Med Surg Gastrointestinal NCLEX Questions with 100% Verified Answers
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 pre-
scheduled for surgery in sented in the question, the nurse should suspect
2 hours. The client begins peritonitis and notify the HCP. Administering pain
to complain of increased medication is not an appropriate intervention.
abdominal pain and be- Heat should never be applied to the abdomen of
gins to vomit. On assess- a client with suspected appendicitis because of
ment, the nurse notes that the risk of rupture. Scheduling surgical time is not
the abdomen is distend- within the scope of nursing practice, although the
ed and bowel sounds are HCP probably would perform the surgery earlier
diminished. Which is the than the prescheduled time.
most appropriate nursing
intervention?
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 A. Administer stool softeners as prescribed.
had a hemorrhoidectomy. C. Encourage a high-fiber diet to promote bowel
Which nursing interven- movements without straining.
tions are appropriate for D. Apply cold packs to the anal-rectal area over
this client? Select all that the dressing until the packing is removed.
apply.
Rationale:
A. Administer stool soft- Nursing interventions after a hemorrhoidectomy
eners as prescribed. are aimed at management of pain and avoidance
B. Instruct the client to of bleeding and incision rupture. Stool soften-
, Med Surg Gastrointestinal NCLEX Questions with 100% Verified Answers
limit fluid intake to avoid ers and a high-fiber diet will help the client to
urinary retention. avoid straining, thereby reducing the chances of
C. Encourage a high-fiber rupturing the incision. An ice pack will increase
diet to promote bow- comfort and decrease bleeding. Options 2 and 5
el movements without are incorrect interventions.
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 bleed-
ing.
3. The nurse is planning to A. Coffee
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 Foods that decrease lower esophageal sphincter
all that apply. (LES) pressure and irritate the esophagus will
increase reflux and exacerbate the symptoms
A. Coffee of GERD and therefore should be avoided. Ag-
B. Chocolate gravating substances include coffee, chocolate,
C. Peppermint peppermint, fried or fatty foods, carbonated bev-
D. Nonfat milk erages, and alcohol. Options 4 and 6 do not
E. Fried chicken promote this effect.
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
ority on which item as part for return of the gag reflex. This assessment
of the client's care plan? addresses the client's airway. The nurse also
monitors the client's vital signs and for a sudden
, Med Surg Gastrointestinal NCLEX Questions with 100% Verified Answers
1. Monitoring the tempera- increase in temperature, which could indicate
ture perforation of the gastrointestinal tract. This com-
2. Monitoring complaints plication would be accompanied by other signs
of heartburn as well, such as pain. Monitoring for sore throat
3. Giving warm gargles for and heartburn are also important; however, the
a sore throat client's airway is the priority.
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 atro-
vitamin B12 in the diet? phy of the lining of the stomach, leading to the
Select all that apply. loss of function of the parietal cells. The source of
intrinsic factor is lost, which results in an inability
A. Nuts to absorb vitamin B12, leading to development
B. Corn of pernicious anemia. Clients must increase their
C. Liver intake of vitamin B12 by increasing consumption
D. Apples of foods rich in this vitamin, such as nuts, organ
E. Lentils meats, dried beans, citrus fruits, green leafy veg-
F. Bananas etables, and yeast.
6. The nurse is monitoring D. A rigid, boardlike abdomen
a client with a diagnosis
of peptic ulcer. Which as- Rationale:
sessment finding would Perforation of an ulcer is a surgical emergency
most likely indicate perfo- and is characterized by sudden, sharp, intolera-
ration of the ulcer? ble severe pain beginning in the mid-epigastric
area and spreading over the abdomen, which
A. Bradycardia becomes rigid and boardlike. Nausea and vomit-
B. Numbness in the legs ing may occur. Tachycardia may occur as hypov-
C. Nausea and vomiting olemic shock develops. Numbness in the legs is
D. A rigid, boardlike ab- not an associated finding.
domen
7.
, Med Surg Gastrointestinal NCLEX Questions with 100% Verified Answers
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),
ative prescription should the proximal remnant of the stomach is anasto-
the nurse question and mosed to the proximal jejunum. Patency of the
verify? nasogastric tube is critical for preventing the re-
tention of gastric secretions. The nurse should
A. Leg exercises never irrigate or reposition the gastric tube after
B. Early ambulation gastric surgery, unless specifically prescribed by
C. Irrigating the nasogas- the health care provider. In this situation, the
tric tube nurse should clarify the prescription. Options 1,
D. Coughing and 2, and 4 are appropriate postoperative interven-
deep-breathing exercises tions.
8. The nurse is providing C. Limit the fluids taken with meals.
discharge instructions to
a client following gas- Rationale:
trectomy and should in- Dumping syndrome is a term that refers to a con-
struct the client to take stellation of vasomotor symptoms that occurs
which measure to as- after eating, especially following a gastrojejunos-
sist in preventing dump- tomy (Billroth II procedure). Early manifestations
ing syndrome? usually occur within 30 minutes of eating and
include vertigo, tachycardia, syncope, sweating,
A. Ambulate following a pallor, palpitations, and the desire to lie down.
meal. The nurse should instruct the client to decrease
B. Eat high-carbohydrate the amount of fluid taken at meals and to avoid
foods. high-carbohydrate foods, including fluids such as
C. Limit the fluids taken fruit nectars; to assume a low Fowler's position
with meals. during meals; to lie down for 30 minutes after
D. Sit in a high Fowler's eating to delay gastric emptying; and to take
position during meals. antispasmodics as prescribed.
9. The nurse is providing A. "I should increase the fiber in my diet."
discharge teaching for a
client with newly diag- Rationale:
nosed Crohn's disease Crohn's disease is an inflammatory disease that
about dietary measures can occur anywhere in the gastrointestinal tract
to implement during exac- but most often affects the terminal ileum and
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 pre-
scheduled for surgery in sented in the question, the nurse should suspect
2 hours. The client begins peritonitis and notify the HCP. Administering pain
to complain of increased medication is not an appropriate intervention.
abdominal pain and be- Heat should never be applied to the abdomen of
gins to vomit. On assess- a client with suspected appendicitis because of
ment, the nurse notes that the risk of rupture. Scheduling surgical time is not
the abdomen is distend- within the scope of nursing practice, although the
ed and bowel sounds are HCP probably would perform the surgery earlier
diminished. Which is the than the prescheduled time.
most appropriate nursing
intervention?
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 A. Administer stool softeners as prescribed.
had a hemorrhoidectomy. C. Encourage a high-fiber diet to promote bowel
Which nursing interven- movements without straining.
tions are appropriate for D. Apply cold packs to the anal-rectal area over
this client? Select all that the dressing until the packing is removed.
apply.
Rationale:
A. Administer stool soft- Nursing interventions after a hemorrhoidectomy
eners as prescribed. are aimed at management of pain and avoidance
B. Instruct the client to of bleeding and incision rupture. Stool soften-
, Med Surg Gastrointestinal NCLEX Questions with 100% Verified Answers
limit fluid intake to avoid ers and a high-fiber diet will help the client to
urinary retention. avoid straining, thereby reducing the chances of
C. Encourage a high-fiber rupturing the incision. An ice pack will increase
diet to promote bow- comfort and decrease bleeding. Options 2 and 5
el movements without are incorrect interventions.
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 bleed-
ing.
3. The nurse is planning to A. Coffee
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 Foods that decrease lower esophageal sphincter
all that apply. (LES) pressure and irritate the esophagus will
increase reflux and exacerbate the symptoms
A. Coffee of GERD and therefore should be avoided. Ag-
B. Chocolate gravating substances include coffee, chocolate,
C. Peppermint peppermint, fried or fatty foods, carbonated bev-
D. Nonfat milk erages, and alcohol. Options 4 and 6 do not
E. Fried chicken promote this effect.
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
ority on which item as part for return of the gag reflex. This assessment
of the client's care plan? addresses the client's airway. The nurse also
monitors the client's vital signs and for a sudden
, Med Surg Gastrointestinal NCLEX Questions with 100% Verified Answers
1. Monitoring the tempera- increase in temperature, which could indicate
ture perforation of the gastrointestinal tract. This com-
2. Monitoring complaints plication would be accompanied by other signs
of heartburn as well, such as pain. Monitoring for sore throat
3. Giving warm gargles for and heartburn are also important; however, the
a sore throat client's airway is the priority.
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 atro-
vitamin B12 in the diet? phy of the lining of the stomach, leading to the
Select all that apply. loss of function of the parietal cells. The source of
intrinsic factor is lost, which results in an inability
A. Nuts to absorb vitamin B12, leading to development
B. Corn of pernicious anemia. Clients must increase their
C. Liver intake of vitamin B12 by increasing consumption
D. Apples of foods rich in this vitamin, such as nuts, organ
E. Lentils meats, dried beans, citrus fruits, green leafy veg-
F. Bananas etables, and yeast.
6. The nurse is monitoring D. A rigid, boardlike abdomen
a client with a diagnosis
of peptic ulcer. Which as- Rationale:
sessment finding would Perforation of an ulcer is a surgical emergency
most likely indicate perfo- and is characterized by sudden, sharp, intolera-
ration of the ulcer? ble severe pain beginning in the mid-epigastric
area and spreading over the abdomen, which
A. Bradycardia becomes rigid and boardlike. Nausea and vomit-
B. Numbness in the legs ing may occur. Tachycardia may occur as hypov-
C. Nausea and vomiting olemic shock develops. Numbness in the legs is
D. A rigid, boardlike ab- not an associated finding.
domen
7.
, Med Surg Gastrointestinal NCLEX Questions with 100% Verified Answers
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),
ative prescription should the proximal remnant of the stomach is anasto-
the nurse question and mosed to the proximal jejunum. Patency of the
verify? nasogastric tube is critical for preventing the re-
tention of gastric secretions. The nurse should
A. Leg exercises never irrigate or reposition the gastric tube after
B. Early ambulation gastric surgery, unless specifically prescribed by
C. Irrigating the nasogas- the health care provider. In this situation, the
tric tube nurse should clarify the prescription. Options 1,
D. Coughing and 2, and 4 are appropriate postoperative interven-
deep-breathing exercises tions.
8. The nurse is providing C. Limit the fluids taken with meals.
discharge instructions to
a client following gas- Rationale:
trectomy and should in- Dumping syndrome is a term that refers to a con-
struct the client to take stellation of vasomotor symptoms that occurs
which measure to as- after eating, especially following a gastrojejunos-
sist in preventing dump- tomy (Billroth II procedure). Early manifestations
ing syndrome? usually occur within 30 minutes of eating and
include vertigo, tachycardia, syncope, sweating,
A. Ambulate following a pallor, palpitations, and the desire to lie down.
meal. The nurse should instruct the client to decrease
B. Eat high-carbohydrate the amount of fluid taken at meals and to avoid
foods. high-carbohydrate foods, including fluids such as
C. Limit the fluids taken fruit nectars; to assume a low Fowler's position
with meals. during meals; to lie down for 30 minutes after
D. Sit in a high Fowler's eating to delay gastric emptying; and to take
position during meals. antispasmodics as prescribed.
9. The nurse is providing A. "I should increase the fiber in my diet."
discharge teaching for a
client with newly diag- Rationale:
nosed Crohn's disease Crohn's disease is an inflammatory disease that
about dietary measures can occur anywhere in the gastrointestinal tract
to implement during exac- but most often affects the terminal ileum and
