EXAM 2
A client admitted for treatment of a gastric ulcer is being prepared for discharge. The client will follow a regimen of antacid therapy. Discharge teaching should include which instructions? Choose all that apply. "Continue to take antacids even if your symptoms subside." "Be sure to take antacids with meals." "You may take antacids with other medications." "You may be prescribed H2-receptor antagonists for up to 1 year." "The antacids will make you sleepy, so do not operate machinery while taking them."
"Continue to take antacids even if your symptoms subside." "Be sure to take antacids with meals." "You may take antacids with other medications." "You may be prescribed H2-receptor antagonists for up to 1 year." "The antacids will make you sleepy, so do not operate machinery while taking them."
The client tells the nurse he has been experiencing "heartburn" at night that awakens him. Which assessment question should the nurse ask? "How much weight have you gained recently?" "What have you done to alleviate the heartburn?" "Do you consume many milk and dairy products?" "Have you been around anyone with a stomach virus?"
"How much weight have you gained recently?" "What have you done to alleviate the heartburn?" "Do you consume many milk and dairy products?" "Have you been around anyone with a stomach virus?"
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." "Eat three balanced meals every day." "Avoid aspirin and products that contain aspirin."
"Increase your intake of fluids containing caffeine." "Stop taking the drugs when your symptoms subside." "Eat three balanced meals every day." "Avoid aspirin and products that contain aspirin."
A nurse is preparing a client for endoscopic retrograde cholangiopancreatography (ERCP). The client asks what this test is used for. Which statements by the nurse explains how ERCP can determine the difference between pancreatitis and other biliary disorders? Select all that apply. "It can detect unhealthy tissues in the pancreas and assess for abscesses and pseudocysts." "It is used in the diagnostic evaluation of acute pancreatitis." "It can evaluate the presence and location of ductal stones and aid in stone removal." "It can assess the anatomy of the pancreas and the pancreatic and biliary ducts." "It can assess for ecchymosis in the body."
"It can detect unhealthy tissues in the pancreas and assess for abscesses and pseudocysts." "It is used in the diagnostic evaluation of acute pancreatitis." "It can evaluate the presence and location of ductal stones and aid in stone removal." "It can assess the anatomy of the pancreas and the pancreatic and biliary ducts." "It can assess for ecchymosis in the body."
A nurse is caring for a client who has had extensive abdominal surgery and is in critical condition. The nurse notes that the complete blood count shows an 8 G/dL hemoglobin and a 30% hematocrit. Dextrose 5% in half-normal saline solution is infusing through a triple lumen central catheter at 125 mL/hr. The physician orders include the following:Gentamicin 80 mg IV piggyback in 50 mL D5W over 30 minutesZantac 50 mg IV piggyback in 50 mL D5W over 30 minutesOne unit of 250 mL of PRBCs (packed red blood cells) over 3 hoursFlush the nasogastric tube with 30 mL normal saline every 2 hours.How many milliliters should the nurse record as the intake for the 8-hour shift? Enter the correct number ONLY
1470
The nurse has administered an antibiotic, a proton pump inhibitor, and Pepto-bismol for peptic ulcer disease secondary to H. Pylori. Which data would indicate to the nurse the medications are effective? A decrease in alcohol intake Maintaining a bland diet A return to previous activities A decrease in gastric distress
A decrease in alcohol intake Maintaining a bland diet A return to previous activities A decrease in gastric distress
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? A reaction to the medication given for the ulcer Ineffective treatment for the peptic ulcer Perforation of the peptic ulcer Gastric penetration
A reaction to the medication given for the ulcer Ineffective treatment for the peptic ulcer Perforation of the peptic ulcer Gastric penetration
As a nurse completes the admission assessment of a client admitted for gastric bypass surgery, the client states, "Finally! I'll be thin and able to eat without much concern." How should the nurse intervene? Ask the client about his or her plans for after surgery. Notify the health care provider that the client is eager to sign the consent form. Evaluate the client's understanding of the procedure. Rejoice with the client.
Ask the client about his or her plans for after surgery. Notify the health care provider that the client is eager to sign the consent form. Evaluate the client's understanding of the procedure. Rejoice with the client.
A patient with a gastric outlet obstruction has been treated with NG decompression. After the first 24 hours, the patient develops nausea and increased upper abdominal bowel sounds. What is the priority action by the nurse? Check the patency of the NG tube Place the patient in a recumbent postion Assess the patient's vital signs and circulatory status Encourage the patient to deep breathe and conscioulsy relax.
Check the patency of the NG tube Place the patient in a recumbent postion Assess the patient's vital signs and circulatory status Encourage the patient to deep breathe and conscioulsy relax.
A very ill client with acute cholecystitis is scheduled for surgery. The surgeon plans to create an incision in the common bile duct to remove stones. The nurse correctly documents this surgery in the electronic medical record using which term? Choledochoduodenostomy Choledochostomy Cholecystostomy Cholecystectomy
Choledochoduodenostomy Choledochostomy Cholecystostomy Cholecystectomy
A nurse is aware that both the sympathetic and parasympathetic portions of the autonomic nervous system affect GI motility. What are the actions of the sympathetic nervous system? Select all that apply. Decreases gastric motility Relaxes the sphincters Increases secretary activities Causes blood vessel constriction Creates an inhibitory effect on the GI tract
Decreases gastric motility Relaxes the sphincters Increases secretary activities Causes blood vessel constriction Creates an inhibitory effect on the GI tract
Following a Billroth II procedure, a patient develops dumping syndrome. The nurse should explain that the symptoms associated with this problem are caused by Distention of the smaller stomach by too much food and fluid intake Hyperglycemia caused by uncontrolled gastric emptying into the small intestine Irritation of the stomach lining by reflux of bile salts because the pylorus has been removed Movement of fluid into the small bowel from concentrated food and fluids moving rapidly into the intestine
Distention of the smaller stomach by too much food and fluid intake Hyperglycemia caused by uncontrolled gastric emptying into the small intestine Irritation of the stomach lining by reflux of bile salts because the pylorus has been removed Movement of fluid into the small bowel from concentrated food and fluids moving rapidly into the intestine
A nurse is preparing a client for surgery. During preoperative teaching, the client asks where is bile stored. The nurse knows that bile is stored in the: Duodenum Gallbladder Common bile duct Cystic duct
Duodenum Gallbladder Common bile duct Cystic duct
The nurse is caring for a client diagnosed with rule-out peptic ulcer disease. Which test confirms this diagnosis? Esophagogastroduodenoscopy Magnetic resonance imaging Occult blood test Gastric acid stimulation
Esophagogastroduodenoscopy Magnetic resonance imaging Occult blood test Gastric acid stimulation
The nurse is working in a diagnostic testing unit focusing on gastrointestinal studies. For which testing procedure is the nurse correct to assess the gag reflex before offering fluids? Esophagogastroduodenoscopy Sigmoidoscopy Peritoneoscopy Colonoscopy
Esophagogastroduodenoscopy Sigmoidoscopy Peritoneoscopy Colonoscopy
A client comes into the emergency department with reports of abdominal pain. What should the nurse ask first? Family history of ruptured appendix Medications taken in the last 8 hours Concerns about impending hospital stay Characteristics and duration of pain
Family history of ruptured appendix Medications taken in the last 8 hours Concerns about impending hospital stay Characteristics and duration of pain
A nurse is assessing an older adult client with gallstones. The nurse is aware that the client may not exhibit typical symptoms, and that particular symptoms that may be exhibited in the elderly client may include what examples? Fever and pain Signs and symptoms of septic shock Nausea and vomiting Chills and jaundice
Fever and pain Signs and symptoms of septic shock Nausea and vomiting Chills and jaundice
A client with peptic ulcer disease wants to know nonpharmacologic ways to prevent recurrence. Which of the following measures would the nurse recommend? Select all that apply. Following a regular schedule for rest, relaxation, and meals Avoidance of alcohol Substituting decaffeinated products for all forms of coffee Eating whenever hungry Smoking cessation
Following a regular schedule for rest, relaxation, and meals Avoidance of alcohol Substituting decaffeinated products for all forms of coffee Eating whenever hungry Smoking cessation
The nurse is collecting a stool specimen from a patient. What characteristic of the stool indicates to the nurse that the patient may have an upper GI bleed? Greasy and foamy Tarry and black Clay-colored Threaded with mucus
Greasy and foamy Tarry and black Clay-colored Threaded with mucus
A client is admitted with a gastrointestinal bleed. What client symptom may indicate a peptic ulcer perforation to the nurse? Hypertension Bradycardia Sudden, severe upper abdominal pain Soft abdomen
Hypertension Bradycardia Sudden, severe upper abdominal pain Soft abdomen
A client has been scheduled for a urea breath test in one month's time. What nursing diagnosis most likely prompted this diagnostic test?
Impaired dentition related to gingivitis Risk for impaired skin integrity related to peptic ulcers Imbalanced nutrition: Less than body requirements related to enzyme deficiency Diarrhea related to Clostridium difficile infection
A patient receives atropine, an anticholinergic drug, in preparation for surgery. The nurse expects this drug to affect the GI tract by doing what? Increasing gastric emptying Relaxing pyloric and ileocecal sphincters Decreasing secretions and peristaltic action Stimulating the nervous system of the GI tract
Increasing gastric emptying Relaxing pyloric and ileocecal sphincters Decreasing secretions and peristaltic action Stimulating the nervous system of the GI tract
The client is admitted to the medical unit with a diagnosis of acute diverticulitis. Which health-care provider's order should the nurse question? Insert a nasogastric tube Start an IV with D5W at 125 mL/hr Put client on a clear liquid diet Place client on bedrest with bathroom privileges
Insert a nasogastric tube Start an IV with D5W at 125 mL/hr Put client on a clear liquid diet Place client on bedrest with bathroom privileges
The nurse is developing a plan of care for a patient with peptic ulcer disease. What nursing interventions should be included in the care plan? Select all that apply. Inserting an indwelling catheter for incontinence Frequently monitoring hemoglobin and hematocrit levels Observing stools and vomitus for color, consistency, and volume Checking the blood pressure and pulse rate every 15 to 20 minutes Making neurovascular checks every 4 hours
Inserting an indwelling catheter for incontinence Frequently monitoring hemoglobin and hematocrit levels Observing stools and vomitus for color, consistency, and volume Checking the blood pressure and pulse rate every 15 to 20 minutes Making neurovascular checks every 4 hours
What is a postoperative nursing intervention for the obese patient who has undergone bariatric surgery? Irrigating and repositioning the nasogastric (NG) tube as needed Delaying ambulation until the patient has enough strength to support self Keeping the patient positioned on the side to facilitate respiratory function Providing adequate suppport to the incision during coughing, deep breathing, and turning.
Irrigating and repositioning the nasogastric (NG) tube as needed Delaying ambulation until the patient has enough strength to support self Keeping the patient positioned on the side to facilitate respiratory function Providing adequate suppport to the incision during coughing, deep breathing, and turning.
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. Irritating foods Participation in highly competitive sports Ingestion of strong acids Overuse of aspirin DASH diet
Irritating foods Participation in highly competitive sports Ingestion of strong acids Overuse of aspirin DASH diet
A patient is admitted to the hospital with a possible common bile duct obstruction. What clinical manifestations does the nurse understand are indicators of this problem? (Select all that apply.) Jaundice Clay-colored feces Pruritus Pain in the left upper abdominal quadrant Amber-colored urine
Jaundice Clay-colored feces Pruritus Pain in the left upper abdominal quadrant Amber-colored urine
A client recovers from an episode of gallbladder inflammation and the client's diet is advanced from a low-fat liquid diet. Which meals will the nurse recommend to the client? Select all that apply. Marinated lean steak, steamed rice, and roasted zucchini. Roasted chicken, mashed potatoes, and green beans. Egg salad sandwich with low fat mayonnaise and a side salad with ranch dressing. Vegetable lasagna, bread sticks, and steamed broccoli. Oatmeal with a cooked fruit compote and hot tea.
Marinated lean steak, steamed rice, and roasted zucchini. Roasted chicken, mashed potatoes, and green beans. Egg salad sandwich with low fat mayonnaise and a side salad with ranch dressing. Vegetable lasagna, bread sticks, and steamed broccoli. Oatmeal with a cooked fruit compote and hot tea.
Which of the following medications is classified as a proton pump inhibitor (PPI)? Omeprazole Famotidine Cimetidine Nizatidine
Omeprazole Famotidine Cimetidine Nizatidine
A client with acute gastritis asks the nurse what might have caused the problem. What is a possible cause of acute gastritis? Select all that apply. Overuse of allergy medicine Excessive alcohol intake Dietary indiscretion Drinking fruit juices Radiation therapy
Overuse of allergy medicine Excessive alcohol intake Dietary indiscretion Drinking fruit juices Radiation therapy
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 Peptic ulcers Colostomy Systemic infection
Pernicious anemia Peptic ulcers Colostomy Systemic infection
A client has experienced symptoms of dumping syndrome following gastric surgery. To what physiologic phenomenon does the nurse attribute this syndrome? Reflux of bile into the distal esophagus Chronic malabsorption of iron and vitamins A and C Irritation of the phrenic nerve due to diaphragmatic pressure Influx of extracellular fluid into the small intestine
Reflux of bile into the distal esophagus Chronic malabsorption of iron and vitamins A and C Irritation of the phrenic nerve due to diaphragmatic pressure Influx of extracellular fluid into the small intestine
The nurse determines a client scheduled to undergo an abdominal ultrasonography should receive which instruction? Restrict eating of solid food for 6 to 8 hours before the test. Avoid exposure to sunlight for at least 6 to 8 hours before the test. Do not undertake any strenuous exercise for 24 hours before the test. Do not consume anything sweet for 24 hours before the test.
Restrict eating of solid food for 6 to 8 hours before the test. Avoid exposure to sunlight for at least 6 to 8 hours before the test. Do not undertake any strenuous exercise for 24 hours before the test. Do not consume anything sweet for 24 hours before the test.
A 68-yr-old patient is in the office for physical. She notes that she no longer has regular bowel movements. Which suggestion by the nurse would be most helpful to the patient? Take an additional laxative to stimulate defecation Eat less acidic foods to enable the gastrointestinal system to increase peristalsis Eat less food at each meal to prevent feces from backing up related to slow peristalsis Attempt defecation after breakfast becasue gastrocolic reflexes increase colon peristalsis at that time
Take an additional laxative to stimulate defecation Eat less acidic foods to enable the gastrointestinal system to increase peristalsis Eat less food at each meal to prevent feces from backing up related to slow peristalsis Attempt defecation after breakfast becasue gastrocolic reflexes increase colon peristalsis at that time
A nurse is assisting with serving dinner trays on the unit. Upon receiving the dinner tray for a client admitted with acute gallbladder inflammation, the nurse will question which of the following foods on the tray? Tapioca pudding Mashed potatoes Dinner roll Fried chicken
Tapioca pudding Mashed potatoes Dinner roll Fried chicken
The client who had an abdominal surgery has a Jackson Pratt (JP) drainage tube. Which assessment data warrant immediate intervention by the nurse? The bulb is round and has 40 mL of fluid The drainage tube is taped to the dressing The JP insertion sige is pink and has no drainage The JP bulb has suction and is sunken in
The bulb is round and has 40 mL of fluid The drainage tube is taped to the dressing The JP insertion sige is pink and has no drainage The JP bulb has suction and is sunken in
The client is two hours post-colonoscopy. Which assessment data warrant intermediate intervention by the nurse? The client has a soft, nontender abdomen The client has a loose, watery stool The client has hyperactive bowel sounds The client's pulse is 104 and BP is 98/60
The client has a soft, nontender abdomen The client has a loose, watery stool The client has hyperactive bowel sounds The client's pulse is 104 and BP is 98/60
The nurse is providing instructions to a client scheduled for a gastroscopy. What should the nurse be sure to include in the instructions? Select all that apply. The client must fast for 8 hours before the examination. The throat will be sprayed with a local anesthetic. After gastroscopy, the client cannot eat or drink until the gag reflex returns (1 to 2 hours). The health care provider will be able to determine if there is a presence of bowel disease. The client must have bowel cleansing prior to the procedure.
The client must fast for 8 hours before the examination. The throat will be sprayed with a local anesthetic. After gastroscopy, the client cannot eat or drink until the gag reflex returns (1 to 2 hours). The health care provider will be able to determine if there is a presence of bowel disease. The client must have bowel cleansing prior to the procedure.
The nurse is caring for a geriatric client experiencing diarrhea. When teaching about the site in the body where water and electrolytes are absorbed, the nurse is most correct to instruct on which location? The small intestine The stomach The large intestine The cecum
The small intestine The stomach The large intestine The cecum
A client was diagnosed with pernicious anemia. Which vitamin cannot be absorbed without an intrinsic factor? Vitamin B12 Vitamin C Vitamin D Vitamin A
Vitamin B12 Vitamin C Vitamin D Vitamin A
The nurse is caring for a client with chronic gastritis. The nurse monitors the client knowing that this client is at risk for which vitamin deficiency? Vitamin E Vitamin A Vitamin C Vitamin B12
Vitamin E Vitamin A Vitamin C Vitamin B12
A nurse is teaching a group of middle-aged men about peptic ulcers. When discussing risk factors for peptic ulcers, the nurse should mention: a sedentary lifestyle and smoking. alcohol abuse and smoking. alcohol abuse and a history of acute renal failure. a history of hemorrhoids and smoking.
a sedentary lifestyle and smoking. alcohol abuse and smoking. alcohol abuse and a history of acute renal failure. a history of hemorrhoids and smoking.
The nurse is admitting a client whose medication regimen includes regular injections of vitamin B12. The nurse should question the client about a history of: gastroesophageal reflux disease (GERD). diverticulitis. total gastrectomy. bariatric surgery.
gastroesophageal reflux disease (GERD). diverticulitis. total gastrectomy. bariatric surgery.
Which neuroregulator increase gastric acid secretion? norepinephrine acetylcholine gastrin Secretin
norepinephrine acetylcholine gastrin Secretin
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? ulcerative colitis peptic ulcer disease appendicitis Diverticulitis
ulcerative colitis peptic ulcer disease appendicitis Diverticulitis
While preparing a client for an upper GI endoscopy (esophagogastroduodenoscopy), the nurse should implement which interventions? Choose all that apply. Administer a preparation to cleanse the GI tract, such as Golytely or Fleets Phospha-Soda. Tell the client he shouldn't eat or drink for 6 to 12 hours before the procedure. Tell the client he must be on a clear liquid diet for 24 hours before the procedure. Inform the client that he will receive a sedative before the procedure. Tell the client that he may eat and drink immediately after the procedure.
Administer a preparation to cleanse the GI tract, such as Golytely or Fleets Phospha-Soda. Tell the client he shouldn't eat or drink for 6 to 12 hours before the procedure. Tell the client he must be on a clear liquid diet for 24 hours before the procedure. Inform the client that he will receive a sedative before the procedure. Tell the client that he may eat and drink immediately after the procedure.
The nurse is caring for an adult client diagnosed with GERD. Which condition is the most common comorbid disease associated with GERD? Adult-onset asthma Pancreatitis Peptic Ulcer Disease Increased gastric emptying
Adult-onset asthma Pancreatitis Peptic Ulcer Disease Increased gastric emptying
The nurse is assessing a client with a bleeding gastric ulcer. When examining the client's stool, which characteristic would the nurse be most likely to find? Bright red blood in stool Green color and texture Clay-like quality Black and tarry appearance
Bright red blood in stool Green color and texture Clay-like quality Black and tarry appearance
The nurse teaches a client scheduled for a colonoscopy. Which instruction should be included as part of the preparation for the procedure? Consume at least 3 quarts of water 30 minutes before the test. Do not void for at least 30 minutes before the test. Follow the dietary and fluid restrictions and bowel preparation procedures. Spray or gargle with a local anesthetic.
Consume at least 3 quarts of water 30 minutes before the test. Do not void for at least 30 minutes before the test. Follow the dietary and fluid restrictions and bowel preparation procedures. Spray or gargle with a local anesthetic.
A nurse is caring for a client admitted with a suspected malabsorption disorder. The nurse knows that one of the accessory organs of the digestive system is the pancreas. What digestive enzymes does the pancreas secrete? Select all that apply. Pepsin Lipase Amylase Trypsin Ptyalin
Pepsin Lipase Amylase Trypsin Ptyalin
A client taking metronidazole for the treatment of H. pylori states that the medication is causing nausea. What teaching should the nurse provide to the client to alleviate the nausea? Take the medication with meals to decrease the nausea. Discontinue the use of the medication. Ask the healthcare provider to prescribe another type of antibiotic. Crush the medication and put it in applesauce.
Take the medication with meals to decrease the nausea. Discontinue the use of the medication. Ask the healthcare provider to prescribe another type of antibiotic. Crush the medication and put it in applesauce.
The nurse is providing care for a client whose peptic ulcer disease will be treated with a Billroth I procedure (gastroduodenostomy). The nurse should address which of the following topics when providing health education? Select all that apply. The client can resume a usual diet in 3 to 5 weeks The client is likely to require long-term total parenteral nutrition (TPN) The client's vagus nerve may be altered Part of the client's stomach and colon will be removed The procedure carries a risk for dumping syndrome
The client can resume a usual diet in 3 to 5 weeks The client is likely to require long-term total parenteral nutrition (TPN) The client's vagus nerve may be altered Part of the client's stomach and colon will be removed The procedure carries a risk for dumping syndrome
A patient comes to the clinic with the complaint, "I think I have an ulcer." What is a characteristic associated with peptic ulcer pain that the nurse should inquire about? Select all that apply. Vomiting without associated nausea Severe gnawing pain that increases in severity as the day progresses Pain that radiates to the shoulder or jaw Burning sensation localized in the back or mid-epigastrium Feeling of emptiness that precedes meals from 1 to 3 hours
Vomiting without associated nausea Severe gnawing pain that increases in severity as the day progresses Pain that radiates to the shoulder or jaw Burning sensation localized in the back or mid-epigastrium Feeling of emptiness that precedes meals from 1 to 3 hours
Duodenal and gastric ulcers have similar as well as differentiating features. What are characteristics unique to duodenal ulcers? Select all that apply Type your answer in lowercase alphabetical order with no spaces or commas (ex. abc) a.Pain is relieved with eating food b.They have a high recurrence rate c.Increased gastric acid secretion occurs d.Associated with H. Pylori infection e.Hemorrhage, perforation, and obstruction my result f.There is burning and cramping in the midepigastric area
acdf
Which digestive substances are active or activated in the stomach? Select all that apply Type your answer in lowercase alphabetical order with no spaces or commas (ex. abc) a.Bile b.Pepsin c.Gastrin d.Maltase e.Secretin f.Amylase
bc
The nurse is caring for a client diagnosed with hemorrhaging duodenal ulcer. Which collaborative interventions should the nurse implement? Select all that apply Type your answer in lowercase alphabetical order with no spaces or commas (ex. abc) a.Perform a complete pain assessment b.Assess the client's vital signs frequently c.Administer a proton pump inhibitor intravenously d.Obtain permission and administer blood products e.Monitor the intake of a soft, bland diet
cd
