ATI RN
ATI Gastrointestinal System Test
1. You’re assessing the stoma of a patient with a healthy, well-healed colostomy. You expect the stoma to appear:
- A. Pale, pink and moist
- B. Red and moist
- C. Dark or purple colored
- D. Dry and black
Correct answer: B
Rationale: A healthy, well-healed colostomy stoma should appear red and moist.
2. Kevin has a history of peptic ulcer disease and vomits coffee-ground emesis. What does this indicate?
- A. He has fresh, active upper GI bleeding.
- B. He needs immediate saline gastric lavage.
- C. His gastric bleeding occurred 2 hours earlier.
- D. He needs a transfusion of packed RBCs.
Correct answer: C
Rationale: Coffee-ground emesis is a sign of upper gastrointestinal bleeding that occurred approximately 2 hours earlier. It results from the breakdown of blood in the stomach due to digestive enzymes, giving it a coffee-ground appearance. Choice A is incorrect because coffee-ground emesis indicates older, partially digested blood, not fresh active bleeding. Choice B is incorrect as gastric lavage is not indicated for coffee-ground emesis. Choice D is incorrect because a transfusion of packed RBCs is not the immediate management for this presentation.
3. Janice is waiting for discharge instructions after her herniorrhaphy. Which of the following instructions do you include?
- A. Eat a low-fiber diet.
- B. Resume heavy lifting in 2 weeks.
- C. Lose weight, if obese.
- D. Resume sexual activity once discomfort is gone.
Correct answer: C
Rationale: Advise the patient to lose weight if obese to reduce the risk of complications after herniorrhaphy.
4. The nurse is caring for a client admitted to the hospital with a suspected diagnosis of acute appendicitis. Which of the following laboratory results would the nurse expect to note if the client indeed has appendicitis?
- A. Leukopenia with a shift to the right
- B. Leukocytosis with a shift to the right
- C. Leukocytosis with a shift to the left
- D. Leukopenia with a shift to the left
Correct answer: C
Rationale: Laboratory findings do not establish the diagnosis of appendicitis, but often moderate elevation of the white blood cell count (leukocytosis) to 10,000 to 18,000 cells/mm3 occurs with a “shift to the left” (an increased number of immature white blood cells.).
5. Which of the following laboratory results would be expected in a client with peritonitis?
- A. Partial thromboplastin time above 100 seconds
- B. Hemoglobin level below 10 mg/dL
- C. Potassium level above 5.5 mEq/L
- D. White blood cell count above 15,000
Correct answer: D
Rationale: A white blood cell count above 15,000 is indicative of an infection, such as peritonitis.
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