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. During an emergency response following a disaster, which client should be recommended for early discharge?
- A. A client with COPD and a respiratory rate of 44/min.
- B. A client with cancer and a sealed implant for radiation therapy.
- C. A client receiving heparin for deep-vein thrombosis.
- D. A client who is 1 day postoperative following a vertebroplasty.
Correct answer: D
Rationale: The client who is 1 day postoperative following a vertebroplasty is stable and can be discharged early. In an emergency response situation, it is crucial to prioritize clients who are medically stable and do not require immediate hospital care. The client with COPD and a respiratory rate of 44/min needs close monitoring and intervention. The client with cancer and a sealed implant for radiation therapy requires specialized care and follow-up. The client receiving heparin for deep-vein thrombosis needs ongoing anticoagulant therapy and monitoring, making early discharge not appropriate.
3. Which of the following is an example of a social determinant of health?
- A. Genetic predisposition
- B. Personal health behaviors
- C. Biological factors
- D. Economic stability
Correct answer: D
Rationale: Economic stability, like having a stable income, is a crucial social determinant of health that can significantly influence an individual's overall well-being. Access to economic resources can affect a person's ability to afford healthcare, nutritious food, safe housing, and other essentials that are vital for good health outcomes.
4. A nurse is reviewing the medical record of a client with major depressive disorder who is taking fluoxetine. Which of the following findings should the nurse report to the provider?
- A. Heart rate of 80/min
- B. Blood pressure 130/80 mm Hg
- C. Weight gain of 2.2 kg (5 lb) in 1 week
- D. Temperature of 37.2°C (99°F)
Correct answer: C
Rationale: The correct answer is C. A weight gain of 2.2 kg (5 lb) in 1 week can indicate fluid retention, a serious side effect of fluoxetine that should be reported to the provider. Choices A, B, and D are within normal ranges and are not alarming findings that would require immediate reporting to the provider. A heart rate of 80/min, blood pressure of 130/80 mm Hg, and a temperature of 37.2°C (99°F) are all within normal limits and not typically concerning in a client taking fluoxetine.
5. How should a healthcare professional prepare a patient for a colonoscopy?
- A. Provide clear instructions on diet
- B. Explain the procedure in detail
- C. Ensure the patient has an empty stomach
- D. Give a bowel prep solution
Correct answer: D
Rationale: Giving a bowel prep solution is essential to clean out the colon thoroughly before a colonoscopy. This process is crucial as it helps to achieve a clear view of the colon during the procedure. Providing clear instructions on diet (Choice A) and ensuring the patient has an empty stomach (Choice C) are important steps in the preparation process but may not be sufficient on their own to adequately cleanse the colon. Explaining the procedure in detail (Choice B) is helpful for patient education but does not directly contribute to the physical preparation required for a successful colonoscopy.
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