Gastrointestinal Exam Questions NCLEX 1-5

These NCLEX Gastrointestinal Exam Questions relate to topics like hemorrhoidectomy, gastroesophageal reflux disease, esophagogastroduodenoscopy, cholangiopancreatography procedure and Hepatitis.

 1. A client has just had a hemorrhoidectomy. Which nursing interventions are appropriate for this client? Select all that apply.

a) Administer stool softeners as prescribed.
b) Instruct the client to limit fluid intake to avoid urinary retention.
c) Instruct the client to avoid activities that will initiate vasovagal responses.
d) Encourage a high-fiber diet to promote bowel movements without straining.
e) Apply cold packs to the anal-rectal area over the dressing until the packing is removed.
f) Help the client to a Fowler’s position to place pressure on the rectal area and decrease bleeding.

2. The nurse is planning to teach a client with gastroesophageal reflux disease about substances to avoid. Which items should the nurse include on this list? Select all that apply.

a) Coffee
b) Chocolate
c) Peppermint
d) Nonfat milk
e) Fried chicken
f) Scrambled eggs

3. Gastrointestinal Exam Questions about a client who has undergone esophagogastroduodenoscopy. The nurse should place highest priority on which item as part of the client’s care plan?

a) Monitoring the temperature
b) Monitoring complaints of heartburn
c) Giving warm gargles for a sore throat
d) Assessing for the return of the gag reflex

4. The nurse has taught the client about an upcoming endoscopic retrograde cholangiopancreatography procedure. The nurse determines that the client needs further information if the client makes which statement?

a) “I know I must sign the consent form.”
b) “I hope the throat spray keeps me from gagging.”
c) “I’m glad I don’t have to lie still for this procedure.”
d) “I’m glad some IV medication will be given to relax me.”

5. The health care provider has determined that a client with hepatitis has contracted the infection from contaminated food. The nurse understands that this client is most likely experiencing what type of hepatitis?

a) Hepatitis A
b) Hepatitis B
c) Hepatitis C
d) Hepatitis D

Gastrointestinal Exam Questions
Answers and Rationale

1) A, D, E
- Rationale: Nursing interventions after a hemorrhoidectomy are aimed at management of pain and avoidance of bleeding and incision rupture. Stool softeners and a high-fiber diet will help the client avoid straining, thereby reducing the chances of rupturing the incision. An ice pack will increase comfort and decrease bleeding. Options B, C, and F are incorrect interventions.

- Test-Taking Strategy: Focus on the subject, postoperative hemorrhoidectomy care. Recall that decreasing fluid intake will cause difficulty with defecation because of hard stool. Recognize that Fowler’s position will increase pressure in the rectal area, causing increased bleeding and increased pain. From the remaining options, think about the vasovagal response and that prevention of the vasovagal response is not a concern with hemorrhoidectomy.

2) A, B, C, E
- Gastrointestinal Exam Questions Rationale: Foods that decrease lower esophageal sphincter (LES) pressure and irritate the esophagus will increase reflux and exacerbate the symptoms of gastroesophageal reflux disease (GERD) and therefore should be avoided. Aggravating substances include chocolate, coffee, fried or fatty foods, peppermint, carbonated beverages, and alcohol. Options D and F do not promote this effect.

- Test-Taking Strategy: Focus on the subject, substances that increase lower esophageal pressure. Use knowledge of the effect of various foods on LES pressure and GERD. However, if you are unsure, select the options that identify the most healthful food item( s).

3) D
- Rationale: The nurse places highest priority on assessing for return of the gag reflex. This assessment addresses the client’s airway. The nurse also monitors the client’s vital signs and for a sudden increase in temperature, which could indicate perforation of the gastrointestinal tract. This complication would be accompanied by other signs as well, such as pain. Monitoring for sore throat and heartburn are also important; however, the client’s airway is the priority.

- Test-Taking Strategy: Note the strategic words highest priority. Use the ABCs— airway, breathing, and circulation. The correct option addresses the airway.

4) C
- Gastrointestinal Exam Questions Rationale: The client does have to lie still for endoscopic retrograde cholangiopancreatography (ERCP), which takes about 1 hour to perform. The client also has to sign a consent form. Intravenous sedation is given to relax the client, and an anesthetic spray is used to help keep the client from gagging as the endoscope is passed.

- Test-Taking Strategy: Note the strategic words needs further information. These words indicate a negative event query and ask you to select an option that is incorrect. Invasive procedures require consent, so option A can be eliminated. Noting the name of the procedure and considering the anatomical location will assist you in eliminating options B and D.

5) A
- Rationale: Hepatitis A is transmitted by the fecal-oral route via contaminated food or infected food handlers. Hepatitis B, C, and D are transmitted most commonly via infected blood or body fluids.

- Test-Taking Strategy: Note the strategic words most likely. Recalling the modes of transmission of the various types of hepatitis is required to answer this question. Remember that hepatitis A is transmitted by the fecal-oral route.

After you reviewed your answers through its rationale, you can now proceed to the next set of questions:

Gastrointestinal Exam Questions NCLEX 6-10

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