NCLEX Review about Gastrointestinal Disorder 36-40

NCLEX Review about Gastrointestinal Disorder

36. The client had been diagnosed to have acute pancreatitis. Which of the following signs and symptoms most likely are experienced by the client? Select all that apply

a) pain in the left upper quadrant of the abdomen
b) bile-stained vomitus
c) elevated serum amylase
d) hypercalcemia
e) steatorrhea
f) hypoglycemia
g) weight loss

37. The child has been diagnosed to have Hirschprung's disease (Aganglionic megacolon) by rectal biopsy. Which of the following findings most likely is experienced by the child?

a) ribbon-like stool
b) currant jelly-like stool
c) olive-sized mass in the abdomen
d) sausage-like mass in the abdomen

38. The nurse assists the physician during paracentesis. In which position does the nurse place the client?

a) lying position
b) sitting position
c) prone position
d) side-lying position

39. The client had been diagnosed to have complete intestinal obstruction. Which of the following assessment findings will the nurse expect?

a) medium-pitched gurgling sounds
b) high-pitched tinkling bowel sounds
c) absence of bowel sounds
d) increased bowel sounds

40. Which of the following physician's orders for a client with acute pancreatitis should be questioned by the nurse?

a) zantac 300mg 1 tablet BID
b) morphine sulfate 5mg/IV every 6 hours
c) bland, low fat diet
d) meperidine hydrochloride 50mg/IV every 4 hours





NCLEX REVIEW ABOUT GASTROINTESTINAL DISORDER:
ANSWERS AND RATIONALE

36) A, B, C, E, G
- other signs and symptoms of acute pancreatitis are hypoglycalcemia and hyperglycemia

37) A
- hirschprung's disease is characterized by intestinal obstruction producing ribbon-like stool. Currant jelly stool and sausage-like mass are characteristics of intussusception. Olive-sized mass is a manifestation of pyloric stenosis.

38) B
- paracentesis is aspiration of fluid from the abdominal cavity. Sitting position allows fluid to settle at lower abdomen. This facilitates aspiration of fluids.

39) C
- absence of bowel sounds indicates complete intestinal obstruction. High-pitched tinkling sounds indicate partial intestinal obstruction.

40) B
- morphine sulfate is contraindicated in a client with acute pancreatitis because it causes spasm of sphincter of Oddi. The drug of choice to relieve pain in acute pancreatitis is Demerol (meperidine HCL).




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