A2 EXAM 2 CH.46 PREP U
A client with peptic ulcer disease has a blood pressure of 88/40 mm Hg, dizziness, and nausea. Which complication will the nurse suspect is occurring with this client? Medication adverse effects Evidence of ulcer healing Bleeding from the ulcer Allergic response to the medication
Bleeding from the ulcer
A client is prescribed tetracycline to treat peptic ulcer disease. Which instruction would the nurse give the client? "Do not drive when taking this medication." "Be sure to wear sunscreen while taking this medicine." "You will not experience GI upset while taking this medication." "Take the medication with milk."
"Be sure to wear sunscreen while taking this medicine."
The nurse determines that teaching for the client with peptic ulcer disease has been effective when the client makes which statement? "I should continue my treatment regimen as long as I have pain." "I have learned some relaxation strategies that decrease my stress." "I should stop all my medications if I develop any side effects." "I can buy whatever antacids are on sale because they all have the same effect."
"I have learned some relaxation strategies that decrease my stress."
A client is recovering from gastric surgery. Toward what goal should the nurse progress the client's enteral intake? Three meals and 120 ml fluid daily Three meals and three snacks and 120 mL fluid daily Six small meals daily with 120 mL fluid between meals Six small meals and 120 mL fluid daily
Six small meals daily with 120 mL fluid between meals
patient is scheduled for a Billroth I procedure for ulcer management. What does the nurse understand will occur when this procedure is performed? The antral portion of the stomach is removed and a vagotomy is performed. A partial gastrectomy is performed with anastomosis of the stomach segment to the duodenum. The vagus nerve is cut and gastric drainage is established. A sectioned portion of the stomach is joined to the jejunum.
A partial gastrectomy is performed with anastomosis of the stomach segment to the duodenum.
A client comes to the clinic after developing a headache, abdominal pain, nausea, hiccupping, and fatigue about 2 hours ago. The client tells the nurse that the last food was buffalo chicken wings and beer. Which medical condition does the nurse find to be most consistent with the client's presenting problems? Duodenal ulcer Acute gastritis Gastric cancer Gastric ulcer
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 in the right shoulder. What is the initial appropriate action by the nurse? Notify the health care provider. Place the client in the high-Fowler's position. Assess the client's abdomen and vital signs. Irrigate the client's NG tube.
Assess the client's abdomen and vital signs.
A client with active schizophrenia has developed acute gastritis after ingesting a strongly alkaline solution during a psychotic episode. Which emergency treatments should the nurse anticipate using with the client? Select all that apply. Syrup of ipecac Gastric lavage Aluminum hydroxide Diluted vinegar Diluted lemon juice
Diluted vinegar Diluted lemon juice
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? Gastric outlet obstruction Dumping syndrome Celiac disease Bile reflux
Dumping syndrome
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? Allows for better absorption of vitamin B12 Slows gastric emptying Removes tension on internal suture line Provides much needed rest
Slows gastric emptying
A health care provider suspects that a client has peptic ulcer disease. With which diagnostic procedure would the nurse most likely prepare to assist? Barium study of the upper gastrointestinal tract Gastric secretion study Endoscopy Stool antigen test
Endoscopy
Which medication is classified as a histamine-2 receptor antagonist? Metronidazole Lansoprazole Esomeprazole Famotidine
Famotidine
A client is prescribed a histamine (H2)-receptor antagonist. The nurse understands that this might include which medication(s)? Select all that apply. Famotidine Lansoprazole Cimetidine Nizatidine Esomeprazole
Famotidine Cimetidine Nizatidine
The nurse is developing a plan of care for a patient with peptic ulcer disease. What nursing interventions should be included in the care plan? Select all that apply. Inserting an indwelling catheter for incontinence Frequently monitoring hemoglobin and hematocrit levels Observing stools and vomitus for color, consistency, and volume Checking the blood pressure and pulse rate every 15 to 20 minutes Making neurovascular checks every 4 hours
Frequently monitoring hemoglobin and hematocrit levels Observing stools and vomitus for color, consistency, and volume Checking the blood pressure and pulse rate every 15 to 20 minutes
A client diagnosed with a peptic ulcer says, "Now I have something else I have to worry about." Which actions will the nurse take to help reduce the client's anxiety? Select all that apply. Help identify the client's current stressors. Interact with the client in a relaxed manner. Discuss potential coping techniques with the client. Offer information about relaxation methods. Inform the client the medication will solve the problem.
Help identify the client's current stressors. Interact with the client in a relaxed manner. Discuss potential coping techniques with the client. Offer information about relaxation methods.
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? Hematemesis Hypertension Bradycardia Polyuria
Hematemesis
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? Hemorrhage Penetration Pyloric obstruction Perforation
Hemorrhage
Review the following four examples of ideal body weight (IBW), actual weight, and body mass index (BMI). Using three criteria for each example, select the body weight that indicates morbid obesity. IBW = 132 lbs; weight = 184 lbs; BMI = 28 kg/m2 IBW = 145 lbs; weight = 290 lbs; BMI = 31 kg/m2 IBW = 175 lbs; weight = 265 lbs; BMI = 29 kg/m2 IBW = 150 lbs; weight = 190 lbs; BMI = 26 kg/m2
IBW = 145 lbs; weight = 290 lbs; BMI = 31 kg/m2
The nurse recognizes that the client diagnosed with a duodenal ulcer will likely experience weight loss. vomiting. hemorrhage. pain 2 to 3 hours after a meal.
pain 2 to 3 hours after a meal.
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. DASH diet Irritating foods Ingestion of strong acids Overuse of aspirin Participation in highly competitive sports
Irritating foods Ingestion of strong acids Overuse of aspirin
Rebleeding may occur from a peptic ulcer and often warrants surgical interventions. Signs of bleeding include which of the following? Bradycardia Bradypnea Mental confusion Hypertension
Mental confusion HYPOTENSION TACYCARDIA
A client undergoes total gastrectomy. Several hours after surgery, the nurse notes that the client's nasogastric (NG) tube has stopped draining. How should the nurse respond? Reposition the tube. Irrigate the tube. Increase the suction level. Notify the health care provider.
Notify the health care provider.
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? Discuss the types of foods the client has been eating. Encourage the client to drink a warm beverage. Notify the primary health care provider. Provide a dose of a proton pump inhibitor.
Notify the primary health care provider.
Peptic ulcer disease occurs more frequently in people with which blood type?
O
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. Cimetidine Famotidine Nizatidine Omeprazole
Omeprazole
Which medication classification represents a proton (gastric acid) pump inhibitor? Metronidazole Famotidine Omeprazole Sucralfate
Omeprazole
Dumping syndrome
Rapid emptying of gastric contents into small intestines. Client experience ab pain, nausea, vomiting, explosive diarrhea, weakness, dizziness, palpitations & tachycardia.
Billroth
Responsible for advances in surgical procedures; best known for gastrectomy procedures
BMI (body mass index)
Underweight - Less than 18.5 Normal - 18.5 - 24.9 Overweight - 25 - 29.9 Obese - 30 - 39.9
morbid obesity
body mass index (BMI) of 40 or greater, which is generally 100 or more pounds over ideal body weight
The nurse is creating a discharge plan of care for a client with a peptic ulcer. The nurse tells the client to avoid skim milk. acetaminophen. octreotide. decaffeinated coffee.
decaffeinated coffee.
A nurse is caring for a client who underwent a subtotal gastrectomy. To manage dumping syndrome, the nurse should advise the client to: don't drink liquids 2 hours before meals. drink liquids only between meals. restrict fluid intake to 1 qt (1,000 ml)/day. drink liquids only with meals.
drink liquids only between meals.
Zollinger-Ellison syndrome
hypersecretion of gastric acid that produces peptic ulcers as a result of a non-beta-cell tumor of the pancreatic islets
DUMPING SYNDROME
increase fat and protein, small frequent meals, lie down after meal to decrease peristalsis. Wait 1 hr after meals to drink
gastritis
inflammation of the stomach
The Zollinger-Ellison syndrome (ZES) consists of severe peptic ulcers, extreme gastric hyperacidity, and gastrin-secreting benign or malignant tumors of the pancreas. The nurse recognizes that an agent that is used to decrease bleeding and decrease gastric acid secretions is vasopressin (Pitressin) omeprazole (Prilosec) nizatidine (Axid) octreotide (Sandostatin)
octreotide (Sandostatin) SUBMIT ANSWER
subtotal gastrectomy
partial removal of stomach
hematemesis
vomiting blood