Med Surge "GI" Exam Study Guide Questions with Correct Answers Top Graded
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Module
Med Surge \\\"GI\\\"
Institution
Med Surge \\\"GI\\\"
1. Which information about an 80-year-old man at the senior center is of most concern to the nurse?
a.
Decreased appetite
b.
Unintended weight loss
c.
Difficulty chewing food
d.
Complaints of indigestion -Correct Answer ANS: B
Unintentional weight loss is not a normal finding and may ind...
Med Surge "GI" Exam Study Guide
Questions with Correct Answers Top
Graded 2024-2025
1. Which information about an 80-year-old man at the senior center is of most concern
to the nurse?
a.
Decreased appetite
b.
Unintended weight loss
c.
Difficulty chewing food
d.
Complaints of indigestion -Correct Answer ✔ANS: B
Unintentional weight loss is not a normal finding and may indicate a problem such as
cancer or depression. Poor appetite, difficulty in chewing, and complaints of indigestion
are common in older patients. These will need to be addressed but are not of as much
concern as the weight loss.
2. A 62- year-old man reports chronic constipation. To promote bowel evacuation, the
nurse will suggest that the patient attempt defecation
a. in the mid-afternoon.
b. after eating breakfast.
c. right after getting up in the morning.
d. immediately before the first daily meal. -Correct Answer ✔ANS: B
The gastrocolic reflex is most active after the first daily meal. Arising in the morning, the
anticipation of eating, and physical exercise do not stimulate these reflexes.
3. When caring for a patient with a history of a total gastrectomy, the nurse will monitor
for
a.
constipation.
b.
dehydration.
c.
elevated total serum cholesterol.
d.
cobalamin (vitamin B12) deficiency. -Correct Answer ✔ANS: D
The patient with a total gastrectomy does not secrete intrinsic factor, which is needed
for cobalamin (vitamin B12) absorption. Because the stomach absorbs only small
amounts of water and nutrients, the patient is not at higher risk for dehydration, elevated
cholesterol, or constipation.
Med Surge "GI"
,Med Surge "GI"
4. The nurse will plan to monitor a patient with an obstructed common bile duct for
a.
melena.
b.
steatorrhea.
c.
decreased serum cholesterol levels.
d.
increased serum indirect bilirubin levels. -Correct Answer ✔ANS: B
A common bile duct obstruction will reduce the absorption of fat in the small intestine,
leading to fatty stools. Gastrointestinal (GI) bleeding is not caused by common bile duct
obstruction. Serum cholesterol levels are increased with biliary obstruction. Direct
bilirubin level is increased with biliary obstruction.
5. The nurse receives the following information about a 51-year-old woman who is
scheduled for a colonoscopy. Which information should be communicated to the health
care provider before sending the patient for the procedure?
a. The patient has a permanent pacemaker to prevent bradycardia.
b. The patient is worried about discomfort during the examination.
c. The patient has had an allergic reaction to shellfish and iodine in the past.
d. The patient refused to drink the ordered polyethylene glycol (GoLYTELY). -Correct
Answer ✔ANS: D
If the patient has had inadequate bowel preparation, the colon cannot be visualized and
the procedure should be rescheduled. Because contrast solution is not used during
colonoscopy, the iodine allergy is not pertinent. A pacemaker is a contraindication to
magnetic resonance imaging (MRI), but not to colonoscopy. The nurse should instruct
the patient about the sedation used during the examination to decrease the patient's
anxiety about discomfort.
6. Which statement to the nurse from a patient with jaundice indicates a need for
teaching?
a. I used cough syrup several times a day last week.
b. I take a baby aspirin every day to prevent strokes.
c. I use acetaminophen (Tylenol) every 4 hours for back pain.
d. I need to take an antacid for indigestion several times a week -Correct Answer
✔ANS: C
Chronic use of high doses of acetaminophen can be hepatotoxic and may have caused
the patient's jaundice. The other patient statements require further assessment by the
nurse, but do not indicate a need for patient education.
7. To palpate the liver during a head-to-toe physical assessment, the nurse
a. places one hand on the patients back and presses upward and inward with the other
hand below the patients right costal margin.
Med Surge "GI"
,Med Surge "GI"
b. places one hand on top of the other and uses the upper fingers to apply pressure and
the bottom fingers to feel for the liver edge.
c. presses slowly and firmly over the right costal margin with one hand and withdraws
the fingers quickly after the liver edge is felt.
d. places one hand under the patients lower ribs and presses the left lower rib cage
forward, palpating below the costal margin with the other hand. -Correct Answer ✔ANS:
A
The liver is normally not palpable below the costal margin. The nurse needs to push
inward below the right costal margin while lifting the patient's back slightly with the left
hand. The other methods will not allow palpation of the liver.
8. Which finding by the nurse during abdominal auscultation indicates a need for a
focused abdominal assessment?
a. Loud gurgles
b. High-pitched gurgles
c. Absent bowel sounds
d. Frequent clicking sounds -Correct Answer ✔ANS: C
Absent bowel sounds are abnormal and require further assessment by the nurse. The
other sounds may be heard normally.
9. After assisting with a needle biopsy of the liver at a patient's bedside, the nurse
should
a.
put pressure on the biopsy site using a sandbag.
b.
elevate the head of the bed to facilitate breathing.
c.
place the patient on the right side with the bed flat.
d.
check the patient's postbiopsy coagulation studies. -Correct Answer ✔ANS: C
After a biopsy, the patient lies on the right side with the bed flat to splint the biopsy site.
Coagulation studies are checked before the biopsy. A sandbag does not exert adequate
pressure to splint the site.
10. A 42-year-old woman is admitted to the outpatient testing area for an ultrasound of
the gallbladder. Which information obtained by the nurse indicates that the ultrasound
may need to be rescheduled?
a.
The patient took a laxative the previous evening.
b.
The patient had a high-fat meal the previous evening.
c.
The patient has a permanent gastrostomy tube in place.
d.
The patient ate a low-fat bagel 4 hours ago for breakfast. -Correct Answer ✔ANS: D
Med Surge "GI"
, Med Surge "GI"
Food intake can cause the gallbladder to contract and result in a suboptimal study. The
patient should be NPO for 8 to 12 hours before the test. A high-fat meal the previous
evening, laxative use, or a gastrostomy tube will not affect the results of the study.
11. The nurse is assessing an alert and independent 78-year-old woman for malnutrition
risk. The most appropriate initial question is which of the following?
a. How do you get to the store to buy your food?
b. Can you tell me the food that you ate yesterday?
c. Do you have any difficulty in preparing or eating food?
d. Are you taking any medications that alter your taste for food? -Correct Answer ✔ANS:
B
This question is the most open-ended, and will provide the best overall information
about the patient's daily intake and risk for poor nutrition. The other questions may be
asked, depending on the patient's response to the first question.
12. A 54-year-old man has just arrived in the recovery area after an upper endoscopy.
Which information collected by the nurse is most important to communicate to the
health care provider?
a. The patient is very drowsy.
b. The patient reports a sore throat.
c. The oral temperature is 101.6 F.
d. The apical pulse is 104 beats/minute. -Correct Answer ✔ANS: C
A temperature elevation may indicate that a perforation has occurred. The other
assessment data are normal immediately after the procedure.
OBJ: Special Questions: Prioritization TOP: Nursing Process: Assessment
13. A 30-year-old man is being admitted to the hospital for elective knee surgery. Which
assessment finding is most important to report to the health care provider?
a. Tympany on percussion of the abdomen
b. Liver edge 3 cm below the costal margin
c. Bowel sounds of 20/minute in each quadrant
d. Aortic pulsations visible in the epigastric area -Correct Answer ✔ANS: B
Normally the lower border of the liver is not palpable below the ribs, so this finding
suggests hepatomegaly. The other findings are within normal range for the physical
assessment.
14. A 58-year-old woman has just returned to the nursing unit after an
esophagogastroduodenoscopy (EGD). Which action by unlicensed assistive personnel
(UAP) requires that the registered nurse (RN) intervene?
a. Offering the patient a drink of water
b. Positioning the patient on the right side
c. Checking the vital signs every 30 minutes
Med Surge "GI"
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