Med Surg Chapter 23: Nursing Management: Patients With Gastric and Duodenal Disorders: PREPU

A client with a peptic ulcer is diagnosed with Helicobacter pylori infection. The nurse is teaching the client about the medications prescribed, including metronidazole, omeprazole, and clarithromycin. Which statement by the client indicates the best understanding of the medication regimen? A. "medications will kill the bacteria and stop the acid production." B. "I should take these medications only when I have pain from my ulcer." C. "My ulcer will heal because these medications will kill the bacteria." D. "These medications will coat the ulcer and decrease the acid production in my stomach."

A

DRUG CLASS THAT CAN CAUSE LIVER FAILURE

ACETAMINOPHEN

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? A.vitamin C B. vitamin B12 C. vitamin B6 D. vitamin A

B.

the term for wasting syndrome.A general state of ill health involving marked weight loss and muscle loss

Chachexia

A patient asks the home health nurse from what the distressing symptoms of dumping syndrome result. What physiological occurrence should the nurse explain? A. Reflux of bile into the distal esophagus b. B. Irritation of the phrenic nerve due to diaphragmatic pressure C. Chronic malabsorption of iron and vitamins A and C D .Osmotic transport of extracellular fluid into the gastrointestinal tract

D

An older adult patient with a diagnosis of chronic gastritis has achieved acceptable control of his condition with the use of an H2 receptor antagonist. This patient's symptom control is a result of what therapeutic action of this drug? A.Activation of the gastric buffer system and release of alkaline gastric secretions B. The occlusion of parietal cells C. An increase in the pH of gastric secretions D. A decrease in HCl production by parietal cells

D

DRUG CLASS THAT CAUSE GASTRITIS

NSAIDS

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. A. Omeprazole (Prilosec) B. Cimetidine (Tagamet) C. Famotidine (Pepcid) D. Ranitidine (Zantac)

A. Omeprazole (Prilosec) is a proton pump inhibitor that, if used according to the health care provider's directions, will result in healing in 90% of patients. The other drugs are H2 receptor antagonists that need to be used for 6 weeks.

Which of the following is considered an early symptom of gastric cancer? A. Pain relieved by antacids B. Weight loss C. Dyspepsia D. Bloating after meals

A. Symptoms of early disease, such as pain relieved by antacids, resemble those of benign ulcers and are seldom definitive. Symptoms of progressive disease include weight loss, bloating after meals, and dyspepsia.

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? A. Oral contrast B. Stool specimen C. Pelvic x-ray D. Nasogastric tube insertion

D.

After teaching a client who has had a Roux-en-Y gastric bypass, which client statement indicates the need for additional teaching? A. "I need to chew my food slowly and thoroughly." B"I should pick cereals with less than 2 g of fiber per serving." C. "I need to drink 8 ounces of water before eating." D."A total serving should amount to be less than one cup.

C. After a Roux-en-Y gastric bypass, the client should not drink fluids with meals, withholding fluids for 15 minutes before eating to 90 minutes after eating.

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

C. Signs of bleeding include tachycardia, tachypnea, hypotension, mental confusion, thirst, and oliguria.

The nurse is conducting a community education program on peptic ulcer disease prevention. The nurse includes that the most common cause of peptic ulcers is: A. ibuprofen and aspirin. B. alcohol and tobacco. C. gram-negative bacteria. D.stress and anxiety.

C. The nurse should include that the most common cause of peptic ulcers is gram-negative bacteria (Helicobacter pylori).

An older adult patient had a gastrectomy performed several weeks ago and is being followed closely by the care team. Due to potential complications of this surgery, the nurse should closely monitor the patient's levels of: A. Prealbumin and bilirubin B. Creatinine and blood urea nitrogen (BUN) C. Ionized calcium and C-reactive protein D. Iron and vitamin B12

D. Dietary deficiencies associated with gastrectomy include malabsorption of organic iron, which may require supplementation with oral or parenteral iron, and a low serum level of vitamin B12, which may require supplementation by the intramuscular route.

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? A. Curling's ulcer B. Meckel's ulcer C. Peptic ulcer D. Esophageal ulcer

A. Ulcer is associated with burns

A nurse is performing discharge teaching with a client who had a total gastrectomy. Which statement indicates the need for further teaching? A. "I will call my physician if I begin to have abdominal pain." B. "I will have to take vitamin B12 shots up to 1 year after surgery." C. "I will weight myself each day and record the weight." D. "I'm going to visit my pastor weekly for a while."

B. After a total gastrectomy, a client will need to take vitamin B12 shots for life. Dietary B12 is absorbed in the stomach, and the inability to absorb it could lead to pernicious anemia

A client with gastric cancer is having a resection. What is the nursing management priority for this client? A. Preventing deep vein thrombosis (DVT) B. Teaching about radiation treatment C. Discharge planning D. Correcting nutritional deficits

D Clients with gastric cancer commonly have nutritional deficits and may have cachexia . Therefore, correcting nutritional deficits is a top priority. Chachexia= wasting syndrome.A general state of ill health involving marked weight loss and muscle loss

The nursing student approaches his instructor to discuss the plan of care for his client diagnosed with peptic ulcer disease. The student asks what is the most common site for peptic ulcer formation? The instructor would state which one of the following? A. Duodenum B.Stomach C. Esophagus D. Pylorus

A

A 70-year-old woman with a complex medical history made an appointment with her primary care provider because she has recently been experiencing heartburn, abdominal pain, and nausea. The clinician has identified that the woman's symptoms are characteristic of acute gastritis. Which of the woman's following statements is suggestive of the etiology of her problem? A. "I remember my father often complaining about heartburn and indigestion." B. "My endocrinologist recently increased my dose of metformin that I take for my diabetes." C. "I've been taking glucosamine supplements because I've been told they'll help my arthritis." D. "I've changed from taking Tylenol for my arthritis pain to taking aspirin."

D

A client with morbid obesity is being scheduled for malabsorptive bariatric surgery. The nurse would provide teaching about which procedure? A. Roux-en-Y gastric bypass B. sleeve gastrectomy C. biliopancreatic diversion D. gastric banding

D.

A client with morbid obesity and a history of severe sleep apnea and severe diabetes is being considered for bariatric surgery. When reviewing the client's medical record, the nurse would identify that which body mass index (BMI) would meet the criteria for such surgery? A. 32 kg/m2 B. 30kg/m2 C. 34 kg/m2 D. 36 kg/m2

D.