NCLEX Gastrointestinal
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Question 1 of 5.
The client with a duodenal ulcer is ready for discharge. Which statement made by the client indicates a need for more teaching about his diet?
A. It's a good thing I gave up drinking alcohol last year.'
B. I will have to drink lots of milk and cream every day.'
C. I will stay away from cola drinks after I am discharged.'
D. Eating three nutritious meals and snacks every day is okay.'
Explanation: Milk and cream cause rebound acidity and are not recommended for ulcer clients. Avoiding alcohol and cola, and eating regular meals and snacks, are appropriate.
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.