RN exams gastrointestinal practice questions, set 2
RN exams · gastrointestinal
RN exams gastrointestinal practice questionsset 2
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
Before administering an intermittent tube feeding through a nasogastric tube, the nurse assesses for gastric residual. The nurse understands that this procedure is important to
A. Confirm proper nasogastric tube placement.
B. Observe gastric contents.
C. Assess fluid and electrolyte status.
D. Evaluate absorption of the last feeding.
Show answer and rationale
Correct answer: D — Evaluate absorption of the last feeding.
Rationale for Correct Answer (D): By assessing for gastric residual before administering another feeding through the nasogastric tube, the nurse can evaluate absorption of the last feeding. If there is a significant amount of residual, it may indicate poor absorption, which could lead to complications such as aspiration. This assessment helps in determining the appropriate timing and amount of the next feeding to prevent complications.
Summary of Incorrect Choices:
A: Confirming proper nasogastric tube placement is typically done using other methods like pH testing or X-ray. This assessment does not directly relate to evaluating absorption.
B: Observing gastric contents may provide information about the patient's gastric secretions but does not specifically help in evaluating the absorption of the last feeding.
C: Assessing fluid and electrolyte status is important but not the primary purpose of checking gastric residual before administering a feeding. This assessment is more focused on monitoring the patient's overall hydration and electrolyte balance.
Question 2
Before administering an intermittent tube feeding through a nasogastric tube, the nurse assesses for gastric residual. The nurse understands that this procedure is important to
A. Confirm proper nasogastric tube placement.
B. Observe gastric contents.
C. Assess fluid and electrolyte status.
D. Evaluate absorption of the last feeding.
Show answer and rationale
Correct answer: D — Evaluate absorption of the last feeding.
Rationale for Correct Answer (D): By assessing for gastric residual before administering another feeding through the nasogastric tube, the nurse can evaluate absorption of the last feeding. If there is a significant amount of residual, it may indicate poor absorption, which could lead to complications such as aspiration. This assessment helps in determining the appropriate timing and amount of the next feeding to prevent complications.
Summary of Incorrect Choices:
A: Confirming proper nasogastric tube placement is typically done using other methods like pH testing or X-ray. This assessment does not directly relate to evaluating absorption.
B: Observing gastric contents may provide information about the patient's gastric secretions but does not specifically help in evaluating the absorption of the last feeding.
C: Assessing fluid and electrolyte status is important but not the primary purpose of checking gastric residual before administering a feeding. This assessment is more focused on monitoring the patient's overall hydration and electrolyte balance.
Question 3
Before administering an intermittent tube feeding through a nasogastric tube, the nurse assesses for gastric residual. The nurse understands that this procedure is important to
A. Confirm proper nasogastric tube placement.
B. Observe gastric contents.
C. Assess fluid and electrolyte status.
D. Evaluate absorption of the last feeding.
Show answer and rationale
Correct answer: D — Evaluate absorption of the last feeding.
Rationale for Correct Answer (D): By assessing for gastric residual before administering another feeding through the nasogastric tube, the nurse can evaluate absorption of the last feeding. If there is a significant amount of residual, it may indicate poor absorption, which could lead to complications such as aspiration. This assessment helps in determining the appropriate timing and amount of the next feeding to prevent complications.
Summary of Incorrect Choices:
A: Confirming proper nasogastric tube placement is typically done using other methods like pH testing or X-ray. This assessment does not directly relate to evaluating absorption.
B: Observing gastric contents may provide information about the patient's gastric secretions but does not specifically help in evaluating the absorption of the last feeding.
C: Assessing fluid and electrolyte status is important but not the primary purpose of checking gastric residual before administering a feeding. This assessment is more focused on monitoring the patient's overall hydration and electrolyte balance.
Question 4
A 25-year-old dental technician has noticed a 10-pound weight loss despite increased appetite, generalized weakness, and constipation with infrequent but unusually voluminous and malodorous stools. On physical examination, he is thin, pale, and appears tired. His abdomen is protuberant but soft. Labs reveal a microcytic anemia. Which of the following is least likely to be helpful?
A. Upper endoscopy
B. 72-hour stool collection for fecal fat
C. CT scan of the abdomen
D. Colonoscopy
Show answer and rationale
Correct answer: D — Colonoscopy
This young man with weight loss, malodorous, bulky stools, increased appetite, and iron deficiency anemia has celiac disease as the most likely diagnosis. Patients occasionally may feel constipated; however, the stools are unusually bulky and consistently malodorous. The disease is diagnosed by biopsy of the small bowel by upper endoscopy (Answer A). Elevated anti-endomysial antibodies are highly suggestive. Fat malabsorption can be rigorously established by fecal fat collection. The differential diagnosis includes chronic pancreatitis, which is best evaluated by CT scan. A colonoscopy is helpful to evaluate iron deficiency anemia to rule out colonic tumors or other causes of occult blood loss or to assess for inflammatory bowel disease. However, in this patient with malabsorption, increased appetite, and young age, sprue is more likely to explain the constipation and iron deficiency anemia. He does not have abdominal pain, blood in the stools, or diarrhea, the most common symptoms of inflammatory bowel disease. Colonoscopy will be less useful.
Question 5
A woman stumbled into the rural health clinic and explained that she had an incredible headache. She was sweating and began vomiting into the wastebasket by the intake nurse’s desk. Which diagnosis should be anticipated by the nurse?
A. Acute panic disorder
B. Acute alcohol intoxication
C. Acute appendicitis
D. Acute pesticide poisoning
Show answer and rationale
Correct answer: D — Acute pesticide poisoning
The correct answer is D, Acute pesticide poisoning. The symptoms described - headache, sweating, vomiting - are consistent with pesticide poisoning. Headache can be a common symptom due to the toxic effects of pesticides. Sweating and vomiting are also typical signs of pesticide poisoning. The setting of a rural area further supports this possibility as pesticide exposure is more common in rural settings.
Now let's analyze why the other choices are incorrect:
A: Acute panic disorder - Symptoms of panic disorder do not typically include sweating and vomiting. Panic attacks are more commonly associated with symptoms such as chest pain, shortness of breath, and palpitations.
B: Acute alcohol intoxication - While alcohol intoxication can lead to vomiting, it is less likely to cause a severe headache and sweating in the absence of other common symptoms like slurred speech or impaired coordination.
C: Acute appendicitis - Appendicitis typically presents with abdominal pain, not just headache. Vomiting may occur but is usually preceded
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Question 6
Which of the following statements regarding the adaptive immune response is false?
A. major histocompatibility complexes (MHC) display both self and non-self antigens
B. the MHC is not required for the activation of T helper cells by a foreign antigen
C. activated effector T helper cells can activate both T and B lymphocytes/cells
D. T cells use 'chemical warfare' while B cells send out antibodies against the foreign antigen
Correct answer:
Answer B is correct because the major histocompatibility complex (MHC) is indeed required for the activation of T helper cells by a foreign antigen. This is because T helper cells recognize antigens presented by MHC molecules on antigen-presenting cells. Without MHC presentation, T helper cells cannot be activated.
Choice A is incorrect because MHC molecules do display both self and non-self antigens, which is crucial for the immune system to distinguish between harmful invaders and healthy cells.
Choice C is incorrect because activated effector T helper cells can indeed activate both T and B lymphocytes/cells, playing a key role in coordinating the adaptive immune response.
Choice D is incorrect because T cells do not use 'chemical warfare'; instead, they directly attack infected cells, while B cells produce antibodies that target specific antigens.
In summary, choice B is false because the MHC is necessary for T helper cell activation, while choices A, C, and D are true statements regarding the adaptive immune response.
Care for which of these clients is most appropriate to assign to the LPN/LVN, under the supervision of an RN?
A. A client with oral cancer who is scheduled in the morning for glossectomy
B. An obese client returned from surgery following a vertical banded gastroplasty
C. A client with anorexia nervosa with muscle weakness and decreased urine output
D. A client with intractable nausea and vomiting related to chemotherapy
Correct answer:
The correct answer is D because the LPN/LVN can provide care for a client with intractable nausea and vomiting related to chemotherapy under the supervision of an RN. The LPN/LVN can administer prescribed antiemetic medications, monitor the client's response, assess for dehydration, and provide comfort measures. This task falls within the scope of practice for an LPN/LVN and does not require the advanced assessment and intervention skills of an RN.
Choice A is incorrect because a client undergoing a glossectomy for oral cancer requires complex post-operative care that is beyond the scope of practice for an LPN/LVN.
Choice B is incorrect because post-operative care for an obese client following a vertical banded gastroplasty involves monitoring for complications such as leaks or infections, which require the expertise of an RN.
Choice C is incorrect because a client with anorexia nervosa with muscle weakness and decreased urine output may have underlying medical issues that require an RN's assessment and intervention skills
Which finding is most important for the nurse to confirm prior to hanging an intravenous (IV) bag containing potassium?
A. Verify a blood pressure of at least 60 mm Hg diastolic.
B. Check for urine output of at least 30 mL/h.
C. Ensure filter placement on the IV line.
D. Verify a pulse of at least 50 beats per minute.
Correct answer:
The correct answer is B: Check for urine output of at least 30 mL/h. Prior to hanging an IV bag containing potassium, it is crucial to ensure an adequate urine output to prevent the risk of hyperkalemia. Potassium is excreted primarily through urine, so monitoring urine output helps assess kidney function and the ability to eliminate potassium efficiently. Low urine output could indicate potential kidney issues, increasing the risk of potassium buildup in the body.
Incorrect choices:
A: Verify a blood pressure of at least 60 mm Hg diastolic - While blood pressure is important for assessing perfusion, it is not directly related to potassium administration.
C: Ensure filter placement on the IV line - While filter placement is important for preventing particulate matter from entering the bloodstream, it is not directly related to potassium administration.
D: Verify a pulse of at least 50 beats per minute - Although pulse rate is essential for assessing cardiac function, it is not specifically related to potassium administration.
A woman stumbled into the rural health clinic and explained that she had an incredible headache. She was sweating and began vomiting into the wastebasket by the intake nurse’s desk. Which diagnosis should be anticipated by the nurse?
A. Acute panic disorder
B. Acute alcohol intoxication
C. Acute appendicitis
D. Acute pesticide poisoning
Correct answer:
The correct answer is D, Acute pesticide poisoning. The symptoms described - headache, sweating, vomiting - are consistent with pesticide poisoning. Headache can be a common symptom due to the toxic effects of pesticides. Sweating and vomiting are also typical signs of pesticide poisoning. The setting of a rural area further supports this possibility as pesticide exposure is more common in rural settings.
Now let's analyze why the other choices are incorrect:
A: Acute panic disorder - Symptoms of panic disorder do not typically include sweating and vomiting. Panic attacks are more commonly associated with symptoms such as chest pain, shortness of breath, and palpitations.
B: Acute alcohol intoxication - While alcohol intoxication can lead to vomiting, it is less likely to cause a severe headache and sweating in the absence of other common symptoms like slurred speech or impaired coordination.
C: Acute appendicitis - Appendicitis typically presents with abdominal pain, not just headache. Vomiting may occur but is usually preceded
Care for which of these clients is most appropriate to assign to the LPN/LVN, under the supervision of an RN?
A. A client with oral cancer who is scheduled in the morning for glossectomy
B. An obese client returned from surgery following a vertical banded gastroplasty
C. A client with anorexia nervosa with muscle weakness and decreased urine output
D. A client with intractable nausea and vomiting related to chemotherapy
Correct answer:
The correct answer is D because the LPN/LVN can provide care for a client with intractable nausea and vomiting related to chemotherapy under the supervision of an RN. The LPN/LVN can administer prescribed antiemetic medications, monitor the client's response, assess for dehydration, and provide comfort measures. This task falls within the scope of practice for an LPN/LVN and does not require the advanced assessment and intervention skills of an RN.
Choice A is incorrect because a client undergoing a glossectomy for oral cancer requires complex post-operative care that is beyond the scope of practice for an LPN/LVN.
Choice B is incorrect because post-operative care for an obese client following a vertical banded gastroplasty involves monitoring for complications such as leaks or infections, which require the expertise of an RN.
Choice C is incorrect because a client with anorexia nervosa with muscle weakness and decreased urine output may have underlying medical issues that require an RN's assessment and intervention skills
A nurse in the neurologic ICU has orders to infuse a hypertonic solution into a patient with increased intracranial pressure. This solution will increase the number of dissolved particles in the patient's blood, creating pressure for fluids in the tissues to shift into the capillaries and increase the blood volume. This process is best described as which of the following?
A. Hydrostatic pressure
B. Osmosis and osmolality
C. Diffusion
D. Active transport
Correct answer:
The correct answer is B: Osmosis and osmolality. Osmosis is the movement of fluid from a region of low solute concentration to a region of high solute concentration across a semipermeable membrane. In this case, the hypertonic solution increases the number of dissolved particles in the blood, causing fluids to shift into the capillaries due to the osmotic pressure gradient. Osmolality refers to the concentration of solutes in a solution. Hydrostatic pressure refers to changes in water or volume related to water pressure, not the movement of fluids due to solute concentration differences. Diffusion is the movement of solutes from an area of greater concentration to lesser concentration; in an intact vascular system, solutes are unable to move freely, so diffusion does not play a significant role in this scenario. Active transport involves the movement of molecules against the concentration gradient with the use of energy, typically at the cellular level, and is not related to the vascular volume changes described in the question.
Which finding is most important for the nurse to confirm prior to hanging an intravenous (IV) bag containing potassium?
A. Verify a blood pressure of at least 60 mm Hg diastolic.
B. Check for urine output of at least 30 mL/h.
C. Ensure filter placement on the IV line.
D. Verify a pulse of at least 50 beats per minute.
Correct answer:
The correct answer is B: Check for urine output of at least 30 mL/h. Prior to hanging an IV bag containing potassium, it is crucial to ensure an adequate urine output to prevent the risk of hyperkalemia. Potassium is excreted primarily through urine, so monitoring urine output helps assess kidney function and the ability to eliminate potassium efficiently. Low urine output could indicate potential kidney issues, increasing the risk of potassium buildup in the body.
Incorrect choices:
A: Verify a blood pressure of at least 60 mm Hg diastolic - While blood pressure is important for assessing perfusion, it is not directly related to potassium administration.
C: Ensure filter placement on the IV line - While filter placement is important for preventing particulate matter from entering the bloodstream, it is not directly related to potassium administration.
D: Verify a pulse of at least 50 beats per minute - Although pulse rate is essential for assessing cardiac function, it is not specifically related to potassium administration.
Which of the following statements regarding the adaptive immune response is false?
A. major histocompatibility complexes (MHC) display both self and non-self antigens
B. the MHC is not required for the activation of T helper cells by a foreign antigen
C. activated effector T helper cells can activate both T and B lymphocytes/cells
D. T cells use 'chemical warfare' while B cells send out antibodies against the foreign antigen
Correct answer:
Answer B is correct because the major histocompatibility complex (MHC) is indeed required for the activation of T helper cells by a foreign antigen. This is because T helper cells recognize antigens presented by MHC molecules on antigen-presenting cells. Without MHC presentation, T helper cells cannot be activated.
Choice A is incorrect because MHC molecules do display both self and non-self antigens, which is crucial for the immune system to distinguish between harmful invaders and healthy cells.
Choice C is incorrect because activated effector T helper cells can indeed activate both T and B lymphocytes/cells, playing a key role in coordinating the adaptive immune response.
Choice D is incorrect because T cells do not use 'chemical warfare'; instead, they directly attack infected cells, while B cells produce antibodies that target specific antigens.
In summary, choice B is false because the MHC is necessary for T helper cell activation, while choices A, C, and D are true statements regarding the adaptive immune response.
What physiologic role does magnesium play in the body?
A. Blood clotting, transmission of nerve impulses, muscle contraction and relaxation
B. Calcium homeostasis, structural integrity of heart muscle
C. No known metabolic function, caries-preventing properties
D. ATP energy release; metabolism of fats, carbohydrates, proteins; regulates acid-base balance
Correct answer:
The correct answer is B. Magnesium plays an important role in maintaining calcium homeostasis and preventing skeletal abnormalities. It is involved in more than 300 enzymatic reactions, including energy metabolism, insulin activity, and glucose use. Magnesium is vital to the structural integrity of heart muscle and other muscles and nerves. While magnesium does play a role in blood clotting, nerve impulses, muscle contraction, relaxation, ATP energy release, and metabolism of fats, carbohydrates, proteins, the primary physiologic role of magnesium in the body is related to calcium homeostasis and maintaining the structural integrity of the heart muscle. Choice A is incorrect because it includes functions of magnesium, but they are not its primary physiologic role. Choice C is incorrect as magnesium has several known metabolic functions. Choice D is incorrect because although magnesium is involved in ATP energy release and metabolism, its primary role is related to calcium homeostasis and structural integrity of muscle.
A nurse is planning care for a client who is hyperventilating. The clients arterial blood gas values are pH 7.30, PaO2 94 mm Hg, PaCO2 31 mm Hg, and HCO3 26 mEq/L. Which question should the nurse ask when developing this clients plan of care?
A. Do you take any over-the-counter medications?
B. You appear anxious. What is causing your distress?
C. Do you have a history of anxiety attacks?
D. You are breathing fast. Is this causing you to feel light-headed?
Correct answer:
The correct answer is B: "You appear anxious. What is causing your distress?" because hyperventilation can be triggered by emotional distress or anxiety. By addressing the underlying cause of the hyperventilation, the nurse can provide appropriate interventions to help the client manage their anxiety and subsequently reduce the hyperventilation episodes.
A: "Do you take any over-the-counter medications?" - This question is not directly related to addressing the client's anxiety or distress, which is the primary concern in hyperventilation.
C: "Do you have a history of anxiety attacks?" - While relevant to understanding the client's medical history, this question does not address the immediate cause of hyperventilation in this specific situation.
D: "You are breathing fast. Is this causing you to feel light-headed?" - This question focuses on the physical symptoms of hyperventilation rather than exploring the emotional or psychological triggers, which are essential in managing hyperventilation caused by anxiety.
RN exams gastrointestinal practice questions, set 2 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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