Upper GI and Nutrition Quiz
A patient with a diagnosis of peptic ulcer disease has just been prescribed omeprazole (Prilosec). How should the nurse best describe this medication's therapeutic action? 1. "This medication will reduce the amount of acid secreted in your stomach." 2. "This medication will make the lining of your stomach more resistant to damage." 3. "This medication will specifically address the pain that accompanies peptic ulcer disease." 4. "This medication will help your stomach lining to repair itself."
1. "This medication will reduce the amount of acid secreted in your stomach." Proton pump inhibitors like Prilosec inhibit the synthesis of stomach acid. PPIs do not increase the durability of the stomach lining, relieve pain, or stimulate tissue repair.
An obese male patient has sought advice from the nurse about the possible efficacy of medications in his efforts to lose weight. What should the nurse teach the patient about pharmacologic interventions for the treatment of obesity? 1. "Medications are usually reserved for people who have had unsuccessful bariatric surgery." 2. "Medications may be of some use, but they don't tend to resolve obesity on their own." 3. "Medications are an excellent option for individuals who prefer not to exercise or reduce their food intake." 4. "Medications have the potential to reduce hunger but they rarely result in weight loss."
2. "Medications may be of some use, but they don't tend to resolve obesity on their own." Medications for obesity rarely result in a loss of more than 10% of total body weight. They are not intended as a substitute for exercise or a healthy diet. They are not solely intended for those individuals who have undergone bariatric surgery.
A critical care nurse is closely monitoring a patient who has recently undergone surgical repair of a bleeding peptic ulcer. The nurse should prioritize assessments of which of the following signs and symptoms of a recurrence of hemorrhage? 1. Restlessness and cyanosis 2. Hypotension and tachycardia 3. Bradypnea and pursed-lip breathing 4. Peripheral and pulmonary edema
2. Hypotension and tachycardia Rebleeding has multiple manifestations. However, an increase in heart rate and a decrease in blood pressure are key signs of a hemorrhage that are present in nearly all patients who are experiencing rebleeding.
The nurse determines that teaching for the client with peptic ulcer disease has been effective when the client makes which statement? 1. "I should stop all my medications if I develop any side effects." 2. "I should continue my treatment regimen as long as I have pain." 3. "I have learned some relaxation strategies that decrease my stress." 4. "I can buy whatever antacids are on sale because they all have the same effect."
3. "I have learned some relaxation strategies that decrease my stress." The nurse assists the client to identify stressful or exhausting situations. A hectic lifestyle and an irregular schedule may aggravate symptoms and interfere with regular meals taken in relaxed settings along with the regular administration of medications. The client may benefit from regular rest periods during the day, at least during the acute phase of the disease. Biofeedback, hypnosis, behavior modification, massage, or acupuncture may be helpful.
The nurse is conducting a community education class on gastritis. The nurse includes that chronic gastritis caused by Helicobacter pylori is implicated in which disease/condition? 1. Pernicious anemia 2. Systemic infection 3. Peptic ulcers 4. Colostomy
3. Peptic ulcers Chronic gastritis caused by Helicobacter pylori is implicated in the development of peptic ulcers. Chronic gastritis is sometimes associated with autoimmune disease, such as pernicious anemia, but not as a cause of the anemia. Chronic gastritis is not implicated in system infections and/or colostomies.
A nurse is providing care for a client recovering from gastric bypass surgery. During assessment, the client exhibits pallor, perspiration, palpitations, headache, and feelings of warmth, dizziness, and drowsiness. The client reports eating 90 minutes ago. What will the nurse suspect? 1. A normal reaction to surgery 2. Dehiscence of the surgical wound 3. Vasomotor symptoms associated with dumping syndrome 4. Peritonitis
3. Vasomotor symptoms associated with dumping syndrome Early manifestations of dumping syndrome occur 15 to 30 minutes after eating. Signs and symptoms include vertigo, tachycardia, syncope, sweating, pallor, palpitations, diarrhea, nausea, and the desire to lie down. Dehiscence of the surgical wound is characterized by pain and a pulling or popping feeling at the surgical site. Peritonitis presents with a rigid, boardlike abdomen, tenderness, and fever. The client's signs and symptoms aren't a normal reaction to surgery.
When caring for a client with an acute exacerbation of a peptic ulcer, the nurse finds the client doubled up in bed with severe pain in the right shoulder. What is the initial appropriate action by the nurse? 1. Notify the health care provider. 2. Irrigate the client's NG tube. 3. Place the client in the high-Fowler's position. 4. Assess the client's abdomen and vital signs.
4. Assess the client's abdomen and vital signs. Signs and symptoms of perforation includes sudden, severe upper abdominal pain (persisting and increasing in intensity); pain may be referred to the shoulders, especially the right shoulder, because of irritation of the phrenic nerve in the diaphragm. The nurse should assess the vital signs and abdomen prior to notifying the physician. Irrigation of the NG tube should not be performed because the additional fluid may be spilled into the peritoneal cavity, and the client should be placed in a position of comfort, usually on the side with the head slightly elevated.
A nurse is caring for a client who has a diagnosis of GI bleed. During shift assessment, the nurse finds the client to be tachycardic and hypotensive, and the client has an episode of hematemesis while the nurse is in the room. In addition to monitoring the client's vital signs and level of conscious, what would be a priority nursing action for this client? 1. Place the client in a prone position. 2. Provide the client with ice water to slow any GI bleeding. 3. Prepare for the insertion of an NG tube. 4. Notify the health care provider.
4. Notify the health care provider. The nurse must always be alert for any indicators of hemorrhagic gastritis, which include hematemesis (vomiting of blood), tachycardia, and hypotension. If these occur, the physician is notified and the client's vital signs are monitored as the client's condition warrants. Putting the client in a prone position could lead to aspiration. Giving ice water is contraindicated as it would stimulate more vomiting.
A client is in the hospital for the treatment of peptic ulcer disease. The client reports vomiting and a sudden severe pain in the abdomen. The nurse then assesses a board-like abdomen. What does the nurse suspect these symptoms indicate? 1. Ineffective treatment for the peptic ulcer 2. A reaction to the medication given for the ulcer 3. Gastric penetration 4. Perforation of the peptic ulcer
4. Perforation of the peptic ulcer Signs and symptoms of perforation include the following: Sudden, severe upper abdominal pain (persisting and increasing in intensity), which may be referred to the shoulders, especially the right shoulder, because of irritation of the phrenic nerve in the diaphragm; vomiting; collapse (fainting); extremely tender and rigid (boardlike) abdomen; and hypotension and tachycardia, indicating shock.
A nurse is caring for a client hospitalized with an exacerbation of chronic gastritis. What health promotion topic should the nurse emphasize? 1. Strategies for maintaining an alkaline gastric environment 2. A safe technique for self-suctioning 3. Techniques for positioning correctly to promote gastric healing 4. Strategies for avoiding irritating foods and beverages
4. Strategies for avoiding irritating foods and beverages Measures to help relieve pain include instructing the client to avoid foods and beverages that may be irritating to the gastric mucosa and instructing the client about the correct use of medications to relieve chronic gastritis. An alkaline gastric environment is neither possible nor desirable. There is no plausible need for self-suctioning. Positioning does not have a significant effect on the presence or absence of gastric healing.