Topic 7: Upper and Lower Gastrointestinal and Nutritional Problems

Last updated about 2 years ago

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Which of the following statements made by the student nurse indicates understanding of the client's GERD syndrome?

"The reflux of the condition can cause damage to the inner lining of your esophagus" 

"It is better to stay away from alcohol as your ileum heals" 

"The increased pH of gastric acid makes you more prone for ulceration" 

"Inhaling air pollutants can exacerbate your symptoms" 

The nurse is caring for a 45 year old woman experiencing GERD symptoms. The client has a history of peptic ulcer disease, IBS, and an abdominal aortic dissection. The RN can attribute the symptoms to which main impairment?

Increased sensitivity of the mid-epigastric tract 

An incompetent esophageal sphincter 

Poor dietary lifestyle consisting of increased spicy food intake 

Unmanaged ulcerations of the stomach lining 

A nurse is caring for a client exhibiting a flare-up of GERD and is reviewing their medication history. Which of the following medications would prompt the nurse to suspect an increase in pressure of the LES? SATA.

Which of the following in the client's diet and medication history would prompt a nurse to suspect an decrease in LES pressure? SATA.

Which of the following medications would NOT prompt a nurse to suspect a decrease in LES pressure?

A client is admitted to the medical-surgical unit for unmanaged and exacerbated symptoms of GERD. The client is complaining of chest pain and suspects a heart attack. Which of the following physiological explanations can be used as a rationale for differentiating the chest pain induced by an MI and GERD?

The chest pain induced by an MI is not treatable 

The chest pain caused by GERD is alleviated through antacids 

The chest pain caused by GERD is a common occurrence of the condition and can vary in intensities without needing medical attention 

The chest pain caused by an MI is usually the result of unmanaged heartburn 

A new grad nurse is providing education about the complications of GERD. Which of the following conditions would the new grad include in their teaching when considering cellular changes and inflammation specific to the lower esophagus?

Barrett's Esophagus 

Esophagitis 

Esophageal Hyperplasia 

Esophageal Decay 

Which of the following conditions would the nurse include in the discharge teaching of a client with GERD?

A client presents to the ED complaining of the classic symptoms associated with gastroesophogeal reflux disease. Which of the following should be the nurse's priority action?

Prepare the client for upcoming motility studies 

Collect the client's comprehensive medical history and complete a physical assessment

Prepare the client for an upper GI endoscopy 

Educate the client about factors that would exacerbate their symptoms 

Which of the following should the nurse use as a priority teaching to a client being discharged with GERD?

The importance of a potential barium swallow study 

Limiting the amount of decaffeinated drinks consumed in a day 

The emphasis on obtaining a yearly upper GI endoscopy 

Following a low-fat diet to avoid symptom exacerbation

A client is expressing concerns and distress about a chronic diagnosis of GERD. Which of the following is the best response by the nurse?

"I can see why your condition frustrates you. Let's discuss some lifestyle habits that will help you manage you condition"

"You must adhere to everything I have taught you, or it will lead to the development of painful complications"

"Just make sure not to bend over and eat within 3 hours of sleeping and you'll be fine" 

"Regular check-ups with your provider can help in the process of finding a permanent solution" 

A client has just been prescribed a medication to help with their symptoms of GERD. The provider has stated that he will order an H2 blocker. Which medication would the nurse anticipate?

Sucralfate 

Esomeperazole 

Metoclopramide 

Famotidine 

Which of the following drug classes works to decrease the conversion of Pepsinogen into Pepsin?

H2 Antagonists

Proton Pump Inhibitors 

Anatcids/ Acid Neutralizers 

Cytoprotectives 

A client is complaining of heartburn and chest pain upon waking up in the morning. Which of the following findings can the nurse suspect as the reason for GERD exacerbation?

Sleeping with the head elevated at 30 degrees using pillows 

Stretching exercises 

Eating a snack at 11 p.m. 

Taking antacids as an off-label prophylaxis 

When providing education about drug therapy treatment for GERD, which of the following information would be included in regards to therapy goals? SATA.

Lifestyle interventions for ileus prevention 

Protecting the esophageal lining 

Decrease the acidity and volume of reflux contents 

Improve LES functioning 

Promotion of normal gut flora 

Decrease esophageal clearance 

A client asks why their prescription of Protonix (Pantoprazole) is so little with such a weak dose. What is the nurse's best response?

"The medication puts you at an increased risk for the development of ascites due to an increase in gastric and LES contraction pressure" 

"Taking this medication for a long time or in higher doses increases the risk for hip, wrist, and spinal fractures" 

"It is only used for short-duration symptom exacerbation" 

"This drug has a high risk of addiction and dependency" 

A client returns to the unit along with their spouse. Their spouse states that ever since they began drug therapy for GERD management, the client has started experiencing hallucinations, increased anxiety, tremors, and dyskinesia. Which medication would the nurse suspect to be the cause of these symptoms?

Which is true of the medications used to treat GERD? SATA.

Proton pump and Histamine blockers are considered most effective 

Misoprostol works by decreasing and blocking the effect of dopamine 

Antacids are the first-line treatment 

Sucralfate can help decrease the incidence of esophageal stricture 

PPI's and H-Blockers are available as prescription and OTC medications 

A client has been admitted to the Med-Surg unit for an asymptomatic cardiac dysrhythmia. The client is complaining of symptoms of heartburn associated with their history of GERD. Which of the following is the nurse's priority action?

Elevate the head of the bed to 30 degrees 

Obtain a 12-lead EKG 

Administer PRN anti-anginal 

Administer the client's scheduled H2 blocker medication 

A client is 1 month post op following a laparoscopic fundoplication procedure to fix an incompetent lower esophageal sphincter. The client is currently complaining of difficulties swallowing. Which of the following statements should the nurse respond with?

"You may be suffering from a post-operative obstruction. Follow-up surgery maybe required"

"This is happening because of post-surgical edema and should resolve on its own" 

"Take your prescribed antacids. This maybe happening because of increased gastric acidity" 

"You are at risk for aspiration pneumonia. Please return to the unit to seek immediate medical attention" 

A client has just been prescribed Aluminum Hydroxide (Amphojel) for temporary heartburn relief. Which of the following side effects should the nurse look out for?

Hypophosphatemia 

Hypercalemia 

Dyskinesia 

Milk-alkali syndrome 

A client asks the nurse about the possible side effects of prolonged calcium carbonate (tums) use. What is the appropriate response?

"these medications are available over the counter, so side effects are rare" 

"your stomach acid pH can drop to dangerously low levels" 

"taking these medications as prescribed will prevent any side effects" 

"there is a chance that you can develop hypercalcemia" 

Which of the following diagnoses would prompt the nurse to take extra caution for in a prescription for magnesium-containing antacids?

Obesity 

Hepatocellular Carcinoma 

Chronic Kidney Disease 

Appendicitis 

A client was just admitted to the observation unit following a Nissen fundoplication. The client has a history of primary hypertension and gout. Which of the following medications would prompt the nurse to take extra precautions?

Sodium- Bicarbonate (Alka-Seltzer) 

Metoclopramide (Reglan) 

Sucralfate (Carafate) 

Bethanechol (Urecholine) 

Which of the following physiological findings would be included in the identification of milk-alkali/ Burnett syndrome? SATA

A 30 year old female reports to the outpatient clinic for a follow up on GERD drug therapy. The client's Beta-HCG test shows a positive result, indicating pregnancy. The client also has a history of hypertension, dysmenorrhea, and hyperlipidemia. Which of the following medications would the APRN most likely stop?

Which of the following explanations of a hiatal hernia is accurate?

A pocket of the stomach herniates into the esophagus through an opening in the diaphragm 

A pocket of the esophagus herniates into the stomach through an opening in the diaphragm 

A pocket of the esophagus herniates into the thoracic cavity through an opening in the esophageal-tracheal tract 

A pocket of the stomach herniates and protrudes into the intestinal tract through an abnormality in the anatomy of the peritoneum 

A student nurse is helping out at the triage station in the local emergency department. 4 clients are experiencing an onset of symptoms similar to that of GERD. Which of the following patients is more likely to have developed a hiatal hernia?

A 36 year old male with a history of GERD

An 80 year old male who smokes and has COPD 

An 80 year old female with stable and managed hypertension 

An 50 year old female in her first trimester of pregnancy 

Which is the main physiological change that occurs with aging that contributes to the development of hiatal hernias?

Weakening of diaphragmatic muscles around the esophogogastric opening 

Loss of elasticity in the inferior intercostal muscles 

Widening of the esophogogastric junction 

More pronounced curve of the stomach fundus 

The nurse is teaching a new-grad about the potential complications of a hiatal hernia. Which complications would the nurse include? SATA

Which would the nurse note as a contributing external factor in the development of hernias in older adults?

Physiological changes associated with aging 

Low carb diets

History of natural child births 

Common gerontological medication regimens 

Which of the following is true when considering esophageal cancer?

Most esophageal cancers are adenocarcinomas 

This form of cancer has a widespread incidence rate throughout the globe 

It is the most common form of gastrointestinal cancer 

Those who are between the ages of 50-60 are most at risk 

A client is admitted to the observation unit of a new diagnosis of esophageal cancer. Which statement is true about the onset of the disease?

The symptoms of the disease have a sudden and rapid onset 

By the time symptoms become present, any tumor(s) are usually advanced in progression 

Which of the following statements made by the student nurse indicates understanding of the client's GERD syndrome? 

"The reflux of the condition can cause damage to the inner lining of your esophagus" 

"It is better to stay away from alcohol as your ileum heals" 

"The increased pH of gastric acid makes you more prone for ulceration" 

"Inhaling air pollutants can exacerbate your symptoms" 

The nurse is caring for a 45 year old woman experiencing GERD symptoms. The client has a history of peptic ulcer disease, IBS, and an abdominal aortic dissection. The RN can attribute the symptoms to which main impairment? 

Increased sensitivity of the mid-epigastric tract 

An incompetent esophageal sphincter 

Poor dietary lifestyle consisting of increased spicy food intake 

Unmanaged ulcerations of the stomach lining 

A nurse is caring for a client exhibiting a flare-up of GERD and is reviewing their medication history. Which of the following medications would prompt the nurse to suspect an increase in pressure of the LES? SATA. 

Fatty foods 

Bethanechol 

Metoclopramide 

Progesterone 

Diltiazem

Which of the following in the client's diet and medication history would prompt a nurse to suspect an decrease in LES pressure? SATA. 

Diltiazem 

Chocolate 

Nicotine 

Alcohol

Fatty foods 

Diphenhydramine

Decaffeinated drinks 

Which of the following medications would NOT prompt a nurse to suspect a decrease in LES pressure? 

Nitroglycerin 

Acetylcholine 

Atenolol 

Morphine 

Progesterone 

A client is admitted to the medical-surgical unit for unmanaged and exacerbated symptoms of GERD. The client is complaining of chest pain and suspects a heart attack. Which of the following physiological explanations can be used as a rationale for differentiating the chest pain induced by an MI and GERD? 

The chest pain induced by an MI is not treatable 

The chest pain caused by GERD is alleviated through antacids 

The chest pain caused by GERD is a common occurrence of the condition and can vary in intensities without needing medical attention 

The chest pain caused by an MI is usually the result of unmanaged heartburn 

A new grad nurse is providing education about the complications of GERD. Which of the following conditions would the new grad include in their teaching when considering cellular changes and inflammation specific to the lower esophagus? 

Barrett's Esophagus 

Esophagitis 

Esophageal Hyperplasia 

Esophageal Decay 

Which of the following conditions would the nurse include in the discharge teaching of a client with GERD? 

Development of cold sores in the mouth 

Barrett's esophagus

Dental erosion or tooth decay 

Esophagitis 

Risk for stomach cancer 

A client presents to the ED complaining of the classic symptoms associated with gastroesophogeal reflux disease. Which of the following should be the nurse's priority action? 

Prepare the client for upcoming motility studies 

Collect the client's comprehensive medical history and complete a physical assessment

Prepare the client for an upper GI endoscopy 

Educate the client about factors that would exacerbate their symptoms 

Which of the following should the nurse use as a priority teaching to a client being discharged with GERD? 

The importance of a potential barium swallow study 

Limiting the amount of decaffeinated drinks consumed in a day 

The emphasis on obtaining a yearly upper GI endoscopy 

Following a low-fat diet to avoid symptom exacerbation

A client is expressing concerns and distress about a chronic diagnosis of GERD. Which of the following is the best response by the nurse? 

"I can see why your condition frustrates you. Let's discuss some lifestyle habits that will help you manage you condition"

"You must adhere to everything I have taught you, or it will lead to the development of painful complications"

"Just make sure not to bend over and eat within 3 hours of sleeping and you'll be fine" 

"Regular check-ups with your provider can help in the process of finding a permanent solution" 

A client has just been prescribed a medication to help with their symptoms of GERD. The provider has stated that he will order an H2 blocker. Which medication would the nurse anticipate? 

Sucralfate 

Esomeperazole 

Metoclopramide 

Famotidine 

Which of the following drug classes works to decrease the conversion of Pepsinogen into Pepsin?

H2 Antagonists

Proton Pump Inhibitors 

Anatcids/ Acid Neutralizers 

Cytoprotectives 

A client is complaining of heartburn and chest pain upon waking up in the morning. Which of the following findings can the nurse suspect as the reason for GERD exacerbation? 

Sleeping with the head elevated at 30 degrees using pillows 

Stretching exercises 

Eating a snack at 11 p.m. 

Taking antacids as an off-label prophylaxis 

When providing education about drug therapy treatment for GERD, which of the following information would be included in regards to therapy goals? SATA. 

Lifestyle interventions for ileus prevention 

Protecting the esophageal lining 

Decrease the acidity and volume of reflux contents 

Improve LES functioning 

Promotion of normal gut flora 

Decrease esophageal clearance 

A client asks why their prescription of Protonix (Pantoprazole) is so little with such a weak dose. What is the nurse's best response? 

"The medication puts you at an increased risk for the development of ascites due to an increase in gastric and LES contraction pressure" 

"Taking this medication for a long time or in higher doses increases the risk for hip, wrist, and spinal fractures" 

"It is only used for short-duration symptom exacerbation" 

"This drug has a high risk of addiction and dependency" 

A client returns to the unit along with their spouse. Their spouse states that ever since they began drug therapy for GERD management, the client has started experiencing hallucinations, increased anxiety, tremors, and dyskinesia. Which medication would the nurse suspect to be the cause of these symptoms? 

Nizatidine 

Metoclopramide (Reglan) 

Bethanechol (Urecholine)

Misoprostol (Cytotec) 

Aluminum/ Magensium combo antacid (Maalox) 

Which is true of the medications used to treat GERD? SATA. 

Proton pump and Histamine blockers are considered most effective 

Misoprostol works by decreasing and blocking the effect of dopamine 

Antacids are the first-line treatment 

Sucralfate can help decrease the incidence of esophageal stricture 

PPI's and H-Blockers are available as prescription and OTC medications 

A client has been admitted to the Med-Surg unit for an asymptomatic cardiac dysrhythmia. The client is complaining of symptoms of heartburn associated with their history of GERD. Which of the following is the nurse's priority action? 

Elevate the head of the bed to 30 degrees 

Obtain a 12-lead EKG 

Administer PRN anti-anginal 

Administer the client's scheduled H2 blocker medication 

A client is 1 month post op following a laparoscopic fundoplication procedure to fix an incompetent lower esophageal sphincter. The client is currently complaining of difficulties swallowing. Which of the following statements should the nurse respond with? 

"You may be suffering from a post-operative obstruction. Follow-up surgery maybe required"

"This is happening because of post-surgical edema and should resolve on its own" 

"Take your prescribed antacids. This maybe happening because of increased gastric acidity" 

"You are at risk for aspiration pneumonia. Please return to the unit to seek immediate medical attention" 

A client has just been prescribed Aluminum Hydroxide (Amphojel) for temporary heartburn relief. Which of the following side effects should the nurse look out for? 

Hypophosphatemia 

Hypercalemia 

Dyskinesia 

Milk-alkali syndrome 

A client asks the nurse about the possible side effects of prolonged calcium carbonate (tums) use. What is the appropriate response? 

"these medications are available over the counter, so side effects are rare" 

"your stomach acid pH can drop to dangerously low levels" 

"taking these medications as prescribed will prevent any side effects" 

"there is a chance that you can develop hypercalcemia" 

Which of the following diagnoses would prompt the nurse to take extra caution for in a prescription for magnesium-containing antacids? 

Obesity 

Hepatocellular Carcinoma 

Chronic Kidney Disease 

Appendicitis 

A client was just admitted to the observation unit following a Nissen fundoplication. The client has a history of primary hypertension and gout. Which of the following medications would prompt the nurse to take extra precautions? 

Sodium- Bicarbonate (Alka-Seltzer) 

Metoclopramide (Reglan) 

Sucralfate (Carafate) 

Bethanechol (Urecholine) 

Which of the following physiological findings would be included in the identification of milk-alkali/ Burnett syndrome? SATA 

Alkalosis 

Acidosis 

Respiratory Depression 

Low CO2 

Acute Kidney Injury 

Hypercalcemia 

A 30 year old female reports to the outpatient clinic for a follow up on GERD drug therapy. The client's Beta-HCG test shows a positive result, indicating pregnancy. The client also has a history of hypertension, dysmenorrhea, and hyperlipidemia. Which of the following medications would the APRN most likely stop? 

Acetaminophen 

Nizatidine 

Famotidine 

Ibuprofen

Misoprostol 

Which of the following explanations of a hiatal hernia is accurate? 

A pocket of the stomach herniates into the esophagus through an opening in the diaphragm 

A pocket of the esophagus herniates into the stomach through an opening in the diaphragm 

A pocket of the esophagus herniates into the thoracic cavity through an opening in the esophageal-tracheal tract 

A pocket of the stomach herniates and protrudes into the intestinal tract through an abnormality in the anatomy of the peritoneum 

A student nurse is helping out at the triage station in the local emergency department. 4 clients are experiencing an onset of symptoms similar to that of GERD. Which of the following patients is more likely to have developed a hiatal hernia? 

A 36 year old male with a history of GERD

An 80 year old male who smokes and has COPD 

An 80 year old female with stable and managed hypertension 

An 50 year old female in her first trimester of pregnancy 

Which is the main physiological change that occurs with aging that contributes to the development of hiatal hernias? 

Weakening of diaphragmatic muscles around the esophogogastric opening 

Loss of elasticity in the inferior intercostal muscles 

Widening of the esophogogastric junction 

More pronounced curve of the stomach fundus 

The nurse is teaching a new-grad about the potential complications of a hiatal hernia. Which complications would the nurse include? SATA

Hypertension 

Stenosis 

Malnutrition 

Esophagitis 

Ulcerations 

GERD

Which would the nurse note as a contributing external factor in the development of hernias in older adults? 

Physiological changes associated with aging 

Low carb diets

History of natural child births 

Common gerontological medication regimens 

Which of the following is true when considering esophageal cancer? 

Most esophageal cancers are adenocarcinomas 

This form of cancer has a widespread incidence rate throughout the globe 

It is the most common form of gastrointestinal cancer 

Those who are between the ages of 50-60 are most at risk 

A client is admitted to the observation unit of a new diagnosis of esophageal cancer. Which statement is true about the onset of the disease? 

The symptoms of the disease have a sudden and rapid onset 

By the time symptoms become present, any tumor(s) are usually advanced in progression 

By the time symptoms first appear, mortality rates are usually low, with most cases seeing a successful survival rate 

The symptoms of this cancer usually follow a intermittent pattern of exacerbation and an asymptomatic period 

Which of the following manifestations are indicative of a possible esophageal cancer diagnosis? SATA

Achalasia 

Substernal Pain 

Oliguria 

Midclavicular pain 

Tumors 

Bleeding

Dysphagia 

How is esophageal cancer definitively diagnosed? 

Laboratory blood tests 

Endoscopic Biopsy 

MRI Scans 

CT scans 

A client is in the Oncology PACU for recovery after having an endoscopic photodynamic therapy procedure. The client is groggy after her procedure and is asking the RN to remind her what procedure she just had done. Which of the following explanations would the nurse provide to the client? 

"You were given a photosensitizer which allowed the provider to direct light endoscopically that kills cancer tissue"

"You were placed under general anesthesia so that the provider can shine a light down your esophagus and resect cancerous tissues" 

"You were given low doses of chemotherapeutic drugs that work to kill cancer tissues progressively and systemically" 

"You were given medications that make cancerous cells more sensitive to light, allowing natural sunlight to help kill the cancerous tissues in your body"

A client was recently diagnosed with esophogeal cancer and is in a conference room with an RN to discuss potential treatment options. Which of the following treatment options would the nurse include in the client teaching? 

Endoscopic Therapy 

Esophogeal Transplant

Chemotherapy 

Surgical Therapy

Radiation Therapy 

STEM Cell Therapy 

Which of the following statements is true in regard to radiation therapy for esophogeal cancer? 

This form of therapy has proven to exceed the disease survival rates 

Radiation therapy has a higher success rate of cancer remission in comparison to other treatment modalities 

This method of treatment is often used alongside gene therapy 

It is more commonly used for palliative care purposes when used with chemo

A student nurse is performing diagnostic assessments to help out at their local community oncology unit. Which of the following statements made by the student nurse indicates understanding of esophageal cancer prognoses? 

"Because the condition is usually diagnosed at advanced stages, and that patients remain asymptomatic until then, prognoses are usually poor" 

"The client should only be informed about a poor prognosis after all measures have been exhausted" 

"When the cancer is caught early, there are significantly greater chances of survival"

"The survival rate of the disease is no higher than 5% throughout the nation" 

The nurse is caring for a client who has just undergone a surgical esophagogastrostomy. The nurse notes that all of the following are complications of esophageal surgery except: SATA 

Urinary Retention 

Fistula Formation

Pulmonary Edema 

Dysrhythmias 

Anastomotic Leaks 

Milk-alkali syndrome 

Sinus Bradycardia 

A client is complaining of increased discomfort and irritation from their NG tube which is on its 4th day of placement. The client is asking the RN if the tube can be repositioned or insert a brand new tube. Which of the following is an appropriate action for the RN to make? 

 Move the NG tube carefully until the client expresses comfort and alleviation 

Order a bedside x-ray to reconfirm NG tube placement 

Prepare for a new NG tube placement 

Inform the client that they will consult with the provider before making any adjustments 

Which of the following statements best defines Peptic Ulcer Disease (PUD) 

Erosion of the GI tract due to HCl acid and Pepsin 

Erosion of the GI tract due to malnutrition and/ or smoking 

Stricture of the upper GI tract from external factors

Erosion of the GI tract due to constant exposure to Pepsinogen 

The nurse is caring for a client with diagnosed peptic ulcer disease. Which of the following symptoms distinguishes the client's condition as being duodenal and not gastric? 

the pain is epigastric in location

the pain is in the back 

the pain is described as burning 

the pain is described as gaseous 

What is the gold standard procedure for diagnosing peptic ulcer disease caused by an H. Pylori infection? 

Serum Amylase 

WBC Count 

Rapid Urease Test 

Upper GI Endoscopy with Biopsy 

Which of the following is true regarding antibiotic therapy for H. Pylori induced peptic ulcer disease? 

Antibiotics are often prescribed with a proton pump inhibitor for 14 days 

Multiple antibiotics are needed to fight off infection

The antibiotics prescribed for this condition require a urease component 

Augmentin is the most common and most effective antibiotic for this condition, often prescribed for 10 days 

The RN is reviewing the complications of PUD with a student nurse. Which of the following statements made by the student indicates understanding? 

A GI bleed is the most lethal complication and should be prepared with having the client sign for a potential blood transfusion 

Perforations are the most lethal complication and calls for an immediate initiation of antibiotics 

Gastric outlet obstruction is the most lethal and is the priority complication

Of the 3 main complications of PUD, gastric outlet obstructions and perforations are considered emergency situations 

Which is true regarding the manifestation of symptoms of PUD in the older adult? 

While some may not experience pain, some will first have symptoms of Charcot's Triad and a decrease in hemoglobin 

While some may not experience pain, some will first have Frank gastric bleeding and a decreased hematocrit 

Some older adults can experience asymptomatic exacerbation of the condition 

Older adults have a similar mortality rate to other age groups across the lifespan (relatively low) 

A preceptor RN is quizzing the new grad nurse on medication interventions for the complications of PUD. Which of the following statements indicates understanding emergency medication intervention? 

"Maalox can be used in the event of gastric outlet obstruction"

"A proton pump inhibitor like Protonix can help alleviate symptoms if a client has a GI bleed"

"I would consult with the provider about having a standby antibiotic order for Amoxicillin in the event that the client has a perforation" 

"I would make sure there is a standby order for an NSAID for the client's pain in case any of the emergency complications occur" 

The nurse is caring for a client with peptic ulcer disease and is reviewing their medication history. Which of the following medications would the nurse note as contributing to the development of the client's condition? 

Ibuprofen 

Prednisone 

Pantoprazole 

Aspirin 

Metoprolol

Glyburide 

Which of the following terms best describes the general pathophysiology of stomach cancer? 

Squamous cell 

Melanoma 

Alpha-Fetoprotein 

Adenocarcinoma 

Which of the following procedures is considered the gold standard in diagnosing stomach cancer? 

CT

Barium Swallow Study 

Upper GI endoscopy 

Endoscopic Ultrasound 

MRI

Which of the following is true regarding the assessment of patients with (or may have) stomach cancer? 

Assessment for stomach cancer requires the anticipation of all viable diagnostic testing 

Assessment for stomach cancer is very similar to the assessment of peptic ulcer disease 

Assessment for stomach cancer is very similar to the assessment of diaphragmatic hernias 

Assessment for stomach cancer involves preplanning for psychiatric evaluation 

A client is about to undergo a partial gastrectomy procedure. Which of the following potential complications should the nurse prepare for? SATA. 

Bleeding 

Milk-Alkali Syndrome 

Dumping Syndrome 

Bile Reflux Gastritis 

Diabetes Insipidus 

Postcrandial Hypoglycemia 

Primary Hypertension

A client is in the outpatient facility for a follow-up appointment following a total gastrectomy 1 month ago. The RN and the client are discussing current lifestyle habits established after the client was discharged home. Which of the following statements indicate the need for further teaching? 

"I split all my meals into 6 small portions throughout the day" 

"I drink more milk to help with increased fat and caloric intake for my energy levels" 

"I have stuck to incorporating more complex carbs throughout the day" 

"I have been eating a ton of red meats and eggs throughout my diet"

Which of the following conditions is characterized by chronic abdominal pain and altered bowel patterns? 

Colorectal Dysplasia 

Gastroesophogeal Reflux Disease 

Chronic Appendicitis 

Irritable Bowel Syndrome 

A nurse is teaching a client about implementing the proper diet habits after a diagnosis of irritable bowel syndrome (IBS). Which of the following statements made by the client indicates a need for further teaching? 

"The [D] in FODMAPs diet indicates I should avoid disaccharide lactose, or milk products" 

"I will try and avoid apples, pears, and stone fruits" 

"I should increase the amount of rye and wheat products to increase my overall fiber intake" 

"I am at risk for exacerbation of symptoms and pain if I follow a high gluten diet" 

A nurse is hosting a seminar to teach clients about the FODMAPs diet. Which of the following would the nurse plan to include in regard to foods that these clients should avoid? SATA 

Legumes and Nuts 

Cherries and Peaches 

Pickled or Fermented foods 

Salmon and Poultry 

Wheat and Rye products 

Garlic and Onions 

Honey 

Apples and Pears 

A client calls the local outpatient clinic with concerns of a new, persistent onset of symptoms. Which of the following main manifestations would lead the nurse to suspect IBS? 

Xerostomia and pyrosis 

Diarrhea and constipation

Flatulence and hypogastric pain 

Nausea and gaseous pain 

Which of the following is not an appropriate classification of IBS? 

IBS with nausea 

IBS mixed

IBS unsubtyped 

IBS with constipation

IBS with diarrhea 

Which of the following is the gold standard diagnostic for IBS? 

Lower GI Colonoscopy 

Upper GI endoscopy 

Rome IV Criterion 

A through history and physical assessment 

The student nurse is reviewing current medication protocols for the treatment of several gastrointestinal problems. Which of the following statements reflect understanding? 

"PPIs and H2 Inhibitors are the most effective treatment for IBS" 

"All clients with IBS can get relief from antispasmodics and antidepressants" 

"Drug therapy is generally similar for all classifications of IBS" 

"All clients with IBS can benefit from the treatment regimens similar to GERD" 

A 50 year old male is admitted to the Emergency Unit following a severe flare-up of IBS symptoms. The client has a history of prior bowel surgery and mechanical obstruction. Which of the following medications would the nurse NOT anticipate? 

Eluxadoline (Viberzi) 

Bisacodyl (Dulcolax) 

Linaclotide (Linzess) 

Alosetron (Lotronex) 

Which of the following accurately differentiates Crohn's Disease from Ulcerative Colitis? 

Crohn's Disease can affect any segment of the GI tract while ulcerative colitis is limited to the colon 

Ulcerative colitis can affect any segment of the GI tract while Crohn's Disease is limited to the colon

Crohn's disease is characterized by remission and exacerbation while ulcerative colitis is continuous 

Ulcerative colitis is characterized by remission and exacerbation while Crohn's Disease is continuous 

Which of the following drug classes are commonly used in the drug therapy for inflammatory bowel disease? SATA 

Corticosteroids 

NSAIDs 

Opioid Analgesics 

Antimicrobials 

Immunomodulators 

H2 Blockers 

Aminosalicylatyes 

Biotherapeutic Drugs 

What is the most common cause for small bowel obstructions? 

Surgical Adhesions

Gastrointestinal ischemia 

Diverticula 

Ischemia 

The nurse is reviewing a client's recent diagnostic study for abdominal pain. Which of the followings would prompt the nurse to anticipate a diagnosis for large bowel obstruction rather than small bowel? 

Lower diaphragmatic hernia 

Malignant Obstruction

Hyperactive peristalsis

Hypogastric pain 

Nurse is providing teaching for a client who has been ordered to undergo conservative therapy for a partial small bowel obstruction. Which of the following would the nurse include in their teaching? 

Advising the client to increase exercise levels 

Adding fiber to daily diets

Emphasizing the need to take their antacids as prescribed for symptom alleviation 

Taking and recording daily weights 

Which of the following conditions is treatable through conservative therapy? 

Partial small bowel obstruction

complete small bowel obstruction 

complete large bowel obstruction 

gastrointestinal stricture 

The client has been diagnosed with a non mechanical obstruction of the large bowel. The client is confused and states confusion about an obstruction not caused through a physical blockage. Which of the following explanations is appropriate for the nurse to give? 

"this type of obstruction is caused by a lack of gastric movement, or peristalsis" 

"your digestive tract has become to narrow and is thinning as your symptoms endure" 

"it is a blockage induced by negative psychosocial thinking" 

"your GI tract is unable to clear these blockages through abnormal emptying processes" 

A client is admitted to the observation unit while awaiting a sigmoidoscopy for further investigation of a large bowel obstruction. Which of the following is the nurse's priority action? 

Place the client on an NPO order 

Monitor for signs of dehydration 

Administer PRN pain medications 

Give IV fluids and electrolyte replacement 

Which of the following contributes to a client becoming at risk for colorectal cancer? 

Family history of CRC

Family history of FAP 

Excessive sodium intake 

Excessive alcohol intake

Excessive intake of red meats 

What is considered the gold standard for detecting and diagnosing colorectal cancer? 

Flexible sigmoidoscopy every 5 years

Colonoscopy every 10 years 

Double-contrast barium enema every 5 years 

CT Colonography every 5 years 

Which of the following goals would the nurse create in anticipation of a surgical resection of the bowel (ostomy surgery)? 

Restoring previous level of functioning of peristalsis 

Resection of a portion if the GI tract for further diagnostic testing

Decrease gastric sensitivity 

Removal of an area of anatomical stricture 

Which of the following manifestations points towards a non-mechanical specification of bowel obstruction? 

An incompetent lower esophogeal sphincter

Dumping syndrome 

Diverticulitis 

Paralytic ileus 

Which of the following are early signs of  colorectal cancer? 

Bleeding 

Abdominal Pain 

Abdominal tenderness 

Weight loss 

Fatigue 

The nurse is volunteering at the community health promotion fair to help locals become more aware of resources and proper health maintenance habits. Which of the following individuals would the nurse advise to seek a colorectal cancer screening? 

An 80 year old female who has been admitted to hospice for Parkinson's 

A 40 year old male who works in a coal mining factory 

A 45 year old male who does not usually pursue preventative medical treatment 

A 12 year old female who has an extensive family history of skin cancer 

A client diagnosed with advanced colorectal cancer has refused to take prescribed palliative medication. The client's family has also noted that the client has become socially withdrawn, refuses enteral feedings, and has become hypertensive in the last few days. Which clinical problem should the nurse document? 

Anxiety 

Altered bowel elimination

Impaired nutrition 

Difficulty coping 