ATI RN
ATI Gastrointestinal System
1. 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?
- A. The procedure will result in enlargement of the pyloric sphincter
- B. The procedure will result in anastomosis of the gastric stump to the jejunum
- C. The procedure will result in removal of the duodenum
- D. The procedure will result in repositioning of the vagus nerve
Correct answer: B
Rationale: The Billroth II procedure involves anastomosis of the gastric stump to the jejunum.
2. Which of the following patients is at greatest risk for developing pressure ulcers?
- A. An alert chronic arthritic patient treated with steroids and aspirin
- B. An 88-year-old incontinent patient with gastric cancer who is confined to bed at home
- C. An apathetic 63-year-old COPD patient receiving nasal oxygen via cannula
- D. A confused 78-year-old patient with congestive heart failure (CHF) who requires assistance to get out of bed
Correct answer: B
Rationale: The correct answer is B. An elderly patient who is incontinent, bedridden, and suffering from a serious illness like gastric cancer is at the highest risk for developing pressure ulcers. Being bedridden and incontinent increases the pressure on certain areas of the body, leading to tissue damage and the development of pressure ulcers. Additionally, the patient's age and underlying health condition further contribute to their risk. It is crucial to identify and address such risk factors promptly to prevent the occurrence of pressure ulcers in vulnerable patients.
3. The nurse is caring for a hospitalized client with a diagnosis of ulcerative colitis. Which finding, if noted on assessment of the client, would the nurse report to the physician?
- A. Bloody diarrhea
- B. Hypotension
- C. A hemoglobin of 12 mg/dL
- D. Rebound tenderness
Correct answer: D
Rationale: Rebound tenderness is a sign of peritonitis, a serious complication that needs to be reported to the physician immediately.
4. A nurse is providing teaching to a group of older adults about sources of complete and incomplete protein. Which of the following foods should the nurse include as a complete protein?
- A. Yogurt
- B. Fresh vegetables
- C. Nuts
- D. Dried Beans
Correct answer: A: Yogurt
Rationale: Yogurt is the correct answer as it is a complete protein source, containing all nine essential amino acids. Fresh vegetables, nuts, and dried beans are incomplete protein sources as they lack one or more essential amino acids required by the body.
5. A healthcare provider is caring for a client who has heart failure and is prescribed enalapril. The provider should monitor the client for which of the following adverse effects?
- A. Hypertension
- B. Hypokalemia
- C. Hyperglycemia
- D. Hyperkalemia
Correct answer: D
Rationale: Corrected Question: When a client with heart failure is prescribed enalapril, monitoring for hyperkalemia is essential. Enalapril is an angiotensin-converting enzyme (ACE) inhibitor that can lead to an increase in potassium levels in the blood. This adverse effect can be serious and potentially life-threatening. Choices A, B, and C are incorrect because enalapril does not typically cause hypertension, hypokalemia, or hyperglycemia as adverse effects. It's essential for healthcare providers to be vigilant in monitoring potassium levels when clients are on ACE inhibitors like enalapril.
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