ATI RN
Gastrointestinal System ATI
1. Christina is receiving an enteral feeding that requires a concentration of 80ml of supplement mixed with 20 ml of water. How much water do you mix with an 8 oz (240ml) can of feeding?
- A. 60 ml.
- B. 70 ml.
- C. 80 ml.
- D. 90 ml.
Correct answer: A
Rationale: For an 8 oz (240 ml) can of feeding, mix 60 ml of water to achieve the required concentration.
2. Kevin has a history of peptic ulcer disease and vomits coffee-ground emesis. What does this indicate?
- A. He has fresh, active upper GI bleeding.
- B. He needs immediate saline gastric lavage.
- C. His gastric bleeding occurred 2 hours earlier.
- D. He needs a transfusion of packed RBCs.
Correct answer: C
Rationale: Coffee-ground emesis is a sign of upper gastrointestinal bleeding that occurred approximately 2 hours earlier. It results from the breakdown of blood in the stomach due to digestive enzymes, giving it a coffee-ground appearance. Choice A is incorrect because coffee-ground emesis indicates older, partially digested blood, not fresh active bleeding. Choice B is incorrect as gastric lavage is not indicated for coffee-ground emesis. Choice D is incorrect because a transfusion of packed RBCs is not the immediate management for this presentation.
3. A nurse is caring for a client who has a new diagnosis of Crohn's disease. Which of the following findings should the nurse expect?
- A. Bloody diarrhea
- B. Fatty stools
- C. Weight gain
- D. High fever
Correct answer: B
Rationale: Clients with Crohn's disease often experience fatty stools (steatorrhea) due to malabsorption of fats. This occurs because the inflammation caused by Crohn's disease can affect the small intestine, impairing the body's ability to absorb nutrients. Bloody diarrhea is more commonly associated with ulcerative colitis. Weight gain is not a typical symptom of Crohn's disease; instead, weight loss is more common due to malabsorption and decreased appetite. High fever can occur during acute flare-ups but is not a primary finding of Crohn's disease.
4. George has a T tube in place after gallbladder surgery. Before discharge, what information or instructions should be given regarding the T tube drainage?
- A. If there is any drainage, notify the surgeon immediately.
- B. The drainage will decrease daily until the bile duct heals.
- C. First, the drainage is dark green; then it becomes dark yellow.
- D. If the drainage stops, milk the tube toward the puncture wound.
Correct answer: B
Rationale: Before discharge, inform the patient that the drainage will decrease daily until the bile duct heals.
5. Your patient has a retractable gastric peptic ulcer and has had a gastric vagotomy. Which factor increases as a result of vagotomy?
- A. Peristalsis.
- B. Gastric acidity.
- C. Gastric motility.
- D. Gastric pH.
Correct answer: D
Rationale: After a gastric vagotomy, the gastric pH increases as a result of reduced acid secretion.
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