QUESTIONS AND CORECT ANSWERS WITH DETAILED

Gastrointestinal {GI} NECLEX-STYLE ACTUAL EXAM 70

QUESTIONS AND CORECT ANSWERS WITH DETAILED

ANSWERS -

A patient with chronic alcohol abuse is admitted with liver failure. You closely monitor the patient's blood pressure because of which change that is associated with the liver failure? 1 Hypoalbuminemia

• Increased capillary permeability
• Abnormal peripheral vasodilation
• Excess rennin release from the kidneys - CORRECT ANSWER-1. 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 kidney's aren't direct ramifications of liver failure.

Arthur has a family history of colon cancer and is scheduled to have a sigmoidoscopy. He is crying as he tells you, "I know that I have colon cancer, too." Which response is most therapeutic?

• "I know just how you feel."

 2 "You seem upset."

• "Oh, don't worry about it, everything will be just fine."

4"Why do you think you have cancer?" - CORRECT ANSWER-2. Making observations about what you see or hear is a useful therapeutic technique. This way, you acknowledge that you are interested in what the patient is saying and feeling.

Sharon has cirrhosis of the liver and develops ascites. What intervention is necessary to decrease the excessive accumulation of serous fluid in her peritoneal cavity? a Restrict fluids b Encourage ambulation c Increase sodium in the diet d Give antacids as prescribed - CORRECT ANSWER-A Restricting fluids decrease the amount of body fluid and the accumulation of fluid in the peritoneal space.

Nathaniel has severe pruritus due to having hepatitis B. What is the best intervention for his comfort?a Give tepid baths. 1 / 3

b Avoid lotions and creams.c Use hot water to increase vasodilation. d Use cold water to decrease the itching. - CORRECT ANSWER-D Rest periods and small frequent meals is indicated during the acute phase of hepatitis B.

What information is correct about stomach cancer? a Stomach pain is often a late symptom.b Surgery is often a successful treatment.c Chemotherapy and radiation are often successful treatments.d The patient can survive for an extended time with TPN. - CORRECT ANSWER-A Stomach pain is often a late sign of stomach cancer; outcomes are particularly poor when the cancer reaches that point. Surgery, chemotherapy, and radiation have minimal positive effects. TPN may enhance the growth of the cancer.

The student nurse is teaching the family of a patient with liver failure. You instruct them to limit which foods in the patient's diet? a Meats and beans.b Butter and gravies.c Potatoes and pastas.d Cakes and pastries. - CORRECT ANSWER-A Meats and beans are high-protein foods. In liver failure, the liver is unable to metabolize protein adequately, causing protein by-products to build up in the body rather than be excreted.

A 53 y.o. patient has undergone a partial gastrectomy for adenocarcinoma of the stomach. An NG tube is in place and is connected to low continuous suction. During the immediate postoperative period, you expect the gastric secretions to be which color?a Brown.b Clear. c Red.d Yellow. - CORRECT ANSWER-C Coffee-ground emesis occurs when there is upper GI bleeding that has undergone gastric digestion. For blood to appear as coffee-ground emesis, it would have to be digested for approximately 2 hours.

George has a T tube in place after gallbladder surgery. Before discharge, what information or instructions should be given regarding the T tube drainage? 2 / 3

a "If there is any drainage, notify the surgeon immediately."  b "The drainage will decrease daily until the bile duct heals." c "First, the drainage is dark green; then it becomes dark yellow." d "If the drainage stops, milk the tube toward the puncture wound." - CORRECT ANSWER-B As healing occurs from the bile duct, bile drains from the tube; the amount of bile should decrease.Teach the patient to expect dark green drainage and to notify the doctor if drainage stops.

The student nurse is participating in colorectal cancer-screening program. Which patient has the fewest risk factors for colon cancer?a Janice, a 45 y.o. with a 25-year history of ulcerative colitis b George, a 50 y.o. whose father died of colon cancer  c Herman, a 60 y.o. who follows a low-fat, high-fiber diet d Sissy, a 72 y.o. with a history of breast cancer - CORRECT ANSWER-C

Which of the following diets is most commonly associated with colon cancer? a Low-fiber, high fat b Low-fat, high-fiber c Low-protein, high-carbohydrate d Low carbohydrate, high protein - CORRECT ANSWER-a. A low-fiber, high-fat diet reduced motility and increases the chance of constipation. The metabolic end products of this type of diet are carcinogenic. A low-fat, high-fiber diet is recommended to prevent colon cancer.

Radiation therapy is used to treat colon cancer before surgery for which of the following reasons? a Reducing the size of the tumor b Eliminating the malignant cells c Curing the cancer d Helping the bowel heal after surgery - CORRECT ANSWER-a. Radiation therapy is used to treat colon cancer before surgery to reduce the size of the tumor, making it easier to be resected.Radiation therapy isn't curative, can't eliminate the malignant cells (though it helps define tumor margins), can could slow postoperative healing.

Which of the following symptoms is a client with colon cancer most likely to exhibit?a A change in appetite  b A change in bowel habits

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