Nokea
A nurse is performing an abdominal assessment of an older adult patient. When collecting and analyzing data, the nurse should be cognizant of what age-related change in gastrointestinal structure and function?
- A. Increased gastric motility
- B. Decreased gastric pH
- C. Increased gag reflex
- D. Decreased mucus secretion
Correct Answer: D
Rationale: Older adults tend to secrete less mucus than younger adults. Gastric motility slows with age and gastric pH rises due to decreased secretion of gastric acids. Older adults tend to have a blunted gag reflex compared to younger adults.
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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 nurse is providing preprocedure education for a patient who will undergo a lower GI tract study the following week. What should the nurse teach the patient about bowel preparation?
- A. You'll need to fast for at least 18 hours prior to your test.
- B. Starting today, take over-the-counter stool softeners twice daily.
- C. You'll need to have enemas the day before the test.
- D. For 24 hours before the test, insert a glycerin suppository every 4 hours.
Correct Answer: C
Rationale: Preparation of the patient includes emptying and cleansing the lower bowel. This often necessitates a low-residue diet 1 to 2 days before the test; a clear liquid diet and a laxative the evening before; NPO after midnight; and cleansing enemas until returns are clear the following morning.
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 is being assessed for a suspected deficit in intrinsic factor synthesis. What diagnostic or assessment finding is the most likely rationale for this examination of intrinsic factor production?
- A. Muscle wasting
- B. Chronic jaundice in the absence of liver disease
- C. The presence of fat in the patient's stool
- D. Persistently low hemoglobin and hematocrit
Correct Answer: D
Rationale: In the absence of intrinsic factor, vitamin B12 cannot be absorbed, and pernicious anemia results. This would result in a marked reduction in hemoglobin and hematocrit.
A patient with a recent history of intermittent bleeding is undergoing capsule endoscopy to determine the source of the bleeding. When explaining this diagnostic test to the patient, what advantage should the nurse describe?
- A. The test allows visualization of the entire peritoneal cavity.
- B. The test allows for painless biopsy collection.
- C. The test does not require fasting.
- D. The test is noninvasive.
Correct Answer: D
Rationale: Capsule endoscopy allows the noninvasive visualization of the mucosa throughout the entire small intestine. Bowel preparation is necessary and biopsies cannot be collected. This procedure allows visualization of the entire GI tract, but not the peritoneal cavity.