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test3.2medsurg1
| Question | Answer |
|---|---|
| Reflux of food into the esophagus from the stomach is prevented by contraction of the: | cardiac sphincter |
| A hormonal regulatory substance that inhibits stomach contraction and gastric secretions is: | secretin |
| During the initial assessment of a patient complaining of increased stomach acid related to stress, the nurse knows that the physician will want to consider the influence of the neuroregulator: | norepinephrine |
| Pancreatic secretions into the duodenum: | are stimulated by hormones released in the presence of chyme as it passes through the duodenum have an alkaline effect on intestinal contents, increase the pH of the food contents. |
| Secretin is a gastrointestinal hormone that: | stimulates the production of bicarbonate in pancreatic juice. |
| Obstruction of the gastrointestinal tract leads to | increased force of intestinal contraction, distention above the point of obstruction, pain and a sense of bloating |
| A nurse who is investigating a patient's statement about duodenal pain should assess the: | epigastric area and consider possible radiation of pain to the right subscapular region |
| The nurse has been directed to position a patient for an examination of the abdomen. She knows to place the patient in the: | supine position with the knees flexed to relax the abdominal muscles |
| The nurse auscultates the abdomen to assess bowel sounds. She documents five to six sounds heard in less than 30 seconds. She documents that the patient's bowel sounds are: | hyperactive. |
| A gastric analysis with stimulation that results in an excess of gastric acid being secreted could be diagnostic of: | a duodenal ulcer. |
| Before a gastroscopy, the nurse should inform the patient that: | he or she must fast for 6 to 12 hours beforeexamination, after gastroscopy he or she cannot eat or drink until the gag reflex returns (1 to 2 hrs),his or her throat will be sprayed with a local anesthetic. |
| For adults who are older than 50 years of age and at low risk for colorectal cancer, the recommended screening is a: | fecal occult blood test anually |
| Magnetic resonance imaging (MRI) is contraindicated for patients who have: | permanent pacemakers, implanted insulin pumps, artificial heart valves. |
| Patient preparation for esophageal manometry requires the withholding of specific medications such as: | anticholinergics, sedatives, calcium-channel blockers. |
| The results of a gastric analysis can be used to diagnose various disease states. An excess amount of acid can indicate the presence of: | a duodenal ulcer |
| Chyme, partially digested food that is mixed with gastric contents, stimulates segmented contractions, which are_______ and intestinal peristalsis, which is ______ | mixed waves that move the intesinal contents back and forth in a churning motion; a movement that propels the contents of the small intestine towards the colon |
| How many hours does it take after eating for food to pass into the terminal ileum? _ How many hours does it take for food to reach and distend the rectum? _ | 4 hours, 12 hours |
| List three structural changes in the esophagus that occur as the result of aging: _ , _ , and _ . | decreased motility and emptying, weakened gag reflex, and decreased resting pressure of the lower sphincter |
| Helps convert protein into amino acids | trypsin |
| Facilitates the production of dextrins and maltose | amylaes |
| Digests protein and helps form polypeptides | pepsin |
| Digests carbohydrates and helps form fructose | sucrase |
| Glucose is a product of this enzyme's action | maltase |
| Helps form galactose | lactase |
| low residue diet one to two days before test | Barium enema |
| Acute gastritis is often caused by: | ingestion of strong acids, irritating foods, overuse of aspirin. |
| To promote fluid balance when treating gastritis, the nurse knows that the minimal daily intake of fluids should be: | 1.5 liters |
| A symptom that distinguishes a chronic gastric ulcer from a chronic duodenal ulcer is the: | normal to below-normal secretion of acid. |
| The percentage of patients with peptic ulcers who experience bleeding is: | 15% |
| A characteristic associated with peptic ulcer pain is a: | burning sensation localized in the back ormidepigastrium, feeling of emptiness that precedes meals from 1-3 hours, c. severe gnawing pain that increases in severity as the day progresses. |
| The best time to administer an antacid is: | 1-3 hours after a meal |
| A Billroth I procedure is a surgical approach to ulcer management whereby: | a partial gastrectomy is performed with anastomosis of the stomach segment to the duodenum. |
| The most common complication of peptic ulcer disease that occurs in 10% to 20% of patients is: | hemorrhage |
| Nursing interventions associated with peptic ulcers include: | checking the blood pressure and pulse rate every 15 to 20 minutes c. observing stools and vomitus for color, consistency, and volume, frequently monitoring hemoglobin and hematocrit levels. |
| If peptic ulcer hemorrhage was suspected, an immediate nursing action would be to: | place the patient in a recumbent position with his or her legs elevated, assess vital signs, prepare a peripheral and central line for intravenous infusion. |
| Pyloric (gastric outlet) obstruction can occur when the area distal to the pyloric sphincter becomes stenosed by: | edema, scar tissue, spasm |
| Symptoms associated with pyloric obstruction include all of the following except: | diarrhea |
| The average weight loss after bariatric surgery is about what percent of previous body weight? | 60% |
| Pulmonary complications frequently follow upper abdominal incisions, because: | the patient tends to have shallow respirations in an attempt to minimize incisional pain |
| Teaching points to help a patient with total gastric resection avoid the dumping syndrome include all of the following | eating small frequent meals, lying down after meals, taking fluids between meals to decrease the total volume in the stomach at one time. |
| Describe the immediate intervention that should be used to treat the ingestion of a corrosive acid or alkali. | dilute and neutralize the offending agent, to neutralize a corrosive acid, use antacids, to neutralize alkali, lemon juice or vinegar |
| Explain why patients with gastritis due to a vitamin deficiency usually have malabsorption of vitamin B12. | b/c pt. with gastritis dut to vit. deficient pt have antibodies against intrinsic factor needed to absorb B12 |
| Name two conditions specifically related to peptic ulcer development:___and____ | Hypersecretion of acid pepsin and weakened gastric mucosal barrier predispose to peptic ulcer developement |
| List several findings characteristic of Zollinger-Ellison syndrome. | Hypersecretion of gastric juice, multiple duodenal ulcers, hypertrophied duodenal glands, gastrinomas(islet cell tumors), in the pancreas |
| Distinguish between Cushing's and Curling's ulcer in terms of cause and location. | cushing's common with brain trauma, occur in stomach, esophagus and duodenum. curling's occur after severe burns and involve the antrum of the stomach and the duodenum |
| Explain the current theory about diet modification for peptic ulcer disease | avoid hypersecretion and hypermotility of gi tract. no harsh temps, no overstimulation by meat extractives, coffee, alcohol, dairy, 3 meals/day with antacid or histimine blocker, |
| Name four major, potential complications of a peptic ulcer: | hemorrhage, perforation, penetration, pyloric obstruction |
| Describe the clinical manifestations associated with peptic ulcer perforation. | severe upper abd. pain, vomiting, fainting, tender abd. can be board like & rigid, signs of shock(hypotension/tachycardia) |
| Bariatric surgery works by:_____ and_____ . | restricting the ability to eat, restricting ingested nutrient absorption. |
| The stomach pouches created by gastric bypass or bonding surgery can hold up to___ mL of food and fluids. | 30 mL |
| The most common, primary, malignant tumor of the duodenum is_ . Which portions of the duodenum does it involve? The___and_____portions of the duodenum. | adenosarcoma, second and third portions |
| Lack of hydrochloric acid in digestive secretions of the stomach | achlorhydria |
| The pathophysiology of constipation may be related to interference with: | myoelectric activity of the colon, processes involved in defecation, mucosal transport. |
| Nursing suggestions to help a person break the constipation habit include all of the following except: | low residue bland diet |
| An example of a stimulant laxative that works in 6 to 8 hours is: | dulcolax |
| The classification of moderate diarrhea refers to the quantity of daily unformed stools described as: | 3-6 bowell movements a day |
| In assessing stool characteristics associated with diarrhea, the nurse knows that the presence of greasy stools suggests: | intestinal malabsorption |
| A disorder of malabsorption that inactivates pancreatic enzymes is: | zolinger ellison |
| A positive Rovsing's sign is indicative of appendicitis. The nurse knows to assess for this indicator by pal¬ pating the: | LLQ |
| The most common site for diverticulitis is the: | sigmoid |
Created by:
sandjlambert1