ATI RN
Gastrointestinal System Nursing Exam Questions Questions
Question 1 of 5
The nurse assesses the client's understanding of the relationship between body position and gastroesophageal reflux. Which response would indicate that the client understands measures to avoid problems with reflux while sleeping?
Correct Answer: D
Rationale: The correct answer is D: "I can elevate the head of the bed 4 to 6 inches." Elevating the head of the bed helps to prevent gastroesophageal reflux by promoting gravity to keep stomach acid from moving back into the esophagus. This position helps to keep the stomach contents in place and reduces the likelihood of reflux during sleep. Choice A is incorrect because elevating the foot of the bed would not be effective in preventing reflux; it may even exacerbate the issue. Choice B is incorrect as sleeping on the stomach can increase pressure on the stomach and worsen reflux. Choice C is also incorrect as sleeping on the back without a pillow under the head may not provide the necessary elevation to prevent reflux effectively.
Question 2 of 5
A nurse is inserting a nasogastric tube in an adult client. During the procedure, the client begins to cough and has difficulty breathing. Which of the following is the most appropriate nursing action?
Correct Answer: B
Rationale: The correct answer is B: Pull back on the tube and wait until the respiratory distress subsides. This action allows for the nurse to relieve the pressure on the airway caused by the nasogastric tube, potentially alleviating the client's difficulty in breathing. It is important to prioritize the client's respiratory status and ensure they can breathe comfortably before proceeding with the procedure. A: Removing the tube may worsen the respiratory distress and delay appropriate intervention. C: Quickly inserting the tube can further compromise the client's breathing and cause more distress. D: While notifying the physician is important, immediate intervention to address the breathing difficulty is crucial before seeking further assistance.
Question 3 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 4 of 5
The nurse aspirates 40 mL of undigested formula from the client's nasogastric tube. Before administering an intermittent tube feeding, the nurse understands that the 40 mL of gastric aspirate should be
Correct Answer: B
Rationale: The correct answer is B because pouring the 40 mL of gastric aspirate back into the nasogastric tube through a syringe with the plunger removed ensures the undigested formula is returned to the stomach for digestion. This method maintains the balance of electrolytes and nutrients and prevents potential complications. Choice A is incorrect because discarding the aspirate without returning it to the stomach can lead to electrolyte imbalances and nutritional deficiencies. Choice C is incorrect because mixing the aspirate with formula before administering it can cause inaccurate dosing and potential nutrient interactions. Choice D is incorrect because diluting the aspirate with water and forcibly injecting it back into the stomach can cause discomfort and potential complications for the client.
Question 5 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.