Gastrointestinal Nursing Test Banks 1. A client is admitted to the health care facility with a diagnosis of a bleeding gastric ulcer.

The nurse expects this client's stools to be: a. coffee-ground-like. b. clay-colored. c. black and tarry. d. bright red. 2. A client is admitted with increased ascites related to cirrhosis. Which nursing diagnosis should receive top priority? a. Fatigue b. Excessive fluid volume c. Ineffective breathing pattern d. Imbalanced nutrition: Less than body requirements 3. Nursing Test banks question about a client that comes to the emergency department complaining of acute GI distress. When obtaining the client's history, the nurse inquires about the family history. Which disorder has a familial basis? a. Hepatitis b. Iron deficiency anemia c. Ulcerative colitis d. Chronic peritonitis 4. The physician orders a stool culture to help diagnose a client with prolonged diarrhea. The nurse who obtains the stool specimen should: a. take the specimen to the laboratory immediately. b. apply a solution to the stool specimen. c. collect the specimen in a sterile container. d. store the specimen on ice. 5. While palpating a client's right upper quadrant (RUQ), the nurse would expect to find which of the following structures? a. Sigmoid colon b. Appendix c. Spleen d. Liver Nursing Test Banks: Answers and Rationale 1) C - Black, tarry stools are a sign of bleeding high in the GI tract, as from a gastric ulcer, and result from the action of digestive enzymes on the blood. Vomitus associated with upper GI tract bleeding commonly is described as coffee-ground-like. Clay-colored stools are associated with biliary obstruction. Bright red stools indicate lower GI tract bleeding. 2) C - In ascites, accumulation of large amounts of fluid causes extreme abdominal distention, which may put pressure on the diaphragm and interfere with respiration. If uncorrected, this may lead to atelectasis or pneumonia. Although fluid volume excess is present, the diagnosis Ineffective breathing pattern takes precedence because it can lead more quickly to life-threatening consequences. The nurse can deal with fatigue and altered nutrition after the client establishes and maintains an effective breathing pattern.

3) C - Ulcerative colitis is more common in people who have family members with the disease. (The same is true of some types of GI cancers, ulcers, and Crohn's disease.) Hepatitis, iron deficiency anemia, and chronic peritonitis are acquired disorders that don't run in families. 4) C - The nurse should collect the stool specimen using sterile technique and a sterile stool container. The stool may be collected for 3 consecutive days; no follow-up care is needed. Although a stool culture should be taken to the laboratory as soon as possible, it need not be delivered immediately (unlike stool being examined for ova and parasites). Applying a solution to a stool specimen would contaminate it; this procedure is done when testing stool for occult blood, not organisms. The nurse shouldn't store a stool culture on ice because the abrupt temperature change could kill the organisms. 5) D - The RUQ contains the liver, gallbladder, duodenum, head of the pancreas, hepatic flexure of the colon, portions of the ascending and transverse colon, and a portion of the right kidney. The sigmoid colon is located in the left lower quadrant; the appendix, in the right lower quadrant; and the spleen, in the left upper quadrant.