ATI RN
ATI Gastrointestinal System
1. A client is admitted to the hospital after vomiting bright red blood and is diagnosed with a bleeding duodenal ulcer. The client develops a sudden, sharp pain in the midepigastric area along with a rigid, boardlike abdomen. These clinical manifestations most likely indicate which of the following?
- A. An intestinal obstruction has developed
- B. Additional ulcers have developed
- C. The esophagus has become inflamed
- D. The ulcer has perforated
Correct answer: D
Rationale: A sudden, sharp pain in the midepigastric area along with a rigid, boardlike abdomen indicates that the ulcer has perforated.
2. The client being treated for esophageal varices has a Sengstaken-Blakemore tube inserted to control the bleeding. The most important assessment is for the nurse to:
- A. Check that the hemostat is on the bedside
- B. Monitor IV fluids for the shift
- C. Regularly assess respiratory status
- D. Check that the balloon is deflated on a regular basis
Correct answer: C
Rationale: Regularly assessing respiratory status is crucial when a Sengstaken-Blakemore tube is inserted to control bleeding in esophageal varices.
3. A client with ulcerative colitis is diagnosed with a mild case of the disease. The nurse doing dietary teaching gives the client examples of foods to eat that represent which of the following therapeutic diets?
- A. High-fat with milk
- B. High-protein without milk
- C. Low-roughage without milk
- D. Low-roughage with milk
Correct answer: C
Rationale: The client with a mild case of ulcerative colitis is often advised to follow a diet low in roughage and avoid milk. This dietary approach helps reduce the frequency of diarrhea in these clients. Therefore, the correct therapeutic diet for the client with ulcerative colitis in this scenario is a low-roughage diet without milk. Choices A, B, and D are incorrect because high-fat, high-protein, and low-roughage with milk diets are not typically recommended for clients with ulcerative colitis, especially those with mild cases.
4. You’re caring for Betty with liver cirrhosis. Which of the following assessment findings leads you to suspect hepatic encephalopathy in her?
- A. Asterixis
- B. Chvostek’s sign
- C. Trousseau’s sign
- D. Hepatojugular reflex
Correct answer: A
Rationale: Asterixis, a flapping tremor of the hands, is a sign of hepatic encephalopathy.
5. You’re caring for a 28 y.o. woman with hepatitis B. She’s concerned about the duration of her recovery. Which response isn’t appropriate?
- A. Encourage her to not worry about the future.
- B. Encourage her to express her feelings about the illness.
- C. Discuss the effects of hepatitis B on future health problems.
- D. Provide avenues for financial counseling if she expresses the need.
Correct answer: A
Rationale: Encouraging the patient to not worry about the future is not appropriate. Instead, address her concerns and provide information.
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