NCLEX Review about Gastrointestinal Distress 1-5

NCLEX Review about Gastrointestinal Distress

1. The client had been diagnosed to have a cholelithiasis. He had undergone laparoscopic cholecystectomy. Which of the following does the nurse recognize as normal signs and symptoms after the surgery?

a) abdominal pain and bloating
b) diminished lung sounds
c) bile-stained vomitus
d) hyperactive bowel sounds

2. The client has been diagnosed to have cancer of the colon. She is for colostomy. The client says, "The doctor told me that there are complications of colostomy." The best initial action by the nurse is

a) discuss complications of colostomy to the patient
b) provide pre-operation teachings
c) ask what are the complications of colostomy
d) ask the client to sign consent form

3. A nurse is caring for a client with colostomy created 3 days earlier. The client is beginning to pass malodorous flatus from stoma. The nurse interprets that:

a) this is normal, expected event
b) this indicates inadequate preoperative bowel preparation
c) the client is experiencing early signs of impaired circulation
d) the client should not have the nasogastric tube movement

4. A client who has gastrostomy tube for feeding refuses to participate in the plan of care, will not make eye contact and does not speak to family or visitors. A nurse assesses that this client is using which type of coping mechanism?

a) self-control
b) distancing
c) problem-solving
d) accepting responsibility

5. A nurse is preparing a diet plan for a post-gastrectomy client to prevent dumping syndrome. Which of the following would not be a component of this teaching plan?

a) lie down after eating
b) drink liquids with meals
c) eat small meals, six times daily
d) avoid concentrated sweets




NCLEX REVIEW ABOUT GASTROINTESTINAL DISTRESS:
ANSWERS AND RATIONALE

1) A
- carbon dioxide insufflation of the abdomen is done during laparoscopic cholecystectomy. This leads to abdominal pain and bloating 24 hours post-procedure

2) C
- assess what the client knows, before giving teachings. This provides the starting point of discussion

3) A
- passage of flatus indicates return of peristalsis. This is normal, expected event 3 days after colostomy.

4) B
- when a client refuses to communicate, he/she is using distancing as coping mechanism.

5) B
- to prevent dumping syndrome, the client should drink fluids after meals, not with meals. This is to prevent rapid emptying of the stomach.



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