ATI RN
ATI Gastrointestinal System
1. A client is recovering from an ileostomy that was performed to treat inflammatory bowel disease. During discharge teaching for this client, the nurse should stress:
- A. increasing fluid intake to prevent dehydration.
- B. wearing an appliance pouch at all times.
- C. consuming a low-protein, high-fiber diet.
- D. avoiding enteric-coated medications.
Correct answer: A
Rationale: The correct answer is A: increasing fluid intake to prevent dehydration. An ileostomy typically drains liquid waste, so the client is at risk of fluid loss. By increasing fluid intake, the client can prevent dehydration. It's essential for the client to wear a collection appliance at all times because ileostomy drainage is incontinent. Consuming a low-protein, high-fiber diet is not recommended as high-fiber foods can cause intestinal irritation. Enteric-coated medications should be avoided because they may not be absorbed properly after an ileostomy.
2. A healthcare provider is teaching a client who has a new prescription for levothyroxine. Which of the following instructions should the healthcare provider include?
- A. Take this medication with meals.
- B. Take this medication at the same time every day.
- C. Report any chest pain to your healthcare provider immediately.
- D. Take an antacid if indigestion occurs.
Correct answer: B
Rationale: The correct instruction for a client prescribed levothyroxine is to take the medication at the same time every day. This consistency is important for maintaining stable thyroid hormone levels. Choice A is incorrect because levothyroxine should be taken on an empty stomach to ensure proper absorption. Choice C is important but not directly related to the administration of levothyroxine. Choice D is incorrect as antacids can interfere with the absorption of levothyroxine.
3. Which of the following are characteristic, localized cardinal signs of acute inflammation? (Select all that apply.)
- A. Redness
- B. Fatigue
- C. Swelling
- D. Warmth
Correct answer: A, C, D
Rationale: The correct answers are A, C, and D. Redness, swelling, and warmth are classic signs of acute inflammation. Redness occurs due to increased blood flow, swelling is caused by leakage of fluid into tissues, and warmth is due to the vasodilation and increased blood flow in the affected area. Fatigue is not a cardinal sign of acute inflammation and is not directly associated with the inflammatory response.
4. According to Piaget, in which stage of cognitive development is four-year-old R’Monte who engages in make-believe play by stirring beads in a bowl and saying, “Soup is ready!�
- A. sensorimotor
- B. preoperational
- C. concrete operational
- D. sociocultural
Correct answer: B
Rationale: According to Piaget's theory of cognitive development, four-year-old R’Monte's engagement in make-believe play, such as pretending to stir beads in a bowl and creating imaginary soup, indicates that he is in the preoperational stage of cognitive development. This stage is characterized by symbolic thinking, pretend play, language development, and egocentrism. Choice A, sensorimotor, is incorrect as this stage occurs in infancy and focuses on sensory experiences and object permanence. Choice C, concrete operational, is incorrect as this stage occurs around ages 7-11 and involves logical reasoning about concrete events. Choice D, sociocultural, is incorrect as it does not correspond to Piaget's stages of cognitive development.
5. A client with a new diagnosis of diabetes mellitus is being taught about foot care. What instruction should the nurse include?
- A. Apply lotion between the toes after bathing
- B. Wear shoes at all times
- C. Cut toenails in a rounded shape
- D. Inspect the feet weekly
Correct answer: B
Rationale: The correct answer is to wear shoes at all times. This instruction is vital for clients with diabetes mellitus as it helps protect the feet and reduces the risk of injury. Option A is incorrect as applying lotion between the toes can increase moisture and the risk of fungal infections. Option C is incorrect as cutting toenails in a rounded shape may lead to ingrown toenails. Option D is also incorrect as inspecting the feet weekly is not sufficient for proper foot care in clients with diabetes mellitus.
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