ATI RN
ATI Gastrointestinal System
1. Which of the following conditions can cause a hiatal hernia?
- A. Increased intrathoracic pressure
- B. Weakness of the esophageal muscle
- C. Increased esophageal muscle pressure
- D. Weakness of the diaphragmic muscle
Correct answer: D
Rationale: Weakness of the diaphragmic muscle can lead to a hiatal hernia as it allows part of the stomach to push through the diaphragm into the chest cavity.
2. An intubated patient is receiving continuous enteral feedings through a Salem sump tube at a rate of 60ml/hr. Gastric residuals have been 30-40ml when monitored Q4H. You check the gastric residual and aspirate 220ml. What is your first response to this finding?
- A. Notify the doctor immediately.
- B. Stop the feeding, and clamp the NG tube.
- C. Discard the 220ml, and clamp the NG tube.
- D. Give a prescribed GI stimulant such as metoclopramide (Reglan).
Correct answer: B
Rationale: If gastric residuals are high during continuous enteral feedings, the first response is to stop the feeding and clamp the NG tube.
3. A client with rectal cancer may exhibit which of the following symptoms?
- A. Abdominal fullness
- B. Gastric fullness
- C. Rectal bleeding
- D. Right upper quadrant pain
Correct answer: C
Rationale: Rectal bleeding is a common symptom in clients with rectal cancer.
4. A patient who underwent abdominal surgery now has a gaping incision due to delayed wound healing. Which method is correct when you irrigate a gaping abdominal incision with sterile normal saline solution, using a piston syringe?
- A. Rapidly instill a stream of irrigating solution into the wound.
- B. Apply a wet-to-dry dressing to the wound after the irrigation.
- C. Moisten the area around the wound with normal saline solution after the irrigation.
- D. Irrigate continuously until the solution becomes clear or all of the solution is used.
Correct answer: D
Rationale: Irrigating continuously until the solution becomes clear or all of the solution is used is the correct method when irrigating a gaping abdominal incision.
5. Your patient has a retractable gastric peptic ulcer and has had a gastric vagotomy. Which factor increases as a result of vagotomy?
- A. Peristalsis.
- B. Gastric acidity.
- C. Gastric motility.
- D. Gastric pH.
Correct answer: D
Rationale: After a gastric vagotomy, the gastric pH increases as a result of reduced acid secretion.
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