Chapter 57; Coordinating Care for Patients with Stomach Disorders

The nurse plans care for several patients who are admitted to the medical unit. Which patients require preventative measures for peptic ulcer disease (PUD)? Select all that apply. 1. The patient admitted for the treatment of sarcoidosis. 2. The patient admitted for the treatment of tuberculosis (TB). 3. The patient admitted for the treatment of hypoparathyroidism. 4. The patient admitted for treatment of a Crohn's disease exacerbation. 5. The patient admitted for treatment after a motor vehicle crash (MVC).

1, 2, 4, 5

The nurse monitors for which clinical manifestations in the patient diagnosed with a perforation secondary to peptic ulcer disease? Select all that apply. 1. Sudden onset of pain 2. Early satiety 3. Intense epigastric discomfort 4. Rigid abdominal muscles 5. Vomiting

1, 3, 4

The nurse monitors for which clinical manifestations in the patient diagnosed with gastroenteritis? Select all that apply. 1. Arterial pH 7.30 2. Serum glucose 140 mg/dL 3. Serum BUN 30 mg/dL 4. Serum potassium 3.0 mEq/L 5. Urine specific gravity 1.010

1, 3, 4

The nurse provides discharge instructions for a patient who is diagnosed with peptic ulcer disease (PUD). Which patient statement indicates the need for further teaching? 1. "I can still drink a cup of coffee in the morning." 2. "I will take the prescribed ranitidine to decrease acid production." 3. "I will eat six small meals per day." 4. "Because I take ibuprofen every day, the misoprostol prevents damage to my stomach lining."

1; "I can still drink a cup of coffee in the morning."

The nurse correlates which assessment data in the patient diagnosed with early gastric cancer? 1. Anorexia 2. Nausea and vomiting 3. Iron-deficiency anemia 4. Palpable epigastric mass

1; Anorexia

Which food is allowed for the patient diagnosed with gastritis when the diet is advanced to heavier liquids? 1. Milk 2. Broth 3. Gelatin 4. Carbonated beverages

1; Milk

The nurse is providing care to a patient who is status post partial gastrectomy for the treatment of gastric carcinoma. Which should the nurse include in the plan of care to decrease the risk of dumping syndrome? 1. Providing smaller meals at more frequent intervals 2. Providing meals high in simple carbohydrates 3. Providing liquids and solids together 4. Providing liquids only

1; Providing smaller meals at more frequent intervals

The nurse monitors for which clinical manifestations of gastrointestinal bleeding in the patient hospitalized for complications associated with peptic ulcer disease? 1. Tarry stools 2. Pain in the right arm 3. Absent bowel sounds 4. Emesis of undigested food

1; Tarry stools

In completing a history on a patient diagnosed with gastroenteritis caused by Salmonella, which recently ingested food does the nurse recognize as the most likely cause of this diagnosis? 1. Undercooked eggs 2. Undercooked pork 3. Steamed shrimp 4. Grilled beef

1; Undercooked eggs

The nurse is providing care to a patient who is diagnosed with gastritis secondary to Helicobacter pylori. When planning care, the nurse correlates which medications as first-line triple dose therapy for a patient who is allergic to penicillin? Select all that apply. 1. Amoxicillin 2. Metronidazole 3. Clarithromycin 4. Bismuth subsalicylate 5. Proton pump inhibitor

2, 3, 5

When planning care for a patient diagnosed with peptic ulcer disease related to Helicobacter pylori, which medications does the nurse administer as first-line quadruple dose therapy? Select all that apply. 1. Amoxicillin 2. Metronidazole 3. Clarithromycin 4. Bismuth subsalicylate 5. Proton pump inhibitor

2, 4, 5

Which statement by the patient taking proton pump inhibitors for peptic ulcer disease indicates understanding about the action of this medication? 1. "This medication coats the lining of my stomach." 2. "This medication suppresses secretion of acid in my stomach." 3. "This medication decreases vomiting." 4. "This medication neutralizes the acid in my stomach"

2; "This medication suppresses secretion of acid in my stomach."

The nurse recognizes which patient at greatest risk for the development of gastric cancer? 1. African American female with a history of chronic gastritis 2. Asian American male with a history of high alcohol consumption 3. Caucasian female with a history of cigarette smoking 4. Hispanic male who works as an architect

2; Asian American male with a history of high alcohol consumption

The nurse is caring for a patient admitted with severe dehydration secondary to gastroenteritis. Which item on the patient's meal tray does the nurse question? 1. Apple juice 2. Coffee 3. Broth 4. Caffeine-free soda

2; Coffee

The nurse monitors for which clinical manifestations in the patient diagnosed with acute gastritis? 1. Eructation 2. Epigastric pain 3. Constipation 4. Peripheral edema

2; Epigastric pain

The nurse monitors for which clinical manifestations of organ penetration in the patient who is hospitalized for complications associated with peptic ulcer disease? 1. Tarry stools 2. Pain in the right arm 3. Absent bowel sounds 4. Emesis of undigested food

2; Pain in the right arm

The nurse is providing care to a patient who is prescribed sequential therapy for the treatment of peptic ulcer disease. Which medications does the nurse educate this patient about based on this data? 1. Proton pump inhibitor, levofloxacin, and amoxicillin 2. Proton pump inhibitor, amoxicillin, and clarithromycin 3. Proton pump inhibitor, clarithromycin, and metronidazole 4. Proton pump inhibitor, bismuth subsalicylate, metronidazole, and tetracycline

2; Proton pump inhibitor, amoxicillin, and clarithromycin

Which statement by the patient diagnosed with gastritis indicates the need for further teaching? 1. "I will eat bland, non-spicy foods." 2. "I will eat smaller, more frequent meals." 3. "I will take aspirin for headaches." 4. "I will take an antacid if my symptoms continue."

3; "I will take aspirin for headaches."

The nurse monitors for which clinical manifestations of perforation in the patient hospitalized for complications associated with peptic ulcer disease? 1. Tarry stools 2. Pain in the right arm 3. Absent bowel sounds 4. Emesis of undigested food

3; Absent bowel sounds

The nurse monitors for which assessment data that indicates active bleeding in the patient diagnosed with peptic ulcer disease? 1. Absent bowel sounds 2. Coffee-ground emesis 3. Bright red blood in emesis 4. Black tarry stools with a foul odor

3; Bright red blood in emesis

Which principal risk factor does the nurse assess for during the health history in a patient who is suspected of having peptic ulcer disease? 1. Stress 2. Anxiety 3. Helicobacter pylori infection 4. Use of acetaminophen

3; Helicobacter pylori infection

In providing care to the patient admitted for gastritis, which clinical manifestation requires immediate notification of the healthcare provider? 1. Nausea 2. Anorexia 3. Hematemesis 4. Epigastric pain

3; Hematemesis

The nurse monitors for which pattern of pain in the patient diagnosed with a gastric ulcer? 1. Pain that awakens the patient from sleep 2. Pain that is relieved with food 3. Pain that is aggravated by eating 4. Pain relieved by antacids

3; Pain that is aggravated by eating

The nurse correlates an increased risk of gastroenteritis in the patient taking which medication? 1. Antacids 2. NSAIDs 3. Proton pump inhibitors (PPIs) 4. Steroids

3; Proton pump inhibitors (PPIs)

Which prescribed medication does the nurse administer to act as a physical barrier to the patient diagnosed with gastritis? 1. Maalox 2. Mylanta 3. Pepcid 4. Carafate

4; Carafate

Which assessment finding requires an immediate intervention by the nurse for the patient after surgery for the treatment of gastric cancer? 1. Anorexia 2. Nausea 3. Pain 4. Diaphoresis

4; Diaphoresis

The nurse monitors for which clinical manifestations of obstruction in the patient hospitalized for complications associated with peptic ulcer disease? 1. Tarry stools 2. Pain in the right arm 3. Absent bowel sounds 4. Emesis of undigested food

4; Emesis of undigested food

The nurse monitors for which clinical manifestation in the patient diagnosed with advanced gastric cancer? 1. Anorexia 2. Indigestion 3. Epigastric pain 4. Iron-deficiency anemia

4; Iron-deficiency anemia

In collecting a health history, the nurse correlates which risk factor to the development of peptic ulcer disease? 1. Acetaminophen use for pain 2. Hypoparathyroidism 3. Social drinking 4. Sarcoidosis

4; Sarcoidosis

Which diagnostic test does the nurse correlate to the diagnosis of an active infection with Helicobacter pylori for a patient diagnosed with gastritis? 1. Guaiac 2. Hematest 3. Hemoccult 4. Urea breathing test

4; Urea breathing test