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. A nurse is caring for a client with cirrhosis of the liver. To minimize the effects of the disorder, the nurse teaches the client about foods that are high in thiamine. The nurse determines that the client has best understanding of the dietary measures to follow of the client states an intention to increase intake of:
- A. Pork
- B. Milk
- C. Chicken
- D. Broccoli
Correct answer: A
Rationale: The client with cirrhosis needs to consume foods high in thiamine. Thiamine is present in a variety of foods of plant and animal origin. Pork products are especially rich in this vitamin. Other good food sources include nuts, whole grain cereals, and legumes. Milk contains vitamins A, D, and B2. Broccoli contains vitamins C, E, and K and folic acid.
3. Regina is a 46 y.o. woman with ulcerative colitis. You expect her stools to look like:
- A. Watery and frothy.
- B. Bloody and mucoid.
- C. Firm and well-formed.
- D. Alternating constipation and diarrhea.
Correct answer: B
Rationale: Stools in ulcerative colitis are typically bloody and mucoid.
4. 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.
5. You’re performing an abdominal assessment on Brent who is 52 y.o. In which order do you proceed?
- A. Observation, percussion, palpation, auscultation
- B. Observation, auscultation, percussion, palpation
- C. Percussion, palpation, auscultation, observation
- D. Palpation, percussion, observation, auscultation
Correct answer: B
Rationale: The correct order for performing an abdominal assessment is observation, auscultation, percussion, and palpation.
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