GI Patient Assessment & Documentation 2 — Questions and Answers
Question 1: A patient reports epigastric pain that worsens 2-3 hours after eating and improves with food or antacids. Which condition does this pattern most suggest?
- Gastric ulcer
- Duodenal ulcer (Correct answer)
- Gastroesophageal reflux disease
- Acute pancreatitis
Correct answer: Duodenal ulcer
Duodenal ulcers classically cause pain that occurs 2-3 hours postprandially and is relieved by food or antacids, unlike gastric ulcers which often worsen with eating.
Question 2: When documenting bowel sounds, which term correctly describes high-pitched, tinkling sounds heard over a distended abdomen?
- Borborygmi
- Hypoactive bowel sounds
- Hyperactive bowel sounds (Correct answer)
- Absent bowel sounds
Correct answer: Hyperactive bowel sounds
High-pitched tinkling bowel sounds over a distended abdomen are hyperactive and suggest early intestinal obstruction or gastroenteritis.
Question 3: A patient's chart shows a Bristol Stool Scale type 1. How should the nurse document this finding?
- Watery, entirely liquid stool
- Soft blobs with clear-cut edges
- Separate hard lumps like nuts (Correct answer)
- Sausage-shaped with cracks on surface
Correct answer: Separate hard lumps like nuts
Bristol Stool Scale type 1 describes separate hard lumps resembling nuts, indicating severe constipation.
Question 4: During abdominal assessment, the nurse notes guarding and rigidity in the right lower quadrant with rebound tenderness. Which condition is most suspected?
- Irritable bowel syndrome
- Acute appendicitis (Correct answer)
- Crohn's disease flare
- Hepatomegaly
Correct answer: Acute appendicitis
Guarding, rigidity, and rebound tenderness localized to the right lower quadrant are classic peritoneal signs of acute appendicitis.
Question 5: A patient undergoing a colonoscopy prep is instructed to follow a clear liquid diet. Which item is acceptable?
- Milk
- Orange juice with pulp
- Chicken broth (Correct answer)
- Vanilla ice cream
Correct answer: Chicken broth
Clear chicken broth is a clear liquid; milk, pulpy juice, and ice cream are not clear liquids and can interfere with colonoscopy visualization.
Question 6: Which subjective data element is most important to document when a patient reports nausea and vomiting?
- The patient's weight
- Onset, duration, frequency, and any associated symptoms (Correct answer)
- Last colonoscopy date
- Skin turgor assessment
Correct answer: Onset, duration, frequency, and any associated symptoms
For nausea and vomiting, documenting onset, duration, frequency, and associated symptoms (e.g., fever, abdominal pain) provides critical diagnostic context.
Question 7: A nurse documents 'melena' in a patient's chart. What does this term indicate?
- Bright red blood per rectum
- Black, tarry, foul-smelling stool (Correct answer)
- Clay-colored stool
- Undigested food particles in stool
Correct answer: Black, tarry, foul-smelling stool
Melena refers to black, tarry, foul-smelling stool caused by digested blood, typically indicating an upper GI bleed.
GI Patient Assessment & Documentation 2
A patient reports epigastric pain that worsens 2-3 hours after eating and improves with food or antacids.
Which condition does this pattern most suggest?