Med surge 3 chapter 52-55

Which diagnostic test is the gold standard for diagnosing gastritis? A. EGD B. CT scan C. Upper GI series D. Cholangiogram

A

Which nursing intervention is the priority in the care of a patient with a sliding hiatal hernia? A. Providing nutrition education. B. Promoting regular exercise. C. Providing medication education. D. Instructing the patient on signs and symptoms of intestinal strangulation.

A

Which statement is true about Barrett's epithelium in a patient with GERD? A. It is considered pre-malignant and is associated with higher risk for cancer. B. This new tissue is less resistant to acid so it must be removed. C. Barrett's epithelium is resistant to the development of cancer. D. Esophageal strictures are less likely to occur with this type of epithelium.

A

Which statements with the nurse include when providing health teaching for a patient with a hiatal hernia? Select all that apply. A. Elevate the head of your bed at least 6 inches for sleeping at night B. Remain in the upright position for several hours after eating C. Avoid straining or excessive vigorous exercise D. After surgery you will have no dietary restriction E. Avoid wearing clothing that is tight around the abdomen F. Avoid eating in the late evening

A B C E F

The healthcare provider prescribes magic mouthwash for a patient experiencing oral pain from cancer treatments. What is the nurses best response when the patient asks what ingredients are in this concoction? Select all that apply. A. Lidocaine B. Benadryl C. Maalox D. Tetracycline E. Nystatin F. Carafate

A B C F

Which substances predispose a patient to peptic ulcer disease and G.I. bleeding? Select all that apply. A. NSAIDs B. Anticoagulants C. Aspirin D. Lasix E. Digital F. Caffeine

A B C F

The nurse is caring for a patient with abdominal pain, while assessing the patient which questions while the nurse asked the patient? Select all that apply. A. Is the pain burning, gnawing or stabbing? B can you point to where you feel the pain? C. Do you have a family history of cancer? D. When did you first notice the pain? E. Have you gained weight since the pain began? F. Does the pain spread anywhere?

A B D F

Which diagnostic results does the nurse recognize that support the diagnosis of peptic ulcer disease? Select all that apply. A. Low hemoglobin B. Low white blood cell level C. Low hematocrit D. Positive for H. pylori bacteria E. Low potassium of 3.4

A C D

A client has a large oral tumor. What assessment by the nurse takes priority? A. Airway B. Circulation C. Breathing D. Nutrition

A

A client has a nasogastric (NG) tube after a Nissen fundoplication. The nurse answers the call light and finds the client vomiting bright red blood with the NG tube lying on the floor. What action should the nurse take first? A. Put on a pair of gloves. B. Reinsert the NG tube. C. Take a set of vital signs. D. Notify the surgeon.

A

A female client hospitalized for an unrelated problem has a large pearly-white lesion on her lip, to which she continues to apply lipstick that she will not remove for inspection. The client refuses to discuss the lesion with the nurse or health care provider. What action by the nurse is best? A. Work with the client to establish a trusting relationship. B. Inform the client that early-stage cancer is curable. C. Ignore the lesion since the client will not discuss it. D. Ask the client why her appearance is so important.

A

A patient with chronic gastritis is being admitted. Which sign/symptoms does the nurse identify as being associated with this patient? A. Pernicious anemia B. Gastric hemorrhage C. Hematemesis D. Dyspepsia

A

After abdominal surgery which question should the nurse assess the patient to determine whether peristaltic movement is returning? A. Have you passed flats? B. Are you hungry? C. Do you have any nausea? D. Is your pain level manageable?

A

And EGD confirms that a patient has peptic ulcer disease. Three hours later the patient is admitted to the medical unit for work up and further testing. On a mission the patient reports midline epigastric tenderness and indigestion. the patient is prescribed triple therapy. Which drugs does the nurse prepare to administer? A. Proton pump inhibitor (PPI) and 2 antibiotics B. Antibiotic into PPIs C. Histamine antagonist, antacid ,and PPI D. Antacid, PPI, and prostaglandin analogue

A

The community clinic nurses discussing risk factors for esophageal cancer with a group of clients. Which client behavior requires further teaching? A. Smokes one pack of cigarettes daily B. Walks the shopping mall three times weekly C. Elevates pillows at night D. It's a small snack each night before bedtime

A

The nurse reads a client's chart and sees that the health care provider assessed mucosal erythroplasia. What should the nurse understand that this means for the client? A. Early sign of oral cancer B. Inflammation of the gums C. Obvious oral tumor D. Fungal mouth infection

A

A client is scheduled for a total gastrectomy for gastric cancer. What preoperative laboratory result should the nurse report to the surgeon immediately? A. Albumin: 2.1 g/dL B. International normalized ratio (INR): 4.2 C. Hemoglobin: 8.1 mg/dL D. Hematocrit: 28%

B

A client has dumping syndrome after a partial gastrectomy. Which action by the nurse would be most helpful? A. Increase fluid intake. B. Arrange a dietary consult. C. Make the client NPO. D. Limit the client's foods.

B

An older patient with poor oral hygiene was admitted after a fall in which his sustained a fractured hip. What is the priority nursing intervention? A. Initiate oral care every four hours B. Implement aspiration precautions C. Request a consult with the registered dietitian D. Use swabs to moisten the mouth as needed

B

If patient is scheduled to have several diagnostic test to verify the medical diagnoses of GERD. Which diagnostic test is the most accurate method of diagnosing this disorder? A. EGD B. Ambulatory pH monitoring examination C. Esophageal manometry D. Motility testing

B

The nurse has provided postoperative teaching for a patient who underwent a laparoscopic Nissen fundoplication (LNF). Which statement by the patient indicates a need for additional teaching. A. I will walk every day B. I will no longer need the anti-reflux drugs after the surgery. C. Every party fever above 101°F D. I remove the guys dressing two days after the surgery and shower.

B

It's 68-year-old patient with a history of arthritis and hypertension is the minute reporting progress of epigastric cramping dyspepsia, nausea, and dark sticky stools for 3 days . Which order will the nurse question? A. Guaiac stool sample B. Stool sample for bacteria testing C. IV fluids normal saline at 125ml/hr D. Naproxen 500 mg twice daily

D

A nurse has conducted a community screening event for oral cancer. What client is the highest priority for referral to a dentist? A. Client who tans for an upcoming vacation B. Client who has poor oral hygiene practices C. Client who smokes and drinks daily D. Client who occasionally uses illicit drugs

C

A patient being seen in the emergency department has been vomiting blood for the past 12 hours what test will likely be ordered for the patient? A. Endoscopic retrograde cholangiopancreatography B. Upper G I radiographic series C. EGD D. Barium enema

C

A patient is in clinic for a nonhealing sore on the lower left corner of her bottom lip and right side of her tongue. The lesions are red raised and have erosions. After taking a history the nurse suspects the patient may have which type of oral cancer? A. Basal cell carcinoma B. Kaposi's sarcoma C. Squamous cell carcinoma D. Erythroplakia

C

The patient was a gastric ulcer suddenly develop shirt constant epigastric pain that spreads over the entire abdomen. What complication has the patient most likely developed? A. Hemorrhage B. Gastric erosion C. Preformation D. Gastric cancer

C

The patient with GERD describes painful swallowing. What symptom does the nurse identify? A. Dyspepsia B. Regurgitation C. Odynophagia D. Dysphagia

C

What is the name of the first 12 inches of the small intestine? A. Jejunum B. Ileum C. Duodenum D. Esophagus

C

A 23-year-old female patient reports having red raised lesions at the base of her tongue and on the inside of her mouth for the past three weeks. What priority assessment question should the nurse asked? A. Do you smoke cigarettes? B. What type of work do you do? C. Have you seen a dentist lately? D. Do you have a history of human papillomavirus?

D

A client has gastroesophageal reflux disease (GERD). The provider prescribes a proton pump inhibitor. About what medication should the nurse anticipate teaching the client? A. Magnesium hydroxide (Maalox) B. Ranitidine (Zantac) C. Famotidine (Pepcid) D. Omeprazole (Prilosec)

D

The nurse is caring for a patient who vomited coffee ground emesis. Where does the nurse suspect the patient is bleeding? A. Colon B. Rectum C. Small intestine D. Upper GI system

D

The nurse is taking a history from a patient with peptic ulcer disease which factor in the case the largest rest for stomach cancer? A. History of GERD for six weeks B. History of hiatal hernia C. History of gastritis D. History of infection with H. Pylori

D

What diagnostic test best identifies a hiatal hernia? A. EGD B. 24 hour ambulatory pH monitoring C. Esophageal manometry D. Barium swallow study with fluoroscopy

D

What structure is involved in the protective function of the liver? A. Sphincter of Oddi B. Gallbladder C. Pancreas D. Kupffer cells

D

Which G.I. problem is related to anorexia? A. Heartburn B. Constipation C. Steatorrhea D. Loss of appetite

D

What assessment variable requires immediate nursing intervention post esophagectomy? A. Respiratory rate of 28. B. Blood pressure of 170/88 C. Temperature of 38.1°C D. Pain assessment of six on a scale of 0 to 10

A

Client reports ongoing episodes of heartburn. The nurse educated the client on prevention and control of reflux by recommending dietary elimination of which Food Item? A. Lean steak B. Carrot sticks C. Chocolate candy D. Air popped popcorn

C

The nurse is performing medication reconciliation for a Newly admitted client the nurse recognizes which drugs contribute to signs and symptoms of gastritis. Select all that apply. A. Aspirin taken once daily to prevent cardiac concerns B. Naproxen taken once daily for joint pain associated with arthritis C. Amoxicillin taking over a 10 day period for an acute sinus infection D. Bacitracin ointment applied to minor scrapes on arms and legs E. Prednisone Tapered over a 14 day period to decrease inflammation associated with an acute sinus infection

A B E

As the patient prepares for discharge the nurse provided education about behaviors that reduce symptoms and aggravate peptic ulcer's. Which teaching does the nurse provide? Select all that apply. A. Sit upright 30 to 60 minutes after meals B. Spices should be added to food to enhance flavor C. Extreme vomiting should be reported to your physician D. H. pylori Can be a concern in patiences with peptic ulcers E. The goal of initial intervention is to control symptoms and prevent further complications

A C D E

Which are symptoms of early dumping syndrome? Select all that apply. A. Tachycardia B. Confusion C. Desire to lie down. D. syncope E. Occurs 30 minutes after eating F. Palpitations

A C D E

A nurse is preparing a health teaching session about early detection of COLORECT AL cancer. Which test should the nurse include? Select all that apply. A. Colonoscopy every 10 years. B. Single sample fecal immunochemical test (FIT). C. Flexible sigmoidoscopy every 5 years. D. Stool DNA test (sDNA) every 3 years. E. Double contrast barium enema every 5 years. F. Take home yearly guaiac fecal occult blood test (gFOBT).

A C D E F

By which actions do drugs used to treat GERD help to decrease the pain and discomfort the patient experiences? Select all that apply. A. Inhibition of gastric acid production B. Blocking of pain sensation in the CNS C. Accelerating gastric emptying D. Decreasing lower esophageal sphincter pressure E. Protecting the gastric mucosa F. Destroying H. pylori bacteria

A C E

Dyspepsia is characterized by which factors? Select all that apply A. Indigestion associated with eating B. Loss of appetite for food C. Malabsorption of fats D. Heartburn associated with eating E. Vomiting that occurs after eating F. Unintentional weight loss

A D

The nurse is caring for a client with peptic ulcer disease who reports sudden onset of sharp abdominal pain. On palpation, the client's abdomen is tense and rigid. What action takes priority? A. Take and document a set of vital signs. B. Notify the health care provider immediately. C. Administer the prescribed pain medication. D. Percuss all four abdominal quadrants.

B

The nurse is performing a physical assessment on a clients abdomen. The nurse inspects the abdomen and finds it asymmetrical with a non-pulsating mass in the RUQ. What is the priority nursing intervention? A. Document the findings in the electronic health record. B. Auscultate for bowel sounds and bruits. C. Lightly palpate the mass. D. Notify the primary healthcare provider of the findings.

B

The nurse is performing in oral assessment on a patient and notes white plaque like lesions on the tongue, palate, pharynx and buccual mucosa. When the patches are wiped away the underlying surface is red and sore. What disorder does the nurse suspect the patient has? A. Leukoplakia B. Candida albicans C. Erythroplakia D. Kaposi's sarcoma

B

When teaching a patient about pernicious anemia which statement does the nurse include? A. Patients with pernicious anemia are not able to digest fats B. Pernicious anemia results from deficiency of vitamin B 12 C. All patients with G.I. bleeding will eventually develop pernicious anemia D. Oral iron supplements are in effective treatment for pernicious anemia

B

When the nurse assesses the patient after abdominal surgery assessment reveals the managed hypo active bowel sounds what is the nurse's best action? A.Notify the surgeon immediately B. Document of finding and continue to monitor. C. Place a NG tube D. Obtain a stat abdominal x-ray.

B

Which physiologic factor contributes to GERD? A. Accelerated gastric emptying. B. Irritation from reflux of stomach contents. C. Competent lower esophageal sphincter. D. Increased esophageal clearance.

B

Which type of oral cavity tumor appears as a red velvety lesion on the tongue, palate, floor of the mouth or mandibular mucosa.? A. Leukoplakia B. Erythroplakia C. Basal cell carcinoma D. Kaposi's sarcoma

B

The pancreas performs which functions.? select all that apply A. Breaks down amino acid's B. Secretes enzymes for digestion from the exocrine part of the organ C. Breaks down fatty acids and triglycerides D. Produces glucagon from the endocrine part of the organ E. Produces enzymes that digest carbohydrates fats and proteins F. Detoxifies potentially harmful compounds

B D E

When taking a history for a patient with G.I. problems which daily client behavior requires further nursing assessment? Select all that apply. A. Eats multiple servings of vegetables. B. Takes 800 mg of ibuprofen for arthritis pain. C. Walks 30 minutes. D. Chews tobacco . E. Take senna to assist with bowel movements. F. Listens to music to promote relaxation.

B D E

The nurse is caring for a client who have been diagnosed with esophageal cancer. The client appears anxious and asked the nurse does this mean I am going to die? Which nursing responses are appropriate? Select all that apply A. No surgery can cure you B. It sounds like death frightens you C. Let me call the hospital chaplain to talk with you D. You can beat this disease if you just put your mind to it E. Let me sit with you for a while and we can discuss how you're feeling about this

B E

A patient is scheduled to start chemotherapy. What oral cavity problem does the nurse teach the patient that may occur? A. Stomatitis B. Candidiasis C. Kerostomia D. Oral abscess

C

The nurse is caring for a patient with a long history of osteoarthritis. Which risk factors will the nurse teach the patient that may contribute to the development of GERD? A. Weight of 130 pounds. B. What's 20 minutes once daily. C. Frequently takes NSAIDs for pain. D. Consumes foods with calcium supplementation

C

The nurse is caring for a patient with peptic ulcer disease. Which patient statement requires nursing teaching? A. When I eat out I avoid spicy foods B. I set up for at least an hour after I eat my meals C. My doctor said to take ibuprofen for my aches and pains D. After I clicked work my stress level decreased substantially

C

The nurse is providing care for a patient after EGD. What is the first priority action after this diagnostic study? A. Monitor vital signs B. Auscultate breath sounds C. Keep patient NPO until gag reflex returns D. Keep accurate intake and output

C

What is the nursing priority in the management of a patient with a newly active upper G.I. bleed? A. Obtain vital signs B. Notify the physician C. Apply oxygen by nasal cannula D. Type and crossmatch the patient for blood products

C

Which group of drugs is the main treatment for severe GERD? A. Antacids B. Histamine receptor agonists C. Proton pump inhibitor's D. Gaviscon preparations

C

A client with peptic ulcer disease asks the nurse about taking slippery elm supplements. What response by the nurse is best? A. "There is no evidence that this will work." B. "You should not take any herbal remedies." C. "Slippery elm has no benefit for this problem." D. "Slippery elm is often used for this disorder."

D

A nurse works on the surgical unit. After receiving the hand-off report, which client should the nurse see first? A. Client who underwent diverticula removal with a pulse of 106/min B. Client who underwent hernia repair, reporting incisional pain of 7/10 C. Client who had esophageal dilation and is attempting first postprocedure oral intake D. Client who had an esophagectomy with a respiratory rate of 32/min

D

A student nurse is providing care to an older client with stomatitis and dysphagia. What action by the student nurse requires the registered nurse to intervene? A. Teaching the client to use a soft-bristled toothbrush B. Assisting the client to perform oral care every 2 hours C. Reminding the client not to swallow nystatin (Mycostatin) D. Preparing to administer a viscous lidocaine gargle

D

After hiatal hernia repair surgery, a client is on IV pantoprazole (Protonix). The client asks the nurse why this medication is given since there is no history of ulcers. What response by the nurse is best? A. "The medication keeps your blood pH low." B. "This operation often causes ulcers." C. "Bacteria can often cause ulcers." D. "It prevents stress-related ulcers."

D

Which patient statement alerts the nurse to perform a thorough GI history and focused assessment? A. "I don't like the taste of spicy food." B. " I got dentures four years ago." C. " I experience occasional constipation." D. " I take ibuprofen 3 times daily for arthritis."

D