NCLEX PN SUANDERS GI DISORDERS

A nurse is preparing to administer a soapsuds enema to a client. Into which position does the nurse place the client to administer the enema? Refer to figure.

3. 3 left side lying

A client with Crohn's disease has a prescription to begin taking antispasmodic medication. The nurse should time the medication so that each dose is taken:

3. 30 minutes before meals

After a liver biopsy, the nurse places the client in which of the following positions?

4. A right side-lying position with a small pillow or folded towel under the puncture site

A nurse is providing discharge instructions to a client who has had a total gastrectomy. The nurse tells the client about the importance of returning to the health care clinic as scheduled for which priority assessment?

4. Vitamin B12 and folic acid studies

A client has been diagnosed with chronic gastritis and has been told that there is too little intrinsic factor being produced. The nurse tells the client that which of the following will be prescribed to treat the problem?

4. Vitamin B12 injections

A client is admitted to the hospital with viral hepatitis and is complaining of a loss of appetite. In order to provide adequate nutrition, the nurse encourages the client to:

2. Increase intake of fluids.

A client with ascites is scheduled for a paracentesis. The nurse is assisting the health care provider in performing the procedure. Which of the following positions will the nurse assist the client to assume for this procedure?

2. Upright

A client with a peptic ulcer is scheduled for a vagotomy, and the client asks the nurse about the purpose of this procedure. The nurse tells the client that a vagotomy:

3. Reduces the stimulation of acid secretions

A client has just undergone a gastroscopy. Which action should be taken by the nurse as the essential post-procedure nursing intervention?

. 4. Monitoring for the gag reflex

A sexually active 20-year-old client has developed viral hepatitis. Which of the following statements, if made by the client, would indicate a need for teaching?

1. ""I can never drink alcohol again."

A nurse is teaching a client with a newly diagnosed hiatal hernia about measures to prevent recurrence of symptoms. Which statement would be included in the teaching?

1. "Be sure to sleep with your head elevated in bed."

A nurse observes that a client's nasogastric tube has suddenly stopped draining. The tube is connected to suction, the machine is on and functioning and all connections are snug. The tube is secured properly and does not appear to have been dislodged. After checking placement, the nurse gently flushes the tube with 30 mL of normal saline, but the tube still is not draining. The nurse analyzes this problem as:

1. Channels of gastric secretions may be bypassing the holes in the tube; turning the client will promote stomach emptying

A client with a Sengstaken-Blakemore tube in place to treat esophageal varices suddenly becomes restless. The client's heart rate and blood pressure increase and the client has difficulty breathing. The important initial nursing action is to:

1. Cut the tube and pull it out.

A nurse documents that a client with a hiatal hernia is implementing effective health maintenance measures after the client reports doing which of the following?

1. Eating low-fat or nonfat foods

It has been determined that a client with hepatitis has contracted the infection from contaminated food. What type of hepatitis is this client most likely experiencing?

1. Hepatitis A

A client complains of stomach pain 30 minutes to 1 hour after eating. The pain is not relieved by further intake of food, although it is relieved by vomiting. A gastric ulcer is suspected. Which of the following data would further support this diagnosis?

1. History of alcohol use, smoking, and weight loss

A client with hiatal hernia chronically experiences heartburn after meals. The nurse would teach the client to avoid which of the following, which is contraindicated with hiatal hernia?

1. Lying recumbent after meals

A nurse who is assisting in the care of a client within the first 24 hours following a total gastrectomy for gastric cancer should focus interventions on which of the following?

1. Maintaining a patent nasogastric (NG) tube

A nurse is collecting data on a client admitted to the hospital with hepatitis. Which data would indicate that the client may have liver damage?

1. Pruritus

A nurse is preparing to administer an intermittent tube feeding to a client with a nasogastric tube. The nurse checks the residual and obtains an amount of 200 mL. The nurse would:

1. Hold the feeding.

A nurse has given the client with hepatitis instructions about postdischarge management during convalescence. The nurse determines that the client needs further teaching if the client states to:

3. Resume full activity level within 1 week.

A nurse is providing home care instructions to a client following a gastric resection. The nurse includes which of the following in the instructions?

3. Take actions to prevent dumping syndrome.

A nurse has assisted the health care provider with a liver biopsy, which was done at the bedside. Upon completion of the procedure, the nurse assists the client into which of the following positions?

2. Right side-lying with a small pillow or towel under the puncture site

A nurse who is providing instructions to a client following gastric resection would include which of the following suggestions?

2. Take action to prevent dumping syndrome.

A licensed practical nurse (LPN) is preparing to assist a registered nurse (RN) with removing a nasogastric (NG) tube from the client. The LPN would instruct the client to do which of the following?

3. Take and hold a deep breath.

A nurse provides information to a client following a gastrectomy about the signs and symptoms of pernicious anemia. The nurse understands that:

4. Regular monthly injections of vitamin B12 are used to treat this disorder.

A nurse is collecting data on a client with a diagnosis of peptic ulcer disease. Which of the following is least likely associated with this disease?

4. History of the use of acetaminophen (Tylenol) for pain and discomfort

A nurse planning care for a client with hepatitis plans to meet the client's safety needs by:

4. Monitoring prothrombin and partial thromboplastin values

A client is admitted to the hospital with a bowel obstruction secondary to a recurrent malignancy, and the health care provider plans to insert a Miller-Abbott tube. When the nurse tries to explain the procedure, the client interrupts the nurse and states, "I don't want to hear about that. Just let the doctor do it." Based on the client's statement, the nurse determines that the best action is to:

4. Remain with the client and be silent.

A nurse is caring for a client with a nasogastric tube. Which observation is reliable in determining that the tube is correctly placed?

4. The pH of the aspirate is 5.

A health care provider asks a nurse to obtain a Salem Sump tube for gastric intubation. The nurse selects which of the following tubes from the unit storage area?

4. Tube with a lumen and an air vent

A nurse is evaluating the effect of dietary counseling on the client with cholecystitis. The nurse determines that the client understands the instructions given if the client states that which food item is acceptable to include in the diet?

4. Turkey and lettuce sandwich

A nurse is teaching the client about an upcoming colonoscopy procedure. The nurse would include in the instructions that the client will be placed in which of the following positions for the procedure?

Left Sims' position

A client has been diagnosed with acute gastroenteritis. Which of the following diets should the nurse anticipate would be prescribed for the client?

2. Low fiber

A nurse has assisted in the insertion of a Levin tube for gastrointestinal (GI) decompression. The nurse plans to set the suction to which of the following pressures?

3. Low and intermittent

A nurse has assisted with the insertion of a Levin tube for gastrointestinal (GI) decompression. The nurse expects that the health care provider will prescribe the suction setting at:

3. Low and intermittent

A client is scheduled for an endoscopic retrograde cholangiopancreatography (ERCP). The nurse includes which intervention in the plan of care for the client?

2. After the procedure, keep client nothing by mouth (NPO) until the gag reflex returns.

A client has undergone esophagogastroduodenoscopy (EGD). The nurse places highest priority on which of the following items as part of the client's care plan?

2. Checking for return of a gag reflex

A nurse is assigned to care for a client with a Sengstaken-Blakemore tube. The nurse should suspect that the client has which diagnosis?

2. Esophageal varices

A nurse is assisting in caring for a client with a Sengstaken-Blakemore tube. To prevent ulceration and necrosis of oral and nasal mucosa, the nurse plans to:

2. Give frequent oral and nasal care.

A nurse analyzes the results of laboratory studies performed on a client with peptic ulcer disease. Which of the following laboratory values would indicate a complication associated with the disease?

2. Hemoglobin 10.2 g/dL

A client has asymptomatic diverticular disease. What type of diet should the nurse anticipate to be prescribed?

2. High-fiber diet

A client is seen in the ambulatory care office for a routine examination. Which statement by the client would be important for the nurse to follow up?

1. "I just lost a family to gastrointestinal cancer."

A nurse is checking a client for the correct placement of a nasogastric (NG) tube. The nurse aspirates the client's stomach contents and checks their pH level. Which of the following pH values indicates the correct placement of the tube?

1. 4.0

A nurse has been reinforcing dietary teaching for a client with peptic ulcer disease who has a routine follow-up visit. Which behavior is the best indicator of a successful outcome for this client?

1. A decrease in sour eructation

A client arrives at the emergency department and complains of severe abdominal pain. The initial diagnosis is acute abdomen, and an x-ray and an abdominal ultrasonogram are prescribed to be obtained immediately. The nurse prepares the client for these diagnostic tests and reviews the health care provider's prescriptions. Which of the following prescriptions would the nurse question if written on the health care provider's prescription form?

1. Administration of an analgesic

A nurse is preparing to administer an enema to an adult client. Choose the interventions that the nurse would perform for this procedure. Select all that apply.

1. Apply disposable gloves. 3. Lubricate the enema tube and insert it approximately 4 inches. 4. Clamp the tubing if the client expresses discomfort during the procedure. 6. Ensure that the temperature of the solution is between 100° F (37.8° C) and 105° F (40.5° C).

A client who has undergone a barium enema is being readied for discharge from the ambulatory care unit. The nurse determines that the client has understood the discharge instructions if the client states:

2. "I should take a laxative and my stool should return to normal color."

A nurse is instructing a client who had a herniorrhaphy about how to reduce postoperative swelling following the procedure. Which of the following would the nurse suggest to the client to prevent swelling?

2. Elevate the scrotum.

A client with Crohn's disease is seen by the health care provider, and a complete blood count (CBC) has been prescribed. The nurse provides instructions to the client who will be reporting to the laboratory in the morning to have the blood test drawn. The nurse gives the client which of the following information about this test?

2. No special preparation is necessary.

A nurse is caring for a client with a nasogastric (NG) tube and tests the pH of the aspirate to determine correct placement. The nurse notes that the pH is 5 and determines that the:

2. Placement of the NG tube is accurate.

A post-gastrectomy client is at high risk for hyperglycemia related to uncontrolled gastric emptying of fluid and food into the small intestine (dumping syndrome). Because of this risk, the nurse plans to monitor the:

2. Postprandial blood glucose readings

A client presents to the urgent care center with complaints of abdominal pain. Suddenly the client vomits bright red blood. The nurse takes which immediate action?

2. Takes the client's vital signs

A nurse gathers data from a client admitted to the hospital with gastroesophageal reflux disease (GERD) who is scheduled for a Nissen fundoplication. Based on an understanding of this disease, the nurse determines that the client may be at risk for which complication?

3. Aspiration

A nurse is providing medication instructions to a client with peptic ulcer disease. Which of the following represents correct information given by the nurse?

3. Cimetidine (Tagamet) results in decreased secretion of stomach acid.

A client who has undergone barium enema is being readied for discharge. The nurse determines that the client has understood discharge instructions when the client states:

4. "I should take a laxative, and my stool will then return to a normal color."

A nurse is collecting data from a client admitted to the hospital with a diagnosis of suspected gastric ulcer and is asking the client questions about pain. Which statement, if made by the client, would support the diagnosis of gastric ulcer?

4. "My pain comes shortly after I eat, maybe a half hour or so later.

The nurse observes that a client with a nasogastric tube connected to continuous gastric suction is mouth breathing, has dry mucous membranes, and has a foul breath odor. In planning care, which nursing intervention would be best to maintain the integrity of this client's oral mucosa?

4. Brush the client's teeth frequently. Use diluted mouthwash and water to rinse the mouth.

A nurse is providing post-procedure teaching after a client underwent an upper gastrointestinal (GI) series. The nurse reminds the client that the stools will remain white for approximately:

1. 1 to 2 days

A client with viral hepatitis states to the nurse, "I am so yellow." The nurse would appropriately:

1. Assist the client in expressing feelings.

A client who has a history of chronic ulcerative colitis is anemic. The nurse interprets that which factor is likely responsible for this laboratory finding?

1. Blood loss

A nurse documents that a client with a hiatal hernia is complying with the prescribed treatment if the client reports doing which of the following?

1. Consuming low-fat or nonfat foods

A client with acute pancreatitis is experiencing severe pain. After noting an absence of an analgesic prescription on the health care provider prescription sheet, the nurse would suggest contacting the health care provider to request a prescription for which of the following medications?

1. Meperidine hydrochloride (Demerol)

nurse is caring for a client in the emergency department who has right lower quadrant abdominal pain. After noting a white blood cell count of 16,500/mm3, the nurse should question a prescription for which of the following?

1. Milk of magnesia

A licensed practical nurse (LPN) is providing follow-up teaching after a client underwent an upper gastrointestinal (GI) series. The nurse reminds the client that the stools will remain white for approximately:

1. One day

A nurse reinforces instructions to a client following a gastrectomy about the signs and symptoms of pernicious anemia, knowing that:

1. Regular monthly injections of vitamin B12 will prevent this complication.

A client who has undergone a subtotal gastrectomy is being prepared for discharge. Which item concerning ongoing self-management should the nurse reinforce to the client?

1. Smaller and more frequent meals should be eaten.

A client has undergone subtotal gastrectomy and the nurse is preparing the client for discharge. Which item should be included when teaching the client about ongoing self-management?

1. Smaller, more frequent meals should be eaten

A nurse is monitoring a client for the early signs and symptoms of dumping syndrome. Which of the following symptoms indicate this occurrence?

1. Sweating and pallor

A client had a Miller-Abbott tube inserted 24 hours ago. The nurse is asked to check the client to determine whether the tube is in the appropriate location at this time. Which of the following findings would indicate adequate location of the tube?

1. The aspirate from the tube has a pH of 7.45.

A nurse is collecting data about how well a client with a gastrointestinal (GI) disorder is able to absorb food. While carrying out this function, the nurse recalls that absorption is best defined as:

1. The transfer of digested food molecules from the GI tract into the bloodstream

A nurse is caring for a client with pneumonia who has a history of bleeding esophageal varices. Based on this information, the nurse plans care, knowing that it is important to prevent:

1. Vigorous coughing

Of the following infection control methods, which would be the priority to include in the plan of care to specifically prevent hepatitis B in a client considered to be at high risk for exposure?

1. Hepatitis B vaccine

A health care provider asks the licensed practical nurse (LPN) to give preprocedure instructions to a client who will undergo a barium swallow (esophagography) in a few days. The LPN includes which of the following items in this discussion?

3. Remove all metal and jewelry before the test.

nurse is caring for a client with anorexia. The nurse plans care for the client, focusing on which of the following as the primary problem?

2. Impaired nutritional status

A nurse should include which of the following in a teaching plan for a client who has peptic ulcer disease?

2. Learn to use stress reduction techniques.

A client with acute pancreatitis is experiencing severe pain from the disorder. The nurse tells the client to avoid which position that could aggravate the pain?

2. Lying flat

A client with a tentative diagnosis of gastroesophageal reflux is going to undergo ambulatory pH monitoring. The nurse brings which of the following items to the bedside?

2. Nasogastric (NG) tube

A client who has been prescribed indomethacin (Indocin) for gout is asked to provide a stool sample for guaiac testing. The nurse explains that the purpose of the test is to determine:

2. Occult blood

A client with peptic ulcer disease has been prescribed to take misoprostol (Cytotec) and sucralfate (Carafate). The nurse teaches the client that these two medications will work primarily to:

4. Protect the gastric mucosa.

A nurse is monitoring for stoma prolapse in a client with a colostomy. The nurse would observe which of the following appearances in the stoma if prolapse occurred?

4. Protruding and swollen

A nurse has taught a client about an upcoming endoscopic retrograde cholangiopancreatography (ERCP) procedure. The nurse determines that the client needs additional information if the client makes which statement?

3. "I'm glad I don't have to lie still for this procedure."

A client with a possible hiatal hernia complains of frequent heartburn and regurgitation. Which sign or symptom would support this diagnosis?

3. Difficulty swallowing both liquids and solids

A nurse is reviewing the health care record of a client with a diagnosis of chronic pancreatitis. Which data noted in the record indicate poor absorption of dietary fats?

3. Difficulty swallowing both liquids and solids

A nurse is collecting admission data on the client with hepatitis. Which of the following findings would be a direct result of this client's condition?

3. Drowsiness

Before administering an intermittent tube feeding through a nasogastric tube, the nurse checks for gastric residual volume. The nurse understands that the rationale for checking gastric residual volume before administering the tube feeding is to:

3. Evaluate absorption of the last feeding.

A client is admitted to the hospital with severe jaundice and is having diagnostic testing. Because the client has no complaints of fatigue, the client is encouraged to ambulate in the hall to maintain muscle strength. The client paces around the room but will not enter the hall. Which of the following problems most likely is the reason for the client's reluctance to walk in the hall?

3. Feeling self-conscious about appearance

A nurse is preparing to administer an enteral feeding through a nasogastric tube. The nurse would place the client in which position during and after the feedings?

3. Fowler's

A nurse is assisting with the insertion of a nasogastric tube into a client. The nurse places the client in which position for insertion?

3. High Fowler's position

A nurse is working with a client diagnosed with anorexia nervosa. The nurse plans care, focusing on which of the following as the primary problem?

3. Impaired nutritional status

A client is resuming a diet after partial gastrectomy. To minimize complications, the nurse would tell the client to avoid doing which of the following?

3. Lying down after eating

A nurse will be providing postprocedure care to a client who has undergone esophagogastroduodenoscopy (EGD). The nurse would plan to do which of the following first once the client arrives?

3. Monitor for return of the gag reflex.

A nurse is caring for a client with esophageal varices who is going to have a Sengstaken-Blakemore tube inserted. The nurse brings which priority item to the bedside so that it is available at all times?

4. A pair of scissors

A nurse is monitoring a client with a diagnosis of peptic ulcer. Which finding would most likely indicate perforation of the ulcer?

4. A rigid, boardlike abdomen

A client has just undergone gastroscopy. Which of the following is the essential post-procedure nursing intervention?

4. Check the gag reflex before giving oral foods or fluids.

A client receiving a high cleansing enema complains of pain and cramping. The nurse would take which corrective action?

4. Clamp the tubing for 30 seconds and restart the flow at a slower rate

A client with hepatic encephalopathy is receiving lactulose (Cephulac). The nurse determines that the medication is effective if which of the following is observed?

4. Client previously oriented to person only; can now state name, year, and present location

A nurse is reinforcing dietary instructions to a client with peptic ulcer disease. The nurse encourages the client to:

4. Eat anything as long as it does not aggravate or cause pain.

After the deflation of the balloon of a client's Sengstaken-Blakemore tube, the nurse monitors the client closely for which esophageal complication?

4. Hemorrhage

A nurse is caring for a client with a resolved intestinal obstruction who has a nasogastric tube in place. The health care provider has now prescribed the nasogastric tube to be discontinued. To determine the client's readiness for discontinuation of the nasogastric tube, the nurse should check for:

4. Presence of bowel sounds in all four quadrants

A client with peptic ulcer disease has been prescribed misoprostol (Cytotec) and sucralfate (Carafate). The nurse teaches the client that these two medications will work primarily to:

4. Protect the gastric mucosa.

A nurse assigned to care for a client with cirrhosis reviews the medical record and notes that the client has difficulty maintaining an effective breathing pattern due to pressure on the diaphragm. The nurse plans care, knowing that which client position will best assist in facilitating breathing?

4. Semi-Fowler's

A nurse provides medication instructions to a client with peptic ulcer disease. Which statement by the client indicates the best understanding of the medication therapy?

4."The nizatidine (Axid) will cause me to produce less stomach acid."

A licensed practical nurse (LPN) is assisting in insertion of a nasogastric (NG) tube for an adult client. The LPN helps determine the correct length to insert the tube by measuring:

3. From the tip of the client's nose to the earlobe and then down to the xiphoid process

A nurse has been caring for a client with a Sengstaken-Blakemore tube. The health care provider arrives on the nursing unit and deflates the esophageal balloon. Following deflation of the balloon, the nurse should monitor the client most closely for which of the following?

3. Hematemesis

A client complains of stomach pain 30 minutes to 1 hour after eating. The pain is not relieved by further intake of food, although it is relieved by vomiting, and a gastric ulcer is suspected. The nurse should gather which of the following additional supportive data for this diagnosis from the client?

3. History of alcohol use, smoking, and weight loss

A nurse has given postprocedure instructions to a client who has undergone a colonoscopy. The nurse determines that the client did not fully understand the directions if the client states that:

3. It is all right to drive an hour after the test is finished.

A nurse would include which of the following when reinforcing home care instructions for a client who has peptic ulcer disease?

3. Learn to use stress reduction techniques.

A nurse provides instructions to a client after a liver biopsy. The nurse tells the client to:

3. Lie on the right side for 2 hours.

The nurse is providing discharge instructions to a client after gastrectomy. Which measure will the nurse instruct the client to follow to help prevent dumping syndrome?

3. Limit the fluids taken with meals.

Treatment measures have been implemented for a client with bleeding esophageal varices and have been unsuccessful. The health care provider states that a Sengstaken-Blakemore tube will be used to control the resulting hemorrhage. The nurse prepares for insertion via which of the following routes?

3. Nasogastric

A nurse is caring for a client with a Sengstaken-Blakemore tube. To prevent ulceration and necrosis of oral and nasal mucosa, the nurse should plan to:

3. Provide frequent oral and nasal care on a regular basis.

A nurse is performing an abdominal assessment on a client. The nurse interprets that which finding is abnormal and should be reported to the registered nurse (RN) or health care provider?

3. Pulsation between the umbilicus and pubis

A nurse is administering a cleansing enema to a client with a fecal impaction. Before administering the enema, the nurse assists the client to which of the following positions?

Left Sims' position

A client has just returned from the radiology department following an upper gastrointestinal (GI) series. The nurse reviews the health care provider's prescriptions, expecting to note which of the following needed for routine post-procedure care?

1. A laxative

A nurse is reviewing the prescriptions of a client admitted to the hospital with a diagnosis of acute pancreatitis. Choose the interventions that the nurse would expect to be prescribed for the client. Select all that apply.

1. Administer antacids, as prescribed. 3. Encourage coughing and deep breathing. 4. Administer anticholinergics, as prescribed.

A nurse is collecting data about how well a client with a gastrointestinal (GI) disorder is able to digest food. The nurse recalls that digestion is best defined as:

3. A mechanical and chemical process involving the breakdown of foods

A nurse notes that the medical record of a client with cirrhosis states that the client has asterixis. To verify this information, the nurse would do which of the following?

3. Ask the client to extend the arms.

A client with a history of gastrointestinal upset has been diagnosed with acute diverticulitis. To aid the client in symptom management, the nurse suggests foods that are on which of the following diets?

4. A low-fiber diet

A client with peptic ulcer disease is scheduled for a pyloroplasty and the client asks the nurse about the procedure. The nurse bases the response on which of the following?

4. A pyloroplasty involves an incision and resuturing of the pylorus to relax the muscle and enlarge the opening from the stomach to the duodenum.

A client is admitted to an acute care facility with complications of celiac disease. Which question would be helpful initially in obtaining information for the nursing care plan?

3. "What is your understanding of celiac disease?"