PUCH40

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

A

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

A

Which of the following is the most successful treatment for gastric cancer? a. Removal of the tumor b. Chemotherapy c. Palliation d. Radiation

A

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: a. Intractable ulcer b. Hemorrhage c. Perforation d. Pyloric obstruction

B

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? a. Clay-colored b. Coffee-ground-like c. Black and tarry d. Bright red

C

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 A c. vitamin B12 d. vitamin B6

C

A client is newly diagnosed with stomach cancer. The nurse will plan to provide the client education on which treatment? a. Chemotherapy b. Intermittent monitoring c. Surgery d. Radiation

C

A client with an H. pylori infection asks why bismuth subsalicylate is prescribed. Which response will the nurse make? a. "It helps propel food from the stomach into the duodenum." b. "It improves digestion in the stomach." c. "It aids in the healing of the stomach lining." d. "It enhances the function of the pyloric sphincter."

C

A client with chronic peptic ulcers is considering a vagotomy. Which information will the nurse provide to the client about this surgical procedure? a. The lower part of the stomach is attached to the duodenum. b. It can cause anemia, weight loss, and malabsorption. c. Adverse effects such as dumping syndrome and gastritis can occur. d. It widens the pylorus to allow increased stomach emptying.

C

A client with peptic ulcer disease has a blood pressure of 88/40 mm Hg, dizziness, and nausea. Which complication will the nurse suspect is occurring with this client? a. Evidence of ulcer healing b. Allergic response to the medication c. Bleeding from the ulcer d. Medication adverse effects

C

A client with peptic ulcer disease has been prescribed sucralfate. What health education should the nurse provide to this client? a. Take the medication at bedtime to accommodate sedative effects b. Blood levels will be evaluated after 1 week c. Take the medication 2 hours before or after other medications d. Ensure adequate potassium intake during therapy

C

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. A normal reaction to surgery b. Dehiscence of the surgical wound c. Vasomotor symptoms associated with dumping syndrome d. Peritonitis

C

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

C

The nurse advises the patient who has just been diagnosed with acute gastritis to: a. Restrict food and fluids for 12 hours. b. Take an emetic to rid the stomach of the irritating products. c. Refrain from food until the GI symptoms subside. d. Restrict all food for 72 hours to rest the stomach.

C

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 can buy whatever antacids are on sale because they all have the same effect." c. "I have learned some relaxation strategies that decrease my stress." d. "I should continue my treatment regimen as long as I have pain."

C

A client being treated for a peptic ulcer seeks medical attention for vomiting blood. Which statement indicates to the nurse the reason for the client developing hematemesis? a. "I only ate dinner yesterday and it gave me an upset stomach." b. "I felt better but then just got really nauseated and threw up." c. "I think the soda that I drank irritated my stomach." d. "The pain stopped so I stopped taking the medications."

D

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. Duodenal ulcer b. Gastric ulcer c. Gastric cancer d. Acute gastritis

D

A client is recovering from gastric surgery. What is the correct position for the nurse to place this client? a. Supine b. Semi-Fowler's c. Trendelenburg d. Fowler's

D

A client is scheduled for removal of the lower portion of the antrum of the stomach and a small portion of the duodenum and pylorus. What surgical procedure will the nurse prepare the client for? a. Pyloroplasty b. Vagotomy c. Billroth II d. Billroth I

D

A client 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 client? a. Esophageal ulcer b. Meckel's ulcer c. Peptic ulcer d. Curling's ulcer

D

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. Bile reflux b. Gastric outlet obstruction c. Celiac disease d. Dumping syndrome

D

A client with gastric cancer is planning to receive chemotherapy. Which medication will be used as the primary agent to improve the tumor response rate? a. Paclitaxel b. Docetaxel c. Carboplatin d. Fluorouracil

D

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. Penetration b. Perforation c. Pyloric obstruction d. Hemorrhage

D

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

D

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

D

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. Hypertension d. Mental confusion

D

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. Stool specimen b. Oral contrast c. Pelvic x-ray d. Nasogastric tube insertion

D

The nurse is assessing a client with advanced gastric cancer. The nurse anticipates that the assessment will reveal which finding? a. Weight gain b. Abdominal pain below the umbilicus c. Increased appetite d. Bloating after meals

D

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 between gastric and duodenal ulcers. a. Presence of H. pylori b. Sensitivity to the use of nonsteroidal anti-inflammatory drugs (NSAIDs) c. Patient's age d. Amount of hydrochloric acid (HCL) secretion in the stomach

D

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

D

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

D

Which medication classification represents a proton (gastric acid) pump inhibitor? a. Metronidazole b. Sucralfate c. Famotidine d. Omeprazole

D

The nurse is caring for a patient who has been diagnosed with gastritis. To promote fluid balance when treating gastritis, the nurse knows that what minimal daily intake of fluids is required? a. 1.0 L b. 1.5 L c. 2.5 L d. 2.0 L

B

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

A

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. drink liquids only with meals. c. don't drink liquids 2 hours before meals. d. restrict fluid intake to 1 qt (1,000 ml)/day.

A

A nursing student is preparing a teaching plan about peptic ulcer disease. The student knows to include teaching about the percentage of clients with peptic ulcers who experience bleeding. The percentage is a. 15% b. Less than 5% c. Greater than 50% d. 25%

A

During a home visit the nurse notes that a client recovering from peptic ulcer disease is experiencing cool clammy skin and has a heart rate of 96 beats a minute. Which action will the nurse take? a. Notify the primary health care provider. b. Discuss the types of foods the client has been eating. c. Encourage the client to drink a warm beverage. d. Provide a dose of a proton pump inhibitor.

A

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. Bradycardia c. Polyuria d. Hypertension

A

The nurse is caring for a client who has developed dumping syndrome while recovering from a gastrectomy. What recommendation should the nurse make to the client? a. Eat several small meals daily spaced at equal intervals. b. Sit upright when eating and for 30 minutes afterward. c. Drink a minimum of 12 ounces of fluid with each meal. d. Choose foods that are high in simple carbohydrates.

A

The nurse is evaluating a client's ulcer symptoms to differentiate ulcer as duodenal or gastric. Which symptom should the nurse at attribute to a duodenal ulcer? a. Awakening in pain b. Hemorrhage c. Constipation d. Vomiting

A

The nurse is preparing a teaching tool about delayed release proton pump inhibitors used to treat duodenal ulcer disease caused by H. pylori. Which statement will the nurse include that would apply to most types of proton pump inhibitor prescribed to treat this condition? a. The medication is to be swallowed whole and taken before meals b. May cause diarrhea and hyperglycemia c. Abdominal pain and abnormal liver function tests are expected effects d. Interferes with the metabolism of digoxin, iron, and warfarin

A

The nurse visits the home of a client recovering from acute gastritis. Which observation indicates that teaching about the disorder was effective? a. Medications placed in a pillbox b. Cup of caffeinated coffee on the kitchen table c. Extinguished cigarettes in an ashtray d. Tomato sauce simmering on the stove

A

A nurse is providing care for a client who is postoperative day 2 following gastric surgery. The nurse's assessment should be planned in light of the possibility of what potential complications? Select all that apply. a. Pneumonia b. Hemorrhage c. Atelectasis d. Chronic gastritis e. Malignant hyperthermia

A, B, C

A client diagnosed with a peptic ulcer says, "Now I have something else I have to worry about." Which actions will the nurse take to help reduce the client's anxiety? Select all that apply. a. Offer information about relaxation methods. b. Help identify the client's current stressors. c. Interact with the client in a relaxed manner. d. Inform the client the medication will solve the problem. e. Discuss potential coping techniques with the client.

A, B, C, E

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. Esophagus b. Duodenum c. Stomach d. Pylorus

B

Which is a true statement regarding the nursing considerations in administration of metronidazole? a. Metronidazole decreases the effect of warfarin. b. It leaves a metallic taste in the mouth. c. It may cause weight gain. d. The drug should be given before meals.

B

Which of the following interventions are appropriate for clients with gastritis? Select all that apply. a. Provide general education about how to prevent recurrences. b. Use a calm approach to reduce anxiety. c. Give the client food and fluids every 4 hours. d. Notify the physician of indicators of hemorrhagic gastritis. e. Discourage cigarette smoking.

A, B, D, E

Which of the following clients is at highest risk for peptic ulcer disease? a. Client with blood type B b. Client with blood type O c. Client with blood type A d. Client with blood type AB

B

A client has recently been diagnosed with gastric cancer. On palpation, the nurse would note what two signs that confirm metastasis to the liver? Select all that apply. a. Hepatomegaly b. Sister Mary Joseph's nodules c. Ascites d. Distended bladder e. Petechiae at the palpation site

A, C

A client is admitted with a new onset of pyloric obstruction. What client symptoms should the nurse anticipate? Select all that apply. a. Epigastric fullness b. Diarrhea c. Nausea and vomiting d. Anorexia e. Weight loss

A, C, D

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

A, C, D

Which of the following manifestations are associated with a deficiency of vitamin B12? Select all that apply. a. Pernicious anemia b. Loss of hair c. Macrocytic anemia d. Thrombocytopenia e. Lethargy

A, C, D

A client is preparing for discharge to home following a partial gastrectomy and vagotomy. Which is the best rationale for the client being taught to lie down for 30 minutes after each meal? a. Slows gastric emptying b. Allows for better absorption of vitamin B12 c. Provides much needed rest d. Removes tension on internal suture line

A

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. "The medications will kill the bacteria and stop the acid production." b. "My ulcer will heal because these medications will kill the bacteria." c. "I should take these medications only when I have pain from my ulcer." d. "These medications will coat the ulcer and decrease the acid production in my stomach."

A

A client with gastric ulcers caused by H. pylori is prescribed metronidazole. Which client statement indicates to the nurse that teaching about this medication was effective? a. "It might cause a metallic taste in my mouth." b. "I can take this medication with my blood thinner." c. "I can have an alcoholic drink in the evenings." d. "My appetite may increase while taking this medication."

A

The nurse is caring for a client with chronic gastritis. Which interventions will the nurse add to this client's plan of care? Select all that apply. a. Provide omeprazole as prescribed. b. Suggest using over the counter ibuprofen for pain control. c. Remind to avoid alcohol intake. d. Instruct to avoid foods that aggravate the condition. e. Review actions to reduce stress.

A, C, D, E

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. a. "You may be prescribed H2-receptor antagonists for up to 1 year." b. "The antacids will make you sleepy, so do not operate machinery while taking them." c. "You may take antacids with other medications." d. "Continue to take antacids even if your symptoms subside." e. "Be sure to take antacids with meals."

A, D

A client is newly diagnosed with a peptic ulcer. For which medications will the nurse prepare teaching for this client? Select all that apply. a. Bismuth subsalicylate b. Warfarin c. Diphenhydramine d. Metronidazole e. Omeprazole

A, D, E

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

B, C, D

A client with peptic ulcer disease must begin triple medication therapy. For how long will the client follow this regimen? a. 7 to 9 days b. 10 to 14 days c. 15 to 20 days d. 4 to 6 days

B

Which of the following appears to be a significant factor in the development of gastric cancer? a. Ethnicity b. Age c. Diet d. Gender

C

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

B

Which ulcer is associated with extensive burn injury? a. Peptic ulcer b. Duodenal ulcer c. Curling ulcer d. Cushing ulcer

C

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. Famotidine b. Omeprazole c. Cimetidine d. Nizatidine

B

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 = 175 lbs; weight = 265 lbs; BMI = 29 kg/m2 b. IBW = 145 lbs; weight = 290 lbs; BMI = 31 kg/m2 c. IBW = 150 lbs; weight = 190 lbs; BMI = 26 kg/m2 d. IBW = 132 lbs; weight = 184 lbs; BMI = 28 kg/m2

B

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

A client is prescribed tetracycline to treat peptic ulcer disease. Which instruction would the nurse give the client? a. "Do not drive when taking this medication." b. "Be sure to wear sunscreen while taking this medicine." c. "You will not experience GI upset while taking this medication." d. "Take the medication with milk."

B

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

B

A 66-year-old African-American client has recently visited a physician to confirm a diagnosis of gastric cancer. The client has a history of tobacco use and was diagnosed 10 years ago with pernicious anemia. He and his family are shocked about the possibility of cancer because he was asymptomatic prior to recent complaints of pain and multiple gastrointestinal symptoms. On the basis of knowledge of disease progression, the nurse assumes that organs adjacent to the stomach are also affected. Which of the following organs may be affected? Choose all that apply. a. Bladder b. Duodenum c. Liver d. Lungs e. Pancreas

B, C, E

A client has been taking famotidine at home. What teaching should the nurse include with the client? a. Famotidine will improve the mixing of foods and gastric secretions. b. Famotidine will shorten the time required for digestion in the stomach. c. Famotidine will inhibit gastric acid secretions. d. Famotidine will neutralize acid in the stomach.

C