Gastrointestinal System Nursing Exam Questions

Gastrointestinal System Nursing Exam Questions Related

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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: D

Rationale: 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

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To prevent gastroesophageal reflux in a client with hiatal hernia, the nurse should provide which discharge instructions?

  • A. Lie down after meals to promote digestion.
  • B. Avoid coffee and alcoholic beverages.
  • C. Take antacids before meals.
  • D. Limit fluids with meals.
Correct Answer: B

Rationale: The correct answer is B: Avoid coffee and alcoholic beverages. This is because both coffee and alcohol can relax the lower esophageal sphincter, leading to increased risk of gastroesophageal reflux in clients with hiatal hernia.

A: Lying down after meals can actually worsen reflux symptoms by allowing stomach acid to flow back into the esophagus.
C: Taking antacids before meals may provide temporary relief but does not address the underlying cause of reflux.
D: Limiting fluids with meals can help reduce reflux by not distending the stomach, but it is not as crucial as avoiding coffee and alcohol.

A nurse is reviewing the orders of a client admitted to the hospital with a diagnosis of acute pancreatitis. Select the interventions that the nurse would expect to be prescribed for the client.

  • A. Small, frequent high-calorie feedings.
  • B. Meperidine (Demerol) as prescribed for pain.
  • C. Place the client in a side-lying position with the head elevated 45-degrees.
  • D. Administer antacids and anticholinergics to suppress gastrointestinal secretions.
Correct Answer: B

Rationale: The correct answer is B: Meperidine (Demerol) as prescribed for pain. In acute pancreatitis, pain management is crucial, and Meperidine is commonly used due to its minimal effect on the sphincter of Oddi.

Incorrect options:
A: Small, frequent high-calorie feedings can exacerbate pancreatitis by stimulating pancreatic enzyme secretion.
C: Placing the client in a side-lying position with the head elevated is not a specific intervention for pancreatitis.
D: Administering antacids and anticholinergics is not a standard treatment for pancreatitis and may not address the underlying cause of the condition.

After gastric resection surgery, which of the following signs and symptoms would alert the nurse to the development of a leaking anastomosis?

  • A. Pain, fever, and abdominal rigidity.
  • B. Diarrhea with fat in the stool.
  • C. Palpitations, pallor, and diaphoresis after eating.
  • D. Feelings of fullness and nausea after eating.
Correct Answer: A

Rationale: Rationale for choice A: Pain, fever, and abdominal rigidity are classic signs of a leaking anastomosis after gastric resection surgery. Pain indicates inflammation, fever suggests infection, and abdominal rigidity points to peritonitis. These symptoms are indicative of a surgical complication that requires immediate attention to prevent further complications like sepsis.

Summary of other choices:
B: Diarrhea with fat in the stool is more indicative of malabsorption issues, such as pancreatic insufficiency, rather than a leaking anastomosis.
C: Palpitations, pallor, and diaphoresis after eating are more suggestive of cardiovascular issues or anxiety rather than a leaking anastomosis.
D: Feelings of fullness and nausea after eating are common postoperative symptoms and do not specifically indicate a leaking anastomosis.

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: A

Rationale: 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.

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.
Correct Answer: D

Rationale: 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.

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