NCLEX Qs GI

The nurse has provided dietary instructions to a client with a diagnosis of peptic ulcer disease. Which client statement indicates that education was effective?

"Baked foods such as chicken or fish are all right to eat."

The nurse is caring for a client with new-onset abdominal pain who was diagnosed with acute gastritis. The client asks the nurse what may have caused this condition. Which of the following client factors increases the risk of acute gastritis? Select all that apply.

-H- pylori infection -Long-term corticosteroid therapy -Consuming multiple cups of coffee daily -Consuming five alcoholic beverages approximately 3 times per week

The nurse is assisting a client who had a hemorrhoidectomy 2 days ago with a sitz bath. The client asks the nurse how long the sitz baths are recommended after surgery. What is the appropriate nursing response?

1 to 2 weeks

The nurse is reviewing the laboratory results of a client diagnosed with cirrhosis. Which of the following international normalized ratios (INR) would the nurse expect in a client with cirrhosis?

1.6

The nurse is reviewing the pathophysiology of hypernatremia. The nurse correctly identifies which conditions as risk factors for hypernatremia? Select all that apply.

Diarrhea Diabetes insipidus Primary hyperaldosteronism

The nurse is caring for a client who has just returned from the operating room after colectomy to remove a bowel tumor and the creation of a colostomy. The nurse is assessing the drainage in the pouch attached to the site where the colostomy was formed and notes serosanguineous drainage. Which nursing action is appropriate based on this assessment?

Document the amount and characteristics of the drainage.

The nurse is providing instructions to a client diagnosed with irritable bowel syndrome (IBS) who is experiencing abdominal distention, flatulence, and diarrhea. What interventions would the nurse plan to include in the instructions? Select all that apply.

Eat yogurt. Take loperamide to treat diarrhea. Use stress management techniques. Avoid foods such as cabbage and broccoli.

A client is admitted to the hospital with acute viral hepatitis. Which sign or symptom would the nurse expect to note based on this diagnosis?

Fatigue

A client reports having six episodes of loose stools that have a foul odor. The nurse suspects that the client has Clostridium difficile. To confirm this, the nurse would anticipate which test to be ordered?

Fecal gastrointestinal pathogen panel—polymerase chain reaction

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.

Fever Complaints of indigestion Pain in the upper right quadrant after a fatty meal

The nurse has implemented a bowel maintenance program for an unconscious client. The nurse would evaluate the plan as best meeting the needs of the client if which method was successful in stimulating a bowel movement?

Glycerin suppository

The nursing instructor is teaching a nursing student about hepatitis B and groups that would benefit from hepatitis B virus (HBV) screening. Which individuals would be recommended to receive HBV screening? Select all that apply.

Health care workers An individual with cirrhosis An individual who uses intravenous drugs An individual with multiple sexual partners

The nurse is assigned to care for a client with a Sengstaken-Blakemore tube for the treatment of esophageal varices. Which laboratory result is mostfocused on evaluating the effectiveness of this tube?

Hemoglobin

The nurse is performing an assessment on a client with suspected irritable bowel syndrome (IBS). Which laboratory test would the nurse anticipate being ordered to confirm this diagnosis?

Hydrogen breath test

The nurse is caring for a client with suspected celiac disease undergoing diagnostic evaluation. Which laboratory tests would the nurse expect to be ordered to aid in the diagnosis of this disease?

IgA

The emergency department nurse is admitting a client who sustained several traumatic injuries after being hit by a car while crossing the street. The client has signs and symptoms of abdominal trauma in addition to several other injuries. The client's imaging results indicate a fractured mandible. Computed tomography (CT) scans are pending, but the client's pelvic x-ray is negative for fracture.

Insert a nasogastric tube.

A client with severe ulcer disease in the distal stomach undergoes a gastrojejunostomy (Billroth II procedure). Which postoperative prescription would the nurse question and verify?

Irrigating the nasogastric tube

The nurse is providing discharge instructions to a client following gastrectomy and would instruct the client to take which measure to assist in preventing dumping syndrome?

Limit the fluids taken with meals.

The nurse is caring for a client currently being treated for a Clostridium difficile (C. difficile) infection. The client asks the nurse about factors that increase the risk of contracting this infection. The nurse would tell the client that which factors increase the risk of C. difficileinfection? Select all that apply.

Living in a long-term care facility History of previous C. difficile infection Taking nitrofurantoin for a urinary tract infection (UTI)Taking pantoprazole daily for gastroesophageal reflux disease (GERD)

The nurse is caring for a client with common bile duct obstruction. The nurse would anticipate that the primary health care provider (PHCP) will prescribe which diet for this client?

Low fat

A client with hiatal hernia chronically experiences heartburn following meals. The nurse would plan to teach the client to avoid which action because it is contraindicated with a hiatal hernia?

Lying recumbent following meals

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.

Maintain NPO (nothing by mouth) status. Encourage coughing and deep breathingGive hydromorphone intravenously as prescribed for pain.

The nurse is creating a care plan for a client diagnosed with gastrointestinal bleeding from a gastric ulcer. How would the nurse plan to monitor the client for occult signs of gastrointestinal bleeding?

Monitoring the client's respiratory rate and work of breathing

The nurse is assessing a client for signs and symptoms of peritonitis. Which of the following signs or symptoms would alert the nurse to the possibility of this condition? Select all that apply.

Nausea Vomiting Temperature of 102 ℉ (38.9 ℃)

A client in the emergency department is suspected of having peritonitis. Upon assessment, which findings would the nurse expect to note? Select all that apply.

Nausea and vomiting Lying in a fetal position Temperature of 101.7° F (38.7° Reports sudden sharp pain in the midepigastric region

The nurse is interpreting a client's laboratory screening results for hepatitis B. Which laboratory result would indicate that the client does not have an active hepatitis B infection, but has no protection against hepatitis B and would benefit from immunization?

Negative HBsAg and negative anti-HBs

The nurse is caring for a client with a serum sodium level of 151 mEq/L (151 mmol/L). Which priority assessment would the nurse include in the care plan for this client?

Neurological assessment

The emergency department nurse is assessing a client with suspected appendicitis with complaints of right lower quadrant pain, nausea, vomiting, and anorexia. Which diet orders would the nurse anticipate?

Nothing by mouth (NPO)

Upon assessment of a client with a hernia, the nurse notes that the hernia cannot be reduced. Which nursing action is the priority?

Notify the primary health care provider.

The nurse in a primary health care provider setting is calculating a client's body mass index (BMI). The nurse determines the client's BMI is 30.2 kg/m2. How would the nurse classify the client's BMI based on this value?

Obese

The nurse is caring for a client with a potassium level of 5.9 mEq/L and is assisting the client in choosing lunch. The nurse determines there is a need for further teaching if the client selects which food item from the menu?

Omelet with spinach, tomato, potatoes

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 would assess the client for which manifestation of duodenal ulcer?

Pain relieved by food intake

The nurse is providing care for a client with a recent transverse colostomy created to resolve a bowel obstruction. Which observation requires immediatenotification of the primary health care provider?

Purple discoloration of the stoma

A client asks the nurse what causes gastroesophageal reflux disease (GERD). Knowing that GERD has many causative factors, the nurse would list which as contributors to GERD? Select all that apply.

Reduced esophageal motility Reflux of bile from the small intestine Lower esophageal sphincter dysfunction Reflux of gastric contents into the esophagus

A client has been advanced to a solid diet after undergoing a subtotal gastrectomy. What is the appropriate nursing intervention in preventing dumping syndrome?

Remove fluids from the meal tray.

The nurse provides home care instructions to the parents of a child with celiac disease. The nurse would teach the parents to include which food item in the child's diet?

Rice

The nurse is reviewing the pathophysiology of bowel perforation. Which of the following would the nurse identify as a noniatrogenic cause of a bowel perforation?

Ruptured gastric ulcer

A client with a history of gastrointestinal upset has been diagnosed with acute diverticulitis. The nurse would anticipate a prescription from the primary health care provider for which type of diet for this client?

A low-fiber diet

The nurse is monitoring a client with a diagnosis of peptic ulcer. Which assessment finding would most likelyindicate perforation of the ulcer?

A rigid, boardlike abdomen

A client with ulcerative colitis has a prescription to begin a salicylate compound medication to reduce inflammation. What instruction would the nurse give the client regarding when to take this medication?

After meals

The nurse has taught the client with chronic pancreatitis about risk factor modification to reduce the incidence of recurrences. The nurse determines that teaching was effective if the client states that it will be necessary to control which factor?

Alcohol intake

A 4-year-old child diagnosed with Hirschsprung disease is undergoing surgery in the morning at 0700. Before the procedure the nurse can anticipate that which will be prescribed preoperatively? Select all that apply.

Antibiotics Saline enemas Laboratory studies NPO after midnight

The nurse caring for a client diagnosed with inflammatory bowel disease (IBD) recognizes that which classifications of medications may be prescribed to treat the disease and induce remission? Select all that apply.

Antimicrobial Corticosteroid Aminosalicylate Biological therapy Immunosuppressant

The nurse is educating a client being discharged from the hospital following treatment for acute pancreatitis regarding dietary needs to prevent further acute attacks. What statement by the client indicates teaching was effective?

"I need to eat low-fat foods and fresh fruits and vegetables to help prevent further attacks."

A client diagnosed with viral hepatitis is complaining of "no appetite" and "losing my taste for food." What instruction would the nurse give the client to provide adequate nutrition?

Increase intake of fluids, including juices.

The nurse is providing dietary instructions to a client with a diagnosis of irritable bowel syndrome. The nurse determines that education was effective if the client states the need to avoid which food?

Corn

The nurse is caring for a client with gallbladder disease who is experiencing nutrition problems due to biliary obstruction. The nurse understands that obstruction of which passage is related to the client's condition?

Cystic duct

The nurse is reviewing the laboratory results for a female client diagnosed with Crohn's disease (CD). Which laboratory results would indicate that the client is experiencing an acute inflammatory process related to CD? Select all that apply

D-dimer of 75 ng/mL (4.5 mmol/L) White blood cell (WBC) count of 14,000/mm3(14 × 109/L) Erythrocyte sedimentation rate (ESR) of 30 mm/hr

The nurse inspects the color of the drainage from a nasogastric tube on a postoperative client approximately 24 hours after gastric surgery. Which finding indicates the need to notify the primary health care provider (PHCP)?

Dark red drainage

Diphenoxylate hydrochloride with atropine sulfate is prescribed for a client with ulcerative colitis. The nurse would monitor the client for which therapeutic effect of this medication?

Decreased diarrhea

The nurse is providing discharge instructions for a client following a Roux-en-Y gastric bypass surgery 3 days ago. What will the nurse include in the instructions? Select all that apply.

Do not drink fluids with meals. Avoid foods high in carbohydrates. Eat 6 small meals a day that are high in protein.

The nurse is caring for a client with diagnosed appendicitis that is awaiting surgical intervention scheduled the next day. In which of the following positions would it be best for the nurse to place the client?

Semi-Fowler's position

The nurse is caring for a client who has a small-bowel obstruction (SBO) and has reported vomiting for over the past 12 hours. The nurse assesses the client for signs and symptoms of which acid-base imbalance?

Metabolic alkalosis

Lactulose is prescribed for a hospitalized client with a diagnosis of hepatic encephalopathy. Which assessment finding indicates that the client is responding to this medication therapy as anticipated?

The fecal pH is acidic.

The nurse is caring for a client being evaluated for peritonitis due to suspected gastric ulcer perforation. Which of the following findings on an abdominal x-ray supports this diagnosis?

The presence of free air in the abdominal cavity

The nurse is caring for a client who sustained abdominal injuries in a motor vehicle accident. Which laboratory result would alert the nurse the client sustained kidney damage?

Urinalysis positive for trace amounts of blood

The nurse is reviewing the pathophysiology of bowel obstruction and the mechanical and nonmechanical causes of obstruction. Which would the nurse identify as a mechanical cause of intestinal obstruction? Select all that apply.

Ventral hernia Gastric malignancy Bowel intussusception

The nurse in a primary health care provider setting is assessing an obese male client for risk factors of metabolic syndrome. Based on the assessment, the nurse determines that which finding is a risk factor for metabolic syndrome?

Waist circumference 40 inches (102 centimeters)

The nurse is giving instructions to a client with cholecystitis about food to exclude from the diet. Which food item identified by the client indicates that the educational session was successful?

Brown gravy

The nurse is caring for a client with suspected celiac disease who had a skin biopsy of a red, pruritic lesion located on the buttocks. If the suspicious lesion is dermatitis herpetiformis, which skin biopsy result would the nurse expect?

IgA deposits in the dermis

The nurse is caring for a client with acute pancreatitis and is monitoring the client for paralytic ileus. Which assessment data would alert the nurse to this occurrence?

Inability to pass flatus

The nurse is caring for a client diagnosed with acute pancreatitis. The nurse reviews the client's laboratory results, expecting which trend in the laboratory report?

Increased lipase

The nurse is creating a care plan for a client diagnosed with a bleeding gastric ulcer related to Helicobacter pylori (H. pylori) infection. The nurse plans to monitor the client for which signs and symptoms that indicate an upper gastrointestinal (GI) bleed? Select all that apply.

Melena New-onset confusion Coffee-ground vomitus

The nurse is assessing a client with ulcerative colitis (UC). The nurse is gathering information related to the client's bowel habits, and the client reports having approximately five nonbloody stools a day. How would the nurse classify the severity of this client's UC?

Moderate

The nurse is assessing a client with a duodenal ulcer. The nurse interprets that which sign or symptom is mostconsistent with the typical presentation of duodenal ulcer?

Pain that is relieved by food intake

A client with a diagnosis of stomach ulcer from gastric hyperacidity asks the nurse why the acid has not caused an ulcer in the small intestine as well. The nurse responds that the pH of intestinal contents is raised by bicarbonate, which is present in which area of the body?

Pancreatic juice

The nurse is performing a gastrointestinal assessment on a client with a small bowel obstruction. The nurse notes that the client has absent bowel sounds. Which would the nurse suspect as the cause of the obstruction?

Paralytic ileus

The nurse is reviewing the laboratory results for a client with cirrhosis and notes that the ammonia level is 85 mcg/dL (51 mcmol/L). Which dietary selection does the nurse suggest to the client?

Pasta with sauce

The registered nurse is precepting a new nurse who is caring for a client with pernicious anemia as a result of a gastrectomy. Which statement made by the new nurse indicates understanding of this diagnosis?

"Decreased production of intrinsic factor by the stomach affects absorption of vitamin B12 in the small intestine."

The nurse has given instructions to a client with hepatitis about postdischarge management during convalescence. The nurse determines that further teaching is needed if the client makes which statement?

"I can resume a full activity level within 1 week."

The nurse is providing teaching to a client with suspected irritable bowel syndrome (IBS) who is scheduled to have a hydrogen breath test done to assist in confirming the diagnosis. Which of the following client statements would indicate a need for further teaching?

"I cannot have anything to eat or drink for at least 12 hours before the test."

The nurse is teaching the postgastrectomy client about measures to prevent dumping syndrome. Which statement by the client indicates a need for further teaching?

"I need to drink liquids with meals."

The nurse is performing an assessment on a client with suspected acute pancreatitis. Which complaint made by the client supports the diagnosis?

"I've been experiencing constant, severe abdominal pain that is unrelieved by vomiting."

The nurse is teaching a client with gastroesophageal reflux disease (GERD) about lifestyle modifications to take to reduce GERD symptoms. The nurse determines there is a need for further teaching if the client makes which statement?

"Skipping breakfast and lunch and eating a large dinner will decrease my symptoms."

A client diagnosed with a severe ulcerative colitis (UC) exacerbation has developed an intestinal abscess. The client asks the nurse to explain what this means. How would the nurse describe this complication?

"The bowel has developed localized pockets containing pus in the ulcerated bowel lining."

A client diagnosed with an anal fistula asks the nurse to describe this condition. Which of the following is the appropriate nursing response?

"The condition refers to an abnormal connection or tunnel originating from the anus or rectum."

The nurse teaches a preoperative client about the use of a nasogastric (NG) tube for the planned surgery. Which statement indicates to the nurse that the client understands when the tube can be removed in the postoperative period?

"When my bowels begin to function again, and I begin to pass gas."

A client presents to the emergency department with upper gastrointestinal (GI) bleeding from a gastric ulcer and is in moderate distress. In planning care, which nursing action would be the priority for this client?

Assessment of vital signs

The registered nurse (RN) is overseeing a new graduate nurse who is taking care of a client with a Clostridium difficile (C. difficile) infection. The RN would determine that the new graduate nurse requires a need for further teaching if the RN observes the new graduate nurse take which of the following actions during the care of this client?

Auscultating lung sounds with the nurse's own stethoscope

The nurse is performing discharge teaching for a client with chronic pancreatitis. Which information would the nurse include?

Avoid caffeine because it may aggravate symptoms.

The nurse is reviewing the etiology of peritonitis. Which of the following would the nurse identify as a chemical cause of peritonitis?

Bile leakage from the gallbladder

The nurse is caring for a client with a history of a small perforated duodenal ulcer that spontaneously healed on its own. The client asks the nurse about potential complications from a healed ulcer. The nurse would tell the client that which of the following is a complication of a self-healed duodenal ulcer?

Bowel stricture

The nurse in a primary health care provider setting is assessing a client who is there for an annual examination. After weighing and measuring the client, the nurse calculates the client's body mass index (BMI) and determines that the client falls into the morbidly obese category. Which BMI value supports this assessment finding?

40.0 kg/m2

The nursing instructor is conducting a lecture on various esophageal disorders. How would the nursing instructor plan to describe achalasia?

A disorder in which peristalsis of the distal two-thirds of the esophageal smooth muscle is absent

The nurse is admitting a client with chronic peptic ulcer disease who is complaining of severe abdominal pain. Which order from the primary health care provider requires a need for follow-up?

Administer 15 milligrams (mg) ketorolac intravenously every 6 hours as needed for moderate pain.

A client arrives at the hospital emergency department complaining of acute right lower quadrant abdominal pain. Appendicitis is suspected, and appropriate laboratory tests are performed. The emergency department nurse reviews the test results and notes that the client's white blood cell (WBC) count is elevated. The nurse also reviews the prescriptions from the primary health care provider (PHCP). The nurse would contact the PHCP to question which order if noted in the client's record?

Apply a heating pad to the lower abdomen for comfort.

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 would the nurse assess for its presence?

Ask the client to extend the arms.

A client is scheduled for an upper gastrointestinal (GI) endoscopy. Which assessment is essential to include in the plan of care following the procedure?

Assessing for the presence of the gag reflex

After undergoing Billroth I gastric surgery, the client experiences fatigue and complains of numbness and tingling in the feet and difficulties with balance. On the basis of these symptoms, the nurse suspects which postoperative complication?

Pernicious anemia

The nurse is assisting a physician with the insertion of a Miller-Abbott tube. The nurse understands that the procedure places the client at risk for aspiration and would therefore plan which action to decrease this risk?

Place the client in a semi-Fowler's to high-Fowler's position.

The nurse is assessing a client diagnosed with acute pancreatitis. The nurse notes grayish-blue discoloration on the client's left and right flanks. How would the nurse interpret this assessment finding?

Positive Grey Turner's sign

The nursing instructor asks a nursing student which substance provides a protective function for the stomach against autodigestion and subsequent gastritis. The nursing student responds correctly by identifying which substance?

Prostaglandins

The nurse is providing dietary instructions to a client hospitalized for pancreatitis. Which food would the nurse instruct the client to avoid?

Salsa and corn chips

The nurse is caring for a group of clients on the surgical nursing unit. The nurse anticipates that the client who underwent which procedure is most likely to have some long-term residual difficulty with absorption of nutrients?

Small bowel resection

The nurse is assessing a client with cholecystitis due to an obstructing cholelithiasis. The nurse notes that the client's stools are foul-smelling and oily. How would the nurse document this finding?

Steatorrhea

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

Sweating and pallor

A nurse is obtaining a past medical history for a client suspected of cholecystitis. Which finding would the nurse report to the primary health care provider?

The client is taking oral contraceptives.

The nurse is reviewing the medical record of a client with chronic pancreatitis. Which manifestations would the nurse expect to note documented in the record? Select all that apply.

Weight loss Steatorrhea Constipation Mild jaundice Gnawing, burning, cramping epigastric pain

The nurse is reviewing the laboratory results of a client diagnosed with peritonitis. Which of the following laboratory results supports this diagnosis?

White blood cell (WBC) count 22,000 mm3(22 × 109/L)

A client with a new ileostomy is concerned about the odor from stool in the ostomy drainage bag. The nurse would teach the client to include which food in the diet to reduce odor?

Yogurt