ATI NURSING GASTROINTESTINAL (MEDSURG) EXAM 2024

The nurse provides discharge teaching to a client who had a laparoscopic cholecystectomy and evaluated the client's understanding of the teaching. What statement by the client indicates an understanding of the teaching? A. I may need to be on a low-fat diet for a few weeks B. I cant return to work until 2 weeks after surgery C. Redness and swelling at my surgery site is expected D. I understand that I can not shower for 7 days after the surgery A. I may need to be on a low-fat diet for a few weeks An older adult is being admitted with a 2-day history of watery; foul-smelling diarrhea; nausea and fever. What is a priority action by the nurse? A. Place the client on contact isolation B. Provide the client a bedside commode C. Send a stool sample to the lab D. Place a disposable adult diaper on the client. A. Place the client on contact isolation (Note: Patient indicates C-diff) The nurse is caring for a client who reports severe abdominal pain and rigidity for three days. The skin is jaundiced. Serum amylase and lipase levels are elevated. How should the nurse intervene? A. Administer kayexalate rectally B. Maintain a NPO status C. Administer hydrocodone-acetaminophen D. Provide lemon glycerin swabs for dry mouth B. Maintain a NPO status A client with chronic liver failure has developed hemoptysis. A sengstaken- blakemore tube has been inserted. What assessment findings would cause the nurse to intervene? A. A deflated gastric balloon B. Balloon pressure of 35mmHg C. Hematemesis when the balloons are deflated D. A decrease in hemoptysis with balloon inflation A. A deflated gastric balloon After a colon resection, the client has a dehiscence of the midline abdominal incision. What intervention is warranted? A. Take a culture of the drainage B. Measure the abdominal incision C. Saturate the incision with betadine D. Apply sterile gauze soaked in sterile saline D. Apply sterile gauze soaked in sterile saline The nurse is reviewing the chart of a client that just had abdominal surgery. The healthcare provider writes a prescription for "advanced diet as tolerated." The client reports vomiting after eating ice chips. How should the nurse respond? A. It's hard to chew ice. Try some water instead of ice chips. B. Perhaps the ice is too cold. Here is some apple juice instead. C. This toast and applesauce will help settle your stomach. D. You should stop drinking for now, lets try again in a few hours. D. You should stop drinking for now, lets try again in a few hours. The nurse is caring for a client following abdominal surgery. Which assessment finding is a PRIORITY for the nurse to communicate to the health care team? A. Vomited 200mL brown liquid with fecal odor B. Urine output of 60mL/hr C. High-pitched bowel sounds D. Temperature of 100.8F A. Vomited 200mL brown liquid with fecal odor The nurse has taught a client multiple strategies to improve symptoms of irritable bowel syndrome. Which statement by the client indicates FOLLOW-UP is required by the nurse? A. Hypnosis and acupuncture are not helpful for my symptoms B. I should take the prescribed antispasmodic medication to reduce pain and diarrhea C. I should keep a diary of my diet symptoms and stress levels D. I should exercise regularly A. Hypnosis and acupuncture are not helpful for my symptoms The nurse is preparing to administer sennosides to a client experiencing constipation. What assessment data should prompt the nurse to hold this medication? A. No bowel movement in four days B. Abdominal fullness and discomfort C. Hypoactive bowel sounds D. Acute abdominal pain D. Acute abdominal pain The nurse is caring for a client diagnosed with gastroesophageal reflux disease (GERD). Which client outcomes suggest that treatment has been effective? Select all that apply. A. Experiences flatulence nightly B. Absence of cough or hoarseness C. Reports decreased epigastric pain D. Experiences belching only after meals E. Eats a well-balanced diet with no regurgitation B. Absence of cough or hoarseness C. Reports decreased epigastric pain E. Eats a well-balanced diet with no regurgitation A client is in the hospital for complications after surgery of the gastrointestinal tract. The nurse reviews the clients chart and learns that the client has lost 15lbs since the surgery. Labs reveal low albumin, prealbumin, and transferrin levels. What should the nurse do next? A. Ask the client about their usual daily intake and preferences B. Ask the unlicensed assistive personnel to feed the client C. Request the provider prescribe enteral tube feedings D. Provide nutritional supplements between each meal A. Ask the client about their usual daily intake and preferences A client is admitted to the medical floor with a 4-day history of diarrheal vomiting and poor appetite. You review the following documentation from the patients chart: "1700: Mucous membranes pale and dry. Skin warm and dry to touch. Poor turgor with tenting present. Bowel sounds hyperactive x 4 quadrants. Client states, "I am unable to keep anything down." Vital signs: BP 96/68, HR 96, Temp 101.1F, and spO2 94% on room air." What is the priority intervention by the nurse? A. Administer an antipyretic for the fever B. Provide the client with oral fluids C. Ensure a patent IV and start IV fluids D. Administer an antiemetic for the vomiting C. Ensure a patent IV and start IV fluids (Note: Managing the fever is not a priority action. Oral fluids are not correct because the patient is vomiting. Administering an antiemetic for the vomiting should happen, but is not the priority. The patient is experiencing dehydration. The priority action would be IV and IV fluids.) Total parenteral nutrition (TPN) is being administered to a client. What is an appropriate nursing intervention? A. Checking blood glucose levels B. Adding electrolytes to the TPN bag C. Ensuring the bag is replaced every 8 hours D. Setting the rate of the fat emulsion at 0.20 g/kg/hour A. Checking blood glucose levels A client was admitted with an upper gastrointestinal bleed and the nurse provides discharge teaching to the client. What statement by the client indicates further teaching is needed? A. I understand that I should get some help to stop drinking alcohol. B. Ill contact my health care provider before I start taking any herbal remedies. C. I know it will be important to continue taking my daily aspirin to prevent a heart attack D. I will need to change my pain medication from naproxen to acetaminophen C. I know it will be important to continue taking my daily aspirin to prevent a heart attack (Note: Aspirin is an NSAID. This is the response needing further teaching.) A client presents to the emergency department with a 6 hour history of vomiting that is 'dark brown in appearance.' The client reports a history of gastric ulcers; hypertension; diabetes; and chronic pain for which naproxen is taken. What is a priority nursing action? A. Assess the clients abdomen for hardness, tenseness, and rigidity. B. Insert an indwelling urinary catheter C. Place an IV and start lactated ringers D. Prepare to start intravenous administration of a proton pump inhibitor A. Assess the clients abdomen for hardness, tenseness, and rigidity. An elderly resident is brought to the emergency department via ambulance. The client is barely able to stand because of weakness and reports several episodes of diarrhea in the past 2 days. The client describes stools as watery and very foul- smelling. What is the priority action by the nurse? A. Collect a stool sample B. Start an IV C. Place the client on contact isolation D. Administer an antidiarrheal agent C. Place the client on contact isolation (Note: Client symptoms relate to C-Diff) The nurse is caring for a client taking clopidogrel after having an embolic event. The client shares that since starting the medication he has noticed that his stools are darker in color. What is an appropriate response by the nurse? A. That is typical with this medication B. Tell me what you mean by darker? C. Often dietary changes cause this D. When is the last time you had a BM? B. Tell me what you mean by darker? (Note: Side-effects of this medication does not include dark stools.) A nurse is suggesting interventions for a client with chronic constipation. In which order should the nurse make these recommendations? Place them in order from the 1st recommendation to the last. (1-5_ Increased fiber intake Prune Juice Enema Docusate Bisacodyl 1. Prune juice 2. Increased fiber intake 3. Docusate 4. Bisacodyl 5. Enema The nurse is caring for a client with a poor appetite; nausea and abdominal distension. What should the nurse anticipate upon auscultation of the abdomen? A. Hyperactivity throughout B. Normal sounds C. Tympanic sounds D. Diminished throughout D. Diminished throughout A client is prescribed a diet that can be advanced as tolerated. How does the nurse recognize that the client is ready to be started on regular food? Select all that apply. A. Bowel sounds are present B. Hunger is verbalized C. The client has been NPO for 5 days D. The albumin level is within normal range E. The health care provider says so A. Bowel sounds are present B. Hunger is verbalized The charge nurse is reviewing another nurses documentation for a postoperative client who just returned to the unit following abdominal surgery with a general anesthetic. The nurse caring for the client documented that active bowel sounds were heard in all 4 quadrants. What is the most appropriate action by the charge nurse? A. Compliment the nurse on documentation B. Question the nurse about hearing bowel sounds when assessing this client C. Go into the clients room and assess the client with a focused abdominal assessment D. Do nothing and wait to see what the nurse documents next time they assess the client. B. Question the nurse about hearing bowel sounds when assessing this client The nurse is caring for a client experiencing pain following abdominal surgery. The client has a prescription for morphine IV push. What is the nurse's first action when administering this medication? A. Explain the procedure to the client B. Identify the client using 2 identifiers C. Ask the client if they have any questions D. Clean injection port with alcohol swab B. Identify the client using 2 identifiers A client with a medical diagnosis of cirrhosis has been admitted to a medical unit. What complaint from the client requires immediate follow-up? A. Bloody expectorant with coughing episodes B. Jeans cannot sip because of enlarged abdomen C. Swelling in the feet and lower legs D. Yellowing of the eyes and mucus membranes A. Bloody expectorant with coughing episodes A client on the surgical unit is preparing to be discharged after a colectomy for an intestinal obstruction. The nurse finds the client passed out on the bathroom floor. Which response by the nurse would be most appropriate? A. Call another nurse to help get the client back to bed B. Call the clients healthcare provider C. Check the clients abdominal wound for bleeding D. Determine if the client is breathing and has a pulse D. Determine if the client is breathing and has a pulse A client in the clinic returns for a follow-up visit complaining of recurrent irritable bowel syndrome and symptoms such as nausea, bloating, flatulence, abdominal distension, and severe headache. What does the nurse further assess to help determine the next course of action? A. Complaints of constipation and straining at stool B. Compliance with a high fiber diet, including green leafy vegetables C. The client shares that they went out to eat Mexican food the evening before. D. The client states that they took an opioid twice in the last 12 hours for the severe headache. A. Complaints of constipation and straining at stool The clinic nurse is interviewing a new client who presents with increasing frequency of stools and says the last health care provider gave a diagnosis of ulcerative colitis. Which statement made by the client requires immediate follow- up? A. Im having more frequent loose stools than I did last week B. Ive developed a high fever and severe abdominal pain since yesterday C. My last health care provider said I have a genetic link for developing this disease D. This is a depressing disease to have B. I've developed a high fever and severe abdominal pain since yesterday The nurse is implementing teaching with a client with gastroesophageal reflux (GER). Which statement by the client demonstrates a further need for teaching? A. Ill be sleeping on 2-3 pillows B. Ill take my medication to prevent reflux before my evening meals C. Reflux can cause erosion of my stomach lining D. We like to eat Mexican food at least once per week D. We like to eat Mexican food at least once per week A young client undergoes a laparotomy in the epigastric region from a small bowel obstruction. Which nursing intervention is indicated to prevent the most concerning complication of this surgery? A. Sterile dressing changes and IV antibiotics B. High fiber diet with adequate oral hydration C. Coughing and using an incentive spirometer every two hours D. Turning every two hours and padding bony prominences C. Coughing and using an incentive spirometer every two hours A client returns from surgery for placement of a colostomy secondary to ulcerative colitis. Two hours after the surgery the nurse is most concerned about which assessment? A. Hypoactive bowel sounds x 4 quadrants B. Decreased breath sounds in the bases of the lungs C. Slight distension of the bladder D. A blood pressure below the baseline value. D. A blood pressure below the baseline value. A young client is receiving total parental nutrition as a treatment for Crohn's disease. The client asks for the rationale for this treatment. Which statement by the nurse accurately describes the reason for this treatment? A. The nutrition in you IV line is more complete than what you can eat B. TPN allows your intestines to rest and heal for a while C. This treatment assists you in getting the nutrients you need without the allergies D. With this treatment you do not need to eat by mouth, so you can get the rest you need. B. TPN allows your intestines to rest and heal for a while A client has chronic diarrhea, bloating, and abdominal pain. The healthcare provider is ruling out celiac disease. The client asks the nurse about dietary guidelines. What would be the best answer from the nurse? A. You will need to eat foods that bind to the bowels, like bananas, rice, and toast B. You should eat a low-fiber diet that limits seeds and skins C. Foods that you cannot eat include wheat proteins or gluten-based starches of fillers D. You will need to discuss this with a nutritionist C. Foods that you cannot eat include wheat proteins or gluten-based starches of fillers