NURS 309 Gastrointestinal-1
A client with gastroesophageal reflux is to receive metoclopramide (Reglan) 15 mg orally before meals. The concentrated solution contains 10 mg/mL. How much solution should the nurse administer? _____ mL
1.5 mL
The nurse is teaching a patient about health promotion and maintenance to prevent gastritis. Which information does the nurse include? SATA A. "A balanced diet can help prevent gastritis" B. "To prevent gastritis, you should limit your intake of salt" C. "If you stop smoking, there is less of a chance that you will develop gastritis" D. "Yoga has been found to be effective in preventing gastritis" E. "Although regular exercise is good for you, it has not been found to influence the prevention of gastritis" F. "To prevent gastritis, alcohol should be avoided"
A. "A balanced diet can help prevent gastritis" C. "If you stop smoking, there is less of a chance that you will develop gastritis" D. "Yoga has been found to be effective in preventing gastritis" F. "To prevent gastritis, alcohol should be avoided"
The nurse is providing discharge teaching for a patient after a gastrectomy. Which teaching points will the nurse include to help the patient minimize dumping syndrome? SATA A. "Eat small frequent meals" B. "Drink an 8-ounce glass of water with each meal" C. "Eliminate alcohol and caffeine from your diet" D. "Lie flat for a short time after eating" E. "Take B12 injections as prescribed by your healthcare provider" F. "Begin a smoking cessation program"
A. "Eat small frequent meals" C. "Eliminate alcohol and caffeine from your diet" D. "Lie flat for a short time after eating" E. "Take B12 injections as prescribed by your healthcare provider" F. "Begin a smoking cessation program"
Which statements will the nurse include when providing health teaching for a patient with hiatal hernia? SATA A. "Elevate the head of your bed at least 6 inches for sleeping at night" B. "Remain in the upright position for several hours after eating" C. "Avoid straining or excessive vigorous exercise" D. "After surgery, you will have no dietary restriction" E. "Avoid wearing clothing that is tight around the abdomen" F. "Avoid eating in the late evening"
A. "Elevate the head of your bed at least 6 inches for sleeping at night" B. "Remain in the upright position for several hours after eating" C. "Avoid straining or excessive vigorous exercise" E. "Avoid wearing clothing that is tight around the abdomen" F. "Avoid eating in the late evening"
A patient who has been prescribed famotidine is being discharged home. Which statement by the patient indicates the need for further teaching by the nurse? A. "I will double up on the dose if I begin to feel increased heartburn" B. "I will avoid all alcohol" C. "I will call the health care provider if I continue to have heartburn" D. "This drug is available over the counter"
A. "I will double up on the dose if I begin to feel increased heartburn"
The nurse is teaching a patient with dumping syndrome about diet. Which statement by the patient indicates that teaching has been effective?" A. "I will use sugar-free gelatin with caution" B. "I will avoid rice in my diet" C. "Meat in my diet will consist of a total of 8 ounces a day" D. "I will limit fluids with my meals to 8 ounces"
A. "I will use sugar-free gelatin with caution"
The health care provider has prescribed therapy for a patient with PUD due to H. pylori infection. Which drugs will the nurse expect to administer? SATA A. A proton pump inhibitor (PPI) B. Sucralfate C. Two antibiotics D. A histamine H2 antagonist E. Bismuth F. Two antacids
A. A proton pump inhibitor (PPI) C. Two antibiotics E. Bismuth
The nurse is caring for several patients with gastric and duodenal ulcers. Which differential features of gastric ulcers compared to duodenal ulcers does the nurse identify? SATA A. In gastric ulcers, there is normal secretion or hyposecretion B. Gastric ulcers are relieved by ingestion of food C. Hematemesis is more common than melena D. No gastritis is present E. Most often, the patient has type O blood F. Pain occurs 30-60 minutes after a meal and at night
A. In gastric ulcers, there is normal secretion or hyposecretion C. Hematemesis is more common than melena F. Pain occurs 30-60 minutes after a meal and at night
The nurse is collaborating with the speech-language pathologist to assist the patient with oral exercises to improve swallowing (swallowing therapy) and with the occupational therapists for feeding therapy. Which key points must be included when teaching this patient? SATA A. Ask the patient to suck on a lollipop to enhance tongue strength B. Teach the patient to reach for food particles on the lips or chin using the tongue C. Instruct the patient to place food at the front of the mouth D. In preparation for swallowing, remind the patient to position the head forward in flexion (chin tuck) E. Monitor the patient for sealing of the lips and for tongue movements while eating F. Check for pocketing of food under the tongue after swallowing
A. Ask the patient to suck on a lollipop to enhance tongue strength B. Teach the patient to reach for food particles on the lips or chin using the tongue D. In preparation for swallowing, remind the patient to position the head forward in flexion (chin tuck) E. Monitor the patient for sealing of the lips and for tongue movements while eating
Three days after admission to the hospital for a brain attack (CVA), a client has a nasogastric tube inserted and is receiving continuous tube feedings. What should the nurse do to best evaluate whether the feeding is being absorbed? A. Aspirate for a residual volume B. Evaluate the intake in relation to the output C. Instill air into the client's stomach while auscultating D. Compare the client's body weight with the baseline data
A. Aspirate for a residual volume
A nurse is providing discharge instructions for a client with a diagnosis of gastroesophageal reflux disease (GERD). What should the nurse advise the client to do to limit symptoms of GERD? SATA A. Avoid heavy lifting B. Lie down after eating C. Eat small, frequent meals D. Increase fluid intake with meals E. Wear an abdominal binder or girdle
A. Avoid heavy lifting C. Eat small, frequent meals D. Increase fluid intake with meals
The nurse is caring for a patient with esophageal cancer who is scheduled to undergo an esophagogastrostomy with a section of the jejunum to replace the esophagus. Which procedure does the nurse expect to perform preoperatively? A. Complete bowel preparation B. Abdominal shave C. Urinary catheter placement D. Nasogastric tube placement for feeding
A. Complete bowel preparation
Which type of gastric ulcer does the nurse expect may occur when caring for a patient with extensive burns? A. Curling's ulcer B. Cushing's ulcer C. Stress ulcer D. Ischemic ulcer
A. Curling's ulcer
The nurse is assessing a patient's nasogastric drainage following a conventional fundoplication procedure. How does the nurse expect the drainage to appear in the first 8 hours after surgery? A. Dark brown B. Bright mixed with brown C. Yellowish to green D. Green to clear
A. Dark brown
Uncontrolled gastroesophageal reflux disease (GERD) can be cause of which adult-onset disorders? SATA A. Dental decay B. Aspiration pneumonia C. Laryngitis D. Diverticulitis E. Asthma F. Cardiac disease
A. Dental decay B. Aspiration pneumonia C. Laryngitis E. Asthma F. Cardiac disease
A patient with severe gastroesophageal reflux disease (GERD) tells the nurse that she has pain after each meal that lasts for 45 minutes and is worse when she lies down. What interventions should the nurse teach this patient? SATA A. Drink fluids B. When you lie down, try lying on your sie C. Take an antacid as prescribed by your healthcare provider D. Eat something bland such as a slice of white bread E. Maintain an upright position for at least 1 hour after you eat F. Try pressing over your abdomen to mobilize the food in your stomach
A. Drink fluids C. Take an antacid as prescribed by your healthcare provider E. Maintain an upright position for at least 1 hour after you eat
The nurse is giving discharge instructions to a patient after a fundoplication procedure. The patient is instructed to avoid which activities? SATA A. Drinking carbonated beverages B. Beginning clear liquids when peristalsis has returned C. Drinking with a straw D. Eating gas-producing foods E. Eating soft foods that are easy to swallow F. Chewing gum
A. Drinking carbonated beverages C. Drinking with a straw D. Eating gas-producing foods F. Chewing gum
Which are the two most common manifestations of gastroesophageal reflux disease (GERD)? SATA A. Dyspepsia B. Eructation C. Water brash D. Regurgitation E. Odynophagia F. Flatulence
A. Dyspepsia D. Regurgitation
When performing an assessment on a patient with an active upper GI bleed, which conditions does the nurse identify as common causes of upper GI bleeding? SATA A. Esophageal cancer B. Esophageal varices C. Gastroesophageal reflux disease D. Duodenal ulcer E. Gastritis F. Gastric cancer
A. Esophageal cancer B. Esophageal varices D. Duodenal ulcer E. Gastritis F. Gastric cancer
Which diagnostic test is the gold standard for diagnosing gastritis? A. Esophagogastroduodenoscopy (EDG) with biopsy B. Computed tomography (CT) scan C. Upper gastrointestinal (GI) series D. Cholangiogram
A. Esophagogastroduodenoscopy (EDG) with biopsy
A patient with peptic ulcer disease is receiving Maalox. Which actions does the nurse take when administering this medication? SATA A. Give the medication 2 hours after the patient's meal B. Instruct the patient to lie on the left side after taking an antacid C. Assess the patient for a history of renal disease before giving Maalox D. Assess the patient for a history of heart failure before giving Maalox E. Observe the patient for the side effect of constipation F. Do not give other drugs within 1-2 hours of antacids
A. Give the medication 2 hours after the patient's meal C. Assess the patient for a history of renal disease before giving Maalox D. Assess the patient for a history of heart failure before giving Maalox F. Do not give other drugs within 1-2 hours of antacids
What manifestations are expected when a patient has esophageal diverticula? SATA A. Halitosis B. Dysphagia C. Swelling with difficulty breathing D. Nocturnal cough E. Regurgitation F. Pain radiating to the right arm
A. Halitosis B. Dysphagia D. Nocturnal cough E. Regurgitation
By which actions do drugs used to treat gastroesophageal reflux disease (GERD) help to decrease the pain and discomfort the patient experiences? SATA A. Inhibition of gastric acid production B. Blocking of pain sensation in the CNS C. Accelerating gastric emptying D. Decreasing lower esophageal sphincter pressure E. Protecting the gastric mucosa F. Destroying H. pylori bacteria
A. Inhibition of gastric acid production C. Accelerating gastric emptying E. Protecting the gastric mucosa
Which statement is true about Barrett's epithelium in the patient with gastroesophageal reflux disease (GERD)? A. It is considered premalignant and is associated with a higher risk for cancer B. This new tissue is less resistant to acid so it must be removed C. Barrett's epithelium is resistant to the development of cancer D. Esophageal strictures are less likely to occur with this type of epithelium
A. It is considered premalignant and is associated with a higher risk for cancer
Which statements about Barrett's esophagus are accurate? SATA A. It is considered to be a premalignant condition B. It is associated with excessive intake of fresh fruits and vegetables C. It results from exposure to acid and pepsin D. It is associated with pickled and fermented foods E. Normal cells undergo dysplasia to become cancerous F. It is more common in younger adults
A. It is considered to be a premalignant condition C. It results from exposure to acid and pepsin D. It is associated with pickled and fermented foods E. Normal cells undergo dysplasia to become cancerous
The patient with a gastric ulcer presents with a rigid, tender, and painful abdomen. He prefers lying in a knee-chest (fetal) position. What is the nurse's priority action at this time? A. Notify the health care provider B. Administer opioid pain medication C. Reposition the patient supine D. Measure the abdominal circumference
A. Notify the health care provider
An older adult with gastroesophageal reflux disease (GERD) is prescribed omeprazole. What priority teaching point must the nurse instruct the patient about while taking this drug? A. Older adults taking this drug may be at increased risk for hip fracture because it interferes with calcium absorption B. Because of this drug's effect of decreasing potassium, the patient may be prescribed a potassium supplement C. This drug causes sodium retention so the patient may be prescribed a sodium restriction D. A heart monitor may be needed because of changes in magnesium that can lead to life threatening dysrhythmias
A. Older adults taking this drug may be at increased risk for hip fracture because it interferes with calcium absorption
Which statements about gastroesophageal reflux disease (GERD) are correct? SATA A. Overweight and obese patients are at an increased risk B. Thin and underweight patients are at an increased risk C. It is a common disorder in the Asian and Hispanic population D. There is a high incidence in patients who eat mostly hot and spicy foods E. It is a common upper gastrointestinal disorder in the United States F. Eating large meals predisposes a patient to reflux
A. Overweight and obese patients are at an increased risk E. It is a common upper gastrointestinal disorder in the United States F. Eating large meals predisposes a patient to reflux
Drug therapy for peptic ulcer disease (PUD) is implemented for which purposes? SATA A. Pain relief B. Rebuild the mucosal lining of the stomach C. Eliminate H. pylori infection D. Heal ulcerations E. Prevent recurrence F. Control bleeding
A. Pain relief C. Eliminate H. pylori infection D. Heal ulcerations E. Prevent recurrence
Which statement about general principles of diet therapy for patients with dumping syndrome is true? A. Patients with dumping syndrome should have liquids between meals only B. Patients with dumping syndrome should be encouraged to eat a diet high in roughage C. Patients with dumping syndrome should eat a high-carbohydrate diet D. The diet for a patient with dumping syndrome must be low in fat and protein
A. Patients with dumping syndrome should have liquids between meals only
A patient with chronic gastritis is being admitted. Which sign/symptom does the nurse identify as being associated with the patient's condition? A. Pernicious anemia B. Gastric hemorrhage C. Hematemesis D. Dyspepsia
A. Pernicious anemia
Which are possible complications of chronic gastritis? SATA A. Pernicious anemia B. Thickening of the stomach lining C. Gastric cancer D. Decreased gastric acid secretion E. Peptic ulcer disease F. Local irritation from radiation therapy
A. Pernicious anemia C. Gastric cancer D. Decreased gastric acid secretion E. Peptic ulcer disease
What is the primary focus of care after conventional surgery for hiatal hernia? A. Prevention of respiratory complications B. Pain management C. Management of fluid balance D. Teaching the patient self-care activities
A. Prevention of respiratory complications
Which strategies does the nurse expect to implement in the management of dumping syndrome? SATA A. Provide more frequent smaller meals B. Provide a high-carbohydrate diet C. Eliminate liquids ingested with meals D. Increase protein and fat in the diet E. Administer acarbose to decrease carbohydrate absorption F. Subcutaneous octreotide (Sandostatin) 2-3 times a day, 30 minutes before meals as prescribed
A. Provide more frequent smaller meals C. Eliminate liquids ingested with meals D. Increase protein and fat in the diet E. Administer acarbose to decrease carbohydrate absorption F. Subcutaneous octreotide (Sandostatin) 2-3 times a day, 30 minutes before meals as prescribed
A patient develops an active upper GI bleed. Which are the priority actions the nurse takes in caring for this patient? SATA A. Provide oxygen B. Start 1-2 large bore IV lines C. Prepare to infuse 0.9% normal saline solution D. Monitor serum electrolytes E. Prepare for nasogastric (NG) tube insertion F. Monitor hematocrit and hemoglobin
A. Provide oxygen B. Start 1-2 large bore IV lines C. Prepare to infuse 0.9% normal saline solution E. Prepare for nasogastric (NG) tube insertion F. Monitor hematocrit and hemoglobin
Nonsurgical treatment options for cancer of the esophagus can include which therapies? SATA A. Swallowing therapy B. Chemoradiation C. Targeted therapies D. Smoking cessation programs E. Photodynamic therapy F. Endoscopic therapies
A. Swallowing therapy B. Chemoradiation C. Targeted therapies E. Photodynamic therapy F. Endoscopic therapies
Which are symptoms of early dumping syndrome? SATA A. Tachycardia B. Confusion C. Desire to lie down D. Syncope E. Occurs in 30 minutes after eating F. Palpitations
A. Tachycardia C. Desire to lie down D. Syncope E. Occurs in 30 minutes after eating
The patient with esophageal cancer has an excess of HER2 protein on the cell surface. What therapy does the nurse expect will be ordered for this patient? A. Targeted therapy with IV trastuzumab B. Chemoradiation with chemotherapy during the first and fifth weeks C. Radiation therapy alone to shrink the tumor D. Nutrition and swallowing therapy to prevent malnutrition
A. Targeted therapy with IV trastuzumab
In the postoperative period, following an open fundoplication repair for a paraesophageal (rolling) hernia, the nurse notes that with oral feedings, the patient has continuous dysphagia. What is the nurse's best interpretation of this finding? A. The fundoplication is too tight, and dilation may be required B. The patient is not ready for any nutrition other than clear liquids C. The health care provider will need to prescribe a stool softener D. The patient needs a nasogastric tube placed to decompress the stomach
A. The fundoplication is too tight, and dilation may be required
The nursing student caring for a patient with a duodenal ulcer is about to administer a proton pump inhibitor (PPI). Which statement about this medication is true? A. These drugs should not be used for a prolonged period because they may contribute to osteoporosis-related fractures B. PPIs may not be given via feeding tube C. These drugs help prevent stress-induced ulcers D. PPIs work by coating the stomach with protective barriers
A. These drugs should not be used for a prolonged period because they may contribute to osteoporosis-related fractures
The student nurse is performing a gastric lavage on a patient with an active upper GI bleed. Which action by the student requires intervention by the supervising nurse? A. Using an ice-cold solution to perform lavage on stomach B. Instilling the lavage solution in volumes of 200-300 mL C. Continuing the lavage until the solution returned is clear or light pink without clots D. Positioning the patient on his left side during the procedure
A. Using an ice-cold solution to perform lavage on stomach
Which are pathologic changes associated with acute gastritis? SATA A. Vascular congestion B. Severe mucosal damage and ruptured vessels C. Autodigestion D. Acute inflammatory cell infiltration E. Increased cell production in the superficial epithelium of the stomach lining F. Edema
A. Vascular congestion B. Severe mucosal damage and ruptured vessels D. Acute inflammatory cell infiltration F. Edema
The nurse is caring for a patient who underwent gastric resection. On assessment, the nurse notes that the patient's tongue is smooth and shiny and appears "beefy." What does the nurse suspect has occurred? A. Vitamin B12 deficiency B. Anemia C. Hypovolemia D. Inadequate nutrition
A. Vitamin B12 deficiency
The nurse is teaching a patient with dumping syndrome. Which foods should the patient be instructed are permitted and encouraged? SATA A. White bread, rolls, and crackers B. Sweetened juice or fruit C. Cooked vegetables D. Carbonated drinks E. Fish, poultry, beef, or pork F. Butter and salad dressing
A. White bread, rolls, and crackers C. Cooked vegetables E. Fish, poultry, beef, or pork F. Butter and salad dressing
Which types of ulcers are included in peptic ulcer disease? SATA A. Esophageal ulcers B. Gastric ulcers C. Pressure ulcer D. Duodenal ulcers E. Stress ulcer F. Colon ulcers
B. Gastric ulcers D. Duodenal ulcers E. Stress ulcer
Which is the most commonly reported symptom associated with peptic ulcer disease (PUD)? A. Rebound pain B. Indigestion C. Bleeding D. Diarrhea
B. Indigestion
Which physiologic factor contributes to gastroesophageal reflux disease (GERD)? A. Accelerated gastric emptying B. Irritation from reflux of stomach contents C. Competent lower esophageal sphincter D. Increased esophageal clearance
B. Irritation from reflux of stomach contents
A nurse is obtaining a history and performing a physical assessment of a client who has cancer of the tongue. Which clinical findings should the nurse expect to identify? SATA A. Halitosis B. Leukoplakia C. Bleeding gums D. Substernal pain E. Alteration in taste F. Enlarged cervical lymph nodes
B. Leukoplakia E. Alteration in taste F. Enlarged cervical lymph nodes
The nurse has provided postoperative teaching for a patient who underwent a laparoscopic Nissen fundoplication. Which statement by the patient indicates a need for additional teaching? A. "I will walk everyday" B. "I will no longer need the anti-reflux drugs after the surgery" C. "I will report a fever above 101.1" D. "I'll remove the gauze dressing 2 days after surgery and shower"
B. "I will no longer need the anti-reflux drugs after the surgery"
The nurse has provided instructions for a patient prescribed sucralfate to treat a gastric ulcer. Which statement by the patient indicates that the teaching has been effective? A. "This drug will stop the secretion of acid in my stomach" B. "I will take this drug on an empty stomach" C. "I will not be able to take ranitidine (Zantac) with this drug" D. "The main side effect of this drug that I can expect is diarrhea"
B. "I will take this drug on an empty stomach"
When teaching a patient about pernicious anemia, which statement does the nurse include? A. "Patients with pernicious anemia are not able to digest fats" B. "Pernicious anemia results from a deficiency of vitamin B12" C. "All patients with gastrointestinal bleeding will eventually develop pernicious anemia" D. "Oral iron supplements are an effective treatment for pernicious anemia"
B. "Pernicious anemia results from a deficiency of vitamin B12"
The nurse is teaching a patient about ranitidine (Zantac) prescribed for gastritis. Which statement by the patient indicates effective teaching by the nurse? A. "The drug will heal the areas of my stomach that are sore" B. "This drug will block the secretions of my stomach" C. "Zantac will coat the inside of my stomach to protect it from acid" D. "This pill kills the bacterial infection I have in my stomach"
B. "This drug will block the secretions of my stomach"
A patient is scheduled to have several diagnostic tests to verify the medical diagnosis of gastroesophageal reflux disease (GERD). Which diagnostic test is the most accurate method of diagnosing this disorder? A. Esophagogastroduodenoscopy (EGD) B. Ambulatory pH monitoring examination C. Esophageal manometry D. Motility testing
B. Ambulatory pH monitoring examination
Which lifestyle adjustment may a patient have to make to best control esophageal reflux disease (GERD)? A. Sleep in the Trendelenburg position B. Attain and maintain ideal body weight C. Wear snug-fitting belts and waistbands D. Engage in strenuous exercise such as weightlifting
B. Attain and maintain ideal body weight
The nurse is caring for a postoperative patient after esophageal surgery. On assessment, the nurse discovers that the patient's temperature is 101, heart rate is 120/minute, and respiratory rate is 32/minute. Lung sounds include bilateral crackles. What is the nurse's priority first action? A. Raise the head of the patient's bed B. Call the rapid response team C. Apply oxygen at 2 L per nasal cannula D. Administer IV normal saline at 75 mL/hour
B. Call the rapid response team
A client with gastroesophageal reflux disease reports having difficulty sleeping at night. What should the nurse instruct the client to do? A. Drink a glass of milk before retiring B. Elevate the head of the bed on blocks C. Eliminate carbohydrates from the diet D. Take antacids such as sodium bicarbonate
B. Elevate the head of the bed on blocks
Which procedure would the health care provider recommend for immediate relief of dysphagia? A. Photodynamic therapy B. Esophageal dilation C. Targeted therapy D. Chemoradiation therapy
B. Esophageal dilation
The nurse is teaching a patient with gastroesophageal reflux disease (GERD) about lifestyle changes. Which key points would the nurse include? SATA A. Consume 4-6 large meals per day B. Limit or eliminate alcohol and tobacco C. Eat slowly and chew food thoroughly D. Elevate the head of your bed 3-5 inches using wooden blocks E. Do not wear restrictive clothing F. Reduce or eliminate spicy foods that cause increased gastric acid
B. Limit or eliminate alcohol and tobacco C. Eat slowly and chew food thoroughly E. Do not wear restrictive clothing F. Reduce or eliminate spicy foods that cause increased gastric acid
A patient with gastroesophageal reflux disease (GERD) is on a medication that raises the pH of gastric contents. Which drug does the nurse expect to administer? A. Ranitidine B. Mylanta C. Gaviscon D. Omeprazole
B. Mylanta
A client has a nasogastric feeding tube inserted, and the health care provider orders the prescribed feeding to be instituted immediately. What should the nurse do first? A. Instill normal saline into the tube to maintain patency B. Obtain an x-ray to verify that the tube is in the stomach C. Auscultate the epigastric area while instilling 15 mL of air D. Withdraw 30 mL of stomach contents to verify tube placement
B. Obtain an x-ray to verify that the tube is in the stomach
Which therapy may be used as a cure for patients who have small localized tumors? A. Chemotherapy B. Photodynamic therapy C. Nutrition therapy D. Radiation therapy
B. Photodynamic therapy
The patient tells the nurse that he is fearful of developing stomach cancer, which caused his father's death. Which foods should the nurse teach the patient to avoid? A. Foods that cause reflux B. Pickled and processed foods C. Large and heavy meals D. Heavily spiced foods
B. Pickled and processed foods
Which instruction would the nurse be sure to give to the unlicensed assistive personnel (UAP) who will be assisting a patient with an esophageal tumor to eat? A. Feed the patient as fast as you can because there are three more patients who will need help B. Position the patient in a high Fowler's position before feedings C. Always suction the patient between bites to avoid aspiration D. Remind the patient to cough and deep breathe between bites of food
B. Position the patient in a high Fowler's position before feedings
Which simple noninvasive tests can be used to detect H. pylori in a patient with peptic ulcer disease (PUD)? SATA A. Echocardiogram B. Serologic testing for antibodies C. Urea breath test D. Stool antigen test E. CT scan F. MRI
B. Serologic testing for antibodies C. Urea breath test D. Stool antigen test
The nurse is supervising a senior nursing student in the care of a patient after esophageal surgery. For which action by the student nurse must the nurse intervene? A. Student secures the NG tube to prevent dislodgement B. Student prepares to irrigate NG tube C. Student provides mouth care very 2-4 hours D. Student elevates the head of the patient's bed
B. Student prepares to irrigate NG tube
Which statements about gastritis are accurate? SATA A. The diagnosis of gastritis is made solely on clinical symptoms B. The onset of infection with Helicobacter pylori can result in acute gastritis C. Long-term use of acetaminophen is a high-risk factor for acute gastritis D. Atrophic gastritis is a form of chronic gastritis that is seen most in older adults E. Type B chronic gastritis affects the glands in the antrum but may affect all the stomach F. Type A chronic gastritis involves erosion in the fundus of the stomach
B. The onset of infection with Helicobacter pylori can result in acute gastritis D. Atrophic gastritis is a form of chronic gastritis that is seen most in older adults E. Type B chronic gastritis affects the glands in the antrum but may affect all the stomach
A patient is undergoing a workup for carcinoma of the esophagus. What are the two primary risk factors associated with the development of this carcinoma? A. High-fat, low-fiber diet and tobacco use B. Tobacco use and obesity C. Sedentary lifestyle and family history of squamous cell carcinoma D. Heavy alcohol intake and high-fat, low-fiber diet
B. Tobacco use and obesity
A client has a fractured mandible that is immobilized with wires. For which life-threatening postoperative problem should the nurse monitor this client? A. Infection B. Vomiting C. Osteomyelitis D. Bronchospasms
B. Vomiting
What is the cause of late dumping syndrome? A. Rapid emptying of food into the small intestine B. Shift of fluids into the gut leading to abdominal distension C. Release of an excessive amount of insulin D. Rapid entry of high-protein foods into the jejunum
C. Release of an excessive amount of insulin
After an esophagectomy, what is the nurse's priority for patient care? A. Wound care B. Nutrition care C. Respiratory care D. Hydration care
C. Respiratory care
A client with gastroesophageal disease (GERD) should make diet and lifestyle changes. What instructions should the nurse include in the client's discharge teaching? SATA A. Add milk to coffee B. Elevate the foot of the bed C. Avoid caffeine containing products D. Eat three evenly spaced meals daily E. Chew thoroughly while eating slowly
C. Avoid caffeine containing products E. Chew thoroughly while eating slowly
Which drug would the health care provider prescribe to treat H. pylori infection? A. Ranitidine B. Omeprazole C. Clarithromycin D. Pantoprazole
C. Clarithromycin
What is the most common symptom of esophageal cancer reported by patients? A. Productive cough B. Reflux especially at night C. Difficulty with swallowing D. Shortness of breath
C. Difficulty with swallowing
An older adult patient is admitted with an upper GI bleed. Which finding does the nurse expect to assess in the patient? A. Decreased pulse B. Increased hemoglobin and hematocrit C. Dizziness D. Increased blood pressure
C. Dizziness
The definitive diagnosis for esophageal cancer is made with which procedure? A. Barium swallow B. Esophageal manometry C. Esophageal ultrasound with fine needle aspiration D. Esophagogastroduodenoscopy (EDG)
C. Esophageal ultrasound with fine needle aspiration
The nurse is assessing a patient who has had a total gastrectomy today and notes bright-red blood in the nasogastric (NG) tube and abdominal distention. What does the nurse do next? A. Irrigate the NG tube B. Reposition the NG tube C. Inform the surgeon of these findings D. Remove the NG tube
C. Inform the surgeon of these findings
The patient with gastroesophageal reflux disease (GERD) describes painful swallowing. Which symptom does the nurse identify? A. Dyspepsia B. Regurgitation C. Odynophagia D. Dysphagia
C. Odynophagia
A client who had an incision and drainage of an oral abscess is to be discharged. For which clinical finding, if it should occur, should the nurse instruct the client to notify the health care provider? A. Foul odor to the breath B. Pain associated with swallowing C. Pain with swelling after one week D. Tenderness in the mouth when chewing
C. Pain with swelling after one week
The patient with a gastric ulcer suddenly develops sharp constant epigastric pain that spreads over the entire abdomen. What complication has the patient most likely developed? A. Hemorrhage B. Gastric erosion C. Perforation D. Gastric cancer
C. Perforation
Which group of drugs is the main treatment for severe gastroesophageal reflux disease (GERD)? A. Antacids B. Histamine receptor agonists C. Proton pump inhibitors D. Gaviscon preparations
C. Proton pump inhibitors
The patient develops abdominal bloating along with nausea and vomiting. Which complication of peptic ulcer disease (PUD) does the nurse recognize? A. Perforation B. Hemorrhage C. Pyloric obstruction D. Intractable PUD
C. Pyloric obstruction
Which statement about esophageal trauma caused by chemical injury is accurate? A. Alkaline substances tend to affect the superficial mucosal lining B. Acid burns cause deep penetrating injuries C. Strong alkalis can cause full perforation of the esophagus within 1 minute D. Chemical injuries damage the mouth and esophagus over a period of several hours
C. Strong alkalis can cause full perforation of the esophagus within 1 minute
The nurse has provided teaching to a patient with gastroesophageal reflux disease (GERD). Which statement by the patient indicates the teaching has been effective? A. "I will eat three meals a day" B. "I will not snack 1 hour before I go to bed" C. "I will stay up for at least 15-30 minutes after eating dinner before going to bed" D. "I won't lift heavy objects"
D. "I won't lift heavy objects"
The nurse is teaching a patient being discharged home about taking prescribed medications that include sucralfate. Which statement by the patient indicates teaching has been effective? A. "The main side effect of sucralfate is diarrhea" B. "I will take sucralfate with meals" C. "I will take sucralfate along with the antacid medication I take" D. "Sucralfate works to heal my ulcer"
D. "Sucralfate works to heal my ulcer"
A patient has returned to the unit after a Stretta procedure for gastroesophageal reflux disease (GERD). Which action by the student nurse required the supervising nurse to intervene? A. The patient is offered clear liquids in the early postoperative period B. The patient's routine 81 mg aspirin is held C. A proton pump inhibitor is administered D. A nasogastric tube is prepared for insertion
D. A nasogastric tube is prepared for insertion
A patient comes to the emergency department (ED) reporting rapid onset of epigastric pain with nausea and vomiting. The patient says the pain is worse than any heartburn he has had, and that he has not had an appetite for the past day. What does the nurse suspect this patient has? A. Peritonitis B. H. pylori infection C. Duodenal ulcer D. Acute gastritis
D. Acute gastritis
Which statement about the use of antacids in the treatment of gastric ulcers is true? A. Antacids should be administered with meals B. Patients should take calcium carbonate C. The patient should take antacids on an empty stomach D. Avoid using antacids with phenytoin
D. Avoid using antacids with phenytoin
What diagnostic test best identifies a hiatal hernia? A. Esophagogastroduodenoscopy (EGD) B. 24-hour ambulatory pH monitoring C. Esophageal manometry D. Barium swallow study with fluoroscopy
D. Barium swallow study with fluoroscopy
Which type of nonsteroidal anti-inflammatory (NSAID) drug is less likely to cause mucosal damage to the stomach? A. Ibuprofen B. Aspirin C. Acetaminophen D. Celecoxib
D. Celecoxib
A client is receiving hypertonic tube feedings. What should the nurse consider to be the main reason this client may experience diarrhea? A. Increased fiber intake B. Bacterial contamination C. Inappropriate positioning D. High osmolarity of the feedings
D. High osmolarity of the feedings
The nurse is taking a history from a patient with peptic ulcer disease. Which factor indicates the largest risk for stomach cancer? A. History of GERD for 6 weeks B. History of hiatal hernia C. History of gastritis D. History of infection with H. pylori
D. History of infection with H. pylori
Which statement is true about the drug rabeprazole for treatment of gastroesophageal reflux disease (GERD)? A. It is rapidly released into the body after it is administered B. The tablets are large and may be crushed if the patient has difficulty swallowing them C. It is a histamine receptor antagonist D. If once-a-day dosing does not control symptoms, it may be taken twice a day
D. If once-a-day dosing does not control symptoms, it may be taken twice a day
A patient is prescribed pantoprazole. What does the nurse tell the patient is the major action of this medication? A. It produces a coating on the stomach lining B. It neutralizes gastric acid C. It heals esophageal irritation D. It inhibits gastric acid secretion
D. It inhibits gastric acid secretion
A nurse is collecting a health history from a client who has a diagnosis of cancer of the tongue. For which risk factor commonly associated with cancer of the tongue should the nurse assess when collecting the client's history? A. Nail biting B. Poor dental habits C. Frequent gum chewing D. Large consumption of alcohol
D. Large consumption of alcohol
Which peptic ulcer disease drug is useful to protect patients against NSAID-induced ulcers? A. Magnesium hydroxide B. Omeprazole C. Esomeprazole D. Misoprotsol
D. Misoprostol
The patient describes experiencing a dull and steady substernal pain, especially after drinking cold liquids. Which manifestations of esophageal cancer does the nurse recognize? A. Angina B. Aspiration C. Dysphagia D. Odynophagia
D. Odynophagia
A patient with acute gastritis is receiving treatment to block and buffer gastric acid secretions to relieve pain. Which drug does the nurse identify as an antisecretory agent (proton pump inhibitor)? A. Sucralfate B. Ranitidine C. Mylanta D. Omeprazole
D. Omeprazole
For which patient is radiation therapy contraindicated? A. Patient with lung cancer B. Patient with esophageal tumor C. Patient with sliding hernia D. Patient with tracheoesophageal fistula
D. Patient with tracheoesophageal fistula
The postoperative patient who had esophageal surgery has an NG tube in place. What intervention should the nurse delegate to the unlicensed assistive personnel (UAP)? A. Check the NG tube for proper placement B. Teach the patient about the purpose of the NG tube C. Assess the patient's lungs for the presence of abnormal breath sounds D. Provide the patient with thorough mouth and nasal care every 2-4 hours
D. Provide the patient with thorough mouth and nasal care every 2-4 hours
A health care provider orders intermittent nasogastric tube feedings to supplement a client's oral nutritional intake. Which hazard associated with a nasogastric tube feeding will be reduced if the nurse administers this feeding over 30 to 60 minutes? A. Distention B. Flatulence C. Indigestion D. Regurgitation
D. Regurgitation
During administration of an enema, a client reports having intestinal cramps. What should the nurse do? A. Discontinue the procedure B. Instill the fluid at a slower rate C. Lower the height of the container D. Stop the fluid until the cramps subside
D. Stop the fluid until the cramps subside
The nurse is caring for a patient who vomited coffee-ground emesis. Where does the nurse suspect the patient is bleeding? A. Colon B. Rectum C. Small intestine D. Upper GI system
D. Upper GI system
