Gastrointestinal System

1. A 32-year-old patient underwent an abdominal bowel resection he has been back at the surgery unit since late this morning. At the beginning of the evening shift, the LPN observes that the patient has a pale face and clammy skin. The patient’s vital signs are as follows: BP: 90/52, pulse at 102 bpm, resp. at 26 bpm, and SpO2 90% despite an O2 supply of 2L/min by nasal cannula. The patient is complaining of dull abdominal pain rate 8/10 when at rest, and feeling a pressure sensation despite repeated use of a patient-administered analgesia (PCA) pump. The patient’s surgical dressing has extended beyond the delimited area by 3cm on each side. The LPN is worried about hypovolemic shock. Which intervention should take priority in this situation? *
2. A patient is hospitalized in the surgical ward after having undergone a bowel resection for colon cancer. The patient has a stoma, and an intravenous infusion is in place. The patient has just returned from the recovery room, and the LPN must take care of him. Identify the appropriate intervention for immediate postoperative care. *
3. Mr. Lucien Tremblay, 63 years old, arrives on the medical floor after vomiting a large amount of dark red blood at home. He appears pale, anxious, and weak, telling the LPN that he has had severe epigastric pain for two days. His vital signs now show BP 92/58, HR 122, RR 24, T 36.2°C, SpO₂ 95% on 2 L/min. The LPN notes cold, clammy skin and mild confusion. The physician orders: NPO, two large-bore IVs, IV pantoprazole, normal saline at 150 mL/hr, complete blood count, and prepare for possible endoscopy.
As the LPN prepares equipment, Mr. Tremblay says he feels dizzy when sitting up. What should the LPN do first? *
4. Ms. Joanie Desrosiers, 27 years old, arrives complaining of right lower abdominal pain that began near her navel and moved to the RLQ. She feels nauseated and cannot eat. On assessment, she is guarding her abdomen and grimaces when moving. Her vitals show BP 118/72, HR 104, RR 20, T 38.2°C, SpO₂ 98%. The physician orders: NPO, IV normal saline 125 mL/hr, CBC, abdominal ultrasound, and morphine only if pain becomes severe. The patient asks for a heating pad because the pain is worsening. What is the appropriate action? *
5. Ms. Linda Blais, 49 years old, presents with severe right upper quadrant pain radiating to her back after eating a fatty dinner. She feels nauseated and vomited once. Her vitals are BP 140/88, HR 108, RR 22, T 38.1°C, SpO₂ 97%. The physician orders: NPO, IV fluids, ultrasound of gallbladder, morphine IV PRN, and antiemetic IV PRN.
She tells the LPN she feels “pressure” rising when she lies flat. What intervention should the LPN prioritize? *
6. Mr. Amir Khoury, 33 years old, has been vomiting and experiencing diarrhea for 24 hours. He is very weak and says he “cannot keep anything down.” He appears lethargic, his mucous membranes are dry, and his skin turgor is poor. His vitals show BP 96/64, HR 118, RR 22, T 37.8°C, SpO₂ 98%. Physician orders: IV normal saline at 150 mL/hr, electrolytes, antiemetic, stool sample. While preparing supplies, the LPN notices the patient becoming dizzy when sitting up. Which action should be done first? *
7. Mr. René Caron, 71 years old, complains of cramping abdominal pain, vomiting, and abdominal distension for 2 days. On assessment, bowel sounds are high-pitched and tinkling. His vitals: BP 110/68, HR 102, RR 20, T 37.4°C, SpO₂ 98%. The physician orders: NPO, NG tube to low suction, IV fluids, and abdominal X-ray. The NG tube is at the bedside, ready for use. What is the priority action? *
8. Mr. Jeff Morel, 46 years old, arrives with severe epigastric pain radiating to the back. He is curled forward and sweating heavily. His vitals: BP 104/70, HR 116, RR 26, T 38.5°C, SpO₂ 95%. He has a history of alcohol use. The physician orders: NPO, IV fluids at high rate, morphine IV, serum amylase and lipase, and abdominal CT. The patient asks for a glass of water. What should the LPN do? *
9. Mrs. Eliane Dion, 58 years old, reports left-lower-quadrant abdominal pain, fever, and nausea. Her vitals show BP 128/84, HR 102, RR 20, T 38.3°C, SpO₂ 97%. The physician orders: NPO, IV antibiotics, CT scan, IV fluids, and pain management. She says she feels constipated and wants a laxative. What is the correct response? *
10. Mr. Marc-André Laplante, 55 years old, arrives with burning epigastric pain relieved by food but returning 1–2 hours later. Today, the pain is sudden and sharp. His vitals show BP 98/60, HR 118, RR 26, T 37.1°C, SpO₂ 98%. He looks pale and rigid. The physician orders: NPO, IV fluids, CBC, abdominal X-ray, proton pump inhibitor IV, and observe for perforation. Which finding would require immediate reporting? *
11. Mr. Ismet Erden, 66 years old, has worsening abdominal distention and shortness of breath due to ascites. His vitals: BP 128/80, HR 98, RR 22, T 36.7°C, SpO₂ 95%. The physician orders: daily weights, abdominal girth measurement, fluid restriction, low-sodium diet, and diuretics. He asks for extra soup because he “feels hungry.” What is the appropriate LPN action? *
12. Ms. Coralie St-Pierre, 34 years old, comes in with jaundice, fatigue, and right-upper-quadrant discomfort. Her vitals: BP 116/70, HR 88, RR 18, T 37.9°C, SpO₂ 98%. Physician orders: liver panel, rest, increase fluids, avoid acetaminophen, and light diet. She asks for a glass of wine, saying it's “just one.” What is the correct response? *
13. Mr. Samuel O’Hara, 41 years old, experiences burning chest discomfort after meals. Vitals are normal: BP 122/80, HR 78, RR 16, T 36.5°C, SpO₂ 100%. Physician orders: head-of-bed elevation, avoid trigger foods, antacid PRN, and weight reduction. He asks the LPN if he can lie flat after eating because he is tired. What should the LPN say? *
14. Ms. Erin Lauzon, 29 years old, has alternating diarrhea and constipation worsened by stress. Vitals normal. Physician orders: stress management, increase fiber, avoid trigger foods, hydrate well. She tells the LPN she wants to stop all fiber because it “makes me gassy.” What is the correct intervention? *
15. Mr. Léo Dubreuil, 32, arrives with bloody diarrhea, abdominal cramping, and fatigue. His vitals: BP 110/70, HR 100, RR 20, T 38.0°C. Physician orders: IV fluids, stool cultures, anti-inflammatory medication, rest, NPO if severe pain. He asks for raw vegetables with his lunch tray. What should the LPN do? *
16. Mrs. Sophia Nguyen, 56, with diabetes, reports early satiety and vomiting undigested food. Vitals stable. Physician orders: small frequent meals, metoclopramide, glycemic control, avoid high-fat foods. She asks for a large fried meal. What should the LPN do? *
17. Mr. Jean Talbot, 65, has severe abdominal pain with rigid abdomen. Vitals: BP 100/60, HR 112, RR 24, T 38.7°C. Physician orders: NPO, prepare for surgery, IV fluids, antibiotics, no analgesics until surgeon examines. He requests food, saying he hasn’t eaten since morning. What is the correct LPN action? *
18. Ms. Camille Henry, 45, is one day post-op after bowel resection. She reports no flatus, increased bloating, and nausea. Vitals: BP 118/74, HR 98, RR 20, T 37.6°C. Physician orders: NPO, NG suction, IV fluids, ambulate every 2 hours. Which intervention promotes bowel motility? *
19. Mrs. Asha Patel, 37, has vomiting, abdominal cramps, and mild fever. Vitals: BP 122/82, HR 98, RR 18, T 38.1°C. Physician orders: hydration, stool sample, antiemetic PRN, hand hygiene reinforcement. She asks if she can take antidiarrheal medication. What should the LPN reply? *
20. Mr. Hugo Lafrance, 59, is recovering from abdominal surgery and taking opioids for pain. He reports no bowel movement for 3 days. Vitals normal. Physician orders: stool softeners, increase fluids, high-fiber diet, ambulate. What is the best intervention? *
21. Ms. Valérie Généreux, 53, reports black tarry stools and fatigue. Vitals: BP 104/70, HR 108, RR 18, T 36.9°C. Physician orders: CBC, NPO, IV fluids, proton pump inhibitor IV, monitor stool output. She asks for a large coffee. What should the LPN do? *
22. Mr. Patrick Nadeau, 62, had a colostomy formed two days ago. He says he feels overwhelmed and scared to look at the stoma. His vitals are stable. Physician orders: ostomy teaching, skin assessment, monitor output, encourage patient participation.
The pouch needs emptying. What should the LPN do? *