NCLEX Quiz: Trivia Questions On Digestive And Gastrointestinal System Disorders

1. Colon cancer is most closely associated with which of the following conditions?

Appendicitis

Hemorrhoids

Hiatal hernia

Ulcerative colitis

Gastric acid contains large amounts of potassium. chloride. and hydrogen ions. Excessive loss of these substances. such as from vomiting. can lead to metabolic alkalosis and hypokalemia.

Explanation

Gastric acid contains large amounts of potassium. chloride. and hydrogen ions. Excessive loss of these substances. such as from vomiting. can lead to metabolic alkalosis and hypokalemia.

2. Which of the following laboratory results would be expected in a client with peritonitis?

Partial thromboplastin time above 100 seconds

Hemoglobin level below 10 mg/dL

Potassium level above 5.5 mEq/L

White blood cell count above 15.000

Because of infection. the client’s WBC count will be elevated. A hemoglobin level below 10 mg/dl may occur from hemorrhage. A PT time longer than 100 seconds may suggest disseminated intravascular coagulation. a serious complication of septic shock. A potassium level above 5.5 mEq/L may indicate renal failure.

Explanation

Because of infection. the client’s WBC count will be elevated. A hemoglobin level below 10 mg/dl may occur from hemorrhage. A PT time longer than 100 seconds may suggest disseminated intravascular coagulation. a serious complication of septic shock. A potassium level above 5.5 mEq/L may indicate renal failure.

3. Which of the following therapies is not included in the medical management of a client with peritonitis?

Broad-spectrum antibiotics

Electrolyte replacement

I.V. fluids

Regular diet

The client with peritonitis usually isn’t allowed anything orally until the source of peritonitis is confirmed and treated. The client also requires broad-spectrum antibiotics to combat the infection. I.V. fluids are given to maintain hydration and hemodynamic stability and to replace electrolytes.

Explanation

The client with peritonitis usually isn’t allowed anything orally until the source of peritonitis is confirmed and treated. The client also requires broad-spectrum antibiotics to combat the infection. I.V. fluids are given to maintain hydration and hemodynamic stability and to replace electrolytes.

4. Which of the following symptoms would a client in the early stages of peritonitis exhibit?

Abdominal distention

Abdominal pain and rigidity

Hyperactive bowel sounds

Right upper quadrant pain

Abdominal pain causing rigidity of the abdominal muscles is characteristic of peritonitis. Abdominal distention may occur as a late sign but not early on. Bowel sounds may be normal or decreased but not increased. Right upper quadrant pain is characteristic of cholecystitis or hepatitis.

Explanation

Abdominal pain causing rigidity of the abdominal muscles is characteristic of peritonitis. Abdominal distention may occur as a late sign but not early on. Bowel sounds may be normal or decreased but not increased. Right upper quadrant pain is characteristic of cholecystitis or hepatitis.

5. Which of the following conditions is most likely to directly cause peritonitis?

Cholelithiasis

Gastritis

Perforated ulcer

Incarcerated hernia

The most common cause of peritonitis is a perforated ulcer. which can pour contaminates into the peritoneal cavity. causing inflammation and infection within the cavity. The other conditions don’t by themselves cause peritonitis. However. if cholelithiasis leads to rupture of the gallbladder. gastritis leads to erosion of the stomach wall. or an incarcerated hernia leads to rupture of the intestines. peritonitis may develop.

Explanation

The most common cause of peritonitis is a perforated ulcer. which can pour contaminates into the peritoneal cavity. causing inflammation and infection within the cavity. The other conditions don’t by themselves cause peritonitis. However. if cholelithiasis leads to rupture of the gallbladder. gastritis leads to erosion of the stomach wall. or an incarcerated hernia leads to rupture of the intestines. peritonitis may develop.

6. A client with irritable bowel syndrome is being prepared for discharge. Which of the following meal plans should the nurse give the client?

Low fiber. low-fat

High fiber. low-fat

Low fiber. high-fat

High-fiber. high-fat

The client with irritable bowel syndrome needs to be on a diet that contains at least 25 grams of fiber per day. Fatty foods are to be avoided because they may precipitate symptoms.

Explanation

The client with irritable bowel syndrome needs to be on a diet that contains at least 25 grams of fiber per day. Fatty foods are to be avoided because they may precipitate symptoms.

7. Which of the following aspects is the priority focus of nursing management for a client with peritonitis?

Fluid and electrolyte balance

Gastric irrigation

Pain management

Psychosocial issues

Peritonitis can advance to shock and circulatory failure. so fluid and electrolyte balance is the priority focus of nursing management. Gastric irrigation may be needed periodically to ensure patency of the nasogastric tube. Although pain management is important for comfort and psychosocial care will address concerns such as anxiety. focusing on fluid and electrolyte imbalance will maintain hemodynamic stability.

Explanation

Peritonitis can advance to shock and circulatory failure. so fluid and electrolyte balance is the priority focus of nursing management. Gastric irrigation may be needed periodically to ensure patency of the nasogastric tube. Although pain management is important for comfort and psychosocial care will address concerns such as anxiety. focusing on fluid and electrolyte imbalance will maintain hemodynamic stability.

8. Which of the following treatments is used for rectal cancer but not for colon cancer?

Chemotherapy

Colonoscopy

Radiation

Surgical resection

A client with rectal cancer can expect to have radiation therapy in addition to chemotherapy and surgical resection of the tumor. A colonoscopy is performed to diagnose the disease. Radiation therapy isn’t usually indicated in colon cancer.

Explanation

A client with rectal cancer can expect to have radiation therapy in addition to chemotherapy and surgical resection of the tumor. A colonoscopy is performed to diagnose the disease. Radiation therapy isn’t usually indicated in colon cancer.

9. Five days after undergoing surgery. a client develops a small-bowel obstruction. A Miller-Abbott tube is inserted for bowel decompression. Which nursing diagnosis takes priority?

Imbalanced nutrition: Less than body requirements

Acute pain

Deficient fluid volume

Excess fluid volume

Fluid shifts to the site of the bowel obstruction. causing a fluid deficit in the intravascular spaces. If the obstruction isn’t resolved immediately. the client may experience an imbalanced nutritional status (less than body requirements); however. deficient fluid volume takes priority. The client may also experience pain. but that nursing diagnosis is also of lower priority than deficient fluid volume.

Explanation

Fluid shifts to the site of the bowel obstruction. causing a fluid deficit in the intravascular spaces. If the obstruction isn’t resolved immediately. the client may experience an imbalanced nutritional status (less than body requirements); however. deficient fluid volume takes priority. The client may also experience pain. but that nursing diagnosis is also of lower priority than deficient fluid volume.

10. When teaching an elderly client how to prevent constipation. which of the following instructions should the nurse include?

“Drink 6 glasses of fluid each day.”

“Avoid grain products and nuts.”

“Add at least 4 grams of bran to your cereal each morning.”

“Be sure to get regular exercise.”

Exercise helps prevent constipation. Fluids and dietary fiber promote normal bowel function. The client should drink eight to ten glasses of fluid each day. Although adding bran to cereal helps prevent constipation by increasing dietary fiber. the client should start with a small amount and gradually increase the amount as tolerated to a maximum of 2 grams a day.

Explanation

Exercise helps prevent constipation. Fluids and dietary fiber promote normal bowel function. The client should drink eight to ten glasses of fluid each day. Although adding bran to cereal helps prevent constipation by increasing dietary fiber. the client should start with a small amount and gradually increase the amount as tolerated to a maximum of 2 grams a day.