MED SURG GASTROINTESTINAL NCLEX QUESTIONS
AND ANSWERS LATEST VERSION VERIFIED
RATIONALE GRADED A+
A client arrives at the hospital emergency department complaining of acute right lower quadrant
abdominal pain, and appendicitis is suspected. Laboratory tests are performed, and the nurse notes that
the client's white blood cell (WBC) count is elevated. On the basis of these findings, the nurse should
question which health care provider (HCP) prescription documented in the client's medical record?
A. Apply a cold pack to the abdomen.
B. Administer 30 mL of milk of magnesia (MOM).
C. Maintain nothing by mouth (nil per os [NPO]) status.
D. Initiate an intravenous (IV) line for the administration of IV fluids. - ansB. Administer 30 mL of milk of
magnesia (MOM).
Rationale:
Appendicitis should be suspected in a client with an elevated WBC count complaining of acute right
lower abdominal quadrant pain. Laxatives are never prescribed because if appendicitis is present, the
effect of the laxative may cause a rupture with resultant peritonitis. Cold packs may be prescribed for
comfort. The client would be NPO and given IV fluids in preparation for possible surgery.
A client arrives at the hospital emergency department complaining of acute right lower quadrant
abdominal pain. Appendicitis is suspected, and appropriate laboratory tests are performed. The
emergency department nurse reviews the test results and notes that the client's white blood cell (WBC)
count is elevated. The nurse also reviews the prescriptions from the health care provider (HCP). The
nurse should contact the HCP to question which prescription if noted in the client's record?
A. Maintain a semi Fowler's position.
B. Maintain on NPO (nothing by mouth) status.
C.Apply a heating pad to the lower abdomen for comfort.
D. Initiate an intravenous (IV) line with the administration of IV fluids. - ansC.Apply a heating pad to the
lower abdomen for comfort.
Rationale:
Appendicitis should be suspected in a client with an elevated WBC count who is complaining of acute
right lower quadrant abdominal pain. A semi Fowler's position is maintained for comfort. The client
,MED SURG GASTROINTESTINAL NCLEX QUESTIONS
AND ANSWERS LATEST VERSION VERIFIED
RATIONALE GRADED A+
would be on NPO status and given IV fluids in preparation for possible surgery. Heat should never be
applied to the abdomen because this may increase circulation to the appendix, potentially leading to
increased inflammation and perforation.
A client experiencing chronic dumping syndrome makes the following comments to the nurse. Which
one indicates the need for further teaching?
A. "I eat at least 3 large meals each day."
B. "I eat while lying in a semirecumbent position."
C. "I have eliminated taking liquids with my meals."
D. "I eat a high-protein, low- to moderate-carbohydrate diet." - ansA. "I eat at least 3 large meals each
day."
Rationale:
Dumping syndrome describes a group of symptoms that occur after eating. It is believed to result from
rapid dumping of gastric contents into the small intestine, which causes fluid to shift into the intestine.
Signs and symptoms of dumping syndrome include diarrhea, abdominal distention, sweating, pallor,
palpitations, and syncope. To manage this syndrome, clients are encouraged to decrease the amount of
food taken at each sitting, eat in a semirecumbent position, eliminate ingesting fluids with meals, and
avoid consumption of high-carbohydrate meals.
A client had a new colostomy created 2 days earlier and is beginning to pass malodorous flatus from the
stoma. What is the correct interpretation by the nurse?
A. This is a normal, expected event.
B. The client is experiencing early signs of ischemic bowel.
C. The client should not have the nasogastric tube removed.
D. This indicates inadequate preoperative bowel preparation. - ansA. This is a normal, expected event.
Rationale:
,MED SURG GASTROINTESTINAL NCLEX QUESTIONS
AND ANSWERS LATEST VERSION VERIFIED
RATIONALE GRADED A+
As peristalsis returns following creation of a colostomy, the client begins to pass malodorous flatus. This
indicates returning bowel function and is an expected event. Within 72 hours of surgery, the client
should begin passing stool via the colostomy. Options 2, 3, and 4 are incorrect interpretations.
A client has a large, deep duodenal ulcer diagnosed by endoscopy. Which sign or symptom indicative of a
complication should the nurse look for during the client's postprocedure assessment?
A. Bradycardia
B. Nausea and vomiting
C. Numbness in the legs
D. A rigid, boardlike abdomen - ansD. A rigid, boardlike abdomen
Rationale:
The client with a large, deep duodenal ulcer is at risk for perforation of the ulcer. If this occurs, the client
will experience sudden, sharp, intolerable severe pain beginning in the midepigastric area and spreading
over the abdomen, which then becomes rigid and boardlike. Tachycardia, not bradycardia, may occur as
hypovolemic shock develops. Nausea and vomiting may not occur if the pyloric sphincter is intact.
Numbness in the legs is not an associated finding.
A client has just had a hemorrhoidectomy. Which nursing interventions are appropriate for this client?
Select all that apply.
A. Administer stool softeners as prescribed.
B. Instruct the client to limit fluid intake to avoid urinary retention.
C. Encourage a high-fiber diet to promote bowel 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. -
ansA. Administer stool softeners as prescribed.
C. Encourage a high-fiber diet to promote bowel movements without straining.
D. Apply cold packs to the anal-rectal area over the dressing until the packing is removed.
, MED SURG GASTROINTESTINAL NCLEX QUESTIONS
AND ANSWERS LATEST VERSION VERIFIED
RATIONALE GRADED A+
Rationale:
Nursing interventions after a hemorrhoidectomy are aimed at management of pain and avoidance of
bleeding and incision rupture. Stool softeners and a high-fiber diet will help the client to avoid straining,
thereby reducing the chances of rupturing the incision. An ice pack will increase comfort and decrease
bleeding. Options 2 and 5 are incorrect interventions.
A client has just had surgery to create an ileostomy. The nurse assesses the client in the immediate
postoperative period for which most frequent complication of this type of surgery?
A. Folate deficiency
B. Malabsorption of fat
C. Intestinal obstruction
D. Fluid and electrolyte imbalance - ansD. Fluid and electrolyte imbalance
Rationale:
A frequent complication that occurs following ileostomy is fluid and electrolyte imbalance. The client
requires constant monitoring of intake and output to prevent this from occurring. Losses require
replacement by intravenous infusion until the client can tolerate a diet orally. Intestinal obstruction is a
less frequent complication. Fat malabsorption and folate deficiency are complications that could occur
later in the postoperative period.
A client has undergone esophagogastroduodenoscopy. The nurse should place highest priority on which
item as part of the client's care plan?
1. Monitoring the temperature
2. Monitoring complaints of heartburn
3. Giving warm gargles for a sore throat
4. Assessing for the return of the gag reflex - ans4. Assessing for the return of the gag reflex
AND ANSWERS LATEST VERSION VERIFIED
RATIONALE GRADED A+
A client arrives at the hospital emergency department complaining of acute right lower quadrant
abdominal pain, and appendicitis is suspected. Laboratory tests are performed, and the nurse notes that
the client's white blood cell (WBC) count is elevated. On the basis of these findings, the nurse should
question which health care provider (HCP) prescription documented in the client's medical record?
A. Apply a cold pack to the abdomen.
B. Administer 30 mL of milk of magnesia (MOM).
C. Maintain nothing by mouth (nil per os [NPO]) status.
D. Initiate an intravenous (IV) line for the administration of IV fluids. - ansB. Administer 30 mL of milk of
magnesia (MOM).
Rationale:
Appendicitis should be suspected in a client with an elevated WBC count complaining of acute right
lower abdominal quadrant pain. Laxatives are never prescribed because if appendicitis is present, the
effect of the laxative may cause a rupture with resultant peritonitis. Cold packs may be prescribed for
comfort. The client would be NPO and given IV fluids in preparation for possible surgery.
A client arrives at the hospital emergency department complaining of acute right lower quadrant
abdominal pain. Appendicitis is suspected, and appropriate laboratory tests are performed. The
emergency department nurse reviews the test results and notes that the client's white blood cell (WBC)
count is elevated. The nurse also reviews the prescriptions from the health care provider (HCP). The
nurse should contact the HCP to question which prescription if noted in the client's record?
A. Maintain a semi Fowler's position.
B. Maintain on NPO (nothing by mouth) status.
C.Apply a heating pad to the lower abdomen for comfort.
D. Initiate an intravenous (IV) line with the administration of IV fluids. - ansC.Apply a heating pad to the
lower abdomen for comfort.
Rationale:
Appendicitis should be suspected in a client with an elevated WBC count who is complaining of acute
right lower quadrant abdominal pain. A semi Fowler's position is maintained for comfort. The client
,MED SURG GASTROINTESTINAL NCLEX QUESTIONS
AND ANSWERS LATEST VERSION VERIFIED
RATIONALE GRADED A+
would be on NPO status and given IV fluids in preparation for possible surgery. Heat should never be
applied to the abdomen because this may increase circulation to the appendix, potentially leading to
increased inflammation and perforation.
A client experiencing chronic dumping syndrome makes the following comments to the nurse. Which
one indicates the need for further teaching?
A. "I eat at least 3 large meals each day."
B. "I eat while lying in a semirecumbent position."
C. "I have eliminated taking liquids with my meals."
D. "I eat a high-protein, low- to moderate-carbohydrate diet." - ansA. "I eat at least 3 large meals each
day."
Rationale:
Dumping syndrome describes a group of symptoms that occur after eating. It is believed to result from
rapid dumping of gastric contents into the small intestine, which causes fluid to shift into the intestine.
Signs and symptoms of dumping syndrome include diarrhea, abdominal distention, sweating, pallor,
palpitations, and syncope. To manage this syndrome, clients are encouraged to decrease the amount of
food taken at each sitting, eat in a semirecumbent position, eliminate ingesting fluids with meals, and
avoid consumption of high-carbohydrate meals.
A client had a new colostomy created 2 days earlier and is beginning to pass malodorous flatus from the
stoma. What is the correct interpretation by the nurse?
A. This is a normal, expected event.
B. The client is experiencing early signs of ischemic bowel.
C. The client should not have the nasogastric tube removed.
D. This indicates inadequate preoperative bowel preparation. - ansA. This is a normal, expected event.
Rationale:
,MED SURG GASTROINTESTINAL NCLEX QUESTIONS
AND ANSWERS LATEST VERSION VERIFIED
RATIONALE GRADED A+
As peristalsis returns following creation of a colostomy, the client begins to pass malodorous flatus. This
indicates returning bowel function and is an expected event. Within 72 hours of surgery, the client
should begin passing stool via the colostomy. Options 2, 3, and 4 are incorrect interpretations.
A client has a large, deep duodenal ulcer diagnosed by endoscopy. Which sign or symptom indicative of a
complication should the nurse look for during the client's postprocedure assessment?
A. Bradycardia
B. Nausea and vomiting
C. Numbness in the legs
D. A rigid, boardlike abdomen - ansD. A rigid, boardlike abdomen
Rationale:
The client with a large, deep duodenal ulcer is at risk for perforation of the ulcer. If this occurs, the client
will experience sudden, sharp, intolerable severe pain beginning in the midepigastric area and spreading
over the abdomen, which then becomes rigid and boardlike. Tachycardia, not bradycardia, may occur as
hypovolemic shock develops. Nausea and vomiting may not occur if the pyloric sphincter is intact.
Numbness in the legs is not an associated finding.
A client has just had a hemorrhoidectomy. Which nursing interventions are appropriate for this client?
Select all that apply.
A. Administer stool softeners as prescribed.
B. Instruct the client to limit fluid intake to avoid urinary retention.
C. Encourage a high-fiber diet to promote bowel 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. -
ansA. Administer stool softeners as prescribed.
C. Encourage a high-fiber diet to promote bowel movements without straining.
D. Apply cold packs to the anal-rectal area over the dressing until the packing is removed.
, MED SURG GASTROINTESTINAL NCLEX QUESTIONS
AND ANSWERS LATEST VERSION VERIFIED
RATIONALE GRADED A+
Rationale:
Nursing interventions after a hemorrhoidectomy are aimed at management of pain and avoidance of
bleeding and incision rupture. Stool softeners and a high-fiber diet will help the client to avoid straining,
thereby reducing the chances of rupturing the incision. An ice pack will increase comfort and decrease
bleeding. Options 2 and 5 are incorrect interventions.
A client has just had surgery to create an ileostomy. The nurse assesses the client in the immediate
postoperative period for which most frequent complication of this type of surgery?
A. Folate deficiency
B. Malabsorption of fat
C. Intestinal obstruction
D. Fluid and electrolyte imbalance - ansD. Fluid and electrolyte imbalance
Rationale:
A frequent complication that occurs following ileostomy is fluid and electrolyte imbalance. The client
requires constant monitoring of intake and output to prevent this from occurring. Losses require
replacement by intravenous infusion until the client can tolerate a diet orally. Intestinal obstruction is a
less frequent complication. Fat malabsorption and folate deficiency are complications that could occur
later in the postoperative period.
A client has undergone esophagogastroduodenoscopy. The nurse should place highest priority on which
item as part of the client's care plan?
1. Monitoring the temperature
2. Monitoring complaints of heartburn
3. Giving warm gargles for a sore throat
4. Assessing for the return of the gag reflex - ans4. Assessing for the return of the gag reflex
