410 GI ATI Questions

A nurse is teaching a client who is postoperative for an ileostomy. Which of the following statements should the nurse include?

" You will have a stoma placed in your right lower abdomen." (An ileostomy stoma is placed in the right lower abdomen)

A nurse is caring for a client following the surgical placement of a colostomy. Which of the following statements indicates the client understands the dietary teaching?

"Eating yogurt can help decrease the amount of gas that I have" (The client who has a colostomy can include yogurt into his diet to help reduce odors and intestinal gas.)

A nurse is providing teaching about ileostomy care to a client. Which of the following statements by the client indicates a need for further teaching?

"I will be certain to take enteric coated medications" (This is not an appropriate statement and indicates a need for additional teaching. Enteric-coated medications should be avoided to reduce the risk of blockage caused by the coating.)

A nurse is providing teaching to a client who has a new colostomy. Which of the following information should the nurse include in the teaching?

"You may experience a small amount of bleeding around the stoma." (A small amount of bleeding around the stoma and its stem can occur. However, the client should report an increase in bleeding to the surgeon.)

A nurse is teaching a client who is preoperative for a sigmoid colostomy. Which of the following statements should the nurse include?

"You will have a stoma in your left lower abdomen." (The stoma of a sigmoid colostomy is placed in the client's left lower abdomen.)

A nurse is preparing to administer an enteral feeding via nasogastric tube. Identify the correct sequence the nurse should follow to initiate the feeding.

1. Verify tube placement 2. Check the residual feeding contents 3. Administer the feeding 4. Evaluate tolerance of feeding

A nurse is assessing clients in a health clinic for risk factors for contracting hepatitis. Which of the following clients is at risk for developing hepatitis C?

A client who has multiple tattoos (Hepatitis C is transmitted via blood-to-blood contact. The nurse should recognize that improperly maintained tattoo equipment may aid in transmission and could increase the client's risk for contracting hepatitis C.)

A nurse is assessing four female clients for obesity. Which of the following clients have manifestations of obesity?

A client who weighs 28% above ideal body weight (For a female client, obesity is classified as a weight 20% greater than ideal weight. A client whose weight is 28% above ideal body weight is classified as obese.)

A nurse is planning care for a client who has cirrhosis of the liver. Which of the following actions should the nurse include in the plan? (select all that apply)

Administer furosemide, implement a low-sodium diet, measure the client's abdominal girth

A nurse is caring for a client who has cancer and is receiving total parenteral nutrition (TPN). Which of the following lab values indicates the treatment is effective?

Albumin 4.2 g/dL (Clients who have cancer can receive TPN to provide needed proteins and glucose they are otherwise unable to obtain. An albumin level of 4.2 g/dL is within the expected reference range and indicates the client is receiving adequate amounts of protein.)

A nurse is reviewing the laboratory data of a client who has acute pancreatitis. The nurse should expect to find an elevation of which of following values?

Amylase (Amylase is an enzyme that changes complex sugars into simple sugars that can be used by the body. It is produced by the pancreas and salivary glands and released into the mouth, stomach, and intestines to aid in digestion. The amylase level of a client who has acute pancreatitis usually increases within 12 to 24 hr and can remain elevated for 2 to 3 days.)

A nurse is caring for a client who has gastrointestinal bleeding. Which of the following actions should the nurse take first?

Assess orthostatic pressure (Using the nursing process, the first action the nurse should take is to assess the client by measuring the client's orthostatic blood pressure. This action determines if the client is hypovolemic and establishes a baseline for further measurements.)

A nurse is preparing dietary instructions for a client who has episodes of biliary colic from chronic cholecystitis. Which of he following instructions should the nurse include in the teaching plan?

Avoid foods high in fat (The nurse should instruct the client to follow a low-fat diet to decrease episodes of biliary colic. A client who has chronic cholecystitis has intolerance to fatty foods.)

A nurse is teaching a class about preventative care to clients who are at risk for acquiring viral hepatitis. Which of the following information should the nurse include in the presentation?

Avoid foods prepared with tap water (To decrease the risk for acquiring viral hepatitis, clients should prepare foods with purified water.)

A nurse is assessing an adolescent who experienced bunt trauma to the abdomen. Which of the following findings is the nurse's priority?

Blood pressure 92/50 mmHg (The expected reference range for blood pressure in an adolescent is 110/65 to 120/80 mm Hg. A blood pressure 92/50 mm Hg indicates the adolescent is hypotensive and unstable. Therefore, this finding is the priority. Blunt abdominal trauma can cause internal hemorrhage that leads to hypotension.)

A nurse is caring for a client who has ulcerative colitis and is teaching about the common link with Crohn's disease. Which of the following information should the nurse include?

Both are inflammatory (The nurse should inform the client that both disease processes are an inflammatory process of the gastrointestinal tract.)

A nurse is assessing a client who is receiving total parenteral nutrition (TPN) therapy via an infusion pump. Which of the following actions should the nurse take?

Change the IV tubing every 24 hr (The nurse should change the client's IV tubing every 24 hr, or per facility protocol, to prevent bacteria from developing in the tubing.)

A nurse is teaching a client who has a history of ulcerative colitis and a new diagnosis of anemia. Which of the following manifestations of colitis should the nurse identify as a contributing factor to the development of the anemia?

Chronic blood loss (A client with long-standing ulcerative colitis is most likely anemic due to chronic blood loss in small amounts that occurs over time, although the colitis may result in erosion of the intestine and hemorrhage. These clients often report bloody stools and are therefore at increased risk for developing anemia.)

A nurse is caring for a client who has a history of alcohol use disorder and reports bruising and frequent nosebleeds. The nurse should recognize that this client in manifesting which of the following conditions?

Cirrhosis (The nurse should recognizes this client is displaying manifestations of cirrhosis. A history of alcohol use disorder increases the client's risk of developing cirrhosis and coagulation defects are a common complication of cirrhosis.)

A nurse is caring for a client who has an active upper gastrointestinal bleed. After inserting a NG tube into the client, which of the following findings should the nurse anticipate?

Coffee-ground drainage ("Coffee-ground" drainage or emesis indicates the presence of blood. The coffee ground appearance is the result of the effects of methemoglobin on the hemoglobin.)

A nurse is caring for a client who has suspected cholecystitis. The nurse should expect the client's urine to appear which of the following colors?

Dark and foamy (The nurse should expect the client to have dark and foamy urine, which indicates the kidneys are filtering excess bilirubin from the blood.)

A nurse prepares to replace the nearly empty container of total parenteral nutrition (TPN) for a client when she finds that there has been a delay in receiving the new container of solution from the pharmacy. Which of the following solutions should the nurse infuse until the next container of TPN solution becomes available?

Dextrose 10% in water (Sudden withdrawal from TPN, which is a hypertonic solution that contains dextrose, vitamins, electrolytes and sometimes lipids, can result in a sudden drop in the client's blood glucose levels. Administering an infusion of 10% dextrose will prevent hypoglycemia.)

A nurse is assessing a client who is receiving a parental lipid infusion. Which of the following findings is a manifestation of fat overload syndrome?

Elevated temperature (An elevated temperature is an early manifestation of fat overload syndrome. The client is at risk for coagulopathy and multi-organ system failure due to fat overload syndrome.)

A nurse is developing a teaching plan for a client who has an ileostomy and will require stoma care. Which of the following information should the nurse include?

Empty the pouch when its 1/2 full (The nurse should instruct the client to empty the pouch when it is 1/3 to 1/2 full.)

A nurse is planning care for a client who has hepatitis B. Which of the following interventions should the nurse include in the plan?

Encourage short periods of ambulation (The nurse should encourage a client who has hepatitis B to alternate between activity and rest.)

A nurse is providing nutritional teaching to a client who has dumping syndrome following a hemi-colectomy. Which of the following foods should the nurse teach instruct the client to avoid?

Fresh apples (Clients with dumping syndrome following a hemi-colectomy should avoid fresh fruits and choose canned or well-cooked fruits instead.)

A nurse is interviewing a client who has acute pancreatitis. Which of the following factors should the nurse anticipate finding in the client's history?

Gallstones (The client's history might reveal biliary obstruction from a gallstone causing bile to inflame the pancreas)

A nurse is planning care for a client who has diverticulitis. Which of the following menu selections should the nurse include in the plan?

Grilled chicken breast with white rice (Both of these items are low in fiber which is advised during the inflammation of diverticulitis. In the presence of diverticulosis, a high-fiber diet is indicated.)

A nurse is caring for a client who has cirrhosis and has a prescription for bumetanide. When delivering the client's lunch tray, which of the following items should the nurse identify as contraindicated for the client?

Ham sandwich (Ham is high in sodium and can increase fluid retention, leading to edema. Clients who have cirrhosis are prone to edema as the osmotic pressures change due to a decrease in plasma albumin and are placed on low-sodium diets.)

A nurse is assessing a client who has peptic ulcer disease. Which of the following findings should the nurse identify as the priority?

Hematemesis (When using the urgent vs. non-urgent approach to client care, the nurse should determine that the priority finding is hematemesis, which indicates massive bleeding.)

A nurse is caring for a client who has esophageal varices and is hypotensive after vomiting 500 mL of blood. Which of the following actions is the nurse's priority?

Increase the client's IV fluid rate (When using the urgent vs. nonurgent approach to client care, the nurse should determine that the priority action is to increase the client's IV fluid rate. Providing fluid to the client will restore circulating volume and increase blood pressure.)

A nurse admits a client to the emergency department who reports nausea and vomiting that worsens when he lies down. Antacids do not help. The provider suspects acute pancreatitis. Which of the following laboratory test results should the nurse expect to see?

Increased serum amylase (With acute pancreatitis, serum amylase rises within 24 hr of the start of the client's symptoms.)

A nurse is teaching a client who has hepatitis A. Which of the following information should the nurse include?

Manifestations of the virus are similar to flu-like symptoms (The nurse should include in the teaching that the manifestations of hepatitis A are similar to having the flu or a gastrointestinal illness. Often the client is unaware that they have acquired the virus.)

A nurse is caring for a client who is experiencing severe nausea and vomiting after a course of chemotherapy. The nurse should monitor the client for which of the following clinical manifestations?

Metabolic Alkalosis (Metabolic alkalosis can occur in clients who have excessive vomiting because of the loss of hydrochloric acid.)

A nurse is caring for a client who has Crohn's disease and is receiving parenteral nutrition. Which of the following interventions should the nurse include in the care of this client?

Monitor daily laboratory values and report as needed (Laboratory data, as well as observation of clinical signs, are important to prevent the development of nutrient deficiencies or toxicities.)

A nurse is teaching a client about causes of biliary cirrhosis. Which of the following information should the nurse include in the teaching?

Obstruction of the bile duct (Prolonged obstruction of the common bile duct is the most common cause of biliary cirrhosis.)

A nurse is admitting a client who has acute pancreatitis. Which of the following provider prescriptions should the nurse anticipate?

Pantroprazole 80 mg IV bolus twice daily (The nurse should anticipate a provider's prescription for a proton pump inhibitor to decrease gastric acid production, which ultimately decrease pancreatic secretions.)

A nurse is providing teaching to a client with a colostomy about appropriate food choices. Which of the following foods should the nurse include in the teaching?

Pasta (Pasta may thicken stool and is an appropriate food choice for a client with a colostomy)

A nurse is caring for a client who acquired hepatitis A from consuming contaminated food. The client's mouth is an example of which of the following links in the chain of infection?

Portal of entry (The mouth is the portal of entry for the hepatitis A. The portal of entry is the location in which the infectious agent entered the body.)

A nurse is providing teaching about a low-FODMAP diet for a client who has irritable bowel syndrome (IBS). The nurse should instruct the client to avoid which of the following foods?

Raisins ( A low-FODMAP diet limits the intake of foods that contain high amounts of fructose and other short-chain carbohydrates, which have been found to decrease the incidence and severity of symptoms in clients who have IBS. Dried fruits, such as raisins, have an increased amount of fructose, which can increase the severity and incidence of symptoms in clients who have IBS.)

A nurse is teaching a client who has a new colostomy. Which of the following outcomes should the nurse expect?

Report of empowerment (Education about the colostomy should provide the client with feelings of empowerment and assist the client in taking control of their care.)

A nurse is teaching self-management to a client who has hepatitis B. Which of the following Instructions should the nurse include in the teaching?

Rest frequently throughout the day (Limiting activity is usually recommended until the symptoms of hepatitis have subsided. The nurse should recommend the client rest frequently throughout the day to reduce the metabolic demands upon the liver and decrease energy demands.)

A nurse is assessing a client who has cirrhosis. Which of the following is an expected finding for this client?

Spider angiomas (Spider angiomas are lesions with a red center and numerous extensions that spread out like a spider web. This is an expected finding for a client who has cirrhosis.)

A nurse is admitting a client who has hepatitis C. Which of the following precautions should the nurse implement?

Standard (Hepatitis C is a blood-borne pathogen that is commonly spread by needle stick injury, sharing of IV drug paraphernalia and sexual contact. The nurse should implement standard precautions when in contact with blood, body fluids (except sweat), broken skin, and mucous membranes. The nurse should wear additional personal protective equipment if there is possible blood contact or a risk for splashes or sprays of blood or body fluids.)

A nurse is caring for a client who has peptic ulcer disease. The nurse should monitor the client for which of the following findings as an indication of gastrointestinal perforation?

Sudden abdominal pain (Classic indications of gastrointestinal perforation include sudden sharp abdominal pain with a rigid abdomen, declining peristalsis, and progression to septicemia and hypovolemic shock.)

A nurse is caring for a client following a CVA and observes the client experiencing severe dysphagia. The nurse notifies the provider. Which of the following nutritional therapies will likely be prescribed?

Supplements via nasogastric tube (Supplements via nasogastric tube provide enteral nutrition for clients who are at risk for aspiration caused by a diminished gag reflex or difficulty swallowing. This nutritional therapy will likely be prescribed.)

A nurse is assessing a client who is receiving intermittent enteral nutrition through a nasogastric tube. Which of the following assessments is the nurse's priority?

The client is regurgitating the enteral formula (Using the safety and risk reduction framework, the nurse should identify that the client regurgitating the enteral formula is the priority. This can be an indication of a displaced feeding tube that can result in pulmonary aspiration. The nurse should immediately report this finding to the provider.)

A nurse is assessing a client who has a colostomy. Which of the following findings should the nurse report to the provider?

The stoma is pale in color (The stoma should be pinkish to cherry red in color, which indicates an adequate blood supply. If the stoma becomes pale, bluish, or dark, the nurse should report this finding to the provider immediately.)

A nurse is caring for a client who has cirrhosis and a prothrombin time of 30 seconds. Which of the following medications should the nurse plan to administer?

Vitamin K (A prothrombin time of 30 seconds indicates the clotting time is prolonged and bleeding could occur. Vitamin K injection increases the synthesis of prothrombin by the liver; therefore, the nurse should plan to administer vitamin k.)

A nurse is assessing a client who has an obstruction of the common bile duct resulting from chronic cholecystitis. Which of the following findings should the nurse expect?

Fatty stools (Chronic cholecystitis occurs following several bouts of acute cholecystitis. The repeated episodes of inflammation result in a fibrotic and contracted gallbladder. Because of inflammation in the gallbladder, bile needed to absorb fat and fat-soluble vitamins is unable to enter the bowel, resulting in steatorrhea (fatty stools).

A nurse in a PACU is assessing a client who has a newly created colostomy. Which of the following findings should the nurse report to the provider?

Purplish colored stoma (A stoma that is purplish in color indicates ischemia. The nurse should notify the provider immediately)

A nurse is assessing a client and discovers the infusion pump with the client's total parenteral nutrition (TPN) solution is not infusing. The nurse should monitor the client for which of the following conditions?

Shakiness and diaphoresis (When a sudden interruption in the infusion of TPN occurs, the client is at risk for hypoglycemia. Shakiness and diaphoresis are manifestations of hypoglycemia.)

A nurse is teaching a client who has a hiatal hernia about dietary recommendations. Which of the following statements indicates an understanding of the teaching? (Select all that apply).

"I will consume less caffeine and fewer spicy foods." "I will sleep with the head of my bed elevated." "I will try not to gain weight."

A nurse is caring for a client who is receiving total parenteral nutrition (TPN). The pharmacy is delayed in supplying the client's next container of TPN. Which of the following fluids should the nurse infuse until the next container arrives?

Dextrose 10% in water (TPN contains high concentrations of dextrose and proteins. To avoid hypoglycemia, the nurse should infuse dextrose 10% or 20% in water until the next container of TPN solution arrives.)

A nurse is teaching a class about long-term effects of childhood obesity. The nurse should include which of the following conditions as a potential complication of childhood obesity?

Diabetes Mellitus (Type 2 diabetes mellitus is a potential complication of childhood obesity)

A nurse is caring for an older adult client who has had surgery for an intestinal obstruction and has an NG tube to wall suction. Which of the following interventions should the nurse include in the client's postoperative plan of care? (Select all that apply.)

Discontinue suction when assessing for peristalsis, Irrigate the NG tube with 0.9% sodium chloride irrigation solution, Place sequential compression devices on the bilateral lower extremities, Reposition the client from side to side every 2 hr

A nurse is completing dietary teaching on consuming a low fiber diet with a client who has ulcerative colitis. Which of the following foods should be eliminated in the client's diet?

Dried apricots (A nurse should instruct a client who has ulcerative colitis to consume a diet low in fiber and should eliminate dried apricots from his diet. Dried apricots are high in fiber and may cause an exacerbation of the client's disease process.)

A nurse is assessing a client who is receiving total parenteral nutrition (TPN). Which of the following findings should the nurse recognize as a complication of this therapy?

Hyperglycemia (TPN is prescribed when extensive nutritional support for prolonged periods of time is required. It is delivered through a central venous access device, usually via the internal jugular or subclavian vein. TPN contains a high concentration of dextrose, which can result in hyperglycemia. Frequent glucose monitoring should be implemented in clients receiving TPN.)

A nurse is planning care for a client who has diverticulitis. The nurse should plan to monitor the client for which of the following complications of diverticulitis?

Peritonitis (Clients who have diverticulitis are at risk for a perforation of the colon, which can cause peritonitis. The nurse should monitor the client for manifestations of peritonitis, such as fever and a rigid abdomen.)

A nurse is assessing a client who has advanced cirrhosis. Which of the following manifestations should the nurse expect?

Petechiae (A manifestation of advanced cirrhosis is petechiae due to impaired coagulation from a dysfunctional liver.)

A nurse is preparing to administer the hepatitis B vaccine to a client. Which of the following techniques should the nurse use to locate the deltoid muscle?

Place one finger across the acromion process and measure 3 finger breaths below to the midpoint and center of the lateral aspect of the upper arm

A nurse is teaching a client has hepatitis A about preventing transmission of the virus. Which of the following strategies should the nurse include in the teaching?

Practice effective hand hygiene (Effective hand hygiene—along with immunization, sewer sanitation, and a safe water supply—are the most effective strategies for preventing the transmission of hepatitis A.)

A nurse is planning care for a client who has viral hepatitis. Which of the following actions should the nurse include in the plan of care?

Provide a high carbohydrate diet (A client with hepatitis should have a diet high in carbohydrates due to altered nutrient metabolism.)

A nurse is caring for a client who was admitted with bleeding esophageal varices and has an esophagogastric balloon tamponade with a Sengstaken-Blakemore tube to control the bleeding. Which of the following actions should the nurse take?

Provide frequent oral and nares care (A client who has a Sengstaken-Blakemore tube in place is unable to swallow. If the client is alert, the nurse should encourage the client to spit saliva into a tissue or basin. If the client is not alert, gentle suctioning of the oral cavity and nares might be required to remove secretions.)

A nurse is caring for a client who is being admitted for an acute exacerbation of ulcerative colitis. Which of the following actions should the nurse take first?

Review the client's electrolyte values (The greatest risk to this client is injury from impaired function of cardiac or respiratory muscles; therefore, the first action the nurse should take is to review the client's electrolyte values. The client might have low sodium, potassium, and chloride from frequent diarrhea.)

A nurse is reviewing the medication list for a client who has a new diagnosis of a small bowel obstruction. The nurse should withhold which of the following medications?

Senna (Laxatives are contraindicated in clients who have fecal impaction, bowel obstruction, and acute abdominal surgery to prevent perforation. Because the bowel does not allow for any passage of stool with a complete small bowel obstruction, laxatives will cause increased abdominal cramping and discomfort.)

A nurse is caring for a client who requires total parenteral nutrition (TPN). Which of the following actions should the nurse take when finding that the TPN solution is infusing too rapidly?

Sit the client upright (Fluid overload can cause dyspnea. The nurse should slow the infusion rate and sit the client upright to help prevent or treat dyspnea. The nurse should also administer oxygen if necessary.)