for 25 years. c. A 46-year-old Indonesian woman who is under normal weight and has recently had radiation treatments. d. A 50-year-old obese Mexican American woman who has type 1 diabetes. ANS: D Obesity, diabetes mellitus (DM), rapid weight loss, and Crohn disease increase the risk for the development of gallstones. Native Americans and Mexican Americans have an ethnic predisposition to gallstones. PTS:1 DIF: Cognitive Level: Analysis REF: 628 OBJ:1 (theory) TOP: Gallstones: Risk Factors KEY: Nursing Process Step: Assessment MSC: NCLEX: Health Promotion and Maintenance 3. The home health nurse is caring for the patient with tuberculosis who is taking rifampin and isoniazid (INH). The nurse should carefully monitor the patient for which potential side effect? a. Gallstones b. Liver disorders c. Bleeding ulcers d. Esophagitis ANS: B Rifampin and INH are both hepatotoxic. PTS:1 DIF: Cognitive Level: Application REF: 629 OBJ:2 TOP: Liver Disorders: Etiology KEY: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity: Pharmacological Therapies 4. The nurse is obtaining a history of a patient with hepatitis A. Which question is most appropriate for the nurse to ask? a. “If using drugs, do you share needles?” b. “Do you always practice safe sex?” c. “Have you traveled to Canada in the last month?” d. “Do you eat shellfish or oysters often?” ANS: D Shellfish and mollusks can be contaminated by living in feces-contaminated water. Drug use and unprotected sex are not part of the etiology of hepatitis A but are for hepatitis B. Travel to Canada is not associated with hepatitis A. PTS:1 DIF: Cognitive Level: Application REF: 629, Health Promotion OBJ:1 (clinical) TOP: Hepatitis A: Etiology KEY: Nursing Process Step: Assessment MSC: NCLEX: Health Promotion and Maintenance 5. The nurse is caring for a patient who complains, “I don’t see why I can’t have a CT scan instead of the expensive MRI!” Which response is most appropriate for the nurse to make? a. “The MRI provides better contrast between normal and pathologic tissue.” b. “The MRI requires less analysis and is easier to read.” c. “The MRI produces a digital image that can be transmitted via e-mail.” d. “The MRI exposes the patient to less radiation.” ANS: A Magnetic resonance imaging (MRI) uses radiofrequency signals to determine how hydrogen atoms behave in the magnetic field. Inaddition, the MRI provides a better contrast than computed tomography (CT) between healthy tissues and pathologic tissues. PTS:1 DIF: Cognitive Level: Comprehension REF: 631, Table 27-1 OBJ:4 TOP: MRI: Advantages KEY: Nursing Process Step: Implementation MSC: NCLEX: Physiological Integrity: Basic Care and Comfort 6. The nurse is preparing to administer liquid laxative to a patient in preparation for a colonoscopy. Which action should the nurse take? a. Offer a small snack. b. Take the patient’s temperature. c. Mix the laxative with orange juice. d. Chill the laxative and pour it over ice.