gastrointestinal QUIZ

1. Following administration of a dose of metoclopramide (Reglan) to the patient, the nurse determines that the medication has been effective when what is noted?

A. Decreased blood pressure
B. Absence of muscle tremors
C. Relief of nausea and vomiting 
D. No further episodes of diarrhea

2. The patient receiving chemotherapy rings the call bell and reports the onset of nausea. The nurse should prepare an as-needed dose of which medication?

A. Morphine sulfate
B. Zolpidem (Ambien)
C. Ondansetron (Zofran)
D. Dexamethasone (Decadron)

3. The patient who is admitted with a diagnosis of diverticulitis and a history of irritable bowel disease and gastroesophageal reflux disease (GERD) has received a dose of Mylanta 30 mL PO. The nurse should evaluate its effectiveness by questioning the patient as to whether which symptom has been resolved?

A. Diarrhea
B. Heartburn 
C. Constipation
D. Lower abdominal pain

4. A patient complains of nausea. When administering a dose of metoclopramide (Reglan), the nurse should teach the patient to report which potential adverse effect?

A. Tremors 
B. Constipation
C. Double vision
D. Numbness in fingers and toes

5. After administering a dose of promethazine (Phenergan) to a patient with nausea and vomiting, what common temporary adverse effect of the medication does the nurse explain may be experienced?

A. Tinnitus
B. Drowsiness 
C. Reduced hearing
D. Sensation of falling

6. The nurse determines that a patient has experienced the beneficial effects of therapy with famotidine (Pepcid) when which symptom is relieved?

A. Nausea
B. Belching
C. Epigastric pain 
D. Difficulty swallowing

7. A patient reports having a dry mouth and asks for something to drink. The nurse recognizes that this symptom can most likely be attributed to a common adverse effect of which medication that the patient is taking?

A. Digoxin (Lanoxin)
B. Cefotetan (Cefotan)
C. Famotidine (Pepcid)
D. Promethazine (Phenergan)

8. A patient with a history of peptic ulcer disease has presented to the emergency department reporting severe abdominal pain and has a rigid, boardlike abdomen that prompts the health care team to suspect a perforated ulcer. What intervention should the nurse anticipate?

A. Providing IV fluids and inserting a nasogastric (NG) tube
B. Administering oral bicarbonate and testing the patient's gastric pH level
C. Performing a fecal occult blood test and administering IV calcium gluconate
D. Starting parenteral nutrition and placing the patient in a high-Fowler's position

9. A female patient has a sliding hiatal hernia. What nursing interventions will prevent the symptoms of heartburn and dyspepsia that she is experiencing?

A. Keep the patient NPO.
B. Put the bed in the Trendelenberg position.
C. Have the patient eat 4 to 6 smaller meals each day. 
D. Give various antacids to determine which one works for the patient.

10. A 72-year-old patient was admitted with epigastric pain due to a gastric ulcer. Which patient assessment warrants an urgent change in the nursing plan of care?

A. Chest pain relieved with eating or drinking water
B. Back pain 3 or 4 hours after eating a meal
C. Burning epigastric pain 90 minutes after breakfast
D. Rigid abdomen and vomiting following indigestion

11. The patient with chronic gastritis is being put on a combination of medications to eradicate H. pylori. Which drugs does the nurse know will probably be used for this patient?

A. Antibiotic(s), antacid, and corticosteroid
B. Antibiotic(s), aspirin, and antiulcer/protectant
C. Antibiotic(s), proton pump inhibitor, and bismuth 
D. Antibiotic(s) and nonsteroidal antiinflammatory drugs (NSAIDs)

12. The nurse should administer an as-needed dose of magnesium hydroxide (MOM) after noting what information while reviewing a patient's medical record?

A. Abdominal pain and bloating
B. No bowel movement for 3 days 
C. A decrease in appetite by 50% over 24 hours
D. Muscle tremors and other signs of hypomagnesemia

13. The nurse is preparing to administer a dose of bisacodyl (Dulcolax). In explaining the medication to the patient, the nurse would explain that it acts in what way?

A. Increases bulk in the stool
B. Lubricates the intestinal tract to soften feces
C. Increases fluid retention in the intestinal tract
D. Increases peristalsis by stimulating nerves in the colon wall

14. What should the nurse instruct the patient to do to best enhance the effectiveness of a daily dose of docusate sodium (Colace)?

A. Take a dose of mineral oil at the same time.
B. Add extra salt to food on at least one meal tray.
C. Ensure dietary intake of 10 g of fiber each day. 
D. Take each dose with a full glass of water or other liquid.

15. The nurse would question the use of which cathartic agent in a patient with renal insufficiency?

A. Bisacodyl (Dulcolax)
B. Lubiprostone (Amitiza)
C. Cascara sagrada (Senekot)
D. Magnesium hydroxide (Milk of Magnesia)

16. The nurse is caring for a 68-year-old patient admitted with abdominal pain, nausea, and vomiting. The patient has an abdominal mass, and a bowel obstruction is suspected. The nurse auscultating the abdomen listens for which type of bowel sounds that are consistent with the patient's clinical picture?

A. Low-pitched and rumbling above the area of obstruction 
B. High-pitched and hypoactive below the area of obstruction
C. Low-pitched and hyperactive below the area of obstruction
D. High-pitched and hyperactive above the area of obstruction

17. The nurse is planning care for a 68-year-old patient with an abdominal mass and suspected bowel obstruction. Which factor in the patient's history increases the patient's risk for colorectal cancer?

A. Osteoarthritis
B. History of colorectal polyps 
C. History of lactose intolerance
D. Use of herbs as dietary supplements

18. A 61-year-old patient with suspected bowel obstruction had a nasogastric tube inserted at 4:00 AM. The nurse shares in the morning report that the day shift staff should check the tube for patency at what times?

A. 7:00 AM, 10:00 AM, and 1:00 PM
B. 8:00 AM, 12:00 PM, and 4:00 PM 
C. 9:00 AM and 3:00 PM
D. 9:00 AM, 12:00 PM, and 3:00 PM

19. What information would have the highest priority to be included in preoperative teaching for a 68-year-old patient scheduled for a colectomy?

A. How to care for the wound
B. How to deep breathe and cough 
C. The location and care of drains after surgery
D. Which medications will be used during surgery

20. Two days following a colectomy for an abdominal mass, a patient reports gas pains and abdominal distention. The nurse plans care for the patient based on the knowledge that the symptoms are occurring as a result of

A. impaired peristalsis. 
B. irritation of the bowel.
C. nasogastric suctioning.
D. inflammation of the incision site.p                                                                                                                                                                                                                                               

21. The nurse is caring for a postoperative patient with a colostomy. The nurse is preparing to administer a dose of famotidine (Pepcid) when the patient asks why the medication was ordered since the patient does not have a history of heartburn or gastroesophageal reflux disease (GERD). What response by the nurse would be the most appropriate?

A. "This will prevent air from accumulating in the stomach, causing gas pains."
B. "This will prevent the heartburn that occurs as a side effect of general anesthesia."
C. "The stress of surgery is likely to cause stomach bleeding if you do not receive it."
D. "This will reduce the amount of HCl in the stomach until the nasogastric tube is removed and you can eat a regular diet again." 

22. A stroke patient who primarily uses a wheelchair for mobility has diarrhea with fecal incontinence. What should the nurse assess first?

A. Fecal impaction 
B. Perineal hygiene
C. Dietary fiber intake
D. Antidiarrheal agent use

23. Which clinical manifestations of inflammatory bowel disease are common to both patients with ulcerative colitis (UC) and Crohn's disease (select all that apply)?

A. Restricted to rectum
B. Strictures are common.
C. Bloody, diarrhea stools 
D. Cramping abdominal pain 
E. Lesions penetrate intestine.

24. After the nurse teaches a patient with gastroesophageal reflux disease (GERD) about recommended dietary modifications, which statement by the patient indicates that the teaching has been effective?

A. "I can have a glass of low-fat milk at bedtime."
B. "I will have to eliminate all spicy foods from my diet." 
C. "I will have to use herbal teas instead of caffeinated drinks."
D. "I should keep something in my stomach all the time to neutralize the excess acids.

4000 Avenue De Courtrai,

Montreal, Quebec

H3S 1C3 ROOM 201

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