ATI RN
ATI Gastrointestinal System
1. The nurse is caring for a client following a Billroth II procedure. On review of the post-operative orders, which of the following, if prescribed, would the nurse question and verify?
- A. Irrigating the nasogastric tube
- B. Coughing a deep breathing exercises
- C. Leg exercises
- D. Early ambulation
Correct answer: A
Rationale: Irrigating the nasogastric tube is typically not recommended after a Billroth II procedure unless specifically ordered by a physician due to the risk of disrupting the surgical site.
2. A client is scheduled for oral cholecystography. Which one of the following actions would the nurse plan to implement before the test?
- A. Have the client drink 1000 mL of water.
- B. Ask the client about possible allergies to iodine or shellfish.
- C. Administer an intravenous contrast agent the evening before the test.
- D. Administer tap-water enemas until clear.
Correct answer: B
Rationale: Iodine compounds used as radiographic contrast agents, such as iopanoic acid (Telepaque), should not be administered to the client with iodine and seafood allergies because anaphylaxis may occur.
3. A client with liver dysfunction is having difficulty with protein metabolism. The nurse anticipates that the results of which of the following serum laboratory studies will be elevated?
- A. Lactic acid
- B. Ammonia
- C. Albumin
- D. Lactase
Correct answer: B
Rationale: During deamination of proteins, the liver splits the amino group from the carbon-containing compound, which results in the formation of ammonia and a carbon residue. The liver then converts the toxic ammonia substance into urea, which can be excreted by the kidneys. Clients with liver dysfunction may have high serum ammonia levels as a result.
4. Which of the following would be an expected nutritional outcome for a client who has undergone a subtotal gastrectomy for cancer?
- A. Regain weight loss within 1 month after surgery
- B. Resume normal dietary intake of three meals per day
- C. Control nausea and vomiting through regular use of antiemetics
- D. Achieve optimal nutritional status through oral or parenteral feedings
Correct answer: D
Rationale: Achieving optimal nutritional status through oral or parenteral feedings is an expected nutritional outcome for a client who has undergone a subtotal gastrectomy for cancer.
5. Before bowel surgery, Lee is to administer enemas until clear. During administration, he complains of intestinal cramps. What do you do next?
- A. Discontinue the procedure.
- B. Lower the height of the enema container.
- C. Complete the procedure as quickly as possible.
- D. Continue administration of the enema as ordered without making any adjustments.
Correct answer: B
Rationale: If a patient complains of intestinal cramps during an enema, lowering the height of the enema container can help reduce discomfort.
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