Chapter 57

The nurse is providing care to a patient who is diagnosed with peptic ulcer disease. When planning care, which should the nurse include as first-line triple dose therapy? Select all that apply. 1) Amoxicillin 2) Metronidazole 3) Clarithromycin 4) Bismuth subsalicylate 5) Proton pump inhibitor

1) Amoxicillin 3) Clarithromycin 5) Proton pump inhibitor 1. This is incorrect. Amoxicillin is included in the first-line triple dose therapy for a patient diagnosed with peptic ulcer disease. 2. This is correct. Metronidazole is included in the first-line triple dose therapy only for a patient who is allergic to penicillin and diagnosed with peptic ulcer disease. 3. This is correct. Clarithromycin is included in the first-line triple dose therapy for a patient who is diagnosed with peptic ulcer disease. 4. This is incorrect. Bismuth subsalicylate is included in the first-line quadruple, not triple, dose therapy for a patient diagnosed with peptic ulcer disease. 5. This is correct. A proton pump inhibitor is included in the first-line triple dose therapy for a patient diagnosed with peptic ulcer disease.

Which assessment data collected by the nurse supports the patient's diagnosis of early gastric cancer? 1) Anorexia 2) Nausea and vomiting 3) Iron-deficiency anemia 4) Palpable epigastric mass

1) Anorexia 1 Anorexia is a clinical manifestation with early gastric cancer. 2 Nausea and vomiting are clinical manifestations of advanced gastric cancer. 3 Iron-deficiency anemia is a clinical manifestation of advanced gastric cancer. 4 A palpable epigastric mass is a clinical manifestation of advanced gastric cancer.

Which diagnostic test should the nurse anticipate to rule out anemia when providing care to a patient diagnosed with peptic ulcer disease? 1) Hematocrit 2) Stool antigen 3) White blood cell 4) Fecal occult blood

1) Hematocrit 1 Hematocrit is used to monitor the patient for anemia. 2 A stool antigen test is a noninvasive test for peptic ulcer disease. 3 A patient's white blood cell count is used to monitor the patient for peritonitis when diagnosed with peptic ulcer disease. 4 A fecal occult blood test is used to monitor for blood in the stool when diagnosed with peptic ulcer disease

Which food should the nurse encourage for a patient, diagnosed with gastritis, when a heavier liquid diet is prescribed? 1) Milk 2) Broth 3) Gelatin 4) Carbonated beverages

1) Milk 1 Milk is a heavier liquid. 2 Broth is a clear liquid. 3 Gelatin is a clear liquid. 4 Carbonated beverages are clear liquids.

The nurse is providing care to a patient who is prescribed levofloxacin-based triple therapy for the treatment of peptic ulcer disease. Which drugs should the nurse educate this patient about based on this data? 1) Proton pump inhibitor, levofloxacin, and amoxicillin 2) Proton pump inhibitor, amoxicillin, and clarithromycin 3) Proton pump inhibitor, clarithromycin, and metronidazole 4) Proton pump inhibitor, bismuth subsalicylate, metronidazole, and tetracycline

1) Proton pump inhibitor, levofloxacin, and amoxicillin 1 These drugs are included in levofloxacin-based triple therapy for peptic ulcer disease. 2 These drugs are included in the sequential therapy for peptic ulcer disease. 3 These drugs are included in triple therapy for peptic ulcer disease when the patient is allergic to penicillin. 4 These drugs are included in quadruple therapy for peptic ulcer disease.

The nurse is providing care to a patient who is status post partial gastrectomy for the treatment of gastric carcinoma. Which should the nurse include in the plan of care to decrease the risk of dumping syndrome? 1) Providing smaller meals at more frequent intervals 2) Providing larger meals at less frequent intervals 3) Providing liquids and solids together 4) Providing liquids only

1) Providing smaller meals at more frequent intervals 1 The patient who is status post a partial gastrectomy should be provided small meals at frequent intervals to decrease the risk for dumping syndrome. 2 Larger meals at less frequent intervals is likely to cause dumping syndrome. 3 To decrease the risk for dumping syndrome, the nurse should offer solids and liquids at separate times. 4 A liquid only diet is not known to decrease the risk for dumping syndrome.

The nurse is providing care to a patient who is hospitalized for complications associated with peptic ulcer disease. Which data supports the patient is experiencing a gastrointestinal bleed? 1) Tarry stools 2) Pain in the right arm 3) Absent bowel sounds 4) Emesis of undigested food

1) Tarry stools 1 Tarry stools indicate gastrointestinal bleeding. 2 Referred pain, such as that in the arm, is indicative of penetration to another organ. 3 Absent bowel sounds is indicative of perforation. 4 Emesis of undigested food is indicative of obstruction.

The nurse is providing discharge instructions for a patient diagnosed with peptic ulcer disease. Which statement indicates the need for additional education? 1) "I will avoid spicy foods." 2) "I will be sure to eat a large meal before bedtime." 3) "I will use acetaminophen rather than aspirin for headache." 4) "I will avoid caffeinated beverages, such as coffee, as this increases symptoms."

2) "I will be sure to eat a large meal before bedtime." 1 Spicy foods should be avoided; therefore, this statement indicates correct understanding. 2 The patient should avoid eating two hours prior to bedtime; therefore, this statement indicates the need for further education. 3 Aspirin and NSAIDs should be avoided; therefore, this statement indicates correct understanding. 4 Caffeine is known to exacerbate peptic ulcer disease; therefore, this statement indicates correct understanding.

Which is the priority nursing diagnosis when planning care for this patient who is diagnosed with acute gastritis? 1) Anxiety 2) Acute pain 3) Deficient knowledge 4) Risk for deficient fluid volume

2) Acute pain 1 While anxiety is an important diagnosis, physiological diagnoses take priority over psychosocial diagnoses. 2 Acute pain is a physiological diagnosis that take priority in this situation. 3 While knowledge deficit is an important diagnosis, physiological diagnoses take priority. 4 Risk for diagnoses do not take priority over actual diagnoses.

Which food should the nurse encourage for a patient, diagnosed with gastritis, when a clear liquid diet is prescribed? 1) Milk 2) Broth 3) Pudding 4) Cream soup

2) Broth 1 Milk is a heavier liquid. 2 Broth is a clear liquid. 3 Pudding is a heavier liquid. 4 Cream soup is a heavier liquid.

The nurse is providing care to a patient who is diagnosed with acute gastritis. Which assessment data supports this diagnosis? 1) Weight gain 2) Epigastric pain 3) Increased appetite 4) Increased blood pressure

2) Epigastric pain 1 Weight loss is a clinical manifestation associated with acute gastritis. 2 Epigastric pain is a clinical manifestation associated with acute gastritis. 3 A decreased, not increased, appetite is a clinical manifestation with acute gastritis. 4 A decreased, not increased, blood pressure is a clinical manifestation of acute gastritis with acute fluid loss.

The nurse is providing care to a patient who is diagnosed with peptic ulcer disease. When planning care, which should the nurse include as first-line triple dose therapy for a patient who is allergic to penicillin? Select all that apply. 1) Amoxicillin 2) Metronidazole 3) Clarithromycin 4) Bismuth subsalicylate 5) Proton pump inhibitor

2) Metronidazole 3) Clarithromycin 5) Proton pump inhibitor 1. This is incorrect. Amoxicillin is not included in the first-line triple dose therapy for a patient who is allergic to penicillin. 2. This is correct. Metronidazole is included in the first-line triple dose therapy for a patient who is allergic to penicillin. 3. This is correct. Clarithromycin is included in the first-line triple dose therapy for a patient who is allergic to penicillin. 4. This is incorrect. Bismuth subsalicylate is included in the first-line quadruple, not triple, dose therapy. 5. This is correct. A proton pump inhibitor is included in the first-line triple dose therapy for a patient who is allergic to penicillin.

The nurse is providing care to a patient who is diagnosed with peptic ulcer disease. When planning care, which should the nurse include as first-line quadruple dose therapy? Select all that apply. 1) Amoxicillin 2) Metronidazole 3) Clarithromycin 4) Bismuth subsalicylate 5) Proton pump inhibitor

2) Metronidazole 4) Bismuth subsalicylate 5) Proton pump inhibitor 1. This is incorrect. Amoxicillin is included in the first-line triple dose therapy for a patient who is diagnosed with peptic ulcer disease. 2. This is correct. Metronidazole is included in first-line quadruple dose therapy for a patient who is diagnosed with peptic ulcer disease. 3. This is incorrect. Clarithromycin is included in the first-line triple dose therapy for a patient who is diagnosed with peptic ulcer disease. 4. This is incorrect. Bismuth subsalicylate is included in the first-line quadruple dose therapy for a patient diagnosed with peptic ulcer disease. 5. This is correct. A proton pump inhibitor is included in the first-line quadruple dose therapy for a patient diagnosed with peptic ulcer disease.

The nurse is providing care to a patient who is hospitalized for complications associated with peptic ulcer disease. Which data supports the patient is experiencing penetration to another organ? 1) Tarry stools 2) Pain in the right arm 3) Absent bowel sounds 4) Emesis of undigested food

2) Pain in the right arm 1 Tarry stools indicate gastrointestinal bleeding. 2 Referred pain, such as that in the arm, is indicative of penetration to another organ. 3 Absent bowel sounds is indicative of perforation. 4 Emesis of undigested food is indicative of obstruction.

The nurse is providing care to a patient who is prescribed sequential therapy for the treatment of peptic ulcer disease. Which drugs should the nurse educate this patient about based on this data? 1) Proton pump inhibitor, levofloxacin, and amoxicillin 2) Proton pump inhibitor, amoxicillin, and clarithromycin 3) Proton pump inhibitor, clarithromycin, and metronidazole 4) Proton pump inhibitor, bismuth subsalicylate, metronidazole, and tetracycline

2) Proton pump inhibitor, amoxicillin, and clarithromycin 1 These drugs are included in levofloxacin-based triple therapy for peptic ulcer disease. 2 These drugs are included in the sequential therapy for peptic ulcer disease. 3 These drugs are included in triple therapy for peptic ulcer disease when the patient is allergic to penicillin. 4 These drugs are included in quadruple therapy for peptic ulcer disease.

The nurse is providing education for a patient who is diagnosed with gastritis. Which statement indicates the need for further education? 1) "I will eat bland, nonspicy foods." 2) "I will eat smaller, more frequent meals." 3) "I will take aspirin for headaches from now on." 4) "I will take an antacid if my symptoms continue."

3) "I will take aspirin for headaches from now on." 1 This statement indicates correct understanding. 2 This statement indicates correct understanding. 3 Aspirin should be avoided for a patient who is diagnosed with gastritis. This statement indicates the need for further education. 4 This statement indicates correct understanding.

The nurse is providing care to a patient who is hospitalized for complications associated with peptic ulcer disease. Which data supports the patient is experiencing a perforation? 1) Tarry stools 2) Pain in the right arm 3) Absent bowel sounds 4) Emesis of undigested food

3) Absent bowel sounds 1 Tarry stools indicate gastrointestinal bleeding. 2 Referred pain, such as that in the arm, is indicative of penetration to another organ. 3 Absent bowel sounds is indicative of perforation. 4 Emesis of undigested food is indicative of obstruction.

Which assessment data would indicate active bleeding for a patient who is diagnosed with peptic ulcer disease? 1) Absent bowel sounds 2) Coffee-ground emesis 3) Bright red blood in emesis 4) Black tarry stools with a foul odor

3) Bright red blood in emesis 1 Absent bowel sounds indicates perforation, not active bleeding. 2 Coffee-ground emesis indicates older blood. 3 Bright red blood in the emesis indicates active bleeding. 4 Black tarry stools with a foul odor indicates older blood.

Which principal risk factor should the nurse assess for during the health history in a patient who is suspected of having peptic ulcer disease? 1) Stress 2) Anxiety 3) H. pylori infection 4) Use of acetaminophen

3) H. pylori infection 1 Stress is no longer considered a principal risk factor in the development of peptic ulcer disease. 2 Anxiety is no longer considered a principal risk factor in the development of peptic ulcer disease. 3 H. pylori infection is a principal risk factor in the development of peptic ulcer disease. 4 Use of NSAIDs, not acetaminophen, is a principal risk factor in the development of peptic ulcer disease.

Which diagnostic test should the nurse anticipate to rule out peritonitis when providing care to a patient diagnosed with peptic ulcer disease? 1) Hematocrit 2) Stool antigen 3) White blood cell 4) Fecal occult blood

3) White blood cell 1 Hematocrit is used to monitor the patient for anemia. 2 A stool antigen test is a noninvasive test for peptic ulcer disease. 3 A patient's white blood cell count is used to monitor the patient for peritonitis when diagnosed with peptic ulcer disease. 4 A fecal occult blood test is used to monitor for blood in the stool when diagnosed with peptic ulcer disease.

Which medication, acting as a physical barrier, does the nurse anticipate for a patient diagnosed with gastritis? 1) Maalox 2) Mylanta 3) Pepcid 4) Carafate

4) Carafate 1 This drug is used to neutralize acid. 2 This drug is used to neutralize acid. 3 This drug is used to decrease the production of gastric acid. 4 Carafate is a drug that acts as a physical barrier protecting the lining of the stomach from gastric acid

The nurse is providing care to a patient who is hospitalized for complications associated with peptic ulcer disease. Which data supports the patient is experiencing an obstruction? 1) Tarry stools 2) Pain in the right arm 3) Absent bowel sounds 4) Emesis of undigested food

4) Emesis of undigested food 1 Tarry stools indicate gastrointestinal bleeding. 2 Referred pain, such as that in the arm, is indicative of penetration to another organ. 3 Absent bowel sounds is indicative of perforation. 4 Emesis of undigested food is indicative of obstruction.

Which assessment data collected by the nurse supports the patient's diagnosis of advanced gastric cancer? 1) Anorexia 2) Indigestion 3) Epigastric pain 4) Palpable epigastric mass

4) Palpable epigastric mass 1 Anorexia is a clinical manifestation with early gastric cancer. 2 Indigestion is a clinical manifestation with early gastric cancer. 3 Epigastric pain is a clinical manifestation with early gastric cancer. 4 A palpable epigastric mass is a clinical manifestation of advanced gastric cancer.

The nurse is conducting an assessment for a patient who is suspected of having peptic ulcer disease. Which is a risk factor identified in the patient's health history? 1) Acetaminophen use for pain 2) Hypoparathyroidism 3) Social drinking 4) Sarcoidosis

4) Sarcoidosis 1 NSAID and aspirin, not acetaminophen, use are risk factors for peptic ulcer disease. 2 Hyper-, not hypoparathyroidism, is a risk factor for peptic ulcer disease. 3 Heavy, not social, drinking is a risk factor for peptic ulcer disease. 4 Sarcoidosis is a risk factor for the development of peptic ulcer disease.

Which diagnostic test should the nurse anticipate to detect active infection with H. pylori for a patient diagnosed with gastritis? 1) Guaiac 2) Hematest 3) Hemoccult 4) Urea breathing test

4) Urea breathing test 1 Guaiac is anticipated to detect blood in the stool for a patient diagnosed with gastritis. 2 Hematest is anticipated to detect blood in the stool for a patient diagnosed with gastritis. 3 Hemoccult is anticipated to detect blood in the stool for a patient diagnosed with gastritis. 4 A urea breathing test is anticipated to detect active infection with H. pylori for a patient who is diagnosed with gastritis