ATI GI

A nurse is preparing to administer metoclopramide 15mg PO QID before meals and at bedtime for a client who has GERD. The amount available is metoclopramide 5mg/5mL. How many mL should the nurse administer? (Round the answer to the nearest whole number)

15 mL

A nurse is preparing to administer liquid famotidine 20mg every 6 hr for a client who has GERD. Available is famotidine 40mg/5mL. How many mL should the nurse administer? (Round the answer to the nearest tenth. Use a leading zero is it applies. Do not use a trailing zero)

2.5 mL

A nurse is caring for a client who has gastrointestinal bleeding. Which of the following actions should the nurse take first? a. Assess orthostatic blood pressure b. Explain the procedure for an upper gastrointestinal series c. Administer pain medication d. Test the client's emesis for blood

A rational: During the nursing process, the first action the nurse should take is to assess the client by measuring the clients' orthostatic blood pressure. This action determines if the client is hypovolemic and establishes a baseline for further measurements

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? a. Hyperactive bowel sounds b. Sudden abdominal pain c. Increased blood pressure d. Bradycardia

B rationale: Classic indications of gastrointestinal perforation include sudden sharp abdominal pain with rigid abdomen, declining peristalsis, and progression to septicemia

A nurse is providing teaching for a client who has a new diagnosis of gastroesophageal reflux disease (GERD). The client asks about foods he should avoid eating. Which of the following foods should the nurse tell him to avoid a. Nonfat milk b. Chocolate c. Apples d. Oatmeal

B rationale: The client should avoid foods that reduce pressure on the lower esophageal sphincter. These include fatty and fried foods, chocolate, caffeine, alcohol, and carbonated drinks

A nurse is reviewing the medical record of a client who has a peptic ulcer. Which of the following findings should the nurse recognize as a risk factor for this condition? a. History of bulimia b. History of NSAID use c. Drinks green tea d. Has a glass of wine with dinner each day

B rationale: The nurse should recognize that long-term use of NSAIDs is a risk factor for peptic ulcer disease. NSAIDs break down the mucosal barrier and cause production of prostaglandins to decrease, which results in local gastric mucosal injury

A nurse is caring for a client who has esophageal varices and is hypotensive after vomiting 500mL of blood. Which of the following action is the nurse's priority? a. Elevate the client's feet b. Increase the client's IV fluid rate c. Initiate a dopamine IV infusion for the client d. Administer a unit of RBCs

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

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 a. Metabolic acidosis b. Metabolic alkalosis c. Respiratory acidosis d. Respiratory alkalosis

B rationale: metabolic alkalosis can occur in clients who have excessive vomiting because of the loss of hydrochloric acid

A nurse caring for a client who is vomiting. Which of the following actions should the nurse take first? a. Provide the client with an emesis basin b. Notify housekeeping c. Prevent the client from aspirating d. Administer an antiemetic to the client

C rational: When using the airway, breathing, circulation approach to client care, the nurse determines the priority action is to prevent the client from aspiration by turning the client to his side and suctioning his airway

A nurse is caring for a client who has an active gastrointestinal bleed. After inserting a NG tube into the client, which of the following findings should the nurse anticipate? a. Frothy pink drainage b. Dark amber drainage c. Coffee-grond drainage d. Greenish-yellow drainage

C rationale: "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 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? a. Dietary iron restrictions b. Intestinal malabsorption syndrome c. Chronic blood loss d. Intestinal parasites

C rationale: A client with long-standing ulcerative colitis is most likely anemic due to chronic blood loss in small amount 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 teaching a client who has prescription of a nasogastric tube (NG) to treat a pyloric obstruction. Which of the following rationales for the use of the nasogastric tube should the nurse include in the teaching? a. Determine the pH of the gastric secretions b. Supply nutrients via tube feedings c. Decompress the stomach d. Administer medications

C rationale: A pyloric obstruction, also called gastric outlet obstruction, is caused by edema, scarring, or spasm, often result of gastritis or peptic ulcer disease. The nurse should inform the client that because the stomach is dilated and may contain undigested food, it must be decompressed, necessitating the placement of an NG tube

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? a. Remove the parenteral nutrition solution from the refrigerator 2 hr before infusion b. Remove unused parenteral nutrition after 12hr of use c. Monitor daily laboratory values and report as needed d. Monitor the flow rate of the parenteral nutrition carefully and increase the rate as needed if it falls behind

C rationale: Laboratory data, as well as observation of clinical signs, are important to prevent the development of nutrient deficiencies or toxicities

A nurse is providing teaching for a client who has gastroesophageal reflux disease (GERD) about ways to manage his condition. Which of the following instructions should the nurse include? a. "sleep on your left side" b. "Drink milk to soothe your stomach" c. "Eat four small meals each day" d. "Wait to go to bed for 1 hr after eating"

C rationale: The client should avoid eating large meals because of the pressure it places on the stomach. Instead, he should eat four to six meals per day

A nurse is caring for a client following an esophagogastroduodenoscopy (EGD) procedure. Which of the following assessments is the nurse's priority? a. Pain b. Nausea c. Gag reflex d. Level of consciousness

C rationale: The greatest risk to the client's safety following an EGD is aspiration. Until the client's gag reflex returns, the nurse must keep the client NPO and prepare to intervene to keep the airway open and unobstructed

A nurse is teaching a client who has gastroesophageal reflux disease about managing his illness. Which of the following recommendations should the nurse include in the teaching? a. Limit fluid intake not related to meals b. Chew on mint leaves to relieve indigestion c. Avoid eating within 3hr of bedtime d. Season foods with black pepper

C rationale: The nurse should instruct the client to eat small, frequent meals but to avoid eating with 3hr of bedtime

A nurse is providing teaching for a client who has experienced an acute episode of gastritis. Which of the following instructions should the nurse include in the teaching? a. Limit drinking milk b. Take NSAIDs for pain c. Avoid drinking alcohol d. Limit strenuous exercise

C rationale: The nurse should teach the client to avoid drinking alcohol because it increases manifestation of gastritis

A nurse is teaching a client who has stomatitis. Which of the following instructions should the nurse include? a. Rinse with a commercial mouthwash b. Use toothpaste that contains sodium laurel sulfate c. Cleanse the mouth with lemon-glycerine swabs d. Brush teeth with a soft toothbrush

D rationale: The client should use a soft toothbrush and gently brush after each meal to reduce mouth irritation and prevent superinfections

A nurse is teaching a client about strategies to manage gastroestophageal reflux disease (GERD). Which of the following statements should the nurse include? a. "Elevate the head of your bed by 18 inches" b. "Avoid snacking between meals" c. "Limit foods that are high in fiber" d. "Lie on your right side when sleeping"

D rationale: The nurse should instruct the client to lie on the right side when sleeping to prevent nighttime reflux

A nurse is assessing a client who has peptic ulcer disease. Which of the following findings should the nurse identify as the priority? a. Epigastric discomfort b. Dyspepsia c. Epigastric discomfort d. Hematemesis

D rationale: When using the urgent vs. non-urgent approach to client care, the nurse should determine that the priority is hematemesis, which indicates massive bleeding

A nurse is providing discharge teaching to a client who has gastroesophageal reflux disease. Which of the following statements by the client indicates an understanding of the teaching a. "The type of foods I eat does not affect this condition" b. "I will sleep on my left side" c. "I will eat a snack just before going to bed" d. "I will sleep with the head of my bed elevated"

D rationale: the client should sleep with the head of the bed elevated by 6 to 12 inches to prevent reflux at night