ATI RN
Gastrointestinal System Nursing Exam Questions Questions
Question 1 of 5
Vasopressin (Pitressin) therapy is prescribed for a client with a diagnosis of bleeding esophageal varices. The nurse is preparing to administer the medication to the client. Which of the following essential items is needed during the administration of this medication?
Correct Answer: A
Rationale: The correct answer is A: A cardiac monitor. Vasopressin is a vasoconstrictor medication used to decrease blood flow to the bleeding esophageal varices. It can cause significant changes in blood pressure and heart rate, hence requiring close monitoring of the client's cardiac status. A cardiac monitor is essential to continuously monitor the client's heart rate and rhythm during vasopressin therapy. B: An intubation set is not necessary for administering vasopressin to a client with bleeding esophageal varices. C: A suction setup is not directly related to the administration of vasopressin for bleeding esophageal varices. D: A tracheotomy set is not required for the administration of vasopressin for bleeding esophageal varices.
Question 2 of 5
A client with a history of gastric ulcer suddenly complains of a sharp-severe pain in the mid epigastric area, which then spreads over the entire abdomen. The client's abdomen is rigid and board-like to palpation, and the client obtains most comfort from lying in the knee-chest position. The nurse calls the physician immediately suspecting that the client is experiencing which of the following complications of peptic ulcer disease?
Correct Answer: A
Rationale: The correct answer is A: Perforation. The sudden onset of sharp-severe pain, rigidity, and board-like abdomen are classic signs of a perforated gastric ulcer. The spreading pain and relief in the knee-chest position indicate free air in the peritoneal cavity. Perforation is a serious complication requiring immediate medical attention to prevent peritonitis and sepsis. Choice B: Obstruction is incorrect because it typically presents with a gradual onset of pain, bloating, vomiting, and inability to pass stool or gas. Choice C: Hemorrhage is incorrect as it usually presents with symptoms like hematemesis, melena, and signs of blood loss such as hypotension and tachycardia. Choice D: Intractability is incorrect because it refers to the condition being difficult to manage or cure, which is not the acute presentation described in the question.
Question 3 of 5
The nurse is caring for a client admitted to the hospital with a suspected diagnosis of acute appendicitis. Which of the following laboratory results would the nurse expect to note if the client indeed has appendicitis?
Correct Answer: C
Rationale: The correct answer is C: Leukocytosis with a shift to the left. In acute appendicitis, the body responds with an increase in white blood cells (leukocytosis) as a sign of infection. A shift to the left indicates an increase in immature neutrophils, which is a common response to acute bacterial infections like appendicitis. Leukopenia (choices A and D) would not be expected in appendicitis. Leukopenia is a decrease in white blood cells, which is not typical in an acute infection like appendicitis. Leukocytosis with a shift to the right (choice B) could be seen in chronic infections or conditions like leukemia, not in acute appendicitis where a shift to the left is more common due to the rapid response to infection.
Question 4 of 5
To prevent gastroesophageal reflux in a client with hiatal hernia, the nurse should provide which discharge instructions?
Correct Answer: B
Rationale: The correct answer is B: Avoid coffee and alcoholic beverages. This is because both coffee and alcohol can relax the lower esophageal sphincter, leading to increased risk of gastroesophageal reflux in clients with hiatal hernia. A: Lying down after meals can actually worsen reflux symptoms by allowing stomach acid to flow back into the esophagus. C: Taking antacids before meals may provide temporary relief but does not address the underlying cause of reflux. D: Limiting fluids with meals can help reduce reflux by not distending the stomach, but it is not as crucial as avoiding coffee and alcohol.
Question 5 of 5
Which of the following activities should the nurse encourage the client with a peptic ulcer to avoid?
Correct Answer: B
Rationale: The correct answer is B: Smoking cigarettes. Smoking can increase stomach acid production and decrease blood flow to the stomach lining, which can worsen peptic ulcers. Chewing gum can actually help by increasing saliva production, which can neutralize stomach acid. Eating chocolate and taking acetaminophen are generally safe for peptic ulcer patients as long as they do not have specific allergies or sensitivities.