NCLEX Gastrointestinal Disorders Practice Exam

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NCLEX Gastrointestinal Disorders Practice Exam

 

Which of the following is the primary symptom of gastroesophageal reflux disease (GERD)?

A) Abdominal cramping
B) Heartburn
C) Vomiting
D) Diarrhea

A nurse is teaching a patient with peptic ulcer disease about dietary modifications. Which of the following should the nurse recommend?

A) Avoid spicy foods
B) Increase intake of citrus fruits
C) Drink coffee in moderation
D) Eat large meals three times a day

A client with cirrhosis is at risk for which complication?

A) Hyperkalemia
B) Hypertension
C) Ascites
D) Hypoglycemia

The nurse is caring for a client with a colostomy. Which of the following should be included in the teaching plan?

A) The ostomy bag should be emptied when it is half full.
B) The stoma should be cleaned with alcohol.
C) It is important to change the ostomy bag once a week.
D) A pink or red stoma indicates poor perfusion.

The nurse is caring for a patient with appendicitis. Which of the following signs would indicate a potential perforation of the appendix?

A) Severe abdominal pain with rigidity
B) Pain in the right lower quadrant (RLQ)
C) Mild fever
D) Decreased appetite

A nurse is caring for a patient with pancreatitis. Which lab result is most indicative of this condition?

A) Elevated serum amylase
B) Low albumin levels
C) Elevated calcium levels
D) Decreased liver enzymes

A client with chronic gastritis is prescribed antacids. Which of the following should the nurse monitor for?

A) Hypercalcemia
B) Hypokalemia
C) Renal failure
D) Respiratory distress

The nurse is caring for a patient with a diagnosis of irritable bowel syndrome (IBS). Which of the following should the nurse recommend to the patient?

A) Increase fiber intake
B) Decrease fluid intake
C) Avoid consuming dairy products
D) Limit exercise

Which of the following is a classic symptom of celiac disease?

A) Abdominal bloating
B) Hematemesis
C) Night sweats
D) Hypertension

A patient with liver cirrhosis develops hepatic encephalopathy. Which intervention should the nurse implement first?

A) Administer lactulose
B) Monitor for signs of hypoglycemia
C) Encourage increased oral intake
D) Prepare the patient for a liver transplant

The nurse is teaching a patient with diverticulosis about dietary changes. Which of the following is the most important recommendation?

A) Increase dietary fiber
B) Avoid eating fatty foods
C) Decrease protein intake
D) Limit sodium consumption

A patient with a diagnosis of ulcerative colitis presents with severe abdominal pain. The nurse should be concerned about which potential complication?

A) Pneumonia
B) Peritonitis
C) Deep vein thrombosis
D) Liver failure

The nurse is assessing a client for signs of dehydration. Which finding would the nurse expect to find in a patient with diarrhea?

A) Increased urine output
B) Dry mucous membranes
C) Elevated blood pressure
D) Decreased heart rate

A nurse is caring for a patient who has just undergone a cholecystectomy. Which of the following actions is appropriate?

A) Encourage the patient to eat fatty foods to stimulate bile production.
B) Assess for signs of infection at the incision site.
C) Keep the patient NPO for 72 hours post-surgery.
D) Administer pain medication after meals.

A nurse is educating a patient on the management of irritable bowel disease (IBD). Which of the following should the nurse include in the teaching?

A) Drink caffeinated beverages to ease symptoms
B) Avoid high-fiber foods during flare-ups
C) Use over-the-counter laxatives regularly
D) Avoid high-protein diets

A patient with a history of chronic hepatitis C presents with jaundice and abdominal swelling. The nurse suspects that the patient may have developed which condition?

A) Gallstones
B) Liver cirrhosis
C) Pancreatitis
D) Esophageal varices

Which of the following interventions is appropriate for a patient with a diagnosis of acute pancreatitis?

A) Encourage high-fat meals to promote nutrition
B) Administer morphine for pain control
C) Provide a high-protein, high-calorie diet
D) Maintain NPO status and provide IV fluids

A patient with a diagnosis of Crohn’s disease is being discharged. The nurse should instruct the patient to avoid which of the following?

A) High-protein foods
B) Whole grains and high-fiber foods
C) Lean meats
D) Fluid intake greater than 2 liters daily

 

A nurse is caring for a patient post-operatively following a gastric bypass. The patient is at risk for which of the following?

A) Anemia
B) Hyperglycemia
C) Hypertension
D) Hyperkalemia

A client with a history of gastric ulcers is receiving proton pump inhibitors (PPIs). The nurse should monitor the patient for which potential side effect?

A) Hypercalcemia
B) Hyperkalemia
C) Hypomagnesemia
D) Hypoglycemia

A patient with a hernia is being discharged. Which instruction should the nurse include in the teaching plan?

A) Avoid lifting heavy objects
B) Limit fluid intake
C) Engage in strenuous physical activity
D) Avoid wearing tight clothing

Which of the following is the most likely cause of non-viral hepatitis?

A) Alcohol abuse
B) Eating contaminated food
C) Exposure to contaminated water
D) Family history of liver disease

The nurse is caring for a patient with a nasogastric tube for gastric decompression. Which of the following should the nurse assess for?

A) Increased bowel sounds
B) Painful swallowing
C) Fluid overload
D) Respiratory distress

Which of the following interventions should the nurse implement for a patient diagnosed with gastric cancer?

A) Encourage a high-fat, low-fiber diet
B) Provide antacids regularly
C) Administer pain medication as prescribed
D) Restrict fluids during meals

A patient is being evaluated for a suspected gastrointestinal bleed. Which of the following findings would be most concerning?

A) Hematemesis
B) Weight gain
C) Increased appetite
D) Abdominal bloating

A nurse is teaching a patient about managing chronic constipation. Which of the following should be included in the teaching plan?

A) Avoid consuming fiber-rich foods
B) Drink plenty of fluids
C) Limit exercise
D) Take laxatives daily

A patient has been diagnosed with a small bowel obstruction. Which of the following is a typical sign of this condition?

A) Hyperactive bowel sounds
B) Absence of bowel sounds
C) Abdominal distension
D) Rapid weight loss

Which of the following is a typical symptom of colorectal cancer?

A) Weight loss
B) Chest pain
C) Increased thirst
D) Night sweats

A nurse is educating a patient on hepatitis A prevention. Which of the following should the nurse recommend?

A) Regular handwashing
B) Smoking cessation
C) Restricting alcohol use
D) Daily vitamin C intake

A patient with diverticulitis is being treated with antibiotics. Which of the following should the nurse monitor for?

A) Hypoglycemia
B) Gastrointestinal bleeding
C) Hypercalcemia
D) Severe dehydration

 

A patient presents with severe epigastric pain that is aggravated by eating. Which of the following conditions is most likely?

A) Gastroesophageal reflux disease (GERD)
B) Peptic ulcer disease
C) Irritable bowel syndrome (IBS)
D) Gallstones

32. The nurse is caring for a patient with a gastric ulcer. Which of the following should the nurse instruct the patient to avoid?

A) Foods high in protein
B) Antacids
C) Alcohol
D) Frequent small meals

33. A patient with a history of alcohol abuse is admitted with ascites. The nurse should monitor for which of the following complications?

A) Liver failure
B) Hypokalemia
C) Acute renal failure
D) Bowel obstruction

34. A nurse is educating a patient about the proper care of a colostomy. Which of the following should the nurse include in the teaching plan?

A) Avoid all types of fiber
B) Apply the ostomy bag tightly to prevent leaks
C) Clean the skin around the stoma with soap and water
D) Change the ostomy bag every 48 hours

35. A patient is diagnosed with cirrhosis. The nurse would expect to assess which of the following findings?

A) Hepatomegaly
B) Hypoglycemia
C) Bradycardia
D) Weight gain

36. A client with a history of Crohn’s disease is admitted with acute symptoms. Which of the following interventions should the nurse prioritize?

A) Encourage oral intake of high-fiber foods
B) Assess for dehydration
C) Promote regular exercise
D) Administer a low-protein diet

37. A nurse is assessing a patient with a possible diagnosis of appendicitis. Which of the following findings would be most concerning?

A) Tenderness in the right upper quadrant
B) Positive rebound tenderness in the lower right quadrant
C) Fever and chills
D) Persistent nausea and vomiting

38. A patient with chronic hepatitis B is scheduled for a liver biopsy. The nurse should instruct the patient to:

A) Fast for 12 hours before the procedure
B) Lie flat for 12 hours after the procedure
C) Take aspirin to prevent bleeding
D) Limit fluid intake the day before the procedure

39. A patient is receiving lactulose for hepatic encephalopathy. The nurse should monitor the patient for which of the following?

A) Hyperglycemia
B) Diarrhea
C) Hypertension
D) Hyperkalemia

40. A patient with a history of peptic ulcer disease is prescribed a proton pump inhibitor (PPI). The nurse should explain that PPIs work by:

A) Increasing gastric acid production
B) Neutralizing gastric acid
C) Blocking acid production
D) Stimulating mucosal healing

41. The nurse is caring for a patient after a total gastrectomy. Which of the following complications is the patient at risk for?

A) Gastric reflux
B) Iron deficiency anemia
C) Hypertension
D) Obesity

42. A client with a history of diverticulosis is hospitalized for diverticulitis. Which of the following interventions is appropriate?

A) Encourage the patient to eat a high-fiber diet
B) Provide a clear liquid diet initially
C) Restrict fluids
D) Administer anti-diarrheal medications

43. A patient who is recovering from a cholecystectomy is experiencing bloating and discomfort. Which of the following interventions should the nurse implement?

A) Encourage the patient to consume high-fat meals
B) Avoid dairy products for a short time
C) Increase fluid intake to promote bile production
D) Administer pain medication before meals

44. A patient presents with abdominal pain, bloating, and irregular bowel movements. The nurse suspects irritable bowel syndrome (IBS). Which of the following is a typical characteristic of IBS?

A) Abdominal pain that is relieved after bowel movements
B) Pain associated with fever and vomiting
C) Sudden weight loss
D) Continuous, severe abdominal pain

45. A nurse is caring for a patient with a diagnosis of colorectal cancer. Which of the following is the most important aspect of post-operative care?

A) Monitoring for signs of infection
B) Encouraging high-fiber foods
C) Teaching the patient about chemotherapy
D) Restricting fluid intake to prevent bowel distention

46. A nurse is caring for a patient with a suspected bowel obstruction. Which of the following findings is most consistent with this condition?

A) Hyperactive bowel sounds
B) Abdominal distension with absent bowel sounds
C) Bradycardia
D) Fever

47. A patient with cirrhosis is at risk for bleeding due to the reduced synthesis of which of the following substances?

A) Albumin
B) Antidiuretic hormone (ADH)
C) Coagulation factors
D) Vitamin D

48. The nurse is teaching a patient with gastroesophageal reflux disease (GERD) about lifestyle changes. Which of the following recommendations should the nurse make?

A) Eat large meals before bedtime
B) Sleep with the head of the bed elevated
C) Drink caffeinated beverages throughout the day
D) Lie down immediately after eating

49. A patient with a history of alcohol abuse is diagnosed with pancreatitis. Which of the following laboratory results is most indicative of this condition?

A) Elevated liver enzymes
B) Elevated amylase and lipase
C) Low platelet count
D) Elevated potassium levels

50. A nurse is caring for a patient with a diagnosis of hepatitis C. Which of the following should be included in the patient’s teaching plan?

A) Hepatitis C is curable with antibiotics
B) Hepatitis C can be transmitted through sexual contact
C) Hepatitis C can only be transmitted through blood transfusions
D) The patient should avoid alcohol to reduce liver damage

51. A patient with a history of chronic constipation is advised to increase fiber in their diet. Which of the following foods should the nurse recommend?

A) White rice
B) Whole grain bread
C) Cheese
D) Red meat

52. The nurse is caring for a patient with jaundice. Which of the following laboratory findings would the nurse expect to see?

A) Decreased bilirubin levels
B) Elevated liver enzymes
C) Decreased white blood cell count
D) Elevated albumin levels

53. A patient is receiving chemotherapy for colon cancer and is at risk for mucositis. Which of the following interventions should the nurse implement?

A) Encourage the use of mouthwash containing alcohol
B) Provide ice chips to soothe the mouth
C) Offer spicy, acidic foods to promote healing
D) Instruct the patient to avoid oral hygiene

54. A patient is diagnosed with a duodenal ulcer. Which of the following interventions is appropriate for the nurse to implement?

A) Encourage the patient to take aspirin to relieve pain
B) Instruct the patient to eat three large meals a day
C) Provide small, frequent meals to reduce irritation
D) Administer antacids before meals

55. A nurse is caring for a patient with a small bowel obstruction. Which of the following interventions is a priority?

A) Encouraging deep breathing exercises
B) Administering pain medications as prescribed
C) Maintaining an NPO status
D) Starting IV fluids

56. The nurse is caring for a patient with chronic liver disease. Which of the following complications should the nurse monitor for?

A) Hyperthyroidism
B) Hepatic encephalopathy
C) Hypoglycemia
D) Polycythemia

57. A patient is being treated for gastroenteritis. Which of the following is the priority nursing action?

A) Administer antiemetics as prescribed
B) Monitor vital signs for signs of dehydration
C) Encourage the patient to drink milk
D) Restrict oral intake for 48 hours

58. A patient is diagnosed with a hernia. Which of the following instructions should the nurse provide to the patient postoperatively?

A) Engage in heavy lifting within the first week
B) Avoid coughing and straining
C) Consume a low-protein diet
D) Keep the incision site dry for 24 hours

59. A nurse is caring for a patient with a history of diverticulosis. Which of the following should the nurse advise the patient to avoid?

A) Fiber-rich foods
B) Foods with seeds and nuts
C) Lean meats
D) Whole grains

60. A patient is recovering from a gastric bypass surgery. Which of the following complications should the nurse monitor for?

A) Hypertension
B) Nutritional deficiencies
C) Hyperglycemia
D) Dehydration

 

61. A nurse is caring for a patient with acute pancreatitis. Which of the following laboratory results would the nurse expect to see elevated?

A) White blood cell count
B) Serum amylase and lipase
C) Serum sodium
D) Platelets

62. A patient presents with a sudden onset of severe abdominal pain, nausea, and vomiting. The nurse suspects peritonitis. Which of the following signs would confirm this diagnosis?

A) Abdominal rigidity and rebound tenderness
B) Increased bowel sounds
C) Dull, diffuse abdominal pain
D) Positive Murphy’s sign

63. A patient with ulcerative colitis is experiencing an acute flare-up. Which of the following interventions should the nurse prioritize?

A) Administering corticosteroids as prescribed
B) Encouraging high-fiber foods to reduce irritation
C) Promoting frequent bowel movements
D) Restricting fluid intake

64. A nurse is teaching a patient with peptic ulcer disease (PUD) about the use of proton pump inhibitors (PPIs). Which of the following is the most important teaching point?

A) Take the medication with food to enhance absorption
B) The medication should be taken 30 minutes before meals
C) Proton pump inhibitors should be stopped immediately once symptoms improve
D) The medication can be taken at any time during the day

65. The nurse is providing discharge teaching to a patient who has undergone a gastrectomy. Which of the following instructions should the nurse include?

A) The patient should take iron supplements as prescribed
B) It is safe to resume normal eating habits within 2 weeks
C) A high-fiber diet is recommended for the first few months
D) The patient should avoid all forms of exercise for 6 months

66. A patient with liver cirrhosis is experiencing pruritus. Which of the following interventions should the nurse implement?

A) Apply lotions containing alcohol to the skin
B) Use warm water when bathing to avoid skin dryness
C) Provide the patient with a high-protein diet
D) Encourage the patient to scratch the affected areas to relieve itching

67. A patient with a history of gastroesophageal reflux disease (GERD) is experiencing worsening symptoms. Which of the following actions should the nurse suggest?

A) Elevate the head of the bed while sleeping
B) Eat three large meals a day
C) Lie down immediately after meals to improve digestion
D) Drink caffeinated beverages to help with digestion

68. The nurse is caring for a patient with an ileostomy. Which of the following complications should the nurse monitor for?

A) Dehydration
B) Hypokalemia
C) Hypertension
D) Respiratory distress

69. A patient with celiac disease is planning to travel abroad. Which of the following foods should the nurse advise the patient to avoid during their travels?

A) Rice
B) Wheat-based pasta
C) Potatoes
D) Fresh fruits and vegetables

70. A nurse is assessing a patient with a history of diverticulitis. Which of the following findings would be most concerning?

A) Abdominal distension and tenderness in the lower left quadrant
B) Decreased bowel sounds
C) Complaints of occasional bloating and flatulence
D) Frequent diarrhea without abdominal discomfort

71. A patient who underwent a liver transplant is taking immunosuppressive medications. Which of the following is the highest priority for the nurse to monitor?

A) Blood glucose levels
B) White blood cell count
C) Blood pressure
D) Urine output

72. A nurse is caring for a patient with chronic pancreatitis. The patient is at risk for which of the following complications?

A) Peptic ulcer disease
B) Hepatitis
C) Hyperglycemia
D) Cholecystitis

73. A nurse is teaching a patient with a history of gallstones about the prevention of gallbladder disease. Which of the following dietary recommendations should the nurse make?

A) Increase intake of saturated fats
B) Eat low-fat meals and avoid fried foods
C) Drink full-fat milk
D) Avoid fiber-rich foods

74. A patient with cirrhosis is being assessed for encephalopathy. Which of the following findings is most consistent with hepatic encephalopathy?

A) Confusion and disorientation
B) Decreased urine output
C) Increased bilirubin levels
D) Elevated red blood cell count

75. A patient is admitted with a suspected bowel perforation. Which of the following is the most appropriate nursing intervention?

A) Administer intravenous (IV) antibiotics as ordered
B) Encourage oral fluids to maintain hydration
C) Prepare the patient for abdominal surgery
D) Provide the patient with a high-protein diet

76. A nurse is caring for a patient with malabsorption syndrome. Which of the following interventions is a priority?

A) Providing a high-carbohydrate diet
B) Administering vitamin and mineral supplements
C) Encouraging the patient to eat high-protein foods
D) Limiting the patient’s fluid intake

77. A patient with ulcerative colitis is receiving immunosuppressive therapy. The nurse should instruct the patient to:

A) Avoid large crowds to reduce the risk of infection
B) Eat raw fruits and vegetables to increase fiber intake
C) Discontinue the medication if symptoms improve
D) Increase fluid intake to promote healing

78. The nurse is teaching a patient with irritable bowel syndrome (IBS) about dietary management. Which of the following foods should the nurse recommend?

A) Spicy foods
B) High-fat foods
C) Low-residue foods
D) Low-fiber foods

79. A nurse is caring for a patient with a history of Crohn’s disease who presents with a flare-up. Which of the following interventions should the nurse prioritize?

A) Administering antidiarrheal medications
B) Promoting high-fiber foods to reduce symptoms
C) Encouraging fluid intake and monitoring electrolytes
D) Providing frequent meals to reduce weight loss

80. A patient with a history of gallbladder disease is undergoing an ultrasound. The nurse should expect to find which of the following if the patient has cholecystitis?

A) Hypoactive bowel sounds
B) Distended gallbladder with stones
C) Thin, transparent bile
D) Normal-sized liver

81. A nurse is caring for a patient with cirrhosis who is at risk for spontaneous bacterial peritonitis. Which of the following symptoms should the nurse monitor for?

A) Fever and abdominal pain
B) Jaundice and increased appetite
C) Increased urine output and fatigue
D) Nausea and decreased bowel sounds

82. A patient with a duodenal ulcer asks why they are prescribed a histamine-2 blocker. The nurse’s best response is:

A) “The medication helps to neutralize stomach acid.”
B) “The medication helps to block acid production.”
C) “The medication helps to coat the ulcer and promote healing.”
D) “The medication helps to reduce the production of bile.”

83. A patient is recovering from a cholecystectomy. Which of the following is a priority nursing assessment in the immediate postoperative period?

A) Assessing for signs of infection at the incision site
B) Monitoring for signs of bleeding or bile leakage
C) Encouraging early ambulation to prevent blood clots
D) Instructing the patient to follow a low-fat diet

84. A nurse is providing discharge teaching for a patient with a new diagnosis of colorectal cancer. Which of the following is the most important aspect of post-operative care?

A) Increasing fiber intake to prevent constipation
B) Monitoring for signs of an infection or fever
C) Restricting fluid intake to prevent bowel distension
D) Engaging in light physical activities immediately

85. A patient with hepatitis B is being discharged. Which of the following should the nurse include in the teaching plan?

A) Hepatitis B is highly contagious and can be spread through sexual contact
B) The patient can safely drink alcohol in moderation
C) The patient should avoid using all over-the-counter medications
D) Hepatitis B is self-limiting and does not require treatment

86. A nurse is caring for a patient who is at risk for gastrointestinal bleeding. Which of the following findings would be most concerning?

A) Decreased blood pressure and increased heart rate
B) Mild abdominal cramping
C) Occasional nausea without vomiting
D) Occasional flatulence

87. A patient with esophageal varices is at risk for rupture. Which of the following interventions should the nurse implement?

A) Administering intravenous fluids as ordered
B) Limiting oral intake to small amounts of clear liquids
C) Applying a pressure dressing to the abdomen
D) Encouraging the patient to cough frequently

 

88. A nurse is caring for a patient who has been diagnosed with Crohn’s disease. Which of the following symptoms should the nurse expect the patient to exhibit during a flare-up?

A) Bloody diarrhea and rectal bleeding
B) Chronic abdominal pain and weight loss
C) Severe bloating and flatulence
D) Nausea and vomiting only

89. A nurse is caring for a patient with a history of gastroesophageal reflux disease (GERD) who is taking a proton pump inhibitor (PPI). Which of the following instructions should the nurse provide to the patient regarding the medication?

A) Take the medication after meals to help with digestion
B) Take the medication 30 minutes before meals for optimal effectiveness
C) Take the medication at bedtime to prevent acid reflux
D) Discontinue the medication once symptoms resolve

90. A patient presents with right upper quadrant pain, jaundice, and dark urine. The nurse suspects a diagnosis of hepatitis. Which of the following laboratory tests should the nurse expect to be elevated in this condition?

A) Blood glucose
B) Bilirubin
C) Creatinine
D) Hemoglobin

91. A nurse is caring for a patient who is recovering from a colectomy. Which of the following signs would indicate a possible complication that requires immediate intervention?

A) Decreased bowel sounds
B) Absence of bowel movement or flatus for 48 hours
C) Low-grade fever and mild abdominal discomfort
D) Increased appetite and thirst

92. A patient with cirrhosis is at risk for developing ascites. Which of the following is the most appropriate nursing intervention to prevent fluid accumulation?

A) Restrict fluid intake to less than 1 liter per day
B) Administer diuretics as prescribed and monitor electrolytes
C) Provide high-protein meals to increase albumin levels
D) Encourage frequent ambulation to promote fluid movement

93. A patient is experiencing a gastrointestinal bleed and is receiving an endoscopic procedure for treatment. The nurse should monitor for which of the following complications post-procedure?

A) Hypotension and tachycardia
B) Hypothermia and cold extremities
C) Hyperthermia and chills
D) Increased bowel sounds and fever

94. A nurse is teaching a patient with diverticulosis about dietary management. Which of the following foods should the nurse recommend?

A) High-fiber foods such as whole grains, fruits, and vegetables
B) Fried foods and processed meats
C) Foods high in sugar and simple carbohydrates
D) Low-residue foods like white bread and cheese

95. A nurse is caring for a patient who has been diagnosed with colorectal cancer and is preparing for surgery. Which of the following actions should the nurse prioritize in the preoperative period?

A) Instructing the patient on post-surgical pain management
B) Ensuring the patient has an understanding of chemotherapy treatment
C) Ensuring that informed consent for surgery has been obtained
D) Encouraging the patient to avoid all food and fluids until after the procedure

96. A nurse is caring for a patient with acute pancreatitis. Which of the following should the nurse avoid when planning care?

A) Encouraging early oral intake
B) Providing pain relief with prescribed analgesics
C) Monitoring for signs of infection
D) Administering intravenous fluids as prescribed

97. A nurse is caring for a patient with a diagnosis of peptic ulcer disease (PUD) who is taking an antacid. The nurse should instruct the patient to:

A) Take the antacid immediately after meals to neutralize acid
B) Avoid taking the antacid on an empty stomach
C) Take the antacid 1 hour before meals to reduce stomach acid
D) Take the antacid with food to enhance absorption

98. A nurse is caring for a patient with a history of chronic hepatitis C. Which of the following is most important to assess in the patient’s health history?

A) Risk for liver failure due to cirrhosis
B) Risk of transmission through bloodborne pathogens
C) History of alcohol use to assess for liver damage
D) History of frequent upper respiratory infections

99. A nurse is teaching a patient with a new diagnosis of irritable bowel syndrome (IBS). Which of the following statements indicates the patient understands the teaching?

A) “I should avoid foods that contain gluten.”
B) “I need to eat meals at regular times every day.”
C) “I should reduce my intake of fiber to relieve symptoms.”
D) “I need to increase my intake of dairy products.”

100. A nurse is caring for a patient who has been diagnosed with hepatitis A. The nurse should teach the patient to:

A) Avoid contact with others to prevent transmission
B) Take acetaminophen as needed for pain relief
C) Engage in regular exercise to promote liver function
D) Consume a high-fat diet to prevent weight loss

101. A nurse is caring for a patient with a suspected gastrointestinal obstruction. Which of the following is the priority nursing action?

A) Administering prescribed pain medication
B) Assessing for signs of bowel perforation
C) Encouraging the patient to ambulate frequently
D) Increasing the patient’s oral fluid intake

102. A nurse is caring for a patient who has been diagnosed with a gastric ulcer. Which of the following symptoms should the nurse expect the patient to report?

A) Severe burning pain 1-2 hours after eating
B) Colicky abdominal pain that improves after eating
C) Abdominal bloating and a sense of fullness
D) Nausea and vomiting without abdominal pain

103. A nurse is caring for a patient with a diagnosis of irritable bowel disease (IBD). Which of the following interventions should the nurse prioritize for a patient with an active flare-up?

A) Administering corticosteroids as prescribed
B) Encouraging the patient to engage in physical activity
C) Providing high-fiber foods to relieve symptoms
D) Reducing fluid intake to minimize diarrhea

104. A patient with ascites due to liver cirrhosis is admitted to the hospital. Which of the following interventions should the nurse expect to implement?

A) Restrict sodium intake and administer diuretics as prescribed
B) Encourage a high-protein diet and administer iron supplements
C) Restrict fluid intake and administer potassium-sparing diuretics
D) Administer pain medications and increase fluid intake

105. A nurse is providing discharge instructions to a patient with peptic ulcer disease (PUD). Which of the following should the nurse include in the teaching plan?

A) “It is important to avoid eating spicy foods.”
B) “You should eat small, frequent meals to reduce gastric irritation.”
C) “You should avoid taking proton pump inhibitors long-term.”
D) “It is safe to drink alcohol in moderation once symptoms improve.

 

106. A nurse is caring for a patient with cirrhosis. Which of the following interventions is a priority for this patient?

A) Monitoring for signs of gastrointestinal bleeding
B) Encouraging high-fat foods to prevent malnutrition
C) Administering opioids as prescribed for pain relief
D) Encouraging physical activity to improve liver function

107. A nurse is caring for a patient with a history of chronic gastritis. The patient is receiving a proton pump inhibitor (PPI). The nurse should monitor the patient for which potential side effect?

A) Hyperkalemia
B) Osteoporosis
C) Hyperglycemia
D) Hypertension

108. A nurse is caring for a patient with acute gastroenteritis. The patient is experiencing dehydration. Which of the following is the most important intervention for this patient?

A) Administering antidiarrheal medications
B) Encouraging high-protein, solid foods
C) Administering oral rehydration solutions
D) Restricting oral intake to clear liquids

109. A patient is receiving a blood transfusion after a diagnosis of acute gastrointestinal bleeding. The nurse should monitor for which of the following signs of a transfusion reaction?

A) Increased blood pressure and decreased heart rate
B) Hemoptysis and crackles in the lungs
C) Fever, chills, and back pain
D) Decreased urine output and abdominal bloating

110. A nurse is caring for a patient with a history of gastroesophageal reflux disease (GERD) who reports heartburn. Which of the following instructions should the nurse provide to the patient?

A) “Lie down immediately after meals to relieve symptoms.”
B) “Eat large meals and avoid snacks to reduce reflux.”
C) “Wear tight-fitting clothing to improve digestion.”
D) “Avoid eating within 2-3 hours before bedtime.”

111. A nurse is caring for a patient with a diagnosis of appendicitis. Which of the following findings would indicate that the patient’s condition is worsening and may require emergency intervention?

A) Decreased appetite and low-grade fever
B) Sudden relief of abdominal pain followed by increased pain
C) Tenderness in the left lower quadrant of the abdomen
D) Gradual increase in pain with mild nausea

112. A nurse is caring for a patient with a diagnosis of cholecystitis. The nurse should assess the patient for which of the following symptoms?

A) Severe epigastric pain radiating to the left shoulder
B) Severe right upper quadrant pain that worsens after eating fatty foods
C) Diarrhea and weight loss
D) Yellowing of the skin and sclera with fever

113. A nurse is teaching a patient with irritable bowel syndrome (IBS) about dietary changes. Which of the following should the nurse recommend to the patient?

A) High-fat, low-fiber foods
B) Low-residue, bland foods
C) High-fiber foods such as fruits and vegetables
D) High-protein, low-carbohydrate foods

114. A nurse is assessing a patient with a diagnosis of acute pancreatitis. Which of the following findings would the nurse expect to find during the assessment?

A) Decreased blood pressure and increased heart rate
B) Decreased abdominal tenderness and increased bowel sounds
C) Severe epigastric pain that radiates to the back
D) Abdominal distention with firm, non-tender abdomen

115. A nurse is caring for a patient with a diagnosis of diverticulitis. Which of the following interventions is most appropriate to prevent complications?

A) Encouraging a high-fiber diet
B) Administering antibiotics as prescribed
C) Promoting bed rest to reduce abdominal strain
D) Encouraging the patient to avoid fluid intake to reduce bowel movement

116. A nurse is caring for a patient with a diagnosis of colon cancer. Which of the following is a priority nursing intervention post-surgery?

A) Encouraging deep breathing exercises to prevent pneumonia
B) Monitoring for signs of wound infection and dehiscence
C) Encouraging early oral intake of solid foods
D) Administering analgesics as prescribed for pain management

117. A nurse is assessing a patient with a diagnosis of hepatitis B. Which of the following interventions should be included in the care plan?

A) Encourage the patient to drink large amounts of fluids
B) Limit the patient’s activity to prevent liver strain
C) Encourage the patient to abstain from alcohol to prevent liver damage
D) Provide a high-fat diet to improve liver function

118. A nurse is caring for a patient with a diagnosis of cirrhosis and ascites. Which of the following laboratory findings is most likely to be present?

A) Increased bilirubin levels
B) Decreased prothrombin time
C) Increased albumin levels
D) Decreased serum ammonia levels

119. A patient with a history of peptic ulcer disease (PUD) is experiencing a sudden onset of severe upper abdominal pain. The nurse should assess the patient for which of the following complications?

A) Gastric perforation
B) Gastrointestinal bleeding
C) Pancreatitis
D) Acute appendicitis

120. A nurse is caring for a patient with a diagnosis of gastroesophageal reflux disease (GERD) who is being prescribed omeprazole. The nurse should instruct the patient to:

A) Take the medication immediately before meals
B) Take the medication after meals to avoid reflux
C) Take the medication at bedtime to prevent symptoms
D) Take the medication 30 minutes before meals for optimal absorption

 

121. A nurse is caring for a patient with a history of Crohn’s disease. Which of the following interventions is most important to prevent complications?

A) Encourage a low-fiber, low-residue diet
B) Promote increased fluid intake to prevent dehydration
C) Administer immunosuppressive drugs as prescribed
D) Encourage the patient to engage in strenuous physical activity

122. A nurse is teaching a patient about a low-fat diet following a diagnosis of gallbladder disease. Which of the following foods should the nurse recommend avoiding?

A) Fresh fruits and vegetables
B) Whole-grain bread
C) Fried chicken
D) Skim milk

123. A nurse is caring for a patient with a suspected bowel obstruction. Which of the following symptoms would be most indicative of this condition?

A) Severe, crampy abdominal pain and vomiting
B) Steady, dull abdominal pain and mild fever
C) Abdominal distention with absent bowel sounds
D) Mild, intermittent pain and diarrhea

124. A nurse is caring for a patient who has undergone a colonoscopy. Which of the following should the nurse monitor for post-procedure?

A) Presence of abdominal pain or cramping
B) Urinary retention
C) Bowel incontinence
D) Elevated white blood cell count

125. A nurse is caring for a patient with a diagnosis of hepatitis C. The nurse should educate the patient about the importance of which of the following?

A) Getting a yearly influenza vaccine
B) Avoiding alcohol consumption
C) Engaging in regular exercise
D) Using herbal supplements to boost immunity

126. A nurse is assessing a patient with a diagnosis of ulcerative colitis. Which of the following laboratory findings would the nurse expect to see?

A) Elevated hemoglobin levels
B) Increased white blood cell count
C) Decreased serum bilirubin levels
D) Elevated calcium levels

127. A nurse is caring for a patient with diverticulitis. Which of the following should the nurse encourage the patient to avoid?

A) A low-fiber diet
B) Laxatives and enemas
C) Drinking clear liquids only
D) Resting in bed to reduce abdominal strain

128. A nurse is caring for a patient with cirrhosis who has developed hepatic encephalopathy. The nurse should assess the patient for which of the following symptoms?

A) Tremors and confusion
B) Increased appetite and weight gain
C) Severe pain in the right upper quadrant
D) Decreased urine output and dark urine

129. A nurse is caring for a patient with a diagnosis of pancreatitis. Which of the following actions is most appropriate in the early stages of pancreatitis?

A) Encourage oral intake of clear liquids
B) Administer opioid pain medication as prescribed
C) Promote ambulation to reduce complications
D) Restrict all food and fluids for bowel rest

130. A nurse is teaching a patient with gastroesophageal reflux disease (GERD) about lifestyle modifications. Which of the following statements indicates the patient understands the teaching?

A) “I should lie down immediately after meals to promote digestion.”
B) “I will eat three large meals a day to prevent reflux.”
C) “I will avoid wearing tight-fitting clothes around my waist.”
D) “I will drink large amounts of fluids with my meals.”

131. A nurse is caring for a patient who is recovering from a cholecystectomy. Which of the following is an expected finding postoperatively?

A) Bile in the urine
B) Increased abdominal tenderness and distention
C) Yellowing of the skin and sclera
D) Decreased bowel sounds

132. A nurse is preparing to discharge a patient after an appendectomy. Which of the following instructions should the nurse include?

A) “You may resume a regular diet immediately after discharge.”
B) “Take a warm bath and avoid showering for two weeks.”
C) “Report any fever or increased abdominal pain to your provider.”
D) “Avoid walking for the next week to promote healing.”

133. A nurse is assessing a patient with celiac disease. The nurse should instruct the patient to avoid which of the following foods?

A) Rye bread
B) Rice cakes
C) Oatmeal
D) Potatoes

134. A nurse is teaching a patient about colorectal cancer prevention. Which of the following should the nurse recommend to the patient?

A) Limiting intake of fiber-rich foods
B) Increasing intake of red meat and processed foods
C) Undergoing regular screening colonoscopies
D) Avoiding fruits and vegetables

135. A nurse is caring for a patient with a history of gastric ulcers. Which of the following medications is most commonly prescribed to treat this condition?

A) Proton pump inhibitors (PPIs)
B) Antihistamines
C) Antibiotics
D) Anticholinergics

136. A nurse is assessing a patient with a diagnosis of peptic ulcer disease. Which of the following symptoms would be most concerning for a potential complication?

A) Occasional heartburn
B) Mild abdominal discomfort after eating
C) Sudden, severe abdominal pain with guarding
D) Nausea that improves with vomiting

137. A nurse is teaching a patient about the use of lactulose for the treatment of hepatic encephalopathy. Which of the following statements should the nurse include in the teaching?

A) “Lactulose will cause diarrhea to help reduce ammonia levels.”
B) “Lactulose should be taken on an empty stomach to increase absorption.”
C) “You should avoid taking lactulose if you develop constipation.”
D) “Lactulose will help reduce swelling in your legs and abdomen.”

138. A nurse is caring for a patient with a history of irritable bowel syndrome (IBS). Which of the following dietary recommendations is most appropriate for this patient?

A) Limit caffeine and alcohol intake
B) Increase intake of red meat
C) Avoid fiber-rich foods
D) Encourage frequent high-fat meals

139. A nurse is assessing a patient with a diagnosis of cirrhosis. Which of the following findings is most indicative of portal hypertension?

A) Splenomegaly
B) Hyperkalemia
C) Elevated white blood cell count
D) Decreased albumin levels

140. A nurse is teaching a patient who has had a gastrectomy. Which of the following statements by the patient indicates a need for further teaching?

A) “I will eat small, frequent meals.”
B) “I will avoid drinking liquids with my meals.”
C) “I will follow a low-protein, high-carbohydrate diet.”
D) “I will take vitamin B12 supplements as prescribed.”

 

141. A nurse is caring for a patient with a diagnosis of acute cholecystitis. Which of the following is a common symptom of this condition?

A) Severe right upper quadrant pain radiating to the back
B) Nausea and vomiting without fever
C) Pain relieved by eating
D) Yellowing of the sclera and skin

142. A nurse is caring for a patient with a history of diverticulosis. The nurse should instruct the patient to avoid which of the following foods to prevent complications?

A) Whole grain bread
B) Fresh fruits and vegetables
C) Popcorn and nuts
D) Low-fat dairy products

143. A nurse is caring for a patient with hepatitis B. The nurse should inform the patient about the importance of which of the following?

A) Receiving a flu vaccine
B) Avoiding excessive alcohol consumption
C) Using aspirin for pain management
D) Engaging in strenuous exercise

144. A nurse is caring for a patient who has undergone a colectomy. Which of the following is a priority intervention postoperatively?

A) Encouraging the patient to drink large amounts of water
B) Monitoring for signs of infection at the surgical site
C) Encouraging deep breathing and coughing exercises
D) Promoting a high-fiber diet to promote bowel movement

145. A nurse is caring for a patient with gastric cancer who is scheduled for surgery. Which of the following should the nurse include in the preoperative teaching?

A) The patient may need to make dietary changes after surgery.
B) The patient will need to avoid liquids for 24 hours after surgery.
C) The patient will be placed on a clear liquid diet for life.
D) The patient will be required to use a nasogastric tube for several weeks postoperatively.

146. A nurse is caring for a patient with acute pancreatitis. Which of the following is the priority nursing intervention for this patient?

A) Monitor for signs of gastrointestinal bleeding
B) Administer prescribed pain medications as ordered
C) Encourage oral fluid intake
D) Promote ambulation and early mobilization

147. A nurse is caring for a patient with a diagnosis of cirrhosis and ascites. Which of the following should the nurse include in the patient’s care plan?

A) Monitor for decreased abdominal girth
B) Encourage a low-sodium diet
C) Restrict fluid intake to prevent dehydration
D) Increase protein intake to promote liver healing

148. A nurse is caring for a patient with a diagnosis of peptic ulcer disease. Which of the following medications should the nurse anticipate the provider to prescribe to treat this condition?

A) Histamine-2 receptor antagonists
B) Diuretics
C) Antihypertensive medications
D) Beta-blockers

149. A nurse is teaching a patient with irritable bowel syndrome (IBS) about dietary modifications. Which of the following foods should the nurse advise the patient to avoid?

A) Low-fat dairy
B) High-fiber fruits
C) Fatty foods and caffeine
D) Whole-grain products

150. A nurse is teaching a patient who is recovering from a liver transplant. Which of the following instructions is most important?

A) Avoid large meals to prevent gastrointestinal discomfort
B) Follow a low-fat diet to reduce strain on the liver
C) Take immunosuppressive medications as prescribed
D) Avoid all forms of physical activity until further notice

151. A nurse is caring for a patient with Crohn’s disease. Which of the following complications should the nurse monitor for?

A) Electrolyte imbalances due to diarrhea
B) Increased risk of blood clots
C) Decreased risk for kidney stones
D) Elevated liver function tests

152. A nurse is teaching a patient who has undergone an esophagectomy about post-operative care. Which of the following should the nurse emphasize in the teaching?

A) The importance of consuming small, frequent meals
B) The need for a high-fiber diet to promote bowel movements
C) The patient should avoid all solid foods for six weeks
D) The need for routine colonoscopy screenings

153. A nurse is caring for a patient with a diagnosis of gastroesophageal reflux disease (GERD). Which of the following lifestyle modifications should the nurse recommend?

A) Encourage the patient to eat large meals before bedtime
B) Advise the patient to avoid lying down after eating
C) Recommend that the patient wear tight-fitting clothing to reduce reflux
D) Suggest that the patient increase caffeine and alcohol intake

154. A nurse is caring for a patient with a diagnosis of irritable bowel syndrome (IBS) who is experiencing constipation. Which of the following should the nurse recommend?

A) Increased intake of dietary fiber
B) Increased intake of caffeine and alcohol
C) Decreased intake of liquids
D) Avoidance of high-fiber foods

155. A nurse is caring for a patient with acute hepatitis. The nurse should prioritize which of the following?

A) Preventing complications from portal hypertension
B) Administering medications to manage pain
C) Monitoring liver function tests and jaundice
D) Encouraging frequent meals to increase caloric intake

156. A nurse is caring for a patient with cirrhosis who has developed spontaneous bacterial peritonitis (SBP). The nurse should anticipate the administration of which of the following medications?

A) Broad-spectrum antibiotics
B) Diuretics
C) Beta-blockers
D) Anticoagulants

157. A nurse is caring for a patient with a diagnosis of gastroenteritis. Which of the following is the most important to monitor for in this patient?

A) Dehydration due to vomiting and diarrhea
B) Increased appetite and weight gain
C) Elevated blood pressure
D) Signs of infection at the surgical site

158. A nurse is caring for a patient with a diagnosis of Crohn’s disease who is experiencing a flare-up. Which of the following interventions should the nurse prioritize?

A) Encourage a high-fiber diet to promote bowel movements
B) Administer corticosteroids as prescribed to reduce inflammation
C) Promote regular physical activity to reduce symptoms
D) Encourage the patient to eat three large meals a day

159. A nurse is teaching a patient with hepatitis C about the importance of regular screening for liver cancer. Which of the following is the best rationale for this recommendation?

A) Hepatitis C can lead to chronic liver inflammation, increasing the risk for liver cancer.
B) Hepatitis C causes an increase in liver enzymes, which increases the risk for liver cancer.
C) Hepatitis C directly damages the liver, causing cancerous cells to form.
D) Hepatitis C decreases bile production, increasing the likelihood of liver cancer.

160. A nurse is caring for a patient with a diagnosis of appendicitis. Which of the following interventions is a priority before the patient goes to surgery?

A) Apply heat to the abdomen to reduce pain
B) Administer analgesics as prescribed
C) Encourage the patient to eat a light meal to maintain strength
D) Avoid administering any fluids or food

Gastrointestinal Disorders NCLEX  Questions and Answers for Study Guide

 

Describe the pathophysiology, clinical manifestations, and nursing interventions for a patient with acute pancreatitis.

Answer:

Pathophysiology:

Acute pancreatitis is an inflammation of the pancreas caused by the premature activation of pancreatic enzymes. This can lead to autodigestion of the pancreas and surrounding tissues. Common causes include gallstones, alcohol abuse, and trauma. Enzymes such as amylase, lipase, and trypsin begin digesting the pancreas, causing inflammation, edema, and tissue damage.

Clinical Manifestations:

The patient may experience severe, sudden-onset epigastric pain that may radiate to the back, nausea, vomiting, fever, and abdominal distention. The pain often worsens after eating and is typically relieved by leaning forward or curling into a fetal position. Elevated levels of amylase and lipase are key diagnostic indicators.

Nursing Interventions:

  1. Pain management: Administer analgesics as prescribed (e.g., opioids) to relieve pain and promote comfort.
  2. Fluid and electrolyte balance: Monitor vital signs, intake and output, and lab values, including serum electrolytes, to assess for dehydration and electrolyte imbalances.
  3. Nutritional support: Withhold oral intake initially and progress to a clear liquid diet, followed by a low-fat, high-protein diet as tolerated. Provide intravenous fluids to maintain hydration.
  4. Patient education: Instruct the patient on the importance of avoiding alcohol, smoking, and high-fat meals in the future to reduce the risk of recurrent pancreatitis.

 

Explain the management and nursing interventions for a patient with cirrhosis and ascites.

Answer:

Pathophysiology of Cirrhosis and Ascites:

Cirrhosis is the advanced scarring of the liver tissue due to chronic liver disease, commonly caused by alcohol abuse, hepatitis, and fatty liver disease. Ascites is the accumulation of fluid in the peritoneal cavity, typically occurring as a complication of cirrhosis due to portal hypertension and hypoalbuminemia, which causes fluid retention and shift into the abdominal cavity.

Clinical Manifestations:

Common symptoms of cirrhosis include fatigue, jaundice, abdominal pain, weight loss, and spider angiomas. Ascites presents with visible abdominal distention, weight gain, and discomfort. The patient may also experience shortness of breath and a decrease in appetite.

Nursing Interventions:

  1. Fluid and Electrolyte Management:
    Monitor the patient’s fluid status, daily weight, and abdominal girth. Administer diuretics (such as spironolactone and furosemide) to help reduce fluid buildup.
  2. Abdominal Paracentesis:
    If ascites is severe, a paracentesis may be performed to remove excess fluid from the abdomen. Ensure the patient is positioned correctly and assist with the procedure as necessary.
  3. Monitor for Complications:
    Monitor for signs of bleeding (due to esophageal varices), confusion (due to hepatic encephalopathy), and infection. Keep track of lab results, particularly liver function tests and electrolyte levels.
  4. Patient Education:
    Teach the patient about the importance of a low-sodium diet to reduce fluid retention, the need for consistent medication adherence, and the avoidance of alcohol to prevent liver damage.

 

Discuss the nursing care for a patient with gastroesophageal reflux disease (GERD).

Answer:

Pathophysiology of GERD:

Gastroesophageal reflux disease (GERD) is a condition where stomach acid or bile irritates the esophagus, leading to symptoms such as heartburn, regurgitation, and chest pain. The lower esophageal sphincter (LES) becomes weak or relaxes inappropriately, allowing stomach contents to flow back into the esophagus.

Clinical Manifestations:
Patients with GERD may report a burning sensation in the chest (heartburn), a sour or bitter taste in the mouth (regurgitation), dysphagia, cough, and hoarseness. Severe cases may lead to esophageal ulcers or Barrett’s esophagus, which increases the risk for esophageal cancer.

Nursing Interventions:

  1. Medication Management:
    Administer proton pump inhibitors (PPIs) such as omeprazole, or H2 blockers like ranitidine, to decrease gastric acid production. Antacids may also be used for immediate relief.
  2. Lifestyle Modifications:
    Encourage the patient to avoid eating large meals, refrain from lying down after eating, and reduce the intake of acidic or spicy foods, caffeine, and alcohol. Advise the patient to lose weight if applicable and quit smoking, as both contribute to GERD symptoms.
  3. Positioning and Comfort:
    Advise the patient to elevate the head of the bed to prevent reflux while sleeping. Ensure they avoid tight-fitting clothing that may exacerbate symptoms.
  4. Patient Education:
    Teach the patient about the importance of adhering to medication regimens and making dietary changes. Instruct the patient to seek medical attention if they develop chest pain or difficulty swallowing, as these could indicate complications.

 

What are the nursing interventions for a patient with inflammatory bowel disease (IBD), specifically Crohn’s disease?

Answer:

Pathophysiology of Crohn’s Disease:

Crohn’s disease is a type of inflammatory bowel disease (IBD) that causes chronic inflammation anywhere in the gastrointestinal tract, most commonly in the ileum and colon. The inflammation leads to ulceration, abscess formation, and fistulae in severe cases. The exact cause is unknown, but it is believed to involve genetic, environmental, and immune factors.

Clinical Manifestations:

Patients with Crohn’s disease may experience symptoms such as abdominal pain, diarrhea (which may be bloody), fatigue, weight loss, fever, and malnutrition. The disease can also cause complications like fistulas, abscesses, and bowel perforation.

Nursing Interventions:

  1. Managing Symptoms and Inflammation:
    Administer corticosteroids or immunosuppressive drugs as prescribed to reduce inflammation and manage flare-ups. Ensure the patient receives adequate hydration and electrolyte replacement due to diarrhea and fluid loss.
  2. Nutritional Support:
    Provide a high-protein, low-residue diet to reduce irritation and promote healing. Consider a TPN (total parenteral nutrition) regimen if the patient is unable to meet nutritional needs through oral intake.
  3. Monitoring for Complications:
    Observe for signs of bowel obstruction, bleeding, or signs of infection (such as fever or elevated white blood cell count). Monitor lab values, especially hemoglobin and albumin levels, to assess for malnutrition and anemia.
  4. Psychosocial Support:
    Provide emotional support, as patients with Crohn’s disease may experience anxiety or depression due to the chronic nature of the disease. Offer education on stress management techniques and encourage participation in support groups.

 

What is the nursing care for a patient with peptic ulcer disease (PUD)?

Answer:

Pathophysiology of PUD:

Peptic ulcer disease (PUD) refers to sores that develop on the lining of the stomach or duodenum due to the erosion caused by gastric acid. The most common causes of PUD include infection with Helicobacter pylori (H. pylori) and the long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs). The ulceration leads to pain, bleeding, and potential perforation of the gastrointestinal wall.

Clinical Manifestations:

Symptoms of PUD include burning or gnawing pain in the epigastric area, often occurring after meals or during the night. The pain may be relieved by eating or taking antacids. Complications can include hemorrhage (vomiting blood or melena), perforation (sudden, sharp abdominal pain), and obstruction.

Nursing Interventions:

  1. Medications:
    Administer proton pump inhibitors (PPIs) such as omeprazole or histamine-2 receptor antagonists to reduce gastric acid production. Antibiotics should be prescribed if H. pylori infection is diagnosed.
  2. Pain Management:
    Provide pain relief with medications, including antacids or mucosal protectants like sucralfate, as prescribed. Monitor the patient for adequate pain relief and document any changes in pain intensity.
  3. Dietary Modifications:
    Advise the patient to avoid spicy foods, caffeine, alcohol, and smoking, as these can exacerbate symptoms. Encourage smaller, more frequent meals to avoid overproduction of gastric acid.
  4. Monitoring for Complications:
    Monitor for signs of gastrointestinal bleeding, such as black tarry stools or vomiting blood, and report immediately to the healthcare provider if these occur.

 

Discuss the nursing management for a patient with a gastrointestinal bleed.

Answer:

Pathophysiology:

Gastrointestinal bleeding refers to any hemorrhage that occurs within the gastrointestinal tract. It may result from conditions such as peptic ulcers, varices, Mallory-Weiss tears, diverticulosis, or esophageal or gastric cancers. GI bleeds can be classified as upper or lower based on their location in the gastrointestinal tract.

Clinical Manifestations:

The patient may present with hematemesis (vomiting blood), melena (black, tarry stools), or hematochezia (bright red blood in stools). Symptoms include hypotension, tachycardia, dizziness, weakness, and signs of shock in severe cases. The patient may also complain of abdominal pain depending on the underlying cause.

Nursing Interventions:

  1. Assessment and Monitoring:
    Quickly assess the patient’s vital signs, noting changes in blood pressure, heart rate, and respiratory rate. Establish baseline measurements for input and output, monitor hematocrit levels, and assess stool for occult blood.
  2. Fluid Resuscitation:
    Administer IV fluids such as normal saline or lactated Ringer’s to maintain circulatory volume. Blood products may be required for significant blood loss, including packed red blood cells or platelets.
  3. Medications:
    Administer proton pump inhibitors (PPIs) to reduce stomach acid production and H2 blockers for mild cases. Vasopressors such as octreotide may be used for variceal bleeding to decrease portal pressure.
  4. Endoscopic and Surgical Management:
    Monitor for endoscopic procedures that may be performed to control bleeding, such as banding of varices or cauterization of bleeding ulcers. Prepare the patient for possible surgery if bleeding cannot be controlled with endoscopy or medication.
  5. Patient Education:
    Instruct the patient on the importance of avoiding NSAIDs, alcohol, and smoking, as these may exacerbate conditions leading to gastrointestinal bleeding. Teach the patient to report any symptoms of recurrent bleeding, such as vomiting blood or dark, tarry stools.

 

Explain the nursing interventions for a patient with a large bowel obstruction.

Answer:

Pathophysiology:

A large bowel obstruction occurs when there is a blockage in the colon that prevents normal bowel movements. It can result from conditions such as colorectal cancer, diverticulitis, volvulus, or fecal impaction. This obstruction leads to the accumulation of gases and fluids above the site of obstruction, causing distention, pain, and an inability to pass stool or gas.

Clinical Manifestations:

The patient may present with symptoms of abdominal bloating, cramping, constipation, and vomiting. Physical examination may reveal a distended abdomen with high-pitched bowel sounds. In severe cases, signs of shock may develop, including tachycardia, hypotension, and fever.

Nursing Interventions:

  1. Assessment:
    Conduct thorough assessment of the patient’s abdominal symptoms, including abdominal girth, bowel sounds, and frequency of bowel movements. Evaluate vital signs for signs of dehydration, fever, or shock.
  2. IV Fluid and Electrolyte Management:
    Initiate IV fluids to prevent dehydration and correct electrolyte imbalances (e.g., hypokalemia). Monitor serum electrolytes regularly to avoid complications.
  3. Nasogastric Tube (NGT) Placement:
    Insert an NGT to decompress the stomach and reduce vomiting. Monitor the drainage from the tube and assess for any blood or unusual contents.
  4. Surgical Consultation and Preparation:
    Prepare the patient for possible surgical intervention, such as resection of the obstructed bowel. Provide preoperative teaching, including the need for bowel preparation and postoperative care.
  5. Pain and Comfort Management:
    Administer analgesics for pain management, ensuring that the medication does not mask symptoms of complications. Monitor for any signs of perforation, such as sudden sharp pain or peritonitis.

 

Describe the care of a patient undergoing a colonoscopy.

Answer:

Purpose of Procedure:

A colonoscopy is a diagnostic procedure used to visualize the interior of the colon and rectum, typically for screening purposes or to evaluate symptoms like chronic diarrhea, rectal bleeding, or unexplained weight loss. It is also used to remove polyps or take biopsies.

Pre-Procedure Nursing Care:

  1. Patient Education:
    Educate the patient about the procedure, including the need for bowel cleansing before the test. Explain that sedation will be provided to ensure comfort during the procedure.
  2. Bowel Preparation:
    Instruct the patient on the importance of following a clear liquid diet 24 hours before the procedure and taking prescribed bowel preparation solutions to ensure a clean colon for optimal visualization.
  3. Pre-procedural Assessment:
    Obtain baseline vital signs and assess for any contraindications to sedation. Review the patient’s medical history, including any allergies to medications and history of heart or lung diseases, to guide sedation and procedural planning.

During the Procedure:

  1. Monitoring:
    Continuously monitor the patient’s vital signs, oxygen saturation, and comfort level. Ensure the patient is sedated and relaxed.
  2. Assisting the Physician:
    Assist the physician by providing necessary equipment, such as biopsy forceps or snare devices, and maintaining a sterile field if needed.

Post-Procedure Care:

  1. Recovery from Sedation:
    After the procedure, monitor the patient as they recover from sedation. Assess their ability to tolerate oral intake before discharge. Ensure that the patient has a responsible adult to drive them home.
  2. Patient Education:
    Instruct the patient about possible side effects, such as bloating or mild cramping, and advise them to contact the healthcare provider if they experience severe pain, fever, or heavy bleeding.
  3. Dietary Instructions:
    Offer clear liquids after the procedure and advance the diet as tolerated. Recommend a high-fiber diet to promote regular bowel movements.

 

Discuss the nursing interventions for a patient with hepatitis.

Answer:

Pathophysiology:

Hepatitis is inflammation of the liver, which can be caused by viral infections (hepatitis A, B, C, D, or E), alcohol consumption, toxins, or autoimmune diseases. Hepatitis leads to liver cell injury, impaired liver function, and may progress to cirrhosis or liver failure in severe cases.

Clinical Manifestations:

Patients with hepatitis may present with fatigue, anorexia, nausea, jaundice, dark urine, and light-colored stools. There may also be pain in the upper right quadrant of the abdomen, indicating liver involvement.

Nursing Interventions:

  1. Monitoring and Assessment:
    Monitor liver function tests, including ALT, AST, bilirubin, and albumin levels. Assess for signs of jaundice, fluid retention (edema or ascites), and mental status changes (hepatic encephalopathy).
  2. Rest and Nutritional Support:
    Encourage adequate rest and a balanced diet that is high in calories and protein to support liver regeneration. Avoid fatty foods and alcohol.
  3. Medications:
    Administer antiviral medications for viral hepatitis (e.g., interferons or nucleoside analogs for hepatitis B and C). Provide symptomatic treatment for nausea and pruritus as prescribed.
  4. Patient Education:
    Educate the patient about the importance of rest, avoiding alcohol, and taking medications as prescribed. Teach the patient how to prevent the spread of hepatitis if it is a viral form (e.g., safe sex practices and hand hygiene for hepatitis A).

 

What is the nursing management for a patient with diverticulitis?

Answer:

Pathophysiology:

Diverticulitis occurs when diverticula (small, bulging pouches in the colon wall) become inflamed or infected. This condition is typically associated with a low-fiber diet and can lead to complications like abscess formation, perforation, or bleeding.

Clinical Manifestations:

Patients may report lower left abdominal pain, fever, nausea, vomiting, and changes in bowel habits (such as constipation or diarrhea). The pain may be localized to the left lower quadrant, and in severe cases, there may be signs of peritonitis or shock.

Nursing Interventions:

  1. Pain Management:
    Administer analgesics as prescribed, avoiding narcotics that can cause constipation. Apply heat to the abdomen if indicated to relieve cramping.
  2. Antibiotics and Fluid Therapy:
    Administer broad-spectrum antibiotics to treat infection. Ensure adequate hydration through IV fluids and monitor for electrolyte imbalances.
  3. Bowel Rest and Diet Modification:
    Initially, withhold food and fluids to allow the bowel to rest. Once symptoms subside, gradually introduce a low-fiber diet, progressing to a high-fiber diet once healing occurs.
  4. Monitor for Complications:
    Regularly assess for signs of abscess, perforation, or bleeding. Prepare the patient for possible surgical intervention if complications develop, such as bowel resection.