ATI RN
Gastrointestinal System Nursing Exam Questions Questions
Question 1 of 5
A client who has had gastrectomy is not producing sufficient intrinsic factor. The nurse interprets that the client has lost the ability to absorb cyanocobalamin (vitamin B12) in the
Correct Answer: B
Rationale: The correct answer is B: Small intestine. After a gastrectomy, where the stomach is removed or bypassed, intrinsic factor production is reduced, impacting the absorption of vitamin B12. Intrinsic factor is necessary for the absorption of B12 in the small intestine, specifically in the ileum. If vitamin B12 is not absorbed in the small intestine, it can lead to pernicious anemia. Therefore, the small intestine is crucial for the absorption of vitamin B12 in the absence of intrinsic factor. Choices A, C, and D are incorrect as the stomach, large intestine, and colon do not play a significant role in the absorption of vitamin B12.
Question 2 of 5
A nurse is preparing to remove a nasogastric tube from a client. The nurse would instruct the client to do which of the following just before the nurse removes the tube?
Correct Answer: B
Rationale: The correct answer is B: To take hold and hold a deep breath. This is because holding a deep breath helps prevent the aspiration of gastric contents when removing the nasogastric tube. By taking a deep breath and holding it, the client creates positive pressure in the lungs, which can help prevent the contents from entering the airway. Rationale for other choices: A: Performing Valsalva's maneuver (straining while holding breath) can increase intra-abdominal pressure and potentially push gastric contents upward, increasing the risk of aspiration. C: Exhaling does not provide the same protection against aspiration as holding a deep breath. D: Inhaling and exhaling quickly does not create the same protective mechanism as holding a deep breath.
Question 3 of 5
The nurse is planning to teach the client with gastroesophageal reflux disease about substances that will increase the lower esophageal sphincter pressure. Which of the following items would the nurse include on this list?
Correct Answer: B
Rationale: The correct answer is B: Nonfat milk. Nonfat milk is alkaline and can help increase lower esophageal sphincter pressure, reducing reflux symptoms. Fatty foods (A) can relax the sphincter and worsen symptoms. Chocolate (C) and coffee (D) are known triggers for reflux and can also decrease sphincter pressure. Therefore, the nurse would include nonfat milk in the teaching to help manage symptoms of gastroesophageal reflux disease.
Question 4 of 5
Lactulose (Chronulac) is prescribed for a client with a diagnosis of hepatic encephalopathy. The nurse would determine that this medication has had a therapeutic effect if which of the following is noted?
Correct Answer: B
Rationale: The correct answer is B: Decreased serum ammonia level. Lactulose is used to treat hepatic encephalopathy by reducing serum ammonia levels through its laxative effect, promoting the excretion of ammonia in the feces. Decreased ammonia levels indicate that the medication is effectively managing the condition. Increased red blood cell count (A), increased protein level (C), and decreased white blood cell level (D) are not directly related to the therapeutic effect of lactulose in hepatic encephalopathy.
Question 5 of 5
A nurse has been caring for a client with a Sengstaken-Blakemore tube. The physician arrives on the nursing unit and deflates the esophageal balloon. The nurse should monitor the client most closely for which of the following?
Correct Answer: C
Rationale: The correct answer is C: Vomiting blood. When the esophageal balloon of the Sengstaken-Blakemore tube is deflated, the risk of esophageal variceal bleeding increases. Vomiting blood indicates active bleeding and requires immediate intervention. Swelling of the abdomen (A) is not directly related to deflating the balloon. Bloody diarrhea (B) is not a common complication of deflating the balloon. An elevated temperature and a rise in blood pressure (D) are not typical signs of complications related to the deflation of the esophageal balloon.