ATI RN
ATI Gastrointestinal System Quizlet
1. In a client with diarrhea, which outcome indicates that fluid resuscitation is successful?
- A. The client passes formed stools at regular intervals
- B. The client reports a decrease in stool frequency and liquidity
- C. The client exhibits firm skin turgor
- D. The client no longer experiences perianal burning
Correct answer: C
Rationale: Firm skin turgor indicates adequate hydration, which is a key goal of fluid resuscitation. Formed stools, decreased stool frequency, and relief from perianal burning are important but do not directly indicate successful fluid resuscitation.
2. A female client complains of gnawing epigastric pain for a few hours after meals. At times, when the pain is severe, vomiting occurs. Specific tests are indicated to rule out:
- A. Cancer of the stomach
- B. Peptic ulcer disease
- C. Chronic gastritis
- D. Pylorospasm
Correct answer: A
Rationale: Specific tests are indicated to rule out cancer of the stomach when a client complains of gnawing epigastric pain and vomiting after meals.
3. After a subtotal gastrectomy, the nurse should anticipate that nasogastric tube drainage will be what color for about 12 to 24 hours after surgery?
- A. Dark brown
- B. Bile green
- C. Bright red
- D. Cloudy white
Correct answer: A
Rationale: Dark brown drainage is expected for about 12 to 24 hours after surgery.
4. The client who has undergone creation of a colostomy has a nursing diagnosis of Disturbed body image. The nurse would evaluate that the client is making the most significant progress toward identified goals if the client:
- A. Watches the nurse empty the colostomy bag
- B. Looks at the ostomy site
- C. Reads the ostomy product literature
- D. Practices cutting the ostomy appliance
Correct answer: D
Rationale: The correct answer is D: Practices cutting the ostomy appliance. This choice indicates that the client is actively involved in self-care and adapting to the colostomy. By practicing cutting the ostomy appliance, the client is demonstrating independence and self-management skills, showing significant progress towards overcoming the disturbed body image. Choices A, B, and C do not involve active participation in self-care tasks related to the colostomy, which are essential for the client's adaptation and acceptance.
5. The nurse is performing a colostomy irrigation on a client. During the irrigation, a client begins to complain of abdominal cramps. Which of the following is the most appropriate nursing action?
- A. Notify the physician
- B. Increase the height of the irrigation
- C. Stop the irrigation temporarily.
- D. Medicate with dilaudid and resume the irrigation
Correct answer: C
Rationale: If a client experiences abdominal cramps during a colostomy irrigation, it is appropriate to stop the irrigation temporarily to allow the cramps to subside.
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