ATI RN
ATI Gastrointestinal System Test
1. Elmer is scheduled for a proctoscopy and has an I.V. The doctor wrote an order for 5mg of I.V. diazepam(Valium). Which order is correct regarding diazepam?
- A. Give diazepam in the I.V. port closest to the vein.
- B. Mix diazepam with 50 ml of dextrose 5% in water and give over 15 minutes.
- C. Give diazepam rapidly I.V. to prevent the bloodstream from diluting the drug mixture.
- D. Question the order because I.V. administration of diazepam is contraindicated.
Correct answer: A
Rationale: The correct method for administering I.V. diazepam is to give it in the I.V. port closest to the vein.
2. Which of the following tests can be used to diagnose ulcers?
- A. Abdominal x-ray
- B. Barium swallow
- C. Computed tomography (CT) scan
- D. Esophagogastroduodenoscopy (EGD)
Correct answer: D
Rationale: Esophagogastroduodenoscopy (EGD) is a diagnostic test that involves visualizing the esophagus, stomach, and duodenum to diagnose ulcers.
3. Which of the following techniques would the nurse use first to determine if a nasogastric tube is positioned in the stomach?
- A. Aspirating with a syringe and observing for the return of gastric contents.
- B. Irrigating with normal saline and observing for the return of solution.
- C. Placing the tube's free end in water and observing for air bubbles.
- D. Instilling air and auscultating over the epigastric area for the presence of the tube.
Correct answer: A
Rationale: The initial way to determine if a nasogastric tube is in the stomach is to apply suction to the tube with a syringe and observe for the return of stomach contents. Then the pH of the aspirate can be measured. This is the method of choice. One would not irrigate until tube placement is confirmed. Observing for air bubbles when the free end of the tube is placed under water is an unacceptable, unsafe method of determining tube placement. Another method is to instill air into the tube with a syringe while auscultating over the epigastric area. Hearing the air enter the stomach helps ensure proper placement, but the method is not foolproof and is no longer considered an effective or preferred way to determine placement.
4. During the assessment of a client’s mouth, the nurse notes the absence of saliva. The client is also complaining of pain near the area of the ear. The client has been NPO for several days because of the insertion of an NG tube. Based on these findings, the nurse suspects that the client is developing which of the following mouth conditions?
- A. Stomatitis
- B. Oral candidiasis
- C. Parotitis
- D. Gingivitis
Correct answer: C
Rationale: The correct answer is C, Parotitis. Parotitis, inflammation of the parotid glands, can occur due to the absence of saliva and dehydration, often associated with being NPO and having an NG tube. Stomatitis (choice A) is inflammation of the oral mucosa, not specifically related to absent saliva. Oral candidiasis (choice B) is a fungal infection that can occur in the mouth, not directly related to the absence of saliva. Gingivitis (choice D) is inflammation of the gums and is not typically associated with the absence of saliva and dehydration.
5. After a right hemicolectomy for treatment of colon cancer, a 57-year old client is reluctant to turn while on bed rest. Which action by the nurse would be appropriate?
- A. Asking a co-worker to help turn the client
- B. Explaining to the client why turning is important.
- C. Allowing the client to turn when he’s ready to do so
- D. Telling the client that the physician’s order states he must turn every 2 hours
Correct answer: B
Rationale: Educating the client about the importance of turning can encourage compliance and promote understanding of the necessity to prevent complications such as pressure ulcers and pneumonia.
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