ATI RN
Gastrointestinal System Nursing Exam Questions
1. Lactulose (Chronulac) is prescribed for a client with a diagnosis of hepatic encephalopathy. The nurse would determine that this medication has had a therapeutic effect if which of the following is noted?
- A. Increased red blood cell count
- B. Decreased serum ammonia level
- C. Increased protein level
- D. Decreased white blood cell level
Correct answer: B
Rationale: Lactulose is prescribed for the client with hepatic encephalopathy to reduce bacterial breakdown of protein in the bowel. The medication creates an acidic environment in the bowel and causes the ammonia to leave the bloodstream and enter the colon. Ammonia then becomes trapped in the bowel. Lactulose also has a laxative effect that allows for the elimination of the ammonia.
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. A patient is prescribed medroxyprogesterone acetate (Provera) for endometriosis. What should the nurse teach the patient about the proper use of this medication?
- A. Take the medication at the same time each day to maintain consistent hormone levels.
- B. Avoid prolonged sun exposure while taking this medication.
- C. Discontinue the medication if side effects occur.
- D. Apply the medication once a week.
Correct answer: A
Rationale: The correct answer is to take the medication at the same time each day to maintain consistent hormone levels and effectiveness. Consistency in timing helps regulate the hormone levels in the body, ensuring the medication's optimal benefit. Choice B is incorrect as there is no specific need to avoid sun exposure with this medication. Choice C is incorrect because discontinuing the medication without consulting the healthcare provider may not be safe. Choice D is incorrect as medroxyprogesterone acetate is typically taken orally and not applied topically once a week.
4. The patient has been in bed for several days and needs to be ambulated. What action should the nurse take first?
- A. Dangle the patient at the bedside.
- B. Encourage isometric exercises.
- C. Suggest a high-calcium diet.
- D. Maintain a narrow base of support.
Correct answer: A
Rationale: The correct answer is A: 'Dangle the patient at the bedside.' When a patient has been in bed for an extended period and needs to be ambulated, it is essential to dangle the patient at the bedside first. Dangling involves helping the patient sit on the edge of the bed with their legs over the side before standing up. This action helps prevent orthostatic hypotension, a sudden drop in blood pressure when moving from lying down to standing up, which can lead to dizziness or fainting. Encouraging isometric exercises (choice B) or suggesting a high-calcium diet (choice C) are not the first actions to take before ambulating a patient. Maintaining a narrow base of support (choice D) is related to assisting with ambulation but is not the initial step that should be taken.
5. When teaching an adolescent about managing tinea pedis, which statement indicates an understanding of the teaching?
- A. I should buy some plastic shoes to wear at the swimming pool
- B. I should wear sandals as much as possible
- C. I should place the permethrin cream between my toes twice daily
- D. I should seal my non-washable shoes in plastic bags for a couple of weeks
Correct answer: B
Rationale: Wearing sandals allows air circulation around the feet, reducing perspiration and eliminating the environment for bacteria and fungus to thrive. This promotes the healing of the fungal infection. Therefore, the correct answer is B.
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