Chapter 41, Nursing Management: Peptic Ulcer Disease

Which dietary instructions should the nurse provide the caregiver of a postoperative patient with dumping syndrome? Select all that apply. "Avoid giving cheese." "Avoid giving jelly and jam." "Avoid giving fluids with meals." "Give the patient eggs and meat." "Divide the meals into three feedings."

"Avoid giving jelly and jam." "Avoid giving fluids with meals." "Give the patient eggs and meat."

The nurse is completing a health history on a patient diagnosed with peptic ulcer disease. Which questions are appropriate while assessing the patient's cognitive-perceptual pattern? Select all that apply. "Do you experience hematemesis?" "Do you have any black, tarry stools?" "Do you experience any nocturnal pain?" "Do you have a family history of peptic ulcer disease?" "Do you experience high epigastric pain one to two hours after eating?"

"Do you experience any nocturnal pain?" "Do you experience high epigastric pain one to two hours after eating?"

A patient is being discharged after receiving a diagnosis of a duodenal ulcer. Which patient statements would indicate that the patient understands the nurse's discharge teaching regarding the management of his or her condition? Select all that apply. "I should really drink less coffee." "I will only take my medications when I'm having stomach pain." "This is the excuse I needed to quit smoking. Then my ulcer will heal faster." "I won't change brands of OTC antacids without first talking to my doctor." "Black, tarry stools are to be expected and are not a cause for concern." "Drinking milk will decrease the amount of acid my stomach produces."

"I should really drink less coffee." "This is the excuse I needed to quit smoking. Then my ulcer will heal faster." "I won't change brands of OTC antacids without first talking to my doctor."

The results of a patient's recent endoscopy indicate the presence of peptic ulcer disease (PUD). Which teaching point should the nurse provide to the patient based on this new diagnosis? "You'll need to drink at least two to three glasses of milk daily." "It would likely be beneficial for you to eliminate drinking alcohol." "Many people find that a minced or pureed diet eases their symptoms of PUD." "Your medications should allow you to maintain your present diet while minimizing symptoms."

"It would likely be beneficial for you to eliminate drinking alcohol."

The nurse is caring for a patient with suspected stress-related mucosal disease (SRMD). Which medication can be co-administered with antisecretory agent for the patient's condition? Ranitidine Amoxicillin Pantoprazole Aluminum hydroxide

Aluminum hydroxide

Which medications increase the risk of ulcer development? Select all that apply. Aspirin Fluoxetine Misoprostol Bethanechol Metoclopramide

Aspirin Fluoxetine

A nurse is teaching a patient about prevention of peptic ulcers. What instructions should the nurse give the patient? Select all that apply. Avoid smoking. Consume raw uncooked food. Use nonsteroidal antiinflammatory drugs (NSAIDs) for treatment of pain. Wash hands thoroughly with soap after using the restroom and before eating. Report symptoms of gastric irritation, such as nausea and epigastric pain, to the health care provider.

Avoid smoking. Wash hands thoroughly with soap after using the restroom and before eating. Report symptoms of gastric irritation, such as nausea and epigastric pain, to the health care provider.

What surgical procedure involves the removal of two-thirds of the stomach and anastomosis of the gastric stump to the duodenum? Vagotomy Pyloroplasty Billroth I operation Billroth II operation

Billroth I operation A Billroth I operation, also known as a gastroduodenostomy, is a partial gastrectomy in which the distal two thirds of the stomach is removed and there is an anastomosis of the gastric stump to the duodenum.

Which medications can be used concurrently with antacids to provide ulcer relief? Select all that apply. Cimetidine Amoxicillin Famotidine Omeprazole Clarithromycin

Cimetidine Famotidine

Following a gastrectomy performed for peptic ulcer disease, the patient has recovered and is ready for discharge. What instructions should the nurse include in discharge teaching to prevent dumping syndrome? Take fluids along with meals. Reduce protein and fats in the diet. Divide meals into six small feedings. Use concentrated sweets like honey, jam, and jelly.

Divide meals into six small feedings.

A postmenopausal patient complains of back pain and burning pain in midepigastric region three hours after a meal. The medical history of the patient reveals hyperparathyroidism. Which condition does the nurse suspect in the patient? Gastric ulcer Duodenal ulcer Zollinger-Ellison syndrome Postprandial hypoglycemia

Duodenal ulcer

The nurse is obtaining a health history from a patient who comes to the office for evaluation of gastric distress. The patient indicates that the symptoms occur two to five hours after meals, and the pain is "burning" and sometimes like a cramp in the midepigastric region, just below the xiphoid process. Based on these descriptions, the nurse suspects that the patient has which disorder? Esophagitis Gastric ulcer Duodenal ulcer Chronic gastritis

Duodenal ulcer

Which surgical therapy is used to treat pyloric obstruction? Vagotomy Endoscopy Gastrojejunostomy Gastroduodenostomy

Endoscopy

A nurse assesses a patient with suspected peptic ulcer disease. Which symptom will the patient most likely report? Vomiting after meals Abdominal distention after eating Intolerance of fatty and spicy foods Epigastric discomfort relieved by eating

Epigastric discomfort relieved by eating Symptoms of peptic ulcer disease (PUD) are variable and often absent. However, discomfort, if present, may occur before meals or two to three hours after meals and at bedtime. The discomfort may be relieved by eating because the food will dilute and buffer gastric acid.

What are the first clinical manifestations of peptic ulcer disease that occur in elderly patients? Select all that apply. Indigestion Abdominal pain Abdominal sounds Frank gastric bleeding Decrease in hematocrit

Frank gastric bleeding Decrease in hematocrit

What are the characteristics of gastric ulcers? Select all that apply. Gastric ulcer lesions are superficial. Gastric ulcers increase the gastric secretion. Gastric ulcers predominantly occur in antrum. Gastric ulcers cause pain one to two hours after meals. Gastric ulcers manifest as burning, cramping pain in the midepigastrium.

Gastric ulcer lesions are superficial. Gastric ulcers predominantly occur in antrum. Gastric ulcers cause pain one to two hours after meals.

Which laboratory results determine the type and amount of intravenous fluids administered? Select all that apply. Hematocrit Electrolytes Hemoglobin Liver enzymes Serum amylase

Hematocrit Electrolytes Hemoglobin

The nurse is caring for a patient who presents with tachycardia, lower abdominal pain, and nausea and vomiting. Upon clinical examination, the primary health care provider identifies a rigid and board-like abdomen. Which surgical therapy is beneficial for the patient? Billroth I Vagotomy Laparoscopy Pyloroplasty

Laparoscopy Tachycardia, lower abdomen pain, nausea, and vomiting are the clinical manifestations of perforation, a complication of peptic ulcer disease. A laparoscopy involves a simple closure with an omentum graft, which will repair the perforation with appropriate source control and limit the parietal cell acid secretion.

Which medication is prescribed for the prevention of peptic ulcer caused by nonsteroidal antiinflammatory drugs (NSAIDs) and aspirin? Famotidine Imipramine Misoprostol Clarithromycin

Misoprostol

Which histamine-receptor blocker is available only for oral administration? Nizatidine Ranitidine Cimetidine Famotidine

Nizatidine

A nurse is caring for a patient diagnosed with peptic ulcer disease. On assessment, the nurse identifies spillage of gastric contents into the duodenal cavity. Which complication supports the finding? Perforation Hemorrhage Dumping syndrome Gastric outlet obstruction

Perforation

A patient who underwent surgical therapy for peptic ulcer disease complains of sweating, weakness, mental confusion, and increased heart rate two hours after eating. Which complication does the nurse anticipate? Achalasia Bile reflux gastritis Dumping syndrome Postprandial hypoglycemia

Postprandial hypoglycemia

The patient with peptic ulcer disease is on sucralfate medication. Which outcome does the nurse anticipate? Healing of ulcer Reduction in acid secretion Protection of ulcer from acids Neutralization of gastric acid secretion

Protection of ulcer from acids

A patient with a history of peptic ulcer disease has presented to the emergency department reporting severe abdominal pain and has a rigid, board-like abdomen that prompts the health care team to suspect a perforated ulcer. What intervention should the nurse anticipate? Providing intravenous (IV) fluids and inserting a nasogastric (NG) tube Administering oral bicarbonate and testing the patient's gastric pH level Performing a fecal occult blood test and administering IV calcium gluconate Starting parenteral nutrition and placing the patient in a high Fowler's position

Providing intravenous (IV) fluids and inserting a nasogastric (NG) tube

A patient is on drug therapy for a peptic ulcer. Which medication does the nurse anticipate to be prescribed to help reduce hydrochloric acid secretion? Ranitidine Sucralfate Tetracycline Aluminum hydroxide gel

Ranitidine

A patient has what is suspected to be a gastric ulcer perforation. Which symptom does the nurse expect will be present? Pyrosis Rigid abdomen Bright-red emesis Clay-colored stools

Rigid abdomen

A 72-year-old patient was admitted with epigastric pain caused by a gastric ulcer. Which patient assessment warrants an urgent change in the nursing plan of care? Chest pain relieved with eating or drinking water Back pain three or four hours after eating a meal Burning epigastric pain 90 minutes after breakfast Rigid abdomen and vomiting following indigestion

Rigid abdomen and vomiting following indigestion

The nurse is caring for a patient with suspected posterior duodenal ulcer penetration of the pancreas. Which laboratory study would diagnose the patient's condition? Liver enzyme studies Serum amylase determination Complete blood count (CBC) test Serum gastrin level determination

Serum amylase determination

A patient with severe burns is admitted in an emergency department. The medical reports of the patient reveal coagulopathy. Which condition does the nurse suspect in the patient? Bile reflux gastritis Dumping syndrome Zollinger-Ellison syndrome Stress-related mucosal disease

Stress-related mucosal disease

Which medication is prescribed for cytoprotective drug therapy? Tofranil Sucralfate Cimetidine Misoprostol

Sucralfate

Which medications are beneficial in relieving the pain through their effects on afferent pain fiber transmission? Select all that apply. Tofranil Bismuth Imipramine Misoprostol Pantoprazole

Tofranil Imipramine

Which enzyme activates the immune response with antibody production and the release of inflammatory cytokines? Pepsin Urease Bile salts Serum amylase

Urease

Which condition can be diagnosed by measuring fasting serum gastrin levels? Acute gastritis Pyloric obstruction Gastric outlet obstruction Zollinger-Ellison syndrome

Zollinger-Ellison syndrome