RN exams gastrointestinal practice questions, set 14
RN exams · gastrointestinal
RN exams gastrointestinal practice questionsset 14
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
The function of the gastrointestinal tract can be classified in several ways. Which of the following functions is most important for survival immediately after a meal?
A. Absorption and retention of water and electrolytes
B. Elimination of toxins
C. Maintenance of barrier function
D. Extraction of maximum value from nutrients
Show answer and rationale
Correct answer: A — Absorption and retention of water and electrolytes
The correct answer is A: Absorption and retention of water and electrolytes. Immediately after a meal, the body needs to absorb water and electrolytes to maintain proper hydration and electrolyte balance, crucial for survival. This process helps in nutrient absorption and maintaining overall body function.
Reasons for why the other choices are incorrect:
B: Elimination of toxins - While important for overall health, elimination of toxins is not the most critical function immediately after a meal for survival.
C: Maintenance of barrier function - While important for protecting against harmful substances, it is not the most vital function immediately after a meal for survival.
D: Extraction of maximum value from nutrients - While important for optimal nutrition, it is not as crucial as absorption and retention of water and electrolytes for immediate survival post-meal.
Question 2
The nurse is doing preoperative teaching with the client who is about to undergo creation of a Kock pouch. The nurse interprets that the client has the best understanding of the nature of the surgery if the client makes which of the following statements?
A. I will need to drain the pouch regularly with a catheter.
B. I will need to wear a drainage bag for the rest of my life.
C. The drainage from this type of ostomy will be formed.
D. I will be able to pass stool from the rectum eventually.
Show answer and rationale
Correct answer: A — I will need to drain the pouch regularly with a catheter.
The correct answer is A: "I will need to drain the pouch regularly with a catheter." This answer demonstrates an accurate understanding of the Kock pouch procedure, which involves the creation of a reservoir that needs to be drained periodically to prevent complications like overflow or infection.
Rationale:
1. A Kock pouch is a continent ileostomy that requires regular catheterization for drainage.
2. Choice B is incorrect because wearing a drainage bag for life is not necessary with a Kock pouch.
3. Choice C is incorrect as a Kock pouch does not produce formed drainage.
4. Choice D is incorrect because passing stool from the rectum is not possible after a Kock pouch surgery.
In summary, choice A is the correct answer as it aligns with the specific care requirements of a Kock pouch surgery, while the other options misrepresent the nature of the procedure.
Question 3
A nurse assesses a client who is admitted with an acid-base imbalance. The clients arterial blood gas values are pH 7.32, PaO2 85 mm Hg, PaCO2 34 mm Hg, and HCO3 16 mEq/L. What action should the nurse take next?
A. Assess clients rate, rhythm, and depth of respiration.
B. Measure the clients pulse and blood pressure.
C. Document the findings and continue to monitor.
D. Notify the physician as soon as possible.
Show answer and rationale
Correct answer: A — Assess clients rate, rhythm, and depth of respiration.
The correct answer is A: Assess clients rate, rhythm, and depth of respiration. The arterial blood gas values indicate a respiratory acidosis due to low pH and low PaCO2. The nurse should assess the respiratory status to determine if the client is hypoventilating, which is causing the retention of CO2 and subsequent acidosis. Assessing the rate, rhythm, and depth of respiration will help determine if the client requires immediate intervention such as oxygen therapy, mechanical ventilation, or respiratory treatment.
Choice B is incorrect because measuring pulse and blood pressure does not directly address the underlying cause of the acid-base imbalance. Choice C is incorrect as the nurse should take immediate action to address the imbalance rather than passively monitoring. Choice D is incorrect as immediate intervention is needed to address the respiratory acidosis.
Question 4
Identify one nursing intervention indicated for each of the following desired outcomes of tube feeding.
A. Prevention of aspiration
B. Prevention of diarrhea
C. Maintenance of tube patency
D. Maintenance of tube placement
Show answer and rationale
Correct answer: A — Prevention of aspiration
The correct answer is A: Prevention of aspiration. This is essential in tube feeding to avoid the risk of food or liquid entering the lungs, causing aspiration pneumonia. Nursing interventions for this include ensuring proper positioning during and after feeding, checking residual volumes before each feeding, and using the appropriate tube size and placement.
Incorrect Choices:
B: Prevention of diarrhea - Diarrhea is not directly related to tube feeding complications, but rather to factors such as infection, medication side effects, or underlying conditions.
C: Maintenance of tube patency - While important, this focuses on ensuring the tube remains clear and functional, not directly related to preventing aspiration.
D: Maintenance of tube placement - Ensuring proper tube placement is crucial for effective feeding but does not directly address the risk of aspiration.
Question 5
A 48-year-old man with a history cirrhosis secondary to hepatitis C presents to the emergency room with confusion, altered mentation, and erratic behavior. He is afebrile. His examination is notable for grossly normal motor strength throughout, hyperreflexia, asterixis, bulging flanks, and shifting dullness. His total bilirubin is 6 mg/dL, his creatinine is 1.8 mg/dL, and his prothrombin time is elevated. His white blood cell count is 11,000/µL with $85 \%$ neutrophils. His ammonia level is 30 µg/dL (normal 15-45 µg/dL). Which of the following statements is correct?
A. Given his normal ammonia level, he does not have hepatic encephalopathy and another cause for his change in mental status should be entertained
B. Despite his normal temperature, his ascitic fluid should be sampled to rule out bacterial peritonitis
C. Empiric antibiotic therapy with an aminoglycoside should be started to cover gram-negative enteric organisms
D. Lactulose should be started and the dose titrated to achieve an ammonia level of less than $10 \mu \mathrm{g} / \mathrm{dL}$
Show answer and rationale
Correct answer: B — Despite his normal temperature, his ascitic fluid should be sampled to rule out bacterial peritonitis
The correct answer is B. Ascitic fluid sampling is crucial in ruling out bacterial peritonitis in patients with cirrhosis presenting with altered mental status. The presence of ascites, bulging flanks, and shifting dullness in the patient's examination indicates ascites, which increases the risk of spontaneous bacterial peritonitis (SBP). SBP can lead to hepatic encephalopathy, contributing to the patient's altered mental status. Sampling ascitic fluid allows for culture and analysis to identify bacterial infection. Choice A is incorrect because normal ammonia levels do not exclude hepatic encephalopathy, which can still be present due to other factors. Choice C is incorrect as aminoglycosides are not recommended for empiric antibiotic therapy in SBP. Choice D is incorrect as lactulose is indicated for hepatic encephalopathy but not for treating bacterial peritonitis.
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Question 6
The nurse is doing preoperative teaching with the client who is about to undergo creation of a Kock pouch. The nurse interprets that the client has the best understanding of the nature of the surgery if the client makes which of the following statements?
A. I will need to drain the pouch regularly with a catheter.
B. I will need to wear a drainage bag for the rest of my life.
C. The drainage from this type of ostomy will be formed.
D. I will be able to pass stool from the rectum eventually.
Correct answer:
The correct answer is A: "I will need to drain the pouch regularly with a catheter." This answer demonstrates an accurate understanding of the Kock pouch procedure, which involves the creation of a reservoir that needs to be drained periodically to prevent complications like overflow or infection.
Rationale:
1. A Kock pouch is a continent ileostomy that requires regular catheterization for drainage.
2. Choice B is incorrect because wearing a drainage bag for life is not necessary with a Kock pouch.
3. Choice C is incorrect as a Kock pouch does not produce formed drainage.
4. Choice D is incorrect because passing stool from the rectum is not possible after a Kock pouch surgery.
In summary, choice A is the correct answer as it aligns with the specific care requirements of a Kock pouch surgery, while the other options misrepresent the nature of the procedure.
What should be the next step in the nursing research process?
A. Review related literature
B. Seek permission from the hospital administrator
C. Identify the research problem
D. Develop methods for data collection
Correct answer:
The correct answer is 'Develop methods for data collection' (Choice D). In the nursing research process, after the research problem has been identified, the next step would typically be to develop methods for how data will be collected. This is essential to effectively address the research problem. 'Review related literature' (Choice A), while an important step, usually occurs after the research problem has been identified and before methods for data collection are developed. 'Seek permission from the hospital administrator' (Choice B) might be necessary at some point in certain situations, but it is not the immediate next step in the research process. 'Identify the research problem' (Choice C) would typically come before developing methods for data collection. Therefore, according to the typical sequence of steps in the nursing research process, Choice D is correct.
Which single statement about fat digestion and absorption is correct?
A. Absorption of fatty acids in the intestine occurs mainly through FABP and FAT/CD36 transport proteins in the enterocytes of the distal duodenum
B. After absorption, medium chain triglycerides (MCT) enter the lymphatic system, whereas long chain triglycerides enter the portal blood system.
C. The products of partial digestion of triglycerides (triacylglycerols) can form mixed micelles with pancreatic cholesterol and phospholipids and this increases absorption
D. Triglycerides (triacylglycerols) must be emulsified and digested before the fatty acids can be transported
Correct answer:
Rationale for Correct Answer D (Triglycerides must be emulsified and digested before fatty acids can be transported):
1. Triglycerides are large molecules that cannot be directly absorbed by the intestinal cells.
2. Emulsification breaks down triglycerides into smaller droplets, increasing the surface area for enzyme action.
3. Enzymatic digestion of triglycerides by lipases results in the release of fatty acids and monoglycerides.
4. These breakdown products are then absorbed by enterocytes in the small intestine.
Summary of Why Other Choices are Incorrect:
A: FABP and FAT/CD36 proteins are involved in fatty acid transport, not triglyceride digestion.
B: Both medium and long-chain triglycerides are absorbed into the lymphatic system via chylomicrons.
C: While mixed micelles aid in lipid absorption, they are not essential for the initial digestion of triglycerides.
Which statement accurately describes buffering activities of the respiratory system?
A. The respiratory system can react to changes in pH within seconds by modifying the rate and depth of breathing.
B. When the pH of arterial blood increases, the respiratory system is reflexively triggered to decrease the depth and rate of breathing.
C. The respiratory system can only buffer against increases in arterial [H+].
D. The respiratory system can only counteract changes in pH that result from nonrespiratory causes.
Correct answer:
Step 1: The respiratory system can react to changes in pH quickly due to its ability to modify the rate and depth of breathing.
Step 2: By increasing the rate and depth of breathing, excess CO2 is expelled, reducing H+ concentration and restoring pH balance.
Step 3: This rapid response allows the respiratory system to buffer against pH changes within seconds.
Step 4: Choice A is correct as it accurately describes the buffering activities of the respiratory system.
Summary:
Choice B is incorrect because an increase in pH would lead to a decrease in H+ concentration, triggering an increase in the depth and rate of breathing.
Choice C is incorrect as the respiratory system can buffer against both increases and decreases in arterial [H+].
Choice D is incorrect as the respiratory system can counteract changes in pH from both respiratory and nonrespiratory causes.
What are sheets/forms that provide an efficient and time-saving way to record information that must be obtained repeatedly at regular and/or short intervals of time? This does not replace progress notes; instead, it records information on vital signs, intake and output, treatment, postoperative care, postpartum care, and diabetic regimen, etc. These are used whenever specific measurements or observations need to be documented repeatedly. What is this?
A. Nursing Kardex
B. Graphic Flow Sheets
C. Discharge Summary
D. Medicine and Treatment Record
Correct answer:
The correct answer is A, Nursing Kardex. Nursing Kardex is a tool used for documenting essential patient information that needs to be recorded repeatedly at regular intervals. It includes vital signs, intake and output, treatment details, postoperative care, postpartum care, and diabetic regimen. This tool is efficient and time-saving for healthcare professionals. Choice B, Graphic Flow Sheets, may be used for visual representation of patient data but is not specifically designed for repeated documentation of essential information. Choice C, Discharge Summary, is a document outlining the patient's care and condition at the time of discharge, not for repeated recording of ongoing data. Choice D, Medicine and Treatment Record, focuses more on specific medications and treatments rather than a comprehensive recording of various patient data needed at regular intervals.
A nurse is preparing an intervention plan for a client who is receiving tube feedings after an oral surgery. Which of the following measures can prevent improper infusion and assist in preventing vomiting?
A. Consulting the physician and dietitian
B. Administering the feedings at room temperature
C. Changing the tube feeding container and tubing
D. Checking the tube placement and gastric residual prior to feedings
Correct answer:
The correct answer is D: Checking the tube placement and gastric residual prior to feedings. This is crucial to ensure proper placement of the tube and to assess if there is any undigested food in the stomach, which can lead to vomiting if fed through the tube. By checking these factors before administering feedings, the nurse can prevent complications.
A: Consulting the physician and dietitian is important but does not directly prevent improper infusion or vomiting.
B: Administering feedings at room temperature is a good practice but does not directly prevent vomiting.
C: Changing the tube feeding container and tubing may be necessary for hygiene but does not directly prevent improper infusion or vomiting.
In summary, checking the tube placement and gastric residual is essential in preventing vomiting and ensuring proper feeding, making it the correct choice.
A patient with a diagnosis of hypocalcemia is being treated with calcium gluconate. Which nursing intervention is essential while administering this medication?
A. Monitor the patient for bradycardia and hypotension.
B. Check for signs of increased intracranial pressure.
C. Observe for symptoms of hyperkalemia.
D. Evaluate for nausea and vomiting post-administration.
Correct answer:
Rationale for Correct Answer A: While administering calcium gluconate for hypocalcemia, monitoring for bradycardia and hypotension is essential due to the potential risk of cardiac arrhythmias with rapid calcium infusion. Bradycardia and hypotension are common signs of calcium gluconate toxicity. Therefore, close monitoring of vital signs is crucial to prevent serious complications.
Summary of Incorrect Choices:
B: Checking for signs of increased intracranial pressure is not directly related to calcium gluconate administration for hypocalcemia.
C: Observing for symptoms of hyperkalemia is not relevant as calcium gluconate does not typically cause hyperkalemia.
D: Evaluating for nausea and vomiting post-administration is not a priority compared to monitoring for bradycardia and hypotension, which are more critical potential side effects of calcium gluconate.
A 52-year-old man with a history of hypertension presents for a follow-up visit. He denies any complaints. His only medication is hydrochlorothiazide. He has some laboratory tests done that reveal mild elevations of his ALT and AST levels. His total bilirubin and alkaline phosphatase levels are normal. He is brought back to have his tests repeated and to have further testing. His AST and ALT are still elevated. His iron studies are normal. His hepatitis C antibody is negative. His hepatitis A IgM is negative. His hepatitis B surface antigen and antibody are negative. His IgM antibody to hepatitis B core antigen (IgM anti-HBc) is positive. Which of the following statements is correct?
A. He is a chronic carrier of the hepatitis B virus
B. There is a $90 \%$ chance that he is positive for hepatitis D
C. Hepatitis B infection has been ruled out
D. If his hepatitis B surface antibody turns positive in three months, then he had an acute hepatitis B infection
Correct answer:
The most specific marker for the diagnosis of acute hepatitis B is IgM antibody to hepatitis B core antigen (IgM anti-HBc). However, false positives can occur. Chronic carriers of hepatitis B will typically have a positive hepatitis B surface antigen (HbsAg) and a positive IgG antibody to hepatitis B core antigen (IgG anti-HBc). Patients may sometimes be low-level carriers with a negative HbsAg and only a positive IgG anti-HBc. Hepatitis D requires the presence of HbsAg to cause infection. It is associated with acute HBV infection (predominantly in intravenous drug users) but the overall incidence is low. When a patient presents with this pattern, repeating the tests in two to three months may assist in the diagnosis. If the IgM anti-HBc disappears and either a hepatitis B surface antibody or IgG anti-HBc appears, then it is likely that he had an acute infection.
A 52-year-old man with a history of hypertension presents for a follow-up visit. He denies any complaints. His only medication is hydrochlorothiazide. He has some laboratory tests done that reveal mild elevations of his ALT and AST levels. His total bilirubin and alkaline phosphatase levels are normal. He is brought back to have his tests repeated and to have further testing. His AST and ALT are still elevated. His iron studies are normal. His hepatitis C antibody is negative. His hepatitis A IgM is negative. His hepatitis B surface antigen and antibody are negative. His IgM antibody to hepatitis B core antigen (IgM anti-HBc) is positive. Which of the following statements is correct?
A. He is a chronic carrier of the hepatitis B virus
B. There is a $90 \%$ chance that he is positive for hepatitis D
C. Hepatitis B infection has been ruled out
D. If his hepatitis B surface antibody turns positive in three months, then he had an acute hepatitis B infection
Correct answer:
The most specific marker for the diagnosis of acute hepatitis B is IgM antibody to hepatitis B core antigen (IgM anti-HBc). However, false positives can occur. Chronic carriers of hepatitis B will typically have a positive hepatitis B surface antigen (HbsAg) and a positive IgG antibody to hepatitis B core antigen (IgG anti-HBc). Patients may sometimes be low-level carriers with a negative HbsAg and only a positive IgG anti-HBc. Hepatitis D requires the presence of HbsAg to cause infection. It is associated with acute HBV infection (predominantly in intravenous drug users) but the overall incidence is low. When a patient presents with this pattern, repeating the tests in two to three months may assist in the diagnosis. If the IgM anti-HBc disappears and either a hepatitis B surface antibody or IgG anti-HBc appears, then it is likely that he had an acute infection.
A 52-year-old man with a history of hypertension presents for a follow-up visit. He denies any complaints. His only medication is hydrochlorothiazide. He has some laboratory tests done that reveal mild elevations of his ALT and AST levels. His total bilirubin and alkaline phosphatase levels are normal. He is brought back to have his tests repeated and to have further testing. His AST and ALT are still elevated. His iron studies are normal. His hepatitis C antibody is negative. His hepatitis A IgM is negative. His hepatitis B surface antigen and antibody are negative. His IgM antibody to hepatitis B core antigen (IgM anti-HBc) is positive. Which of the following statements is correct?
A. He is a chronic carrier of the hepatitis B virus
B. There is a $90 \%$ chance that he is positive for hepatitis D
C. Hepatitis B infection has been ruled out
D. If his hepatitis B surface antibody turns positive in three months, then he had an acute hepatitis B infection
Correct answer:
The most specific marker for the diagnosis of acute hepatitis B is IgM antibody to hepatitis B core antigen (IgM anti-HBc). However, false positives can occur. Chronic carriers of hepatitis B will typically have a positive hepatitis B surface antigen (HbsAg) and a positive IgG antibody to hepatitis B core antigen (IgG anti-HBc). Patients may sometimes be low-level carriers with a negative HbsAg and only a positive IgG anti-HBc. Hepatitis D requires the presence of HbsAg to cause infection. It is associated with acute HBV infection (predominantly in intravenous drug users) but the overall incidence is low. When a patient presents with this pattern, repeating the tests in two to three months may assist in the diagnosis. If the IgM anti-HBc disappears and either a hepatitis B surface antibody or IgG anti-HBc appears, then it is likely that he had an acute infection.
RN exams gastrointestinal practice questions, set 14 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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