Gastric & Duodenal Disorders

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) Skim milk C) Nothing by mouth D) Regular diet

C) Nothing by mouth

Which medication classification represents a proton (gastric acid) pump inhibitor? A) Metronidazole B) Famotidine C) Omeprazole D) Sucralfate

C) Omeprazole

The nurse recognizes that the client diagnosed with a duodenal ulcer will likely experience: A) Vomiting. B) Weight loss. C) Pain 2-3 hours after meals. D) Hemorrhage.

C) Pain 2-3 hours after meals.

In patients with gastric cancer a _____ may be used to evaluate for the presence of anemia.

CBC

Currently, the most commonly used therapy for peptic ulcers is a combination of _____, proton pump inhibitors, and bismuth salts that suppresses or eradicates H. pylori.

Antibiotics

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 stimulates the central nervous system and thus gastric activity and secretions, which need to be minimized to promote recovery." C) "Caffeine increases the fluid volume in your system, which irritates your digestive organs." D) "Caffeine can interfere with absorption of vitamin B12, which leads to anemia and further digestive problems."

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

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

C) "Be sure to wear sunscreen while taking this medicine."

A client with peptic ulcer disease must begin triple medication therapy. For how long will the client follow this regimen? A) 7-9 days B) 15-20 days C) 10-14 days D) 4-6 days

C) 10-14 days

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

C) Client with O blood type.

Which diagnostic test would be used first to evaluate a client with upper GI bleeding? A) Upper GI series B) Endoscopy C) H&H D) Arteriography

C) H&H

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

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

A nurse practitioner, who is treating a patient with GERD, knows that responsiveness to this drug classification is validation of the disease. The drug classification is: A) Bright red B) Clay-colored C) Coffee-ground-like D) Black and tarry

D) Black and tarry

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

D) O

_____ may occur a result any surgical procedure that involves the removal of a significant portion of the stomach or includes resection or removal of the pylorus.

Dumping syndrome

T or F: Acute gastritis is a prolonged inflammation due to benign or malignant ulcers of the stomach.

False

T or F: The most common site for a peptic ulcer formation is in the pyloris.

False

Gastritis and _____ from peptic ulcer disease are the two most common causes of upper GI tract bleeding.

Hemorrhage

T or F: Most peptic ulcers result from infection with the gram-negative bacteria H. pylori, which may be acquired through ingestion of food and water.

True

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? A) Hematemesis B) Hypertension C) Polyuria D) Bradycardia

A) Hematemesis

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) Perforation C) Pyloric obstruction D) Penetration

A) Hemorrhage

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? A) Peptic ulcers B) Pernicious anemia C) Colostomy D) Systemic infection

A) Peptic ulcers

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

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

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

A) Diet

Which is an accurate statement regarding gastric cancer? A) The incidence of stomach cancer continues to decrease in the United States. B) A diet high in smoked foods and low in fruits and vegetables may decrease the risk of gastric cancer. C) Most gastric cancer-related deaths occur in people younger than 40 years. D) Females have a higher incidence of gastric cancers than men.

A) The incidence of stomach cancer continues to decrease in the United States.

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

A) Vasomotor symptoms associated with dumping syndrome

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) Gastric penetration B) Ineffective treatment for the peptic ulcer C) Perforation of the peptic ulcer D) A reaction to the medication given for the ulcer

C) Perforation of the peptic ulcer

Which of the following medications used for obesity improves cardiovascular disease risk factors in obese patients with metabolic syndrome? A) Alli B) Sibutramine (Meridia) C) Rimonabant (Acomplia) D) Orlistat (Xenical)

C) Rimonabant (Acomplia)

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) Acute gastritis B) Duodenal ulcer C) Gastric ulcer D) Gastric cancer

A) Acute gastritis

The nurse is assessing an 80-year-old client for signs and symptoms of gastric cancer. The nurse differentiates which as a sign/symptom of gastric cancer in the geriatric client, but not in a client under the age of 75? A) Agitation B) Hepatomegaly C) Ascites D) Abdominal mass

A) Agitation

Tumors of the small intestine are uncommon, of these approximately 64% are _____.

Malignant

T or F: The best time to teach a client to take proton pump inhibitors is 30 min before a meal.

True

T or F: The vest majority of gastric cancers are acquired and not inherited.

True

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) Gastric outlet obstruction B) Dumping syndrome C) Bile reflux D) Celiac disease

B) Dumping syndrome

Which of the following is the most successful treatment for gastric cancer? A) Palliation B) Removal of the tumor C) Chemotherapy D) Radiation

B) Removal of the tumor

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

B) Cimetidine C) Nizatidine D) Famotidine

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) Place the client in the high-Fowler's position B) Assess the client's abdomen and vital signs C) Notify the health care provider D) Irrigate the client's NGT

B) Assess the client's abdomen and vital signs

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. A) IBW = 150 lbs; weight = 190 lbs; BMI = 26 kg/m2 B) IBW = 175 lbs; weight = 265 lbs; BMI = 29 kg/m2 C) IBW = 132 lbs; weight = 184 lbs; BMI = 28 kg/m2 D) IBW = 145 lbs; weight = 290 lbs; BMI = 31 kg/m2

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

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

A) Six small meals daily with 120 mL fluid between meals

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. A) Amount of hydrochloric acid (HCL) secretion in the stomach B) Sensitivity to the use of nonsteroidal anti-inflammatory drugs (NSAIDs) C) Presence of H. pylori D) Patient's age

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

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

A) Drink liquids only between meals.