ATI RN
ATI Gastrointestinal System
1. The nurse is providing discharge instructions to a client following gastrectomy. Which measure will the nurse instruct the client to follow to assist in preventing dumping syndrome?
- A. Eat high-carbohydrate foods
- B. Limit the fluids taken with meals
- C. Ambulate following a meal
- D. Sit in a high-Fowlers position during meals
Correct answer: B
Rationale: To prevent dumping syndrome after a gastrectomy, it is recommended to limit fluids taken with meals to slow down gastric emptying and reduce the symptoms.
2. The client with peptic ulcer disease is scheduled for a pyloroplasty. The client asks the nurse about the procedure. The nurse plans to respond knowing that a pyloroplasty involves:
- A. Cutting the vagus nerve
- B. Removing the distal portion of the stomach
- C. Removal of the ulcer and a large portion of the cells that produce hydrochloric acid
- D. An incision and resuturing of the pylorus to relax the muscle and enlarge the opening from the stomach to the duodenum.
Correct answer: D
Rationale: A pyloroplasty involves making an incision in the pylorus (the opening from the stomach to the duodenum) and then resuturing it to relax the muscle and enlarge the opening.
3. When a client has peptic ulcer disease, the nurse would expect a priority intervention to be:
- A. Assisting in inserting a Miller-Abbott tube
- B. Assisting in inserting an arterial pressure line
- C. Inserting a nasogastric tube
- D. Inserting an I.V.
Correct answer: C
Rationale: Inserting a nasogastric tube is a priority intervention for a client with peptic ulcer disease to decompress the stomach.
4. The client being treated for esophageal varices has a Sengstaken-Blakemore tube inserted to control the bleeding. The most important assessment is for the nurse to:
- A. Check that the hemostat is on the bedside
- B. Monitor IV fluids for the shift
- C. Regularly assess respiratory status
- D. Check that the balloon is deflated on a regular basis
Correct answer: C
Rationale: Regularly assessing respiratory status is crucial when a Sengstaken-Blakemore tube is inserted to control bleeding in esophageal varices.
5. 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.
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