PRACTICE QUESTIONS CHAPTER 41 - UPPER GI BLEED

The nurse will anticipate preparing an older patient who is vomiting "coffee-ground" emesis for a. endoscopy. b. angiography. c. barium studies. d. gastric analysis.

a. endoscopy.

The nurse is assessing a patient who had a total gastrectomy 8 hours ago. What information is most important to report to the health care provider? a. Hemoglobin (Hgb) 10.8 g/dL b. Temperature 102.1°F (38.9°C) c. Absent bowel sounds in all quadrants d. Scant nasogastric (NG) tube drainage

b. Temperature 102.1°F (38.9°C)

The family member of a patient who has suffered massive abdominal trauma in an automobile accident asks the nurse why the patient is receiving famotidine (Pepcid). The nurse will explain that the medication will a. prevent aspiration of gastric contents. b. inhibit the development of stress ulcers. c. lower the chance for H. pylori infection. d. decrease the risk for nausea and vomiting.

b. inhibit the development of stress ulcers.

A patient who has gastroesophageal reflux disease (GERD) is experiencing increasing discomfort. Which patient statement to the nurse indicates that additional teaching about GERD is needed? a. "I take antacids between meals and at bedtime each night." b. "I sleep with the head of the bed elevated on 4-inch blocks." c. "I eat small meals during the day and have a bedtime snack." d. "I quit smoking several years ago, but I still chew a lot of gum."

c. "I eat small meals during the day and have a bedtime snack."

Which prescribed action will the nurse implement first for a patient who has vomited 1100 mL of blood? a. Give an IV H2 receptor antagonist. b. Draw blood for typing and crossmatching. c. Administer 1 L of lactated Ringer's solution. d. Insert a nasogastric (NG) tube and connect to suction.

c. Administer 1 L of lactated Ringer's solution.

The teaching plan for the patient being discharged after an acute episode of upper gi bleeding includes information concerning the importance of (select all that apply): a. Limiting etoh to one serving per day b. Only taking aspirin with milk or bread products c. Avoiding taking aspirin and drugs containing aspirin d. Only taking drugs prescribed by the health care provider e. Taking all drugs 1 hour before mealtime to prevent further bleeding

c. Avoiding taking aspirin and drugs containing aspirin d. Only taking drugs prescribed by the health care provider

A 68-yr-old male patient with a stroke is unconscious and unresponsive to stimuli. After learning that the patient has a history of gastroesophageal reflux disease (GERD), the nurse will plan to do frequent assessments of the patient's a. apical pulse. b. bowel sounds. c. breath sounds. d. abdominal girth.

c. breath sounds.

The nurse teaches a patient with a history of upper gi bleeding how to check for bloody stools. Which statement by the nurse is appropriate? a. "if vomiting of bright red blood occurs, stools will not be black and sticky." b. "blood is never obvious in stools and must be detected by a lab test." c. "acute bleeding in your stomach will cause bright red blood in your stools." d. "stools that are black and tarry occur with slow bleeding from the stomach."

d. "stools that are black and tarry occur with slow bleeding from the stomach."

A patient vomiting blood-streaked fluid is admitted to the hospital with acute gastritis. To determine possible risk factors for gastritis, the nurse will ask the patient about a. the amount of saturated fat in the diet. b. a family history of gastric or colon cancer. c. a history of a large recent weight gain or loss. d. use of nonsteroidal antiinflammatory drugs (NSAIDs).

d. use of nonsteroidal antiinflammatory drugs (NSAIDs).

A patient with recurring heartburn receives a new prescription for esomeprazole (Nexium). In teaching the patient about this medication, the nurse explains that this drug a.neutralizes stomach acid and provides relief of symptoms in a few minutes. b.reduces the reflux of gastric acid by increasing the rate of gastric emptying. c. coats and protects the lining of the stomach and esophagus from gastric acid. d.treats gastroesophageal reflux disease by decreasing stomach acid production.

d.treats gastroesophageal reflux disease by decreasing stomach acid production.