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A patient has come to the clinic complaining of blood in his stool. A FOBT test is performed but is negative. Based on the patient's history, the physician suggests a colonoscopy, but the patient refuses, citing a strong aversion to the invasive nature of the test. What other test might the physician order to check for blood in the stool?
- A. A laparoscopic intestinal mucosa biopsy
- B. A quantitative fecal immunochemical test
- C. Computed tomography (CT)
- D. Magnetic resonance imagery (MRI)
Correct Answer: B
Rationale: Quantitative fecal immunochemical tests may be more accurate than guaiac testing and useful for patients who refuse invasive testing. CT or MRI cannot detect blood in stool. Laparoscopic intestinal mucosa biopsy is not performed.
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A clinic patient has described recent dark-colored stools; the nurse recognizes the need for fecal occult blood testing (FOBT). What aspect of the patient's current health status would contraindicate FOBT?
- A. Gastroesophageal reflux disease (GERD)
- B. Peptic ulcers
- C. Hemorrhoids
- D. Recurrent nausea and vomiting
Correct Answer: C
Rationale: FOBT should not be performed when there is hemorrhoidal bleeding. GERD, peptic ulcers and nausea and vomiting do not contraindicate the use of FOBT as a diagnostic tool.
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.
A nurse is promoting increased protein intake to enhance a patient's wound healing. The nurse knows that enzymes are essential in the digestion of nutrients such as protein. What is the enzyme that initiates the digestion of protein?
- A. Pepsin
- B. Intrinsic factor
- C. Lipase
- D. Amylase
Correct Answer: A
Rationale: The enzyme that initiates the digestion of protein is pepsin. Intrinsic factor combines with vitamin B12 for absorption by the ileum. Lipase aids in the digestion of fats and amylase aids in the digestion of starch.
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.
A patient has been scheduled for a urea breath test in one month's time. What nursing diagnosis most likely prompted this diagnostic test?
- A. Impaired Dentition Related to Gingivitis
- B. Risk For Impaired Skin Integrity Related to Peptic Ulcers
- C. Imbalanced Nutrition: Less Than Body Requirements Related to Enzyme Deficiency
- D. Diarrhea Related to Clostridium Difficile Infection
Correct Answer: B
Rationale: Urea breath tests detect the presence of Helicobacter pylori, the bacteria that can live in the mucosal lining of the stomach and cause peptic ulcer disease. This test does not address fluid volume, nutritional status, or dentition.