ATI RN
ATI Gastrointestinal System
1. The client with GERD complains of a chronic cough. The nurse understands that in a client with GERD this symptom may be indicative of which of the following conditions?
- A. Development of laryngeal cancer
- B. Irritation of the esophagus
- C. Esophageal scar tissue formation
- D. Aspiration of gastric contents
Correct answer: D
Rationale: Aspiration of gastric contents can lead to a chronic cough in clients with GERD.
2. 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.
3. The nurse is reviewing the medication record of a client with acute gastritis. Which medication if noted on the client’s record, would the nurse question?
- A. Digoxin (Lanoxin)
- B. Indomethacin (Indocin)
- C. Furosemide (Lasix)
- D. Propranolol hydrochloride (Inderal)
Correct answer: B
Rationale: Indomethacin (Indocin) is a Nonsteroidal anti-inflammatory drug and can cause ulceration of the esophagus, stomach, duodenum, or small intestine. Indomethacin is contraindicated in a client with gastrointestinal disorders. Furosemide (Lasix) is a loop diuretic. Digoxin is an antidysrhythmic. Propranolol (Inderal) is a B- adrenergic blocker. Furosemide, digoxin, and propranolol are not contraindicated in clients with gastric disorders.
4. A nurse is providing instructions to a client who will collect a stool specimen for occult blood. The nurse instructs the client to avoid which of the following for 3 days before the collection of the stool specimen?
- A. Milk products
- B. Hard cheese
- C. Turnips
- D. Cottage cheese
Correct answer: C
Rationale: The correct answer is C: Turnips. The nurse would instruct the client to avoid red meat, poultry, fish, turnips, horseradish, and foods such as fruits and vegetables for 3 days before and during testing. These products may alter test results. Choices A, B, and D are incorrect because they are not specifically mentioned as items to avoid before collecting a stool specimen for occult blood.
5. If a client had irritable bowel syndrome, which of the following diagnostic tests would determine if the diagnosis is Crohn’s disease or ulcerative colitis?
- A. Abdominal computed tomography (CT) scan
- B. Abdominal x-ray
- C. Barium swallow
- D. Colonoscopy with biopsy
Correct answer: D
Rationale: A colonoscopy with biopsy is the most definitive diagnostic test to differentiate between Crohn's disease and ulcerative colitis.
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