ATI RN
Gastrointestinal System ATI
1. Kevin has a history of peptic ulcer disease and vomits coffee-ground emesis. What does this indicate?
- A. He has fresh, active upper GI bleeding.
- B. He needs immediate saline gastric lavage.
- C. His gastric bleeding occurred 2 hours earlier.
- D. He needs a transfusion of packed RBCs.
Correct answer: C
Rationale: Coffee-ground emesis is a sign of upper gastrointestinal bleeding that occurred approximately 2 hours earlier. It results from the breakdown of blood in the stomach due to digestive enzymes, giving it a coffee-ground appearance. Choice A is incorrect because coffee-ground emesis indicates older, partially digested blood, not fresh active bleeding. Choice B is incorrect as gastric lavage is not indicated for coffee-ground emesis. Choice D is incorrect because a transfusion of packed RBCs is not the immediate management for this presentation.
2. You’re caring for Lewis, a 67 y.o. patient with liver cirrhosis who develops ascites and requires paracentesis. Relief of which symptom indicated that the paracentesis was effective?
- A. Pruritus
- B. Dyspnea
- C. Jaundice
- D. Peripheral Neuropathy
Correct answer: B
Rationale: Dyspnea relief indicates that the paracentesis was effective in reducing ascites.
3. You’re caring for a patient with a sigmoid colostomy. The stool from this colostomy is:
- A. Formed
- B. Semisolid
- C. Semiliquid
- D. Watery
Correct answer: A
Rationale: The stool from a sigmoid colostomy is typically formed.
4. 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.
5. Your teaching Anthony how to use his new colostomy. How much skin should remain exposed between the stoma and the ring of the appliance?
- A. 1/16”
- B. 1/4″
- C. 1/2”
- D. 1”
Correct answer: A
Rationale: When teaching a patient how to use a colostomy, only 1/16” of skin should remain exposed between the stoma and the ring of the appliance to prevent skin irritation.
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