ATI RN
ATI Gastrointestinal System
1. A client being treated for chronic cholecystitis should be given which of the following instructions?
- A. Increase rest
- B. Avoid antacids
- C. Increase protein in diet
- D. Use anticholinergics as prescribed
Correct answer: D
Rationale: Using anticholinergics as prescribed can help manage the symptoms of chronic cholecystitis.
2. The client has had a new colostomy created 2 days earlier. The client is beginning to pass malodorous flatus from the stoma. The nurse interprets that
- A. This indicates inadequate preoperative bowel preparation.
- B. This is a normal, expected event.
- C. The client is experiencing early signs of ischemic bowel.
- D. The client should not have the nasogastric tube removed.
Correct answer: B
Rationale: As peristalsis returns following creation of a colostomy, the client begins to pass malodorous flatus. This indicates returning bowel function and is an expected event. Within 72 hours of surgery, the client should begin passing stool via the colostomy.
3. Of the following signs and symptoms of bowel obstruction, which is related primarily to small bowel obstruction rather than large bowel obstruction?
- A. Profuse vomiting.
- B. Cramping abdominal pain.
- C. Abdominal distention.
- D. High-pitched bowel sounds above the obstruction.
Correct answer: A
Rationale: Profuse vomiting is the classic sign of small bowel obstruction and rarely occurs with large bowel obstruction. Abdominal discomfort and distention are present in both small and large bowel obstructions, but distention is more common in large bowel obstruction. High-pitched bowel sounds indicate hyperperistalsis, which occurs early in obstruction.
4. The nurse is doing pre-op teaching with the client who is about to undergo creation of a Kock pouch. The nurse interprets that the client has the best understanding of the nature of the surgery if the client makes which of the following statements?
- A. I will need to drain the pouch regularly with a catheter.
- B. I will need to wear a drainage bag for the rest of my life.
- C. The drainage from this type of ostomy will be formed.
- D. I will be able to pass stool from my rectum eventually.
Correct answer: A
Rationale: A Kock pouch is a type of continent ileostomy that requires catheterization to empty the internal reservoir. Understanding the need for regular catheterization indicates the client comprehends the procedure.
5. The nurse is assessing for stoma prolapse in a client with a colostomy. The nurse would observe which of the following if stoma prolapse occurred?
- A. Sunken and hidden stoma
- B. Dark- and bluish-colored stoma
- C. Narrowed and flattened stoma
- D. Protruding stoma
Correct answer: D
Rationale: A protruding stoma is indicative of stoma prolapse, which occurs when the bowel protrudes excessively through the stoma.
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