ATI RN
Chapter 15 The Gastrointestinal System Review Questions Questions
Question 1 of 5
Which esophageal disorder is described as a precancerous lesion associated with GERD?
Correct Answer: B
Rationale: Barrett's esophagus is the correct answer because it is a precancerous condition resulting from long-term GERD. The constant exposure to stomach acid causes changes in the esophageal lining, increasing the risk of esophageal cancer. Achalasia (A) is a motility disorder characterized by difficulty swallowing due to impaired esophageal muscle movement. Esophageal strictures (C) are narrowing of the esophagus, commonly caused by chronic inflammation or scarring, but not directly associated with GERD. Esophageal diverticula (D) are outpouchings in the esophageal wall, not specifically linked to GERD or cancer risk.
Question 2 of 5
An important nursing intervention for a patient with a small intestinal obstruction who has an NG tube is to
Correct Answer: B
Rationale: The correct answer is B: provide mouth care every 1 to 2 hours. This is crucial to maintain oral hygiene and comfort for the patient with an NG tube to prevent complications like dry mouth and infection. Offering ice chips (choice A) may worsen the obstruction. Irrigating the tube with normal saline (choice C) can disrupt the bowel and is not recommended. Keeping the patient supine with the head of the bed elevated (choice D) is a general measure but not specific to NG tube care.
Question 3 of 5
The patient experienced a blood transfusion reaction. How should the nurse explain to the patient the cause of the hemolytic jaundice that occurred?
Correct Answer: D
Rationale: The correct answer is D. Hemolytic jaundice in a blood transfusion reaction is due to increased breakdown of red blood cells (RBCs) causing elevated serum unconjugated bilirubin. This occurs when the patient's immune system reacts to the transfused blood, leading to destruction of RBCs. The breakdown of these cells releases hemoglobin, which is metabolized into bilirubin. This unconjugated bilirubin then accumulates in the blood, causing jaundice. Choice A is incorrect because hepatocellular disease does not directly cause hemolytic jaundice. Choice B is incorrect as malaria parasite breaking apart RBCs leads to hemolysis, not a blood transfusion reaction. Choice C is incorrect as decreased bile flow through the liver or biliary system typically causes obstructive jaundice, not hemolytic jaundice.
Question 4 of 5
What manifestation in the patient does the nurse recognize as an early sign of hepatic encephalopathy?
Correct Answer: D
Rationale: The correct answer is D: Is irritable and lethargic. Early signs of hepatic encephalopathy often include behavioral changes like irritability and lethargy due to impaired brain function from liver dysfunction. This is because the liver is unable to properly detoxify ammonia, leading to its accumulation in the bloodstream and affecting brain function. Asterixis, unconsciousness, and oliguria are more severe manifestations seen in later stages of hepatic encephalopathy. Therefore, recognizing irritability and lethargy in a patient would prompt early intervention to prevent further progression of hepatic encephalopathy.
Question 5 of 5
What treatment for acute cholecystitis will prevent further stimulation of the gallbladder?
Correct Answer: A
Rationale: The correct answer is A: NPO with NG suction. This treatment prevents further stimulation of the gallbladder by resting the digestive system and reducing the secretion of bile. NPO stands for "nothing by mouth," which reduces gallbladder contractions. NG suction removes stomach contents, preventing bile from reaching the gallbladder. Incisional cholecystectomy is a surgical removal of the gallbladder and not a preventive measure. Antiemetics help control nausea and vomiting but do not directly prevent gallbladder stimulation. Anticholinergics inhibit the parasympathetic nervous system but are not typically used to prevent gallbladder stimulation.