ATI RN
ATI Gastrointestinal System
1. A female client complains of gnawing epigastric pain for a few hours after meals. At times, when the pain is severe, vomiting occurs. Specific tests are indicated to rule out:
- A. Cancer of the stomach
- B. Peptic ulcer disease
- C. Chronic gastritis
- D. Pylorospasm
Correct answer: A
Rationale: Specific tests are indicated to rule out cancer of the stomach when a client complains of gnawing epigastric pain and vomiting after meals.
2. What information is correct about stomach cancer?
- A. Stomach pain is often a late symptom.
- B. Surgery is often a successful treatment.
- C. Chemotherapy and radiation are often successful treatments.
- D. The patient can survive for an extended time with TPN.
Correct answer: A
Rationale: Stomach pain is often a late symptom of stomach cancer.
3. 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.
4. You promote hemodynamic stability in a patient with upper GI bleeding by:
- A. Encouraging oral fluid intake.
- B. Monitoring central venous pressure.
- C. Monitoring laboratory test results and vital signs.
- D. Giving blood, electrolyte and fluid replacement.
Correct answer: D
Rationale: Promoting hemodynamic stability in a patient with upper GI bleeding involves giving blood, electrolyte, and fluid replacement.
5. The nurse is reviewing the medication record of a client with acute gastritis. Which medication if noted on the client’s record, would the nurse question?
- A. Digoxin (Lanoxin)
- B. Indomethacin (Indocin)
- C. Furosemide (Lasix)
- D. Propranolol hydrochloride (Inderal)
Correct answer: B
Rationale: Indomethacin (Indocin) is a Nonsteroidal anti-inflammatory drug and can cause ulceration of the esophagus, stomach, duodenum, or small intestine. Indomethacin is contraindicated in a client with gastrointestinal disorders. Furosemide (Lasix) is a loop diuretic. Digoxin is an antidysrhythmic. Propranolol (Inderal) is a B- adrenergic blocker. Furosemide, digoxin, and propranolol are not contraindicated in clients with gastric disorders.
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