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14. A patient was admitted after a Roux-en-Y gastric bypass (RYGBP). A nursing student asks the nurse what type of surgery is a RYGBP. What would be an appropriate response from the nurse? · "It is an esophagectomy performed using the transthoracic approach." · "It is an esophagectomy performed using a transhiatal approach." · "It is a combination of restrictive and malabsorption types of bariatric surgery. · "It is a standard operation for pancreatic cancer."

· "It is a combination of restrictive and malabsorption types of bariatric surgery.

13. A patient was admitted with severe epigastric pain and has been diagnosed with cancer. The patient is scheduled for an esophagectomy. The patient asks about the procedure. What would be an appropriate response from the nurse? · "This procedure is usually performed for cancer of the proximal esophagus and gastroesophageal junction." · "This procedure is usually performed for cancer of the distal esophagus and gastroesophageal junction." · "This procedure is usually performed for cancer of the pancreatic head." · "The procedure is usually performed for varices of the distal esophagus and gastroesophageal junction."

· "This procedure is usually performed for cancer of the distal esophagus and gastroesophageal junction."

9. A patient with acute pancreatitis is complaining of a pain in the left upper quadrant. Using a 1- to 10-point pain scale, the patient states the current level is at an 8. What intervention would the nurse include in the patient's plan of care to facilitate pain control? · Administer analgesics only as needed. · Administer analgesics around the clock. · Educate the patient and family on lifestyle changes. · Teach relaxation and distraction techniques.

· Administer analgesics around the clock.

10. A patient with a history of chronic alcoholism was admitted with acute pancreatitis. The nurse is developing a patient education plan. Which topic would the nurse include in the plan? · Diabetes management · Alcohol cessation · Occult blood testing · Anticoagulation management

· Alcohol cessation

5. Which nursing intervention is a priority for a patient with gastrointestinal hemorrhage? · Positioning the patient in a high Fowler's position · Ensuring the patient has a patent airway · Irrigating the nasogastric tube with iced saline · Maintaining venous access so that fluids and blood can be administered

· Ensuring the patient has a patent airway

18. A patient has been admitted with pancreatitis. Which clinical manifestations would the nurse expect to observe in support of this diagnosis? Select all that apply. · Epigastric and abdominal pain · Nausea and vomiting · Diaphoresis · Jaundice · Hyperactive bowel sounds · Fever

· Epigastric and abdominal pain · Nausea and vomiting · Diaphoresis · Jaundice · Fever

6. The nurse is caring for a patient with acute liver failure. The practitioner asks the nurse to assess the patient for asterixis. How should the nurse assess for this symptom? · Inflate a blood pressure cuff on the patient's arm. · Have the patient bring the knees to the chest. · Have the patient extend the arms and dorsiflex the wrists. · Dorsiflex the patient's foot.

· Have the patient extend the arms and dorsiflex the wrists.

3. A patient is admitted with a severe head injury. The nurse knows that critically ill patients are at risk for gastrointestinal hemorrhage due to stress-related mucosal disease. The nurse would monitor the patient for which signs and symptoms? · Metabolic acidosis and hypovolemia · Decreasing hemoglobin and hematocrit · Hyperkalemia and hypernatremia · Hematemesis and melena

· Hematemesis and melena

12. The nurse is caring for a patient with acute liver failure. The patient has elevated ammonia levels. Which medication would the nurse expect the practitioner to order for this patient? · Insulin · Vitamin K · Lactulose · Lorazepam

· Lactulose

19. A patient has been admitted with acute liver failure. Which interventions would the nurse expect as part of the interprofessional collaborative management plan? Select all that apply. · Administer benzodiazepines for agitation. · Monitor oxygen saturation. · Initiate an insulin drip for hyperglycemia. · Monitor serum electrolyte levels. · Assess for signs of cerebral edema.

· Monitor oxygen saturation. · Monitor serum electrolyte levels. · Assess for signs of cerebral edema.

8. A patient with a history of chronic alcoholism was admitted with acute pancreatitis. What intervention would the nurse include in the patient's plan of care? · Monitor the patient for hypovolemic shock from plasma volume depletion. · Observe the patient for hypoglycemia and hypercalcemia. · Initiate enteral feedings after the nasogastric tube is placed. · Place the patient on a fluid restriction to avoid the fluid sequestration.

· Monitor the patient for hypovolemic shock from plasma volume depletion.

1. A patient is admitted with an upper gastrointestinal bleed. Which disorder is the leading cause of upper gastrointestinal (GI) hemorrhage? · Stress ulcers · Peptic ulcers · Nonspecific erosive gastritis · Esophageal varices

· Peptic ulcers

2. A patient is admitted with a gastrointestinal hemorrhage due to esophagogastric varices. The nurse knows that varices are caused by which pathophysiologic mechanism? · Portal hypertension · Superficial mucosal erosions · Breakdown the mucosal resistance · Inflammation and ulceration

· Portal hypertension

7. A patient was admitted with acute pancreatitis. The nurse understands that pancreatitis occurs as a result of what pathophysiologic mechanism? · Uncontrolled hypoglycemia caused by an increased release of insulin · Loss of storage capacity for senescent red blood cells · Premature activation of inactive digestive enzymes, resulting in autodigestion · Release of glycogen into the serum, resulting in hyperglycemia

· Premature activation of inactive digestive enzymes, resulting in autodigestion

16. The nurse is caring for a patient after an esophagectomy. In the immediate postoperative period, which nursing intervention would have the highest priority? · Preventing atelectasis · Managing pain · Promoting ambulation · Preventing infection

· Preventing atelectasis

11. A Salem sump nasogastric tube has two lumens. The first lumen is for suction and drainage. What is the purpose of the second lumen? · Allows for administration of tube feeding. · Allows for testing of gastric secretions. · Prevents tube from adhering to the gastric wall. ·Prevents the tube from advancing.

· Prevents tube from adhering to the gastric wall.

17. A patient is admitted with the diagnosis of acute pancreatitis. The nurse expects which laboratory values to be elevated? Select all that apply. · Calcium · Serum amylase · Serum glucose · Potassium · WBC · Serum lipase

· Serum amylase · Serum glucose · WBC · Serum lipase

15. The nurse is caring for a patient after an esophagectomy. The nurse knows the patient is at risk for an anastomotic leak. Which finding would indicate this occurrence? · Crackles in the lung bases · Subcutaneous emphysema · Incisional bleeding · Absent of bowel sounds

· Subcutaneous emphysema

4. A patient is admitted with a gastrointestinal hemorrhage due to esophagogastric varices. What medication would the nurse expect the practitioner to order for this patient? Select all that apply. · Histamine2 (H2) antagonists · Vasopressin · Heparin · Antacids · Somatostatin · Octreotide

Vasopressin Somatostatin · Octreotide