Chapter 47

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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

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."

A nurse is caring for a client who is undergoing a diagnostic workup for a suspected GI problem. The client reports gnawing epigastric pain following meals and heartburn. The nurse suspects the client has:

peptic ulcer disease.

A client with a peptic ulcer is about to begin a therapeutic regimen that includes a bland diet, antacids, and famotidine (Pepcid). Before the client is discharged, the nurse should provide which instruction?

"Avoid aspirin and products that contain aspirin."

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

10 to 14 days

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

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.

The nurse is assessing a patient with progressive gastric cancer. The nurse anticipates that the assessment will reveal which of the following findings?

Bloating after meals

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

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

Diet

Which of the following is the first portion of the small intestine?

Duodenum

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

Gastric banding

The nurse is assessing a patient with an ulcer for signs and symptoms of hemorrhage. The nurse interprets which of the following as a sign/symptom of possible hemorrhage?

Hematemesis

During assessment of a patient with gastritis, the nurse practitioner attempts to distinguish acute from chronic pathology. One criteria, characteristic of gastritis would be the:

Immediacy of the occurrence.

The nurse is conducting a community health education program on obesity. The nurse includes which of the following diseases/disorders in the program?

Obstructive sleep apnea

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

Omeprazole (Prilosec)

Which of the following medications used for the treatment of obesity prevents the absorption of triglycerides?

Orlistat (Xenical)

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

Removal of the tumor

Which of the following bariatric surgical procedures is optimal for long-term weight loss?

Roux-en-Y

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.

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

To keep gastric pH at 3.0 to 3.5

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 teaching a group of middle-aged men about peptic ulcers. When discussing risk factors for peptic ulcers, the nurse should mention:

alcohol abuse and smoking.

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 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.)

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

A client weighs 215 lbs and is 5' 8" tall. The nurse would calculate this client's body mass index (BMI) as which of the following?

32.7

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

A nursing student is caring for a client with gastritis. Which of the following would the student recognize as a common cause of gastritis? Choose all that apply.

• Ingestion of strong acids • Irritating foods • Overuse of aspirin

Symptoms associated with pyloric obstruction include all of the following except:

Diarrhea

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

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.

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

pain 2 to 3 hours after a meal.

A patient comes to the clinic with the complaint, "I think I have an ulcer." What is a characteristic associated with peptic ulcer pain that the nurse should inquire about? (Select all that apply.)

• Burning sensation localized in the back or mid-epigastrium • Feeling of emptiness that precedes meals from 1 to 3 hours • Severe gnawing pain that increases in severity as the day progresses


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