Nutrition
a client diagnosed with a duodenal ulcer asks, "what is likely to be prescribed next?" which is the nurse's best response? 1. "medication. this provides healing for most peptic ulcers" 2. "managements of pain while you are eating. this is when pain usually occurs" 3. "surgery. this is usually performed soon after the first attack" 4. "aggressive treatment. untreated ulcers can lead to cancer of the stomach"
1
which information would the nurse include in the client's medication teaching on the administration of aspirin 650 mg every 6 hours as needed for arthritic pain? select all that apply 1. "report persistent abdominal pain" 2. "do not chew enteric-coated tablets" 3. "tale the aspirin with meals or a snack" 4. "see a dentist if bleeding gums develop" 5. "switch to acetaminophen if tinnitus occurs"
1, 2, 3
which interventions would the nurse include in the plan of care for a client with gastroesophageal reflux disease (GERD)? select all that apply 1. encourage client to follow the prescribed treatment regimen 2. keep the head of the bed elevated to approximately 30 degrees 3. avoid placing the client in the supine position for 2 to 3 hours after a meal 4. instruct the client to eat six small meals a day with the last just before bedtime 5. instruct the client to take a proton pump inhibitor be
1, 2, 3
which medication is classified an an H2 receptor antagonist? select all that apply 1. nizatidine 2. ranitidine 3. famotidine 4. lansoprazole 5. metoclopramide
1, 2, 3
which finding is an indication of ulcer perforation in a client with peptic ulcer disease (PUD)? select all that apply 1. tachycardia 2. hypotension 3. rigid abdomen 4. nausea and vomiting 5. back and shoulder pain
1, 2, 3, 4, 5
which nursing assessment would be indicated for an infant admitted with pyloric stenosis and 3 days of vomiting? select all that apply 1. tissue turgor 2. neurologic status 3. time of last feeding 4. amount of last void 5. character of the vomitus
1, 2, 4
which clinal manifestation would the nurse expect to assess in an infant diagnosed with hypertrophic pyloric stenosis (HPS)? select all that apply 1. white vomitus 2. abdominal pain 3. peristaltic waves 4. insatiable hunger 5. abdominal distention
1, 3, 4
a client with gastroesophageal reflux disease (GERD) needs to make dietary and lifestyle changes. which instructions would the nurse include in the client's discharge teaching? select all that apply 1. encourage the client to quit smoking 2. elevate the foot of the bed 3. avoid milk and dairy products 4. eat three large, evenly spaced meals daily 5. avoid lying down for 2 to 3 hours after eating
1, 5
a client is admitted to the hospital with a diagnosis of peptic ulcer. which common complication would the nurse assess for in this client? 1. perforation 2. hemorrhage 3. pyloric obstruction 4. esophageal varices
2
which clinical finding would the nurse expect when assessing an infant with pyloric stenosis? select all that apply 1. birdlike abdomen 2, visible peristaltic waves 3. decreased bowel sounds 4. cramping movements in the lower abdomen 5. olive-shaped mass in the right upper quadrant
2, 5
a client is evaluated at a clinic, and the health care provider suspects that the client has anemia and a peptic ulcer. to determine if the client has a peptic ulcer, the nurse expects that which diagnostic test will be performed? 1. barium enema 2. gastric biopsy 3. gastric culture 4. stool examination
3
a client presents with gastric pain, vomiting, dehydration, weakness, lethargy, and shallow respirations. laboratory results indicate metabolic alkalosis. a diagnosis of gastric ulcer is made. which is the primary nursing concern? 1. chronic pain 2. risk for injury 3. electrolyte imbalance 4. inadequate gas exchange
3
which administration instruction would the nurse five a client prescribed ranitidine 150 mg daily to treat peptic ulcer disease (PUD)? 1. as needed 2. with meals 3. at bedtime 4. before meals
3
the nurse is caring for ancient with gastrointestinal reflux disease (GERD). which information would the nurse provide the client to prevent worsening of the disorder? select all that apply 1. eat a snack before bed 2. include vigorous exercise 3. wear loose-fitting clothing 4. begin a weight-loss program 5. sleep with head of bed elevated
3, 4, 5
a client is diagnosed with a peptic ulcer. the nurse instructs the client to contact the health care provider immediately if the client's stool has which appearance? 1. frothy 2. ribbon-shaped 3. pale or clay-colored 4. dark brown or black
4
an infant has had a pyloromyotomy performed after the diagnosis of hypertrophic pyloric stenosis. in which position would the nurse teach the parent to place the infant during and after feeding? 1. supine for feedings; held upright afterward to be burped 2. side-lying for feedings; rocked afterward to reduce crying 3. at a 45-degree angle for feedings; prone with the upper body elevated afterward 4. at a 90-degree angle for feedings; on the right side with the upper body elevated afterward
4
which rationale explains why the nurse also monitors a client with a history of gastroesophageal reflux disease (GERD) for clinical manifestations of heart disease? 1. esophageal pain may imitate the symptoms of a heart attack 2. GERD may predispose the client to the development of heart disease 3. strenuous exercise may exacerbate reflux problems 4. similar laboratory study changes may occur in both problems
1
which rationale would the nurse expect for a mother being reluctant to feed her 6-week old infant who recently had surgery for hypertrophic pyloric stenosis (HPS)? 1. afraid the her baby's vomiting will resume 2. unaware that she is allowed to feed her baby 3. not sure how to feed her baby with a special nipple 4. uncertain whether her baby will tolerate the thickened formula
1
which type of pain would the nurse expect a client with a duodenal ulcer to report? 1. pain that is relieved with eating 2. pain that is worse with antacids 3. pain that is relieved with sleep 4. pain that is worse 1 hour after eating
1
which manifestation of hypertrophic pyloric stenosis in an infant would the nurse expect when palatine the abdomen? 1. a distended colon 2. marked tenderness around the umbilicus 3. an olive-sized mass in the right upper quadrant 4. rhythmic peristaltic waves in the lower abdomen
3
which assessment finding would the nurse report to the primary healthcare provider because it likely indicates pyloric stenosis? 1. loud bowel sounds 2. sudden expulsion of diarrheal stool 3. peristaltic waves that traverse the epigastrium 4. regurgitation of a portion of the feeding when burped
3
which clinical finding would the nurse expect when assessing a 3-week old infant with hypertrophic pyloric stenosis who is severely dehydrated? 1. weight loss of 5% 2. severe allergic reaction s 3. depressed anterior fontanel 4. urine specific gravity of 1.014
3
which explanation would the nurse provide to a client with gastric ulcer disease who asks the nurse why the healthcare provider has prescribed metronidazole? 1. to augment the immune response 2. to potentiate the effect of antacids 3. to treat H. pylori infection 4. to reduce hydrochloric acid secretion
3
which postoperative feeding regimen is most appropriate for the infant who had surgery to correct hypertrophic pyloric stenosis? 1. thickened formula 24 hours after surgery 2. withholding of feedings for the first 24 hours 3. regular formula feeding within 24 hours of the surgery 4. additional glucose feedings as desired after the first 24 hours
3
the nurse is teaching a client about gastresophageal reflux disease (GERD). which statement made by the client indicates correct understanding of GERD management? 1. "three meals per day is the best regimen to avoid GERD symptoms" 2. "I can reduce my GERD symptoms through a high-carbohydrate, low-fat diet" 3. "a snack at bedtime will help reduce the acidity of my stomach during the night" 4. "I will place a 6-inch block under the head of my bed wit help with digestion"
4
the registered nurse is caring for a client with peptic ulcers and dysphagia. which task would not be delegated to an unlicensed assistive personnel (UAP) who is assisting in the care of a client with peptic ulcers and dysphagia? 1. assisting the client with feeding 2. assisting the client with bathing 3. assisting the client in oral hygiene 4. assisting the client in administering the medications
4
which assessment would then nurse choose for a 4-week-old boy whose mother reports. "he cries all the time and always acts hungry, but he throws up everything?" 1. inspecting the anus for rectal prolapse 2. obtaining the elimination history for celiac disease 3. noting the color of vomitus for a bile duct obstruction 4. palpating the abdomen for hypertrophic pyloric stenosis
4
which condition is treated with a proton pump inhibitor (PPI)? 1. diarrhea 2. vomiting 3. cardiac dysrhythmias 4. gastroesophageal reflux disease (GERD)
4
which information would the nurse reinforce when teaching a client with gastroesophageal reflux disease (GERD) about antacid therapy? 1. antacids should be taken 1 hour before meals 2. these should be scheduled at 4-hour intervals 3. antacid tablets are just as fast and effective. as the liquid form 4. antacids commonly interfere with the absorption of other medications
4
which mechanism of action is a characteristic of famotidine prescribed for a client with peptic ulcer disease? 1. increased gastric motility 2. neutralizes gastric acidity 3. facilitates histamine release 4. inhibits gastric acid secretion
4
which statement by a client who has a gastric ulcer and asks what to do if epigastric pain occurs indicates that teaching was effective? 1. "eliminating fluids with meals will prevent pain" 2. "I will increase my food intake to avoid an empty stomach" 3. "taking an aspirin with milk will relieve my pain and coat my ulcer" 4. " taking an antacid preparation will decrease pain due to gastric acid"
4
which medication would the nurse question when reviewing the home medication list for a client admitted with peptic ulcer disease (PUD)? 1. iron 2. ibuprofen 3. famotidine 4. acetaminophen
2
which diet would the nurse anticipate for a 4-week old infant after surgical repair for hypertrophic pyloric stenosis (HPS)? 1. electrolyte solution 2. full-strength formula 3. half-strength formula 4. cereal-thickened water
1
a client with gastroesophageal reflux disease (GERD) is being treated with dietary management. the client states, "I like to have a glass of juice every day." which juice will the nurse recommend? 1. apple 2. orange 3. tomato 4. grapefruit
1
after an acute episode of upper GI bleeding, a client vomits undigested antacids and reports having severe epigastric pain. the nursing assessment reveals an absence of bowel sounds, a pulse rate of 134, and shallows respirations of 32 per minute. in addition to calling the health care provider, what action should the nurse take? 1. prepare the client for surgery 2. request a stat chest x-ray (radiograph) 3. place the client in the supine position, with legs elevated 4. ask the client if the
1
the nurse is instructing a client with peptic ulcer disease (PUD) about the diet that should be followed during the acute phase. which type of diet would the nurse stress? 1. bland foods 2. regular diet 3. gluten-free foods 4. low-carbohydrate foods
1
the nurse provided education to a client with peptic ulcer disease (PUD) regarding foods and substances to avoid that would increase the secretion of gastric acid. which food choice for breakfast selection made by the client indicates a need for further teaching? 1. coffee and toast 2. grapes and cheese 3. apple juice and pancakes 4. cheese and crackers
1
which explanation would the nurse provide the mother of an infant who vomits the first feeding after corrective surgery for hypertrophic pyloric stenosis? 1. "this often occurs after the first feeding" 2. "the baby is ridding postoperative mucus" 3. "your feeding technique may need to be changed" 4. "feedings will have to be stopped until peristalsis improves"
1
which family history would the nurse recognize as a risk factor for an infant developing hypertrophic pyloric stenosis (HPS)? 1. a first cousin underwent surgery for HPS 2. the birth was preterm, and the birth weight was 4 lbs 3. an older brother has idiopathic vomiting during infancy 4. the older sister experienced an intestinal obstruction during early infancy
1
which management strategy is the treatment of choice for hypertrophic pyloric stenosis (HPS)? 1. surgery 2. daily medications during infancy 3. slow feeding for several months 4. dietary restrictions throughout childhood
1
which medication may contribute to development of a peptic ulcer in a client receiving immunosuppressive therapy? 1. prednisone 2. azathioprine 3. cyclosporine 4. cyclophosphamide
1
which parent education would the nurse provide for an infant who is restarting bottle feedings after surgery for hypertrophic pyloric stenosis (HPS)? 1. start with small. frequent feedings 2. rock for 20 minutes after a feeding 3. keep the infant awake for 30 minutes after feeding 4. position the infant flat on the right side during feedings
1
the nurse is providing discharge instructions for a client with a diagnosis of gastroesophageal reflux disease (GERD). which recommendations would the nurse give to the client to limit symptoms of GERD? select all that apply 1. avoid heavy lifting 2. lie down after eating 3. avoid drinking alcohol 4. eat small, frequent meals 5. increase fluid intake with meals 6. wear an abdominal binder or girdle
1, 3, 4,
a client reports pain because of a gastric ulcer. the nurse expects which clinical finding? select all that apply 1. vomiting relieves pain 2. eating food prevents pain 3. pain is described as gnawing 4. flatulence accompanies pain 5. pain occurs 30 minutes after meals
1, 3, 5
a health care provider prescribes dietary and medication therapy for a client with a diagnosis of gastroesophageal reflux disease (GERD). what is appropriate for the nurse to teach the client about meal management? 1. consume a snack each evening 2. divid food into four to six meals a day 3. eat the last of three daily meals by 8 pm" 4. "suck on a peppermint candy after each meal"
2
the nurse is caring for an infant who is to undergo surgery for hypertrophic pyloric stenosis (HPS). which clinal scenario would the nurse recognize as important for surgical success? 1. vomiting is not yet severe and projectile 2. fluid and electrolyte imbalances are corrected 3. small feedings of thickened formula are tolerated 4. amount of drainage from gastric decompression is sufficient
2
the nurse is obtaining a health history from a client with a diagnosis of peptic ulcer disease. the nurse identifies a possible contributory risk factor when the client makes which statement? 1. "my blood type is A positive" 2. "I smoke one pack of cigarettes a day" 3. "I have been overweight most of my life" 4. "my blood pressure has been high lately"
2
which assessment would the nurse perform while caring or an infant with a tentative diagnosis of hypertrophic pyloric stenosis (HPS)? 1. quality of the cry 2. signs of dehydration 3. coughing up of feedings 4. characteristics of the stool
2
which client would the nurse suspect as having peptic ulcer disease after reviewing the morning laboratory reports? 1. haemophilus influenza 2. helicobacter pylori 3. pseudomonas aeruginosa 4. staphylococcus aureus
2
which clinical finding would the nurse expect when assessing an infant with a tentative diagnosis of hypertrophic pyloric stenosis (HPS)? 1. visible peristaltic waves across the lower abdomen 2. palpable mass in the epigastric area to the right of the umbilicus 3. tenderness over the epigastric region not relieved by heat application 4. lower abdominal distention with vomiting of bile-stained gastric contents
2
which education would the nurse provide the parent of an infant with pyloric stenosis? 1. it is unlikely that surgery will be necessary 2. this is a condition with an excellent prognosis 3. this condition results from an error of metabolism 4. special feedings will be needed for a few weeks after surgery
2
which explanation would the nurse provide to a client with burns and crushing injuries caused by an accident prescribed oral antacids and intravenous ranitidine who asks how these medications work? 1. "these medications work together to decrease bowel irritability" 2. "they limit acidity in the gastrointestinal tract" 3. "they are very effective in clients with multiple trauma" 4. "these medications decrease nausea and vomiting"
2
which information would be included in the teaching plan for the older adult client with peptic ulcer disease who is taking an antacid and sucralfate? 1. antacids should be taken 30 minutes before a meal 2. sucralfate should be taken on an empty stomach 1 hour before meals 3. sucralfate is prescribed for the long-term maintenance of peptic ulcer disease 4. sodium bicarbonate is an inexpensive over-the-counter antacid with few adverse effects
2
which is the priority intervention for a dependent client with peptic ulcer disease (PUD) who is vomiting bright red blood? 1. apply oxygen 2. place the client in a side-lying position 3. prepare to administer packed red blood cells 4. assess the client's pulse and blood pressure
2
which parent teaching would the nurse provide the parents of an infant being discharged after surgery for pyloric stenosis? 1. "offer the baby creamy cereal at each feeding and follow it with a regular formula" 2. "hold the baby while continuing to feed a regular formula slowly and burp frequently" 3. "allow the baby to drink about 1 oz (30 mL) of a regular formula per hour for a week, and progress slowly to larger amounts" 4. "place the baby on the right side in the crib during feedings wit
2
which parent teaching would the nurse provide to prevent vomiting in an infant who had corrective surgery for hypertrophic pyloric stenosis? 1. rock the infant 2. keep the infant's head elevated 3. place the infant flat on the right side 4. keep the infant awake with sensory stimulation
2
why is the vomitus of an infant with pyloric stenosis white rather then bile-stained? 1. the pyloric sphincter obstructs the bile duct 2. there is an obstruction above the opening of the common bile duct 3. the bile duct sphincter is connected to the hypertrophied pyloric muscle 4. there is a constriction of the cardiac sphincter that obstructs the flow of bile
2
which pain description would the nurse expect a client to report when describing pain associated with a suspected duodenal peptic ulcer? 1. an ache radiating to McBurney point 2. an intermittent, colicky right-flank pain 3. a gnawing sensation in the epigastric area 4. a generalized abdominal pain intensified by movement
3
