NCLEX-PN
NCLEX Gastrointestinal Questions
Question 1 of 5
The client is diagnosed with salmonellosis secondary to eating some slightly cooked hamburger meat. Which clinical manifestations should the nurse expect the client to report?
Correct Answer: A
Rationale: Salmonellosis typically causes abdominal cramping, nausea, and vomiting due to bacterial irritation of the GI tract. Paralysis is botulism, bloody diarrhea is more typical of other pathogens, and rice water stool is cholera.
Question 2 of 5
Which signs and symptoms should the nurse report to the health-care provider for the client recovering from an open cholecystectomy?
Correct Answer: A,B,E
Rationale: Clay-colored stools and yellow-tinted sclera indicate possible bile duct obstruction or jaundice, while abdominal pain suggests complications like infection or bile leak, all requiring HCP notification. Amber urine and approximated wounds are less urgent.
Question 3 of 5
The nurse is caring for the newly admitted client with acute necrotizing pancreatitis. Which interventions, if prescribed, should the nurse implement?
Correct Answer: A, B, C, F
Rationale: Giving an IV bolus followed by fluids at 250 mL/hour should be implemented. A large amount of fluids is lost due to third spacing into the retroperitoneum and intraabdominal area. Fluids are needed to prevent hypovolemia and maintain hemodynamic stability. B. Nasojejunal enteral feedings with a low-fat formula should be initiated to decrease the secretion of secretin, meet calorie needs, and maintain a positive nitrogen balance. C. Antibiotics, usually medications of the imipenem class such as imipenem-cilastatin (Primaxin), are used when pancreatitis is complicated by infected pancreatic necrosis. They have greater potency and a broader antimicrobial spectrum than other beta-lactam antibiotics. D. The client should be maintained on bedrest to decrease the metabolic rate and therefore reduce pancreatic secretions. E. Discomfort frequently improves with the client in the supine position rather than side-lying. F. A urinary catheter should be inserted to closely monitor urine output for circulating fluid volume status and to monitor for complications.
Question 4 of 5
The nurse is preparing a client diagnosed with GERD for surgery. Which information warrants notifying the HCP?
Correct Answer: C
Rationale: An elevated WBC count (14,000/mm3) suggests infection or inflammation, which could complicate surgery and requires immediate attention. A positive Bernstein test and hiatal hernia are expected in GERD, and a hemoglobin of 13.8 g/dL is within normal limits.
Question 5 of 5
The nurse is irrigating the client's colostomy when the client complains of cramping. What is the most appropriate initial action by the nurse?
Correct Answer: C
Rationale: Pinching the tubing stops the flow, relieving cramping caused by rapid fluid instillation during colostomy irrigation.