ATI RN
Gastrointestinal System Nursing Exam Questions Questions
Question 1 of 5
Which of the following techniques would the nurse use first to determine if a nasogastric tube is positioned in the stomach?
Correct Answer: A
Rationale: The correct answer is A: Aspirating with a syringe and observing for the return of gastric contents. This technique is used first because it directly confirms the tube's placement by withdrawing gastric contents. If the tube is in the stomach, gastric contents will be aspirated. Choice B is incorrect because irrigating with normal saline does not confirm the tube placement in the stomach. Choice C is incorrect because placing the tube's free end in water and observing for air bubbles is not an accurate method to confirm stomach placement. Choice D is incorrect because instilling air and auscultating over the epigastric area may not provide definitive confirmation of tube placement in the stomach.
Question 2 of 5
When preparing the client with hepatitis A for extended convalescence, the nurse teaches the client about problems that may occur. The nurse knows that the client has understood the teaching when he says that he is most likely to have difficulty:
Correct Answer: D
Rationale: The correct answer is D: Maintaining a positive, optimistic outlook. This is because having a positive mindset can help the client cope better with the challenges of extended convalescence. It can improve overall well-being, mental health, and motivation for recovery. A: Controlling abdominal pain - While abdominal pain may be a symptom of hepatitis A, it is not the most crucial aspect for extended convalescence. B: Maintaining a regular bowel elimination pattern - While important for overall health, this is not specifically related to complications from hepatitis A. C: Preventing respiratory complications - While respiratory complications can occur in severe cases of hepatitis A, it is not the most likely difficulty the client will face during extended convalescence.
Question 3 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 4 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 5 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.