Med Surg Gastrointestinal NCLEX Questions / ATI Med Surg Gastrointestinal Detailed Answer Key
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Med Surg Gastrointestinal NCLEX
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Med Surg Gastrointestinal NCLEX
Med Surg Gastrointestinal NCLEX Questions / ATI Med Surg Gastrointestinal Detailed Answer Key
The nurse is caring for a group of clients on the surgical nursing unit. The nurse anticipates that the client who underwent which procedure is most likely to have some long-term residual difficulty with ...
Med Surg Gastrointestinal NCLEX
Questions / ATI Med Surg
Gastrointestinal Detailed Answer Key
The nurse is caring for a group of clients on the surgical nursing unit. The nurse
anticipates that the client who underwent which procedure is most likely to have
some long-term residual difficulty with absorption of nutrients?
,A. Colectomy
B. Appendectomy
C. Ascending colostomy
D. Small bowel resection - ✔✔✔ANSWER-D. Small bowel resection
Rationale:
The small intestine is responsible for the absorption of most nutrients. The client
who has undergone removal of a segment of the small bowel is the one who has a
decreased area with which to absorb nutrients. Decreased absorption is not a likely
complication with the surgical procedures identified in the remaining options.
The nurse is caring for a client with spinal cord injury (SCI) who is participating in
a bowel retraining program. What should the nurse anticipate to promote during
the bowel retraining program?
A. Sufficiently low water content in the stool
B. Low intestinal roughage that promotes easier digestion
C. Constriction of the anal sphincter based on voluntary control
D. Stimulation of the parasympathetic reflex center at the S1 to S4 level in the
spinal cord - ✔✔✔ANSWER-D. Stimulation of the parasympathetic reflex center
at the S1 to S4 level in the spinal cord
Rationale:
The principal reflex center for defecation is located in the parasympathetic center
at the S1 to S4 level of the spinal cord. This center is most active after the first
meal of the day. Other factors that contribute to satisfactory stool passage are
sufficient fluid and roughage in the diet and the Valsalva maneuver (which is lost
with SCI). During defecation, the anal sphincter relaxes.
,The nurse is monitoring a client admitted to the hospital with a diagnosis of
appendicitis who is scheduled for surgery in 2 hours. The client begins to complain
of increased abdominal pain and begins to vomit. On assessment, the nurse notes
that the abdomen is distended and bowel sounds are diminished. Which is the most
appropriate nursing intervention?
A. Notify the health care provider (HCP).
B. Administer the prescribed pain medication.
C. Call and ask the operating room team to perform surgery as soon as possible.
D. Reposition the client and apply a heating pad on the warm setting to the client's
abdomen. - ✔✔✔ANSWER-A. Notify the health care provider (HCP).
Rationale:
On the basis of the signs and symptoms presented in the question, the nurse should
suspect peritonitis and notify the HCP. Administering pain medication is not an
appropriate intervention. Heat should never be applied to the abdomen of a client
with suspected appendicitis because of the risk of rupture. Scheduling surgical time
is not within the scope of nursing practice, although the HCP probably would
perform the surgery earlier than the prescheduled time.
A client has just had a hemorrhoidectomy. Which nursing interventions are
appropriate for this client? Select all that apply.
A. Administer stool softeners as prescribed.
B. Instruct the client to limit fluid intake to avoid urinary retention.
C. Encourage a high-fiber diet to promote bowel movements without straining.
D. Apply cold packs to the anal-rectal area over the dressing until the packing is
removed.
, E. Help the client to a Fowler's position to place pressure on the rectal area and
decrease bleeding. - ✔✔✔ANSWER-A. Administer stool softeners as prescribed.
C. Encourage a high-fiber diet to promote bowel movements without straining.
D. Apply cold packs to the anal-rectal area over the dressing until the packing is
removed.
Rationale:
Nursing interventions after a hemorrhoidectomy are aimed at management of pain
and avoidance of bleeding and incision rupture. Stool softeners and a high-fiber
diet will help the client to avoid straining, thereby reducing the chances of
rupturing the incision. An ice pack will increase comfort and decrease bleeding.
Options 2 and 5 are incorrect interventions.
The nurse is planning to teach a client with gastroesophageal reflux disease
(GERD) about substances to avoid. Which items should the nurse include on this
list? Select all that apply.
A. Coffee
B. Chocolate
C. Peppermint
D. Nonfat milk
E. Fried chicken
F. Scrambled eggs - ✔✔✔ANSWER-A. Coffee
B. Chocolate
C. Peppermint
E. Fried chicken
Rationale:
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