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Exam (elaborations)

med surg EXAM A+ GRADE ASSURED COMPLETE SOLUTIONS AND VERIFIED ANSWERS

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med surg EXAM A+ GRADE ASSURED COMPLETE SOLUTIONS AND VERIFIED ANSWERS

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EXAM

Exam Solution ga




Med Surg Gastrointestinal NCLEX Questions 2026 A+ GR
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ADE ASSURED COMPLETE SOLUTIONS AND VERIFIED A
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NSWERS (ECE2F) ga




QUESTION 1 ga




The nurse is planning to teach a client with gastroesophageal reflux disease (GERD) abo
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ut substances to avoid. Which items should the nurse include on this list? Select all that
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apply.
A. Coffee
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B. Chocolate
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C. Peppermint
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D. Nonfat milk
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E. Fried chicken F. Scrambled eggs
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ANSWER

A. Coffee
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B. Chocolate
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C. Peppermint
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E. Fried chicken Rationale: Foods that decrease lower esophageal sphincter (LES) pressure and irritate
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the esophagus will increase reflux and exacerbate the symptoms of GERD and therefore should be avoi
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ded. Aggravating substances include coffee, chocolate, peppermint, fried or fatty foods, carbonated beve
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rages, and alcohol. Options 4 and 6 do not promote this effect.
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QUESTION 2 ga




A client has undergone esophagogastroduodenoscopy. The nurse should place highest pr
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iority on which item as part of the client's care plan? 1. Monitoring the temperature 2. M
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onitoring complaints of heartburn 3. Giving warm gargles for a sore throat 4. Assessing f
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or the return of the gag reflex
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ANSWER

4. Assessing for the return of the gag reflex Rationale: The nurse places highest priority on assessing fo
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r return of the gag reflex. This assessment addresses the client's airway. The nurse also monitors the cli
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ent's vital signs and for a sudden increase in temperature, which could indicate perforation of the gastr
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,ointestinal tract. This complication would be accompanied by other signs as well, such as pain. Monitori
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ng for sore throat and heartburn are also important; however, the client's airway is the priority.
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QUESTION 3 ga




The nurse is providing dietary teaching for a client with a diagnosis of chronic gastritis.
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The nurse instructs the client to include which foods rich in vitamin B12 in the diet? Sel
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ect all that apply.
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A. Nuts
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B. Corn
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C. Liver
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D. Applesga



E. Lentils F. Bananas
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ANSWER

A. Nuts
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C. Liver
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E. Lentils Rationale: Chronic gastritis causes deterioration and atrophy of the lining of the stomach, lea
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ding to the loss of function of the parietal cells. The source of intrinsic factor is lost, which results in an
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ainability to absorb vitamin B12, leading to development of pernicious anemia. Clients must increase the
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ir intake of vitamin B12 by increasing consumption of foods rich in this vitamin, such as nuts, organ me
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ats, dried beans, citrus fruits, green leafy vegetables, and yeast.
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QUESTION 4 ga




The nurse is monitoring a client with a diagnosis of peptic ulcer. Which assessment findi
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ng would most likely indicate perforation of the ulcer?
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A. Bradycardia
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B. Numbness in the legs
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C. Nausea and vomiting
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D. A rigid, boardlike abdomen
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ANSWER

D. A rigid, boardlike abdomen Rationale: Perforation of an ulcer is a surgical emergency and is characte
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rized by sudden, sharp, intolerable severe pain beginning in the mid-
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epigastric area and spreading over the abdomen, which becomes rigid and boardlike. Nausea and vomit
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ing may occur. Tachycardia may occur as hypovolemic shock develops. Numbness in the legs is not an a
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ssociated finding. ga




QUESTION 5 ga




The nurse is caring for a client following a gastrojejunostomy (Billroth II procedure). W
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hich postoperative prescription should the nurse question and verify?
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A. Leg exercises
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B. Early ambulation
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, C. Irrigating the nasogastric tube
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D. Coughing and deep-breathing exercises
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ANSWER

C. Irrigating the nasogastric tube Rationale: In a gastrojejunostomy (Billroth II procedure), the proximal
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remnant of the stomach is anastomosed to the proximal jejunum. Patency of the nasogastric tube is cri
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tical for preventing the retention of gastric secretions. The nurse should never irrigate or reposition the
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gastric tube after gastric surgery, unless specifically prescribed by the health care provider. In this situ
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ation, the nurse should clarify the prescription. Options 1, 2, and 4 are appropriate postoperative interv
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entions.



QUESTION 6 ga




The nurse is providing discharge instructions to a client following gastrectomy and shou
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ld instruct the client to take which measure to assist in preventing dumping syndrome?
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A. Ambulate following a meal.
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B. Eat high-carbohydrate foods.
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C. Limit the fluids taken with meals.
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D. Sit in a high Fowler's position during meals.
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ANSWER

C. Limit the fluids taken with meals. Rationale: Dumping syndrome is a term that refers to a constellati
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on of vasomotor symptoms that occurs after eating, especially following a gastrojejunostomy (Billroth II
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procedure). Early manifestations usually occur within 30 minutes of eating and include vertigo, tachyc
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ardia, syncope, sweating, pallor, palpitations, and the desire to lie down. The nurse should instruct the
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client to decrease the amount of fluid taken at meals and to avoid high-
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carbohydrate foods, including fluids such as fruit nectars; to assume a low Fowler's position during me
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als; to lie down for 30 minutes after eating to delay gastric emptying; and to take antispasmodics as pr
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escribed.



QUESTION 7 ga




The nurse is doing an admission assessment on a client with a history of duodenal ulcer.
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To determine whether the problem is currently active, the nurse should assess the clien
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t for which sign(s)/symptom(s) of duodenal ulcer?
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A. Weight loss
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B. Nausea and vomiting
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C. Pain relieved by food intake
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D. Pain radiating down the right arm
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ANSWER

C. Pain relieved by food intake Rationale: A frequent symptom of duodenal ulcer is pain that is relieved
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by food intake. These clients generally describe the pain as a burning, heavy, sharp, or "hungry" pain th
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at often localizes in the mid-
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epigastric area. The client with duodenal ulcer usually does not experience weight loss or nausea and v
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omiting. These symptoms are more typical in the client with a gastric ulcer.
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