Evaluative Exam Gastrointestinal System

EVALUATIVE EXAM - GASTROINTESTINAL SYSTEM 6/16/23, 6:22 PM
EVALUATIVE EXAM
- GASTROINTESTINAL SYSTEM
Total points 17/30
Prepared by: Prof. Mike Chavez RN, USRN
Email *
prettythalia2000@gmail.com
Email *
prettythalia2000@gmail.com
Name (Surname, First Name, M.I) *
GLORI, THALIA RHODA L.
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School (Complete Name of School) *
ST. SCHOLASTICA'S COLLEGE TACLOBAN
Section *
Option 2
MANILA 1
MANILA 2
MANILA 3
MANILA 4
MANILA 5
MANILA 6
MANILA 7
MANILA 8
MANILA 9
MANILA 10
MANILA 11
MANILA 12
MANILA 13
MANILA 14
QUEZON CITY 1
QUEZON CITY 2
MARIKINA 1
MARIKINA 2
CALOOCAN
CAVITE
BATANGAS
LUCENA
BULACAN 1
BULACAN 2
BAGUIO 1
BAGUIO 2
BAGUIO 3
BAGUIO 4
BAGUIO 5
BAGUIO 6
BAGUIO 7
BAGUIO 8
CABANATUAN 1
CABANATUAN 1
NUEVA VIZCAYA
LAOAG
DAGUPAN
PAMPANGA
BATAAN
LEGAZPI 1
LEGAZPI 2
NAGA 1
NAGA 2
ZAMBOANGA 1
ZAMBOANGA 2
CEBU 1
CEBU 2
CDO 1
CDO 2
ILOILO 1
ILOILO 2
DAVAO 1
DAVAO 2
DAVAO 3
DAVAO 4
PURE ONLINE 1
PURE PNLINE 2
WEEKEND CLASS 1
WEEKEND CLASS 2
WEEKEND CLASS 3
EVENING CLASS 1
EVENING CLASS 2
CRASH COURSE
FAST TRACK
1. The nurse reports the observation that would indicate blocked flow of *1/1
bile from the liver to the intestine, which is:
A. clay-colored stools
B. jaundice
C. high blood pressure
D. tachycardia
2. The nurse explains that pruritus in the patient with hepatitis is related *0/1
to:
A. Decreased fat intake
B. Accumulation of bile salts under the skin
C. Poor appetite and therefore poor protein intake
D. Altered urinary output of bile
Correct answer
C. Poor appetite and therefore poor protein intake
3. When the client’s common bile duct is obstructed, the nurse should *1/1
evaluate the client for signs and symptoms of which of the following
complications?
A. Respiratory distress
B. Circulatory overload
C. Urinary tract infection
D. Prolonged bleeding time
4. When preparing the discharge teaching plan of a client following an *0/1

acute episode of hepatic encephalopathy, which topic should the nurse
include?
A. Fluid restriction
B. Low-fat diet
C. Reduced protein Intake
D. Use of polystyrene resin (Kayexalate)
Correct answer
C. Reduced protein Intake
5. Lactulose (Chronulac) has been prescribed for a client with advanced *1/1
liver disease. Which of the following assessments would the nurse use to
evaluate the effectiveness of this treatment?
A. An increase in appetite
B. A decrease in fluid retention
C. A decrease in lethargy
D. A reduction in jaundice
6. Lactulose (Cephulac) is ordered for the client with cirrhosis. Which of *1/1
the following serum laboratory tests should the nurse monitor to
determine if the drug is having the desired effect?
A. Albumin
B. Ammonia
C. Sodium
D. Lactate
7. A high ammonia level contributes to hepatic encephalopathy. As this *1/1

level increases, the nursing implementation that needs to be added to the
nursing care plan is:
A. mouth care
B. eizure precautions
C. oxygen saturation monitoring
D. intake and output
8. A nurse, planning dietary and fluid management for a client with *0/1
alcohol-induced cirrhosis and elevated serum ammonia levels,
recognizes that which of the following is the most appropriate to include
in the plan?
A. Sodium restriction of 2.5g /day
B. Restrict foods high in magnesium
C. Fluid restriction of 1000 mL/day
D. Protein restriction of 75 to 100 grams per day
Correct answer
D. Protein restriction of 75 to 100 grams per day
9. The client who is developing hepatic encephalopathy may exhibit *1/1

which of the following symptoms?
A. Asterixis
B. Good concentration
C. Increased energy
D. Talkativeness
10. What diet should be implemented for a client who has liver cirrhosis *0/1
with encepalopathy?
A. Initiate a protein restricted diet
B. High fat, High protein
C. Small frequent meals, low protein
D. Low-carbohydrate, low-sodium.
Correct answer
C. Small frequent meals, low protein
11. A client with cirrhosis is admitted to the hospital. Which of the *1/1
following assessment made by the nurse would indicate the development
of portal hypertension?
A. Hematemesis
B. Asterixis
C. Elevated blood pressure
D. Confusion
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12. The instruction that should be given to the patient with portal *1/1
hypertension to reduce the threat of hemorrhage is to:
A. eat bland foods
B. increase fluid intake
C. avoid straining to have a bowel movement
D. use an electric razor to shave
13. The instruction that should be given to the patient with portal *1/1
hypertension to reduce the threat of hemorrhage is to:
A. Eat bland foods
B. Increase fluid intake
C. Avoid straining to have a bowel movement
D. Use an electric razor to shave
14. A client with a long history of alcohol-induced cirrhosis is brought to *1/1

the emergency room via ambulance, after the client's wife called 911 to
report her husband was vomiting up large amounts of blood. The client is
diagnosed with bleeding esophageal varicies. The emergency room
physician plans to insert a Sengstaken-Blakemore nasogastric tube for
balloon tamponade. The emergency room nurse should anticipate and
prepare for which of the following before the insertion of the nasogastric
tube?
A. Upper endoscopy
B. Gastric lavage
C. Endotracheal intubation
D. Variceal ligation
15. When a client who has a liver disorder is having an invasive *1/1
procedure, the nurse helps assure safety by assessing the results of
which of the following tests?
A. Coagulation studies
B. Liver enzyme levels
C. Serum chemistries
D. White blood cell count
16. Immediately after a liver biopsy, which of the following complications *1/1
should the client be closely monitored for?
A. Abdominal cramping
B. Hemorrhage
C. Nausea and vomiting
D. Potential infection
17. After a liver biopsy, the nurse should place the client in which of the *0/1
following positions?
A. Left side-lying position, with the bed flat
B. Right side-lying position, with the bed fiat
C. Left side-lying position, with the bed in semi-Fowler’s position
D. Supine with the right arm above the overhead table
Correct answer
D. Supine with the right arm above the overhead table
18. The client has just had a liver biopsy. Which of the following nursing *1/1
action would be the priority after the biopsy?
A. Monitor pulse and blood pressure every 30 minutes until stable then hourly
up to 24 hours
B. Ambulate every 4 hours for the first day as long as the client van tolerate this
C. Measure urine specific gravity every 8 hours for the next 48 hours
D. Maintain NPO status for 24 hours post-biopsy
19. A client with cholecystitis is complaining of severe right upper *0/1

quadrant pain. Which of the following medications should the nurse
anticipate administering to relieve the client’s pain?
A. eperidine (Demerol)
B. Promethazine (Phenergan)
C. Acetaminophen (Tylenol) with codeine
D. Morphine sulfate
Correct answer
B. Promethazine (Phenergan)
20. The client who has cholelithiasis is scheduled for extracorporeal *1/1
shock wave Lithotripsy. The nurse should tell the client about which of
these symptoms that may occur after this procedure?
A. Colic-type pain
B. Headache
C. Diarrhea
D. Hiccups
21. After Gastrectomy the patient develops dumping syndrome. Which of *1/1
the following is/are the manifestation/s of dumping syndrome? SATA:
A. Diaphoresis
B. Diarrhea
C. Palpitation
D. Pallor
E. Early satiety
22. To reduce the risk of dumping syndrome, the nurse should teach the *1/1
client which of the following interventions? SATA:
A. Sit upright for 30 minutes after meals B. Drink liquids with meals, avoiding
caffeine
C. High fat diet should not be recommended
D. Lie on your left side after eating
E. Avoid milk and other dairy products
F. Decrease the carbohydrate content of meals
G. Lie on your right side after eating
23.The nurse reports the observation that would indicate abnormal *1/1
distribution of bile due to cirrhosis of the liver? SATA:
A. clay-colored stools
B. jaundice
C. malabsorption of water-soluble vitamins
D.high blood pressure
E. bradycardia
F.vitamin ADEK deficiency
G.fatty stool
H. pruritus
Recto a 30 year old male, is admitted at hospital de probinsya with *0/1

epigastric pain and vomiting, he stated that he took Maalox with no relief.
Upon admission the nurse in charge took his vital signs and recorded as
follows, BP 90/60, HR 110 bbm and a respiratory rate of 35 bbm. The
following questions refers to this situation:
24.What would be the possible sign if this could be pancreatitis?
A. Epigastric pain that radiates to right upper quadrant
B. Epigastric pain that radiates to left upper quadrant
C. Epigastric pain that radiates to right lower quadrant
D. Epigastric pain that radiates to right lower quadrant
Correct answer
B. Epigastric pain that radiates to left upper quadrant
25. Which of the following conditions or actions can cause acute *0/1
pancreatitis?
A. Alcoholism
B. High fat diet
C. stress
D. low fiber diet
Correct answer
A. Alcoholism
26. Which intervention would be appropriate for Recto: * 0/1
A. Apply warm compress if pain persists
B. Position the client to semi fowler’s
C. assess for signs of rovsing’s
D. high carbohydrates and protein diet
Correct answer
B. Position the client to semi fowler’s
27. Recto asks for information about the pain Pancreatitis. Which of the *0/1
following statement about Pancreatitis is correct?
A. It is a a type of pain that is relieved with vomiting
B. Demerol is the drug of choice to relieve the pain
C. The pain could be intermittent
D. The pain is excruciating
Correct answer
A. It is a a type of pain that is relieved with vomiting
28. Which of the following laboratory studies is most relevant to diagnose *0/1
a client who has a acute Pancreatitis?
A. Elevated serum: lipase, amylase, trypsin and low levels of serum bilirubin
B. Elevated serum: lipase, amylase, trypsin and low levels of serum calcium
C. Elevated serum: lipase, amylase, glucose and low levels of serum bilirubin
D. Elevated serum: lipase, amylase, glucose and low levels of serum calcium
Correct answer
D. Elevated serum: lipase, amylase, glucose and low levels of serum calcium
Bong a 30-year-old client with dehydration is admitted to a semiprivate *0/1

room in a progressive care unit. The client complains that he spent most
his time in the toilet because of diarrhea, that seemed not to stop. The
doctor diagnosed Bong with Inflammatory bowel disease. The following
questions refers to this situation:
29. Inflammatory bowel disease such as Cronh’s disease and Ulcerative

colitis is caused by?
A. Defective antibodies that cause inflammation of the bowels
B. Food toxins that cause irritation and hyperstimulation of the stomach
C. Bacteria and viruses that cause infection to alimentary system
D. Poor hygiene and low socioeconomic status that leads to ulceration of the
intestines
Correct answer
A. Defective antibodies that cause inflammation of the bowels
30.Bong wants to know the difference between Ulcerative colitis from *0/1
Crohn’s disease. The nurse who performs the assessment, knows that
which of the following is/are a clinical manifestation associated with the
latter?
A. The disease usually originates inflammation at the distal part of the colon
B. Diarrhea is so severe that it could be bloody with 10-20 stools per day
C. Fistula formation and malabsorption syndrome are common complication
D. The disease is permanent and it is mark with remission and exacerbation
Correct answer
C. Fistula formation and malabsorption syndrome are common complication
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EVALUATIVE EXAM - GASTROINTESTINAL SYSTEM 6/16/23, 6:22 PM

Prepared by: Prof. Mike Chavez RN, USRN

Name (Surname, First Name, M.I) *

GLORI, THALIA RHODA L.

School (Complete Name of School) *

ST. SCHOLASTICA'S COLLEGE TACLOBAN

C. high blood pressure

A. Decreased fat intake

B. Accumulation of bile salts under the skin

C. Poor appetite and therefore poor protein intake

D. Altered urinary output of bile

C. Poor appetite and therefore poor protein intake

C. Urinary tract infection

D. Prolonged bleeding time

4. When preparing the discharge teaching plan of a client following an *0/1

C. Reduced protein Intake

D. Use of polystyrene resin (Kayexalate)

C. Reduced protein Intake

B. A decrease in ﬂuid retention

7. A high ammonia level contributes to hepatic encephalopathy. As this *1/1

C. oxygen saturation monitoring

D. intake and output

A. Sodium restriction of 2.5g /day

B. Restrict foods high in magnesium

C. Fluid restriction of 1000 mL/day

D. Protein restriction of 75 to 100 grams per day

D. Protein restriction of 75 to 100 grams per day

9. The client who is developing hepatic encephalopathy may exhibit *1/1

A. Initiate a protein restricted diet

B. High fat, High protein

C. Small frequent meals, low protein

C. Small frequent meals, low protein

C. Elevated blood pressure

A. eat bland foods

B. increase ﬂuid intake

C. avoid straining to have a bowel movement

D. use an electric razor to shave

A. Eat bland foods

B. Increase ﬂuid intake

C. Avoid straining to have a bowel movement

D. Use an electric razor to shave

14. A client with a long history of alcohol-induced cirrhosis is brought to *1/1

B. Liver enzyme levels

D. White blood cell count

C. Nausea and vomiting

A. Left side-lying position, with the bed ﬂat

B. Right side-lying position, with the bed ﬁat

C. Left side-lying position, with the bed in semi-Fowler’s position

D. Supine with the right arm above the overhead table

D. Supine with the right arm above the overhead table

D. Maintain NPO status for 24 hours post-biopsy

19. A client with cholecystitis is complaining of severe right upper *0/1

C. Acetaminophen (Tylenol) with codeine

C. High fat diet should not be recommended

D. Lie on your left side after eating

E. Avoid milk and other dairy products

F. Decrease the carbohydrate content of meals

G. Lie on your right side after eating