LEWIS MED SURG - UPPER AND LOWER GI NCLEX
PRACTICE QUESTIONS AND ANSWERS 2024 VERSION
VERIFIED RATIONALE GRADED A+
A perforated peptic ulcer requires IV replacement of fluid losses and continued gastric aspiration by NG
tube. Nothing is given by mouth, and gastric pH testing is not a priority. Calcium gluconate is not a
medication directly relevant to the patient's suspected diagnosis, and parenteral nutrition is not a priority
in the short term.
A stroke patient who primarily uses a wheelchair for mobility has diarrhea with fecal incontinence. What
should the nurse assess first?
A. Fecal impaction
B. Perineal hygiene
C. Dietary fiber intake
D. Antidiarrheal agent use - ansA. Fecal impaction
Patients with limited mobility are at risk for fecal impactions due to constipation that may lead to liquid
stool leaking around the hardened impacted feces, so assessing for fecal impaction is the priority.
Perineal hygiene can be assessed at the same time. Assessing the dietary fiber and fluid intake and
antidiarrheal agent use will be assessed and considered next.
After administering a dose of promethazine (Phenergan) to a patient with nausea and vomiting, what
common temporary adverse effect of the medication does the nurse explain may be experienced?
A. Tinnitus
B. Drowsiness
C. Reduced hearing
D. Sensation of falling - ansB. Drowsiness
Although being given to this patient as an antiemetic, promethazine also has sedative and amnesic
properties. For this reason, the patient is likely to experience drowsiness as an adverse effect of the
medication. Tinnitus, reduced hearing, and loss of balance are not side effects of promethazine.
, LEWIS MED SURG - UPPER AND LOWER GI NCLEX
PRACTICE QUESTIONS AND ANSWERS 2024 VERSION
VERIFIED RATIONALE GRADED A+
After the nurse teaches a patient with gastroesophageal reflux disease (GERD) about recommended
dietary modifications, which statement by the patient indicates that the teaching has been effective?
A. "I can have a glass of low-fat milk at bedtime."
B. "I will have to eliminate all spicy foods from my diet."
C. "I will have to use herbal teas instead of caffeinated drinks."
D. "I should keep something in my stomach all the time to neutralize the excess acids." - ansC. "I will have
to use herbal teas instead of caffeinated drinks."
Rationale: Patients with gastroesophageal reflux disease should avoid foods (such as tea and coffee) that
decrease lower esophageal pressure. Patients should also avoid milk, especially at bedtime, as it
increases gastric acid secretion. Patients may eat spicy foods, unless these foods cause reflux. Small,
frequent meals help prevent overdistention of the stomach, but patients should avoid late evening meals
and nocturnal snacking.
Following administration of a dose of metoclopramide (Reglan) to the patient, the nurse determines that
the medication has been effective when what is noted?
A. Decreased blood pressure
B. Absence of muscle tremors
C. Relief of nausea and vomiting
D. No further episodes of diarrhea - ansC. Relief of nausea and vomiting
Metoclopramide is classified as a prokinetic and antiemetic medication. If it is effective, the patient's
nausea and vomiting should resolve. Metoclopramide does not affect blood pressure, muscle tremors, or
diarrhea.
Following bowel resection, a patient has a nasogastric (NG) tube to suction, but complains of nausea and
abdominal distention. The nurse irrigates the tube as necessary as ordered, but the irrigating fluid does
not return. What should be the priority action by the nurse?
A. Notify the physician.
PRACTICE QUESTIONS AND ANSWERS 2024 VERSION
VERIFIED RATIONALE GRADED A+
A perforated peptic ulcer requires IV replacement of fluid losses and continued gastric aspiration by NG
tube. Nothing is given by mouth, and gastric pH testing is not a priority. Calcium gluconate is not a
medication directly relevant to the patient's suspected diagnosis, and parenteral nutrition is not a priority
in the short term.
A stroke patient who primarily uses a wheelchair for mobility has diarrhea with fecal incontinence. What
should the nurse assess first?
A. Fecal impaction
B. Perineal hygiene
C. Dietary fiber intake
D. Antidiarrheal agent use - ansA. Fecal impaction
Patients with limited mobility are at risk for fecal impactions due to constipation that may lead to liquid
stool leaking around the hardened impacted feces, so assessing for fecal impaction is the priority.
Perineal hygiene can be assessed at the same time. Assessing the dietary fiber and fluid intake and
antidiarrheal agent use will be assessed and considered next.
After administering a dose of promethazine (Phenergan) to a patient with nausea and vomiting, what
common temporary adverse effect of the medication does the nurse explain may be experienced?
A. Tinnitus
B. Drowsiness
C. Reduced hearing
D. Sensation of falling - ansB. Drowsiness
Although being given to this patient as an antiemetic, promethazine also has sedative and amnesic
properties. For this reason, the patient is likely to experience drowsiness as an adverse effect of the
medication. Tinnitus, reduced hearing, and loss of balance are not side effects of promethazine.
, LEWIS MED SURG - UPPER AND LOWER GI NCLEX
PRACTICE QUESTIONS AND ANSWERS 2024 VERSION
VERIFIED RATIONALE GRADED A+
After the nurse teaches a patient with gastroesophageal reflux disease (GERD) about recommended
dietary modifications, which statement by the patient indicates that the teaching has been effective?
A. "I can have a glass of low-fat milk at bedtime."
B. "I will have to eliminate all spicy foods from my diet."
C. "I will have to use herbal teas instead of caffeinated drinks."
D. "I should keep something in my stomach all the time to neutralize the excess acids." - ansC. "I will have
to use herbal teas instead of caffeinated drinks."
Rationale: Patients with gastroesophageal reflux disease should avoid foods (such as tea and coffee) that
decrease lower esophageal pressure. Patients should also avoid milk, especially at bedtime, as it
increases gastric acid secretion. Patients may eat spicy foods, unless these foods cause reflux. Small,
frequent meals help prevent overdistention of the stomach, but patients should avoid late evening meals
and nocturnal snacking.
Following administration of a dose of metoclopramide (Reglan) to the patient, the nurse determines that
the medication has been effective when what is noted?
A. Decreased blood pressure
B. Absence of muscle tremors
C. Relief of nausea and vomiting
D. No further episodes of diarrhea - ansC. Relief of nausea and vomiting
Metoclopramide is classified as a prokinetic and antiemetic medication. If it is effective, the patient's
nausea and vomiting should resolve. Metoclopramide does not affect blood pressure, muscle tremors, or
diarrhea.
Following bowel resection, a patient has a nasogastric (NG) tube to suction, but complains of nausea and
abdominal distention. The nurse irrigates the tube as necessary as ordered, but the irrigating fluid does
not return. What should be the priority action by the nurse?
A. Notify the physician.
