What nursing diagnostic statement would be assigned the highest priority in the plan of care for a patient who has ulcerative colitis?
1
Activity intolerance
2
Deficient fluid volume
3
Impaired tissue integrity
4
Risk for impaired skin integrity
In ulcerative colitis, fluid is not absorbed from the distal large intestine because of ulceration, bleeding, and, later, scarring and narrowing of the lumen of the bowel. Fluid and electrolytes are also lost in the stool; therefore, deficient fluid volum
Which condition can be diagnosed by measuring fasting serum gastrin levels?
1
Acute gastritis
2
Pyloric obstruction
3
Gastric outlet obstruction
Correct4
Zollinger-Ellison syndrome
Zollinger-Ellison syndrome can be diagnosed by measuring fasting serum gastrin levels, which will determine the amount of gastrin secreted by G cells of the stomach. Acute gastritis is diagnosed by endoscopic examination with biopsy. Pyloric obstruction i
Which medication for peptic ulcer disease causes hallucinations?
1
Nizatidine
Incorrect2
Sucralfate
3
Omeprazole
Correct4
Metoclopramide
Metoclopramide is a prokinetic agent that causes central nervous system side effects such as hallucinations and anxiety. Nizatidine is a histamine (H2) receptor blocker that causes abdominal pain, headache, diarrhea, and constipation. Sucralfate is an ant
A patient has what is suspected to be a gastric ulcer perforation. Which symptom does the nurse expect will be present?
Incorrect1
Pyrosis
Correct2
Rigid abdomen
3
Bright-red emesis
4
Clay-colored stools
Perforation results in spillage of gastric or duodenal contents into the upper peritoneal cavity. The patient experiences sudden upper abdominal pain because the spillage causes irritation of pain receptors in the visceral and parietal layers of the perit
A patient who has a family history of colon cancer asks the nurse about tests for colon cancer. Which of these is considered the best method for colorectal cancer (CRC) screening?
Correct1
Colonoscopy
Incorrect2
Barium enema
3
Sigmoidoscopy
4
Fecal occult
Colonoscopy is the gold standard for CRC screening because the entire colon is examined (only 50 percent of CRCs are detected by sigmoidoscopy), biopsies can be obtained, and polyps can be removed immediately and sent to the laboratory for examination. A
Which surgical therapy is used to treat pyloric obstruction?
1
Vagotomy
Correct2
Endoscopy
Incorrect3
Gastrojejunostomy
4
Gastroduodenostomy
An endoscopy with balloon dilations is used in the treatment of pyloric obstruction. A vagotomy is the severing of the vagus nerve either totally or selectively to decrease gastric acid secretion. A gastrojejunostomy involves a partial gastrectomy with re
A 61-year-old patient with suspected bowel obstruction had a nasogastric tube inserted at 4:00 AM. The nurse shares in the morning report that the day shift staff should check the tube for patency at what times?
Incorrect1
7:00 AM, 10:00 AM, and 1:00 PM
C
A nasogastric tube should be checked for patency routinely at four-hour intervals. Thus, if the tube were inserted at 4:00 AM, it would be due to be checked at 8:00 AM, 12:00 PM, and 4:00 PM
The nurse is caring for a patient who is scheduled to receive a course of long-term broad spectrum antibiotic therapy. The nurse knows the patient will need instruction on actions to take to prevent infection with which organism?
1
Salmonella
Correct2
Clo
The development of C. difficile is associated with the administration of broad-spectrum antibiotics. Although Salmonella, Rotavirus, and E. coli 0157:H7 are bacterial infections affecting the colon, their occurrence is not associated with antibiotic admin
The nurse is caring for a patient who presents with tachycardia, lower abdominal pain, and nausea and vomiting. Upon clinical examination, the primary health care provider identifies a rigid and board-like abdomen. Which surgical therapy is beneficial for
Tachycardia, lower abdomen pain, nausea, and vomiting are the clinical manifestations of perforation, a complication of peptic ulcer disease. A laparoscopy involves a simple closure with an omentum graft, which will repair the perforation with appropriate
What is the cause of nonmechanical intestinal obstruction?
1
Hernia
2
Intussusception
Correct3
Thoracic spinal fracture
4
Strictures from Crohn's disease
Intestinal obstruction occurs when intestinal contents are unable to pass through the gastrointestinal tract. Paralytic ileus is the most common form of nonmechanical obstruction. A thoracic spinal fracture is a cause of paralytic ileus. Hernia, intussusc
The nurse is preparing to insert a nasogastric (NG) tube into a 68-year-old female patient who is nauseated and vomiting. The patient has an abdominal mass and suspected small intestinal obstruction. The patient asks the nurse why this procedure is necess
The NG tube is used to decompress the stomach by draining stomach contents, and thereby prevent further vomiting. The NG tube will not push past the blocked area. Potential surgery is not indicated currently. The location of the obstruction will determine
When assessing a patient with a gastrointestinal disorder, the nurse finds an absence of bowel sounds and peristalsis. The assessment findings are indicative of what condition?
1
Volvulus
2
Borborygmi
Correct3
Paralytic ileus
4
Pseudopolyps
Lack of intestinal peristalsis and an absence of bowel sounds indicate paralytic ileus, which occurs due to paralysis of intestinal muscles. Volvulus is an intestinal obstruction that occurs by the bowel twisting around a focal point. Borborygmi are audib
A patient is admitted to the hospital with a severe duodenal ulcer. The patient suddenly complains of severe pain spreading over the entire abdomen, likely due to a perforation. What should be the most immediate intervention by the nurse, if prescribed?
1
The immediate focus of management for a patient with a perforation is to stop the spillage of gastric or duodenal contents into the peritoneal cavity and restore blood volume. An NG tube is inserted into the stomach to provide continuous aspiration and ga
Which medication is prescribed for cytoprotective drug therapy?
1
Tofranil
2
Sucralfate
3
Cimetidine
4
Misoprostol
Sucralfate provides cytoprotective for the esophagus, stomach, and duodenum by forming a protective layer and serves as a barrier against acids, bile salts, and enzymes. Tofranil is a tricyclic antidepressant that provides pain relief in peptic ulcer dise
Which medication is prescribed for the prevention of peptic ulcer caused by nonsteroidal antiinflammatory drugs (NSAIDs) and aspirin?
1
Famotidine
2
Imipramine
3
Misoprostol
4
Clarithromycin
Because of its protective and antisecretory effects on gastric mucosa, misoprostol (a synthetic prostaglandin analog) is prescribed to prevent peptic ulcers caused by NSAIDS and aspirin. Famotidine is a histamine-receptor blocker used to heal ulcers. Imip
The nurse recognizes that which treatment strategy is beneficial for patients with stage I colorectal tumors?
1
Resection
2
Reanastomosis
3
Chemotherapy
4
Laparoscopic surgery
Laparoscopic surgery is used to treat stage I colorectal tumors. Stage II colorectal tumors are treated with resection and reanastomosis. Chemotherapy is used to treat high-risk stage II, stage III, and stage IV colorectal tumors.
Which histamine-receptor blocker is available only for oral administration?
1
Nizatidine
2
Ranitidine
3
Cimetidine
4
Famotidine
Nizatidine is available only for oral administration but not for intravenous (IV) administration; the medication is used to promote ulcer healing. Ranitidine, cimetidine, and famotidine are histamine (H2) blockers that can be given orally or through IV.
A colectomy is scheduled for an 81-year-old man with an abdominal mass, suspected bowel obstruction, and a history of rectal polyps. The nurse should plan to include which prescribed measure in the preoperative preparation of this patient?
1
Rectal acetam
Preoperative preparation for bowel surgery typically includes bowel cleansing with oral antibiotics such as oral neomycin and cleansing enemas, including Fleet enemas. Rectal acetaminophen is not the best choice for pain control. Anticoagulants should not
Which type of intestinal obstruction does the nurse recall is observed in a patient with collagen vascular disease?
1
Pseudo-obstruction
2
Vascular obstruction
3
Mechanical obstruction
4
Nonmechanical obstruction
Pseudo-obstruction is a type of intestinal obstruction caused by collagen vascular disease. Vascular obstruction occurs due to emboli and atherosclerosis of the mesenteric arteries. Hernias and strictures due to Crohn's disease cause mechanical obstructio
While reviewing the laboratory reports of a patient with chronic inflammation of the gastrointestinal tract, the nurse suspects toxic megacolon in the patient. Which laboratory finding supports the nurse's suspicion?
Incorrect1
Decreased albumin
Correct2
Chronic inflammation of the gastrointestinal tract indicates inflammatory bowel disease. Toxic megacolon is a condition characterized by swelling and dilation of the large intestine due to inflammation of the intestinal wall and accumulation of excess gas
The nurse is educating a patient about dietary fiber and the ways to incorporate it into the daily diet. What information should the nurse include while teaching this patient about fiber intake?
Correct1
Drink at least 2 liters of water daily.
2
Avoid hav
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Which gastrointestinal disorder does the nurse recall occurs because of trauma from a knife wound?
Correct1
Peritonitis
2
Colonic polyps
3
Gastroenteritis
4
Inflammatory bowel disease
Peritonitis is the localized or generalized inflammation of the periton
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Which medications increase the risk of ulcer development? Select all that apply.
Correct1
Aspirin
Correct2
Fluoxetine
3
Misoprostol
4
Bethanechol
5
Metoclopramide
Aspirin and fluoxetine are ulcerogenic drugs that inhibit the synthesis of prostaglandins, i
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A patient with a peptic ulcer begins vomiting. The nurse would expect and be concerned with which type of vomitus?
1
Fecal
2
Bilious
Correct3
"Coffee ground"
4
Undigested food
The appearance of blood exposed to hydrochloric acid and other digestive enzyme
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