ATI RN
Gastrointestinal System Nursing Exam Questions
1. The nurse assesses the client's understanding of the relationship between body position and gastroesophageal reflux. Which response would indicate that the client understands measures to avoid problems with reflux while sleeping?
- A. I can elevate the foot of the bed 4 to 6 inches.
- B. I can sleep on my stomach with my head turned to the left.
- C. I can sleep on my back without a pillow under my head.
- D. I can elevate the head of the bed 4 to 6 inches.
Correct answer: D
Rationale: Sleeping with the head of the bed elevated encourages movement of food through the esophagus by gravity. By fostering esophageal acid clearance, gravity helps keep the acidic pepsin and alkaline biliary secretions from contacting the esophagus. Elevating the foot of the bed does not affect clearance of esophageal acid. Sleeping on the stomach with the head turned to the left will not decrease reflux incidence. Sleeping flat without a pillow under the head does not enhance clearance.
2. Which of the following dietary measures would be useful in preventing esophageal reflux?
- A. Eating small, frequent meals
- B. Increasing fluid intake
- C. Avoiding air swallowing with meals
- D. Adding a bedtime snack to the dietary plan
Correct answer: A
Rationale: Eating small, frequent meals helps prevent esophageal reflux.
3. Which of the following nursing interventions should be implemented to manage a client with appendicitis?
- A. Assessing for pain
- B. Encouraging oral intake of clear fluids
- C. Providing discharge teaching
- D. Assessing for symptoms of peritonitis
Correct answer: D
Rationale: The correct answer is D: Assessing for symptoms of peritonitis. This intervention is crucial in managing a client with appendicitis because it indicates a possible rupture of the inflamed appendix. Symptoms of peritonitis include severe abdominal pain, fever, nausea, vomiting, and abdominal rigidity. Prompt recognition of these symptoms is essential for timely intervention and surgical management. Choices A, B, and C are incorrect because while assessing for pain is important, assessing for symptoms of peritonitis takes precedence due to the critical nature of appendicitis. Encouraging oral intake of clear fluids and providing discharge teaching are not immediate priorities in the management of a client with acute appendicitis.
4. A 53 y.o. patient has undergone a partial gastrectomy for adenocarcinoma of the stomach. An NG tube is in place and is connected to low continuous suction. During the immediate postoperative period, you expect the gastric secretions to be which color?
- A. Brown.
- B. Clear.
- C. Red.
- D. Yellow.
Correct answer: C
Rationale: During the immediate postoperative period after a partial gastrectomy, gastric secretions are expected to be red.
5. A 40-year-old male client has been hospitalized with peptic ulcer disease. He is being treated with a histamine receptor antagonist (cimetidine), antacids, and diet. The nurse doing discharge planning will teach him that the action of cimetidine is to:
- A. Reduce gastric acid output
- B. Protect the ulcer surface
- C. Inhibit the production of hydrochloric acid (HCl)
- D. Inhibit vagus nerve stimulation
Correct answer: C
Rationale: Cimetidine inhibits the production of hydrochloric acid (HCl), which helps to treat peptic ulcer disease.
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