a patient with crohns disease is admitted after 4 days of diarrhea which of the following urine specific gravity values do you expect to find in this

ATI RN

ATI Gastrointestinal System Test

1. A patient with Crohn’s disease is admitted after 4 days of diarrhea. Which of the following urine specific gravity values do you expect to find in this patient?

A. 1.005
B. 1.011
C. 1.02
D. 1.03

Correct answer: D

Rationale: A urine specific gravity of 1.030 indicates concentrated urine, which is expected in a patient with dehydration due to diarrhea from Crohn’s disease.

2. The nurse has inserted a nasogastric tube to the level of the oropharynx and has repositioned the client’s head in a flexed-forward position. The client has been asked to begin swallowing. The nurse starts slowly to advance the nasogastric tube with each swallow. The client begins to cough, gag, and choke. Which nursing action would least likely result in proper tube insertion and promote client relaxation?

A. Continuing to advance the tube to the desired distance
B. Pulling the tube back slightly
C. Checking the back of the pharynx using a tongue blade and flashlight.
D. Instructing the client to breathe slowly and take sips of water.

Correct answer: A

Rationale: As the nasogastric tube is passed through the oropharynx, the gag reflex is stimulated, which may cause coughing, gagging, or choking. Instead of passing through to the esophagus, the nasogastric tube may coil around itself in the oropharynx, or it may enter the larynx and obstruct the airway, pulling the tube back slightly will remove it from the larynx; advancing the tube might position it in the trachea. Swallowing closes the epiglottis over the trachea and helps move the tube into the esophagus. Slow breathing helps the client relax to reduce the gag response. The nurse should check the back of the client’s throat to note if the tube has coiled. The tube may be advanced after the client relaxes.

3. Which of the following therapies is not included in the medical management of a client with peritonitis?

A. Broad-spectrum antibiotics
B. Electrolyte replacement
C. I.V. fluids
D. Regular diet

Correct answer: D

Rationale: A regular diet is not included in the medical management of peritonitis, which requires bowel rest and IV fluids.

4. Which of the following mechanisms can facilitate the development of diverticulosis into diverticulitis?

A. Treating constipation with chronic laxative use, leading to dependence on laxatives
B. Chronic constipation causing an obstruction, reducing forward flow of intestinal contents
C. Herniation of the intestinal mucosa, rupturing the wall of the intestine
D. Undigested food blocking the diverticulum, predisposing the area to bacterial invasion

Correct answer: D

Rationale: The correct answer is D. Undigested food blocking the diverticulum can lead to bacterial invasion, causing inflammation and turning diverticulosis into diverticulitis. Choices A, B, and C do not directly facilitate the development of diverticulitis. Choice A involves a different mechanism related to laxative use, choice B describes a complication of chronic constipation but does not necessarily lead to diverticulitis, and choice C refers to a different condition involving herniation of the intestinal mucosa.