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A nurse asks a patient for a stool sample to perform the guaiac test. How does the nurse best explain the purpose of this test?
- A. This test replaces the need for screening colonoscopy.
- B. We are looking for infectious organisms in your stool.
- C. The screening assesses for blood in your stool.
- D. This test assesses for antibodies to colon cancer.
Correct Answer: C
Rationale: The guaiac test (C) detects occult blood in stool, screening for GI bleeding or cancer. It doesn't replace colonoscopy (A), detect organisms (B), or assess antibodies (D).
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A nurse is caring for a patient who had abdominal surgery and has a nasogastric tube attached to low suction. Which nursing actions are appropriate when caring for this patient? Select all that apply.
- A. Irrigating the tube with 30-mL normal saline solution
- B. Confirming tube placement via pH testing of gastric secretions
- C. Positioning the air vent at the level of the patient's umbilicus
- D. Instilling irrigation via the blue air vent
- E. Monitoring the patient's abdomen for distention
- F. Documenting the nasogastric irrigation and drainage with I & O
Correct Answer: A,B,E,F
Rationale: Appropriate actions include irrigating with saline (A), confirming placement via pH (B), monitoring for distention (E), and documenting I&O (F). The air vent should be above the stomach, not at the umbilicus (C), and irrigation goes through the main lumen, not the air vent (D).
A nurse is scheduling tests for a patient who has been experiencing epigastric pain. The health care provider ordered the following tests: (a) barium enema, (b) fecal occult blood test, (c) endoscopic studies, and (d) an upper GI series. What is the correct order for performing the tests?
- A. c, b, d, a
- B. d, c, a, b
- C. a, b, d, c
- D. b, a, d, c
Correct Answer: D
Rationale: Fecal occult blood test (b) comes first to detect bleeding, followed by barium enema (a), upper GI series (d), and endoscopic studies (c) to avoid barium interference and prioritize non-invasive tests (D).
A nurse is planning a bowel program for a patient with frequent constipation after sustaining a spinal cord injury. What is the first step the nurse will take?
- A. Offering a diet that is low in residue
- B. Increasing fluid intake to 3,000 mL daily
- C. Administering daily enemas to stimulate peristalsis
- D. Assessing the patient's bowel patterns
Correct Answer: D
Rationale: The first step is assessing bowel patterns (D) to understand frequency, consistency, and triggers, following the nursing process. Diet (A), fluids (B), and enemas (C) are interventions based on assessment findings.
A nurse prepares to assist a patient with a newly created ileostomy. Which recommended patient teaching points would the nurse stress? Select all that apply.
- A. When you inspect the stoma, it should be dark purple-blue.
- B. The size of the stoma will stabilize within 2 weeks.
- C. Keep the skin around the stoma site clean and moist.
- D. The stool from an ileostomy is normally liquid.
- E. Eat dark-green vegetables to control the odor of the stool.
- F. You may have a tendency to develop food blockages.
Correct Answer: D,E,F
Rationale: Ileostomy stool is liquid (D), dark-green vegetables reduce odor (E), and food blockages are a risk (F). The stoma should be pink/red, not purple-blue (A), stabilizes in 4-6 weeks, not 2 (B), and skin should be clean and dry, not moist (C).
A nurse working on a GI unit is caring for a group of patients. In patients with which health problems or issues could the assessment possibly reveal decreased or absent bowel sounds after listening for 2 minutes? Select all that apply.
- A. Peritonitis
- B. Prolonged bedrest
- C. Diarrhea
- D. Gastroenteritis
- E. Early bowel obstruction
- F. Postoperative paralytic ileus
Correct Answer: A,B,F
Rationale: Decreased or absent bowel sounds indicate reduced motility, common in peritonitis (A), prolonged bedrest (B), and paralytic ileus (F). Diarrhea (C), gastroenteritis (D), and early bowel obstruction (E) typically cause hyperactive bowel sounds due to increased motility.