ATI RN
ATI Gastrointestinal System
1. Which of the following tests can be performed to diagnose a hiatal hernia?
- A. Colonoscopy
- B. Lower GI series
- C. Barium swallow
- D. Abdominal x-rays
Correct answer: C
Rationale: A barium swallow is a diagnostic test that can visualize the esophagus, stomach, and small intestine to diagnose a hiatal hernia.
2. The nurse is caring for a client following a Billroth II procedure. On review of the postoperative orders, which of the following if prescribed, should the nurse question and verify?
- A. Irrigating the nasogastric tube
- B. Coughing and deep breathing exercises
- C. Leg exercises
- D. Early ambulation
Correct answer: A
Rationale: In a Billroth II procedure the proximal remnant of the stomach is anastomosed to the proximal jejunum. Patency of the nasogastric tube is critical for preventing the retention of gastric secretions. The nurse should never irrigate or reposition the gastric tube after gastric surgery, unless specifically ordered by the physician. In this situation the nurse should clarify the order. Coughing and deep breathing exercises, leg exercises, and early ambulation are appropriate postoperative interventions.
3. A client with viral hepatitis has no appetite, and food makes the client nauseated. Which of the following interventions would be most appropriate?
- A. Explain that high-fat diets usually are tolerated better.
- B. Encourage intake of foods high in protein.
- C. Explain that the majority of calories need to be consumed in the evening hours.
- D. Monitor for fluid and electrolyte imbalance.
Correct answer: D
Rationale: If nausea occurs and persists, the client will need to be assessed for fluid and electrolyte imbalance. Explaining to the client that the majority of calories should be eaten in the morning hours is important because nausea occurs most often in the afternoon and evening. Clients should select a diet high in calories because energy is required for healing. Protein increases the workload on the liver. Changes in bilirubin interfere with fat absorption, so low-fat diets are tolerated better.
4. A 40-year-old male client has been hospitalized with peptic ulcer disease. He is being treated with a histamine receptor antagonist (cimetidine), antacids, and diet. The nurse doing discharge planning will teach him that the action of cimetidine is to:
- A. Reduce gastric acid output
- B. Protect the ulcer surface
- C. Inhibit the production of hydrochloric acid (HCl)
- D. Inhibit vagus nerve stimulation
Correct answer: C
Rationale: Cimetidine inhibits the production of hydrochloric acid (HCl), which helps to treat peptic ulcer disease.
5. Michael, a 42 y.o. man is admitted to the med-surg floor with a diagnosis of acute pancreatitis. His BP is 136/76, pulse 96, Resps 22 and temp 101. His past history includes hyperlipidemia and alcohol abuse. The doctor prescribes an NG tube. Before inserting the tube, you explain the purpose to patient. Which of the following is a most accurate explanation?
- A. It empties the stomach of fluids and gas.
- B. It prevents spasms at the sphincter of Oddi.
- C. It prevents air from forming in the small intestine and large intestine.
- D. It removes bile from the gallbladder.
Correct answer: A
Rationale: Explain to the patient that the NG tube is used to empty the stomach of fluids and gas, which helps relieve symptoms of acute pancreatitis.
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