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9. A patient with acute pancreatitis is complaining of a pain in the left upper quadrant. Using a 1- to 10-point pain scale, the patient states the current level is at an 8. What intervention would the nurse include in the patient's plan of care to facilitate pain control? a. Administer analgesics only as needed. b. Administer analgesics around the clock. c. Educate the patient and family on lifestyle changes. d. Teach relaxation and distraction techniques.

b. Administer analgesics around the clock.

A patient with a history of chronic alcoholism was admitted with acute pancreatitis. The nurse is developing a patient education plan. Which topic would the nurse include in the plan? a. Diabetes management b. Alcohol cessation c. Occult blood testing d. Anticoagulation management

b. Alcohol cessation

5. Which nursing intervention is a priority for a patient with gastrointestinal hemorrhage? a. Positioning the patient in a high-Fowler position b. Ensuring the patient has a patent airway c. Irrigating the nasogastric tube with iced saline d. Maintaining venous access so that fluids and blood can be administered

b. Ensuring the patient has a patent airway

16. The nurse is caring for a patient after an esophagectomy. In the immediate postoperative period, which nursing intervention is the highest priority? a. Preventing atelectasis b. Managing pain c. Promoting ambulation d. Preventing infection

b. Managing pain

1. A patient is admitted with an upper gastrointestinal bleed. Which disorder is the leading cause of upper gastrointestinal (GI) hemorrhage? a. Stress ulcers b. Peptic ulcers c. Nonspecific erosive gastritis d. Esophageal varices

b. Peptic ulcers

18. A patient was admitted with acute liver failure. The patient is lethargic, confused, and has marked asterixis. What stage of hepatic encephalopathy is the patient exhibiting? a. Stage 1 b. Stage 2 c. Stage 3 d. Stage 4

b. Stage 2

4. A patient is admitted with a gastrointestinal hemorrhage due to esophagogastric varices. What medication would the nurse expect the provider to order for this patient? a. Histamine2 (H2) antagonists b. Vasopressin c. Heparin d. Antacids

b. Vasopressin

19. A patient is admitted with a gastrointestinal hemorrhage due to esophagogastric varices. The patient has been started on a vasopressin drip. Which side effect is the nurse monitoring for? a. Constipation b. Diarrhea c. Chest pain d. Bleeding

c. Chest pain

11. A Salem sump nasogastric tube has two lumens. The first lumen is for suction and drainage. What is the purpose of the second lumen? a. Allows for administration of tube feeding b. Allows for testing of gastric secretions c. Prevents the tube from adhering to the gastric wall d. Prevents the tube from advancing

c. Prevents the tube from adhering to the gastric wall

21. A patient has been admitted with severe abdominal pain. When examining the patient, the nurse notes hypoactive bowel sounds, abdominal guarding, distention, and a discoloration around the umbilicus. The nurse suspects the patient may have which condition? a. Peptic ulcer disease b. Esophageal varices c. Acute liver failure d. Acute pancreatitis

d. Acute pancreatitis

3. A patient is admitted with a severe head injury. The nurse knows that critically ill patients are at risk for gastrointestinal hemorrhage due to stress-related mucosal disease. The nurse would monitor the patient for which signs and symptoms? a. Metabolic acidosis and hypovolemia b. Decreasing hemoglobin and hematocrit c. Hyperkalemia and hypernatremia d. Hematemesis and melena

d. Hematemesis and melena

20. How would the nurse administer sucralfate through a gastric tube? a. Crushed and mixed with 10 mL of water b. Dissolved in 10 mL of water to form a slurry c. Mixed in 15 mL of water to form a solution d. Administered as a whole pill with a 35-mL water flush

`b. Dissolved in 10 mL of water to form a slurry

8. A patient with a history of chronic alcoholism was admitted with acute pancreatitis. What intervention would the nurse include in the patient's plan of care? a. Monitor the patient for hypovolemic shock from plasma volume depletion. b. Observe the patient for hypoglycemia and hypercalcemia. c. Initiate enteral feedings after the nasogastric tube is placed. d. Place the patient on a fluid restriction to avoid the fluid sequestration.

a. Monitor the patient for hypovolemic shock from plasma volume depletion.

2. A patient is admitted with a gastrointestinal hemorrhage due to esophagogastric varices. The nurse knows that varices are caused by which pathophysiologic mechanism? a. Portal hypertension resulting in diversion of blood from a high-pressure area to a low-pressure area b. Superficial mucosal erosions because of increased stress levels c. Loss of protective mechanisms resulting in the breakdown the mucosal resistance d. Inflammation and ulceration secondary to nonsteroidal anti-inflammatory drug use

a. Portal hypertension resulting in diversion of blood from a high-pressure area to a low-pressure area

13. A patient was admitted with severe epigastric pain and has been diagnosed with cancer. The patient is scheduled for an esophagectomy. The patient asks about the procedure. What is the best response by the nurse? a. "This procedure is usually performed for cancer of the proximal esophagus and gastroesophageal junction." b. "This procedure is usually performed for cancer of the distal esophagus and gastroesophageal junction." c. "This procedure is usually performed for cancer of the pancreatic head." d. "The procedure is usually performed for varices of the distal esophagus and gastroesophageal junction."

b. "This procedure is usually performed for cancer of the distal esophagus and gastroesophageal junction."

15. The nurse is caring for a patient after an esophagectomy. The nurse knows the patient is at risk for an anastomotic leak. Which finding would indicate this occurrence? a. Crackles in the lung bases b. Subcutaneous emphysema c. Incisional bleeding d. Absent of bowel sounds

b. Subcutaneous emphysema

14. A patient was admitted after a Roux-en-Y gastric bypass (RYGBP). A nursing student asks the nurse what type of surgery an RYGBP is. What is the best response by the nurse? a. "It is an esophagectomy performed using the transthoracic approach." b. "It is an esophagectomy performed using a transhiatal approach." c. "It is a combination of restrictive and malabsorption types of bariatric surgery." d. "It is a standard operation for pancreatic cancer."

c. "It is a combination of restrictive and malabsorption types of bariatric surgery."

17. An older patient reports taking cimetidine for several years. The nurse knows that this medication can cause central nervous system side effects. Which side effect would the nurse monitor the patient for? a. Tremors b. Dizziness c. Confusion d. Hallucinations

c. Confusion

6. The nurse is caring for a patient with acute liver failure. The provider asks the nurse to assess the patient for asterixis. How should the nurse assess for this symptom? a. Inflate a blood pressure cuff on the patient's arm. b. Have the patient bring the knees to the chest. c. Have the patient extend the arms and dorsiflex the wrists. d. Dorsiflex the patient's foot.

c. Have the patient extend the arms and dorsiflex the wrists.

12. The nurse is caring for a patient with acute liver failure. The patient has elevated ammonia levels. Which medication would the nurse expect the provider to order for this patient? a. Insulin b. Vitamin K c. Lactulose d. Lorazepam

c. Lactulose

7. A patient was admitted with acute pancreatitis. The nurse understands that pancreatitis occurs because of what pathophysiologic mechanism? a. Uncontrolled hypoglycemia caused by an increased release of insulin b. Loss of storage capacity for senescent red blood cells c. Premature activation of inactive digestive enzymes, resulting in autodigestion d. Release of glycogen into the serum, resulting in hyperglycemia

c. Premature activation of inactive digestive enzymes, resulting in autodigestion