LEWIS MED SURG - UPPER AND LOWER GI NCLEX
PRACTICE QUESTIONS AND ANSWERS 2024 VERSION
VERIFIED RATIONALE GRADED A+
A 61-year-old pa�ent with suspected bowel obstruc�on had a nasogastric tube inserted at 4:00 AM. The
nurse shares in the morning report that the day shi� staff should check the tube for patency at what
�mes?
A. 7:00 AM, 10:00 AM, and 1:00 PM
B. 8:00 AM, 12:00 PM, and 4:00 PM
C. 9:00 AM and 3:00 PM
D. 9:00 AM, 12:00 PM, and 3:00 PM - ansB. 8:00 AM, 12:00 PM, and 4:00 PM
A nasogastric tube should be checked for patency rou�nely at 4-hour intervals. Thus if the tube were
inserted at 4:00 AM, it would be due to be checked at 8:00 AM, 12:00 PM, and 4:00 PM.
A 72-year-old pa�ent was admited with epigastric pain due to a gastric ulcer. Which pa�ent assessment
warrants an urgent change in the nursing plan of care?
A. Chest pain relieved with ea�ng or drinking water
B. Back pain 3 or 4 hours a�er ea�ng a meal
C. Burning epigastric pain 90 minutes a�er breakfast
D. Rigid abdomen and vomi�ng following indiges�on - ansD. Rigid abdomen and vomi�ng following
indiges�on
A rigid abdomen with vomi�ng in a pa�ent who has a gastric ulcer indicates a perfora�on of the ulcer,
especially if the manifesta�ons of perfora�on appear suddenly. Midepigastric pain is relieved by ea�ng,
drinking water, or antacids with duodenal ulcers, not gastric ulcers. Back pain 3-4 hours a�er a meal is
more likely to occur with a duodenal ulcer. Burning epigastric pain 1-2 hours a�er a meal is an expected
manifesta�on of a gastric ulcer related to increased gastric secre�ons and does not cause an urgent
change in the nursing plan of care.
, LEWIS MED SURG - UPPER AND LOWER GI NCLEX
PRACTICE QUESTIONS AND ANSWERS 2024 VERSION
VERIFIED RATIONALE GRADED A+
A female pa�ent has a sliding hiatal hernia. What nursing interven�ons will prevent the symptoms of
heartburn and dyspepsia that she is experiencing?
A. Keep the pa�ent NPO.
B. Put the bed in the Trendelenberg posi�on.
C. Have the pa�ent eat 4 to 6 smaller meals each day.
D. Give various antacids to determine which one works for the pa�ent. - ansC. Have the pa�ent eat 4 to
6 smaller meals each day.
Ea�ng smaller meals during the day will decrease the gastric pressure and the symptoms of hiatal hernia.
Keeping the pa�ent NPO or in a Trendelenberg posi�on are not safe or realis�c for a long period of �me
for any pa�ent. Varying antacids will only be done with the care provider's prescrip�on, so this is not a
nursing interven�on.
A pa�ent complains of nausea. When administering a dose of metoclopramide (Reglan), the nurse
should teach the pa�ent to report which poten�al adverse effect?
A. Tremors
B. Cons�pa�on
C. Double vision
D. Numbness in fingers and toes - ansA. Tremors
Extrapyramidal side effects, including tremors and tardive dyskinesias, may occur as a result of
metoclopramide (Reglan) administra�on. Cons�pa�on, double vision, and numbness in fingers and toes
are not adverse effects of metoclopramide.
A pa�ent reports having a dry mouth and asks for something to drink. The nurse recognizes that this
symptom can most likely be atributed to a common adverse effect of which medica�on that the pa�ent
is taking?
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