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. George has a T tube in place after gallbladder surgery. Before discharge, what information or instructions should be given regarding the T tube drainage?
- A. If there is any drainage, notify the surgeon immediately.
- B. The drainage will decrease daily until the bile duct heals.
- C. First, the drainage is dark green; then it becomes dark yellow.
- D. If the drainage stops, milk the tube toward the puncture wound.
Correct answer: B
Rationale: Before discharge, inform the patient that the drainage will decrease daily until the bile duct heals.
3. Which of the following techniques would the nurse use first to determine if a nasogastric tube is positioned in the stomach?
- A. Aspirating with a syringe and observing for the return of gastric contents.
- B. Irrigating with normal saline and observing for the return of solution.
- C. Placing the tube's free end in water and observing for air bubbles.
- D. Instilling air and auscultating over the epigastric area for the presence of the tube.
Correct answer: A
Rationale: The initial way to determine if a nasogastric tube is in the stomach is to apply suction to the tube with a syringe and observe for the return of stomach contents. Then the pH of the aspirate can be measured. This is the method of choice. One would not irrigate until tube placement is confirmed. Observing for air bubbles when the free end of the tube is placed under water is an unacceptable, unsafe method of determining tube placement. Another method is to instill air into the tube with a syringe while auscultating over the epigastric area. Hearing the air enter the stomach helps ensure proper placement, but the method is not foolproof and is no longer considered an effective or preferred way to determine placement.
4. Which of the following symptoms would a client in the early stages of peritonitis exhibit?
- A. Abdominal distention
- B. Abdominal pain and rigidity
- C. Hyperactive bowel sounds
- D. Right upper quadrant pain
Correct answer: B
Rationale: In the early stages of peritonitis, the client would exhibit abdominal pain and rigidity due to inflammation.
5. Radiation therapy is used to treat colon cancer before surgery for which of the following reasons?
- A. Reducing the size of the tumor
- B. Eliminating the malignant cells
- C. Curing the cancer
- D. Helping the bowel heal after surgery
Correct answer: A
Rationale: Radiation therapy is used before surgery to reduce the size of the tumor, making it easier to remove.
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