RN exams gastrointestinal practice questions, set 12
RN exams · gastrointestinal
RN exams gastrointestinal practice questionsset 12
You read GI bleed, liver, and nutrition stems and pick the intervention that protects the patient now. Five of the 15 questions include the correct answer and rationale. The other ten keep answers in the study hub. Continue with the RN exams exam guide or more RN exams practice questions.
Five gastrointestinal questions with answers
Cover the key. Write the first action. Then open the rationale and name why the other choices fail.
Question 1
While a female client is being prepared for discharge, the nasogastric (NG) feeding tube becomes clogged. To remedy this problem and teach the client's family how to deal with it at home, what should the nurse do?
A. Irrigate the tube with warm water.
B. Advance the tube into the intestine.
C. Apply intermittent suction to the tube.
D. Withdraw the obstruction with a 30-ml syringe.
Show answer and rationale
Correct answer: A — Irrigate the tube with warm water.
The correct answer is A: Irrigate the tube with warm water. This is the correct action because irrigating the NG tube with warm water can help dislodge the clog and clear the obstruction. Here is a step-by-step rationale:
1. Gather necessary supplies: warm water, syringe, and towel.
2. Disconnect the tube from the feeding pump.
3. Draw up warm water into the syringe.
4. Gently insert the syringe into the tube and slowly push the warm water to flush out the clog.
5. Repeat the process as needed until the tube is clear.
Other choices are incorrect:
B: Advancing the tube into the intestine can be dangerous and should not be done without proper medical supervision.
C: Applying intermittent suction may not effectively clear the clog and could potentially worsen the situation.
D: Using a 30-ml syringe to withdraw the obstruction may not be as effective as irrigating with warm water.
Question 2
A 34-year-old male client has diagnoses of liver failure, ascites, and hepatic encephalopathy secondary to alcohol abuse. The client's family is questioning the care team as to why his abdomen is so large even though he is undernourished and emaciated. Which of the following statements most accurately underlies the explanation that a member of the care team would provide the family?
A. An inordinate amount of interstitial fluid is accumulating in his abdomen.
B. The transcellular component of the intracellular fluid compartment contains far more fluid than normal.
C. Normally small transcellular fluid compartment, or third space, is becoming enlarged.
D. Gravity-dependent plasma is accumulating in his peritoneal cavity.
Show answer and rationale
Correct answer: C — Normally small transcellular fluid compartment, or third space, is becoming enlarged.
The correct answer is C: Normally small transcellular fluid compartment, or third space, is becoming enlarged. In liver failure with ascites, there is an abnormal accumulation of fluid in the peritoneal cavity due to low oncotic pressure from decreased albumin production by the liver. This results in an enlarged transcellular fluid compartment, known as the "third space," leading to the distended abdomen. Options A, B, and D are incorrect because they do not accurately explain the specific fluid compartment enlargement seen in ascites related to liver failure. Option A refers to interstitial fluid, not the transcellular compartment. Option B incorrectly mentions the intracellular fluid compartment, which is not the primary issue in ascites. Option D incorrectly refers to plasma accumulating in the peritoneal cavity, which is not the mechanism behind the abdominal distension in this case.
Question 3
The pharyngeal phase of swallowing is ______ , which is controlled by ______ muscle.
A. involuntary; smooth
B. voluntary; smooth
C. involuntary; skeletal
D. voluntary; skeletal
Show answer and rationale
Correct answer: C — involuntary; skeletal
The pharyngeal phase of swallowing is an involuntary process, meaning it occurs automatically without conscious control. This phase involves the contraction of skeletal muscles in the pharynx to propel the food bolus towards the esophagus. Skeletal muscles are under voluntary control, but in the context of swallowing, the pharyngeal phase is involuntary. Thus, the correct answer is C: involuntary; skeletal.
Choice A (involuntary; smooth) is incorrect because smooth muscles are not typically involved in the pharyngeal phase of swallowing. Choice B (voluntary; smooth) is incorrect because the pharyngeal phase is not under voluntary control, and smooth muscles are not the primary muscles involved. Choice D (voluntary; skeletal) is incorrect because the pharyngeal phase is involuntary and skeletal muscles, not smooth muscles, are responsible for the muscle contractions during this phase.
Question 4
The oral cavity is the site of a wide variety of systemic disease manifestations due to:
A. Rapid cellular turnover
B. Constant attack by microorganisms
C. Trauma-intense environment
D. All of the above
Show answer and rationale
Correct answer: D — All of the above
The oral cavity is indeed the site of various systemic disease manifestations due to multiple factors. Firstly, the rapid cellular turnover in the oral mucosa makes it susceptible to diseases. Secondly, the constant presence of microorganisms in the oral cavity contributes to the development of systemic diseases. Finally, the oral cavity being a trauma-intense environment further increases the risk of systemic manifestations. Therefore, all the provided options - rapid cellular turnover, constant attack by microorganisms, and a trauma-intense environment - play a role in making the oral cavity a site for various systemic diseases. Hence, the correct answer is 'All of the above.' Choices A, B, and C are incorrect individually as they each represent only one aspect of why the oral cavity is prone to systemic disease manifestations, whereas the correct answer encompasses all these factors.
Question 5
Following a laparoscopic cholecystectomy, what should the nurse expect to be part of the plan of care?
A. Return to work in 2 to 3 weeks
B. Be hospitalized for 3 to 5 days postoperatively
C. Have a T-tube placed in the common bile duct to provide bile drainage
D. Have up to four small abdominal incisions covered with small dressings
Show answer and rationale
Correct answer: D — Have up to four small abdominal incisions covered with small dressings
The correct answer is D. After a laparoscopic cholecystectomy, the patient typically has up to four small abdominal incisions that are covered with small dressings. This is because laparoscopic cholecystectomy is a minimally invasive procedure involving small incisions, which do not require extensive wound care. The incisions are small and usually heal well with minimal scarring.
Explanation for why other choices are incorrect:
A: Return to work in 2 to 3 weeks - This is not part of the immediate postoperative plan of care. Patients may need more time to recover before returning to work.
B: Be hospitalized for 3 to 5 days postoperatively - Patients undergoing laparoscopic cholecystectomy typically have a shorter hospital stay, usually 1 to 2 days, not 3 to 5 days.
C: Have a T-tube placed in the common bile duct to provide bile drainage - This is not typically done after a laparoscopic
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Question 6
After eating, a patient with an inflamed gallbladder experiences pain caused by contraction of the gallbladder. What is the mechanism responsible for this action?
A. Production of bile by the liver
B. Production of secretin by the duodenum
C. Release of gastrin from the stomach antrum
D. Production of cholecystokinin by the duodenum
Correct answer:
The correct answer is D: Production of cholecystokinin by the duodenum. Cholecystokinin (CCK) is released by the duodenum in response to the presence of fatty acids and amino acids. It stimulates the gallbladder to contract, causing the release of bile into the small intestine to aid in digestion. This is directly related to the patient's symptoms of gallbladder pain after eating, as the contraction of the gallbladder is triggered by CCK.
A: Production of bile by the liver is not the mechanism responsible for the gallbladder contraction.
B: Production of secretin by the duodenum is involved in regulating the pH of the duodenum, not gallbladder contraction.
C: Release of gastrin from the stomach antrum is related to stomach acid secretion, not gallbladder contraction.
In summary, the correct answer, D, is directly related to the mechanism responsible for gallbladder pain after eating,
A male client with a recent history of rectal bleeding is being prepared for a colonoscopy. How should the nurse position the client for this test initially?
A. Lying on the right side with legs straight
B. Lying on the left side with knees bent
C. Prone with the torso elevated
D. Bent over with hands touching the floor
Correct answer:
The correct answer is B: Lying on the left side with knees bent. This position allows for better visualization and access to the colon during the colonoscopy procedure. By lying on the left side, the client's colon is in a more optimal position for the scope to navigate through the colon. Additionally, bending the knees helps to relax the abdominal muscles and make the procedure more comfortable for the client.
Incorrect choices:
A: Lying on the right side with legs straight - This position does not provide optimal access to the colon and may make the procedure more difficult.
C: Prone with the torso elevated - This position is not suitable for a colonoscopy as it does not allow for proper access to the colon.
D: Bent over with hands touching the floor - This position is not recommended for a colonoscopy as it is not conducive to the procedure and may cause discomfort for the client.
The pharyngeal phase of swallowing is ______ , which is controlled by ______ muscle.
A. involuntary; smooth
B. voluntary; smooth
C. involuntary; skeletal
D. voluntary; skeletal
Correct answer:
The pharyngeal phase of swallowing is an involuntary process, meaning it occurs automatically without conscious control. This phase involves the contraction of skeletal muscles in the pharynx to propel the food bolus towards the esophagus. Skeletal muscles are under voluntary control, but in the context of swallowing, the pharyngeal phase is involuntary. Thus, the correct answer is C: involuntary; skeletal.
Choice A (involuntary; smooth) is incorrect because smooth muscles are not typically involved in the pharyngeal phase of swallowing. Choice B (voluntary; smooth) is incorrect because the pharyngeal phase is not under voluntary control, and smooth muscles are not the primary muscles involved. Choice D (voluntary; skeletal) is incorrect because the pharyngeal phase is involuntary and skeletal muscles, not smooth muscles, are responsible for the muscle contractions during this phase.
A 36-year-old woman complains of reflux symptoms and intermittent diarrhea. The diagnosis of gastrinoma is suspected so a fasting serum gastrin is obtained and found to be 280 pg/mL (normal <115 pg/mL). An abdominal CT is negative. What would you do now?
A. Refer her for an exploratory laparotomy
B. Measure serum gastrin in response to secretin infusion
C. Treat her for H. pylori
D. Measure gastric acid secretion
Correct answer:
The correct answer is D: Measure gastric acid secretion. In a suspected case of gastrinoma, elevated serum gastrin levels can lead to increased gastric acid secretion. Measuring gastric acid secretion can help confirm the diagnosis of gastrinoma by assessing for increased acid production. This can be done with tests like the gastric acid stimulation test or the secretin stimulation test.
Option A is incorrect as an exploratory laparotomy is an invasive procedure and should not be the first step in the diagnostic process. Option B, measuring serum gastrin in response to secretin infusion, may be helpful in confirming the diagnosis but measuring gastric acid secretion is more directly related to the pathophysiology of gastrinoma. Option C, treating for H. pylori, is not indicated in this case as the patient's symptoms are more suggestive of gastrinoma rather than H. pylori infection.
A client returns from surgery with a sigmoid colostomy. An ostomy appliance is attached. The priority nursing diagnosis for daily observation and care is:
A. Diarrhea related to alteration in bowel elimination.
B. Impaired skin integrity related to seepage.
C. Impaired nutrition: More than body requirements related to high-fat diet.
D. Impaired physical mobility related to surgical procedure.
Correct answer:
The correct answer is B: Impaired skin integrity related to seepage. This is the priority nursing diagnosis because a colostomy appliance can lead to skin breakdown due to seepage of stool, which can cause irritation and skin breakdown. Maintaining skin integrity is crucial to prevent infection and promote healing.
A: Diarrhea is not the priority as it is a common issue after colostomy surgery but can be managed with appropriate interventions.
C: Impaired nutrition is not the priority as it is not specifically related to the immediate care of the colostomy appliance.
D: Impaired physical mobility is not the priority as it is not directly related to the immediate care of the colostomy appliance.
In summary, choice B is the correct answer because maintaining skin integrity is essential for the client's well-being and to prevent complications associated with a colostomy appliance.
The nurse is monitoring a client who has just had a thyroidectomy. The client complains of tingling in the fingers and around the mouth. Which of these findings should the nurse assess first?
A. Calcium level
B. Chvostek's sign
C. Trousseau's sign
D. Serum potassium level
Correct answer:
The correct answer is B, Chvostek's sign. This is a classic sign of hypocalcemia, which can occur after a thyroidectomy due to injury or removal of the parathyroid glands. Hypocalcemia can lead to serious complications like tetany and laryngospasm, necessitating immediate attention. Assessing Chvostek's sign helps in early identification and management of hypocalcemia. Choices A, C, and D are not the priority in this situation. While assessing the calcium level is important for diagnosing hypocalcemia, the immediate concern is to identify clinical signs like Chvostek's sign, which indicate acute hypocalcemia. Trousseau's sign is also related to hypocalcemia but is not the most critical sign to assess first. Serum potassium level, although important for overall electrolyte balance, is not directly related to the client's current symptoms of tingling in the fingers and around the mouth.
In report, the nurse learns that the patient has a transverse colostomy. What should the nurse expect when providing care for this patient?
A. Semiliquid stools with increased fluid requirements
B. Liquid stools in a pouch and increased fluid requirements
C. Formed stools with a pouch, needing irrigation, but no fluid needs
D. Semiformed stools in a pouch with the need to monitor fluid balance
Correct answer:
The correct answer is A: Semiliquid stools with increased fluid requirements. A transverse colostomy is located in the upper part of the colon, where stool consistency is more liquid. This type of colostomy typically produces semiliquid stools due to the shorter transit time in the colon, leading to increased fluid requirements to prevent dehydration.
Summary of other choices:
B: Liquid stools in a pouch and increased fluid requirements - Incorrect because transverse colostomies produce semiliquid stools, not entirely liquid.
C: Formed stools with a pouch, needing irrigation, but no fluid needs - Incorrect as transverse colostomies do not produce formed stools, and fluid intake is necessary.
D: Semiformed stools in a pouch with the need to monitor fluid balance - Incorrect because transverse colostomies produce semiliquid stools, not semiformed, and increased fluid intake is needed.
A 22-year-old patient calls the outpatient clinic complaining of nausea and vomiting and right lower abdominal pain. What should the nurse advise the patient to do?
A. Use a heating pad to relax the muscles at the site of the pain.
B. Drink at least 2 quarts of juice to replace the fluid lost in vomiting.
C. Take a laxative to empty the bowel before examination at the clinic.
D. Have the symptoms evaluated by a health care provider right away.
Correct answer:
The correct answer is D because the patient is experiencing symptoms that could indicate appendicitis, a serious condition that requires immediate medical attention. Nausea, vomiting, and right lower abdominal pain are classic signs of appendicitis. Advising the patient to have the symptoms evaluated by a healthcare provider right away is crucial to prevent potential complications like a ruptured appendix.
Choice A is incorrect because using a heating pad may worsen the condition if it is indeed appendicitis. Choice B is incorrect because drinking juice may not address the underlying cause of the symptoms. Choice C is incorrect because taking a laxative is not recommended as it could potentially aggravate the condition.
In summary, choice D is the correct answer as it prioritizes the patient's health and safety by seeking prompt medical evaluation for the concerning symptoms.
A patient who has chronic constipation asks the nurse about the use of psyllium (Metamucil). Which information will the nurse include in the response?
A. Fiber-containing laxatives may reduce the absorption of fat-soluble vitamins.
B. Dietary sources of fiber should be eliminated to prevent excessive gas formation.
C. Use of this type of laxative to prevent constipation does not cause adverse effects.
D. Large amounts of fluid should be taken to prevent impaction or bowel obstruction.
Correct answer:
Rationale for Correct Answer D:
- Psyllium is a bulk-forming laxative that works by absorbing water in the intestines, forming a gel-like mass that helps with bowel movements.
- Taking large amounts of fluid is essential when using psyllium to prevent the gel-like mass from hardening and causing impaction or bowel obstruction.
- Adequate fluid intake is crucial for the safe and effective use of psyllium as a laxative.
Summary of Incorrect Choices:
- Choice A is incorrect because fiber-containing laxatives like psyllium do not directly impact the absorption of fat-soluble vitamins.
- Choice B is incorrect as dietary sources of fiber should not be eliminated entirely but rather balanced to prevent excessive gas.
- Choice C is incorrect as all medications, including laxatives, can have potential adverse effects; however, psyllium is generally well-tolerated when used appropriately.
You take a deep breath; you raise your larynx and hyoid bone; your epiglottis closes off the larynx; the soft palate closes off the nasopharynx; the diaphragm and abdominal muscles contract and the lower esophageal sphincter relaxes. What has just happened?
A. Low blood glucose levels caused these hunger pangs.
B. Irritation in the GI tract caused the vomiting reflex.
C. Bolus has entered the larynx and stimulated the gagging reflex.
D. Bolus has entered the oropharynx, which initiated the swallowing reflex.
Correct answer:
The correct answer is D because the described sequence of events matches the process of swallowing. Raising the larynx and hyoid bone helps to protect the airway, closing the epiglottis prevents food from entering the trachea, closing the soft palate blocks the nasopharynx to prevent food from entering the nasal cavity, and the contraction of the diaphragm and abdominal muscles along with relaxation of the lower esophageal sphincter facilitate the movement of food into the esophagus. This series of actions is characteristic of the swallowing reflex.
Choices A, B, and C are incorrect. Low blood glucose levels do not directly trigger the swallowing reflex. Irritation in the GI tract would not lead to the described sequence of events. Bolus entering the larynx or nasopharynx would not be part of the normal swallowing process and would typically trigger the gagging reflex instead.
RN exams gastrointestinal practice questions, set 12 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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