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 RBC’s.
Correct answer: C
Rationale: Coffee-ground emesis indicates that the gastric bleeding occurred 2 hours earlier.
2. The student nurse is participating in colorectal cancer-screening program. Which patient has the fewest risk factors for colon cancer?
- A. Janice, a 45 y.o. with a 25-year history of ulcerative colitis
- B. George, a 50 y.o. whose father died of colon cancer
- C. Herman, a 60 y.o. who follows a low-fat, high-fiber diet
- D. Sissy, a 72 y.o. with a history of breast cancer
Correct answer: C
Rationale: Herman, a 60 y.o. who follows a low-fat, high-fiber diet, has the fewest risk factors for colon cancer.
3. Your patient has a retractable gastric peptic ulcer and has had a gastric vagotomy. Which factor increases as a result of vagotomy?
- A. Peristalsis.
- B. Gastric acidity.
- C. Gastric motility.
- D. Gastric pH.
Correct answer: D
Rationale: After a gastric vagotomy, the gastric pH increases as a result of reduced acid secretion.
4. Your patient with peritonitis is NPO and complaining of thirst. What is your priority?
- A. Increase the I.V. infusion rate.
- B. Use diversion activities.
- C. Provide frequent mouth care.
- D. Give ice chips every 15 minutes.
Correct answer: C
Rationale: Providing frequent mouth care is the priority for a patient with peritonitis who is NPO and complaining of thirst.
5. 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.
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