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. 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. Sitty, a 66 y.o. patient underwent a colostomy for ruptured diverticulum. She did well during the surgery and returned to your med-surg floor in stable condition. You assess her colostomy 2 days after surgery. Which finding do you report to the doctor?
- A. Blanched stoma
- B. Edematous stoma
- C. Reddish-pink stoma
- D. Brownish-black stoma
Correct answer: A
Rationale: A blanched stoma 2 days after colostomy surgery should be reported to the doctor as it may indicate compromised blood flow.
4. An intubated patient is receiving continuous enteral feedings through a Salem sump tube at a rate of 60ml/hr. Gastric residuals have been 30-40ml when monitored Q4H. You check the gastric residual and aspirate 220ml. What is your first response to this finding?
- A. Notify the doctor immediately.
- B. Stop the feeding, and clamp the NG tube.
- C. Discard the 220ml, and clamp the NG tube.
- D. Give a prescribed GI stimulant such as metoclopramide (Reglan).
Correct answer: B
Rationale: If gastric residuals are high during continuous enteral feedings, the first response is to stop the feeding and clamp the NG tube.
5. Develop a teaching care plan for Angie who is about to undergo a liver biopsy. Which of the following points do you include?
- A. You’ll need to lie on your stomach during the test.
- B. You’ll need to lie on your right side after the test.
- C. During the biopsy you’ll be asked to exhale deeply and hold it.
- D. The biopsy is performed under general anesthesia.
Correct answer: B
Rationale: Instruct the patient to lie on their right side after the biopsy to apply pressure and prevent bleeding.
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