1.

Which of the following are aged-related changes that affect

gastrointestinal function?

a. Decline in sense of taste and smell, decrease in salivary secretion
b. Diminished capacity of the gastric mucosa to resist such factors as
Helicobacter pylori
c. Achlorhydria or insufficient hydrochloric acid in the stomach
d. Decreases in intestinal absorption, motility, and blood flow


2. Which of the following are risk factors associated with nursing
home residents and dysphagia?



a. Feeding bed-bound residents in the semi-reclined position
b. Administering thin liquids quickly via a straw
c. Providing thickened liquids to the patient during meals
d. Busy and overburdened staff who are assigned a case-load of several
patients to feed at the same scheduled time

RATIONALE
Bed-bound patients should not be fed in the semi-reclined position or fed thin liquids that might quickly
drain into the esophagus before the swallow reflex is triggered. A heavy caseload of clients might cause
healthcare providers to rush-feed patients, resulting in reflux of nutrients and gastric acid.
3. Which of the following types of gastritis is associated with
Helicobacter pylori and duodenal ulcers?

a. Erosive (hemorrhagic) gastritis
b. fundic gland gastritis (type A)
c. Antral gland gastritis (type B)
d. Aspiring-induced gastric ulcer

RATIONALE
Erosive (hemorrhagic) gastritis can be caused by ingestion of substances that irritate the gastric mucosa.
Fundic gland gastritis (type A) is associated with diffuse severe mucosal atrophy and the presence of
pernicious anemia. Antral gland gastritis (type B) is the most common form of gastritis, and is associated
with Helicobacter pylori and duodenal ulcers.

4. In planning care for a patient with ulcerative colitis, the nurse
should anticipate which of the following diagnostic procedures?

a. Sigmoidoscopy
b. Colonoscopy
c. Rectal mucosa biopsy
d. All of the above

5.The physician has prescribed rantidine (Zantac) for a client with
erosive gastritis. The nurse should administer the medication:

a. 30 minutes before meals
b. With each meal
c. In a single dose at bedtime
d. 60 minutes after meals

Zantac (rantidine) is a histamine blocker that should be given with meals for optimal
effect, not before meals. However, Tagamet (cimetidine) is a histamine blocker that can
be given in one dose at bedtime. Neither of these drugs should be given before or after
meals, so answers A and D are incorrect.

6.patient with chronic alcohol abuse is admitted with liver failure.
You closely monitor the patients blood pressure because of which
change that is associated with the liver failure?
a. Hypoalbuminemia
b. Increased capillary permeability
c.Abnormal peripheral vasodilation
d.Excess rennin release from the kidneys
RATIONALE: Blood pressure decreases as the body is unable to
maintain normal oncotic pressure with liver failure, so patients with
liver failure require close blood pressure monitoring. Increased
capillary permeability, abnormal peripheral vasodilation, and excess
rennin released from the kidneys arent direct ramifications of liver
failure.

7.Youre performing an abdominal assessment on Brent who is
52 y.o. In which order do you proceed?
a. Observation, percussion, palpation, auscultation
b. Observation, auscultation, percussion, palpation
c..Percussion, palpation, auscultation, observation
d. Palpation, percussion, observation, auscultation
8.The nurse is providing discharge instructions to a male client
following gastrectomy and instructs the client to take which
measure to assist in preventing dumping syndrome?
a .ambulate following a meal
b. Eat high carbohydrate foods
c. Limit the fluid taken with meal
d. Sit in a high-Fowlers position during meals
RATIO NALE:
Dumping syndrome is a term that refers to a constellation of vasomotor symptoms that occurs after eating,
especially following a Billroth II procedure. Early manifestations usually occur within 30 minutes of eating and
include vertigo, tachycardia, syncope, sweating, pallor, palpitations, and the desire to lie down. The nurse should
instruct the client to decrease the amount of fluid taken at meals and to avoid high-carbohydrate foods, including
fluids such as fruit nectars; to assume a low-Fowlers position during meals; to lie down for 30 minutes after eating
to delay gastric emptying; and to take antispasmodics as prescribed.

9. The nurse is reviewing the medication record of a female
client with acute gastritis. Which medication, if noted on the
clients record, would the nurse question?
a.Digoxin (Lanoxin)
b. Furosemide (Lasix)
c. Indomethacin (Indocin)
d. Propranolol hydrochloride (Inderal)
RATIONALE
ndomethacin (Indocin) is a nonsteroidal anti-inflammatory drug and can cause ulceration of the esophagus,
stomach, or small intestine. Indomethacin is contraindicated in a client with gastrointestinal disorders. Furosemide
(Lasix) is a loop diuretic. Digoxin is a cardiac medication. Propranolol (Inderal) is a -adrenergic blocker.
Furosemide, digoxin, and propranolol are not contraindicated in clients with gastric disorders.

10. The nurse is caring for a male client with a diagnosis of chronic gastritis. The nurse
monitors the client knowing that this client is at risk for which vitamin deficiency?
a. vitamin a
b.vitamin B12
c.vitamin c
d.vitamin d
RATIONALE
Chronic gastritis causes deterioration and atrophy of the lining of the stomach, leading to the loss of the function of
the parietal cells. The source of the intrinsic factor is lost, which results in the inability to absorb vitamin B12. This
leads to the development of pernicious anemia. The client is not at risk for vitamin A, C, or E deficiency.







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