Medical Surgical Nursing Patient Centered Collaborative Care, 7th Edition by Donna D.
Medical Surgical Nursing Patient Centered Collaborative Care, 7th Edition by Donna D.
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Chapter 55: Assessment of the Gastrointestinal System
Complete Chapter Questions With Answers
Sample Questions Are Posted Below
MULTIPLE CHOICE
| a. | Failure to absorb nutrients from the stomach |
| b. | Inability to digest protein |
| c. | Impaired ability to soften and break down food |
| d. | Difficulty swallowing food |
ANS: C
Saliva is responsible for the softening of food in the mouth and contains an enzyme, salivary amylase (ptyalin), which assists in the breakdown of carbohydrates. Radiation to the oral cavity can result in reduction of saliva production. Radiation to the mouth will not impair swallowing, ability to digest protein, or ability to absorb nutrients from the stomach.
DIF: Cognitive Level: Application/Applying or higher REF: N/A
TOP: Client Needs Category: Health Promotion and Maintenance (Health and Wellness)
MSC: Integrated Process: Nursing Process (Planning)
| a. | “Have you traveled outside the country recently?” |
| b. | “Have you had a colonoscopy lately?” |
| c. | “Do you have any trouble swallowing?” |
| d. | “Do you have any allergies?” |
ANS: A
A history of recent travel may help pinpoint an infectious source for the client’s diarrhea. A colonoscopy will not cause acute diarrhea. Trouble swallowing is not related to diarrhea. Allergic reactions do not typically cause acute diarrhea.
DIF: Cognitive Level: Application/Applying or higher REF: N/A
TOP: Client Needs Category: Physiological Integrity (Physiological Adaptation—Alterations in Body Systems) MSC: Integrated Process: Nursing Process (Assessment)
| a. | “Have you experienced any constipation?” |
| b. | “Have you had any stomach pain or indigestion?” |
| c. | “Have you had any difficulty swallowing?” |
| d. | “Have you noticed any weight loss lately?” |
ANS: B
Long-term use of NSAIDs for chronic pain can precipitate peptic ulcer formation through inhibition of prostaglandins, which normally protects the gastric mucosa. The client should be assessed for stomach pain or indigestion. This medication does not typically cause constipation or difficulty swallowing. Weight loss would not be related to this medication.
DIF: Cognitive Level: Application/Applying or higher REF: N/A
TOP: Client Needs Category: Health Promotion and Maintenance (Health Screening)
MSC: Integrated Process: Nursing Process (Assessment)
| a. | Older white client with irritable bowel syndrome |
| b. | Middle-aged African-American client who smokes cigars |
| c. | Middle-aged Asian client who travels and eats out frequently |
| d. | Older American Indian client taking hormone replacement therapy |
ANS: B
Colon cancer is more prevalent among African Americans and smokers. Irritable bowel syndrome, travel, and hormone replacement therapy do not increase the risk for colon cancer.
DIF: Cognitive Level: Comprehension/Understanding REF: p. 1181
TOP: Client Needs Category: Health Promotion and Maintenance (Health Promotion/Disease Prevention) MSC: Integrated Process: Nursing Process (Assessment)
| a. | Assess the client’s blood sugar level. |
| b. | Assess the client’s stool for occult blood. |
| c. | Instruct the client in oral hygiene techniques. |
| d. | Assess the client for petechiae, itching, and jaundice. |
ANS: A
A fruity odor to the breath may indicate uncontrolled or undiagnosed diabetes mellitus. The client’s blood sugar level should be checked immediately for hyperglycemia. The nurse may perform the other assessment tests for the client, but they will not be helpful in determining the cause of the fruity breath.
DIF: Cognitive Level: Application/Applying or higher REF: N/A
TOP: Client Needs Category: Physiological Integrity (Physiological Adaptation—Alterations in Body Systems) MSC: Integrated Process: Nursing Process (Assessment)
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