Chapter 40

A client is prescribed tetracycline to treat peptic ulcer disease. Which instruction would the nurse give the client? a. "Take the medication with milk." b. "Be sure to wear sunscreen while taking this medicine." c. "You will not experience GI upset while taking this medication." d. "Do not drive when taking this medication."

"Be sure to wear sunscreen while taking this medicine."

The nurse determines that teaching for the client with peptic ulcer disease has been effective when the client makes which statement? a. "I should stop all my medications if I develop any side effects." b. "I should continue my treatment regimen as long as I have pain." c. "I have learned some relaxation strategies that decrease my stress." d. "I can buy whatever antacids are on sale because they all have the same effect."

"I have learned some relaxation strategies that decrease my stress."

A client being treated for a peptic ulcer seeks medical attention for vomiting blood. Which statement indicates to the nurse the reason for the client developing hematemesis? a. "I only ate dinner yesterday and it gave me an upset stomach." b. "The pain stopped so I stopped taking the medications." c. "I felt better but then just got really nauseated and threw up." d. "I think the soda that I drank irritated my stomach."

"The pain stopped so I stopped taking the medications."

A patient has been diagnosed with acute gastritis and asks the nurse what could have caused it. What is the best response by the nurse? (Select all that apply.) a. "It is a hereditary disease." b. "You may have ingested some irritating foods." c. "It can be caused by ingestion of strong acids." d. "It is probably your nerves." e. "Is it possible that you are overusing aspirin."

"You may have ingested some irritating foods." "It can be caused by ingestion of strong acids." "Is it possible that you are overusing aspirin."

A client comes to the clinic after developing a headache, abdominal pain, nausea, hiccupping, and fatigue about 2 hours ago. The client tells the nurse that the last food was buffalo chicken wings and beer. Which medical condition does the nurse find to be most consistent with the client's presenting problems? a. Acute gastritis b. Duodenal ulcer c. Gastric ulcer d. Gastric cancer

Acute gastritis

The nurse practitioner suspects that a patient may have a gastric ulcer after completing a history and physical exam. Select an indicator that can be used to help establish the distinction between gastric and duodenal ulcers. a. Sensitivity to the use of nonsteroidal anti-inflammatory drugs (NSAIDs) b. Patient's age c. Amount of hydrochloric acid (HCL) secretion in the stomach d. Presence of H. pylori

Amount of hydrochloric acid (HCL) secretion in the stomach

The nurse reviews dietary guidelines with a client who had a gastric banding. Which teaching points are included? Select all that apply. Limit meal size to 450 to 500 mL. Avoid fruit drinks and soda. Eat six meals a day. Do not eat and drink at the same time. Drink plenty of water, from 90 minutes after each meal to 15 minutes before each meal.

Avoid fruit drinks and soda. Do not eat and drink at the same time. Drink plenty of water, from 90 minutes after each meal to 15 minutes before each meal.

A client is prescribed a histamine (H2)-receptor antagonist. The nurse understands that this might include which medication(s)? Select all that apply. Cimetidine Lansoprazole Esomeprazole Nizatidine Famotidine

Cimetidine Nizatidine Famotidine

A client sustained second- and third-degree burns over 30% of the body surface area approximately 72 hours ago. What type of ulcer should the nurse be alert for while caring for this client? a. Peptic ulcer b. Meckel's ulcer c. Esophageal ulcer d. Curling's ulcer

Curling's ulcer

The nurse in the ED admits a client with suspected gastric outlet obstruction. The client's symptoms include nausea and vomiting. The nurse anticipates that the physician will issue which order? a. Nasogastric tube insertion b. Pelvic x-ray c. Stool specimen d. Oral contrast

Nasogastric tube insertion

The nurse is assessing a client with an ulcer for signs and symptoms of hemorrhage. The nurse interprets which condition as a sign/symptom of possible hemorrhage? a. Polyuria b. Hematemesis c. Bradycardia d. Hypertension

Hematemesis

Which is a true statement regarding gastric cancer? a. The prognosis for gastric cancer is good. b. Most cases are discovered before metastasis. c. Women have a higher incidence of gastric cancer. d. Most clients are asymptomatic during the early stage of the disease.

Most clients are asymptomatic during the early stage of the disease.

Peptic ulcer disease occurs more frequently in people with which blood type? a. AB b. A c. O d. B

O

A client is in the hospital for the treatment of peptic ulcer disease. The client reports vomiting and a sudden severe pain in the abdomen. The nurse then assesses a board-like abdomen. What does the nurse suspect these symptoms indicate? a. Ineffective treatment for the peptic ulcer b. Gastric penetration c. Perforation of the peptic ulcer d. A reaction to the medication given for the ulcer

Perforation of the peptic ulcer

Which of the following is the most successful treatment for gastric cancer? a. Chemotherapy b. Palliation c. Removal of the tumor d. Radiation

Removal of the tumor

A client with peptic ulcer disease has been prescribed sucralfate. What health education should the nurse provide to this client? a. Blood levels will be evaluated after 1 week b. Ensure adequate potassium intake during therapy c. Take the medication 2 hours before or after other medications d. Take the medication at bedtime to accommodate sedative effects

Take the medication 2 hours before or after other medications

A nurse is caring for a client who underwent a subtotal gastrectomy. To manage dumping syndrome, the nurse should advise the client to: a. restrict fluid intake to 1 qt (1,000 ml)/day. b. don't drink liquids 2 hours before meals. c. drink liquids only with meals. d. drink liquids only between meals.

drink liquids only between meals.

The nurse recognizes that the client diagnosed with a duodenal ulcer will likely experience a. vomiting. b. hemorrhage. c. pain 2 to 3 hours after a meal. d. weight loss.

pain 2 to 3 hours after a meal.

A client with an H. pylori infection asks why bismuth subsalicylate is prescribed. Which response will the nurse make? a. "It aids in the healing of the stomach lining." b. "It helps propel food from the stomach into the duodenum." c. "It enhances the function of the pyloric sphincter." d. "It improves digestion in the stomach."

"It aids in the healing of the stomach lining."

A client with gastric ulcers caused by H. pylori is prescribed metronidazole. Which client statement indicates to the nurse that teaching about this medication was effective? a. "It might cause a metallic taste in my mouth." b. "My appetite may increase while taking this medication." c. "I can have an alcoholic drink in the evenings." d. "I can take this medication with my blood thinner."

"It might cause a metallic taste in my mouth."

A patient is scheduled for a Billroth I procedure for ulcer management. What does the nurse understand will occur when this procedure is performed? a. A sectioned portion of the stomach is joined to the jejunum. b. The antral portion of the stomach is removed and a vagotomy is performed. c. A partial gastrectomy is performed with anastomosis of the stomach segment to the duodenum. d. The vagus nerve is cut and gastric drainage is established.

A partial gastrectomy is performed with anastomosis of the stomach segment to the duodenum.

When caring for a client with an acute exacerbation of a peptic ulcer, the nurse finds the client doubled up in bed with severe pain in the right shoulder. What is the initial appropriate action by the nurse? a. Assess the client's abdomen and vital signs. b. Irrigate the client's NG tube. c. Notify the health care provider. d. Place the client in the high-Fowler's position.

Assess the client's abdomen and vital signs.

A client is preparing for discharge to home following a partial gastrectomy and vagotomy. Which is the best rationale for the client being taught to lie down for 30 minutes after each meal? a. Provides much needed rest b. Allows for better absorption of vitamin B12 c. Removes tension on internal suture line d. Slows gastric emptying

Slows gastric emptying

A client is admitted with a gastrointestinal bleed. What client symptom may indicate a peptic ulcer perforation to the nurse? a. Bradycardia b. Hypertension c. Sudden, severe upper abdominal pain d. Soft abdomen

Sudden, severe upper abdominal pain

Clients with Type O blood are at higher risk for which of the following GI disorders? a. Duodenal ulcers b. Esophageal varices c. Diverticulitis d. Gastric cancer

Duodenal ulcers

A client is admitted to the health care facility with a diagnosis of a bleeding gastric ulcer. The nurse expects the client's stools to have which description? a. Coffee-ground-like b. Bright red c. Clay-colored d. Black and tarry

Black and tarry

A client with peptic ulcer disease has a blood pressure of 88/40 mm Hg, dizziness, and nausea. Which complication will the nurse suspect is occurring with this client? a. Evidence of ulcer healing b. Bleeding from the ulcer c. Medication adverse effects d. Allergic response to the medication

Bleeding from the ulcer

A client who had a Roux-en-Y bypass procedure for morbid obesity ate a chocolate chip cookie after a meal. After ingestion of the cookie, the client reported cramping pains, dizziness, and palpitation. After having a bowel movement, the symptoms resolved. What should the nurse educate the client about regarding this event? a. Gastric outlet obstruction b. Celiac disease c. Dumping syndrome d. Bile reflux

Dumping syndrome

Which medication classification represents a proton (gastric acid) pump inhibitor? a. Famotidine b. Metronidazole c. Sucralfate d. Omeprazole

Omeprazole

The nurse is preparing to administer ondansetron to an older adult client. Which safety warning(s) should the nurse consider when administering the medication? Select all that apply. a. Explain that there is a risk for dehydration. b. Explain that it must be started before travel to be effective. c. It increases sedation if used with opiates. d. Do not use if the client has a heart block or prolonged QT interval. e. Emphasize prevention. The client must take consistently to prevent nausea and vomiting.

Do not use if the client has a heart block or prolonged QT interval. It increases sedation if used with opiates. Emphasize prevention. The client must take consistently to prevent nausea and vomiting.

The nurse is caring for a client who has developed dumping syndrome while recovering from a gastrectomy. What recommendation should the nurse make to the client? a. Eat several small meals daily spaced at equal intervals. b. Sit upright when eating and for 30 minutes afterward. c. Choose foods that are high in simple carbohydrates. d. Drink a minimum of 12 ounces of fluid with each meal.

Eat several small meals daily spaced at equal intervals.

The nurse is caring for a client who has developed dumping syndrome while recovering from a gastrectomy. What recommendation should the nurse make to the client? a. Sit upright when eating and for 30 minutes afterward. b. Drink a minimum of 12 ounces of fluid with each meal. c. Choose foods that are high in simple carbohydrates. d. Eat several small meals daily spaced at equal intervals.

Eat several small meals daily spaced at equal intervals.

A health care provider suspects that a client has peptic ulcer disease. With which diagnostic procedure would the nurse most likely prepare to assist? a. Endoscopy b. Stool antigen test c. Barium study of the upper gastrointestinal tract d. Gastric secretion study

Endoscopy

During a home visit the nurse notes that a client recovering from peptic ulcer disease is experiencing cool clammy skin and has a heart rate of 96 beats a minute. Which action will the nurse take? a. Notify the primary health care provider. b. Encourage the client to drink a warm beverage. c. Discuss the types of foods the client has been eating. d. Provide a dose of a proton pump inhibitor.

Notify the primary health care provider.

A nurse is teaching a group of middle-aged men about peptic ulcers. When discussing risk factors for peptic ulcers, the nurse should mention: a. alcohol abuse and a history of acute renal failure. b. alcohol abuse and smoking. c. a sedentary lifestyle and smoking. d. a history of hemorrhoids and smoking.

alcohol abuse and smoking.