Gastritis

3. The nurse is assessing the client diagnosed with chronic gastritis. Which symptom(s) support this diagnosis? A. Rapid onset of midsternal discomfort B. Epigastric pain relieved by eating food C. Dyspepsia and hematemesis D. Nausea and projectile vomiting

3. Answer: B Chronic pain in the epigastric area relieved by ingesting food is a sign of chronic gastritis

1. "Which of the following types of gastritis is associated with Helicobacter pylori and duodenal ulcers? A. Erosive (hemorrhagic) gastritis B. Fundic gland gastritis (type A) C. Antral gland gastritis (type B) D. Aspiring-induced gastric ulcer

1. Answer: C Erosive (hemorrhagic) gastritis can be caused by ingestion of substances that irritate the gastric mucosa. Fundic gland gastritis (type A) is associated with diffuse severe mucosal atrophy and the presence of pernicious anemia. Antral gland gastritis (type B) is the most common form of gastritis, and is associated with Helicobacter pylori and duodenal ulcers

2. The nurse is caring for a male client with a diagnosis of chronic gastritis. The nurse monitors the client knowing that this client is at risk for which vitamin deficiency? A. Vitamin A B. Vitamin B12 C. Vitamin C D. Vitamin E

2. Answer: B Chronic gastritis causes deterioration and atrophy of the lining of the stomach, leading to the loss of the function of the parietal cells. The source of the intrinsic factor is lost, which results in the inability to absorb vitamin B12. This leads to the development of pernicious anemia. The client is not at risk for vitamin A, C, or E deficiency

5. The pernicious anemia that may accompany gastritis is due to which of the following? 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 resulting from an inrease in acid-secreting parietal cells and degradation of RBC's

5. Answer: C Rationale: Gastritis may cause a loss of parietal cells as a result of atrophy. The source of intrinsic factor is also lostthe loss of intrinsic factor, a substance essential for the absorption of cobalamin in the terminal ileum, ultimately results in cobalamin deficiency. With time, the body's storage of cobalamin is depleted, and a deficiency state exists. Because it is essential for the growth and maturation of red blood cells, the lack of cobalamin results in pernicious anemia and neurologic complications

4. "The nurse is caring for the client diagnosed with chronic gastritis. Which symptom(s) would support this diagnosis? A. Rapid onset of mid-sternal discomfort. B. Epigastric pain relieved by eating food C. Dyspepsia and hematemesis. D. Nausea and projectile vomiting

4. Answer: B Rationale by answer: A. Acute gastritis is characterized by sudden epigastric pain or discomfort, not mid-sternal chest pain. B. Chronic pain in the epigastric area that is relieved by ingesting food is a sign of chronic gastritis (CORRECT). C. Dyspepsia (heartburn) and hematemesis (vomiting blood) are frequent symptoms of acute gastritis. D. Projective vomiting is not a sign of chronic gastritis

6. A male client is diagnosed with acute gastritis secondary to alcoholism and cirrhosis. When obtaining the client's history, the nurse gives priority to the client's statement that: A. His pain increases after meals. B. He experiences nausea frequently. C. His stools have a black appearance. D. He recently joined Alcoholics Anonymous

6. Answer: C A. Investigation of bleeding takes priority later the nurse should help to identify irritating foods that are to be avoided. B. Nausea is a common symptom of gastritis, but it is not life threatening. C. Black (tarry) stools indicate upper GI bleeding digestive enzymes act on the blood resulting in tarry stools. Hemorrhage can occur if erosion extends to blood vessels. D. Attempts to control alcoholism should be supported but this is a long-term goal assessment of bleeding takes priority

7. The nurse is reviewing the medication record of a female client with acute gastritis. Which medication, if noted on the client's record, would the nurse question? A. Digoxin (Lanoxin) B. Furosemide (Lasix) C. Indomethacin (Indocin) D. Propranolol hydrochloride (Inderal)

7. Answer: C Indomethacin (Indocin) is a nonsteroidal anti-inflammatory drug and can cause ulceration of the esophagus, stomach, or small intestine. Indomethacin is contraindicated in a client with gastrointestinal disorders. Furosemide (Lasix) is a loop diuretic. Digoxin is a cardiac medication. Propranolol (Inderal) is a β-adrenergic blocker. Furosemide, digoxin, and propranolol are not contraindicated in clients with gastric disorders

8. Which of the following definitions best describes gastritis? A. Erosion of the gastric mucosa B. Inflammation of a diverticulum C. Inflammation of the gastric mucosa D. Reflux of stomach acid into the esophagus

8. Answer: C Gastritis is an inflammation of the gastric mucosa that may be acute (often resulting from exposure to local irritants) or chronic (associated with autoimmune infections or atrophic disorders of the stomach). Erosion of the mucosa results in ulceration. Inflammation of a diverticulum is called diverticulitis; reflux of stomach acid is known as gastroesophageal disease.

9. Which of the following substances is most likely to cause gastritis? A. Milk B. Bicarbonate of soda, or baking soda C. Enteric coated aspirin D. Nonsteriodal anti-inflammatory drugs

9. Answer: D NSAIDS are a common cause of gastritis because they inhibit prostaglandin synthesis. Milk, once thought to help gastritis, has little effect on the stomach mucosa. Bicarbonate of soda, or baking soda, may be used to neutralize stomach acid, but it should be used cautiously because it may lead to metabolic acidosis. ASA with enteric coating shouldn't contribute significantly to gastritis because the coating limits the aspirin's effect on the gastric mucosa.