Week 2 Assessment
Gastrointestinal Knowledge Assessment
Welcome to the Gastrointestinal Knowledge Assessment quiz! This comprehensive quiz is designed for healthcare professionals and students to test their understanding of gastrointestinal health, nutrition, and related medical conditions.
With 52 carefully crafted questions, you will cover a range of topics including:
- Physical assessment of the GI system
- Nutritional requirements and malnutrition
- Common GI disorders and their management
A patient is admitted to the hospital with diarrhea and dehydration. The nurse recognizes that increased peristalsis resulting in diarrhea can be related to
A. Sympathetic inhibition.
B. Mixing and propulsion.
C. Sympathetic stimulation.
D. Parasympathetic stimulation.
A patient has a high blood level of indirect (unconjugated) bilirubin. One cause of this finding is that
A. The gallbladder is unable to contract to release stored bile.
B. Bilirubin is not being conjugated and excreted into the bile by the liver.
C. the Kupffer cells in the liver are unable to remove bilirubin from the blood.
D. There is an obstruction in the biliary tract preventing flow of bile into the small intestine
As gastric contents move into the small intestine, the bowel is normally protected from the acidity of gastric contents by the
A. Inhibition of secretin release.
B. Secretion of mucus by goblet cells.
C. Release of pancreatic digestive enzymes.
D. Release of gastrin by the duodenal mucosa
A patient has jaundice with pale colored stools. This is most likely related to
A. Decreased bile flow into the intestine.
B. Increased production of urobilinogen.
C. Increased bile and bilirubin in the blood
D. Increased production of cholecystokinin.
An 80-year-old man states that, although he adds a lot of salt to his food, it still does not have much taste. The nurse’s response is based on the knowledge that the older adult
A. Should not have any changes in taste.
B. Has a loss of taste buds, especially for sweet and salt.
C. Has some loss of taste but no problems chewing food.
D. Loses some sense of taste related to the increased ability to smell.
When the nurse is assessing the health perception–health maintenance pattern as related to gastrointestinal function, an appropriate question to ask is
A. “What is your usual bowel elimination pattern?”
B. “What percentage of your income is spent on food?”
C. “Have you traveled to a foreign country in the last year?”
D. “Do you have diarrhea when you are under a lot of stress?”
When assessing the abdomen, the nurse should
A. Position the patient in the supine position with the bed flat and knees straight.
B. Listen for bowel sounds in the epigastrium and all 4 quadrants for 2 minutes.
C. Describe bowel sounds as absent if no sound is heard in a quadrant after 2 minutes.
D. Use the following order of techniques: inspection, palpation, percussion, auscultation.
Normal physical assessment findings of the gastrointestinal system are (select all that apply)
A. Nonpalpable spleen.
B. Borborygmi in upper right quadrant.
C. Tympany on percussion of the abdomen.
D. Liver edge 2 to 4 cm below the costal margin.
E. Finding of a firm, nodular edge on the rectal examination.
In preparing a patient for a colonoscopy, the nurse explains that
A. A signed permit is not needed
B. Sedation will be used during the procedure.
C. One cleansing enema part of the required preparation.
D. Light meals should be eaten for 3 days before the procedure
The percentage of daily calories for a healthy person consists of
A. 50% carbohydrates, 25% protein, 25% fat, and <10% of fat from saturated fatty acids.
B. 65% carbohydrates, 25% protein, 25% fat, and >10% of fat from saturated fatty acids.
C. 50% carbohydrates, 40% protein, 10% fat, and <10% of fat from saturated fatty acids.
D. 40% carbohydrates, 30% protein, 30% fat, and >10% of fat from saturated fatty acids.
Place in order the substrates the body uses for energy during starvation, beginning with 1 for the first component and ending with 4 for the last component.
B. Glycogen
A. Skeletal protein
D. Fat stores
C. Visceral protein
A complete nutrition assessment including anthropometric measurements is most important for the patient who
A. Has a BMI of 25.5 kg/m2.
B. Reports episodes of nightly nocturia.
C. Reports a 5-year history of chronic constipation.
D. Reports unintentional weight loss of 10 lb in 2 months.
Which method is best to use when confirming initial placement of a blindly inserted small-bore NG feeding tube?
A. X-ray
B. Air insertion
C. Observing patient for coughing
D. pH measurement of gastric aspirate
A patient is receiving peripheral parenteral nutrition. The solution is completed before the new solution arrives on the unit. The nurse gives
A. 20% intralipids.
B. 5% dextrose solution.
C. 0.45% normal saline solution.
D. 5% lactated Ringer’s solution
A patient with anorexia nervosa shows signs of malnutrition. During initial refeeding, the nurse carefully assesses the patient for (select all that apply)
A. hypokalemia.
B. hypoglycemia.
C. hypercalcemia
D. hypomagnesemia.
E. hypophosphatemia.
M.J. Calls the clinic and tells the nurse that her 85-year-old mother has been nauseated all day and has vomited twice. Before the nurse hangs up and calls the HCP, she should tell M.J. to
A. Administer antiemetic drugs and assess her mother’s skin turgor.
B. Give her mother sips of water and elevate the head of her bed to prevent aspiration
C. Offer her mother large quantities of Gatorade to decrease the risk for sodium depletion.
D. Give her mother a high-protein liquid supplement to drink to maintain her nutrition needs
The nurse explains to the patient with Vincent’s infection that treatment will include
A. Tetanus vaccinations.
B. Viscous lidocaine rinses.
C. amphotericin B suspension.
D. Topical application of antibiotics.
The nurse teaching young adults about behaviors that put them at risk for oral cancer includes
A. Discouraging use of chewing gum.
B. Avoiding use of perfumed lip gloss
C. Avoiding use of smokeless tobacco.
D. Discouraging drinking of carbonated beverages
Which instructions would the nurse include in a teaching plan for a patient with mild gastroesophageal reflux disease (GERD)?
A. “The best time to take an as-needed antacid is 1 to 3 hours after meals.”
B. “A glass of warm milk at bedtime will decrease your discomfort at night.”
C. “Do not chew gum; the excess saliva will cause you to secrete more acid.”
D. “Limit your intake of foods high in protein because they take longer to digest.”
A patient who had an esophagectomy for esophageal cancer develops increasing pain, fever, and dyspnea after starting a full-liquid diet. The nurse recognizes that these symptoms are most indicative of
A. An intolerance to the feedings.
B. Extension of the tumor into the aorta.
C. Leakage of fluids into the mediastinum.
D. Esophageal perforation with fistula formation into the lung.
The nurse monitors a patient with gastritis for pernicious anemia due to
A. Chronic autoimmune destruction of cobalamin stores in the body.
B. Progressive gastric atrophy from chronic breakage in the mucosal barrier and blood loss.
C. A lack of intrinsic factor normally produced by acid-secreting cells of the gastric mucosa.
D. Hyperchlorhydria from an increase in acid-secreting parietal cells and degradation of RBCs.
The nurse is teaching the patient and family that peptic ulcers are
A. Caused by a stressful lifestyle and other acid-producing factors, such as H. pylori.
B. Inherited within families and reinforced by bacterial spread of Staphylococcus aureus in childhood.
C. Promoted by factors that cause oversecretion of acid, such as excess diet fats, smoking, and alcohol use.
D. Promoted by a combination of factors that cause erosion of the gastric mucosa, including certain drugs and H. pylori.
An optimal teaching plan for an outpatient with stomach cancer receiving radiation therapy should include information about
A. Cancer support groups, alopecia, and stomatitis.
B. Nutrition supplements, ostomy care, and support groups.
C. Prosthetic devices, wound and skin care, and grief counseling.
D. Wound and skin care, nutrition, drugs, and community resources.
The discharge teaching plan for the patient after an acute episode of upper GI bleeding includes information about the importance of (select all that apply)
A. Limiting alcohol intake to 1 serving per day.
B. Only taking aspirin with milk or bread products.
C. Avoiding taking aspirin and drugs containing aspirin.
D. Only taking drugs prescribed by the health care provider.
E. Taking all drugs 1 hour before mealtime to prevent further bleeding.
Several patients come to the urgent care center with nausea, vomiting, and diarrhea that began 2 hours ago while attending a large family reunion potluck dinner. You ask the patients specifically about foods they ingested containing
A. beef.
B. Meat and milk.
C. Poultry and eggs.
D. home-preserved vegetables.
The most appropriate therapy for a patient with acute diarrhea caused by a viral infection is to
A. Increase fluid intake.
B. Administer an antibiotic.
C. Administer an antimotility drug
D. Quarantine the patient to prevent spread of the virus
A 35-year-old female patient is admitted to the emergency department with acute abdominal pain. Which medical diagnoses should you consider as possible causes of her pain? (select all that apply)
A. Gastroenteritis
B. Ectopic pregnancy
C. Gastrointestinal bleeding
D. Irritable bowel syndrome
E. Inflammatory bowel disease
Assessment findings suggestive of peritonitis include (select all that apply)
A. Abdominal pain.
B. Rebound tenderness
C. A soft, distended abdomen.
D. Shallow respirations with bradypnea.
E. Observing that the patient is lying still.
In planning care for the patient with Crohn’s disease, the nurse recognizes that a major difference between ulcerative colitis and Crohn’s disease is that Crohn’s disease
A. Often results in toxic megacolon
B. Causes fewer nutrition deficiencies than ulcerative colitis.
C. Often recurs after surgery, while ulcerative colitis is curable with a colectomy.
D. Is manifested by rectal bleeding and anemia more often than is ulcerative colitis.
The nurse performs an abdominal assessment of a patient with a possible bowel obstruction, knowing that manifestations of an obstruction in the large intestine are (select all that apply)
A. Persistent abdominal pain
B. Marked abdominal distention
C. Diarrhea that is loose or liquid
D. colicky, severe, intermittent pain.
E. Profuse vomiting that relieves abdominal pain.
A patient with stage I colorectal cancer is scheduled for surgery. Patient teaching for this patient would include an explanation that
A. Chemotherapy will begin after the patient recovers from the surgery.
B. Both chemotherapy and radiation can be used as palliative treatments.
C. follow-up colonoscopies will be needed to ensure that the cancer does not recur
D. A wound, ostomy, and continence nurse will visit the patient to identify the site for the ostomy
The nurse determines a patient undergoing ileostomy surgery understands the procedure when the patient states
A. “I should only have to change the pouch every 4 to 7 days.”
B. “The drainage in the pouch will look like my normal stools.”
C. “I may not need to wear a drainage pouch if I irrigate it daily.”
D. “Limiting my fluid intake should decrease the amount of output.”
In contrast to diverticulitis, the patient with diverticulosis
A. Has rectal bleeding.
B. Often has no symptoms.
C. Usually develops peritonitis.
D. Has localized cramping pain.
A nursing intervention that is most appropriate to decrease postoperative edema and pain after an inguinal herniorrhaphy is to
A. Maintain the patient on bedrest.
B. Allow the patient to stand to void.
C. Support the incision during coughing.
D. Apply a scrotal support with an ice bag.
The nurse determines that the goals of diet teaching have been met when the patient with celiac disease selects from the menu
A. Scrambled eggs and sausage.
B. Buckwheat pancakes with syrup.
C. oatmeal, skim milk, and orange juice
D. yogurt, strawberries, and rye toast with butter.
What should a patient be taught after a hemorrhoidectomy?
A. Take mineral oil before bedtime
B. Eat a low-fiber diet to rest the colon.
C. Use a daily oil-retention enema to empty the colon.
D. Take prescribed pain medications before a bowel movement.
A characteristic common to all hormones is that they
A. Circulate in the blood bound to plasma proteins.
B. Influence cellular activity of specific target tissues
C. Accelerate the metabolic processes of all body cells.
D. Enter a cell and change the cell’s metabolism or gene expression.
A patient is receiving radiation therapy for renal cancer. The nurse monitors the patient for signs and symptoms of damage to the
A. pancreas.
B. Thyroid gland.
C. Adrenal glands.
D. Posterior pituitary gland.
A patient has a serum sodium level of 152 mEq/L (152 mmol/L). The normal hormonal response to this situation is
A. Release of ADH.
B. Release of ACTH
C. Secretion of aldosterone
D. Secretion of corticotropin-releasing hormone.
When obtaining subjective data from a patient during assessment of the endocrine system, the nurse asks specifically about
A. Energy level.
B. Intake of vitamin C.
C. Employment history
D. Frequency of sexual intercourse.
An appropriate technique to use during physical assessment of the thyroid gland is
A. Asking the patient to hyperextend the neck during palpation.
B. Percussing the neck for dullness to define the size of the thyroid.
C. Having the patient swallow water during inspection and palpation of the gland.
D. Using deep palpation to determine the extent of a visibly enlarged thyroid gland
Endocrine problems often go unrecognized in the older adult because
A. Symptoms are often attributed to aging.
B. Older adults rarely have identifiable symptoms
C. Endocrine problems are uncommon in an older adult.
D. Older adults usually have endocrine problems with lesser symptoms.
Abnormal findings during an endocrine assessment include (select all that apply)
A. Excess facial hair on a woman
B. Blood pressure of 100/70 mm Hg.
C. soft, formed stool every other day.
D. 3-lb weight gain over last 6 months.
E. Hyperpigmented coloration in lower legs.
A patient has a total serum calcium level of 3 mg/dL (1.5 mEq/L). If this finding reflects hypoparathyroidism, the nurse expects further diagnostic testing to reveal
A. Decreased serum PTH.
B. Increased serum ACTH.
C. Increased serum glucose.
D. Decreased serum cortisol levels.
The nurse is assessing a patient newly diagnosed with type 1 diabetes. Which symptom reported by the patient correlates with the diagnosis?
A. Excessive thirst
B. Gradual weight gain
C. Overwhelming fatigue
D. Recurrent blurred vision
When distinguishing between persons with type 1 diabetes from type 2 diabetes, the nurse is aware that
A. Persons with type 1 diabetes require insulin therapy.
B. Autoantibodies to pancreatic β-cells are found in type 2 diabetes.
C. Persons with type 1 diabetes may be managed with metformin alone.
D. Hyperosmolar hyperglycemia syndrome is more common in type 1 diabetes.
Goals of managing the patient with diabetes include (select all that apply)
A. Keeping the target A1C greater than 9%.
B. Teaching self-monitoring of glucose levels
C. Preventing complications of hypoglycemia.
D. Monitoring for ophthalmologic complications.
E. Maintaining the LDL cholesterol greater than 100 mg/dL (2.6 mmol/L)
Which patient statement demonstrates an understanding of the role of exercise in managing diabetes?
A. “I cannot exercise if I am taking insulin and metformin.”
B. “Exercise increases insulin resistance, so I will need a higher dose of insulin.”
C. “It is better to exercise before a meal if I take medication that causes hypoglycemia.”
D. “My insulin dose may need to be changed if I have low glucose levels after exercising.”
You are caring for a patient with newly diagnosed type 2 diabetes who was started on metformin. What information should you include in discharge teaching? (Select all that apply.)
A. Need to reduce physical activity
B. Eliminate all forms of sugar from diet
C. Use of a portable blood glucose meter
D. Hypoglycemia prevention, symptoms, and treatment
E. Procedures that require IV contrast media are contraindicated
What is the priority action for the nurse to take if the patient with type 2 diabetes reports headache, nervousness, and dizziness?
A. Administer glucagon.
B. Give insulin as ordered.
C. Check the patient’s glucose level.
D. Assess for other signs of neurologic stroke
A patient with diabetes has a serum glucose level of 824 mg/dL (45.7 mmol/L) and is unresponsive. After assessing the patient, the nurse suspects diabetes-related ketoacidosis rather than hyperosmolar hyperglycemia syndrome based on the finding of
A. polyuria.
B. Severe dehydration.
C. rapid, deep respirations.
D. Decreased serum potassium.
Which are appropriate therapies for patients with diabetes? (Select all that apply.)
A. Use of statins to reduce CVD risk
B. Use of diuretics to treat nephropathy
C. Use of β-blockers to treat retinopathy
D. Use of serotonin agonists to decrease appetite
E. Use of ACE or ARB inhibitors to treat nephropathy
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