ATI RN
Gastrointestinal System ATI
1. 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.
2. A client with a peptic ulcer is scheduled for a vagotomy. The client asks the nurse about the purpose of this procedure. The nurse tells the client that the procedure:
- A. Decreases food absorption in the stomach
- B. Heals the gastric mucosa
- C. Halts stress reactions
- D. Reduces the stimulus to acid secretions
Correct answer: D
Rationale: A vagotomy reduces the stimulus to acid secretions by cutting the vagus nerve, which innervates the stomach.
3. Which of the following therapies is not included in the medical management of a client with peritonitis?
- A. Broad-spectrum antibiotics
- B. Electrolyte replacement
- C. I.V. fluids
- D. Regular diet
Correct answer: D
Rationale: A regular diet is not included in the medical management of peritonitis, which requires bowel rest and IV fluids.
4. Which of the following expected outcomes would be appropriate for the client who has ulcerative colitis?
- A. The client maintains a daily record of intake and output.
- B. The client verbalizes the importance of small, frequent feedings.
- C. The client uses a heating pad to decrease abdominal cramping.
- D. The client accepts that a colostomy is inevitable at some time in his life.
Correct answer: B
Rationale: Small, frequent feedings are better tolerated by clients with ulcerative colitis as they lessen the amount of fecal material present in the gastrointestinal tract and decrease stimulation. The client does not need to maintain a daily record of intake and output unless an exacerbation of the disease occurs. A heating pad should not be applied to the intestine as it is inflamed. It is not inevitable that the client will require surgery to treat ulcerative colitis.
5. A client who has ulcerative colitis has persistent diarrhea. He is thin and has lost 12 pounds since the exacerbation of his ulcerative colitis. The nurse should anticipate that the physician will order which of the following treatment approaches to help the client meet his nutritional needs?
- A. Initiate continuous enteral feedings
- B. Encourage a high protein, high-calorie diet
- C. Implement total parenteral nutrition
- D. Provide six small meals a day.
Correct answer: C
Rationale: Implementing total parenteral nutrition helps meet the nutritional needs of a client with persistent diarrhea and significant weight loss due to ulcerative colitis.
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