Chapter 41: Upper GI Problems

A patient requires a dose of promethazine for nausea. The prescription states to give 25 mg intravenous (IV) push q8hr as needed. On hand is a vial labeled "100 mg/mL." How many milliliters should the nurse administer? A. 0.15 mL B. 0.25 mL C. 0.5 mL D. 1 mL

B. 0.25 mL

The patient has a new prescription to receive omeprazole 20 mg daily. Available are 40 mg tablets. How many tablets should the nurse administer? A. 0.25 tablet B. 0.5 tablet C. 1.5 tablets D. 2 tablets

B. 0.5 tablet

Which medication does the nurse expect to be beneficial to the patient who works outdoors, has high levels of emotional stress, and complains of lip lesions and painful ulcers? A. Ampicillin B. Acyclovir C. Prednisone D. Amphotericin B

B. Acyclovir

The nurse reviews a patient's medication profile and identifies that which medication has a direct, irritating effect on the gastrointestinal (GI) tract? A. Sucralfate B. Alendronate C. Bethanechol D. Metoclopramide

B. Alendronate

The nurse identifies that a patient is at risk for upper gastrointestinal bleeding based on the patient's history of what? A. Hiatal hernia B. Renal failure C. Pernicious anemia D. Pancreatic disease

B. Renal failure

The nurse is conducting a health interview for a patient with suspected stomach cancer. Which questions are relevant in determining the diagnosis? Select all that apply. A. "Do you experience unexplained weight loss?" B. "Have you received blood transfusions in the past?" C. "Do you have other illnesses, such as liver cirrhosis?" D. "Do you have dyspepsia or intestinal gas discomfort?" E. "Do you have a religious preference that prohibits the use of blood?"

A. "Do you experience unexplained weight loss?" D. "Do you have dyspepsia or intestinal gas discomfort?"

A patient presents with uterine cramping, abdominal cramping, and diarrhea. The patient takes a medication for treatment of peptic ulcer disease. The nurse identifies that which medication is the likely cause of the patient's symptoms? A. Misoprostol B. Bethanechol C. Esomeprazole D. Metoclopramide

A. Misoprostol

A patient presents with suspected upper gastrointestinal bleeding. Which questions are appropriate for the nurse to ask to assess the patient's cognitive-perceptual pattern? Select all that apply. A. "Do you have abdominal cramps?" B. "Do you experience any epigastric pain?" C. "Do you have a family history of bleeding?" D. "Do you experience weakness and fainting?" E. "Do you experience acute or chronic stress?"

A. "Do you have abdominal cramps?" B. "Do you experience any epigastric pain?"

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. A. "I should really drink less coffee." B. "I will only take my medications when I'm having stomach pain." C. "This is the excuse I needed to quit smoking. Then my ulcer will heal faster." D. "I won't change brands of OTC antacids without first talking to my doctor." E. "Black, tarry stools are to be expected and are not a cause for concern." F. "Drinking milk will decrease the amount of acid my stomach produces."

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

The nurse is teaching an older patient about treatment and management of peptic ulcer disease. Which statement made by the patient indicates the need for further teaching? A. "I should report abdominal pain or discomfort to the nurse." B. "I should avoid irritating substances that cause peptic ulcer." C. "I should take nonsteroidal antiinflammatory drugs (NSAIDs) with food, milk, or antacids." D. "I should adhere to proton pump inhibitor (PPI) and histamine-receptor blocker therapy as prescribed."

A. "I should report abdominal pain or discomfort to the nurse."

The nurse has a prescription to give famotidine 20 mg by the intravenous (IV) push route. To administer this drug safely, the nurse should give this medication over a minimum of how many minutes? A. 2 minutes B. 5 minutes C. 10 minutes D. 15 minutes

A. 2 minutes

Which condition is associated with symptoms of weight loss, halitosis, nocturnal regurgitation, and an inability to belch? A. Achalasia B. Esophageal varices C. Esophageal stricture D. Eosinophilic esophagitis (EE)

A. Achalasia

A patient diagnosed with Eosinophilic esophagitis (EE) may require a referral to which kind of specialist because of the underlying pathology and etiology of the condition? A. Allergist B. Cardiologist C. Pulmonologist D. Rheumatologist

A. Allergist

Which symptoms noted by the patient would indicate a severe adverse reaction to metoclopramide? Select all that apply. A. Anxiety B. Tremor C. Bradycardia D. Hallucinations E. Altered sense of smell

A. Anxiety B. Tremor D. Hallucinations

Which factors increase intraabdominal pressure and lead to the development of a hiatal hernia? Select all that apply. A. Ascites B. Obesity C. Pregnancy D. Fatty foods E. Peppermint

A. Ascites B. Obesity C. Pregnancy

Which medication causes gastritis? A. Aspirin B. Amoxicillin C. Lansoprazole D. Metronidazole

A. Aspirin

Which medications increase the risk of ulcer development? Select all that apply. A. Aspirin B. Fluoxetine C. Misoprostol D. Bethanechol E. Metoclopramide

A. Aspirin B. Fluoxetine

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

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

A nurse is teaching an obese patient with gastroesophageal reflux disease (GERD) measures that should be taken to prevent complications. What instructions should the nurse give? Select all that apply. A. Avoid tea and coffee. B. Maintain a low-fat diet. C. Avoid smoking cigarettes. D. Lie down immediately after having food. E. Use anticholinergic drugs, as prescribed.

A. Avoid tea and coffee. B. Maintain a low-fat diet. C. Avoid smoking cigarettes.

The nurse recognizes that which therapy is used to treat lesions in the pyloric region? A. Billroth I B. Chemotherapy C. Radiation therapy D. Total gastrectomy with esophagojejunostomy

A. Billroth I

A patient with gastroesophageal reflux disease (GERD) is on cimetidine therapy. Which parameter does the nurse monitor to provide effective care? A. Bowel sounds B. Motor movements C. Serum calcium levels D. Serum magnesium levels

A. Bowel sounds

The nurse explains to the patient with gastroesophageal reflux disease (GERD) that this is a disorder that can be aggravated by which of the following? Select all that apply. A. Caffeine B. Chocolate C. Dietary fiber D. Orange juice E. Cigarette smoking F. High-protein foods

A. Caffeine B. Chocolate D. Orange juice E. Cigarette smoking

Which otolaryngologic symptoms occur in gastroesophageal reflux disease (GERD)? Select all that apply. A. Choking B. Dyspnea C. Wheezing D. Hoarseness E. Sore throat

A. Choking D. Hoarseness E. Sore throat

Which of the conditions is not a common cause of an upper gastrointestinal (GI) bleed? A. Cholecystitis B. Stomach cancer C. Esophageal varices D. Nonsteroidal antiinflammatory drugs (NSAIDS)

A. Cholecystitis

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

A. Cimetidine C. Famotidine

The nurse is preparing to administer a dose of octreotide to a patient who is experiencing an acute episode of upper gastrointestinal (GI) bleeding and is waiting for an endoscopy procedure. The nurse knows that the octreotide will have which mechanism of action? Select all that apply. A. Decreases blood flow to the GI tract B. Increases the production of mucus in the stomach C. Causes tissue edema and pressure on the source of bleeding D. Decreases hydrochloric acid secretion by decreasing the release of gastrin E. Causes vasoconstriction, reducing pressure in the portal circulation and stopping bleeding

A. Decreases blood flow to the GI tract D. Decreases hydrochloric acid secretion by decreasing the release of gastrin

Which condition results from sympathetic activation? A. Diaphoresis B. Increase in salivation C. Increase in gastric motility D. Relaxation of lower esophageal sphincter

A. Diaphoresis

The nurse is caring for a patient who is on misoprostol medication for peptic ulcer disease. Which side effects does the nurse anticipate in this patient? Select all that apply. A. Diarrhea B. Tachycardia C. Blurred vision D. Uterine cramping E. Abdominal cramp

A. Diarrhea D. Uterine cramping E. Abdominal cramp

A patient undergoes gastrectomy. What should the nurse recommend to decrease the symptoms of dumping syndrome? A. Drinking no fluids with meals B. Remaining in a high Fowler's position after meals C. Increasing the carbohydrate intake with each meal D. Consuming a large amount of water with each meal

A. Drinking no fluids with meals

Which medication used in gastroesophageal reflux disease decreases the conversion of pepsinogen to pepsin? A. Famotidine B. Misoprostol C. Rabeprazole D. Metoclopramide

A. Famotidine

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

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

A 65-year-old female patient who has been on warfarin for five years reports nausea, episodes of vomiting, and pain in the abdomen upon palpation. What could be the reason for the patient's condition? A. Gastritis B. Oral cancer C. Stomach cancer D. Peptic ulcer disease

A. Gastritis

A patient presents with burning pain in the epigastrium accompanied by nausea. On interviewing the patient, the nurse finds that the patient has been taking nonsteroidal antiinflammatory drugs (NSAIDs) on a regular basis to relieve headaches. Which condition should the nurse suspect? A. Gastritis B. Achalasia C. Esophagitis D. Gastroesophageal reflux disease (GERD)

A. Gastritis

Assessment findings of a patient include a reflux of bile and pancreatic secretions and clinical manifestations of shock. The nurse suspects which diagnosis? A. Gastritis B. Achalasia C. Stomach cancer D. Upper gastrointestinal bleeding

A. Gastritis

Which surgery is used to attach the stomach subdiaphragmatically to prevent reherniation? A. Gastropexy B. Herniotomy C. Herniorrhaphy D. Heller myotomy

A. Gastropexy

Which laboratory test is beneficial for diagnosing the presence of a small amount of blood in gastric secretions and stools? A. Guaiac test B. Liver enzyme studies C. Complete blood count (CBC) D. Serum amylase determination

A. Guaiac test

The patient has a prescription for rabeprazole. The nurse would assess the effectiveness of the medication by noting whether the patient obtained relief from which symptom? A. Heartburn B. Flatulence C. Constipation D. Abdominal pain

A. Heartburn

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

A. Hematocrit B. Electrolytes C. Hemoglobin

A gastrectomy is performed on a patient with upper gastrointestinal bleeding. While assessing the patient postoperatively, the nurse suspects a leak at the anastomosis site. Which findings support the nurse's suspicion? Select all that apply. A. Increased dyspnea B. Nausea and vomiting C. Recurrence of bleeding D. Sweating and vivid hallucinations E. Elevation in the body temperature

A. Increased dyspnea E. Elevation in the body temperature

The nurse is caring for a patient with anorexia, nausea, vomiting, epigastric pain, and feeling of fullness. Which interventions are beneficial to the patient? Select all that apply. A. Inserting a nasogastric tube B. Administering intravenous fluids C. Maintaining the patient on nothing-bymouth (NPO) status D. Educating the patient that fainting may occur due to cimetidine E. Providing the patient with nonirritating diet consisting of six small feedings a day

A. Inserting a nasogastric tube B. Administering intravenous fluids C. Maintaining the patient on nothing-by mouth (NPO) status

Several patients are seen at an urgent care center with symptoms of nausea, vomiting, and diarrhea that began two hours ago while attending an office picnic. The nurse will question the patients about foods they ate that included which of these? Select all that apply. A. Milk products B. Fried chicken C. Salad dressings D. Cream-filled pastries E. Home-preserved vegetables.

A. Milk products C. Salad dressings D. Cream-filled pastries

A patient has had persistent nausea and vomiting for the last five days. Which immediate nursing interventions available are appropriate for this patient? Select all that apply. A. Monitor the vital signs continuously. B. Encourage patient to do physical activity. C. Administer opioid drugs to sedate the patient. D. Administer intravenous fluids and electrolytes. E. Insert a nasogastric tube connected to suction.

A. Monitor the vital signs continuously. D. Administer intravenous fluids and electrolytes. E. Insert a nasogastric tube connected to suction.

The nurse is preparing a care plan for a patient who underwent an open high abdominal incision. Which necessary interventions should the nurse include in the care plan? Select all that apply. A. Monitoring pulse rate B. Monitoring bowel sounds C. Monitoring blood glucose D. Monitoring respiratory rate E. Monitoring serum creatinine

A. Monitoring pulse rate D. Monitoring respiratory rate

Which histamine-receptor blocker is available only for oral administration? A. Nizatidine B. Ranitidine C. Cimetidine D. Famotidine

A. Nizatidine

A patient has had esophageal surgery, and a jejunostomy feeding tube is inserted to administer oral fluids. The nurse has been told to check for signs of intolerance and leakage of feeding into the mediastinum. Which signs should the nurse be observant for? Select all that apply. A. Pain B. Dyspnea C. Acid reflux D. Tachycardia E. Increased temperature

A. Pain B. Dyspnea E. Increased temperature

While providing fluids to a postgastrectomy patient, which symptoms support the nurse's suspicion that there is leakage from a jejunostomy feeding tube? Select all that apply. A. Pain B. Fever C. Cough D. Regurgitation E. Difficulty breathing

A. Pain B. Fever E. Difficulty breathing

A registered nurse is evaluating the medication charts of four patients that have been prepared by a student nurse. Which patient's medication chart needs correction? A. Patient 1 B. Patient 2 C. Patient 3 D. Patient 4

A. Patient 1

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? A. Perforation B. Hemorrhage C. Dumping syndrome D. Gastric outlet obstruction

A. Perforation

Which complications can occur due to long-term use of proton pump inhibitors in patients with gastroesophageal reflux disease (GERD)? Select all that apply. A. Pneumonia B. Renal calculi C. Uterine rupture D. Decreased bone density E. Chronic hypochlorhydria

A. Pneumonia D. Decreased bone density E. Chronic hypochlorhydria

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? A. Providing intravenous (IV) fluids and inserting a nasogastric (NG) tube B. Administering oral bicarbonate and testing the patient's gastric pH level C. Performing a fecal occult blood test and administering IV calcium gluconate D. Starting parenteral nutrition and placing the patient in a high Fowler's position

A. 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? A. Ranitidine B. Sucralfate C. Tetracycline D. Aluminum hydroxide gel

A. Ranitidine

While caring for a patient with esophageal cancer, the nurse finds regurgitation of blood-flecked esophageal contents. What does the nurse expect to be the reason behind the patient's condition? A. Severe esophageal stenosis B. Tumor in the upper third of the esophagus C. Obstruction of the esophagus at the diaphragm D. Cancer eroding through the esophagus and into the aorta

A. Severe esophageal stenosis

The nurse is caring for a patient with liver cirrhosis. Which medication should be used with caution in this patient? A. Sodium citrate B. Magnesium oxide C. Calcium carbonate D. Aluminum hydroxide

A. Sodium citrate

Which microorganism is the cause of erythema and mouth ulcers in a patient complaining of ear pain and absence of saliva? A. Streptococcus B. Candida albicans C. Vincent spirochetes D. Herpes simplex virus

A. Streptococcus

Which medication for treating gastroesophageal reflux disease (GERD) may cause constipation? A. Sucralfate B. Misoprostol C. Bethanechol D. Esomeprazole

A. Sucralfate

Which side effect occurs in a patient with gastroesophageal reflux disease who is on bethanechol therapy? A. Syncope B. Flatulence C. Renal calculi D. Hallucinations

A. Syncope

The nurse is teaching care guidelines to the caregiver of a patient with upper gastrointestinal (GI) bleeding. In the follow-up visit, the patient complains of traces of blood in the vomit. Which action of the patient's caregiver is responsible for the patient's condition? A. The caregiver gave aspirin to the patient on an empty stomach. B. The caregiver allowed the patient to drink 10 mL of alcohol once a month. C. The caregiver encouraged the patient to practice deep breathing exercises. D. The caregiver gave the patient an analgesic along with a proton pump inhibitor.

A. The caregiver gave aspirin to the patient on an empty stomach.

The nurse is interviewing a patient with a duodenal ulcer. Which characteristic of pain is the nurse likely to find? A. The pain is cramplike. B. The pain is aggravated by food intake. C. The pain occurs one to two hours after a meal. D. The pain is located high up in the epigastrium.

A. The pain is cramplike.

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

A. Tofranil C. Imipramine

What are the late symptoms of cancer of the tongue? Select all that apply. A. Toothache B. Slurred speech C. Increased salivation D. Cancerous lesions on the tongue E. Limited movement of the tongue

A. Toothache B. Slurred speech C. Increased salivation

A patient complains of nausea. When administering a dose of metoclopramide, the nurse should teach the patient to report which potential adverse effect? A. Tremors B. Constipation C. Double vision D. Numbness in fingers and toes

A. Tremors

Which technique should the nurse use to effectively administer a dose of promethazine by the intramuscular (IM) route? A. Use the Z-track technique. B. Inject at a 45-degree angle. C. Numb the area with ice before injection. D. Administer in the flank area to increase absorption.

A. Use the Z-track technique.

A patient presents to the ambulatory clinic complaining of "stomach upset" that has occurred intermittently for the past several months. The patient does not want an invasive workup and would prefer to avoid medication therapy. Working with the patient, which goals would the nurse discuss and document in the care plan? Select all that apply. A. Weight reduction by 15 lb B. Smoking cessation within the next 60 days C. Avoiding caffeinated and alcoholic beverages D. Exercise three times a week for 30 minutes or more E. Increase of fruit consumption with citrus and tomato-based products daily

A. Weight reduction by 15 lb B. Smoking cessation within the next 60 days C. Avoiding caffeinated and alcoholic beverages

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

B. Rigid abdomen

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

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

The nurse is providing instructions to a patient who has been treated for gastrointestinal bleeding and is planned for discharge. Which statement made by the patient indicates effective learning? A. "I should take low doses of aspirin." B. "I should take aspirin with omeprazole." C. "I should read the labels of over-the-counter drugs." D. "I should take the lansoprazole one hour after meals."

B. "I should take aspirin with omeprazole."

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? A. "You'll need to drink at least two to three glasses of milk daily." B. "It would likely be beneficial for you to eliminate drinking alcohol." C. "Many people find that a minced or pureed diet eases their symptoms of PUD." D. "Your medications should allow you to maintain your present diet while minimizing symptoms."

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

The nurse is caring for a patient with a hiatal hernia. Which instructions should the nurse include teaching? Select all that apply. A. "You may drink soda." B. "You should avoid caffeine." C. "You should avoid chocolate." D. "You should suck peppermint." E. "You should drink orange juice."

B. "You should avoid caffeine." C. "You should avoid chocolate."

Which statement made by the nurse to an achalasia patient about how to manage symptoms needs correction? A. "You should eat slowly." B. "You should only eat soft food." C. "You should drink fluids with meals." D. "You should sleep with your head elevated."

B. "You should only eat soft food."

Which instruction should the nurse provide to the patient with inflammation of the parotid glands? A. "You should eat fibrous food." B. "You should try chewing gum." C. "You should avoid warm compresses." D. "You should avoid sucking on hard candy."

B. "You should try chewing gum."

The nurse is caring for a patient diagnosed with Helicobacter pylori (H. pylori) infection. Which medications should the nurse expect to be included in the triple-drug therapy? Select all that apply. A. Cimetidine B. Amoxicillin C. Omeprazole D. Tetracycline E. Clarithromycin

B. Amoxicillin C. Omeprazole E. Clarithromycin

The nurse suspects that a patient is experiencing upper gastrointestinal bleeding after undergoing endoscopic therapy. Which diagnostic test is best to confirm the nurse's suspicion? A. Biopsy B. Angiography C. Laparoscopy D. Endoscopic ultrasound

B. Angiography

Which findings indicate that a patient with gastroesophageal reflux disease has aspirated gastric contents into the respiratory system? Select all that apply. A. Cough B. Asthma C. Pneumonia D. Bronchospasm E. Chronic bronchitis

B. Asthma C. Pneumonia E. Chronic bronchitis

Which medication increases lower esophageal sphincter pressure? A. Diazepam B. Bethanechol C. Theophylline D. Morphine sulfate

B. Bethanechol

A patient complains of burning pain in the abdomen four hours after eating a meal. Upon assessment, the nurse identifies the pain in midepigastric region. Which risk factors are associated with the pain? Select all that apply. A. Bile reflux B. Chronic pancreatitis C. Chronic kidney disease D. Zollinger-Ellison syndrome E. Incompetent pyloric sphincter

B. Chronic pancreatitis C. Chronic kidney disease D. Zollinger-Ellison syndrome

A patient experiences chronic gastritis with a loss of parietal cells due to atrophy. The nurse determines that the patient is at risk for a complication associated with the loss of the parietal cells. Which diagnostic test will assist in making this determination? A. Liver enzyme studies B. Complete blood count C. Secretin stimulation test D. Serum amylase determination

B. Complete blood count

Which intervention should the nurse perform when finding that a postgastrectomy patient has greenish yellow discharge eight hours after insertion of a nasogastric tube? A. Remove the nasogastric tube. B. Document it as a normal finding. C. Notify the primary health care provider. D. Place the patient in a semi-Fowler's position.

B. Document it as a normal finding.

After administering a dose of promethazine to a patient with nausea and vomiting, the nurse explains that what may be experienced as a common temporary adverse effect of the medication? A. Tinnitus B. Drowsiness C. Reduced hearing D. Sensation of falling

B. Drowsiness

After administering a dose of promethazine, the nurse explains that which common temporary adverse effect may occur? A. Tinnitus B. Drowsiness C. Urinary retention D. Sensation of falling

B. Drowsiness

The nurse is caring for a patient treated with intravenous (IV) fluid therapy for severe vomiting. As the patient recovers and begins to tolerate oral intake, the nurse understands that which food choice would be most appropriate? A. Iced tea B. Dry toast C. Hot coffee D. Plain hamburger

B. Dry toast

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? A. Gastric ulcer B. Duodenal ulcer C. Zollinger-Ellison syndrome D. Postprandial hypoglycemia

B. Duodenal ulcer

A patient is seeking emergency care after choking on a piece of steak. The nursing assessment reveals a history of alcoholism, cigarette smoking, and hemoptysis. Which diagnostic study is most likely to be performed on this patient? A. Barium swallow B. Endoscopic biopsy C. Capsule endoscopy D. Endoscopic ultrasonography

B. Endoscopic biopsy

Which surgical therapy is used to treat pyloric obstruction? A. Vagotomy B. Endoscopy C. Gastrojejunostomy D. Gastroduodenostomy

B. Endoscopy

Which infection does the nurse suspect in a patient with periodontitis who complains of bleeding during brushing and reveals the he or she has a high intake of soft foods? A. Parotitis B. Gingivitis C. Stomatitis D. Oral candidiasis

B. Gingivitis

When administering a dose of ondansetron, the nurse would teach the patient to report which common adverse effect? A. Nausea B. Headache C. Paresthesias D. Double vision

B. Headache

The patient who is admitted with a diagnosis of diverticulitis and a history of irritable bowel disease and gastroesophageal reflux disease (GERD) has received a dose of Mylanta 30 mL orally. The nurse should evaluate its effectiveness by questioning the patient as to whether which symptom has resolved? A. Diarrhea B. Heartburn C. Constipation D. Lower abdominal pain

B. Heartburn

The nurse is aware that the primary symptoms of a sliding hiatal hernia are associated with reflux and should assess the patient for which symptoms? A. Jaundice, ascites, and edema B. Heartburn, regurgitation, and dysphagia C. Abdominal cramps, diarrhea, and anorexia D. Pelvic pain, fever, and board-like abdominal rigidity

B. Heartburn, regurgitation, and dysphagia

A patient presents with upper gastrointestinal (GI) bleeding. During the patient's assessment, the nurse notes coffee ground vomitus. How should the nurse classify the finding? A. Melena B. Hematemesis C. Occult bleeding D. Mallory-Weiss tear

B. Hematemesis

Which condition does the nurse expect in a patient with gastroesophageal reflux disease (GERD) who has esophagitis and stenosis? A. Achalasia B. Hiatal hernia C. Esophageal strictures D. Eosinophilic esophagitis

B. Hiatal hernia

Which antiemetic medication causes xerostomia as a side effect? A. Granisetron B. Scopolamine C. Perphenazine D. Domperidone

B. Scopolamine

After assessing a patient with gastrointestinal bleeding, the nurse suspects shock in the patient. Which findings in the patient support the nurse's conclusion? Select all that apply. A. Dry skin B. Increased thirst C. Rapid, weak pulse D. High blood pressure E. Increased temperature

B. Increased thirst C. Rapid, weak pulse

Which treatment strategy does the nurse expect to be beneficial for an elderly patient with a hiatal hernia who has a cardiovascular complication? A. Antireflux surgery B. Laparoscopic surgery C. Calcium channel blocker therapy D. Nonsteroidal antiinflammatory drugs (NSAIDs)

B. Laparoscopic surgery

Which condition does the nurse suspect in a patient with oral cancer who has "smoker's patch" on the mucosa of the mouth? A. Pyrosis B. Leukoplakia C. Erythroplasia D. Hyperkeratosis

B. Leukoplakia

After reviewing the medical reports of a patient with portal hypertension, the nurse concludes that the patient has esophageal varices. Which other finding supports the nurse's conclusion? A. Kyphosis B. Liver cirrhosis C. Throat lacerations D. Squamous cell cancer

B. Liver cirrhosis

A patient is experiencing persistent vomiting with emesis consisting of contents from the small intestine. Which alteration in blood gas will the nurse expect to occur? A. Metabolic alkalosis B. Metabolic acidosis C. Respiratory alkalosis D. Respiratory acidosis

B. Metabolic acidosis

The patient history indicates the patient was taking ondansetron at home before admission. The nurse inquires as to the effectiveness of this medication in treating which symptom? A. Pain B. Nausea C. Headache D. Leg cramps

B. Nausea

Which medication does the nurse expect to be beneficial to the patient who reports difficulty swallowing and is diagnosed with achalasia? A. Cisplatin B. Nifedipine C. Prednisone D. Porfimer sodium

B. Nifedipine

Which medications decrease lower esophageal sphincter pressure in elderly patients with a hiatal hernia and gastroesophageal reflux disease (GERD)? Select all that apply. A. Aspirin B. Nifedipine C. Potassium D. Imipramine E. Isosorbide dinitrate

B. Nifedipine D. Imipramine E. Isosorbide dinitrate

While caring for a postoperative patient with a nasogastric tube, the nurse suspects that the tube is repositioned. What is the priority nursing intervention to prevent complications in the patient? A. Inserting a new nasogastric tube B. Notifying the primary health care provider immediately C. Irrigating the nasogastric tube with normal saline solution D. Monitoring for the symptoms of edema and inflammation

B. Notifying the primary health care provider immediately

The nurse is caring for a patient who is diagnosed with gastrointestinal (GI) bleeding. Diagnostic test results indicate a Mallory-Weiss tear. The nurse anticipates that which medication will be prescribed? A. Cisplatin B. Octreotide C. Oxaliplatin D. Epinephrine

B. Octreotide

The nurse is caring for a patient who is diagnosed with upper gastrointestinal (GI) bleeding. The patient's medical history indicates that the bleeding is due to preexisting liver cirrhosis. Which medications will best help the patient? Select all that apply. A. Cisplatin B. Octreotide C. Oxaliplatin D. Epinephrine E. Vasopressin

B. Octreotide E. Vasopressin

The nurse provides information to a student nurse about appropriate goals for patients with upper gastrointestinal bleeding. The identification of which goals by the student nurse indicates the need for further teaching? Select all that apply. A. Hemodynamic stability B. Optimal nutritional status C. Decreased hemoglobin level D. Minimal symptoms of pain or anxiety E. Absence of gastrointestinal bleeding

B. Optimal nutritional status C. Decreased hemoglobin level

The nurse is involved in a health promotion program for teenagers related to the potential development of oral cancer. Which behaviors can put a person at risk for oral cancer? Select all that apply. A. Chewing gum B. Overexposure to the sun C. Using smokeless tobacco D. Drinking carbonated beverages E. Excessive drinking of alcoholic beverages

B. Overexposure to the sun C. Using smokeless tobacco E. Excessive drinking of alcoholic beverages

The nurse is caring for a patient who underwent surgical therapy for peptic ulcer disease. Upon clinical examination, the primary health care provider suspected that a complication occurred due to loss of intrinsic factor. Which complication does the nurse suspect? A. Bile reflux gastritis B. Pernicious anemia C. Dumping syndrome D. Postprandial hypoglycemia

B. Pernicious anemia

The nurse finds that a patient with weight loss reports nausea, vomiting, difficulty swallowing, and a burning sensation in the chest. The biopsy and endoscopy reports reveal infiltration of eosinophils. Which medication does the nurse expect to be beneficial to the patient? A. Sucralfate B. Prednisone C. Misoprostol D. Methotrexate

B. Prednisone

Deep muscle injection is the preferred route of administration of this drug used to treat nausea and vomiting because of its necrotizing effect on tissue when infiltration occurs. A. Methergine B. Promethazine C. Metoclopramide D. Prochlorperazine

B. Promethazine

The nurse finds that a patient taking a prescribed medication for gastroesophageal reflux disease (GERD) had a miscarriage. Which medication does the nurse expect to be responsible for the miscarriage? A. Cholinergics B. Prostaglandins C. Antiulcer agents D. Histamine (H 2) receptor blockers

B. Prostaglandins

The primary health care provider orders endoscopic nutrition via a nasogastric tube for a postsurgical patient whose nutrition is disrupted. Which interventions should the nurse perform for this patient? Select all that apply. A. Irrigating the tube B. Providing oral care C. Providing nasal care D. Assessing the drainage E. Repositioning the tube

B. Providing oral care C. Providing nasal care D. Assessing the drainage

A patient who underwent a surgery for peptic ulcer disease (PUD) complains of continuous upper abdominal pain and vomiting. Upon assessment, the nurse identifies that the patient is on cholestyramine medication. Which surgery did the patient undergo? A. Vagotomy B. Pyloroplasty C. Gastrojejunostomy D. Gastroduodenostomy

B. Pyloroplasty

A patient with gastroesophageal reflux disease reports to the nurse, "I feel like there is a hot, bitter liquid in my mouth." What does the nurse document in the patient's medical record? A. Dysphagia B. Regurgitation C. Hypersalivation D. Hyperchlorhydria

B. Regurgitation

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? A. Liver enzyme studies B. Serum amylase determination C. Complete blood count (CBC) test D. Serum gastrin level determination

B. Serum amylase determination

The nurse is caring for a patient with atrophic gastritis who has a cyanocobalamin deficiency. The nurse suspects what diagnosis? A. Gastric ulcer B. Stomach cancer C. Nonsteroidal-induced gastritis D. Upper gastrointestinal bleeding

B. Stomach cancer

To prevent the recurrence of gastritis, what instruction should the nurse provide to the patient? A. Take acetaminophen and ibuprofen for pain. B. Stop smoking and do not consume alcoholic beverages. C. Consume a soft diet with moderate spices and seasonings. D. Stop smoking and consume alcoholic beverages in moderation.

B. Stop smoking and do not consume alcoholic beverages.

Which medication is prescribed for cytoprotective drug therapy? A. Tofranil B. Sucralfate C. Cimetidine D. Misoprostol

B. Sucralfate

The nurse finds that the patient has a hard, painless ulcer on the upper lip. What treatment does the nurse expect the primary health care provider to prescribe? A. Glossectomy B. Surgical excision C. Mandibulectomy D. Hemiglossectomy

B. Surgical excision

The nurse is teaching a patient about measures to prevent Salmonella poisoning. Which action indicates effective learning? A. The patient avoids eating cheese. B. The patient avoids eating half-boiled eggs. C. The patient avoids purchasing canned items. D. The patient avoids eating rewarmed meat dishes.

B. The patient avoids eating half-boiled eggs.

The nurse is teaching a patient preventive strategies to avoid staphylococcal poisoning. Which action indicates effective learning? A. The patient avoids cooking meat at a high temperature. B. The patient refrigerates leftover food to eat the next day. C. The patient avoids eating food immediately after cooking it. D. The patient boils canned food for five minutes before eating it.

B. The patient refrigerates leftover food to eat the next day.

A patient presents with suspected gastric carcinoma. The nurse anticipates that which diagnostic test will be prescribed? A. Radiology B. Tissue biopsy C. Rapid urease testing D. Endoscopic ultrasound

B. Tissue biopsy

Why does a primary health care provider place stents endoscopically while preparing a patient with esophageal cancer for surgery? A. To prevent regurgitation B. To improve nutrition status C. To improve gastric emptying D. To prevent respiratory complications

B. To improve nutrition status

The nurse finds fever, bleeding ulcers in the mouth, and bad oral odor in a patient with bleeding and painful gums. Which intervention is most beneficial to the patient? A. Oral tablets of acyclovir B. Topical application of antibiotics C. Oral suspension of amphotericin B D. Topical application of corticosteroids

B. Topical application of antibiotics

A patient with stomach cancer presents with weight loss, dumping syndrome, and impaired wound healing. The nurse suspects that which surgical treatment may have caused the patient's symptoms? A. Pyloroplasty B. Total gastrectomy C. Partial gastrectomy D. Esophagojejunostomy

B. Total gastrectomy

Which is a common antireflux surgery for repair of a hiatal hernia? A. Cryotherapy B. Toupet fundoplication C. Photodynamic therapy D. Endoscopic mucosal resection

B. Toupet fundoplication

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

B. Urease

What is the mechanism of action of vasopressin, a peptide hormone formed in the hypothalamus? A. Tissue edema B. Vasoconstriction C. Decreased hydrochloric acid secretion D. Decreased esophageal and gastric mucosal irritation

B. Vasoconstriction

After administering a dose of metoclopramide to the patient, the nurse determines that the medication has not been effective when which symptom is noted? A. Vertigo B. Vomiting C. Diarrhea D. Migraine headache

B. Vomiting

A patient with a peptic ulcer begins vomiting. The nurse would expect and be concerned with which type of vomitus? A. Fecal B. Bilious C. "Coffee ground" D. Undigested food

C. "Coffee ground"

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. A. "Do you experience hematemesis?" B. "Do you have any black, tarry stools?" C. "Do you experience any nocturnal pain?" D. "Do you have a family history of peptic ulcer disease?" E. "Do you experience high epigastric pain one to two hours after eating?"

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

The nurse is giving a patient instructions regarding the management of gastroesophageal reflux disease (GERD). Which statement indicates that further teaching is required? A. "So I don't have to follow a specific diet?" B. "Chewing gum may help relieve my symptoms." C. "I can have warm milk at bedtime, just not chocolate milk." D. "Instead of eating three large meals a day, I should eat small frequent meals throughout the day."

C. "I can have warm milk at bedtime, just not chocolate milk."

The registered nurse explains a dietary plan to a postoperative patient of gastric surgery who is preparing for discharge. Which statement made by the patient indicates the need for further teaching? A. "I should reduce my meal size." B. "I should reduce my intake of liquids with meals." C. "I should consume more sugar with every meal." D. "I should consume dry foods with low carbohydrate content."

C. "I should consume more sugar with every meal."

The nurse is teaching about home care to a patient with gastrointestinal reflux disease (GERD). Which statement made by the patient indicates the need for further teaching? A. "I should not bend over after eating." B. "I should sleep with the head of the bed elevated." C. "I should lie down for two to three hours after eating." D. "I should avoid eating within three hours of bedtime."

C. "I should lie down for two to three hours after eating."

The nurse is evaluating a patient after teaching about management of peptic ulcer disease. Which statement by the patient indicates the need for further teaching? Select all that apply. A. "I should report increased vomiting or epigastric pain." B. "I should avoid smoking because it may delay healing of the ulcer." C. "I should take over-the-counter drugs that have ingredients like aspirin." D. "I should avoid spicy and acidic food that may cause epigastric distress." E. "I should take medications that include only antisecretory class of drugs."

C. "I should take over-the-counter drugs that have ingredients like aspirin." E. "I should take medications that include only antisecretory class of drugs."

The nurse is teaching a group of high school students about the prevention of food poisoning. Which comment by the student shows understanding of foodborne illness protection? A. "We like to mix up the ingredients so the flavors will meld before we cook our beef stew." B. "For a snack, I like to eat raw cookie dough from the package instead of baking the cookies." C. "When they gave me a pink hamburger, I sent it back and also asked for a new bun and clean plate." D. "We only have one cutting board, so we cut up our chicken and salad vegetables at the same time."

C. "When they gave me a pink hamburger, I sent it back and also asked for a new bun and clean plate."

Which teaching should the nurse include in the discharge instructions for a postgastrectomy patient? A. "You should consume only liquid foods." B. "You should be aware that heartburn occurs after the surgery." C. "You should report it to the primary health care provider if regurgitation occurs." D. "You should inform the primary health care provider if dysphagia occurs within one month of the surgery."

C. "You should report it to the primary health care provider if regurgitation occurs."

The patient undergoing chemotherapy is nauseated and can have promethazine 12.5-25 mg intravenous (IV) push q4-6hr as needed (PRN) for nausea. On hand is a vial labeled "25 mg/mL." How many milliliters should the nurse administer to give a 12.5-mg dose? A. 5 mL B. 1 mL C. 0.5 mL D. 0.25 mL

C. 0.5 mL

The nurse plans to give a scheduled dose of metoclopramide at what most beneficial time? A. 0200 B. 0500 C. 1130 D. 1345

C. 1130

The patient has a prescription for metoclopramide 10 mg intravenously (IV). Available is a premixed IV bag containing 40 mg/50 mL. How many mL of this solution should be infused? A. 1.25 mL B. 3.75 mL C. 12.5 mL D. 37.5 mL

C. 12.5 mL

A patient has a prescription to receive famotidine (Pepcid) 30 mg intravenous piggyback (IVPB) or intravenous push (IVP) q12hr. Available is a vial containing 10 mg/mL. How many milliliters should the nurse draw up to administer this dose? A. 0.2 mL B. 0.75 mL C. 3 mL D. 5 mL

C. 3 mL

The patient has a prescription for amoxicillin 750 mg by mouth. Available is 125 mg/5 mL. How many milliliters should the nurse administer? A. 3 mL B. 13 mL C. 30 mL D. 0.3 mL

C. 30 mL

A patient is diagnosed with gastrointestinal bleeding after a surgical operation for peptic ulcer disease. On a follow-up visit, the nurse identifies a block in the nasogastric (NG) tube. Which complication is likely to occur? A. Perforation B. Dumping syndrome C. Abdominal distention D. Gastric outlet obstruction

C. Abdominal distention

Regurgitation is defined as what? A. A forceful expulsion of stomach contents without nausea B. A feeling of discomfort in the epigastrium with a conscious desire to vomit C. An effortless process in which partially digested food slowly comes up from the stomach D. Involuntary wavelike movements occurring within the alimentary canal that force contents onward

C. An effortless process in which partially digested food slowly comes up from the stomach

The patient with chronic gastritis is being put on a combination of medications to eradicate Helicobacter pylori. The nurse should know that which drugs probably will be used for this patient? A. Antibiotic(s), antacid, and corticosteroid B. Antibiotic(s), aspirin, and antiulcer/protectant C. Antibiotic(s), proton pump inhibitor, and bismuth D. Antibiotic(s) and nonsteroidal antiinflammatory drugs (NSAIDs)

C. Antibiotic(s), proton pump inhibitor, and bismuth

While reviewing the laboratory reports of a patient believed to have stomach cancer, the nurse finds that the patient has vitamin B 12 deficiency. Which does the nurse suspect in the patient? A. Hiatal hernia B. Bile reflux gastritis C. Autoimmune gastritis D. Gastroesophageal reflux disease (GERD)

C. Autoimmune gastritis

The nurse is caring for a patient with a long-term complication that exists post-operation of peptic ulcer disease. On a follow-up visit, the primary health care provider identifies spillage of gastric contents into the space between the abdominal cavity and the abdominal wall. Which complication may occur if the condition is untreated? A. Pernicious anemia B. Bile reflux gastritis C. Bacterial peritonitis D. Postprandial hypoglycemia

C. Bacterial peritonitis

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

C. Billroth I operation

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

C. Billroth I operation

Which medication has a side effect of milk-alkali syndrome? A. Misoprostol B. Metoclopramide C. Calcium carbonate D. Aluminum hydroxide

C. Calcium carbonate

A patient reports pain in the upper abdomen after eating. Upon reviewing the medical reports, the nurse finds that the patient underwent pylorus surgery. Which medication does the nurse expect the primary health care provider to prescribe? A. Fluticasone B. Misoprostol C. Cholestyramine D. Isosorbide dinitrate

C. Cholestyramine

The nurse is caring for a patient who is experiencing continuous epigastric distress and vomiting after undergoing a peptic ulcer surgery. Which medication does the nurse expect to be beneficial for the patient? A. Omeprazole B. Metronidazole C. Cholestyramine D. Aluminum hydroxide gel

C. Cholestyramine

Which pathophysiologic condition is associated with duodenal ulcers? A. Shock B. Sepsis C. Cirrhosis D. Large hiatal hernia

C. Cirrhosis

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? A. Take fluids along with meals. B. Reduce protein and fats in the diet. C. Divide meals into six small feedings. D. Use concentrated sweets like honey, jam, and jelly.

C. Divide meals into six small feedings.

Which medication increases gastric motility and gastric emptying? A. Droperidol B. Scopolamine C. Domperidone D. Dexamethasone

C. Domperidone

Which is the oral active cannabinoid used in the prevention of chemotherapy-induced emesis? A. Aprepitant B. Droperidol C. Dronabinol D. Dexamethasone

C. Dronabinol

A patient who underwent abdominal surgery complains of sweating, weakness, palpitations, and dizziness 20 minutes after a meal. Upon auscultation, the nurse finds the patient to have borborygmi. The laboratory test reports reveal decrease in the plasma volume. Which complication does the nurse suspect in the patient? A. Achalasia B. Bile reflux gastritis C. Dumping syndrome D. Postprandial hypoglycemia

C. Dumping syndrome

The patient is having a gastroduodenostomy (Billroth I operation) for stomach cancer. What long-term complication is occurring when the patient reports generalized weakness, sweating, palpitations, and dizziness 15 to 30 minutes after eating? A. Malnutrition B. Bile reflux gastritis C. Dumping syndrome D. Postprandial hypoglycemia

C. Dumping syndrome

The nurse is caring for a patient who presents with burning pain in the midepigastric region five hours after eating. The patient's medical history reveals pancreatic disease. Which condition does the nurse suspect? A. Gastric ulcer B. Acute gastritis C. Duodenal ulcer D. Stomach cancer

C. 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? A. Esophagitis B. Gastric ulcer C. Duodenal ulcer D. Chronic gastritis

C. Duodenal ulcer

Which condition does the nurse suspect in a patient who reports pain and discomfort in the upper abdomen? A. Pyrosis B. Halitosis C. Dyspepsia D. Water brash

C. Dyspepsia

In planning treatment for a patient with oral candidiasis, which interventions would the nurse anticipate being helpful? Select all that apply. A. Use of warm salt water rinses. B. Inclusion of spicy food in the diet. C. Education on a mechanical soft diet. D. Avoidance of citrus fruits and vegetables. E. Use of an antiseptic mouthwash frequently.

C. Education on a mechanical soft diet. D. Avoidance of citrus fruits and vegetables. E. Use of an antiseptic mouthwash frequently.

The nurse determines that a patient has experienced the beneficial effects of therapy with famotidine when which symptom is relieved? A. Nausea B. Belching C. Epigastric pain D. Difficulty swallowing

C. Epigastric pain

The nurse is caring for a patient with upper gastrointestinal (GI) bleeding caused by acute hemostasis. Which medication is beneficial to this patient? A. Etoposide B. Octreotide C. Epinephrine D. Vasopressin

C. Epinephrine

The nurse reviews the medical record of a patient and notes documentation of gastrointestinal (GI) bleeding from an ulceration. The nurse anticipates that which medication will be prescribed? A. Etoposide B. Octreotide C. Epinephrine D. Vasopressin

C. Epinephrine

Which is the first indication of gastroesophageal reflux disease and a hiatal hernia in elderly patients? A. Halitosis B. Pernicious anemia C. Esophageal bleeding D. Epigastric tenderness

C. Esophageal bleeding

Which condition is indicated by endoscopic findings of saclike pouches on the esophagus? A. Esophageal varices B. Esophageal stricture C. Esophageal diverticula D. Eosinophilic esophagitis

C. Esophageal diverticula

Which esophageal disorder does the nurse expect in a patient who has ingested a strong acid and is admitted to the emergency unit? A. Achalasia B. Esophageal varices C. Esophageal stricture D. Eosinophilic esophagitis (EE)

C. Esophageal stricture

Which microorganism causes Vincent's infection? A. Staphylococcus B. Candida albicans C. Fusiform bacteria D. Herpes simplex virus

C. Fusiform bacteria

A female patient has a sliding hiatal hernia. What nursing interventions will prevent the symptoms of heartburn and dyspepsia that she is experiencing? A. Keep the patient nothing by mouth (NPO). B. Put the bed in the Trendelenburg position. C. Have the patient eat four to six smaller meals each day. D. Give various antacids to determine which one works for the patient.

C. Have the patient eat four to six smaller meals each day.

Linked to stomach cancer and non-Hodgkin's lymphoma, what is a common cause of gastritis? A. Syphilis B. Cytomegalovirus C. Helicobacter pylori D. Mycobacterium species

C. Helicobacter pylori

Which complication occurs when cancer erodes through the esophagus and into the aorta? A. Choking B. Hoarseness C. Hemorrhage D. Blood-flecked regurgitation

C. Hemorrhage

A patient has received a dose of aluminum hydroxide with magnesium and simethicone 30 mL by mouth (PO). The nurse would evaluate its effectiveness by questioning the patient as to whether which symptom resolved? A. Flatus B. Diarrhea C. Indigestion D. Constipation

C. Indigestion

The patient has a prescription for promethazine 25 mg. To prevent harm to the patient, the dose should be administered through which site? A. Intravenous B. Intradermal C. Intramuscular D. Subcutaneous

C. Intramuscular

The nurse is connecting a nasogastric tube (NG) to suction for a patient who underwent abdominal surgery. Which therapy should be maintained in this condition? A. Adjuvant therapy B. Triple-drug therapy C. Intravenous therapy D. Cobalamin replacement therapy

C. Intravenous therapy

The nurse is caring for a patient who presents with abdominal pain, rigid board-like abdomen and shallow grunting respirations after undergoing a surgery. Which surgery does the nurse expect to be beneficial for the patient? A. Vagotomy B. Endoscopy C. Laparoscopy D. Pyloroplasty

C. Laparoscopy

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? A. Billroth I B. Vagotomy C. Laparoscopy D. Pyloroplasty

C. Laparoscopy

Which diagnostic or surgical procedure can best determine the spread of stomach cancer to the peritoneum? A. Biopsy B. Ultrasound C. Laparoscopy D. Computed tomography (CT)

C. Laparoscopy

Which respiratory complication occurs due to irritation of the upper airway by gastric secretions? A. Asthma B. Pneumonia C. Laryngospasm D. Chronic bronchitis

C. Laryngospasm

On reviewing the previous medical history of a patient with a sore mouth who has been on a high-dose of antibiotics for a year, the nurse finds bluish-white "milk-curd" lesions in the mouth. Which medication will the nurse expect to be beneficial? A. Acyclovir B. Fluticasone C. Miconazole D. Tetracycline

C. Miconazole

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

C. Misoprostol

The patient is having an esophagoenterostomy with anastomosis of a segment of the colon to replace the resected portion. What initial postoperative care should the nurse expect when this patient returns to the nursing unit? A. Turn, deep breathe, cough, and use spirometer every four hours B. Maintain an upright position for at least two hours after eating C. Nasogastric (NG) tube will have bloody drainage and it should not be repositioned D. Keep in a supine position to prevent movement of the anastomosis

C. Nasogastric (NG) tube will have bloody drainage and it should not be repositioned

The nurse explains to the patient with oral candidiasis that treatment will include which of these? A. Oral acyclovir B. Viscous lidocaine rinses C. Nystatin oral suspension D. Topical application of antibiotics

C. Nystatin oral suspension

A nurse on an inpatient medical-surgical unit is taking care of a patient with acute gastritis. The patient has a nasogastric tube (NGT) to low intermittent suction with bilious aspirate. Upon reassessment, the nurse finds the aspirate to have become blood-tinged. What should the nurse do next? A. Page the physician. B. Assess the patient's pain. C. Obtain a set of vital signs. D. Record the information in the patient's record.

C. Obtain a set of vital signs.

A 54-year-old patient admitted with cancer has not been able to eat because of nausea. Which strategies should the nurse use to increase the patient's intake? Select all that apply. A. Serve foods that are warm to hot in temperature. B. Offer the patient meats and foods with mild spices. C. Offer a diet that appeals to the patient's preferences. D. Administer antiemetics one hour before meals to prevent nausea. E. Offer the patient foods, such as cooked cereal and soft or canned fruits.

C. Offer a diet that appeals to the patient's preferences. D. Administer antiemetics one hour before meals to prevent nausea. E. Offer the patient foods, such as cooked cereal and soft or canned fruits.

The patient receiving chemotherapy rings the call light and reports the onset of nausea. The nurse should prepare an as needed dose of which medication? A. Morphine sulfate B. Zolpidem C. Ondansetron D. Dexamethasone

C. Ondansetron

The nurse is assessing a patient who has suspected esophageal cancer. Which of these is the most common symptom of esophageal cancer? A. Weight loss B. Regurgitation C. Progressive dysphagia D. Epigastric pain during swallowing.

C. Progressive dysphagia

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

C. Protection of ulcer from acids

Which diagnostic test detects reflux of gastric contents? A. Biopsy B. Endoscopy C. Radionuclide test D. Manometric studies

C. Radionuclide test

Following administration of a dose of metoclopramide to the patient, the nurse determines that the medication has been effective when what is noted? A. Decreased blood pressure B. Absence of muscle tremors C. Relief of nausea and vomiting D. No further episodes of diarrhea

C. Relief of nausea and vomiting

A patient reports abdominal pain, weight loss, indigestion, and a feeling of fullness in stomach. Diagnostic test results indicate atrophic gastritis. Based on the assessment findings, the nurse suspects which diagnosis? A. Achalasia B. Gastric ulcer C. Stomach cancer D. Upper gastrointestinal bleeding

C. Stomach cancer

Which disorder does the nurse suspect to be present in an alcoholic patient who complains of excessive salivation? A. Parotitis B. Gingivitis C. Stomatitis D. Aphthous stomatitis

C. Stomatitis

On a follow-up visit, the nurse finds that a patient prescribed prokinetic medication to treat nausea and vomiting has discontinued the medication. Which complication does the nurse expect to be present? A. Xerostomia B. Somnolence C. Tardive dyskinesia D. Elevated liver function tests

C. Tardive dyskinesia

The nurse is teaching care management to a patient with gastroesophageal reflux disease (GERD). In the follow-up visit, the patient complains of severe heartburn. Which actions indicate the need for further teaching? Select all that apply. A. The patient chews gum daily. B. The patient eats ginger daily. C. The patient eats oranges daily. D. The patient eats ice cream often. E. The patient drinks 2 L of water daily. F. The patient drinks a cup of milk at bedtime.

C. The patient eats oranges daily. D. The patient eats ice cream often. F. The patient drinks a cup of milk at bedtime.

The nurse identifies that radiation therapy is used concurrently with chemotherapy for cancer treatment for what reason? A. To stage the disease B. To examine histology C. To reduce tumor mass D. To determine peritoneal spread

C. To reduce tumor mass

The primary health care provider is severing the vagus nerve in a patient with a peptic ulcer that is unresponsive to medical management. Which surgical procedure should the nurse expect for this patient? A. Billroth I B. Billroth II C. Vagotomy D. Pyloroplasty

C. Vagotomy

A patient presents to the outpatient clinic with concerns over persistent signs and symptoms of heartburn (pyrosis) . What is the most appropriate response for the nurse? A. "Is your throat sore?" B. "Are you waking up during the night coughing and choking?" C. "Give the medication time to take effect. You will be feeling better really soon." D. "I know it is uncomfortable for you. Have you been taking your medication as prescribed and making the necessary dietary adjustments?"

D. "I know it is uncomfortable for you. Have you been taking your medication as prescribed and making the necessary dietary adjustments?"

Which patient statement indicates a need for further teaching regarding appropriate dietary choices for illness with vomiting? A. "I should eat hard candy." B. "I should eat plain baked potatoes." C. "I should drink warm tea with crackers." D. "I should drink carbonated beverages on ice."

D. "I should drink carbonated beverages on ice."

Which finding supports the nurse's conclusion that a patient with an infection of the mouth has oral candidiasis? A. Development of pus B. Formation of abscess C. Eroding necrotic lesions of interdental papillae D. "Milk-curd" membranous lesion on mucosa of mouth

D. "Milk-curd" membranous lesion on mucosa of mouth

The postoperative patient states that he or she has never taken pantoprazole in the past. The patient asks why he or she is getting this medication if the patient has never had heartburn. What is the best response by the nurse? A. "This will prevent gas pains from the excess air in your small intestine." B. "This will prevent the heartburn that occurs as a side effect of your diabetes." C. "The stress of surgery is likely to cause stomach bleeding if you do not receive it." D. "This will reduce the amount of acid in your stomach until you can eat a regular diet again."

D. "This will reduce the amount of acid in your stomach until you can eat a regular diet again."

The nurse provides education to a group of student nurses about preoperative preparations for bowel surgery. Which statement made by a student nurse indicates the need for further teaching? A. "Administer enemas to cleanse the bowel." B. "Correct malnourishment in the patient prior to surgery." C. "Administer antibiotics to reduce the intestinal bacteria." D. "Transfuse packed red blood cells (RBC) to correct anemia."

D. "Transfuse packed red blood cells (RBC) to correct anemia."

A dose of ondansetron 4 mg is scheduled to be given by the intravenous (IV) route at 0800. Available is a vial containing 6 mg/mL for injection. How many mL of this medication should be drawn up to give this dose? A. 0.4 mL B. 0.5 mL C. 0.6 mL D. 0.7 mL

D. 0.7 mL

Where does Zenker's diverticulum occur? A. At the wall of the esophagus B. Near the esophageal midpoint C. At the lower portion of the esophagus D. Above the upper esophageal sphincter

D. Above the upper esophageal sphincter

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? A. Ranitidine B. Amoxicillin C. Pantoprazole D. Aluminum hydroxide

D. Aluminum hydroxide

Which antacid used in the treatment of gastrointestinal reflux disease (GERD) causes phosphorus depletion with chronic use? A. Magnesium oxide B. Calcium carbonate C. Sodium bicarbonate D. Aluminum hydroxide

D. Aluminum hydroxide

Which medication is beneficial to a patient reporting coughing, dyspnea, and radiating pain to the back, neck, and jaw? A. Nifedipine B. Prednisone C. Isosorbide dinitrate D. Aluminum hydroxide

D. Aluminum hydroxide

Which condition does the nurse suspect in a patient with a chronic infection of the pharynx who reports ulcers in the mouth and lips with severe pain? A. Stomatitis B. Herpes simplex C. Vincent's infection D. Aphthous stomatitis

D. Aphthous stomatitis

A chronic smoker reports chest tightness, loss of appetite, feeling of fullness, and epigastric pain. The laboratory reports of the patient reveal low levels of chloride. Which is the most likely diagnosis for this patient? A. Stomach cancer B. Bile reflux gastritis C. Esophageal cancer D. Autoimmune gastritis

D. Autoimmune gastritis

The nurse is caring for a patient with variceal bleeding. Which procedure should be used for this patient? A. Gastrectomy B. Billroth I and II C. Radiation therapy D. Balloon tamponade

D. Balloon tamponade

Which diagnostic test is best suited to help identify gastric outlet obstruction? A. Endoscopy B. Urea breath test C. Rapid urease testing D. Barium contrast study

D. Barium contrast study

Which complication does the nurse expect in a patient with gastroesophageal reflux disease (GERD) who has been taking dexlansoprazole for one year? A. Syncope B. Dyskinesia C. Renal calculi D. Bone fracture

D. Bone fracture

A patient who is admitted with an upper gastrointestinal bleed has a history of two previous heart attacks and is presently being given large doses of intravenous fluids. For which possible complication(s) should the nurse monitor the patient? Select all that apply. A. Infection B. Vomiting C. Arrhythmias D. Cardiac failure E. Pulmonary edema

D. Cardiac failure E. Pulmonary edema

The nurse is caring for a patient with chronic gastritis. Which of these symptoms is associated specifically with this condition? A. Severe diarrhea B. Gastric hemorrhage C. Nausea and vomiting D. Cobalamin deficiency

D. Cobalamin deficiency

The nurse is caring for a patient who underwent a gastrectomy. Upon clinical examination, the primary health care provider suspects a long-term complication such as pernicious anemia. Which therapy is beneficial for the patient? A. Triple-drug therapy B. Intravenous therapy C. Quadruple-drug therapy D. Cobalamin replacement therapy

D. Cobalamin replacement therapy

During rounds, the nurse notes that a patient who had a total gastrectomy the day before has a very small amount of fluid draining from the nasogastric (NG) tube. What is the nurse's priority action? A. Increase the power on the suction device. B. Irrigate the NG tube with 50 mL of sterile saline. C. Notify the primary health care provider immediately. D. Continue to monitor the patient and NG tube drainage.

D. Continue to monitor the patient and NG tube drainage.

Which medication is responsible for causing flatulence in a patient on medication therapy for gastroesophageal reflux disease (GERD)? A. Sucralfate B. Famotidine C. Misoprostol D. Dexlansoprazole

D. Dexlansoprazole

On a follow-up visit, a patient on medication for vomiting and nausea reports hallucinations to the nurse. Which medication does the nurse expect to be the reason for this condition? A. Droperidol B. Palonosetron C. Perphenazine D. Domperidone

D. Domperidone

Which procedure involves the disruption of the lower esophageal sphincter using balloons? A. Heller myotomy B. Esophagectomy C. Esophagoenterostomy D. Endoscopic pneumatic dilation

D. Endoscopic pneumatic dilation

Which diagnostic study is used to stage esophageal cancer? A. Radionuclide tests B. Manometric studies C. Esophagram (barium swallow) D. Endoscopic ultrasonography (EUS)

D. Endoscopic ultrasonography (EUS)

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

D. Epigastric discomfort relieved by eating

A patient presents with complaints of abdominal cramping and diarrhea, which initially was watery but is now bloody. Symptoms began three days ago after eating out with friends. You suspect the patient is experiencing which infection? A. Botulism B. Clostridial C. Staphylococcal toxin D. Escherichia coli O157:H7 infection

D. Escherichia coli O157:H7 infection

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

D. Frank gastric bleeding E. Decrease in hematocrit

Which microorganism causes gastritis? A. Streptococcus B. Fusiform bacteria C. Candida albicans D. Helicobacter pylori

D. Helicobacter pylori

In assessing the vital signs of a patient with an upper gastrointestinal (GI) bleed, it is important to determine whether the patient is in which kind of shock? A. Septic B. Neurogenic C. Cardiogenic D. Hypovolemic

D. Hypovolemic

Which treatment will the nurse expect will provide short-term relief to an elderly patient who has difficulty swallowing food and has chest pain immediately after meals? A. Heller myotomy B. Endoscopic pneumatic dilation C. Endoscopic stapling diverticulotomy D. Injection of botulinum toxin endoscopically

D. Injection of botulinum toxin endoscopically

A patient is admitted to the hospital with a severe duodenal ulcer. The patient suddenly complains of severe pain spreading over the entire abdomen, likely due to a perforation. What should be the most immediate intervention by the nurse, if prescribed? A. Administer nitrates. B. Administer pain medication. C. Prepare for laparoscopic surgery. D. Insert a nasogastric (NG) tube into the stomach.

D. Insert a nasogastric (NG) tube into the stomach.

A patient underwent abdominal surgery four days ago and has sutures in the upper epigastric region. Which is the most appropriate initial nursing intervention to prevent pulmonary complications? A. Administer steam inhalation. B. Encourage early ambulation. C. Administer bronchodilator drugs. D. Instruct the patient to splint the incision site with a pillow while coughing.

D. Instruct the patient to splint the incision site with a pillow while coughing.

Which antacid does the nurse expect the primary health care provider to prescribe to a patient who reports mild, intermittent chest pain after meals? A. Sodium citrate B. Calcium carbonate C. Aluminum carbonate D. Magnesium trisilicate

D. Magnesium trisilicate

Which medication for peptic ulcer disease causes hallucinations? A. Nizatidine B. Sucralfate C. Omeprazole D. Metoclopramide

D. Metoclopramide

Which medication used to treat nausea and vomiting may cause dyskinesia? A. Nizatidine B. Sucralfate C. Omeprazole D. Metoclopramide

D. Metoclopramide

The nurse reviews the rates of stomach cancer in ethnic groups. Of the four groups that the nurse reviewed, which one has the lowest rate? A. Hispanics B. Pacific Islanders C. Asian Americans D. Non-Hispanic whites

D. Non-Hispanic whites

The nurse identifies that a patient is at risk for upper gastrointestinal bleeding based on the patient's history of taking medications in what drug class? A. Antacids B. Anticholinergics C. Tricyclic antidepressants D. Nonsteroidal antiinflammatory drugs (NSAIDs)

D. Nonsteroidal antiinflammatory drugs (NSAIDs)

The nurse is assisting a patient who has been admitted with severe abdominal pain. Suddenly, the patient vomits a large amount of emesis that looks similar to coffee grounds. Which action by the nurse is a A. Ask the patient about the timing of the last meal. B. Offer the patient sips of water to prevent dehydration. C. Monitor the patient for any further episodes of nausea and vomiting. D. Notify the primary health care provider about the patient's condition.

D. Notify the primary health care provider about the patient's condition.

Which action of the nurse is appropriate if, while administering fluids through a jejunostomy feeding tube to a patient who underwent an esophageal surgery, the nurse suspects that the tube is misplaced? A. Reinsert the tube. B. Reposition the tube. C. Document the findings and continue to administer. D. Notify the primary health care provider immediately.

D. Notify the primary health care provider immediately.

The nurse is caring for a patient diagnosed with gastric outlet obstruction. Which assessment findings support the diagnosis? Select all that apply. A. Rigid board-like abdomen B. Audible abdominal sounds C. Continuous epigastric distress D. Overtime dilation of the stomach E. Visible swelling in the upper abdomen

D. Overtime dilation of the stomach E. Visible swelling in the upper abdomen

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? A. Achalasia B. Bile reflux gastritis C. Dumping syndrome D. Postprandial hypoglycemia

D. Postprandial hypoglycemia

A patient reports having a dry mouth and asks for something to drink. The nurse recognizes that this symptom most likely can be attributed to a common adverse effect of which medication that the patient is taking? A. Digoxin B. Cefotetan C. Famotidine D. Promethazine

D. Promethazine

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? A. Chest pain relieved with eating or drinking water B. Back pain three or four hours after eating a meal C. Burning epigastric pain 90 minutes after breakfast D. Rigid abdomen and vomiting following indigestion

D. Rigid abdomen and vomiting following indigestion

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? A. Chest pain relieved with eating or drinking water B. Back pain three or four hours after eating a meal C. Burning epigastric pain 90 minutes after breakfast D. Rigid abdomen and vomiting following indigestion

D. Rigid abdomen and vomiting following indigestion

A patient is on nonsteroidal antiinflammatory drugs (NSAIDs). Which complication does the nurse anticipate? A. Achalasia B. Duodenal ulcer C. Stomach cancer D. Silent peptic ulcer

D. Silent peptic ulcer

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? A. Bile reflux gastritis B. Dumping syndrome C. Zollinger-Ellison syndrome D. Stress-related mucosal disease

D. Stress-related mucosal disease

A patient presents with severe abdominal burns. Diagnostic tests reveal a discrete, deep ulcer in the fundus of the stomach. The nurse expects that the patient will be diagnosed with what? A. Gastric ulcer B. Duodenal ulcer C. Stomach cancer D. Stress-related mucosal disease (SRMD)

D. Stress-related mucosal disease (SRMD)

The nurse reviews a patient's medical record and notes a history of traumatic injuries as a result of a car fire that occurred one month prior to the current admission. The nurse recognizes that the patient is at risk for which condition? A. Gastritis B. Duodenal ulcer C. Stomach cancer D. Stress-related mucosal disease (SRMD)

D. Stress-related mucosal disease (SRMD)

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

D. Zollinger-Ellison syndrome