ATI RN
ATI Gastrointestinal System
1. If a gastric acid perforates, which of the following actions should not be included in the immediate management of the client?
- A. Blood replacement
- B. Antacid administration
- C. Nasogastric tube suction
- D. Fluid and electrolyte replacement
Correct answer: B
Rationale: Antacid administration should not be included in the immediate management of a gastric perforation.
2. Jerod is experiencing an acute episode of ulcerative colitis. What is the priority for this patient?
- A. Replace lost fluid and sodium.
- B. Monitor for increased serum glucose levels from steroid therapy.
- C. Restrict dietary intake of foods high in potassium.
- D. Note any change in the color and consistency of stools.
Correct answer: A
Rationale: The correct answer is to replace lost fluid and sodium. During an acute episode of ulcerative colitis, the priority is to manage the patient's fluid and electrolyte balance. This is crucial due to the potential for dehydration and electrolyte imbalances resulting from diarrhea and inflammation in the colon. Monitoring serum glucose levels (Choice B) may be important for patients on steroid therapy, but in this scenario, fluid and electrolyte balance take precedence. Restricting dietary intake of foods high in potassium (Choice C) is not a priority in the acute phase of ulcerative colitis. While noting changes in stool color and consistency (Choice D) is important for assessing the patient's gastrointestinal status, it is not the priority when managing acute ulcerative colitis.
3. The nurse assesses the client's understanding of the relationship between body position and gastroesophageal reflux. Which response would indicate that the client understands measures to avoid problems with reflux while sleeping?
- A. I can elevate the foot of the bed 4 to 6 inches.
- B. I can sleep on my stomach with my head turned to the left.
- C. I can sleep on my back without a pillow under my head.
- D. I can elevate the head of the bed 4 to 6 inches.
Correct answer: D
Rationale: Sleeping with the head of the bed elevated encourages movement of food through the esophagus by gravity. By fostering esophageal acid clearance, gravity helps keep the acidic pepsin and alkaline biliary secretions from contacting the esophagus. Elevating the foot of the bed does not affect clearance of esophageal acid. Sleeping on the stomach with the head turned to the left will not decrease reflux incidence. Sleeping flat without a pillow under the head does not enhance clearance.
4. You’re developing the plan of care for a patient experiencing dumping syndrome after a Billroth II procedure. Which dietary instructions do you include?
- A. Omit fluids with meals.
- B. Increase carbohydrate intake.
- C. Decrease protein intake.
- D. Decrease fat intake.
Correct answer: A
Rationale: To manage dumping syndrome, it is important to omit fluids with meals to slow gastric emptying.
5. 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.
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