Gastrointestinal NCLEX
Home / Nursing & Allied Health Certifications / NCLEX PN / Gastrointestinal
Question 1 of 5.
The nurse completes discharge teaching for the client after a small bowel resection for Crohn's disease. The nurse determines that more education is needed when overhearing which statement made by the client to the client's spouse?
A. “I'm so glad I'll never need surgery again for Crohn's disease.â€
B. “I'll need to get a new scale so I can continue to monitor my weight.â€
C. “I'll likely need to be on hydrocortisone if an exacerbation occurs.â€
D. “I will probably have to take vitamin supplements all of my life.â€
Explanation: A. The nurse should determine that the client needs additional education with this statement. Crohn's disease can occur throughout the GI tract. Surgery in one area of the GI tract will not prevent the disease from recurring in another area. This recurrence can result in the need for further surgery. B. Clients with Crohn's disease will always need to monitor their weight. C. Most likely, the client will need some type of glucocorticoid medication such as hydrocortisone to treat a future exacerbation. D. Clients will need vitamins to maintain adequate nutrient levels, since inflamed areas of the GI tract do not absorb nutrients well.
Question 2 of 5.
The nurse caring for a client diagnosed with GERD writes the client problem of 'behavior modification.' Which intervention should be included for this problem?
A. Teach the client to sleep with a foam wedge under the head.
B. Encourage the client to decrease the amount of smoking.
C. Instruct the client to take over-the-counter medication for relief of pain.
D. Discuss the need to attend Alcoholics Anonymous to quit drinking.
Explanation: Sleeping with a foam wedge elevates the head, reducing reflux by preventing stomach acid from flowing into the esophagus during sleep, a key behavioral modification for GERD. Smoking cessation is beneficial but less specific to immediate symptom relief, and the other options are not directly related to behavior modification for GERD.
Question 3 of 5.
The nurse is administering morning medications at 0730. Which medication should have priority?
A. A proton pump inhibitor.
B. A nonnarcotic analgesic.
C. A histamine receptor antagonist.
D. A mucosal barrier agent.
Explanation: Proton pump inhibitors (PPIs) are the mainstay treatment for GERD, reducing acid production and preventing esophageal damage. They should be prioritized over analgesics, histamine receptor antagonists, or mucosal barrier agents, which are less critical for immediate symptom control and healing.
Question 4 of 5.
Which disease is the client diagnosed with GERD at greater risk for developing?
A. Hiatal hernia.
B. Gastroenteritis.
C. Esophageal cancer.
D. Gastric cancer.
Explanation: Chronic GERD increases the risk of esophageal cancer, particularly adenocarcinoma, due to prolonged acid exposure causing Barrett's esophagus, a precancerous condition. Hiatal hernia is a risk factor for GERD, not a consequence, and gastroenteritis and gastric cancer are less directly linked.
Question 5 of 5.
The client diagnosed with IBD is prescribed total parenteral nutrition (TPN). Which intervention should the nurse implement?
A. Check the client's glucose level.
B. Administer an oral hypoglycemic.
C. Assess the peripheral intravenous site.
D. Monitor the client's oral food intake.
Explanation: TPN, high in dextrose, can cause hyperglycemia, so monitoring glucose levels is essential, especially in IBD patients with potential metabolic stress. Oral hypoglycemics are inappropriate, TPN uses central lines, and oral intake is typically minimal.