Digestive & Gastrointestinal System Disorders | NCLEX Quiz 65

1. You're patient. post-op drainage of a pelvic abscess secondary to diverticulitis. begins to cough violently after drinking water. His wound has ruptured and a small segment of the bowel is protruding. What's your priority?

Ask the patient what happened. call the doctor. and cover the area with a water-soaked bedsheet.

Obtain vital signs. call the doctor. and obtain emergency orders.

Have a CAN hold the wound together while you obtain vital signs. call the doctor and flex the patient’s knees.

The priority in this situation is to have the doctor called while remaining with the patient, flexing the patient's knees, and covering the wound with sterile towels soaked in sterile saline solution. This is because the patient's wound has ruptured and a small segment of the bowel is protruding, indicating a medical emergency that requires immediate attention. Flexing the patient's knees can help alleviate pressure on the abdomen, and covering the wound with sterile towels soaked in sterile saline solution can help prevent infection and further complications.

Explanation

The priority in this situation is to have the doctor called while remaining with the patient, flexing the patient's knees, and covering the wound with sterile towels soaked in sterile saline solution. This is because the patient's wound has ruptured and a small segment of the bowel is protruding, indicating a medical emergency that requires immediate attention. Flexing the patient's knees can help alleviate pressure on the abdomen, and covering the wound with sterile towels soaked in sterile saline solution can help prevent infection and further complications.

2. Christina is receiving an enteral feeding that requires a concentration of 80 ml of supplement mixed with 20 ml of water. How much water do you mix with an 8 oz (240ml) can of feeding?

60 ml.

70 ml.

80 ml.

90 ml.

Dosage problem. It’s 80/20 = 240/X. X=60.

Explanation

Dosage problem. It’s 80/20 = 240/X. X=60.

3. The student nurse is participating in colorectal cancer-screening program. Which patient has the fewest risk factors for colon cancer?

Janice. a 45 y.o. with a 25-year history of ulcerative colitis

George. a 50 y.o. whose father died of colon cancer

Herman. a 60 y.o. who follows a low-fat. high-fiber diet

Sissy. a 72 y.o. with a history of breast cancer

Herman has the fewest risk factors for colon cancer because he follows a low-fat, high-fiber diet. Risk factors for colon cancer include a personal history of inflammatory bowel disease (such as ulcerative colitis, which Janice has), a family history of colon cancer (which George has), and a history of other types of cancer (which Sissy has). Following a low-fat, high-fiber diet is actually a protective factor against colon cancer, as it promotes healthy digestion and reduces the risk of developing polyps in the colon.

Explanation

Herman has the fewest risk factors for colon cancer because he follows a low-fat, high-fiber diet. Risk factors for colon cancer include a personal history of inflammatory bowel disease (such as ulcerative colitis, which Janice has), a family history of colon cancer (which George has), and a history of other types of cancer (which Sissy has). Following a low-fat, high-fiber diet is actually a protective factor against colon cancer, as it promotes healthy digestion and reduces the risk of developing polyps in the colon.

4. A 53 y.o. patient has undergone a partial gastrectomy for adenocarcinoma of the stomach. An NG tube is in place and is connected to low continuous suction. During the immediate postoperative period. you expect the gastric secretions to be which color?

Brown.

Clear.

Red.

Yellow.

Normally. drainage is bloody for the first 24 hours after a partial gastrectomy; then it changes to brown-tinged and then to yellow or clear.

Explanation

Normally. drainage is bloody for the first 24 hours after a partial gastrectomy; then it changes to brown-tinged and then to yellow or clear.

5. George has a T tube in place after gallbladder surgery. Before discharge. what information or instructions should be given regarding the T tube drainage?

“If there is any drainage. notify the surgeon immediately.”

“The drainage will decrease daily until the bile duct heals.”

“First. the drainage is dark green; then it becomes dark yellow.”

“If the drainage stops. milk the tube toward the puncture wound.”

As healing occurs from the bile duct. bile drains from the tube; the amount of bile should decrease. Teach the patient to expect dark green drainage and to notify the doctor if drainage stops.

Explanation

As healing occurs from the bile duct. bile drains from the tube; the amount of bile should decrease. Teach the patient to expect dark green drainage and to notify the doctor if drainage stops.

6. Kevin has a history of peptic ulcer disease and vomits coffee-ground emesis. What does this indicate?

He has fresh. active upper GI bleeding.

He needs immediate saline gastric lavage.

His gastric bleeding occurred 2 hours earlier.

He needs a transfusion of packed RBC’s.

Coffee-ground emesis occurs when there is upper GI bleeding that has undergone gastric digestion. For blood to appear as coffee-ground emesis. it would have to be digested for approximately 2 hours.

Explanation

Coffee-ground emesis occurs when there is upper GI bleeding that has undergone gastric digestion. For blood to appear as coffee-ground emesis. it would have to be digested for approximately 2 hours.

7. Which stoma would you expect a malodorous. enzyme-rich. caustic liquid output that is yellow. green. or brown?

Ileostomy.

Ascending colostomy.

Transverse colostomy.

Descending colostomy.

The output from an Ileostomy is described.

Explanation

The output from an Ileostomy is described.

8. Your patient with peritonitis is NPO and complaining of thirst. What is your priority?

Increase the I.V. infusion rate.

Use diversion activities.

Provide frequent mouth care.

Give ice chips every 15 minutes.

Frequent mouth care helps relieve dry mouth.

Explanation

Frequent mouth care helps relieve dry mouth.

9. Your patient has a retractable gastric peptic ulcer and has had a gastric vagotomy. Which factor increases as a result of vagotomy?

Peristalsis.

Gastric acidity.

Gastric motility.

Gastric pH.

If the vagus nerve is cut as it enters the stomach. gastric acid secretion is decreased. but intestinal motility is also decreased and gastric emptying is delayed. Because gastric acids are decreased. gastric pH increases.

Explanation

If the vagus nerve is cut as it enters the stomach. gastric acid secretion is decreased. but intestinal motility is also decreased and gastric emptying is delayed. Because gastric acids are decreased. gastric pH increases.

10. Your patient Maria takes NSAIDS for her degenerative joint disease. has developed peptic ulcer disease. Which drug is useful in preventing NSAID-induced peptic ulcer disease?

Calcium carbonate (Tums)

Famotidine (Pepcid)

Misoprostol (Cytotec)

Sucralfate (Carafate)

Misoprostol restores prostaglandins that protect the stomach from NSAIDS. which diminish the prostaglandins.

Explanation

Misoprostol restores prostaglandins that protect the stomach from NSAIDS. which diminish the prostaglandins.