Chapter 05 Care of the Patient with a Gastrointestinal Disorder

Chapter 05  Care of the Patient with a Gastrointestinal Disorder

MULTIPLE CHOICE

1. The end-products of carbohydrate and protein digestion are absorbed by the

1. bloodstream.
2. blood vessels in the villi.
3. lymphatic system.
4. lymph vessels in the villi.

ANS: B
The inner surface of the small intestine contains millions of tiny, fingerlike projections called villi, which contain small blood vessels. They are responsible for absorbing the products of digestion.

DIF: Cognitive Level: Knowledge REF: Page 178 OBJ: 2 TOP: Digestive KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity

2. A 56-year-old patient with diverticulitis has been admitted to the medical unit. The nurse will most likely document which assessment in the charting?

1. Chest pain
2. Pain in the upper right quadrant
3. Pain in the left lower quadrant
4. Progressive weight loss

ANS: C
Patients with diverticulitis will complain of mild to severe pain in the left lower quadrant.

DIF: Cognitive Level: Comprehension REF: Page 213 OBJ: 8 TOP: Diverticulitis KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity

3. An ileostomy was performed on a patient for the treatment of debilitating ulcerative colitis disease. A problem the nurse should watch for in patients after this surgery is

1. fluid imbalance.
2. sexual activity restriction.
3. skin excoriation.
4. the collecting appliance being bulky and large.

ANS: C
The nurse should assess the peristomal skin for impairment of integrity. DIF: Cognitive Level: Analysis REF: Page 209, Box 5-5

Mosby items and derived items © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Test Bank 5-2

OBJ: 11 TOP: Ulcerative colitis
KEY: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity

4. A patient with cancer of the esophagus has been receiving radiation therapy. The nurse realizes that this patient should be assessed for

1. aspiration from fistula formation.
2. hemorrhage.
3. incompetence of the suture line.
4. dumping syndrome.

ANS: A
Radiation therapy may be curative or palliative. Special problems associated with radiation therapy include the development of an esophagotracheal fistula. Aspiration from the fistula and edema from the radiation must be anticipated.

DIF: Cognitive Level: Analysis REF: Page 188 OBJ: 5 TOP: Cancer of esophagus KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity

5. A patient has been admitted for diagnostic procedures including an esophagogastroduodenoscopy. The nurse explains to this patient that during this procedure, the physician will

1. use a long, rigid, fiberoptic scope.
2. order NPO status 1 hour before the procedure.
3. view the esophagus, stomach, and upper small intestine.
4. visualize the intestine but cannot remove polyps.

ANS: C
The esophagus, stomach, and duodenum can be evaluated not only by endoscopy, but also by the use of a longer flexible fiberoptic scope. This procedure is called an esophagogastroduodenoscopy.

DIF: Cognitive Level: Comprehension REF: Page 192 OBJ: 5 TOP: Diagnostic procedures KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity

6. The nurse determines that a patient has a knowledge deficit regarding her diagnosis of achalasia. The nurse begins patient teaching by explaining that achalasia is

1. a white patch on the mouth or tongue mucosa.
2. caused by frequent ulceration on the lip.
3. caused by excess exposure to sun and wind.
4. caused by the inability of a muscle to relax.

ANS: D
The abnormal condition characterized by the inability of a muscle to relax is achalasia.

DIF: Cognitive Level: Knowledge REF: Pages 188-189
Mosby items and derived items © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Test Bank 5-3

OBJ: 5 TOP: Achalasia KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity