ATI RN
Gastrointestinal System ATI
1. 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.
2. 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.
3. 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.
4. A nurse is caring for a client who has a new diagnosis of Crohn's disease. Which of the following findings should the nurse expect?
- A. Bloody diarrhea
- B. Fatty stools
- C. Weight gain
- D. High fever
Correct answer: B
Rationale: Clients with Crohn's disease often experience fatty stools (steatorrhea) due to malabsorption of fats. This occurs because the inflammation caused by Crohn's disease can affect the small intestine, impairing the body's ability to absorb nutrients. Bloody diarrhea is more commonly associated with ulcerative colitis. Weight gain is not a typical symptom of Crohn's disease; instead, weight loss is more common due to malabsorption and decreased appetite. High fever can occur during acute flare-ups but is not a primary finding of Crohn's disease.
5. George has a T tube in place after gallbladder surgery. Before discharge, what information or instructions should be given regarding the T tube drainage?
- A. If there is any drainage, notify the surgeon immediately.
- B. The drainage will decrease daily until the bile duct heals.
- C. First, the drainage is dark green; then it becomes dark yellow.
- D. If the drainage stops, milk the tube toward the puncture wound.
Correct answer: B
Rationale: Before discharge, inform the patient that the drainage will decrease daily until the bile duct heals.
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