Nokea
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.
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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.
The options for colon cancer screening for people over the age of 50 include which of the following? (Select all that apply.)
- A. Colonoscopy every 10 years
- B. CT colonography
- C. Double-contrast barium enema
- D. Flexible sigmoidoscopy every 5 years
- E. Fecal occult blood test annually
Correct Answer: A,C,D
Rationale: Colonoscopy every 10 years, CT colonography, double-contrast barium enema, and flexible sigmoidoscopy every 5 years are standard options for colon cancer screening in people over 50. Fecal occult blood test annually is also a screening option, but it was not listed in the original document and is included here for completeness.
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.
The nurse working in the gastrointestinal clinic sees clients who are anemic. What are common causes for which the nurse assesses in these clients? (Select all that apply.)
- A. Colon cancer
- B. Diverticulitis
- C. Inflammatory bowel disease
- D. Peptic ulcer disease
- E. Pernicious anemia
Correct Answer: A,B,C,D
Rationale: In adults, the most common cause of anemia is GI bleeding. This is commonly associated with colon cancer, diverticulitis, inflammatory bowel disease, and peptic ulcer disease. Pernicious anemia is not associated with GI bleeding.
A client had a colossoscopy and biopsy yesterday and calls the gastrointestinal clinic to report a spot of bright red blood on the toilet paper today. What response by the nurse is best?
- A. Come to the clinic immediately for evaluation.
- B. Monitor the bleeding and call back if it worsens.
- C. Take an over-the-counter stool softener.
- D. Avoid strenuous activity for a week.
Correct Answer: B
Rationale: A small amount of bright red blood on the toilet paper after a colonoscopy with biopsy is not uncommon due to minor irritation or trauma from the procedure. The nurse should advise the client to monitor the bleeding and call back if it worsens, as this could indicate a more serious issue. Immediate clinic evaluation is not necessary for a small spot of blood. Stool softeners or activity restrictions are not directly relevant unless specified by the provider.