Nokea
The nurse is caring for a client who is scheduled for a percutaneous liver biopsy. Which diagnostic test is obtained prior?
- A. Complete blood count (CBC)
- B. Prothrombin time (PT)
- C. Blood chemistry
- D. Erythrocyte sedimentation rate (ESR)
Correct Answer: B
Rationale: The client must have coagulation studies (PT, aPTT, INR, platelet count) before the procedure because a major complication after a liver biopsy is bleeding. Clients at risk for serious bleeding may receive precautionary vitamin K. A complete blood count and blood chemistry may be completed for baseline values. Typically, an ESR is not associated with the procedure.
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The nurse is working in a diagnostic testing unit focusing on gastrointestinal studies. For which testing procedure is the nurse correct to assess the gag reflex before offering fluids?
- A. Esophagogastroduodenoscopy
- B. Sigmoidoscopy
- C. Peritoneoscopy
- D. Colonoscopy
Correct Answer: A
Rationale: The nurse is correct to assess the gag reflex prior to offering fluids for a client having an esophagogastroduodenoscopy (EGD). The other options are lower gastrointestinal studies typically requiring a bowel preparation.
The nurse is instructing a client prior to a colonoscopy. The client asks, 'Why do I have to drink this disgusting liquid?' The nurse is most correct to verbalize the goal of the oral preparation as which of the following?
- A. To allow ease of passage of the scope through the colon
- B. To decrease pain associated with fecal matter being pressed against the colon wall
- C. To cleanse the bowel to promote clear visualization of structures
- D. To eliminate gas from the internal portion of the colon
Correct Answer: C
Rationale: The goal of the oral preparation is to eliminate fecal matter to visualize the colon structures. Having a clean colon free of fecal matter does allow for ease of passage of the scope and eliminates gas. The client is sedated throughout the procedure so does not experience pain.
The nurse is scheduling gastrointestinal (GI) diagnostic testing for a client. Which GI test should be scheduled first?
- A. Radiography of the gallbladder
- B. Barium enema
- C. Small bowel series
- D. Barium swallow
Correct Answer: A
Rationale: Radiography of the gallbladder should be performed before the other GI exams listed in which barium is used because residual barium tends to obscure the images of the gallbladder and its duct.
The nurse is providing community education at the mall. The nurse is instructing on the muscular tube that connects the mouth to the stomach. The nurse outlines this structure on a drawing and labels it with which of the following?
- A. Pharynx
- B. Pylorus
- C. Esophagus
- D. Ileum
Correct Answer: C
Rationale: The esophagus begins at the base of the pharynx and ends at the opening of the stomach. Layers of muscular tissue surround the esophagus. The pharynx is part of the throat situated immediately inferior to the mouth and nasal cavity. The pylorus is the region of the stomach that connects to the duodenum. The ileum is a portion of the small intestine.
The nurse is instructing the client who was newly diagnosed with peptic ulcers. Which of the following diagnostic studies would the nurse anticipate reviewing with the client?
- A. A complete blood count including differential
- B. Serum antibodies for H. pylori
- C. A sigmoidoscopy
- D. Gastric analysis
Correct Answer: B
Rationale: Helicobacter pylori, a bacterium, is believed to be responsible for the majority of peptic ulcers. Blood tests are used to determine whether there are antibodies to H. pylori in the blood. A complete blood count with differential can indicate bleeding and infection associated with a bleeding ulcer. A sigmoidoscopy assesses the lower gastrointestinal tract. Gastric analysis is more common in analyzing gastric fluid in determining problems with the secretory activity of the gastric mucosa.