SAUNDERS - GI QUESTIONS AND ANSWERS UPDATED
2024/2025 ALL ANSWERS 100% CORRECT VERIFIED BEST
GRADED TO SCORE A+ FOR SUCCESS
Saunders Comprehensive Review for the NCLEX-RN Examination 7th
Content Area -> Adult Health -> Gastrointestinal -> 171 Questions
Text -> 26 Questions - CORRECT ANSWERS
1) The nurse is monitoring a client admitted to the hospital with a diagnosis of appendicitis
who is scheduled for surgery in 2 hours. The client begins to complain of increased
abdominal pain and begins to vomit. On assessment, the nurse notes that the abdomen is
distended and bowel sounds are diminished. Which is the most appropriate nursing
intervention?
a. Notify the health care provider (HCP).
b. Administer the prescribed pain medication.
c. Call and ask the operating room team to perform surgery as soon as possible.
d. Reposition the client and apply a heating pad on the warm setting to the client's
abdomen.
Source: Saunders - Adult GI - CORRECT ANSWERS ANS: A
Rationale:
On the basis of the signs and symptoms presented in the question, the nurse should suspect
peritonitis and notify the HCP. Administering pain medication is not an appropriate
intervention. Heat should never be applied to the abdomen of a client with suspected
appendicitis because of the risk of rupture. Scheduling surgical time is not within the scope
of nursing practice, although the HCP probably would perform the surgery earlier than the
prescheduled time.
Cognitive Ability: Analyzing
Client Needs: Physiological Integrity
Integrated Process: Nursing Process: Implementation
Content Area: Adult Health: Gastrointestinal
Strategy(ies): Abnormality Exists, Strategic Words
Priority Concepts: Clinical Judgment, Inflammation
,SAUNDERS - GI QUESTIONS AND ANSWERS UPDATED
2024/2025 ALL ANSWERS 100% CORRECT VERIFIED BEST
GRADED TO SCORE A+ FOR SUCCESS
Test-Taking Strategy:
Note the strategic words, most appropriate. determine if an abnormality exists, focus on the
signs and symptoms in the question, and consider the complications that can occur with
appendicitis. Noting that the signs presented in the question indicate a complication will
assist in directing you to the correct option.
Review:
Care of the client with appendicitis
Color Key:
Cyan = Strategy
Magenta = Content Review
Reference(s):
Ignatavicius, Workman (2016), pp. 1168-1169.
2) A client admitted to the hospital with a suspected diagnosis of acute pancreatitis is being
assessed by the nurse. Which assessment findings would be consistent with acute
pancreatitis? Select all that apply.
a. Diarrhea
b. Black, tarry stools
c. Hyperactive bowel sounds
d. Gray-blue color at the flank
e. Abdominal guarding and tenderness
f. Left upper quadrant pain with radiation to the back
Source: Saunders - Adult GI - CORRECT ANSWERS ANS: D E F
Rationale:
,SAUNDERS - GI QUESTIONS AND ANSWERS UPDATED
2024/2025 ALL ANSWERS 100% CORRECT VERIFIED BEST
GRADED TO SCORE A+ FOR SUCCESS
Grayish-blue discoloration at the flank is known as Grey-Turner's sign and occurs as a result
of pancreatic enzyme leakage to cutaneous tissue from the peritoneal cavity. The client may
demonstrate abdominal guarding and may complain of tenderness with palpation. The pain
associated with acute pancreatitis is often sudden in onset and is located in the epigastric
region or left upper quadrant with radiation to the back. The other options are incorrect.
Cognitive Ability: Analyzing
Client Needs: Physiological Integrity
Integrated Process: Nursing Process: Assessment
Content Area: Adult Health: Gastrointestinal
Strategy(ies): Comparable or Alike Options
Priority Concepts: Inflammation, Pain
Test-Taking Strategy:
Noting that options 1 and 3 are comparable or alike will assist you in eliminating these
options first. Then recall that black, tarry stools occur when there is gastrointestinal
bleeding, so this can also be eliminated. From the remaining options, recall the anatomical
location of the pancreas, the pain characteristics, and the effect of enzymes leaking into the
tissues to direct you to the correct options.
Review:
Manifestations of acute pancreatitis
Color Key:
Cyan = Strategy
Magenta = Content Review
Reference(s):
Ignatavicius, Workman (2016), pp. 1219-1221.
3) The nurse is assessing a client who is experiencing an acute episode of cholecystitis.
Which of these clinical manifestations support this diagnosis? Select all that apply.
, SAUNDERS - GI QUESTIONS AND ANSWERS UPDATED
2024/2025 ALL ANSWERS 100% CORRECT VERIFIED BEST
GRADED TO SCORE A+ FOR SUCCESS
a. Fever
b. Positive Cullen's sign
c. Complaints of indigestion
d. Palpable mass in the left upper quadrant
e. Pain in the upper right quadrant after a fatty meal
f. Vague lower right quadrant abdominal discomfort
Source: Saunders - Adult GI - CORRECT ANSWERS ANS: A C E
Rationale:
During an acute episode of cholecystitis, the client may complain of severe right upper
quadrant pain that radiates to the right scapula or shoulder or experience epigastric pain
after a fatty or high-volume meal. Fever and signs of dehydration would also be expected, as
well as complaints of indigestion, belching, flatulence, nausea, and vomiting. Options 4 and
6 are incorrect because they are inconsistent with the anatomical location of the gallbladder.
Option 2 (Cullen's sign) is associated with pancreatitis.
Cognitive Ability: Analyzing
Client Needs: Physiological Integrity
Integrated Process: Nursing Process: Assessment
Content Area: Adult Health: Gastrointestinal
Strategy(ies): Subject
Priority Concepts: Inflammation, Pain
Test-Taking Strategy:
Focus on the subject, the location and characteristics of pain associated with cholecystitis.
Recalling the anatomical location of the gallbladder will also direct you to the correct option.
Review:
Cholecystitis
2024/2025 ALL ANSWERS 100% CORRECT VERIFIED BEST
GRADED TO SCORE A+ FOR SUCCESS
Saunders Comprehensive Review for the NCLEX-RN Examination 7th
Content Area -> Adult Health -> Gastrointestinal -> 171 Questions
Text -> 26 Questions - CORRECT ANSWERS
1) The nurse is monitoring a client admitted to the hospital with a diagnosis of appendicitis
who is scheduled for surgery in 2 hours. The client begins to complain of increased
abdominal pain and begins to vomit. On assessment, the nurse notes that the abdomen is
distended and bowel sounds are diminished. Which is the most appropriate nursing
intervention?
a. Notify the health care provider (HCP).
b. Administer the prescribed pain medication.
c. Call and ask the operating room team to perform surgery as soon as possible.
d. Reposition the client and apply a heating pad on the warm setting to the client's
abdomen.
Source: Saunders - Adult GI - CORRECT ANSWERS ANS: A
Rationale:
On the basis of the signs and symptoms presented in the question, the nurse should suspect
peritonitis and notify the HCP. Administering pain medication is not an appropriate
intervention. Heat should never be applied to the abdomen of a client with suspected
appendicitis because of the risk of rupture. Scheduling surgical time is not within the scope
of nursing practice, although the HCP probably would perform the surgery earlier than the
prescheduled time.
Cognitive Ability: Analyzing
Client Needs: Physiological Integrity
Integrated Process: Nursing Process: Implementation
Content Area: Adult Health: Gastrointestinal
Strategy(ies): Abnormality Exists, Strategic Words
Priority Concepts: Clinical Judgment, Inflammation
,SAUNDERS - GI QUESTIONS AND ANSWERS UPDATED
2024/2025 ALL ANSWERS 100% CORRECT VERIFIED BEST
GRADED TO SCORE A+ FOR SUCCESS
Test-Taking Strategy:
Note the strategic words, most appropriate. determine if an abnormality exists, focus on the
signs and symptoms in the question, and consider the complications that can occur with
appendicitis. Noting that the signs presented in the question indicate a complication will
assist in directing you to the correct option.
Review:
Care of the client with appendicitis
Color Key:
Cyan = Strategy
Magenta = Content Review
Reference(s):
Ignatavicius, Workman (2016), pp. 1168-1169.
2) A client admitted to the hospital with a suspected diagnosis of acute pancreatitis is being
assessed by the nurse. Which assessment findings would be consistent with acute
pancreatitis? Select all that apply.
a. Diarrhea
b. Black, tarry stools
c. Hyperactive bowel sounds
d. Gray-blue color at the flank
e. Abdominal guarding and tenderness
f. Left upper quadrant pain with radiation to the back
Source: Saunders - Adult GI - CORRECT ANSWERS ANS: D E F
Rationale:
,SAUNDERS - GI QUESTIONS AND ANSWERS UPDATED
2024/2025 ALL ANSWERS 100% CORRECT VERIFIED BEST
GRADED TO SCORE A+ FOR SUCCESS
Grayish-blue discoloration at the flank is known as Grey-Turner's sign and occurs as a result
of pancreatic enzyme leakage to cutaneous tissue from the peritoneal cavity. The client may
demonstrate abdominal guarding and may complain of tenderness with palpation. The pain
associated with acute pancreatitis is often sudden in onset and is located in the epigastric
region or left upper quadrant with radiation to the back. The other options are incorrect.
Cognitive Ability: Analyzing
Client Needs: Physiological Integrity
Integrated Process: Nursing Process: Assessment
Content Area: Adult Health: Gastrointestinal
Strategy(ies): Comparable or Alike Options
Priority Concepts: Inflammation, Pain
Test-Taking Strategy:
Noting that options 1 and 3 are comparable or alike will assist you in eliminating these
options first. Then recall that black, tarry stools occur when there is gastrointestinal
bleeding, so this can also be eliminated. From the remaining options, recall the anatomical
location of the pancreas, the pain characteristics, and the effect of enzymes leaking into the
tissues to direct you to the correct options.
Review:
Manifestations of acute pancreatitis
Color Key:
Cyan = Strategy
Magenta = Content Review
Reference(s):
Ignatavicius, Workman (2016), pp. 1219-1221.
3) The nurse is assessing a client who is experiencing an acute episode of cholecystitis.
Which of these clinical manifestations support this diagnosis? Select all that apply.
, SAUNDERS - GI QUESTIONS AND ANSWERS UPDATED
2024/2025 ALL ANSWERS 100% CORRECT VERIFIED BEST
GRADED TO SCORE A+ FOR SUCCESS
a. Fever
b. Positive Cullen's sign
c. Complaints of indigestion
d. Palpable mass in the left upper quadrant
e. Pain in the upper right quadrant after a fatty meal
f. Vague lower right quadrant abdominal discomfort
Source: Saunders - Adult GI - CORRECT ANSWERS ANS: A C E
Rationale:
During an acute episode of cholecystitis, the client may complain of severe right upper
quadrant pain that radiates to the right scapula or shoulder or experience epigastric pain
after a fatty or high-volume meal. Fever and signs of dehydration would also be expected, as
well as complaints of indigestion, belching, flatulence, nausea, and vomiting. Options 4 and
6 are incorrect because they are inconsistent with the anatomical location of the gallbladder.
Option 2 (Cullen's sign) is associated with pancreatitis.
Cognitive Ability: Analyzing
Client Needs: Physiological Integrity
Integrated Process: Nursing Process: Assessment
Content Area: Adult Health: Gastrointestinal
Strategy(ies): Subject
Priority Concepts: Inflammation, Pain
Test-Taking Strategy:
Focus on the subject, the location and characteristics of pain associated with cholecystitis.
Recalling the anatomical location of the gallbladder will also direct you to the correct option.
Review:
Cholecystitis
