ATI RN
ATI Gastrointestinal System Test
1. Nathaniel has severe pruritus due to having hepatitis B. What is the best intervention for his comfort?
- A. Give tepid baths.
- B. Avoid lotions and creams.
- C. Use hot water to increase vasodilation.
- D. Use cold water to decrease the itching.
Correct answer: A
Rationale: Giving tepid baths can help soothe severe pruritus due to hepatitis B.
2. The hospitalized client with GERD is complaining of chest discomfort that feels like heartburn following a meal. After administering an ordered antacid, the nurse encourages the client to lie in which of the following positions?
- A. Supine with the head of the bed flat
- B. On the stomach with the head flat
- C. On the left side with the head of the bed elevated 30 degrees
- D. On the right side with the head of the bed elevated 30 degrees.
Correct answer: C
Rationale: Lying on the left side with the head of the bed elevated 30 degrees helps prevent reflux by keeping stomach contents from moving up into the esophagus.
3. A nurse orientee is preparing to insert a nasogastric tube, and a nurse educator is observing the procedure. Which of the following supplies if obtained by the nurse orientee would indicate a need for further education regarding this procedure?
- A. Half-inch or one-inch tape
- B. Oil-soluble lubricant
- C. A glass of tap water with a straw
- D. A 50-mL catheter tip syringe
Correct answer: B
Rationale: Water-soluble lubricant is used to lubricate 3 to 4 inches of the tube at the insertion end. An oil lubricant is not used because if the tube accidentally goes into the bronchus, pneumonia can develop. Half-inch tape is used to secure the tube after the correct placement is verified. A 50-mL catheter tip syringe is used to aspirate gastric contents to confirm placement. The client will be asked to take a sip of water through a straw to help with the passage of the tube.
4. The nurse is reviewing the physician’s orders written for a client admitted with acute pancreatitis. Which physician order would the nurse question if noted on the client’s chart?
- A. NPO status
- B. Insert a nasogastric tube
- C. An anticholinergic medication
- D. Morphine for pain
Correct answer: D
Rationale: Morphine for pain should be questioned as it can cause spasms of the sphincter of Oddi, worsening pancreatitis.
5. Which stoma would you expect a malodorous, enzyme-rich, caustic liquid output that is yellow, green, or brown?
- A. Ileostomy.
- B. Ascending colostomy.
- C. Transverse colostomy.
- D. Descending colostomy.
Correct answer: A
Rationale: An ileostomy would have a malodorous, enzyme-rich, caustic liquid output that is yellow, green, or brown.
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