CMSRN Gastrointestinal and Hepatic Care 3

Question 1

A patient returns to the unit after a Whipple procedure (pancreaticoduodenectomy). Which complication should the nurse be most vigilant for in the first 24 postoperative hours?

Accepted Answer

Anastomotic leak and hemorrhage

Answer

Hypertensive crisis

Answer

Deep vein thrombosis

Answer

Atelectasis only

Question 2

A patient with a nasogastric tube on low suction reports nausea and abdominal cramping. What is the nurse's first action?

Accepted Answer

Verify tube placement and patency

Answer

Offer oral ice chips for comfort

Answer

Administer an antiemetic as prescribed

Answer

Increase the suction pressure setting

Question 3

Following a right hemicolectomy, which assessment finding best indicates the return of bowel function?

Accepted Answer

Passage of flatus

Answer

Absence of abdominal pain

Answer

Tolerance of clear liquids without nausea

Answer

Hypoactive bowel sounds in all quadrants

Question 4

A patient with irritable bowel syndrome (IBS) asks about dietary modifications to reduce symptoms. Which recommendation has the strongest evidence base?

Accepted Answer

Follow a low-FODMAP diet

Answer

Increase fiber with daily psyllium supplementation

Answer

Eliminate all dairy products indefinitely

Answer

Consume at least 3 liters of water daily

Question 5

A patient post-gastric bypass surgery is being discharged. Which dietary teaching is most important to prevent dumping syndrome?

Accepted Answer

Eat small, frequent meals and avoid concentrated sweets

Answer

Eat three large structured meals per day for adequate nutrition

Answer

Drink 8 ounces of fluid with each meal to aid digestion

Answer

Maximize protein at each meal and limit carbohydrates only

Question 6

A patient is admitted with suspected small bowel obstruction. Which assessment finding is most consistent with this diagnosis?

Accepted Answer

High-pitched hyperactive bowel sounds with abdominal distension

Answer

Absent bowel sounds in all four quadrants

Answer

Bright red rectal bleeding with severe lower abdominal pain

Answer

Jaundice with right upper quadrant tenderness

Question 7

Which electrolyte imbalance should the nurse most vigilantly monitor for in a patient with prolonged vomiting from a bowel obstruction?

Accepted Answer

Hypokalemia and metabolic alkalosis

Answer

Hyperkalemia and metabolic acidosis

Answer

Hyponatremia and respiratory alkalosis

Answer

Hypernatremia and metabolic acidosis