Chapter 38 Gastrointestinal System

Chapter 38  Gastrointestinal System

Complete Chapter Questions And Answers
 

Sample Questions

MULTIPLE CHOICE

1. An 83-year-old client tells the nurse, “My food doesn’t taste as good anymore.” Which of these responses by the nurse is correct?
a.
“As we age our taste buds decrease. Experiment with various seasonings, but avoid salt.”
b.
“If your dentures don’t fit well, improper chewing could affect your ability to taste food.”
c.
“Try holding your food in your mouth longer to provide increased taste.”
d.
“You may find smaller, more frequent meals to be more satisfying.”

ANS: A
As the body ages, several changes occur in the digestive system: peristalsis decreases, chewing is more difficult, eating and drinking may take longer, and the number of taste buds decreases.

PTS: 1 DIF: Comprehension REF: White (2010)

2. Which of these questions is essential to include during the nursing assessment of a client who has digestive system symptoms?
a.
whether the client was breast-fed or bottle-fed as an infant
b.
whether the client consumes coffee or tea with meals
c.
client’s knowledge of the food pyramid
d.
client’s medication history, including over-the-counter drugs

ANS: D
When a client is experiencing gastrointestinal symptoms, the nurse should obtain data: history of the present complaint, including such aspects as length and frequency of symptoms, when symptoms occur, and factors that aggravate symptoms; the client’s medication history, including both prescribed and over-the-counter drugs and the effectiveness of these medications; complete nutritional history, including foods that increase or decrease the symptoms, the effect of meals on symptoms, the appearance of symptoms within a certain time frame following meals, and the amount of fat, fiber, and fluids usually consumed; psychosocial factors, including compliance and noncompliance with health status and the client’s typical meal patterns; physical examination, including the client’s ability to chew and swallow and abdominal inspection, auscultation, percussion, and palpation; the client’s bowel elimination patterns, including frequency, consistency, and quantity of bowel movements; and evaluation of diagnostic data, including reports of the client’s laboratory, radiologic, and endoscopic examinations.

PTS: 1 DIF: Application REF: White (2010)

3. A client develops stomatitis as a complication of cancer chemotherapy. Which of these approaches should be included in the client’s nursing care?
a.
oral care q.d.
c.
diet as tolerated
b.
high-calorie liquid diet
d.
intravenous (IV) morphine

ANS: C
Stomatitis is a disorder of the mouth that is characterized by inflammation and ulcerations resulting from infection, substances that irritate the mucous membranes, or chemotherapy. Medical management includes prescription of topical anesthetics, analgesics, and anti-infectives as necessary. Nursing care focuses on monitoring the client’s oral mucous membranes, relieving the client’s pain, and maintaining adequate nutrition.

PTS: 1 DIF: Application REF: White (2010)

4. A nurse is caring for a client who has esophageal varices. A difference of how many mmHg in orthostatic blood pressure could indicate a change in fluid volume and possible recurrence of varix bleeding?
a.
10
c.
30
b.
20
d.
40

ANS: B
Esophageal varices are enlarged, twisted esophageal veins that are usually associated with chronic liver obstruction such as occurs in cirrhosis; they are asymptomatic until they rupture and hemorrhage. Medical management includes sclerotherapy or ligation; balloon tamponade is used during active bleeding. Medications may also be prescribed to prevent esophageal irritation, to control bleeding, and to control pain following sclerotherapy. Surgical treatment includes creation of a portosystemic shunt or a transjugular intrahepatic portosystemic shunt. Nursing care focuses on monitoring the client’s vital signs and overall condition for evidence of bleeding, orthostatic blood pressure(20 mmHg drop) could indicate a change in fluid volume and possible recurrence of varix bleeding and alleviating client anxiety.

PTS: 1 DIF: Application REF: White (2010)

5. A client is being treated for bleeding esophageal varices with a Sengstaken-Blakemore tube. Nursing care will include which of these approaches?
a.
allowing the client to assume a position of choice
b.
emptying the drainage bottle and recording output
c.
periodically deflating the balloon
d.
providing sips of ice water every 30 to 45 minutes

ANS: C
Esophageal varices are enlarged, twisted esophageal veins that are usually associated with chronic liver obstruction such as occurs in cirrhosis; they are asymptomatic until they rupture and hemorrhage. Medical management includes sclerotherapy or ligation; balloon tamponade is used during active bleeding. Medications may also be prescribed to prevent esophageal irritation, to control bleeding, and to control pain following sclerotherapy. Surgical treatment includes creation of a portosystemic shunt or a transjugular intrahepatic portosystemic shunt. Nursing care focuses on monitoring the client’s vital signs and overall condition for evidence of bleeding, periodically deflating the balloon if a Sengstaken-Blakemore tube is used, and alleviating client anxiety.

PTS: 1 DIF: Application REF: White (2010)