Gastrointestinal NCLEX

A patient expresses concerns over having black stool. The fecal occult test is negative. Which response by the nurse is most appropriate?

"Do you take iron supplements?"

A nurse is educating a patient on how to irrigate an ostomy bag. Which statement by the patient indicates the need for further instruction?

"I can use a fleet enema to save money because it contains the same irrigation solution."

The nurse is caring for a postoperative patient with a colostomy. The nurse is preparing to administer a dose of famotidine (Pepcid) when the patient asks why the medication was ordered since the patient does not have a history of heartburn or gastroesophageal reflux disease (GERD). What response by the nurse would be the most appropriate?

"This will reduce the amount of HCl in the stomach until the nasogastric tube is removed and you can eat a regular diet again."

Routine postoperative intravenous fluids are designed to supply hydration and electrolytes an only limited energy. Because 1 L of a 5% destrose solution contains 50 grams of sugar, 3 L/day woul supply approximately:

600 kilocalories

A 61-year-old patient with suspected bowel obstruction had a nasogastric tube inserted at 4:00 AM. The nurse shares in the morning report that the day shift staff should check the tube for patency at what times?

8:00 AM, 12:00 PM, and 4:00 PM

When preparing a client to go home with TPN, the nurse should help the client plan:

A schedule of administration around regular activity

A client has symptoms associated with salmonellosis. Relevant data to gather from this client include a history of:

All foods eaten in the past 24 hours

The nurse cares for a postoperative patient who has just vomited yellow green liquid and reports nausea. Which action would be an appropriate nursing intervention?

Apply a cool washcloth to the forehead and provide mouth care.

The nurse would expect the least formed stool to be present in which portion of the digestive tract?

Ascending

The client with gastroesophageal reflux disease (GERD) complains of a chronic cough. The nurse understands that in a client with GERD this symptom may be indicative of which of the following conditions?

Aspiration of gastric contents.

A 79-year-old client is admitted to the hospital with painful abdominal spasms and severe diarrhea of 2 days' duration. The orer of physical skills the nurse should follow when performing an admitting examination of this client should be "inpection" followed by:

Auscultation, palpation, percussion

The physician orders three stool specimens for occult blood from a client who complains of blood-streaked stools and a 10-pound weight loss in 1 month. To ensure valid test results the nurse should instruct the client to:

Avoid eating red meat before testing

The nurse knows that the ideal time to change an ostomy pouch is:

Before eating a meal, when the patient is comfortable

Which clinical manifestations of inflammatory bowel disease are common to both patients with ulcerative colitis (UC) and Crohn's disease

Bloody, diarrhea stools and Cramping abdominal pain

When a client develops steatorrhea, the nurse should describe this stool as:

Bulky and foul smelling

A client has a BMI of 35 and verbalized the need to lose weight. The nurse should encourage the client to lose weight safely by:

Decreasing portion size and fat intake

The nurse has attempted to administer a tap water enema for a patient with fecal impaction with no success. What is the next priority nursing action?

Donning gloves for digital removal of the stool

The nurse knows that most nutrients are absorbed in which portion of the digestive tract?

Duodenum

The nurse is reviewing preoperative instructions with a cliet who is scheduled for orthopedic surgery at 8 o'clock the next morning. The nurse advises the client to:

Eat a light evening meal and no food or fluid after midnight

A client with achalasia is to have bougienage to dilate the lower esophagus and cardiac sphincter. After the procedure the nurse should assess the client for espoageal perforation, which is indicated by:

Elevated heart rate and abdominal pain

After a patient returns from a barium swallow, the nurse's priority is to:

Encourage the patient to increase fluids to flush out the barium.

A client is scheduled for a barium swallow: the nurse should:

Ensure a laxative is ordered after after the test

When assessing a client's abdomen, the nurse palpates the area directly above the umbilicus. This area is known as:

Epigastric area

The physician orders intestinal decompression with a Cantor tube for a client with an intestinal obstruction. In order to determine effectiveness of intestinal decompression the nurse should evaluate the client to determine if:

Fluid and gas have been removed from the intestine.

A female patient has a sliding hiatal hernia. What nursing interventions will prevent the symptoms of heartburn and dyspepsia that she is experiencing?

Have the patient eat 4 to 6 smaller meals each day.

The nurse is caring for a 68-year-old patient admitted with abdominal pain, nausea, and vomiting. The patient has an abdominal mass, and a bowel obstruction is suspected. The nurse auscultating the abdomen listens for which type of bowel sounds that are consistent with the patient's clinical picture?

High-pitched and hyperactive above the area of obstruction

The nurse is planning care for a 68-year-old patient with an abdominal mass and suspected bowel obstruction. Which factor in the patient's history increases the patient's risk for colorectal cancer?

History of colorectal polyps

To motivate an obese client to eventually include aerobic exercises in a weight-reduction program, the nurse should discuss exercise and its relationship to weight loss. The nurse would know that this teaching was effective when the client states, "I know that exercixe will:

Increase my lean body mass

A client with Parkinson's disease complains about a problem with elimination. The nurse should encourage the client to:

Increase residue in the diet

After surgical implantation of radon seeds for oral cancer, the nurse should observe the client for the side effects of the radiation including:

Nausea and/or vomiting

The patient receiving chemotherapy rings the call bell and reports the onset of nausea. The nurse should prepare an as-needed dose of which medication?

Ondansetron (Zofran)

The nurse is emptying an ileostomy pouch for a patient. Which assessment finding would the nurse report immediately?

Presence of blood in the stool

A nurse is assessing a client who has been admitted with a diagnosis of an obstruction in the small intestine. The nurse should assess the client for?

Projectile vomiting, Rapid onset of dehydration. Increased bowel sounds.

A patient with a history of peptic ulcer disease has presented to the emergency department reporting severe abdominal pain and has a rigid, boardlike abdomen that prompts the health care team to suspect a perforated ulcer. What intervention should the nurse anticipate?

Providing IV fluids and inserting a nasogastric (NG) tube

Following administration of a dose of metoclopramide (Reglan) to the patient, the nurse determines that the medication has been effective when what is noted?

Relief of nausea and vomiting

Following bowel resection, a patient has a nasogastric (NG) tube to suction, but complains of nausea and abdominal distention. The nurse irrigates the tube as necessary as ordered, but the irrigating fluid does not return. What should be the priority action by the nurse?

Reposition the tube and check for placement.

Immediately after esophageal surgery the priority nursing assessment concerns the client's:

Respirations

The nurse should teach the client with GERD taht after meals the client should:

Rest in a sitting position for one-half hour

After insertion of a nasoenteric tube, the nurse should place the client in which position?

Right side-lying.

A 72-year-old patient was admitted with epigastric pain due to a gastric ulcer. Which patient assessment warrants an urgent change in the nursing plan of care?

Rigid abdomen and vomiting following indigestion

A patient is diagnosed with a bowel obstruction. The nurse chooses which type of tube for gastric decompression?

Salem sump

A nurse is pouching an ostomy on a patient with an ileostomy. Which action by the nurse is most appropriate?

Selecting a pouch that is able to hold excess output to reduce the frequency of pouch emptying

The physician orders TPN 1L q12h. Theprimary nursing responsibility should be to monitor the client's:

Serum glucose levels

When teaching a client how to prevent constipation, the nurse identifies that the dietary teaching is understood when the client states that the preferred breakfast cereal is:

Shredded Wheat

The nurse is caring for a patient who had a colostomy placed yesterday. The nurse should report which assessment finding immediately?

Stoma is purple.

Because of multiple physical injuries and emotional concerns, a hospitalized client is at high risk to develop a stress (Curling's) ulcer. The nurse should know that stress ulcers usually are evidenced by:

Sudden massive hemorrhage

Which physiological change can cause a paralytic ileus?

Surgery for Crohn's disease and anesthesia

The client is scheduled to have an upper gastrointestinal tract series of x-rays. Following the x-rays, the nurse should instruct the client to:

Take a laxative.

After abdominal surgery, a client is placed on a progressive postsurgical diet. This diet is characterized by progressive alterations in the:

Texture and digestibility of food

Because ofchronic crampy pain, diarrhea, and cachexia, a young adult is to receive TPN via a central line. Before preparing the client for the insertion of the catheter, the nurse should understan that:

The feeding will be administered intermittently

A client with cancer of the tongue has radon seeds implanted. The plan of care states that the client is to receive meticulous oral hygient. This plan can best be implemented by:

Using a gentle spray of normal saline

Two days following a colectomy for an abdominal mass, a patient reports gas pains and abdominal distention. The nurse plans care for the patient based on the knowledge that the symptoms are occurring as a result of

impaired peristalsis.