ATI RN
ATI Gastrointestinal System
1. When obtaining a nursing history on a client with a suspected gastric ulcer, which signs and symptoms would the nurse expect to see? Select ONE that does not apply.
- A. Epigastric pain at night
- B. Relief of epigastric pain after eating
- C. Vomiting
- D. Weight loss
Correct answer: B
Rationale: Signs and symptoms of a gastric ulcer include epigastric pain at night, vomiting, and weight loss. Relief of epigastric pain after eating is not typically associated with gastric ulcers.
2. Which of the following nursing interventions should be implemented to manage a client with appendicitis?
- A. Assessing for pain
- B. Encouraging oral intake of clear fluids
- C. Providing discharge teaching
- D. Assessing for symptoms of peritonitis
Correct answer: D
Rationale: The correct answer is D: Assessing for symptoms of peritonitis. This intervention is crucial in managing a client with appendicitis because it indicates a possible rupture of the inflamed appendix. Symptoms of peritonitis include severe abdominal pain, fever, nausea, vomiting, and abdominal rigidity. Prompt recognition of these symptoms is essential for timely intervention and surgical management. Choices A, B, and C are incorrect because while assessing for pain is important, assessing for symptoms of peritonitis takes precedence due to the critical nature of appendicitis. Encouraging oral intake of clear fluids and providing discharge teaching are not immediate priorities in the management of a client with acute appendicitis.
3. Which of the following symptoms best describes Murphy’s sign?
- A. Periumbilical ecchymosis exists
- B. On deep palpation and release, pain is elicited
- C. On deep inspiration, pain is elicited and breathing stops
- D. Abdominal muscles are tightened in anticipation of palpation
Correct answer: C
Rationale: Murphy's sign is described as pain elicited on deep inspiration when the examiner's fingers are placed under the right costal margin.
4. The client is admitted to the hospital for treatment of acute hepatitis B. Which activity order would the nurse expect to be prescribed?
- A. Bedrest
- B. Encourage ambulation
- C. Out of bed in a chair
- D. No activity restrictions
Correct answer: A
Rationale: Fatigue is a normal response to hepatic cellular damage. During the acute stage, rest is an essential intervention to reduce the metabolic demands on the liver and its blood supply.
5. A client with ulcerative colitis has an order to begin salicylate medication to reduce inflammation. The nurse instructs the client to take the medication:
- A. 30 minutes before meals
- B. On an empty stomach
- C. After meals
- D. On arising
Correct answer: C
Rationale: The correct answer is C: After meals. Salicylate medications for ulcerative colitis should be taken after meals to minimize gastrointestinal irritation and enhance absorption. Taking the medication on an empty stomach (Choice B) may increase the risk of gastrointestinal side effects. Taking it 30 minutes before meals (Choice A) may not provide enough protection for the stomach lining. Taking it on arising (Choice D) is not recommended as it may not coincide with the peak absorption times of the medication.
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