ATI Gastrointestinal Questions with CORRECT
Answers
Question:
The nurse is monitoring a client admitted to the hospital with a diagnosis of appendicitis
who is scheduled for surgery in 2 hours. The client begins to complain of increased
abdominal pain and begins to vomit. On assessment, the nurse notes that the abdomen
is distended and bowel sounds are diminished. Which is the most appropriate nursing
intervention?
A. Notify the health care provider (HCP).
B. Administer the prescribed pain medication.
C. Call and ask the operating room team to perform surgery as soon as possible.
D. Reposition the client and apply a heating pad on the warm setting to the client's
abdomen.
Answer:
A. Notify
the health care provider (HCP).
Question:
On the basis of the signs and symptoms presented in the question, the nurse should
suspect peritonitis and notify the HCP. Administering pain medication is not an
appropriate intervention. Heat should never be applied to the abdomen of a client with
suspected appendicitis because of the risk of rupture. Scheduling surgical time is not
within the scope of nursing practice, although the HCP probably would perform the
surgery earlier than the prescheduled time. A client has just had a hemorrhoidectomy.
Which nursing interventions are appropriate for this client? Select all that apply.
A. Administer stool softeners as prescribed.
B. Instruct the client to limit fluid intake to avoid urinary retention.
C. Encourage a high-fiber diet to promote bowel movements without straining.
D. Apply cold packs to the anal-rectal area over the dressing until the packing is
removed.
E. Help the client to a Fowler's position to place pressure on the rectal area and
decrease
bleeding.
Answer:
A. Administer stool softeners as prescribed.
,Question:
The nurse places highest priority on assessing for return of the gag reflex. This
assessment addresses the client's airway. The nurse also monitors the client's vital
signs and for a sudden increase in temperature, which could indicate perforation of the
gastrointestinal tract. This complication would be accompanied by other signs as well,
such as pain. Monitoring for sore throat and heartburn are also important; however, the
client's airway is the priority. The nurse is providing dietary teaching for a client with a
diagnosis of chronic gastritis. The nurse instructs the client to include which foods rich in
vitamin B12 in the diet? Select all that apply.
A. Nuts
B. Corn
C. Liver
D. Apples
E. Lentils
F. Bananas
Answer:
A. Nuts
Question:
Perforation of an ulcer is a surgical emergency and is characterized by sudden, sharp,
intolerable severe pain beginning in the mid-epigastric area and spreading over the
abdomen, which becomes rigid and boardlike. Nausea and vomiting may occur.
Tachycardia may occur as hypovolemic shock develops. Numbness in the legs is not an
associated finding. The nurse is caring for a client following a gastrojejunostomy
(Billroth II procedure). Which postoperative prescription should the nurse question and
verify?
A. Leg exercises
B. Early ambulation
C. Irrigating the nasogastric tube
D. Coughing and deep-breathing exercises
Answer:
C. Irrigating the nasogastric tube
,Question:
In a gastrojejunostomy (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 prescribed by the
health care provider. In this situation, the nurse should clarify the prescription. Options
1, 2, and 4 are appropriate postoperative interventions. The nurse is providing
discharge instructions to a client following gastrectomy and should instruct the client to
take which measure to assist in preventing dumping syndrome?
A. Ambulate following a meal.
B. Eat high-carbohydrate foods.
C. Limit the fluids taken with meals.
D. Sit in a high Fowler's position during meals.
Answer:
C. Limit the fluids taken with meals.
Question:
Crohn's disease is an inflammatory disease that can occur anywhere in the
gastrointestinal tract but most often affects the terminal ileum and leads to thickening
and scarring, a narrowed lumen, fistulas, ulcerations, and abscesses. It is characterized
by exacerbations and remissions. If stress increases the symptoms of the disease, the
client is taught stress management techniques and may require additional counseling.
The client is taught to avoid gastrointestinal stimulants containing caffeine and to follow
a high-calorie and high-protein diet. A low-fiber diet may be prescribed, especially
during periods of exacerbation. The nurse is doing an admission assessment on a client
with a history of duodenal ulcer. To determine whether the problem is currently active,
the nurse should assess the client for which sign(s)/symptom(s) of duodenal ulcer?
A. Weight loss
B. Nausea and vomiting
C. Pain relieved by food intake
D. Pain radiating down the right arm
Answer:
C. Pain relieved by food intake
, Question:
A frequent symptom of duodenal ulcer is pain that is relieved by food intake. These
clients generally describe the pain as a burning, heavy, sharp, or "hungry" pain that
often localizes in the mid-epigastric area. The client with duodenal ulcer usually does
not experience weight loss or nausea and vomiting. These symptoms are more typical in
the client with a gastric ulcer. A client with hiatal hernia chronically experiences
heartburn following meals. The nurse should plan to teach the client to avoid which
action because it is contraindicated with a hiatal hernia?
A. Lying recumbent following meals
B. Consuming small, frequent, bland meals
C. Taking H2-receptor antagonist medication
D. Raising the head of the bed on 6-inch (15 cm) blocks
Answer:
A. Lying recumbent following meals
Question:
Hiatal hernia is caused by a protrusion of a portion of the stomach above the diaphragm
where the esophagus usually is positioned. The client usually experiences pain from
reflux caused by ingestion of irritating foods, lying flat following meals or at night, and
eating large or fatty meals. Relief is obtained with the intake of small, frequent, and
bland meals; use of H2-receptor antagonists and antacids; and elevation of the thorax
following meals and during sleep. The nurse is providing care for a client with a recent
transverse colostomy. Which observation requires immediate notification of the health
care provider?
A. Stoma is beefy red and shiny
B. Purple discoloration of the stoma
C. Skin excoriation around the stoma
D. Semi-formed stool noted in the ostomy pouch
Answer:
B. Purple discoloration of the stoma
Answers
Question:
The nurse is monitoring a client admitted to the hospital with a diagnosis of appendicitis
who is scheduled for surgery in 2 hours. The client begins to complain of increased
abdominal pain and begins to vomit. On assessment, the nurse notes that the abdomen
is distended and bowel sounds are diminished. Which is the most appropriate nursing
intervention?
A. Notify the health care provider (HCP).
B. Administer the prescribed pain medication.
C. Call and ask the operating room team to perform surgery as soon as possible.
D. Reposition the client and apply a heating pad on the warm setting to the client's
abdomen.
Answer:
A. Notify
the health care provider (HCP).
Question:
On the basis of the signs and symptoms presented in the question, the nurse should
suspect peritonitis and notify the HCP. Administering pain medication is not an
appropriate intervention. Heat should never be applied to the abdomen of a client with
suspected appendicitis because of the risk of rupture. Scheduling surgical time is not
within the scope of nursing practice, although the HCP probably would perform the
surgery earlier than the prescheduled time. A client has just had a hemorrhoidectomy.
Which nursing interventions are appropriate for this client? Select all that apply.
A. Administer stool softeners as prescribed.
B. Instruct the client to limit fluid intake to avoid urinary retention.
C. Encourage a high-fiber diet to promote bowel movements without straining.
D. Apply cold packs to the anal-rectal area over the dressing until the packing is
removed.
E. Help the client to a Fowler's position to place pressure on the rectal area and
decrease
bleeding.
Answer:
A. Administer stool softeners as prescribed.
,Question:
The nurse places highest priority on assessing for return of the gag reflex. This
assessment addresses the client's airway. The nurse also monitors the client's vital
signs and for a sudden increase in temperature, which could indicate perforation of the
gastrointestinal tract. This complication would be accompanied by other signs as well,
such as pain. Monitoring for sore throat and heartburn are also important; however, the
client's airway is the priority. The nurse is providing dietary teaching for a client with a
diagnosis of chronic gastritis. The nurse instructs the client to include which foods rich in
vitamin B12 in the diet? Select all that apply.
A. Nuts
B. Corn
C. Liver
D. Apples
E. Lentils
F. Bananas
Answer:
A. Nuts
Question:
Perforation of an ulcer is a surgical emergency and is characterized by sudden, sharp,
intolerable severe pain beginning in the mid-epigastric area and spreading over the
abdomen, which becomes rigid and boardlike. Nausea and vomiting may occur.
Tachycardia may occur as hypovolemic shock develops. Numbness in the legs is not an
associated finding. The nurse is caring for a client following a gastrojejunostomy
(Billroth II procedure). Which postoperative prescription should the nurse question and
verify?
A. Leg exercises
B. Early ambulation
C. Irrigating the nasogastric tube
D. Coughing and deep-breathing exercises
Answer:
C. Irrigating the nasogastric tube
,Question:
In a gastrojejunostomy (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 prescribed by the
health care provider. In this situation, the nurse should clarify the prescription. Options
1, 2, and 4 are appropriate postoperative interventions. The nurse is providing
discharge instructions to a client following gastrectomy and should instruct the client to
take which measure to assist in preventing dumping syndrome?
A. Ambulate following a meal.
B. Eat high-carbohydrate foods.
C. Limit the fluids taken with meals.
D. Sit in a high Fowler's position during meals.
Answer:
C. Limit the fluids taken with meals.
Question:
Crohn's disease is an inflammatory disease that can occur anywhere in the
gastrointestinal tract but most often affects the terminal ileum and leads to thickening
and scarring, a narrowed lumen, fistulas, ulcerations, and abscesses. It is characterized
by exacerbations and remissions. If stress increases the symptoms of the disease, the
client is taught stress management techniques and may require additional counseling.
The client is taught to avoid gastrointestinal stimulants containing caffeine and to follow
a high-calorie and high-protein diet. A low-fiber diet may be prescribed, especially
during periods of exacerbation. The nurse is doing an admission assessment on a client
with a history of duodenal ulcer. To determine whether the problem is currently active,
the nurse should assess the client for which sign(s)/symptom(s) of duodenal ulcer?
A. Weight loss
B. Nausea and vomiting
C. Pain relieved by food intake
D. Pain radiating down the right arm
Answer:
C. Pain relieved by food intake
, Question:
A frequent symptom of duodenal ulcer is pain that is relieved by food intake. These
clients generally describe the pain as a burning, heavy, sharp, or "hungry" pain that
often localizes in the mid-epigastric area. The client with duodenal ulcer usually does
not experience weight loss or nausea and vomiting. These symptoms are more typical in
the client with a gastric ulcer. A client with hiatal hernia chronically experiences
heartburn following meals. The nurse should plan to teach the client to avoid which
action because it is contraindicated with a hiatal hernia?
A. Lying recumbent following meals
B. Consuming small, frequent, bland meals
C. Taking H2-receptor antagonist medication
D. Raising the head of the bed on 6-inch (15 cm) blocks
Answer:
A. Lying recumbent following meals
Question:
Hiatal hernia is caused by a protrusion of a portion of the stomach above the diaphragm
where the esophagus usually is positioned. The client usually experiences pain from
reflux caused by ingestion of irritating foods, lying flat following meals or at night, and
eating large or fatty meals. Relief is obtained with the intake of small, frequent, and
bland meals; use of H2-receptor antagonists and antacids; and elevation of the thorax
following meals and during sleep. The nurse is providing care for a client with a recent
transverse colostomy. Which observation requires immediate notification of the health
care provider?
A. Stoma is beefy red and shiny
B. Purple discoloration of the stoma
C. Skin excoriation around the stoma
D. Semi-formed stool noted in the ostomy pouch
Answer:
B. Purple discoloration of the stoma
