Nursing textbooks gastrointestinal practice questions, set 2
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Nursing textbooks gastrointestinal practice questionsset 2
You read GI bleed, liver, and nutrition stems and pick the intervention that protects the patient now. Five of the 15 questions include the correct answer and rationale. The other ten keep answers in the study hub. Continue with the Nursing textbooks exam guide or more Nursing textbooks practice questions.
Five gastrointestinal questions with answers
Cover the key. Write the first action. Then open the rationale and name why the other choices fail.
Question 1
A nurse in the neurologic ICU has orders to infuse a hypertonic solution into a patient with increased intracranial pressure. This solution will increase the number of dissolved particles in the patients blood, creating pressure for fluids in the tissues to shift into the capillaries and increase the blood volume. This process is best described as which of the following?
A. Hydrostatic pressure
B. Osmosis and osmolality
C. Diffusion
D. Active transport
Show answer and rationale
Correct answer: B — Osmosis and osmolality
Osmosis is the movement of fluid from a region of low solute concentration to a region of high solute concentration across a semipermeable membrane. Hydrostatic pressure refers to changes in water or volume related to water pressure. Diffusion is the movement of solutes from an area of greater concentration to lesser concentration; the solutes in an intact vascular system are unable to move so diffusion normally should not be taking place. Active transport is the movement of molecules against the concentration gradient and requires adenosine triphosphate (ATP) as an energy source; this process typically takes place at the cellular level and is not involved in vascular volume changes.
Question 2
A nurse working in a pediatric clinic provides codes for a patient's services to a third-party payer who pays all or most of the care. How does the nurse refer to this method of payment?
A. Out-of-pocket payment
B. Individual private insurance
C. Employer-based group private insurance
D. Government financing
Show answer and rationale
Correct answer: B — Individual private insurance
The four basic modes of paying for health care are out-of-pocket payment, individual private insurance, employer-based group private insurance, and government financing. With individual private insurance, members pay monthly premiums either by themselves or in combination with employer payments. These plans are called third-party payers because the insurance company pays all or most of the cost of care. Out-of-pocket payment is paying for health care with cash payments. Employer-based private insurance is employer-sponsored coverage, and government financing is provided through Medicare and Medicaid, and other federally funded programs.
Question 3
A nurse cares for a client who is prescribed lactulose (Heptalac). The client states, 'I do not want to take this medication because it causes diarrhea.' How should the nurse respond?
A. Diarrhea is expected; that's how your body gets rid of ammonia.
B. You may take Kaopectate liquid daily for loose stools.
C. Do not take any more of the medication until your stools firm up.
D. We will need to send a stool specimen to the laboratory.
Show answer and rationale
Correct answer: A — Diarrhea is expected; that's how your body gets rid of ammonia.
The purpose of administering lactulose to this client is to help ammonia leave the circulatory system through the colon. Lactulose draws water into the bowel with its high osmotic gradient, thereby producing a laxative effect and subsequently evacuating ammonia from the bowel. The client must understand that this is an expected therapeutic effect for him or her to remain compliant. The nurse should not suggest administering anything that would decrease the excretion of ammonia or holding the medication. There is no need to send a stool specimen to the laboratory because diarrhea is the therapeutic response to this medication.
Question 4
The nurse is preparing to insert a peripheral IV catheter into a patient who will require fluids and IV antibiotics. How should the nurse always start the process of insertion?
A. Leave one hand ungloved to assess the site.
B. Cleanse the skin with normal saline.
C. Ask the patient about allergies to latex or iodine.
D. Remove excessive hair from the selected site.
Show answer and rationale
Correct answer: C — Ask the patient about allergies to latex or iodine.
Before preparing the skin, the nurse should ask the patient if he or she is allergic to latex or iodine, which are products commonly used in preparing for IV therapy. A local reaction could result in irritation to the IV site, or, in the extreme, it could result in anaphylaxis, which can be life threatening. Both hands should always be gloved when preparing for IV insertion, and latex-free gloves must be used or the patient must report not having latex allergies. The skin is not usually cleansed with normal saline prior to insertion. Removing excessive hair at the selected site is always secondary to allergy inquiry.
Question 5
You are the nurse caring for a 77-year-old male patient who has been involved in a motor vehicle accident. You and your colleague note that the patients labs indicate minimally elevated serum creatinine levels, which your colleague dismisses. What can this increase in creatinine indicate in older adults?
A. Substantially reduced renal function
B. Acute kidney injury
C. Decreased cardiac output
D. Alterations in ratio of body fluids to muscle mass
Show answer and rationale
Correct answer: A — Substantially reduced renal function
Normal physiologic changes of aging, including reduced cardiac, renal, and respiratory function, and reserve and alterations in the ratio of body fluids to muscle mass, may alter the responses of elderly people to fluid and electrolyte changes and acidbase disturbances. Renal function declines with age, as do muscle mass and daily exogenous creatinine production, excretion. Therefore, a high-normal or minimally elevated blood serum creatinine value, may be used to substantially reduce renal function in older adults. An acute indication of injury would likely cause a more significant increase of serum creatinine.
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Question 6
A nurse is caring for a client receiving bismuth subsalicylate for the relief of diarrhea. Which of the following interventions should the nurse perform to promote an optimal response to the prescribed drug therapy?
A. Thoroughly mix and stir the drug before administering.
B. Administer the drug after each loose bowel movement.
C. Ensure the client receives adequate sunlight.
D. Encourage the client to lightly exercise on a daily basis.
Correct answer:
The nurse should administer the drug after each loose bowel movement to promote an optimal response to the prescribed drug therapy in the client with diarrhea. The nurse should inspect each bowel movement before making a decision to administer the drug. Laxatives that are in powder, flake, or granule form are mixed and stirred before being administered to the client with constipation. The nurse need not ensure that the client receives adequate sunlight or encourage the client to lightly exercise on a daily basis as these interventions will not help in promoting an optimal response to the prescribed drug therapy.
Our world is connected by a sophisticated communication system that makes much health information instantly accessible, no matter where the patient is being treated. This instant access to health information has impacted health care delivery strategies, including the delivery of nursing care. What is one way the delivery of health care has been impacted by this phenomenon?
A. Brisk changes as well as swift obsolescence
B. Rapid change that is nearly permanent
C. Limitations on the settings where care can be provided
D. Increased need for social acceptance
Correct answer:
The sophisticated communication systems that connect most parts of the world, with the capability of rapid storage, retrieval, and dissemination of information, have stimulated brisk change as well as swift obsolescence in health care delivery strategies. The other answers are incorrect because, although we have rapid change in the delivery of nursing care, it does not last a long time; it is evolving as health care itself evolves. Giving nursing care has not become easier, it becomes more complex with every change; and it does not need to be more socially acceptable; it needs to be more culturally sensitive.
A nurse cares for a client with hepatitis C. The client's brother states, 'I do not want to contract this infection, so I will not go into his room.' How should the nurse respond?
A. If you wear a gown and gloves, you will not get this virus.
B. Hepatitis C is not spread through casual contact.
C. This virus is only transmitted through a fecal specimen.
D. I can give you an update on your brother's status from here.
Correct answer:
Although family members may be afraid that they will contract hepatitis C, the nurse should educate the client's family about how the virus is spread. Hepatitis C is spread via blood-to-blood transmission and is associated with illicit IV drug use, needle sharing, blood and organ transplantation, accidental needle sticks, unsanitary tattoo equipment, and sharing of intranasal cocaine paraphernalia. Wearing a gown and gloves will not decrease the transmission of this virus. Hepatitis C is not spread through casual contact or a fecal specimen. Sharing the client's status without consent would violate privacy.
A physician has prescribed difenoxin with atropine to a client with acute diarrhea. The client informs the nurse that he is also taking MAOI antidepressants. The nurse would assess the client for which of the following that might result from the interaction of the two drugs?
A. Decreased effect of difenoxin
B. Increased risk of hypertensive crisis
C. Increased cholinergic blocking adverse reactions
D. Increased risk of CNS depression
Correct answer:
The nurse should monitor the client for an increased risk of hypertensive crisis as an effect of the interaction between difenoxin with atropine and MAOI antidepressants. When the client is administered antihistamines, opioids, sedatives, or hypnotics with antidiarrheal drugs, there will be increased risk of CNS depression. When the client is administered antihistamines and general antidepressants with antidiarrheal drugs, there will be increased cholinergic blocking adverse reactions. There will not be a decreased effect of difenoxin when there is an interaction between difenoxin and MAOI antidepressants.
The nurse is caring for a client with oral cancer who reports severe mouth sensitivity. The client asks the nurse what might be done about the condition. What should the nurse include in the response?
A. I can arrange a nutritional consultation.
B. Cold liquids may help soothe the sensitivity.
C. An anesthetic mouthwash may be used, but I will need to consult with the primary provider.
D. A special diet may be necessary based on your ability to chew and swallow.
E. Your doctor may prescribe a systemic analgesic for pain relief if necessary.
Correct answer:
When responding to a client reporting severe mouth sensitivity due to oral cancer, the nurse should inform the client of possible options for managing the sensitivity. These include nutritional consultations, the use of anesthetic mouthwash if approved by the primary provider, the formulation of a special diet around the client's ability to chew and swallow, and a systemic analgesic for pain relief if the provider deems it necessary. It is inaccurate for the nurse to respond that cold liquids may soothe the sensitivity, because cold and hot liquids may increase the discomfort of sensitive oral tissues.
You are caring for a 65-year-old male patient admitted to your medical unit 72 hours ago with pyloric stenosis. A nasogastric tube placed upon admission has been on low intermittent suction ever since. Upon review of the mornings blood work, you notice that the patients potassium is below reference range. You should recognize that the patient may be at risk for what imbalance?
A. Hypercalcemia
B. Metabolic acidosis
C. Metabolic alkalosis
D. Respiratory acidosis
Correct answer:
Probably the most common cause of metabolic alkalosis is vomiting or gastric suction with loss of hydrogen and chloride ions. The disorder also occurs in pyloric stenosis in which only gastric fluid is lost. Vomiting, gastric suction, and pyloric stenosis all remove potassium and can cause hypokalemia. This patient would not be at risk for hypercalcemia; hyperparathyroidism and cancer account for almost all cases of hypercalcemia. The nasogastric tube is removing stomach acid and will likely raise pH. Respiratory acidosis is unlikely since no change was reported in the patients respiratory status.
You are caring for a patient who is being treated on the oncology unit with a diagnosis of lung cancer with bone metastases. During your assessment, you note that the patient complains of a new onset of weakness with abdominal pain. Further assessment suggests that the patient likely has a fluid volume deficit. You should recognize that this patient may be experiencing what electrolyte imbalance?
A. Hypernatremia
B. Hypomagnesemia
C. Hypophosphatemia
D. Hypercalcemia
Correct answer:
The most common causes of hypercalcemia are malignancies and hyperparathyroidism. Anorexia, nausea, vomiting, and constipation are common symptoms of hypercalcemia. Dehydration occurs with nausea, vomiting, anorexia, and calcium reabsorption at the proximal renal tubule. Abdominal and bone pain may also be present. Primary manifestations of hypernatremia are neurologic and would not include abdominal pain and dehydration. Tetany is the most characteristic manifestation of hypomagnesemia, and this scenario does not mention tetany. The patient's presentation is inconsistent with hypophosphatemia.
A medical nurse educator is reviewing a patients recent episode of metabolic acidosis with members of the nursing staff. What should the educator describe about the role of the kidneys in metabolic acidosis?
A. The kidneys retain hydrogen ions and excrete bicarbonate ions to help restore balance.
B. The kidneys excrete hydrogen ions and conserve bicarbonate ions to help restore balance.
C. The kidneys react rapidly to compensate for imbalances in the body.
D. The kidneys regulate the bicarbonate level in the intracellular fluid.
Correct answer:
The kidneys regulate the bicarbonate level in the ECF; they can regenerate bicarbonate ions as well as reabsorb them from the renal tubular cells. In respiratory acidosis and most cases of metabolic acidosis, the kidneys excrete hydrogen ions and conserve bicarbonate ions to help restore balance. In respiratory and metabolic alkalosis, the kidneys retain hydrogen ions and excrete bicarbonate ions to help restore balance. The kidneys obviously cannot compensate for the metabolic acidosis created by renal failure. Renal compensation for imbalances is relatively slow (a matter of hours or days).
A client who has recovered from anesthesia following oral surgery for lip cancer is experiencing difficulty breathing deeply and coughing up secretions. Which measure will help ease the client's discomfort?
A. Keeping the head of the bed elevated.
B. Positioning the client flat on the abdomen or side.
C. Providing a tracheostomy tray near the bed.
D. Turning the client's head to the side.
Correct answer:
It is essential to position the client with the head of the bed elevated because it is easier for the client to breathe deeply and cough up secretions after recovering from the anesthetic. Positioning the client flat either on the abdomen or side with the head turned to the side will facilitate drainage from the mouth until the client has recovered from anesthesia. A tracheostomy tray is kept by the bed for respiratory distress or airway obstruction. When mouth irrigation is carried out, the nurse should turn the client's head to the side to allow the solution to run in gently and flow out.
A nurse is caring for an elderly client who has received cimetidine. Which of the following interventions should the nurse perform?
A. Monitor the client for complaints of pain or sour taste.
B. Monitor the client for concentrated urine and restlessness.
C. Closely monitor the client for confusion and dizziness.
D. Report symptoms of tardive dyskinesia to the primary health care provider.
Correct answer:
The nurse should closely monitor the elderly client who has been administered cimetidine for confusion and dizziness. When the client is receiving an antiemetic, the nurse monitors the client frequently for continued complaints of pain, sour taste, spitting blood, or coffee-ground-colored emesis. When antacids are given to the client, the nurse should observe the client for concentrated urine and restlessness. When the client is administered prolonged doses of metoclopramide, the nurse reports any sign of tardive dyskinesia or extrapyramidal symptoms to the primary health care provider.
About these Nursing textbooks gastrointestinal questions
Nursing textbooks gastrointestinal practice questions, set 2 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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