Digestive & Gastrointestinal System Disorders | NCLEX Quiz 86

1. A male client has undergone a colon resection. While turning him. wound dehiscence with evisceration occurs. The nurse's first response is to:

Call the physician.

Place saline-soaked sterile dressings on the wound.

Take a blood pressure and pulse.

Pull the dehiscence closed.

The nurse should first place saline-soaked sterile dressings on the open wound to prevent tissue drying and possible infection. Then the nurse should call the physician and take the client’s vital signs. The dehiscence needs to be surgically closed. so the nurse should never try to close it.

Explanation

The nurse should first place saline-soaked sterile dressings on the open wound to prevent tissue drying and possible infection. Then the nurse should call the physician and take the client’s vital signs. The dehiscence needs to be surgically closed. so the nurse should never try to close it.

2. The nurse is monitoring a female client receiving paregoric to treat diarrhea for drug interactions. Which drugs can produce additive constipation when given with an opium preparation?

Antiarrhythmic drugs

Anticholinergic drugs

Anticoagulant drugs

Antihypertensive drugs

Paregoric has an additive effect of constipation when used with anticholinergic drugs. Antiarrhythmics. anticoagulants. and antihypertensives aren’t known to interact with paregoric.

Explanation

Paregoric has an additive effect of constipation when used with anticholinergic drugs. Antiarrhythmics. anticoagulants. and antihypertensives aren’t known to interact with paregoric.

3. Which of the following factors can cause hepatitis A?

Contact with infected blood

Blood transfusions with infected blood

Eating contaminated shellfish

Sexual contact with an infected person

Hepatitis A can be caused by consuming contaminated water. milk. or food — especially shellfish from contaminated water. Hepatitis B is caused by blood and sexual contact with an infected person. Hepatitis C is usually caused by contact with infected blood. including receiving blood transfusions.

Explanation

Hepatitis A can be caused by consuming contaminated water. milk. or food — especially shellfish from contaminated water. Hepatitis B is caused by blood and sexual contact with an infected person. Hepatitis C is usually caused by contact with infected blood. including receiving blood transfusions.

4. While palpating a female client's right upper quadrant (RUQ). the nurse would expect to find which of the following structures?

Sigmoid colon

Appendix

Spleen

Liver

The RUQ contains the liver. gallbladder. duodenum. head of the pancreas. hepatic flexure of the colon. portions of the ascending and transverse colon. and a portion of the right kidney. The sigmoid colon is located in the left lower quadrant; the appendix. in the right lower quadrant; and the spleen. in the left upper quadrant.

Explanation

The RUQ contains the liver. gallbladder. duodenum. head of the pancreas. hepatic flexure of the colon. portions of the ascending and transverse colon. and a portion of the right kidney. The sigmoid colon is located in the left lower quadrant; the appendix. in the right lower quadrant; and the spleen. in the left upper quadrant.

5. The nurse is caring for a female client with active upper GI bleeding. What is the appropriate diet for this client during the first 24 hours after admission?

Regular diet

Skim milk

Nothing by mouth

Clear liquids

Shock and bleeding must be controlled before oral intake. so the client should receive nothing by mouth. A regular diet is incorrect. When the bleeding is controlled. the diet is gradually increased. starting with ice chips and then clear liquids. Skim milk shouldn’t be given because it increases gastric acid production. which could prolong bleeding. A liquid diet is the first diet offered after bleeding and shock are controlled.

Explanation

Shock and bleeding must be controlled before oral intake. so the client should receive nothing by mouth. A regular diet is incorrect. When the bleeding is controlled. the diet is gradually increased. starting with ice chips and then clear liquids. Skim milk shouldn’t be given because it increases gastric acid production. which could prolong bleeding. A liquid diet is the first diet offered after bleeding and shock are controlled.

6. Nurse Hannah is teaching a group of middle-aged men about peptic ulcers. When discussing risk factors for peptic ulcers. the nurse should mention:

A sedentary lifestyle and smoking.

A history of hemorrhoids and smoking.

Alcohol abuse and a history of acute renal failure.

Alcohol abuse and smoking.

Risk factors for peptic (gastric and duodenal) ulcers include alcohol abuse. smoking. and stress. A sedentary lifestyle and a history of hemorrhoids aren’t risk factors for peptic ulcers. Chronic renal failure. not acute renal failure. is associated with duodenal ulcers.

Explanation

Risk factors for peptic (gastric and duodenal) ulcers include alcohol abuse. smoking. and stress. A sedentary lifestyle and a history of hemorrhoids aren’t risk factors for peptic ulcers. Chronic renal failure. not acute renal failure. is associated with duodenal ulcers.

7. A male client has just been diagnosed with hepatitis A. On assessment. the nurse expects to note:

Severe abdominal pain radiating to the shoulder.

Anorexia. nausea. and vomiting.

Eructation and constipation.

Abdominal ascites.

Hallmark signs and symptoms of hepatitis A include anorexia. nausea. vomiting. fatigue. and weakness. Abdominal pain may occur but doesn’t radiate to the shoulder. Eructation and constipation are common in gallbladder disease. not hepatitis A. Abdominal ascites is a sign of advanced hepatic disease. not an early sign of hepatitis A.

Explanation

Hallmark signs and symptoms of hepatitis A include anorexia. nausea. vomiting. fatigue. and weakness. Abdominal pain may occur but doesn’t radiate to the shoulder. Eructation and constipation are common in gallbladder disease. not hepatitis A. Abdominal ascites is a sign of advanced hepatic disease. not an early sign of hepatitis A.

8. A male client with cholelithiasis has a gallstone lodged in the common bile duct. When assessing this client. the nurse expects to note:

Yellow sclera.

Light amber urine.

Circumoral pallor.

Black. tarry stools.

Yellow sclerae may be the first sign of jaundice. which occurs when the common bile duct is obstructed. Urine normally is light amber. Circumoral pallor and black. tarry stools don’t occur in common bile duct obstruction; they are signs of hypoxia and GI bleeding. respectively.

Explanation

Yellow sclerae may be the first sign of jaundice. which occurs when the common bile duct is obstructed. Urine normally is light amber. Circumoral pallor and black. tarry stools don’t occur in common bile duct obstruction; they are signs of hypoxia and GI bleeding. respectively.

9. A male client is recovering from an ileostomy that was performed to treat inflammatory bowel disease. During discharge teaching. the nurse should stress the importance of:

Increasing fluid intake to prevent dehydration.

Wearing an appliance pouch only at bedtime.

Consuming a low-protein. high-fiber diet.

Taking only enteric-coated medications.

Because stool forms in the large intestine. an ileostomy typically drains liquid waste. To avoid fluid loss through ileostomy drainage. the nurse should instruct the client to increase fluid intake. The nurse should teach the client to wear a collection appliance at all times because ileostomy drainage is incontinent. to avoid high-fiber foods because they may irritate the intestines. and to avoid enteric-coated medications because the body can’t absorb them after an ileostomy

Explanation

Because stool forms in the large intestine. an ileostomy typically drains liquid waste. To avoid fluid loss through ileostomy drainage. the nurse should instruct the client to increase fluid intake. The nurse should teach the client to wear a collection appliance at all times because ileostomy drainage is incontinent. to avoid high-fiber foods because they may irritate the intestines. and to avoid enteric-coated medications because the body can’t absorb them after an ileostomy

10. A female client with viral hepatitis A is being treated in an acute care facility. Because the client requires enteric precautions. the nurse should:

Place the client in a private room.

Wear a mask when handling the client’s bedpan.

Wash the hands after touching the client.

Wear a gown when providing personal care for the client.

To maintain enteric precautions. the nurse must wash the hands after touching the client or potentially contaminated articles and before caring for another client. A private room is warranted only if the client has poor hygiene — for instance. if the client is unlikely to wash the hands after touching infective material or is likely to share contaminated articles with other clients. For enteric precautions. the nurse need not wear a mask and must wear a gown only if soiling from fecal matter is likely.

Explanation

To maintain enteric precautions. the nurse must wash the hands after touching the client or potentially contaminated articles and before caring for another client. A private room is warranted only if the client has poor hygiene — for instance. if the client is unlikely to wash the hands after touching infective material or is likely to share contaminated articles with other clients. For enteric precautions. the nurse need not wear a mask and must wear a gown only if soiling from fecal matter is likely.