ATI RN
ATI Gastrointestinal System Questions
Question 1 of 5
After a subtotal gastrectomy, the nurse should anticipate that nasogastric tube drainage will be what color for about 12 to 24 hours after surgery?
Correct Answer: A
Rationale: In the context of a subtotal gastrectomy, the correct answer is A) Dark brown for nasogastric tube drainage 12 to 24 hours postoperatively. This drainage color indicates the presence of old blood from the surgical site. After gastrointestinal surgery, it is common for blood to be present in the gastrointestinal tract due to manipulation and tissue trauma during the procedure. Option B) Bile green is incorrect because bile typically has a greenish-yellow color and would not be expected in nasogastric drainage immediately after surgery. Option C) Bright red is incorrect as it would suggest active bleeding, which would be a concerning sign postoperatively and would require immediate intervention. Option D) Cloudy white is incorrect as it does not reflect the typical drainage color seen after a gastrectomy. Educationally, understanding the expected postoperative drainage colors helps nurses provide appropriate care and identify potential complications promptly. This knowledge enables nurses to differentiate between normal and abnormal findings, ensuring optimal patient outcomes in the postoperative period.
Question 2 of 5
Which of the following would be an expected nutritional outcome for a client who has undergone a subtotal gastrectomy for cancer?
Correct Answer: D
Rationale: In the scenario of a client who has undergone a subtotal gastrectomy for cancer, the expected nutritional outcome would be to achieve optimal nutritional status through oral or parenteral feedings, which is option D. This is because a subtotal gastrectomy involves the removal of a significant portion of the stomach, impacting the client's ability to adequately digest and absorb nutrients from food. As a result, they may require supplemental nutrition through oral or parenteral routes to meet their nutritional needs and prevent malnutrition. Option A, regaining weight loss within 1 month after surgery, is not the most appropriate outcome to focus on immediately post subtotal gastrectomy as the client's ability to consume and absorb nutrients will be compromised. Option B, resuming normal dietary intake of three meals per day, may not be feasible due to the reduced stomach capacity and altered digestion post-surgery. Option C, controlling nausea and vomiting through regular use of antiemetics, addresses symptoms but does not directly address the client's nutritional needs. In an educational context, understanding the nutritional implications of gastrointestinal surgeries like subtotal gastrectomy is crucial for nursing students. It highlights the importance of individualized nutritional care plans and the use of alternative feeding methods to ensure clients receive adequate nutrition despite anatomical changes. This knowledge helps students provide holistic care and support to clients undergoing such procedures.
Question 3 of 5
The client with GERD complains of a chronic cough. The nurse understands that in a client with GERD this symptom may be indicative of which of the following conditions?
Correct Answer: D
Rationale: In a client with GERD (Gastroesophageal Reflux Disease) experiencing a chronic cough, the indicative condition would be option D: Aspiration of gastric contents. This occurs when stomach contents reflux back into the esophagus and then are aspirated into the respiratory tract, leading to respiratory symptoms like coughing. Option A, development of laryngeal cancer, is incorrect as chronic cough in GERD is not directly linked to cancer but rather to the reflux of gastric contents. Option B, irritation of the esophagus, while a common consequence of GERD, does not directly cause a chronic cough. Option C, esophageal scar tissue formation, is also a possible complication of GERD but is not the primary reason for a chronic cough in this scenario. Educationally, understanding these relationships is crucial for nurses caring for patients with GERD. Recognizing the manifestations of GERD and its potential complications, like aspiration of gastric contents leading to respiratory symptoms, enables nurses to provide appropriate interventions and education to manage symptoms effectively and prevent further complications.
Question 4 of 5
Which of the following dietary measures would be useful in preventing esophageal reflux?
Correct Answer: A
Rationale: In the context of preventing esophageal reflux, the correct answer is A) Eating small, frequent meals. This dietary measure helps by reducing the amount of food in the stomach at one time, which can decrease the likelihood of gastric contents refluxing back into the esophagus. By eating smaller, more frequent meals, there is less pressure on the lower esophageal sphincter, the muscle that normally prevents reflux. Option B) Increasing fluid intake is not directly related to preventing esophageal reflux. While staying hydrated is important for overall health, it does not specifically address the issue of reflux. Option C) Avoiding air swallowing with meals is more relevant to preventing gas and bloating rather than esophageal reflux. Option D) Adding a bedtime snack to the dietary plan can actually worsen esophageal reflux. Eating close to bedtime can increase the risk of reflux due to lying down shortly after eating, which can allow stomach acid to flow back into the esophagus. In the educational context of medical-surgical nursing, understanding the impact of dietary measures on gastrointestinal health is crucial. By selecting the appropriate dietary interventions, nurses can help patients manage and prevent conditions like esophageal reflux, promoting better outcomes and quality of life. It is essential to educate patients on the importance of dietary modifications in managing gastrointestinal disorders to enhance their understanding and self-care abilities.
Question 5 of 5
A client is admitted to the hospital after vomiting bright red blood and is diagnosed with a bleeding duodenal ulcer. The client develops a sudden, sharp pain in the midepigastric area along with a rigid, boardlike abdomen. These clinical manifestations most likely indicate which of the following?
Correct Answer: D
Rationale: In this scenario, the correct answer is D) The ulcer has perforated. When a client with a bleeding duodenal ulcer presents with sudden, sharp pain in the midepigastric area and a rigid, boardlike abdomen, it suggests a serious complication like perforation of the ulcer. Perforation leads to the leaking of gastric contents into the peritoneal cavity, causing severe pain and abdominal rigidity. Option A) An intestinal obstruction is incorrect because the symptoms described do not align with those of an obstruction. Option B) Additional ulcers developing is unlikely to cause the sudden, sharp pain and rigidity described. Option C) Inflammation of the esophagus does not typically present with a rigid, boardlike abdomen and sudden, severe pain. In the context of medical-surgical nursing, understanding the complications of gastrointestinal disorders is crucial for timely intervention and preventing further deterioration. Recognizing the signs of a perforated ulcer is essential for nurses to promptly alert healthcare providers for appropriate management, which may include surgical intervention. This knowledge ensures optimal patient outcomes and highlights the importance of thorough assessment and clinical reasoning in nursing practice.