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NURS NCLEX GASTROINTESTINAL SYSTEM DISORDERS EXAM QUSTIONS WITH ANSWERS 2022
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NURS NCLEX GASTROINTESTINAL SYSTEM DISORDERS EXAMQUSTIONS WITH ANSWERS 2022
The client with GERD complains of a chronic cough. The nurse understands that in a client
with GERD this symptom may be indicative of which of the following conditions?
A. Development of laryngeal cancer.
B. Irritation of the esophagus.
C. Esophageal scar tissue formation.
D. Aspiration of gastric contents.
Answer: D. Aspiration of gastric contents
Clients with GERD can develop pulmonary symptoms such as coughing, wheezing, and dyspnea that are
caused by the aspiration of gastric contents. It is frequently thought that GERD plays a big role in
chronic cough; there are reports that 25% or more of chronic cough cases are associated with GERD.
Option A: GERD does not predispose the client to the development of laryngeal cancer. The
most intuitive theory is called the reflux theory, whereby reflux rises above the esophagus and
upper esophageal sphincter, resulting in microaspiration as microdroplets land in the larynx or
occasionally enter the bronchial tree, directly causing cough as a protective mechanism
against reflux.
Option B: Irritation of the esophagus can develop as a result of GERD. However, GERD is more
likely to cause painful and difficult swallowing. In the reflex theory, because of the common
embryologic origin of the respiratory tract and the digestive tract, a little bit of reflux in the
esophagus can lead to an esophagobronchial reflex that causes cough.
Option C: Esophageal scar tissue formation can develop as a result of GERD. GERD occurs in
approximately 20% of Americans, and chronic cough is a very common problem, which patients
,NURS NCLEX GASTROINTESTINAL SYSTEM DISORDERS EXAM
QUSTIONS WITH ANSWERS 2022
with GERD are not immune to developing. Due to the baseline GERD rate of 20%, it is difficult to
separate the presence of the disorder from the causative effect of the disorder.
Which of the following tasks should be included in the immediate postoperative management
of a client who has undergone gastric resection?
A. Monitoring gastric pH to detect complications.
B. Assessing for bowel sounds.
C. Providing nutritional support.
D. Monitoring for symptoms of hemorrhage.
Answer: D. Monitoring for symptoms of hemorrhage.
The client should be monitored closely for signs and symptoms of hemorrhage, such as bright red blood
in the nasogastric tube suction, tachycardia, or a drop in blood pressure. Identify signs and symptoms
requiring medical evaluation such as persistent nausea and vomiting or abdominal fullness; weight loss;
diarrhea; foul-smelling fatty or tarry stools; bloody or coffee-ground vomitus or presence of bile, fever.
Instruct the patient to report changes in pain characteristics.
Option A: Gastric pH may be monitored to evaluate the need for histamine-2 receptor
antagonists. Caution the patient to read labels and avoid products containing ASA, ibuprofen.
This can cause gastric irritation and bleeding. Review medication purpose, dosage, and
schedule, and possible side effects.
Option B: Bowel sounds may not return for up to 72 hours postoperatively. Auscultate for
resumption of bowel sounds and note passage of flatus. Peristalsis can be expected to return
about the third postoperative day, signaling readiness to resume oral intake.
Option C: Nutritional needs should be addressed soon after surgery. Monitor tolerance to fluid
and food intake, noting abdominal distension, reports of increased pain, cramping, nausea,
and vomiting. Avoid milk and high-carbohydrate foods in the diet because this may trigger
dumping syndrome.
Which of the following would be an expected nutritional outcome for a client who
has undergone a subtotal gastrectomy for cancer?
A. Regain weight loss within 1 month after surgery.
B. Resume normal dietary intake of three meals per day.
C. Control nausea and vomiting through regular use of antiemetics.
D. Achieve optimal nutritional status through oral or parenteral feedings.
Answer: D. Achieve optimal nutritional status through oral or parenteral feedings.
,NURS NCLEX GASTROINTESTINAL SYSTEM DISORDERS EXAM
QUSTIONS WITH ANSWERS 2022
An appropriate expected outcome is for the client to achieve optimal nutritional status through the use
of oral feedings or total parenteral nutrition (TPN). TPN may be used to supplement oral intake, or it
may be used alone if the client cannot tolerate oral feedings. Maintain patency of NG tube. Notify the
physician if the tube becomes dislodged. This provides rest for the GI tract during the acute
postoperative phase until the return of normal function.
Option A: The client would not be expected to regain lost weight within 1 month after surgery.
Note admission weight and compare with subsequent readings. This provides information about
the adequacy of dietary intake and determination of nutritional needs.
Option B: The client would not be expected to tolerate a normal dietary intake of three meals
per day. Monitor tolerance to fluid and food intake, noting abdominal distension, reports of
increased pain, cramping, nausea, and vomiting. Complications of paralytic ileus, obstruction,
delayed gastric emptying, and gastric dilation may occur, possibly requiring reinsertion of the
NG tube.
Option C: Nausea and vomiting would not be considered an expected outcome of gastric
surgery, and regular use of antiemetics would not be anticipated. Progress diet as tolerated,
advancing from clear liquid to bland diet with several small feedings. Usually, the NG tube is
clamped for specified periods of time when peristalsis returns to determine tolerance. After the
NG tube is removed, intake is advanced gradually to prevent gastric irritation and distension.
The nurse would assess the client experiencing an acute episode of cholecystitis for pain that
is located in the right
A. Upper quadrant and radiates to the left scapula and shoulder.
B. Upper quadrant and radiates to the right scapula and shoulder.
C. Lower quadrant and radiates to the umbilicus.
D. Lower quadrant and radiates to the back.
Answer: B. Upper quadrant and radiates to the right scapula and shoulder
During an acute “gallbladder attack,” the client may complain of severe right upper quadrant pain
that radiates to the right scapula and shoulder. This is governed by the pattern on dermatomes in the
body. Acute cholecystitis is inflammation of the gallbladder that occurs due to occlusion of the cystic
duct or impaired emptying of the gallbladder. Often this impaired emptying is due to stones or biliary
sludge.
Option A: When cystic duct blockage is caused by a stone, it is called acute calculous
cholecystitis. It is important to know, one can have pain due to temporary obstruction by
gallstones, and that is called biliary colic. The diagnosis of biliary colic is upgraded to acute
calculous cholecystitis if the pain does not resolve in six hours. If no stone is identified, it is
called acute acalculous cholecystitis.
Option C: Cases of chronic cholecystitis present with progressing right upper quadrant
abdominal pain with bloating, food intolerances (especially greasy and spicy foods), increased
, NURS NCLEX GASTROINTESTINAL SYSTEM DISORDERS EXAM
QUSTIONS WITH ANSWERS 2022
gas, nausea, and vomiting. Pain in the mid-back or shoulder may also occur. This pain could be
present for years until diagnosis.
Option D: The pathophysiologic mechanism of acute cholecystitis is blockage of the cystic duct.
Cholecystitis is a condition best treated with surgery; however, it can be treated conservatively if
necessary. This condition can be associated with or without the presence of gallstones and can
also be classified as acute or chronic.
After a subtotal gastrectomy, care of the client’s nasogastric tube and drainage system
should include which of the following nursing interventions?
A. Irrigate the tube with 30 ml of sterile water every hour if needed.
B. Reposition the tube if it is not draining well.
C. Monitor the client for N/V, and abdominal distention.
D. Turn the machine to high suction if the drainage is sluggish on low suction.
Answer: C. Monitor the client for N/V, and abdominal distention.
Nausea, vomiting, or abdominal distention indicated that gas and secretions are accumulating within the
gastric pouch due to impaired peristalsis or edema at the operative site and may indicate that the
drainage system is not working properly. Assess the comfort of the client. Check for presence of nausea
and vomiting, feeling of fullness, or pain. May indicate incorrect operation of NG suction or blockage in
the tube.
Option A: Saline solution is used to irrigate nasogastric tubes. Hypotonic solutions such as water
increase electrolyte loss. In addition, a physician’s order is needed to irrigate the NG tube,
because this procedure could disrupt the suture line. Irrigations are recorded as intake. Drainage
from the NG tube is measured as output every 8 hours. If drainage is copious, more frequent
emptying of the collection container will be necessary. Documentation provides an accurate
record of the client’s response to NG drainage.
Option B: After gastric surgery, only the surgeon repositions the NG tube because of the danger
of rupturing or dislodging the suture line. Always verify if the NG tube placed is in the stomach
by aspirating a small amount of stomach contents. An X-ray study is the best way to verify
placement.
Option D: The amount of suction varies with the type of tube used and is ordered by the
physician. High suction may create too much tension on the gastric suture line. Inspect suction
apparatus. Check that setting is correct for the type of suction (continuous or intermittent),
range of suction (low, medium, high), and that movement of drainage through the tubing is
present.
A client with a peptic ulcer is scheduled for a vagotomy. The client asks the nurse about
the purpose of this procedure. The nurse tells the client that the procedure:
A. Decreases food absorption in the stomach.
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