ATI RN
Gastrointestinal System Nursing Exam Questions
1. A nurse is giving dietary instructions to a client who has a new colostomy. The nurse encourages the client to eat foods representing which of the following diets for the first 4 to 6 weeks postoperatively?
- A. High-protein
- B. High-carbohydrate
- C. Low-calorie
- D. Low-residue
Correct answer: D
Rationale: For the first 4 to 6 weeks following colostomy formation, the client should take in a low-residue diet. Following this period, the client should eat a high-carbohydrate, high-protein diet. The nurse also instructs the client to add new foods, one at a time, to determine tolerance to that food.
2. 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
- A. After meals.
- B. Mixed with fruit juice.
- C. Via rectal suppository.
- D. At least 3 hours before meals.
Correct answer: B
Rationale: 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.
3. The nurse is preparing a discharge teaching plan for the client who had an umbilical hernia repair. Which of the following would the nurse include in the plan?
- A. Restricting pain medication
- B. Maintaining bedrest
- C. Avoiding coughing
- D. Irrigating the drain
Correct answer: C
Rationale: Bedrest is not required following this surgical procedure. The client should take analgesics as needed and as prescribed to control pain. A drain is not used in this surgical procedure, although the client may be instructed in simple dressing changes. Coughing is avoided to prevent disruption of the tissue integrity, which can occur because of the location of this surgical procedure.
4. A 30-year-old woman is admitted to the hospital with complaints of severe abdominal cramping and diarrhea. The nurse evaluates the effectiveness of the patient's intravenous therapy. Which of the following laboratory tests BEST reflects hydration status?
- A. Erythrocyte sedimentation rate.
- B. White blood cell count.
- C. Hematocrit.
- D. Serum glucose.
Correct answer: C
Rationale: Hematocrit is the best indicator of hydration status because it reflects the proportion of red blood cells in the blood. An increased hematocrit indicates dehydration, as the blood becomes more concentrated due to fluid loss. Erythrocyte sedimentation rate (Choice A) is a nonspecific marker of inflammation, not hydration status. White blood cell count (Choice B) is an indicator of infection or inflammation. Serum glucose (Choice D) is used to monitor blood sugar levels, not hydration status.
5. A client is admitted with a diagnosis of ulcerative colitis. Which of the following symptoms should the nurse expect the client to report when responding to questions about his bowel elimination pattern?
- A. Constipation.
- B. Bloody, diarrheal stools.
- C. Steatorrhea.
- D. Alternating periods of constipation and diarrhea.
Correct answer: B
Rationale: Diarrhea is the primary symptom of ulcerative colitis. It is profuse and severe; the client may pass as many as 15 to 20 watery stools per day. Stools may contain blood, mucus, and pus. The frequent diarrhea is often accompanied by anorexia and nausea. Constipation is not a sign or symptom of ulcerative colitis. Steatorrhea (fatty stools) is more typical of pancreatitis and cholecystitis. Alternating diarrhea and constipation is associated with irritable bowel syndrome.
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