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A patient has been experiencing significant psychosocial stress in recent weeks. The nurse is aware of the hormonal effects of stress, including norepinephrine release. Release of this substance would have what effect on the patient's gastrointestinal function?
- A. Decreased motility
- B. Increased sphincter tone
- C. Increased enzyme release
- D. Inhibition of secretions
- E. Increased peristalsis
Correct Answer: A,B,D
Rationale: Norepinephrine generally decreases GI motility and secretions, but increases muscle tone of sphincters. Norepinephrine does not increase the release of enzymes.
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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.
A nurse is assessing the abdomen of a patient just admitted to the unit with a suspected GI disease. Inspection reveals several diverse lesions on the patient's abdomen. How should the nurse best interpret this assessment finding?
- A. Abdominal lesions are usually due to age-related skin changes.
- B. Integumentary diseases often cause GI disorders.
- C. GI diseases often produce skin changes.
- D. The patient needs to be assessed for self-harm.
Correct Answer: C
Rationale: Abdominal lesions are of particular importance, because GI diseases often produce skin changes. Skin problems do not normally cause GI disorders. Age-related skin changes do not have a pronounced effect on the skin of the abdomen when compared to other skin surfaces. Self-harm is a less likely explanation for skin lesions on the abdomen.
A patient with cystic fibrosis takes pancreatic enzyme replacements on a regular basis. The patient's intake of trypsin facilitates what aspect of GI function?
- A. Vitamin D synthesis
- B. Digestion of fats
- C. Maintenance of peristalsis
- D. Digestion of proteins
Correct Answer: D
Rationale: Trypsin facilitates the digestion of proteins. It does not influence vitamin D synthesis, the digestion of fats, or peristalsis.
The nurse is caring for a patient who has a diagnosis of AIDS. Inspection of the patient's mouth reveals the new presence of white lesions on the patient's oral mucosa. What is the nurse's most appropriate response?
- A. Encourage the patient to gargle with salt water twice daily.
- B. Attempt to remove the lesions with a tongue depressor.
- C. Make a referral to the unit's dietitian.
- D. Inform the primary care provider of this finding.
Correct Answer: D
Rationale: The nurse should inform the primary care provider of this abnormal finding in the patient's oral cavity, since it necessitates medical treatment. It would be inappropriate to try to remove skin lesions from a patient's mouth and salt water will not resolve this problem, which is likely due to candidiasis. A dietitian referral is unnecessary.
A patient who has been experiencing changes in his bowel function is scheduled for a barium enema. What instruction should the nurse provide for postprocedure recovery?
- A. Remain NPO for 6 hours postprocedure.
- B. Administer a Fleet enema to cleanse the bowel of the barium.
- C. Increase fluid intake to evacuate the barium.
- D. Avoid dairy products for 24 hours postprocedure.
Correct Answer: C
Rationale: Adequate fluid intake is necessary to rid the GI tract of barium. The patient must not remain NPO after the test and enemas are not used to cleanse the bowel of barium. There is no need to avoid dairy products.