Chapter 23: Patients With Gastric and Duodenal Disorders PREPU

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.

Omeprazole (Prilosec)

Which of the following is included as a dietary guideline for a patient who has had bariatric surgery?

Restrict total meal size to less than 1 cup.

A nurse is caring for a client who had gastric bypass surgery 2 days ago. Which assessment finding requires immediate intervention?

The client's right lower leg is red and swollen.

Which of the following surgical procedures for obesity utilizes a prosthetic device to restrict oral intake?

Gastric banding

A client is prescribed tetracycline to treat peptic ulcer disease. Which of the following instructions would the nurse give the client?

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

Which of the following is a manifestation of decreased hemoglobin?

Anemia

A patient has a BMI ranger greater than 40 kg/m2. What would this patient's obesity classification be?

Class III

Which of the following appears to be a significant factor in the development of gastric cancer?

Diet

Rebleeding may occur from a peptic ulcer and often warrants surgical interventions. Signs of bleeding include which of the following?

Mental confusion

Which of the following are classified as a histamine-2 receptor antagonist?

Pepcid

A patient has a Class II classification of obesity. What level of health risk does this pose for the patient?

Severe risk

Which of the following medications used for the treatment of obesity prevents the reuptake of serotonin and norepinephrine?

Sibutramine hydrochloride (Meridia)

A client is admitted to the health care facility with a diagnosis of a bleeding gastric ulcer. The nurse expects this client's stools to be:

black and tarry.

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.)

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

The nurse reviews dietary guidelines with a patient who had a gastric banding. Which of the following teaching points are included? Select all that apply.

• Do not eat and drink at the same time. • Drink plenty of water, from 90 minutes after each meal to 15 minutes before each meal. • Avoid fruit drinks and soda.

Which of the following clients is at highest risk for peptic ulcer disease?

A 52-year-old male accountant

Which of the following is the most successful treatment for gastric cancer?

Removal of the tumor

A nurse is caring for a client who underwent a subtotal gastrectomy. To manage dumping syndrome, the nurse should advise the client to:

drink liquids only between meals.

A client with peptic ulcer disease wants to know nonpharmacological ways that he can prevent recurrence. Which of the following measures would the nurse recommend? Select all that apply.

• Following a regular schedule for rest, relaxation, and meals • Smoking cessation • Avoidance of alcohol

A client admitted for treatment of a gastric ulcer is being prepared for discharge on antacid therapy. Discharge teaching should include which instruction?

"Continue to take antacids even if your symptoms subside."

A client reports to the clinic, stating that she rapidly developed headache, abdominal pain, nausea, hiccuping, and fatigue about 2 hours ago. For dinner, she ate buffalo chicken wings and beer. Which of the following medical conditions is most consistent with the client's presenting problems?

Acute gastritis

A patient is scheduled for removal of the lower portion of the antrum of the stomach and a small portion of the duodenum and pylorus. What is the name of this surgical procedure for peptic ulcer disease?

Billroth I

The nurse is assessing a client with a bleeding gastric ulcer. When examining the client's stool, which of the following characteristics would the nurse be most likely to find?

Black and tarry appearance

A client with gastric cancer is having a resection. What is the nursing management priority for this client?

Correcting nutritional deficits

A nurse caring for a patient in a burn treatment center knows to assess for the presence of which of the following types of ulcer about 72 hours post injury?

Curling's

A client experienced extensive burns and 72 hours later has developed an ulcer. Which of the following types of ulcer is most likely in this client?

Curling's ulcer

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?

Curling's ulcer

Which of the following ulcers is associated with extensive burn injury?

Curling's ulcer

Clients with Type O blood are at higher risk for which of the following GI disorders?

Duodenal ulcers

A physician suspects that a client has peptic ulcer disease. With which of the following diagnostic procedures would the nurse most likely prepare to assist?

Endoscopy

The nurse advises the patient who has just been diagnosed with acute gastritis to:

Refrain from food until the GI symptoms subside.

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. The nurse suspects:

Vasomotor symptoms associated with dumping syndrome

A nurse is providing follow-up teaching at a clinic visit for a client recovering from gastric resection. The client reports sweating, diarrhea, nausea, palpitations, and the desire to lie down 15 to 30 minutes after meals. The nurse suspects the client has:

dumping syndrome.

A nurse is caring for a client who underwent a subtotal gastrectomy 24 hours ago. The client has a nasogastric (NG) tube. The nurse should:

irrigate the NG tube gently with normal saline solution if ordered.

The nurse is aware that hemorrhage is a common complication of peptic ulcer disease. Therefore, assessment for indicators of bleeding is an important nursing responsibility. Which of the following are indicators of bleeding? Select all that apply.

• Melena • Tachypnea • Thirst • Mental confusion

A client with a peptic ulcer is diagnosed with Heliobacter pylori infection. The nurse is teaching the client about the medications prescribed, including metronidazole (Flagyl), omeprazole (Prilosec), and clarithromycin (Biaxin). Which statement by the client indicates the best understanding of the medication regimen?

"The medications will kill the bacteria and stop the acid production."

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 of the following explanations from the nurse would be most accurate?

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

The nurse determines that teaching for the client with peptic ulcer disease has been effective when the client states:

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

A client with peptic ulcer disease must begin triple medication therapy. For how long will the client follow this regimen?

10 to 14 days

Which of the following is a true statement regarding gastric cancer?

Most patients are asymptomatic during the early stage of the disease.

Which of the following represents the medication classification of a proton (gastric acid) pump inhibitor?

Omeprazole (Prilosec)

A patient is in the hospital for the treatment of peptic ulcer disease. The nurse finds the patient vomiting and complaining of a sudden severe pain in the abdomen. The nurse then assesses a board-like abdomen. What does the nurse suspect these symptoms indicate?

Perforation of the peptic ulcer

A client is recovering from gastric surgery. Toward what goal should the nurse progress the client's enteral intake?

Six small meals daily with 120 mL fluid between meals

Which of the following are signs/symptoms of perforation?

Sudden, severe upper abdominal pain

Delayed wound healing is an indicator of a nutritional deficiency after bariatric surgery. Select the deficiency.

Zinc

Morbid obesity is defined as being how many pounds over the person's ideal body weight?

100

A nurse is receiving report from the emergency room regarding a new client being admitted to the medical-surgical unit with a diagnosis of peptic ulcer disease. The nurse expects the age of the client will be between

40 and 60 years

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 partial gastrectomy is performed with anastomosis of the stomach segment to the duodenum.

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, and labored breathing; the client also appears to be confused. Which of the following complications has the client most likely developed?

Hemorrhage

The client has been taking famotidine (Pepcid) at home. The nurse prepares a teaching plan for the client indicating that the medication acts primarily to achieve which of the following?

Inhibit gastric acid secretions.

Why are antacids administered regularly, rather than as needed, in peptic ulcer disease?

To keep gastric pH at 3.0 to 3.5

The nurse recognizes that the patient diagnosed with a duodenal ulcer will likely experience

pain 2 to 3 hours after a meal.

A patient taking metronidazole (Flagyl) for the treatment of H. pylori states that the medication is causing nausea. What suggestion can the nurse provide to the patient to alleviate this problem?

Take the medication with meals to decrease the nausea.

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 to his right shoulder. The intial appropriate action by the nurse is to

Assess the client's abdomen and vital signs.

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?

Nothing by mouth

Which of the following clients is at highest risk for peptic ulcer disease?

Client with blood type O