ATI RN
Gastrointestinal System ATI
1. The student nurse is participating in colorectal cancer-screening program. Which patient has the fewest risk factors for colon cancer?
- A. Janice, a 45 y.o. with a 25-year history of ulcerative colitis
- B. George, a 50 y.o. whose father died of colon cancer
- C. Herman, a 60 y.o. who follows a low-fat, high-fiber diet
- D. Sissy, a 72 y.o. with a history of breast cancer
Correct answer: C
Rationale: Herman, a 60 y.o. who follows a low-fat, high-fiber diet, has the fewest risk factors for colon cancer.
2. Your patient has a retractable gastric peptic ulcer and has had a gastric vagotomy. Which factor increases as a result of vagotomy?
- A. Peristalsis.
- B. Gastric acidity.
- C. Gastric motility.
- D. Gastric pH.
Correct answer: D
Rationale: After a gastric vagotomy, the gastric pH increases as a result of reduced acid secretion.
3. A client’s ulcerative colitis symptoms have been present for longer than 1 week. The nurse recognizes that the client should be assessed carefully for signs of which of the following complications?
- A. Heart failure
- B. DVT
- C. Hypokalemia
- D. Hypocalcemia
Correct answer: C
Rationale: The client should be assessed carefully for signs of hypokalemia, a common complication of prolonged ulcerative colitis symptoms.
4. You have to teach ostomy self care to a patient with a colostomy. You tell the patient to measure and cut the wafer:
- A. To the exact size of the stoma.
- B. About 1/16” larger than the stoma.
- C. About 1/8” larger than the stoma.
- D. About 1/4″ larger than the stoma.
Correct answer: C
Rationale: The wafer should be measured and cut about 1/8” larger than the stoma to ensure proper fit and prevent skin irritation.
5. A client is admitted with a diagnosis of ulcerative colitis. Which of the following symptoms should the nurse expect the client to report when responding to questions about his bowel elimination pattern?
- A. Constipation.
- B. Bloody, diarrheal stools.
- C. Steatorrhea.
- D. Alternating periods of constipation and diarrhea.
Correct answer: B
Rationale: Diarrhea is the primary symptom of ulcerative colitis. It is profuse and severe; the client may pass as many as 15 to 20 watery stools per day. Stools may contain blood, mucus, and pus. The frequent diarrhea is often accompanied by anorexia and nausea. Constipation is not a sign or symptom of ulcerative colitis. Steatorrhea (fatty stools) is more typical of pancreatitis and cholecystitis. Alternating diarrhea and constipation is associated with irritable bowel syndrome.
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