Chapter 46 Coursepoint

Peptic ulcer disease occurs more frequently in people with which blood type? 1. AB 2. O 3. A 4. B

2

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. Black and tarry B. Bright red C. Clay-colored D. Coffee-ground-like

A

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

A

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

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

A

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. Ascites B. Hepatomegaly C. Petechiae at the palpation site D. Distended bladder E. Sister Mary Joseph's nodules

A B

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. Metronidazole B. Omeprazole C. Warfarin D. Diphenhydramine E. Bismuth subsalicylate

A B E

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 nurse is teaching a group of middle-aged men about peptic ulcers. When discussing risk factors for peptic ulcers, the nurse should mention: A. a history of hemorrhoids and smoking. B. alcohol abuse and smoking. C. alcohol abuse and a history of acute renal failure. D. a sedentary lifestyle and smoking.

B

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

B

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. Bradycardia B. Hematemesis C. Polyuria D. Hypertension

B

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

B

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. Allows for better absorption of vitamin B12 B. Removes tension on internal suture line C. Slows gastric emptying D. Provides much needed rest

C

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. Provide a dose of a proton pump inhibitor. B. Discuss the types of foods the client has been eating. C. Notify the primary health care provider. D. Encourage the client to drink a warm beverage.

C

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. Nasogastric tube insertion D. Pelvic x-ray

C

The nurse recognizes that the client diagnosed with a duodenal ulcer will likely experience A. hemorrhage. B. vomiting. C. pain 2 to 3 hours after a meal. D. weight loss.

C

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

C

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

C

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

C

A client recovering from surgery for gastric cancer develops dumping syndrome. Which teachings will the nurse provide to reduce the symptoms of this condition? Select all that apply. A. Drink fluids with meals. B. Remain upright after meals. C. Ingest 6 small meals a day. D. Select foods high in sugar. E. Eat foods low in carbohydrates.

C E

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

D

A client with peptic ulcer disease asks for pain medication. Which response will the nurse make? A. "Using pain medication is what caused the ulcer to develop." B. "I will ask the health care provider to prescribe pain medication." C. "Eating more food will help reduce the pain." D. "The medications for the ulcer will reduce the pain."

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. Perforation B. Pyloric obstruction C. Penetration D. Hemorrhage

D

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

D

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

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

D

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

D