MED SURGE GI EXAM | ALL QUESTIONS AND
CORRECT ANSWERS | LATEST EXAM | JUST
RELEASED | VERIFIED ANSWERS | GRADED A+
A 26-year-old patient with a family history of stomach cancer asks the
nurse about ways to decrease the risk for developing stomach cancer. The
nurse will teach the patient to avoid
a. emotionally stressful situations.
b. smoked foods such as ham and bacon.
c. foods that cause distention or bloating.
d. chronic use of H2 blocking medications. ---------CORRECT ANSWER-----
------------ANS: B
Smoked foods such as bacon, ham, and smoked sausage increase
the risk for stomach cancer. Stressful situations, abdominal
distention, and use of H2 blockers are not associated with an
increased incidence of stomach cancer.
The nurse is assessing a patient who had a total gastrectomy 8 hours ago.
What information is most important to report to the health care provider?
a.
Absent bowel sounds
b.
Complaints of incisional pain
c.
Temperature 102.1° F (38.9° C)
d.
Scant nasogastric (NG) tube drainage ---------CORRECT ANSWER-----------
------ANS: C
An elevation in temperature may indicate leakage at the anastomosis,
which may require return to surgery or keeping the patient NPO. The
other findings are expected in the immediate postoperative period for
patients who have this surgery.
,A 58-year-old patient has just been admitted to the emergency department
with nausea and vomiting. Which information requires the most rapid
intervention by the nurse?
a. The patient has been vomiting for 4 days.
b. The patient takes antacids 8 to 10 times a day.
c. The patient is lethargic and difficult to arouse.
d. The patient has undergone a small intestinal resection. ---------
CORRECT ANSWER-----------------ANS: C
A lethargic patient is at risk for aspiration, and the nurse will need to
position the patient to decrease aspiration risk. The other information
is also important to collect, but it does not require as quick action as
the risk for aspiration.
A 26-year-old woman has been admitted to the emergency department with
nausea and vomiting. Which action could the RN delegate to unlicensed
assistive personnel (UAP)?
a. Auscultate the bowel sounds.
b. Assess for signs of dehydration.
c. Assist the patient with oral care.
d. Ask the patient about the nausea. ---------CORRECT ANSWER-------------
----ANS: C
Oral care is included in UAP education and scope of practice. The
other actions are all assessments that require more education and a
higher scope of nursing practice.
A 49-year-old man has been admitted with hypotension and dehydration
after 3 days of nausea and vomiting. Which order from the health care
provider will the nurse implement first?
a. Insert a nasogastric (NG) tube.
b. Infuse normal saline at 250 mL/hr.
c. Administer IV ondansetron (Zofran).
d. Provide oral care with moistened swabs. ---------CORRECT ANSWER----
-------------ANS: B
Because the patient has severe dehydration, rehydration with IV fluids
is the priority. The other orders should be accomplished as quickly as
possible after the IV fluids are initiated.
,Which patient should the nurse assess first after receiving change-of-shift
report?
a. A patient with nausea who has a dose of metoclopramide (Reglan) due
b. A patient who is crying after receiving a diagnosis of esophageal cancer
c. A patient with esophageal varices who has a blood pressure of 92/58
mm Hg
d. A patient admitted yesterday with gastrointestinal (GI) bleeding who has
melena ---------CORRECT ANSWER-----------------ANS: C
The patient's history and blood pressure indicate possible
hemodynamic instability caused by GI bleeding. The data about the
other patients do not indicate acutely life-threatening complications.
A patient returned from a laparoscopic Nissen fundoplication for hiatal
hernia 4 hours ago. Which assessment finding is most important for the
nurse to address immediately?
a.
The patient is experiencing intermittent waves of nausea.
b.
The patient complains of 7/10 (0 to 10 scale) abdominal pain.
c.
The patient has absent breath sounds in the left anterior chest.
d.
The patient has hypoactive bowel sounds in all four quadrants. ---------
CORRECT ANSWER-----------------ANS: C
Decreased breath sounds on one side may indicate a pneumothorax,
which requires rapid diagnosis and treatment. The nausea and
abdominal pain should also be addressed but they are not as high
priority as the patient's respiratory status. The patient's decreased
bowel sounds are expected after surgery and require ongoing
monitoring but no other action.
Which assessment should the nurse perform first for a patient who just
vomited bright red blood?
, a. Measuring the quantity of emesis
b. Palpating the abdomen for distention
c. Auscultating the chest for breath sounds
d. Taking the blood pressure (BP) and pulse ---------CORRECT ANSWER--
---------------ANS: D
The nurse is concerned about blood loss and possible hypovolemic
shock in a patient with acute gastrointestinal (GI) bleeding. BP and
pulse are the best indicators of these complications. The other
information is important to obtain, but BP and pulse rate are the best
indicators for assessing intravascular volume.
Which order from the health care provider will the nurse implement first for
a patient who has vomited 1200 mL of blood?
a.
Give an IV H2 receptor antagonist.
b.
Draw blood for typing and crossmatching.
c.
Administer 1000 mL of lactated Ringer's solution.
d.
Insert a nasogastric (NG) tube and connect to suction. ---------CORRECT
ANSWER-----------------ANS: C
Because the patient has vomited a large amount of blood, correction
of hypovolemia and prevention of hypovolemic shock are the
priorities. The other actions also are important to implement quickly
but are not the highest priorities.
The nurse is administering IV fluid boluses and nasogastric irrigation to a
patient with acute gastrointestinal (GI) bleeding. Which assessment finding
is most important for the nurse to communicate to the health care provider?
a. The bowel sounds are hyperactive in all four quadrants.
b. The patients lungs have crackles audible to the midchest.
c. The nasogastric (NG) suction is returning coffee-ground material. d. The
patients blood pressure (BP) has increased to 142/84 mm Hg. ---------
CORRECT ANSWER-----------------ANS: B
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