Gastrointestinal NCLEX Questions
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Question 1 of 5.
The nurse is caring for the client who is 6 hours post—open cholecystectomy. The client's T—tube drainage bag is empty, and the nurse notes slight jaundice of the sclera. Which action by the nurse is most important?
A. Reposition the client to promote T-tube drainage
B. Telephone the surgeon to report these findings
C. Ask a nursing assistant to obtain a blood pressure
D. Record the findings and continue to monitor the client
Explanation: A. Repositioning the client might promote bile flow into the T—tube if the client were lying on the tube. However, the jaundice indicates that the problem is internal. B. The T-tube is placed in the common bile duct to ensure patency of the duct. Lack of bile draining into the T—tube and jaundiced sclera are signs of an obstruction to the bile flow. This is most important to report to the surgeon. C. The client's BP would not be affected by this situation. D. Recording the findings and continuing to monitor the client are inappropriate because the client is experiencing signs of a complication.
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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