ATI RN
ATI Gastrointestinal System
1. Which of the following tasks should be included in the immediate postoperative management of a client who has undergone gastric resection?
- A. Monitoring gastric pH to detect complications
- B. Assessing for bowel sounds
- C. Providing nutritional support
- D. Monitoring for symptoms of hemorrhage
Correct answer: D
Rationale: Monitoring for symptoms of hemorrhage is a crucial part of the immediate postoperative management of a client who has undergone gastric resection.
2. A client with peptic ulcer is scheduled for a Vagotomy. The client asks the nurse about the purpose of this procedure. The nurse tells the client that the procedure
- A. Decreases food absorption in the stomach.
- B. Heals the gastric mucosa.
- C. Halts stress reactions.
- D. Reduces the stimulus to acid secretions.
Correct answer: D
Rationale: A vagotomy, or cutting of the vagus nerve, is done to eliminate parasympathetic stimulation of gastric secretion, thereby reducing the stimulus to acid secretions. Options A, B, and C are incorrect as a vagotomy does not affect food absorption, heal the gastric mucosa, or halt stress reactions.
3. A client is scheduled for an abdominal perineal resection with permanent colostomy. Which of the following measures would most likely be included in the plan for the client's preoperative preparation?
- A. Keep the client NPO for 2 days before surgery.
- B. Administer kanamycin (Kantrex) the night before surgery.
- C. Inform the client that chest tubes will be in place after surgery.
- D. Advise the client to limit activity.
Correct answer: B
Rationale: Antibiotics are administered preoperatively to reduce the bacterial count in the colon. The client will be placed on a low residue diet to help cleanse the bowel before surgery but typically is not placed on NPO status until 8 to 12 hours before surgery. Laxatives and enemas may also be administered. Chest tubes would not be expected postoperatively. There is no need to limit the client's activity before surgery.
4. The nurse provides medication instructions to a client with peptic ulcer disease. Which statement, if made by the client, indicates best understanding of the medication therapy?
- A. The cimetidine (Tagamet) will cause me to produce less stomach acid.
- B. Sucralfate (Carafate) will change the fluid in my stomach.
- C. Antacids will coat my stomach.
- D. Omeprazole (Prilosec) will coat the ulcer and help it heal.
Correct answer: A
Rationale: Cimetidine (Tagamet) a Histamine H2 receptor antagonist, will decrease the secretion of gastric acid. Sucralfate (Carafate) promotes healing by coating the ulcer. Antacids neutralize acid in the stomach. Omeprazole (Prilosec) inhibits gastric acid secretion.
5. You’re discharging Nathaniel with hepatitis B. Which statement suggests understanding by the patient?
- A. Now I can never get hepatitis again.
- B. I can safely give blood after 3 months.
- C. I’ll never have a problem with my liver again, even if I drink alcohol.
- D. My family knows that if I get tired and start vomiting, I may be getting sick again.
Correct answer: D
Rationale: Understanding that family needs to be aware of symptoms that may indicate a recurrence of hepatitis B shows proper understanding by the patient.
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