NCTEL gastrointestinal practice.docx

7/26/2019 NCTEL gastrointestinal practice.docx

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http://nurseslabs.com/nclex-exam-gastrointestinal-disorders-180-items/

1. Topics

Included topics in this practice quiz are:

Liver Failure

Liver Disorders

Ostomy Care

Guidelines

Follow the guidelines below to make the most out o this e!am:

"ead each question careully and choose the best answer#

$ou are given one minute per question# %pend your time wisely&

'nswers and rationales are given below# (e sure to read them#

I you need more clariications) please direct them to the comments section#

*uestion +

Donald is a ,+ y#o# man with diverticulitis# Diverticulitis is characterized by:

' -eriodic rectal hemorrhage

( .ypertension and tachycardia

C /omiting and elevated temperature

D Crampy and lower let quadrant pain and low0grade ever

*uestion 1

$ou2re advising a 1+ y#o# with a colostomy who reports problems with latus# 3hat ood

should you recommend4

' -eas( Cabbage

C (roccoli

D $ogurt

*uestion 5


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$ou2re caring or (eth who underwent a (illroth II procedure 6surgical removal o the

pylorus and duodenum7 or treatment o a peptic ulcer# 3hich indings suggest that the

patient is developing dumping syndrome) a complication associated with this procedure4

' Flushed) dry skin#

( .eadache and bradycardia

C Dizziness and sweating#D Dyspnea and chest pain

*uestion 8

$ou2re assessing the stoma o a patient with a healthy) well0healed colostomy# $ou e!pect

the stoma to appear:

' -ale) pink and moist

( "ed and moist

C Dark or purple colored

D Dry and black

*uestion 9

'ter an abdominal resection or colon cancer) adeline returns to her room with a;ackson0-ratt drain in place#


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*uestion B

$ou2re caring or (etty with liver cirrhosis# 3hich o the ollowing assessment indings

leads you to suspect hepatic encephalopathy in her4

' 'steri!is

( Chvostek2s sign

C ive ice chips every +9 minutes

*uestion +1

(renda) a 5, y#o# patient is on your loor with acute pancreatitis#


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*uestion +9

Dark) tarry stools indicate bleeding in which location o the >I tract4

' Epper colon

( Lower colon

C Epper >I tract

D %mall intestine

*uestion +,

'nnabelle is being discharged with a colostomy) and you2re teaching her about colostomy

care# 3hich statement correctly describes a healthy stoma4

' 't irst) the stoma may bleed slightly when touched#G

(


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*uestion 1+


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*uestion 1?

=leanor) a ,1 y#o# woman with diverticulosis is your patient# 3hich interventions would

you e!pect to include in her care4

' Low0iber diet and luid restrictions

(


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$our patient has a >I tract that is unctioning) but has the inability to swallow oods#

3hich is the preerred method o eeding or your patient4

' eeding

D Oral liquid supplements*uestion 58


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ichael) a 81 y#o# man is admitted to the med0surg loor with a diagnosis o acute

pancreatitis# .is (- is +5,J?,) pulse B,) "esps 11 and temp ++# .is past history includes

hyperlipidemia and alcohol abuse# tube# (eore inserting thetube) you e!plain the purpose to patient# 3hich o the ollowing is a most accurate

e!planation4

' It empties the stomach o luids and gas#G( It prevents spasms at the sphincter o Oddi#G

C It prevents air rom orming in the small intestine and large intestine#G

D It removes bile rom the gallbladder#G

*uestion 8

"alph has a history o alcohol abuse and has acute pancreatitis# 3hich lab value is most

likely to be elevated4

' Calcium

( >lucose

C agnesium

D -otassium*uestion 8+

>lenda has cholelithiasis 6gallstones7# $ou e!pect her to complain o:

' -ain in the right upper quadrant) radiating to the shoulder

( -ain in the right lower quadrant) with rebound tenderness

C -ain in the let upper quadrant) with shortness o breath

D -ain in the let lower quadrant) with mild cramping

*uestion 81

' 1B y#o# patient has an acute episode o ulcerative colitis# 3hat diagnostic test conirms

this diagnosis4

' (arium %wallow#( %tool e!amination

C >astric analysis

D %igmoidoscopy

*uestion 85

Claire) a 55 y#o# is on your loor with a possible bowel obstruction# 3hich intervention is

priority or her4

' Obtain daily weights

( easure abdominal girth

C eep strict intake and output

D =ncourage her to increase luids*uestion 88

3hich stoma would you e!pect a malodorous) enzyme0rich) caustic liquid output that is

yellow) green) or brown4

' Ileostomy

( 'scending colostomy

C


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*uestion 89

$our patient) Christopher) has a diagnosis o ulcerative colitis and has severe abdominal

pain aggravated by movement) rebound tenderness) ever) nausea) and decreased urineoutput#


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'n intubated patient is receiving continuous enteral eedings through a %alem sump tube

at a rate o ,mlJhr# >astric residuals have been 508ml when monitored *8.# $ou

check the gastric residual and aspirate 11ml# 3hat is your irst response to this inding4

' Aotiy the doctor immediately

( %top the eeding) and clamp the A> tube

C Discard the 11ml) and clamp the A> tubeD >ive a prescribed >I stimulant such as metoclopramide 6"eglan7

*uestion 9+

$ou2re caring or ;ane) a 9? y#o# patient with liver cirrhosis who developed ascites and

requires paracentesis# (eore her paracentesis) you instruct her to:

' =mpty her bladder

( Lie supine in bed

C "emain A-O or 8 hours

D Clean her bowels with an enema

*uestion 91

%tephen is a ,1 y#o# patient that has had a liver biopsy# 3hich o the ollowing groups osigns alert you to a possible pneumothora!4

' Dyspnea and reduced or absent breath sounds over the right lung

(


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*uestion 9,

evin has a history o peptic ulcer disease and vomits coee0ground emesis# 3hat does

this indicate4

' .e has resh) active upper >I bleeding#

( .e needs immediate saline gastric lavage#

C .is gastric bleeding occurred 1 hours earlier#D .e needs a transusion o packed "(Cs#

*uestion 9?

$ou have a patient with achalasia 6incomplete muscle rela!tion o the >I tract) especially

sphincter muscles7# 3hich medications do you anticipate to administer4

' Isosorbide dinitrate 6Isordil7

( Digo!in 6Lano!in7

C Captopril 6Capoten7

D -ropranolol 6Inderal7

*uestion 9@

$ou2re caring or Lewis) a ,? y#o# patient with liver cirrhosis who developed ascites andrequires paracentesis# "elie o which symptom indicated that the paracentesis was

eective4

' -ruritus

( Dyspnea

C ;aundice

D -eripheral Aeuropathy

*uestion 9B

'rthur has a amily history o colon cancer and is scheduled to have a sigmoidoscopy# .e

is crying as he tells you) I know that I have colon cancer) too#G 3hich response is most

therapeutic4' I know ust how you eel#G

( $ou seem upset#G

C Oh) don2t worry about it) everything will be ust ine#G

D 3hy do you think you have cancer4G

*uestion ,

$our teaching 'nthony how to use his new colostomy# .ow much skin should remain

e!posed between the stoma and the ring o the appliance4

' +J+,G

( +J8

C +J1GD +G

*uestion ,+

'nthony) a , y#o# patient) has ust undergone a bowel resection with a colostomy# During

the irst 18 hours) which o the ollowing observations about the stoma should you reportto the doctor4

' -ink color

( Light edema


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C %mall amount o oozing

D ertrude who has ulcerative colitis who needs

surgery to create an ileoanal reservoir# 3hich inormation do you include4

' ' reservoir is created that e!its through the abdominal wall#( ' second surgery is required +1 months ater the irst surgery#

C ' permanent ileostomy is created#

D


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( =at si! small meals a day

C =at the largest meal in the evening

D "estrict luid intake

*uestion ,@

'nna is 89 y#o# and has a bleeding ulcer# Despite multiple blood transusions) her .>( is

?#9gJdl and .C< is 1?K# .er doctor determines that surgical intervention is necessaryand she undergoes partial gastrectomy# -ostoperative nursing care includes:

' >iving pain medication *,.

( Flushing the A> tube with sterile water

C -ositioning her in high Fowler2s position

D eeping her A-O until the return o peristalsis

*uestion ,B

ailstates)GI I lie still and avoid turning ater the operation) I2ll avoid pain# Do you think this

is a good idea4G 3hat is the best response4

' $ou2ll need to turn rom side to side every 1 hours#G

( It2s always a good idea to rest quietly ater surgery#G

C


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( $ou2ll need to lie on your right side ater the test#G

C During the biopsy you2ll be asked to e!hale deeply and hold it#G

D eorge has a < tube in place ater gallbladder surgery# (eore discharge) what

inormation or instructions should be given regarding the < tube drainage4' I there is any drainage) notiy the surgeon immediately#G

( I bleeding by:

' =ncouraging oral luid intake

( onitoring central venous pressure

C onitoring laboratory test results and vital signs

D >iving blood) electrolyte and luid replacement

*uestion ?,

%itty) a ,, y#o# patient underwent a colostomy or ruptured diverticulum# %he did well

during the surgery and returned to your med0surg loor in stable condition# $ou assess hercolostomy 1 days ater surgery# 3hich inding do you report to the doctor4

' (lanched stoma

( =dematous stoma

C "eddish0pink stoma

D (rownish0black stoma

*uestion ??

$ou2re developing the plan o care or a patient e!periencing dumping syndrome ater a(illroth II procedure# 3hich dietary instructions do you include4

' Omit luids with meals

( Increase carbohydrate intake

C Decrease protein intake

D Decrease at intake

*uestion ?@

'ter abdominal surgery) your patient has a severe coughing episode that causes wound

evisceration# In addition to calling the doctor) which intervention is most appropriate4

' Irrigate the wound N organs with (etadine

( Cover the wound with a saline soaked sterile dressingC 'pply a dry sterile dressing N binder

D -ush the organs back N cover with moist sterile dressings

*uestion ?B

Aathaniel has severe pruritus due to having hepatitis (# 3hat is the best intervention or

his comort4

' >ive tepid baths


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( 'void lotions and creams

C Ese hot water to increase vasodilation

D Ese cold water to decrease the itching

*uestion @

"egina is a 8, y#o# woman with ulcerative colitis# $ou e!pect her stools to look like:

' 3atery and rothy

( (loody and mucous

C Firm and well0ormed

D 'lternating constipation and diarrhea

Once you are inished) click the button below# 'ny items you have not completed will be

marked incorrect#

Practice Mode:


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A ormed

B /emisolid

! /emili0uid

" atery

Question 2

Youre advising a &1 y.o. with a colostomy who reports problems with 3atus.

hat food should you recommend?

A *eas

B !abbage

! Broccoli

" Yogurt

Question 4

You have to teach ostomy self care to a patient with a colostomy. You tell the

patient to measure and cut the wafer)

A -o the e$act si5e of the stoma

B About 16178 larger than the stoma

! About 1698 larger than the stoma

" About 162larger than the stoma

Question 7

Youre performing an abdominal assessment on Brent who is 4& y.o. n which

order do you proceed?

A :bservation' percussion' palpation' auscultation

B :bservation' auscultation' percussion' palpation

! *ercussion' palpation' auscultation' observation

" *alpation' percussion' observation' auscultation

Question ;

Youre doing preoperative teaching with


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A A reservoir is created that e$its through the abdominal wall.

B A second surgery is re0uired 1& months after the =rst surgery.

! A permanent ileostomy is created.

" -he surgery occurs in two stages.

Question 9

Youre caring for !arin who has >ust had ileostomy surgery. "uring the =rst &2

hours post(op' how much drainage can you e$pect from the ileostomy?

A 1 ml

B 4 ml

! 14 ml

" 4 ml

Question @

Youre preparing a teaching plan for a &; y.o. named e who underwent

surgery to close a temporary ileostomy. hich nutritional guideline do you

include in this plan?

A -here is no need to change eating habits

B #at si$ small meals a day

! #at the largest meal in the evening

" +estrict 3uid inta%e

Question 1

Arthur has a family history of colon cancer and is scheduled to have a

sigmoidoscopy. He is crying as he tells you' C %now that have colon cancer'

too.8 hich response is most therapeutic?

A C %now >ust how you feel.8

B CYou seem upset.8

! C:h' dont worry about it' everything will be >ust =ne.8

" Chy do you thin% you have cancer?8

Question 11


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Youre caring for Beth who underwent a Billroth procedure Dsurgical removal

of the pylorus and duodenumE for treatment of a peptic ulcer. hich =ndings

suggest that the patient is developing dumping syndrome' a complication

associated with this procedure?

A lushed' dry s%in.

B Headache and bradycardia

! "i55iness and sweating.

" "yspnea and chest pain

Question 1&

Youre developing the plan of care for a patient e$periencing dumping

syndrome after a Billroth procedure. hich dietary instructions do you

include?

A :mit 3uids with meals

B ncrease carbohydrate inta%e

! "ecrease protein inta%e

" "ecrease fat inta%e

Question 1,

Youre caring for Fewis' a 7; y.o. patient with liver cirrhosis who developed

ascites and re0uires paracentesis. +elief of which symptom indicated that theparacentesis was eective?

A *ruritus

B "yspnea

! aundice

" *eripheral Geuropathy

Question 12

Youre caring for ane' a 4; y.o. patient with liver cirrhosis who developed

ascites and re0uires paracentesis. Before her paracentesis' you instruct her

to)

A #mpty her bladder

B Fie supine in bed


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! +emain G*: for 2 hours

" !lean her bowels with an enema

Question 14

After abdominal surgery' your patient has a severe coughing episode thatcauses wound evisceration. n addition to calling the doctor' which

intervention is most appropriate?

A rrigate the wound organs with Betadine

B !over the wound with a saline soa%ed sterile dressing

! Apply a dry sterile dressing binder

" *ush the organs bac% cover with moist sterile dressings

Question 17

Youre caring for Betty with liver cirrhosis. hich of the following assessment

=ndings leads you to suspect hepatic encephalopathy in her?

A Asteri$is

B !hvoste%s sign

! -rousseaus sign

" Hepato>ugular re3e$

Question 1;

You are developing a care plan on /ally' a 7; y.o. patient with hepatic

encephalopathy. hich of the following do you include?

A Administering a lactulose enema as ordered

B #ncouraging a protein(rich diet

! Administering sedatives' as necessary

" #ncouraging ambulation at least four times a day

Question 19

You have a patient with achalasia Dincomplete muscle rela$tion of the


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B "igo$in DFano$inE

! !aptopril D!apotenE

" *ropranolol DnderalE

Question 1@

-he student nurse is preparing a teaching care plan to help improve nutrition

in a patient with achalasia. You include which of the following)

A /wallow foods while leaning forward

B :mit 3uids at mealtimes

! #at meals sitting upright

" Avoid soft and semi soft foods

Question &

Britney' a & y.o. student is admitted with acute pancreatitis. hich

laboratory =ndings do you e$pect to be abnormal for this patient?

A /erum creatinine and BIG

B Alanine aminotransferase DAF-E and aspartate aminotransferase DA/-E

! /erum amylase and lipase

" !ardiac en5ymes

Question &1

A patient with !rohns disease is admitted after 2 days of diarrhea. hich of

the following urine speci=c gravity values do you e$pect to =nd in this

patient?

A 1.4

B 1.11

! 1.&

" 1.,

Question &&

Your goal is to minimi5e "avids ris% of complications after a herniorrhaphy.

You instruct the patient to)


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A Avoid the use of pain medication.

B !ough and deep breathe Q&H.

! /plint the incision if he cant avoid snee5ing or coughing.

" Apply heat to scrotal swelling.

Question &,

anice is waiting for discharge instructions after her herniorrhaphy. hich of

the following instructions do you include?

A #at a low(=ber diet

B +esume heavy lifting in & wee%s

! Fose weight' if obese

" +esume se$ual activity once discomfort is gone

Question &2

"evelop a teaching care plan for Angie who is about to undergo a liver biopsy.

hich of the following points do you include?

A CYoull need to lie on your stomach during the test.8

B CYoull need to lie on your right side after the test.8

! C"uring the biopsy youll be as%ed to e$hale deeply and hold it.8

" C-he biopsy is performed under general anesthesia.8

Question &4

/tephen is a 7& y.o. patient that has had a liver biopsy. hich of the following

groups of signs alert you to a possible pneumothora$?

A "yspnea and reduced or absent breath sounds over the right lung

B -achycardia' hypotension' and cool' clammy s%in

! ever' rebound tenderness' and abdominal rigidity

" +edness' warmth' and drainage at the biopsy site

Question &7

Jichael' a 2& y.o. man is admitted to the med(surg 3oor with a diagnosis of

acute pancreatitis. His B* is 1,76;7' pulse @7' +esps && and temp 11. His

past history includes hyperlipidemia and alcohol abuse. -he doctor prescribes


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an G< tube. Before inserting the tube' you e$plain the purpose to patient.

hich of the following is a most accurate e$planation?

A Ct empties the stomach of 3uids and gas.8

B Ct prevents spasms at the sphincter of :ddi.8

! Ct prevents air from forming in the small intestine and large intestine.8

" Ct removes bile from the gallbladder.8

Question &;

ason' a && y.o. accident victim' re0uires an G< tube for feeding. hat should

you immediately do after inserting an G< tube for li0uid enteral feedings?

A Aspirate for gastric secretions with a syringe

B Begin feeding slowly to prevent cramping

!


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Jatt is a 2@ y.o. with a hiatal hernia that you are about to counsel. Health

care counseling for Jatt should include which of the following instructions?

A +estrict inta%e of high(carbohydrate foods

B ncrease 3uid inta%e with meals

! ncrease fat inta%e

" #at three regular meals a day

Question ,1

erod is e$periencing an acute episode of ulcerative colitis. hich is priority

for this patient?

A +eplace lost 3uid and sodium

B Jonitor for increased serum glucose level from steroid therapy

! +estrict the dietary inta%e of foods high in potassium

" Gote any change in the color and consistency of stools

Question ,&

A &@ y.o. patient has an acute episode of ulcerative colitis. hat diagnostic

test con=rms this diagnosis?

A Barium /wallow.

B /tool e$amination

!


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+egina is a 27 y.o. woman with ulcerative colitis. You e$pect her stools to loo%

li%e)

A atery and frothy

B Bloody and mucous

! irm and well(formed

" Alternating constipation and diarrhea

Question ,4

"onald is a 71 y.o. man with diverticulitis. "iverticulitis is characteri5ed by)

A *eriodic rectal hemorrhage

B Hypertension and tachycardia

! Lomiting and elevated temperature

" !rampy and lower left 0uadrant pain and low(grade fever

Question ,7

Brenda' a ,7 y.o. patient is on your 3oor with acute pancreatitis. -reatment

for her includes)

A !ontinuous peritoneal lavage

B +egular diet with increased fat

! Gutritional support with -*G

" nsertion of a - tube to drain the pancreas

Question ,;


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A rrigate the incision with a saline solution

B *revent bacterial infection of the incision

! Jeasure the amount of 3uid lost after surgery

" *revent accumulation of drainage in the wound

Question ,@

Anthony' a 7 y.o. patient' has >ust undergone a bowel resection with a

colostomy. "uring the =rst &2 hours' which of the following observations

about the stoma should you report to the doctor?

A *in% color

B Fight edema

! /mall amount of oo5ing

" -ric%les of bright red blood

Question 2

Your teaching Anthony how to use his new colostomy. How much s%in should

remain e$posed between the stoma and the ring of the appliance?

A 16178

B 162

! 16&8

" 18

Question 21

!laire' a ,, y.o. is on your 3oor with a possible bowel obstruction. hich

intervention is priority for her?

A :btain daily weights

B Jeasure abdominal girth

! Meep strict inta%e and output

" #ncourage her to increase 3uids

Question 2&

Your patient has a


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A -*G

B **G

! G< feeding

" :ral li0uid supplements

Question 2,

Youre patient is complaining of abdominal pain during assessment. hat is

your priority?

A Auscultate to determine changes in bowel sounds.

B :bserve the contour of the abdomen

! *alpate the abdomen for a mass.

" *ercuss the abdomen to determine if 3uid is present.

Question 22

Before bowel surgery' Fee is to administer enemas until clear. "uring

administration' he complains of intestinal cramps. hat do you do ne$t?

A "iscontinue the procedure

B Fower the height of the enema container

! !omplete the procedure as 0uic%ly as possible

"!ontinue administration of the enema as ordered without ma%ing any

ad>ustments

Question 24

Feigh Ann is receiving pancrelipase DLio%aseE for chronic pancreatitis. hich

observation best indicates the treatment is eective?

A -here is no s%in brea%down

B Her appetite improves

! /he loses more than 1 lbs

" /tools are less fatty and decreased in fre0uency

Question 27

+alph has a history of alcohol abuse and has acute pancreatitis. hich lab

value is most li%ely to be elevated?


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A !alcium

B


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Question 4

Matrina is diagnosed with lactose intolerance. -o avoid complications with lac%

of calcium in the diet' which food should be included in the diet?

A ruit

B hole grains

! Jil% and cheese products

" "ar% green' leafy vegetables

Question 41

Gathaniel has severe pruritus due to having hepatitis B. hat is the best

intervention for his comfort?

A


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! Cll never have a problem with my liver again' even if drin% alcohol.8

"CJy family %nows that if get tired and start vomiting' may be getting sic%

again.8

Question 42


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A CAt =rst' the stoma may bleed slightly when touched.8

B C-he stoma should appear dar% and have a bluish hue.8

! CA burning sensation under the stoma faceplate is normal.8

" C-he stoma should remain swollen away from the abdomen.8

Question 49

A patient who underwent abdominal surgery now has a gaping incision due to

delayed wound healing. hich method is correct when you irrigate a gaping

abdominal incision with sterile normal saline solution' using a piston syringe?

A +apidly instill a stream of irrigating solution into the wound.

B Apply a wet(to(dry dressing to the wound after the irrigation.

! Joisten the area around the wound with normal saline solution after theirrigation.

" rrigate continuously until the solution becomes clear or all of the solution is used.

Question 4@

Hepatic encephalopathy develops when the blood level of which substance

increases?

A Ammonia

B Amylase

! !alcium

" *otassium

Question 7

Your patient recently had abdominal surgery and tells you that he feels a

popping sensation in his incision during a coughing spell' followed by severe

pain. You anticipate an evisceration. hich supplies should you ta%e to his

room?

A A suture %it.

B /terile water and a suture %it.

! /terile water and sterile dressings.

" /terile saline solution and sterile dressings.


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Question 71

indings during an endoscopic e$am include a cobblestone appearance of the

colon in your patient. -he =ndings are characteristic of which disorder?

A Ilcer

B !rohns disease

! !hronic gastritis

" Ilcerative colitis

Question 7&

hat information is correct about stomach cancer?

A /tomach pain is often a late symptom

B /urgery is often a successful treatment

! !hemotherapy and radiation are often successful treatments

" -he patient can survive for an e$tended time with -*G

Question 7,

"ar%' tarry stools indicate bleeding in which location of the


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A #ncouraging oral 3uid inta%e

B Jonitoring central venous pressure

! Jonitoring laboratory test results and vital signs

"


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-he student nurse is teaching the family of a patient with liver failure. You

instruct them to limit which foods in the patients diet?

A Jeats and beans

B Butter and gravies

! *otatoes and pastas

" !a%es and pastries

Question ;

An intubated patient is receiving continuous enteral feedings through a

/alem sump tube at a rate of 7ml6hr.


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Question ;,

A 4, y.o. patient has undergone a partial gastrectomy for adenocarcinoma of

the stomach. An G< tube is in place and is connected to low continuous

suction. "uring the immediate postoperative period' you e$pect the gastric

secretions to be which color?

A Brown

B !lear

! +ed

" Yellow

Question ;2

Your patient has a retractable gastric peptic ulcer and has had a gastric

vagotomy. hich factor increases as a result of vagotomy?

A *eristalsis

B


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B Ascending colostomy

! -ransverse colostomy

" "escending colostomy

Question ;;


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ruptured and a small segment of the bowel is protruding. hats your

priority?

AAs% the patient what happened' call the doctor' and cover the area with a water(

soa%ed bedsheet.

B :btain vital signs' call the doctor' and obtain emergency orders.

!Have a !AG hold the wound together while you obtain vital signs' call the doctor

and 3e$ the patients %nees.

"Have the doctor called while you remain with the patient' 3e$ the patients %nees'

and cover the wound with sterile towels soa%ed in sterile saline solution.

:nce you are =nished' clic% the button below. Any items you have not

completed will be mar%ed incorrect.

InText Mode:

'll questions and answers are given or reading and answering at yourown pace# $ou can also copy this e!am and make a print out#

1. A patient with chronic alcohol abuse is admitted with liver ailure. !ou closel"

monitor the patient#s blood pressure because o which change that is associated with

the liver ailure$

+# .ypoalbuminemia

1# Increased capillary permeability

5# 'bnormal peripheral vasodilation

8# =!cess rennin release rom the kidneys

%. !ou#re assessing the stoma o a patient with a health"& well-healed colostom". !ou

expect the stoma to appear:

+# -ale) pink and moist

1# "ed and moist

5# Dark or purple colored

8# Dry and black

'. !ou#re caring or a patient with a sigmoid colostom". The stool rom thiscolostom" is:

+# Formed

1# %emisolid

5# %emiliquid

8# 3atery


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(. !ou#re advising a %1 ".o. with a colostom" who reports problems with latus.

)hat ood should "ou recommend$

+# -eas

1# Cabbage

5# (roccoli

8# $ogurt

*. !ou have to teach ostom" sel care to a patient with a colostom". !ou tell the

patient to measure and cut the waer:

+#


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2. !ou#re preparing a teaching plan or a % ".o. named 3e who underwent surger"

to close a temporar" ileostom". )hich nutritional guideline do "ou include in this

plan$

+#


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+# -ruritus

1# Dyspnea

5# ;aundice

8# -eripheral Aeuropathy

1(. !ou#re caring or 3ane& a * ".o. patient with liver cirrhosis who developed

ascites and re;uires paracentesis. ,eore her paracentesis& "ou instruct her to:

+# =mpty her bladder#

1# Lie supine in bed#

5# "emain A-O or 8 hours#

8# Clean her bowels with an enema#

1*. Ater abdominal surger"& "our patient has a severe coughing episode that causes

wound evisceration. n addition to calling the doctor& which intervention is most

appropriate$

+# Irrigate the wound N organs with (etadine#

1# Cover the wound with a saline soaked sterile dressing#

5# 'pply a dry sterile dressing N binder#

8# -ush the organs back N cover with moist sterile dressings#

1+. !ou#re caring or ,ett" with liver cirrhosis. )hich o the ollowing assessment

indings leads "ou to suspect hepatic encephalopath" in her$

+# 'steri!is

1# Chvostek2s sign

5#


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+# Isosorbide dinitrate 6Isordil7

1# Digo!in6Lano!in7

5# Captopril 6Capoten7

8# -ropranolol6Inderal7

12. The student nurse is preparing a teaching care plan to help improve nutrition in

a patient with achalasia. !ou include which o the ollowing:

+# %wallow oods while leaning orward#

1# Omit luids at mealtimes#

5# =at meals sitting upright#

8# 'void sot and semi sot oods#

%0. ,ritne"& a %0 ".o. student is admitted with acute pancreatitis. )hich laborator"

indings do "ou expect to be abnormal or this patient$

+# %erum creatinine and (EA

1# 'lanine aminotranserase 6'L


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+# =at a low0iber diet#

1# "esume heavy liting in 1 weeks#

5# Lose weight) i obese#

8# "esume se!ual activity once discomort is gone#

%(. evelop a teaching care plan or Angie who is about to undergo a liver biops".

)hich o the ollowing points do "ou include$

+# $ou2ll need to lie on your stomach during the test#G

1# $ou2ll need to lie on your right side ater the test#G

5# During the biopsy you2ll be asked to e!hale deeply and hold it#G

8#


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%8. =tephanie& a %8 ".o. accident victim& re;uires T@. The rationale or T@ is to

provide:

+# Aecessary luids and electrolytes to the body#

1# Complete nutrition by the I#/# route#

5#


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+# Low0iber diet and luid restrictions#

1# ed b":

+# -eriodic rectal hemorrhage#

1# .ypertension and tachycardia#

5# /omiting and elevated temperature#

8# Crampy and lower let quadrant pain and low0grade ever#

'+. ,renda& a '+ ".o. patient is on "our loor with acute pancreatitis. Treatment or

her includes:

+# Continuous peritoneal lavage#

1# "egular diet with increased at#

5# Autritional support with


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5# easure the amount o luid lost ater surgery#

8# -revent accumulation o drainage in the wound#

'2. Anthon"& a +0 ".o. patient& has ust undergone a bowel resection with a

colostom". uring the irst %( hours& which o the ollowing observations about the

stoma should "ou report to the doctor$

+# -ink color#

1# Light edema#

5# %mall amount o oozing#

8#


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5# -alpate the abdomen or a mass#

8# -ercuss the abdomen to determine i luid is present#

((. ,eore bowel surger"& ee is to administer enemas until clear. uring

administration& he complains o intestinal cramps. )hat do "ou do next$

+# Discontinue the procedure#

1# Lower the height o the enema container#

5# Complete the procedure as quickly as possible#

8# Continue administration o the enema as ordered without making any adustments#

(*. eigh Ann is receiving pancrelipase Cio6ase9 or chronic pancreatitis. )hich

observation best indicates the treatment is eective$

+# lucose

5# agnesium

8# -otassium

(. Anna is (* ".o. and has a bleeding ulcer. espite multiple blood transusions& her

4G, is .*g/dl and 4T is %D. 4er doctor determines that surgical intervention is

necessar" and she undergoes partial gastrectom". @ostoperative nursing care

includes:

+# >iving pain medication *,.#

1# Flushing the A> tube with sterile water#

5# -ositioning her in high Fowler2s position#8# eeping her A-O until the return o peristalsis#

(8. =itt"& a ++ ".o. patient underwent a colostom" or ruptured diverticulum. =he did

well during the surger" and returned to "our med-surg loor in stable condition. !ou

assess her colostom" % da"s ater surger". )hich inding do "ou report to the

doctor$


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+# (lanched stoma

1# =dematous stoma

5# "eddish0pink stoma

8# (rownish0black stoma

(2. =haron has cirrhosis o the liver and develops ascites. )hat intervention is

necessar" to decrease the excessive accumulation o serous luid in her peritoneal

cavit"$

+# "estrict luids

1# =ncourage ambulation

5# Increase sodium in the diet

8# >ive antacids as prescribed

*0. Eatrina is diagnosed with lactose intolerance. To avoid complications with lac6

o calcium in the diet& which ood should be included in the diet$

+# Fruit

1# 3hole grains

5# ilk and cheese products

8# Dark green) leay vegetables

*1. athaniel has severe pruritus due to having hepatitis ,. )hat is the best

intervention or his comort$

+# >ive tepid baths#

1# 'void lotions and creams#

5# Ese hot water to increase vasodilation#

8# Ese cold water to decrease the itching#

*%.


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+# Aow I can never get hepatitis again#G

1# I can saely give blood ater 5 months#G

5# I2ll never have a problem with my liver again) even i I drink alcohol#G

8# y amily knows that i I get tired and start vomiting) I may be getting sick again#G

*(. Gail is scheduled or a cholec"stectom". Ater completion o preoperative

teaching& Gail states&7 lie still and avoid turning ater the operation& #ll avoid

pain. o "ou thin6 this is a good idea$7 )hat is the best response$

+# $ou2ll need to turn rom side to side every 1 hours#G

1# It2s always a good idea to rest quietly ater surgery#G

5#


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+# "apidly instill a stream o irrigating solution into the wound#

1# 'pply a wet0to0dry dressing to the wound ater the irrigation#

5# oisten the area around the wound with normal saline solution ater the irrigation#

8# Irrigate continuously until the solution becomes clear or all o the solution is used#

*2. 4epatic encephalopath" develops when the blood level o which substance

increases$

+# 'mmonia

1# 'mylase

5# Calcium

8# -otassium

+0. !our patient recentl" had abdominal surger" and tells "ou that he eels a

popping sensation in his incision during a coughing spell& ollowed b" severe pain.

!ou anticipate an evisceration. )hich supplies should "ou ta6e to his room$

+# ' suture kit#

1# %terile water and a suture kit#

5# %terile water and sterile dressings#

8# %terile saline solution and sterile dressings#

+1. Findings during an endoscopic exam include a cobblestone appearance o the

colon in "our patient. The indings are characteristic o which disorder$

+# Elcer

1# Crohn2s disease

5# Chronic gastritis

8# Elcerative colitis

+%. )hat inormation is correct about stomach cancer$

+# %tomach pain is oten a late symptom#

1# %urgery is oten a successul treatment#

5# Chemotherapy and radiation are oten successul treatments#8#


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5# Epper >I tract#

8# %mall intestine#

+(. A patient has an acute upper G hemorrhage. !our interventions include:

+#


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5# Corticosteroids#

8# .istamine10receptor blockers#

+2. The student nurse is teaching the amil" o a patient with liver ailure. !ou

instruct them to limit which oods in the patient#s diet$

+# eats and beans#

1# (utter and gravies#

5# -otatoes and pastas#

8# Cakes and pastries#

0. An intubated patient is receiving continuous enteral eedings through a =alem

sump tube at a rate o +0ml/hr. Gastric residuals have been '0-(0ml when

monitored (4. !ou chec6 the gastric residual and aspirate %%0ml. )hat is "our

irst response to this inding$

+# Aotiy the doctor immediately#

1# %top the eeding) and clamp the A> tube#

5# Discard the 11ml) and clamp the A> tube#

8# >ive a prescribed >I stimulant such as metoclopramide 6"eglan7#

1. !our patient with peritonitis is @H and complaining o thirst. )hat is "our

priorit"$

+# Increase the I#/# inusion rate#

1# Ese diversion activities#

5# -rovide requent mouth care#

8# >ive ice chips every +9 minutes#

%. Eevin has a histor" o peptic ulcer disease and vomits coee-ground emesis.

)hat does this indicate$

+# .e has resh) active upper >I bleeding#

1# .e needs immediate saline gastric lavage#

5# .is gastric bleeding occurred 1 hours earlier#8# .e needs a transusion o packed "(C2s#

'. A *' ".o. patient has undergone a partial gastrectom" or adenocarcinoma o the

stomach. An G tube is in place and is connected to low continuous suction. uring

the immediate postoperative period& "ou expect the gastric secretions to be which

color$


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+# (rown#

1# Clear#

5# "ed#

8# $ellow#

(. !our patient has a retractable gastric peptic ulcer and has had a gastric

vagotom". )hich actor increases as a result o vagotom"$

+# -eristalsis#

1# >astric acidity#

5# >astric motility#

8# >astric p.#

*. hristina is receiving an enteral eeding that re;uires a concentration o 80 ml o

supplement mixed with %0 ml o water. 4ow much water do "ou mix with an 8 o>

%(0ml9 can o eeding$

+# , ml#

1# ? ml#

5# @ ml#

8# B ml#

+. )hich stoma would "ou expect a malodorous& en>"me-rich& caustic li;uid output

that is "ellow& green& or brown$

+# Ileostomy#

1# 'scending colostomy#

5#


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+# Calcium carbonate 6eorge) a 9 y#o# whose ather died o colon cancer

5# .erman) a , y#o# who ollows a low0at) high0iber diet

8# %issy) a ?1 y#o# with a history o breast cancer

80. !ou#re patient& post-op drainage o a pelvic abscess secondar" to diverticulitis&

begins to cough violentl" ater drin6ing water. 4is wound has ruptured and a small

segment o the bowel is protruding. )hat#s "our priorit"$

+# 'sk the patient what happened) call the doctor) and cover the area with a water0soaked

bedsheet#

1# Obtain vital signs) call the doctor) and obtain emergency orders#

5# .ave a C'A hold the wound together while you obtain vital signs) call the doctor and

le! the patient2s knees#

8# .ave the doctor called while you remain with the patient) le! the patient2s knees) and

cover the wound with sterile towels soaked in sterile saline solution#

Answers and +ationale

1. Answer: 1. 4"poalbuminemia

(lood pressure decreases as the body is unable to maintain normal oncotic pressure with

liver ailure) so patients with liver ailure require close blood pressure monitoring#

Increased capillary permeability) abnormal peripheral vasodilation) and e!cess rennin

released rom the kidney2s aren2t direct ramiications o liver ailure#

%. Answer: %. ood circulation causes tissues to be moist and red) so a healthy) well0healed stoma

appears red and moist#

'. Answer: 1. Formed

' colostomy in the sigmoid colon produces a solid) ormed stool#


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(. Answer: (. !ogurt

.igh0iber oods stimulate peristalsis) and a result) latus# $ogurt reduces gas ormation#

*. Answer: %. About 1/1+7 larger than the stoma.

' proper it protects the skin) but doesn2t impair circulation# ' +J+,G should be cut#

+. Answer: %. Hbservation& auscultation& percussion& palpation

Observation) auscultation) percussion) palpation

. Answer: (. The surger" occurs in two stages.

'n ileoanal reservoir is created in two stages# >iness and sweating.

'ter a (illroth II procedure) a large amount o hypertonic luid enters the intestine#


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1%. Answer: 1. Hmit luids with meals.

>astric emptying time can be delayed by omitting luids rom your patient2s meal# ' diet

low in carbs and high in at N protein is recommended to treat dumping syndrome#

1'. Answer: %. "spnea

'scites puts pressure on the diaphragm# -aracentesis is done to remove luid and

reducing pressure on the diaphragm#


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-ancreatitis involves activation o pancreatic enzymes) such as amylase and lipase# ing or coughing.


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%2. Answer: 1. ause atroph" o the parietal cells.

I tract by


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' ;ackson0-ratt drain promotes wound healing by allowing luid to escape rom the

wound#

'2. Answer: (. Tric6les o bright red blood.

'ter creation o a colostomy) e!pect to see a stoma that is pink) slightly edematous) with

some oozing# (right red blood) regardless o amount) indicates bleeding and should be

reported to the doctor#

(0. Answer: 1. 1/1+7

Only a small amount o skin should be e!posed and more than +J+,G o skin allows the

e!crement to irritate the skin#

(1. Answer: %. ?easure abdominal girth.

easuring abdominal girth provides quantitative inormation about increases or

decreases in the amount o distention#

(%. Answer: '. G eeding

(ecause the >I tract is unctioning) eeding methods involve the enteral route which

bypasses the mouth but allows or a maor portion o the >I tract to be used#

('. Answer: %. Hbserve the contour o the abdomen.


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>lucose level increases and diabetes mellitus may result dJt the pancreatic damage to the

islets o langerhans#

(. Answer: (. Eeeping her @H until the return o peristalsis.

'ter surgery) she remains A-O until peristaltic activity returns#


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+'. Answer: '. Ipper G tract.

elena is the passage o dark) tarry stools that contain a large amount o digested blood#

It occurs with bleeding rom the upper >I tract#

+(. Answer: 1. Treating h"povolemia.

' patient with an acute upper >I hemorrhage must be treated or hypovolemia and

hemorrhagic shock# $ou as a nurse can2t diagnose the problem# Controlling the bleeding

may require surgery or intensive medical treatment#

+*. Answer: (. Giving blood& electrol"te and luid replacement.


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' gastric residual greater than 1 hours worth o eeding or +0+9ml is considered too

high# tube clamped) and then allow time or the

stomach to empty beore additional eeding is added#

1. Answer: '. @rovide re;uent mouth care.

Frequent mouth care helps relieve dry mouth#

%. Answer: '. 4is gastric bleeding occurred % hours earlier.

Coee0ground emesis occurs when there is upper >I bleeding that has undergone gastric

digestion# For blood to appear as coee0ground emesis) it would have to be digested or

appro!imately 1 hours#

'. Answer: '.


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isoprostol restores prostaglandins that protect the stomach rom A%'ID%) which

diminish the prostaglandins#

2. Answer: '. 4erman& a +0 ".o. who ollows a low-at& high-iber diet

80. Answer: (. 4ave the doctor called while "ou remain with the patient& lex the

patient#s 6nees& and cover the wound with sterile towels soa6ed in sterile saline

solution.

%. Topics

Included topics in this practice quiz are:

'ppendicitis

Diverticulitis

Inlammatory (owel Diseases

Guidelines

Follow the guidelines below to make the most out o this e!am:

"ead each question careully and choose the best answer#

$ou are given one minute per question# %pend your time wisely&

'nswers and rationales are given below# (e sure to read them#

I you need more clariications) please direct them to the comments section#

InExam Mode: 'll questions are shown in random and the results) answers and

rationales 6i any7 will only be given ateryou2ve inished the quiz# $ou are given +

minute per question) a total o 100 minutesor this e!am#

NCLEX Exam: Gastrointestinal Disorders 2 (100 Items)

@@)12

Question 1

-he nurse is monitoring a client for the early signs of dumping syndrome.

hich symptom indicates this occurrence?

A Abdominal cramping and pain


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B Bradycardia and indigestion

! /weating and pallor

" "ouble vision and chest pain

Question &

Jedical management of the client with diverticulitis should include which of

the following treatments?

A +educed 3uid inta%e

B ncreased =ber in diet

! Administration of antibiotics

" #$ercises to increase intra(abdominal pressure

Question ,

hich of the following factors is believed to be lin%ed to !rohns disease?

A !onstipation

B "iet

! Hereditary

" Fac% of e$ercise

Question 2

hich goal of the clients care should ta%e priority during the =rst days of

hospitali5ation for an e$acerbation of ulcerative colitis?

A *romoting self(care and independence

B Janaging diarrhea

! Jaintaining ade0uate nutrition

" *romoting rest and comfort

Question 4

hich of the following diagnostic tests may be performed to determine if a

client has gastric cancer?

A Barium enema


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B !olonoscopy

!


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Based on these =ndings' the nurse suspects that the client is developing

which of the following mouth conditions?

A /tomatitis

B :ral candidiasis

! *arotitis

"


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Question 1,

hich of the following complications of gastric resection should the nurse

teach the client to watch for?

A !onstipation

B "umping syndrome

!


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-he client with a new colostomy is concerned about the odor from the stool in

the ostomy drainage bag. -he nurse teaches the client to include which of the

following foods in the diet to reduce odor?

A Yogurt

B Broccoli

! !ucumbers

" #ggs

Question 19

-he client with !rohns disease has a nursing diagnosis of acute pain. -he

nurse would teach the client to avoid which of the following in managing this

problem?

A Fying supine with the legs straight

B Jassaging the abdomen

! Ising antispasmodic medication

" Ising rela$ation techni0ues

Question 1@

-he nurse would 0uestion an order for which type of antacid in patients withchronic renal failure?

A Aluminum(containing antacids

B !alcium(containing antacids

! Jagnesium(containing antacids

" All of the above.

Question &

n a client with diarrhea' which outcome indicates that 3uid resuscitation is

successful?

A -he client passes formed stools at regular intervals

B -he client reports a decrease in stool fre0uency and li0uidity

! -he client e$hibits =rm s%in turgor


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" -he client no longer e$periences perianal burning.

Question &1

hich of the following laboratory results would be e$pected in a client withperitonitis?

A *artial thromboplastin time above 1 seconds

B Hemoglobin level below 1 mg6dF

! *otassium level above 4.4 m#06F

" hite blood cell count above 14'

Question &&

hich of the following de=nitions best describes diverticulosis?

A An in3amed outpouching of the intestine

B A nonin3amed outpouching of the intestine

! -he partial impairment of the forward 3ow of intestinal contents

" An abnormal protrusion of an organ through the structure that usually holds it.

Question &,

hich of the following diets is most commonly associated with colon cancer?

A Fow(=ber' high fat

B Fow(fat' high(=ber

! Fow(protein' high(carbohydrate

" Fow carbohydrate' high protein

Question &2

-he nurse instructs the ileostomy client to do which of the following as a partof essential care of the stoma?

A !leanse the peristomal s%in meticulously

B -a%e in high(=ber foods such as nuts

! Jassage the area below the stoma


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" Fimit 3uid inta%e to prevent diarrhea.

Question &4

-he nurse would monitor for which of the following adverse reactions to

aluminum(containing antacids such as aluminum hydro$ide DAmpho>elE?

A "iarrhea

B !onstipation

!


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! Ising long(term steroid therapy

" ncreasing physical activity

Question &@

hen used with hyperacidic disorders of the stomach' antacids are given toelevate the gastric pH to)

A &.

B 2.

! 7.

" 9.

Question ,

-he nurse is preparing a discharge teaching plan for the client who had an

umbilical hernia repair. hich of the following would the nurse include in the

plan?

A +estricting pain medication

B Jaintaining bedrest

! Avoiding coughing

" rrigating the drain

Question ,1

-he nurse is teaching the client how to perform a colostomy irrigation. -o

enhance the eectiveness of the irrigation and fecal returns' what measure

should the nurse instruct the client to do?

A ncrease 3uid inta%e

B +educe the amount of irrigation solution

! *erform the irrigation in the evening

" *lace heat on the abdomen

Question ,&

hich of the following nursing diagnoses is appropriate for a patient receiving

famotidine D*epcidE?

A ncreased ris% for infection due to immunosuppression


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B *otential ris% for bleeding related to thrombocytopenia

! Alteration in urinary elimination related to retention

" Alteration in tissue perfusion related to hypertension

Question ,,

-he client with a colostomy has an order for irrigation of the colostomy. -he

nurse used which solution for irrigation?

A "istilled water

B -ap water

! /terile water

" Factated +ingers

Question ,2

-he nurse is doing pre(op teaching with the client who is about to undergo

creation of a Moc% pouch. -he nurse interprets that the client has the best

understanding of the nature of the surgery if the client ma%es which of the

following statements?

A C will need to drain the pouch regularly with a catheter.8

B C will need to wear a drainage bag for the rest of my life.8

! C-he drainage from this type of ostomy will be formed.8

" C will be able to pass stool from my rectum eventually.8

Question ,4

hich of the following symptoms is a client with colon cancer most li%ely to

e$hibit?

A A change in appetite

B A change in bowel habit

! An increase in body weight

" An increase in body temperature

Question ,7


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A client with gastric cancer can e$pect to have surgery for resection. hich of

the following should be the nursing management priority for the preoperative

client with gastric cancer?

A "ischarge planning

B !orrection of nutritional de=cits

! *revention of "L-

" nstruction regarding radiation treatment

Question ,;

-he mechanism of action of dipheno$ylate DFotomilE is)

A An increase in intestinal e$cretion of water

B An increase in intestinal motility

! A decrease in peristalsis in the intestinal wall

" A decrease in the reabsorption of water in the bowel

Question ,9

hich of the following tests should be administered to a client suspected of

having diverticulosis?

A Abdominal ultrasound

B Barium enema

! Barium swallow

"


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-he nurse would monitor a patient using sodium bicarbonate to treat gastric

hyperacidity for signs and symptoms of)

A Jetabolic al%alosis

B Jetabolic acidosis

! Hyper%alemia

" Hypercalcemia

Question 21

Histamine&(receptor antagonists)

A !ompete with histamine for binding sites on the parietal cells

B rreversibly bind to HP6MPA-*ase

! !ause a decrease in stomach pH

" "ecrease signs and symptoms of allergies related to histamine release

Question 2&

hich of the following types of diets is implicated in the development of

diverticulosis?

A Fow(=ber diet

B High(=ber diet

! High(protein diet

" Fow(carbohydrate diet

Question 2,

hich of the following mechanisms can facilitate the development of

diverticulosis into diverticulitis?

A-reating constipation with chronic la$ative use' leading to dependence on

la$atives

B!hronic constipation causing an obstruction' reducing forward 3ow of intestinal

contents

! Herniation of the intestinal mucosa' rupturing the wall of the intestine

" Indigested food bloc%ing the diverticulum' predisposing the area to bacterial


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invasion.

Question 22

-he client has been admitted with a diagnosis of acute pancreatitis. -he

nurse would assess this client for pain that is)

A /evere and unrelenting' located in the epigastric area and radiating to the bac%.

B/evere and unrelenting' located in the left lower 0uadrant and radiating to the

groin.

! Burning and aching' located in the epigastric area and radiating to the umbilicus.

" Burning and aching' located in the left lower 0uadrant and radiating to the hip.

Question 24

-o avoid fecal impaction' psyllium DJetamucilE should be administered with atleast how many ounces of 3uid?

A 2

B 7

! 9

" 1

Question 27

hich of the following de=nitions best describes gastritis?

A #rosion of the gastric mucosa

B n3ammation of a diverticulum

! n3ammation of the gastric mucosa

" +e3u$ of stomach acid into the esophagus

Question 2;

hich area of the alimentary canal is the most common location for !rohnsdisease?

A Ascending colon

B "escending colon

! /igmoid colon


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" -erminal ileum

Question 29

-he nurse is reviewing the record of a client with !rohns disease. hich of

the following stool characteristics would the nurse e$pect to note

documented on the clients record?

A !hronic constipation

B "iarrhea

! !onstipation alternating with diarrhea

" /tool constantly oo5ing from the rectum

Question 2@

-he nurse is caring for a hospitali5ed client with a diagnosis of ulcerativecolitis. hich =nding' if noted on assessment of the client' would the nurse

report to the physician?

A Bloody diarrhea

B Hypotension

! A hemoglobin of 1& mg6dF

" +ebound tenderness

Question 4

-he client who has undergone creation of a colostomy has a nursing

diagnosis of "isturbed body image. -he nurse would evaluate that the client

is ma%ing the most signi=cant progress toward identi=ed goals if the client)

A atches the nurse empty the colostomy bag

B Foo%s at the ostomy site

! +eads the ostomy product literature

" *ractices cutting the ostomy appliance

Question 41

hen planning care for a client with ulcerative colitis who is e$periencing

symptoms' which client care activities can the nurse appropriately delegate

to a unlicensed assistant? /elect all that apply.

A Assessing the clients bowel sounds


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B *roviding s%in care following bowel movements

! #valuating the clients response to antidiarrheal medications

" Jaintaining inta%e and output records

# :btaining the clients weight

Question 4&

/ucralfate D!arafateE achieves a therapeutic eect by)

A Geutrali5ing gastric acid

B #nhancing gastric absorption

! orming a protective barrier around gastric mucosa

" nhibiting gastric acid secretion

Question 4,

hich of the following therapies is not included in the medical management

of a client with peritonitis?

A Broad(spectrum antibiotics

B #lectrolyte replacement

! .L. 3uids

" +egular diet

Question 42

A ,(year old client e$periences weight loss' abdominal distention' crampy

abdominal pain' and intermittent diarrhea after birth of her &nd child.

"iagnostic tests reveal gluten(induced enteropathy. hich foods must she

eliminate from her diet permanently?

A Jil% and dairy products

B *rotein(containing foods

! !ereal grains De$cept rice and cornE

" !arbohydrates

Question 44


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A client has a percutaneous endoscopic gastrostomy tube inserted for tube

feedings. Before starting a continuous feeding' the nurse should place the

client in which position?

A /emi(owlers

B /upine

! +everse -rendelenburg

" High owlers

Question 47

A client has >ust had surgery for colon cancer. hich of the following

disorders might the client develop?

A *eritonitis

B "iverticulosis

! *artial bowel obstruction

" !omplete bowel obstruction

Question 4;

n a client with !rohns disease' which of the following symptoms should not

be a direct result from antibiotic therapy?

A "ecrease in bleeding

B "ecrease in temperature

! "ecrease in body weight

" "ecrease in the number of stools

Question 49

!are for the postoperative client after gastric resection should focus on which

of the following problems?

A Body image

B Gutritional needs

! /%in care

" /piritual needs


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Question 4@

A patient unable to tolerate oral medications may be prescribed which of the

following proton pump inhibitors to be administered intravenously?

A lansopra5ole D*revacidE

B omepra5ole D*rilosecE

! pantopra5ole D*rotoni$E

" esomepra5ole DGe$iumE

Question 7

After a right hemicolectomy for treatment of colon cancer' a 4;(year old

client is reluctant to turn while on bed rest. hich action by the nurse would

be appropriate?

A As%ing a cowor%er to help turn the client

B #$plaining to the client why turning is important

! Allowing the client to turn when hes ready to do so

" -elling the client that the physicians order states he must turn every & hours

Question 71

A client with which of the following conditions may be li%ely to develop rectal

cancer?

A Adenomatous polyps

B "iverticulitis

! Hemorrhoids

" *eptic ulcer disease

Question 7&

-he nurse would teach patients that antacids are eective in treatment of

hyperacidity because they)

A Geutrali5e gastric acid

B "ecrease stomach motility

! "ecrease gastric pH


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" "ecrease duodenal pH

Question 7,

hen administering sucralfate D!arafateE to a patient with a nasogastric

tube' it is important to)

A !rush the tablet into a =ne powder before mi$ing with water

B Administer with a bolus tube feeding

! Allow the tablet to dissolve in water before administering

" Administer with an antacid for ma$imum bene=t

Question 72

A client presents to the emergency room' reporting that he has been

vomiting every , to 2 minutes for the past 9 hours. re0uent vomiting putshim at ris% for which of the following?

A Jetabolic acidosis with hyper%alemia

B Jetabolic acidosis with hypo%alemia

! Jetabolic al%alosis with hyper%alemia

" Jetabolic al%alosis with hypo%alemia

Question 74

A nurse is monitoring a client admitted to the hospital with a diagnosis of

appendicitis. -he client is scheduled for surgery in & hours. -he client begins

to complain of increased abdominal pain and begins to vomit. :n assessment

the nurse notes that the abdomen is distended and the bowel sounds are

diminished. hich of the following is the most appropriate nursing

intervention?

A Administer dilaudid

B Gotify the physician

! !all and as% the operating room team to perform the surgery as soon as possible

"+eposition the client and apply a heating pad on a warm setting to the clients

abdomen

Question 77


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!olon cancer is most closely associated with which of the following

conditions?

A Appendicitis

B Hemorrhoids

! Hiatal hernia


Question 7;

A client who has ulcerative colitis has persistent diarrhea. He is thin and has

lost 1& pounds since the e$acerbation of his ulcerative colitis. -he nurse

should anticipate that the physician will order which of the following

treatment approaches to help the client meet his nutritional needs?

A nitiate continuous enteral feedings

B #ncourage a high protein' high(calorie diet

! mplement total parenteral nutrition

" *rovide si$ small meals a day

Question 79

+adiation therapy is used to treat colon cancer before surgery for which of

the following reasons?

A +educing the si5e of the tumor

B #liminating the malignant cells

! !uring the cancer

" Helping the bowel heal after surgery

Question 7@

hich of the following symptoms is associated with ulcerative colitis?

A "umping syndrome

B +ectal bleeding

! /oft stools

" istulas


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Question ;

:ne of your patients is receiving digitalis orally and is also to receive an

antacid at the same time. Your most appropriate action' based on the

pharmaco%inetics of antacids' is to)

A "elay the digitalis for 1 to & hours until the antacid is absorbed

B


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" ncarcerated hernia

Question ;2

/ide eects of loperamide DmodiumE include all of the following e$cept?

A "iarrhea

B #pigastric pain

! "ry mouth

" Anore$ia

Question ;4

A clients ulcerative colitis symptoms have been present for longer than 1

wee%. -he nurse recogni5es that the client should be assessed carefully for

signs of which of the following complications?

A Heart failure

B "L-

! Hypo%alemia

" Hypocalcemia

Question ;7

-he nurse is reviewing the physicians orders written for a client admitted

with acute pancreatitis. hich physician order would the nurse 0uestion if

noted on the clients chart?

A G*: status

B nsert a nasogastric tube

! An anticholinergic medication

" Jorphine for pain

Question ;;

"uring the =rst few days of recovery from ostomy surgery for ulcerative

colitis' which of the following aspects should be the =rst priority of client

care?

A Body image

B :stomy care


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! /e$ual concerns

" /%in care

Question ;9

hich of the following symptoms may be e$hibited by a client with !rohns

disease?

A Bloody diarrhea

B Garrow stools

! G6L

" /teatorrhea

Question ;@

hich of the following factors is believed to cause ulcerative colitis?

A Acidic diet

B Altered immunity

! !hronic constipation

" #motional stress

Question 9

-he client has >ust had surgery to create an ileostomy. -he nurse assesses the

client in the immediate post(op period for which of the following most

fre0uent complications of this type of surgery?

A ntestinal obstruction

B luid and electrolyte imbalance

! Jalabsorption of fat

" olate de=ciency

Question 91

hich of the following nursing interventions should be implemented to

manage a client with appendicitis?

A Assessing for pain


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B #ncouraging oral inta%e of clear 3uids

! *roviding discharge teaching

" Assessing for symptoms of peritonitis

Question 9&

A client with rectal cancer may e$hibit which of the following symptoms?

A Abdominal fullness

B


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! Fow =ber' high(fat

" High(=ber' high(fat

Question 97

hich of the following terms best describes the pain associated with

appendicitis?

A Aching

B leeting

! ntermittent

" /teady

Question 9;

istulas are most common with which of the following bowel disorders?

A !rohns disease

B "iverticulitis

! "iverticulosis


Question 99

hich of the following aspects is the priority focus of nursing management

for a client with peritonitis?

A luid and electrolyte balance

B


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A *asta

B Boiled rice

! Bran

" Fow(fat cheese

Question @

ive days after undergoing surgery' a client develops a small(bowel

obstruction. A Jiller(Abbott tube is inserted for bowel decompression. hich

nursing diagnosis ta%es priority?

A mbalanced nutrition) Fess than body re0uirements

B Acute pain

! "e=cient 3uid volume

" #$cess 3uid volume

Question @1

hich of the following symptoms would a client in the early stages of

peritonitis e$hibit?

A Abdominal distention

B Abdominal pain and rigidity

! Hyperactive bowel sounds

" +ight upper 0uadrant pain

Question @&

-he nurse is doing an admission assessment on a client with a history of

duodenal ulcer. -o determine whether the problem is currently active' the

nurse would assess the client for which of the following most fre0uent

symptomDsE of duodenal ulcer?

A *ain that is relieved by food inta%e

B *ain that radiated down the right arm

! G6L

" eight loss

Question @,


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hich of the following substances is most li%ely to cause gastritis?

A Jil%

B Bicarbonate of soda' or ba%ing soda

! #nteric coated aspirin

" Gonsteroidal anti(in3ammatory drugs

Question @2

An enema is prescribed for a client with suspected appendicitis. hich of the

following actions should the nurse ta%e?

A *repare ;4 ml of irrigating solution warmed to 1

B Question the physician about the order

! *rovide privacy and e$plain the procedure to the client

" Assist the client to left lateral /ims position

Question @4

hich of the following symptoms indicated diverticulosis?

A Go symptoms e$ist

B !hange in bowel habits

! Anore$ia with low(grade fever

" #pisodic' dull' or steady midabdominal pain

Question @7

-he nurse is performing a colostomy irrigation on a client. "uring the

irrigation' a client begins to complain of abdominal cramps. hich of the

following is the most appropriate nursing action?

A Gotify the physician

B ncrease the height of the irrigation

! /top the irrigation temporarily

" Jedicate with dilaudid and resume the irrigation

Question @;


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hich of the following areas is the most common site of =stulas in clients

with !rohns disease?

A Anorectal

B leum

! +ectovaginal

" -ransverse colon

Question @9

hich of the following treatments is used for rectal cancer but not for colon

cancer?

A !hemotherapy

B !olonoscopy

! +adiation

" /urgical resection

Question @@

-he client being seen in a physicians oRce has >ust been scheduled for a

barium swallow the ne$t day. -he nurse writes down which of the following

instructions for the client to follow before the test?

A ast for 9 hours before the test

B #at a regular supper and brea%fast

! !ontinue to ta%e all oral medications as scheduled

" Jonitor own bowel movement pattern for constipatio

Question 1

A client with gastric cancer may e$hibit which of the following symptoms?

A Abdominal cramping

B !onstant hunger

! eeling of fullness

" eight gain


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:nce you are =nished' clic% the button below. Any items you have not

completed will be mar%ed incorrect.

Practice Mode:


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A #rosion of the gastric mucosa

B n3ammation of a diverticulum

! n3ammation of the gastric mucosa

" +e3u$ of stomach acid into the esophagus

Question 4

hich of the following substances is most li%ely to cause gastritis?

A Jil%

B Bicarbonate of soda' or ba%ing soda

! #nteric coated aspirin

" Gonsteroidal anti(in3ammatory drugs

Question 7

hich of the following de=nitions best describes diverticulosis?

A An in3amed outpouching of the intestine

B A nonin3amed outpouching of the intestine

! -he partial impairment of the forward 3ow of intestinal contents

" An abnormal protrusion of an organ through the structure that usually holds it.

Question ;

hich of the following types of diets is implicated in the development of

diverticulosis?

A Fow(=ber diet

B High(=ber diet

! High(protein diet

" Fow(carbohydrate diet

Question 9

hich of the following mechanisms can facilitate the development of

diverticulosis into diverticulitis?

A -reating constipation with chronic la$ative use' leading to dependence on


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la$atives

B!hronic constipation causing an obstruction' reducing forward 3ow of intestinal

contents

! Herniation of the intestinal mucosa' rupturing the wall of the intestine

"Indigested food bloc%ing the diverticulum' predisposing the area to bacterial

invasion.

Question @

hich of the following symptoms indicated diverticulosis?

A Go symptoms e$ist

B !hange in bowel habits

! Anore$ia with low(grade fever

" #pisodic' dull' or steady midabdominal pain

Question 1

hich of the following tests should be administered to a client suspected of

having diverticulosis?

A Abdominal ultrasound

B Barium enema

! Barium swallow

"


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A -he entire length of the large colon

B :nly the sigmoid area

! -he entire large colon through the layers of mucosa and submucosa

" -he small intestine and colonO aecting the entire thic%ness of the bowel

Question 1,

hich area of the alimentary canal is the most common location for !rohns

disease?

A Ascending colon

B "escending colon

! /igmoid colon

" -erminal ileum

Question 12

hich of the following factors is believed to be lin%ed to !rohns disease?

A !onstipation

B "iet

! Hereditary

" Fac% of e$ercise

Question 14

hich of the following factors is believed to cause ulcerative colitis?

A Acidic diet

B Altered immunity

! !hronic constipation

" #motional stress

Question 17

istulas are most common with which of the following bowel disorders?

A !rohns disease

B "iverticulitis


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! "iverticulosis


Question 1;

hich of the following areas is the most common site of =stulas in clients

with !rohns disease?

A Anorectal

B leum

! +ectovaginal

" -ransverse colon

Question 19

hich of the following associated disorders may a client with ulcerative colitis

e$hibit?

A


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B Garrow stools

! G6L

" /teatorrhea

Question &1

hich of the following symptoms is associated with ulcerative colitis?

A "umping syndrome

B +ectal bleeding

! /oft stools

" istulas

Question &&

f a client had irritable bowel syndrome' which of the following diagnostic

tests would determine if the diagnosis is !rohns disease or ulcerative colitis?

A Abdominal computed tomography D!-E scan

B Abdominal $(ray

! Barium swallow

" !olonoscopy with biopsy

Question &,

hich of the following interventions should be included in the medical

management of !rohns disease?

A ncreasing oral inta%e of =ber

B Administering la$atives

! Ising long(term steroid therapy

" ncreasing physical activity

Question &2

n a client with !rohns disease' which of the following symptoms should not

be a direct result from antibiotic therapy?

A "ecrease in bleeding

B "ecrease in temperature


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! "ecrease in body weight

" "ecrease in the number of stools

Question &4

/urgical management of ulcerative colitis may be performed to treat which of

the following complications?

A


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A Appendicitis

B Hemorrhoids

! Hiatal hernia


Question &@

hich of the following diets is most commonly associated with colon cancer?

A Fow(=ber' high fat

B Fow(fat' high(=ber

! Fow(protein' high(carbohydrate

" Fow carbohydrate' high protein

Question ,

hich of the following diagnostic tests should be performed annually over

age 4 to screen for colon cancer?

A Abdominal !- scan

B Abdominal $(ray

! !olonoscopy

" ecal occult blood test

Question ,1

+adiation therapy is used to treat colon cancer before surgery for which of

the following reasons?

A +educing the si5e of the tumor

B #liminating the malignant cells

! !uring the cancer

" Helping the bowel heal after surgery

Question ,&

hich of the following symptoms is a client with colon cancer most li%ely to

e$hibit?

A A change in appetite


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B A change in bowel habit

! An increase in body weight

" An increase in body temperature

Question ,,

A client has >ust had surgery for colon cancer. hich of the following

disorders might the client develop?

A *eritonitis

B "iverticulosis

! *artial bowel obstruction

" !omplete bowel obstruction

Question ,2

A client with gastric cancer may e$hibit which of the following symptoms?

A Abdominal cramping

B !onstant hunger

! eeling of fullness

" eight gain

Question ,4

hich of the following diagnostic tests may be performed to determine if a

client has gastric cancer?

A Barium enema

B !olonoscopy

!


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A "ischarge planning

B !orrection of nutritional de=cits

! *revention of "L-

" nstruction regarding radiation treatment

Question ,;

!are for the postoperative client after gastric resection should focus on which

of the following problems?

A Body image

B Gutritional needs

! /%in care

" /piritual needs

Question ,9

hich of the following complications of gastric resection should the nurse

teach the client to watch for?

A !onstipation

B "umping syndrome

!


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B "iverticulitis

! Hemorrhoids

" *eptic ulcer disease

Question 21

hich of the following treatments is used for rectal cancer but not for colon

cancer?

A !hemotherapy

B !olonoscopy

! +adiation

" /urgical resection

Question 2&

hich of the following conditions is most li%ely to directly cause peritonitis?

A !holelithiasis

B


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B Hemoglobin level below 1 mg6dF

! *otassium level above 4.4 m#06F

" hite blood cell count above 14'

Question 24

hich of the following therapies is not included in the medical management

of a client with peritonitis?

A Broad(spectrum antibiotics

B #lectrolyte replacement

! .L. 3uids

" +egular diet

Question 27

hich of the following aspects is the priority focus of nursing management

for a client with peritonitis?

A luid and electrolyte balance

B


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A Jetabolic acidosis with hyper%alemia

B Jetabolic acidosis with hypo%alemia

! Jetabolic al%alosis with hyper%alemia

" Jetabolic al%alosis with hypo%alemia

Question 2@

ive days after undergoing surgery' a client develops a small(bowel

obstruction. A Jiller(Abbott tube is inserted for bowel decompression. hich

nursing diagnosis ta%es priority?

A mbalanced nutrition) Fess than body re0uirements

B Acute pain

! "e=cient 3uid volume

" #$cess 3uid volume

Question 4

hen teaching an elderly client how to prevent constipation' which of the

following instructions should the nurse include?

A C"rin% 7 glasses of 3uid each day.8

B CAvoid grain products and nuts.8

! CAdd at least 2 grams of bran to your cereal each morning.8

" CBe sure to get regular e$ercise.8

Question 41

n a client with diarrhea' which outcome indicates that 3uid resuscitation is

successful?

A -he client passes formed stools at regular intervals

B -he client reports a decrease in stool fre0uency and li0uidity

! -he client e$hibits =rm s%in turgor

" -he client no longer e$periences perianal burning.

Question 4&

hen teaching a community group about measures to prevent colon cancer'

which instruction should the nurse include?


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A CFimit fat inta%e to &N to &4N of your total daily calories.8

B Cnclude 14 to & grams of =ber into your daily diet.8

! C


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Question 47

An enema is prescribed for a client with suspected appendicitis. hich of the

following actions should the nurse ta%e?

A *repare ;4 ml of irrigating solution warmed to 1

B Question the physician about the order

! *rovide privacy and e$plain the procedure to the client

" Assist the client to left lateral /ims position

Question 4;

-he client being seen in a physicians oRce has >ust been scheduled for a

barium swallow the ne$t day. -he nurse writes down which of the following

instructions for the client to follow before the test?

A ast for 9 hours before the test

B #at a regular supper and brea%fast

! !ontinue to ta%e all oral medications as scheduled

" Jonitor own bowel movement pattern for constipatio

Question 49

-he nurse is monitoring a client for the early signs of dumping syndrome.

hich symptom indicates this occurrence?

A Abdominal cramping and pain

B Bradycardia and indigestion

! /weating and pallor

" "ouble vision and chest pain

Question 4@

-he nurse is preparing a discharge teaching plan for the client who had an

umbilical hernia repair. hich of the following would the nurse include in the

plan?

A +estricting pain medication

B Jaintaining bedrest

! Avoiding coughing


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" rrigating the drain

Question 7

-he nurse is caring for a hospitali5ed client with a diagnosis of ulcerativecolitis. hich =nding' if noted on assessment of the client' would the nurse

report to the physician?

A Bloody diarrhea

B Hypotension

! A hemoglobin of 1& mg6dF

" +ebound tenderness

Question 71

-he nurse is reviewing the record

NCTEL gastrointestinal practice.docx

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