ATI RN
ATI Gastrointestinal System
1. To accurately assess for jaundice in a patient with dark skin pigmentation, the nurse should examine which body areas?
- A. Nail beds
- B. Skin on the back of the hand
- C. Hard palate of the mouth
- D. Soles of the feet
Correct answer: C
Rationale: To accurately assess for jaundice in a patient with dark skin pigmentation, the nurse should examine the hard palate of the mouth. Jaundice is best assessed in the sclera; however, in dark-skinned patients, normal yellow pigmentation may be present in the sclera, making it difficult to detect jaundice. Inspection of the hard palate for a yellow color can confirm the presence of jaundice. Cyanosis is best observed in the nail beds, not indicative of jaundice. While skin on the palm of the hand can indicate jaundice, the back of the hand is not a typical area for assessment. Jaundice can be assessed on the soles of the feet in dark-skinned patients, but it is better visualized in the hard palate for accurate evaluation.
2. The nurse is scheduling diagnostic tests for a client. If all of the following diagnostic tests are ordered, which would be performed last?
- A. Gallbladder series
- B. Barium enema
- C. Barium swallow
- D. Oral cholecystogram
Correct answer: C
Rationale: The correct answer is C, 'Barium swallow.' A barium swallow should be done after a barium enema or gallbladder series to prevent the contrast used in the barium swallow from obstructing the view of other organs. It takes several days for swallowed barium to pass completely out of the gastrointestinal tract. Choices A, B, and D are incorrect because a barium swallow should be the last test performed to ensure clear imaging without interference from residual contrast material.
3. Dark, tarry stools indicate bleeding in which location of the GI tract?
- A. Upper colon.
- B. Lower colon.
- C. Upper GI tract.
- D. Small intestine.
Correct answer: C
Rationale: Dark, tarry stools indicate bleeding in the upper GI tract.
4. The most important pathophysiologic factor contributing to the formation of esophageal varices is:
- A. Decreased prothrombin formation
- B. Decreased albumin formation by the liver
- C. Portal hypertension
- D. Increased central venous pressure
Correct answer: C
Rationale: Portal hypertension is the most important pathophysiologic factor contributing to the formation of esophageal varices.
5. During the assessment of a client’s mouth, the nurse notes the absence of saliva. The client is also complaining of pain near the area of the ear. The client has been NPO for several days because of the insertion of an NG tube. Based on these findings, the nurse suspects that the client is developing which of the following mouth conditions?
- A. Stomatitis
- B. Oral candidiasis
- C. Parotitis
- D. Gingivitis
Correct answer: C
Rationale: The correct answer is C, Parotitis. Parotitis, inflammation of the parotid glands, can occur due to the absence of saliva and dehydration, often associated with being NPO and having an NG tube. Stomatitis (choice A) is inflammation of the oral mucosa, not specifically related to absent saliva. Oral candidiasis (choice B) is a fungal infection that can occur in the mouth, not directly related to the absence of saliva. Gingivitis (choice D) is inflammation of the gums and is not typically associated with the absence of saliva and dehydration.
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