ATI RN
ATI Gastrointestinal System
1. The nurse is evaluating the plan of care for a client with peptic ulcer disease with a nursing diagnosis of Acute Pain. The nurse would determine that the client has not met the expected outcomes if the client states
- A. That pain is relieved with histamine H2 receptor antagonists.
- B. That irritating foods have been eliminated from the diet.
- C. The client is being awakened at 2 AM with heartburn.
- D. The client has absence of pain before meals.
Correct answer: C
Rationale: Expected outcomes for the client with peptic ulcer disease experiencing pain include elimination of irritating foods from the diet, ability to take prescribed medications that will reduce pain, reporting that the pain is relieved or prevented with medication, and an ability to sleep through the night without pain. The client who continues to be awakened by pain requires further modification of medication therapy, which may include adjustment of timing of histamine H2 receptor antagonist or an additional dose of antacid before the time when pain awakens the client.
2. A client is recovering from an ileostomy that was performed to treat inflammatory bowel disease. During discharge teaching for this client, the nurse should stress:
- A. increasing fluid intake to prevent dehydration.
- B. wearing an appliance pouch at all times.
- C. consuming a low-protein, high-fiber diet.
- D. avoiding enteric-coated medications.
Correct answer: A
Rationale: The correct answer is A: increasing fluid intake to prevent dehydration. An ileostomy typically drains liquid waste, so the client is at risk of fluid loss. By increasing fluid intake, the client can prevent dehydration. It's essential for the client to wear a collection appliance at all times because ileostomy drainage is incontinent. Consuming a low-protein, high-fiber diet is not recommended as high-fiber foods can cause intestinal irritation. Enteric-coated medications should be avoided because they may not be absorbed properly after an ileostomy.
3. Risk factors for the development of hiatal hernias are those that lead to increased abdominal pressure. Which of the following complications DOES NOT cause increased abdominal pressure?
- A. Obesity
- B. Volvulus
- C. Constipation
- D. Intestinal obstruction
Correct answer: B
Rationale: Obesity, constipation, and intestinal obstruction can all lead to increased abdominal pressure, which in turn can cause a hiatal hernia.
4. A client has been taking aluminum hydroxide 30 mL six times per day at home to treat his peptic ulcer. He tells the nurse that he has been unable to have a bowel movement for 3 days. Based on this information, the nurse would determine that which of the following is the most likely cause of the client’s constipation?
- A. The client has not been including enough fiber in his diet
- B. The client needs to increase his daily exercise
- C. The client is experiencing a side effect of the aluminum hydroxide.
- D. The client has developed a gastrointestinal obstruction.
Correct answer: C
Rationale: The client is experiencing a common side effect of aluminum hydroxide, which is constipation.
5. Which of the following dietary measures would be useful in preventing esophageal reflux?
- A. Eating small, frequent meals
- B. Increasing fluid intake
- C. Avoiding air swallowing with meals
- D. Adding a bedtime snack to the dietary plan
Correct answer: A
Rationale: Eating small, frequent meals helps prevent esophageal reflux.
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