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 oral cholecystography. Which one of the following actions would the nurse plan to implement before the test?
- A. Have the client drink 1000 mL of water.
- B. Ask the client about possible allergies to iodine or shellfish.
- C. Administer an intravenous contrast agent the evening before the test.
- D. Administer tap-water enemas until clear.
Correct answer: B
Rationale: Iodine compounds used as radiographic contrast agents, such as iopanoic acid (Telepaque), should not be administered to the client with iodine and seafood allergies because anaphylaxis may occur.
3. Which stoma would you expect a malodorous, enzyme-rich, caustic liquid output that is yellow, green, or brown?
- A. Ileostomy.
- B. Ascending colostomy.
- C. Transverse colostomy.
- D. Descending colostomy.
Correct answer: A
Rationale: An ileostomy would have a malodorous, enzyme-rich, caustic liquid output that is yellow, green, or brown.
4. Lactulose (Chronulac) is prescribed for a client with a diagnosis of hepatic encephalopathy. The nurse would determine that this medication has had a therapeutic effect if which of the following is noted?
- A. Increased red blood cell count
- B. Decreased serum ammonia level
- C. Increased protein level
- D. Decreased white blood cell level
Correct answer: B
Rationale: Lactulose is prescribed for the client with hepatic encephalopathy to reduce bacterial breakdown of protein in the bowel. The medication creates an acidic environment in the bowel and causes the ammonia to leave the bloodstream and enter the colon. Ammonia then becomes trapped in the bowel. Lactulose also has a laxative effect that allows for the elimination of the ammonia.
5. After a subtotal gastrectomy, the nurse should anticipate that nasogastric tube drainage will be what color for about 12 to 24 hours after surgery?
- A. Dark brown
- B. Bile green
- C. Bright red
- D. Cloudy white
Correct answer: A
Rationale: Dark brown drainage is expected for about 12 to 24 hours after surgery.
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