ATI RN
Chapter 15 The Gastrointestinal System Review Questions Questions
Question 1 of 5
A patient asks the nurse about taking phentermine and topiramate (Qsymia) for weight loss. To avoid side effects
Correct Answer: A
Rationale: The correct answer is A because it is essential to determine if the patient has a history of certain conditions before prescribing Qsymia. This medication can worsen glaucoma (not just a history of it) making option B incorrect. Option C is incorrect because Qsymia can actually help manage hypertension. Option D is incorrect because while valvular heart disease can be a concern, it is not the primary factor to consider before prescribing this medication.
Question 2 of 5
Priority Decision: In instituting a bowel training program for a patient with fecal incontinence, what should the nurse first plan to do?
Correct Answer: D
Rationale: The correct answer is D because assisting the patient to the bathroom at the time of their normal defecation helps establish a routine for bowel movements, which is crucial in bowel training. This step maximizes the chances of success by utilizing the body's natural cues. Teaching the patient to use a perianal pouch (A) does not address the underlying issue of incontinence. Inserting a rectal suppository (B) may provide temporary relief but does not promote long-term bowel control. Placing the patient on a bedpan (C) at a specific time does not actively involve the patient in the process of bowel training.
Question 3 of 5
An important nursing intervention for a patient with a small intestinal obstruction who has an NG tube is to
Correct Answer: B
Rationale: The correct answer is B: provide mouth care every 1 to 2 hours. This is crucial to maintain oral hygiene and comfort for the patient with an NG tube to prevent complications like dry mouth and infection. Offering ice chips (choice A) may worsen the obstruction. Irrigating the tube with normal saline (choice C) can disrupt the bowel and is not recommended. Keeping the patient supine with the head of the bed elevated (choice D) is a general measure but not specific to NG tube care.
Question 4 of 5
The patient experienced a blood transfusion reaction. How should the nurse explain to the patient the cause of the hemolytic jaundice that occurred?
Correct Answer: D
Rationale: The correct answer is D. Hemolytic jaundice in a blood transfusion reaction is due to increased breakdown of red blood cells (RBCs) causing elevated serum unconjugated bilirubin. This occurs when the patient's immune system reacts to the transfused blood, leading to destruction of RBCs. The breakdown of these cells releases hemoglobin, which is metabolized into bilirubin. This unconjugated bilirubin then accumulates in the blood, causing jaundice. Choice A is incorrect because hepatocellular disease does not directly cause hemolytic jaundice. Choice B is incorrect as malaria parasite breaking apart RBCs leads to hemolysis, not a blood transfusion reaction. Choice C is incorrect as decreased bile flow through the liver or biliary system typically causes obstructive jaundice, not hemolytic jaundice.
Question 5 of 5
What manifestation in the patient does the nurse recognize as an early sign of hepatic encephalopathy?
Correct Answer: D
Rationale: The correct answer is D: Is irritable and lethargic. Early signs of hepatic encephalopathy often include behavioral changes like irritability and lethargy due to impaired brain function from liver dysfunction. This is because the liver is unable to properly detoxify ammonia, leading to its accumulation in the bloodstream and affecting brain function. Asterixis, unconsciousness, and oliguria are more severe manifestations seen in later stages of hepatic encephalopathy. Therefore, recognizing irritability and lethargy in a patient would prompt early intervention to prevent further progression of hepatic encephalopathy.