ATI RN
ATI Gastrointestinal System Test
1. An intubated patient is receiving continuous enteral feedings through a Salem sump tube at a rate of 60ml/hr. Gastric residuals have been 30-40ml when monitored Q4H. You check the gastric residual and aspirate 220ml. What is your first response to this finding?
- A. Notify the doctor immediately.
- B. Stop the feeding, and clamp the NG tube.
- C. Discard the 220ml, and clamp the NG tube.
- D. Give a prescribed GI stimulant such as metoclopramide (Reglan).
Correct answer: B
Rationale: If gastric residuals are high during continuous enteral feedings, the first response is to stop the feeding and clamp the NG tube.
2. 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.
3. Type A chronic gastritis can be distinguished from type B by its ability to:
- A. Cause atrophy of the parietal cells.
- B. Affect only the antrum of the stomach.
- C. Thin the lining of the stomach walls.
- D. Decrease gastric secretions.
Correct answer: A
Rationale: Type A chronic gastritis can cause atrophy of the parietal cells, which is a distinguishing feature from type B.
4. A nurse is reviewing the orders of a client admitted to the hospital with a diagnosis of acute pancreatitis. Select the interventions that the nurse would expect to be prescribed for the client.
- A. Small, frequent high-calorie feedings.
- B. Meperidine (Demerol) as prescribed for pain.
- C. Place the client in a side-lying position with the head elevated 45-degrees.
- D. Administer antacids and anticholinergics to suppress gastrointestinal secretions.
Correct answer: B
Rationale: The correct intervention for a client with acute pancreatitis is to prescribe pain medications such as meperidine to manage the abdominal pain, which is a prominent symptom of the condition. The other options are incorrect because: A) Clients with acute pancreatitis are normally placed on NPO (nothing by mouth) status to rest the pancreas, so small, frequent high-calorie feedings are not indicated. C) Placing the client in a side-lying position with the head elevated 45-degrees helps decrease tension on the abdomen and may ease pain, but it is not a standard intervention for acute pancreatitis. D) Administering antacids and anticholinergics to suppress gastrointestinal secretions is not a routine intervention for acute pancreatitis.
5. You’re preparing a teaching plan for a 27 y.o. named Jeff who underwent surgery to close a temporary ileostomy. Which nutritional guideline do you include in this plan?
- A. There is no need to change eating habits.
- B. Eat six small meals a day.
- C. Eat the largest meal in the evening.
- D. Restrict fluid intake.
Correct answer: B
Rationale: After ileostomy closure surgery, it is recommended to eat six small meals a day to aid digestion and absorption.
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