GI Disorder exam

Aria Jones, a 37-year-old travel blogger, comes to the local clinic after experiencing bouts of vomiting and diarrhea. She recalls eating street food during her recent travels. Suspecting food poisoning, the nurse knows that certain preventive measures could have minimized Aria's risk.
Which of the following nursing interventions could best prevent food poisoning? Select all that apply

Jane Davis, a 35-year-old office worker, is diagnosed with irritable bowel syndrome (IBS). She visits the clinic complaining of frequent bloating, abdominal discomfort, and alternating diarrhea and constipation. Her healthcare provider recommends dietary modifications as part of her management plan. Jane expresses concern about what foods she should avoid to manage her symptoms effectively.

Which of the following dietary recommendations should the nurse include when teaching Jane about managing irritable bowel syndrome (IBS)? Select all that apply

Mrs. Eleanor Rigby is a 68-year-old retired librarian. Acute Care Medical Unit of Springfield General Hospital.
An RN is supervising an LPN/LVN assigned to manage her enteral feeding.
Given the details of the case, which question will the RN most likely ask the LPN/LVN about Mrs. Rigby's enteral feeding with a small-bore feeding tube?

Samantha Lee, a 38-year-old graphic designer, has just completed a colonoscopy. The nurse prepares to give her post-procedure care and instructions.

Which of the following nursing considerations are essential after Samantha's endoscopy?

Raj Patel, a 60-year-old librarian, has been struggling with chronic constipation for several months. Despite dietary changes, increased fluid intake, and the use of over-the-counter laxatives, his symptoms persist. His healthcare provider has recommended an enema to provide immediate relief from his discomfort. Raj is feeling anxious about the procedure as this is his first time receiving an enema.

As the nurse responsible for administering the enema, it is essential to take several factors into account to ensure the procedure is both safe and effective. You are also responsible for educating Raj about the process to alleviate his concerns and ensure a smooth experience.

Which of the following nursing considerations are most important during the administration of an enema for Mr. Patel? Select all that apply

Name: Clara Thompson
Age: 72
Setting: Acute care unit in Central City Hospital
Initial assessment indicates she has been severely malnourished for an extended period. The team decided to start her on nutritional support, but they are wary of potential refeeding syndrome.

As a nurse responsible for Ms. Thompson's care, what is your priority assessment to prevent the complications associated with refeeding syndrome?

William Jacobs, a 60-year-old man, is brought to the ER after vomiting bright red blood. He has a history of chronic alcohol use and previously had peptic ulcers.
He also reports passing black, tarry stools for the past few days.
What is/are the priority intervention(s) for William? Select all that apply

Lisa Wilson, a 58-year-old woman, presents to the clinic with complaints of persistent itching, fatigue, and jaundice. She has a history of autoimmune disorders. Physical examination reveals hepatomegaly and excoriations from scratching.
Labs show elevated alkaline phosphatase, ALT, and bilirubin.
Ultrasound of the liver shows evidence of cirrhosis, and her physician suspects primary biliary cirrhosis.

Which of the following nursing interventions is most appropriate for Lisa’s condition? Select all that apply

Laura Mitchell, a 48-year-old construction worker, visits the outpatient surgical clinic. She complains of a bulging lump in her groin area that disappears when she lies down. She reports occasional pain in the area, especially after lifting heavy materials at work. The nurse begins to assess potential risk factors for hernias.

Which of the following are recognized risk factors in hernias?

Jennifer Lopez, a 52-year-old schoolteacher, arrives at the clinic to have a Fecal Occult Blood Test (FOBT) done as part of her annual health check-up. She asks the nurse about any specific dietary precautions she needs to follow before the test.

Which of the following foods and medications should Jennifer avoid before undergoing FOBT?

George Turner, a 67-year-old retired accountant, presents with complaints of significant weight loss, jaundice, and upper abdominal pain radiating to the back. He has a history of chronic pancreatitis and diabetes.
A CT scan reveals a mass in the head of the pancreas, and the physician suspects adenocarcinoma.

What three nursing actions should be prioritized for George?

Mr. James Walker, a 67-year-old retired mechanic, has been admitted to the acute medical unit with a diagnosis of cirrhosis. He presents with confusion, asterixis (flapping tremor of the hands), and elevated ammonia levels, indicating hepatic encephalopathy.
 His medical history includes chronic alcohol use and a previous diagnosis of liver disease.

As the nurse caring for Mr. Walker, which of the following interventions would be most appropriate to manage his hepatic encephalopathy and cirrhosis?

Eva Ortiz, a 56-year-old journalist, seeks care for discomfort and pain associated with hemorrhoids. Upon examination, external hemorrhoids are evident. As Eva's primary nurse, it is crucial to offer guidance and manage her care effectively.
Which of the following two nursing considerations is most appropriate for Eva's care?

Samantha Brooks, a 45-year-old woman, has experienced a significant, unexplained weight loss of 15 pounds in two months. She complains of fatigue, changes in bowel habits, and occasional blood in her stool.
Samantha denies any intentional dieting or changes to her eating habits.

Vital Signs:
BP: 110/65 mmHg, HR: 74 bpm, RR: 18 breaths/min, Temp: 36.8°C (98.2°F)

Which nursing interventions are appropriate for investigating the cause of Samantha’s weight loss? Select all that apply

Sophie Evans, a 30-year-old elementary school teacher, visits her primary care provider's office. She reports persistent diarrhea, and stools that have a characteristic foul explained weight loss and fatigue over the past few months. She also mentions a family history of autoimmune disorders. She asks the nurse to provide guidance on the most appropriate interventions.

Complete the diagram below by dragging from the choice below what condition the client is most likely experiencing, 2 actions the nurse would take to address that condition, and 2 parameters to monitor pertinent to her condition.

A 58-year-old male patient recently underwent a total colectomy due to colon cancer and now has a newly placed ileostomy. He is worried about leakage and skin irritation and asks the nurse about the proper initial care of his ostomy.
Which of the following is a recommended practice for the initial care of a new ostomy?

Michael O'Leary, a 65-year-old retired engineer, has been admitted to the hospital with a diagnosis of ascites secondary to liver cirrhosis. Due to the discomfort and difficulty in breathing caused by the ascites, the physician has decided to perform a paracentesis. As the nurse in charge, you are required to ensure Michael is in the correct position for the procedure.
Which of the following positions is the most appropriate for a paracentesis?

John Thompson, a 52-year-old accountant with a sedentary lifestyle, visits a gastroenterology clinic for a routine check-up. He mentions that both his parents were diagnosed with colorectal cancer in their late 60s. The nurse is considering which screening modalities to recommend for John, given his family history.
Which of the following are recommended screening modalities for colorectal cancer in a patient with a family history like John's? Select all that apply

John Smith, a 52-year-old male, underwent gastric bypass surgery three weeks ago and reports symptoms of nausea, dizziness, and abdominal cramping about 30 minutes after eating meals. 
John is concerned that he isn’t absorbing enough nutrients and asks for advice.

Vital Signs:
BP: 115/70 mmHg, HR: 96 bpm, RR: 16 breaths/min, Temp: 36.9°C (98.4°F)

Which dietary precautions should the nurse recommend to help John manage dumping syndrome?

A 62-year-old male with a descending colostomy is interested in irrigation to regulate his bowel movements and potentially not wearing a pouch continually. He seeks guidance on the process.

Which of the following is an essential step in the irrigation care of a descending colostomy?

Patient: Mr. Sanjay Kumar, a 52-year-old bank manager.
Setting: Intensive Care Unit, St. Michael's Hospital.
Clinical Background: Mr. Kumar was admitted with severe abdominal pain and was diagnosed with acute pancreatitis.

Question: As a nurse monitoring Mr. Kumar's condition, which potential complication of acute pancreatitis should you be particularly alert for?

Paul Turner, a 65-year-old man with a history of alcoholic cirrhosis, is admitted to the hospital with increasing jaundice, fatigue, and abdominal distension. His platelet count is 80,000/mm³, and his INR is 2.0, indicating an increased risk of bleeding.

What nursing interventions are necessary to prevent further bleeding and observe for bleeding tendencies in Paul? Select all that apply

Complete the following sentences by choosing the most likely options for the missing information from the lists of options provided.

Patient: Michael Carter, 45-year-old male

Setting: Urgent Care Clinic

Chief Complaint: Severe abdominal pain (Possible acute pancreatitis)

History of Present Illness:

Michael presented to the clinic with a 48-hour history of sudden onset, sharp, and persistent pain in the upper abdomen.

The pain seems to and is aggravated by eating, especially after consuming

He notes that the pain is somewhat relieved when he or

Over the last 24 hours, Michael has also experienced nausea and has vomited twice.

Past Medical History:

Michael admits to on weekends.

He also mentions a history of biliary disease about two years ago but hasn't faced any complications from them since.

Physical Examination:

Upon physical examination, Michael's abdomen is tender to the touch in the .

He has a and shows signs of dehydration. His skin and sclera of his eyes have a faint yellowish tinge, suggesting jaundice.

Labs:

Preliminary blood tests reveal a and lipase. Liver enzymes are slightly raised, and there's a moderate elevation in bilirubin levels.

Clinical Impression:

Given the history, clinical presentation, and laboratory findings, Michael is suspected to have acute pancreatitis, likely due to a combination of .

Immediate hospitalization for supportive care and further diagnostic evaluation is recommended.

Jennifer Carter, a 35-year-old woman, presents with right upper quadrant pain that radiates to the shoulder, especially after eating fatty meals. She reports nausea and bloating. The physician diagnoses her with cholelithiasis.

Vital Signs:
BP: 118/75 mmHg, HR: 80 bpm, RR: 16 breaths/min, Temp: 37.1°C (98.8°F)

What are the common food intolerances for clients with cholelithiasis? Select all that apply

Clara Thompson, a 50-year-old accountant, recently underwent a gastric bypass surgery to help manage her morbid obesity. During a post-operative consultation, she expressed concern about post-operative dietary changes to prevent complications like dumping syndrome. The nurse needs to provide guidance on this.
Which of the following two dietary recommendations is most appropriate to avoid dumping syndrome?

A 45-year-old female with a colostomy returns to the clinic expressing concerns about odor and gas.
She is interested in learning about pouching systems for her ostomy.
Which of the following is crucial when choosing a pouching system for a colostomy?

Samuel Green, a 50-year-old accountant, visits his primary care physician with a complaint of a noticeable bulge in his groin area. It becomes more prominent when he coughs and reduces when he lies down.
Given the clinical signs, the nurse recognizes it could be a hernia.

Which of the following types of hernias is Samuel most likely experiencing?

Alex Thompson is an experienced charge nurse in the medical-surgical unit.
Setting: Medical-Surgical Unit, Coastal Medical Center.
Clinical Background: On a busy morning shift, Nurse Thompson has to prioritize care for 7 patients with different digestive system diseases.

Given the following patients and their immediate presenting symptoms, which patient should Nurse Thompson prioritize first?

Gregory White, an 83-year-old man residing in an assisted living facility, has a history of chronic constipation. Over the last week, his caregivers have noticed that he has not had a bowel movement, seems more uncomfortable, and has a distended abdomen.
The nurse recognizes the need for interventions to prevent fecal impaction.

Which of the following interventions are recommended for preventing fecal impaction in elderly patients like Gregory? Select all that apply

Maria Gonzalez, a 52-year-old businesswoman, presents to the emergency department with complaints of progressive abdominal distention, yellowing of the skin (jaundice), and a feeling of malaise. 
Given Maria's presentation and history, which of the following nursing actions would be most appropriate for her care?