Chapter 40- Patient Management- Gastrointestinal System My Nursing Test Banks

 

1.

A young refugee from Uganda who recently arrived in the United States has been admitted to the critical care unit for treatment of severe infection of a sore on his leg. What nutrient should the nurse realize will be most deficient in this patient?

A)

Protein

B)

Lipids

C)

Carbohydrates

D)

Minerals

2.

A patient requires a nasogastric tube for enteral feeding. The nurse selects a small-caliber feeding tube for the patient. What are the advantages of using a small-caliber tube? Select all that apply.

A)

Can be used to decompress the stomach

B)

Allows monitoring of gastric pH

C)

Is more comfortable for the patient

D)

Is capable of delivering medications and feedings

E)

Has lower risk of self-extubation

3.

A patient in the critical care unit is on a ventilator and requires nutritional support, likely for 3 weeks. This patient has a transected spinal cord at C4. Which would be the best choice of nutritional support for this patient?

A)

Nasogastric tube

B)

Nasoduodenal tube

C)

Gastrostomy tube

D)

Total parenteral nutrition

4.

A patient with gastric cancer must receive long-term nutritional support. Due to the cancer, the patient has impaired gastric function and delayed gastric emptying, but the remainder of her gastrointestinal tract is intact and functional. Which of the following would be the best choice of nutritional support for this patient?

A)

Jejunostomy tube

B)

Nasoduodenal tube

C)

Gastrostomy tube

D)

Central parenteral nutrition

5.

A patient with Crohns disease is receiving enteral feeding. The nurse administers an elemental formula to the patient. What is the best rationale for this choice?

A)

Lower cost

B)

Pleasant taste

C)

Easier to digest

D)

More complete nutrition

6.

A patient is receiving enteral feeding via a nasogastric tube of a polymeric formula. Under what conditions should the nurse discontinue enteral feeding? Select all that apply.

A)

Three instances of gastric residual volume of 175 mL

B)

Regurgitation

C)

Two instances of gastric residual volume of 600 mL

D)

Vomiting

E)

Aspiration

F)

Diarrhea

7.

A patient with severe hemorrhagic pancreatitis requires long-term nutritional support. Which of the following would be the best form of nutritional support for this patient?

A)

Nasoduodenal tube

B)

Gastrostomy tube

C)

Total parenteral nutrition

D)

Peripheral parenteral nutrition

8.

A patient with anorexia nervosa requires parenteral nutrition support. This patient demonstrates signs of marasmus. What intervention should the nurse make to prevent a complication for which this patient is at increased risk?

A)

Limiting of initial dextrose dosing

B)

Depletion of potassium before TPN initiation

C)

Proper hand hygiene

D)

Change of TPN solution bag every 24 hours

9.

A patient who is receiving total parenteral nutrition (TPN) via a temporary catheter has previously experienced catheter occlusion due to fibrin buildup. What substance can be added to the standard parenteral formula to best help prevent this complication?

A)

Insulin

B)

Dextrose

C)

Potassium

D)

Heparin

10.

A patient in the ICU is experiencing gastroesophageal reflux disease. Which medication should the nurse administer to this patient?

A)

Promethazine

B)

Loperamide

C)

Cimetidine

D)

Misoprostol

11.

A patient with a serious illness is being cared for in a CCU. Considering energy expenditure during illness and the potential for healing, what is most appropriate nursing action?

A)

Maintain complete bed rest with minimal activity

B)

Ensure complete pharmacological sedation

C)

Limit visits to immediate family only

D)

Facilitate nutrition assessment and delivery

12.

After a serious injury, a patient has not received nutritional supplementation for several days. What body system is most likely to experience damage first?

A)

Cardiac

B)

Musculoskeletal

C)

Neurologic

D)

Integumentary

13.

A patient has been in the CCU with serious illness for several days. What collaborative nursing action is most important to prevent immunosuppression?

A)

Nutritional support

B)

Antimicrobial administration

C)

Erythropoietin administration

D)

Adhering to hand hygiene protocol

14.

A patient has been admitted with severe malnutrition from prolonged calorie deficiency. The patient has severe muscle wasting but normal electrolytes and serum albumin. He is lethargic, with a flat affect. What treatment does the nurse anticipate?

A)

Rapid infusion of high-calorie enteral feedings

B)

Use of total parenteral nutrition

C)

Slow balanced enteral feedings

D)

Rapid infusion of high-protein feedings

15.

A patient with critical illness on complete bed rest has been without oral intake for several days. The patients general instability has prevented routine turning and repositioning for the past 24 hours. The patients weight has increased by 10 pounds since admission and the nurse notices evidence of skin breakdown starting. What is the most likely cause of this breakdown?

A)

Proteincalorie malnutrition

B)

Hazards of immobility

C)

Peripheral edema formation

D)

Effects of medications

16.

During a critical illness, a patient has been without enteral nutrition for several days. What is the most significant complication this situation places the patient at increased risk for?

A)

Sepsis

B)

Pneumonia

C)

Fecal impaction

D)

Abdominal pain

17.

A critically ill patient is being evaluated for nutritional support using the enteral route. What contraindication for enteral feedings does the nurse assess for?

A)

Lack of evidence of severe malnutrition

B)

Ability to chew and swallow

C)

Evidence of prolonged ileus

D)

Presence of intravenous access

18.

A patient is being fed continuously through a nasogastric tube. According to unit policy, the nurse checks tube placement regularly. What method is most accurate?

A)

Air insufflation and auscultation over the stomach

B)

Inspection of tube aspirate for color and consistency

C)

Measuring gastric pH after holding feeding 60 minutes

D)

Obtaining a radiograph of the upper abdomen

19.

A critically ill patient is receiving intravenous total parenteral nutrition (TPN). The patient is also being supported by several constant IV vasoactive medications, is pharmacologically sedated and paralyzed with constant IV medications, and is receiving three antimicrobial mediations by intermittent IV infusion. The nurse ensures that the TPN is infusing into a separate line and not mixing with any other fluid or medication. What is the best rationale for this precaution?

A)

Complies with hospital and unit policy

B)

Prevents risk of contamination and precipitation

C)

Contains trace amounts of electrolytes

D)

Contains high fat concentrations

20.

A patient is receiving total parenteral nutrition (TPN). To monitor for the development of a complication directly related to the composition of the TPN, what intervention does the nurse initiate?

A)

Vital signs every 15 minutes

B)

Strict adherence to hand hygiene protocol

C)

Continuous capnography

D)

Frequent monitoring of blood glucose

Answer Key

1.

A

2.

C, E

3.

B

4.

A

5.

C

6.

B, C, D, E

7.

C

8.

A

9.

D

10.

C

11.

D

12.

C

13.

A

14.

C

15.

A

16.

A

17.

C

18.

D

19.

B

20.

D

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