RN exams gastrointestinal practice questions, set 5
RN exams · gastrointestinal
RN exams gastrointestinal practice questionsset 5
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 patient is admitted to the unit with the diagnosis of rhabdomyolysis. The patient is started on intravenous (IV) fluids and IV mannitol. What action by the nurse is best?
A. Assess the patient's hearing.
B. Assess the patient's lungs.
C. Decrease IV fluids once the diuretic has been administered.
D. Give extra doses before giving radiological contrast agents.
Show answer and rationale
Correct answer: B — Assess the patient's lungs.
The correct answer is B: Assess the patient's lungs. In rhabdomyolysis, muscle breakdown leads to the release of myoglobin which can cause renal damage. IV fluids and mannitol are given to prevent kidney injury. Assessing the patient's lungs is important to monitor for potential complications such as pulmonary edema, a serious side effect of mannitol therapy. This assessment will help the nurse detect any signs of respiratory distress early on, allowing for prompt intervention.
Choices A, C, and D are incorrect:
A: Assess the patient's hearing - This is not directly related to the treatment of rhabdomyolysis and mannitol administration.
C: Decrease IV fluids once the diuretic has been administered - Decreasing IV fluids prematurely can lead to inadequate hydration and worsen kidney function.
D: Give extra doses before giving radiological contrast agents - This is not indicated in the treatment of rhabdomyolysis and can potentially harm the patient.
Question 2
A 47-year-old web designer has a 14-year history of ulcerative colitis. He recently moved to your area and presents to your office for continued management of his ulcerative colitis. He has been asymptomatic for the past two years and off all medications for one year with no rectal bleeding, diarrhea, abdominal pain, tenesmus, or fever. Before that he had very active colitis requiring steroids and immunosuppressants. He brings records from his previous physician that include his last three colonoscopy and pathology reports. The reports from 6 and 12 years ago documented active colitis with friable mucosa from the mid-transverse colon to the rectum, superficial ulcerations, crypt abscesses and crypt distortion, and acute and chronic inflammation. The most recent report, from almost three years ago, was fairly unremarkable endoscopically. Numerous random biopsies had been obtained. They showed mucosal changes on histology also consistent with a history of ulcerative colitis, but there was no evidence of active disease. What do you recommend?
A. Initiate steroids; if stools are heme-occult positive, then refer for colonoscopy
B. Do not start steroids; if stools are heme-occult positive, then refer for colonoscopy
C. Start steroids; refer for colonoscopy
D. Do not start steroids; refer for colonoscopy
Show answer and rationale
Correct answer: D — Do not start steroids; refer for colonoscopy
The patient has not had active disease for several years and remains well despite being off medications for the past year. Steroids are indicated for active disease only, and steroids do not prevent recurrence. Ulcerative colitis is a chronic disease with recurrence expected. An argument can be made for azulfidine or mesalamine; 5-ASA agents have been documented to decrease flares and appear to decrease the risk of dysplasia and eventual colon cancer. Patients with ulcerative colitis for more than eight years should undergo colonoscopy every two years with random biopsies taken every $10 \mathrm{~cm}$ to rule out dysplasia; then more frequently after 20 years of disease. Definitive evidence of dysplasia requires referral for colectomy to avoid the extremely high risk of colon cancer. Presence of occult blood in the stool will not change endoscopic management because this patient needs to be on a regular screening protocol regardless of heme-occult status.
Question 3
The nurse is caring for a patient with a potassium level of 2.9 mEq/L. The nurse should carefully monitor the patient for which potential problem?
A. Excessive urinary output
B. Abdominal distention
C. Increased reflexes
D. Hyperactive bowel sounds
Show answer and rationale
Correct answer: B — Abdominal distention
The correct answer is B: Abdominal distention. A low potassium level (hypokalemia) can lead to gastrointestinal issues, such as decreased bowel motility, which can result in abdominal distention. Here's the step-by-step rationale:
1. Hypokalemia can cause smooth muscle weakness, leading to decreased bowel motility.
2. Decreased bowel motility can result in the accumulation of gas and fluid in the intestines, causing abdominal distention.
3. Monitoring for abdominal distention is crucial as it can indicate potential complications like bowel obstruction or ileus.
Summary:
A: Excessive urinary output is more commonly associated with conditions like diabetes or diuretic use, not specifically related to hypokalemia.
C: Increased reflexes are not typically associated with hypokalemia; instead, hyporeflexia may be seen in severe cases.
D: Hyperactive bowel sounds are more indicative of conditions like gastroenteritis or bowel obstruction, not directly related to
Question 4
The nurse has provided home care instructions to a client who had a subtotal gastrectomy. The nurse instructs the client regarding the signs and symptoms associated with dumping syndrome. Which of the following signs and symptoms, if identified by the client, indicates an understanding of this potential complication following gastrointestinal surgery?
A. Hiccups and diarrhea
B. Fatigue and abdominal pain
C. Constipation and fever
D. Diaphoresis and diarrhea
Show answer and rationale
Correct answer: D — Diaphoresis and diarrhea
The correct answer is D: Diaphoresis and diarrhea. Diaphoresis (excessive sweating) and diarrhea are classic signs of dumping syndrome, a common complication after gastrectomy. Diaphoresis occurs due to the rapid movement of food into the intestines, triggering the release of hormones leading to sweating. Diarrhea results from the rapid emptying of undigested food into the intestines. These symptoms typically occur within 30 minutes to 3 hours after eating in dumping syndrome.
Explanation for why the other choices are incorrect:
A: Hiccups and diarrhea - Hiccups are not typically associated with dumping syndrome.
B: Fatigue and abdominal pain - Fatigue and abdominal pain are not specific symptoms of dumping syndrome.
C: Constipation and fever - Constipation and fever are not typical signs of dumping syndrome.
In summary, diaphoresis and diarrhea are classic symptoms of dumping syndrome due to rapid emptying of food into the intestines, making
Question 5
The nurse recognizes that teaching a patient following a laparoscopic cholecystectomy has been effective when the patient makes which statement?
A. "I can take a shower and walk around the house tomorrow."Â
B. "I need to limit my activities and not return to work for 4 weeks."Â
C. "I can expect yellowish drainage from the incision for a few days."Â
D. "I will follow a low-fat diet for life because I do not have a gallbladder."Â
Show answer and rationale
Correct answer: A — "I can take a shower and walk around the house tomorrow."Â
Rationale for Correct Answer (A): The statement "I can take a shower and walk around the house tomorrow" indicates an understanding of post-operative activity expectations. After a laparoscopic cholecystectomy, early ambulation is encouraged to prevent complications like blood clots. Additionally, showering promotes wound healing and hygiene.
Incorrect Choices:
B: "I need to limit my activities and not return to work for 4 weeks" - This choice is incorrect as it overestimates the recovery time for a laparoscopic cholecystectomy, which typically allows for a quicker return to normal activities.
C: "I can expect yellowish drainage from the incision for a few days" - While drainage is common after surgery, the color and duration mentioned are not typical for this procedure.
D: "I will follow a low-fat diet for life because I do not have a gallbladder" - Following a low-fat diet is recommended after surgery, but the statement is too extreme as dietary
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Question 6
A 22-yr-old female patient with an exacerbation of ulcerative colitis is having 15 to 20 stools daily and has excoriated perianal skin. Which patient behavior indicates that teaching regarding maintenance of skin integrity has been effective?
A. The patient uses incontinence briefs to contain loose stools.
B. The patient uses witch hazel compresses to soothe irritation.
C. The patient asks for antidiarrheal medication after each stool.
D. The patient cleans the perianal area with soap after each stool.
Correct answer:
The correct answer is B: The patient uses witch hazel compresses to soothe irritation. Witch hazel has astringent and anti-inflammatory properties, which can help reduce inflammation and soothe irritated skin. By using witch hazel compresses, the patient is actively taking steps to alleviate discomfort and promote skin healing.
A: The patient using incontinence briefs to contain loose stools does not address the issue of skin integrity maintenance and may lead to prolonged exposure of the skin to stool, exacerbating the problem.
C: Asking for antidiarrheal medication after each stool does not directly address the need for skin integrity maintenance. While it may help reduce stool frequency, it does not specifically target skin healing.
D: Cleaning the perianal area with soap after each stool can be harsh on the already excoriated skin and may further irritate it. Using soap can strip the skin of its natural oils and hinder the healing process.
The nurse has provided home care instructions to a client who had a subtotal gastrectomy. The nurse instructs the client regarding the signs and symptoms associated with dumping syndrome. Which of the following signs and symptoms, if identified by the client, indicates an understanding of this potential complication following gastrointestinal surgery?
A. Hiccups and diarrhea
B. Fatigue and abdominal pain
C. Constipation and fever
D. Diaphoresis and diarrhea
Correct answer:
The correct answer is D: Diaphoresis and diarrhea. Diaphoresis (excessive sweating) and diarrhea are classic signs of dumping syndrome, a common complication after gastrectomy. Diaphoresis occurs due to the rapid movement of food into the intestines, triggering the release of hormones leading to sweating. Diarrhea results from the rapid emptying of undigested food into the intestines. These symptoms typically occur within 30 minutes to 3 hours after eating in dumping syndrome.
Explanation for why the other choices are incorrect:
A: Hiccups and diarrhea - Hiccups are not typically associated with dumping syndrome.
B: Fatigue and abdominal pain - Fatigue and abdominal pain are not specific symptoms of dumping syndrome.
C: Constipation and fever - Constipation and fever are not typical signs of dumping syndrome.
In summary, diaphoresis and diarrhea are classic symptoms of dumping syndrome due to rapid emptying of food into the intestines, making
What is the most common health issue faced by rural residents in the United States?
A. Cancer
B. Cardiovascular diseases
C. Respiratory diseases
D. Chronic conditions such as diabetes and hypertension
Correct answer:
The correct answer is D: Chronic conditions such as diabetes and hypertension. Rural residents in the U.S. often face challenges accessing healthcare services, leading to undiagnosed or poorly managed chronic conditions. Diabetes and hypertension are prevalent in rural areas due to lifestyle factors like poor diet and limited physical activity. These conditions can significantly impact the overall health and quality of life of rural residents.
Summary of other choices:
A: Cancer - While cancer is a significant health issue, chronic conditions like diabetes and hypertension are more prevalent in rural areas.
B: Cardiovascular diseases - Cardiovascular diseases are a concern, but chronic conditions like diabetes and hypertension are more common in rural populations.
C: Respiratory diseases - Respiratory diseases can be a problem in certain rural areas, but chronic conditions like diabetes and hypertension are more widespread among rural residents.
Which statement about protein digestion and absorption is most correct?
A. The products of protein digestion may be absorbed as free amino acids or as di- or tripeptides
B. Gastric digestion of all proteins is equally efficient because of the grinding action of the antrum
C. Gastric zymogenic (chief) cells produce and secrete chymotrypsin, elastase and carboxypeptidase A and this initiates the process of protein digestion
D. The products of digestion of dietary protein by luminal and brush-border enzymes are only absorbed by one of the 14 different amino acid transporters
Correct answer:
The correct answer is A because it accurately states that the products of protein digestion can be absorbed as free amino acids or as di- or tripeptides. This is true as the final breakdown products of proteins, whether they are individual amino acids or smaller peptide chains, can be absorbed through the intestinal wall into the bloodstream.
Choice B is incorrect because not all proteins are digested equally in the stomach, and the efficiency of digestion can vary based on factors like protein structure and presence of inhibitors.
Choice C is incorrect because chymotrypsin, elastase, and carboxypeptidase A are actually produced and secreted by the pancreas, not the gastric zymogenic cells.
Choice D is incorrect because there are more than 14 different amino acid transporters involved in the absorption of digested protein products, not just one.
Therefore, choice A is the most correct statement regarding protein digestion and absorption.
The patient is admitted to the unit with the diagnosis of rhabdomyolysis. The patient is started on intravenous (IV) fluids and IV mannitol. What action by the nurse is best?
A. Assess the patient's hearing.
B. Assess the patient's lungs.
C. Decrease IV fluids once the diuretic has been administered.
D. Give extra doses before giving radiological contrast agents.
Correct answer:
The correct answer is B: Assess the patient's lungs. In rhabdomyolysis, muscle breakdown leads to the release of myoglobin which can cause renal damage. IV fluids and mannitol are given to prevent kidney injury. Assessing the patient's lungs is important to monitor for potential complications such as pulmonary edema, a serious side effect of mannitol therapy. This assessment will help the nurse detect any signs of respiratory distress early on, allowing for prompt intervention.
Choices A, C, and D are incorrect:
A: Assess the patient's hearing - This is not directly related to the treatment of rhabdomyolysis and mannitol administration.
C: Decrease IV fluids once the diuretic has been administered - Decreasing IV fluids prematurely can lead to inadequate hydration and worsen kidney function.
D: Give extra doses before giving radiological contrast agents - This is not indicated in the treatment of rhabdomyolysis and can potentially harm the patient.
Which nursing action will be included in the plan of care for a 25-yr-old male patient with a new diagnosis of irritable bowel syndrome (IBS)?
A. Encourage the patient to express concerns and ask questions about IBS.
B. Suggest that the patient increase the intake of milk and other dairy products.
C. Teach the patient to avoid using nonsteroidal antiinflammatory drugs (NSAIDs).
D. Teach the patient about the use of alosetron (Lotronex) to reduce IBS symptoms.
Correct answer:
Step 1: Encouraging the patient to express concerns and ask questions about IBS is important for providing emotional support and promoting understanding.
Step 2: This action shows empathy and fosters a therapeutic relationship, which can help the patient cope with the new diagnosis.
Step 3: By expressing concerns and asking questions, the patient can gain knowledge about IBS and actively participate in their care.
Step 4: This approach aligns with patient-centered care principles and empowers the patient to be involved in decision-making regarding their health.
Summary:
- Option B is incorrect as increasing intake of dairy products can exacerbate IBS symptoms in some individuals.
- Option C is incorrect as avoiding NSAIDs is generally recommended for IBS patients due to potential gastrointestinal side effects.
- Option D is incorrect as alosetron is a medication with potential serious side effects and should not be the first-line treatment for IBS.
The nurse recognizes that teaching a patient following a laparoscopic cholecystectomy has been effective when the patient makes which statement?
A. "I can take a shower and walk around the house tomorrow."
B. "I need to limit my activities and not return to work for 4 weeks."
C. "I can expect yellowish drainage from the incision for a few days."
D. "I will follow a low-fat diet for life because I do not have a gallbladder."
Correct answer:
Rationale for Correct Answer (A): The statement "I can take a shower and walk around the house tomorrow" indicates an understanding of post-operative activity expectations. After a laparoscopic cholecystectomy, early ambulation is encouraged to prevent complications like blood clots. Additionally, showering promotes wound healing and hygiene.
Incorrect Choices:
B: "I need to limit my activities and not return to work for 4 weeks" - This choice is incorrect as it overestimates the recovery time for a laparoscopic cholecystectomy, which typically allows for a quicker return to normal activities.
C: "I can expect yellowish drainage from the incision for a few days" - While drainage is common after surgery, the color and duration mentioned are not typical for this procedure.
D: "I will follow a low-fat diet for life because I do not have a gallbladder" - Following a low-fat diet is recommended after surgery, but the statement is too extreme as dietary
A 22-yr-old female patient with an exacerbation of ulcerative colitis is having 15 to 20 stools daily and has excoriated perianal skin. Which patient behavior indicates that teaching regarding maintenance of skin integrity has been effective?
A. The patient uses incontinence briefs to contain loose stools.
B. The patient uses witch hazel compresses to soothe irritation.
C. The patient asks for antidiarrheal medication after each stool.
D. The patient cleans the perianal area with soap after each stool.
Correct answer:
The correct answer is B: The patient uses witch hazel compresses to soothe irritation. Witch hazel has astringent and anti-inflammatory properties, which can help reduce inflammation and soothe irritated skin. By using witch hazel compresses, the patient is actively taking steps to alleviate discomfort and promote skin healing.
A: The patient using incontinence briefs to contain loose stools does not address the issue of skin integrity maintenance and may lead to prolonged exposure of the skin to stool, exacerbating the problem.
C: Asking for antidiarrheal medication after each stool does not directly address the need for skin integrity maintenance. While it may help reduce stool frequency, it does not specifically target skin healing.
D: Cleaning the perianal area with soap after each stool can be harsh on the already excoriated skin and may further irritate it. Using soap can strip the skin of its natural oils and hinder the healing process.
Which of the following is a goal of the Institute for Healthcare Improvement Triple Aim Theory?
A. Improving the experience of care
B. Improving population health
C. Reducing healthcare costs
D. All of the above
Correct answer:
The correct answer is D: All of the above. The Institute for Healthcare Improvement Triple Aim Theory aims to achieve three goals simultaneously: improving the experience of care, improving population health, and reducing healthcare costs. This approach recognizes that these three components are interrelated and essential for achieving overall healthcare system improvement. Improving the experience of care focuses on patient satisfaction and quality of care delivery. Improving population health emphasizes the health outcomes of a community or population. Reducing healthcare costs aims to enhance efficiency and sustainability of healthcare delivery. Choosing option D is correct because it encompasses all three vital goals of the Triple Aim Theory. The other options are incorrect because they represent individual components of the theory, whereas the correct answer acknowledges the comprehensive approach of addressing all three goals simultaneously.
What is the most common health issue faced by rural residents in the United States?
A. Cancer
B. Cardiovascular diseases
C. Respiratory diseases
D. Chronic conditions such as diabetes and hypertension
Correct answer:
The correct answer is D: Chronic conditions such as diabetes and hypertension. Rural residents in the U.S. often face challenges accessing healthcare services, leading to undiagnosed or poorly managed chronic conditions. Diabetes and hypertension are prevalent in rural areas due to lifestyle factors like poor diet and limited physical activity. These conditions can significantly impact the overall health and quality of life of rural residents.
Summary of other choices:
A: Cancer - While cancer is a significant health issue, chronic conditions like diabetes and hypertension are more prevalent in rural areas.
B: Cardiovascular diseases - Cardiovascular diseases are a concern, but chronic conditions like diabetes and hypertension are more common in rural populations.
C: Respiratory diseases - Respiratory diseases can be a problem in certain rural areas, but chronic conditions like diabetes and hypertension are more widespread among rural residents.
RN exams gastrointestinal practice questions, set 5 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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