MS Chap 33
A patient is recovering from a Billroth I procedure and has a nasogastric Levin tube set to low intermittent suction. As the patient turns in bed, the Levin tube is partially pulled out. Which action should the nurse take? a. Notify the registered nurse (RN). b. Irrigate the tube. c. Advance the tube. d. Place suction on continuous.
a
A patient who is unconscious begins to vomit blood. What action should the nurse take first? a. Turn patient onto side. b. Use water to rinse out mouth. c. Provide oral care to the patient. d. Administer antiemetic medication.
a
A patient with a nasogastric tube connected to suction is NPO (nothing by mouth) and reports a dry mouth and gagging feeling. What action should the nurse take? a. Provide oral care. b. Pull tube out 1 inch. c. Offer ice chips to swallow. d. Give lidocaine solution to coat the mouth.
a
The nurse is caring for a patient recovering from radical neck dissection for cancer and tracheostomy placement. What action by the nurse should take priority? a. Ensuring airway patency b. Ensuring adequate nutrition c. Teaching about smoking cessation d. Establishing ways of communication
a
The nurse is caring for a patient who complains of nausea related to gastric cancer. Which supplement should the nurse suggest? a. Ginger b. Lemon c. Butterscotch d. Black licorice
a
The nurse is caring for a patient who has a nasogastric tube in place following gastric surgery. Why should the nurse use normal saline to irrigate the nasogastric tube? a. It decreases electrolytes. b. It maintains electrolytes. c. It maintains fluid volume. d. It increases fluid volume.
b
The nurse is checks the gastric pH and provides antacids as prescribed to a patient recovering from a motor vehicle crash. What is the nurse attempting to prevent by these interventions? a. Shock b. Stress ulcers c. Malnutrition d. Metabolic acidosis
b
The nurse is collecting data for a patient who is taking Prevacid for peptic ulcer disease. Which data collection finding requires immediate intervention? a. A rash b. Tarry stools c. Constipation d. Changes in mental status
b
The nurse is evaluating care provided to a patient with bulimia nervosa. Which observation indicates that addition care is required? a. Patient sits and talks with others after eating a meal b. Patient states that looking in a mirror makes her nauseated c. Patient states importance of continuing with therapy sessions d. Patient plans meals and appropriate snacks at the beginning of the day
b
The nurse is reinforcing teaching with a patient who had a large portion of the stomach removed. Which patient statement indicates understanding of why the patient will need to receive vitamin B12 for life? a. Sickle cell anemia b. Pernicious anemia c. Iron-deficiency anemia d. Acquired hemolytic anemia
b
. The nurse is reinforcing teaching provided to a patient being tested for type B gastritis. Which patient statement indicates a correct understanding of the test that is used to diagnose this condition? a. Colonoscopy. b. Barium enema. c. Abdominal x-ray. d. Esophagogastroduodenoscopy.
d
A patient with a nasogastric tube to low intermittent suction after surgery begins to vomit bright red blood. Which action should the nurse take first? a. Administer oxygen. b. Irrigate the nasogastric tube. c. Increase the intravenous rate. d. Turn the patient onto his or her side.
d
The nurse is caring for a patient with bulimia. Which complication should the nurse recognize that this patient is at risk for developing? a. Weight gain b. Fluid overload c. Ischemic stroke d. Metabolic alkalosis
d
The nurse is providing care to a patient 3 days after a Billroth I procedure. About which observation should the nurse be most concerned? a. Pulse 58 beats per minute b. Incisional pain score 4 on a 1 to 10 scale c. Patient becomes tearful while viewing the incision d. Reports of abdominal cramping shortly after eating
d
The nurse is reinforcing teaching provided to a patient scheduled for pyloroplasty. Which patient statement indicates a correct understanding of the procedure? a. The doctor will stitch the top of my stomach to help me lose weight. b. The doctor will cut the nerve that goes to my stomach so less acid is released. c. The pylorus will be narrowed to prevent gastric reflux and help my ulcers heal. d. The surgery will improve the movement of food from my stomach to my small intestine.
d
The nurse is reinforcing teaching provided to a patient with a peptic ulcer. Which patient statement indicates understanding of the medication ranitidine (Zantac)? a. It clings to the ulcer. b. It coats your stomach. c. It neutralizes stomach acid. d. It reduces production of gastric acid.
d
The nurse is reinforcing teaching provided to a patient with dumping syndrome. Which patient statement indicates a correct understanding of this condition? a. It is delayed gastric emptying. b. Glucose is dumped into the bloodstream. c. Digestive secretions enter the esophagus. d. There is rapid entry of food into the jejunum
d
The nurse is caring for a patient with gastroesophageal reflux disease (GERD). Which patient statement indicates a need for nutritional instruction? a. I should drink milk, as it is the perfect food. b. Nutrition can affect health positively or negatively. c. Excessive intake of a nutrient can interfere with others. d. Classes of nutrients are carbohydrates, fats, proteins, vitamins, minerals, and water
a
The nurse is contributing to a patients teaching plan on how to avoid dumping syndrome after a gastrectomy. What should be included in the teaching? a. Avoid fluids with meals. b. Increase activity after eating. c. Increase carbohydrate intake. d. Eat heavy meals to delay emptying
a
The nurse is preparing to calculate a patients body mass index. What measurements does the nurse need to make this calculation? a. Height and weight b. Waist and hip measurements c. Weight and waist measurement d. Waist measurement and height
a
The nurse is teaching a patient about gastric surgery and dumping syndrome. Which statement indicates that the patient understands dumping syndrome? a. I need to eat small frequent meals. b. I should drink lots of fluids with meals. c. I need to sit up for 2 hours after each meal. d. I can expect the symptoms to begin 2 hours after eating.
a
The nurse is visiting the home of a patient recovering from a sleeve gastrectomy. Which observation indicates that this surgery has been successful for the patient? a. Patient claims that she never feels hungry b. Patients skin is dry and hair is falling out c. Patient states that she is constantly hungry d. Patient has injected 100 mL of saline solution in the pouch
a
The nurse teaching a patient with gastroesophageal reflux about the influence of body position on the disease process. Which patient statement indicates that teaching has been effective? a. I elevate the head of the bed 4 to 6 inches. b. I elevate the foot of the bed 12 to 16 inches. c. I sleep on my back without a pillow under my head. d. I sleep on my stomach with my head turned to the left.
a
After collecting data the nurse suspects that an adolescent patient is at risk for developing anorexia nervosa. What data did the nurse use to come to this conclusion? (Select all that apply.) a. Age 17 years b. Phobia about weight gain c. Fearful of mother present during the interview d. Asked the nurse repeatedly why certain information was needed e. Texted with friends on the smartphone while interview in progress
a, b, c, d
The nurse is caring for a patient who has a nursing diagnosis of acute postoperative pain after a gastrectomy. The patient has a nasogastric (NG) tube. What interventions should the nurse implement? (Select all that apply.) a. Encourage total bedrest. b. Monitor NG tube functioning. c. Reposition NG tube once a shift. d. Provide pain medication as ordered. e. Start a regular diet once bowel sounds are detected. f. Evaluate pain regularly and report changes to the RN.
a, b, d
The nurse is participating in planning care for a patient who is experiencing nausea. Which interventions should be included in this patients plan of care? (Select all that apply.) a. Provide antiemetics as prescribed b. Ensure the environment is odor-free c. Monitor intake, output, and vital signs d. Provide oral care every 2 hours as needed e. Instruct to avoid odors or foods that precipitate nausea
a, b, d, e
A patient is considering surgery to treat obesity. Which factors meet established criteria for the use of surgery in the treatment of obesity? (Select all that apply.) a. Hypertension b. Presence of gallstones c. Gross obesity for 5 years d. Psychiatric and social stability e. Body weight 50% above ideal weight f. Failure to reduce weight with other forms of therapy
a, c, d, f
The nurse is caring for a patient recovering from a bleeding gastric ulcer. Which patient statements indicate correct understanding of beverages to avoid after treatment of a bleeding gastric ulcer? (Select all that apply.) a. Beer b. Milk c. Coffee d. Iced tea e. Lemonade f. Diet soda pop
a, c, d, f
A patient with morbid obesity is admitted to the hospital for leg wounds. Which observations should the nurse expect when collecting data from this patient? (Select all that apply.) a. BMI 41 b. Hyper-excitable c. Lethargy and malaise d. Shortness of breath with walking e. Body weight 120 lbs over ideal weight
a, d, e
A patient with a duodenal peptic ulcer vomits old blood. What description should the nurse use to document the appearance of the vomitus? a. Duodenal fecal matter b. Coffee-ground particles c. Undigested particles of food d. Chyme streaked with a black syrupy material
b
A patient with a hiatal hernia is experiencing heartburn. Which should the nurse suggest to this patient? a. Eat large meals. b. Avoid bedtime snacks. c. Sleep flat without a pillow. d. Recline 1 hour before meals.
b
The nurse is caring for a patient on a gastrointestinal unit. Which patient statement should cause the nurse the most concern? a. My stool has been dark green and hard to pass lately. b. Lately, Ive had two or three loose, sticky black stools every day. c. Usually I move my bowels every day and the stool is light brown. d. My stool is soft and dark brown; I usually move my bowels twice a day.
b
The nurse is providing care to a patient anticipating radiation therapy for head and neck cancer. What should the nurse include in pre-therapy education? (Select all that apply.) a. Water is an appropriate substitute for saliva. b. Good oral hygiene habits are important to prevent decay. c. Tooth decay occurs less frequently when oral tissues are dry. d. It is important that you visit the dentist before radiation therapy begins. e. All of your teeth will need to be pulled before you start radiation therapy. f. Artificial saliva can be used if the radiation therapy causes drying of the mouth
b, d, f
The nurse is caring for a patient who has developed esophagitis from gastroesophageal reflux disease (GERD). For which additional complication should the nurse anticipate providing care to this patient? a. Laryngospasm b. Bronchospasm c. Barretts esophagus d. Aspiration pneumonia
c
The nurse is caring for a patient who suddenly begins having large amounts of bright red hematemesis. After the patient is turned onto the side, what should the nurse do? a. Encourage iced oral fluids. b. Lower the head of the bed. c. Obtain the patients vital signs. d. Place a cool cloth on the patients forehead.
c
The nurse is caring for a patient with a sliding hiatal hernia. In which position should the nurse expect the patient to report that the symptoms are more acute? a. Sitting b. Standing c. Lying down d. Semi-Fowlers
c
The nurse is caring for a patient with a vented nasogastric tube ordered to suction after a gastrectomy. What type of suction should the nurse use to decrease the development of complications? a. Continuous low suction b. Continuous high suction c. Intermittent low suction d. Intermittent high suction
c
The nurse is reinforcing teaching provided to a patient with a hiatal hernia. Which patient statement indicates a correct understanding of lifestyle modification to reduce symptoms? a. Avoid high-stress situations. b. Perform daily aerobic exercise. c. Avoid nicotine and alcohol use. d. Carefully space activity periods with rest.
c
The nursing assistant is delivering patient meals. Which meal should the nurse expect to be delivered to a patient who had gastric bypass surgery the day before? a. Soft diet b. Full liquids c. Clear liquids d. General diet
c
The nurse is caring for a patient who has aphthous stomatitis. What care should the nurse provide? (Select all that apply.) a. Make patient NPO. b. Place on fluid restriction. c. Apply a topical anesthetic. d. Teach to avoid irritating foods. e. Suggest stress management techniques.
c, d, e
The nurse has instructed a patient prescribed omeprazole (Prilosec) for peptic ulcer disease on use of the medication. What patient statements indicate understanding of the instructions? (Select all that apply.) a. I should not take antacids while Im on this medication. b. If I wish, I can open the capsule and sprinkle it on food. c. I will take the capsule before eating a meal in the morning. d. I will need to take this drug for 3 weeks for my ulcer to heal. e. I will report any abdominal pain, diarrhea, or bleeding that occurs. f. Ill have to have regular blood counts and tests of my liver enzymes.
c, e, f