Free Gastrointestinal Systems practice for ATI Gastrointestinal System Quizlet (ATI RN). Answer 52 nursing exam-style questions with rationales, exam mode, and
After abdominal surgery, your patient has a severe coughing episode that causes wound evisceration. In addition to calling the doctor, which intervention is most appropriate?
Select the best answer.
Explanation:
Covering the wound with a saline soaked sterile dressing is the most appropriate intervention for wound evisceration.
A nurse is providing the client with biliary obstruction a simple overview of the anatomy of the liver and gallbladder. The nurse tells the client that normally the liver stores bile in the gallbladder, which is connected to the liver by the?
Select the best answer.
Explanation:
The gallbladder receives bile from the liver through the cystic duct. The liver collects bile in the canaliculi. Bile then flows into the common hepatic duct. From the common hepatic duct, the bile can be stored in the gallbladder through the cystic duct. Otherwise, the bile can flow directly into the duodenum by way of the common bile duct.
A client has been diagnosed with adenocarcinoma of the stomach and is scheduled to undergo a subtotal gastrectomy (Billroth II procedure). During pre-operative teaching, the nurse is reinforcing information about the procedure. Which of the following explanations is most accurate?
Select the best answer.
Explanation:
The Billroth II procedure involves anastomosis of the gastric stump to the jejunum.
Which of the following nursing measures would be inappropriate when caring for a client with a Cantor tube?
Select the best answer.
Explanation:
Intestinal tubes are not irrigated. Injecting air into the tube, applying water-soluble lubricant, and coiling extra tubing are appropriate nursing measures.
Which of the following complications of gastric resection should the nurse teach the client to watch for?
Select the best answer.
Explanation:
Clients should be taught to watch for symptoms of dumping syndrome, a common complication after gastric resection.
Janice is waiting for discharge instructions after her herniorrhaphy. Which of the following instructions do you include?
Select the best answer.
Explanation:
Advise the patient to lose weight if obese to reduce the risk of complications after herniorrhaphy.
Cholestyramine resin (Questran Light) is prescribed for the client with an elevated serum cholesterol level. The nurse would instruct the client to take the medication
Select the best answer.
Explanation:
Cholestyramine resin binds with bile salts in the intestines to form a compound that is excreted in the feces. The client should be instructed to mix the medication with 3 to 6 oz of water, milk, fruit juice, or soup. The medication should be administered before meals. The medication is not administered via rectal suppository.
Care for the postoperative client after gastric resection should focus on which of the following problems?
Select the best answer.
Explanation:
Postoperative care after gastric resection should focus on the client's nutritional needs to ensure proper healing and recovery.
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?
Select the best answer.
Explanation:
Disturbed Sleep Pattern related to epigastric pain is appropriate because the client reports pain that frequently awakens her at night.
A nurse is reviewing the orders of a client admitted to the hospital with a diagnosis of acute pancreatitis. Select the interventions that the nurse would expect to be prescribed for the client.
Select the best answer.
Explanation:
The correct intervention for a client with acute pancreatitis is to prescribe pain medications such as meperidine to manage the abdominal pain, which is a prominent symptom of the condition. The other options are incorrect because: A) Clients with acute pancreatitis are normally placed on NPO (nothing by mouth) status to rest the pancreas, so small, frequent high-calorie feedings are not indicated. C) Placing the client in a side-lying position with the head elevated 45-degrees helps decrease tension on the abdomen and may ease pain, but it is not a standard intervention for acute pancreatitis. D) Administering antacids and anticholinergics to suppress gastrointestinal secretions is not a routine intervention for acute pancreatitis.
The client with ascites is scheduled for a paracentesis. The nurse is assisting the physician in performing the procedure. Which of the following positions will the nurse assist the client to assume for this procedure?
Select the best answer.
Explanation:
An upright position allows the intestine to float posteriorly and helps prevent intestinal laceration during catheter insertion.
A 30-year old client experiences weight loss, abdominal distention, crampy abdominal pain, and intermittent diarrhea after the birth of her 2nd child. Diagnostic tests reveal gluten-induced enteropathy. Which foods must she eliminate from her diet permanently?
Select the best answer.
Explanation:
Gluten-induced enteropathy, or celiac disease, requires the elimination of gluten-containing grains like wheat, barley, and rye. Dairy, proteins, and carbohydrates are not excluded unless the client has specific intolerances.
When counseling a client in ways to prevent cholecystitis, which of the following guidelines is most important?
Select the best answer.
Explanation:
Eating a low-fat, low-cholesterol diet is most important for preventing cholecystitis.
The nurse is assessing for stoma prolapse in a client with a colostomy. The nurse would observe which of the following if stoma prolapse occurred?
Select the best answer.
Explanation:
A protruding stoma is indicative of stoma prolapse, which occurs when the bowel protrudes excessively through the stoma.
The client has just had surgery to create an ileostomy. The nurse assesses the client in the immediate post-op period for which of the following most frequent complications of this type of surgery?
Select the best answer.
Explanation:
Fluid and electrolyte imbalance is a common complication following ileostomy surgery due to the loss of large volumes of fluid and electrolytes through the stoma. Monitoring and replacing fluids and electrolytes is essential.
Britney, a 20 y.o. student is admitted with acute pancreatitis. Which laboratory findings do you expect to be abnormal for this patient?
Select the best answer.
Explanation:
Serum amylase and lipase levels are typically elevated in patients with acute pancreatitis.
When planning care for a client with ulcerative colitis who is experiencing symptoms, which client care activities can the nurse appropriately delegate to a unlicensed assistant?
Select the best answer.
Explanation:
Providing skin care following bowel movements, maintaining intake and output records, and obtaining the client's weight can be delegated to a unlicensed assistant.
The nurse is performing an assessment on a client with acute pancreatitis who was admitted to the hospital. Which of the following assessment questions most specifically would elicit information regarding the pain that is associated with acute pancreatitis?
Select the best answer.
Explanation:
The pain that is associated with acute pancreatitis is often severe and is located in the epigastric region and radiates to the back. Options 1, 3, and 4 are incorrect because they are not specific for the pain experienced by the client with pancreatitis.
A client with liver dysfunction is having difficulty with protein metabolism. The nurse anticipates that the results of which of the following serum laboratory studies will be elevated?
Select the best answer.
Explanation:
During deamination of proteins, the liver splits the amino group from the carbon-containing compound, which results in the formation of ammonia and a carbon residue. The liver then converts the toxic ammonia substance into urea, which can be excreted by the kidneys. Clients with liver dysfunction may have high serum ammonia levels as a result.
Before bowel surgery, Lee is to administer enemas until clear. During administration, he complains of intestinal cramps. What do you do next?
Select the best answer.
Explanation:
If a patient complains of intestinal cramps during an enema, lowering the height of the enema container can help reduce discomfort.
A client with suspected gastric cancer undergoes an endoscopy of the stomach. Which of the following assessments made after the procedure would indicate the development of a potential complication?
Select the best answer.
Explanation:
A sudden increase in temperature after an endoscopy can indicate a potential complication, such as perforation.
The nurse is doing preoperative teaching with the client who is about to undergo creation of a Kock pouch. The nurse interprets that the client has the best understanding of the nature of the surgery if the client makes which of the following statements?
Select the best answer.
Explanation:
A Kock pouch is a continent ileostomy. As the ileostomy begins to function, the client drains it every 3 to 4 hours and then decreases the draining about 3 times a day or as needed when full. The client does not need to wear a drainage bag but should wear an absorbent dressing to absorb mucous drainage from the stoma. Ileostomy drainage is liquid. The client would be able to pass stool only from the rectum if an ileal-anal pouch or anastomosis were created. This type of operation is a two-stage procedure.
Which of the following symptoms is associated with ulcerative colitis?
Select the best answer.
Explanation:
Rectal bleeding is a common symptom of ulcerative colitis due to the inflammation and ulceration of the colon lining.
The client has been admitted with a diagnosis of acute pancreatitis. The nurse would assess this client for pain that is:
Select the best answer.
Explanation:
Acute pancreatitis typically presents with severe, unrelenting pain in the epigastric area that radiates to the back. This pain is due to inflammation and autodigestion of the pancreas.
The nurse provides discharge instructions to a patient with hepatitis B. Which of the following statements, if made by the patient, would indicate the need for further instruction?
Select the best answer.
Explanation:
The correct answer is D. This patient statement indicates a need for further teaching. The patient should be instructed that, in order to avoid complications, alcohol should be avoided for six months to one year. Illicit drugs and toxic chemicals should also be avoided. Acetaminophen may be taken only when necessary and not beyond the recommended dosage. Choices A, B, and C are correct statements regarding precautions to prevent the spread of hepatitis B and do not indicate a need for further instruction.
The nurse is caring for a client on the first postoperative day following a surgical repair of an abdominal aortic aneurysm. Which nursing diagnosis is the most important for this client?
Select the best answer.
Explanation:
Peripheral tissue perfusion is a major concern in the postoperative period following an abdominal aneurysm repair. Peripheral pulses should be checked frequently during the first 24 hours. A weak or absent pulse may be a sign of embolization or graft closure, especially if accompanied by a pale, cold, mottled extremity; the nurse should immediately report this to the surgeon. Risk for infection, deficient knowledge, and activity intolerance are all important nursing diagnoses in the postoperative period, but peripheral tissue perfusion is the most immediate concern.
The nurse instructs the ileostomy client to do which of the following as a part of essential care of the stoma?
Select the best answer.
Explanation:
Cleansing the peristomal skin meticulously is crucial to prevent irritation and infection around the stoma.
You promote hemodynamic stability in a patient with upper GI bleeding by:
Select the best answer.
Explanation:
Promoting hemodynamic stability in a patient with upper GI bleeding involves giving blood, electrolyte, and fluid replacement.
The nurse provides medication instructions to a client with peptic ulcer disease. Which statement, if made by the client, indicates the best understanding of the medication therapy?
Select the best answer.
Explanation:
Cimetidine (Tagamet) works by reducing stomach acid production, which helps to manage peptic ulcer disease.
A nurse orientee is preparing to insert a nasogastric tube, and a nurse educator is observing the procedure. Which of the following supplies if obtained by the nurse orientee would indicate a need for further education regarding this procedure?
Select the best answer.
Explanation:
Water-soluble lubricant is used to lubricate 3 to 4 inches of the tube at the insertion end. An oil lubricant is not used because if the tube accidentally goes into the bronchus, pneumonia can develop. Half-inch tape is used to secure the tube after the correct placement is verified. A 50-mL catheter tip syringe is used to aspirate gastric contents to confirm placement. The client will be asked to take a sip of water through a straw to help with the passage of the tube.
Which of the following diagnostic tests may be performed to determine if a client has gastric cancer?
Select the best answer.
Explanation:
A gastroscopy is performed to visualize the stomach lining and obtain biopsies to diagnose gastric cancer.
Before administering an intermittent tube feeding through a nasogastric tube, the nurse assesses for gastric residual. The nurse understands that this procedure is important to
Select the best answer.
Explanation:
Evaluating the absorption of the last feeding is important because administration of a tube feeding to a full stomach could result in overdistention, thus predisposing the client to regurgitation and possible aspiration.
A patient who underwent abdominal surgery now has a gaping incision due to delayed wound healing. Which method is correct when you irrigate a gaping abdominal incision with sterile normal saline solution, using a piston syringe?
Select the best answer.
Explanation:
Irrigating continuously until the solution becomes clear or all of the solution is used is the correct method when irrigating a gaping abdominal incision.
While caring for a client with peptic ulcer disease, the client reports that he has been nauseated most of the day and is now feeling lightheaded and dizzy. Based upon these findings, which nursing actions would be most appropriate for the nurse to take?
Select the best answer.
Explanation:
Monitoring the client's vital signs and notifying the physician of the client's symptoms are crucial actions based on the reported symptoms.
Which stoma would you expect a malodorous, enzyme-rich, caustic liquid output that is yellow, green, or brown?
Select the best answer.
Explanation:
An ileostomy would have a malodorous, enzyme-rich, caustic liquid output that is yellow, green, or brown.
Which of the following medications is most effective for treating the pain associated with irritable bowel disease?
Select the best answer.
Explanation:
Acetaminophen is often the first line of treatment for pain associated with irritable bowel disease due to its safety profile.
A client has been diagnosed with gastroesophageal reflux disease. The nurse interprets that the client has dysfunction of which of the following parts of the digestive system?
Select the best answer.
Explanation:
The lower esophageal sphincter is a functional sphincter that normally remains closed except when food or fluids are swallowed. If relaxation of this sphincter occurs, the client could experience symptoms of gastroesophageal reflux disease.
Which of the following factors is believed to cause ulcerative colitis?
Select the best answer.
Explanation:
Ulcerative colitis is believed to be caused by an altered immune response in the gastrointestinal tract.
The nurse is planning to teach the client with gastroesophageal reflux disease about substances that will increase the lower esophageal sphincter pressure. Which of the following items would the nurse include on this list?
Select the best answer.
Explanation:
Foods that increase the lower esophageal sphincter (LES) pressure will decrease reflux, and lessen the symptoms of gastroesophageal reflux disease (GERD). The food substance that will increase the LES pressure is nonfat milk. The other substances listed decrease the LES pressure, thus increasing reflux symptoms. Aggravating substances include chocolate, coffee, fatty foods and alcohol.
Surgical management of ulcerative colitis may be performed to treat which of the following complications?
Select the best answer.
Explanation:
Surgical management of ulcerative colitis may be necessary to treat complications such as bowel perforation.
The nurse has given instructions to the client with an ileostomy about foods to eat to thicken the stool. The nurse determines that the client needs further instructions if the client stated to eat which of the following foods to make the stools less watery?
Select the best answer.
Explanation:
Bran is high in fiber and should not be consumed to thicken the stool as it will make the stools more watery.
Which of the following tests can be performed to diagnose a hiatal hernia?
Select the best answer.
Explanation:
A barium swallow is a diagnostic test that can visualize the esophagus, stomach, and small intestine to diagnose a hiatal hernia.
A client with peptic ulcer disease tells the nurse that he has black stools, which he has not reported to his physician. Based on this information, which nursing diagnosis would be appropriate for this client?
Select the best answer.
Explanation:
Deficient knowledge related to unfamiliarity with significant signs and symptoms is appropriate because the client did not report the black stools, which can be a sign of bleeding.
The nurse provides medication instructions to a client with peptic ulcer disease. Which statement, if made by the client, indicates best understanding of the medication therapy?
Select the best answer.
Explanation:
Cimetidine (Tagamet) a Histamine H2 receptor antagonist, will decrease the secretion of gastric acid. Sucralfate (Carafate) promotes healing by coating the ulcer. Antacids neutralize acid in the stomach. Omeprazole (Prilosec) inhibits gastric acid secretion.
The nurse is scheduling diagnostic tests for a client. If all of the following diagnostic tests are ordered, which would be performed last?
Select the best answer.
Explanation:
The correct answer is C, 'Barium swallow.' A barium swallow should be done after a barium enema or gallbladder series to prevent the contrast used in the barium swallow from obstructing the view of other organs. It takes several days for swallowed barium to pass completely out of the gastrointestinal tract. Choices A, B, and D are incorrect because a barium swallow should be the last test performed to ensure clear imaging without interference from residual contrast material.
The nurse develops a plan of care for a client with a T tube. Which one of the following nursing interventions should be included?
Select the best answer.
Explanation:
The correct nursing intervention to include in the plan of care for a client with a T tube is to inspect the skin around the T tube daily for irritation. Bile is erosive and can cause skin irritation, so it is crucial to keep the skin clean and dry. T tubes are not routinely irrigated; irrigation is done only with a physician's order. It is unnecessary to maintain the client in a supine position; instead, assist the client into a position of comfort. T tubes are not typically clamped unless ordered by a physician, and if clamped, it is usually done 1 to 2 hours before and after meals.
Nathaniel has severe pruritus due to having hepatitis B. What is the best intervention for his comfort?
Select the best answer.
Explanation:
Giving tepid baths can help soothe severe pruritus due to hepatitis B.
A 29 y.o. patient has an acute episode of ulcerative colitis. What diagnostic test confirms this diagnosis?
Select the best answer.
Explanation:
Sigmoidoscopy is the diagnostic test that confirms the diagnosis of an acute episode of ulcerative colitis.
A client returns from surgery with a sigmoid colostomy. An ostomy appliance is attached. The priority nursing diagnosis for daily observation and care is:
Select the best answer.
Explanation:
Impaired skin integrity would be the priority nursing diagnosis for daily care of the colostomy because the effluent from the colostomy can be irritating to the skin. Diarrhea isn't a concern at this point. The client will be allowed nothing by mouth until peristalsis returns. The client should get out of bed on the first postoperative day, so mobility shouldn't be a problem.
A client with gastric cancer may exhibit which of the following symptoms?
Select the best answer.
Explanation:
Clients with gastric cancer may experience a feeling of fullness due to the presence of the tumor.
Elmer is scheduled for a proctoscopy and has an I.V. The doctor wrote an order for 5mg of I.V. diazepam(Valium). Which order is correct regarding diazepam?
Select the best answer.
Explanation:
The correct method for administering I.V. diazepam is to give it in the I.V. port closest to the vein.
Which of the following expected outcomes would be appropriate for the client who has ulcerative colitis?
Select the best answer.
Explanation:
Small, frequent feedings are better tolerated by clients with ulcerative colitis as they lessen the amount of fecal material present in the gastrointestinal tract and decrease stimulation. The client does not need to maintain a daily record of intake and output unless an exacerbation of the disease occurs. A heating pad should not be applied to the intestine as it is inflamed. It is not inevitable that the client will require surgery to treat ulcerative colitis.
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