ATI RN
ATI Gastrointestinal System
1. A client is admitted to the hospital after vomiting bright red blood and is diagnosed with a bleeding duodenal ulcer. The client develops a sudden, sharp pain in the midepigastric area along with a rigid, boardlike abdomen. These clinical manifestations most likely indicate which of the following?
- A. An intestinal obstruction has developed
- B. Additional ulcers have developed
- C. The esophagus has become inflamed
- D. The ulcer has perforated
Correct answer: D
Rationale: A sudden, sharp pain in the midepigastric area along with a rigid, boardlike abdomen indicates that the ulcer has perforated.
2. You’re performing an abdominal assessment on Brent who is 52 y.o. In which order do you proceed?
- A. Observation, percussion, palpation, auscultation
- B. Observation, auscultation, percussion, palpation
- C. Percussion, palpation, auscultation, observation
- D. Palpation, percussion, observation, auscultation
Correct answer: B
Rationale: The correct order for performing an abdominal assessment is observation, auscultation, percussion, and palpation.
3. The nurse is performing an assessment on a client with acute pancreatitis who was admitted to the hospital. Which of the following assessment questions most specifically would elicit information regarding the pain that is associated with acute pancreatitis?
- A. Does the pain in your abdomen radiate to your groin.
- B. Does the pain in your stomach radiate to the back?
- C. Does the pain in your stomach radiate to your lower middle abdomen?
- D. Does the pain in your lower abdomen radiate to the hip?
Correct answer: B
Rationale: The pain that is associated with acute pancreatitis is often severe and is located in the epigastric region and radiates to the back. Options 1, 3, and 4 are incorrect because they are not specific for the pain experienced by the client with pancreatitis.
4. The client with ascites is scheduled for a paracentesis. The nurse is assisting the physician in performing the procedure. Which of the following positions will the nurse assist the client to assume for this procedure?
- A. Supine
- B. Left side-lying
- C. Right side-lying
- D. Upright position.
Correct answer: D
Rationale: An upright position allows the intestine to float posteriorly and helps prevent intestinal laceration during catheter insertion.
5. A patient who underwent abdominal surgery now has a gaping incision due to delayed wound healing. Which method is correct when you irrigate a gaping abdominal incision with sterile normal saline solution, using a piston syringe?
- A. Rapidly instill a stream of irrigating solution into the wound.
- B. Apply a wet-to-dry dressing to the wound after the irrigation.
- C. Moisten the area around the wound with normal saline solution after the irrigation.
- D. Irrigate continuously until the solution becomes clear or all of the solution is used.
Correct answer: D
Rationale: Irrigating continuously until the solution becomes clear or all of the solution is used is the correct method when irrigating a gaping abdominal incision.
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