NCLEX Review about Digestive Problems 41-45

NCLEX Review about Digestive Problems

41. The client with liver cirrhosis has developed esophageal varices. Which of the following should the nurse advise the client to avoid? Select all that apply

a) coughing
b) straining at stool
c) yawning
d) bending and stooping
e) swallowing
f) heavy lifting
g) spicy foods

42. The client had undergone Billroth II surgery. Which of the following health teachings should be taken to the client before discharge? Select all that apply

a) take dry, high protein foods
b) limit concentrated carbohydrates
c) lie down in left side-lying position after meals
d) take fluids with meals
e) take small, frequent meals
f) start meal with hot foods and beverages

43. The nurse is taking care of a patient with a positive clostridium difficile culture result. The charge nurse will intervene if she observes the nurse to be

a) wearing gloves in handling secretions
b) washing hands before and after entering the room and giving care to the patient
c) instructing the patient to wash hands with antimicrobial soap
d) wearing gown, gloves, mask, and cap while giving care to the patient

44. After gastrojejunostomy, which of the following instructions should be included in the health teachings of the patient?

a) limit carbohydrates in your diet
b) increase fluid intake
c) avoid lying down after eating
d) limit proteins in your diet

45. Arrange in sequence the following actions when cleaning an abdominal incision.

a) prepare supplies
b) apply sterile gloves
c) do hand washing apply clean gloves
d) remove soiled dressings
e) clean from the top to the bottom of the abdominal incision
g) apply sterile dressings




NCLEX REVIEW ABOUT DIGESTIVE PROBLEMS:
ANSWERS AND RATIONALE

41) A, B, D, F, G
- these factors should be avoided by the client with liver cirrhosis to prevent rupture of esophageal varices.

42) A, B, C, E
- these are preventive measures for dumping syndrome. To prevent dumping syndrome, avoid factors that cause rapid emptying of gastric content.

43) D
- clostridium difficile is characterized by severe diarrhea. It requires contact precaution which involves use of gloves and gown only. There is no need to wear mask and cap.

44) A
- after gastric surgery, dumping syndrome should be prevented. Dumping syndrome is caused by rapid emptying of gastric content into the jejunum. The hypertonic gastric content emptied into the jejunum causes shifting of plasma from the intestinal capillaries. This reduces the circulating volume and may lead to shock. Carbohydrates should be limited in the diet because these foods empty the stomach rapidly.

45) C, D, A, B, E, F
- this is the correct sequence of actions when cleaning an abdominal incision. Practice asepsis and infection control measures.



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