NCLEX Gastrointestinal
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Question 1 of 5.
The 20-year-old female is being admitted to the hospital with exacerbation of Crohn's disease. The client is alert and oriented and has been taking azathioprine for disease control. Into which room should the charge nurse place the client?
A. Private room across from the nurse's station
B. Room with a female who has Crohn's disease
C. Private room that has a private attached bathroom
D. Room with an elderly female who is on bedrest
Explanation: A. The client is alert and oriented; there is no need to be near the nurse's station. B. The client is at an increased risk for infection and should have a private room rather than rooming with another female with Crohn's disease. C. The client should be in a private room with a private bathroom due to an increased risk for infection with azathioprine (Imuran). Azathioprine suppresses cell-mediated immune responses and may cause bone marrow suppression. It is also a biohazard medication. D. The client is at an increased risk for infection and should have a private room rather than rooming with another female.
Question 2 of 5.
The nurse is preparing a client diagnosed with GERD for discharge following an esophagogastroduodenoscopy (EGD). Which statement indicates the client understands the discharge instructions?
A. I should not eat for at least one (1) day following this procedure.
B. I can lie down whenever I want after a meal. It won't make a difference.
C. The stomach contents won't bother my esophagus but will make me nauseous.
D. I should avoid orange juice and eating tomatoes until my esophagus heals.
Explanation: Avoiding acidic foods like orange juice and tomatoes reduces irritation to the esophagus, indicating understanding of dietary modifications for GERD. Not eating for a day is unnecessary, lying down after meals worsens reflux, and nausea is not the primary concern with GERD.
Question 3 of 5.
The nurse is preparing a client diagnosed with GERD for surgery. Which information warrants notifying the HCP?
A. The client's Bernstein esophageal test was positive.
B. The client's abdominal x-ray shows a hiatal hernia.
C. The client's WBC count is 14,000/mm3.
D. The client's hemoglobin is 13.8 g/dL.
Explanation: An elevated WBC count (14,000/mm3) suggests infection or inflammation, which could complicate surgery and requires immediate attention. A positive Bernstein test and hiatal hernia are expected in GERD, and a hemoglobin of 13.8 g/dL is within normal limits.
Question 4 of 5.
Which sign/symptom should the nurse expect to find in a client diagnosed with ulcerative colitis?
A. Twenty bloody stools a day.
B. Oral temperature of 102°F.
C. Hard, rigid abdomen.
D. Urinary stress incontinence.
Explanation: Ulcerative colitis commonly causes frequent bloody stools due to inflammation and ulceration of the colon mucosa. Fever may occur but is less specific, a hard abdomen suggests complications like perforation, and urinary incontinence is unrelated.
Question 5 of 5.
The client is diagnosed with an acute exacerbation of IBD. Which priority intervention should the nurse implement?
A. Weigh the client daily and document in the client's chart.
B. Teach coping strategies such as dietary modifications.
C. Record the frequency, amount, and color of stools.
D. Monitor the client's oral fluid intake every shift.
Explanation: Recording stool frequency, amount, and color is critical in acute IBD exacerbation to assess disease activity and guide treatment. Weight and fluid monitoring are important but secondary, and teaching is less urgent during an acute phase.