ATI RN
ATI Gastrointestinal System
1. The client has orders for a nasogastric (NG) tube insertion. During the procedure, instructions that will assist in the insertion would be:
- A. Instruct the client to tilt his head back for insertion in the nostril, then flex his neck for the final insertion
- B. After insertion into the nostril, instruct the client to extend his neck
- C. Introduce the tube with the client’s head tilted back, then instruct him to keep his head upright for final insertion
- D. Instruct the client to hold his chin down, then back for insertion of the tube
Correct answer: A
Rationale: Instructing the client to tilt his head back for insertion in the nostril, then flex his neck for the final insertion helps facilitate the NG tube insertion.
2. The client with a duodenal ulcer may exhibit which of the following findings on assessment?
- A. Hematemesis
- B. Malnourishment
- C. Melena
- D. Pain with eating
Correct answer: C
Rationale: Melena (black, tarry stools) can be an indication of a duodenal ulcer.
3. The client being seen in a physician’s office has just been scheduled for a barium swallow the next day. The nurse writes down which of the following instructions for the client to follow before the test?
- A. Fast for 8 hours before the test.
- B. Eat a regular supper and breakfast.
- C. Continue to take all oral medications as scheduled.
- D. Monitor own bowel movement pattern for constipation
Correct answer: A
Rationale: A barium swallow is an x-ray study that uses a substance called barium for contrast to highlight abnormalities in the gastrointestinal tract. The client should fast for 8 to 12 hours before the test, depending on physician instructions. Most oral medications also are withheld before the test. After the procedure the nurse must monitor for constipation, which can occur as a result of the presence of barium in the gastrointestinal tract.
4. Which of the following conditions can cause a hiatal hernia?
- A. Increased intrathoracic pressure
- B. Weakness of the esophageal muscle
- C. Increased esophageal muscle pressure
- D. Weakness of the diaphragmic muscle
Correct answer: D
Rationale: Weakness of the diaphragmic muscle can lead to a hiatal hernia as it allows part of the stomach to push through the diaphragm into the chest cavity.
5. A client with a peptic ulcer reports epigastric pain that frequently awakens her at night, a feeling of fullness in the abdomen, and a feeling of anxiety about her health. Based on this information, which nursing diagnosis would be most appropriate?
- A. Imbalanced Nutrition: Less than Body Requirements related to anorexia.
- B. Disturbed Sleep Pattern related to epigastric pain
- C. Ineffective Coping related to exacerbation of duodenal ulcer
- D. Activity Intolerance related to abdominal pain
Correct answer: B
Rationale: Disturbed Sleep Pattern related to epigastric pain is appropriate because the client reports pain that frequently awakens her at night.
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