Answer these NCLEX Questions on Gastrointestinal system disorders:

NCLEX Questions: Gastrointestinal

1. An adult who has cholecystitis reports clay colored stools and moderate jaundice. Which is the best explanation for the presence of clay colored stools and jaundice?
1. There is an obstruction in the pancreatic duct.
2. There are gallstones in the gallbladder.
3. Bile is no longer produced by the gallbladder.
4. There is an obstruction in the common bile duct.

2. Atropine 0.5 mg is ordered for a client having an acute attack of cholecystitis. What is the primary purpose of this drug for this client? To
1. decrease skeletal muscle spasms.
2. increase gastrointestinal peristalsis
3. decrease smooth muscle contractions
4. decrease anxiety

3. Following a cholecystectomy, drainage form the T tube for the first 24 hours postoperative was 350 cc. Proper nursing action in response to this should be to
1. notify the physician .
2. raise the level of the drainage bag to decrease rate of flow.
3. increase the IV flow rate to compensate for the loss.
4. continue to observe and measure drainage.

4. An adult male is admitted to the hospital complaining of burning epigastric pain. He reports to the nurse that he has gained 14 pounds over the last two months. Which nursing response is best?
1. “Why were you eating more?”
2. “Has the weight gain been intentional?”
3. “Does your weight usually fluctuate this much?”
4. “How did your eating habits change?”

5. An adult male client is admitted with a diagnosis of probable duodenal ulcer. Which of the following laboratory tests would it be most essential for the nurse to assess immediately?
1. Hemoglobin and Hematocrit
2. SGPT and SGOT
3. Na and K
4. BUN and creatinine

6. An adult client is to have a gastroduodenoscopy in the morning. The nurse’s instructions should include the information that he will be
1. given a general anesthetic during the procedure.
2. given a local anesthetic to ease the discomfort during the procedure.
3. asked to assist by coughing during the procedure.
4. asked to assist by performing a Valsalva maneuver during the procedure.

7. Which nursing intervention is essential immediately following a gastroduodenoscopy?
1. Force fluids.
2. Position him supine.
3. Instruct him not to eat or drink.
4. Encourage coughing and deep breathing.

8. Because a client has a nasogastric tube attached to intermittent drainage the nurse should be particularly alert for the development of which complication?
1. Hypocalcemia.
2. Hypermagnesemia.
3. Hypokalemia.
4. Hypoglycemia.

9. A barium enema is ordered for an adult male client. The nurse is teaching him what to expect regarding the procedure. Which statement should be included in the teaching?
1. Fecal matter must be cleansed from the bowel for good visualization.
2. There will be no food restrictions before the test.
3. He will not have to change positions during the procedure.
4. He will be asked to drink barium during the procedure.

10. An abdomino-perineal resection with a transverse colostomy is planned for an adult male client. Neomycin sulfate p.o. is ordered prior to surgery. The primary purpose for administering this drug is to reduce
1. electrolyte imbalances.
2. bacterial content in the colon.
3. peristaltic action in the colon.
4. feces in the bowel.

11. In preparation for an abdomino-perineal resection the client is placed on a low residue diet. Which of the following food lists is appropriate for him to eat on a low residue diet?
1. Ground lean beef, soft boiled eggs, tea.
2. Lettuce, spinach, corn.
3. Prunes, grapes, apples.
4. Bran cereal, whole wheat toast, coffee.

12. The nurse is caring for a client who has had a colostomy. Which of the following client behaviors is indicative of a willingness to be involved in self-care following a colostomy?
1. Discussing the cost of his hospitalization.
2. Asking what time the surgeon will be in.
3. Asking questions about the equipment being used.
4. Complaining about the noise in the adjacent room.

13. An adult is admitted with a duodenal ulcer. On the second day after admission, the client develops severe, persistent pain radiating to the shoulder. What action should the nurse take first?
1. Notify the physician.
2. Place client in a high-Fowler’s position to decrease pressure on the gastric area and shoulder.
3. Examine the client for board-like rigidity of the abdomen.
4. Administer ordered prn pain medication.

14. The client with a duodenal ulcer is ready for discharge. Which statement made by the client indicates a need for more teaching about his diet?
1. “It’s a good thing I gave up drinking alcohol last year.”
2. “I will have to drink lots of milk and cream every day.”
3. “I will stay away from cola drinks after I am discharged.”
4. “Eating three nutritious meals and snacks every day is okay.”

15. A young college student comes to the emergency room with nausea, vomiting and severe abdominal pain of six hours duration. While examining the client the physician asks her to stand on her toes and drop to her heels with a thump. Which of the following interpretations of this procedure is the most accurate?
1. An irritated bowel will become less tender.
2. If the client has an acute inflammation she will feel localized pain in the inflamed area.
3. This procedure will create more flaccid abdominal muscles allowing easier abdominal exam.
4. The client with appendicitis will experience brief relief following this action.

16. The nurse is admitting a client with a diagnosis of appendicitis to the surgical unit. Which question is it essential to ask?
1. “When did you last eat?”
2. “Have you had surgery before?”
3. “Have you ever had this type of pain before?”
4. “What do you usually take to relieve your pain?

17. The client with appendicitis asks the nurse for a laxative to help relieve her constipation. The nurse explains to her that laxatives are not given to persons with possible appendicitis. What is the primary reason for this?
1. Laxatives will decrease the spread of infection.
2. Laxatives are not given prior to any type of surgery.
3. The patient does not have true constipation. She only has pressure.
4. Laxatives could cause rupture of the appendix.

18. The nurse is preparing a client with Crohn’s disease for discharge. Which statement he makes indicates he needs further teaching?
1. “Stress can make it worse.”
2. “Since I have Crohn’s disease I don’t have to worry about colon cancer.”
3. “I realize I shall always have to monitor my diet.”
4. “I understand there is a high incidence of familial occurrence with this disease.”

19. A client is admitted to the hospital with ulcerative colitis. Admitting orders include a low residue diet. Which food would be contraindicated for this client?
1. Roast beef.
2. Fresh peas.
3. Mashed potatoes.
4. Baked chicken.

20. An adult client is to have a sigmoidoscopy in the morning. What should the nurse plan to do?
1. Give him an enema 1 hour before the examination.
2. Keep him NPO for 8 hours before the examination.
3. Order a low fat, low residue diet for breakfast.
4. Administer enemas until clear this evening.

21. A client has an order for irrigation of a nasogastric tube. What should the nurse do before irrigating the nasogastric tube?
1. Inject a small amount of air while listening with a stethoscope over the stomach for a “swoosh.”
2. Instill 5 cc of normal saline and observe for development of coughing and dyspnea.
3. Place the end of the nasogastric tube in a glass of water and observe for bubbles.
4. Aspirate and check the pH.

22. The client who has had a hemorrhoidectomy wants to know why she cannot take a sitz bath immediately upon return from the operating room. The nurse’s response is based upon which of the following concepts?
1. Heat can stimulate bowel movement too quickly after surgery.
2. Patients are generally not awake enough for several hours to safely take sitz baths.
3. Heat applied immediately post-operatively increases the possibility of hemorrhage.
4. Sitting in water before the sutures are removed may cause infection.

23. A client with pancreatitis tells the nurse that he fears nighttime. Which of the following statements most likely relates to the client’s concerns?
1. The pain is worse at night and aggravated in the recumbent position.
2. He is afraid of the dark.
3. The mattress is uncomfortable.
4. The pain increases after a day of activity.

24. The client asks how he contracted hepatitis A. He reports all of the following. Which one is most likely related to hepatitis A?
1. He ate home canned tomatoes.
2. He ate oysters his roommate brought home from a fishing trip.
3. He stepped on a nail 2 weeks ago.
4. He donated blood 2 weeks before he got sick.

25. The client has had a liver biopsy. The nurse should position him on his right side with a pillow under his rib cage. What is the primary reason for this position?
1. To immobilize the diaphragm.
2. To facilitate full chest expansion.
3. To minimize the danger of aspiration.
4. To reduce the likelihood of bleeding

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