ATI RN
ATI Gastrointestinal System Test
1. You’re caring for Jane, a 57 y.o. patient with liver cirrhosis who develops ascites and requires paracentesis. Before her paracentesis, you instruct her to:
- A. Empty her bladder.
- B. Lie supine in bed.
- C. Remain NPO for 4 hours.
- D. Clean her bowels with an enema.
Correct answer: A
Rationale: Before paracentesis, instruct the patient to empty her bladder to avoid bladder injury during the procedure.
2. A client with a 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 reduces the stimulus to acid secretions by cutting the vagus nerve, which innervates the stomach.
3. You’re preparing a patient with a malignant tumor for colorectal surgery and subsequent colostomy. The patient tells you he’s anxious. What should your initial step be in working with this patient?
- A. Determine what the patient already knows about colostomies.
- B. Show the patient some pictures of colostomies.
- C. Arrange for someone who has a colostomy to visit the patient.
- D. Provide the patient with written material about colostomy care.
Correct answer: A
Rationale: When a patient with a malignant tumor is anxious about colorectal surgery and a colostomy, the initial step is to determine what the patient already knows about colostomies.
4. Which of the following mechanisms can facilitate the development of diverticulosis into diverticulitis?
- A. Treating constipation with chronic laxative use, leading to dependence on laxatives
- B. Chronic constipation causing an obstruction, reducing forward flow of intestinal contents
- C. Herniation of the intestinal mucosa, rupturing the wall of the intestine
- D. Undigested food blocking the diverticulum, predisposing the area to bacterial invasion
Correct answer: D
Rationale: The correct answer is D. Undigested food blocking the diverticulum can lead to bacterial invasion, causing inflammation and turning diverticulosis into diverticulitis. Choices A, B, and C do not directly facilitate the development of diverticulitis. Choice A involves a different mechanism related to laxative use, choice B describes a complication of chronic constipation but does not necessarily lead to diverticulitis, and choice C refers to a different condition involving herniation of the intestinal mucosa.
5. Which of the following complications is thought to be the most common cause of appendicitis?
- A. A fecalith
- B. Bowel kinking
- C. Internal bowel occlusion
- D. Abdominal bowel swelling
Correct answer: A
Rationale: A fecalith is a hardened stool that can block the appendix, leading to inflammation and infection, which is the most common cause of appendicitis.
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