ATI RN
Med-Surg Gastrointestinal NCLEX Questions Questions
Question 1 of 5
Which explanation about weight reduction should be included when teaching the obese patient and her obese husband?
Correct Answer: C
Rationale: The correct answer is C) Fat is not burned until the glycogen-water pool is depleted. This statement is crucial in educating the obese patient and her husband about weight reduction. It highlights the physiological process of weight loss, emphasizing the importance of depleting glycogen stores before the body starts burning fat for energy. This information helps set realistic expectations and encourages adherence to a healthy weight loss plan. Option A is incorrect because while psychological factors can contribute to weight gain, the primary focus should be on addressing lifestyle habits and physiological processes for effective weight reduction. Option B is incorrect because daily weighing can lead to fluctuations due to factors like water retention, causing unnecessary stress. Weekly weigh-ins are typically recommended for a more accurate assessment of progress. Option D is incorrect because while it is true that men may have a higher percentage of less metabolically active fat than women, the rate of weight loss is more influenced by factors like metabolism and calorie deficit rather than gender. In an educational context, understanding the science behind weight reduction is essential for patients to make informed decisions about their health. By explaining the process of glycogen depletion before fat burning, individuals are more likely to adhere to a sustainable weight loss plan and achieve long-term success in managing their weight.
Question 2 of 5
The nurse evaluates that management of the patient with upper GI bleeding is effective when assessment and laboratory findings reveal which result?
Correct Answer: C
Rationale: In the management of upper GI bleeding, the correct answer is option C) Decreasing blood urea nitrogen (BUN). When a patient is effectively managing upper GI bleeding, the BUN level tends to decrease. This is because upper GI bleeding results in the loss of blood, leading to a decrease in the concentration of urea nitrogen in the blood. Therefore, a decreasing BUN level indicates that the bleeding is under control and the patient is responding well to treatment. Option A) Hematocrit (Hct) of 35% is not the most appropriate indicator for evaluating the effectiveness of managing upper GI bleeding. While a decrease in hematocrit may indicate ongoing bleeding, it is not as specific to the management of upper GI bleeding as the BUN level. Option B) Urinary output of 20 mL/hr is important in monitoring renal function but may not directly reflect the effectiveness of managing upper GI bleeding. Option D) Urine specific gravity of 1.030 is related to the concentration of solutes in the urine and may not directly reflect the management of upper GI bleeding. In an educational context, understanding the laboratory values and assessments relevant to upper GI bleeding is crucial for nurses caring for these patients. Recognizing the significance of BUN levels in assessing the effectiveness of treatment can help nurses make informed decisions and provide optimal care for patients with upper GI bleeding.
Question 3 of 5
Priority Decision: A patient with ulcerative colitis has a total proctocolectomy with formation of a terminal ileum stom What is the most important nursing intervention for this patient postoperatively?
Correct Answer: A
Rationale: In this scenario, the correct answer is A) Measure the ileostomy output to determine the status of the patient's fluid balance. This is the most important nursing intervention postoperatively for a patient with a total proctocolectomy and ileostomy. Measuring the ileostomy output is crucial as it helps assess the patient's fluid balance, enabling early detection of dehydration or electrolyte imbalances, common postoperative complications. Monitoring output volume, color, consistency, and changes over time can provide valuable information on the patient's condition. Option B is incorrect as changing the ileostomy appliance every 3 to 4 hours is unnecessary and may lead to skin breakdown. Option C is incorrect as stating the ostomy is temporary may not be accurate for all patients and can cause confusion. Option D is incorrect as a high-fiber, low-carbohydrate diet is not typically recommended postoperatively for ileostomy patients. Educationally, understanding the rationale behind the priority nursing intervention postoperatively for patients with ileostomies is crucial for providing safe and effective care. By emphasizing the importance of monitoring ileostomy output for fluid balance assessment, nurses can prevent complications and promote optimal patient outcomes.
Question 4 of 5
The patient asks the nurse to explain what the physician meant when he said the patient had an anorectal abscess. Which description should the nurse use to explain this to the patient?
Correct Answer: B
Rationale: The correct answer is B) Collection of perianal pus. An anorectal abscess refers to a localized collection of pus near the anus or rectum, often caused by an infection. This description helps the patient understand that there is a buildup of infected material in the area, which requires medical attention such as drainage and antibiotics. Option A) Ulcer in anal wall is incorrect because an anorectal abscess is not an ulcer but rather a collection of pus. Option C) Sacrococcygeal hairy tract is incorrect as it refers to a pilonidal sinus, a different condition involving a tract or tunnel in the sacrococcygeal area, not the anorectal region. Option D) Tunnel leading from the anus or rectum is incorrect because while an abscess can sometimes form a tunnel called a fistula, the primary characteristic of an anorectal abscess is the collection of pus rather than the tunnel itself. Educationally, understanding the terminology related to gastrointestinal conditions is crucial for nurses to effectively communicate with patients and provide accurate explanations. By clarifying these terms, nurses can empower patients to participate in their care and make informed decisions about their treatment.
Question 5 of 5
The patient presents with jaundice and itching, steatorrhea, and liver enlargement. This patient has also had ulcerative colitis for several years. What diagnosis should the nurse expect for this patient?
Correct Answer: D
Rationale: The correct answer is D) Primary sclerosing cholangitis. Primary sclerosing cholangitis is a chronic liver disease characterized by inflammation and scarring of the bile ducts inside and outside the liver. It is commonly associated with ulcerative colitis, an inflammatory bowel disease. The patient's symptoms of jaundice, itching, steatorrhea, and liver enlargement are indicative of liver dysfunction and bile duct involvement, which align with primary sclerosing cholangitis. Option A) Cirrhosis is a chronic liver disease characterized by liver scarring due to various factors such as alcoholism, viral hepatitis, or non-alcoholic fatty liver disease. While cirrhosis can present with jaundice and liver enlargement, the presence of ulcerative colitis and steatorrhea in this case points more towards primary sclerosing cholangitis. Option B) Acute liver failure is a rapid deterioration of liver function, leading to hepatic encephalopathy and coagulopathy. The patient's symptoms are more indicative of a chronic rather than acute liver condition. Option C) Hepatorenal syndrome is a condition where there is kidney failure in the setting of advanced liver disease. The patient's symptoms do not specifically point towards kidney involvement at this stage. Educationally, understanding the relationship between primary sclerosing cholangitis and ulcerative colitis is crucial for nurses caring for patients with these conditions. Recognizing the symptoms and complications of primary sclerosing cholangitis can aid in early detection and management to improve patient outcomes. Nurses should also be aware of the differential diagnoses for liver diseases to provide comprehensive care and support to patients with gastrointestinal conditions.