Chapter 39: Nursing Assessment: Gastrointestinal System

Chapter 39: Nursing Assessment: Gastrointestinal System

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE
1. The nurse is performing an assessment of an 80-year-old patient. Which information
obtained by the nurse will be of most concern?
a. Decreased appetite
b. Difficulty chewing food
c. Unintentional weight loss
d. Complaints of indigestion
ANS: C
Unintentional weight loss is not a normal finding in older patients and may indicate a
problem such as cancer or depression. Poor appetite, difficulty in chewing, and
complaints of indigestion are common in older patients. These will need to be addressed,
but are not of as much concern as the weight loss.
DIF: Cognitive Level: Application REF: 903-906
TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity
2. To promote bowel evacuation in a patient with chronic complaints of constipation, the
nurse will suggest that the patient should attempt defecation
a. in the mid-afternoon.
b. after eating breakfast.
c. right after getting up in the morning.
d. immediately before the first daily meal.
ANS: B
These reflexes are most active after the first daily meal. Arising in the morning, the
anticipation of eating, and physical exercise do not stimulate these reflexes.
DIF: Cognitive Level: Application REF: 902-903
TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity
3. When a patient has a history of a total gastrectomy, the nurse will monitor for clinical
manifestations of
a. constipation.
b. dehydration.
c. elevated total cholesterol.
d. cobalamin (vitamin B12) deficiency.
ANS: D
Test Bank 39-2
The patient with a total gastrectomy does not secrete intrinsic factor, which is needed for
cobalamin (vitamin B12) absorption. Because the stomach absorbs only small amounts of
water and nutrients, the patient is not at higher risk for dehydration, elevated cholesterol,
or constipation.
DIF: Cognitive Level: Application REF: 901
TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity
4. The nurse will monitor a patient who has an obstruction of the common bile duct for
a. melena.
b. steatorrhea.
c. decreased serum cholesterol levels.
d. increased serum indirect bilirubin levels.
ANS: B
A common bile duct obstruction will reduce the absorption of fat in the small intestine,
leading to fatty stools. Gastrointestinal (GI) bleeding is not caused by common bile duct
obstruction. Serum cholesterol levels are increased with biliary obstruction. Direct
bilirubin level is increased with biliary obstruction.
DIF: Cognitive Level: Application REF: 912 | 918
TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity