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Textbook of Basic Nursing 10th Edition Rosdahl Kowalski Test Bank

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Textbook of Basic Nursing 10th Edition Rosdahl Kowalski Test Bank

ISBN-13: 978-1605477725

ISBN-10: 1605477729

 

Description

Textbook of Basic Nursing 10th Edition Rosdahl Kowalski Test Bank

ISBN-13: 978-1605477725

ISBN-10: 1605477729

 

 

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Below you will find some free nursing test bank questions from this test bank:

Chapter 88- Digestive Disorders

1. The nurse is studying anatomy and physiology of the digestive system. Which of the following are considered accessory organs of digestion? Select all that apply.
  A) Mouth
  B) Anus
  C) Liver
  D) Gallbladder
  E) Stomach
  F) Pancreas
  Ans: C, D, F
  Feedback:
  The major organs of digestion are those within the gastrointestinal (GI) tract, which begins with the mouth and ends with the anus. The accessory organs of digestion include the liver, gallbladder, and pancreas.

 

 

2. For which of the following clients would a nurse who is an enterostomal therapist be consulted?
  A) A client with enterocolitis
  B) A client with a peptic ulcer
  C) A client with an ileostomy
  D) A client with pancreatitis
  Ans: C
  Feedback:
  The enterostomal therapist (ET) is a nurse who assists people with learning to care for surgically adapted openings, called ostomies, into the stomach (gastrostomy), intestine (ileostomy), or colon (colostomy).

 

 

3. The nurse is scheduling blood tests for a client suspected of having pancreatitis. Which of the following tests detects inflammation or disease of the pancreas, or obstruction of surrounding ducts?
  A) Alkaline phosphatase (ALP)
  B) Cholesterol
  C) Triglyceride levels
  D) Serum amylase
  Ans: D
  Feedback:
  Pancreatic enzyme tests, such as serum amylase and lipase, may be ordered to detect inflammation or disease of the pancreas, or obstruction of surrounding ducts. ALP, cholesterol, and triglyceride levels are liver function tests.

 

 

4. The nurse is preparing a client who is experiencing rectal bleeding for an occult blood test. Which of the following tests is the most inexpensive and simplest test used to detect occult blood in the stool?
  A) Hematest
  B) Culture and sensitivity study
  C) HemoQuant stool test
  D) Albumin test
  Ans: A
  Feedback:
  The Hematest is the most inexpensive and simplest test used to detect occult blood in the stool; the client can perform the test at home, or the nurse or physician can perform the test in the office, clinic, or hospital. A culture and sensitivity study may be ordered for suspected pathogenic causes of severe diarrhea, such as Salmonella, Shigella dysenteriae, Staphylococcus aureus, or Clostridium difficile. The HemoQuant can be done only in the laboratory, thus, it requires more time and is less convenient than the Hematest. Albumin is a liver function blood test.

 

 

5. A client presents at the ER with signs and symptoms of gallstones. What test would be the preferred diagnostic tool to confirm this condition?
  A) Angiography
  B) Ultrasound
  C) Computed tomography
  D) Nuclear uptake scan
  Ans: B
  Feedback:
  Ultrasound can identify gallstones and abdominal tumors. This test is becoming the preferred diagnostic tool, especially to rule out gallstones, pancreatic cysts, and cancerous tumors. Angiography and arteriography may be done to evaluate vascular structures, and CT scans are used to identify various abnormalities or tumors. Nuclear uptake scans using a radionuclide, such as technetium 99 (Tc-99m sulfide), will show size, structure, and abnormalities of the stomach, liver, and hepatobiliary system.

 

 

6. A client has been prescribed GoLYTELY before a barium study. What instruction should the nurse provide to this client regarding its method of use?
  A) Mix the solution thoroughly before drinking.
  B) Drink the solution in the evening and again in the morning.
  C) Drink the solution along with a glass of warm milk.
  D) Eat high-fiber foods the evening before the procedure.
  Ans: A
  Feedback:
  The nurse should instruct the client to mix the solution thoroughly before drinking. GoLYTELY is taken only in the evening and also after supper. Fleet Phospho Soda or magnesium citrate may be taken in the evening and again in the morning. The solution should not be taken with a glass of warm milk. It should be taken chilled. On the evening before the procedure, the client should eat a light supper, not high-fiber foods.

 

 

7. A client is scheduled for a cholecystogram to check for gallstones. Which of the following would the nurse instruct the client to do to prepare for this procedure?
  A) Eat foods rich in fat the night before the x-ray study.
  B) Take a radiopague dye via an enema.
  C) Eat nothing for 12 hours after taking radiopague dye.
  D) Continue smoking and chewing gum before the test, if desired.
  Ans: C
  Feedback:
  A cholecystogram (gallbladder series) may be ordered to show the outline of the gallbladder and any existing gallstones. Before a cholecystogram, the client must prepare by eating a fat-free supper the night before the x-ray study, taking a radiopaque dye by mouth, eating nothing for the next 12 hours (after taking the radiopaque dye), stopping smoking and chewing gum, which cause premature emptying of the dye from the gallbladder, and administering an enema in the morning, if ordered.

 

 

8. A nurse is preparing a client with severe gastrointestinal reflux disease (GERD) for a test to determine the extent of damage caused by the disorder. Which of the following tests would be ordered for this client?
  A) Cholecystogram
  B) Lower GI series
  C) Colonoscopy
  D) Esophagogastroduodenoscopy (EGD)
  Ans: D
  Feedback:
  Esophagogastroduodenoscopy (EGD) provides direct visualization of the esophagus, stomach, and duodenum to determine damage to these structures. A cholecystogram (gallbladder series) may be ordered to show the outline of the gallbladder and any existing gallstones. A lower GI series, or barium enema, is given to examine the contours of the lower bowel. Colonoscopy can be used to follow up on abnormal x-ray examinations. It can help identify growths and inflammatory disease of the lower GI tract.

 

 

9. A client is to undergo endoscopic retrograde cholangiopancreatography. Before the procedure, what client education should the nurse provide?
  A) Procedure will be done under general anesthesia.
  B) Fullness and pressure may be felt in the stomach.
  C) Endoscopic tube may hinder normal breathing.
  D) Procedure will take 2 to 3 hours.
  Ans: B
  Feedback:
  The nurse should tell the client that fullness and pressure might be felt in the stomach. This is because air is instilled into the stomach to expand it completely so that the entire interior surface can be visualized. General anesthesia is not used. Instead, conscious sedation is used. This allows introduction and manipulation of the endoscope, yet the client is relaxed and can respond. The client should be informed that the endoscopic tube will not hinder normal breathing. The procedure usually takes 15 minutes to 1 hour, not 2 to 3 hours.

 

 

10. The physician has ordered an endoscopic procedure for a client to directly visualize the stomach and duodenum for tumors. The nurse knows that which test would most likely be scheduled?
  A) Gastroscopy
  B) Esophagoscopy
  C) Colonoscopy
  D) Sigmoidoscopy
  Ans: A
  Feedback:
  Gastroscopy is used for direct visualization of the stomach and duodenum. Esophagoscopy provides direct visualization of the esophagus, colonoscopy direct visualization of the large intestine (colon), and sigmoidoscopy or proctosigmoidoscopy direct visualization of the anus, rectum, and sigmoid colon.

 

 

11. The nurse is preparing a client who is undergoing ERCP to facilitate the passage of stones in the common bile duct. Which of the following is a teaching point for this client?
  A) Tell the client that the procedure will be performed under general anesthesia.
  B) Tell the client that oxygen will be given because the endoscope will hinder breathing.
  C) Tell the client to avoid aspirin, ibuprofen, or anticoagulants 5 to 7 days before the test.
  D) Tell the client that the procedure will take 1 to 2 hours to perform.
  Ans: C
  Feedback:
  Before the test, the client may be instructed to avoid aspirin, ibuprofen, or anticoagulants for 5 to 7 days because these medications prolong bleeding times and may cause excessive bleeding if tissue is removed during the procedure. A technique called conscious sedation is used for these procedures. The adult client is usually sedated with a short-acting intravenous (IV) analgesic, such as fentanyl (Sublimaze), or a sedative, such as midazolam (Versed). A mouthpiece protects the client’s mouth and the endoscope tube, but the endoscope tube will not hinder normal breathing. The procedure takes 15 minutes to 1 hour.

 

 

12. The nurse is caring for a client following a liver biopsy. Which of the following is a recommended postoperative intervention?
  A) Position the client on the left side.
  B) Apply pressure to the biopsied side for 4 to 6 hours.
  C) Take vital signs hourly for 24 hours.
  D) Observe the client for signs of dehydration.
  Ans: B
  Feedback:
  Following a liver biopsy, the nurse should position the client on the right side and apply pressure to the biopsied site (usually the right side) for 4 to 6 hours, using a sandbag or folded bath blanket to help prevent bleeding. The nurse should take vital signs every 15 minutes for 1 hour; every 30 minutes for 4 hours; and then hourly for 8 hours and observe the client closely for signs of bleeding. Hemorrhage may be into the abdomen (watch for signs of shock) or from the puncture site.

 

 

13. The nurse is caring for a client with a Levin GI suction tube. Which of the following is a recommended nursing care guideline for this type of tube?
  A) Irrigate tube frequently with small amounts of saline or air to keep it patent.
  B) Clear the air port with air to keep it open and keep the distal tip from the wall of the stomach.
  C) Provide nasotracheal suctioning because swallowing is impossible.
  D) Use a humidifier to keep the skin and secretions moist.
  Ans: A
  Feedback:
  The Levin tube should be irrigated frequently with small amounts of saline or air to keep it patent. The nurse should clear the air port of the Salem sump tube with air to keep it open and prevent the distal tip from sucking against the wall of the stomach and causing irritation. The Sengstaken-Blakemore tube is rarely used and nasotracheal suctioning must be provided because the client cannot swallow. The nurse should not use a humidifier with these tubes because of bacteria in the air.

 

 

14. The nurse is removing a nasogastric tube at the bedside of a client. Which of the following are recommended steps for this procedure? Select all that apply.
  A) Unclamp the tube before removal.
  B) Call the physician to remove the tube.
  C) Ask the client to hold his or her breath when pulling out the tube.
  D) Pull out the tube slowly, and then quickly, when the client coughs.
  E) Pull the tube harder if resistance is encountered.
  F) Place the tube in a towel and discard in appropriate receptacle.
  Ans: C, D, F
  Feedback:
  The nurse should temporarily clamp the tube before removal to make sure the client can tolerate its absence. Usually, the physician removes the long nasoenteric tubes, but the nurse may be instructed to remove shorter tubes. The nurse should ask the client to hold his or her breath and remove the tube by simply pulling it out, slowly at first, then more rapidly when the client begins to cough. The nurse should crimp or pinch the tube as it exits to prevent leakage of the tube contents. The nurse should not remove the tube if resistance is encountered. Generally, another attempt in an hour or so will be successful. The nurse should place the tube in a towel after removal and discard it in the appropriate receptacle.

 

 

15. The nurse is providing nutrition for a postoperative client who has a normally functioning GI tract. Which of the following would be the best form of nutrition for this client?
  A) Total parenteral nutrition
  B) Hyperalimentation
  C) Parenteral nutrition
  D) Enteral nutrition
  Ans: D
  Feedback:
  For enteral tube feedings, it is essential that the client have a normally functioning GI tract. Parenteral nutrition involves direct IV administration of fluids and nutrients into the circulatory system. This method is referred to as parenteral nutrition because it does not access the digestive system (the enteral route). Total parenteral nutrition (TPN) is sometimes called total parenteral alimentation. Hyperalimentation is incorrect terminology because the amounts given are not excessive. If the stomach is functioning normally, it is safer and more appropriate to use enteral nutrition.

 

 

16. A client is undergoing bariatric surgery in the morning. The nurse explains the procedure to the client stating that the surgeon will design a smaller stomach to form a gastric pouch, and the pouch will then be connected directly to the jejunum (bypassing the rest of the stomach and the duodenum). The nurse is preparing the client for what type of bariatric surgery?
  A) Laparoscopic gastric band
  B) Roux-en-Y gastric bypass
  C) Vertical sleeve gastrectomy
  D) Biliopancreatic diversion with duodenal switch
  Ans: B
  Feedback:
  In Roux-en-Y gastric bypass a smaller stomach is surgically designed to form a gastric pouch, which is connected directly to the jejunum (bypassing the rest of the stomach and the duodenum). With laparoscopic gastric band surgery, an adjustable, bracelet-like band is placed around the top of the stomach, which produces a smaller stomach. With vertical sleeve gastrectomy, one side of the stomach is removed leaving a much smaller banana-sized stomach. Biliopancreatic diversion with duodenal switch is similar to Roux-en-Y gastric bypass but is more complex. A large portion of the stomach is removed; the small intestine and bile and digestive juices are diverted.

 

 

17. The nurse is caring for a client with Crohn’s disease who had surgery to create a continent bowel diversion. Which of the following describes this type of surgery?
  A) The client’s own tissues are formed into internal receptacles for stool.
  B) An opening is made into the colon and intestines are brought outside the body.
  C) An opening is made in the ileum and intestines are brought outside the body.
  D) A loop of intestine is brought through a stoma to allow for feces drainage.
  Ans: A
  Feedback:
  In some cases, the use of surgical techniques results in the removal and rerouting of intestinal tissues internally with the goal of avoiding external ostomies. In these instances, the client’s own tissues may be formed into internal receptacles for stool.  A bowel diversion (also known as fecal diversion) occurs when a portion or all of the ileum or bowel is removed, creating the need for an artificial opening for bowel elimination. An incision is made in the abdomen, and a loop of intestine is brought through the incision and opened to allow for feces drainage. The opening is called a stoma or ostomy. A colostomy is an opening into the colon, whereas an ileostomy is an opening into the ileum.

 

 

18. A client has undergone a colostomy and is wearing an ostomy pouch at the beltline. What should the nurse include in the client education?
  A) Avoid lifting heavy weights for about 2 months.
  B) Avoid lifting weights heavier than 10 pounds.
  C) Avoid swimming and taking a shower.
  D) Avoid drinking Gatorade and broth.
  Ans: A
  Feedback:
  The nurse should instruct the client to avoid lifting heavy weights for about 2 months. The client should avoid lifting weights heavier than 5 pounds. Swimming and showers need not be avoided, because most ostomy pouches are waterproof. The nurse should encourage the client to drink Gatorade and broth, which contain electrolytes. The client loses fluid and electrolytes during elimination because stools are less formed.

 

 

19. Which of the following clients would the nurse monitor for stomatitis?
  A) A client with diabetes
  B) A client with kidney failure
  C) A client undergoing a bone marrow transplant
  D) A client with emphysema
  Ans: C
  Feedback:
  Stomatitis may be a clinical manifestation of a systemic condition or the result of an infection in the oral cavity. Nutritional disorders and bone marrow disorders are some of the systemic causes of inflammation of the oral mucosa. Treatment of this problem depends on the cause and usually involves avoiding oral irritants and providing comfort with frequent oral hygiene.

 

 

20. A client has a few canker sores in her mouth. What nursing care measure should the nurse provide?
  A) Add iodized salt to the client’s diet.
  B) Ask the client to apply a silver nitrate stick, as ordered.
  C) Ask the client to chew a few nuts.
  D) Provide nasogastric tube feedings to let the mouth rest.
  Ans: B
  Feedback:
  Canker sores are painful sores in the mouth. Applying a silver nitrate stick, as ordered, destroys nerve endings and may provide pain relief to the client. Such sores have been linked to highly salted foods and some forms of nuts. Therefore, salt intake should be restricted and nuts should be avoided. A client with canker sores in the mouth need not be fed through a nasogastric tube; this method of feeding is used for clients with mouth cancer.

 

 

21. The nurse is providing teaching for a client with gastroesophageal reflux disease (GERD). Which of the following is a recommended guideline to help relieve the symptoms of this disorder?
  A) Elevate the foot of the bed.
  B) Lie down for at least 2 hours after meals.
  C) Eat fewer, but larger meals.
  D) Do not wear tight belts or waistbands.
  Ans: D
  Feedback:
  Nursing considerations center around client teaching and postoperative care. The nurse should instruct the client not to lie down for at least 2 hours after meals and not to wear tight belts or waistbands. The client with GERD should stop smoking, elevate the head of the bed, avoid gastric irritants, eat small meals, and maintain proper weight.

 

 

22. A nurse is caring for a client with a peptic ulcer. What should the nurse include in the client’s diet?
  A) Fresh fruits
  B) Milk
  C) Popcorn
  D) Coffee
  Ans: B
  Feedback:
  Milk can be included in the client’s diet, although not in large quantities. Fresh fruits and popcorn are high in roughage and should be eliminated from the diet. Coffee should also be omitted because it can stimulate the secretion of hydrochloric acid.

 

 

23. A client has been diagnosed with a functional obstruction of the intestine. Which of the following types of obstructions might be the diagnosis?
  A) Volvulus
  B) Paralytic ileus
  C) Stenosis
  D) Intussusception
  Ans: B
  Feedback:
  Ileus is obstruction of the intestine. It can be caused by a mechanical or functional difficulty and occurs when gas or fluid cannot move normally through the bowel. Functional obstructions occur when the intestinal motility (peristalsis) is defective, as in paralytic ileus. Mechanical obstructions occur when there is a blockage in the lumen or pressure exerted from outside the intestine. Examples include volvulus, stenosis, and intussusception.

 

 

24. Which of the following disorders is the most common functional disorder of the GI tract, causing increased motility of the small or large intestine?
  A) Constipation
  B) Diarrhea
  C) Irritable bowel syndrome
  D) Ulcerative colitis
  Ans: C
  Feedback:
  Irritable bowel syndrome (IBS) is also known as spastic colon, spastic colitis, mucous colitis, and irritable colon. This condition is the most common functional disorder of the GI tract, causing increased motility of the small or large intestine. Constipation is a condition in which the client has infrequent, hard bowel movements accompanied by mucus. Diarrhea consists of stools that are liquid or semiliquid and often very light colored. Ulcerative colitis involves inflammation and ulceration of mucosa and submucosa (the colon’s lining).

 

 

25. A client with a family history of ulcerative colitis is to undergo a screening test for early detection of colon cancer. In what group is colon cancer more common?
  A) Clients who have frequent diarrhea
  B) Clients between the age of 30 and 35
  C) Clients who consume a low-calorie diet
  D) Clients who show monilial patches on the tongue
  Ans: A
  Feedback:
  Clients who frequently have diarrhea or constipation are more likely to develop colon cancer. Clients who are older than 40 years of age and those who consume a high-calorie, high-fat diet are likely to have colon cancer. Monilial patches on the tongue are caused by a fungal infection. Such infections do not increase the risk of colon cancer.

 

 

26. A morbidly obese client has hepatitis. What measure should the nurse undertake when caring for the client?
  A) Encourage intake of large amounts of water
  B) Suggest high intensity exercise on alternate days
  C) Keep the head of the bed parallel to the floor
  D) Have the client wear rubber-soled shoes
  Ans: D
  Feedback:
  The nurse should have the client wear rubber-soled shoes to limit the possibility of slipping. The client should be advised not to drink large amounts of water; it might be dangerous for a client with a liver disorder. Exercise need not be high intensity but needs to be routine. The head of the bed should not be parallel to the floor. The bed should be such that the client’s feet just touch the floor. Blocks may be placed under the head of the bed, because the electric latch may not work owing to the weight of the client.

 

 

27. A nurse is caring for a client with a duodenal ulcer. What sign and symptom noticed during nursing assessment indicates a potential hemorrhagic complication?
  A) Bradycardia
  B) High blood pressure
  C) Hard and tender abdomen
  D) Coffee ground vomitus
  Ans: D
  Feedback:
  Coffee ground vomitus indicates blood in the vomitus and is a sign of a hemorrhagic complication. Hemorrhage is associated with tachycardia or a rapid pulse rate, not bradycardia. A hard and tender abdomen is a sign of abdominal perforation and not of hemorrhage. Hemorrhage leads to a drop in the blood pressure and not an increase in blood pressure.

 

 

28. A nurse is caring for a client with spastic colitis. What sign and symptom should be reported to the physician for further evaluation?
  A) Diarrhea
  B) Flatulence
  C) Abdominal pain
  D) Fever
  Ans: D
  Feedback:
  If the client has a fever, it should be reported to the physician for further evaluation. Fever is not a symptom associated with spastic colitis. Diarrhea, flatulence, and abdominal pain are symptoms associated with spastic colitis. These symptoms may vary in intensity and pattern.

 

 

29. A nurse is caring for a female client with anorexia nervosa. What would the nurse observe during the nursing assessment of the client?
  A) Menorrhagia
  B) Rapid pulse
  C) Alopecia
  D) Hypertension
  Ans: C
  Feedback:
  The nurse would observe alopecia in clients with anorexia nervosa. Such clients may be amenorrheic rather than menorrhagic. They have a slow pulse and hypotension and not a rapid pulse and hypertension.