ATI RN
ATI Gastrointestinal System Questions
Question 1 of 5
Risk factors for the development of hiatal hernias are those that lead to increased abdominal pressure. Which of the following complications DOES NOT cause increased abdominal pressure?
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 3 retries using GPT-3.5.
Question 2 of 5
The nurse develops a plan of care for a client with a T tube. Which one of the following nursing interventions should be included?
Correct Answer: A
Rationale: The correct nursing intervention to include in the plan of care for a client with a T tube is to inspect the skin around the T tube daily for irritation. Bile is erosive and can cause skin irritation, so it is crucial to keep the skin clean and dry. T tubes are not routinely irrigated; irrigation is done only with a physician's order. It is unnecessary to maintain the client in a supine position; instead, assist the client into a position of comfort. T tubes are not typically clamped unless ordered by a physician, and if clamped, it is usually done 1 to 2 hours before and after meals.
Question 3 of 5
A client with peptic ulcer is scheduled for a Vagotomy. The client asks the nurse about the purpose of this procedure. The nurse tells the client that the procedure
Correct Answer: D
Rationale: A vagotomy is a surgical procedure performed to treat peptic ulcers by severing branches of the vagus nerve, which provides parasympathetic innervation to the stomach. The vagus nerve stimulates gastric acid secretion through the release of acetylcholine, which activates parietal cells in the stomach lining to produce hydrochloric acid. Excessive acid production is a primary cause of peptic ulcers, as it erodes the mucosal lining, leading to pain, bleeding, or perforation. By interrupting this neural pathway, a vagotomy significantly reduces the acid output, thereby decreasing the acidic environment that perpetuates ulcer formation and allowing the ulcer to heal over time. This directly aligns with option D, which states that the procedure "reduces the stimulus to acid secretions." The stimulus here refers to the vagal nerve signals that trigger acid production, so cutting the nerve effectively dampens this response, providing long-term relief for patients with refractory ulcers not controlled by medications like proton pump inhibitors or H2 blockers. Now, let's examine why the other options are incorrect. Option A, "decreases food absorption in the stomach," is inaccurate because the stomach's primary role is digestion and initial mixing of food with gastric juices, not nutrient absorption—that occurs mainly in the small intestine via villi and microvilli. A vagotomy targets acid regulation and may indirectly affect gastric motility or emptying (depending on the type, like truncal vs. selective vagotomy), but it does not impair absorption mechanisms. In fact, without addressing acid hypersecretion, absorption could be hindered by ongoing inflammation, but the procedure itself isn't designed for that purpose. Option B, "heals the gastric mucosa," oversimplifies the outcome. While reduced acid does promote mucosal healing by minimizing erosion, the vagotomy itself doesn't directly repair or regenerate tissue. Healing is a secondary effect facilitated by the lower acid load, often supported by postoperative medications like antacids or sucralfate. The procedure's core mechanism is preventive—stopping further damage—rather than regenerative, which is why it's not the primary explanation a nurse would give. Option C, "halts stress reactions," is unrelated to the vagotomy's function. Stress can exacerbate ulcers by increasing acid production via the hypothalamic-pituitary-adrenal axis (releasing cortisol and stimulating vagal activity), but the surgery doesn't address psychological or physiological stress responses systemically. It only severs the vagal pathway to the stomach, leaving other stress mediators intact. Managing stress might involve lifestyle changes or therapy, but that's not the goal of this procedure. In summary, understanding the vagus nerve's role in parasympathetic control of gastric function is key: it ramps up acid for digestion, but in peptic ulcer disease, this becomes pathological. A vagotomy restores balance by neural interruption, making D the precise rationale a nurse should convey to educate the client on expected benefits and risks, such as potential dumping syndrome or need for supplemental vitamins if motility is affected. This targeted approach has largely been replaced by less invasive options today, but historically and in select cases, it remains effective for acid control.
Question 4 of 5
A client is providing instructions to a client who is scheduled for an oral cholecystogram. The nurse tells the client to
Correct Answer: C
Rationale: For an oral cholecystogram, the client should eat a fat-free meal the evening before the procedure and avoid oral intake except for water on the day of the procedure. During the test, the client may be given a high-fat meal or drink to stimulate gallbladder emptying. Choice A is incorrect because the client should have a fat-free meal, not a high-fat meal. Choice B is incorrect as strict NPO status is not required. Choice D is incorrect as a high-fat meal is not recommended for breakfast on the day of the procedure.
Question 5 of 5
The nurse is scheduling diagnostic tests for a client. If all of the following diagnostic tests are ordered, which would be performed last?
Correct Answer: C
Rationale: The correct answer is C, 'Barium swallow.' A barium swallow should be done after a barium enema or gallbladder series to prevent the contrast used in the barium swallow from obstructing the view of other organs. It takes several days for swallowed barium to pass completely out of the gastrointestinal tract. Choices A, B, and D are incorrect because a barium swallow should be the last test performed to ensure clear imaging without interference from residual contrast material.