ATI RN
Gastrointestinal System Nursing Exam Questions
1. A nurse orientee is preparing to insert a nasogastric tube, and a nurse educator is observing the procedure. Which of the following supplies if obtained by the nurse orientee would indicate a need for further education regarding this procedure?
- A. Half-inch or one-inch tape
- B. Oil-soluble lubricant
- C. A glass of tap water with a straw
- D. A 50-mL catheter tip syringe
Correct answer: B
Rationale: Water-soluble lubricant is used to lubricate 3 to 4 inches of the tube at the insertion end. An oil lubricant is not used because if the tube accidentally goes into the bronchus, pneumonia can develop. Half-inch tape is used to secure the tube after the correct placement is verified. A 50-mL catheter tip syringe is used to aspirate gastric contents to confirm placement. The client will be asked to take a sip of water through a straw to help with the passage of the tube.
2. Glenda has cholelithiasis (gallstones). You expect her to complain of:
- A. Pain in the right upper quadrant, radiating to the shoulder.
- B. Pain in the right lower quadrant, with rebound tenderness.
- C. Pain in the left upper quadrant, with shortness of breath.
- D. Pain in the left lower quadrant, with mild cramping.
Correct answer: A
Rationale: Patients with cholelithiasis often complain of pain in the right upper quadrant, radiating to the shoulder.
3. Your patient with peritonitis is NPO and complaining of thirst. What is your priority?
- A. Increase the I.V. infusion rate.
- B. Use diversion activities.
- C. Provide frequent mouth care.
- D. Give ice chips every 15 minutes.
Correct answer: C
Rationale: The correct answer is C: Provide frequent mouth care. In a patient with peritonitis who is NPO and thirsty, the priority is to maintain oral hygiene and provide comfort by moistening the mouth with frequent mouth care. This helps alleviate the sensation of thirst and maintains oral health. Increasing the IV infusion rate (choice A) may not address the patient's discomfort directly related to thirst. Using diversion activities (choice B) is not as critical as addressing the patient's immediate need for oral care. Giving ice chips every 15 minutes (choice D) is not recommended for a patient with peritonitis who is NPO, as it can lead to complications or worsen the condition.
4. A client with ulcerative colitis has an order to begin salicylate medication to reduce inflammation. The nurse instructs the client to take the medication:
- A. 30 minutes before meals
- B. On an empty stomach
- C. After meals
- D. On arising
Correct answer: C
Rationale: The correct answer is C: After meals. Salicylate medications for ulcerative colitis should be taken after meals to minimize gastrointestinal irritation and enhance absorption. Taking the medication on an empty stomach (Choice B) may increase the risk of gastrointestinal side effects. Taking it 30 minutes before meals (Choice A) may not provide enough protection for the stomach lining. Taking it on arising (Choice D) is not recommended as it may not coincide with the peak absorption times of the medication.
5. The nurse is reviewing the physician’s orders written for a client admitted with acute pancreatitis. Which physician order would the nurse question if noted on the client’s chart?
- A. NPO status
- B. Insert a nasogastric tube
- C. An anticholinergic medication
- D. Morphine for pain
Correct answer: D
Rationale: Morphine for pain should be questioned as it can cause spasms of the sphincter of Oddi, worsening pancreatitis.
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