PRACTICE QUESTIONS AND ANSWERS 2024 VERSION
VERIFIED RATIONALE GRADED A+
A 61-year-old patient with suspected bowel obstruction had a nasogastric
tube inserted at 4:00 AM. The nurse shares in the morning report that the
day shift staff should check the tube for patency at what times?
A. 7:00 AM, 10:00 AM, and 1:00 PM
B. 8:00 AM, 12:00 PM, and 4:00 PM
C. 9:00 AM and 3:00 PM
D. 9:00 AM, 12:00 PM, and 3:00 PM - ansB. 8:00 AM, 12:00 PM, and 4:00 PM
A nasogastric tube should be checked for patency routinely at 4-hour
intervals. Thus if the tube were inserted at 4:00 AM, it would be due to be
checked at 8:00 AM, 12:00 PM, and 4:00 PM.
A 72-year-old patient was admitted with epigastric pain due to a gastric
ulcer. Which patient assessment warrants an urgent change in the nursing
plan of care?
A. Chest pain relieved with eating or drinking water
B. Back pain 3 or 4 hours after eating a meal
C. Burning epigastric pain 90 minutes after breakfast
D. Rigid abdomen and vomiting following indigestion - ansD. Rigid abdomen
and vomiting following indigestion
A rigid abdomen with vomiting in a patient who has a gastric ulcer indicates
a perforation of the ulcer, especially if the manifestations of perforation
appear suddenly. Midepigastric pain is relieved by eating, drinking water, or
,LEWIS MED SURG - UPPER AND LOWER GI NCLEX
PRACTICE QUESTIONS AND ANSWERS 2024 VERSION
VERIFIED RATIONALE GRADED A+
antacids with duodenal ulcers, not gastric ulcers. Back pain 3-4 hours after a
meal is more likely to occur with a duodenal ulcer. Burning epigastric pain 1-
2 hours after a meal is an expected manifestation of a gastric ulcer related
to increased gastric secretions and does not cause an urgent change in the
nursing plan of care.
A female patient has a sliding hiatal hernia. What nursing interventions will
prevent the symptoms of heartburn and dyspepsia that she is experiencing?
A. Keep the patient NPO.
B. Put the bed in the Trendelenberg position.
C. Have the patient eat 4 to 6 smaller meals each day.
D. Give various antacids to determine which one works for the patient. -
ansC. Have the patient eat 4 to 6 smaller meals each day.
Eating smaller meals during the day will decrease the gastric pressure and
the symptoms of hiatal hernia. Keeping the patient NPO or in a
Trendelenberg position are not safe or realistic for a long period of time for
any patient. Varying antacids will only be done with the care provider's
prescription, so this is not a nursing intervention.
A patient complains of nausea. When administering a dose of
metoclopramide (Reglan), the nurse should teach the patient to report which
potential adverse effect?
A. Tremors
B. Constipation
, LEWIS MED SURG - UPPER AND LOWER GI NCLEX
PRACTICE QUESTIONS AND ANSWERS 2024 VERSION
VERIFIED RATIONALE GRADED A+
C. Double vision
D. Numbness in fingers and toes - ansA. Tremors
Extrapyramidal side effects, including tremors and tardive dyskinesias, may
occur as a result of metoclopramide (Reglan) administration. Constipation,
double vision, and numbness in fingers and toes are not adverse effects of
metoclopramide.
A patient reports having a dry mouth and asks for something to drink. The
nurse recognizes that this symptom can most likely be attributed to a
common adverse effect of which medication that the patient is taking?
A. Digoxin (Lanoxin)
B. Cefotetan (Cefotan)
C. Famotidine (Pepcid)
D. Promethazine (Phenergan) - ansD. Promethazine (Phenergan)
A common adverse effect of promethazine, an antihistamine/antiemetic
agent, is dry mouth; another is blurred vision. Common side effects of
digoxin are yellow halos and bradycardia. Common side effects of cefotetan
are nausea, vomiting, stomach pain, and diarrhea. Common side effects of
famotidine are headache, abdominal pain, constipation, or diarrhea.
A patient with a history of peptic ulcer disease has presented to the
emergency department reporting severe abdominal pain and has a rigid,
boardlike abdomen that prompts the health care team to suspect a
perforated ulcer. What intervention should the nurse anticipate?