NCLEX Gastrointestinal Questions

NCLEX Gastrointestinal Questions

A patient's vomitus is dark brown and has a coffee-ground appearance. the nurse recognizes that

this emsis is charactristic of:

• stomach bleeding
• an intestinal obstruction
• bile reflux
• active bleeding of lower esophagus - a. stomach bleeding

A patient who has been vomiting for several days from an unknown cause is admitted to

hospital. the nurse anticipates collaborative care to include:

• oral admin of broth and tea
• admin of parenteral antiemetics
• insertion of NG tube to suction
• IV replacement of fluid and electrolytes - d. IV replacement of fluid and electrolytes

Zofran is prescribed for a patient with cancer chemo induced vomiting. The nurse understands

this drug:

• is a derivative of cannabis
• has a strong antihistamine effect that provides sedation and sleep
• is used only when other therapies are ineffective
• relieves vomiting centrally by action in the vomiting center and peripherally by promoting

gastric emptying - d. relieves vomiting centrally by action in the vomiting center and peripherally by promoting gastric emptying

A patient with oral cancer has a history of heavy smoking, excessive alcohol intake, and personal neglect. During the patient's early postop course the nurse anticpates that the patient may need:

• oral nutritional supplements
• drug therapy to prevent substance withdrawal symptoms - b. drug therapy to prevent substance

withdrawal symptoms

the nurse teaches the patient with a hiatal hernia or GERD to control symptoms by:

• drinking 10-12 oz of water with meals
• spacing six small meals a day
• sleeping with the head of the bed elevated 4-6 inches
• perfrming aily exercises of toe touch - c. sleeping with the head of the bed elevated 4-6 inches

A patient is returned to the surgical unit following a laparoscopic fundoplication for repair of hiatal hernia with an IV, NG tube to suction, and several small abdominal incisions. To prevent

disruption of the surgical site, it is most important for the nurse to - maintain the patency of the NG tube

Nursing management of the patient with chronic gastritis includes teaching the patient to:

• maintain a bland diet with six small meals a day
• take antacids before meals
• use NSAIDS instead of aspirin for pain relief
• eliminate alcohol and caffein - a. maintain a bland diet with six small meals a day

Patient admitted to ER has profuse bright-red hematemesis. During intial care of the patient, the

nurse's first priority is to:

• perform a nursing assessment of patient's status
• establish 2 IV sites
• obtain a thorough health history - a. perform a nursing assessment of patient's status

In teaching patients at risk for upper GI bleeding to prevent bleeding episodes, the nurse stresses

that:

• all stools and vomit must be tested for blood
• the use of over the counter meds of any kind should be avoided - b. the use of over the counter

meds of any kind should be avoided

Management of patient with upper GI bleeding is effective the lab results reveal:

• decreasing BUN
• normal hematocrit
• urine output of 20 ml hr
• specific gravity of 1.03 - a. decreasing BUN

Regardless of precipitating factor, the injury to mucosal cells in PUD is caused by:

• acid back-diffusion into the mucosa
• ammonia formation in the mucus wall
• breakdown of gastric mucosal barrier
• release of histamine for cells - a. acid back-diffusion into the mucosa

Patient with an ulcer of the posterior portion of duodenum experiences:

• pain that occurs after not eating all day
• back pain that occurs 2-4 hrs after eating
• midepigastric pain unrelieved with antacids
• high epigastric burning relieved with food - b. back pain that occurs 2-4 hrs after eating

Diagnostic testing is planned fr a patient with suspected peptic ulcer. Most reliable test is:

• endoscopy
• gastric analysis
• barium swallow
• serologic test for H pylori - a. endoscopy

Nurse teaches a patient with newly diagnosed PUD to

• maintain bland diet
• use alcohol and caffeine in moderation
• eat as normally as possible, eliminating foods that cause pain
• avoid milk and milk products - c. eat as normally as possible, eliminating foods that cause pain

Teaching is effective when patient with PUD states:

• "I should stop all meds if i develop side effects"
• "I should continue treatment as long as i have pain"
• "I have learned some relaxation strategies that decrease my stress" - c. "I have learned some

relaxation strategies that decrease my stress"

Patient with history of PUD is hospitalized with symptoms of a perforation. During initial

assessment nurse would expect to find:

• vomit of bright red blood
• projectile vomiting
• sudden, severe upper abdominal pain and shoulder pain
• hyperactive - c. sudden, severe upper abdominal pain and shoulder pain

A patient with NG tube develops nausea and increased upper abominal bowel sounds.

Appropriate action is to:

• check the patency of the NG tube
• place client in recumbant position
• assess vital signs
• ecourage deep breathing - a. check the patency of the NG tube

Following a Billroth 2 procedure, patient develops dumping syndrome. The nurse explains that

the symptoms associated wti h this problem are caused by:

• distention of smaller stomach by too much food and fluid intake
• hyperglycemia caused by uncontrolled gastric emptying into the small intestine
• irritation of the stomach lining by reflux of bile salts
• movement of fluid into the bowel because concentrated foods and fluids move quickly into the

intestine - d. movement of fluid into the bowel because concentrated foods and fluids move quickly into the intestine

Nurse determines teaching needed when patient with dumping syndrome says

• "I should eat bread with every meal"
• "I should avoid drinking fluids with meals"
• "I should eat small meals about 6x day" - a. "I should eat bread with every meal"

Patient with cancer of stomach undergoes total gastrecotmy with esophagojejunostomy. Postop

the nurse teaches the patient to expect:

• rapid healing
• ability to return to normal dietary habits
• close follow up for development of ulcers
• lifelong intramuscular or intranasal admin of cobalamin - d. lifelong intramuscular or

intranasal admin of cobalamin

The preferred immediate treatment for acute episode of constipation is:

• soapsud enema
• stimulant cthartics
• stool sofenting cathartic
• tap water or hypertonic enemas - d. tap water or hypertonic enemas

On 2nd postop day, patient who had exploratory laparotomy complains if abdominal distention

and gas pains. Best response to this is:

• Abdominal distention occurs as a normal response to inflammation and healing
• Gas pains occur when NG tube is not used correctly
• This occurs because of bowel immobility caused by anesthesia and manipulation of abdominal

contents during surgery - c. This occurs because of bowel immobility caused by anesthesia and manipulation of abdominal contents during surgery

Postop patient has nursing diagnosis of pain r/t to immobility, meds, and decreased motility as evidenced by abdominal pain and distention and inability to pass flatus. An appropriate nursing

intervention for the patient is to: - ambulate patient more frequently

A 22 yr old calls the clinic complaining of N&V and RLQ abdominal pain. The nurse advises the

patient to:

• have the symptoms evaluated by a MD right away
• use a heating pad
• drink at least 2 qts of juice
• take a laxative to empty the bowel - a. have the symptoms evaluated by a MD right away

7) A patient with a gun shot wound to the abdomen develops a bacterial peritonitis after surgery

to repair the bowel. This problem is caused primarily by: