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. A patient who underwent abdominal surgery now has a gaping incision due to delayed wound healing. Which method is correct when you irrigate a gaping abdominal incision with sterile normal saline solution, using a piston syringe?
- A. Rapidly instill a stream of irrigating solution into the wound.
- B. Apply a wet-to-dry dressing to the wound after the irrigation.
- C. Moisten the area around the wound with normal saline solution after the irrigation.
- D. Irrigate continuously until the solution becomes clear or all of the solution is used.
Correct answer: D
Rationale: Irrigating continuously until the solution becomes clear or all of the solution is used is the correct method when irrigating a gaping abdominal incision.
3. You’re patient, post-op drainage of a pelvic abscess secondary to diverticulitis, begins to cough violently after drinking water. His wound has ruptured and a small segment of the bowel is protruding. What’s your priority?
- A. Ask the patient what happened, call the doctor, and cover the area with a water-soaked bedsheet.
- B. Obtain vital signs, call the doctor, and obtain emergency orders.
- C. Have a CAN hold the wound together while you obtain vital signs, call the doctor and flex the patient’s knees.
- D. Have the doctor called while you remain with the patient, flex the patient’s knees, and cover the wound with sterile towels soaked in sterile saline solution.
Correct answer: D
Rationale: For a patient with a ruptured wound and protruding bowel, call the doctor while remaining with the patient, flex the patient’s knees, and cover the wound with sterile towels soaked in sterile saline solution.
4. A client presents to the emergency room, reporting that he has been vomiting every 30 to 40 minutes for the past 8 hours. Frequent vomiting puts him at risk for which of the following?
- A. Metabolic acidosis with hyperkalemia
- B. Metabolic acidosis with hypokalemia
- C. Metabolic alkalosis with hyperkalemia
- D. Metabolic alkalosis with hypokalemia
Correct answer: D
Rationale: Frequent vomiting can lead to metabolic alkalosis with hypokalemia due to the loss of stomach acid and electrolytes.
5. The nurse is reviewing the medication record of a client with acute gastritis. Which medication if noted on the client’s record, would the nurse question?
- A. Digoxin (Lanoxin)
- B. Indomethacin (Indocin)
- C. Furosemide (Lasix)
- D. Propranolol hydrochloride (Inderal)
Correct answer: B
Rationale: Indomethacin (Indocin) is a Nonsteroidal anti-inflammatory drug and can cause ulceration of the esophagus, stomach, duodenum, or small intestine. Indomethacin is contraindicated in a client with gastrointestinal disorders. Furosemide (Lasix) is a loop diuretic. Digoxin is an antidysrhythmic. Propranolol (Inderal) is a B- adrenergic blocker. Furosemide, digoxin, and propranolol are not contraindicated in clients with gastric disorders.
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