ATI RN
Gastrointestinal System ATI
1. Your patient Maria takes NSAIDS for her degenerative joint disease, has developed peptic ulcer disease. Which drug is useful in preventing NSAID-induced peptic ulcer disease?
- A. Calcium carbonate (Tums)
- B. Famotidine (Pepcid)
- C. Misoprostol (Cytotec)
- D. Sucralfate (Carafate)
Correct answer: C
Rationale: Misoprostol (Cytotec) is useful in preventing NSAID-induced peptic ulcer disease.
2. The nurse is assessing a client 24 hours following a cholecystectomy. The nurse notes that the T-tube has drained 750ml of green-brown drainage. Which nursing intervention is most appropriate?
- A. Notify the physician
- B. Document the findings
- C. Irrigate the T-tube
- D. Clamp the T-tube
Correct answer: B
Rationale: Documenting the findings is the most appropriate action as 750ml of green-brown drainage is expected after a cholecystectomy.
3. The client with Crohn’s disease has a nursing diagnosis of acute pain. The nurse would teach the client to avoid which of the following in managing this problem?
- A. Lying supine with the legs straight
- B. Massaging the abdomen
- C. Using antispasmodic medication
- D. Using relaxation techniques
Correct answer: A
Rationale: Lying supine with the legs straight can increase abdominal tension and exacerbate pain. The client should be advised to lie with the legs bent to reduce muscle tension and discomfort.
4. 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.
5. A client presents to the emergency room, reporting that he has been vomiting every 30 to 40 minutes for the past 8 hours. Frequent vomiting puts him at risk for which of the following?
- A. Metabolic acidosis with hyperkalemia
- B. Metabolic acidosis with hypokalemia
- C. Metabolic alkalosis with hyperkalemia
- D. Metabolic alkalosis with hypokalemia
Correct answer: D
Rationale: Frequent vomiting can lead to metabolic alkalosis with hypokalemia due to the loss of stomach acid and electrolytes.
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