NCLEX-PN
NCLEX Questions Gastrointestinal System Questions
Extract:
Question 1 of 5
Which problem is highest priority for the nurse to identify in the client who had an open cholecystectomy surgery?
Correct Answer: D
Rationale: Pain (alteration in comfort) is the highest priority post-cholecystectomy, as it affects recovery and mobility. Nutrition, skin, and urinary issues are secondary in the immediate postoperative period.
Question 2 of 5
Which blood test results would confirm a diagnosis of appendicitis?
Correct Answer: A
Rationale: An elevated WBC count (e.g., 13,000) indicates inflammation, supporting an appendicitis diagnosis. Normal RBC and platelet counts are not specific, and a heterophil antibody test is for infectious mononucleosis.
Question 3 of 5
The client had Billroth II surgery 24 hours ago. The client’s son approaches the nurse in the hallway and asks for information regarding his father’s condition. The wife is listed as the designated contact person. Which nurse response is best?
Correct Answer: B
Rationale: A. Discussing client information in a hospital hallway is inappropriate; individuals passing by could overhear confidential client information. B. Going into the client’s room together allows the client to determine if he wants to disclose information and how much information he wants to disclose. C. Even if in a private location, the nurse should not share confidential client information with anyone unless the client has specifically given permission. D. The nurse should not review the medical record of the client with a family member without permission. Some facilities require the client to complete a form requesting permission to review his or her own medical records.
Question 4 of 5
The client is hospitalized with a large bowel obstruction resulting in massive abdominal distention. Which assessment findings should be most concerning to the nurse?
Correct Answer: C
Rationale: Decreased lung sounds are the most concerning finding because it can be life-threatening. Massive distention can impair function of the diaphragm, which in turn leads to atelectasis and compromised respiratory function.
Question 5 of 5
The client with a history of peptic ulcer disease is admitted into the intensive care department with frank gastric bleeding. Which priority intervention should the nurse implement?
Correct Answer: B
Rationale: Inserting an NG tube with saline lavage helps remove blood, assess bleeding severity, and stabilize the client with frank gastric bleeding. Intake/output monitoring, calorie counts, and rest are secondary to controlling active hemorrhage.