Questions on Gastrointestinal Tract

Questions on Gastrointestinal Tract Related

Review Questions on Gastrointestinal Tract related questions and content

A 22-yr-old female patient with an exacerbation of ulcerative colitis is having 15 to 20 stools daily and has excoriated perianal skin. Which patient behavior indicates that teaching regarding maintenance of skin integrity has been effective?

  • A. The patient uses incontinence briefs to contain loose stools.
  • B. The patient uses witch hazel compresses to soothe irritation.
  • C. The patient asks for antidiarrheal medication after each stool.
  • D. The patient cleans the perianal area with soap after each stool.
Correct Answer: B

Rationale: The correct answer is B: The patient uses witch hazel compresses to soothe irritation. Witch hazel has astringent and anti-inflammatory properties, which can help reduce inflammation and soothe irritated skin. By using witch hazel compresses, the patient is actively taking steps to alleviate discomfort and promote skin healing.

A: The patient using incontinence briefs to contain loose stools does not address the issue of skin integrity maintenance and may lead to prolonged exposure of the skin to stool, exacerbating the problem.

C: Asking for antidiarrheal medication after each stool does not directly address the need for skin integrity maintenance. While it may help reduce stool frequency, it does not specifically target skin healing.

D: Cleaning the perianal area with soap after each stool can be harsh on the already excoriated skin and may further irritate it. Using soap can strip the skin of its natural oils and hinder the healing process.

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Priority Decision: A patient returns to the surgical unit with a nasogastric (NG) tube to low intermittent suction, IV fluids, and a Jackson-Pratt drain at the surgical site following an exploratory laparotomy and repair of a bowel perforation. Four hours after admission, the patient experiences nausea and vomiting. What is a priority nursing intervention for the patient?

  • A. Assess the abdomen for distention and bowel sounds.
  • B. Inspect the surgical site and drainage in the Jackson-Pratt.
  • C. Check the amount and character of gastric drainage and the patency of the NG tube.
  • D. Administer prescribed prochlorperazine (Compazine) to control the nausea and vomiting.
Correct Answer: C

Rationale: The correct answer is C: Check the amount and character of gastric drainage and the patency of the NG tube. This is the priority nursing intervention because the patient is experiencing nausea and vomiting, which could indicate potential complications related to the NG tube, such as blockage or displacement. By checking the gastric drainage and NG tube patency, the nurse can assess if the patient's symptoms are related to these issues and take appropriate actions to address them.

Choice A is incorrect because assessing the abdomen for distention and bowel sounds is important but not the priority in this situation where the patient is experiencing nausea and vomiting. Choice B is incorrect as inspecting the surgical site and drainage in the Jackson-Pratt drain is also important but not as urgent as checking the NG tube patency in this case. Choice D is incorrect as administering medication should not be the first action taken without first assessing the underlying cause of the symptoms.

Which is most characteristic of carcinoma of the cecum or right colon (in contrast to carcinoma of the rectum)?

  • A. anemia
  • B. associated polyposis
  • C. bowel obstruction
  • D. diarrhea
Correct Answer: A

Rationale: The correct answer is A: anemia. Carcinoma of the cecum or right colon often presents with chronic blood loss, leading to iron deficiency anemia. This is due to the longer transit time in the right colon allowing for more time for blood to be lost and for the iron in the blood to be absorbed. Choices B, C, and D are less characteristic of carcinoma of the cecum or right colon. Polyposis is more commonly associated with familial adenomatous polyposis, bowel obstruction is more common in advanced stages regardless of location, and diarrhea is more commonly seen in rectal carcinomas due to irritation of the rectal mucosa.

Which of the following structures forms a cavity or pocket between the layers of mesenteries?

  • A. visceral pleura
  • B. parietal pleura
  • C. omental bursa
  • D. retroperitoneum
Correct Answer: C

Rationale: The correct answer is C: omental bursa. The omental bursa is a potential space located behind the stomach and in front of the pancreas, forming a cavity or pocket between the layers of mesenteries. This structure allows for movement and accommodation of the stomach during digestion.

A: Visceral pleura and B: Parietal pleura are layers of the pleural membrane in the thoracic cavity, not related to mesenteries or cavity formation. D: Retroperitoneum refers to the space behind the peritoneum, not specifically forming a cavity or pocket between mesenteries.

The nervous system or systems that can control peristalsis in the inferior esophagus, stomach, small intestine and large intestine is (are) the

  • A. somatic motor nervous system.
  • B. sympathetic nervous system.
  • C. sympathetic and parasympathetic nervous systems.
  • D. autonomic and somatic motor nervous systems.
Correct Answer: C

Rationale: The correct answer is C because peristalsis, the involuntary movement of the digestive tract, is controlled by both sympathetic and parasympathetic nervous systems. The parasympathetic nervous system stimulates peristalsis, while the sympathetic nervous system inhibits it. Choice A is incorrect because the somatic motor nervous system controls voluntary movements, not peristalsis. Choice B is incorrect because the sympathetic nervous system inhibits peristalsis. Choice D is incorrect because the somatic motor nervous system does not control peristalsis in the digestive tract; it controls skeletal muscle movements.

The nurse is teaching a client about sexual modifications for clients with an ostomy. Which of the following strategies would the nurse suggest when anticipating sexual activity?

  • A. Leave the stoma open to air and cover with a towel.
  • B. Instruct the client to limit foods that activate the bowel.
  • C. Bathe and apply a fresh pouch after having sex.
  • D. Consult with members of a local ostomy support group.
Correct Answer: B

Rationale: The correct answer is B because limiting foods that activate the bowel can help reduce the chances of embarrassing situations during sexual activity. Certain foods can cause gas or increase stool output, which may affect the client's confidence and comfort. Leaving the stoma open to air and covering with a towel (choice A) is not recommended during sexual activity as it may lead to odor and potential leakage. Bathing and applying a fresh pouch after sex (choice C) is important for hygiene but does not directly address preparation for sexual activity. Consulting with an ostomy support group (choice D) is beneficial for emotional support but does not specifically address strategies for anticipating sexual activity.

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