ATI LPN Med Sur on Gastrointestinal

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Sample questions from ATI LPN Med Sur on Gastrointestinal

This material has 90 questions with answers and rationales. Here are the first 5.

1. 1.In a long-term care facility, an older adult with a history of diverticulosis reports new lower-left abdominal pain and a temperature of 38.2 C. Which action should the practical nurse take?

   • A.Apply a heating pad to the abdomen and encourage the client to sleep.
   • B.Collect focused observations and promptly report the new pain and fever to the RN.
   • C.Offer a high-fiber snack and reassess the pain at the end of the shift.
   • D.Administer an over-the-counter laxative from the medication cart.

   Rationale: New abdominal pain with fever may indicate diverticulitis or another acute complication, so the PN should collect relevant observations and promptly report the change to the RN. A high-fiber snack is not an appropriate response to acute symptoms, and a laxative could worsen discomfort or be unsafe without direction. Applying heat and delaying reassessment could mask or delay evaluation of a worsening condition.

2. 2.Refer to the client's chart. Which findings should the practical nurse promptly report to the RN as evidence of possible worsening gastrointestinal blood loss? Select all that apply.

   • A.The client reports dizziness when sitting upright at 1000.
   • B.The heart rate rises from 92/min to 118/min between 0800 and 1000.
   • C.The blood pressure falls from 118/72 mm Hg to 92/58 mm Hg between 0800 and 1000.
   • D.The client passes a black, tarry stool at 1000.
   • E.The client reports mild thirst after being kept NPO.

   Rationale: Dizziness on sitting, a black tarry stool, a rising heart rate, and a falling blood pressure are concerning chart changes that can indicate ongoing blood loss and require prompt reporting. Mild thirst while NPO should be documented and managed according to the care instructions, but by itself it does not indicate worsening hemorrhage. The PN should report the concerning findings rather than independently changing the treatment plan.

3. 3.A parent of a 4-year-old with acute gastroenteritis asks how to give the prescribed oral rehydration solution at home. Which response should the practical nurse provide?

   • A.Replace the solution with undiluted apple juice to provide more calories.
   • B.Stop all fluids until the child has had no diarrhea for 24 hours.
   • C.Offer a large glass of solution at once after each episode of vomiting.
   • D.Give small, frequent sips and continue as directed, even if the child has occasional loose stools.

   Rationale: Small, frequent amounts of oral rehydration solution support fluid replacement and are often better tolerated by a child with gastroenteritis. Undiluted juice can worsen diarrhea because of its sugar content, and a large volume at once may trigger vomiting. Withholding fluids increases dehydration risk; the parent should follow the prescribed plan and report signs of dehydration.

4. 4.At change of shift, the nurse receives report on four clients. Which client should the practical nurse report to the RN first?

   • A.A client with a new ileostomy whose stoma is dusky and cool to touch.
   • B.A client with chronic constipation who has not had a bowel movement for 2 days and denies pain.
   • C.A client with hemorrhoids who reports mild itching after a bowel movement.
   • D.A client with reflux who asks for an antacid before breakfast.

   Answer and rationale are in the full material.

5. 5.During a home visit, a client with cirrhosis says, "I am taking my lactulose, but I have had six watery stools today and feel weak." What should the practical nurse do?

   • A.Tell the client to stop the medication permanently.
   • B.Advise the client to double the next dose to prevent confusion.
   • C.Report the frequent watery stools and weakness to the RN or provider promptly.
   • D.Reassure the client that watery stools are expected and no follow-up is needed.

   Answer and rationale are in the full material.