michael a 42 yo man is admitted to the med surg floor with a diagnosis of acute pancreatitis his bp is 13676 pulse 96 resps 22 and temp 101 his past h

ATI RN

ATI Gastrointestinal System Test

1. Michael, a 42 y.o. man is admitted to the med-surg floor with a diagnosis of acute pancreatitis. His BP is 136/76, pulse 96, Resps 22 and temp 101. His past history includes hyperlipidemia and alcohol abuse. The doctor prescribes an NG tube. Before inserting the tube, you explain the purpose to patient. Which of the following is a most accurate explanation?

A. It empties the stomach of fluids and gas.
B. It prevents spasms at the sphincter of Oddi.
C. It prevents air from forming in the small intestine and large intestine.
D. It removes bile from the gallbladder.

Correct answer: A

Rationale: Explain to the patient that the NG tube is used to empty the stomach of fluids and gas, which helps relieve symptoms of acute pancreatitis.

2. A client has been taking aluminum hydroxide 30 mL six times per day at home to treat his peptic ulcer. He tells the nurse that he has been unable to have a bowel movement for 3 days. Based on this information, the nurse would determine that which of the following is the most likely cause of the client’s constipation?

A. The client has not been including enough fiber in his diet
B. The client needs to increase his daily exercise
C. The client is experiencing a side effect of the aluminum hydroxide.
D. The client has developed a gastrointestinal obstruction.

Correct answer: C

Rationale: The client is experiencing a common side effect of aluminum hydroxide, which is constipation.

3. Hepatic encephalopathy develops when the blood level of which substance increases?

A. Ammonia
B. Amylase
C. Calcium
D. Potassium

Correct answer: A

Rationale: Hepatic encephalopathy develops when the blood level of ammonia increases.

4. 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.

5. A client with liver dysfunction is having difficulty with protein metabolism. The nurse anticipates that the results of which of the following serum laboratory studies will be elevated?

A. Lactic acid
B. Ammonia
C. Albumin
D. Lactase

Correct answer: B

Rationale: During deamination of proteins, the liver splits the amino group from the carbon-containing compound, which results in the formation of ammonia and a carbon residue. The liver then converts the toxic ammonia substance into urea, which can be excreted by the kidneys. Clients with liver dysfunction may have high serum ammonia levels as a result.