NCLEX-PN
NCLEX Gastrointestinal Questions
Extract:
Question 1 of 5
Which assessment data indicate to the nurse the client recovering from an open cholecystectomy may require pain medication?
Correct Answer: B
Rationale: Shallow respirations suggest pain, as patients avoid deep breathing to minimize discomfort. Normal pulse, bowel sounds, and splinting are less direct indicators of pain.
Question 2 of 5
A child with appendicitis is scheduled for surgery this evening. The nurse enters the room and sees the child's mother starting to place hot, wet washcloths on her daughter's abdomen so that 'she will feel better.' The nurse explains that this action is contraindicated because heat:
Correct Answer: A
Rationale: Heat can increase inflammation and blood flow, risking appendix rupture and peritonitis in appendicitis.
Question 3 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 4 of 5
The nurse is working in an outpatient clinic. Which client is most likely to have a diagnosis of diverticulosis?
Correct Answer: A
Rationale: Diverticulosis is more common in older adults with sedentary lifestyles, which contribute to constipation and increased colonic pressure. Childbirth, hemorrhoids, and family history are less direct risk factors.
Question 5 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.