ATI RN
Gastrointestinal System Nursing Exam Questions
1. 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.
2. What does continuous bubbling in the water seal chamber of a chest tube indicate?
- A. An air leak
- B. Drainage in the chest tube
- C. A blocked chest tube
- D. Normal chest tube function
Correct answer: A
Rationale: Continuous bubbling in the water seal chamber of a chest tube indicates an air leak. This signifies that air is escaping from the patient's pleural space into the chest tube system rather than being evacuated properly. An air leak can lead to lung collapse or pneumothorax and requires immediate attention. Therefore, choice A is the correct answer. Choices B, C, and D are incorrect because continuous bubbling does not indicate normal chest tube function, drainage in the chest tube, or a blocked chest tube.
3. When caring for a client with a new prescription for enoxaparin for the prevention of DVT, what is an appropriate action by the nurse?
- A. Expel any air bubbles at the top of the prefilled syringe
- B. Massage the injection site to evenly distribute the medication
- C. Inject the medication into the lateral abdominal wall
- D. Administer an NSAID for injection site discomfort
Correct answer: C
Rationale: When administering enoxaparin for the prevention of DVT, the nurse should inject the medication into the lateral abdominal wall. This site is preferred for subcutaneous injections of enoxaparin to reduce the risk of bleeding or injury. Expelling air bubbles, massaging the injection site, or administering an NSAID for discomfort are not appropriate actions and could lead to complications or ineffective medication delivery.
4. A nurse at a long-term care facility is amending the care plan of a resident who has just been diagnosed with essential thrombocythemia (ET). The nurse should anticipate the administration of what medication?
- A. Dalteparin
- B. Allopurinol
- C. Hydroxyurea
- D. Hydrochlorothiazide
Correct answer: C
Rationale: Hydroxyurea is effective in lowering the platelet count for patients with ET.
5. Radiation therapy is used to treat colon cancer before surgery for which of the following reasons?
- A. Reducing the size of the tumor
- B. Eliminating the malignant cells
- C. Curing the cancer
- D. Helping the bowel heal after surgery
Correct answer: A
Rationale: Radiation therapy is used before surgery to reduce the size of the tumor, making it easier to remove.
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