a nurse has been caring for a client with a sengstaken blakemore tube the physician arrives on the nursing unit and deflates the esophageal balloon th
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Nursing Elites

ATI RN

Gastrointestinal System Nursing Exam Questions

1. A nurse has been caring for a client with a Sengstaken-Blakemore tube. The physician arrives on the nursing unit and deflates the esophageal balloon. The nurse should monitor the client most closely for which of the following?

Correct answer: C

Rationale: A Sengstaken-Blakemore tube is inserted into a client with a diagnosis of cirrhosis and ruptured esophageal varices. The tube has an esophageal and a gastric balloon. The esophageal balloon exerts pressure on the bleeding. The pressure of the esophageal balloon is released at intervals to decrease the risk of trauma to esophageal tissues, including esophageal rupture or necrosis. When the balloon is deflated the client may begin to bleed again from the esophageal varices, noted by vomiting of blood.

2. A client has just had surgery for colon cancer. Which of the following disorders might the client develop?

Correct answer: C

Rationale: After surgery for colon cancer, the client may develop a partial bowel obstruction.

3. The client has just had surgery to create an ileostomy. The nurse assesses the client in the immediate post-op period for which of the following most frequent complications of this type of surgery?

Correct answer: B

Rationale: Fluid and electrolyte imbalance is a common complication following ileostomy surgery due to the loss of large volumes of fluid and electrolytes through the stoma. Monitoring and replacing fluids and electrolytes is essential.

4. Which of the following symptoms indicates diverticulosis?

Correct answer: A

Rationale: Diverticulosis often has no symptoms and is usually found incidentally during tests for other conditions.

5. A client with peptic ulcer is scheduled for a Vagotomy. The client asks the nurse about the purpose of this procedure. The nurse tells the client that the procedure

Correct answer: D

Rationale: A vagotomy, or cutting of the vagus nerve, is done to eliminate parasympathetic stimulation of gastric secretion, thereby reducing the stimulus to acid secretions. Options A, B, and C are incorrect as a vagotomy does not affect food absorption, heal the gastric mucosa, or halt stress reactions.

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