Nokea
A nurse is caring for an 83-year-old patient who is being assessed for recurrent and intractable nausea. What age-related change to the GI system may be a contributor to the patient's health complaint?
- A. Stomach emptying takes place more slowly.
- B. The villi and epithelium of the small intestine become thinner.
- C. The esophageal sphincter becomes incompetent.
- D. Saliva production decreases.
Correct Answer: A
Rationale: Delayed gastric emptying occurs in older adults and may contribute to nausea. Changes to the small intestine and decreased saliva production would be less likely to contribute to nausea. Loss of esophageal sphincter function is pathologic and is not considered an age-related change.
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The nurse is preparing to perform a patient's abdominal assessment. What examination sequence should the nurse follow?
- A. Inspection, auscultation, percussion, and palpation
- B. Inspection, palpation, auscultation, and percussion
- C. Inspection, percussion, palpation, and auscultation
- D. Inspection, palpation, percussion, and auscultation
Correct Answer: A
Rationale: When performing a focused assessment of the patient's abdomen, auscultation should always precede percussion and palpation because they may alter bowel sounds. The traditional sequence for all other focused assessments is inspection, palpation, percussion, and auscultation.
The nurse is caring for a patient with a duodenal ulcer and is relating the patient's symptoms to the physiologic functions of the small intestine. What do these functions include?
- A. Secretion of hydrochloric acid (HCl)
- B. Reabsorption of water
- C. Secretion of mucus
- D. Absorption of nutrients
- E. Movement of nutrients into the bloodstream
Correct Answer: C,D,E
Rationale: The small intestine folds back and forth on itself, providing approximately 7000 cm^2 (70 m^2) of surface area for secretion and absorption, the process by which nutrients enter the bloodstream through the intestinal walls. Water reabsorption primarily takes place in the large bowel. HCl is secreted by the stomach.
A nursing student has auscultated a patient's abdomen and noted one or two bowel sounds in a 2-minute period of time. How would you tell the student to document the patient's bowel sounds?
- A. Normal
- B. Hypoactive
- C. Hyperactive
- D. Paralytic ileus
Correct Answer: B
Rationale: Documenting bowel sounds is based on assessment findings. The terms normal (sounds heard about every 5 to 20 seconds), hypoactive (one or two sounds in 2 minutes), hyperactive (5 to 6 sounds heard in less than 30 seconds), or absent (no sounds in 3 to 5 minutes) are frequently used in documentation. Paralytic ileus is a medical diagnosis that may cause absent or hypoactive bowel sounds, but the nurse would not independently document this diagnosis.
A patient has sought care because of recent dark-colored stools. As a result, a fecal occult blood test has been ordered. The nurse should instruct the patient to avoid which of the following prior to collecting a stool sample?
- A. NSAIDs
- B. Acetaminophen
- C. OTC vitamin D supplements
- D. Fiber supplements
Correct Answer: A
Rationale: NSAIDs can cause a false-positive fecal occult blood test. Acetaminophen, vitamin D supplements, and fiber supplements do not have this effect.
The nurse educator is reviewing the blood supply of the GI tract with a group of medical nurses. The nurse is explaining the fact that the veins that return blood from the digestive organs and the spleen form the portal venous system. What large veins will the nurse list when describing this system?
- A. Splenic vein
- B. Inferior mesenteric vein
- C. Gastric vein
- D. Inferior vena cava
- E. Saphenous vein
Correct Answer: A,B,C
Rationale: This portal venous system is composed of five large veins: the superior mesenteric, inferior mesenteric, gastric, splenic, and cystic veins, which eventually form the vena portac that enters the liver. The inferior vena cava is not part of the portal system. The saphenous vein is located in the leg.