ATI RN
ATI Gastrointestinal System
1. The pain of a duodenal ulcer can be distinguished from that of a gastric ulcer by which of the following characteristics?
- A. Early satiety
- B. Pain on eating
- C. Dull upper epigastric pain
- D. Pain on empty stomach
Correct answer: D
Rationale: Pain on an empty stomach is characteristic of a duodenal ulcer, while pain on eating is characteristic of a gastric ulcer.
2. A client has been diagnosed with gastroesophageal reflux disease. The nurse interprets that the client has dysfunction of which of the following parts of the digestive system?
- A. Chief cells of the stomach
- B. Parietal cells of the stomach
- C. Lower esophageal sphincter
- D. Upper esophageal sphincter
Correct answer: C
Rationale: The lower esophageal sphincter is a functional sphincter that normally remains closed except when food or fluids are swallowed. If relaxation of this sphincter occurs, the client could experience symptoms of gastroesophageal reflux disease.
3. A nurse is assigned to a 40-year-old client who has a diagnosis of chronic pancreatitis. The nurse reviews the laboratory result, anticipating a laboratory report that indicates a serum amylase level of
- A. 45 units/L
- B. 100 units/L
- C. 300 units/L
- D. 500 units/L
Correct answer: C
Rationale: The normal serum amylase level is 25 to 151 IU/L. With chronic cases of pancreatitis, the rise in serum amylase levels usually does not exceed three times the normal value. In acute pancreatitis, the value may exceed five times the normal value. Options 1 and 2 are within normal limits. Option 3 is an extremely elevated level seen in acute pancreatitis.
4. 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.
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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