Gastrointestinal System

Question 1: The nurse is caring for a patient, a 57 y.o. a. The ulcer has perforated
with liver cirrhosis who develops ascites and requires b. The esophagus has become inflamed
paracentesis. Before her paracentesis, you instruct her c. An intestinal obstruction has developed
to: d. Additional ulcers have developed
a. Remain NPO for 4 hours Question 6: The nurse correctly judges that the patient
b. Empty her bladder was probably ignoring important warning signs of
c. Lie supine in bed bleeding when the patient reports that prior to
d. Clean her bowels with an enema admission the color of his stool was

Question 2: A patient with peptic ulcer disease tells the a. light brown
nurse that he has black stools, which he has not b. gray
reported to his doctor. Based on this information, which c. black
nursing diagnosis would be appropriate for this patient? d. dark green

a. Constipation related to decreased gastric Question 7: The nurse is monitoring a female client with
motility a diagnosis of peptic ulcer. These assessment findings
b. Ineffective Coping related to fear of diagnosis of would most likely indicate perforation of the ulcer
chronic illness Except:
c. Imbalanced nutrition: less than body a. hypotension
requirements related to gastric bleeding b. Nausea and vomiting
d. Deficient knowledge related to unfamiliarity c. A rigid, board-like abdomen
with significant signs and symptoms d. Bradycardia

Question 3: The nurse is caring for a patient with liver Question 8: The patient has cirrhosis of the liver and
cirrhosis. Which of the following assessment findings develops ascites. What intervention is necessary to
leads the nurse to suspect hepatic encephalopathy in decrease the excessive accumulation of serous fluid in
the patient? her peritoneal cavity?

a. Hepatojugular reflex a. Encourage ambulation

b. Chvostek’s sign b. Restrict fluids
c. Asterixis c. Increase sodium in the diet
d. Trousseau’s sign d. Give antacids as prescribed

Question 9: The nurse is performing an abdominal

Question 4: While the patient is bleeding. It will be assessment and inspects the skin of the abdomen. The
essential for the nurse to assess the patient frequently nurse performs which assessment technique next?
for the signs of early shock. All the choices are indicators
of early shock, EXCEPT: a. Palpates the abdomen for size
b. Percusses the right lower abdominal quadrant
a. tachycardia c. Listens to bowel sounds in all for quadrants
b. cool clammy skin d. Palpates the liver at the right rib margin
c. increased urine output
d. restlessness Question 10: The patient is 45 y.o. and has a bleeding
ulcer. Despite multiple blood transfusions, her HGB is
Question 5: A patient is admitted to the hospital after 7.5g/dl and HCT is 27%. Her doctor determines that
vomiting bright red blood and is diagnosed with a surgical intervention is necessary and she undergoes
bleeding duodenal ulcer. The patient develops a sudden, partial gastrectomy. Postoperative nursing care includes:
sharp pain in the midepigastric region along with a rigid,
boardlike abdomen. These clinical manifestations most a. Positioning her in high Fowler’s position
likely indicate which of the following? b. Flushing the NG tube with sterile water
 c. Keeping her NPO until the return of peristalsis
d. Giving pain medication Q6H
Question 11: Dark, tarry stools indicate bleeding in
which location of the GI tract?
Question 16: A nurse admitted a patient in medical ward
an ulcer that occur in the lesser curvature of the
stomach, near the pylorus. This is classified as:

a. Lower colon a. Esophageal ulcer

b. Upper GI tract b. Stress ulcer
c. Small intestine c. Gastric ulcer
d. Upper colon d. Duodenal ulcer

Question 12: A nurse is performing an assessment on a Question 17: A patient was brought to the hospital with
patient with PUD. The nurse understands that which upper GI bleeding and is in moderate distress. The
data are unrelated to the patient's disorder? priority nursing action is to:

a. Use of acetaminophen a. insert NGT and hematest the emesis

b. history of tarry black tools b. obtain vital signs
c. history of alcohol abuse c. Administer low flow oxygen
d. complains of gastric pain 2 to 4 hours after d. ask the patient about the precipitating events
meals
Question 18: One of the manifestations of PUD is black,
Question 13: The nurse is caring for 67 y.o. patient with tarry, foul smelling stool which is an is an indication of
liver cirrhosis who develops ascites and requires bleeding. This is recorded as:
paracentesis. Relief of which symptom indicated that
a. Hematemesis
the paracentesis was effective?
b. Hemoptysis
a. Jaundice c. Melena
b. Peripheral Neuropathy d. Dyspepsia
c. Dyspnea
Question 19: A patient has an acute upper GI
d. Pruritus
hemorrhage. Your interventions include:
Question 14: In caring for a client with PUD, If
a. Treating hypovolemia
hemorrhage is a concern, the nurse will assess for
b. Controlling the bleeding source
faintness or dizziness and nausea, before or with
c. Treating hypervolemia
bleeding; test stool for occult or gross blood; It is
d. Treating shock and diagnosing the bleeding
essential to monitor vital signs frequently as follows
source.
Except:
Question 20: The nurse is caring for a client with
a. Tachypnea
cirrhosis of the liver. To minimize the effects of the
b. Tachycardia
disorder, the nurse teaches the client about foods that
c. Hypotension
are high in thiamine. The nurse determines that the
d. Hyperthermia
client has the best understanding of the dietary
Question 15: The nurse is performing an abdominal measures to follow if the client states an intention to
assessment on a patient who is 52 y.o. In which order do increase the intake of:
the nurse proceed?
a. pork
a. Palpation, percussion, observation, b. milk
auscultation c. broccoli
b. Percussion, palpation, auscultation, d. chicken
observation
c. Observation, percussion, palpation,
auscultation
d. Observation, auscultation, percussion, palpation
Question 1: A patient is seen in the clinic with COPD. Question 7: A patient with COPD is admitted to the
Which information given by the patient would help most hospital. How can the nurse best position the patient to
in confirming a diagnosis of chronic bronchitis? improve gas exchange?

A. The patient tells the nurse about a family history
of bronchitis
B. The patient denies having any respiratory
problems until the last 6 months
C. The patient's history indicates a 40 pack-year
cigarette history
D. The patient complains about having a
productive cough every winter for 2 months
A. Sitting up at the bedside in a chair and leaning
slightly forward
B. Resting in bed with the head elevated to 45 to
60 degrees
C. In the Trendelenburg's position with several
pillows behind the head
D. Resting in bed in a high-Fowler's position with
the knees flexed

Question 2: The nurse assesses a patient with shortness Question 8: Type II Acute Respiratory Failure is also
of breath for evidence of long-standing hypoxemia by known as:
inspecting
A. Hypercapnic Respiratory Failure
A. Chest excursion B. Perioperative Respiratory Failure
B. Spinal curvatures C. Hypoxemic Respiraory Failure
C. Respiratory pattern
Question 9: The nurse makes a diagnosis of impaired gas
D. Fingernail and its base
exchange for a patient with COPD in acute respiratory
Question 3: Identify whether the condition distress, based on the assessment finding of:
is PRIMARY OR SECONDARY causes of ARDS:
A. A pulse oximetry reading of 86%
SMOKE INHALATION B. Dyspnea and respiratory rate of 36
C. Use of the accessory respiratory muscles
A. primary cause
D. The presence of crackles in both lungs
B. secondary cause
Question 10: Identify whether the condition
Question 4: Identify whether the condition
is PRIMARY OR SECONDARY causes of ARDS:
is PRIMARY OR SECONDARY causes of ARDS:
TRAUMA
SEPSIS
A. secondary cause
A. secondary cause
B. primary cause
B. primary cause
Question 11: Identify whether the condition
Question 5: Represents the failure of the lungs to
is PRIMARY OR SECONDARY causes of ARDS:
remove a sufficient amt. of CO2.
FAT EMBOLI
A. Type I ARF
B. Type II ARF A. secondary cause
B. primary cause
Question 6: What procedure is considered as non-
invasive method that provides estimates of arterial Question 12: A cyanotic client with an unknown
oxyhemoglobin saturation (SaO2) by utilizing selected diagnosis is admitted to the emergency room. In relation
wavelengths of light to noninvasively determine the to oxygen, the first nursing action would be to:
saturation of oxyhemoglobin?
A. Wait until the client's lab work is done
A. Arterial Blood Gas B. Not administer oxygen unless ordered by the
B. Pulse Oximetry physician
C. Transcutaneous monitoring C. Administer oxygen at 2 liters flow per minute
D. Complete Blood Count D. Administer oxygen at 10 liters flow per minute
and check the client's nail beds
Question 13: For a client with COPD, what is the main Question 19: Type I of Acute Respiratory failure is also
risk factor for pulmonary infection? known as:

A. Fluid imbalance with pitting edema A. Classic Hypoxemic Respiratory Failure

B. Decrease of fluid intake and loss of body weight B. High-Demand Respiratory Failure
C. Pooling of respiratory secretions
Question 20: Identify whether the condition
D. Decreased anterior-posterior diameter of the
is PRIMARY OR SECONDARY causes of ARDS:
chest
ASPIRATION
Question 14: Which assessment finding should cause
the nurse to suspect the early onset of hypoxemia? A. primary cause
B. secondary cause
A. Restlessness
B. Central cyanosis

Question 15: The patient was diagnosed of having ARDS.

ARDS usually results from:

A. Inflammation of the lung parenchyma

commonly caused by microbial agents
B. Characterized by sudden and progressive
edema, increasing bilateral infiltrates and
reduced lung compliance
C. Permanent distention of the air spaces with
destruction of the alveolar walls
D. Caused by airflow obstruction which is usually
progressive and irreversible

Question 16: The patient with a history of heart failure

and acute respiratory failure has thick secretions that
she is having difficulty coughing up. Which intervention
would best help to mobilize her secretions?

A. Administer more IV fluid

B. Administration of normal saline nebulization
C. Suction airways nasopharyngeally

Question 17: The following are causes of Impaired Gas

exchange for client with Acute Respiratory Failure
except:

A. aspiration of foreign body

B. pulmonary edema
C. ARDS
D. aspiration pneumonia

Question 18: Identify whether the condition

is PRIMARY OR SECONDARY causes of ARDS:

BACTERIAL PNEUMONIA

A. primary cause
B. secondary cause