RN exams gastrointestinal practice questions, set 9
RN exams · gastrointestinal
RN exams gastrointestinal practice questionsset 9
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 nurse is caring for a patient who has a massive burn injury and possible
A. Which assessment data should be of most concern to the nurse?
B. Urine output is 30 mL/hr.
C. Blood pressure is 90/40 mm Hg.
D. Oral fluid intake is 100 mL for 8 hours.
Show answer and rationale
Correct answer: A — Which assessment data should be of most concern to the nurse?
The correct answer is A because in a patient with a massive burn injury, the most concerning assessment data would be related to the extent and depth of the burns, the presence of airway compromise, and signs of infection or sepsis. These factors can significantly impact the patient's prognosis and require immediate intervention.
Choice B is not the most concerning as urine output of 30 mL/hr may be expected in a burn patient due to fluid shifts and decreased perfusion.
Choice C indicates hypotension, which is concerning but not as immediate as assessing the extent and severity of the burns.
Choice D, while indicating inadequate fluid intake, is not the most critical assessment in this scenario compared to evaluating the burn injury itself and potential complications.
Therefore, choice A is the correct answer as it focuses on the most critical aspect of care for a patient with a massive burn injury.
Question 2
The nurse notes a serum calcium level of 7.9 mg/dL for a patient who has chronic malnutrition. Which action should the nurse expect to take first?
A. Monitor ionized calcium level.
B. Give oral calcium citrate tablets.
C. Check parathyroid hormone level.
D. Administer vitamin D supplements.
Show answer and rationale
Correct answer: A — Monitor ionized calcium level.
The correct answer is A: Monitor ionized calcium level.
Step-by-step rationale:
1. Monitoring ionized calcium level is crucial to assess the patient's current calcium status accurately.
2. In chronic malnutrition, there may be alterations in protein binding of calcium, affecting total calcium levels.
3. Ionized calcium is the physiologically active form and provides a more accurate reflection of calcium status.
4. This action helps guide further interventions and treatment based on the actual calcium levels.
Summary:
- Choice B: Giving oral calcium citrate tablets may not be appropriate without knowing the patient's ionized calcium level.
- Choice C: Checking parathyroid hormone level may be relevant but is not the immediate priority.
- Choice D: Administering vitamin D supplements may be beneficial in the long term but does not address the immediate need to assess the patient's calcium status accurately.
Question 3
What describes a common physical change of aging that can affect an older adult's nutrition?
A. reduced salivary output
B. increased gastrointestinal motility
C. abnormal cortisol production
D. increase in number of taste buds
Show answer and rationale
Correct answer: A — reduced salivary output
Reduced salivary output is a common physical change in aging. This can affect an older adult's nutrition by impacting chewing, swallowing, and taste perception. The decrease in saliva production can make it harder to chew and swallow food effectively, affecting the overall eating experience. Additionally, saliva plays a role in taste perception, so a reduction in salivary output can lead to alterations in how food tastes, potentially impacting an individual's appetite and food choices. Increased gastrointestinal motility (choice B) is not typically associated with aging and would not directly affect nutrition. Abnormal cortisol production (choice C) is related to hormonal changes and is not a common physical change of aging that affects nutrition. An increase in the number of taste buds (choice D) is not a typical change associated with aging and would not have a significant impact on an older adult's nutrition.
Question 4
In most regions of the GI tract (exceptions are oral cavity and stomach), smooth muscle fibers of the muscularis are arranged into:
A. inner circular and outer longitudinal layers
B. outer circular and inner longitudinal layers
C. circular and longitudinal layers whose relative position varies from region to region
D. an interwoven meshwork of circular and longitudinal muscle fibers
Show answer and rationale
Correct answer: A — inner circular and outer longitudinal layers
The correct answer is A because in most regions of the GI tract, the smooth muscle fibers of the muscularis are arranged into inner circular and outer longitudinal layers. This arrangement allows for peristalsis, the coordinated contraction and relaxation of the muscles to move food along the digestive tract. The inner circular layer constricts the lumen, while the outer longitudinal layer shortens the tube. This arrangement is consistent throughout the GI tract to facilitate the smooth movement of food.
Choice B is incorrect because the outer circular and inner longitudinal layers are not the typical arrangement in the GI tract. Choice C is incorrect because although there are circular and longitudinal layers, their relative position does not vary significantly from region to region. Choice D is incorrect as it describes a meshwork pattern which is not typical of the muscularis arrangement in the GI tract.
Question 5
A client with pancreatitis experiences a seizure due to alcohol withdrawal. Which of the following interventions should a nurse consider to minimize the risk for injury?
A. Initiate precautions by restraining the client
B. Observe the client throughout the seizure
C. Administer oxygen throughout the seizure
D. Administer an analgesic during the seizure
Show answer and rationale
Correct answer: C — Administer oxygen throughout the seizure
The correct answer is C: Administer oxygen throughout the seizure. Oxygen administration is crucial during a seizure to maintain oxygenation and prevent hypoxia. Hypoxia can exacerbate brain damage in clients experiencing seizures. Administering oxygen helps ensure adequate oxygen supply to the brain and other vital organs, reducing the risk of injury.
A: Initiate precautions by restraining the client - Restraint can increase the risk of injury and worsen the seizure.
B: Observe the client throughout the seizure - While important, simply observing the client does not actively prevent injury during the seizure.
D: Administer an analgesic during the seizure - Analgesics are not indicated during a seizure and may not address the risk for injury.
Administering oxygen is the most appropriate intervention to minimize the risk for injury during a seizure in a client with pancreatitis and alcohol withdrawal.
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Question 6
Which of the following statements about non-expansion states is/are true, according to the CRS’s overview of Medicaid expansion?
A. Medicaid income eligibility for parents in all non-expansion states starts from 100% FPL.
B. In most non-expansion states, adults without dependent children are not eligible for Medicaid.
C. In 2019, over half of the individuals in the coverage gap were from Texas and Florida.
D. Non-expansion states have the same FMAP rate as expansion states.
Correct answer:
The correct answer is D. The Federal Medical Assistance Percentage (FMAP) rate refers to the share of Medicaid expenses paid by the federal government. Non-expansion states have the same FMAP rate as expansion states, as mandated by federal law. This is to ensure that states that did not expand Medicaid still receive the same federal funding support for their Medicaid programs as the expansion states.
A: This statement is incorrect because Medicaid income eligibility for parents in non-expansion states varies and is not necessarily set at 100% of the Federal Poverty Level (FPL).
B: This statement is incorrect because eligibility criteria for adults without dependent children in non-expansion states vary and may differ from state to state.
C: This statement is incorrect because the distribution of individuals in the coverage gap varies among non-expansion states, not just limited to Texas and Florida.
Which two regions of a tooth contain living cells?
A. dentin and enamel
B. anatomical crown and cementum
C. enamel and cementum
D. dentin and cementum
Correct answer:
The correct answer is D. Dentin and cementum are the two regions of a tooth that contain living cells. Dentin is the hard tissue beneath the enamel and cementum that forms the bulk of the tooth structure. It contains living cells called odontoblasts responsible for dentin formation. Cementum is the hard tissue covering the tooth root and is essential for anchoring the tooth in the jawbone. Cementum contains living cells called cementoblasts responsible for cementum formation. Therefore, both dentin and cementum are vital regions of a tooth that house living cells involved in tooth development and maintenance.
A: Dentin and enamel - Enamel is the outermost layer of the tooth and does not contain living cells.
B: Anatomical crown and cementum - Anatomical crown is not a region of the tooth containing living cells.
C: Enamel and cementum - Enamel does not contain living cells, only mineralized structures.
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 patients 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. When a hypertonic solution is infused, it increases the number of dissolved particles in the blood, creating an osmotic pressure gradient. This causes fluids in the tissues to shift into the capillaries, increasing blood volume. Osmosis is the movement of solvent (water) across a semi-permeable membrane to equalize solute concentrations. Osmolality refers to the concentration of solutes in a solution.
Hydrostatic pressure (choice A) is the force exerted by a fluid against a wall when it is under pressure, not related to the movement of solutes.
Diffusion (choice C) is the movement of solute molecules from an area of high concentration to low concentration, not involving a semi-permeable membrane.
Active transport (choice D) requires energy to move molecules across a membrane against their concentration gradient, not the mechanism described in the scenario.
Once absorbed into the epithelial cell of the small intestine, free fatty acids and glycerol are recombined and a protein coat is added to form a
A. chylomicron.
B. micelle.
C. lipoprotein.
D. fatty droplet.
Correct answer:
The correct answer is A: chylomicron. After absorption, free fatty acids and glycerol are recombined in the epithelial cell to form triglycerides. These triglycerides are then packaged with proteins to form chylomicrons, which are lipoprotein particles that transport dietary fats through the lymphatic system and bloodstream. Chylomicrons are essential for the absorption of dietary fats and fat-soluble vitamins.
Summary:
- B: Micelle is incorrect because micelles are formed in the lumen of the small intestine to aid in the absorption of lipids but do not involve recombination of fatty acids and glycerol.
- C: Lipoprotein is incorrect because while chylomicrons are a type of lipoprotein, the specific process described in the question is not about general lipoprotein formation.
- D: Fatty droplet is incorrect as it does not involve the recombination and protein coating process described in the question.
The nurse is caring for a patient who has a massive burn injury and possible
A. Which assessment data should be of most concern to the nurse?
B. Urine output is 30 mL/hr.
C. Blood pressure is 90/40 mm Hg.
D. Oral fluid intake is 100 mL for 8 hours.
Correct answer:
The correct answer is A because in a patient with a massive burn injury, the most concerning assessment data would be related to the extent and depth of the burns, the presence of airway compromise, and signs of infection or sepsis. These factors can significantly impact the patient's prognosis and require immediate intervention.
Choice B is not the most concerning as urine output of 30 mL/hr may be expected in a burn patient due to fluid shifts and decreased perfusion.
Choice C indicates hypotension, which is concerning but not as immediate as assessing the extent and severity of the burns.
Choice D, while indicating inadequate fluid intake, is not the most critical assessment in this scenario compared to evaluating the burn injury itself and potential complications.
Therefore, choice A is the correct answer as it focuses on the most critical aspect of care for a patient with a massive burn injury.
A nurse on the day shift is preparing to change a client's total parenteral nutrition (TPN) solution, but the new TPN solution has not arrived from the pharmacy. The client receives additional IV fat emulsion during the night shift. Which of the following actions should the nurse take?
A. Hang dextrose 10% in water (D10W) until the TPN solution is delivered.
B. Saline lock the IV catheter after discontinuing the TPN solution.
C. Hang the IV fat emulsion solution.
D. Call the provider for new TPN orders.
Correct answer:
The correct answer is A: Hang dextrose 10% in water (D10W) until the TPN solution is delivered. This is the correct action because the client is dependent on TPN for nutrition and cannot go without it. D10W provides a source of glucose to prevent hypoglycemia until the TPN solution arrives. It is important to maintain the client's glucose levels to prevent complications.
Choice B is incorrect because saline locking the IV catheter would not address the client's nutritional needs.
Choice C is incorrect because hanging the IV fat emulsion solution alone would not provide the necessary nutrients that the client needs from the TPN solution.
Choice D is incorrect because calling the provider for new TPN orders would delay the client from receiving essential nutrition. Hanging D10W is the most appropriate action to ensure the client's safety and well-being while waiting for the TPN solution to arrive.
The nurse notes a serum calcium level of 7.9 mg/dL for a patient who has chronic malnutrition. Which action should the nurse expect to take first?
A. Monitor ionized calcium level.
B. Give oral calcium citrate tablets.
C. Check parathyroid hormone level.
D. Administer vitamin D supplements.
Correct answer:
The correct answer is A: Monitor ionized calcium level.
Step-by-step rationale:
1. Monitoring ionized calcium level is crucial to assess the patient's current calcium status accurately.
2. In chronic malnutrition, there may be alterations in protein binding of calcium, affecting total calcium levels.
3. Ionized calcium is the physiologically active form and provides a more accurate reflection of calcium status.
4. This action helps guide further interventions and treatment based on the actual calcium levels.
Summary:
- Choice B: Giving oral calcium citrate tablets may not be appropriate without knowing the patient's ionized calcium level.
- Choice C: Checking parathyroid hormone level may be relevant but is not the immediate priority.
- Choice D: Administering vitamin D supplements may be beneficial in the long term but does not address the immediate need to assess the patient's calcium status accurately.
A client with pancreatitis experiences a seizure due to alcohol withdrawal. Which of the following interventions should a nurse consider to minimize the risk for injury?
A. Initiate precautions by restraining the client
B. Observe the client throughout the seizure
C. Administer oxygen throughout the seizure
D. Administer an analgesic during the seizure
Correct answer:
The correct answer is C: Administer oxygen throughout the seizure. Oxygen administration is crucial during a seizure to maintain oxygenation and prevent hypoxia. Hypoxia can exacerbate brain damage in clients experiencing seizures. Administering oxygen helps ensure adequate oxygen supply to the brain and other vital organs, reducing the risk of injury.
A: Initiate precautions by restraining the client - Restraint can increase the risk of injury and worsen the seizure.
B: Observe the client throughout the seizure - While important, simply observing the client does not actively prevent injury during the seizure.
D: Administer an analgesic during the seizure - Analgesics are not indicated during a seizure and may not address the risk for injury.
Administering oxygen is the most appropriate intervention to minimize the risk for injury during a seizure in a client with pancreatitis and alcohol withdrawal.
When considering tube feedings for a patient with severe protein-calorie malnutrition, what is an advantage of a gastrostomy tube versus a nasogastric (NG) tube?
A. There is less irritation to the nasal and esophageal mucosa.
B. The patient experiences the sights and smells associated with eating.
C. Aspiration resulting from reflux of formulas into the esophagus is less common.
D. Routine checking for placement is not required because gastrostomy tubes do not become displaced.
Correct answer:
Step-by-step rationale for why option A is correct:
1. Gastrostomy tube is inserted directly into the stomach, bypassing the esophagus, reducing irritation to nasal and esophageal mucosa.
2. NG tube goes through the nose, potentially causing irritation and discomfort to the mucosa.
3. In severe protein-calorie malnutrition, preservation of mucosal integrity is crucial for nutrient absorption.
4. Hence, choosing a gastrostomy tube minimizes additional stress on already compromised mucosa.
Summary of why other options are incorrect:
- Option B: The sensory experience of eating is unrelated to the nutritional benefits of tube feeding.
- Option C: Aspiration risk is not directly affected by the type of tube used but rather by proper feeding techniques and patient positioning.
- Option D: All feeding tubes require periodic checking for placement to prevent complications, including gastrostomy tubes.
Which of the following statements about non-expansion states is/are true, according to the CRS’s overview of Medicaid expansion?
A. Medicaid income eligibility for parents in all non-expansion states starts from 100% FPL.
B. In most non-expansion states, adults without dependent children are not eligible for Medicaid.
C. In 2019, over half of the individuals in the coverage gap were from Texas and Florida.
D. Non-expansion states have the same FMAP rate as expansion states.
Correct answer:
The correct answer is D. The Federal Medical Assistance Percentage (FMAP) rate refers to the share of Medicaid expenses paid by the federal government. Non-expansion states have the same FMAP rate as expansion states, as mandated by federal law. This is to ensure that states that did not expand Medicaid still receive the same federal funding support for their Medicaid programs as the expansion states.
A: This statement is incorrect because Medicaid income eligibility for parents in non-expansion states varies and is not necessarily set at 100% of the Federal Poverty Level (FPL).
B: This statement is incorrect because eligibility criteria for adults without dependent children in non-expansion states vary and may differ from state to state.
C: This statement is incorrect because the distribution of individuals in the coverage gap varies among non-expansion states, not just limited to Texas and Florida.
RN exams gastrointestinal practice questions, set 9 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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