NCLEX Gastrointestinal Disorders
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Question 1 of 5.
Which assessment data supports the client's diagnosis of gastric ulcer to the nurse?
A. Presence of blood in the client's stool for the past month.
B. Reports of a burning sensation moving like a wave.
C. Sharp pain in the upper abdomen after eating a heavy meal.
D. Complaints of epigastric pain 30 to 60 minutes after ingesting food.
Explanation: Gastric ulcers typically cause epigastric pain 30–60 minutes after eating due to acid irritation of the ulcerated mucosa. Blood in stool is more indicative of lower GI issues, a wave-like sensation is vague, and sharp pain after heavy meals is less specific.
Question 2 of 5.
The client who had abdominal surgery tells the nurse, 'I felt something give way in my stomach.' Which intervention should the nurse implement first?
A. Notify the surgeon immediately.
B. Instruct the client to splint the incision.
C. Assess the abdominal wound incision.
D. Administer pain medication intravenously.
Explanation: Assessing the wound first determines if dehiscence or evisceration has occurred, guiding further action. Notification, splinting, or pain medication follow based on findings.
Question 3 of 5.
The client who had an abdominal surgery has a Jackson Pratt (JP) drainage tube. Which assessment data warrant immediate intervention by the nurse?
A. The bulb is round and has 40 mL of fluid.
B. The drainage tube is taped to the dressing.
C. The JP insertion site is pink and has no drainage.
D. The JP bulb has suction and is sunken in.
Explanation: A round JP bulb with 40 mL of fluid indicates loss of suction, risking fluid accumulation and infection, requiring immediate intervention. Taping, pink site, and suction are normal.
Question 4 of 5.
The 84-year-old client comes to the clinic complaining of right lower abdominal pain. Which question is most appropriate for the nurse to ask the client?
A. When was your last bowel movement?
B. Did you have a high-fat meal last night?
C. Can you describe the type of pain?
D. Have you been experiencing any gas?
Explanation: Describing the type of pain (e.g., sharp, dull, colicky) helps differentiate causes like appendicitis, diverticulitis, or obstruction, guiding diagnosis. Bowel movements, diet, and gas are secondary.
Question 5 of 5.
The female client diagnosed with anorexia nervosa is admitted to the hospital. The client is 67 inches tall and weighs 40 kg. Which client problem has the highest priority?
A. Altered nutrition.
B. Low self-esteem.
C. Disturbed body image.
D. Altered sexuality.
Explanation: Altered nutrition is the priority due to severe underweight (BMI ~13.2), risking organ failure and death. Self-esteem, body image, and sexuality are psychosocial and secondary.
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