NCLEX Review about Gastrointestinal Problems 26-30

NCLEX Review about Gastrointestinal Problems

26. The client had gastrectomy 2 days ago. To prevent dumping syndrome, which of the following is not a component of the interventions?

a) eating small frequent meals
b) lying down after meals for 30 minutes
c) drinking fluids during meals
d) avoiding concentrated sugar

27. After liver biopsy, what is the most appropriate next action of the RN?

a) take vital signs
b) place the client in right sided-lying position
c) place the client in semi-fowler's position
d) place the client in left sided-lying position

28. A fluid challenge is begun with a postop gastric surgery client. Which assessment will give the best indication of the client's response to this treatment?

a) CVP (central venous pressure) reading and hourly urine output
b) blood pressure and apical rate
c) lung sounds and arterial blood gases
d) electrolytes, BUN levels

29. Which of the following facts best explains why the duodenum is not removed during a subtotal gastrectomy?

a) the head of the pancreas is adherent to the duodenal wall
b) the common bile duct empties into the duodenal villi
c) the wall of the jejunum contains no intestinal villi
d) the jejunum receives its blood supply through the duodenum

30. Which of the following expected outcomes should the nurse inform the client after laparoscopic cholecystectomy?

a) redness and swelling on the operative site
b) serosanguinous drainage on the dressing
c) shoulder pain for 24 hours
d) nausea and vomiting for 24 hours




NCLEX REVIEW ABOUT GASTROINTESTINAL PROBLEMS:
ANSWERS AND RATIONALE

26) C
- drinking fluids with meals will further cause rapid emptying of gastric content. To prevent dumping syndrome, the client should drink fluids after meals.

27) B
- after liver biopsy, the RN should place the client in right side-lying position. To apply pressure in the area and prevent bleeding.

28) A
- CVP reading and hourly urine output are the most objective indicators of fluid balance and circulating volume.

29) B
- the duodenum is not removed during subtotal gastrectomy to allow the common bile duct to transport bile into the duodenum

30) C
- abdominal insufflation with carbon dioxide is done during the procedure. This causes bloating and abdominal pain that radiates to the shoulder during the first 24 hours postop.




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Test Prep for Nursing Exam about Pediatric Nursing (31-35)

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31. Which of the following data best indicates dehydration in an 8-year old child?

a) dry mucuous membrane
b) poor skin turgor
c) 5% decrease in weight
d) fever

32. A 15-month old child was brought by his mother for regular clinic visit. The child is scheduled to receive MMR immunization. Which of the following is a contraindication for MMR immunization of the child?

a) the client has been receiving prednisone since two weeks ago
b) the client has been taking non-steroidal anti-inflammatory drugs (NSAID's) for the past three days
c) the client has temperature of 37.4 C
d) the client's teeth are about to erupt

33. A mother brought her child in a clinic for scheduled physical examination. What essential question does the nurse need to ask regarding lead poisoning?

a) do you live near the chemical dump site
b) when was the last time that you have your plumbing checked?
c) what toys does your child usually play
d) where do you keep your cleaning chemicals?

34. An 8-year old child is admitted in the pediatric unit. Which of the following is the most appropriate activity for the client?

a) talking on the phone
b) collecting baseball cards
c) listening to music
d) playing chess

35. A nurse is interviewing a mother in a regular clinic visit. Which of the following children should concern the nurse most?

a) my 5-year old son doesn't want to eat breakfast every morning
b) my 8-year old so doesn't like to wear helmet while riding on a bicycle
c) my 9-year old son who rides on a bicycle with his helmet on goes in the same direction with the traffic
d) my 3-year old son bed wets every night



ANSWERS AND RATIONALE

31) C
- weight loss is one of the most accurate indicators of dehydration

32) A
- a child who is receiving steroids is immuno-compromised. A child who is immune-compromised should not receive MMR.

33) B
- lead poisoning (plumbism) sources are as follows: lead-based plumbing -> water, soil, dust, vehicles (leaded gas), lead-based paint.

34) B
- a schools age child likes to engage in activities that involve classifying, sorting, collecting, like collecting baseball cards.

35) B
- safety should be given highest priority. Helmet, elbow pads and knee pads should be worn by a child while riding a bicycle.


Related Topics:

• Test Prep for Nursing Exam about Pediatric Nursing (36-40) 
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NCLEX Secrets about Musculoskeletal Injuries (31-35)

NCLEX Secrets about Musculoskeletal Injuries

31. The client is diagnosed to have fibromyalgia. Which of the following signs and symptoms is commonly experienced by the client?

a) irritability
b) headache
c) fever
d) lethargy

32. The client is being prepared for crutch-walking. Which of the following health teachings should be included?

a) flex the arms at 90 degree angle with the crutches
b) the axillae should rest on both crutches
c) bear weight on the palms of the hands
d) going up and down the stairs is not allowed when using crutches

33. The nurse notes that the client on cast has diminished distal pulse. Which of the following is the most appropriate nursing action?

a) check the client's vital signs
b) get doppler and check for distal pulse
c) elevate the affected feet
d) notify the physician

34. The client will go electromyography (EMG). Which of the following information should be given when preparing the client for this procedure?

a) a contrast medium will be injected into your vein
b) you will be placed in a tunnel-like device
c) electrode needles will be inserted into your muscles
d) scalp electrodes will be applied and graphical recording of electrical activities of your brain will be done

35. X-rays confirm that a patient has a fractured femur. While the patient is in balanced skeletal traction, which of these measures is important?

a) adjusting the weights when moving him up in bed
b) supporting his affected leg in plantar flexion
c) raising him up in bed whenever he slips down
d) maintaining him in semi-fowler's position





NCLEX Secrets about Musculoskeletal Injuries:
ANSWERS AND RATIONALE

31) B
- fibromyalgia is a chronic syndrome of musculoskeletal tissues characterized by chronic widespread pain. Assessment: painful muscles, fatigue, sleep disturbances, headache, restlessness leg syndrome, depression.

32) C
- when using crutches, the client should bear weight on the palms of the hands not on the axillae. This is to prevent crutch palsy.

33) D
- diminished distal pulse in an extremity on cast indicates that the cast is too tight. This leads to circulatory impairment. Therefore, the physician should be notified. Bivalving/splitting of the cast will be done by the physician to prevent necrosis and gangrene formation.

34) C
- in EMG, electrode needles will be inserted into the muscles. There will be mild discomfort.

35) C
- raising the patient with traction, up in bed whenever he slips down maintains efficiency of the traction.


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NCLEX Preparation Course - Critical Thinking Exercises VI (Questions 11-20)

Here are the Answers to NCLEX Preparation Course - Critical Thinking VI (11-20) -->

11. The client has been diagnosed to have sickle cell anemia. Which of the following is appropriate nursing action when the client experiences joint pains?

a) apply cold compress to the area
b) apply warm compress to the area
c) immobilize the involved area
d) massage the involved area

12. Which of the following statements when made by the client with systemic lupus erythematosus indicates that she has good understanding of her care plan?

a) I will avoid using lotion after bathing
b) I need to have adequate sunlight in the morning
c) I am allowed to go and watch basketball games
d) range of motion of my joints will be good to maintain joint and muscle functions

13. Which of the following is least likely be included when the nurse is giving information about hepatitis A? Select all that apply

a) it is transmitted through oro-fecal route
b) it is associated with eating shellfish from contaminated water
c) it is common in places with poor sanitation
d) it may be associated with multiple blood transfusion
e) it is a co-infection with hepatitis B
f) it usually follows intake of certain drugs
g) it is transmitted through blood and body fluids

14. The patient had been diagnosed to have Addison's disease. The nursing care plan of the client should include the following appropriate interventions. Select all that apply

a) monitor the client's weight and vital signs
b) restrict potassium-rich foods in the diet
c) monitor serum glucose levels
d) check for hypertension and hyperglycemia
e) observe for masculinization in women
f) avoid exposure to infection

15. The Monitor Tech called the attention of the nurse in a loud and urgent voice informing her that the patient is in asystole in her monitor. In responding to the situation, what should the nurse do first?

a) call code blue immediately
b) call the physician for orders
c) go to the patient, check for presence of pulse and blood pressure
d) get the crash cart and defibrillate the patient

16. Which among the following patient has the highest priority for a referral to an interdisciplinary team?

a) a post-CVA patient with hemiparesis for physical therapy evaluation and teaching
b) a patient with chronic pancreatitis for dietary teaching by the nutritionist
c) a patient with 1-week old carpal tunnel syndrome who wants immediate session with the occupational therapist
d) a patient with fracture of the femur who is in cast

17. The client has been complaining of severe discomfort during menstrual period. She would not take any analgesic but considers herbal approach. What would you suggest to her?

a) cranberry relieves spastic pain during menstrual period
b) echinacea should be taken because aside from enhancing the immune system, it relieves spasm during menstruation
c) ginseng promote uterine circulation
d) black cohosh relieves spastic pain of menstruation

18. A client had undergone herniorrhaphy. Which of the following measures should be included in the nursing interventions postop?

a) increase fluid intake
b) encourage to do deep breathing and coughing exercises
c) place the client in semi-fowler's position most of the time
d) provide liquid diet until wound heals

19. Which of the following problems should be given highest priority by the nurse when caring for a client with Guillain-Barre Syndrome?

a) weakness
b) aspiration
c) difficulty in speaking
d) ascending paralysis

20. The patient has positive (+) carpal spasm response. The appropriate action by the nurse is

a) take BP on the other arm
b) wait for 15 minutes and reassess again by taking BP at the same arm
c) take the BP on both arms every hour
d) repeat taking BP on the same arm after 4 hours


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Related Topics:

• Fundamentals of Nursing  Concepts
• Medical-Surgical Concepts
• Maternal and Child Concepts

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