Ch. 46 PrepU
Which of the following are characteristics associated with the Zollinger-Ellison syndrome (ZES)?
Extreme gastric hyperacidity Severe peptic ulcers Gastrin- secreting tumors of the pancreas
Which medication is classified as a histamine-2 receptor antagonist?
Famotidine
A client has been taking famotidine at home. What teaching should the nurse include with the client?
Famotidine will inhibit gastric acid secretions.
Health teaching for a patient with GERD is directed toward decreasing lower esophageal sphincter pressure and irritation. The nurse instructs the patient to do which of the following?
Avoid beer, especially in the evening Elevate the head of the bed on 6- to 8-inch blocks Elevate the upper body on pillows
The nurse is evaluating a client's ulcer symptoms to differentiate ulcer as duodenal or gastric. Which symptom should the nurse at attribute to a duodenal ulcer?
Awakening in pain
A client sustained second- and third-degree burns over 30% of the body surface area approximately 72 hours ago. What type of ulcer should the nurse be alert for while caring for this client?
Curling's ulcer
Which is the primary symptom of achalasia?
Difficulty swallowing
The nurse reviews dietary guidelines with a client who had a gastric banding. Which teaching points are included?
Do not eat and drink at the same time Drink plenty of water, from 90 minutes after each meal to 15 minutes before each meal Avoid fruit drinks and soda
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
The nurse is preparing to assess the donor site of a client who underwent a myocutaneous flap after a radical neck dissection. The nurse prepares to assess the most commonly used muscle for this surgery. Which muscle should the nurse assess?
Pectoralis major
A nurse is caring for a client who is suspected to have developed a peptic ulcer hemorrhage. Which action would the nurse perform first?
Place the client in a recumbent position with the legs elevated
Tube feedings are advised for a client who is recovering from oral surgery. The nurse manages the tube feedings to minimize the risk of aspiration. Which measures should the nurse include in the care plan to reduce the risk of aspiration?
Place the client in semi-Fowler's position during and 30 to 60 minutes after an intermittent feeding Check tube placement and gastric residual prior to feedings
Which term describes an inflammation of the salivary glands?
Sialadenitis
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?
Slows gastric emptying
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 partial gastrectomy is performed with anastomosis of the stomach segment to the duodenum
A nurse is performing an assessment for a client who presents to the clinic with an erythemic, fissuring lip lesion with white hyperkeratosis. What does the nurse suspect that these findings are characteristic of?
Actinic cheilitis
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?
Acute gastritis
While stripping wax from surfboards, a client accidentally ingested a refrigerated strong base cleaning solution, thinking it was water. What interventions would the nurse anticipate including in this client's care plan?
Administer medication for report of pain Insert an IV catheter for administration of IV fluids Maintain nothing by mouth status Asses respiratory status every 4 hours and prn
A patient has been NPO for two days anticipating surgery which has been repeatedly delayed. In addition to risks of nutritional and fluid deficits, the nurse determines that this patient is at the greatest risk for:
Altered oral mucous membranes
The nurse is examining the mouth of a client who is HIV positive. On the inner side of the lip, the nurse sees a shallow ulcer with a yellow center and red border. The client says the area has been painful for about 5 days or so. Which condition is most consistent with these findings?
Aphthous stomatitis
Which of the following are functions of saliva?
Lubrication, Protection against harmful bacteria, digestion
A client is prescribed tetracycline to treat peptic ulcer disease. Which instruction would the nurse give the client?
Be sure to wear sunscreen while taking this medicine
The nurse is caring for a client with a history of bulimia. The client complains of retrosternal pain and dysphagia after forcibly causing herself to vomit after a large meal. The nurse suspects which condition?
Boerhaave syndrome
A nurse inspects the Stensen duct of the parotid gland to determine inflammation and possible obstruction. What area in the oral cavity would the nurse examine?
Buccal mucosa next to the upper molars
A client is prescribed a histamine (H2)-receptor antagonist. The nurse understands that this might include which medication(s)?
Cimetidine Nizatidine Famotidine
A client has given a confirmed diagnosis of gastric cancer. Two more procedures may be performed to assess tumor depth and lymph node involvement and surgical respectability. Which two are the procedures?
Computed tomography (CT) Endoscopic ultrasound
A morbidly obese client asks the nurse if medications are available to assist with weight loss. The nurse knows that the client would not be a candidate for phentermine if the following is part of the client's health history:
Coronary artery disease
As a nurse completes the admission assessment of a client admitted for gastric bypass surgery, the client states, "Finally! I'll be thin and able to eat without much concern." How should the nurse intervene?
Evaluate the client's understanding of the procedure`
During a psychotic episode, a client with schizophrenia swallows a small wooden spoon. Which medication would the nurse in the emergency department be most likely to administer to facilitate removal of the foreign body?
Glucagon
The nurse is cautiously assessing a client admitted with peptic ulcer disease because the most common complication that occurs in 10% to 20% of clients is:
Hemorrhage
The nurse is caring for a client during the postoperative period following radical neck dissection. Which finding should be reported to the physician?
High epigastric pain and/or discomfort
After teaching a client who has had a Roux-en-Y gastric bypass, which client statement indicates the need for additional teaching?
I need to drink 8 ounces of water before eating
A nurse is performing discharge teaching with a client who had a total gastrectomy. Which statement indicates the need for further teaching?
I will have to take vitamin B12 shots up to 1 year after surgery
A nurse is providing education to a client with GERD. The client asks what measures can be taken independently to help reduce the symptoms. Which interventions would the nurse recommend?
Maintaining an upright position following meals Avoiding foods that intensify symptoms
A nursing student is caring for a client with gastritis. Which of the following would the student recognize as a common cause of gastritis?
Ingestion of strong acids Irritating foods Overuse of aspirin
The nurse is caring for a client receiving chemotherapy. For which mouth conditions associated with HIV infection should the nurse assess?
Kaposi sarcoma Stomatitis
The nurse is reviewing the chart of a client with swallowing problems. Which factors would raise suspicion that the client has cancer of the esophagus?
Male gender Previous treatment for gastroesophageal reflux disease Smoking history of 20 years
A client experienced surgical resection of a tumor of the esophagus. After recovery from the anesthesia, what will the nurse include in the postoperative care plans?
Monitor drainage in the closed chest drainage system Assess lung sounds every 4 hours and prn Verify rhythm on the cardiac monitoring system
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?
NPO
A client is admitted with a new onset of pyloric obstruction. What client symptoms should the nurse anticipate?
Nausea and vomiting Epigastric fullness Anorexia
The nurse is creating a discharge teaching plan for a client after surgery for oral cancer. Which should be included in the teaching plan?
Oral hygiene Follow-up dental appointment Follow-up medical appointment Use of humidification
The nurse recognizes that the client diagnosed with a duodenal ulcer will likely experience
Pain 2-3 hours after a meal
A client has been diagnosed with Zenker's diverticulum. What treatment does the nurse include in the client education?
Surgical removal of the diverticulum
A client is admitted to the hospital with an exacerbation of chronic gastritis. When assessing the client's nutritional status, the nurse should expect to find what type of deficiency?
Vitamin B12
Which of the following is the most common type of diverticulum?
Zenker's diverticulum
A patient tells the nurse that it feels like food is "sticking" in the lower portion of the esophagus. What motility disorder does the nurse suspect these symptoms indicate?
achalasia
A client has undergone a radical neck dissection. His skin graft site is pale. This indicates which condition?
arterial thrombosis
A client with achalasia recently underwent pneumatic dilation. The nurse intervenes after the procedure by
assessing lung sounds
A client has a new order for metoclopramide. What potential side effects should the nurse educate the client about?
extrapyramidal
Rebleeding may occur from a peptic ulcer and often warrants surgical interventions. Signs of bleeding include which of the following?
mental confusion
The nurse is providing discharge instructions for a slightly overweight client seen in the Emergency Department with gastroesophageal reflux disease (GERD). The nurse notes in the client's record that the client is taking carbidopa/levodopa. Which order for the client by the health care provider should the nurse question?
metaclopramide
The healthcare provider of a client with oral cancer has ordered the placement of a GI tube to provide nutrition and to deliver medications. What would be the preferred route?
nasogastric intubation
A nurse practitioner, who is treating a patient with GERD, knows that responsiveness to this drug classification is validation of the disease. The drug classification is:
proton pump inhibitors
