Upper GI tract

after a subtotal gastrectomy, the nurse is developing a plan with the client to assist the client to gain weight. to help the client meet nutritional goals at home, the nurse should: a. instruct the client to increase the amount eaten at each meal b. encourage the client to eat smaller amounts more frequently c. explain that if vomiting occurs after a meal, nothing more should be eaten that day d. inform that client that bland foods are typically less nutritional and should be used minimally

B. encourage the client to eat smaller amounts more frequently

a client is taking cimetidine (Tagamet) to treat a hiatal hernia. the nurse should evaluate the client to determine that the drug has been effective in preventing which of the following? a. esophageal reflux b. dysphagia c. esophagitis d. ulcer formation

C. esophagitis

a client is taking an antacid for treatment of a peptic ulcer. which of the following statements best indicates that the client understands how to correctly take the antacid? a. "I should take my antacid before I take my other medications" b. "I need to decrease my intake of fluids so that i don't dilute the effects of my antacid" c. "my antacid will be most effective if i take it whenever i experience stomach pains" d. "it is best for me to take my antacid 1 to 3 hours after meals"

D. "it is best for me to take my antacid 1-3 hours after meals"

one month following a subtotal gastrectomy for cancer, the nurse is evaluating the nursing care goal related to nutrition. which of the following indicates that the client has attained the goal? the client has: a. regained weight loss b. resumed normal dietary intake of three meals a day c. controlled nausea and vomiting through regular use of antiemetics d. achieved optimal nutritional status through oral or parenteral feedings

D. achieved optimal nutritional status through oral or parenteral feedings

a client with peptic ulcer reports epigastric pain that frequently causes the client to wake up during the night. the nurse should instruct the client to do which activities? select all that apply. a. obtain adequate rest to reduce stimulation b. eat small, frequent meals throughout the day c. take all medications on time as prescribed d. sit up for 1 hour when awakened at nigh e. stay away from crowded areas

A, B, C, D

the nurse instructs the clients on health maintenance activities to help control symptoms from a hiatal hernia. which of the following statements would indicate that the client has understood the instructions? a. "I'll avoid lying down after a meal." b. "I can still enjoy my potato chips and cola at bedtime." c. "I wish I didn't have to give up swimming" d. "If i wear a girdle, I'll have more support for my stomach"

A. "I'll avoid lying down after a meal"

after a subtotal gastrectomy, the NG tube drainage will be what color for about 12-24 hours after surgery? a. dark brown b. bile green c. bright red d. cloudy white

A. dark brown

which of the following dietary measures would be useful in preventing esophageal reflux? a. eating small, frequent meals b. increasing fluid intake c. avoiding air swallowing with meals d. adding a bedtime snack to the dietary plan

A. eating small, frequent meals

the client attends two sessions with the dietitian to learn about diet modifications to minimize gastroesophageal reflux. the teaching would be considered successful if the client decreases the intake of which of the following foods? a. fats b. high-sodium foods c. carbs d. high-calcium foods

A. fats

the nurse is obtaining a health history from a client who has a sliding hiatal hernia associated with reflux. the nurse should ask the client about the presence of which of the following symptoms? a. heartburn b. jaundice c. anorexia d. stomatitis

A. heartburn

the physician prescribes metoclopramide hydrochloride for the client with hiatal hernia. this drug is used in hiatal hernia therapy to accomplish which of the following objectives? a. increase tone of the esophageal sphincter b. neutralize gastric secretions c. delay gastric emptying d. reduce secretion of digestive juices

A. increase tone of the esophageal sphincter

after surgery for gastric cancer, a client is scheduled to undergo radiation therapy. it will be MOST important for the nurse to include information about which of the following in the client's teaching plan? a. nutritional intake b. management of alopecia c. exercise and activity levels d. access to community resources

A. nutritional intake

the nurse is caring for a client who has just had an upper GI endoscopy. the client's vital signs must be taken every 30 minutes for 2 hours after the procedure. the nurse assigns an unlicensed nursing personnel (UAP) to take the vital signs. one hour later, the UAP reports the client, who was previously afebrile, has developed a temperature of 101.8F. what should the nurse do in response to these reported assessment data? a. promptly assess the client for potential perforation b. tell the assistant to change thermometers and retake the temperature c. plan to give the client acetaminophen to lower the temperature d. ask the UAP to bathe the client with tepid water

A. promptly assess the client for potential perforation.

the client is scheduled to have an upper gastrointestinal tract series of x-rays. following the x-rays. the nurse should instruct the client to: a. take a laxative b. follow a clear liquid diet c. administer an enema d. take an antiemetic

A. take a laxative

a client is admitted to the hospital after vomiting bright red blood and is diagnosed with a bleeding duodenal ulcer. the client develops a sudden, sharp pain in the midepigastric region along with a rigid, boardlike abdomen. the nurse should do which of the following first? a. administer pain medication as prescribed b. raise the HOB c. prepare to insert an NG tube d. notify HCP

D. notify HCP

a client reports vomiting every hour for the past 8-10 hours. the nurse should assess the client for risk of which of the following? select all that apply. a. metabolic acidosis b. metabolic alkalosis c. hypokalemia d. hyperkalemia e. hyponatremia

B, C

a client with PUD reports being nauseated most of the day and now feeling light-headed and dizzy. based upon these findings, which nursing actions would be MOST appropriate for the nurse to take? select all that apply. a. administering an antacid hourly until nausea subsides b. monitoring the client's vital signs c. notifying the physician of the client's symptoms d. initiating oxygen therapy e. reassessing the client in an hour

B, C

the nurse should assess the client who is being admitted to the hospital with upper GI bleeding for which of the following? select all that apply. a. dry, flushed skin b. decreased urine output c. tachycardia d. widening pulse pressure e. rapid respirations f. thirst

B, C, E, F

the nurse is caring for a client who has had a gastroscopy. which of the following may indicate that the client is developing a complication related to the procedure? select all that apply. a. the client has a sore throat b. the client has a temperature of 100F c. the client appears drowsy following the procedure d. the client has epigastric pain e. the client experiences hematemesis

B, D, E

a client with a peptic ulcer has been instructed to avoid intense physical activity and stress. which strategy should the client incorporate into the home care plan? a. conduct physical activity in the morning in order to be able to rest in the afternoon b. have the family agree to perform the necessary yard work at home c. give up jogging and substitute a less demanding hobby d. incorporate periods of physical and mental rest in the daily schedule

D. incorporate periods of physical and mental rest in the daily schedule

the client asks the nurse if surgery is needed to correct a hiatal hernia. which reply by the nurse would be MOST accurate? a. "surgery is usually required, although medical treatment is attempted first." b. "hiatal hernia symptoms can usually be successfully managed with diet modifications, medications, and lifestyle changs." c. "surgery is not performed for this type of hernia" d. "a minor surgical procedure to reduce the size of the diaphragmatic opening will probably be planned"

B. "hiatal hernia symptoms can usually be managed with diet modifications, medications, and lifestyle changes"

the nurse finds a client who has been diagnosed with a peptic ulcer surrounded by papers from a briefcase and arguing on the telephone with a coworker. the nurse's response to observing these actions should be based on knowledge that: a. involvement with the job will keep the client from becoming bored b. a relaxed environment will promote ulcer healing c. not keeping up with the job will increase the client's stress level d. setting limits on the client's behavior is an important nursing responsibility

B. a relaxed environment will promote ulcer healing

which of the following factors would MOST likely contribute to the development of a client's hiatal hernia? a. having a sedentary desk job b. being 5'3" tall and weighing 190 lb c. using laxatives frequently d. being 40 years old

B. being 5'3" tall and weighing 190 lbs

in developing a teaching plan for the client with a hiatal hernia, the nurse's assessment of which work-related factors would be MOST useful? a. number and length of breaks b. body mechanics used in lifting c. temperature in the work area d. cleaning solvents used

B. body mechanics used in lifting

which of the following instructions should the nurse include in the teaching plan for a client who is experiencing GERD a. limit caffeine intake to two cups of coffee per day b. do not lie down for 2 hours after eating c. follow a low-protein diet d. take medications with milk to decrease irritation

B. do not lie down or 2 hours after eating

which of the following lifestyle modifications should the nurse encourage the client with a hiatal hernia to include in activities of daily living? a. daily aerobic exercise b. eliminating smoking and alcohol use c. balancing activity and rest d. avoiding high-stress situations

B. eliminating smoking and alcohol use

which of the following would be an expected outcome for a client with PUD? the client will: a. demonstrate appropriate use of analgesics to control pain b. explain the rationale for eliminating alcohol from the diet c. verbalize the importance of monitoring hemoglobin and hematocrit every 3 months d. eliminate engaging in contact sports

B. explain the rationale for eliminating alcohol from the diet

a client has been diagnosed with adenocarcinoma of the stomach and is scheduled to undergo a subtotal gastrectomy (Bilroth II procedure). During preoperative teaching, the nurse is reinforcing information about the surgical procedure. which of the following explanations is MOST accurate? a. the procedure will result in enlargement of the pyloric sphincter b. the procedure will result in anastomosis of the gastric stump to the jejunum c. the procedure will result in removal of the duodenum d. the procedure will result in repositioning of the vagus nerve

B. the procedure will result in anastomosis of the gastric stump to the jejunum

bethanechol has been prescribed for a client with GERD. the nurse should assess the client for which of the following adverse effects? a. constipation b. urinary urgency c. hypertension d. dry oral mucosa

B. urinary urgency

the nurse has been assigned to provide care for four clients. in what order should the nurse assess these clients? a. a client awaiting surgery for a hiatal hernia repair at 11 am b. a client with suspected gastric surgery who is NPO status for tests c. a client with PUD experiencing a sudden onset of acute stomach pain d. a client who is requesting pain medication 2 days after surgery to repair a fractured jaw

C, D, B, A

what should the nurse teach a client about how to avoid the dumping syndrome? select all that apply. a. consume three regularly spaced meals per day b. eat a diet with high-carb foods with each meal c. reduce fluids with meals, but take them between meals d. obtain adequate amounts of protein and fat in each meal e. eat in a relaxing environment

C, D, E

when obtaining a nursing hx from a client with a suspected gastric ulcer, which signs and symptoms should the nurse assess? select all that apply. a. epigastric pain at night b. relief of epigastric pain after eating c. vomiting d. weight loss e. melena

C, D, E

a client with PUD is taking ranitidine. what is the expected outcome of this drug? a. heal the ulcer b. protect the ulcer surface from acids c. reduce acid concentration d. limit gastric acid secretion

D. limit gastric acid secretion

the nurse is preparing to teach a client with a peptic ulcer about the diet that should be followed after discharge. the nurse should explain that the client should eat which of the following? a. bland foods. b. high-protein foods c. any foods that are tolerated d. a glass of milk with each meal

C. any foods that are tolerated

which of the following nursing interventions would MOST likely promote self-care behaviors in the client with a hiatal hernia? a. introduce the client to other people who are successfully managing their care b. include the client's daughter in the teaching so that she can help implement the plan c. ask the client to identify other situations in which the client changed health care habits d. provide reassurance that the client will be able to implement all aspects of the plan successfully

C. ask the client to identify other situations in which the client changed health care habits

a client is to take one daily dose of ranitidine (Zantac) at home to treat a peptic ulcer. the client understands proper drug administration of ranitidine when the client will take the drug at which of the following times. a. before meals b. with meals c. at bedtime d. when pain occurs

C. at bedtime

the client has been taking magnesium hydroxide (milk of magnesia) to control hiatal hernia symptoms. the nurse should assess the client for which of the following conditions most commonly associated with the ongoing use of magnesium-based antacids? a. anorexia b. weight gain c. diarrhea d. constipation

C. diarrhea

a client who has been diagnosed with a GERD has heartburn. to decrease the heartburn, the nurse should instruct the client to eliminate which of the following items from the diet? a. lean beef b. air-popped popcorn c. hot chocolate d. raw vegetables

C. hot chocolate

since the diagnosis of stomach cancer, the client has been having trouble sleeping and is frequently preoccupied with thoughts about how life will change. the client says, "I wish my life could stay the same." Based on this information, the nurse should understand that the client: a. is having difficulty coping b. has a sleep disorder c. is grieving d. is anxious

C. is grieving

a client with suspected gastric cancer undergoes an endoscopy of the stomach. which of the following assessments made after the procedure would indicate the development of a potential complication? a. the client has a sore throat b. the client displays signs of sedation c. the client experiences a sudden increase in temperature d. the client demonstrates lack of appetite

C. the client experiences a sudden increase in temperature

a client has been taking aluminum hydroxide 30 mL six times per day at home to prevent a peptic ulcer. the client has been unable to have a bowel movement for 3 days. based on this information, the nurse would determine that which of the following is the MOST likely to cause the client's constipation? a. the client has not been including enough fiber in the diet b. the client needs to increase the daily exercise c. the client is experiencing an adverse effect of the aluminum hydroxide d. the client has developed a gastrointestinal obstruction

C. the client is experiencing an adverse effect of the aluminum hydroxide

the client with GERD has a chronic cough. this symptom may be indicative of which of the following? a. development of laryngeal cancer b. irritation of the esophagus c. esophageal scar tissue formation d. aspiration of gastric contents

D. aspiration of gastric contents

a client admitted to the hospital with PUD tells the nurse about having black, tarry stools. the nurse should: a. encourage the client to increase fluid intake b. advise the client to avoid iron-rich foods c. place the client on contact precautions d. report the finding to the HCP

D. report the findings to the HCP

following a gastrectomy, the nurse should position the client in which of the following positions? a. prone b. supine c. low fowler's d. right or left sims

c. low fowler's

a client has a NG tube following a subtotal gastrectomy. the nurse should: a. irrigate the tube with 30 mL of sterile water every hour, if needed b. reposition the tube if it is not draining well c. monitor the client for nausea, vomiting, and abdominal distention d. turn the machine to high suction if the drainage is sluggish on low suction

c. monitor the client for nausea, vomiting, and abdominal distention

a client who is recovering from a subtotal gastrectomy experiences dumping syndrome. the client asks the nurse, "when will i be able to eat three meals a day again like i used to?" which of the following response by the nurse is MOST appropriate? a. "eating six meals a day is time-consuming, isn't it?" b. "you will have to eat six meals a day for the rest of your life." c. "you will be able to tolerate three meals a day before you are discharged." d. "most clients can resume their normal meal patterns in about 6-12 months"

d. "most clients can resume their normal meal patterns in about 6-12 months"

the nurse should instruct the client to avoid which of the following drugs while taking metoclopramide hydrochloride? a. antacids b. antihypertensives c. anticoagulants d. alcohol

d. alcohol

to reduce the risk of dumping syndrome, the nurse should teach the client to do which of the following? a. sit upright for 30 minutes after meals b. drink liquids with meals, avoiding caffeine c. avoid milk and other dairy products d. decrease the carb content of meals

d. decrease the carb content of meals