GASTROINTESTINAL &GENTOURINARY
NCLEX QUESTIONS & CORRECT
ANSWERS GRADED A+ 2024/2025
The nurse preparing for the annual physical exam of a 50-year-old man will plan to teach the patient about
a. endoscopy.
b. colonoscopy.
c. computerized tomography screening.
d. carcinoembryonic antigen (CEA) testing.
At age 50, individuals with an average risk for colorectal cancer (CRC) should begin screening for CRC. Colonoscopy is the gold standard for CRC
screening. The other diagnostic tests are not recommended as part of a routine annual physical exam at age 50.
A 71-year-old patient had an abdominal-perineal resection for colon cancer. Which nursing action is most important to include in the plan of
care for the day after surgery?
a. Teach about a low-residue diet.
b. Monitor output from the stoma.
c. Assess the perineal drainage and incision.
d. Encourage acceptance of the colostomy stoma.
Because the perineal wound is at high risk for infection, the initial care is focused on assessment and care of this wound. Teaching about diet is
best done closer to discharge from the hospital. There will be very little drainage into the colostomy until peristalsis returns. The patient will be
encouraged to assist with the colostomy, but this is not the highest priority in the immediate postoperative period.
.
A 47-year-old female patient is transferred from the recovery room to a surgical unit after a transverse colostomy. The nurse observes the
stoma to be deep pink with edema and a small amount of sanguineous drainage. The nurse should
a. place ice packs around the stoma.
b. notify the surgeon about the stoma.
c. monitor the stoma every 30 minutes.
d. document stoma assessment findings.
,The stoma appearance indicates good circulation to the stoma. There is no indication that surgical intervention is needed or that frequent
stoma monitoring is required. Swelling of the stoma is normal for 2 to 3 weeks after surgery, and an ice pack is not needed.
.
Which information will the nurse include in teaching a patient who had a proctocolectomy and ileostomy for ulcerative colitis?
a. Restrict fluid intake to prevent constant liquid drainage from the stoma.
b. Use care when eating high-fiber foods to avoid obstruction of the ileum.
c. Irrigate the ileostomy daily to avoid having to wear a drainage appliance.
d. Change the pouch every day to prevent leakage of contents onto the skin.
High-fiber foods are introduced gradually and should be well chewed to avoid obstruction of the ileostomy. Patients with ileostomies lose the
absorption of water in the colon and need to take in increased amounts of fluid. The pouch should be drained frequently but i s changed every 5
to 7 days. The drainage from an ileostomy is liquid and continuous, so control by irrigation is not possible.
.
The nurse will determine that teaching a 67-year-old man to irrigate his new colostomy has been effective if the patient
a. inserts the irrigation tubing 4 to 6 inches into the stoma.
b. hangs the irrigating container 18 inches above the stoma.
c. stops the irrigation and removes the irrigating cone if cramping occurs.
d. fills the irrigating container with 1000 to 2000 mL of lukewarm tap water.
The irrigating container should be hung 18 to 24 inches above the stoma. If cramping occurs, the irrigation should be temporarily stopped and
the cone left in place. Five hundred to 1000 mL of water should be used for irrigation. An irrigation cone, rather than tubing, should be inserted
into the stoma; 4 to 6 inches would be too far for safe insertion.
.
The nurse admitting a patient with acute diverticulitis explains that the initial plan of care is to
a. administer IV fluids.
b. give stool softeners and enemas.
c. order a diet high in fiber and fluids.
,d. prepare the patient for colonoscopy.
A patient with acute diverticulitis will be NPO and given parenteral fluids. A diet high in fiber and fluids will be implemented before discharge.
Bulk-forming laxatives, rather than stool softeners, are usually given, and these will be implemented later in the hospitalization. The patient
with acute diverticulitis will not have enemas or a colonoscopy because of the risk for perforation and peritonitis.
A patient has been assigned the nursing diagnosis of imbalanced nutrition: less than body requirements related to painful oral ulcers. Which
nursing action will be most effective in improving oral intake?
a. Offer the patient frequent small snacks between meals.
b. Assist the patient to choose favorite foods from the menu.
c. Provide teaching about the importance of nutritional intake.
d. Apply the ordered anesthetic gel to oral lesions before meals.
Because the etiology of the patient's poor nutrition is the painful oral ulcers, the best intervention is to apply anesthetic gel to the lesions
before the patient eats. The other actions might be helpful for other patients with impaired nutrition, but would not be as h elpful for this
patient.
.
A patient with cancer has a nursing diagnosis of imbalanced nutrition: less than body requirements related to altered taste s ensation. Which
nursing action is most appropriate?
a. Add strained baby meats to foods such as casseroles.
b. Teach the patient about foods that are high in nutrition.
c. Avoid giving the patient foods that are strongly disliked.
d. Add extra spice to enhance the flavor of foods that are served.
The patient will eat more if disliked foods are avoided and foods that the patient likes are included instead. Additional spice is not usually an
effective way to enhance taste. Adding baby meats to foods will increase calorie and protein levels, but does not address the issue of taste. The
patient's poor intake is not caused by a lack of information about nutrition.
.
The nurse is caring for a patient who has been diagnosed with stage I cancer of the colon. When assessing the need for psychologic support,
which question by the nurse will provide the most information?
a. "How long ago were you diagnosed with this cancer?"
, b. "Do you have any concerns about body image changes?"
c. "Can you tell me what has been helpful to you in the past when coping with stressful events?"
d. "Are you familiar with the stages of emotional adjustment to a diagnosis like cancer of the colon?"
Information about how the patient has coped with past stressful situations helps the nurse determine usual coping mechanisms and their
effectiveness. The length of time since the diagnosis will not provide much information about the patient's need for support. The pati ent's
knowledge of typical stages in adjustment to a critical diagnosis does not provide insight into patient needs for assistance. Because surgical
interventions for stage I cancer of the colon may not cause any body image changes, this question is not appropriate at this time.
.
Which topic is most important for the nurse to discuss preoperatively with a patient who is scheduled for abdominal surgery for an open
cholecystectomy?
a. Care for the surgical incision
b. Medications used during surgery
c. Deep breathing and coughing techniques
d. Oral antibiotic therapy after discharge home
Preoperative teaching, demonstration, and redemonstration of deep breathing and coughing are needed on patients having abdomi nal surgery
to prevent postoperative atelectasis. Incisional care and the importance of completing antibiotics are better discussed after surgery, when the
patient will be more likely to retain this information. The patient does not usually need information about medications that are used
intraoperatively.
.
The nasogastric (NG) tube is removed on the second postoperative day, and the patient is placed on a clear liquid diet. Four hours later, the
patient complains of sharp, cramping gas pains. What action by the nurse is the most appropriate?
a. Reinsert the NG tube.
b. Give the PRN IV opioid.
c. Assist the patient to ambulate.
d. Place the patient on NPO status.
Ambulation encourages peristalsis and the passing of flatus, which will relieve the patient's discomfort. If distention persists, the patient may
need to be placed on NPO status, but usually this is not necessary. Morphine administration will further decrease intestinal motility. Gas pains
are usually caused by trapping of flatus in the colon, and reinsertion of the NG tube will not relieve the pains.
NCLEX QUESTIONS & CORRECT
ANSWERS GRADED A+ 2024/2025
The nurse preparing for the annual physical exam of a 50-year-old man will plan to teach the patient about
a. endoscopy.
b. colonoscopy.
c. computerized tomography screening.
d. carcinoembryonic antigen (CEA) testing.
At age 50, individuals with an average risk for colorectal cancer (CRC) should begin screening for CRC. Colonoscopy is the gold standard for CRC
screening. The other diagnostic tests are not recommended as part of a routine annual physical exam at age 50.
A 71-year-old patient had an abdominal-perineal resection for colon cancer. Which nursing action is most important to include in the plan of
care for the day after surgery?
a. Teach about a low-residue diet.
b. Monitor output from the stoma.
c. Assess the perineal drainage and incision.
d. Encourage acceptance of the colostomy stoma.
Because the perineal wound is at high risk for infection, the initial care is focused on assessment and care of this wound. Teaching about diet is
best done closer to discharge from the hospital. There will be very little drainage into the colostomy until peristalsis returns. The patient will be
encouraged to assist with the colostomy, but this is not the highest priority in the immediate postoperative period.
.
A 47-year-old female patient is transferred from the recovery room to a surgical unit after a transverse colostomy. The nurse observes the
stoma to be deep pink with edema and a small amount of sanguineous drainage. The nurse should
a. place ice packs around the stoma.
b. notify the surgeon about the stoma.
c. monitor the stoma every 30 minutes.
d. document stoma assessment findings.
,The stoma appearance indicates good circulation to the stoma. There is no indication that surgical intervention is needed or that frequent
stoma monitoring is required. Swelling of the stoma is normal for 2 to 3 weeks after surgery, and an ice pack is not needed.
.
Which information will the nurse include in teaching a patient who had a proctocolectomy and ileostomy for ulcerative colitis?
a. Restrict fluid intake to prevent constant liquid drainage from the stoma.
b. Use care when eating high-fiber foods to avoid obstruction of the ileum.
c. Irrigate the ileostomy daily to avoid having to wear a drainage appliance.
d. Change the pouch every day to prevent leakage of contents onto the skin.
High-fiber foods are introduced gradually and should be well chewed to avoid obstruction of the ileostomy. Patients with ileostomies lose the
absorption of water in the colon and need to take in increased amounts of fluid. The pouch should be drained frequently but i s changed every 5
to 7 days. The drainage from an ileostomy is liquid and continuous, so control by irrigation is not possible.
.
The nurse will determine that teaching a 67-year-old man to irrigate his new colostomy has been effective if the patient
a. inserts the irrigation tubing 4 to 6 inches into the stoma.
b. hangs the irrigating container 18 inches above the stoma.
c. stops the irrigation and removes the irrigating cone if cramping occurs.
d. fills the irrigating container with 1000 to 2000 mL of lukewarm tap water.
The irrigating container should be hung 18 to 24 inches above the stoma. If cramping occurs, the irrigation should be temporarily stopped and
the cone left in place. Five hundred to 1000 mL of water should be used for irrigation. An irrigation cone, rather than tubing, should be inserted
into the stoma; 4 to 6 inches would be too far for safe insertion.
.
The nurse admitting a patient with acute diverticulitis explains that the initial plan of care is to
a. administer IV fluids.
b. give stool softeners and enemas.
c. order a diet high in fiber and fluids.
,d. prepare the patient for colonoscopy.
A patient with acute diverticulitis will be NPO and given parenteral fluids. A diet high in fiber and fluids will be implemented before discharge.
Bulk-forming laxatives, rather than stool softeners, are usually given, and these will be implemented later in the hospitalization. The patient
with acute diverticulitis will not have enemas or a colonoscopy because of the risk for perforation and peritonitis.
A patient has been assigned the nursing diagnosis of imbalanced nutrition: less than body requirements related to painful oral ulcers. Which
nursing action will be most effective in improving oral intake?
a. Offer the patient frequent small snacks between meals.
b. Assist the patient to choose favorite foods from the menu.
c. Provide teaching about the importance of nutritional intake.
d. Apply the ordered anesthetic gel to oral lesions before meals.
Because the etiology of the patient's poor nutrition is the painful oral ulcers, the best intervention is to apply anesthetic gel to the lesions
before the patient eats. The other actions might be helpful for other patients with impaired nutrition, but would not be as h elpful for this
patient.
.
A patient with cancer has a nursing diagnosis of imbalanced nutrition: less than body requirements related to altered taste s ensation. Which
nursing action is most appropriate?
a. Add strained baby meats to foods such as casseroles.
b. Teach the patient about foods that are high in nutrition.
c. Avoid giving the patient foods that are strongly disliked.
d. Add extra spice to enhance the flavor of foods that are served.
The patient will eat more if disliked foods are avoided and foods that the patient likes are included instead. Additional spice is not usually an
effective way to enhance taste. Adding baby meats to foods will increase calorie and protein levels, but does not address the issue of taste. The
patient's poor intake is not caused by a lack of information about nutrition.
.
The nurse is caring for a patient who has been diagnosed with stage I cancer of the colon. When assessing the need for psychologic support,
which question by the nurse will provide the most information?
a. "How long ago were you diagnosed with this cancer?"
, b. "Do you have any concerns about body image changes?"
c. "Can you tell me what has been helpful to you in the past when coping with stressful events?"
d. "Are you familiar with the stages of emotional adjustment to a diagnosis like cancer of the colon?"
Information about how the patient has coped with past stressful situations helps the nurse determine usual coping mechanisms and their
effectiveness. The length of time since the diagnosis will not provide much information about the patient's need for support. The pati ent's
knowledge of typical stages in adjustment to a critical diagnosis does not provide insight into patient needs for assistance. Because surgical
interventions for stage I cancer of the colon may not cause any body image changes, this question is not appropriate at this time.
.
Which topic is most important for the nurse to discuss preoperatively with a patient who is scheduled for abdominal surgery for an open
cholecystectomy?
a. Care for the surgical incision
b. Medications used during surgery
c. Deep breathing and coughing techniques
d. Oral antibiotic therapy after discharge home
Preoperative teaching, demonstration, and redemonstration of deep breathing and coughing are needed on patients having abdomi nal surgery
to prevent postoperative atelectasis. Incisional care and the importance of completing antibiotics are better discussed after surgery, when the
patient will be more likely to retain this information. The patient does not usually need information about medications that are used
intraoperatively.
.
The nasogastric (NG) tube is removed on the second postoperative day, and the patient is placed on a clear liquid diet. Four hours later, the
patient complains of sharp, cramping gas pains. What action by the nurse is the most appropriate?
a. Reinsert the NG tube.
b. Give the PRN IV opioid.
c. Assist the patient to ambulate.
d. Place the patient on NPO status.
Ambulation encourages peristalsis and the passing of flatus, which will relieve the patient's discomfort. If distention persists, the patient may
need to be placed on NPO status, but usually this is not necessary. Morphine administration will further decrease intestinal motility. Gas pains
are usually caused by trapping of flatus in the colon, and reinsertion of the NG tube will not relieve the pains.
