RN exams gastrointestinal practice questions, set 8
RN exams · gastrointestinal
RN exams gastrointestinal practice questionsset 8
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
Which nursing measure would be most effective in helping the client cough and deep breathe after a cholecystectomy?
A. Having the client take rapid, shallow breaths to decrease pain.
B. Having the client lay on the left side while coughing and deep breathing.
C. Teaching the client to use a folded blanket or pillow to splint the incision.
D. Withholding pain medication so the client can be alert enough to follow the nurse's instructions.
Show answer and rationale
Correct answer: C — Teaching the client to use a folded blanket or pillow to splint the incision.
The correct answer is C: Teaching the client to use a folded blanket or pillow to splint the incision. This measure helps support the incision site, reducing pain during coughing and deep breathing. Splinting the incision promotes effective coughing and deep breathing post-surgery, aiding in lung expansion and preventing complications like atelectasis.
Explanation of why other choices are incorrect:
A: Having the client take rapid, shallow breaths to decrease pain is incorrect as it can lead to inadequate lung expansion and retention of secretions.
B: Having the client lay on the left side while coughing and deep breathing is incorrect as it does not directly support the incision site and may not be as effective in reducing pain.
D: Withholding pain medication so the client can be alert enough to follow the nurse's instructions is incorrect as pain management is crucial post-surgery for comfort and optimal recovery.
Question 2
What is the role of the small intestine's MALT?
A. secreting mucus
B. buffering acidic chyme
C. activating pepsin
D. preventing bacteria from entering the bloodstream
Show answer and rationale
Correct answer: D — preventing bacteria from entering the bloodstream
The role of the small intestine's MALT (Mucosa-Associated Lymphoid Tissue) is to prevent bacteria from entering the bloodstream. MALT contains immune cells that help protect the body from harmful pathogens in the gut. When bacteria breach the intestinal barrier, MALT responds by generating an immune response to eliminate the invaders and prevent systemic infection. This function is crucial for maintaining the body's overall health and preventing infections.
Choice A (secreting mucus) is incorrect because mucus secretion is primarily performed by goblet cells in the intestine to lubricate and protect the intestinal lining, not by MALT.
Choice B (buffering acidic chyme) is incorrect as buffering acidic chyme is mainly done by bicarbonate secreted by the pancreas to neutralize stomach acid, not by MALT.
Choice C (activating pepsin) is incorrect as pepsin activation occurs in the stomach, not in the small intestine's MALT.
Question 3
Why is it not accurate to refer to body fluids as 'body water'?
A. because body fluids also include fluid inside internal body cavities, which are technically external to the body
B. because body fluids also include fluid outside the body, like sweat
C. because body fluid is lipid based
D. because body fluid is water plus the solutes dissolved in it
Show answer and rationale
Correct answer: D — because body fluid is water plus the solutes dissolved in it
Correct Answer: D
Rationale:
1. Body fluids consist of water and solutes dissolved in it, such as ions, proteins, and other molecules.
2. Referring to body fluids as 'body water' would not account for the presence of solutes in the fluids.
3. It is essential to acknowledge that body fluids are a combination of water and various dissolved substances.
4. By recognizing that body fluids are water plus solutes, the complexity and composition of these fluids are accurately represented.
Summary of other choices:
A. Incorrect. Internal body cavities are still considered part of the body, so this does not explain why 'body water' is inaccurate.
B. Incorrect. Sweat is still a body fluid that contains water and solutes, so this does not address the inaccuracy in the term 'body water.'
C. Incorrect. While some body fluids may contain lipids, not all body fluids are lipid-based, so this does not explain the inaccuracy of the term '
Question 4
A patient with chronic cholecystitis asks the nurse whether she will need to continue a low-fat diet after she has a cholecystectomy. What is the best response by the nurse?
A. A low-fat diet will prevent the development of further gallstones and should be continued.'
B. Yes; because you will not have a gallbladder to store bile, you will not be able to digest fats adequately.'
C. A low-fat diet is recommended for a few weeks after surgery until the intestine adjusts to receiving a continuous flow of bile.'
D. Removal of the gallbladder will eliminate the source of your pain associated with fat intake, so you may eat whatever you like.'
Show answer and rationale
Correct answer: C — A low-fat diet is recommended for a few weeks after surgery until the intestine adjusts to receiving a continuous flow of bile.'
The correct answer is C because after a cholecystectomy, the gallbladder is removed, and bile flows continuously from the liver into the intestine. Initially, the intestine may struggle to adjust to this continuous flow of bile, leading to difficulty in digesting fats. Therefore, a low-fat diet is recommended for a few weeks post-surgery to aid in this adjustment period. This answer acknowledges the temporary need for a low-fat diet until the body adapts.
Choice A is incorrect because the primary purpose of a low-fat diet post-cholecystectomy is not to prevent further gallstones but to aid in fat digestion. Choice B is incorrect as the body can still digest fats adequately even without a gallbladder, though it may take some time to adjust. Choice D is incorrect because while the pain associated with fat intake may be eliminated, it is still important to follow dietary recommendations post-surgery for optimal recovery.
Question 5
The nurse is caring for a patient who returns to the floor at lunchtime after undergoing an upper GI (UGI) series. Which action is most important for the nurse to perform first?
A. Administer a laxative.
B. Educate the patient about the possibility of white stools.
C. Offer the patient a small snack.
D. Provide oral care.
Show answer and rationale
Correct answer: A — Administer a laxative.
The correct answer is A: Administer a laxative. After an upper GI series, it is important to help the patient eliminate the contrast dye used during the procedure. Administering a laxative will facilitate the removal of the dye from the gastrointestinal tract. This is crucial to prevent any potential complications or adverse effects from the contrast dye.
Explanation for incorrect choices:
B: Educating the patient about the possibility of white stools is not the most immediate concern after an upper GI series. While this information is important for the patient to know, it is not the most urgent action to take.
C: Offering the patient a small snack may be appropriate after the procedure, but ensuring the elimination of the contrast dye through a laxative is more critical.
D: Providing oral care is important for overall patient comfort and hygiene, but it is not the priority immediately following an upper GI series.
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Question 6
A 42-year-old accountant is referred to your office for evaluation of progressive weight loss. He has lost 20 pounds over the last 6 months. He has a long history (16 years) of insulin-dependent diabetes mellitus. He denies alcohol abuse but admits to heavy smoking (2 packs of cigarettes per day for 20 years). Three days ago he noticed that his urine became dark and that his skin started to itch. He had a CT scan of the abdomen last week that revealed fullness in the head of the pancreas with dilatation of intra- and extrahepatic biliary ducts. The CT scan did not demonstrate a discrete mass in the pancreas or liver, gallstones, or pancreatitis. His physical examination is normal except for obvious jaundice. His blood work reveals WBC count 6.4, total bilirubin 5.7 mg/dL, alkaline phosphatase 340 U/L, amylase 64 U/L, and lipase 47 U/L. Which of the following tests would you order next?
A. Hepatobiliary scintigraphy (HIDA-scan)
B. Abdominal ultrasound
C. Endoscopic retrograde cholangiopancreatography (ERCP)
D. Transcutaneous transhepatic cholangiography
Correct answer:
The correct answer is C: Endoscopic retrograde cholangiopancreatography (ERCP). ERCP is the next appropriate step for this patient due to the presence of jaundice, dark urine, and dilatation of the biliary ducts on CT scan, which indicate a likely biliary obstruction. ERCP allows direct visualization of the biliary tree and pancreatic duct, as well as therapeutic interventions such as stent placement or stone removal. This procedure can help identify the cause of the jaundice and guide further management.
Choice A (Hepatobiliary scintigraphy) is used to evaluate gallbladder function but is not the most appropriate test in this scenario where biliary obstruction is suspected. Choice B (Abdominal ultrasound) can help identify biliary dilatation but does not provide direct visualization or therapeutic options like ERCP. Choice D (Transcutaneous transhepatic cholangiography) is an invasive test that is typically reserved
A patient with chronic cholecystitis asks the nurse whether she will need to continue a low-fat diet after she has a cholecystectomy. What is the best response by the nurse?
A. A low-fat diet will prevent the development of further gallstones and should be continued.'
B. Yes; because you will not have a gallbladder to store bile, you will not be able to digest fats adequately.'
C. A low-fat diet is recommended for a few weeks after surgery until the intestine adjusts to receiving a continuous flow of bile.'
D. Removal of the gallbladder will eliminate the source of your pain associated with fat intake, so you may eat whatever you like.'
Correct answer:
The correct answer is C because after a cholecystectomy, the gallbladder is removed, and bile flows continuously from the liver into the intestine. Initially, the intestine may struggle to adjust to this continuous flow of bile, leading to difficulty in digesting fats. Therefore, a low-fat diet is recommended for a few weeks post-surgery to aid in this adjustment period. This answer acknowledges the temporary need for a low-fat diet until the body adapts.
Choice A is incorrect because the primary purpose of a low-fat diet post-cholecystectomy is not to prevent further gallstones but to aid in fat digestion. Choice B is incorrect as the body can still digest fats adequately even without a gallbladder, though it may take some time to adjust. Choice D is incorrect because while the pain associated with fat intake may be eliminated, it is still important to follow dietary recommendations post-surgery for optimal recovery.
Following a thyroidectomy, a patient reports "a tingling feeling around my mouth." Which assessment should the nurse complete first?
A. Verify the serum potassium level.
B. Test for presence of Chvostek's sign.
C. Observe for blood on the neck dressing.
D. Confirm a prescription for thyroid replacement.
Correct answer:
The correct answer is B: Test for presence of Chvostek's sign. After a thyroidectomy, tingling around the mouth could indicate hypocalcemia, which can lead to tetany. Chvostek's sign is a test for hypocalcemia, where facial twitching occurs when the facial nerve is tapped. This assessment is crucial to identify potential complications and initiate timely interventions.
Incorrect choices:
A: Verify the serum potassium level - While electrolyte imbalances can occur post-thyroidectomy, hypocalcemia is more likely to cause the tingling sensation around the mouth.
C: Observe for blood on the neck dressing - While assessing for bleeding is important, it does not directly address the tingling sensation reported by the patient.
D: Confirm a prescription for thyroid replacement - While important for long-term management post-thyroidectomy, it does not address the immediate concern of tingling sensation related to hypocalcemia.
The patient has hepatic encephalopathy. What is a priority nursing intervention to keep the patient safe?
A. Turn the patient every 3 hours.
B. Encourage increasing ambulation.
C. Assist the patient to the bathroom.
D. Prevent constipation to reduce ammonia production.
Correct answer:
The correct answer is D: Prevent constipation to reduce ammonia production. In hepatic encephalopathy, the liver is unable to metabolize ammonia, leading to its accumulation and brain dysfunction. Preventing constipation helps reduce the production of ammonia by promoting regular bowel movements. This is crucial in managing hepatic encephalopathy to prevent worsening of symptoms and improve patient safety.
A: Turning the patient every 3 hours is important for preventing pressure ulcers but is not directly related to managing hepatic encephalopathy.
B: Encouraging increasing ambulation may be beneficial for overall patient health but does not directly address the priority of reducing ammonia production in hepatic encephalopathy.
C: Assisting the patient to the bathroom is important for maintaining hygiene and comfort but does not address the underlying issue of reducing ammonia production in hepatic encephalopathy.
The unequal distribution of positively and negatively charged solutes across the plasma membrane is known as what?
A. disequilibrium constant
B. charge separation
C. membrane potential
D. chemical disequilibrium
Correct answer:
The correct answer is C: membrane potential. Membrane potential refers to the difference in electrical charge between the inside and outside of a cell due to the unequal distribution of positively and negatively charged ions across the plasma membrane. This potential difference is crucial for various cellular processes such as nerve conduction and muscle contraction.
A: Disequilibrium constant is a term used in chemical reactions to describe the ratio of product concentrations to reactant concentrations at equilibrium, not related to the distribution of charged solutes in a cell.
B: Charge separation is a generic term and does not specifically refer to the unequal distribution of charged solutes across the plasma membrane.
D: Chemical disequilibrium refers to a state where a system is not at equilibrium in terms of chemical reactions, not directly related to the distribution of charged solutes across the membrane.
Which nursing measure would be most effective in helping the client cough and deep breathe after a cholecystectomy?
A. Having the client take rapid, shallow breaths to decrease pain.
B. Having the client lay on the left side while coughing and deep breathing.
C. Teaching the client to use a folded blanket or pillow to splint the incision.
D. Withholding pain medication so the client can be alert enough to follow the nurse's instructions.
Correct answer:
The correct answer is C: Teaching the client to use a folded blanket or pillow to splint the incision. This measure helps support the incision site, reducing pain during coughing and deep breathing. Splinting the incision promotes effective coughing and deep breathing post-surgery, aiding in lung expansion and preventing complications like atelectasis.
Explanation of why other choices are incorrect:
A: Having the client take rapid, shallow breaths to decrease pain is incorrect as it can lead to inadequate lung expansion and retention of secretions.
B: Having the client lay on the left side while coughing and deep breathing is incorrect as it does not directly support the incision site and may not be as effective in reducing pain.
D: Withholding pain medication so the client can be alert enough to follow the nurse's instructions is incorrect as pain management is crucial post-surgery for comfort and optimal recovery.
The nurse is caring for a patient who returns to the floor at lunchtime after undergoing an upper GI (UGI) series. Which action is most important for the nurse to perform first?
A. Administer a laxative.
B. Educate the patient about the possibility of white stools.
C. Offer the patient a small snack.
D. Provide oral care.
Correct answer:
The correct answer is A: Administer a laxative. After an upper GI series, it is important to help the patient eliminate the contrast dye used during the procedure. Administering a laxative will facilitate the removal of the dye from the gastrointestinal tract. This is crucial to prevent any potential complications or adverse effects from the contrast dye.
Explanation for incorrect choices:
B: Educating the patient about the possibility of white stools is not the most immediate concern after an upper GI series. While this information is important for the patient to know, it is not the most urgent action to take.
C: Offering the patient a small snack may be appropriate after the procedure, but ensuring the elimination of the contrast dye through a laxative is more critical.
D: Providing oral care is important for overall patient comfort and hygiene, but it is not the priority immediately following an upper GI series.
What is the primary reason that extracellular fluid volume must be closely regulated?
A. to maintain blood pressure
B. to maintain adequate urine formation
C. to prevent changes in ICF osmolarity
D. to prevent cells from swelling or shrinking
Correct answer:
The correct answer is A: to maintain blood pressure. Extracellular fluid volume regulation is crucial for maintaining blood pressure within a normal range. Any imbalance in extracellular fluid volume can lead to changes in blood pressure, potentially causing issues like hypotension or hypertension. Adequate blood pressure is necessary for proper perfusion of organs and tissues.
Choice B (to maintain adequate urine formation) is incorrect because extracellular fluid volume regulation primarily affects blood pressure, not urine formation. Choice C (to prevent changes in ICF osmolarity) is incorrect because extracellular fluid volume regulation does not directly impact intracellular fluid osmolarity. Choice D (to prevent cells from swelling or shrinking) is incorrect because intracellular fluid volume regulation, not extracellular fluid volume, is primarily responsible for preventing cellular swelling or shrinking.
The patient has hepatic encephalopathy. What is a priority nursing intervention to keep the patient safe?
A. Turn the patient every 3 hours.
B. Encourage increasing ambulation.
C. Assist the patient to the bathroom.
D. Prevent constipation to reduce ammonia production.
Correct answer:
The correct answer is D: Prevent constipation to reduce ammonia production. In hepatic encephalopathy, the liver is unable to metabolize ammonia, leading to its accumulation and brain dysfunction. Preventing constipation helps reduce the production of ammonia by promoting regular bowel movements. This is crucial in managing hepatic encephalopathy to prevent worsening of symptoms and improve patient safety.
A: Turning the patient every 3 hours is important for preventing pressure ulcers but is not directly related to managing hepatic encephalopathy.
B: Encouraging increasing ambulation may be beneficial for overall patient health but does not directly address the priority of reducing ammonia production in hepatic encephalopathy.
C: Assisting the patient to the bathroom is important for maintaining hygiene and comfort but does not address the underlying issue of reducing ammonia production in hepatic encephalopathy.
What is the primary reason that extracellular fluid volume must be closely regulated?
A. to maintain blood pressure
B. to maintain adequate urine formation
C. to prevent changes in ICF osmolarity
D. to prevent cells from swelling or shrinking
Correct answer:
The correct answer is A: to maintain blood pressure. Extracellular fluid volume regulation is crucial for maintaining blood pressure within a normal range. Any imbalance in extracellular fluid volume can lead to changes in blood pressure, potentially causing issues like hypotension or hypertension. Adequate blood pressure is necessary for proper perfusion of organs and tissues.
Choice B (to maintain adequate urine formation) is incorrect because extracellular fluid volume regulation primarily affects blood pressure, not urine formation. Choice C (to prevent changes in ICF osmolarity) is incorrect because extracellular fluid volume regulation does not directly impact intracellular fluid osmolarity. Choice D (to prevent cells from swelling or shrinking) is incorrect because intracellular fluid volume regulation, not extracellular fluid volume, is primarily responsible for preventing cellular swelling or shrinking.
RN exams gastrointestinal practice questions, set 8 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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Keep going past these 15 questions
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