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. The nurse has given instructions to the client with an ileostomy about foods to eat to thicken the stool. The nurse determines that the client needs further instructions if the client stated to eat which of the following foods to make the stools less watery?
- A. Pasta
- B. Boiled rice
- C. Bran
- D. Low-fat cheese
Correct answer: C
Rationale: Bran is high in fiber and should not be consumed to thicken the stool as it will make the stools more watery.
3. The client with a duodenal ulcer may exhibit which of the following findings on assessment?
- A. Hematemesis
- B. Malnourishment
- C. Melena
- D. Pain with eating
Correct answer: C
Rationale: Melena (black, tarry stools) can be an indication of a duodenal ulcer.
4. Kevin has a history of peptic ulcer disease and vomits coffee-ground emesis. What does this indicate?
- A. He has fresh, active upper GI bleeding.
- B. He needs immediate saline gastric lavage.
- C. His gastric bleeding occurred 2 hours earlier.
- D. He needs a transfusion of packed RBCs.
Correct answer: C
Rationale: Coffee-ground emesis is a sign of upper gastrointestinal bleeding that occurred approximately 2 hours earlier. It results from the breakdown of blood in the stomach due to digestive enzymes, giving it a coffee-ground appearance. Choice A is incorrect because coffee-ground emesis indicates older, partially digested blood, not fresh active bleeding. Choice B is incorrect as gastric lavage is not indicated for coffee-ground emesis. Choice D is incorrect because a transfusion of packed RBCs is not the immediate management for this presentation.
5. Which of the following diagnostic tests should be performed annually over age 50 to screen for colon cancer?
- A. Abdominal CT scan
- B. Abdominal x-ray
- C. Colonoscopy
- D. Fecal occult blood test
Correct answer: D
Rationale: A fecal occult blood test should be performed annually for individuals over age 50 to screen for colon cancer.
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