NCLEX Questions Gastrointestinal System
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Question 1 of 5.
The RN overhears the LPN talking with the client who is being prepared for a total colectomy with the creation of an ileoanal reservoir for ulcerative colitis. Which statement made by the LPN should the RN clarify to decrease the client's anxiety?
A. “This surgery will prevent you from developing colon cancer.â€
B. “After this surgery you will no longer have ulcerative colitis.â€
C. “After surgery you may not have solid food for several days.â€
D. “You'll have a permanent ileostomy after having this surgery.â€
Explanation: A. The client will not be at risk for colon cancer because with a total colectomy the entire colon is removed. B. Since this surgery removes the total colon, the ulcerative colitis will be cured. C. The client will be unable to eat until peristalsis returns, and then it may take several days before solid foods are tolerated. D. The client will initially have an ileostomy; after the reservoir has healed, the ileostomy will be closed. Knowing that the ileostomy will be temporary is important information for the client to decrease anxiety.
Question 2 of 5.
The nurse is caring for a client diagnosed with GERD. Which nursing interventions should be implemented?
A. Place the client prone in bed and administer nonsteroidal anti-inflammatory medications.
B. Have the client remain upright at all times and walk for 30 minutes three (3) times a week.
C. Instruct the client to maintain a right lateral side-lying position and take antacids before meals.
D. Elevate the head of the bed (HOB) 30 degrees and discuss lifestyle modifications with the client.
Explanation: Elevating the head of the bed prevents reflux during sleep, and lifestyle modifications (e.g., avoiding trigger foods, not lying down after meals) are key to managing GERD. Prone positioning worsens reflux, remaining upright at all times is impractical, and right lateral positioning is less effective than head elevation.
Question 3 of 5.
Which statement made by the client indicates to the nurse the client may be experiencing GERD?
A. My chest hurts when I walk up the stairs in my home.
B. I take antacid tablets with me wherever I go.
C. My spouse tells me I snore very loudly at night.
D. I drink six (6) to seven (7) soft drinks every day.
Explanation: Frequent use of antacids suggests ongoing heartburn or reflux symptoms, a hallmark of GERD. Chest pain with exertion is more suggestive of cardiac issues, snoring may indicate sleep apnea, and soft drink consumption is a risk factor but not a direct symptom.
Question 4 of 5.
The client diagnosed with inflammatory bowel disease has a serum potassium level of 3.4 mEq/L. Which action should the nurse implement first?
A. Notify the health-care provider (HCP).
B. Assess the client for muscle weakness.
C. Request telemetry for the client.
D. Prepare to administer potassium IV.
Explanation: A potassium level of 3.4 mEq/L is slightly low, warranting assessment for symptoms like muscle weakness, which could indicate hypokalemia severity. Notification or intervention would follow based on clinical findings, but assessment is the first step.
Question 5 of 5.
The client diagnosed with ulcerative colitis has an ileostomy. Which statement indicates the client needs more teaching concerning the ileostomy?
A. My stoma should be pink and moist.
B. I will irrigate my ileostomy every morning.
C. If I get a red, bumpy, itchy rash I will call my HCP.
D. I will change my pouch if it starts leaking.
Explanation: Ileostomies typically do not require routine irrigation, as the output is liquid and continuous, unlike colostomies. The other statements reflect correct understanding of stoma care and management.
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