NCLEX Review about Intestinal Disorders 21-25

NCLEX Review about Intestinal Disorders

16. Which of the following assessment findings should concern the nurse most, when assessing client who had undergone colonoscopy?

a) abdominal distention
b) 300 ml of bile-stained vomitus
c) complaints of anal pain
d) complaints of drowsiness and fatigue

17. A client has hepatic cirrhosis and gastric bleeding. Which of the following tasks may be delegated to the nursing assistant?

a) assist the client in taking a bath
b) hourly intake and output monitoring
c) assist the client to sit before changing the bed linen
d) assist the client in ambulation

18. A client diagnosed with gastric ulcer is for discharge. Which of the following should be included by the nurse in the health teachings regarding diet?

a) you must eat bland diet
b) you can eat most foods as long as they don't bother your stomach
c) you should refrain from eating fruits and vegetables
d) you should eat low fiber diet

19. The client who was diagnosed to have gastric cancer had undergone gastrectomy. Which of the following statements when made by the client indicates that he understands the health teachings

a) I'll take vitamin K for life
b) I'll take vitamin B12 for life
c) I'll take vitamin C for life
d) I'll take vitamin B6 for life

20. The client had been diagnosed to have liver cirrhosis and esophageal varices. Which of the following should the nurse include when giving health teachings? Select all that apply

a) avoid spicy foods
b) avid straining at stool
c) increase fluid intake
d) open mouth if coughing or sneezing could not be avoided
e) avoid bending or stooping
f) take acetaminophen instead of aspirin for pain
g) avoid heavy lifting




NCLEX REVIEW ABOUT INTESTINAL DISORDERS:
ANSWERS AND RATIONALE

16) B
- bile-stained vomitus is a sign of lower GI obstruction . Options A, C, and D are expected findings after colonoscopy.

17) B
- input and output monitoring may be delegated to nursing assistant. the client with hepatic cirrhosis and gastric bleeding should be on bed rest to prevent further bleeding. A, C, and D involve getting the client out of bed, which may cause bleeding.

18) B
- food tolerance varies from individual to individual. There is no need for special diet for the client with gastric ulcer during remission.

19) B
- if a client had undergone gastrectomy, intrinsic factor is no longer produced. Therefore vitamin B12 will not be absorbed. Post-gastrectomy clients are prone to pernicious anemia. Therefore, the client should take vitamin B12 for life.

20) A, B, D, E, G
- to prevent rupture of esophageal varices, the client should avoid spicy foods, straining at stool, bending and stooping, and heavy lifting. The client should open his mouth if coughing and sneezing could not be avoided. Acetaminophen is hepatotoxic; aspirin may cause bleeding and therefore, are contraindicated in the client with liver cirrhosis.




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