MLQ Ch. 46

A client is recovering from gastric surgery. Toward what goal should the nurse progress the client's enteral intake? A. Six small meals and 120 mL fluid daily B. Three meals and 120 ml fluid daily C. Six small meals daily with 120 mL fluid between meals D. Three meals and three snacks and 120 mL fluid daily

C

The nurse is conducting a community education program on peptic ulcer disease prevention. The nurse includes that the most common cause of peptic ulcers is: A. gram-negative bacteria. B. alcohol and tobacco. C. stress and anxiety. D. ibuprofen and aspirin.

A

The nurse recognizes that the client diagnosed with a duodenal ulcer will likely experience A. pain 2 to 3 hours after a meal. B. hemorrhage. C. vomiting. D. weight loss.

A

The nursing student approaches his instructor to discuss the plan of care for his client diagnosed with peptic ulcer disease. The student asks what is the most common site for peptic ulcer formation? The instructor would state which one of the following? A. Duodenum B. Pylorus C. Stomach D. Esophagus

A

Which of the following appears to be a significant factor in the development of gastric cancer? A. Ethnicity B. Age C. Diet D. Gender

C

A client comes to the clinic after developing a headache, abdominal pain, nausea, hiccupping, and fatigue about 2 hours ago. The client tells the nurse that the last food was buffalo chicken wings and beer. Which medical condition does the nurse find to be most consistent with the client's presenting problems? A. Duodenal ulcer B. Gastric ulcer C. Gastric cancer D. Acute gastritis

D

A client is preparing for discharge to home following a partial gastrectomy and vagotomy. Which is the best rationale for the client being taught to lie down for 30 minutes after each meal? A. Slows gastric emptying B. Allows for better absorption of vitamin B12 C. Removes tension on internal suture line D. Provides much needed rest

A

A client with severe peptic ulcer disease has undergone surgery and is several hours postoperative. During assessment, the nurse notes that the client has developed cool skin, tachycardia, labored breathing, and appears to be confused. Which complication has the client most likely developed? A. Hemorrhage B. Penetration C. Pyloric obstruction D. Perforation

A

Clients with Type O blood are at higher risk for which of the following GI disorders? A. Duodenal ulcers B. Esophageal varices C. Gastric cancer D. Diverticulitis

A

The nurse is caring for a client who has just returned from the PACU after surgery for peptic ulcer disease. For what potential complications does the nurse know to monitor? Select all that apply. A. Hemorrhage B. Penetration C. Pyloric obstruction D. Inability to clear secretions E. Cachexia F. Perforation

A, B, C, F

A client is prescribed a histamine (H2)-receptor antagonist. The nurse understands that this might include which medication(s)? Select all that apply. A. Cimetidine B. Famotidine C. Lansoprazole D. Esomeprazole E. Nizatidine

A, B, E

A client is admitted to the health care facility with a diagnosis of a bleeding gastric ulcer. The nurse expects the client's stools to have which description? A. Clay-colored B. Black and tarry C. Bright red D. Coffee-ground-like

B

A client is prescribed tetracycline to treat peptic ulcer disease. Which instruction would the nurse give the client? A. "Take the medication with milk." B. "Be sure to wear sunscreen while taking this medicine." C. "You will not experience GI upset while taking this medication." D. "Do not drive when taking this medication."

B

Peptic ulcer disease occurs more frequently in people with which blood type? A. B B. O C. AB D. A

B

A client undergoes total gastrectomy. Several hours after surgery, the nurse notes that the client's nasogastric (NG) tube has stopped draining. How should the nurse respond? A. Irrigate the tube. B. Increase the suction level. C. Notify the health care provider. D. Reposition the tube.

C

A nurse is caring for a client who is undergoing a diagnostic workup for a suspected gastrointestinal problem. The client reports gnawing epigastric pain following meals and heartburn. What would the nurse suspect this client has? A. diverticulitis B. appendicitis C. peptic ulcer disease D. ulcerative colitis

C

A nurse is caring for a client with active upper GI bleeding. What is the appropriate diet for this client during the first 24 hours after admission? A. Clear liquids B. Regular diet C. Nothing by mouth D. Skim milk

C

A client with a peptic ulcer is diagnosed with Helicobacter pylori infection. The nurse is teaching the client about the medications prescribed, including metronidazole, omeprazole, and clarithromycin. Which statement by the client indicates the best understanding of the medication regimen? A. "These medications will coat the ulcer and decrease the acid production in my stomach." B. "My ulcer will heal because these medications will kill the bacteria." C. "The medications will kill the bacteria and stop the acid production." D. "I should take these medications only when I have pain from my ulcer."

C

Which of the following are characteristics associated with the Zollinger-Ellison syndrome (ZES)? Select all that apply. A. Constipation B. Gastrin-secreting tumors of the pancreas C. Severe peptic ulcers D. Extreme gastric hyperacidity E. Hypocalcemia

B, C, D

A nursing student is caring for a client with gastritis. Which of the following would the student recognize as a common cause of gastritis? Choose all that apply. A. DASH diet B. Ingestion of strong acids C. Participation in highly competitive sports D. Irritating foods E. Overuse of aspirin

B, D, E

A nurse is teaching a client with gastritis about the need to avoid the intake of caffeinated beverages. The client asks why this is so important. Which explanation from the nurse would be most accurate? A. "Caffeine intake can cause tears in your esophagus and intestines, which can lead to hemorrhage." B. "Caffeine increases the fluid volume in your system, which irritates your digestive organs." C. "Caffeine stimulates the central nervous system and thus gastric activity and secretions, which need to be minimized to promote recovery." D. "Caffeine can interfere with absorption of vitamin B12, which leads to anemia and further digestive problems."

C

A client has been taking famotidine at home. What teaching should the nurse include with the client? A. Famotidine will improve the mixing of foods and gastric secretions. B. Famotidine will neutralize acid in the stomach. C. Famotidine will shorten the time required for digestion in the stomach. D. Famotidine will inhibit gastric acid secretions.

D

The nurse is providing preoperative care for a client with gastric cancer who is having a resection. What is the nursing management priority for this client? A. Teaching about radiation treatment B. Discharge planning C. Preventing deep vein thrombosis (DVT) D. Correcting nutritional deficits

D

The nurse is teaching a client with peptic ulcer disease who has been prescribed misoprostol. What information from the nurse would be most accurate about misoprostol? A. Works best when taken on an empty stomach B. Increases the speed of gastric emptying C. Decreases mucus production D. Prevents ulceration in clients taking nonsteroidal anti-inflammatory drugs (NSAIDs)

D

A health care provider suspects that a client has peptic ulcer disease. With which diagnostic procedure would the nurse most likely prepare to assist? A. Barium study of the upper gastrointestinal tract B. Stool antigen test C. Gastric secretion study D. Endoscopy

D

A nurse is caring for a client who underwent a subtotal gastrectomy. To manage dumping syndrome, the nurse should advise the client to: A. don't drink liquids 2 hours before meals. B. drink liquids only with meals. C. restrict fluid intake to 1 qt (1,000 ml)/day. D. drink liquids only between meals.

D

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? A. Assess the client's abdomen and vital signs. B. Notify the health care provider. C. Irrigate the client's NG tube. D. Place the client in the high-Fowler's position.

A

Which is a true statement regarding gastric cancer? A. Most clients are asymptomatic during the early stage of the disease. B. The prognosis for gastric cancer is good. C. Most cases are discovered before metastasis. D. Women have a higher incidence of gastric cancer.

A

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? A. A normal reaction to surgery B. Vasomotor symptoms associated with dumping syndrome C. Peritonitis D. Dehiscence of the surgical wound

B

A nurse practitioner prescribes drug therapy for a patient with peptic ulcer disease. Choose the drug that can be used for 4 weeks and has a 90% chance of healing the ulcer. A. Nizatidine B. Omeprazole C. Cimetidine D. Famotidine

B

Rebleeding may occur from a peptic ulcer and often warrants surgical interventions. Signs of bleeding include which of the following? A. Bradycardia B. Mental confusion C. Hypertension D. Bradypnea

B

The nurse is cautiously assessing a client admitted with peptic ulcer disease because the most common complication that occurs in 10% to 20% of clients is: A. Pyloric obstruction B. Hemorrhage C. Intractable ulcer D. Perforation

B

The nurse is evaluating a client's ulcer symptoms to differentiate ulcer as duodenal or gastric. Which symptom should the nurse at attribute to a duodenal ulcer? A. Constipation B. Awakening in pain C. Hemorrhage D. Vomiting

B

A patient has been diagnosed with acute gastritis and asks the nurse what could have caused it. What is the best response by the nurse? (Select all that apply.) A. "It is a hereditary disease." B. "It can be caused by ingestion of strong acids." C. "It is probably your nerves." D. "You may have ingested some irritating foods." E. "Is it possible that you are overusing aspirin."

B, D, E

A client who had a Roux-en-Y bypass procedure for morbid obesity ate a chocolate chip cookie after a meal. After ingestion of the cookie, the client reported cramping pains, dizziness, and palpitation. After having a bowel movement, the symptoms resolved. What should the nurse educate the client about regarding this event? A. Celiac disease B. Bile reflux C. Dumping syndrome D. Gastric outlet obstruction

C

A nurse practitioner prescribes drug therapy for a patient with peptic ulcer disease. Choose the drug that can be used for 4 weeks and has a 90% chance of healing the ulcer. A. Cimetidine B. Famotidine C. Omeprazole D. Nizatidine

C

Which ulcer is associated with extensive burn injury? A. Duodenal ulcer B. Cushing ulcer C. Curling ulcer D. Peptic ulcer

C

A 66-year-old African-American client has recently visited a physician to confirm a diagnosis of gastric cancer. The client has a history of tobacco use and was diagnosed 10 years ago with pernicious anemia. He and his family are shocked about the possibility of cancer because he was asymptomatic prior to recent complaints of pain and multiple gastrointestinal symptoms. On the basis of knowledge of disease progression, the nurse assumes that organs adjacent to the stomach are also affected. Which of the following organs may be affected? Choose all that apply. A. Lungs B. Liver C. Pancreas D. Bladder E. Duodenum

B, C, E

A patient is scheduled for a Billroth I procedure for ulcer management. What does the nurse understand will occur when this procedure is performed? A. The vagus nerve is cut and gastric drainage is established. B. A sectioned portion of the stomach is joined to the jejunum. C. The antral portion of the stomach is removed and a vagotomy is performed. D. A partial gastrectomy is performed with anastomosis of the stomach segment to the duodenum.

D

A client sustained second- and third-degree burns over 30% of the body surface area approximately 72 hours ago. What type of ulcer should the nurse be alert for while caring for this client? A. Peptic ulcer B. Meckel's ulcer C. Esophageal ulcer D. Curling's ulcer

D