Video Library
Medical Surgery Exam Custom GI
ATI Medical Surgery Exam Custom GI
Total Questions : 42
Showing 10 questions Sign up for moreA nurse is reinforcing discharge teaching with a client who has a new diagnosis of gastroesophageal disease (GERD). Which of the following foods should the nurse include in the list of foods the client should avoid?
Explanation
A. Oatmeal: Oatmeal is often considered a bland and low-acid food that can be soothing for individuals with GERD. It's generally not a trigger for GERD symptoms and can be included in the diet of someone with this condition.
B. Non-fat milk: Non-fat milk and other low-fat dairy products are often recommended for individuals with GERD. However, individual tolerance varies, and some people might find that milk triggers their symptoms. It's best for the patient to monitor their own reactions to dairy products.
C. Chocolate: Chocolate is known to relax the lower esophageal sphincter, allowing stomach acid to flow back into the esophagus. For many people with GERD, chocolate can exacerbate symptoms and is typically advised to be avoided.
D. Apples: Apples are generally considered a safe and healthy food for individuals with GERD. However, some people may find that raw apples trigger their symptoms due to their natural acidity. Cooking or baking apples can often make them more tolerable for people with GERD.
A nurse is assisting in the plan of care for a client who had surgery for a bowel obstruction. The client has a nasogastric tube in place. Which of the following actions should the nurse include in the client's plan of care? (Select all that apply.)
Explanation
A. Perform leg exercises every 2 hr: Performing leg exercises every 2 hours is essential for preventing blood clots and maintaining circulation in immobile patients. This is especially important after surgery to prevent complications like deep vein thrombosis.
B. Irrigate the nasogastric tube every 4 to 8 hr: Irrigating the nasogastric tube is not a standard nursing practice and should not be done without a physician's order. The nasogastric tube is typically used for decompression, drainage, or feeding. If the tube becomes clogged or there are concerns about drainage, the nurse should contact the healthcare provider for further instructions.
C. Maintain bed rest for 48 hr following surgery: While some bed rest might be necessary immediately after surgery, the goal is to encourage mobility as soon as possible to prevent complications such as atelectasis and deep vein thrombosis. Patients are usually encouraged to mobilize as soon as they are medically stable, often within hours after surgery.
D. Encourage hourly use of an incentive spirometer while awake: Using an incentive spirometer helps prevent atelectasis and promotes lung expansion after surgery. Encouraging the patient to use the incentive spirometer hourly while awake is a common nursing intervention to maintain respiratory function postoperatively.
E. Document the color, consistency, and amount of nasogastric drainage: Documenting the color, consistency, and amount of nasogastric drainage is crucial for monitoring the patient's condition. Changes in these factors could indicate bleeding, infection, or other complications, and timely documentation helps healthcare providers assess the patient's status and make appropriate interventions.
A nurse is collecting data from a client who has obstruction and inflammation of the common bile duct due to cholelithiasis. Which of the following findings is expected for this condition?
Explanation
A. Ecchymosis of the extremities: Ecchymosis refers to the medical term for a bruise. It's characterized by a discoloration of the skin resulting from bleeding underneath, typically caused by trauma to the blood vessels. This is not directly related to cholelithiasis.
B. Tenderness in the left upper abdomen: Tenderness in the left upper abdomen might be associated with conditions such as pancreatitis or splenic issues, not directly with obstruction and inflammation of the common bile duct due to cholelithiasis.
C. Straw-colored urine: Straw-colored urine is normal and healthy. Dark-colored or cloudy urine might indicate underlying issues, but straw-colored urine is generally a sign of proper hydration.
D. Fatty stools: When the common bile duct is obstructed due to cholelithiasis, proper digestion of fats doesn't occur, leading to the passage of fatty stools. This is due to the inability to properly digest and absorb fats, leading to their presence in the stool.
A nurse is collecting data from a client who has acute gastroenteritis. Which of the following data collection findings should the nurse identify as the priority?
Explanation
A. Blood glucose 150 mg/dL:
This blood glucose level is slightly elevated but not significantly concerning on its own. It may be related to stress or other factors. In the context of acute gastroenteritis, it might be secondary to dehydration, but it is not an immediate priority unless the client is diabetic.
B. Potassium 2.5 mEq/L:
This is the correct answer. Low potassium levels (hypokalemia) are a severe concern, especially in the context of acute gastroenteritis where there can be significant losses through vomiting and diarrhea. Hypokalemia can lead to cardiac arrhythmias and needs urgent correction.
C. Weight loss of 3% of total body weight:
While weight loss is an important parameter, a 3% weight loss is usually not an immediate concern. In cases of acute gastroenteritis, rapid weight loss might indicate severe dehydration, but this choice is not as urgent as addressing a severe electrolyte imbalance like hypokalemia.
D. Urine specific gravity 1.035:
This specific gravity indicates concentrated urine, which could be due to dehydration. While this finding is important and indicates the need for rehydration, it is not as urgent as correcting a critically low potassium level.
A nurse is calculating a client's fluid intake over the past 8 hr. The client had one 8-oz cup of coffee, 3 oz of juice, and 12 oz of soda. The client's water pitcher had 300 ml and 200 ml remains. The client also had IV fluids infusing as 40 mL/hr via an infusion pump. How many ml should the nurse document as the client's total Intake for the shift?
Explanation
8-oz cup of coffee = 8 oz (since 1 fluid ounce is approximately 30 ml, this is roughly 240 ml).
3 oz of juice = 3 oz (approximately 90 ml).
12 oz of soda = 12 oz (approximately 360 ml).
Water pitcher had 300 ml, and 200 ml remains, so the client consumed 300 ml - 200 ml = 100 ml of water.
IV fluids infusing at 40 mL/hr for 8 hours = 40 ml/hr * 8 hr = 320 ml.
Now, sum up these values:
240 ml (coffee) + 90 ml (juice) + 360 ml (soda) + 100 ml (water) + 320 ml (IV fluids) = 1,110 ml
So, the nurse should document the client's total intake for the shift as 1,110 ml.
A nurse is planning care for a client who has anorexia and has manifestations of malnutrition. When reviewing the client's laboratory values. which of the following test results should the nurse expect to be low?
Explanation
A. Troponin:
Troponin is a protein found in the heart muscle. Elevated levels of troponin in the blood indicate damage to the heart, often due to a heart attack or other cardiac issues. This marker is crucial in diagnosing heart-related problems.
B. Albumin:
Albumin is a protein produced by the liver and is essential for maintaining blood volume and regulating fluid balance. It also helps transport various substances in the blood. Low levels of albumin are indicative of malnutrition, liver disease, or kidney disorders.
C. D-dimer:
D-dimer is a substance in the blood that is released when a blood clot breaks up. Elevated levels of D-dimer can indicate the presence of an abnormal blood clot, but it is not specific to malnutrition. It is often used in diagnosing conditions like deep vein thrombosis (DVT) or pulmonary embolism (PE).
D. Creatinine:
Creatinine is a waste product produced by the muscles and excreted by the kidneys. Creatinine levels in the blood can indicate how well the kidneys are functioning. Elevated levels can suggest kidney damage or other kidney-related issues but are not directly related to malnutrition.
A nurse is reinforcing teaching about dietary recommendations for a client who has a hiatal hernia. Which of the following client statements indicate understanding of the teaching? (Select all that apply)
Explanation
A. "I will consume less caffeine and spicy foods":
Spicy foods and caffeine can irritate the esophagus, exacerbating symptoms of hiatal hernia. Avoiding these can help in managing symptoms.
B. "I will sleep with the head of my bed elevated”:
Keeping the head elevated can prevent stomach acid from flowing back into the esophagus, reducing symptoms like heartburn. This is a helpful strategy for managing hiatal hernia.
C. "I will lie down for one half hour after meals”:
Lying down after meals can worsen symptoms because gravity can't help keep stomach acid in the stomach. Staying upright after eating helps prevent acid reflux.
D. "I will drink less fluid":There is no need to reduce fluid intake. Staying hydrated is important, and fluids do not typically contribute to hiatal hernia symptoms. However, drinking large amounts of fluid with meals should be avoided as it can increase stomach pressure.
E. "I will try not to gain weight”:
Maintaining a healthy weight is important. Excess weight can increase pressure on the abdomen, potentially worsening hiatal hernia symptoms.
A nurse is reviewing the laboratory values of a client who is receiving total parenteral nutrition (TPN): glucose 72 mg/dL, chloride 100 mEq/L sodium 138 mEq/L, and potassium 3.0 mEq/L. Which of the following actions should the nurse plan to take?
Explanation
A. Check the client for a positive Chvostek’s sign:
Chvostek's sign is a clinical sign of hypocalcemia, not related to the given laboratory values. The symptoms include facial muscle twitching when the facial nerve (VII) is tapped. There's no indication for this assessment based on the provided information.
B. Discontinue the TPN infusion:
The glucose level is within the normal range (70-99 mg/dL). Discontinuing TPN based solely on this glucose level is not warranted.
C. Request a potassium replacement:
The potassium level is low (normal range typically 3.5-5.0 mEq/L). Given the low potassium level, the nurse should plan to request a potassium replacement. Potassium is crucial for various physiological functions, and a deficiency can lead to significant complications.
D. Administer glucagon IM:
Glucagon is used to treat hypoglycemia, but the client's glucose level is within the normal range, so administering glucagon is not indicated.
A nurse in a provider's office is caring for a client who has a gastric ulcer caused by Helicobacter pylori. The nurse should anticipate that in addition to cimetidine and sucralfate, the provider will prescribe which of the following?
Explanation
A. Desmopressin:
Desmopressin is used to treat conditions like diabetes insipidus and bedwetting (enuresis) but is not related to the treatment of gastric ulcers caused by H. pylori.
B. Clarithromycin:
Correct Choice. Clarithromycin is an antibiotic often prescribed in combination with other medications to treat H. pylori infections. It helps eradicate the bacteria from the stomach, playing a crucial role in the treatment of gastric ulcers caused by H. pylori.
C. Mexiletine:
Mexiletine is an antiarrhythmic medication used to treat irregular heartbeats. It is not indicated in the treatment of gastric ulcers caused by H. pylori.
D. Filgrastim:
Filgrastim is a medication used to stimulate the production of white blood cells in the body. It is not used in the treatment of gastric ulcers caused by H. pylori.
A nurse is planning care for a client who is 1 day postoperative following a partial bowel resection. The client requires a complete dressing change, total parental nutrition administration, daily weight and is reporting pain at a level of 6 on a 0 to 10 scale. Which of the following nursing actions should the nurse plan to complete first?
Explanation
A. Obtain the client's vital signs:
Vital signs are essential for assessing the client's overall condition and can provide crucial information about the client's stability. However, in this scenario, there's a higher priority nursing action that needs immediate attention.
B. Weigh the client:
Daily weight measurement is important, especially in postoperative patients, to monitor for fluid retention or loss. However, this is not the most urgent action in this situation.
C. Change the client's dressing:
Changing the dressing involves maintaining the surgical site's cleanliness and preventing infections. While this is important, it's not the highest priority in this situation.
D. Administer pain medication:
Correct Choice. Addressing the client's pain is a priority to ensure their comfort and well-being, especially postoperatively. Managing pain effectively is crucial for the client's recovery and can facilitate other necessary activities, such as changing the dressing or weighing the client.
You just viewed 10 questions out of the 42 questions on the ATI Medical Surgery Exam Custom GI Exam. Subscribe to our Premium Package to obtain access on all the questions and have unlimited access on all Exams. Subscribe Now
