ATI RN
ATI Gastrointestinal System
1. The client being treated for esophageal varices has a Sengstaken-Blakemore tube inserted to control the bleeding. The most important assessment is for the nurse to:
- A. Check that the hemostat is on the bedside
- B. Monitor IV fluids for the shift
- C. Regularly assess respiratory status
- D. Check that the balloon is deflated on a regular basis
Correct answer: C
Rationale: Regularly assessing respiratory status is crucial when a Sengstaken-Blakemore tube is inserted to control bleeding in esophageal varices.
2. To accurately assess for jaundice in a patient with dark skin pigmentation, the nurse should examine which body areas?
- A. Nail beds
- B. Skin on the back of the hand
- C. Hard palate of the mouth
- D. Soles of the feet
Correct answer: C
Rationale: To accurately assess for jaundice in a patient with dark skin pigmentation, the nurse should examine the hard palate of the mouth. Jaundice is best assessed in the sclera; however, in dark-skinned patients, normal yellow pigmentation may be present in the sclera, making it difficult to detect jaundice. Inspection of the hard palate for a yellow color can confirm the presence of jaundice. Cyanosis is best observed in the nail beds, not indicative of jaundice. While skin on the palm of the hand can indicate jaundice, the back of the hand is not a typical area for assessment. Jaundice can be assessed on the soles of the feet in dark-skinned patients, but it is better visualized in the hard palate for accurate evaluation.
3. The nurse is reviewing the medication record of a client with acute gastritis. Which medication, if noted on the client’s record, would the nurse question?
- A. Digoxin (Lanoxin)
- B. Indomethacin (Indocin)
- C. Furosemide (Lasix)
- D. Propranolol hydrochloride (Inderal)
Correct answer: B
Rationale: Indomethacin (Indocin) is an NSAID that can aggravate acute gastritis and should be questioned.
4. Which of the following tests can be performed to diagnose a hiatal hernia?
- A. Colonoscopy
- B. Lower GI series
- C. Barium swallow
- D. Abdominal x-rays
Correct answer: C
Rationale: A barium swallow is a diagnostic test that can visualize the esophagus, stomach, and small intestine to diagnose a hiatal hernia.
5. Which of the following best describes the method of action of medications, such as ranitidine (Zantac), which are used in the treatment of peptic ulcer disease?
- A. Neutralize acid
- B. Reduce acid secretions
- C. Stimulate gastrin release
- D. Protect the mucosal barrier
Correct answer: B
Rationale: Medications like ranitidine (Zantac) are H2 receptor antagonists that reduce acid secretions in the stomach, helping to treat peptic ulcer disease.
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