Gastrointestinal NCLEX Questions
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Question 1 of 5.
The nurse is assigned to care for four clients. The nurse should plan to assess which client first?
A. The client with ascites who is having mild dyspnea with activity
B. The client with a peptic ulcer who now has severe vomiting
C. The client who had a colonoscopy and is having diarrheal stools
D. The client with Crohn's disease who received an initial dose of certolizumab (Cimzia) and is having generalized rashes
Explanation: D. The client with Crohn's disease who received an initial dose of certolizumab (Cimzia) and is having generalized rashes should be attended to first. Generalized rash indicates an allergic reaction. This could develop into an anaphylactic reaction. B. The client with a peptic ulcer who now has severe vomiting should be attended to second. Vomiting in PUD may indicate a complication such as mechanical obstruction from scarring. C. The client who had a colonoscopy and is having diarrheal stools should be attended to third. Diarrhea may have been the indication for the client's colonoscopy or a side effect of the bowel prep. A. The client with ascites who is having mild dyspnea with activity can be attended to last. The dyspnea is usually due to the enlarged abdomen.
Question 2 of 5.
The male client tells the nurse he has been experiencing 'heartburn' at night that awakens him. Which assessment question should the nurse ask?
A. How much weight have you gained recently?
B. What have you done to alleviate the heartburn?
C. Do you consume many milk and dairy products?
D. Have you been around anyone with a stomach virus?
Explanation: Asking what the client has done to alleviate the heartburn helps the nurse understand the severity, triggers, and any self-management strategies, which are critical for assessing GERD. Weight gain, dairy consumption, or exposure to a stomach virus are less directly related to the immediate assessment of heartburn symptoms.
Question 3 of 5.
The nurse is caring for an adult client diagnosed with GERD. Which condition is the most common comorbid disease associated with GERD?
A. Adult-onset asthma.
B. Pancreatitis.
C. Peptic ulcer disease.
D. Increased gastric emptying.
Explanation: GERD is commonly associated with adult-onset asthma due to acid reflux irritating the airways, leading to bronchospasm. Pancreatitis and peptic ulcer disease are less directly linked, and increased gastric emptying is not a typical comorbidity.
Question 4 of 5.
The nurse is performing an admission assessment on a client diagnosed with GERD. Which signs and symptoms would indicate GERD?
A. Pyrosis, water brash, and flatulence.
B. Weight loss, dysarthria, and diarrhea.
C. Decreased abdominal fat, proteinuria, and constipation.
D. Midepigastric pain, positive H. pylori test, and melena.
Explanation: Pyrosis (heartburn), water brash (regurgitation of sour fluid), and flatulence are classic symptoms of GERD due to acid reflux and gas buildup. The other options include symptoms more associated with other conditions like peptic ulcer disease or systemic disorders.
Question 5 of 5.
The client is diagnosed with an acute exacerbation of ulcerative colitis. Which intervention should the nurse implement?
A. Provide a low-residue diet.
B. Rest the client's bowel.
C. Assess vital signs daily.
D. Administer antacids orally.
Explanation: During an acute exacerbation of ulcerative colitis, resting the bowel (often via NPO status or clear liquids) reduces inflammation and irritation. A low-residue diet is used in stable phases, daily vital signs are routine, and antacids are irrelevant.
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