Digestive & Gastrointestinal System Disorders | NCLEX Quiz 80

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Questions: 10 | Attempts: 1,307 | Updated: Mar 20, 2023

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Questions and Answers

1.

Which of the following factors should be the main focus of nursing management for a client hospitalized for cholecystitis?
- A.
  
  Administration of antibiotics
- B.
  
  Assessment for complications
- C.
  
  Preparation for lithotripsy
- D.
  
  Preparation for surgery
Correct Answer
B. Assessment for complications

Explanation
The client with acute cholecystitis should first be monitored for perforation. fever. abscess. fistula. and sepsis. After assessment. antibiotics will be administered to reduce the infection. Lithotripsy is used only for a small percentage of clients. Surgery is usually done after the acute infection has subsided.

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2.

A client being treated for chronic cholecystitis should be given which of the following instructions?
- A.
  
  Increase rest
- B.
  
  Avoid antacids
- C.
  
  Increase protein in diet
- D.
  
  Use anticholinergics as prescribed
Correct Answer
D. Use anticholinergics as prescribed

Explanation
Conservative therapy for chronic cholecystitis includes weight reduction by increasing physical activity. a low-fat diet. antacid use to treat dyspepsia. and anticholinergic use to relax smooth muscles and reduce ductal tone and spasm. thereby reducing pain.

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3.

The client with a duodenal ulcer may exhibit which of the following findings on assessment?
- A.
  
  Hematemesis
- B.
  
  Malnourishment
- C.
  
  Melena
- D.
  
  Pain with eating
Correct Answer
C. Melena

Explanation
The client with a duodenal ulcer may have bleeding at the ulcer site. which shows up as melena (black tarry stool). The other findings are consistent with a gastric ulcer.

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4.

The pain of a duodenal ulcer can be distinguished from that of a gastric ulcer by which of the following characteristics?
- A.
  
  Early satiety
- B.
  
  Pain on eating
- C.
  
  Dull upper epigastric pain
- D.
  
  Pain on empty stomach
Correct Answer
D. Pain on empty stomach

Explanation
Pain on empty stomach is relieved by taking foods or antacids. The other symptoms are those of a gastric ulcer.

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5.

The client has orders for a nasogastric (NG) tube insertion. During the procedure. instructions that will assist in the insertion would be:
- A.
  
  Instruct the client to tilt his head back for insertion in the nostril. then flex his neck for the final insertion
- B.
  
  After insertion into the nostril. instruct the client to extend his neck
- C.
  
  Introduce the tube with the client’s head tilted back. then instruct him to keep his head upright for final insertion
- D.
  
  Instruct the client to hold his chin down. then back for insertion of the tube
Correct Answer
A. Instruct the client to tilt his head back for insertion in the nostril. then flex his neck for the final insertion

Explanation
NG insertion technique is to have the client first tilt his head back for insertion into the nostril. then to flex his neck forward and swallow. Extension of the neck (2) will impede NG tube insertion.

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6.

The most important pathophysiologic factor contributing to the formation of esophageal varices is:
- A.
  
  Decreased prothrombin formation
- B.
  
  Decreased albumin formation by the liver
- C.
  
  Portal hypertension
- D.
  
  Increased central venous pressure
Correct Answer
C. Portal hypertension

Explanation
As the liver cells become fatty and degenerate. they are no longer able to accommodate a large amount of blood necessary for homeostasis. The pressure in the liver increases and causes increased pressure in the venous system. As the portal pressure increases. fluid exudes into the abdominal cavity. This is called ascites.

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7.

The client being treated for esophageal varices has a Sengstaken-Blakemore tube inserted to control the bleeding. The most important assessment is for the nurse to:
- A.
  
  Check that the hemostat is on the bedside
- B.
  
  Monitor IV fluids for the shift
- C.
  
  Regularly assess respiratory status
- D.
  
  Check that the balloon is deflated on a regular basis
Correct Answer
C. Regularly assess respiratory status

Explanation
The respiratory system can become occluded if the balloon slips and moves up the esophagus. putting pressure on the trachea. This would result in respiratory distress and should be assessed frequently. Scissors should be kept at the bedside to cut the tube if distress occurs. This is a safety intervention.

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8.

The nurse is caring for a client with chronic gastritis. The nurse monitors the client. knowing that this client is at risk for which of the following vitamin deficiencies?
- A.
  
  Vitamin A
- B.
  
  Vitamin B12
- C.
  
  Vitamin C
- D.
  
  Vitamin E
Correct Answer
B. Vitamin B12

Explanation
Peptic ulcer disease is characteristically gnawing epigastric pain that may radiate to the back. Vomiting usually reflects pyloric spasm from muscular spasm or obstruction. Cancer (1) would not evidence pain or vomiting unless the pylorus was obstructed.

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1
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9.

When a client has peptic ulcer disease. the nurse would expect a priority intervention to be:
- A.
  
  Assisting in inserting a Miller-Abbott tube
- B.
  
  Assisting in inserting an arterial pressure line
- C.
  
  Inserting a nasogastric tube
- D.
  
  Inserting an I.V.
Correct Answer
C. Inserting a nasogastric tube

Explanation
An NG tube insertion is the most appropriate intervention because it will determine the presence of active GI bleeding. A Miller-Abbott tube (1) is a weighted. mercury-filled ballooned tube used to resolve bowel obstructions. There is no evidence of shock or fluid overload in the client; therefore. an arterial line (2) is not appropriate at this time and an IV (4) is optional.

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10.

A 40-year-old male client has been hospitalized with peptic ulcer disease. He is being treated with a histamine receptor antagonist (cimetidine). antacids. and diet. The nurse doing discharge planning will teach him that the action of cimetidine is to:
- A.
  
  Reduce gastric acid output
- B.
  
  Protect the ulcer surface
- C.
  
  Inhibit the production of hydrochloric acid (HCl)
- D.
  
  Inhibit vagus nerve stimulation
Correct Answer
A. Reduce gastric acid output

Explanation
These drugs inhibit the action of histamine on the H2 receptors of parietal cells. thus reducing gastric acid output.

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Digestive & Gastrointestinal System Disorders | NCLEX Quiz 80

Which of the following factors should be the main focus of nursing management for a client hospitalized for cholecystitis?

A client being treated for chronic cholecystitis should be given which of the following instructions?

The client with a duodenal ulcer may exhibit which of the following findings on assessment?

The pain of a duodenal ulcer can be distinguished from that of a gastric ulcer by which of the following characteristics?

The client has orders for a nasogastric (NG) tube insertion. During the procedure. instructions that will assist in the insertion would be:

The most important pathophysiologic factor contributing to the formation of esophageal varices is:

The client being treated for esophageal varices has a Sengstaken-Blakemore tube inserted to control the bleeding. The most important assessment is for the nurse to:

The nurse is caring for a client with chronic gastritis. The nurse monitors the client. knowing that this client is at risk for which of the following vitamin deficiencies?

When a client has peptic ulcer disease. the nurse would expect a priority intervention to be:

A 40-year-old male client has been hospitalized with peptic ulcer disease. He is being treated with a histamine receptor antagonist (cimetidine). antacids. and diet. The nurse doing discharge planning will teach him that the action of cimetidine is to: