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A medical patient's CA 19-9 levels have become available and they are significantly elevated. How should the nurse best interpret this diagnostic finding?
- A. The patient may have cancer, but other GI disease must be ruled out.
- B. The patient most likely has early-stage colorectal cancer.
- C. The patient has a genetic predisposition to gastric cancer.
- D. The patient has cancer, but the site is unknown.
Correct Answer: A
Rationale: CA 19-9 levels are elevated in most patients with advanced pancreatic cancer, but they may also be elevated in other conditions such as colorectal, lung, and gallbladder cancers; gallstones; pancreatitis; cystic fibrosis; and liver disease. A cancer diagnosis cannot be made solely on CA 19-9 results.
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A nurse is caring for a patient with recurrent hematemesis who is scheduled for upper gastrointestinal fibroscopy (UGF). How should the nurse in the radiology department prepare this patient?
- A. Insert a nasogastric tube.
- B. Administer a micro Fleet enema at least 3 hours before the procedure.
- C. Have the patient lie in a supine position for the procedure.
- D. Apply local anesthetic to the back of the patient's throat.
Correct Answer: D
Rationale: Preparation for UGF includes spraying or gargling with a local anesthetic. A nasogastric tube or a micro Fleet enema is not required for this procedure. The patient should be positioned in a side-lying position in case of emesis.
A patient has come to the outpatient radiology department for diagnostic testing. Which of the following diagnostic procedures will allow the care team to evaluate and remove polyps?
- A. Colonoscopy
- B. Barium enema
- C. ERCP
- D. Upper gastrointestinal fibroscopy
Correct Answer: A
Rationale: During colonoscopy, tissue biopsies can be obtained as needed, and polyps can be removed and evaluated. This is not possible during a barium enema, ERCP, or gastroscopy.
A nurse is caring for a patient with biliary colic and is aware that the patient may experience referred abdominal pain. Where would the nurse most likely expect this patient to experience referred pain?
- A. Midline near the umbilicus
- B. Below the right nipple
- C. Left groin area
- D. Right lower abdominal quadrant
Correct Answer: B
Rationale: Patients with referred abdominal pain associated with biliary colic complain of pain below the right nipple. Referred pain above the left nipple may be associated with the heart. Groin pain may be referred pain from ureteral colic.
A nurse is caring for a newly admitted patient with a suspected GI bleed. The nurse assesses the patient's stool after a bowel movement and notes it to be a tarry-black color. This finding is suggestive of bleeding from what location?
- A. Sigmoid colon
- B. Upper GI tract
- C. Large intestine
- D. Anus or rectum
Correct Answer: B
Rationale: Blood shed in sufficient quantities in the upper GI tract will produce a tarry-black color (melena). Blood entering the lower portion of the GI tract or passing rapidly through it will appear bright or dark red. Lower rectal or anal bleeding is suspected if there is streaking of blood on the surface of the stool or if blood is noted on toilet tissue.
The physiology instructor is discussing the GI system with the pre-nursing class. What should the instructor describe as a major function of the GI tract?
- A. The breakdown of food particles into cell form for digestion
- B. The maintenance of fluid and acid-base balance
- C. The absorption into the bloodstream of nutrient molecules produced by digestion
- D. The control of absorption and elimination of electrolytes
Correct Answer: C
Rationale: Primary functions of the GI tract include the breakdown of food particles into molecular form for digestion; the absorption into the bloodstream of small nutrient molecules produced by digestion; and the elimination of undigested unabsorbed food stuffs and other waste products. Nutrients must be broken down into molecular form, not cell form. Fluid, electrolyte, and acid-base balance are primarily under the control of the kidneys.