ATI RN
Gastrointestinal System Nursing Exam Questions
1. The nurse aspirates 40 mL of undigested formula from the client’s nasogastric tube. Before administering an intermittent tube feeding, the nurse understands that the 40 mL of gastric aspirate should be
- A. Discarded properly and recorded as output on the client’s intake and output record.
- B. Poured into the nasogastric tube through a syringe with the plunger removed.
- C. Mixed with the formula and poured into the nasogastric tube through a syringe with the plunger removed.
- D. Diluted with water and injected into the nasogastric tube by putting pressure on the plunger.
Correct answer: B
Rationale: After checking the residual feeding contents, the gastric contents are reinstalled into the stomach by removing the syringe bulb or plunger and pouring the gastric contents into the syringe and through the nasogastric tube. Gastric contents should be reinstalled to maintain the client’s electrolyte balance. The gastric contents should be poured into the nasogastric tube through a syringe without a plunger and not injected by putting pressure on the plunger. Gastric contents do not need to be mixed with water or should the contents be discarded.
2. A patient with Crohn’s disease is admitted after 4 days of diarrhea. Which of the following urine specific gravity values do you expect to find in this patient?
- A. 1.005
- B. 1.011
- C. 1.02
- D. 1.03
Correct answer: D
Rationale: A urine specific gravity of 1.030 indicates concentrated urine, which is expected in a patient with dehydration due to diarrhea from Crohn’s disease.
3. After an abdominal resection for colon cancer, Madeline returns to her room with a Jackson-Pratt drain in place. The purpose of the drain is to:
- A. Irrigate the incision with a saline solution.
- B. Prevent bacterial infection of the incision.
- C. Measure the amount of fluid lost after surgery.
- D. Prevent accumulation of drainage in the wound.
Correct answer: D
Rationale: The purpose of the Jackson-Pratt drain is to prevent the accumulation of drainage in the wound after an abdominal resection.
4. A patient with chronic alcohol abuse is admitted with liver failure. You closely monitor the patient’s blood pressure because of which change that is associated with the liver failure?
- A. Hypoalbuminemia
- B. Increased capillary permeability
- C. Abnormal peripheral vasodilation
- D. Excess rennin release from the kidneys
Correct answer: C
Rationale: Abnormal peripheral vasodilation is a change associated with liver failure that requires close monitoring of the patient's blood pressure.
5. The nurse is caring for a client following a Billroth II procedure. On review of the postoperative orders, which of the following if prescribed, should the nurse question and verify?
- A. Irrigating the nasogastric tube
- B. Coughing and deep breathing exercises
- C. Leg exercises
- D. Early ambulation
Correct answer: A
Rationale: In a Billroth II procedure the proximal remnant of the stomach is anastomosed to the proximal jejunum. Patency of the nasogastric tube is critical for preventing the retention of gastric secretions. The nurse should never irrigate or reposition the gastric tube after gastric surgery, unless specifically ordered by the physician. In this situation the nurse should clarify the order. Coughing and deep breathing exercises, leg exercises, and early ambulation are appropriate postoperative interventions.
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