ATI RN
Gastrointestinal System Nursing Exam Questions
1. 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.
2. The nurse evaluates the client’s stoma during the initial post-op period. Which of the following observations should be reported immediately to the physician?
- A. The stoma is slightly edematous
- B. The stoma is dark red to purple
- C. The stoma oozes a small amount of blood
- D. The stoma does not expel stool
Correct answer: B
Rationale: A dark red to purple stoma may indicate compromised blood flow or ischemia, which requires immediate medical attention. This color change could be a sign of inadequate blood supply to the stoma tissue, leading to tissue damage or necrosis. Reporting this observation promptly is crucial to prevent further complications. Choices A, C, and D are not indicative of immediate medical concern. A slightly edematous stoma, oozing a small amount of blood, or not expelling stool may not be uncommon findings during the initial post-op period and can be managed without urgent intervention.
3. Which of the following symptoms is common with a hiatal hernia?
- A. Left arm pain
- B. Lower back pain
- C. Esophageal reflux
- D. Abdominal cramping
Correct answer: C
Rationale: Esophageal reflux is a common symptom of a hiatal hernia because the hernia can cause stomach acid to move back up into the esophagus.
4. A client has just had surgery for colon cancer. Which of the following disorders might the client develop?
- A. Peritonitis
- B. Diverticulosis
- C. Partial bowel obstruction
- D. Complete bowel obstruction
Correct answer: C
Rationale: After surgery for colon cancer, the client may develop a partial bowel obstruction.
5. Which of the following associated disorders may a client with ulcerative colitis exhibit?
- A. Gallstones
- B. Hydronephrosis
- C. Nephrolithiasis
- D. Toxic megacolon
Correct answer: D
Rationale: Toxic megacolon is a severe complication that may be exhibited by a client with ulcerative colitis.
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