Quiz #6 Gastrointestinal System

Question 1

Histamine receptor antagonists (H2RBs)

Answer 1

Cimetidine
Famotidine
Nizatidine
Ranitidine

Question 2

H2RBs Indication

Answer 2

Used to treat GERD and ulcers
- works by reducing the amount of stomach acid secreted by the glands in the stomach

Question 3

Cimetidine

Answer 3

CNS effects in clients with kidney and liver dysfunction, confusion in the elderly
Caution in clients with pneumonia and COPD
Increase effects of warfarin
Decreased effects if taken with other antacids
*smoking decreases effects

Question 4

A nurse is teaching a client about cimetidine. Which of the following is an adverse effect?

Answer 4

Gynecomastia is an adverse effect
Confusion is an adverse CNS effect
Impotence is an adverse effect

Question 5

A nurse is teaching a client who will begin taking aluminum hydroxide. Which of the following information should the nurse include in the teaching?

Answer 5

Cimetidine alters the absorption of many medications

Question 6

Mucosal protectants (sucralfate)

Answer 6

May cause dry mouth, nausea, constipation
- Increase fiber and fluid intake.
Taken 1 hr before meals and at bedtime (4x/day)
May impair absorption of other medications
- Take 30 min before or after antacids.
- Maintain 2-hr interval with other medications.

Question 7

a nurse is providing teaching to a client who has peptic ulcer disease and is to start a new prescription for sucralfate. which of the following actions of sucralfate should the nurse include in the teaching?

a. decreases stomach acid secretion
b. neutralizes acids in the stomach
c. forms a protective barrier over ulcers
d. treats ulcers by eradicating h. pylori

Answer 7

c. forms a protective barrier over ulcers

Question 8

A nurse is assessing a client and discovers the infusion pump with the client’s total parenteral nutrition (TPN) solution is not infusing. The nurse should monitor the client for which of the following conditions?

A. Excessive thirst and urination
B. Shakiness and diaphoresis
C. Fever and chills
D. Hypertension and crackles

Answer 8

B. Shakiness and diaphoresis

When a sudden interruption in the infusion of TPN occurs, the client is at risk for hypoglycemia. Shakiness and diaphoresis are manifestations of hypoglycemia.

Question 9

A nurse is providing discharge teaching to a client who will be receiving TPN at home. Which of the following instructions should the nurse include? SATA

A. “Keep the TPN refrigerated when not in use.”
B. “Infuse 10 percent dextrose and water if the solution runs out.”
C. “Shake the TPN bag with fat emulsion if precipitate is present.”
D. “Stop using TPN once weight gain is achieved.”
E. “Maintain TPN infusion rate when behind schedule.”

Answer 9

A, B, E

Question 10

A nurse is caring for a client who is receiving TPN. The nurse notices that the solution bag is almost empty and there is not another bag of TPN to administer. Which of the following IV solutions should the nurse administer until the next bag of TPN solution is available?

A. 10% dextrose in water (D10W)
B. 0.45% sodium chloride (0.45% NaCl)
C. Lactated Ringer’s solution
D. 5% dextrose in lactated Ringer’s solution (D5LR)

Answer 10

A. 10% dextrose in water (D10W)

Question 11

A nurse is preparing a client for placement of a catheter for TPN. Which of the following access sites should the nurse plan to prepare for catheter insertion?

A. Left antecubital vein
B. Right subclavian vein
C. Right femoral artery
D. Left arm radial artery

Answer 11

B. Right subclavian vein

The right subclavian vein is the most common access site for total parenteral nutrition.

Question 12

A nurse is caring for a client who is receiving total parenteral nutrition (TPN). Which of the following laboratory findings indicates that the TPN therapy is effective?

Answer 12

Prealbumin 30 mg/dL

Prealbumin level is a sensitive indicator of nutritional status. The nurse should identify that a level of 30 mg/dL is within the expected reference range of 15 to 36 mg/dL and indicates the TPN is effective.

Question 13

A nurse in a clinic is reviewing the laboratory findings of a client who has type 2 diabetes mellitus. Which of the following findings indicates the client’s plan of care is effective?

Answer 13

HbA1c 6.5%

The nurse should identify that a HbA1c level of less than 7% indicates the plan of care is effective for a client who has type 2 diabetes mellitus.

Question 14

A nurse is assessing 4 female clients for obesity. Which of the following clients have manifestations of obesity?

a) A client who has a body fat of 22%
b) A client who has a BMI of 28
c) A client who has a waist circumference of 81.3 cm (32 in)
d) A client who weighs 28% above ideal body weight

Answer 14

d) A client who weighs 28% above ideal body weight

Question 15

A nurse is caring for a client who came to the ER with abdominal distention and is now on the med-surge unit with an NG tube in place to low gastric suction. The client is reporting anxiety, discomfort, and a feeling of bloating. Which of the following actions is the nurse’s priority?

a) Request a prescription for a medication to ease the client’s anxiety.
b) Irrigate the NG tube with 100 mL of sterile water.
c) Check to see if the suction equipment is working.
d) Remove and reinsert the NG tube.

Answer 15

c) Check to see if the suction equipment is working.

Question 16

A nurse is planning care for a client who has a decreased LOC. The client is receiving continuous enteral feedings via a GI tube due to an inability to swallow. Which of the following is the priority action by the nurse?

a) Observe client’s respiratory status.
b) Elevate the head of the client’s bed 30° to 45°.
c) Monitor intake and output every 8 hr.
d) Check residual volume every 4 to 6 hr

Answer 16

b) Elevate the head of the client’s bed 30° to 45°.

Question 17

A nurse is assessing a client who is receiving intermittent enteral nutrition through nasogastric tube. Which of the following assessment is the nurses priority?

Answer 17

The client is regurgitating the internal formula

Question 18

nurse is preparing to instill an enteral feeding for a client who has an NG tube in place. Which of the following actions is the nurse’s highest assessment priority before preforming this procedure

A. Check how long the feeding container has been open
B. Verify the placement of the NG tube.
C. Confirm the client does not have diarrhea
D. Make sure the client is alert and oriented.

Answer 18

B. Verify the placement of the NG tube.

Question 19

A nurse is assisting with preparing a client who is to have a central venous catheter inserted for the administration of total parenteral nutrition (TPN). Which of the following actions should the nurse take?

A. Verify the amount of TPN solution the client is receiving every 4 hr.
B. Prepare the client for a chest x-ray to verify catheter placement.
C. Use clean technique when changing the catheter dressing.
D. Place the client in Sims’ position for catheter insertion.

Answer 19

B. Prepare the client for a chest x-ray to verify catheter placement.

Question 20

Hyperglycemia- Clinical Manifestations

Answer 20

Polyuria
Polydipsia
Polyphagia
Fatigue, Weakness
Blurred vision
Recurrent infections, delayed wound healing

Question 21

Diabetic ketoacidosis- clinical manifestations

Answer 21

Kussmal respirations
Acetone fruity breath

Question 22

Type 2 Diabetes Risk Factors

Answer 22

Family history, Ethnicity, Age
Obesity, Sedentary lifestyle
Metabolic syndrome- central obesity, hypertension, hyperglycemia, hypercholesterolemia

Question 23

A nurse is admitting an older client who has diabetic neuropathy with painful, burning feet. Which of the following interventions should the nurse anticipate the health care provider to prescribe?

A. Place a bed cradle on the clients bed
B. Inspect the clients feet once weekly
C. Apply graduated compression stockings to the lower extremities
D. Put a heating pad on the clients feet

Answer 23

A. Place a bed cradle on the clients bed

This intervention helps to prevent the weight of the bed covers from pressing on the feet, reducing discomfort and the risk of pressure ulcers.

Question 24

A client who has type 1 diabetes mellitus asks a nurse about beginning an exercise regimen.
Which of the following instructions should the nurse include?

A. Exercise when insulin is at its peak action.
B. Avoid protein before exercising.
C. Inject additional insulin before exercising.
D. Eat a piece of fruit before exercising.

Answer 24

D. Eat a piece of fruit before exercising.

Consuming a piece of fruit before exercising can help provide the body with easily digestible carbohydrates for energy. This can help prevent hypoglycemia during exercise, especially if the client’s blood sugar tends to drop during physical activity.

Question 25

A nurse is teaching a client who has a hiatal hernia about dietary recommendations. Which of the following client statements indicates an understanding of the teaching? Select all that apply.
a. “I will lie down for one half hour after meals.”
b. “I will consume less caffeine and fewer spicy foods.”
c. “I will sleep with the head of my bed elevated.”
d. “I will try not to gain weight.”
e. “I will drink less fluid.”

Answer 25

b. “I will consume less caffeine and fewer spicy foods.”

c. “I will sleep with the head of my bed elevated.”

d. “I will try not to gain weight.”

Question 26

A nurse is reviewing the medical record of a client who has a peptic ulcer. Which of the following findings should the nurse recognize as a risk factor for this condition?

a. History of bulimia
b. History of NSAID use
c. Drinks green tea
d. Has a glass of wine with dinner each

Answer 26

b. History of NSAID use

Question 27

A nurse is providing teaching to a client who has peptic ulcer disease and a new prescription for sucralfate tablets. Which of the following information should the nurse provide?

a. “An antacid may be taken with the medication if indigestion occurs.”
b. “Take sucralfate 1 hour before meals.”
c. “Take the tablets whole.”
d. “Store sucralfate in the refrigerator.”

Answer 27

b. “Take sucralfate 1 hour before meals.”

Question 28

A nurse is teaching a client who has a new prescription for sucralfate to treat a gastric ulcer. Which of the following statements by the client indicates an understanding of the teaching?

a. “I will take this medication as needed to reduce pain.”
b. “I will reduce my fluid intake with this medication.”
c. “I will take this medication with an antacid.”
d. “I will take this medication 1 hour before meals and at bedtime.”

Answer 28

d. “I will take this medication 1 hour before meals and at bedtime.”

Question 29

A nurse is caring for a client with type 1 diabetes mellitus who reports feeling shaky and having palpitations. When the nurse finds the client’s blood glucose to be 48 mg/dL on the glucometer, he should give the client which of the following?​

A. Graham crackers​
B. 1 tsp sugar​
C. 4 oz diet soda​
D. 4 oz skim milk​

Answer 29

A. Graham crackers

After establishing that the client has hypoglycemia, the nurse should give the client about 15 g of​ a rapid-acting, concentrated carbohydrate, such as 4 oz of fruit juice, 8 oz of skim milk, 3 tsp of sugar or honey, 3 graham crackers, or commercially prepared glucose tablets. The nurse should recheck the client’s blood glucose level in 15 minutes.​

Question 30

A nurse is caring for a client who has peptic ulcer disease. The nurse should monitor the client for which of the following findings as an indication of gastrointestinal perforation?

a. Hyperactive bowel sounds
b. Sudden abdominal pain
c. Increased blood pressure
d. Bradycardia

Answer 30

b. Sudden abdominal pain

Question 31

A nurse is a client who is taking metformin XR for type 2 DM. Which of the following instructions should the nurse include in the teaching?

Answer 31

“Take the medication with a meal.” This will help the client avoid HYPOglycemia and GI upset and to provide the most absorption of the medication.

Question 32

A nurse is evaluating teaching with a client who is receiving continuous subcutaneous insulin via an external insulin pump. which of the following statements by the client indicates a need for further teaching?

A. “I will change the needle every 3 days.”
B. “I should store all unused insulin in the refrigerator.”
C. “If I skip lunch, I will skip my mealtime dose of insulin.”
D. “I will use insulin glargine in my insulin pump.”

Answer 32

D. “I will use insulin glargine in my insulin pump.”

The client should use a short-acting insulin in the pump. The pump is designed to administer rapid-acting or short acting insulin 24 hours a da. Glargine is classified as a long-acting insulin and is administered at the same time each day to maintain stable blood glucose concentration for a 24 hours period.

Question 33

A nurse is caring for a client who has diabetes and plans to administer his regular insulin subcutaneously before he eats breakfast at 0800. After checking the client’s morning glucose level, which of the following actions should the nurse take?

A. Give the insulin at 0700.
B. Give the insulin when the breakfast tray arrives.
C. Give the insulin 30 min after breakfast with the client’s other routine medicines.
D. Give the insulin at 0730.

Answer 33

D. Give the insulin at 0730.

Regular insulin has an onset of 30-60 minutes and should be given at a specific time before meals, usually within 30 min. The nurse should always check the blood glucose levels prior to administering short-acting insulin

Question 34

a nurse is teaching a client who has type 2 diabetes mellitus about foot care. which of the following statements by the client indicates an understanding of the teaching?

A. “i will apply moisturizer between my toes”
B. “i will soak my feet daily”
C. “i’ll be sure to wear cotton socks every day”
D. “i’ll use a heating pad to warm my feet”

Answer 34

C. “i’ll be sure to wear cotton socks every day”

Question 35

A nurse is assessing a client who has peptic ulcer disease. Which of the following findings should the nurse identify as the priority?

A. Diarrhea
B. Dyspepsia
C. Epigastric discomfort
D. Hematemesis

Answer 35

D. Hematemesis

Given that peptic ulcer disease can lead to serious complications such as gastrointestinal bleeding, the priority finding for the nurse to identify would be option D, “Hematemesis,” which refers to vomiting blood. This symptom indicates potential bleeding in the upper gastrointestinal tract and requires immediate medical attention to prevent further complications.

Question 36

A nurse is caring for a client who has gastrointestinal bleeding. Which of the following actions should the nurse take first?

a. Assess orthostatic blood pressure
b. Explain the procedure for an upper gastrointestinal series
c. Administer pain medication
d. Test the client’s emesis for blood

Answer 36

a. Assess orthostatic blood pressure

During the nursing process, the first action the nurse should take is to assess the client by measuring the clients’ orthostatic blood pressure. This action determines if the client is hypovolemic and establishes a baseline for further measurements

Question 37

A nurse is teaching a client who has a hiatal hernia about dietary recommendations. Which of the following client statements indicates an understanding of the teaching? Select all that apply.

a. “I will lie down for one half hour after meals.”
b. “I will consume less caffeine and fewer spicy foods.”
c. “I will sleep with the head of my bed elevated.”
d. “I will try not to gain weight.”
e. “I will drink less fluid.”

Answer 37

b. “I will consume less caffeine and fewer spicy foods.”
c. “I will sleep with the head of my bed elevated.”
d. “I will try not to gain weight.”

Question 38

A nurse working for a home health agency is teaching a client who has diabetes mellitus about disease management. Which of the following glycosylated hemoglobin (HbA1c) values should the nurse include in the teaching as an indicator that the client is appropriately controlling his glucose levels?

A. 6.3%
B. 7.86
C. 10%
D. 8.56%

Answer 38

A. 6.3%

This HbA1c level indicates good blood glucose control. It suggests that the client has been effectively managing their blood sugar levels over the past few months.

Question 39

Hyperglycemia management

Answer 39

■ Encourage oral fluid intake of sugar-free fluids to prevent dehydration.
■ Administer insulin as prescribed.
■ Restrict exercise when blood glucose levels are greater than 250 mg/dL.
■ Test urine for ketones and report if outside of expected reference range.
■ Consult the provider if manifestations progress.

Question 40

A nurse is teaching a client who has a new prescription for aluminum hydroxide to treat heartburn. The nurse should instruct the client to monitor for and report which of the following adverse reactions?

A. Constipation
B. Flatulence
C. Palpitations
D. Headache

Answer 40

A. Constipation

Question 41

Aluminum hydroxide

Answer 41

Commonly used as an antacid to treat heartburn, can cause constipation as a side effect.
By advising the client to be vigilant for signs of constipation, the nurse ensures early detection and management of this potential adverse reaction.
Additionally, it’s important to remind the client to drink plenty of fluids and increase dietary fiber intake to help prevent constipation while taking aluminum hydroxide.

Question 42

Peptic ulcer disease - Gastric

Answer 42

Superficial lesion
Antrum of stomach
Pain occurs 30-60 min after a meal
Pain at night less often
Pain exacerbated by food
Hematemesis

Question 43

Peptic ulcer disease- Duodenal

Answer 43

Penetrating lesion
Duodenum
Pain occurs 1.5-3 hrs after meal
Pain during the night
Pain relieved by food or antacid
Melena

Question 44

Risk factors for PUD

Answer 44

H. Pylori infection
ASA, NSAIDs, Corticosteroids
Uncontrolled Stress
Smoking, alcohol, caffeine
Zollinger-Ellison syndrome

Question 45

A nurse is teaching an older adult client who has diabetes mellitus about preventing the long-term complications of retinopathy and nephropathy. Which of the following instructions should the nurse include?

A) “Have an eye examination once per year.”
B) “Examine your feet carefully every day.”
C) “Wear compression stockings daily.”
D) “Maintain stable blood glucose levels.”

Answer 45

D) “Maintain stable blood glucose levels.”