ATI RN
Gastrointestinal System Nursing Exam Questions
1. Which of the following techniques would the nurse use first to determine if a nasogastric tube is positioned in the stomach?
- A. Aspirating with a syringe and observing for the return of gastric contents.
- B. Irrigating with normal saline and observing for the return of solution.
- C. Placing the tube's free end in water and observing for air bubbles.
- D. Instilling air and auscultating over the epigastric area for the presence of the tube.
Correct answer: A
Rationale: The initial way to determine if a nasogastric tube is in the stomach is to apply suction to the tube with a syringe and observe for the return of stomach contents. Then the pH of the aspirate can be measured. This is the method of choice. One would not irrigate until tube placement is confirmed. Observing for air bubbles when the free end of the tube is placed under water is an unacceptable, unsafe method of determining tube placement. Another method is to instill air into the tube with a syringe while auscultating over the epigastric area. Hearing the air enter the stomach helps ensure proper placement, but the method is not foolproof and is no longer considered an effective or preferred way to determine placement.
2. A nurse is caring for a client who has a traumatic brain injury. Which of the following findings should indicate to the nurse the need for immediate intervention?
- A. Axillary temperature 37.2°C (99°F)
- B. Apical pulse 100/min
- C. Respiratory rate 30/min
- D. Blood pressure 140/84 mm Hg
Correct answer: C
Rationale: The correct answer is C. The nurse should prioritize airway and breathing in a client with a traumatic brain injury. An increased respiratory rate may indicate CO2 retention, which could lead to increased intracranial pressure. Choice A, axillary temperature 37.2°C (99°F), is within normal range and does not indicate an immediate need for intervention. Choice B, apical pulse 100/min, is slightly elevated but not as critical as respiratory distress in this scenario. Choice D, blood pressure 140/84 mm Hg, is also within normal limits and does not require immediate intervention compared to the respiratory rate.
3. A parent of a child with attention deficit hyperactivity disorder (ADHD) is being taught by a nurse. Which instruction should the nurse include in the teaching?
- A. Administer methylphenidate at bedtime.
- B. Increase stimuli in the child's environment.
- C. Administer an extra dose of medication if the child is overactive.
- D. Maintain a consistent bedtime routine.
Correct answer: D
Rationale: Maintaining a consistent bedtime routine is essential for children with ADHD as it helps in managing their symptoms effectively. Consistency in bedtime routines aids in regulating the child's sleep patterns, promoting better rest, and ultimately improving their behavior and focus during the day.
4. Selective inattention is seen in which level of anxiety?
- A. Mild
- B. Moderate
- C. Severe
- D. Panic
Correct answer: D
Rationale: Selective inattention is a defense mechanism seen in panic-level anxiety. In panic anxiety, individuals may experience selective inattention, where they focus only on specific aspects and ignore others. Mild anxiety does not typically involve selective inattention as individuals can still function effectively. Moderate and severe anxiety may impair attention, but selective inattention is more characteristic of panic-level anxiety.
5. What is a condition where the heart's mitral valve does not close properly, causing blood to leak backward into the left atrium?
- A. Mitral valve prolapse
- B. Aortic stenosis
- C. Mitral stenosis
- D. Tricuspid regurgitation
Correct answer: A
Rationale: Mitral valve prolapse is the correct answer. It occurs when the mitral valve does not close properly, leading to blood leaking backward into the left atrium. This condition can manifest with symptoms such as palpitations and chest pain. Choices B, C, and D are incorrect because aortic stenosis involves narrowing of the aortic valve, mitral stenosis is the narrowing of the mitral valve, and tricuspid regurgitation is when blood leaks backward through the tricuspid valve.
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