youre patient post op drainage of a pelvic abscess secondary to diverticulitis begins to cough violently after drinking water his wound has ruptured a
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Nursing Elites

ATI RN

Gastrointestinal System ATI

1. 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?

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.

2. The nurse is caring for a client following a Billroth II procedure. On review of the postoperative orders, which of the following if prescribed, should the nurse question and verify?

Correct answer: A

Rationale: In a Billroth II procedure the proximal remnant of the stomach is anastomosed to the proximal jejunum. Patency of the nasogastric tube is critical for preventing the retention of gastric secretions. The nurse should never irrigate or reposition the gastric tube after gastric surgery, unless specifically ordered by the physician. In this situation the nurse should clarify the order. Coughing and deep breathing exercises, leg exercises, and early ambulation are appropriate postoperative interventions.

3. Britney, a 20 y.o. student is admitted with acute pancreatitis. Which laboratory findings do you expect to be abnormal for this patient?

Correct answer: C

Rationale: Serum amylase and lipase levels are typically elevated in patients with acute pancreatitis.

4. The hospitalized client with gastroesophageal reflux disease is complaining of chest discomfort that feels like heartburn following a meal. After administering an ordered antacid, the nurse encourages the client to lie in which of the following positions?

Correct answer: C

Rationale: The discomfort of reflux is aggravated by positions that compress the abdomen and the stomach. Lying flat on the back (supine) or on the stomach (prone) after a meal can exacerbate symptoms. Similarly, lying on the right side can worsen reflux. The most appropriate position to alleviate discomfort in a client with gastroesophageal reflux disease is lying on the left side with the head of the bed elevated at a 30-degree angle. This position helps prevent the backflow of stomach contents into the esophagus, providing relief to the client.

5. Your patient with peritonitis is NPO and complaining of thirst. What is your priority?

Correct answer: C

Rationale: Providing frequent mouth care is the priority for a patient with peritonitis who is NPO and complaining of thirst.

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