kevin has a history of peptic ulcer disease and vomits coffee ground emesis what does this indicate

ATI RN

Gastrointestinal System ATI

1. 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.

2. Which of the following symptoms is common with a hiatal hernia?

A. Left arm pain
B. Lower back pain
C. Esophageal reflux
D. Abdominal cramping

Correct answer: C

Rationale: Esophageal reflux is a common symptom of a hiatal hernia because the hernia can cause stomach acid to move back up into the esophagus.

3. A client with rectal cancer may exhibit which of the following symptoms?

A. Abdominal fullness
B. Gastric fullness
C. Rectal bleeding
D. Right upper quadrant pain

Correct answer: C

Rationale: Rectal bleeding is a common symptom in clients with rectal cancer.

4. A 30-year old client experiences weight loss, abdominal distention, crampy abdominal pain, and intermittent diarrhea after the birth of her 2nd child. Diagnostic tests reveal gluten-induced enteropathy. Which foods must she eliminate from her diet permanently?

A. Milk and dairy products
B. Protein-containing foods
C. Cereal grains (except rice and corn)
D. Carbohydrates

Correct answer: C

Rationale: Gluten-induced enteropathy, or celiac disease, requires the elimination of gluten-containing grains like wheat, barley, and rye. Dairy, proteins, and carbohydrates are not excluded unless the client has specific intolerances.

5. Colon cancer is most closely associated with which of the following conditions?

A. Appendicitis
B. Hemorrhoids
C. Hiatal hernia
D. Ulcerative colitis

Correct answer: D

Rationale: Ulcerative colitis is a condition closely associated with an increased risk of developing colon cancer due to chronic inflammation of the colon.