ATI RN
ATI Gastrointestinal System
1. The client being seen in a physician’s office has just been scheduled for a barium swallow the next day. The nurse writes down which of the following instructions for the client to follow before the test?
- A. Fast for 8 hours before the test.
- B. Eat a regular supper and breakfast.
- C. Continue to take all oral medications as scheduled.
- D. Monitor own bowel movement pattern for constipation
Correct answer: A
Rationale: A barium swallow is an x-ray study that uses a substance called barium for contrast to highlight abnormalities in the gastrointestinal tract. The client should fast for 8 to 12 hours before the test, depending on physician instructions. Most oral medications also are withheld before the test. After the procedure the nurse must monitor for constipation, which can occur as a result of the presence of barium in the gastrointestinal tract.
2. Stephen is a 62 y.o. patient that has had a liver biopsy. Which of the following groups of signs alert you to a possible pneumothorax?
- A. Dyspnea and reduced or absent breath sounds over the right lung
- B. Tachycardia, hypotension, and cool, clammy skin
- C. Fever, rebound tenderness, and abdominal rigidity
- D. Redness, warmth, and drainage at the biopsy site
Correct answer: A
Rationale: Dyspnea and reduced or absent breath sounds over the right lung are signs of a possible pneumothorax.
3. A client is providing instructions to a client who is scheduled for an oral cholecystogram. The nurse tells the client to
- A. Eat a fat-free meal on the evening before the procedure.
- B. Maintain strict NPO status on the day of the procedure.
- C. Avoid oral intake except for water on the day of the procedure.
- D. Eat a high-fat meal for breakfast on the day of the procedure.
Correct answer: C
Rationale: For an oral cholecystogram, the client should eat a fat-free meal the evening before the procedure and avoid oral intake except for water on the day of the procedure. During the test, the client may be given a high-fat meal or drink to stimulate gallbladder emptying. Choice A is incorrect because the client should have a fat-free meal, not a high-fat meal. Choice B is incorrect as strict NPO status is not required. Choice D is incorrect as a high-fat meal is not recommended for breakfast on the day of the procedure.
4. A client presents to the emergency room, reporting that he has been vomiting every 30 to 40 minutes for the past 8 hours. Frequent vomiting puts him at risk for which of the following?
- A. Metabolic acidosis with hyperkalemia
- B. Metabolic acidosis with hypokalemia
- C. Metabolic alkalosis with hyperkalemia
- D. Metabolic alkalosis with hypokalemia
Correct answer: D
Rationale: Frequent vomiting can lead to metabolic alkalosis with hypokalemia due to the loss of stomach acid and electrolytes.
5. Annebell is being discharged with a colostomy, and you’re teaching her about colostomy care. Which statement correctly describes a healthy stoma?
- A. At first, the stoma may bleed slightly when touched.
- B. The stoma should appear dark and have a bluish hue.
- C. A burning sensation under the stoma faceplate is normal.
- D. The stoma should remain swollen away from the abdomen.
Correct answer: A
Rationale: A healthy stoma may bleed slightly when touched initially, which is normal.
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