ATI RN
Gastrointestinal System Nursing Exam Questions Questions
Question 1 of 5
A client with a history of gastric ulcer suddenly complains of a sharp-severe pain in the mid epigastric area, which then spreads over the entire abdomen. The client's abdomen is rigid and board-like to palpation, and the client obtains most comfort from lying in the knee-chest position. The nurse calls the physician immediately suspecting that the client is experiencing which of the following complications of peptic ulcer disease?
Correct Answer: A
Rationale: The correct answer is A: Perforation. The sudden onset of sharp-severe pain, rigidity, and board-like abdomen are classic signs of a perforated gastric ulcer. The spreading pain and relief in the knee-chest position indicate free air in the peritoneal cavity. Perforation is a serious complication requiring immediate medical attention to prevent peritonitis and sepsis. Choice B: Obstruction is incorrect because it typically presents with a gradual onset of pain, bloating, vomiting, and inability to pass stool or gas. Choice C: Hemorrhage is incorrect as it usually presents with symptoms like hematemesis, melena, and signs of blood loss such as hypotension and tachycardia. Choice D: Intractability is incorrect because it refers to the condition being difficult to manage or cure, which is not the acute presentation described in the question.
Question 2 of 5
To prevent gastroesophageal reflux in a client with hiatal hernia, the nurse should provide which discharge instructions?
Correct Answer: B
Rationale: The correct answer is B: Avoid coffee and alcoholic beverages. This is because both coffee and alcohol can relax the lower esophageal sphincter, leading to increased risk of gastroesophageal reflux in clients with hiatal hernia. A: Lying down after meals can actually worsen reflux symptoms by allowing stomach acid to flow back into the esophagus. C: Taking antacids before meals may provide temporary relief but does not address the underlying cause of reflux. D: Limiting fluids with meals can help reduce reflux by not distending the stomach, but it is not as crucial as avoiding coffee and alcohol.
Question 3 of 5
Which of the following activities should the nurse encourage the client with a peptic ulcer to avoid?
Correct Answer: B
Rationale: The correct answer is B: Smoking cigarettes. Smoking can increase stomach acid production and decrease blood flow to the stomach lining, which can worsen peptic ulcers. Chewing gum can actually help by increasing saliva production, which can neutralize stomach acid. Eating chocolate and taking acetaminophen are generally safe for peptic ulcer patients as long as they do not have specific allergies or sensitivities.
Question 4 of 5
A client returns from surgery with a sigmoid colostomy. An ostomy appliance is attached. The priority nursing diagnosis for daily observation and care is:
Correct Answer: B
Rationale: The correct answer is B: Impaired skin integrity related to seepage. This is the priority nursing diagnosis because a colostomy appliance can lead to skin breakdown due to seepage of stool, which can cause irritation and skin breakdown. Maintaining skin integrity is crucial to prevent infection and promote healing. A: Diarrhea is not the priority as it is a common issue after colostomy surgery but can be managed with appropriate interventions. C: Impaired nutrition is not the priority as it is not specifically related to the immediate care of the colostomy appliance. D: Impaired physical mobility is not the priority as it is not directly related to the immediate care of the colostomy appliance. In summary, choice B is the correct answer because maintaining skin integrity is essential for the client's well-being and to prevent complications associated with a colostomy appliance.
Question 5 of 5
The nurse provides medication instructions to a client with peptic ulcer disease. Which statement, if made by the client, indicates best understanding of the medication therapy?
Correct Answer: A
Rationale: Correct Answer: A Rationale: 1. Cimetidine (Tagamet) is an H2 receptor antagonist that decreases stomach acid production. 2. Peptic ulcer disease is often caused by excessive stomach acid. 3. By decreasing stomach acid, cimetidine helps to heal the ulcer and prevent further damage. 4. Understanding this mechanism of action demonstrates the client's comprehension of the medication therapy. Summary: B: Sucralfate does not change stomach fluid; it forms a protective barrier over the ulcer. C: Antacids neutralize stomach acid but do not coat the stomach. D: Omeprazole reduces stomach acid production, not coats the ulcer.