ATI RN
Gastrointestinal System Nursing Exam Questions Questions
Question 1 of 5
A client with a history of gastric ulcer suddenly complains of a sharp-severe pain in the mid epigastric area, which then spreads over the entire abdomen. The client's abdomen is rigid and board-like to palpation, and the client obtains most comfort from lying in the knee-chest position. The nurse calls the physician immediately suspecting that the client is experiencing which of the following complications of peptic ulcer disease?
Correct Answer: A
Rationale: The signs and symptoms described in the question are consistent with perforation of the ulcer, which then progresses to peritonitis if the perforation is large enough. The client with intestinal obstruction most likely would complain of abdominal pain, distension, and nausea and vomiting. The client with hemorrhage would be vomiting blood or coffee-ground-like material or would be expelling black, tarry, or bloody stools. Intractability is a term that refers to continued symptoms of a disease process, despite ongoing medical treatment.
Question 2 of 5
During an abdominal assessment, a nurse finds pulsation between the umbilicus and pubis on a client. What finding should be reported to the physician?
Correct Answer: B
Rationale: The presence of pulsation between the umbilicus and pubis could indicate an abdominal aortic aneurysm, which is a serious condition and should be reported to the physician promptly. A concave, midline umbilicus is a normal finding. Bowel sound frequency can vary widely and is not a cause for concern at 15 sounds per minute. Absence of a bruit is a normal finding in an abdominal assessment and does not require reporting.
Question 3 of 5
The nurse provides medication instructions to a client with peptic ulcer disease. Which statement, if made by the client, indicates best understanding of the medication therapy?
Correct Answer: A
Rationale: Cimetidine (Tagamet) a Histamine H2 receptor antagonist, will decrease the secretion of gastric acid. Sucralfate (Carafate) promotes healing by coating the ulcer. Antacids neutralize acid in the stomach. Omeprazole (Prilosec) inhibits gastric acid secretion.
Question 4 of 5
Before administering an intermittent tube feeding through a nasogastric tube, the nurse assesses for gastric residual. The nurse understands that this procedure is important to
Correct Answer: D
Rationale: Evaluating the absorption of the last feeding is important because administration of a tube feeding to a full stomach could result in overdistention, thus predisposing the client to regurgitation and possible aspiration.
Question 5 of 5
Which nursing measure would be most effective in helping the client cough and deep breathe after a cholecystectomy?
Correct Answer: C
Rationale: After a cholecystectomy, teaching the client to use a folded blanket or pillow to splint the incision will be most effective in helping the client cough and deep breathe. This technique provides support and reduces pain during coughing and deep breathing, promoting better lung expansion. Having the client take rapid, shallow breaths would not be effective in decreasing pain; instead, deep breathing is encouraged to prevent complications like atelectasis. Lying on the left side would limit lung expansion; therefore, the client should be positioned in semi-Fowler's or Fowler's position to maximize lung expansion. Withholding pain medication can lead to discomfort and reluctance to cough and deep breathe, hindering recovery.
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