NCLEX-PN
NCLEX Gastrointestinal Questions
Extract:
Question 1 of 5
The male client had abdominal surgery and the nurse suspects the client has peritonitis. Which assessment data support the diagnosis of peritonitis?
Correct Answer: D
Rationale: A hard, rigid abdomen and elevated WBC count (22,000/mm3) indicate peritonitis due to peritoneal inflammation and infection. Absent bowel sounds are nonspecific, cramping with normal hemoglobin is less indicative, and diarrhea with Campylobacter suggests gastroenteritis.
Question 2 of 5
The client developed a paralytic ileus after abdominal surgery. Which intervention should the nurse include in the plan of care?
Correct Answer: D
Rationale: Maintaining a patent NG tube decompresses the bowel in paralytic ileus, preventing complications. Laxatives and oral fluids are contraindicated, and deep breathing is unrelated.
Question 3 of 5
The nurse is caring for clients on a surgical unit. Which client should the nurse assess first?
Correct Answer: B
Rationale: Sudden resolution of abdominal pain may indicate perforation (e.g., appendicitis), a life-threatening emergency requiring immediate assessment. Urinary retention, absent bowel sounds, and discharge are less urgent.
Question 4 of 5
The nurse writes a problem 'low self-esteem' for a 16-year-old client diagnosed with anorexia. Which client goal should be included in the plan of care?
Correct Answer: D
Rationale: Verbalizing a positive attribute directly addresses low self-esteem by fostering positive self-perception. Time with parents, eating, and milk shakes are unrelated or nutritional.
Question 5 of 5
The client who is obese presents to the clinic before beginning a weight loss program. Which interventions should the nurse teach? Select all that apply.
Correct Answer: A,B,C,E
Rationale: Walking, identifying eating triggers, consistent weighing, and support groups promote sustainable weight loss. Sodium restriction is less critical unless hypertension is present.