Digestive & Gastrointestinal System Disorders NCLEX Quiz

1.

During the initial assessment of a patient post-endoscope, the nurse sees absent bowel sounds, tachycardia, as well as abdominal distention. The nurse would anticipate:

A.

Ischemic bowel
B.

Peritonitis
C.

Hypovolemic shock
D.

Perforated bowel

Correct Answer
D. Perforated bowel

Explanation
In this scenario, the nurse observes absent bowel sounds, tachycardia, and abdominal distention in a patient post-endoscope. These signs and symptoms are indicative of a perforated bowel. A perforated bowel occurs when there is a hole or tear in the wall of the intestine, allowing the contents to leak into the abdominal cavity. This can lead to infection, inflammation, and potentially life-threatening complications. The combination of absent bowel sounds, tachycardia (rapid heart rate), and abdominal distention suggests a perforated bowel as the most likely diagnosis.

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2.

Which test is useful as a diagnostic and therapeutic tool in the biliary system?

A.

Ultrasonography
B.

MRI
C.

Endoscopic retrograde cholangiopancreatography (ERCP)
D.

Computed tomography scan (CT scan)

Correct Answer
C. Endoscopic retrograde cholangiopancreatograpHy (ERCP)

Explanation
Endoscopic retrograde cholangiopancreatography (ERCP) is a useful test in the biliary system because it allows for both diagnosis and treatment of conditions affecting the biliary system. ERCP involves the use of an endoscope to visualize the biliary and pancreatic ducts, and it can be used to identify and remove gallstones, place stents to relieve obstructions, and obtain tissue samples for further analysis. This procedure is particularly useful in cases of suspected bile duct obstruction, biliary strictures, or pancreatitis. Ultrasonography, MRI, and CT scan can also provide valuable information, but they are not as comprehensive or interventional as ERCP.

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3.

Which pharmacologic agent would you anticipate administering to a patient with acute pancreatitis to inhibit pancreatic secretions?

A.

Nitroglycerin
B.

Somatostatin
C.

Pancrelipase
D.

Pepcid

Correct Answer
B. Somatostatin

Explanation
Somatostatin is the correct answer because it is a pharmacologic agent commonly used to inhibit pancreatic secretions in patients with acute pancreatitis. Somatostatin works by inhibiting the release of various hormones, including insulin and glucagon, which in turn reduces the secretion of pancreatic enzymes. By inhibiting pancreatic secretions, somatostatin helps to alleviate the inflammation and pain associated with acute pancreatitis. Nitroglycerin is not typically used for this purpose and Pancrelipase is an enzyme supplement used to aid digestion, not inhibit secretions. Pepcid is an antacid medication used to reduce stomach acid production and is not specific to inhibiting pancreatic secretions.

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4.

Your patient’s ABG reveals an acidic pH, an acidic CO2, and a normal bicarbonate level. What indicates this acid-base disturbance?

A.

Respiratory acidosis
B.

Respiratory alkalosis
C.

Metabolic acidosis
D.

Metabolic alkalosis

Correct Answer
A. Respiratory acidosis

Explanation
The given ABG results show an acidic pH and an acidic CO2 level, indicating an increase in carbon dioxide in the blood. This suggests that the patient is experiencing respiratory acidosis, which occurs when there is inadequate removal of carbon dioxide from the body, leading to an accumulation of carbonic acid and a decrease in pH. The normal bicarbonate level indicates that the acidosis is primarily due to a respiratory issue rather than a metabolic one.

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5.

Hepatorenal syndrome is a functional disorder resulting from a redistribution of _______.

A.

Renal blood flow
B.

Blood loss
C.

Dead white blood cells
D.

None of these

Correct Answer
A. Renal blood flow

Explanation
Hepatorenal syndrome is a condition characterized by impaired kidney function due to liver disease. It is caused by a redistribution of renal blood flow, leading to decreased blood flow to the kidneys. This redistribution occurs as a result of changes in the circulatory system caused by liver dysfunction. Therefore, the correct answer is renal blood flow.

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6.

What assessment finding of a patient with acute pancreatitis would show a bluish discoloration around the umbilicus?

A.

Grey-Turner’s sign
B.

Homan’s sign
C.

Rovsing’s sign
D.

Cullen’s sign

Correct Answer
D. Cullen’s sign

Explanation
Cullen's sign refers to the bluish discoloration around the umbilicus that can be observed in patients with acute pancreatitis. This discoloration is caused by the leakage of pancreatic enzymes into the surrounding tissues, leading to hemorrhage and subsequent bruising. Cullen's sign is a clinical finding that can be indicative of severe pancreatitis and is often associated with intra-abdominal bleeding. It is named after the physician Thomas Stephen Cullen, who first described this sign in 1918.

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7.

A patient with high cirrhosis of the liver develops hepatorenal syndrome. Which nursing assessment data would support this?

A.

Oliguria and azotemia
B.

Metabolic alkalosis
C.

Decreased urinary concentration
D.

Weight gain of less than 1 lb per week

Correct Answer
A. Oliguria and azotemia

Explanation
Oliguria refers to a decreased urine output, while azotemia refers to an increase in nitrogenous waste products in the blood. Both of these assessment data are indicative of kidney dysfunction, which is a characteristic of hepatorenal syndrome. In this condition, liver cirrhosis leads to impaired kidney function, causing a decrease in urine production and an accumulation of waste products in the blood. Therefore, the presence of oliguria and azotemia would support the diagnosis of hepatorenal syndrome in a patient with high cirrhosis of the liver.

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8.

Which phase of hepatitis should the nurse incur strict precautionary measures?

A.

Icteric
B.

Non-icteric
C.

Post-icteric
D.

Pre-icteric

Correct Answer
D. Pre-icteric

Explanation
During the pre-icteric phase of hepatitis, the individual may not show any symptoms and the virus is multiplying rapidly in the liver. This phase is considered highly contagious as the person may unknowingly transmit the infection to others. Therefore, strict precautionary measures should be taken by the nurse during this phase to prevent the spread of the virus to other individuals.

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9.

You are caring for Rona, a 35-year-old female in a hepatic coma. Which evaluation criteria is going to be the most appropriate?

A.

The patient exhibits improved skin integrity.
B.

The patient experiences no evident signs of bleeding.
C.

The patient demonstrates an increase in the level of consciousness.
D.

The patient verbalized decreased episodes of pain.

Correct Answer
C. The patient demonstrates an increase in the level of consciousness.

Explanation
The most appropriate evaluation criteria for a patient in a hepatic coma would be an increase in the level of consciousness. This is because a hepatic coma is a state of unconsciousness caused by severe liver dysfunction. Therefore, any improvement or increase in the patient's level of consciousness would indicate progress in their condition.

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10.

What is the first nursing diagnosis for a 4th to 10th-day postoperative liver transplant patient?

A.

Excess Fluid Volume
B.

Risk for Rejection
C.

Impaired Skin Integrity
D.

Decreased Cardiac Output

Correct Answer
B. Risk for Rejection

Explanation
The first nursing diagnosis for a 4th to 10th-day postoperative liver transplant patient would be "Risk for Rejection." This is because during this time period, the patient is at a high risk of rejecting the transplanted liver as their immune system may recognize it as foreign. Nurses need to closely monitor the patient for signs and symptoms of rejection, such as fever, jaundice, and abdominal pain, and take appropriate interventions to prevent or manage rejection.

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