ATI RN
Gastrointestinal System ATI
1. Kevin has a history of peptic ulcer disease and vomits coffee-ground emesis. What does this indicate?
- A. He has fresh, active upper GI bleeding.
- B. He needs immediate saline gastric lavage.
- C. His gastric bleeding occurred 2 hours earlier.
- D. He needs a transfusion of packed RBCs.
Correct answer: C
Rationale: Coffee-ground emesis is a sign of upper gastrointestinal bleeding that occurred approximately 2 hours earlier. It results from the breakdown of blood in the stomach due to digestive enzymes, giving it a coffee-ground appearance. Choice A is incorrect because coffee-ground emesis indicates older, partially digested blood, not fresh active bleeding. Choice B is incorrect as gastric lavage is not indicated for coffee-ground emesis. Choice D is incorrect because a transfusion of packed RBCs is not the immediate management for this presentation.
2. You’re patient, post-op drainage of a pelvic abscess secondary to diverticulitis, begins to cough violently after drinking water. His wound has ruptured and a small segment of the bowel is protruding. What’s your priority?
- A. Ask the patient what happened, call the doctor, and cover the area with a water-soaked bedsheet.
- B. Obtain vital signs, call the doctor, and obtain emergency orders.
- C. Have a CAN hold the wound together while you obtain vital signs, call the doctor and flex the patient’s knees.
- D. Have the doctor called while you remain with the patient, flex the patient’s knees, and cover the wound with sterile towels soaked in sterile saline solution.
Correct answer: D
Rationale: For a patient with a ruptured wound and protruding bowel, call the doctor while remaining with the patient, flex the patient’s knees, and cover the wound with sterile towels soaked in sterile saline solution.
3. Christina is receiving an enteral feeding that requires a concentration of 80ml of supplement mixed with 20 ml of water. How much water do you mix with an 8 oz (240ml) can of feeding?
- A. 60 ml.
- B. 70 ml.
- C. 80 ml.
- D. 90 ml.
Correct answer: A
Rationale: For an 8 oz (240 ml) can of feeding, mix 60 ml of water to achieve the required concentration.
4. A 53 y.o. patient has undergone a partial gastrectomy for adenocarcinoma of the stomach. An NG tube is in place and is connected to low continuous suction. During the immediate postoperative period, you expect the gastric secretions to be which color?
- A. Brown.
- B. Clear.
- C. Red.
- D. Yellow.
Correct answer: C
Rationale: During the immediate postoperative period after a partial gastrectomy, gastric secretions are expected to be red.
5. Your patient Maria takes NSAIDS for her degenerative joint disease, has developed peptic ulcer disease. Which drug is useful in preventing NSAID-induced peptic ulcer disease?
- A. Calcium carbonate (Tums)
- B. Famotidine (Pepcid)
- C. Misoprostol (Cytotec)
- D. Sucralfate (Carafate)
Correct answer: C
Rationale: Misoprostol (Cytotec) is useful in preventing NSAID-induced peptic ulcer disease.
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