NUR 113 - GI PrepU Practice Question - Patel Test 5

The nurse is creating a discharge plan of care for a client with a peptic ulcer. The nurse tells the client to avoid A. acetaminophen B. decaffeinated coffee C. skim milk D. octreotide

B. decaffeinated coffee

Diagnostic imaging and physical assessment have revealed that a patient 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

A nurse educating a client on the antacid calcium carbonate (Mylanta) should warn the client of which of the following adverse reactions? Select all that apply: A. Rebound hyperacidity B. Anorexia C. Headache D. Dehydration E. Confusion

A. Rebound hyperacidity C. Headache E. Confusion

Health teaching for a patient with GERD is directed toward decreasing lower esophageal sphincter pressure and irritation. The nurse instructs the patient to do which of the following? Select all that apply. A. Drink three, 8 oz. glasses of regular milk daily to coat the esophagus. B. Avoid beer, especially in the evening. C. Eat 1 hour before bedtime so there will be food in the stomach overnight to absorb excess acid. D. Elevate the head of the bed on 6- to 8-inch blocks. E. Elevate the upper body on pillows.

B. Avoid beer, especially in the evening D. Elevate the head of the bed on 6- to 8-inch blocks. E. Elevate the upper body on pillows.

The nurse is preparing to insert a patient's ordered NG tube. What factor should the nurse recognize as a risk for incorrect placement? A. The patient is obese and has a "short neck." B. The patient is agitated. C. The patient has a history of gastroesophageal reflux disease (GERD). D. The patient is being treated for pneumonia.

B. The patient is agitated

The nurse is teaching a client with peptic ulcer disease who has been prescribed misoprostol (Cytotec). What information from the nurse would be most accurate about misoprostol? A. Works best when taken on an empty stomach B. Increases the speed of gastric emptying C. Prevents ulceration in clients taking nonsteroidal anti-inflammatory drugs (NSAIDs) D. Decreases mucus production

C. Prevents ulceration in clients taking nonsteroidal anti-inflammatory drugs (NSAIDs)

When caring for a client with an acute exacerbation of a peptic ulcer, the nurse finds the client doubled up in bed with severe pain to his right shoulder. The intial appropriate action by the nurse is to A. Notify the health care provider. B. Irrigate the client's NG tube. C. Place the client in the high-Fowler's position. D. Assess the client's abdomen and vital signs.

D. Assess the client's abdomen and vital signs

A client is taking an antacid that contains aluminum salts. The nurse would monitor the client for: A. Diarrhea B. Hypercalcemia C. Acid rebound D. Hypophosphatemia

D. Hypophosphatemia

Which of the following terms describes a gastric secretion that combines with vitamin B12 so that it can be absorbed? A. Amylase B. Pepsin C. Trypsin D. Intrinsic factor

D. Intrinsic factor

A nurse is monitoring a client with peptic ulcer disease. Which of the following assessment findings would most likely indicate perforation of the ulcer? Choose all that apply. A. Tachycardia B. Hypotension C. Mild epigastric pain D. A rigid, board-like abdomen E. Diarrhea

A. Tachycardia B. Hypotension D. A rigid, board-like abdomen

A 60-year-old man has scheduled a follow-up appointment with his primary care provider stating that the omeprazole (Prilosec) which he was recently prescribed is ineffective. The client states, "I take it as soon as I feel heartburn coming on, but it doesn't seem to help at all." How should the nurse best respond to this client's statement? A. "It could be that Prilosec isn't the right drug for you, so it would be best to talk this over with your care provider." B. "Prilosec won't really decrease the sensation of heartburn, but it is still minimizing the damage to your throat and stomach that can be caused by the problem." C. "Prilosec will help your heartburn but it's not designed to provide immediate relief of specific episodes of heartburn." D. "A better strategy is to take a dose of Prilosec 15 to 30 minutes before meals or drinks that cause you to get heartburn."

C. "Prilosec will help your heartburn but it's not designed to provide immediate relief of specific episodes of heartburn."

A patient scheduled to undergo an abdominal ultrasonography is advised to do which of the following? A. Do not undertake any strenuous exercise for 24 hours before the test B. Do not consume anything sweet for 24 hours before the test C. Avoid exposure to sunlight for at least 6 to 8 hours before the test D. Restrict eating of solid food for 6 to 8 hours before the test

D. Restrict eating of solid food for 6 to 8 hours before the test

Following an endoscopy, a 66-year-old man has been diagnosed with a duodenal ulcer resulting from Helicobacter pylori infection. Which medication will likely be used in an attempt to eradicate the patient's H. pylori infection? (Select all that apply.) A. Antibiotics B. A PPI C. Aluminum hydroxide D. Ondansetron (Zofran) E. Cisapride (Propulsid)

A. Antibiotics B. A PPI

The nurse is aware that hemorrhage is a common complication of peptic ulcer disease. Therefore, assessment for indicators of bleeding is an important nursing responsibility. Which of the following are indicators of bleeding? Select all that apply. A. Melena B. Polyuria C. Bradycardia D. Tachypnea E. Thirst F. Mental confusion

A. Melena D. Tachypnea E. Thirst F. Mental confusion

Rebleeding may occur from a peptic ulcer and often warrants surgical interventions. Signs of bleeding include which of the following? A. Mental confusion B. Bradycardia C. Bradypnea D. Hypertension

A. Mental confusion

Which of the following medications, used in the treatment of GERD, accelerate gastric emptying? A. Metoclopramide (Reglan) B. Famotidine (Pepcid) C. Nizatidine (Axid) D. Esomeprazole (Nexium)

A. Metoclopramide (Reglan)

A nurse is preparing to administer a prostaglandin drug used to reduce the risk of NSAID-induced gastric ulcers in high-risk clients, such as the elderly or the critically ill. Which medication will the client administer? A. Misoprostol B. Ranitidine C. Pantoprazole D. Sucralfate

A. Misoprostol

A client is prescribed a histamine (H2)-receptor antagonist. The nurse understands that the following are H2-receptor antagonists. Choose all that apply. A. Nizatidithene (Axid) B. Ranitidine (Zantac) C. Famotidine (Pepcid) D. Cimetidine (Tagamet) E. Esomeprazole (Nexium) F. Lansoprazole (Prevacid)

A. Nizatidithene (Axid) B. Ranitidine (Zantac) C. Famotidine (Pepcid) D. Cimetidine (Tagamet)

A nursing instructor is preparing a class about gastrointestinal intubation. Which of the following would the instructor include as reason for this procedure? Select all that apply. A. Remove gas and fluids from the stomach B. Diagnose gastrointestinal motility disorders C. Flush ingested toxins from the stomach D. Evaluate for masses in the large colon E. Administer nutritional substances

A. Remove gas and fluids from the stomach B. Diagnose gastrointestinal motility disorders C. Flush ingested toxins from the stomach E. Administer nutritional substances

A nurse is providing follow-up teaching at a clinic visit for a client recovering from gastric resection. The client reports sweating, diarrhea, nausea, palpitations, and the desire to lie down 15 to 30 minutes after meals. The nurse suspects the client has: A. dumping syndrome. B. dehiscence of the surgical wound. C. peritonitis. D. a normal reaction to surgery.

A. dumping syndrome

A nurse is preparing to administer a drug that reduces the secretion of gastric acid by inhibiting the action of histamine at H2 receptors in the stomach. Which medication might the nurse be preparing to administer? Select all that apply. A. Famotidine B. Ranitidine C. Esomeprazole D. Lansoprazole E. Calcium carbonate

A. Famotidine B. Ranitidine

A client is receiving sodium bicarbonate orally. Which of the following would lead the nurse to suspect that the client is developing systemic alkalosis? (Select all that apply.) A. Headache B. Constipation C. Confusion D. Irritability E. Tetany

A. Headache C. Confusion D. Irritability E. Tetany

A client with severe peptic ulcer disease has undergone surgery and is several hours postoperative. During assessment, the nurse notes that the client has developed cool skin, tachycardia, and labored breathing; the client also appears to be confused. Which of the following complications has the client most likely developed? A. Hemorrhage B. Penetration C. Perforation D. Pyloric obstruction

A. Hemorrhage

Which statement made by a client currently being treated for several medical conditions requires additional medication education by the nurse concerning the use of calcium salts? A. I take an antacid with my morning medications to minimize their effect on my stomach B. The antacids decrease the acidity in my stomach C. The amount of antacids I can take depends on what kind I'm taking D. The antacid I take helps my bones stay strong

A. I take an antacid with my morning medications to minimize their effect on my stomach

A patient presents to the walk-in clinic complaining of vomiting and burning in her mid-epigastria. The nurse knows that in the process of confirming peptic ulcer disease, the physician 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

Which of the following is a proton pump inhibitor used in the treatment of gastroesophageal reflux disease (GERD)? Select all that apply. A. Lansoprazole (Prevacid) B. Rabeprazole (AcipHex) C. Esomeprazole (Nexium) D. Famotidine (Pepcid) E. Nizatidine (Axid)

A. Lansoprazole (Prevacid) B. Rabeprazole (AcipHex) C. Esomeprazole (Nexium)

A patient with gastroesophageal reflux disease (GERD) has a diagnosis of Barrett's esophagus with minor cell changes. Which of the following principles should be integrated into the patient's subsequent care? A. The patient will require an upper endoscopy every 6 months to detect malignant changes. B. Liver enzymes must be checked regularly, as H2 receptor antagonists may cause hepatic damage. C. Small amounts of blood are likely to be present in the stools and are not cause for concern. D. Antacids may be discontinued when symptoms of heartburn subside.

A. The patient will require an upper endoscopy every 6 months to detect malignant changes

A physician plans to send a client home with supplies to complete a hemoccult test on all stools for 3 days. During the client education, the nurse informs the client to avoid which of the following medications while collecting stool for the test? A. ibuprofen (Advil) B. acetaminophen (Tylenol) C. docusate sodium (Colace) D. ciprofloxacin (Cipro XR)

A. ibuprofen (Advil)

A nurse is providing education to a client with GERD. The client asks what measures can be taken independently to help reduce the symptoms. Which interventions would the nurse recommend? Select all that apply. A. maintaining an upright position following meals B. avoiding foods that intensify symptoms C. sleeping in a supine position D. ensuring intake of food and fluids 2 to 3 hours before bedtime

A. maintaining an upright position following meals B. avoiding foods that intensify symptoms

A nurse is assessing a patient receiving tube feedings and suspects dumping syndrome. Which of the following would lead the nurse to suspect this? Select all that apply. A. Hypertension B. Diarrhea C. Decreased bowel sounds D. Tachycardia E. Diaphoresis

B. Diarrhea D. Tachycardia E. Diaphoresis

A patient who had a Roux-en-Y bypass procedure for morbid obesity ate a chocolate chip cookie after a meal. After ingestion of the cookie, the patient complained of cramping pains, dizziness, and palpitation. After having a bowel movement, the symptoms resolved. What should the patient be educated about regarding this event? A. Gastric outlet obstruction B. Dumping syndrome C. Bile reflux D. Celiac disease

B. Dumping syndrome

A nurse caring for a patient who has had bariatric surgery is developing a teaching plan in anticipation of the patient's discharge. Which of the following is essential to include? A. Drink a minimum of 12 ounces of fluid with each meal B. Eat several small meals daily spaced at equal intervals C. Choose foods that are high in simple carbohydrates D. Sit upright when eating and for 30 minutes afterward

B. Eat several small meals daily spaced at equal intervals

A nurse is assessing a patient who has peptic ulcer disease. The patient requests more information about the typical causes of Helicobacter pyloriinfection. What would it be appropriate for the nurse to instruct the patient? A. Most affected patients acquired the infection during international travel B. Infection typically occurs due to ingestion of contaminated food and water C. Many people possess genetic factors causing a predisposition to H. pylori infection D. The H. pylori microorganism is endemic in warm, moist climates

B. Infection typically occurs due to ingestion of contaminated food and water

The nurse is instructing the client who was newly diagnosed with peptic ulcers. Which of the following diagnostic studies would the nurse anticipate reviewing with the client? A. A complete blood count including differential B. Serum antibodies for H. pylori C. A sigmoidoscopy D. Gastric analysis

B. Serum antibodies for H. pylori

The nurse determines that teaching for the client with peptic ulcer disease has been effective when the client states: A. "I should stop all my medications if I develop any side effects." B. "I should continue my treatment regimen as long as I have pain." C. "I have learned some relaxation strategies that decrease my stress." D. "I can buy whatever antacids are on sale because they all have the same effect."

C. "I have learned some relaxation strategies that decrease my stress."

A client with a peptic ulcer is diagnosed with Helicobacter pylori infection. The nurse is teaching the client about the medications prescribed, including metronidazole (Flagyl), omeprazole (Prilosec), and clarithromycin (Biaxin). Which statement by the client indicates the best understanding of the medication regimen? A. "My ulcer will heal because these medications will kill the bacteria." B. "I should take these medications only when I have pain from my ulcer." C. "The medications will kill the bacteria and stop the acid production." D. "These medications will coat the ulcer and decrease the acid producation in my stomach."

C. "The medications will kill the bacteria and stop the acid production."

A patient asks the home health nurse from what the distressing symptoms of dumping syndrome result. What physiological occurrence should the nurse explain? A. Irritation of the phrenic nerve due to diaphragmatic pressure B. Chronic malabsorption of iron and vitamins A and C C. Reflux of bile into the distal esophagus D. Osmotic transport of extracellular fluid into the gastrointestinal tract

D. Osmotic transport of extracellular fluid into the gastrointestinal tract

A nurse is preparing to discharge a client newly diagnosed with peptic ulcer disease. The client's diagnostic test results were positive for H. pyloribacteria. The doctor has ordered the "triple therapy" regimen. Which of the following is the correct representation of "triple therapy" refers? A. H2-receptor antagonist and two antibiotics B. H2-receptor antagonist, proton-pump inhibitor, and an antibiotic C. Proton-pump inhibitor, an antibiotic, and Pepto-Bismol D. Proton-pump inhibitor and two antibiotics

D. Proton-pump inhibitor and two antibiotics

Which of the following assessment findings would be most important for indicating dumping syndrome in a postgastrectomy client? A. Abdominal distention, elevated temperature, weakness before eating B. Constipation, rectal bleeding following bowel movements C. Persistent loose stools, chills, hiccups after eating D. Weakness, diaphoresis, diarrhea 90 minutes after eating

D. Weakness, diaphoresis, diarrhea 90 minutes after eating

The Zollinger-Ellison syndrome (ZES) consists of severe peptic ulcers, extreme gastric hyperacidity, and gastrin-secreting benign or malignant tumors of the pancreas. The nurse recognizes that an agent that is used to decrease bleeding and decrease gastric acid secretions is A. ranitidine (Zantac) B. omeprazole (Prilosec) C. vasopressin (Pitressin) D. octreotide (Sandostatin)

D. octreotide (Sandostatin)

A patient receiving tube feedings is experiencing diarrhea. The nurse and the physician suspect that the patient is experiencing dumping syndrome. What intervention is most appropriate? A. Stop the tube feed and aspirate stomach contents. B. Increase the hourly feed rate so it finishes earlier. C. Dilute the concentration of the feeding solution. D. Administer fluid replacement by IV.

C. Dilute the concentration of the feeding solution

A nurse is addressing the prevention of esophageal cancer in response to a question posed by a participant in a health promotion workshop. What action has the greatest potential to prevent esophageal cancer? A. Promotion of a nutrient-dense, low-fat diet B. Annual screening endoscopy for patients over 50 with a family history of esophageal cancer C. Early diagnosis and treatment of gastroesophageal reflux disease D. Adequate fluid intake and avoidance of spicy foods

C. Early diagnosis and treatment of gastroesophageal reflux disease

A patient describes a burning sensation in the esophagus, pain when swallowing, and frequent indigestion. What does the nurse suspect that these clinical manifestations indicate? A. Peptic ulcer disease B. Esophageal cancer C. Gastroesophageal reflux disease D. Diverticulitis

C. Gastroesophageal reflux disease

A clinic patient has described recent dark-colored stools;the nurse recognizes the need for fecal occult blood testing (FOBT). What aspect of the patient's current health status would contraindicate FOBT? A. Gastroesophageal reflux disease (GERD) B. Peptic ulcers C. Hemorrhoids D. Recurrent nausea and vomiting

C. Hemorrhoids

After teaching a client about collecting a stool sample for occult testing, which client statement indicates effective teaching? Select all that apply. A. "I will avoid eating meat for 1 to 3 days before getting a stool sample." B. "I need to eat foods low in fiber a few days before collecting the sample." C. "I will take the sample from different areas of the stool that I have passed." D. "I need to send the stool sample to the lab in a covered container right away." E. "I can continue to take all of my regular medications at home."

A. "I will avoid eating meat for 1 to 3 days before getting a stool sample." C. "I will take the sample from different areas of the stool that I have passed."

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 is receiving a tube feeding and has developed diarrhea, cramps, and abdominal distention. What should the nurse do? Select all that apply. A. Change the feeding apparatus every 24 hours B. Use a higher volume of formula because the formula may be too hypotonic C. Slow the administration rate D. Use a diluted formula, gradually increasing the volume and concentration E. Anticipate changing to a lactose-free formula

A. Change the feeding apparatus every 24 hours C. Slow the administration rate D. Use a diluted formula, gradually increasing the volume and concentration E. Anticipate changing to a lactose-free formula

After 20 seconds of auscultating for bowel sounds on a client recovering from abdominal surgery, the nurse hears nothing. Which of the following should the nurse do based on the assessment findings? A. Listen longer for the sounds B. Document that the client is constipated C. Call the physician to report absent bowel sounds D. Return in 1 hour and listen again to confirm findings

A. Listen longer for the sounds

A nurse is preparing to place a patient's ordered nasogastric tube. How should the nurse best determine the correct length of the nasogastric tube? A. Place distal tip to nose, then ear tip and end of xiphoid process B. Instruct the patient to lie prone and measure tip of nose to umbilical area C. Insert the tube into the patient's nose until secretions can be aspirated D. Obtain an order from the physician for the length of tube to insert

A. Place distal tip to nose, then ear tip and end of xiphoid process

Which of the following is a true statement regarding older patients, considering the age-related effects on their gastrointestinal (GI) system? A. They tend to have higher physiologic reserves to compensate for fluid loss B. They tend usually to have less control of the rectal sphincter C. They have no awareness of the filling reflex D. They tend to have increased muscle tone and mass

B. They tend usually to have less control of the rectal sphincter

A client with peptic ulcer disease wants to know nonpharmacological ways that he can prevent recurrence. Which of the following measures would the nurse recommend? Select all that apply. A. Smoking cessation B. Substitution of coffee with decaffeinated products C. Avoidance of alcohol D. Eating whenever hungry E. Following a regular schedule for rest, relaxation, and meals

A. Smoking cessation C. Avoidance of alcohol E. Following a regular schedule for rest, relaxation, and meals

A nurse is providing care for a client recovering from gastric bypass surgery. During assessment, the client exhibits pallor, perspiration, palpitations, headache, and feelings of warmth, dizziness, and drowsiness. The client reports eating 90 minutes ago. The nurse suspects: A. Vasomotor symptoms associated with dumping syndrome B. Dehiscence of the surgical wound C. Peritonitis D. A normal reaction to surgery

A. Vasomotor symptoms associated with dumping syndrome

A nurse caring for a patient who has had bariatric surgery is developing a teaching plan in anticipation of the patient's discharge. Which of the following is essential to include? A. Drink a minimum of 12 ounces of fluid with each meal. B. Eat several small meals daily spaced at equal intervals. C. Choose foods that are high in simple carbohydrates. D. Sit upright when eating and for 30 minutes afterward.

B. Eat several small meals daily spaced at equal intervals

A physician suspects that a client has peptic ulcer disease. With which of the following diagnostic procedures would the nurse most likely prepare to assist? A. Barium study of the upper gastrointestinal tract B. Endoscopy C. Gastric secretion study D. Stool antigen test

B. Endoscopy

The nurse is developing a plan of care for a patient with peptic ulcer disease. What nursing interventions should be included in the care plan? Select all that apply. A. Making neurovascular checks every 4 hours B. Frequently monitoring hemoglobin and hematocrit levels C. Observing stools and vomitus for color, consistency, and volume D. Checking the blood pressure and pulse rate every 15 to 20 minutes E. Inserting an indwelling catheter for incontinence

B. Frequently monitoring hemoglobin and hematocrit levels C. Observing stools and vomitus for color, consistency, and volume D. Checking the blood pressure and pulse rate every 15 to 20 minutes

A staff educator is reviewing the causes of gastroesophageal reflux disease (GERD) with new staff nurses. What area of the GI tract should the educator identify as the cause of reduced pressure associated with GERD? A. Pyloric sphincter B. Lower esophageal sphincter C. Hypopharyngeal sphincter D. Upper esophageal sphincter

B. Lower esophageal sphincter

A patient with a history of peptic ulcer disease has presented to the emergency department (ED) in distress. What assessment finding would lead the ED nurse to suspect that the patient has a perforated ulcer? A. The patient has abdominal bloating that developed rapidly B. The patient has a rigid, "boardlike" abdomen that is tender C. The patient is experiencing intense lower right quadrant pain D. The patient is experiencing dizziness and confusion with no apparent hemodynamic changes

B. The patient has a rigid, "boardlike" abdomen that is tender

A client with GERD develops espophagitis. Which diagnostic test would the nurse expect the physician to order to confirm the diagnosis? A. Barium swallow B. Upper endoscopy with biopsy C. Stool testing for occult blood D. 24-hour esophageal pH monitoring

B. Upper endoscopy with biopsy

Suspected ulceration of the stomach necessitates an esophagogastroduodenoscopy. The nurse will implement which of the following for this procedure? Select all that apply. A. Place the client in the supine position B. Maintain the client on NPO status for 2 hours prior to the examination C. Administer the ordered sedative before the procedure D. Assess for the client's gag reflex after the procedure E. Monitor the client's pulse oximetry during and after the procedure

C. Administer the ordered sedative before the procedure D. Assess for the client's gag reflex after the procedure E. Monitor the client's pulse oximetry during and after the procedure

A patient is receiving education about his upcoming Billroth I procedure (gastroduodenostomy). This patient should be informed that he may experience which of the following adverse effects associated with this procedure? A. Persistent feelings of hunger and thirst B. Constipation or bowel incontinence C. Diarrhea and feelings of fullness D. Gastric reflux and belching

C. Diarrhea and feelings of fullness

A nurse is creating a care plan for a patient who is receiving parenteral nutrition. The patient's care plan should include nursing actions relevant to what potential complications? Select all that apply. A. Dumping syndrome B. Clotted or displaced catheter C. Pneumothorax D. Hyperglycemia E. Line sepsis

B. Clotted or displaced catheter C. Pneumothorax D. Hyperglycemia E. Line sepsis

The client is receiving a 25% dextrose solution of parenteral nutrition. The infusion machine is beeping, and the nurse determines the intravenous (IV) bag is empty. The nurse finds there is no available bag to administer. It is most important for the nurse to: A. Request a new bag from the pharmacy department B. Infuse a solution containing 10% dextrose and water C. Flush the line with 10 mL of sterile saline D. Catch up with the next bag when it arrives

B. Infuse a solution containing 10% dextrose and water

The nurse is preparing a teaching plan for a patient who is receiving sucralfate. Which would the nurse need to address? (Select all that apply.) A. Eating a high fiber diet B. Ensuring safety precautions C. Taking the drug on an empty stomach D. Encouraging frequent mouth care E. Limiting fluid intake F. Using an antidiarrheal agent

A. Eating a high fiber diet B. Ensuring safety precautions C. Taking the drug on an empty stomach D. Encouraging frequent mouth care