ATI RN
ATI Gastrointestinal System
1. A client is providing instructions to a client who is scheduled for an oral cholecystogram. The nurse tells the client to
- A. Eat a fat-free meal on the evening before the procedure.
- B. Maintain strict NPO status on the day of the procedure.
- C. Avoid oral intake except for water on the day of the procedure.
- D. Eat a high-fat meal for breakfast on the day of the procedure.
Correct answer: C
Rationale: For an oral cholecystogram, the client should eat a fat-free meal the evening before the procedure and avoid oral intake except for water on the day of the procedure. During the test, the client may be given a high-fat meal or drink to stimulate gallbladder emptying. Choice A is incorrect because the client should have a fat-free meal, not a high-fat meal. Choice B is incorrect as strict NPO status is not required. Choice D is incorrect as a high-fat meal is not recommended for breakfast on the day of the procedure.
2. A client is scheduled for an abdominal perineal resection with permanent colostomy. Which of the following measures would most likely be included in the plan for the client's preoperative preparation?
- A. Keep the client NPO for 2 days before surgery.
- B. Administer kanamycin (Kantrex) the night before surgery.
- C. Inform the client that chest tubes will be in place after surgery.
- D. Advise the client to limit activity.
Correct answer: B
Rationale: Antibiotics are administered preoperatively to reduce the bacterial count in the colon. The client will be placed on a low residue diet to help cleanse the bowel before surgery but typically is not placed on NPO status until 8 to 12 hours before surgery. Laxatives and enemas may also be administered. Chest tubes would not be expected postoperatively. There is no need to limit the client's activity before surgery.
3. A client with peptic ulcer is scheduled for a Vagotomy. The client asks the nurse about the purpose of this procedure. The nurse tells the client that the procedure
- A. Decreases food absorption in the stomach.
- B. Heals the gastric mucosa.
- C. Halts stress reactions.
- D. Reduces the stimulus to acid secretions.
Correct answer: D
Rationale: A vagotomy, or cutting of the vagus nerve, is done to eliminate parasympathetic stimulation of gastric secretion, thereby reducing the stimulus to acid secretions. Options A, B, and C are incorrect as a vagotomy does not affect food absorption, heal the gastric mucosa, or halt stress reactions.
4. Which of the following mechanisms can facilitate the development of diverticulosis into diverticulitis?
- A. Treating constipation with chronic laxative use, leading to dependence on laxatives
- B. Chronic constipation causing an obstruction, reducing forward flow of intestinal contents
- C. Herniation of the intestinal mucosa, rupturing the wall of the intestine
- D. Undigested food blocking the diverticulum, predisposing the area to bacterial invasion
Correct answer: D
Rationale: The correct answer is D. Undigested food blocking the diverticulum can lead to bacterial invasion, causing inflammation and turning diverticulosis into diverticulitis. Choices A, B, and C do not directly facilitate the development of diverticulitis. Choice A involves a different mechanism related to laxative use, choice B describes a complication of chronic constipation but does not necessarily lead to diverticulitis, and choice C refers to a different condition involving herniation of the intestinal mucosa.
5. Rob is a 46 y.o. admitted to the hospital with a suspected diagnosis of Hepatitis B. He’s jaundiced and reports weakness. Which intervention will you include in his care?
- A. Regular exercise.
- B. A low-protein diet.
- C. Allow patient to select his meals.
- D. Rest period after small, frequent meals.
Correct answer: D
Rationale: For a patient with hepatitis B who is jaundiced and reports weakness, providing rest periods after small, frequent meals is important.
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