ATI RN
Gastrointestinal System Nursing Exam Questions Questions
Question 1 of 5
The nurse is preparing a discharge teaching plan for the client who had an umbilical hernia repair. Which of the following would the nurse include in the plan?
Correct Answer: C
Rationale: The correct answer is C: Avoiding coughing. After umbilical hernia repair, coughing can increase intra-abdominal pressure and strain the surgical site, leading to potential complications like hernia recurrence or wound dehiscence. It is crucial to advise the client to avoid coughing to promote proper healing. A: Restricting pain medication is not necessary as pain management is essential for the client's comfort and recovery. B: Maintaining bedrest is not typically required after umbilical hernia repair, as early ambulation is often encouraged to prevent complications like blood clots. D: Irrigating the drain is not typically part of the discharge teaching plan for umbilical hernia repair, as drains are usually removed before discharge.
Question 2 of 5
During an abdominal assessment, a nurse finds pulsation between the umbilicus and pubis on a client. What finding should be reported to the physician?
Correct Answer: B
Rationale: The correct answer is B because pulsation between the umbilicus and pubis could indicate an abdominal aortic aneurysm (AAA), a serious condition that requires immediate medical attention. The pulsation in this area could be the enlargement of the aorta, which can be life-threatening if it ruptures. Reporting this finding to the physician is crucial for further evaluation and intervention. Choice A (Concave, midline umbilicus) is incorrect because it is a normal finding during an abdominal assessment. Choice C (Bowel sound frequency of 15 sounds per minute) is incorrect as it falls within the normal range of bowel sounds. Choice D (Absence of a bruit) is also incorrect as the absence of a bruit is a normal finding and does not indicate any immediate concern.
Question 3 of 5
The nurse is doing preoperative teaching with the client who is about to undergo creation of a Kock pouch. The nurse interprets that the client has the best understanding of the nature of the surgery if the client makes which of the following statements?
Correct Answer: A
Rationale: The correct answer is A: "I will need to drain the pouch regularly with a catheter." This answer demonstrates an accurate understanding of the Kock pouch procedure, which involves the creation of a reservoir that needs to be drained periodically to prevent complications like overflow or infection. Rationale: 1. A Kock pouch is a continent ileostomy that requires regular catheterization for drainage. 2. Choice B is incorrect because wearing a drainage bag for life is not necessary with a Kock pouch. 3. Choice C is incorrect as a Kock pouch does not produce formed drainage. 4. Choice D is incorrect because passing stool from the rectum is not possible after a Kock pouch surgery. In summary, choice A is the correct answer as it aligns with the specific care requirements of a Kock pouch surgery, while the other options misrepresent the nature of the procedure.
Question 4 of 5
A nurse is caring for a client who has just returned from the operating room following the creation of a colostomy. The nurse is assessing the drainage in the pouch attached to the site where the colostomy was formed and notes serosanguineous drainage. Which nursing action is most appropriate based on this assessment?
Correct Answer: B
Rationale: The correct answer is B: Document the amount and characteristics of the drainage. This is appropriate as serosanguineous drainage is expected after colostomy creation. Documenting helps monitor for any changes and provides crucial information for the healthcare team. Choice A (Notify the physician) is not necessary at this point as serosanguineous drainage is normal postoperatively. Choice C (Apply ice to the stoma site) and Choice D (Apply pressure to the site) are both incorrect actions that are not indicated in this situation and could potentially harm the client.
Question 5 of 5
Cholestyramine resin (Questran Light) is prescribed for the client with an elevated serum cholesterol level. The nurse would instruct the client to take the medication
Correct Answer: B
Rationale: The correct answer is B: Mixed with fruit juice. Cholestyramine resin should be taken mixed with a liquid, such as fruit juice, to prevent esophageal irritation and improve absorption. Taking it with a meal can interfere with nutrient absorption. Taking it via rectal suppository is incorrect as it is an oral medication. Taking it at least 3 hours before meals is not necessary and may lead to decreased effectiveness. Mixing it with fruit juice helps improve tolerability and effectiveness.