Gastrointestinal Disorders NCLEX RN
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Question 1 of 5.
Extract:The nurse is caring for a client admitted with an exacerbation of Crohn's disease Item 1 of 1 • History and Physical A 25-year-old male has had Crohn's disease for over six years. He is admitted to the hospital for severe diarrhea, abdominal pain, and fatigue. The client will be admitted for fluid replacement, antibiotics, steroids, and pain control. • Physician Orders • Admit to the medical-surgical unit • Nothing by mouth (NPO) • Gastroenterology consultation • Lactated Ringers at 80 mL/hr • Metronidazole 500 mg intravenous piggyback q 8 hours • Methylprednisolone 125 mg intravenously q 12 hours
Drag the words from the word choices below to fill in each blank of the following sentences: The prescribed------------------------------puts the client at risk for complications such as hyperglycemia. To recognize this complication the nurse should monitor the client's------------------
- A. metronidazole
- B. lactated ringers
- C. methylprednisolone
- D. nothing by mouth status
- E. capillary blood glucose
- F. hemoglobin A1C
- C. methylprednisolone
- E. capillary blood glucose
Correct arrangement
Explanation: Methylprednisolone is a corticosteroid that may cause elevated blood glucose and even hyperglycemia (blood glucose 250 mg/dL or greater). This is a common treatment for exacerbations of inflammatory bowel disorders. Hyperglycemia may complicate outcomes by delaying wound healing and increasing the client's risk for infection. Thus, the nurse should monitor the capillary blood glucose and collaborate with the primary healthcare provider. Monitoring the hemoglobin A1C is useful for monitoring the clinical progress of a client with chronic diabetes. This value is collected every 90-120 days and would not be useful during this acute course of steroids. During an exacerbation of Crohn's disease, it is likely that the client will be prescribed antibiotics such as metronidazole. The client will also have fluid repletion, and isotonic solutions such as lactated ringers may be given to rehydrate the client.
Question 2 of 5.
The nurse is caring for a client with appendicitis experiencing pain. Which pain relief method would be inappropriate for this client?
A. Applying ice packs to the abdomen
B. Practicing breathing exercises with the patient
C. Using a heating pad on the abdomen
D. Encouraging rest
Explanation: Using a heating pad on the abdomen is inappropriate for a client with appendicitis as it may increase inflammation or risk perforation of the appendix. Ice packs, breathing exercises, and rest are safer and more appropriate for pain management.
Question 3 of 5.
Extract:The following scenario applies to the next 1 items The nurse is caring for an older adult in the medical-surgical unit Item 1 of 1 Health History 84-year-old female was admitted to the medical-surgical unit with a three-day history of abdominal pain, distention, nausea, and persistent vomiting. She reports that she has not had a bowel movement in five days and has no appetite. Vital Signs Oral temperature 101.1° F (38.3° C) Pulse 108/minute Respirations 22/minute Blood pressure 100/64 mm Hg Oxygen saturation 96% on room air.
The nurse reviews the client's health history and vital signs. Click to specify if the findings are consistent with a small bowel obstruction or appendicitis. Each row must have at least one but may have more than one response option selected.
| Description | Options |
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| Lorem ipsum dolor sit amet consectetur. |
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| Lorem ipsum dolor sit amet consectetur. |
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| Lorem ipsum dolor sit amet consectetur. |
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| Lorem ipsum dolor sit amet consectetur. |
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Explanation: Small bowel obstruction: A (Unable to pass stool), B (Fever), C (Distended abdomen), E (Nausea and vomiting). Appendicitis: A, B, C, D (Right lower quadrant abdominal pain), E. Both conditions can present with these symptoms, though right lower quadrant pain is more specific to appendicitis.
Question 4 of 5.
Extract:The following scenario applies to the next 1 items The nurse in the emergency department (ED) cares for a 21-year-old male client Item 1 of 1 Nurses' Notes 1650: Client reports severe abdominal pain that radiates to his left shoulder. The client was tossing around the football with friends, and after being tackled, he began experiencing intense pain that worsened. He denies any medical history but is currently being treated for infectious mononucleosis and 'needed to get some fresh air,' so he started playing football with friends. During the assessment, the client was alert and fully oriented. He reports his abdominal pain is in the left upper quadrant, which radiates to his shoulder, as an 8/10 on the Numerical Rating Scale. Slight bruising was noted on the client's abdomen. A blotchy rash was observed on his back. His abdomen was slightly distended, taut, and tender to touch. Lung sounds are clear bilaterally. Peripheral pulses 2+. Skin is hot to the touch. Cervical lymphadenopathy is present. Vital signs: T 100.4°F (38°C), P 110, RR 21, BP 115/76.
Which of the following assessment findings require immediate follow-up? Select all that apply.
A. Reports of abdominal pain
B. Temperature
C. Pulse
D. Rash
E. Cervical lymphadenopathy
F. Abdominal assessment findings
Explanation: Severe abdominal pain (A), elevated pulse (C), and abnormal abdominal findings (F) such as distention and tenderness suggest a serious condition like a ruptured spleen, especially given the history of trauma and infectious mononucleosis. These require urgent evaluation.
Question 5 of 5.
The nurse is caring for a client who has ulcerative colitis (UC). The nurse should teach the client to [Select all that apply].
A. Eat consistent amounts of carbohydrates at mealtimes.
B. Avoid drinking fluids with meals.
C. Obtain recommended colon cancer screenings.
D. Avoid taking anti-diarrheal medication.
E. Increase the intake of non-caffeinated fluids during exacerbations.
Explanation: For ulcerative colitis, avoiding fluids with meals (B) aids digestion, regular colon cancer screenings (C) are critical due to increased risk, and increasing non-caffeinated fluids (E) prevents dehydration during exacerbations. Consistent carbohydrates (A) are not specific, and anti-diarrheals (D) may be used cautiously.
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