ATI RN
ATI Gastrointestinal System
1. The hospitalized client with gastroesophageal reflux disease is complaining of chest discomfort that feels like heartburn following a meal. After administering an ordered antacid, the nurse encourages the client to lie in which of the following positions?
- A. Supine with the head of the bed flat
- B. On the stomach with the head flat
- C. On the left side with the head of the bed elevated 30 degrees
- D. On the right side with the head of the bed elevated 30 degrees
Correct answer: C
Rationale: The discomfort of reflux is aggravated by positions that compress the abdomen and the stomach. Lying flat on the back (supine) or on the stomach (prone) after a meal can exacerbate symptoms. Similarly, lying on the right side can worsen reflux. The most appropriate position to alleviate discomfort in a client with gastroesophageal reflux disease is lying on the left side with the head of the bed elevated at a 30-degree angle. This position helps prevent the backflow of stomach contents into the esophagus, providing relief to the client.
2. A client has a new prescription for Spironolactone. Which of the following instructions should be provided?
- A. Take the medication with food.
- B. Avoid potassium-rich foods.
- C. Increase your intake of sodium.
- D. Monitor your blood pressure daily.
Correct answer: B
Rationale: The correct answer is to 'Avoid potassium-rich foods.' Spironolactone is a potassium-sparing diuretic, and consuming foods high in potassium can lead to hyperkalemia, a potential side effect of the medication. Therefore, the client should be advised to avoid potassium-rich foods to prevent complications. Choices A, C, and D are incorrect. Taking Spironolactone with food is not necessary for its effectiveness. Increasing sodium intake is not typically recommended with Spironolactone therapy. While monitoring blood pressure is important, it is not specifically related to the use of Spironolactone.
3. What is the appropriate needle size for insulin injection?
- A. 18G, 1 ½” long
- B. 22G, 1” long
- C. 22G, 1 ½” long
- D. 25G, 5/8” long
Correct answer: D
Rationale: The appropriate needle size for insulin injection is 25G, 5/8” long. This size allows for accurate and comfortable insulin administration in subcutaneous tissue.
4. A client with diabetes mellitus is experiencing hypoglycemia. Which of the following findings should the nurse expect?
- A. Polyuria
- B. Warm, dry skin
- C. Irritability
- D. Hyperventilation
Correct answer: C
Rationale: Irritability is a common finding in clients with hypoglycemia due to decreased glucose levels in the brain. Polyuria (excessive urination) is not typically associated with hypoglycemia, but rather with hyperglycemia. Warm, dry skin is not a typical finding in hypoglycemia; instead, the skin may be cool and clammy. Hyperventilation is not a common finding in hypoglycemia; instead, shallow breathing or difficulty breathing may occur.
5. Construction is occurring in the Emergency Department, with equipment and sharp items being used by the contractors. As the charge nurse, you are concerned that agitated patients might use the equipment as weapons and you meet with staff to: (EXCEPT)
- A. Notify the nursing supervisor.
- B. Notify security.
- C. Have them check patients to verify safety.
- D. Ask construction workers to be responsible.
Correct answer: D
Rationale: When construction is ongoing in a healthcare setting, it is essential to address safety concerns promptly. While it is crucial to notify the nursing supervisor and security to manage potential risks, having staff check patients for safety is also a valid precautionary measure. However, asking construction workers to be responsible is not a proper action to address the safety concerns posed by the equipment. Construction workers are professionals responsible for their tasks; it is the healthcare facility's responsibility to ensure patient and staff safety in such situations.
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