Adult Nursing - Chapter 46: Management of Patients with Gastric and Duodenal Disorders - PrepU

Which of the following is the most successful treatment for gastric cancer? - Palliation - Radiation - Chemotherapy - Removal of the tumor

- Removal of the tumor

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

- Six small meals daily with 120 mL fluid between meals

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? - peptic ulcer disease - diverticulitis - ulcerative colitis - appendicitis

- peptic ulcer disease

The nurse in the ED admits a client with suspected gastric outlet obstruction. The client's symptoms include nausea and vomiting. The nurse anticipates that the physician will issue which order? - Nasogastric tube insertion - Pelvic x-ray - Stool specimen - Oral contrast

- Nasogastric tube insertion

Which of the following clients is at highest risk for peptic ulcer disease? - Client with blood type A - Client with blood type O - Client with blood type AB - Client with blood type B

- Client with blood type O

A patient 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 patient? - Esophageal ulcer - Curling's ulcer - Peptic ulcer - Meckel's ulcer

- Curling's ulcer

Symptoms associated with pyloric obstruction include all of the following except: - Diarrhea - Anorexia - Epigastric fullness - Nausea and vomiting

- Diarrhea

Which of the following appears to be a significant factor in the development of gastric cancer? - Ethnicity - Gender - Age - Diet

- Diet

A client is admitted to the hospital with an exacerbation of chronic gastritis. When assessing the client's nutritional status, the nurse should expect to find what type of deficiency? - vitamin C - vitamin B12 - vitamin A - vitamin B6

- vitamin B12

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? - Regular diet - Clear liquids - Nothing by mouth - Skim milk

- Nothing by mouth

Which of the following medications is classified as a proton pump inhibitor (PPI)? - Famotidine - Cimetidine - Omeprazole - Ranitidine

- Omeprazole

The nurse determines that teaching for the client with peptic ulcer disease has been effective when the client makes which statement? - "I should continue my treatment regimen as long as I have pain." - "I have learned some relaxation strategies that decrease my stress." - "I can buy whatever antacids are on sale because they all have the same effect." - "I should stop all my medications if I develop any side effects."

- "I have learned some relaxation strategies that decrease my stress."

Which ulcer is associated with extensive burn injury? - Cushing ulcer - Curling ulcer - Duodenal ulcer - Peptic ulcer

- Curling ulcer

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 normal reaction to surgery - Peritonitis - Dehiscence of the surgical wound - Vasomotor symptoms associated with dumping syndrome

- Vasomotor symptoms associated with dumping syndrome

A client with a peptic ulcer is about to begin a therapeutic regimen that includes a bland diet, antacids, and famotidine. Before the client is discharged, the nurse should provide which instruction? - "Increase your intake of fluids containing caffeine." - "Stop taking the drugs when your symptoms subside." - "Avoid aspirin and products that contain aspirin." - "Eat three balanced meals every day."

- "Avoid aspirin and products that contain aspirin."

A client is prescribed tetracycline to treat peptic ulcer disease. Which instruction would the nurse give the client? - "Be sure to wear sunscreen while taking this medicine." - "Take the medication with milk." - "Expect a metallic taste when taking this medicine, which is normal." - "Do not drive when taking this medication."

- "Be sure to wear sunscreen while taking this medicine."

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

- Endoscopy

Which medication is classified as a histamine-2 receptor antagonist? - Famotidine - Lansoprazole - Metronidazole - Esomeprazole

- Famotidine

The nurse is assessing a client with an ulcer for signs and symptoms of hemorrhage. The nurse interprets which condition as a sign/symptom of possible hemorrhage? - Hematemesis - Hypertension - Bradycardia - Polyuria

- Hematemesis

Which diagnostic test would be used first to evaluate a client with upper GI bleeding? - Endoscopy - Hemoglobin and hematocrit - Arteriography - Upper GI series

- Hemoglobin and hematocrit

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? - Hemorrhage - Penetration - Pyloric obstruction - Perforation

- Hemorrhage

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.) - "It can be caused by ingestion of strong acids." - "You may have ingested some irritating foods." - "It is probably your nerves." - "It is a hereditary disease." - "Is it possible that you are overusing aspirin."

- "It can be caused by ingestion of strong acids." - "You may have ingested some irritating foods." - "Is it possible that you are overusing aspirin."

A client weighs 215 lbs and is 5' 8" tall. What would the nurse calculate this client's body mass index (BMI) as being? - 19.5 - 24.8 - 44.9 - 32.7

- 32.7

Review the following four examples of ideal body weight (IBW), actual weight, and body mass index (BMI). Using three criteria for each example, select the body weight that indicates morbid obesity. - IBW = 175 lbs; weight = 265 lbs; BMI = 29 kg/m2 - IBW = 132 lbs; weight = 184 lbs; BMI = 28 kg/m2 - IBW = 150 lbs; weight = 190 lbs; BMI = 26 kg/m2 - IBW = 145 lbs; weight = 290 lbs; BMI = 31 kg/m2

- IBW = 145 lbs; weight = 290 lbs; BMI = 31 kg/m2

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

- O

A client with acute gastritis asks the nurse what might have caused the problem. What is a possible cause of acute gastritis? - Radiation therapy - Overuse of allergy medicine - Drinking fruit juices - Dietary indiscretion - Excessive alcohol intake

- Radiation therapy - Dietary indiscretion - Excessive alcohol intake

Which term refers to the first portion of the small intestine? - Duodenum - Omentum - Pylorus - Peritoneum

- Duodenum

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? - "Caffeine intake can cause tears in your esophagus and intestines, which can lead to hemorrhage." - "Caffeine increases the fluid volume in your system, which irritates your digestive organs." - "Caffeine stimulates the central nervous system and thus gastric activity and secretions, which need to be minimized to promote recovery." - "Caffeine can interfere with absorption of vitamin B12, which leads to anemia and further digestive problems."

- "Caffeine stimulates the central nervous system and thus gastric activity and secretions, which need to be minimized to promote recovery."

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 sectioned portion of the stomach is joined to the jejunum. - The antral portion of the stomach is removed and a vagotomy is performed. - A partial gastrectomy is performed with anastomosis of the stomach segment to the duodenum. - The vagus nerve is cut and gastric drainage is established.

- A partial gastrectomy is performed with anastomosis of the stomach segment to the duodenum.

A client is in the hospital for the treatment of peptic ulcer disease. The client reports vomiting and a sudden severe pain in the abdomen. The nurse then assesses a board-like abdomen. What does the nurse suspect these symptoms indicate? - Ineffective treatment for the peptic ulcer - A reaction to the medication given for the ulcer - Perforation of the peptic ulcer - Gastric penetration

- Perforation of the peptic ulcer

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? - Prevents ulceration in clients taking nonsteroidal anti-inflammatory drugs (NSAIDs) - Decreases mucus production - Increases the speed of gastric emptying - Works best when taken on an empty stomach

- Prevents ulceration in clients taking nonsteroidal anti-inflammatory drugs (NSAIDs)

A nurse is preparing to discharge a client newly diagnosed with peptic ulcer disease. The client's diagnostic test results were positive for H. pylori bacteria. The health care provider has ordered the "triple therapy" regimen. Which medications will the nurse educate the client on? - H2-receptor antagonist and two antibiotics - Proton-pump inhibitor, an antibiotic, and bismuth salts - H2-receptor antagonist, proton-pump inhibitor, and an antibiotic - Proton-pump inhibitor and two antibiotics

- Proton-pump inhibitor and two antibiotics

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

- pain 2 to 3 hours after a meal.

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. - Cimetidine (Tagamet) - Ranitidine (Zantac) - Famotidine (Pepcid) - Omeprazole (Prilosec)

- Omeprazole (Prilosec)

The nurse is conducting a community education class on gastritis. The nurse includes that chronic gastritis caused by Helicobacter pylori is implicated in which disease/condition? - Pernicious anemia - Systemic infection - Peptic ulcers - Colostomy

- Peptic ulcers

A nurse is teaching a group of middle-aged men about peptic ulcers. When discussing risk factors for peptic ulcers, the nurse should mention: - alcohol abuse and smoking. - a sedentary lifestyle and smoking. - a history of hemorrhoids and smoking. - alcohol abuse and a history of acute renal failure.

- alcohol abuse and smoking.

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

- drink liquids only between meals.

Which of the following is considered an early symptom of gastric cancer? - Bloating after meals - Weight loss - Dyspepsia - Pain relieved by antacids

- Pain relieved by antacids

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

- Duodenal ulcers

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: - Hemorrhage - Perforation - Pyloric obstruction - Intractable ulcer

- Hemorrhage

During assessment of a patient with gastritis, the nurse practitioner attempts to distinguish acute from chronic pathology. One criteria, characteristic of gastritis would be the: - Immediacy of the occurrence. - Presence of vomiting. - Frequency of abdominal discomfort. - Incidence of anorexia.

- Immediacy of the occurrence.

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. - Ingestion of strong acids - Irritating foods - DASH diet - Overuse of aspirin - Participation in highly competitive sports

- Ingestion of strong acids - Irritating foods - Overuse of aspirin

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

- Mental confusion

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

- Mental confusion

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

- Most clients are asymptomatic during the early stage of the disease.

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? - Celiac disease - Gastric outlet obstruction - Dumping syndrome - Bile reflux

- Dumping syndrome

The nurse reviews dietary guidelines with a client who had a gastric banding. Which teaching points are included? Select all that apply. - Do not eat and drink at the same time. - Drink plenty of water, from 90 minutes after each meal to 15 minutes before each meal. - Limit meal size to 450 to 500 mL. - Avoid fruit drinks and soda. - Eat six meals a day.

- Do not eat and drink at the same time. - Drink plenty of water, from 90 minutes after each meal to 15 minutes before each meal. - Avoid fruit drinks and soda.

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

- Assess the client's abdomen and vital signs.

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? - Bright red - Black and tarry - Coffee-ground-like - Clay-colored

- Black and tarry

Which medication classification represents a proton (gastric acid) pump inhibitor? - Famotidine - Omeprazole - Sucralfate - Metronidazole

- Omeprazole

A nurse is providing follow-up teaching at a clinic visit for a client recovering from gastric resection. The client reports sweating, diarrhea, nausea, palpitations, and the desire to lie down 15 to 30 minutes after meals. Based on the client's assessment, what will the nurse suspect? - A normal reaction to surgery - Dehiscence of the surgical wound - Peritonitis - Dumping syndrome

- Dumping syndrome

A patient taking metronidazole (Flagyl) for the treatment of H. pylori states that the medication is causing nausea. What suggestion can the nurse provide to the patient to alleviate this problem? - Take the medication with meals to decrease the nausea. - Crush the medication and put it in applesauce. - Discontinue the use of the medication. - Tell the patient to ask the physician to prescribe another type of antibiotic.

- Take the medication with meals to decrease the nausea.

A client reports to the clinic, stating that she rapidly developed headache, abdominal pain, nausea, hiccuping, and fatigue about 2 hours ago. For dinner, she ate buffalo chicken wings and beer. Which of the following medical conditions is most consistent with the client's presenting problems? - Acute gastritis - Gastric cancer - Duodenal ulcer - Gastric ulcer

- Acute gastritis

The nurse practitioner suspects that a patient may have a gastric ulcer after completing a history and physical exam. Select an indicator that can be used to help establish the distinction. - Sensitivity to the use of nonsteroidal anti-inflammatory drugs (NSAIDs) - Patient's age - Presence of H. pylori - Amount of hydrochloric acid (HCL) secretion in the stomach

- Amount of hydrochloric acid (HCL) secretion in the stomach