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Which of the following interventions is helpful in reducing the effects of Gastroesophageal Reflux Disease (GERD)?
- A. Lie down after eating.
- B. Wear a girdle.
- C. Elevate the head of the bed on 4-6 inch blocks.
- D. Increase fluid intake just before bedtime.
Correct Answer: C
Rationale: Elevating the head of the bed (C) reduces GERD symptoms by preventing acid reflux during sleep. Lying down (A), wearing a girdle (B), or increasing fluids at bedtime (D) worsen reflux.
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The nurse is reviewing gastrointestinal assessment with a group of student nurses. It would be correct if the student identifies which of the following would cause hyperactive bowel sounds?
- A. Paralytic ileus
- B. Gastroenteritis
- C. Late bowel obstruction
- D. Peritonitis
Correct Answer: B
Rationale: Gastroenteritis (B) causes hyperactive bowel sounds due to increased intestinal motility from inflammation or infection. Paralytic ileus (A), late bowel obstruction (C), and peritonitis (D) typically cause hypoactive or absent bowel sounds.
The nurse is caring for a client who is receiving prescribed dicyclomine. Which of the following client findings would indicate a therapeutic response?
- A. Decreased abdominal cramping
- B. Absence of nausea and vomiting
- C. Decreased urinary retention
- D. Less burning with urination
Correct Answer: A
Rationale: Dicyclomine, an anticholinergic, reduces intestinal spasms, so decreased abdominal cramping indicates a therapeutic response. It is not primarily for nausea, urinary retention, or dysuria.
The nurse has educated a client scheduled to have an endoscopic retrograde cholangiopancreatography (ERCP). Which of the following client statements would indicate the need for additional teaching by the nurse? Select all that apply.
- A. I will not be able to eat or drink anything for six to eight hours before this procedure.
- B. I will have to do a bowel prep before this procedure.
- C. Someone will have to drive me home after this procedure.
- D. I should notify my physician if I have abdominal pain and distention for one or two days following this procedure.
- E. I can expect to have white stools one to two days following this procedure.
Correct Answer: B,D,E
Rationale: Bowel prep (B) is not typically required for ERCP. Persistent pain and distention (D) post-ERCP require immediate notification, not delayed. White stools (E) are not expected post-ERCP. Fasting (A) and needing a driver (C) are correct.
The nurse is caring for a client who is receiving prescribed metoclopramide for gastroparesis. Which of the following findings require immediate notification to the primary healthcare provider (PHCP)?
- A. Muscle rigidity of the neck
- B. Hyperactive bowel sounds
- C. Frequent diarrhea
- D. Abdominal distention
Correct Answer: A
Rationale: Muscle rigidity of the neck (dystonia) is a serious extrapyramidal side effect of metoclopramide, requiring immediate PHCP notification. Hyperactive bowel sounds, diarrhea, and distention are less urgent or expected with gastroparesis.
The following scenario applies to the next 1 items
The nurse is caring for an older adult in the medical-surgical unit
Item 1 of 1
Health History
84-year-old female was admitted to the medical-surgical unit with a three-day history of abdominal pain, distention, nausea, and persistent vomiting. She reports that she has not had a bowel movement in five days and has no appetite.
Vital Signs
Oral temperature 101.1° F (38.3° C)
Pulse 108/minute
Respirations 22/minute
Blood pressure 100/64 mm Hg
Oxygen saturation 96% on room air.
The nurse reviews the client's health history and vital signs. Click to specify if the findings are consistent with a small bowel obstruction or appendicitis. Each row must have at least one but may have more than one response option selected.
- A. Unable to pass stool
- B. Fever
- C. Distended abdomen
- D. Right lower quadrant abdominal pain
- E. Nausea and vomiting
Correct Answer: A,B,C,E;A,B,C,D,E
Rationale: Small bowel obstruction: A (Unable to pass stool), B (Fever), C (Distended abdomen), E (Nausea and vomiting). Appendicitis: A, B, C, D (Right lower quadrant abdominal pain), E. Both conditions can present with these symptoms, though right lower quadrant pain is more specific to appendicitis.