NCLEX-PN Test #9 2

Question 1

A client is scheduled for a colonoscopy in the morning. Which client statement indicates understanding of the bowel preparation?

Accepted Answer

"I should consume only clear liquids today and complete the prescribed bowel prep solution."

Answer

Bowel prep for colonoscopy requires a clear liquid diet and a complete bowel cleansing solution to evacuate the colon. Adequate prep is essential for visualization and to prevent complications. Milk is NOT a clear liquid. Most medications should be taken as scheduled with small sips of water unless the provider instructs otherwise.

Question 2

The PN is providing care for a client with a new colostomy. Which statement by the client indicates a need for additional teaching?

Accepted Answer

"I will need to irrigate my colostomy every day."

Answer

Daily irrigation is not required for all colostomy clients. Irrigation is typically used for sigmoid colostomies to establish regular, predictable elimination and is a choice, not a requirement. Ascending and transverse colostomies produce liquid stool and cannot be regulated by irrigation. The client's misunderstanding requires correction.

Question 3

A client with chronic liver disease and ascites requires a paracentesis. After the procedure, which complication should the nurse monitor for most closely?

Accepted Answer

Hypovolemic shock from fluid shift

Answer

Rapid removal of large volumes of ascitic fluid (large-volume paracentesis) can cause fluid to shift from the vascular compartment into the peritoneal space, leading to hypovolemic shock. Vital signs, urine output, and mental status must be monitored closely after the procedure. Albumin infusion is often given to maintain intravascular volume.

Question 4

A client is admitted with a GI bleed and hematemesis. Which finding indicates the client is developing hemorrhagic shock?

Accepted Answer

Blood pressure 88/58, HR 124, pale and diaphoretic

Answer

Hemorrhagic shock is characterized by hypotension (BP < 90 systolic), compensatory tachycardia (HR > 100), pallor, and diaphoresis from decreased cardiac output and compensatory sympathetic activation. These are emergency findings requiring immediate IV access, fluid resuscitation, blood products, and urgent endoscopy.

Question 5

The nurse is teaching a client about a low-residue (low-fiber) diet following bowel surgery. Which food choice is appropriate?

Accepted Answer

White rice, well-cooked carrots, and lean chicken

Answer

A low-residue diet minimizes the amount of stool produced to allow bowel rest and healing after surgery. Appropriate choices include white refined grains, well-cooked vegetables without skins/seeds, lean meats, and eggs. High-fiber foods, raw vegetables, whole grains, nuts, and seeds are excluded.

NCLEX Practice Test

NCLEX Practice Test

NCLEX-PN Test #9 2