ATI RN
ATI Gastrointestinal System Test
1. Sitty, a 66 y.o. patient underwent a colostomy for ruptured diverticulum. She did well during the surgery and returned to your med-surg floor in stable condition. You assess her colostomy 2 days after surgery. Which finding do you report to the doctor?
- A. Blanched stoma
- B. Edematous stoma
- C. Reddish-pink stoma
- D. Brownish-black stoma
Correct answer: A
Rationale: A blanched stoma 2 days after colostomy surgery should be reported to the doctor as it may indicate compromised blood flow.
2. Elmer is scheduled for a proctoscopy and has an I.V. The doctor wrote an order for 5mg of I.V. diazepam(Valium). Which order is correct regarding diazepam?
- A. Give diazepam in the I.V. port closest to the vein.
- B. Mix diazepam with 50 ml of dextrose 5% in water and give over 15 minutes.
- C. Give diazepam rapidly I.V. to prevent the bloodstream from diluting the drug mixture.
- D. Question the order because I.V. administration of diazepam is contraindicated.
Correct answer: A
Rationale: The correct method for administering I.V. diazepam is to give it in the I.V. port closest to the vein.
3. Arthur has a family history of colon cancer and is scheduled to have a sigmoidoscopy. He is crying as he tells you, “I know that I have colon cancer, too.” Which response is most therapeutic?
- A. I know just how you feel.
- B. You seem upset.
- C. Oh, don’t worry about it, everything will be just fine.
- D. Why do you think you have cancer?
Correct answer: B
Rationale: Acknowledging the patient's emotions with 'You seem upset' is the most therapeutic response.
4. Brenda, a 36 y.o. patient is on your floor with acute pancreatitis. Treatment for her includes:
- A. Continuous peritoneal lavage.
- B. Regular diet with increased fat.
- C. Nutritional support with TPN.
- D. Insertion of a T tube to drain the pancreas.
Correct answer: C
Rationale: Treatment for acute pancreatitis includes nutritional support with TPN.
5. Jerod is experiencing an acute episode of ulcerative colitis. What is the priority for this patient?
- A. Replace lost fluid and sodium.
- B. Monitor for increased serum glucose levels from steroid therapy.
- C. Restrict dietary intake of foods high in potassium.
- D. Note any change in the color and consistency of stools.
Correct answer: A
Rationale: The correct answer is to replace lost fluid and sodium. During an acute episode of ulcerative colitis, the priority is to manage the patient's fluid and electrolyte balance. This is crucial due to the potential for dehydration and electrolyte imbalances resulting from diarrhea and inflammation in the colon. Monitoring serum glucose levels (Choice B) may be important for patients on steroid therapy, but in this scenario, fluid and electrolyte balance take precedence. Restricting dietary intake of foods high in potassium (Choice C) is not a priority in the acute phase of ulcerative colitis. While noting changes in stool color and consistency (Choice D) is important for assessing the patient's gastrointestinal status, it is not the priority when managing acute ulcerative colitis.
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