the nurse has inserted a nasogastric tube to the level of the oropharynx and has repositioned the clients head in a flexed forward position the client
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Nursing Elites

ATI RN

Gastrointestinal System Nursing Exam Questions

1. The nurse has inserted a nasogastric tube to the level of the oropharynx and has repositioned the client’s head in a flexed-forward position. The client has been asked to begin swallowing. The nurse starts slowly to advance the nasogastric tube with each swallow. The client begins to cough, gag, and choke. Which nursing action would least likely result in proper tube insertion and promote client relaxation?

Correct answer: A

Rationale: As the nasogastric tube is passed through the oropharynx, the gag reflex is stimulated, which may cause coughing, gagging, or choking. Instead of passing through to the esophagus, the nasogastric tube may coil around itself in the oropharynx, or it may enter the larynx and obstruct the airway, pulling the tube back slightly will remove it from the larynx; advancing the tube might position it in the trachea. Swallowing closes the epiglottis over the trachea and helps move the tube into the esophagus. Slow breathing helps the client relax to reduce the gag response. The nurse should check the back of the client’s throat to note if the tube has coiled. The tube may be advanced after the client relaxes.

2. The client with peptic ulcer disease is scheduled for a pyloroplasty. The client asks the nurse about the procedure. The nurse plans to respond knowing that a pyloroplasty involves:

Correct answer: D

Rationale: A pyloroplasty involves making an incision in the pylorus (the opening from the stomach to the duodenum) and then resuturing it to relax the muscle and enlarge the opening.

3. You’re advising a 21 y.o. with a colostomy who reports problems with flatus. What food should you recommend?

Correct answer: D

Rationale: Yogurt can help reduce problems with flatus in patients with a colostomy.

4. The nurse provides medication instructions to a client with peptic ulcer disease. Which statement, if made by the client, indicates the best understanding of the medication therapy?

Correct answer: A

Rationale: Cimetidine (Tagamet) works by reducing stomach acid production, which helps to manage peptic ulcer disease.

5. The nurse is assessing a client 24 hours following a cholecystectomy. The nurse notes that the T-tube has drained 750ml of green-brown drainage. Which nursing intervention is most appropriate?

Correct answer: B

Rationale: Documenting the findings is the most appropriate action as 750ml of green-brown drainage is expected after a cholecystectomy.

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