ATI RN
Gastrointestinal System Nursing Exam Questions Questions
Question 1 of 5
A client is scheduled for an abdominal perineal resection with permanent colostomy. Which of the following measures would most likely be included in the plan for the client's preoperative preparation?
Correct Answer: B
Rationale: The correct answer is B: Administer kanamycin (Kantrex) the night before surgery. This antibiotic is typically given preoperatively to reduce the risk of infection during the surgical procedure. It helps to eliminate or reduce the number of bacteria in the gastrointestinal tract, which could potentially contaminate the surgical site during the abdominal perineal resection with permanent colostomy. A: Keeping the client NPO for 2 days before surgery is not necessary for this procedure and could lead to unnecessary dehydration and discomfort. C: Informing the client that chest tubes will be in place after surgery is not directly related to preoperative preparation for this specific surgery. D: Advising the client to limit activity is important for postoperative recovery, but it is not a preoperative measure specific to this surgery.
Question 2 of 5
The nurse is preparing a discharge teaching plan for the client who had an umbilical hernia repair. Which of the following would the nurse include in the plan?
Correct Answer: C
Rationale: The correct answer is C: Avoiding coughing. After umbilical hernia repair, coughing can increase intra-abdominal pressure and strain the surgical site, leading to potential complications like hernia recurrence or wound dehiscence. It is crucial to advise the client to avoid coughing to promote proper healing. A: Restricting pain medication is not necessary as pain management is essential for the client's comfort and recovery. B: Maintaining bedrest is not typically required after umbilical hernia repair, as early ambulation is often encouraged to prevent complications like blood clots. D: Irrigating the drain is not typically part of the discharge teaching plan for umbilical hernia repair, as drains are usually removed before discharge.
Question 3 of 5
A client has a nasogastric tube inserted at the time of abdominal perineal resection with permanent colostomy. This tube will most likely be removed when the client demonstrates:
Correct Answer: C
Rationale: The correct answer is C: Passage of flatus and feces from the colostomy. This indicates that the gastrointestinal tract is functioning properly post-operatively. The nasogastric tube is typically removed once the client's bowel function has returned, as evidenced by the passage of flatus and feces from the colostomy. This indicates that the client's bowels are working and there is no longer a need for the tube to decompress the stomach. Choices A, B, and D are incorrect because the absence of nausea and vomiting, passage of mucus from the rectum, and absence of stomach drainage do not directly indicate the return of normal bowel function, which is the key factor for removing the nasogastric tube in this scenario.
Question 4 of 5
During an abdominal assessment, a nurse finds pulsation between the umbilicus and pubis on a client. What finding should be reported to the physician?
Correct Answer: B
Rationale: The correct answer is B because pulsation between the umbilicus and pubis could indicate an abdominal aortic aneurysm (AAA), a serious condition that requires immediate medical attention. The pulsation in this area could be the enlargement of the aorta, which can be life-threatening if it ruptures. Reporting this finding to the physician is crucial for further evaluation and intervention. Choice A (Concave, midline umbilicus) is incorrect because it is a normal finding during an abdominal assessment. Choice C (Bowel sound frequency of 15 sounds per minute) is incorrect as it falls within the normal range of bowel sounds. Choice D (Absence of a bruit) is also incorrect as the absence of a bruit is a normal finding and does not indicate any immediate concern.
Question 5 of 5
The nurse is doing preoperative teaching with the client who is about to undergo creation of a Kock pouch. The nurse interprets that the client has the best understanding of the nature of the surgery if the client makes which of the following statements?
Correct Answer: A
Rationale: The correct answer is A: "I will need to drain the pouch regularly with a catheter." This answer demonstrates an accurate understanding of the Kock pouch procedure, which involves the creation of a reservoir that needs to be drained periodically to prevent complications like overflow or infection. Rationale: 1. A Kock pouch is a continent ileostomy that requires regular catheterization for drainage. 2. Choice B is incorrect because wearing a drainage bag for life is not necessary with a Kock pouch. 3. Choice C is incorrect as a Kock pouch does not produce formed drainage. 4. Choice D is incorrect because passing stool from the rectum is not possible after a Kock pouch surgery. In summary, choice A is the correct answer as it aligns with the specific care requirements of a Kock pouch surgery, while the other options misrepresent the nature of the procedure.