MedSurg Gastrointestinal & Renal Care for the NCLEX®

A client has a lipase of 405 U/L. The nurse recognizes this to be an issue with which of the following organs?

The nurse is caring for a client who is being treated for pancreatitis. The provider orders a metabolic panel as part of routine testing and the nurse notes that the client’s calcium level is 5.2 mg/dL. The client asks the nurse what this means. Which of the following responses from the nurse is correct?

The nurse is assessing a client and observes Cullen’s sign and Grey Turner’s sign. The nurse knows that these are signs of which of the following conditions?

A nurse is caring for a client that has been diagnosed with pancreatitis. Which of the following is NOT a complication commonly associated with this disease process?

A nurse is caring for a client with chronic alcohol abuse and is concerned the client may have developed pancreatitis. Which of the following signs are indicative of this? Select all that apply.

The nurse is caring for a client who has pancreatitis and an order to insert a nasogastric (NG) tube. Which response by the nurse is accurate?

The nurse is caring for a client who has been admitted with pancreatitis. Which of the following assessment findings is consistent with this diagnosis?

A nurse is caring for a client who is complaining of abdominal pain. Upon inspection of the abdomen, what sign should the nurse be looking for to alert you to potential pancreatitis?

A nurse is caring for a client with pancreatitis. Which of the following labs would the nurse NOT expect to see? Select all that apply.

A new nurse in the emergency department received a client in the trauma bay. The client was playing football and tackled from behind and now is complaining of severe pain in the abdomen. Another nurse is performing an initial assessment and tells the client that the Grey-Turner sign is positive. The new nurse knows that this indicates the client has bruising to which of the following?

The nurse is caring for a client who is recovering from a gastric resection. The nurse provides teaching about how to prevent dumping syndrome. Which of the following statements are correct? Select all that apply.

The nurse is reviewing orders for a client with peptic ulcer disease (PUD). Which of the following would the nurse question?

The nurse is teaching a client who has been diagnosed with peptic ulcer disease about what foods to eat. Which of the following is a food that the client is allowed to eat with this diagnosis?

A 57-year-old client with peptic ulcer disease is being seen for abdominal pain. Which of the following are assessments for hemorrhage in this client? Select all that apply.

The nurse is working with a client who has peptic ulcer disease. Which of the following labs is important to monitor with this condition?

The nurse is caring for a client with peptic ulcer disease due to H. pylori. Which drug combinations should be given along with a macrolide antibiotic?

The nurse suspects that a client has a duodenal ulcer. Which of the following signs would indicate this condition?

A client with peptic ulcer disease is being assessed for an upper GI bleed. Which signs would the nurse expect to see with this diagnosis? Select all that apply.

A nurse is caring for a client who is suffering from a gastric ulcer. Which of the following is an appropriate nursing intervention? Select all that apply.

The client has a chronic peptic ulcer and wants to know the difference between an acute and chronic peptic ulcer. How does the nurse educate the client?

The nurse is assessing a client who presents to the emergency department with complaints of abdominal pain. Which sign or symptom would indicate to the nurse that the client is having an emergency?

Which of the following would be appropriate nursing interventions for a child with appendicitis? Select all that apply.

The nurse is caring for a client who has been diagnosed with appendicitis and is scheduled for surgery later today. Which of the following assessment findings is the MOST concerning?

A nursing caring for an eight-year-old with appendicitis knows that the most intense area of pain may be at McBurney’s point, which is located where on the abdomen?

An 8 year-old is being admitted for possible appendicitis. Which assignment findings are expected with this diagnosis? Select all that apply.

The nurse caring for a ten-year-old with appendicitis knows which of the following symptoms may be a sign of perforation?

A five-year-old child has been admitted to the hospital with appendicitis. Which statement made by the nurse would be appropriate to include when explaining the procedure to someone of this age?

Your patient had an ileostomy placed 2 weeks ago. Which bowel pattern would be expected for this patient?

The nurse is caring for a client with an ileostomy. During assessment of the client, the nurse notes that the pouch opening is 1/2 inch larger than the stoma site. Which of the following poses a risk for this client?

A nurse is caring for a client post-op colon resection and notes a decreased blood pressure, rigid abdomen and the client reports severe pain. Based on these findings and knowing the possible complications, which of the following lab values would be the MOST appropriate to evaluate at this time?

A 61-year-old client recently had surgery where the surgeon placed an ostomy appliance. Which of the following teaching principles would the nurse include when instructing this client about ostomy care?

A client with irritable bowel syndrome has asked the nurse if there is anything that can be done to decrease the frequency of diarrhea. Which of the following advice is appropriate for a client to develop regular bowel functioning? Select all that apply.

A client presents to the emergency room with c/o nausea, vomiting, and diarrhea. Which of the following medications is appropriate to treat this condition?

The nurse is caring for a client who has been admitted with an acute exacerbation of ulcerative colitis (UC). Which of the following orders would the nurse question?

A client newly diagnosed with ulcerative colitis (UC) asks the nurse about characteristics of the disease. Which of the following is true of this condition? Select all that apply.

A client is admitted to the floor from the ER for Ulcerative Colitis complicated with infection. The client is slurring their words and stumbling. The nurse notes empty mini vodka bottles in the client belonging bag. The client reports that they drink every day and asks the nurse to get them more vodka. What is the nurse’s priority at this time?

The nurse is caring for a client who has ulcerative colitis. The nurse knows to monitor for which of the following abnormal lab work? Select all that apply.

A client with a history of ulcerative colitis is having surgery for placement of an ileoanal reservoir. The nurse is educating the client about what to expect from the procedure. Which of the following statements by the nurse is correct?

A client with Crohn’s disease has been using whey protein shakes for weight gain. What information should the nurse give to this client about the safety of using these types of shakes? Select all that apply.

The nurse is caring for a client diagnosed with Crohn’s disease. Which statement indicates more teaching is needed?

A nurse is preparing to administer a dose IV infliximab for Crohn’s disease. What assessment data should the nurse be most concerned about?

A nurse is caring for a client with a gall stone in the common bile duct. Which letter on the diagram indicates the location of the common bile duct?

A nurse is providing discharge teaching to a client who just had a cholecystectomy. Which of the following statements by the client indicate that further education is required?

A pregnant client is undergoing a laparoscopic cholecystectomy because of severe abdominal pain. Which of the following items should the nurse teach this client about a cholecystectomy?

A client presents to the emergency department complaining of right upper quadrant pain which worsens with palpation. The client has clay-colored stools. Which of the following tests will likely be ordered? Select all that apply.

A nurse is caring for a client who is complaining of RUQ pain. Which sign should the nurse look for to indicate potential cholecystitis?

The nurse is caring for a client and suspects cholecystitis. Upon notification of the provider, the nurse is asked to discover whether the client has a positive Murphy’s sign. Which of the following will verify the presence of a positive Murphy’s sign in this client?

A nurse is assisting a provider with obtaining informed consent for a client who is preparing to undergo a laparoscopic cholecystectomy. What must the nurse consider when determining if the client is competent to sign the informed consent?

A client who has undergone a laparoscopic cholecystectomy is getting ready to be dismissed from the hospital. Which information would the nurse provide as part of post-op instructions for this client? Select all that apply.

A nurse is caring for a client who has developed a surgical site infection following surgery for an open cholecystectomy. Which of the following factors contribute to infection rates in surgical wounds? Select all that apply.

Antilipemics that act on the GI tract include which of the following? Select all that apply.

A client has liver failure and is experiencing increased levels of ammonia. The nurse anticipates an order for which of the following medication?

A nurse is talking with a 65-year-old client about care after a diagnosis of liver cancer. The nurse explains that the client can receive palliative care and the client responds by saying, “I won’t have that kind of care. I’m going to fight this cancer with everything I have!” Which response from the nurse is accurate?

The nurse is caring for a client who has been diagnosed with hepatitis A. Which of the following teaching methods is most important to prevent reoccurrence of this particular type of hepatitis?

A 63-year-old patient with hepatitis C needs assistance with making food choices. The nurse should counsel the patient to restrict which type of food?

A client has cirrhosis of the liver and has developed abdominal pain and ascites. The nurse must administer certain medications, but the client refuses. Which of the following responses from the nurse best indicates that the nurse is acting in a paternalistic manner?

A client is undergoing a liver biopsy for complications of hepatitis. Following the procedure, the nurse positions the client on their right side and tells the client to lie in that position for two hours. Which best describes the rationale for this?

Nursing care of the patient with a three-lumen, double balloon esophageal tube includes all of the following except:

In assessing the patient’s health status, the nurse should know that hematemesis is most commonly caused by:

The nurse recognizes which is a common cause of esophageal varices?

A nurse is caring for a client who has an order for a CT scan with contrast. Which of the following medication orders would require further clarification from the provider?

A client is brought to the trauma bay after sustaining multiple gunshot wounds to the left flank and abdomen. Assessment reveals gross hematuria and an expanding palpable mass to the left flank. Vital Signs are the following: HR 145 BP 78/42 RR 36 O2 sat 96% The nurse anticipate which of the following diagnosis?

The nurse is caring for a client who has suffered an acute kidney injury. Which of the following nursing interventions are appropriate? Select all that apply.

A client has acute renal failure. Which of the following is the most serious complication of acute renal failure?

The nurse is caring for a client with glomerulonephritis. Which of the following orders would the nurse question for this client?

A client is admitted to the unit with glomerulonephritis. Which of the following answers is a common cause of this condition?

The nurse is managing a client’s care who has kidney disease. Which of the following interventions are appropriate because of this condition? Select all that apply.

The nurse is caring for a client scheduled for plasmapheresis. Which of the following information is true regarding this procedure? Select all that apply.

The nurse is assessing a client in the urgent care clinic who is complaining of burning with urination. The urinalysis shows that the client has a urinary tract infection (UTI). Which of the following medications is an appropriate medication to treat this client’s UTI?

A nurse is caring for a client diagnosed with cystitis. What signs and symptoms are expected with this diagnosis? Select all that apply.

A client delivered her third baby via cesarean section 1 day ago. The client needed an indwelling urinary catheter placed because she had an epidural for the procedure. Which nursing intervention would best prevent a catheter-associated urinary tract infection (CAUTI) in this client?

The nurse is caring for a client who has been diagnosed with a urinary tract infection. Which of the following isolation precautions should be implemented?

A nurse is assessing a client with an indwelling urinary catheter for signs of a catheter-associated urinary tract infection (CAUTI). Which assessment finding would best help to identify a CAUTI?

The nurse is caring for a client who has had an indwelling urinary catheter for 2 weeks. The nurse suspects that the client is developing a urinary tract infection. Which of the following assessment findings is inconsistent with this disease process?

An 89-year old client has been diagnosed with a urinary tract infection. Which of the following is the first sign of a urinary tract infection in the older adult?

A client who had an indwelling catheter has developed a urinary tract infection that has spread to the kidneys. The nurse should include which of the following information as part of her teaching?

An 80-year-old client is confused because he has developed a urinary tract infection. The client cowers and screams when the nurse enters the room. Which action of the nurse best demonstrates that she is attempting to minimize the client’s fear in this situation?

The nurse is admitting a client with a history of chronic kidney disease. Which of the following lab values is inconsistent with chronic kidney disease?

A provider has ordered a serum creatinine test for a client who is being assessed for chronic kidney disease. The client asks the nurse about the test. Which of the following responses correctly explains serum creatinine?

The nurse is caring for a client in end stage renal disease. The client has an internal arteriovenous fistula for dialysis. Which of the following interventions are appropriate in caring for the client with an AV fistula? Select all that apply.

A client with severe, uncontrolled hypertension is being evaluated for chronic kidney disease. The provider checks the glomerular filtration rate and determines that it is 22 mL/min. Which stage of chronic kidney disease does this GFR place the client?

A nurse is discussing options for home hemodialysis with a client who has kidney disease. Which of the following is correct regarding home hemodialysis? Select all that apply.

A client is complaining of chest pain. After reviewing the client’s lab values and medical history, the nurse knows which of the following conditions is likely contributing to the client’s condition?

The nurse is caring for a client who has been diagnosed with chronic kidney failure. Which of the following aspects of this client’s history could have contributed to this?

A nurse is caring for a client who is in end-stage renal disease and requires dialysis. Choose which alternative best describes the type of diet the nurse should recommend for this client.

What is the name of the yellow structure in this image?

The nurse is caring for a client who has chronic kidney disease. Which of the following medications would the nurse question?

The nurse is caring for a client scheduled for dialysis at 0930 and is giving the client’s 0900 medications. Which of the following medications requires further clarification?

A client who receives peritoneal dialysis has called the nurse to explain that he is unable to infuse the dialysate into the catheter. When the nurse arrives at the client’s home, which method would the nurse use to assess for an occlusion?

A nurse is taking care of a client who has just returned from a session of hemodialysis. The physician has ordered a percutaneous nephrolithotomy for the client and the nurse does not schedule the procedure until 8 hours later. What is the rationale for this?

Before starting a session of hemodialysis, a nurse assesses her client’s AV fistula. The nurse listens to the fistula with a stethoscope and notes a swishing sound under the skin. Which action of the nurse is most appropriate?

A nurse is caring for a client with diabetes who has experienced a progressive decrease in their kidney function. Which of the following areas will the nurse monitor to track the client’s nephropathy?

A nurse is caring for a client with a newly formed internal arteriovenous fistula. The client asks the nurse about potential complications. Which of the following are common complications for an AV fistula?

Following a client’s first session of hemodialysis, the nurse is providing information to the client and family about care at home. Which of the following information should the client be aware of that will prevent damage to the hemodialysis fistula site?

A client with end-stage renal disease is getting ready to undergo hemodialysis. Which factors would the nurse assess before the client starts the dialysis session? Select all that apply.

A nurse is examining a client who has a nursing diagnosis of fluid volume excess due to renal insufficiency. Which of the following clinical signs is most associated with fluid volume excess in the client with renal insufficiency?

A nurse is caring for a 69-year-old client who has just been diagnosed with disequilibrium syndrome after his first session of hemodialysis. Which symptoms would the nurse expect to see in a client with this syndrome?

Which of the following assessment findings can be seen with pelvic inflammatory disease? Select all that apply.

The nurse is repositioning a client diagnosed with pelvic inflammatory disease in bed. Which of the following positions helps with drainage of infection?

The nurse is providing education to a client recently diagnosed with pelvic inflammatory disease. Which of the following answers is not appropriate to include when providing education?

In which of the following scenarios would hospitalization for pelvic inflammatory disease be expected?

The nurse is caring for a client who complains of yellow vaginal discharge, dysuria, fever, and lower abdominal pain. Which of the following diagnoses do you expect given these assessment findings?

The nurse is providing education to a 25 year old client who is newly diagnosed with endometriosis. Which of the following education topics should you review with the client?

Which of the following non-surgical treatment options is not indicated for treatment of endometriosis?

The nurse is caring for a 25-year-old female who presents with constant pelvic pain that begins six days before her monthly menses, and lasts two to three days into her menses. This has been happening for several months. Additional symptoms include painful sexual intercourse. Which of the following conditions does that nurse suspect given these presenting symptoms?

The nurse is caring for a 30-year-old female who has three children and does not wish to conceive again. She was recently diagnosed with endometriosis and has ovarian masses as well as severe dysmenorrhea. When exploring surgical treatment options, which of the following surgeries does the nurse expect is indicated in this situation?

When considering treatment options for endometriosis, on which of the following items does treatment depend? Select all that apply.

Which of the following lab test results are consistent with menopause?

The nurse is caring for a 50-year-old client who presents with hot flashes, insomnia, vaginal dryness, and weight gain. Which of the following diagnoses do you suspect given these assessment findings?

Which of the following assessment findings is most commonly seen with menopause?

Which of the following answers are correct in relation to how hormone replacement therapy is used with menopause?

A 46-year-old woman is starting to have symptoms of menopause and comes in to the healthcare provider’s clinic. Which element of anticipatory guidance should the nurse include in teaching this client?

Which of the following assessment findings are consistent with menopause? Select all that apply.