Nclex GI Questions-2 PDF

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GI NCLEX questions with answers...

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NCLEX-Style Review – Gastrointestinal II

1. A nurse is caring for a child who has had watery diarrhea for the past 3 days. Which of the following is an appropriate action for the nurse to take? A. B. C. D.

Keep NPO until the diarrhea subsides. Start hypertonic IV solution Offer chicken broth. Initiate oral rehydration therapy

2. A nurse is teaching a group of parents about E. Coli. Which of the following information should the nurse include in the teaching? Select all that apply. A. B. C. D. E.

It is a foodborne pathogen. Severe abdominal cramping occurs. It can lead to hemolytic uremic syndrome. Watery diarrhea is present for more than 5 days. Antibiotics are given for treatment.

3. A nurse is assessing a child who has a rotavirus infection. Which of the following are expected findings? Select all that apply. A. B. C. D. E.

Confusion Bloody stools Vomiting Fever Watery stools

4. A nurse is teaching a group of parents about Salmonella. Which of the following should the nurse include in the teaching. Select all that apply. A. B. C. D. E.

It is a bacterial infection Bloody diarrhea is common Incubation period is nonspecific. Antibiotics are always used for treatment. Transmission can be from house pets.

5. A nurse is caring for a child who is suspected to have Enterobius vermicularis. Which of the following actions should the nurse take? A. B. C. D.

Initiate IV fluids Test the stool for occult blood Perform a tape test Collect a stool specimen for culture.

6. A nurse is caring for an infant who is 4 hours postoperative following cleft lip and palate repair. Which of the following actions should the nurse take? A. B. C. D.

Offer a pacifier with sucrose. Remove the packing in the mouth Assess the mouth with a tongue blade Place the infant in an upright position

7. A nurse is caring for a child who has Meckel’s Diverticulum. Which of the following manifestations should the nurse expect? Select all that apply.

A. B. C. D. E.

Rapid, shallow breathing. Mucous, bloody stools. Abdominal pain. Fever Dark, tarry stools

8. A nurse is caring for a child who has Hirschsprung’s disease. Which of the following actions should the nurse take? A. B. C. D.

Prepare the family for surgery. Initiate bed rest Place an NG tube for decompression Encourage a high-fiber, low protein, low calorie diet.

9. The nurse is caring for a 3-month-old infant with short bowel syndrome (SBS). The parent asks how the disease will affect their child. The best response by the nurse would be:

A. “Because your child has a shorter intestine than most, your child will likely experience constipation and will need to be placed on a bowel regimen.” B. “Unfortunately, most children with this diagnosis do not do very well.” C. “Because your child has a shorter intestine than most, he will not be able to absorb all the nutrients and vitamins in food and will need to get nutrients in other ways.” D. “The prognosis and course of the disease have changed because hyperalimentation is available.”

10. Which child may need extra fluids to prevent dehydration? Select all that apply.

A. 7-day-old receiving phototherapy B. A 13-year-old who has just started her menses C. 6-week-old with newly diagnosed pyloric stenosis D. 2-year-old with pneumonia E. 2-year-old with full-thickness burns to chest, back and abdomen

11. A 10-year-old is being evaluated for possible appendicitis and complains of nausea and sharp abdominal pain in the right lower quadrant. The child vomits, finds the pain relieved, and calls the nurse. What is the nurse’s priority action?

A. Cancel the ultrasound and obtain an order for oral Zofran (ondanstron). B. Immediately notify the physician of the child’s status.

C. Cancel the ultrasound and prepare to administer an intravenous bolus. D. Prepare for probable discharge of patient.

12. The nurse is caring for a 2-year-old child who was admitted to the pediatric floor for moderate dehydration due to vomiting and diarrhea. The child is restless, with periods of irritability. The child is afebrile with a heart rate of 148 and a blood pressure of 90/42. The parents state that the child has not had a wet diaper for 12 hours. After establishing a saline lock, the nurse reviews the physician’s orders. Which order should the nurse question?

A. After the saline bolus, begin maintenance fluids of D5 ¼ NS with 10 mEq KCL/L B. Administer a saline bolus of 10ml/kg, which may be repeated if the child does not urinate. C. Recheck serum electrolytes in 12 hours. D. Give clear liquid diet as tolerated.

13. Which discharge instruction for a child diagnosed with encopresis should the nurse question?

A. Limit the intake of milk. B. Offer a diet high in protein. C. Obtain a complete dietary log. D. Follow up with a child psychologist.

14. The nurse is caring for a 4-month-old with gastroespohageal reflux (GER). The infant is due to receive Zantac (ranitidine). Based on the medication’s mechanism of action, when should this medication be administered?

A. Immediately before a feeding

B. 30 minutes after the feeding C. 30 minutes before the feeding D. At bedtime

15. Which should be included in the plan of care of 14-month-old whose cleft palate was repaired 12 hours ago? Select all that apply.

A. Once liquids have been tolerated, encourage a bland diet such as JellO and saltine crackers. B. Administer pain medication on a regular schedule as opposed to an as-needed schedule. C. Use a Yankauer suction catheter on the infant’s mouth to decrease the risk of aspiration of oral secretions. D. When discharged, remove elbow restraints. E. Allow the infant to have familiar items of comfort, such as a favorite stuffed animal and a soft, short tipped “sippy” cup.

16. Which manifestations would the nurse expect to see in a 4-week-old infant with biliary atresia?

A. Abdominal distention, multiple bruises, and hematuria. B. Yellow sclera and skin tones, excessively oily skin, and prolonged bleeding times. C. Abdominal distention, enlarged liver, enlarged spleen, clay-colored stool, and tea-colored urine. D. No manifestations until the disease has progressed to the advanced stage.

17. The nurse is caring for a 7-week-old infant scheduled for a pylorotomy in 24 hours. Which would the nurse expect to see in the plan of care?

A. Keep infant NPO; begin intravenous fluids at maintenance. B. Keep infant NPO; begin intravenous fluids at maintenance; place nasogastric tube (NGT) to low wall suction. C. Obtain serum electrolytes; keep infant NPO; do not attempt to pass NGT due to obstruction. D. Offer infant small, frequent feedings; keep NPO 2-4 hours before surgery.

18. Which manifestation suggests that an infant is developing necrotizing enterocolitis (NEC)?

A. Decreased residuals prior to feedings B. Bloody diarrhea C. Hyperactive bowel sounds D. Decreased abdominal girth prior to feedings

19. The nurse knows that the Nissen fundoplication involves which of the following?

A. The fundus of the stomach is wrapped around the inferior stomach, mimicking a lower esophageal sphincter. B. The fundus of the stomach is wrapped around the middle portion of the stomach, decreasing the capacity of the stomach. C. The fundus of the stomach is wrapped around the inferior esophagus, mimicking a cardiac sphincter.

D. The fundus of the stomach is dilated, decreasing the likelihood of reflux.

20. A child is hospitalized because of persistent vomiting. The nurse should monitor the child closely for which problem?

A. Diarrhea B. Metabolic acidosis C. Hyperactive bowel sounds D. Metabolic alkalosis

21. The nurse reviews the record of a newborn infant and notes that a diagnosis of esophageal atresia with tracheoesophageal fistula is suspected. The nurse would most likely expect to see which common presentation of this condition documented in the record?

A. Incessant crying B. Choking with feedings C. Coughing at nighttime D. Severe projectile vomiting

22. The nurse provides feeding instructions to a parent of an infant diagnosed with gastroesophageal reflux. Which instruction should the nurse give to the parent to assist in reducing the episodes of emesis?

A. Thicken the feedings by adding rice cereal to the formula. B. Provide less frequent, larger feedings. C. Burp the infant less frequently during feedings.

D. Thin the feedings by adding water to the formula.

23. The nurse is caring for a newborn with a suspected diagnosis of imperforate anus. The nurse monitors the infant, knowing that which is a clinical manifestation of this disorder?

A. Bile-stained fecal emesis B. The passage of currant jelly-like stools C. Failure to pass meconium stool in the first 24 hours after birth D. Sausage-shaped mass palpated in the upper right abdominal quadrant

24. Which interventions should the nurse include when preparing a care plan for a child with hepatitis? Select all that apply

A. Notifying the health care provider (HCP) if jaundice is present. B. Providing a low-fat, well-balanced diet. C. Teaching the child effective hand-washing techniques. D. Instructing the parents to avoid administering medications unless prescribed. E. Arranging for indefinite home schooling because the child will not be able to return to school. F. Scheduling playtime in the playroom with other children

25. A 4-month-old has had vomiting and diarrhea for 24 hours. The infant is fussy and the anterior fontanel is sunken. The nurse notes that the infant does not produce tears when crying. Which task will help confirm the diagnosis of dehydration?

A. Analysis of serum electrolytes B. Urinalysis obtained by bagged specimen C. Urinalysis obtained by sterile catheterization D. Analysis of CBC NCLEX Review – Sarah M. – GI

26. How does the nurse interpret the laboratory analysis of Sarah’s stool sample containing excessive amounts of azotorrhea and steatorrhea?

A. She is not compliant with taking her vitamins. B. She is not compliant with taking her enzymes. C. She is eating too many foods high in fat. D. She is eating too many foods high in fiber.

27. Sarah’s parents ask the nurse in the CF clinic how best to meet her increased nutritional needs when she was an infant. What is the nurse’s best response?

A. “You may need to change Sarah to a higher calorie formula.” B. “You may need to increase the number of fresh fruits and vegetables you give Sarah.” C. “You may need to advance Sarah’s diet to whole cow’s milk because it is higher in fat than formula.” D. “You may need to increase Sarah’s carbohydrate intake.”

28. Sarah’s parents ask the nurse what will need to be done to relieve her constipation. What is the nurse’s best response?

A. “Sarah likely has an obstruction and will need surgery.”

B. “Sarah will likely be given IV fluids.” C. “Sarah will likely be given MiraLAX.” D. “Sarah will be placed on a clear liquid diet.”

29. The clinical manifestations common to the child with cystic fibrosis include. Select all that apply.

A. Meconium ileus at birth B. Delayed growth C. Bulky, greasy stools D. Voracious appetite E. Increased weight F. Chronic cough G. Barrel-shaped chest

30. You are caring for a child with cystic fibrosis who receives pancreatic enzymes with large snacks and meals. Which statement by the mother demonstrates good understanding of the proper administration of the supplemental enzymes?

A. “I will stop the enzymes if my child is given any antibiotics.” B. “I will decrease the dose by half if my child is having greasy stools.” C. “I will give the enzymes between meals to provide the best absorption.” D. “I will give the enzymes at the beginning of every meal and large snack.”

31. The nursing management of a child with cystic fibrosis should include (select all that apply):

A. Minimizing pulmonary complications B. Promoting growth and development C. Facilitating coping of child and family D. Promoting child’s self-esteem...