ATI Standard Quiz- Medical surgical gastrointestinal

A community health nurse is planning an educational program about hepatitis A. When preparing the materials, the nurse should identify that which of the following groups is most at risk for developing hepatis A? A. Children B. Older adults C. Women who are pregnant D. Middle aged men

A

A nurse is caring for a client who is scheduled to undergo a liver biopsy for a suspected malignancy. Which of the following lab findings should the nurse monitor prior to procedure? A. PT time B. Serum lipase C. Bilirubin D. Calcium

A

A nurse is caring for a client who has a percutaneous endoscopic gastrostomy tube and is receiving intermittent feedings. Prior to initiating the feeding, which of the following actions should the nurse take first? A. Flush the tube with water B. Place the client in semi fowlers position C. Cleanse the skin around the tube side D. Aspirate the tube for residual contents

B

A nurse is caring for a client who is scheduled to undergo an EGD. The nurse should identify that this procedure is used to do which of the following? A. To visualize polyps in the colon B. To detect an ulceration in the stomach C. To identify an obstruction in the biliary tract D. To determine the presence of free air in the abd

B An EGD is used to visualize the esophagus, stomach, and duodenum with a lighted tube to detect a tumor, ulceration, or obstruction

A nurse is caring for a client who has a fulminant hepatic failure. Which of the following procedures should the nurse anticipate for this client? A. Endoscopic sclerotherapy B. Liver lobectomy C. Liver transplant D. Transjugular intraheptic portal systemic shunt placement

C Fulminant hepatic failure, most often caused by viral hepatitis, is characterized by the development of hepatic encephalopathy within weeks of onset of disease in a client without prior evidence of heptic dysfunction.

A nurse is completing a history and physical assessment for a client who has chronic pancreatitis. Which of the following findings should the nurse identify as likely cause of the clients condition? A. High calorie diet B. Prior gastrointestinal illnesses C. Tobacco use D. Alcohol use

D

A nurse is caring for a client who has celiac disease. Which of the following foods should the nurse remove from the clients meal tray? A. Wheat toast B. Tapioca pudding C. Hard boiled egg D. Mashed potatoes

A Celiac disease is an autoimmune disorder characterized by a permanent intolerance to wheat, barley, and rye. Wheat toast contains gluten and should be removed from the clients tray

A nurse is caring for a client who has a history of cirrhosis and is admitted with manifestations of hepatic encephalopathy. The nurse should anticipate a prescription for which of the following lab tests to determine the possibility of recent excessive alcohol use? A. GGT B. ALP C. Serum bilirubin D. ALT

A The GGT lab test is specific to the hepatobiliary system in which levels can be raised by alcohol and hepatoxic drugs. Therefore, it is useful for monitoring drug toxicty and excessive alcohol use

A nurse is caring for a client who is 4 hr postoperative following a laparoscopic cholecystectomy. Which of the following findings should the nurse expect? A. Right shoulder pain B. Urine output 20mL/Hr C. Temp 101.1 D. Oxygen 92%

A The client can experience pain the upper right shoulder due to gas injected into the abdominal caivty during the procedure, which can irritate the diaphragm and cause referred pain in the shoulder area

A nurse is teaching a client who has Barretts esophagus and is scheduled to undergo an EGD. Which of the following statements should the nurse include in the teaching? A. This procedure is performed to measure the presence of acid in your esophagus B. This procedure can determine how well the lower part of your esophagus works C. This procedure is performed while you are under anesthesia D. This procedure can determine if you have colon cancer

B An EGD is useful in determining the function of the esophageal lining and the extent of inflammation, potential scarring and strictures

A nurse is assessing a client who is in the early stages of hepatitis A. Which of the following manifestations should the nurse expect? A. Jaundice B. Anorexia C. Dark urine D. Pale feces

B Anorexia is an early manifestation of hepatitis A and is often severe. It is thought to result from the release of a toxin by the damaged liver or by the failure of the damaged liver cells to detoxify an abnormal product

A nurse is preparing a community education program about hepatitis B. Which of the following statements should the nurse include in the teaching? A. A hepatitis B immunization is recommended for those who travel, especially military personnel B. A hepatitis immunization is given to infants and children C. Hepatitis B is acquired by eating foods that are contaminated during handling D. Hepatitis B can be prevented by using good personal hygiene habits and proper sanitation

B Hepatitis B immune globulin is given as part of the standard childhood immunizations. It can be administered as early as birth, especially in infants born to hepatitis B surface negative mothers. These infants should receive the second dose between 1-4 months of age

A nurse is caring for a client who has acute pancreatitis. Which of the following serum lab values should the nurse anticipate returning to the expected reference range within 72 hr after treatment begins? A. Aldolase B. Lipase C. Amylase D. Lactic dehydrogenase

C Pancreatitis is the most common diagnosis for marked elevations in serum amylase. Serum amylase begins to increase about 3-6 hr following onset of acute pancreatitis. The amylase level peaks in 20-30 hr and returns to the expected reference range within 2-3 days

A nurse in the ER is caring for a client who has bleeding esophageal varices. The nurse should anticipate prescription for which of the following medications A. Famotidine B. Esomeprazole C. Vasopressin D. Omeprazole

C Vasopressin constricts the splanchic bed and decreases portal pressure. Vasopressin also constricts the distal esophageal and proximal gastric veins, which reduces inflow into the portal system and used to treat

A nurse is assessing a client who has admitted with a bowel obstruction. The client reports severe abdominal pain. Which of the following findings should indicate to the nurse that possible bowel perforation has occurred? A. Elevated blood pressure B. Bowel sounds increased in frequency and pitch C. Rigid abdomen D. Emesis of undigested food

C Abdominal tenderness and rigidity occur with a bowel perforation. As fluid escapes into the peritoneal cavity, there is a reduction in circulating blood volume and a lowered blood pressure, or hypotension, results

A nurse is providing dietary teaching to a client who has diverticulitis about preventing acute attacks. Which of the following foods should the nurse recommend? A. Foods high in vitamin C B. Foods low in fat C. Foods high in fiber D. Foods low in calories

C The result of long-term, low-fiber eating habits along with increased intracolonic pressure lead to straining during bowel movements, causing development of diverticula.

A nurse is caring for a client who is 2 days postoperative following a gastric bypass. The nurse notes that bowel sounds are present. Which of the following foods should the nurse provider at the initial feeding? A. Vanilla pudding B. Apple juice C. Diet ginger ale D. Clear liquids

D Clear liquids, such as water or broth, can be given for the first oral feedings, but should be limited to only 30mL per feeding. Water does not contain sugar, which could cause diarrhea

A nurse is caring for a client who is dehydrated and is receiving continuous tube feeding through a pump at 75mL/hr. When the nurse assess the client at 0800, which of the following requires intervention by the nurse? A. A full pitcher of water is sitting on the clients bedside table within the clients reach B. The disposable feeding bag is from the previous day at 1000 and contains 200mL of feeding C. The client is lying on the right side with a visible dependent loop in the feeding tube D. The head of the bed is elevated 20 degrees

D The head of the bed should be elevate at least 30 degree while the tube feeding is administered. This position uses gravity to help the feeing move down through the digestive system and lessens the possibility of regurgitation

A nurse is assessing a client who is experiencing perforation of a peptic ulcer. Which of the following manifestations should the nurse expect? A. Increased blood pressure B. Decreased heart rate C. Yellowing of the skin D. Boardlike abdomen

D The nurse should expect the client who is experiencing perforation of a peptic ulcer to exhibit manifestations of a boardlike abd and severe pain in the abd or back that radiates to the right shoulder

A nurse is caring for a client who is receiving TPN therapy and has just returned to the room following physical therapy. The nurse notes that the infusion pump for the clients TPN is turned off. After restarting the infusion pump, the nurse should monitor the client for which of the following findings? A. HTN B. Excessive thirst C. Fever D. Diaphoresis

D The nurse should recongize that the client has potential for the development of hypoglycemia due to the sudden withdrawal of TPN solution