Chapter 13 Abdomen and Gastrointestinal System

Chapter 13  Abdomen and Gastrointestinal System

Complete Chapter Questions And Answers
 

Sample Questions

MULTIPLE CHOICE

1. A patient tells the nurse, “I’ve been having pain in my belly for several days that gets worse after eating.” Which datum from the symptom analysis is consistent with the nurse’s suspicion of peptic ulcer disease?
a.
Gnawing epigastric pain radiates to the back or shoulder that worsens after eating.
b.
Sharp midepigastric pain radiates to the jaw.
c.
Intermittent cramping pain in the left lower quadrant is relieved by defecation.
d.
Colicky pain is felt near the umbilicus with vomiting and constipation.

ANS: A

Feedback
A
Gnawing epigastric pain that radiates to the back or shoulder and worsens after eating is a symptom that is consistent with peptic ulcer disease.
B
Sharp midepigastric pain that radiates to the jaw is not a symptom of peptic ulcer disease.
C
Intermittent cramping pain in the left lower quadrant relieved by defecation is a symptom of diverticular disease rather than peptic ulcer disease.
D
Colicky pain felt near the umbilicus with vomiting and constipation is a symptom of an intestinal obstruction rather than peptic ulcer disease.

DIF: Cognitive Level: Apply REF: 268-269
TOP: Nursing Process: Assessment
MSC: NCLEX Patient Needs: Physiologic Integrity: Physiologic Adaptation: Alteration in Body Systems

2. During an assessment for abdominal pain, a patient reports a colicky abdominal pain and pain in the right shoulder that gets worse after eating fried foods. What question does the nurse ask to confirm the suspicion of cholelithiasis?
a.
“Have you noticed any swelling in your ankles or feet at the end of the day?”
b.
“Have you noticed a change in the color of your urine or stools?”
c.
“Have you vomited up any blood in the last 24 hours?”
d.
“Have you experienced fever, chills, or sweating?”

ANS: B

Feedback
A
This question is related to fluid retention, which may be asked if the patient has renal or heart failure.
B
Gallstones can obstruct the flow of bile to the gastrointestinal tract making urine darker and stools lighter in color.
C
This question applies if the patient has peptic ulcer disease or esophageal varices.
D
This question applies if the patient has gastroenteritis or a urinary tract infection.

DIF: Cognitive Level: Analyze REF: 268-269
TOP: Nursing Process: Assessment
MSC: NCLEX Patient Needs: Physiologic Integrity: Reduction of Risk Potential: System Specific Assessments

3. A patient reports having frequent heartburn. Which question does the nurse ask in response to this information?
a.
“Has your abdomen been distended when you feel the heartburn?”
b.
“What have you eaten in the last 24 hours?”
c.
“Is there a history of heart disease in your family?”
d.
“How long after eating do you have heartburn?”

ANS: D

Feedback
A
The question “Has your abdomen been distended when you feel the heartburn?” is not related to the heartburn. Distention usually is related to intestinal obstruction or liver disease.
B
The question “What have you eaten in the last 24 hours?” relates more to gastroenteritis. Indigestion is usually caused by food eaten in the last meal rather than in the last 24 hours.
C
The question “Is there a history of heart disease in your family?” points to myocardial ischemia. Although heartburn may be a symptom of myocardial ischemia, asking the patient about the family history is not relevant in this case.
D
Asking “How long after eating do you have heartburn?” can aid in determining if the patient has gastroesophageal reflux disease or a hiatal hernia. Both are common disorders that cause indigestion a few hours after meals.

DIF: Cognitive Level: Apply REF: 268-270
TOP: Nursing Process: Assessment
MSC: NCLEX Patient Needs: Health Promotion and Maintenance: Techniques of Physical Assessment

4. A patient reports having abdominal distention. The nurse notices that the patient’s sclerae are yellow. What question is appropriate for the nurse to ask in response to this information?
a.
“Has there been a change in your usual pattern of urination?”
b.
“Have you had any nausea or vomiting?”
c.
“Has there been a change in your bowel habits?”
d.
“Have you had indigestion or heartburn?”

ANS: B

Feedback
A
“Has there been a change in your usual pattern of urination?” is not a question related to the abdominal distention and jaundice.
B
“Have you had any nausea or vomiting?” is an appropriate question because the nurse suspects the patient may have a liver disease based on the abdominal distention and jaundice. The nurse interprets the relationship with data gathered from the history and the observation.
C
“Has there been a change in your bowel habits?” is a question that may be related to the abdominal distention, but not the jaundice.
D
“Have you had indigestion or heartburn?” is not a question related to the abdominal distention and jaundice. It applies more to gastric disorders, such as gastroesophageal reflux disease or hiatal hernia.

DIF: Cognitive Level: Analyze REF: 269-270
TOP: Nursing Process: Assessment
MSC: NCLEX Patient Needs: Physiologic Integrity: Physiologic Adaptation: Alteration in Body Systems

5. A patient reports having abdominal distention and having vomited several times yesterday and today. What question is appropriate for the nurse to ask in response to this information?
a.
“Has there been a change in your usual pattern of urination?”
b.
“Did you have heartburn before the vomiting?”
c.
“What did the vomitus look like?”
d.
“Have you noticed a change in the color of your urine or stools?”

ANS: C

Feedback
A
“Has there been a change in your usual pattern of urination?” is not a question related to abdominal distention and vomiting.
B
Have you noticed a change in the color of your urine or stools?” is not a question related to abdominal distention and vomiting. It is related to elevated bilirubin from liver or gallbladder disease and is accompanied by jaundice.
C
“What did the vomitus look like?” is an appropriate question because the characteristics of the vomitus may help determine its cause. Acute gastritis leads to vomiting of stomach contents, obstruction of the bile duct results in greenish-yellow vomitus, and an intestinal obstruction may cause a fecal odor to the vomitus.
D
This is not a question related to the abdominal distention and vomiting. Heartburn applies more to gastric disorders, such as gastroesophageal reflux disease or hiatal hernia.

DIF: Cognitive Level: Apply REF: 268| 270
TOP: Nursing Process: Assessment
MSC: NCLEX Patient Needs: Physiologic Integrity: Physiologic Adaptation: Alteration in Body Systems