NCLEX Gastrointestinal System Question Paper is given on our page. Check the Syllabus and Exam Pattern details for Gastrointestinal System in the section following. We advise referring the exam pattern before downloading the NCLEX Question Paper with Answers Pdf. Candidates who are looking for the NCLEX Gastrointestinal System Question Paper can get in this section. NCLEX PN Previous Papers helps the applicants during the preparation. We have given the direct link for NCLEX RN exam study material in the section below.
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Gastrointestinal System Questions and Answers for NCLEX-PN and NCLEX-RN
Question 1: A client is admitted to the hospital with a gnawing pain in the mid-epigastric area and black stools for the past week. A diagnosis of chronic duodenal ulcer is made. During the initial nursing assessment, the client makes some statements. Which is most likely related to his admitting diagnosis?
Based on the client’s admitting diagnosis of chronic duodenal ulcer, the statement that is most likely related to this condition is the one that mentions the gnawing pain in the mid-epigastric area. This is a common symptom of duodenal ulcers, as the ulcer is located in the first part of the small intestine, just beyond the stomach. The pain can be described as burning, gnawing, or aching and is often worse when the stomach is empty or at night. Black stools, which indicate the presence of blood in the stool, are also a common symptom of duodenal ulcers. Therefore, both the gnawing pain in the mid-epigastric area and black stools are important clues that the client’s symptoms are related to the diagnosis of chronic duodenal ulcer.
Question 2: An upper GI series is ordered for a client. Which action is essential for the nurse before the test?
Before an upper GI series test, it is essential for the nurse to ensure that the client has followed the necessary preparation instructions. The specific instructions may vary depending on the healthcare facility and the healthcare provider’s preferences, but some common preparations may include:
Fasting for a certain period before the test, typically for at least 8 hours
Drinking a special liquid called barium sulfate, which coats the inside of the digestive tract and helps the X-rays show up better
Avoiding certain foods and medications that may interfere with the test results
Informing the healthcare provider of any allergies, medical conditions, or medications that the client is taking
Therefore, the essential action for the nurse before the upper GI series test is to review and ensure that the client has followed the preparation instructions provided by the healthcare provider or facility. The nurse should also clarify any questions or concerns that the client may have and provide appropriate education and support.
Question 3: The client with a duodenal ulcer is ready for discharge. Which statement made by the client indicates a need for more teaching about his diet?
If a client with a duodenal ulcer makes a statement that indicates a lack of understanding or a need for more teaching about their diet, it could potentially lead to complications or exacerbation of symptoms. Therefore, it is important for the nurse to assess the client’s knowledge and understanding of the diet before discharge. A statement made by the client that indicates a need for more teaching about their diet includes:
“I can’t wait to have a large pepperoni pizza with extra cheese tomorrow.”
This statement suggests that the client is not aware that certain foods can exacerbate the symptoms of a duodenal ulcer, and that a high-fat, spicy, or acidic diet can trigger or worsen pain and discomfort. Therefore, the nurse should provide additional education on the appropriate dietary modifications that the client should make, such as avoiding spicy or fatty foods, limiting caffeine and alcohol intake, and eating frequent, small meals throughout the day.
Question 4: The client, admitted with appendicitis, overhears the physician say that the pain has reached McBurney’s point. She becomes very frightened and asks the nurse to explain what this means. Which is the best response?
The best response would be to explain to the client what McBurney’s point is and what it signifies in relation to their condition.
You could say something like: “McBurney’s point is a spot in the lower right abdomen that’s used to identify potential appendicitis. Your doctor may have mentioned it to indicate that the pain you’re experiencing is likely related to your appendix. It’s a common sign, and your medical team is well-equipped to manage your condition and help you feel better.”
It’s essential to provide the client with accurate and clear information in a calm and reassuring manner, which can help to alleviate their anxiety and build trust in their medical team. It’s also important to encourage them to ask any questions they may have and address their concerns.
Question 5: Which blood test results would confirm a diagnosis of appendicitis?
There is no one blood test that can confirm a diagnosis of appendicitis on its own. However, several blood tests can help support the diagnosis and determine the severity of the condition.
The most commonly ordered blood tests for appendicitis include:
Complete Blood Count (CBC): This test measures the number of white blood cells (WBCs) in the bloodstream. In appendicitis, the WBC count is usually elevated, indicating an infection or inflammation in the body.
C-Reactive Protein (CRP): This test measures the level of CRP in the blood. CRP is a protein that is produced by the liver in response to inflammation in the body. An elevated CRP level may indicate inflammation in the appendix.
Erythrocyte Sedimentation Rate (ESR): This test measures how quickly red blood cells settle to the bottom of a test tube over time. An elevated ESR level may indicate inflammation in the body, which can be a sign of appendicitis.
It’s important to note that these blood tests are not definitive for appendicitis, and a diagnosis is usually made based on a combination of clinical symptoms, physical examination, and imaging studies such as ultrasound or CT scan.
Question 6: The nurse is admitting a client with the diagnosis of appendicitis to the surgical unit. Which question is it essential to ask?
When admitting a client with the diagnosis of appendicitis to the surgical unit, it is essential to ask about their medical history, especially if they have had any previous abdominal surgeries or if they have any medical conditions that could affect the surgical procedure or anesthesia.
Therefore, a crucial question to ask the client would be: “Have you had any previous abdominal surgeries or do you have any medical conditions that could affect the surgical procedure or anesthesia?”
This information is crucial for the surgical team to know to ensure the safety and success of the procedure. Additionally, the nurse should also ask the client about any allergies, current medications, and previous adverse reactions to anesthesia or pain medication.
Question 7: The client with appendicitis asks the nurse for a laxative to help relieve her constipation. The nurse explains to her that laxatives are not given to persons with possible appendicitis. What is the primary reason for this?
The primary reason for not giving laxatives to a person with possible appendicitis is that laxatives can increase the risk of perforation or rupture of the inflamed appendix.
In appendicitis, the appendix becomes inflamed and swollen, which can lead to a partial or complete blockage of the appendix’s lumen. This blockage can cause constipation and other symptoms like abdominal pain, fever, and nausea.
If a person with appendicitis takes a laxative, it can stimulate the bowel’s movement, leading to increased pressure inside the abdomen, which can cause the inflamed appendix to rupture. A ruptured appendix is a severe medical emergency that can lead to life-threatening complications like sepsis, abscess formation, and peritonitis.
Therefore, it is essential to avoid giving laxatives to a person with possible appendicitis, and instead, encourage them to drink fluids and follow the healthcare provider’s recommendations for bowel rest and management of constipation.
Question 8: A child with appendicitis is scheduled for surgery this evening. The nurse enters the room and sees the child’s mother starting to place hot, wet washcloths on her daughter’s abdomen so that “she will feel better.” The nurse explains that this action is contraindicated because heat:
can increase the inflammation and potentially cause the appendix to rupture. The nurse should advise the mother to remove the hot washcloths immediately and notify the healthcare provider if the child experiences any changes in symptoms, such as increased pain or fever.
Appendicitis is a condition where the appendix becomes inflamed and swollen, and it requires surgical removal. Applying heat to the area may provide temporary relief of discomfort, but it can also worsen the inflammation and increase the risk of the appendix rupturing, which can lead to life-threatening complications such as peritonitis or sepsis.
Therefore, it is essential for the mother to understand the potential harm of applying heat to her child’s abdomen in this case and to follow the healthcare provider’s instructions for managing the child’s symptoms before surgery.
Question 9: A client returns from having had abdominal surgery. Her vital signs are stable. She says she is thirsty. What should the nurse give her initially?
if a client returns from surgery and reports feeling thirsty, the nurse should assess their hydration status and provide them with appropriate fluids. Depending on the client’s condition, the nurse may offer small amounts of water, ice chips, or clear fluids such as broth, apple juice, or ginger ale, as tolerated. The nurse should follow the orders of the healthcare provider and any specific instructions related to the client’s surgery and recovery.
Question 10: The client who has had an appendectomy and has a Penrose drain in place has recovered from anesthesia. The nurse places her in a semi-sitting position. What is the primary reason for selecting this position?
The primary reason for placing a client who has had an appendectomy and has a Penrose drain in place in a semi-sitting position is to facilitate drainage of fluid from the wound. The semi-sitting position allows gravity to assist in the drainage of fluids, preventing the accumulation of fluid in the surgical area, which can cause infection or delay wound healing. It also helps to minimize tension on the suture line, which promotes healing and reduces the risk of dehiscence. Additionally, the semi-sitting position can promote respiratory function, as it reduces the pressure on the diaphragm and allows for increased lung expansion.
Question 11: The client is admitted to the hospital complaining of malaise, abdominal discomfort, and severe diarrhea. The diagnosis is possible Crohn’s disease. The client says that he has lost 27 pounds in the last four months even though he has not been dieting. To plan nursing care, which assessment data are most essential for the nurse to obtain?
As the client is admitted to the hospital with possible Crohn’s disease, and presents with symptoms such as malaise, abdominal discomfort, and severe diarrhea, the nurse should focus on obtaining the following assessment data to plan nursing care:
- Medical history: The nurse should obtain a detailed medical history of the client to assess the duration and progression of the symptoms. They should inquire about any previous surgeries or medical conditions.
- Vital signs: The nurse should measure the client’s vital signs, including blood pressure, temperature, and pulse rate. This information will help in assessing the client’s overall health and provide a baseline for future comparisons.
- Gastrointestinal assessment: The nurse should assess the client’s gastrointestinal system, including bowel sounds, the appearance of the abdomen, and the frequency and consistency of the diarrhea.
- Nutritional assessment: The nurse should assess the client’s nutritional status, including weight changes, food intake, and the presence of any nutritional deficiencies.
- Mental status assessment: The nurse should assess the client’s mental status, including their level of anxiety, fear, and coping mechanisms, to identify any psychosocial factors that may be contributing to the symptoms.
- Medication history: The nurse should obtain a detailed medication history, including over-the-counter medications, supplements, and herbal remedies, to identify any potential interactions or adverse effects.
By obtaining these essential assessment data, the nurse can develop an individualized care plan for the client and monitor their condition closely to ensure optimal health outcomes.
Question 12: The nurse is preparing a client with Crohn’s disease for discharge. Which teaching the patient need to know?
When preparing a client with Crohn’s disease for discharge, the nurse should provide the following teaching:
- Diet: The nurse should provide dietary education to the client, emphasizing the importance of a low-fiber diet and avoiding trigger foods that exacerbate their symptoms. They should also recommend small, frequent meals and encourage the client to drink plenty of fluids to prevent dehydration.
- Medications: The nurse should review the client’s medication regimen and provide instructions on how to take their medications as prescribed. The nurse should emphasize the importance of taking medications consistently and reporting any adverse effects or changes in symptoms to their healthcare provider.
- Self-care: The nurse should teach the client about self-care measures to manage their symptoms, including stress reduction techniques, proper hygiene, and skin care to prevent irritation from frequent bowel movements.
- Follow-up appointments: The nurse should provide information on the importance of follow-up appointments with their healthcare provider and schedule a follow-up appointment before discharge.
- Resources: The nurse should provide information on support groups and community resources that the client can access for additional support.
- Signs and symptoms of complications: The nurse should educate the client on the signs and symptoms of potential complications of Crohn’s disease, such as fever, severe abdominal pain, and rectal bleeding, and advise them to seek medical attention immediately if any of these symptoms occur.
By providing comprehensive education to the client with Crohn’s disease, the nurse can help them manage their symptoms effectively and improve their quality of life.
Question 13: A low-residue diet is ordered for a client. Which food would be contraindicated for this person?
A low-residue diet is a type of diet that is often recommended for people with certain medical conditions, such as Crohn’s disease, ulcerative colitis, diverticulitis, or bowel obstruction. The goal of this diet is to reduce the amount of undigested food that passes through the large intestine, thereby minimizing bowel movements and reducing inflammation and irritation in the digestive tract.
Foods that are typically restricted or limited on a low-residue diet include high-fiber foods, such as whole grains, nuts, seeds, and raw fruits and vegetables. These foods can be difficult to digest and may leave a lot of residue in the large intestine. Foods that are generally allowed on a low-residue diet include refined grains, cooked fruits and vegetables without skins or seeds, lean meats, and dairy products.
Given this information, a food that would be contraindicated for a person on a low-residue diet would be a high-fiber food, such as a bran muffin, whole grain bread, nuts, seeds, or raw fruits and vegetables. These foods can increase the amount of undigested residue in the large intestine and exacerbate symptoms in people with certain medical conditions.
Question 14: A client is to have a sigmoidoscopy in the morning. Which activity will be included in the care of this client?
A sigmoidoscopy is a medical procedure that examines the lower part of the colon using a sigmoidoscope, a flexible tube with a light and camera attached to it. To prepare for the procedure, the client may need to follow certain instructions, including bowel preparation and fasting. In addition to these, the following activities may be included in the care of this client:
- Providing instructions: The client should be informed about the procedure, the reason for it, and how to prepare for it. The healthcare provider should provide clear instructions on what to eat and drink, as well as any medications or supplements to avoid before the procedure.
- Ensuring consent: The client must sign a consent form, indicating that they understand the procedure, its risks, and benefits.
- Monitoring vital signs: Before the procedure, the healthcare provider may measure the client’s vital signs, such as blood pressure, heart rate, and temperature, to ensure they are stable.
- Administering sedation: The healthcare provider may give the client a sedative to help them relax and reduce discomfort during the procedure.
- Assisting with positioning: During the procedure, the client may need to lie on their left side with their knees bent. The healthcare provider may help the client assume this position.
- Assisting with the procedure: The healthcare provider will insert the sigmoidoscope into the rectum and advance it into the colon to visualize the lining of the colon.
- Monitoring for complications: After the procedure, the client should be monitored for any signs of complications, such as bleeding or perforation.
Overall, the care of a client undergoing sigmoidoscopy involves providing instructions, obtaining consent, monitoring vital signs, administering sedation, assisting with positioning and the procedure, and monitoring for complications.
Question 15: A client had a barium enema. Following the barium enema, the nurse should anticipate which order?
After a barium enema, which is a medical imaging procedure used to examine the large intestine, the nurse should anticipate the following orders:
- Encourage fluids: The client may be encouraged to drink plenty of fluids to help flush the remaining barium out of their system.
- Monitor bowel movements: The client’s bowel movements should be monitored for the passage of barium. It is normal for the first bowel movement after the procedure to be white or light-colored due to the presence of barium.
- Assess for complications: The nurse should monitor the client for any signs of complications, such as abdominal pain, cramping, or rectal bleeding. These symptoms should be reported to the healthcare provider immediately.
- Offer comfort measures: The client may experience abdominal cramping or discomfort after the procedure. The nurse can offer comfort measures such as a warm compress or pain medication as ordered.
- Restrict solid foods: The client may be advised to avoid solid foods for several hours after the procedure to allow the bowels to return to normal.
- Provide discharge instructions: The nurse should provide the client with written instructions on how to care for themselves at home, including any dietary restrictions and signs of complications to watch for.
Overall, the nurse’s role after a barium enema involves encouraging fluids, monitoring bowel movements, assessing for complications, offering comfort measures, restricting solid foods, and providing discharge instructions.
Question 16: A client is found to have colon cancer. An abdominoperineal resection and colostomy are scheduled. Neomycin is ordered. The nurse explains to the client that the primary purpose for administering this drug is to:
Neomycin is an antibiotic medication that is used to reduce the amount of bacteria in the intestine before surgery, particularly in surgeries involving the colon. The primary purpose of administering neomycin in this case is to prevent infection after the surgery, as the presence of bacteria in the colon can increase the risk of post-operative infection. By reducing the number of bacteria in the intestine, neomycin can help to lower the risk of infection and promote faster healing. It is important for the client to take the medication as directed by their healthcare provider to ensure the best possible outcome from the surgery.
Question 17: The day after surgery in which a colostomy was performed, the client says, “I know the doctor did not really do a colostomy.” The nurse understands that the client is in an early stage of adjustment to the diagnosis and surgery. What nursing action is indicated at this time?
The nurse should provide reassurance to the client and acknowledge their feelings of disbelief or denial. This is a normal reaction to a major change in their body and lifestyle. The nurse should also provide the client with accurate information about the surgery, including the reason for the colostomy and the expected outcomes. Education about how to care for the colostomy and any related equipment should also be provided. The nurse can involve the client’s family or significant others in the education process to help support the client during this difficult time. Additionally, the nurse should encourage the client to express their feelings and concerns and provide emotional support throughout the recovery process.
Question 18: The nurse is irrigating the client’s colostomy when the client complains of cramping. What is the most appropriate initial action by the nurse?
If a client complains of cramping during colostomy irrigation, the most appropriate initial action by the nurse is to stop the irrigation immediately. The nurse should assess the client’s vital signs, abdominal distention, and bowel sounds to determine the severity of the cramping and if there are any other symptoms or signs of complications such as bleeding or infection. The nurse should also assess the client’s fluid and electrolyte status, as cramping can be a sign of dehydration or electrolyte imbalances.
Once the nurse has assessed the client and identified the cause of the cramping, appropriate interventions can be implemented. These may include administering pain medication, adjusting the irrigation flow rate or volume, changing the irrigation solution, or repositioning the client to improve comfort. The nurse should also educate the client on the signs and symptoms of complications related to colostomy irrigation and when to seek medical attention if necessary.
Question 19: A 32-year-old female is admitted for a hemorrhoidectomy. During the nursing assessment, all of the following factors are elicited. Which is most likely to have contributed to the development of hemorrhoids?
There are several factors that can contribute to the development of hemorrhoids, including:
Chronic constipation and straining during bowel movements
Prolonged sitting or standing
Out of these factors, chronic constipation and straining during bowel movements is most likely to have contributed to the development of hemorrhoids in a 32-year-old female. This is because constipation and straining can cause increased pressure in the veins of the rectum and anus, leading to the development of hemorrhoids. It is important for the nurse to assess the client’s bowel habits and provide education on measures to prevent constipation and straining, such as increasing fiber intake, staying hydrated, and using proper toileting techniques.
Question 20: Following a hemorrhoidectomy, the nurse is instructing the client in self-care. Which statement is especially important to include in these instructions?
After a hemorrhoidectomy, the nurse should instruct the client on several self-care measures to promote healing and prevent complications. One statement that is especially important to include in these instructions is:
“Make sure to avoid straining during bowel movements.”
Straining during bowel movements can put pressure on the surgical area and disrupt the healing process. To prevent this, the client should take steps to avoid constipation, such as increasing fiber and fluid intake, and taking stool softeners as prescribed. The nurse may also suggest using a sitz bath or applying ice packs to the surgical area to relieve discomfort and promote healing.