Nokea
The nurse working with clients who have gastrointestinal problems knows that which laboratory values are related to what organ dysfunctions? (Select all that apply.)
- A. Alanine aminotransferase: biliary system
- B. Ammonia: liver
- C. Amylase: liver
- D. Lipase: pancreas
- E. Urobilinogen: stomach
Correct Answer: B,D
Rationale: Alanine aminotransferase and ammonia are related to the liver. Amylase and lipase are related to the pancreas. Urobilinogen evaluates both hepatic and biliary function, not the stomach.
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A client presents to the emergency department reporting severe abdominal pain. On assessment, the nurse finds a bulging, pulsating mass in the abdomen. What action by the nurse is the priority?
- A. Auscultate the abdomen.
- B. Notify the provider immediately.
- C. Order an abdominal flat-plate x-ray.
- D. Palpate the abdomen to assess size.
Correct Answer: B
Rationale: The observation could indicate an abdominal aortic aneurysm, which could be life-threatening and should never be palpated. The nurse notifies the provider at once. An x-ray may be indicated, but it is not the priority. Auscultation is part of the assessment, but the nurse's priority action is to notify the provider.
The student nurse studying the gastrointestinal system understands that chyme refers to what?
- A. Hormenization that reduces acidity.
- B. Liquedied food ready for digestion
- C. Nutrients after being absorbed
- D. Secretions that help digest food
Correct Answer: B
Rationale: Before being digested, food must be broken down into a liquid form. This liquid is called chyme. Secretin is the hormone that inhibits acid production and decreases gastric motility. Absorption is carried out so the nutrients produced by digestion move from the lumen of the GI tract into the body's circulatory system for uptake into individual cells. The secretions that help digest food include hydrochloric acid, bile, and digestive enzymes.
The nurse working with older clients understands age-related changes in the gastrointestinal system. Which changes does this include? (Select all that apply.)
- A. Decreased hydrochloric acid production
- B. Diminished nerve function in the large intestine
- C. Decreased fat digestion
- D. Decreased peristalsis in the large intestine
- E. Increased peristalsis in the large intestine
Correct Answer: A,B,C,D
Rationale: Several age-related changes occur in the gastrointestinal system. These include decreased hydrochloric acid production, diminished nerve function that leads to decreased sensation of the need to pass stool, decreased fat digestion, decreased peristalsis in the large intestine, and calcification of pancreatic vessels. Increased peristalsis is not an age-related change.
A client had an endoscopic retrograde cholangiopancreatography (ERCP). The nurse instructs the client and family about the signs of potential complications, which include what problems? (Select all that apply.)
- A. Cholangitis
- B. Pancreatitis
- C. Perforation
- D. Sepsis
- E. Kidney stones
Correct Answer: A,B,C,E
Rationale: Possible complications after an ERCP include cholangitis, pancreatitis, perforation, sepsis, and bleeding. Kidney stones are not a complication of ERCP.
A client scheduled for a percutaneous transhepatic cholangiography (PTC) denies allergies to medication. What action by the nurse is best?
- A. Ask the client about difficult allergies.
- B. Document this information on the chart.
- C. Insureat that the client has a ride home.
- D. Insureat that the client has a ride home.
Correct Answer: A
Rationale: PTC uses iodinated dye, so the client should be asked about seafood allergies, specifically to shellfish, as these may indicate a risk for iodine allergy. Documentation should occur, but this is not the priority. The client will need a ride home afterward if the procedure is done as an outpatient, but this is not the priority action.