NCLEX Gastrointestinal
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Question 1 of 5.
The experienced nurse is instructing the new nurse. The experienced nurse explains that the definitive diagnosis of PUD involves which test?
A. A urea breath test
B. Upper GI endoscopy with biopsy
C. Barium contrast studies
D. The string test
Explanation: A. A urea breath test only tests for the presence of Helicobacter pylori (H. pylori). B. The gastric mucosa can be visualized with an endoscope. A biopsy is possible to differentiate PUD from gastric cancer and to obtain tissue specimens to identify H. pylori. These are used to make a definitive diagnosis of PUD. C. Barium studies do not provide an opportunity for biopsy and H. pylori testing. D. A urea breath test and a string test only test for the presence of H . pylori.
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.
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