Gastrointestinal System Disorders NCLEX Challenge Exam (Quiz #3: 50 Questions)

A patient with chronic alcohol abuse is admitted with liver failure. You closely monitor the patient’s blood pressure because of which change that is associated with liver failure?

You’re assessing the stoma of a patient with a healthy, well-healed colostomy. You expect the stoma to appear:

You’re caring for a patient with a sigmoid colostomy. The stool from this colostomy is:

You’re advising a 21 y.o. with a colostomy who reports problems with flatus. What food should you recommend?

You have to teach ostomy self-care to a patient with a colostomy. You tell the patient to measure and cut the wafer:

You’re performing an abdominal assessment on Brent who is 52 y.o. In which order do you proceed?

You’re doing preoperative teaching with Gertrude who has ulcerative colitis who needs surgery to create an ileoanal reservoir. Which information do you include?

You’re caring for Carin who has just had ileostomy surgery. During the first 24 hours post-op, how much drainage can you expect from the ileostomy?

You’re preparing a teaching plan for a 27 y.o. named Jeff who underwent surgery to close a temporary ileostomy. Which nutritional guidelines do you include in this plan?

Arthur has a family history of colon cancer and is scheduled to have a sigmoidoscopy. He is crying as he tells you, “I know that I have colon cancer, too.” Which response is most therapeutic?

You’re caring for Beth who underwent a Billroth II procedure (surgical removal of the pylorus and duodenum) for treatment of a peptic ulcer. Which findings suggest that the patient is developing dumping syndrome, a complication associated with this procedure?

You’re developing the plan of care for a patient experiencing dumping syndrome after a Billroth II procedure. Which dietary instructions do you include?

You’re caring for Lewis, a 67 y.o. patient with liver cirrhosis who developed ascites and requires paracentesis. Relief of which symptom indicates that the paracentesis was effective?

You’re caring for Jane, a 57 y.o. patient with liver cirrhosis who developed ascites and requires paracentesis. Before her paracentesis, you instruct her to:

After abdominal surgery, your patient has a severe coughing episode that causes wound evisceration. In addition to calling the doctor, which intervention is most appropriate?

You’re caring for Betty with liver cirrhosis. Which of the following assessment findings leads you to suspect hepatic encephalopathy in her?

You are developing a care plan for Sally, a 67 y.o. patient with hepatic encephalopathy. Which of the following do you include?

You have a patient with achalasia (incomplete muscle relaxation of the GI tract, especially sphincter muscles). Which medications do you anticipate to administer?

The student nurse is preparing a teaching care plan to help improve nutrition in a patient with achalasia. You include which of the following:

Britney, a 20 y.o. student is admitted with acute pancreatitis. Which laboratory findings do you expect to be abnormal for this patient?

A patient with Crohn’s disease is admitted after 4 days of diarrhea. Which of the following urine-specific gravity values do you expect to find in this patient?

Your goal is to minimize David’s risk of complications after a herniorrhaphy. You instruct the patient to:

Janice is waiting for discharge instructions after her herniorrhaphy. Which of the following instructions do you include?

Develop a teaching care plan for Angie who is about to undergo a liver biopsy. Which of the following points do you include?

Stephen is a 62 y.o. patient that has had a liver biopsy. Which of the following groups of signs alert you to a possible pneumothorax?

Michael, 42 y.o. The man is admitted to the med-surg floor with a diagnosis of acute pancreatitis. His BP is 136/76, pulse 96, Resps 22, and temp 101. His past history includes hyperlipidemia and alcohol abuse. The doctor prescribes an NG tube. Before inserting the tube, you explain the purpose to the patient. Which of the following is the most accurate explanation?

Jason, a 22 y.o. accident victim, requires an NG tube for feeding. What should you immediately do after inserting an NG tube for liquid enteral feedings?

Stephanie, a 28 y.o. accident victim, requires TPN. The rationale for TPN is to provide:

Type A chronic gastritis can be distinguished from type B by its ability to:

Matt is a 49 y.o. with a hiatal hernia that you are about to counsel. Health care counseling for Matt should include which of the following instructions?

Jerod is experiencing an acute episode of ulcerative colitis. Which is the priority for this patient?

A 29 y.o. patient has an acute episode of ulcerative colitis. What diagnostic test confirms this diagnosis?

Eleanor, a 62 y.o. woman with diverticulosis is your patient. Which interventions would you expect to include in her care?

Regina is a 46 y.o. woman with ulcerative colitis. You expect her stools to look like:

Donald is a 61 y.o. man with diverticulitis. Diverticulitis is characterized by:

Brenda, a 36 y.o. patient is on your floor with acute pancreatitis. Treatment for her includes:

Glenda has cholelithiasis (gallstones). You expect her to complain of:

After an abdominal resection for colon cancer, Madeline returns to her room with a Jackson-Pratt drain in place. The purpose of the drain is to:

Anthony, a 60 y.o. patient, has just undergone a bowel resection with a colostomy. During the first 24 hours, which of the following observations about the stoma should you report to the doctor?

You’re teaching Anthony how to use his new colostomy. How much skin should remain exposed between the stoma and the ring of the appliance?

Claire, a 33 y.o. is on your floor with a possible bowel obstruction. Which intervention is a priority for her?

Your patient has a GI tract that is functioning, but has the inability to swallow foods. Which is the preferred method of feeding for your patient?

Your patient is complaining of abdominal pain during assessment. What is your priority?

Before bowel surgery, Lee is to administer enemas until clear. During administration, he complains of intestinal cramps. What do you do next?

Leigh Ann is receiving pancrelipase (Viokase) for chronic pancreatitis. Which observation best indicates the treatment is effective?

Ralph has a history of alcohol abuse and has acute pancreatitis. Which lab value is most likely to be elevated?

Anna is 45 y.o. and has a bleeding ulcer. Despite multiple blood transfusions, her HGB is 7.5g/dl and HCT is 27%. Her doctor determines that surgical intervention is necessary and she undergoes partial gastrectomy. Postoperative nursing care includes:

Sitty, a 66 y.o. patient underwent a colostomy for a ruptured diverticulum. She did well during the surgery and returned to your med-surg floor in stable condition. You assess her colostomy 2 days after surgery. Which finding do you report to the doctor?

Sharon has cirrhosis of the liver and develops ascites. What intervention is necessary to decrease the excessive accumulation of serous fluid in her peritoneal cavity?

Katrina is diagnosed with lactose intolerance. To avoid complications with lack of calcium in the diet, which food should be included in the diet?