Question

A client is admitted to the nursing unit with complaints of upper abdominal pain across the entire mid-section. Client reports no bowel movement for 5 days. Temperature 99.4 F with complaints of nausea and vomiting and dark emesis. Which client condition is consistent with these assessments?

Answer 1

Correct Answers:

Small bowel obstruction.

Rationale :

♦️Small bowel obstruction (SBO) presents with cramping upper or mid-abdominal pain, vomiting (which may be dark or feculent), and absence of bowel movement or flatus.

♦️The client’s nausea, vomiting, and dark emesis occur because intestinal contents cannot pass, leading to backflow of bile and partially digested food.

♦️No bowel movement for several days indicates impaired passage of stool due to obstruction proximal to the large intestine.

♦️Bowel sounds are often high-pitched initially and may diminish as obstruction worsens.

♦️The clinical picture rules out appendicitis (localized RLQ pain) and peptic ulcer (epigastric pain only).

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Answer 2

Correct Answers:

Exercise, increased fluid intake and high fiber diet.

Rationale :

🥦A prevention plan should emphasize non-pharmacologic measures that normalize stool form and transit: regular exercise, adequate fluids, and a high-fiber diet.

🥦Fiber (e.g., fruits, vegetables, whole grains) increases stool bulk and retains water, promoting softer, easier-to-pass stools and stimulating peristalsis.

🥦Hydration prevents excessive colonic water reabsorption, avoiding dry, hard stools that are difficult to pass.

🥦Physical activity enhances gut motility, reducing colonic transit time and lowering the risk of fecal impaction.

🥦Establishing routine toileting, responding promptly to the urge to defecate, and limiting constipating foods (e.g., excessive cheese) further support bowel regularity.

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Answer 3

Correct Answers:

The stoma is dry and intact and light brown in color.

Rationale :

🩺A healthy, viable stoma should be moist, shiny, and pink-to-red, indicating adequate perfusion; a dry, light brown/dusky stoma suggests ischemia.

🩺Tissue hypoperfusion can rapidly progress to necrosis, placing the client at risk for infection, dehiscence, and systemic complications.

🩺Early recognition and emergent notification of the surgeon are essential to restore blood flow and preserve stoma viability.

🩺Ongoing monitoring should include color, moisture, turgor, bleeding, and output to trend perfusion status.

🩺Prompt intervention aligns with postoperative stoma standards, protecting patient safety and surgical outcomes.

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Answer 4

Correct Answers:

Flush the NG tube with 30 mL water immediately after giving the medications.

Rationale :

💧A post-medication flush (≈30 mL water) is essential to clear the tube, prevent clogging, and ensure the entire dose reaches the stomach.

💧Medications should be administered separately with pre- and inter-dose flushes to minimize drug–drug interactions and residue in the lumen.

💧Using (sterile) water—particularly in high-risk patients—reduces contamination and supports safety.

💧Maintaining tube patency preserves accuracy of both medication delivery and nutritional therapy.

💧Elevating the head of bed and pausing feeds per protocol are common adjuncts; however, the post-dose flush is the critical action that ensures dose delivery and patency.

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Answer 5

Correct Answers:

Aspirate stomach contents and confirm that the stomach contents is above ph of 5.

Rationale :

🧪Before administering medications via a PEG, verify gastric placement by aspirating and checking pH (gastric typically ≤ 5) to reduce aspiration risk.

🧪Confirming acidic pH validates that the distal end is in the stomach, not dislodged into the esophagus or respiratory tract.

🧪Giving meds without placement verification can lead to pneumonitis, ineffective therapy, and patient harm.

🧪Placement checks are a first-priority safety step before any fluid, feed, or medication via enteral access.

🧪Combine with HOB elevation and appropriate flushing for comprehensive safe enteral medication administration.

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Answer 6

Correct Answers:

Check to see if the suction equipment is working.

Rationale :

🛠When a patient with abdominal distention and an NG tube to suction reports bloating, nausea, and discomfort, the priority is to confirm system function (source of decompression).

🛠A malfunctioning system (e.g., disconnected tubing, occlusion, loss of suction) prevents gastric decompression, allowing gastric/intestinal accumulation and worsened symptoms.

🛠Restoring suction often provides rapid symptom relief, reduces vomiting/aspiration risk, and decreases intraluminal pressure.

🛠Assessment-first aligns with airway/breathing/circulation and Maslow/urgent physiologic needs, correcting the cause rather than masking symptoms.

🛠Verification includes canister, tubing patency, wall unit settings, and NG placement; if issues persist, escalate per protocol.

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Answer 7

Correct Answers:

Omeprazole.

Rationale :

💊Omeprazole is a proton pump inhibitor (PPI) that inhibits gastric acid secretion by blocking the H⁺/K⁺-ATPase enzyme in the stomach’s parietal cells.

💊It effectively relieves dyspepsia (indigestion), heartburn, and esophageal irritation associated with gastroesophageal reflux disease (GERD).

💊PPIs promote healing of erosive esophagitis and reduce acid-related mucosal injury, making them the first-line treatment for GERD.

💊They also prevent reflux complications like strictures or Barrett’s esophagus by lowering chronic acid exposure.

💊The nurse should monitor for long-term risks such as hypomagnesemia and vitamin B12 deficiency in extended use.

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Answer 8

Correct Answers:

Do not crush.

Rationale :

📘Pantoprazole, like other PPIs, is enteric-coated to prevent gastric acid destruction before reaching the duodenum, where absorption occurs.

📘Crushing or chewing the tablet breaks the coating, inactivating the drug and reducing its therapeutic effect.

📘Patients should swallow the tablet whole with water, before meals, ideally in the morning for best acid control.

📘Teaching emphasizes adherence to daily timing for consistent acid suppression.

📘The nurse reinforces avoiding antacids or other acid-suppressants simultaneously unless prescribed, to prevent interference.

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Answer 9

Correct Answers:

"I will lie down for 30 minutes after meals."

Rationale :

🥗Lying down soon after meals increases intra-abdominal pressure, causing reflux of gastric acid into the esophagus, which worsens GERD and hiatal hernia symptoms.

🥗The client should be taught to remain upright for 2–3 hours after eating to aid digestion and prevent reflux.

🥗Recommended strategies include small, frequent meals, avoiding late-night snacks, and limiting triggers like caffeine, chocolate, spicy or fatty foods.

🥗Sleeping with the head of bed elevated 6–8 inches reduces nighttime reflux episodes.

🥗Weight reduction also alleviates pressure on the lower esophageal sphincter (LES), minimizing acid backflow.

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Answer 10

Correct Answers:

Endoscopy.

Rationale :

🔬Upper gastrointestinal endoscopy (esophagogastroduodenoscopy or EGD) is the definitive diagnostic tool for peptic ulcer disease (PUD).

🔬It allows direct visualization of gastric and duodenal mucosa to identify ulcers, bleeding, or H. pylori–related inflammation.

🔬During the procedure, biopsies can be taken for Helicobacter pylori testing and to rule out malignancy.

🔬Endoscopy provides precise information on ulcer size, location, and healing progress after therapy.

🔬Non-invasive tests (e.g., stool antigen, urea breath test) assist in diagnosis, but endoscopy confirms pathology and guides treatment.

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EXAM #4 UPPER AND LOWER GI FALL 25 CLARK STATE COMMUNITY COLLEGE

No.

1 :
A client is admitted to the nursing unit with complaints of upper abdominal pain across the entire mid-section. Client reports no bowel movement for 5 days. Temperature 99.4 F with complaints of nausea and vomiting and dark emesis. Which client condition is consistent with these assessments?

2 :
What information is important to teach a client concerning how they can prevent constipation?

3 :
A client returns from surgery with a colostomy. When assessing the stoma of the new colostomy, which sign and symptom indicates further intervention is needed?

4 :
A nurse is preparing to administer three liquid medications to a client who has an NG feeding tube with continuous enteral feedings. Which of the following actions should the nurse take?

5 :
The nurse is caring for a client who has a percutaneous endoscopic gastrostomy (PEG) tube. Which of the following is an appropriate nursing action prior to administering the client's medication?

6 :
A client with abdominal distention has an NG tube hooked to low gastric suction. The client is reporting anxiety, nausea, discomfort and a feeling of bloating. Which of the following is the nurse's priority action?

7 :
A client with gastroesophageal reflux disease is complaining of dyspepsia. What medication would the nurse expect to find ordered for this client?

8 :
A client with dyspepsia, is taking a proton pump inhibitor, pantoprazole. What teaching instruction should the nurse include in the discharge teaching?

9 :
A client has Gastroesophageal Reflux disease or Hiatal Hernia. You are teaching the client about some dietary recommendations. Which client statement indicates that the client has additional needs for teaching?

10 :
A client comes to the floor with a new diagnosis of peptic ulcer disease. Which test does the nurse anticipate the healthcare provider to order to confirm this diagnosis?

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EXAM #4 UPPER AND LOWER GI FALL 25 CLARK STATE COMMUNITY COLLEGE

No.

1 : A client is admitted to the nursing unit with complaints of upper abdominal pain across the entire mid-section. Client reports no bowel movement for 5 days. Temperature 99.4 F with complaints of nausea and vomiting and dark emesis. Which client condition is consistent with these assessments?

2 : What information is important to teach a client concerning how they can prevent constipation?

3 : A client returns from surgery with a colostomy. When assessing the stoma of the new colostomy, which sign and symptom indicates further intervention is needed?

4 : A nurse is preparing to administer three liquid medications to a client who has an NG feeding tube with continuous enteral feedings. Which of the following actions should the nurse take?

5 : The nurse is caring for a client who has a percutaneous endoscopic gastrostomy (PEG) tube. Which of the following is an appropriate nursing action prior to administering the client's medication?

6 : A client with abdominal distention has an NG tube hooked to low gastric suction. The client is reporting anxiety, nausea, discomfort and a feeling of bloating. Which of the following is the nurse's priority action?

7 : A client with gastroesophageal reflux disease is complaining of dyspepsia. What medication would the nurse expect to find ordered for this client?

8 : A client with dyspepsia, is taking a proton pump inhibitor, pantoprazole. What teaching instruction should the nurse include in the discharge teaching?

9 : A client has Gastroesophageal Reflux disease or Hiatal Hernia. You are teaching the client about some dietary recommendations. Which client statement indicates that the client has additional needs for teaching?

10 : A client comes to the floor with a new diagnosis of peptic ulcer disease. Which test does the nurse anticipate the healthcare provider to order to confirm this diagnosis?

1 :
A client is admitted to the nursing unit with complaints of upper abdominal pain across the entire mid-section. Client reports no bowel movement for 5 days. Temperature 99.4 F with complaints of nausea and vomiting and dark emesis. Which client condition is consistent with these assessments?

2 :
What information is important to teach a client concerning how they can prevent constipation?

3 :
A client returns from surgery with a colostomy. When assessing the stoma of the new colostomy, which sign and symptom indicates further intervention is needed?

4 :
A nurse is preparing to administer three liquid medications to a client who has an NG feeding tube with continuous enteral feedings. Which of the following actions should the nurse take?

5 :
The nurse is caring for a client who has a percutaneous endoscopic gastrostomy (PEG) tube. Which of the following is an appropriate nursing action prior to administering the client's medication?

6 :
A client with abdominal distention has an NG tube hooked to low gastric suction. The client is reporting anxiety, nausea, discomfort and a feeling of bloating. Which of the following is the nurse's priority action?

7 :
A client with gastroesophageal reflux disease is complaining of dyspepsia. What medication would the nurse expect to find ordered for this client?

8 :
A client with dyspepsia, is taking a proton pump inhibitor, pantoprazole. What teaching instruction should the nurse include in the discharge teaching?

9 :
A client has Gastroesophageal Reflux disease or Hiatal Hernia. You are teaching the client about some dietary recommendations. Which client statement indicates that the client has additional needs for teaching?

10 :
A client comes to the floor with a new diagnosis of peptic ulcer disease. Which test does the nurse anticipate the healthcare provider to order to confirm this diagnosis?