Chapter 46

Diagnostic imaging and physical assessment have revealed that a client with peptic ulcer disease has suffered a perforated ulcer. The nurse recognizes that emergency interventions must be performed as soon as possible in order to prevent the development of what complication? a. Peritonitis b. Gastritis c. Gastroesophageal reflux d. Acute pancreatitis

a. Peritonitis

The nurse reviews dietary guidelines with a client who had a gastric banding. Which teaching points are included? Select all that apply. a. Eat six meals a day. b. Limit meal size to 450 to 500 mL. c. Do not eat and drink at the same time. d. Drink plenty of water, from 90 minutes after each meal to 15 minutes before each meal. e. Avoid fruit drinks and soda.

c. Do not eat and drink at the same time. d. Drink plenty of water, from 90 minutes after each meal to 15 minutes before each meal. e. Avoid fruit drinks and soda.

A client admitted for treatment of a gastric ulcer is being prepared for discharge. The client will follow a regimen of antacid therapy. Discharge teaching should include which instructions? Choose all that apply. a. "Continue to take antacids even if your symptoms subside." b. "You may take antacids with other medications." c. "You may be prescribed H2-receptor antagonists for up to 1 year." d. "Be sure to take antacids with meals." e. "The antacids will make you sleepy, so do not operate machinery while taking them."

a. "Continue to take antacids even if your symptoms subside." c. "You may be prescribed H2-receptor antagonists for up to 1 year."

An adult client with a history of dyspepsia has been diagnosed with chronic gastritis. The nurse's health education should include what guidelines? Select all that apply. a. Avoid drinking alcohol b. Adopt a low-residue diet c. Avoid non-steroidal anti-inflammatories d. Take calcium gluconate as prescribed e. Prepare for the possibility of surgery

a. Avoid drinking alcohol c. Avoid non-steroidal anti-inflammatories

The nurse is caring for a client with chronic gastritis. The nurse monitors the client knowing that this client is at risk for which vitamin deficiency? a. Vitamin A b. Vitamin B12 c. Vitamin C d. Vitamin E

b. Vitamin B12

A client is undergoing diagnostic testing for a tumor of the small intestine. What are the most likely symptoms that prompted the client to first seek care? a. Hematemesis and persistent sensation of fullness b. Abdominal bloating and recurrent constipation c. Intermittent pain and bloody stool d. Unexplained bowel incontinence and fatty stools

c. Intermittent pain and bloody stool

A health care provider counsels a client about bariatric surgery and recommends the Roux-en-Y gastric bypass. What is the best response by the nurse to further explain this procedure to the client? a. Gastroplasty with a vertical band allowing for a pouch with a 15 to 20 mL capacity b. Biliopancreatic diversion with a duodenal switch c. Separation of the jejunum with an anastomosis d. Gastric banding that incorporates a prosthetic device to restrict oral intake

c. Separation of the jejunum with an anastomosis

A nurse is preparing to discharge a client after recovery from gastric surgery. What is an appropriate discharge outcome for this client? a. The client's bowel movements maintain a loose consistency. b. The client is able to tolerate three large meals a day. c. The client maintains or gains weight. d. The client consumes a diet high in calcium.

c. The client maintains or gains weight.

A client is recovering from gastric surgery. What is the correct position for the nurse to place this client? a. Supine b. Semi-Fowler's c. Trendelenburg d. Fowler's

d. Fowler's

Which of the following manifestations are associated with a deficiency of vitamin B12? Select all that apply. a. Pernicious anemia b. Macrocytic anemia c. Thrombocytopenia d. Loss of hair e. Lethargy

a. Pernicious anemia b. Macrocytic anemia c. Thrombocytopenia

The nurse is conducting a community education program on peptic ulcer disease prevention. The nurse includes that the most common cause of peptic ulcers is: a. stress and anxiety. b. gram-negative bacteria. c. alcohol and tobacco. d. ibuprofen and aspirin.

b. gram-negative bacteria.

Which of the following interventions are appropriate for clients with gastritis? Select all that apply. a. Use a calm approach to reduce anxiety. b. Give the client food and fluids every 4 hours. c. Discourage cigarette smoking. d. Notify the physician of indicators of hemorrhagic gastritis. e. Provide general education about how to prevent recurrences.

a. Use a calm approach to reduce anxiety. c. Discourage cigarette smoking. d. Notify the physician of indicators of hemorrhagic gastritis.

The nurse is providing care for a client whose peptic ulcer disease will be treated with a Billroth I procedure (gastroduodenostomy). The nurse should address which of the following topics when providing health education? Select all that apply. a. The procedure carries a risk for dumping syndrome b. The client is likely to require long-term total parenteral nutrition (TPN) c. The client's vagus nerve may be altered d. The client can resume a usual diet in 3 to 5 weeks e. Part of the client's stomach and colon will be removed

a. The procedure carries a risk for dumping syndrome c. The client's vagus nerve may be altered

A patient comes to the clinic with the complaint, "I think I have an ulcer." What is a characteristic associated with peptic ulcer pain that the nurse should inquire about? Select all that apply. a. Burning sensation localized in the back or mid-epigastrium b. Feeling of emptiness that precedes meals from 1 to 3 hours c. Severe gnawing pain that increases in severity as the day progresses d. Pain that radiates to the shoulder or jaw e. Vomiting without associated nausea

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

A client with acute gastritis asks the nurse what might have caused the problem. What is a possible cause of acute gastritis? Select all that apply. a. Dietary indiscretion b. Overuse of allergy medicine c. Excessive alcohol intake d. Drinking fruit juices e. Radiation therapy

a. Dietary indiscretion c. Excessive alcohol intake e. Radiation therapy

A client presents to the clinic reporting vomiting and burning in her mid-epigastria. The nurse knows that in the process of confirming peptic ulcer disease, the health care provider is likely to order a diagnostic test to detect the presence of what? a. Infection with Helicobacter pylori b. Excessive stomach acid secretion c. An incompetent pyloric sphincter d. A metabolic acid-base imbalance

a. Infection with Helicobacter pylori

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? Choose the two that apply. a. Barium x-ray of the upper GI tract b. Esophagogastroduodenoscopy (EGD) c. Computed tomography (CT) d. Endoscopic ultrasound

c. Computed tomography (CT) d. Endoscopic ultrasound

A nurse is admitting a client diagnosed with late-stage gastric cancer. The client's family is distraught and angry that she was not diagnosed earlier in the course of her disease. What factor most likely contributed to the client's late diagnosis? a. Gastric cancer does not cause signs or symptoms until metastasis has occurred. b. Adherence to screening recommendations for gastric cancer is exceptionally low. c. Early symptoms of gastric cancer are usually attributed to constipation. d. The early symptoms of gastric cancer are usually not alarming or highly unusual

d. The early symptoms of gastric cancer are usually not alarming or highly unusual