Health Assessment For Nursing Practice 5th Edition by Wilson
Health Assessment For Nursing Practice 5th Edition by Wilson
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Chapter 13: Abdomen and Gastrointestinal System
Complete Chapter Questions With Answers
Sample Questions Are Posted Below
MULTIPLE CHOICE
| a. | Gnawing epigastric pain radiates to the back or shoulder that worsens after eating. |
| b. | Sharp midepigastric pain radiates to the jaw. |
| c. | Intermittent cramping pain in the left lower quadrant is relieved by defecation. |
| d. | Colicky pain is felt near the umbilicus with vomiting and constipation. |
ANS: A
| Feedback | |
| A | Gnawing epigastric pain that radiates to the back or shoulder and worsens after eating is a symptom that is consistent with peptic ulcer disease. |
| B | Sharp midepigastric pain that radiates to the jaw is not a symptom of peptic ulcer disease. |
| C | Intermittent cramping pain in the left lower quadrant relieved by defecation is a symptom of diverticular disease rather than peptic ulcer disease. |
| D | Colicky pain felt near the umbilicus with vomiting and constipation is a symptom of an intestinal obstruction rather than peptic ulcer disease. |
DIF: Cognitive Level: Apply REF: 268-269
TOP: Nursing Process: Assessment
MSC: NCLEX Patient Needs: Physiologic Integrity: Physiologic Adaptation: Alteration in Body Systems
| a. | “Have you noticed any swelling in your ankles or feet at the end of the day?” |
| b. | “Have you noticed a change in the color of your urine or stools?” |
| c. | “Have you vomited up any blood in the last 24 hours?” |
| d. | “Have you experienced fever, chills, or sweating?” |
ANS: B
| Feedback | |
| A | This question is related to fluid retention, which may be asked if the patient has renal or heart failure. |
| B | Gallstones can obstruct the flow of bile to the gastrointestinal tract making urine darker and stools lighter in color. |
| C | This question applies if the patient has peptic ulcer disease or esophageal varices. |
| D | This question applies if the patient has gastroenteritis or a urinary tract infection. |
DIF: Cognitive Level: Analyze REF: 268-269
TOP: Nursing Process: Assessment
MSC: NCLEX Patient Needs: Physiologic Integrity: Reduction of Risk Potential: System Specific Assessments
| a. | “Has your abdomen been distended when you feel the heartburn?” |
| b. | “What have you eaten in the last 24 hours?” |
| c. | “Is there a history of heart disease in your family?” |
| d. | “How long after eating do you have heartburn?” |
ANS: D
| Feedback | |
| A | The question “Has your abdomen been distended when you feel the heartburn?” is not related to the heartburn. Distention usually is related to intestinal obstruction or liver disease. |
| B | The question “What have you eaten in the last 24 hours?” relates more to gastroenteritis. Indigestion is usually caused by food eaten in the last meal rather than in the last 24 hours. |
| C | The question “Is there a history of heart disease in your family?” points to myocardial ischemia. Although heartburn may be a symptom of myocardial ischemia, asking the patient about the family history is not relevant in this case. |
| D | Asking “How long after eating do you have heartburn?” can aid in determining if the patient has gastroesophageal reflux disease or a hiatal hernia. Both are common disorders that cause indigestion a few hours after meals. |
DIF: Cognitive Level: Apply REF: 268-270
TOP: Nursing Process: Assessment
MSC: NCLEX Patient Needs: Health Promotion and Maintenance: Techniques of Physical Assessment
| a. | “Has there been a change in your usual pattern of urination?” |
| b. | “Have you had any nausea or vomiting?” |
| c. | “Has there been a change in your bowel habits?” |
| d. | “Have you had indigestion or heartburn?” |
ANS: B
| Feedback | |
| A | “Has there been a change in your usual pattern of urination?” is not a question related to the abdominal distention and jaundice. |
| B | “Have you had any nausea or vomiting?” is an appropriate question because the nurse suspects the patient may have a liver disease based on the abdominal distention and jaundice. The nurse interprets the relationship with data gathered from the history and the observation. |
| C | “Has there been a change in your bowel habits?” is a question that may be related to the abdominal distention, but not the jaundice. |
| D | “Have you had indigestion or heartburn?” is not a question related to the abdominal distention and jaundice. It applies more to gastric disorders, such as gastroesophageal reflux disease or hiatal hernia. |
DIF: Cognitive Level: Analyze REF: 269-270
TOP: Nursing Process: Assessment
MSC: NCLEX Patient Needs: Physiologic Integrity: Physiologic Adaptation: Alteration in Body Systems
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