Med Surg Gastrointestinal NCLEX Questions
1. The nurse is monitoring A. Notify the health care provider (HCP).
a client admitted to the
hospital with a diagno- Rationale:
sis of appendicitis who is On the basis of the signs and symptoms presented in the question,
scheduled for surgery in 2 the nurse should suspect peritonitis and notify the HCP. Admin-
hours. The client begins to istering pain medication is not an appropriate intervention. Heat
complain of increased ab- should never be applied to the abdomen of a client with suspected
dominal pain and begins appendicitis because of the risk of rupture. Scheduling surgical time
to vomit. On assessment, is not within the scope of nursing practice, although the HCP probably
the nurse notes that the would perform the surgery earlier than the prescheduled time.
abdomen is distended and
bowel sounds are dimin-
ished. Which is the most
appropriate nursing inter-
vention?
A. Notify the health care
provider (HCP).
B. Administer the pre-
scribed pain medication.
C. Call and ask the operat-
ing room team to perform
surgery as soon as possi-
ble.
D. Reposition the client
and apply a heating pad
on the warm setting to the
client's abdomen.
2. A client has just had a he- A. Administer stool softeners as prescribed.
morrhoidectomy. Which C. Encourage a high-fiber diet to promote bowel movements without
nursing interventions are straining.
, Med Surg Gastrointestinal NCLEX Questions
appropriate for this client? D. Apply cold packs to the anal-rectal area over the dressing until the
Select all that apply. packing is removed.
A. Administer stool soften- Rationale:
ers as prescribed. Nursing interventions after a hemorrhoidectomy are aimed at man-
B. Instruct the client to lim- agement of pain and avoidance of bleeding and incision rupture.
it fluid intake to avoid uri- Stool softeners and a high-fiber diet will help the client to avoid
nary retention. straining, thereby reducing the chances of rupturing the incision. An
C. Encourage a high-fiber ice pack will increase comfort and decrease bleeding. Options 2 and
diet to promote bow- 5 are incorrect interventions.
el movements without
straining.
D. Apply cold packs to the
anal-rectal area over the
dressing until the packing
is removed.
E. Help the client to a
Fowler's position to place
pressure on the rectal area
and decrease bleeding.
3. The nurse is planning to A. Cottee
teach a client with gas- B. Chocolate
troesophageal reflux dis- C. Peppermint
ease (GERD) about sub- E. Fried chicken
stances to avoid. Which
items should the nurse in- Rationale:
clude on this list? Select all Foods that decrease lower esophageal sphincter (LES) pressure and
that apply. irritate the esophagus will increase reflux and exacerbate the symp-
toms of GERD and therefore should be avoided. Aggravating sub-
A. Coffee stances include cottee, chocolate, peppermint, fried or fatty foods,
B. Chocolate
, Med Surg Gastrointestinal NCLEX Questions
C. Peppermint carbonated beverages, and alcohol. Options 4 and 6 do not promote
D. Nonfat milk this ettect.
E. Fried chicken
F. Scrambled eggs
4. A client has under- 4. Assessing for the return of the gag reflex
gone esophagogastro-
duodenoscopy. The nurse Rationale:
should place highest pri- The nurse places highest priority on assessing for return of the
ority on which item as part gag reflex. This assessment addresses the client's airway. The nurse
of the client's care plan? also monitors the client's vital signs and for a sudden increase in
temperature, which could indicate perforation of the gastrointestinal
1. Monitoring the temper- tract. This complication would be accompanied by other signs as
ature well, such as pain. Monitoring for sore throat and heartburn are also
2. Monitoring complaints important; however, the client's airway is the priority.
of heartburn
3. Giving warm gargles for
a sore throat
4. Assessing for the return
of the gag reflex
5. The nurse is providing di- A. Nuts
etary teaching for a client C. Liver
with a diagnosis of chron- E. Lentils
ic gastritis. The nurse in-
structs the client to in- Rationale:
clude which foods rich in Chronic gastritis causes deterioration and atrophy of the lining of
vitamin B12 in the diet? Se- the stomach, leading to the loss of function of the parietal cells. The
lect all that apply. source of intrinsic factor is lost, which results in an inability to absorb
vitamin B12, leading to development of pernicious anemia. Clients
A. Nuts must increase their intake of vitamin B12 by increasing consumption
B. Corn
, Med Surg Gastrointestinal NCLEX Questions
C. Liver of foods rich in this vitamin, such as nuts, organ meats, dried beans,
D. Apples citrus fruits, green leafy vegetables, and yeast.
E. Lentils
F. Bananas
6. The nurse is monitoring a D. A rigid, boardlike abdomen
client with a diagnosis of
peptic ulcer. Which assess- Rationale:
ment finding would most Perforation of an ulcer is a surgical emergency and is characterized
likely indicate perforation by sudden, sharp, intolerable severe pain beginning in the mid-epi-
of the ulcer? gastric area and spreading over the abdomen, which becomes rigid
and boardlike. Nausea and vomiting may occur. Tachycardia may
A. Bradycardia occur as hypovolemic shock develops. Numbness in the legs is not
B. Numbness in the legs an associated finding.
C. Nausea and vomiting
D. A rigid, boardlike ab-
domen
7. The nurse is caring for a C. Irrigating the nasogastric tube
client following a gastroje-
junostomy (Billroth II pro-Rationale:
cedure). Which postoper- In a gastrojejunostomy (Billroth II procedure), the proximal remnant
ative prescription should of the stomach is anastomosed to the proximal jejunum. Patency
the nurse question and of the nasogastric tube is critical for preventing the retention of
verify? gastric secretions. The nurse should never irrigate or reposition the
gastric tube after gastric surgery, unless specifically prescribed by
A. Leg exercises the health care provider. In this situation, the nurse should clarify
B. Early ambulation the prescription. Options 1, 2, and 4 are appropriate postoperative
C. Irrigating the nasogas- interventions.
tric tube
D. Coughing and
deep-breathing exercises
1. The nurse is monitoring A. Notify the health care provider (HCP).
a client admitted to the
hospital with a diagno- Rationale:
sis of appendicitis who is On the basis of the signs and symptoms presented in the question,
scheduled for surgery in 2 the nurse should suspect peritonitis and notify the HCP. Admin-
hours. The client begins to istering pain medication is not an appropriate intervention. Heat
complain of increased ab- should never be applied to the abdomen of a client with suspected
dominal pain and begins appendicitis because of the risk of rupture. Scheduling surgical time
to vomit. On assessment, is not within the scope of nursing practice, although the HCP probably
the nurse notes that the would perform the surgery earlier than the prescheduled time.
abdomen is distended and
bowel sounds are dimin-
ished. Which is the most
appropriate nursing inter-
vention?
A. Notify the health care
provider (HCP).
B. Administer the pre-
scribed pain medication.
C. Call and ask the operat-
ing room team to perform
surgery as soon as possi-
ble.
D. Reposition the client
and apply a heating pad
on the warm setting to the
client's abdomen.
2. A client has just had a he- A. Administer stool softeners as prescribed.
morrhoidectomy. Which C. Encourage a high-fiber diet to promote bowel movements without
nursing interventions are straining.
, Med Surg Gastrointestinal NCLEX Questions
appropriate for this client? D. Apply cold packs to the anal-rectal area over the dressing until the
Select all that apply. packing is removed.
A. Administer stool soften- Rationale:
ers as prescribed. Nursing interventions after a hemorrhoidectomy are aimed at man-
B. Instruct the client to lim- agement of pain and avoidance of bleeding and incision rupture.
it fluid intake to avoid uri- Stool softeners and a high-fiber diet will help the client to avoid
nary retention. straining, thereby reducing the chances of rupturing the incision. An
C. Encourage a high-fiber ice pack will increase comfort and decrease bleeding. Options 2 and
diet to promote bow- 5 are incorrect interventions.
el movements without
straining.
D. Apply cold packs to the
anal-rectal area over the
dressing until the packing
is removed.
E. Help the client to a
Fowler's position to place
pressure on the rectal area
and decrease bleeding.
3. The nurse is planning to A. Cottee
teach a client with gas- B. Chocolate
troesophageal reflux dis- C. Peppermint
ease (GERD) about sub- E. Fried chicken
stances to avoid. Which
items should the nurse in- Rationale:
clude on this list? Select all Foods that decrease lower esophageal sphincter (LES) pressure and
that apply. irritate the esophagus will increase reflux and exacerbate the symp-
toms of GERD and therefore should be avoided. Aggravating sub-
A. Coffee stances include cottee, chocolate, peppermint, fried or fatty foods,
B. Chocolate
, Med Surg Gastrointestinal NCLEX Questions
C. Peppermint carbonated beverages, and alcohol. Options 4 and 6 do not promote
D. Nonfat milk this ettect.
E. Fried chicken
F. Scrambled eggs
4. A client has under- 4. Assessing for the return of the gag reflex
gone esophagogastro-
duodenoscopy. The nurse Rationale:
should place highest pri- The nurse places highest priority on assessing for return of the
ority on which item as part gag reflex. This assessment addresses the client's airway. The nurse
of the client's care plan? also monitors the client's vital signs and for a sudden increase in
temperature, which could indicate perforation of the gastrointestinal
1. Monitoring the temper- tract. This complication would be accompanied by other signs as
ature well, such as pain. Monitoring for sore throat and heartburn are also
2. Monitoring complaints important; however, the client's airway is the priority.
of heartburn
3. Giving warm gargles for
a sore throat
4. Assessing for the return
of the gag reflex
5. The nurse is providing di- A. Nuts
etary teaching for a client C. Liver
with a diagnosis of chron- E. Lentils
ic gastritis. The nurse in-
structs the client to in- Rationale:
clude which foods rich in Chronic gastritis causes deterioration and atrophy of the lining of
vitamin B12 in the diet? Se- the stomach, leading to the loss of function of the parietal cells. The
lect all that apply. source of intrinsic factor is lost, which results in an inability to absorb
vitamin B12, leading to development of pernicious anemia. Clients
A. Nuts must increase their intake of vitamin B12 by increasing consumption
B. Corn
, Med Surg Gastrointestinal NCLEX Questions
C. Liver of foods rich in this vitamin, such as nuts, organ meats, dried beans,
D. Apples citrus fruits, green leafy vegetables, and yeast.
E. Lentils
F. Bananas
6. The nurse is monitoring a D. A rigid, boardlike abdomen
client with a diagnosis of
peptic ulcer. Which assess- Rationale:
ment finding would most Perforation of an ulcer is a surgical emergency and is characterized
likely indicate perforation by sudden, sharp, intolerable severe pain beginning in the mid-epi-
of the ulcer? gastric area and spreading over the abdomen, which becomes rigid
and boardlike. Nausea and vomiting may occur. Tachycardia may
A. Bradycardia occur as hypovolemic shock develops. Numbness in the legs is not
B. Numbness in the legs an associated finding.
C. Nausea and vomiting
D. A rigid, boardlike ab-
domen
7. The nurse is caring for a C. Irrigating the nasogastric tube
client following a gastroje-
junostomy (Billroth II pro-Rationale:
cedure). Which postoper- In a gastrojejunostomy (Billroth II procedure), the proximal remnant
ative prescription should of the stomach is anastomosed to the proximal jejunum. Patency
the nurse question and of the nasogastric tube is critical for preventing the retention of
verify? gastric secretions. The nurse should never irrigate or reposition the
gastric tube after gastric surgery, unless specifically prescribed by
A. Leg exercises the health care provider. In this situation, the nurse should clarify
B. Early ambulation the prescription. Options 1, 2, and 4 are appropriate postoperative
C. Irrigating the nasogas- interventions.
tric tube
D. Coughing and
deep-breathing exercises
