GI NCLEX Questions

A client has developed hepatitis A after eating contaminated oysters. The nurse assesses the client for which expected assessment finding? 1. Malaise 2. Dark stools 3. Weight gain 4. Left upper quadrant discomfort

1

A health care provider schedules a paracentesis. What should the nurse instruct the client to do to prepare for the procedure? 1. Empty the bladder before the procedure. 2. Take a laxative the evening before the procedure. 3. Ingest nothing by mouth for 8 hours before the procedure. 4. Self-administer a low soapsuds enema 2 hours before the procedure.

1

The nurse is monitoring a client admitted to the hospital with a diagnosis of appendicitis who is scheduled for surgery in 2 hours. The client begins to complain of increased abdominal pain and begins to vomit. On assessment, the nurse notes that the abdomen is distended and bowel sounds are diminished. Which is the most appropriate nursing intervention? 1. Notify the health care provider (HCP). 2. Administer the prescribed pain medication. 3. Call and ask the operating room team to perform surgery as soon as possible. 4. Reposition the client and apply a heating pad on the warm setting to the client's abdomen.

1

The nurse is monitoring a client for the early signs and symptoms of dumping syndrome. Which findings indicate this occurrence? 1. Sweating and pallor 2. Bradycardia and indigestion 3. Double vision and chest pain 4. Abdominal cramping and pain

1

The nurse is providing discharge teaching for a client with newly diagnosed Crohn's disease about dietary measures to implement during exacerbation episodes. Which statement made by the client indicates a n eed for further in struction? 1. "I should increase the fiber in my diet." 2. "I will need to avoid caffeinated beverages." 3. "I'm going to learn some stress reduction techniques." 4. "I can have exacerbations and remissions with Crohn's disease."

1

The nurse provides instructions to a client about measures to treat inflammatory bowel syndrome (IBS). Which statement by the client indicates a need for further teaching? 1. "I need to limit my intake of dietary fiber." 2. "I need to drink plenty, at least 8 to 10 cups daily." 3. "I need to eat regular meals and chew my food well." 4. "I will take the prescribed medications because they will regulate my bowel patterns."

1

The nurse is reviewing the prescription for a client admitted to the hospital with a diagnosis of acute pancreatitis. Which interventions would the nurse expect to be prescribed for the client? Select all that apply. 1. Maintain NPO (nothing by mouth) status. 2. Encourage coughing and deep breathing. 3. Give small, frequent high-calorie feedings. 4. Maintain the client in a supine and flat position. 5. Give hydromorphone intravenously as prescribed for pain. 6. Maintain intravenous fluids at 10 mL/hour to keep the vein open.

1 2 5

The nurse is assessing a client who is experiencing an acute episode of cholecystitis. Which of these clinical manifestations support this diagnosis? Select all that apply. 1. Fever 2. Positive Cullen's sign 3. Complaints of indigestion 4. Palpable mass in the left upper quadrant 5. Pain in the upper right quadrant after a fatty meal 6. Vague lower right quadrant abdominal discomfort

1 3 5

A client is diagnosed with viral hepatitis, complaining of "no appetite" and "losing my taste for food." What instruction should the nurse give the client to provide adequate nutrition? 1. Select foods high in fat. 2. Increase intake of fluids, including juices. 3. Eat a good supper when anorexia is not as severe. 4. Eat less often, preferably only 3 large meals daily.

2

A client with gastroesophageal reflux disease reports having difficulty sleeping at night. What should the nurse instruct the client to do? 1. Drink a glass of milk before retiring. 2. Elevate the head of the bed on blocks. 3. Eliminate carbohydrates from the diet. 4. Take antacids such as sodium bicarbonate.

2

A nurse is preparing a teaching plan for a client with a history of cholelithiasis. Which information about why the ingestion of fatty foods will cause discomfort should the nurse include in the teaching plan? 1. Fatty foods are hard to digest. 2. Bile flow into the intestine is obstructed. 3. The liver is manufacturing inadequate bile. 4. There is inadequate closure of the ampulla of Vater.

2

A patient with acute pancreatitis is reporting excessive thirst, excessive voiding, and blurred vision. As the nurse, it is priority you? 1. Reassure the patient this is normal with pancreatitis 2. Check the patient's blood glucose 3. Assist the patient with drinking a simple sugar drink like orange juice 4. Provide a dark and calm environment

2

Before a cholecystectomy vitamin K is prescribed. Which element, formed in the presence of vitamin K, should the nurse determine is the purpose of administering this medication? 1. Bilirubin 2. Prothrombin 3. Thromboplastin 4. Cholecystokinin

2

The health care provider has determined that a client has contracted hepatitis A based on flulike symptoms and jaundice. Which statement made by the client supports this medical diagnosis? 1. "I have had unprotected sex with multiple partners." 2. "I ate shellfish about 2 weeks ago at a local restaurant." 3. "I was an intravenous drug abuser in the past and shared needles." 4. "I had a blood transfusion 30 years ago after major abdominal surgery."

2

Your patient is diagnosed with acute cholecystitis. The patient is extremely nauseous. A nasogastric tube is inserted with GI decompression. The patient reports a pain rating of 9 on 1-10 scale and states the pain radiates to the shoulder blade. Select all the appropriate nursing interventions for the patient: 1. Encourage the patient to consume clear liquids. 2. Administered IV fluids per MD order. 3. Provide mouth care routinely. 4. Keep the patient NPO. 5. Administer analgesic as ordered. 6. Maintain low intermittent suction to NG tube.

2 3 4 5 6

A client has a suspected peptic ulcer in the duodenum. What should the nurse expect the client to report when describing the pain associated with this disease? 1. An ache radiating to the left side. 2. An intermittent colicky flank pain. 3. A gnawing sensation relieved by food. 4. A generalized abdominal pain intensified by moving.

3

A client with chronic hepatic failure is soon to be discharged from the hospital. Which diet should the nurse encourage the client to follow based on the health care provider's order? 1. High-fat 2. Low-calorie 3. Low-protein 4. High-sodium

3

A nurse is caring for a client who is positive for hepatitis A. What should the nurse do? 1. Wear a gown when entering the patient's room. 2. Use caution when bringing in the client's food. 3. Use gloves when removing the client's bedpan. 4. Wear a protective mask when entering the client's room.

3

The nurse has taught the client about an upcoming endoscopic retrograde cholangiopancreatography (ERCP) procedure. The nurse determines that the client needs further information if the client makes which statement? 1. "I know I must sign the consent form." 2. "I hope the throat spraykeepsme from gagging." 3. "I'm glad Idon't have to lie still for thisprocedure." 4. "I'm glad some intravenous medication will be given to relax me."

3

The nurse is caring for a client following a gastrojejunostomy (Billroth II procedure). Which postoperative prescription should the nurse question and verify? 1. Leg exercises 2. Early ambulation 3. Irrigating the nasogastric tube 4. Coughing and deep-breathing exercises

3

The nurse is doing an admission assessment on a client with a history of duodenal ulcer. To determine whether the problem is currently active, the nurse should assess the client for which sign(s)/ symptom(s) of duodenal ulcer? 1. Weight loss 2. Nausea and vomiting 3. Pain relieved by food intake 4. Pain radiating down the right arm

3

The nurse is providing discharge instructions to a client following gastrectomy and should instruct the client to take which measure to assist in preventing dumping syndrome? 1. Ambulate following a meal. 2. Eat high-carbohydrate foods. 3. Limit the fluids taken with meals. 4. Sit in a high Fowler's position during meals.

3

The nurse is reviewing the record of a client with a diagnosis of cirrhosis and notes that there is documentation of the presence of asterixis. How should the nurse assess for its presence? 1. Dorsiflex the client's foot. 2. Measure the abdominal girth. 3. Ask the client to extend the arms. 4. Instruct the client to lean forward.

3

Your recent admission has acute cholecystitis. The patient is awaiting a cholecystostomy. What signs and symptoms are associated with this condition? Select all that apply: 1. Right lower quadrant pain with rebound tenderness 2. Negative Murphy's Sign 3. Epigastric pain that radiates to the right scapula 4. Pain and fullness that increases after a greasy or spicy meal 5. Fever 6. Tachycardia 7. Nausea

3 4 5 6 7

A client has undergone esophagogastroduodenoscopy. The nurse should place highest priority on which item as part of the client's care plan? 1. Monitoring the temperature 2. Monitoring complaints of heartburn 3. Giving warm gargles for a sore throat 4. Assessing for the return of the gag reflex

4

A nurse is assessing two clients. One client has ulcerative colitis and the other client has Crohn Disease. Which is more likely to be identified in the client with ulcerative colitis than the client with Crohn disease? 1. Inclusion of transmural involvement. 2. Correlation with increased malignancy because of malabsorption syndrome. 3. Pathology beginning proximally with intermittent plaques found along the colon. 4. Involvement starting distally with rectal bleeding that spreads continuously up the colon.

4

A nurse is caring for a client with a diagnosis of acute pancreatitis and alcoholism. The client asks, "What does my drinking have to do with my diagnosis?" What effect of alcohol should the nurse include in the responding? 1. Promotes the formation of calculi in the cystic duct 2. Stimulates the pancreas to secrete more insulin than it can immediately produce. 3. Alters the composition of enzymes so they are capable of damaging the pancreas. 4. Increases enzyme secretion and pancreatic duct pressure that causes backflow of enzymes into the pancreas.

4

The nurse is monitoring a client with a diagnosis of peptic ulcer. Which assessment finding would most likely indicate perforation of the ulcer? 1. Bradycardia 2. Numbness in the legs 3. Nausea and vomiting 4. A rigid, boardlike abdomen

4

A client admitted to the hospital with a suspected diagnosis of acute pancreatitis is being assessed by the nurse. Which assessment findings would be consistent with acute pancreatitis? Select all that apply. 1. Diarrhea 2. Black, tarry stools 3. Hyperactive bowel sounds 4. Gray-blue color at the flank 5. Abdominal guarding and tenderness 6. Left upper quadrant pain with radiation to the back

4 5 6

A patient has lab work drawn and it shows a positive HBsAg. What education will you provide to the patient? A. Avoid sexual intercourse or intimacy such as kissing until blood work is negative. B. The patient is now recovered from a previous Hepatitis B infection and is now immune. C. The patient is not a candidate from antiviral or interferon medications. D. The patient is less likely to develop a chronic infection.

A

A patient with viral Hepatitis states their flu-like symptoms have subsided. However, they now have yellowing of the skin and sclera along with dark urine. Based on this finding, this is what phase of Hepatitis? A. Icteric B. Posticteric C. Preicteric D. Convalescent

A

A patient is diagnosed with Hepatitis D. What statement is true about this type of viral Hepatitis? Select all that apply: A. The patient will also have the Hepatitis B virus. B. Hepatitis D is most common in Southern and Eastern Europe, Mediterranean, and Middle East. C. Prevention of Hepatitis D includes handwashing and the Hepatitis D vaccine. D. Hepatitis D is most commonly transmitted via the fecal-oral route.

A B

Select all the types of viral Hepatitis that have preventive vaccines available in the United States? A. Hepatitis A B. Hepatitis B C. Hepatitis C D. Hepatitis D E. Hepatitis E

A B

Select ALL the options below that are similarities between ulcerative colitis and Crohn's Disease: A. Each cause inflammation B. Both affect the serosa layer C. Each are found from the mouth to anus D. They both increase colon cancer risk E. The cause of both is unknown F. The cure for both diseases includes total colectomy

A D E

Select ALL of the following that are complications associated with Crohn's Disease: A. Cobble-stone appearance of GI lining B. Lead-pipe sign C. Toxic megacolon D. Fistula E. Abscess F. Anal Fissure

A D E F

You're providing an in-service to new nurse graduates about esophageal varices in patients with cirrhosis. You ask the graduates to list activities that should be avoided by a patient with this condition. Which activities listed are correct: Select all that apply A. Excessive coughing B. Sleeping on the back C. Drinking juice D. Alcohol consumption E. Straining during a bowel movement F. Vomiting

A D E F

Select all the signs and symptoms associated with Hepatitis? A. Arthralgia B. Bilirubin 1 mg/dL C. Ammonia 15 mcg/dL D. Dark urine E. Vision changes F. Yellowing of the sclera G. Fever H. Loss of appetite

A D F G H

A patient with Hepatitis has a bilirubin of 6 mg/dL. What findings would correlate with this lab result? Select all that apply: A. None because this bilirubin level is normal B. Yellowing of the skin and sclera C. Clay-colored stools D. Bluish discoloration on the flanks of the abdomen E. Dark urine F. Mental status changes

B C E

A patient with late-stage cirrhosis develops portal hypertension. Which of the following options below are complications that can develop from this condition? Select all that apply: A. Increase albumin levels B. Ascites C. Splenomegaly D. Fluid volume deficient E. Esophageal varices

B C E

During the posticteric phase of Hepatitis the nurse would expect to find? Select all that apply: A. Increased ALT and AST levels along with an increased bilirubin level B. Decreased liver enzymes and bilirubin level C. Flu-like symptoms D. Resolved jaundice and dark urine

B D

The physician orders Lactulose 30 mL by mouth per day for a patient with cirrhosis. What findings below demonstrates the medication is working effectively? Select all that apply: A. Decrease albumin levels B. Decrease in Fetor Hepaticus C. Patient is stuporous. D. Decreased ammonia blood level E. Presence of asterixis

B D

You're educating a group of outpatients about signs and symptoms of ulcerative colitis. Which of the following are NOT typical signs and symptoms of ulcerative colitis? SELECT-ALL-THAT-APPLY: A. Rectal Bleeding B. Abdominal mass C. Bloody diarrhea D. Fistulae E. Extreme Hungry F. Anemia

B D E

A patient with a history of diverticulosis is admitted with abdominal pain. The physician suspects diverticulitis. What other findings would correlate with diverticulitis? SELECT-ALL-THAT-APPLY: A. Abdominal pain that is mainly present in the upper right quadrant B. Unrelenting cramping type pain C. Pain found at McBurney's Point D. Blood in stool E. Fever F. Reports of constipation G. Abdominal bloating H. Positive Cullen's Sign

B D E F G

A patient with Hepatitis A asks you about the treatment options for this condition. Your response is? A. Antiviral medications B. Interferon C. Supportive care D. Hepatitis A vaccine

C

What is the BEST preventive measure to take to help prevent ALL types of viral Hepatitis? A. Vaccination B. Proper disposal of needles C. Hand hygiene D. Blood and organ donation screening

C

Which of the following is NOT a potential complication associated with ulcerative colitis? A. Toxic megacolon B. Anemia C. Stricture D. Peritonitis

C

You're providing education to a patient with an active Hepatitis B infection. What will you include in their discharge instructions? Select all that apply: A. "Take acetaminophen as needed for pain." B. "Eat large meals that are spread out through the day." C. "Follow a diet low in fat and high in carbs." D. "Do not share toothbrushes, razors, utensils, drinking cups, or any other type of personal hygiene product." E. "Perform aerobic exercises daily to maintain strength."

C D

A 25-year-old patient was exposed to the Hepatitis A virus at a local restaurant one week ago. What education is important to provide to this patient? A. Inform the patient to notify the physician when signs and symptoms of viral Hepatitis start to appear. B. Reassure the patient the chance of acquiring the virus is very low. C. Inform the patient it is very important to obtain the Hepatitis A vaccine immediately to prevent infection. D. Inform the patient to promptly go to the local health department to receive immune globulin.

D

After providing education to a patient with GERD. You ask the patient to list 4 things they can do to prevent or alleviate signs and symptoms of GERD. Which statement is INCORRECT? A. "It is best to try to consume small meals throughout the day than eat 3 large ones." B. "I'm disappointed that I will have to limit my intake of peppermint and spearmint because I love eating those types of hard candies." C. "It is important I avoid eating right before bedtime." D. "I will try to lie down after eating a meal to help decrease pressure on the lower esophageal sphincter."

D