NCLEX-PN
Gastrointestinal NCLEX Questions Questions
Extract:
Question 1 of 5
The nurse is admitting the client with gastric cancer to an oncology unit for treatment. Which assessment finding should prompt the nurse to review the medical record to determine whether the cancer may have metastasized to the peritoneal cavity?
Correct Answer: D
Rationale: A. Nausea is a sign of gastric outlet obstruction or impending hemorrhage. B. Grey Turner’s sign is a symptom of pancreatitis, not metastasis. C. Weight loss is an initial sign associated with cancer. D. The presence of ascites indicates seeding of the tumor in the peritoneal cavity.
Question 2 of 5
The nurse is assigned to care for four clients. The nurse should plan to assess which client first?
Correct Answer: D
Rationale: D. The client with Crohn’s disease who received an initial dose of certolizumab (Cimzia) and is having generalized rashes should be attended to first. Generalized rash indicates an allergic reaction. This could develop into an anaphylactic reaction. B. The client with a peptic ulcer who now has severe vomiting should be attended to second. Vomiting in PUD may indicate a complication such as mechanical obstruction from scarring. C. The client who had a colonoscopy and is having diarrheal stools should be attended to third. Diarrhea may have been the indication for the client’s colonoscopy or a side effect of the bowel prep. A. The client with ascites who is having mild dyspnea with activity can be attended to last. The dyspnea is usually due to the enlarged abdomen.
Question 3 of 5
The RN is caring for the client following a liver biopsy with the assistance of the student nurse. The RN evaluates that the student understands the postprocedure care when making which observation of the student nurse?
Correct Answer: C
Rationale: A. After a liver biopsy VS should be assessed every 15 minutes times two, every 30 minutes times four, and then every hour times four to monitor for shock, peritonitis, and pneumothorax. B. The client should be kept flat in bed for 12 to 14 hours following the procedure to prevent the risk of bleeding. C. Positioning the client on the right side after a liver biopsy splints the puncture site to prevent and decrease bleeding. D. The client should be cautioned to avoid coughing, which could precipitate bleeding.
Question 4 of 5
The client diagnosed with chronic pancreatitis is concerned about pain control. The nurse explains that the initial plan for chronic pancreatic pain control involves the administration of which of the following?
Correct Answer: C
Rationale: A. Opioid analgesics may be prescribed if pancreatic enzymes do not relieve pain. B. NSAIDs, such as ibuprofen, may be used to treat chronic pancreatic pain, but they are not the initial treatment and are usually not sufficient to control the pain. C. The initial pain control measures include exogenous pancreatic enzymes because pancreatic stimulation by food is thought to cause pain. Pancreatic enzymes are coupled with H2 blockers, which block the action of histamine on parietal cells in the stomach. H2 blockers are used because gastric acid destroys the lipase needed to break down fats. D. A nerve block relieves pain in about 50 percent of people who undergo the procedure, but this is not the initial measure for pain control.
Question 5 of 5
The nurse is caring for the client who is 6 hours post—open cholecystectomy. The client's T—tube drainage bag is empty, and the nurse notes slight jaundice of the sclera. Which action by the nurse is most important?
Correct Answer: B
Rationale: A. Repositioning the client might promote bile flow into the T—tube if the client were lying on the tube. However, the jaundice indicates that the problem is internal. B. The T-tube is placed in the common bile duct to ensure patency of the duct. Lack of bile draining into the T—tube and jaundiced sclera are signs of an obstruction to the bile flow. This is most important to report to the surgeon. C. The client’s BP would not be affected by this situation. D. Recording the findings and continuing to monitor the client are inappropriate because the client is experiencing signs of a complication.