Question 1

A 68-year-old patient with a bleeding duodenal ulcer has a nasogastric (NG)tube in place,and the health care provider orders 30 mL of aluminum hydroxide/magnesium hydroxide (Maalox)to be instilled through the tube every hour.To evaluate the effectiveness of this treatment,the nurse

Accepted Answer

A)  monitors arterial blood gas values daily. 
B)  periodically aspirates and tests gastric pH. 
C)  checks each stool for the presence of occult blood. 
D)  measures the volume of residual stomach contents.

Question 2

Which information will the nurse include when teaching a patient with peptic ulcer disease about the effect of ranitidine (Zantac)?

Accepted Answer

A)  "Ranitidine absorbs the gastric acid." 
B)  "Ranitidine decreases gastric acid secretion." 
C)  "Ranitidine constricts the blood vessels near the ulcer." 
D)  "Ranitidine covers the ulcer with a protective material."

Question 3

The nurse is administering IV fluid boluses and nasogastric irrigation to a patient with acute gastrointestinal (GI)bleeding.Which assessment finding is most important for the nurse to communicate to the health care provider?

Accepted Answer

A)  The bowel sounds are hyperactive in all four quadrants. 
B)  The patient's lungs have crackles audible to the midchest. 
C)  The nasogastric (NG) suction is returning coffee-ground material. 
D)  The patient's blood pressure (BP) has increased to 142/84 mm Hg.

Question 4

The nurse and a licensed practical/vocational nurse (LPN/LVN)are working together to care for a patient who had an esophagectomy 2 days ago.Which action by the LPN/LVN requires that the nurse intervene?

Accepted Answer

A)  The LPN/LVN uses soft swabs to provide for oral care. 
B)  The LPN/LVN positions the head of the bed in the flat position. 
C)  The LPN/LVN encourages the patient to use pain medications before coughing. 
D)  The LPN/LVN includes the enteral feeding volume when calculating intake and output.

Question 5

A 26-year-old patient with a family history of stomach cancer asks the nurse about ways to decrease the risk for developing stomach cancer.The nurse will teach the patient to avoid

Accepted Answer

A)  emotionally stressful situations. 
B)  smoked foods such as ham and bacon. 
C)  foods that cause distention or bloating. 
D)  chronic use of H₂ blocking medications.

Question 6

A 53-year-old male patient with deep partial-thickness burns from a chemical spill in the workplace experiences severe pain followed by nausea during dressing changes.Which action will be most useful in decreasing the patient's nausea?

Accepted Answer

A)  Keep the patient NPO for 2 hours before and after dressing changes. 
B)  Avoid performing dressing changes close to the patient's mealtimes. 
C)  Administer the prescribed morphine sulfate before dressing changes. 
D)  Give the ordered prochlorperazine (Compazine) before dressing changes.

Question 7

A 50-year-old man vomiting blood-streaked fluid is admitted to the hospital with acute gastritis.To determine possible risk factors for gastritis,the nurse will ask the patient about

Accepted Answer

A)  the amount of saturated fat in the diet. 
B)  any family history of gastric or colon cancer. 
C)  a history of a large recent weight gain or loss. 
D)  use of nonsteroidal antiinflammatory drugs (NSAIDs).

Question 8

The nurse is assessing a patient who had a total gastrectomy 8 hours ago.What information is most important to report to the health care provider?

Accepted Answer

A)  Absent bowel sounds 
B)  Complaints of incisional pain 
C)  Temperature 102.1° F (38.9° 
C)  
D)  Scant nasogastric (NG) tube drainage

Question 9

The nurse determines that teaching regarding cobalamin injections has been effective when the patient with chronic atrophic gastritis states which of the following?

Accepted Answer

A)  "The cobalamin injections will prevent gastric inflammation." 
B)  "The cobalamin injections will prevent me from becoming anemic." 
C)  "These injections will increase the hydrochloric acid in my stomach." 
D)  "These injections will decrease my risk for developing stomach cancer."

Question 10

Which information will the nurse include for a patient with newly diagnosed gastroesophageal reflux disease (GERD)?

Accepted Answer

A)  "Peppermint tea may reduce your symptoms." 
B)  "Keep the head of your bed elevated on blocks." 
C)  "You should avoid eating between meals to reduce acid secretion." 
D)  "Vigorous physical activities may increase the incidence of reflux."

Question 11

A 73-year-old patient is diagnosed with stomach cancer after an unintended 20-pound weight loss.Which nursing action will be included in the plan of care?

Accepted Answer

A)  Refer the patient for hospice services. 
B)  Infuse IV fluids through a central line. 
C)  Teach the patient about antiemetic therapy. 
D)  Offer supplemental feedings between meals.

Question 12

A 46-year-old female with gastroesophageal reflux disease (GERD)is experiencing increasing discomfort.Which patient statement indicates that additional teaching about GERD is needed?

Accepted Answer

A)  "I take antacids between meals and at bedtime each night." 
B)  "I sleep with the head of the bed elevated on 4-inch blocks." 
C)  "I eat small meals during the day and have a bedtime snack." 
D)  "I quit smoking several years ago, but I still chew a lot of gum."

Question 13

At his first postoperative checkup appointment after a gastrojejunostomy (Billroth II),a patient reports that dizziness,weakness,and palpitations occur about 20 minutes after each meal.The nurse will teach the patient to

Accepted Answer

A)  increase the amount of fluid with meals. 
B)  eat foods that are higher in carbohydrates. 
C)  lie down for about 30 minutes after eating. 
D)  drink sugared fluids or eat candy after meals.

Question 14

Which patient choice for a snack 2 hours before bedtime indicates that the nurse's teaching about gastroesophageal reflux disease (GERD)has been effective?

Accepted Answer

A)  Chocolate pudding 
B)  Glass of low-fat milk 
C)  Cherry gelatin with fruit 
D)  Peanut butter and jelly sandwich

Question 15

The health care provider prescribes antacids and sucralfate (Carafate)for treatment of a patient's peptic ulcer.The nurse will teach the patient to take

Accepted Answer

A)  sucralfate at bedtime and antacids before each meal. 
B)  sucralfate and antacids together 30 minutes before meals. 
C)  antacids 30 minutes before each dose of sucralfate is taken. 
D)  antacids after meals and sucralfate 30 minutes before meals.

Question 16

The nurse will anticipate teaching a patient experiencing frequent heartburn about

Accepted Answer

A)  a barium swallow. 
B)  radionuclide tests. 
C)  endoscopy procedures. 
D)  proton pump inhibitors.

Question 17

Which information will the nurse include when teaching adults to decrease the risk for cancers of the tongue and buccal mucosa?

Accepted Answer

A)  Avoid use of cigarettes and smokeless tobacco. 
B)  Use sunscreen when outside even on cloudy days. 
C)  Complete antibiotic courses used to treat throat infections. 
D)  Use antivirals to treat herpes simplex virus (HSV) infections.

Question 18

Which order from the health care provider will the nurse implement first for a patient who has vomited 1200 mL of blood?

Accepted Answer

A)  Give an IV H2 receptor antagonist. 
B)  Draw blood for typing and crossmatching. 
C)  Administer 1000 mL of lactated Ringer's solution. 
D)  Insert a nasogastric (NG) tube and connect to suction.

Question 19

A 26-year-old woman has been admitted to the emergency department with nausea and vomiting.Which action could the RN delegate to unlicensed assistive personnel (UAP)?

Accepted Answer

A)  Auscultate the bowel sounds. 
B)  Assess for signs of dehydration. 
C)  Assist the patient with oral care. 
D)  Ask the patient about the nausea.

Question 20

A 57-year-old man with Escherichia coli O157:H7 food poisoning is admitted to the hospital with bloody diarrhea and dehydration.Which order will the nurse question?

Accepted Answer

A)  Infuse lactated Ringer's solution at 250 mL/hr. 
B)  Monitor blood urea nitrogen and creatinine daily. 
C)  Administer loperamide (Imodium) after each stool. 
D)  Provide a clear liquid diet and progress diet as tolerated.

Exam 42: Nursing Management: Upper Gastrointestinal Problems

A 68-year-old patient with a bleeding duodenal ulcer has a nasogastric (NG) tube in place,and the health care provider orders 30 mL of aluminum hydroxide/magnesium hydroxide (Maalox) to be instilled through the tube every hour.To evaluate the effectiveness of this treatment,the nurse

Which information will the nurse include when teaching a patient with peptic ulcer disease about the effect of ranitidine (Zantac) ?

The nurse is administering IV fluid boluses and nasogastric irrigation to a patient with acute gastrointestinal (GI) bleeding.Which assessment finding is most important for the nurse to communicate to the health care provider?

The nurse and a licensed practical/vocational nurse (LPN/LVN) are working together to care for a patient who had an esophagectomy 2 days ago.Which action by the LPN/LVN requires that the nurse intervene?

A 26-year-old patient with a family history of stomach cancer asks the nurse about ways to decrease the risk for developing stomach cancer.The nurse will teach the patient to avoid

A 53-year-old male patient with deep partial-thickness burns from a chemical spill in the workplace experiences severe pain followed by nausea during dressing changes.Which action will be most useful in decreasing the patient's nausea?

A 50-year-old man vomiting blood-streaked fluid is admitted to the hospital with acute gastritis.To determine possible risk factors for gastritis,the nurse will ask the patient about

The nurse is assessing a patient who had a total gastrectomy 8 hours ago.What information is most important to report to the health care provider?

The nurse determines that teaching regarding cobalamin injections has been effective when the patient with chronic atrophic gastritis states which of the following?

Which information will the nurse include for a patient with newly diagnosed gastroesophageal reflux disease (GERD) ?

A 73-year-old patient is diagnosed with stomach cancer after an unintended 20-pound weight loss.Which nursing action will be included in the plan of care?

A 46-year-old female with gastroesophageal reflux disease (GERD) is experiencing increasing discomfort.Which patient statement indicates that additional teaching about GERD is needed?

At his first postoperative checkup appointment after a gastrojejunostomy (Billroth II) ,a patient reports that dizziness,weakness,and palpitations occur about 20 minutes after each meal.The nurse will teach the patient to

Which patient choice for a snack 2 hours before bedtime indicates that the nurse's teaching about gastroesophageal reflux disease (GERD) has been effective?

The health care provider prescribes antacids and sucralfate (Carafate) for treatment of a patient's peptic ulcer.The nurse will teach the patient to take

The nurse will anticipate teaching a patient experiencing frequent heartburn about

Which information will the nurse include when teaching adults to decrease the risk for cancers of the tongue and buccal mucosa?

Which order from the health care provider will the nurse implement first for a patient who has vomited 1200 mL of blood?

A 26-year-old woman has been admitted to the emergency department with nausea and vomiting.Which action could the RN delegate to unlicensed assistive personnel (UAP) ?

A 57-year-old man with Escherichia coli O157:H7 food poisoning is admitted to the hospital with bloody diarrhea and dehydration.Which order will the nurse question?