NCLEX Practice Quiz PART I: 50 Questions

Gastrointestinal Disorders
1. Nurse Berlinda is assigned to a 41-year-old client who has a
diagnosis of chronic pancreatitis. The nurse reviews the laboratory
result, anticipating a laboratory report that indicates a serum amylase
level of:
4. Nurse Oliver checks for residual before administering a bolus tube
feeding to a client with a nasogastric tube and obtains a residual
amount of 150 mL. What is the appropriate action for the nurse to
take?

a 45 units/L 1 Hold the feeding

b 100 units/L 2 Reinstill the amount and continue with administering the feeding
c 300 units/L 3 Elevate the client’s head at least 45 degrees and administer the
d 500 units/L feeding
4 Discard the residual amount and proceed with administering the
2. A male client who is recovering from surgery has been advanced feeding
from a clear liquid diet to a full liquid diet. The client is looking
forward to the diet change because he has been “bored” with the clear 5. A nurse is inserting a nasogastric tube in an adult male client.
liquid diet. The nurse would offer which full liquid item to the client? During the procedure, the client begins to cough and has difficulty
breathing. Which of the following is the appropriate nursing action?
a Tea
b Gelatin 1 Quickly insert the tube
c Custard 2 Notify the physician immediately
d Popsicle 3 Remove the tube and reinsert when the respiratory distress
subsides
3. Nurse Juvy is caring for a client with cirrhosis of the liver. To 4 Pull back on the tube and wait until the respiratory distress
minimize the effects of the disorder, the nurse teaches the client about subsides
foods that are high in thiamine. The nurse determines that the client
has the best understanding of the dietary measures to follow if the 6. Nurse Ryan is assessing for correct placement of a nasogastric
client states an intention to increase the intake of: tube. The nurse aspirates the stomach contents and checks the
contents for pH. The nurse verifies correct tube placement if which
1 Pork pH value is noted?
2 Milk
3 Chicken 1 3.5
4 Broccoli 2 7.0
 NCLEX Practice Quiz PART I: 50 Questions
Gastrointestinal Disorders
3 7.35 3 An irrigation set
4 7.5 4 A pair of scissors
7. A nurse is preparing to remove a nasogastric tube from a female
client. The nurse should instruct the client to do which of the 10. Dr. Smith has determined that the client with hepatitis has
following just before the nurse removes the tube? contracted the infection from contaminated food. The nurse
understands that this client is most likely experiencing what type of
1 Exhale hepatitis?
2 Inhale and exhale quickly
3 Take and hold a deep breath 1 Hepatitis A
4 Perform a Valsalva maneuver 2 Hepatitis B
3 Hepatitis C
8. Nurse Joy is preparing to administer medication through a 4 Hepatitis D
nasogastric tube that is connected to suction. To administer the
medication, the nurse would: 11. A client is suspected of having hepatitis. Which diagnostic test
result will assist in confirming this diagnosis?
1 Position the client supine to assist in medication absorption
2 Aspirate the nasogastric tube after medication administration to 1 Elevated hemoglobin level
maintain patency 2 Elevated serum bilirubin level
3 Clamp the nasogastric tube for 30 minutes following 3 Elevated blood urea nitrogen level
administration of the medication 4 Decreased erythrocyte sedimentation rate
4 Change the suction setting to low intermittent suction for 30
minutes after medication administration 12. The nurse is reviewing the physician’s orders written for a male
client admitted to the hospital with acute pancreatitis. Which
9. A nurse is preparing to care for a female client with esophageal physician order should the nurse question if noted on the client’s
varices who just had a Sengstaken-Blakemore tube inserted. The chart?
nurse gathers supplies, knowing that which of the following items
must be kept at the bedside at all times? 1 NPO status
2 Nasogastric tube inserted
1 An obturator 3 Morphine sulfate for pain
2 Kelly clamp 4 An anticholinergic medication
 NCLEX Practice Quiz PART I: 50 Questions
Gastrointestinal Disorders
16. The nurse is caring for a male client with a diagnosis of chronic
13. A female client being seen in a physician’s office has just been gastritis. The nurse monitors the client knowing that this client is at
scheduled for a barium swallow the next day. The nurse writes down risk for which vitamin deficiency?
which instruction for the client to follow before the test?
1 Vitamin A
1 Fast for 8 hours before the test 2 Vitamin B12
2 Eat a regular supper and breakfast 3 Vitamin C
3 Continue to take all oral medications as scheduled 4 Vitamin E
4 Monitor own bowel movement pattern for constipation
17. The nurse is reviewing the medication record of a female client
14. The nurse is performing an abdominal assessment and inspects with acute gastritis. Which medication, if noted on the client’s record,
the skin of the abdomen. The nurse performs which assessment would the nurse question?
technique next?
1 Digoxin (Lanoxin)
1 Palpates the abdomen for size 2 Furosemide (Lasix)
2 Palpates the liver at the right rib margin 3 Indomethacin (Indocin)
3 Listens to bowel sounds in all four quadrants 4 Propranolol hydrochloride (Inderal)
4 Percusses the right lower abdominal quadrant
18. The nurse is assessing a male client 24 hours following a
15. Polyethylene glycol-electrolyte solution (GoLYTELY) is cholecystectomy. The nurse noted that the T-tube has drained 750
prescribed for the female client scheduled for a colonoscopy. The mL of green-brown drainage since the surgery. Which nursing
client begins to experience diarrhea following the administration of intervention is appropriate?
the solution. What action by the nurse is appropriate?
1 Clamp the T-tube
1 Start an IV infusion 2 Irrigate the T-tube
2 Administer an enema 3 Notify the physician
3 Cancel the diagnostic test 4 Document the findings
4 Explain that diarrhea is expected
 NCLEX Practice Quiz PART I: 50 Questions
Gastrointestinal Disorders
19. The nurse is monitoring a female client with a diagnosis of peptic
ulcer. Which assessment findings would most likely indicate 1 Ambulate following a meal
perforation of the ulcer? 2 Eat high carbohydrate foods
3 Limit the fluid taken with meal
1 Bradycardia 4 Sit in a high-Fowler’s position during meals
2 Numbness in the legs
3 Nausea and vomiting 23. The nurse is monitoring a female client for the early signs and
4 A rigid, board-like abdomen symptoms of dumping syndrome. Which of the following indicate
this occurrence?
20. A male client with a peptic ulcer is scheduled for a vagotomy and
the client asks the nurse about the purpose of this procedure. Which 1 Sweating and pallor
response by the nurse best describes the purpose of a vagotomy? 2 Bradycardia and indigestion
3 Double vision and chest pain
1 Halts stress reactions 4 Abdominal cramping and pain
2 Heals the gastric mucosa
3 Reduces the stimulus to acid secretions 24. The nurse is preparing a discharge teaching plan for the male
4 Decreases food absorption in the stomach client who had umbilical hernia repair. What should the nurse include
in the plan?
21. The nurse is caring for a female client following a Billroth II
procedure. Which postoperative order should the nurse question and 1 Irrigating the drain
verify? 2 Avoiding coughing
3 Maintaining bed rest
1 Leg exercises 4 Restricting pain medication
2 Early ambulation
3 Irrigating the nasogastric tube 25. The nurse is instructing the male client who has an inguinal
4 Coughing and deep-breathing exercises hernia repair how to reduce postoperative swelling following the
procedure. What should the nurse tell the client?
22. The nurse is providing discharge instructions to a male client
following gastrectomy and instructs the client to take which measure 1 Limit oral fluid
to assist in preventing dumping syndrome? 2 Elevate the scrotum
 NCLEX Practice Quiz PART I: 50 Questions
Gastrointestinal Disorders
3 Apply heat to the abdomen 29. The nurse is performing colostomy irrigation on a male client.
4 Remain in a low-fiber diet During the irrigation, the client begins to complain of abdominal
cramps. What is the appropriate nursing action?
26. The nurse is caring for a hospitalized female client with a
diagnosis of ulcerative colitis. Which finding, if noted on assessment 1 Notify the physician
of the client, would the nurse report to the physician? 2 Stop the irrigation temporarily
3 Increase the height of the irrigation
1 Hypotension 4 Medicate for pain and resume the irrigation
2 Bloody diarrhea
3 Rebound tenderness 30. The nurse is teaching a female client how to perform a colostomy
4 A hemoglobin level of 12 mg/Dl irrigation. To enhance the effectiveness of the irrigation and fecal
returns, what measure should the nurse instruct the client to do?
27. The nurse is caring for a male client postoperatively following
creation of a colostomy. Which nursing diagnosis should the nurse 1 Increase fluid intake
include in the plan of care? 2 Place heat on the abdomen
3 Perform the irrigation in the evening
1 Sexual dysfunction 4 Reduce the amount of irrigation solution
2 Body image, disturbed
3 Fear related to poor prognosis 31. For a client in hepatic coma, which outcome would be the most
4 Nutrition: more than body requirements, imbalanced appropriate?

28. The nurse is reviewing the record of a female client with Crohn’s
disease. Which stool characteristics should the nurse expect to note
documented in the client’s record?
1 Diarrhea
2 Chronic constipation
3 Constipation alternating with diarrhea
4 Stools constantly oozing from the rectum
1 The client is oriented to time, place, and person.
2 The client exhibits no ecchymotic areas.
3 The client increases oral intake to 2,000 calories/day.
4 The client exhibits increased serum albumin level.
32. Jordin is a client with jaundice who is experiencing pruritus.
Which nursing intervention would be included in the care plan for the
client?
 NCLEX Practice Quiz
Gastrointestinal Disorders
1 Administering vitamin K subcutaneously
2 Applying pressure when giving I.M. injections
3 Decreasing the client's dietary protein intake
4 Keeping the client's fingernails short and smooth
33. Marie, a 51-year-old woman, is diagnosed with cholecystitis.
Which diet, when selected by the client, indicates that the nurse’s
teaching has been successful?
1 4-6 small meals of low-carbohydrate foods daily
2 High-fat, high-carbohydrate meals
3 Low-fat, high-carbohydrate meals
4 High-fat, low protein meals
34. The hospital administrator had undergone percutaneous
transhepatic cholangiography. Which assessment finding indicates
complication after the operation?
1 Fever and chills
2 Hypertension
3 Bradycardia
4 Nausea and diarrhea
35. When planning home care for a client with hepatitis A, which
preventive measure should be emphasized to protect the client’s
family?
1 Keeping the client in complete isolation
2 Using good sanitation with dishes and shared bathrooms
3 Avoiding contact with blood-soiled clothing or dressing
4 Forbidding the sharing of needles or syringes
PART I: 50 Questions
36. For Jayvin who is taking antacids, which instruction would be
included in the teaching plan?
1 "Take the antacids with 8 oz of water."
2 "Avoid taking other medications within 2 hours of this one."
3 "Continue taking antacids even when pain subsides."
4 "Weigh yourself daily when taking this medication."
37. Which clinical manifestation would the nurse expect a client
diagnosed with acute cholecystitis to exhibit?
1 Jaundice, dark urine, and steatorrhea
2 Acute right lower quadrant (RLQ) pain, diarrhea, and dehydration
3 Ecchymosis petechiae, and coffee-ground emesis
4 Nausea, vomiting, and anorexia
38. Pierre, who is diagnosed with acute pancreatitis, is under the care
of Nurse Bryan. Which intervention should the nurse include in the
care plan for the client?
1 Administration of vasopressin and insertion of a balloon
tamponade
2 Preparation for a paracentesis and administration of diuretics
3 Maintenance of nothing-by-mouth status and insertion of
nasogastric (NG) tube with low intermittent suction
4 Dietary plan of a low-fat diet and increased fluid intake to 2,000
ml/day
 NCLEX Practice Quiz
Gastrointestinal Disorders
39. When teaching a client about pancreatic function, the nurse
understands that pancreatic lipase performs which function?
1 Transports fatty acids into the brush border
2 Breaks down fat into fatty acids and glycerol
3 Triggers cholecystokinin to contract the gallbladder
4 Breaks down protein into dipeptides and amino acids
40. A 52-year-old man was referred to the clinic due to increased
abdominal girth. He is diagnosed with ascites by the presence of a
fluid thrill and shifting dullness on percussion. After administering
diuretic therapy, which nursing action would be most effective in
ensuring safe care?
1 Measuring serum potassium for hyperkalemia
2 Assessing the client for hypervolemia
3 Measuring the client's weight weekly
4 Documenting precise intake and output
41. Which assessment finding indicates that lactulose is effective in
decreasing the ammonia level in the client with hepatic
encephalopathy?
1 Passage of two or three soft stools daily
2 Evidence of watery diarrhea
3 Daily deterioration in the client's handwriting
4 Appearance of frothy, foul-smelling stools
PART I: 50 Questions
42. Nurse Farrah is providing care for Kristoff who has jaundice.
Which statement indicates that the nurse understands the rationale for
instituting skin care measures for the client?
1 "Jaundice is associated with pressure ulcer formation."
2 "Jaundice impairs urea production, which produces pruritus."
3 "Jaundice produces pruritus due to impaired bile acid excretion."
4 "Jaundice leads to decreased tissue perfusion and subsequent
breakdown."
43. Which rationale supports explaining the placement of an
esophageal tamponade tube in a client who is hemorrhaging?
1 Allowing the client to help insert the tube
2 Beginning teaching for home care
3 Maintaining the client's level of anxiety and alertness
4 Obtaining cooperation and reducing fear
44. For Rico who has chronic pancreatitis, which nursing intervention
would be most helpful?
1 Allowing liberalized fluid intake
2 Counseling to stop alcohol consumption
3 Encouraging daily exercise
4 Modifying dietary protein
45. Mr. Hasakusa is in end-stage liver failure. Which interventions
should the nurse implement when addressing hepatic
encephalopathy? Select all that apply.
 NCLEX Practice Quiz
Gastrointestinal Disorders
1 Assessing the client's neurologic status every 2 hours
2 Monitoring the client's hemoglobin and hematocrit levels
3 Evaluating the client's serum ammonia level
4 Monitoring the client's handwriting daily
5 Preparing to insert an esophageal tamponade tube
6 Making sure the client's fingernails are short
PART I: 50 Questions
3 Abdominal and foot massages every 2 hours
4 Alternating air pressure mattress
5 Sit in chair for 30 minutes each shift
49. Which of the following will the nurse include in the care plan for
a client hospitalized with viral hepatitis?

46. For a client with hepatic cirrhosis who has altered clotting 1 Increase fluid intake to 3000 ml per day
mechanisms, which intervention would be most important? 2 Adequate bed rest
3 Bland diet
1 Allowing complete independence of mobility 4 Administer antibiotics as ordered
2 Applying pressure to injection sites
3 Administering antibiotics as prescribed 50. Spironolactone (Aldactone) is prescribed for a client with chronic
4 Increasing nutritional intake cirrhosis and ascites. The nurse should monitor the client for which of
the following medication-related side effects?
47. A client with advanced cirrhosis has been diagnosed with hepatic
encephalopathy. The nurse expects to assess for: 1 Jaundice
2 Hyperkalemia
1 Malaise 3 Tachycardia
2 Stomatitis 4 Constipation
3 Hand tremors
4 Weight loss

48. A client diagnosed with chronic cirrhosis who has ascites and
pitting peripheral edema also has hepatic encephalopathy. Which of
the following nursing interventions are appropriate to prevent skin
breakdown? Select all that apply.

1 Range of motion every 4 hours

2 Turn and reposition every 2 hours