ATI GI
A nurse in a clinic is instructing a client about a fecal occult blood test, which requires mailing three specimens. Which of the following statements by the client indicates understanding of the teaching? A. "I will continue taking my warfarin while I complete these tests." B. "I'm glad I don't have to follow any special diet at this time." C."This test determines if I have parasites in my bowel." D."This is an easy way to screen for colon cancer."
. A. Clients are instructed to stop taking anticoagulants prior to obtaining stool specimens for fecal occult blood testing because they can interfere with the results. B. Clients are instructed to avoid consuming red meat, chicken, and fish prior to obtaining stool specimens for fecal occult blood testing because this can interfere with the results. C. Fecal occult blood testing does not identify parasites present in stool. D. CORRECT: Fecal occult blood testing is a screening procedure for colon cancer.
A nurse is teaching about pernicious anemia with a client who has chronic gastritis. Which of the following information should the nurse include in the teaching? A. Pernicious anemia is caused when the cells producing gastric acid are damaged. B. Expect a monthly injection of vitamin B12. C. Plan to take vitamin K supplements. D. Pernicious anemia is caused by an increased production of intrinsic factor.
. A. Damage to parietal cells has occurred, which leads to pernicious anemia and causes a decrease of the intrinsic factor by the stomach parietal cells. B. CORRECT: The nurse should include in the information that the client will receive a monthly injection of vitamin B12 to treat pernicious anemia due to a decrease of the intrinsic factor by the stomach parietal cells. C. Vitamin K supplements are given to clients who have a bleeding disorder. D. Parietal cell damage results in insufficient production of intrinsic factor by the stomach parietal cells.
A nurse is completing an assessment of a client who has a gastric ulcer. Which of the following findings should the nurse expect? (Select all that apply.) A. Client reports pain relieved by eating. B. Client states that pain often occurs at night. C. Client reports a sensation of bloating. D. Client states that pain occurs 30 min to 1 hr after a meal. E. Client experiences pain upon palpation of the epigastric region.
A. A client who has a duodenal ulcer will report that pain is relieved by eating. B. Pain that rarely occurs at night is an expected finding. C. CORRECT: A client report of a bloating sensation is an expected finding. D. CORRECT: A client who has a gastric ulcer will often report pain 30 to 60 min after a meal. E. CORRECT: Pain in the epigastric region upon palpation is an expected finding.
A nurse is completing an admission assessment of a client who has pancreatitis. Which of the following findings should the nurse expect? A. Pain in right upper quadrant radiating to right shoulder B. Report of pain being worse when sitting upright C. Pain relieved with defecation D. Epigastric pain radiating to the left shoulder
A. A client who has cholecystitis will report pain in the right upper quadrant radiating to the right shoulder. B. A client who has pancreatitis will report pain being worse when lying down. C. A client who has pancreatitis will report that pain is relieved by assuming the fetal position. D. CORRECT: A client who has pancreatitis will report severe, boring epigastric pain that radiates to the back, left flank, or left shoulder.
A nurse is caring for a client following a paracentesis. Which of the following findings indicate the bowel was perforated during the procedure? A. Client report of upper chest pain B. Decreased urine output C. Pallor D. Temperature elevation
A. A report of sharp, constant abdominal pain is associated with bowel perforation. B. Decreased urine output is associated with bladder perforation during a paracentesis. C. Pallor may indicate hypovolemia related to fluid removal of ascites fluid during the procedure. D. CORRECT: Fever is an indication of bowel perforation during a paracentesis.
A nurse is caring for a client who has a new diagnosis of gastroesophageal reflux disease (GERD). The nurse should anticipate prescriptions for which of the following medications? (Select all that apply.) A. Antacids B. Histamine2 receptor antagonists C. Opioid analgesics D. Fiber laxatives E. Proton pump inhibitors
A. CORRECT: Antacids neutralize gastric acid which irritates the esophagus during reflux. B. CORRECT: Histamine2 receptor antagonists decrease acid secretion, which contributes to reflux. C. Opioid analgesics are not effective in treating GERD. D. Fiber laxatives are not effective in treating GERD. E. CORRECT: Proton pump inhibitors decrease gastric acid production, which contributes to reflex.
A nurse is reviewing nutrition teaching for a client who has cholecystitis. The nurse should identify that which of the following food choices can trigger cholecystitis? A. Brownie with nuts B. Bowl of mixed fruit C. Grilled turkey D. Baked potato
A. CORRECT: Foods that are high in fat, such as a brownie with nuts, can cause cholecystitis. B. Fruits are low in fat and not associated with cholecystitis. C. Turkey is low in fat and not associated with cholecystitis. D. Baked potatoes are low in fat and not associated with cholecystitis.
A nurse in the emergency department is completing an assessment of a client who has suspected stomach perforation due to a peptic ulcer. Which of the following findings should the nurse expect? (Select all that apply.) A. Rigid abdomen B. Tachycardia C. Elevated blood pressure D. Circumoral cyanosis E. Rebound tenderness
A. CORRECT: Manifestations of perforation include a rigid, board‐like abdomen. B. CORRECT: Tachycardia occurs due to gastrointestinal bleeding that accompanies a perforation. C. Hypotension is an expected finding in a client who has a perforation and bleeding. D. Circumoral cyanosis is not a manifestation of perforation. E. CORRECT: Rebound tenderness is an expected finding in a client who has a perforation.
A nurse is completing nutrition teaching for a client who has pancreatitis. Which of the following statements by the client indicates an understanding of the teaching? (Select all that apply.) A. "I plan to eat small, frequent meals." B. "I will eat easy‐to‐digest foods with limited spice." C."I will use skim milk when cooking." D."I plan to drink regular cola." E. "I will limit alcohol intake to two drinks per day."
A. CORRECT: Small, frequent meals are recommended for the client who has pancreatitis. B. CORRECT: Bland, easy‐to‐digest foods are recommended for the client who has pancreatitis. C. CORRECT: Low‐fat foods are recommended for the client who has pancreatitis. D. Caffeine‐free beverages are recommended for the client who has pancreatitis. Regular cola contains caffeine. E. The client who has pancreatitis should avoid any alcohol intake.
A nurse is planning care for a client who has a new prescription for total parenteral nutrition (TPN). Which of the following interventions should be included in the plan of care? (Select all that apply.) A. Obtain a capillary blood glucose four times daily. B. Administer prescribed medications through a secondary port on the TPN IV tubing. C. Monitor vital signs three times during the 12‐hr shift. D. Change the TPN IV tubing every 24 hr. E. Ensure a daily aPTT is obtained.
A. CORRECT: The client is at risk for hyperglycemia during the administration of TPN and can require supplemental insulin. B. No other medications or fluids should be administered through the IV tubing being used to administer TPN due to the increased risk of infection and disruption of the rate of TPN infusion. C. CORRECT: Vital signs are recommended every 4 to 8 hr to assess for fluid volume excess and infection. D. CORRECT: It is recommended to change the IV tubing that is used to administer TPN every 24 hr. E. aPTT measures the coagulability of the blood, which is unnecessary during the administration of TPN.
A nurse is teaching a client who has a duodenal ulcer and a new prescription for esomeprazole. Which of the following information should the nurse include in the teaching? (Select all that apply.) A. Take the medication 1 hr before a meal. B. Limit NSAIDs when taking this medication. C. Expect skin flushing when taking this medication. D. Increase fiber intake when taking this medication. E. Chew the medication thoroughly before swallowing.
A. CORRECT: The client is instructed to take the medication 1 hr before meals. B. CORRECT: The client is instructed to limit taking NSAIDs when on this medication. C. Skin flushing is not an adverse effect of this medication. D. Fiber intake does not need to be increased when taking this medication. E. The client is instructed to swallow the capsule whole. It should not be crushed or chewed.
A nurse is caring for a client who is receiving TPN solution. The current bag of solution was hung 24 hr ago, and 400 mL remains to infuse. Which of the following is the appropriate action for the nurse to take? A. Remove the current bag and hang a new bag. B. Infuse the remaining solution at the current rate and then hang a new bag. C. Increase the infusion rate so the remaining solution is administered within the hour and hang a new bag. D. Remove the current bag and hang a bag of lactated Ringer's.
A. CORRECT: The current bag of TPN should not hang more than 24 hr due to the risk of infection. B. The current bag of TPN should not hang more than 24 hr due to the risk of infection. C. The rate of TPN infusion should never be increased abruptly due to the risk of hyperglycemia. D. Administration of TPN should never be discontinued abruptly due to the sudden change in blood glucose that can occur.
. A nurse is planning care for a client who has acute gastritis. Which of the following nursing interventions should the nurse include in the plan of care? (Select all that apply.) A. Evaluate intake and output. B. Monitor laboratory reports of electrolytes. C. Provide three large meals a day. D. Administer ibuprofen for pain. E. Observe stool characteristics.
A. CORRECT: The nurse should evaluate the client's intake and output to prevent electrolyte loss and dehydration. B. CORRECT: The nurse should monitor the client's electrolyte laboratory values to prevent fluid loss and dehydration. C. The nurse should instruct the client to eat small, frequent meals. D. The nurse should instruct the client to avoid taking ibuprofen, an NSAID, because of its erosive capabilities. E. CORRECT: The nurse should instruct the client to report to the provider any indication of the presence of blood in the stools, which can indicate gastrointestinal bleeding.
A nurse is reviewing bowel prep using polyethylene glycol with a client scheduled for a colonoscopy. Which of the following instructions should the nurse include in the teaching? A. Check with the provider about taking current medications when consuming bowel prep. B. Consume a normal diet until starting the bowel prep. C. Expect the bowel prep to not begin acting until the day after all the prep is consumed. D. Discontinue the bowel prep once feces start to be expelled.
A. CORRECT: The nurse should instruct the client to check with the provider about taking current medication, because some medications can be withheld when taking polyethylene glycol due to their lack of absorption. B. The nurse should instruct the client to consume a clear liquid diet prior to starting the bowel prep. C. The nurse should instruct the client that the actions of polyethylene glycol begin within 2 to 3 hr after consumption. D. The nurse should instruct the client to consume the full amount prescribed.
A nurse is completing preprocedure teaching for a client who will undergo a sigmoidoscopy. Which of the following information should the nurse include in the teaching? (Select all that apply.) A. Increased flatulence can occur following the procedure. B. NPO status should be maintained preprocedure. C. Conscious sedation is used. D. Repositioning will occur throughout the procedure. E. Fluid intake is limited the day after the procedure.
A. CORRECT: The nurse should teach the client that increased flatulence can occur due to the instillation of air during the procedure. B. CORRECT: The nurse should instruct the client to remain NPO after midnight the night before the procedure. C. The nurse should inform the client that sedation is not indicated for a sigmoidoscopy. D. The nurse should inform the client that the position to lie for the procedure is on the left side. E. The nurse should instruct the client to increase, not limit fluid intake following the procedure
A nurse is having difficulty arousing a client following an esophagogastroduodenoscopy (EGD). Which of the following is the priority action by the nurse? A. Assess the client's airway. B. Allow the client to sleep. C. Prepare to administer an antidote to the sedative. D. Evaluate preprocedure laboratory findings.
A. CORRECT: When using the airway, breathing, and circulation priority‐setting framework, assessing and maintaining an open airway is the priority action the nurse should take. B. The nurse should continue to allow the client to rest. However, another action is the priority. C. The nurse should prepare to administer an antidote to the sedative used during the procedure. However, another action is the priority. D. The nurse should evaluate the preprocedure laboratory findings. However, another action is the priority
A nurse is teaching a client who has a hiatal hernia. Which of the following client statements indicates an understanding of the teaching? A."I can take my medications with soda." B. "Peppermint tea will increase my indigestion." C."Wearing an abdominal binder will limit my symptoms." D."I will drink hot chocolate at bedtime to help me sleep." E. "I can lift weights as a way to exercise."
A. Carbonated beverages decrease LES pressure and should be avoided by the client who has a hiatal hernia. B. CORRECT: Peppermint decreases LES pressure and should be avoided by the client who has a hiatal hernia C. Tight restrictive clothing or abdominal binders should be avoided by the client who has a hiatal hernia, as this increases intra‐abdominal pressure and causes the protrusion of the stomach into the thoracic cavity. D. The client should avoid consuming anything immediately prior to bedtime. Additionally, chocolate relaxes the lower esophageal sphincter and should be avoided by a client who has a hiatal hernia E. Heavy lifting and vigorous activities are to be avoided in the client who has a hiatal hernia.
A nurse is completing discharge teaching for a client who has an infection due to Helicobacter pylori (H. pylori). Which of the following statements by the client indicates understanding of the teaching? A. "I will continue my prescription for corticosteroids." B. "I will schedule a CT scan to monitor improvement." C."I will take a combination of medications for treatment." D."I will have my throat swabbed to recheck for this bacteria
A. Corticosteroid use is a contributing factor to an infection caused by H. pylori. B. An esophagogastroduodenoscopy is done to evaluate for the presence of H. pylori and to evaluate effectiveness of treatment. C. CORRECT: A combination of antibiotics and a histamine2 receptor antagonist is used to treat an infection caused by H. pylori. D. H. pylori is evaluated by obtaining gastric samples, not a throat swab.
A nurse is teaching a client who has a new prescription for famotidine. Which of the following statements by the client indicates understanding of the teaching? A. "The medicine coats the lining of my stomach." B. "The medication should stop the pain right away." C."I will take my pill 1 hr before meals." D."I will monitor for bleeding from my nose
A. Famotidine decreases gastric acid output. It does not have a protective coating action. B. The client might need to take famotidine for several days before pain relief occurs when starting this therapy. C. CORRECT: The client should take famotidine 1 hr before meals to decrease heartburn, acid indigestion, and sour stomach. D. The nurse should instruct the client to monitor for GI bleeding when taking famotidine.
A nurse is completing an assessment of a client who has GERD. Which of the following is an expected finding? A. Absence of saliva B. Loss of tooth enamel C. Sweet taste in mouth D. Absence of eructation
A. Hypersalivation is an expected finding in a client who has GERD. B. CORRECT: Tooth erosion is an expected finding in a client who has GERD. C. A client who has GERD would report a bitter taste in the mouth. D. Increased burping is an expected finding in a client who has GERD.
A nurse is completing discharge teaching with a client who is 3 days postoperative following a transverse colostomy. Which of the following should the nurse include in the teaching? A. Mucus will be present in stool for 5 to 7 days after surgery. B. Expect 500 to 1,000 mL of semi liquid stool after 2 weeks. C. Stoma should be moist and pink. D. Change the ostomy bag when it is 3⁄4 full.
A. Mucus and blood can be present for 2 to 3 days after surgery. B. Output should become stool‐like, semi‐formed, or formed within days to weeks. C. CORRECT: A pink, moist stoma is an expected finding with a transverse colostomy. D. The ostomy bag should be changed when it is 1⁄4 to 1⁄2 full.
A nurse is reviewing a new prescription for ursodiol with a client who has cholelithiasis. Which of the following information should the nurse include in the teaching? A. This medication is used to decrease acute biliary pain. B. This medication requires thyroid function monitoring every 6 months. C. This medication is not recommended for clients who have diabetes mellitus. D. This medication dissolves gallstones gradually over a period of up to 2 years.
A. Opioid analgesics are preferred for the treatment of acute biliary pain. B. The client should have an ultrasound of the gallbladder every 6 months during the first year of treatment to determine effectiveness of the medication. C. Ursodiol is used cautiously in clients who have liver conditions or disorders with varices. D. CORRECT: Ursodiol is a bile acid that gradually dissolves cholesterol‐based gall stones. The medication can be taken for up to 2 years.
A nurse is preparing to administer pancrelipase to a client who has pancreatitis. Which of the following actions should the nurse take? A. Instruct the client to chew the medication before swallowing. B. Offer a glass of water following medication administration. C. Administer the medication 30 min before meals. D. Sprinkle the contents on peanut butter.
A. Pancrelipase should be swallowed without chewing to reduce irritation and slow the release of the medication. B. CORRECT: The client should drink a full glass of water following administration of pancrelipase. C. Pancrelipase should be administered with every meal and snack. D. The contents of the pancrelipase capsule may be sprinkled on nonprotein foods, and peanut butter is a protein food.
A nurse is admitting a client who has bleeding esophageal varices. The nurse should anticipate a prescription for which of the following medications? A. Propranolol B. Metoclopramide C. Ranitidine D. Vasopressin
A. Propranolol is not used for clients who are actively bleeding. It can be given prophylactically to decrease portal hypertension. B. Metoclopramide decreases motility of the esophagus and stomach. C. Histamine2‐receptor antagonists are administered following surgical procedures for bleeding esophageal varices. D. CORRECT: Vasopressin constricts blood vessels and is used to treat bleeding esophageal varices.
A charge nurse is teaching a group of unit nurses about a client who has chronic gastritis and is scheduled for a selective vagotomy. Which of the following statements by a unit nurse indicates understanding of the purpose of the procedure? A. "The client will have increased duodenal gastric emptying." B. "The client will have a reduction of gastric acid secretions." C."The client will have an increase of gastric mucus secretion." D."The client will have an increased secretion of hydrogen/potassium ATPase enzymes
A. Pyloroplasty will increase gastric emptying, which is performed to widen the opening from the stomach to the duodenum. B. CORRECT: Selective vagotomy will reduce gastric acid secretions. C. Prostaglandin analog medication will stimulate mucosal protection and decrease gastric acid secretions. D. A histamine2 antagonist medication will inhibit gastric secretion by inhibiting hydrogen/potassium ATPase enzyme system in the gastric parietal cells.
A nurse is reviewing the health record of a client who has a suspected tumor of the jejunum. The nurse should anticipate a prescription for which of the following tests? (Select all that apply.) A. Serum alpha‐fetoprotein B. Endoscopic retrograde cholangiopancreatography (ERCP) C. Gastrointestinal x‐ray with contrast D. Small bowel capsule endoscopy (M2A) E. Colonoscopy
A. Serum alpha‐fetoprotein is a laboratory test used in cases of suspected liver cancer. B. An ERCP is used to visualize the duodenum, biliary ducts, gall bladder, liver, and pancreas. C. CORRECT: A gastrointestinal x‐ray with contrast involves the client drinking barium, which is then traced through the small intestine to the junction with the colon. This would identify a tumor in the jejunum. D. CORRECT: M2A is a procedure in which the client swallows a capsule with a glass of water for a video enteroscopy to visualize the entire small bowel over an 8‐hr period. E. A colonoscopy is the use of a flexible fiberoptic colonoscope, which enters through the anus, to visualize the rectum and the sigmoid, descending, transverse, and ascending colon.
A nurse is providing care to a client who is 1 day postoperative following a paracentesis. The nurse observes clear, pale‐yellow fluid leaking from the operative site. Which of the following is an appropriate nursing intervention? A. Place a clean towel near the drainage site. B. Apply a dry, sterile dressing. C. Apply direct pressure to the site. D. Place the client in a supine position.
A. Sterile dressings should be applied to the operative site to prevent infection and allow for assessment of drainage. B. CORRECT: Application of a sterile dressing will contain the drainage and allow continuous assessment of color and quantity. C. Application of direct pressure can cause discomfort and potential harm to the client. The nurse should apply a sterile dressing to the site and monitor the quantity and characteristic of the drainage. D. The client should be placed with the head of the bed elevated to promote lung expansion.
A nurse is completing preoperative teaching for a client who is scheduled for a laparoscopic cholecystectomy. Which of the following should be included in the teaching? A. "The scope will be passed through your rectum." B. "you might have shoulder pain after surgery." C."you will have a Jackson‐Pratt drain in place after surgery." D."you should limit how often you walk for 1 to 2 weeks."
A. Surgery is possibly performed through the rectum during the natural orifice transluminal endoscopic surgery (NOTES) approach. B. CORRECT: Shoulder pain is expected postoperatively due to free air that is introduced into the abdomen during laparoscopic surgery. C. A Jackson‐Pratt may be placed during the open surgery approach. D. The client is instructed to ambulate frequently following a laparoscopic surgical approach to minimize the free air that has been introduced.
A nurse is completing the admission assessment of a client who has acute pancreatitis. Which of the following findings is the priority to report? A. History of cholelithiasis B. Elevated serum amylase level C. Decrease in bowel sounds upon auscultation D. Hand spasms present when blood pressure is checked
A. The client is at risk for chronic obstructive pancreatitis from cholelithiasis. However, another finding is the priority to report. B. The client is at risk for pancreatic abscess or pseudocyst, which a continuous elevation of amylase can indicate. Increased serum amylase is expected for 2 to 3 days with acute pancreatitis. However, another finding is the priority to report. C. The client is at risk for paralytic ileus from acute pancreatitis. However, another finding is the priority to report. D. CORRECT: The greatest risk to the client is ECG changes and hypotension from hypocalcemia. Hand spasms when
A nurse is completing discharge teaching to a client who is postoperative following fundoplication. Which of the following statements by the client indicates understanding of the teaching? A. "When sitting in my lounge chair after a meal, I will lower the back of it." B. "I will try to eat three large meals a day." C."I will elevate the head of my bed on blocks." D."When sleeping, I will lay on my left side."
A. The client is instructed to remain upright after eating following a fundoplication. B. The client is instructed to avoid large meals after a fundoplication. C. CORRECT: After a fundoplication, the client is instructed to elevate the head of the bed to limit reflux. D After a fundoplication, the client is instructed to sleep on the right side.
A nurse is teaching a client who has a new diagnosis of dumping syndrome following gastric surgery. Which of the following information should the nurse include in the teaching? A. Eat three moderate‐sized meals a day. B. Drink at least one glass of water with each meal. C. Eat a bedtime snack that contains a milk product. D. Increase protein in the diet.
A. The client should consume small, frequent meals rather than moderate‐sized meals. B. The client should eliminate liquids with meals and for 1 hr prior to and following meals. C. The client should avoid milk products. D. CORRECT: The client should eat a high‐protein, high‐fat, low‐fiber, and moderate‐ to low‐carbohydrate diet.
A nurse is providing discharge teaching to a client who has a new prescription for aluminum hydroxide. Which of the following information should the nurse include in the teaching? A. Take the medication with food. B. Monitor for diarrhea. C. Wait 1 hr before taking other oral medications. D. Maintain a low‐fiber diet.
A. The nurse should advise the client to take aluminum hydroxide on an empty stomach. B. The nurse should include in the teaching that aluminum hydroxide can cause constipation. C. CORRECT: The nurse should advise the client not to take oral medications within 1 hr of an antacid. D. The nurse should include in the teaching for the client to increase dietary fiber due to the constipating effect of the medication.
A nurse in a clinic is reviewing the laboratory reports of a client who has suspected cholelithiasis. Which of the following is an expected finding? A. Serum amylase 80 units/L B. WBC 9,000/mm3 C. Direct bilirubin 2.1 mg/dL D. Alkaline phosphatase 25 units/L
A. The nurse should expect the client who has cholelithiasis to have an elevated serum amylase level if pancreatic involvement is present. A serum amylase of 80 units/L is within the expected reference range. B. The nurse should expect the client who has cholelithiasis to have an elevated WBC level due to inflammation. A WBC of 9,000/mm3 is within the expected reference range. C. CORRECT: The nurse should expect the client who has cholelithiasis to have an elevated direct bilirubin level if the bile duct is obstructed. A direct bilirubin level of 2.1 mg/dL is greater than the expected reference range. D. The nurse should expect the client who has cholelithiasis to have an elevated alkaline phosphatase (ALP) level if the common bile duct is obstructed. An ALP of 25 units/L is less than the expected reference range.
A nurse is assessing a client who has pancreatitis. Which of the following actions should the nurse take to assess the presence of Cullen's sign. A. Tap lightly at the costovertebral margin on the client's back. B. Palpate the right lower quadrant. C. Inspect the skin around the umbilicus. D. Auscultate the area below the scapula
A. This action assesses for pain, which can indicate pyelonephritis. B. This action assesses for the presence of rebound tenderness. C. CORRECT: Cullen's sign is indicated by a bluish‐gray discoloration in the periumbilical area. D. Lung sounds are assessed by auscultating the area below the scapula.
nurse is providing discharge teaching to a client who is postoperative following open cholecystectomy with T‐tube placement. Which of the following instructions should the nurse include in teaching? (Select all that apply.) A. Take baths rather than showers. B. Clamp T‐tube for 1 hr before and after meals. C. Keep the drainage system above the level of the abdomen. D. Expect to have the T‐tube removed 3 days postoperatively. E. Report brown‐green drainage to the provider.
B,C