Chapter 41 - Upper GI Problems

which patient statement indicates that the nurse's teaching following a gastroduodenostomy has been effective? a. "vitamin supplements may prevent anemia" b. "persistent heartburn is common after surgery" c. "I will try to drink more liquids with my meals" d. "I will need to choose high carbohydrate foods"

a. "vitamin supplements may prevent anemia"

which statement by a patient with dumping syndrome should lead the nurse to determine that further dietary teaching is needed? a. "I should eat bread and jam with every meal" b. "I should avoid drinking fluids with my meals" c. "I should eat smaller meals about six times a day" d. "I need to lie down for 30 to 60 minutes after my meals"

a. "I should eat bread and jam with every meal"

Which patient statement indicates that the nurse's teaching following a gastroduodenostomy has been effective? a. "Vitamin supplements may prevent anemia." b. "Persistent heartburn is common after surgery." c. "I will try to drink more liquids with my meals." d. "I will need to choose high carbohydrate foods."

a. "Vitamin supplements may prevent anemia."

which instructions would the nurse include in a teaching plan for a patient with mild GERD? a. "the best time to take an as-needed antacid is 1 to 3 hours after meals" b. "a glass of warm milk at bedtime will decrease your discomfort at night" c. "do not chew gum; the excess saliva will cause you to secrete more acid" d. "limit your intake of foods high in protein because they take longer to digest"

a. "the best time to take an as-needed antacid is 1 to 3 hours after meals"

which patient is at highest risk of having a gastric ulcer? a. 55 yr old female smoker with nausea and vomiting b. 45 yr old female admitted for illicit drug detoxification c. 27 yr old male who is being divorced and has back pain d. 37 yr old male smoker who fell while looking for a job

a. 55 yr old female smoker with nausea and vomiting

Which information will the nurse include when teaching adults to decrease the risk for cancers of the tongue and buccal mucosa? a. Avoid use of cigarettes and smokeless tobacco. b. Use sunscreen when outside even on cloudy days. c. Complete antibiotic courses used to treat throat infections. d. Use antivirals to treat herpes simplex virus (HSV) infections.

a. Avoid use of cigarettes and smokeless tobacco.

which medications are used to decrease gastric or HCl acid secretion? (select all) a. Famotidine (Pepcid) b. Sucralfate (Carafate) c. Omeprazole (Prilosec) d. Misoprostol (Cytotec) e. Bethanechol (Urecholine)

a. Famotidine (Pepcid) c. Omeprazole (Prilosec) d. Misoprostol (Cytotec)

Which action should the nurse in the emergency department anticipate for a 23-year-old patient who has had several episodes of bloody diarrhea? a. Obtain a stool specimen for culture. b. Administer antidiarrheal medication. c. Provide teaching about antibiotic therapy. d. Teach about adverse effects of acetaminophen (Tylenol).

a. Obtain a stool specimen for culture.

Which item should the nurse offer to the patient who is to restart oral intake after being NPO due to nausea and vomiting? a. Glass of orange juice b. Dish of lemon gelatin c. Cup of coffee with cream d. Bowl of hot chicken broth

b. Dish of lemon gelatin

regardless of the precipitating factor, what causes the injury to mucosal cells in peptic ulcers? a. acid back diffusion into the mucosa b. the release of histamine from GI cells c. ammonia formation in the mucosal wall d. breakdown of the gastric mucosal barrier

a. acid back diffusion into the mucosa

which type of gastritis is most likely to occur in a college student who has an isolated drinking binge? a. acute gastritis b. chronic gastritis c. helicobacter pylori gastritis d. autoimmune metaplastic atrophic gastritis

a. acute gastritis

the nurse is planning to teach the patient with GERD about foods or beverages that decrease LES pressure. What should be included in this list? (select all) a. alcohol b. root beer c. chocolate d. citrus fruits e. fatty foods f. cola sodas

a. alcohol c. chocolate e. fatty foods f. cola sodas

which information will the nurse include when teaching adults to decrease the risk of cancers of the tongue and buccal mucosa? a. avoid use of cigarettes and smokeless tobacco b. use sunscreen when outside even on cloudy days c. complete antibiotic courses used to treat throat infections d. use antivirals to treat herpes simplex virus (HSV) infections

a. avoid use of cigarettes and smokeless tobacco

a patient with a gastric outlet obstruction has been treated with NG decompression. After the first 24 hrs, the patient develops nausea and increased upper abdominal bowel sounds. What is the priority action by the nurse? a. check the patency of the NG tube b. place the patient in a recumbent position c. assess the patient's vital signs and circulatory status d. encourage the patient to deep breathe and consciously relax

a. check the patency of the NG tube

a large number of children at a public school have suddenly developed profuse diarrhea and bloody stools. The school nurse suspects food poisoning related to food from the school cafeteria and requests analysis and culture of which food? a. milk b. ground beef c. commercially canned fish d. salads with mayonnaise dressing

b. ground beef

a 50 yr old patient who underwent a gastroduodenostomy (Billroth I) earlier today complains of increasing abdominal pain. The patient has no bowel sounds and 200 mL of bright red NG drainage in the last hour. The highest priority action by the nurse is to.. a. contact the surgeon b. irrigate the NG tube c. monitor the NG drainage d. administer the prescribed morphine

a. contact the surgeon

A 50-year-old patient who underwent a gastroduodenostomy (Billroth I) earlier today complains of increasing abdominal pain. The patient has no bowel sounds and 200 mL of bright red nasogastric (NG) drainage in the last hour. The highest priority action by the nurse is to a. contact the surgeon. b. irrigate the NG tube. c. monitor the NG drainage. d. administer the prescribed morphine.

a. contact the surgeon.

the nurse will anticipate preparing a 71 yr old female patient who is vomiting "coffee-ground" emesis for.. a. endoscopy b. angiography c. barium studies d. gastric analysis

a. endoscopy

The nurse will anticipate preparing a 71-year-old female patient who is vomiting "coffee-ground" emesis for a. endoscopy. b. angiography c. barium studies. d. gastric analysis.

a. endoscopy.

what are characteristics of gingivitis? a. formation of abscesses with loosening of teeth b. caused by upper respiratory tract viral infection c. shallow, painful vesicular ulcerations of lip and mouth d. infectious ulcers of mouth and lips as a result of systemic disease

a. formation of abscesses with loosening of teeth

what type of bleeding will a patient with peptic ulcer disease with a slow upper GI source of bleeding have? a. melena b. occult blood c. coffee-ground emesis d. profuse bright-red hematemesis

a. melena

which action should the nurse in the ED anticipate for a 23 yr old patient who has had several episodes of bloody diarrhea? a. obtain a stool specimen for culture b. administer antidiarrheal medication c. provide teaching about antibiotic therapy d. teach about adverse effects of acetaminophen (Tylenol)

a. obtain a stool specimen for culture

duodenal and gastric ulcers have similar as well as differentiating features. What are characteristics unique to duodenal ulcers? (select all) a. pain is relieved with eating food b. they have a high recurrence rate c. increased gastric acid secretion occurs d. associated with H. pylori infection e. hemorrhage, perforation, and obstruction may result f. there is a burning and cramping in the midepigastric area

a. pain is relieved with eating food c. increased gastric acid secretion occurs d. associated with H. pylori infection f. there is a burning and cramping in the midepigastric area

a patient treated for vomiting is to begin oral intake when the symptoms have subsided. To promote rehydration, the nurse plans to administer which fluid first? a. water b. hot tea c. Gatorade d. warm broth

a. water

Which information about dietary management should the nurse include when teaching a patient with peptic ulcer disease (PUD)? a. "You will need to remain on a bland diet." b. "Avoid foods that cause pain after you eat them." c. "High-protein foods are least likely to cause you pain." d. "You should avoid eating any raw fruits and vegetables."

b. "Avoid foods that cause pain after you eat them."

Which information will the nurse include for a patient with newly diagnosed gastroesophageal reflux disease (GERD)? a. "Peppermint tea may reduce your symptoms." b. "Keep the head of your bed elevated on blocks." c. "You should avoid eating between meals to reduce acid secretion." d. "Vigorous physical activities may increase the incidence of reflux."

b. "Keep the head of your bed elevated on blocks."

Which information will the nurse include when teaching a patient with peptic ulcer disease about the effect of ranitidine (Zantac)? a. "Ranitidine absorbs the gastric acid." b. "Ranitidine decreases gastric acid secretion." c. "Ranitidine constricts the blood vessels near the ulcer." d. "Ranitidine covers the ulcer with a protective material."

b. "Ranitidine decreases gastric acid secretion."

The nurse determines that teaching regarding cobalamin injections has been effective when the patient with chronic atrophic gastritis states which of the following? a. "The cobalamin injections will prevent gastric inflammation." b. "The cobalamin injections will prevent me from becoming anemic." c. "These injections will increase the hydrochloric acid in my stomach." d. "These injections will decrease my risk for developing stomach cancer."

b. "The cobalamin injections will prevent me from becoming anemic."

which information about dietary management should the nurse include when teaching a patient with peptic ulcer disease? a. "you will need to remain on a bland diet" b. "avoid foods that cause pain after you eat them" c. "high-protein foods are least likely to cause you pain" d. "you should avoid eating any raw fruits and vegetables"

b. "avoid foods that cause pain after you eat them"

which information will the nurse include for a patient with newly diagnosed GERD? a. "peppermint tea may reduce your symptoms" b. "keep the head of your bed elevated on blocks" c. "you should avoid eating between meals to reduce acid secretion" d. "vigorous physical activities may increase the incidence of reflux"

b. "keep the head of your bed elevated on blocks"

which information will the nurse include when teaching a patient with peptic ulcer disease about the effect of ranitidine (Zantac)? a. "ranitidine absorbs the gastric acid" b. "ranitidine decreases gastric acid secretion" c. "ranitidine constricts the blood vessels near the ulcer" d. "ranitidine covers the ulcer with a protective material"

b. "ranitidine decreases gastric acid secretion"

the nurse determines that teaching regarding cobalamin injections has been effective when the patient with chronic atrophic gastritis sates which of the following? a. "the cobalamin injections will prevent gastric inflammation" b. "the cobalamin injections will prevent me from becoming anemic" c. "these injections will increase the hydrochloric acid in my stomach" d. "these injections will decrease my risk for developing stomach cancer"

b. "the cobalamin injections will prevent me from becoming anemic"

A 44-year-old man admitted with a peptic ulcer has a nasogastric (NG) tube in place. When the patient develops sudden, severe upper abdominal pain, diaphoresis, and a firm abdomen, which action should the nurse take? a. Irrigate the NG tube. b. Check the vital signs. c. Give the ordered antacid. d. Elevate the foot of the bed.

b. Check the vital signs.

Which medications will the nurse teach the patient about whose peptic ulcer disease is associated with Helicobacter pylori? a. Sucralfate (Carafate), nystatin (Mycostatin), and bismuth (Pepto-Bismol) b. Amoxicillin (Amoxil), clarithromycin (Biaxin), and omeprazole (Prilosec) c. Famotidine (Pepcid), magnesium hydroxide (Mylanta), and pantoprazole (Protonix) d. Metoclopramide (Reglan), bethanechol (Urecholine), and promethazine (Phenergan)

b. Amoxicillin (Amoxil), clarithromycin (Biaxin), and omeprazole (Prilosec)

which esophageal disorder is described as a precancerous lesion and is associated with GERD? a. achalasia b. Barrett's esophagus c. esophageal strictures d. esophageal diverticula

b. Barrett's esophagus

Which nursing action should be included in the postoperative plan of care for a patient after a laparoscopic esophagectomy? a. Notify the doctor about bloody nasogastric (NG) drainage. b. Elevate the head of the bed to at least 30 degrees. c. Reposition the NG tube if drainage stops. d. Start oral fluids when the patient has active bowel sounds.

b. Elevate the head of the bed to at least 30 degrees.

a patient who has been vomiting for several days from an unknown cause is admitted to the hospital. What should the nurse anticipate will first be included in interprofessional care? a. oral administration of broth and tea b. IV replacement of fluid and electrolytes c. administration of parenteral antiemetics d. insertion of a NG tube for suction

b. IV replacement of fluid and electrolytes

a 49 yr old man has been admitted hypotension and dehydration after 3 days of nausea and vomiting. Which order from the health care provider will the nurse implement first? a. insert NG tube b. infuse normal saline at 250 mL/hr c. administer IV ondansetron (Zofran) d. provide oral care with moistened swabs

b. infuse normal saline at 250 mL/hr

A 49-year-old man has been admitted with hypotension and dehydration after 3 days of nausea and vomiting. Which order from the health care provider will the nurse implement first? a. Insert a nasogastric (NG) tube. b. Infuse normal saline at 250 mL/hr. c. Administer IV ondansetron (Zofran). d. Provide oral care with moistened swabs.

b. Infuse normal saline at 250 mL/hr.

a family member of a 28 yr old patient who has suffered massive abdominal trauma in an automobile accident asks the nurse why the patient is receiving famotidine (Pepcid). The nurse will explain that the medication will.. a. decrease nausea and vomiting b. inhibit development of stress ulcers c. lower the risk for H. pylori infection d. prevent aspiration of gastric contents

b. inhibit development of stress ulcers

The nurse and a licensed practical/vocational nurse (LPN/LVN) are working together to care for a patient who had an esophagectomy 2 days ago. Which action by the LPN/LVN requires that the nurse intervene? a. The LPN/LVN uses soft swabs to provide for oral care. b. The LPN/LVN positions the head of the bed in the flat position. c. The LPN/LVN encourages the patient to use pain medications before coughing. d. The LPN/LVN includes the enteral feeding volume when calculating intake and output.

b. The LPN/LVN positions the head of the bed in the flat position.

The nurse isadministering IV fluid boluses and nasogastric irrigation to a patient with acute gastrointestinal (GI) bleeding. Which assessment finding is most important for the nurse to communicate to the health care provider? a. The bowel sounds are hyperactive in all four quadrants. b. The patient's lungs have crackles audible to the midchest. c. The nasogastric (NG) suction is returning coffee-ground material. d. The patient's blood pressure (BP) has increased to 142/84 mm Hg.

b. The patient's lungs have crackles audible to the midchest.

which medications will the nurse teach the patient about whose peptic ulcer disease is associated with H. pylori? a. sucralfate (Carafate), nystatin (Mycostatin), and bismuth (Pepto-Bismol) b. amoxicillin(Amoxil), clarithromycin (Biaxin), and omeprazole (Prilosec) c. famotidine (Pepcid), magnesium hydroxide (Mylanta), and pantoprazole (Protonix) d. metoclopramide (Reglan), bethanechol (Urecholine), and promethazine (Phenergan)

b. amoxicillin(Amoxil), clarithromycin (Biaxin), and omeprazole (Prilosec)

a 44 yr old man admitted with a peptic ulcer has a NG tube in place. When the patient develops sudden, severe upper abdominal pain, diaphoresis, and a firm abdomen, which action should the nurse take? a. irrigate the NG tube b. check the vital signs c. give the ordered antacid d. elevate the foot of the bed

b. check the vital signs

which item should the nurse offer to the patient who is to restart oral intake after being NPO due to nausea and vomiting? a. glass of orange juice b. dish of lemon gelatin c. cup of coffee with cream d. bowl of hot chicken broth

b. dish of lemon gelatin

a patient with oral cancer has a history of heavy smoking, excessive alcohol intake, and personal neglect. During the patient's early postoperative course, what does the nurse anticipate that the patient may need? a. oral nutritional supplements b. drug therapy to prevent substance withdrawal symptoms c. counseling about lifestyle changes to prevent recurrence of the tumor d. less pain medication because of cross-tolerance with CNS depressants

b. drug therapy to prevent substance withdrawal symptoms

which nursing action should be included in the postoperative plan of care for a patient after a laparoscopic esophagectomy? a. notify the doctor about bloody NG drainage b. elevate the HOB to at least 30 degrees c. reposition the NG tube if drainage stops d. start oral fluids when the patient has active bowel sounds

b. elevate the HOB to at least 30 degrees

M.J. calls the clinic and tells the nurse that her 85 yr old mother has been nauseated all day and has vomited twice. Before the nurse hangs up and calls the HCP, she should tell M.J. to.. a. administer antiemetic drugs and observe skin turgor b. give her mother sips of water and elevate the head of her bed to prevent aspiration c. offer her mother a high-protein liquid supplement to drink to maintain her nutritional needs d. offer her mother large quantities of Gatorade to decrease the risk of sodium depletion

b. give her mother sips of water and elevate the head of her bed to prevent aspiration

A family member of a 28-year-old patient who has suffered massive abdominal trauma in an automobile accident asks the nurse why the patient is receiving famotidine (Pepcid). The nurse will explain that the medication will a. decrease nausea and vomiting. b. inhibit development of stress ulcers. c. lower the risk for H. pylori infection. d. prevent aspiration of gastric contents.

b. inhibit development of stress ulcers.

a patient with cancer of the stomach at the lesser curvature undergoes a total gastrectomy with an esophagojejunostomy. Postoperatively, what should the nurse teach the patient to expect? a. rapid healing of the surgical wound b. lifelong administration of cobalamin c. to be able to return to normal dietary habits d. close follow-up for development of peptic ulcers in the jejunum

b. lifelong administration of cobalamin

nursing management of the patient with chronic gastritis includes teaching the patient to a. take antacids before meals to decrease stomach acidity b. maintain a nonirritating diet with six small meals a day c. eliminate alcohol and caffeine from the diet when symptoms occur d. use NSAIDs instead of aspirin for minor pain relief

b. maintain a nonirritating diet with six small meals a day

following a patient's esophagogastrostomy for cancer of the esophagus, what is most important for the nurse to do? a. report any bloody drainage from the NG tube b. maintain the patient in semi-fowler's or fowler's position c. monitor for abdominal distention that may disrupt the surgical site d. except to find decreased breath sounds bilaterally because of the surgical approach

b. maintain the patient in semi-fowler's or fowler's position

several patients are seen at an urgent care center with symptoms of nausea, vomiting, and diarrhea that began 2 hours ago while attending a large family reunion potluck dinner. You question the patients specifically about foods they ingested containing.. a. beef b. meat and milk c. poultry and eggs d. home-preserved vegetables

b. meat and milk

when caring for a patient following a glossectomy with dissection of the floor of the mouth and a radical neck dissection for cancer of the tongue, what is the nurse's primary concern? a. relief of pain b. patent airway c. positive body image d. tube feedings to provide nutrition

b. patent airway

which statements are characteristic of the uses of antacids for peptic ulcer disease? (select all) a. used in patients with verified H. pylori b. patients frequently noncompliant with use c. neutralize HCl acid in the stomach d. cover the ulcer, protecting it from erosion by acids e. high incidence of side effects and contraindications f. high dose and frequency may stimulate release of gastrin

b. patients frequently noncompliant with use c. neutralize HCl acid in the stomach f. high dose and frequency may stimulate release of gastrin

a patient is admitted to the emergency department with profuse bright-red hematemesis. During the initial care of the patient, what is the nurse's first priority? a. establish two IV sites with large-gauge catheters b. perform a focused nursing assessment of the patient's status c. obtain a thorough health history to assist in determining the cause of the bleeding d. perform a gastric lavage with cool tap water in preparation for endoscopic examination

b. perform a focused nursing assessment of the patient's status

a 68 yr old patient with a bleeding duodenal ulcer has a NG tube in place, and the health care provider orders 30 mL of aluminum hydroxide/magnesium hydroxide (Maalox) to be instilled through the tube every hour. To evaluate the effectiveness of this treatment, the nurse... a. monitors arterial blood gas values daily b. periodically aspirates and test gastric pH c. checks each stool for the presence of occult blood d. measures the volume of residual stomach contents

b. periodically aspirates and test gastric pH

A 68-year-old patient with a bleeding duodenal ulcer has a nasogastric (NG) tube in place, and the health care provider orders 30 mL of aluminum hydroxide/magnesium hydroxide (Maalox) to be instilled through the tube every hour. To evaluate the effectiveness of this treatment, the nurse a. monitors arterial blood gas values daily. b. periodically aspirates and tests gastric pH. c. checks each stool for the presence of occult blood. d. measures the volume of residual stomach contents.

b. periodically aspirates and tests gastric pH.

A 26-year-old patient with a family history of stomach cancer asks the nurse about ways to decrease the risk for developing stomach cancer. The nurse will teach the patient to avoid a. emotionally stressful situations. b. smoked foods such as ham and bacon c. foods that cause distention or bloating. d. chronic use of H2 blocking medications.

b. smoked foods such as ham and bacon

a 26 yr old patient with a family history of stomach cancer asks the nurse about ways to decrease the risk for developing stomach cancer. The nurse will teach the patient to avoid.. a. emotionally stressful situations b. smoked foods such as ham and bacon c. foods that cause distention or bloating d. chronic use of H2 blocking medications

b. smoked foods such as ham and bacon

which infection or inflammation is found related to systemic disease and cancer chemotherapy? a. parotitis b. stomatitis c. oral candidiasis d. Vincent's infection

b. stomatitis

the nurse and LPN/LVN are working together to care for a patient who had an esophagectomy 2 days ago. Which action by the LPN/LVN requires that the nurse intervene? a. the LPN/LVN uses soft swabs to provide for oral care b. the LPN/LVN positions the HOB in the flat position c. the LPN/LVN encourages the patient to use pain medications before coughing d. the LPN/LVN includes the enteral feeding volume when calculating intake and output

b. the LPN/LVN positions the HOB in the flat position

the nurse is administering IV fluid boluses and nasogastric irrigation to a patient with acute GI bleeding. Which assessment finding is most important for the nurse to communicate to the health care provider? a. the bowel sounds are hyperactive in all four quadrants b. the patient's lungs have crackles audible to the midchest c. the NG suction is returning coffee-ground material d. the patient's BP has increased to 142/84 mmHg

b. the patient's lungs have crackles audible to the midchest

what should the nurse emphasize when teaching patients at risk for upper GI bleeding to prevent bleeding episodes? a. all stools and vomitus must be tested for the presence of blood b. the use of OTC medications of any kind should be avoided c. antacids should be taken with all prescribed medications to prevent gastric irritation d. misoprostol (Cytotec) should be used to protect the gastric mucosa in individuals with peptic ulcers

b. the use of OTC medications of any kind should be avoided

A 58-year-old woman who recently has been diagnosed with esophageal cancer tells the nurse, "I do not feel ready to die yet." Which response by the nurse is most appropriate? a. "You may have quite a few years still left to live." b. "Thinking about dying will only make you feel worse." c. "Having this new diagnosis must be very hard for you." d. "It is important that you be realistic about your prognosis."

c. "Having this new diagnosis must be very hard for you."

a 46 yr old female with GERD is experiencing increasing discomfort. Which patient statement indicates that additional teaching about GERD is needed? a. "I take antacids between meals and at bedtime each night" b. "I sleep with the HOB elevated on 4-inch blocks" c. "I eat small meals during the day and have a bedtime snack" d. "I quit smoking several years ago, but I still chew a lot of gum"

c. "I eat small meals during the day and have a bedtime snack"

A 46-year-old female with gastroesophageal reflux disease (GERD) is experiencing increasing discomfort. Which patient statement indicates that additional teaching about GERD is needed? a. "I take antacids between meals and at bedtime each night." b. "I sleep with the head of the bed elevated on 4-inch blocks." c. "I eat small meals during the day and have a bedtime snack." d. "I quit smoking several years ago, but I still chew a lot of gum."

c. "I eat small meals during the day and have a bedtime snack."

the nurse determines that teaching for the patient with peptic ulcer disease has been effective when the patient 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"

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

a 58 yr old woman who recently has been diagnosed with esophageal cancer tells the nurse, "I do not feel ready to die yet." Which response by the nurse is most appropriate? a. "you may have quite a few years still left to live" b. "thinking about dying will only make you feel worse" c. "having this new diagnosis must be very hard for you" d. "it is important that you be realistic about your prognosis"

c. "having this new diagnosis must be very hard for you"

Which patient should the nurse assess first after receiving change-of-shift report? a. A patient with nausea who has a dose of metoclopramide (Reglan) due b. A patient who is crying after receiving a diagnosis of esophageal cancer c. A patient with esophageal varices who has a blood pressure of 92/58 mm Hg d. A patient admitted yesterday with gastrointestinal (GI) bleeding who has melena

c. A patient with esophageal varices who has a blood pressure of 92/58 mm Hg

Which order from the health care provider will the nurse implement first for a patient who has vomited 1200 mL of blood? a. Give an IV H2 receptor antagonist. b. Draw blood for typing and crossmatching. c. Administer 1000 mL of lactated Ringer's solution. d. Insert a nasogastric (NG) tube and connect to suction.

c. Administer 1000 mL of lactated Ringer's solution.

A 57-year-old man with Escherichia coli O157:H7 food poisoning is admitted to the hospital with bloody diarrhea and dehydration. Which order will the nurse question? a. Infuse lactated Ringer's solution at 250 mL/hr. b. Monitor blood urea nitrogen and creatinine daily. c. Administer loperamide (Imodium) after each stool. d. Provide a clear liquid diet and progress diet as tolerated.

c. Administer loperamide (Imodium) after each stool.

A 53-year-old male patient with deep partial-thickness burns from a chemical spill in the workplace experiences severe pain followed by nausea during dressing changes. Which action will be most useful in decreasing the patient's nausea? a. Keep the patient NPO for 2 hours before and after dressing changes. b. Avoid performing dressing changes close to the patient's mealtimes. c. Administer the prescribed morphine sulfate before dressing changes. d. Give the ordered prochlorperazine (Compazine) before dressing changes.

c. Administer the prescribed morphine sulfate before dressing changes.

A 26-year-old woman has been admitted to the emergency department with nausea and vomiting. Which action could the RN delegate to unlicensed assistive personnel (UAP)? a. Auscultate the bowel sounds. b. Assess for signs of dehydration. c. Assist the patient with oral care. d. Ask the patient about the nausea.

c. Assist the patient with oral care.

Which patient choice for a snack 2 hours before bedtime indicates that the nurse's teaching about gastroesophageal reflux disease (GERD) has been effective? a. Chocolate pudding b. Glass of low-fat milk c. Cherry gelatin with fruit d. Peanut butter and jelly sandwich

c. Cherry gelatin with fruit

what does the nurse include when teaching a patient with newly diagnosed peptic ulcer disease? a. maintain a bland, soft, low-residue diet b. use alcohol and caffeine in moderation and always with food c. eat as normally as possible, eliminating foods that cause pain or discomfort d. avoid milk and milk products because they stimulate gastric acid production

c. eat as normally as possible, eliminating foods that cause pain or discomfort

An 80-year-old who is hospitalized with peptic ulcer disease develops new-onset auditory hallucinations. Which prescribed medication will the nurse discuss with the health care provider before administration? a. Sucralfate (Carafate) b. Omeprazole (Prilosec) c. Metoclopramide (Reglan) d. Aluminum hydroxide (Amphojel)

c. Metoclopramide (Reglan)

After the nurse has completed teaching a patient with newly diagnosed eosinophilic esophagitis about the management of the disease, which patient action indicates that the teaching has been effective? a. Patient orders nonfat milk for each meal. b. Patient uses the prescribed corticosteroid inhaler. c. Patient schedules an appointment for allergy testing. d. Patient takes ibuprofen (Advil) to control throat pain.

c. Patient schedules an appointment for allergy testing.

Which finding in the mouth of a patient who uses smokeless tobacco is suggestive of oral cancer? a. Bleeding during tooth brushing b. Painful blisters at the lip border c. Red, velvety patches on the buccal mucosa d. White, curdlike plaques on the posterior tongue

c. Red, velvety patches on the buccal mucosa

The nurse is assessing a patient who had a total gastrectomy 8 hours ago. What information is most important to report to the health care provider? a. Absent bowel sounds b. Complaints of incisional pain c. Temperature 102.1° F (38.9° C) d. Scant nasogastric (NG) tube drainage

c. Temperature 102.1° F (38.9° C)

A patient returned from a laparoscopic Nissen fundoplication for hiatal hernia 4 hours ago. Which assessment finding is most important for the nurse to address immediately? a. The patient is experiencing intermittent waves of nausea. b. The patient complains of 7/10 (0 to 10 scale) abdominal pain. c. The patient has absent breath sounds in the left anterior chest. d. The patient has hypoactive bowel sounds in all four quadrants.

c. The patient has absent breath sounds in the left anterior chest.

A 58-year-old patient has just been admitted to the emergency department with nausea and vomiting. Which information requires the most rapid intervention by the nurse? a. The patient has been vomiting for 4 days. b. The patient takes antacids 8 to 10 times a day. c. The patient is lethargic and difficult to arouse. d. The patient has undergone a small intestinal resection.

c. The patient is lethargic and difficult to arouse.

which laboratory findings should the nurse expect in the patient with persistent vomiting? a. decrease pH, increase Na, decrease hematocrit b. increase pH, decrease chloride, decrease hematocrit c. increase pH, decrease potassium, increase hematocrit d. decrease pH, decrease potassium, increase hematocrit

c. increase pH, decrease potassium, increase hematocrit

the pernicious anemia that may accompany gastritis is due to.. a. chronic autoimmune destruction of cobalamin stores in the body b. progressive gastric atrophy from chronic breakage in the mucosal barrier and blood loss c. a lack of intrinsic factor normally produced by acid-secreting cells of the gastric mucosa d. hyperchlorhydria from an increase in acid-secreting parietal cells and degradation of RBC's

c. a lack of intrinsic factor normally produced by acid-secreting cells of the gastric mucosa

which patient should the nurse assess first after receiving change of shift report? a. a patient with nausea who has a dose of metoclopramide (Reglan) due b. a patient who is crying after receiving a diagnosis of esophageal cancer c. a patient with esophageal varices who has a blood pressure of 92/58 mmHg d. a patient admitted yesterday with GI bleeding who has melena

c. a patient with esophageal varices who has a blood pressure of 92/58 mmHg

which order from the health care provider will the nurse implement first for a patient who has vomited 1200 mL of blood? a. give an IV H2 receptor antagonist b. draw blood for typing and crossmatching c. administer 1000 mL of lactated ringer's solution d. insert a NG tube and connect to suction

c. administer 1000 mL of lactated ringer's solution

a 57 yr old man with E. coli food poisoning is admitted to the hospital with bloody diarrhea and dehydration. Which order will the nurse question? a. infuse lactated ringer's solution at 250 mL/hr b. monitor BUN and creatinine daily c. administer loperamide (Imodium) after each stool d. provide a clear liquid diet and progress diet as tolerated

c. administer loperamide (Imodium) after each stool

a 53 yr old male patient with deep partial-thickness burns from a chemical spill in the workplace experiences severe pain followed by nausea during dressing changes. Which action will be most useful in decreasing the patient's nausea? a. keep the patient NPO for 2 hours before and after the dressing changes b. avoid performing dressing changes close to the patient's mealtimes c. administer the prescribed morphine sulfate before dressing changes d. give the ordered prochlorperazine (Compazine) before dressing changes

c. administer the prescribed morphine sulfate before dressing changes

a 38 yr old woman receiving chemotherapy for breast cancer develops a candida albicans oral infection. The nurse will anticipate the need for.. a. hydrogen peroxide rinses b. the use of antiviral agents c. administration of nystatin (Mycostatin) tablets d. referral to a dentist for professional tooth cleaning

c. administration of nystatin (Mycostatin) tablets

A 38-year old woman receiving chemotherapy for breast cancer develops a Candida albicans oral infection. The nurse will anticipate the need for a. hydrogen peroxide rinses. b. the use of antiviral agents. c. administration of nystatin (Mycostatin) tablets. d. referral to a dentist for professional tooth cleaning.

c. administration of nystatin (Mycostatin) tablets.

a 26 yr old woman has been admitted to the ED with nausea and vomiting. Which action could the RN delegate to UAP? a. auscultate the bowel sounds b. assess for signs of dehydration c. assist the patient with oral care d. ask the patient about the nausea

c. assist the patient with oral care

the teaching plan for the patient being discharged after an acute episode of upper GI bleeding includes information concerning the importance of (select all).. a. limiting alcohol intake to one serving per day b. only taking aspirin with milk or bread products c. avoiding taking aspirin and drugs containing aspirin d. only taking drugs prescribed by the health care provider e. taking all drugs 1 hour before mealtime to prevent further bleeding

c. avoiding taking aspirin and drugs containing aspirin d. only taking drugs prescribed by the health care provider

the nurse teaching young adults about behaviors that put them at risk for oral cancer includes.. a. discouraging use of chewing gums b. avoiding use of perfumed lip gloss c. avoiding use of smokeless tobacco d. discouraging drinking of carbonated beverages

c. avoiding use of smokeless tobacco

a 68 yr old male patient with a stroke is unconscious and unresponsive to stimuli. After learning that the patient has a history of GERD, the nurse will plan to do frequent assessments of the patient's.. a. apical pulse b. bowel sounds c. breath sounds d. abdominal girth

c. breath sounds

A 68-year-old male patient with a stroke is unconscious and unresponsive to stimuli. After learning that the patient has a history of gastroesophageal reflux disease (GERD), the nurse will plan to do frequent assessments of the patient's a. apical pulse. b. bowel sounds. c. breath sounds. d. abdominal girth.

c. breath sounds.

which patient choice for a snack 2 hours before bedtime indicates that the nurse's teaching about GERD has been effective? a. chocolate pudding b. glass of low-fat milk c. cherry gelatin with fruit d. peanut butter and jelly sandwich

c. cherry gelatin with fruit

older patients may have cardiac or renal insufficiency and may be more susceptible to problems from vomiting and antiemetic drug side effects. What nursing intervention is most important to implement with these patients? a. keep the patient flat in bed to decrease dizziness b. keep the patient NPO until nausea and vomiting have stopped c. do hourly visual checks or use a sitter to keep the patient safe d. administer IV fluids as rapidly as possible to prevent dehydration

c. do hourly visual checks or use a sitter to keep the patient safe

a patient who has undergone an esophagectomy for esophageal cancer develops increasing pain, fever, and dyspnea when a full liquid diet is started postoperatively. The nurse recognizes that these symptoms are most indicative of.. a. an intolerance of the feedings b. extension of the tumor into the aorta c. leakage of fluids into the mediastinum d. esophageal perforation with fistula formation into the lung

c. leakage of fluids into the mediastinum

at his first postoperative checkup appointment after a gastrojejunostomy (Billroth II), a patient reports that dizziness, weakness, and palpitations occur about 20 minutes after each meal. The nurse will teach the patient to.. a. increase the amount of fluid with meals b. eat foods that are higher in carbohydrates c. lie down for about 30 minutes after eating d. drink sugared fluids or eat candy after meals

c. lie down for about 30 minutes after eating

At his first postoperative checkup appointment after a gastrojejunostomy (Billroth II), a patient reports that dizziness, weakness, and palpitations occur about 20 minutes after each meal. The nurse will teach the patient to a. increase the amount of fluid with meals. b. eat foods that are higher in carbohydrates. c. lie down for about 30 minutes after eating. d. drink sugared fluids or eat candy after meals.

c. lie down for about 30 minutes after eating.

an 80 yr old who is hospitalized with peptic ulcer disease develops new onset auditory hallucinations. Which prescribed medication will the nurse discuss with the health care provider before administration? a. sucralfate (Carafate) b. omeprazole (Prilosec) c. metoclopramide (Reglan) d. aluminum hydroxide (Amphojel)

c. metoclopramide (Reglan)

after the nurse has completed teaching a patient with newly diagnosed eosinophilic esophagitis about the management of the disease, which patient action indicates that the teaching has been effective? a. patient orders nonfat milk for each meal b. patient uses the prescribed corticosteroid inhaler c. patient schedules an appointment for allergy testing d. patient takes ibuprofen (Advil) to control throat pain

c. patient schedules an appointment for allergy testing

which finding in the mouth of a patient who uses smokeless tobacco is suggestive of oral cancer? a. bleeding during tooth brushing b. painful blisters at the lip border c. red, velvety patches on the buccal mucosa d. white, curdlike plaques on the posterior tongue

c. red, velvety patches on the buccal mucosa

how should the nurse teach the patient with a hiatal hernia or GERD to control symptoms? a. drink 10 to 12 oz of water with each meal b. space six small meals a day between breakfast and bedtime c. sleep with the HOB elevated on 4-6 inch blocks d. perform daily exercises of toe-touching, sit-ups, and weight lifting

c. sleep with the HOB elevated on 4-6 inch blocks

a patient with a history of peptic ulcer disease is hospitalized with symptoms of a perforation. During the initial assessment, what should the nurse expect the patient to report? a. vomiting of bright-red blood b. projectile vomiting of undigested food c. sudden, severe generalized abdominal and back pain d. hyperactive bowel sounds and upper abdominal swelling

c. sudden, severe generalized abdominal and back pain

the nurse is assessing a patient who had a total gastrectomy 8 hours ago. What information is most important to report to the health care provider? a. absent bowel sounds b. complaints of incisional pain c. temperature 102.1F (38.9C) d. scant NG tube drainage

c. temperature 102.1F (38.9C)

a patient returned from a laparoscopic Nissen fundoplication for hiatal hernia 4 hours ago. Which assessment finding is most important for the nurse to address immediately? a. the patient is experiencing intermittent waves of nausea b. the patient complains of 7/10 (0 to 10 scale) abdominal pain c. the patient has absent breath sounds in the left anterior chest d. the patient has hypoactive bowel sounds in all four quadrants

c. the patient has absent breath sounds in the left anterior chest

a 58 yr old patient has been just been admitted to the ED with nausea and vomiting. Which information requires the most rapid intervention by the nurse? a. the patient has been vomiting for 4 days b. the patient takes antacids 8 to 10 times a day c. the patient is lethargic and difficult to arouse d. the patient has undergone a small intestinal resection

c. the patient is lethargic and difficult to arouse

corticosteroid medications are associated with the development of peptic ulcers because of which probable pathophysiologic mechanism? a. the enzyme urease is produced b. secretion of HCl acid is increased c. the rate of mucous cell renewal is decreased d. the synthesis of mucus and prostaglandins is inhibited

c. the rate of mucous cell renewal is decreased

a patient is scheduled for biopsy of a painful tongue ulcer. Based on knowledge of risk factors for oral cancer, what should the nurse specifically ask the patient about during a history? a. excessive exposure to sunlight b. recurrent herpes simplex infections c. use of any type of tobacco products d. difficulty swallowing and pain in the ear

c. use of any type of tobacco products

after change of shift report, which patient should the nurse assess first? a. 42 yr old who has acute gastritis and ongoing epigastric pain b. 70 yr old with a hiatal hernia who experiences frequent heartburn c. 53 yr old who has dumping syndrome after a recent partial gastrectomy d. 60 yr old with nausea and vomiting who has dry oral mucosa and lethargy

d. 60 yr old with nausea and vomiting who has dry oral mucosa and lethargy

After change-of-shift report, which patient should the nurse assess first? a. 42-year-old who has acute gastritis and ongoing epigastric pain b. 70-year-old with a hiatal hernia who experiences frequent heartburn c. 53-year-old who has dumping syndrome after a recent partial gastrectomy d. 60-year-old with nausea and vomiting who has dry oral mucosa and lethargy

d. 60-year-old with nausea and vomiting who has dry oral mucosa and lethargy

a patient with upper GI bleeding and melena is treated with several drugs. Which drug should the nurse recognize as a priority to administer before, during, and potentially after endoscopy? a. oral nizatidine (Axid) b. epinephrine injection c. vasopressin injection d. IV esomeprazole (Nexium)

d. IV esomeprazole (Nexium)

A 73-year-old patient is diagnosed with stomach cancer after an unintended 20-pound weight loss. Which nursing action will be included in the plan of care? a. Refer the patient for hospice services. b. Infuse IV fluids through a central line. c. Teach the patient about antiemetic therapy. d. Offer supplemental feedings between meals.

d. Offer supplemental feedings between meals.

Which assessment should the nurse perform first for a patient who just vomited bright red blood? a. Measuring the quantity of emesis b. Palpating the abdomen for distention c. Auscultating the chest for breath sounds d. Taking the blood pressure (BP) and pulse

d. Taking the blood pressure (BP) and pulse

a 50 yr old man vomiting blood-streaked fluid is admitted to the hospital with acute gastritis. To determine possible risk factors for gastritis, the nurse will ask the patient about.. a. the amount of saturated fat in the diet b. any family history of gastric or colon cancer c. a history of a large recent weight gain or loss d. use of NSAIDs

d. use of NSAIDs

A 50-year-old man vomiting blood-streaked fluid is admitted to the hospital with acute gastritis. To determine possible risk factors for gastritis, the nurse will ask the patient about a. the amount of saturated fat in the diet. b. any family history of gastric or colon cancer. c. a history of a large recent weight gain or loss. d. use of nonsteroidal antiinflammatory drugs (NSAIDs).

d. use of nonsteroidal antiinflammatory drugs (NSAIDs).

the health care provider prescribes antacids and sucralfate (Carafate) for treatment of a patient's peptic ulcer. The nurse will teach the patient to take.. a. sucralfate at bedtime and antacids before each meal b. sucralfate and antacids together 30 minutes before meals c. antacids 30 minutes before each dose of sucralfate is taken d. antacids after meals and sucralfate 30 minutes before meals

d. antacids after meals and sucralfate 30 minutes before meals

The health care provider prescribes antacids and sucralfate (Carafate) for treatment of a patient's peptic ulcer. The nurse will teach the patient to take a. sucralfate at bedtime and antacids before each meal. b. sucralfate and antacids together 30 minutes before meals. c. antacids 30 minutes before each dose of sucralfate is taken. d. antacids after meals and sucralfate 30 minutes before meals.

d. antacids after meals and sucralfate 30 minutes before meals.

when caring for a patient with an acute exacerbation of a peptic ulcer, the nurse finds the patient doubled up in bed with shallow, grunting respirations. Which action should the nurse take first? a. irrigate the patient's NG tube b. notify the health care provider c. place the patient in high-fowler's position d. assess the patient's abdomen and vital signs

d. assess the patient's abdomen and vital signs

the nurse evaluates that management of the patient with upper GI bleeding is effective when assessment and laboratory findings reveal which result? a. hematocrit of 35% b. urinary output of 20 mL/hr c. urine specific gravity of 1.030 d. decreasing BUN

d. decreasing BUN

a patient with esophageal cancer is scheduled for a partial esophagectomy. Which nursing intervention is likely to be of highest priority preoperatively? a. practice turning and deep breathing b. brush the teeth and mouth well each day c. teach about postoperative tubes and care d. encourage a high-calorie, high-protein diet

d. encourage a high-calorie, high-protein diet

what physiologically occurs with vomiting? a. the acid-base imbalance most commonly associated with persistent vomiting is metabolic acidosis caused by loss of bicarbonate b. stimulation of the vomiting center by the chemoreceptor trigger zone (CTZ) is commonly caused by stretch and distention of hollow organs c. vomiting requires the coordination of activities of structures including the glottis, respiratory expiration, relaxation of the pylorus, and closure of the lower esophageal sphincter (LES) d. immediately before the act of vomiting, activation of the parasympathetic nervous system causes increased salivation, increased gastric motility, and relaxation of the lower esophageal sphincter (LES)

d. immediately before the act of vomiting, activation of the parasympathetic nervous system causes increased salivation, increased gastric motility, and relaxation of the lower esophageal sphincter (LES)

Ondansetron (Zofran) is prescribed for a patient with cancer chemotherapy-induced vomiting. What should the nurse understand about this drug? a. it is a derivative of cannabis and has a potential for abuse b. it has a strong antihistamine effect that provides sedation and induces sleep c. it is used only when other therapies are ineffective because of side effects of anxiety and hallucinations d. it relieves vomiting centrally by action in the vomiting center and peripherally by promoting gastric emptying

d. it relieves vomiting centrally by action in the vomiting center and peripherally by promoting gastric emptying

a 62 yr old man who requires daily use of a NSAID for the management of severe RA has recently developed melena. The nurse will anticipate teaching the patient about.. a. substitution of acetaminophen (Tylenol) for the NSAID b. use of enteric-coated NSAIDs to reduce gastric irritation c. reasons for using corticosteroids to treat the RA d. misoprostol (Cytotec) to protect the GI mucosa

d. misoprostol (Cytotec) to protect the GI mucosa

A 62-year-old man patient who requires daily use of a nonsteroidal antiinflammatory drug (NSAID) for the management of severe rheumatoid arthritis has recently developed melena. The nurse will anticipate teaching the patient about a. substitution of acetaminophen (Tylenol) for the NSAID. b. use of enteric-coated NSAIDs to reduce gastric irritation. c. reasons for using corticosteroids to treat the rheumatoid arthritis. d. misoprostol (Cytotec) to protect the gastrointestinal (GI) mucosa.

d. misoprostol (Cytotec) to protect the gastrointestinal (GI) mucosa.

following a Billroth II procedure, a patient develops dumping syndrome. The nurse should explain that the symptoms associated with this problem are caused by a. distention of the smaller stomach by too much food and fluid intake b. hyperglycemia caused by uncontrolled gastric emptying into the small intestine c. irritation of the stomach lining by reflux of bile salts because the pylorus has been removed d. movement of fluid into the small bowel from concentrated food and fluids moving rapidly into the intestine

d. movement of fluid into the small bowel from concentrated food and fluids moving rapidly into the intestine

while caring for a patient following a subtotal gastrectomy with a gastroduodenostomy anastomosis, the nurse determines that the NG tube is obstructed. Which action should the nurse take first? a. replace the tube with a new one b. irrigate the tube until return can be aspirated c. reposition the tube and then attempt irrigation d. notify the surgeon to reposition or replace the tube

d. notify the surgeon to reposition or replace the tube

a 73 yr old patient is diagnosed with stomach cancer after an unintended 20lb weight loss. Which nursing action will be included in the plan of care? a. refer the patient for hospice services b. infuse IV fluids through a central line c. teach the patient about antiemetic therapy d. offer supplemental feedings between meals

d. offer supplemental feedings between meals

the nurse is teaching the patient and family that peptic ulcers are.. a. caused by a stressful lifestyle and other acid-producing factors such as H. pylori b. inherited within families and reinforced by bacterial spread of staphylococcus aureus in childhood c. promoted by factors that tend to cause oversecretion of acid, such as excess dietary fats, smoking, and H. pylori d. promoted by a combination of factors that may result in erosion of the gastric mucosa, including certain drugs and alcohol

d. promoted by a combination of factors that may result in erosion of the gastric mucosa, including certain drugs and alcohol

the nurse will anticipate teaching a patient experiencing frequent heartburn about.. a. a barium swallow b. radionuclide tests c. endoscopy procedures d. proton pump inhibitors

d. proton pump inhibitors

The nurse will anticipate teaching a patient experiencing frequent heartburn about a. a barium swallow. b. radionuclide tests. c. endoscopy procedures. d. proton pump inhibitors.

d. proton pump inhibitors.

what is the rationale for treating acute exacerbation of peptic ulcer disease with NG intubation? a. stop spillage of GI contents into the peritoneal cavity b. remove excess fluids and indigested food from the stomach c. feed the patient the nutrients missing from the lack of ingestion d. remove stimulation of HCl acid and pepsin secretion by keeping the stomach empty

d. remove stimulation of HCl acid and pepsin secretion by keeping the stomach empty

what is an accurate description of eosinophilic esophagitis? a. adenocarcinoma or squamous cell tumors of the esophagus b. dilated veins in the esophagus caused by portal hypertension c. inflammation of the esophagus from irritants or acidic gastric reflux d. swelling of the esophagus from an allergic response to food or environmental triggers

d. swelling of the esophagus from an allergic response to food or environmental triggers

which assessment should the nurse perform first for a patient who just vomited bright red blood? a. measuring the quantity of emesis b. palpating the abdomen for distention c. auscultating the chest for breath sounds d. taking the BP and pulse

d. taking the BP and pulse

the nurse explains to the patient with Vincent's infection that treatment will include.. a. tetanus vaccinations b. viscous lidocaine rinses c. amphotericin B suspension d. topical application of antibiotics

d. topical application of antibiotics

when a 72 yr old patient is diagnosed with achalasia, the nurse will teach the patient that.. a. lying down after meals is recommended b. a liquid or blenderized diet will ne necessary c. drinking fluids with meals should be avoided d. treatment may include endoscopic procedures

d. treatment may include endoscopic procedures

When a 72-year-old patient is diagnosed with achalasia, the nurse will teach the patient that a. lying down after meals is recommended. b. a liquid or blenderized diet will be necessary. c. drinking fluids with meals should be avoided. d. treatment may include endoscopic procedures.

d. treatment may include endoscopic procedures.

the nurse explaining esomeprazole (Nexium) to a patient with recurring heartburn describes that the medication.. a. reduces gastroesophageal reflux by increasing the rate of gastric emptying b. neutralizes stomach acid and provides relief of symptoms in a few minutes c. coats and protects the lining of the stomach and esophagus from gastric acid d. treats gastroesophageal reflux disease by decreasing stomach acid production

d. treats gastroesophageal reflux disease by decreasing stomach acid production

The nurse explaining esomeprazole (Nexium) to a patient with recurring heartburn describes that the medication a. reduces gastroesophageal reflux by increasing the rate of gastric emptying. b. neutralizes stomach acid and provides relief of symptoms in a few minutes. c. coats and protects the lining of the stomach and esophagus from gastric acid. d. treats gastroesophageal reflux disease by decreasing stomach acid production.

d. treats gastroesophageal reflux disease by decreasing stomach acid production.

an optimal teaching plan for an outpatient with stomach cancer receiving radiation therapy should include formation about.. a. cancer support groups, alopecia, and stomatitis b. nutrition supplements, ostomy care, and support groups c. prosthetic devices, wound and skin care, and grief counseling d. wound and skin care, nutrition, drugs, and community resources

d. wound and skin care, nutrition, drugs, and community resources