ATI RN
Gastrointestinal System ATI
1. Your patient with peritonitis is NPO and complaining of thirst. What is your priority?
- A. Increase the I.V. infusion rate.
- B. Use diversion activities.
- C. Provide frequent mouth care.
- D. Give ice chips every 15 minutes.
Correct answer: C
Rationale: The correct answer is C: Provide frequent mouth care. In a patient with peritonitis who is NPO and thirsty, the priority is to maintain oral hygiene and provide comfort by moistening the mouth with frequent mouth care. This helps alleviate the sensation of thirst and maintains oral health. Increasing the IV infusion rate (choice A) may not address the patient's discomfort directly related to thirst. Using diversion activities (choice B) is not as critical as addressing the patient's immediate need for oral care. Giving ice chips every 15 minutes (choice D) is not recommended for a patient with peritonitis who is NPO, as it can lead to complications or worsen the condition.
2. Which of the following aspects is the priority focus of nursing management for a client with peritonitis?
- A. Fluid and electrolyte balance
- B. Gastric irrigation
- C. Pain management
- D. Psychosocial issues
Correct answer: A
Rationale: The priority focus of nursing management for a client with peritonitis is fluid and electrolyte balance to prevent shock.
3. When counseling a client in ways to prevent cholecystitis, which of the following guidelines is most important?
- A. Eat a low-protein diet
- B. Eat a low-fat, low-cholesterol diet
- C. Limit exercise to 10 minutes/day
- D. Keep weight proportionate to height
Correct answer: B
Rationale: Eating a low-fat, low-cholesterol diet is most important for preventing cholecystitis.
4. A client is admitted to the hospital with acute viral hepatitis. Which of the following signs or symptoms would the nurse expect to note based on this diagnosis?
- A. Spider angiomas
- B. Fatigue
- C. Pale urine
- D. Weight gain
Correct answer: B
Rationale: Common signs of acute viral hepatitis include weight loss, dark urine, and fatigue. The client is anorexic, possibly from a toxin produced by the diseased liver, and finds food distasteful. The urine darkens because of excess bilirubin being excreted by the kidneys. Fatigue occurs during all phases of hepatitis.
5. A home care nurse is visiting a client with a diagnosis of pernicious anemia that developed as a result of gastric surgery. The nurse instructs the client that because the stomach lining produces a decreased amount of intrinsic factor in this disorder, the client will need
- A. Vitamin B12 injections.
- B. Vitamin B6 injections.
- C. An antibiotic.
- D. An antacid.
Correct answer: A
Rationale: A lack of the intrinsic factor needed to absorb vitamin B12 occurs in pernicious anemia. Vitamin B12 is needed for the maturation of red blood cells. Vitamin B6 is not necessarily needed for pernicious anemia and can be taken orally. An antibiotic and antacids may be prescribed for certain types of gastric ulcers.
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