Question 1

A 49-yr-old man has been admitted with hypotension and dehydration after 3 days of nausea and vomiting. Which prescribed action will the nurse implement first?

Accepted Answer

A) Insert a nasogastric (NG) tube. 
B) Infuse normal saline at 250 mL/hr. 
C) Administer IV ondansetron (Zofran). 
D) Provide oral care with moistened swabs.

Question 2

Which patient should the nurse assess first after receiving change-of-shift report?

Accepted Answer

A) A patient with nausea who has a dose of metoclopramide (Reglan) due 
B) A patient who is crying after receiving a diagnosis of esophageal cancer 
C) A patient with esophageal varices who has a blood pressure of 92/58 mm Hg 
D) A patient admitted yesterday with gastrointestinal (GI) bleeding who has melena

Question 3

An 80-yr-old patient who is hospitalized with peptic ulcer disease develops new-onset auditory hallucinations. Which prescribed medication will the nurse discuss with the health care provider before administration?

Accepted Answer

A) Sucralfate (Carafate) 
B) Aluminum hydroxide 
C) Omeprazole (Prilosec) 
D) Metoclopramide (Reglan)

Question 4

When a patient is diagnosed with achalasia,the nurse will teach the patient that

Accepted Answer

A) lying down after meals is recommended. 
B) a liquid or blenderized diet will be necessary. 
C) drinking fluids with meals should be avoided. 
D) treatment may include endoscopic procedures.

Question 5

A patient has peptic ulcer disease that has been associated with Helicobacter pylori. About which medications will the nurse plan to teach the patient?

Accepted Answer

A) Sucralfate (Carafate), nystatin, and bismuth (Pepto-Bismol) 
B) Metoclopramide (Reglan), bethanechol (Urecholine), and promethazine 
C) Amoxicillin (Amoxil), clarithromycin (Biaxin), and omeprazole (Prilosec) 
D) Famotidine (Pepcid), magnesium hydroxide (Mylanta), and pantoprazole (Protonix)

Question 6

The nurse explaining esomeprazole (Nexium)to a patient with recurring heartburn describes that the medication

Accepted Answer

A) reduces gastroesophageal reflux by increasing the rate of gastric emptying. 
B) neutralizes stomach acid and provides relief of symptoms in a few minutes. 
C) coats and protects the lining of the stomach and esophagus from gastric acid. 
D) treats gastroesophageal reflux disease by decreasing stomach acid production.

Question 7

Vasopressin 0.1 unit/min infusion is prescribed for a patient with acute arterial gastrointestinal (GI)bleeding. The vasopressin label states vasopressin 100 units/250 mL normal saline. How many mL/hr will the nurse infuse?

Accepted Answer

The answer of Vasopressin 0.1 unit/min infusion is prescribed for...

Question 8

A 58-yr-old patient has just been admitted to the emergency department with nausea and vomiting. Which information requires the most rapid intervention by the nurse?

Accepted Answer

A) The patient has been vomiting for 4 days. 
B) The patient takes antacids 8 to 10 times a day. 
C) The patient is lethargic and difficult to arouse. 
D) The patient has had a small intestinal resection.

Question 9

A 53-yr-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 dressing changes. 
B) Give the ordered prochlorperazine before dressing changes. 
C) Administer the prescribed morphine sulfate before dressing changes. 
D) Avoid performing dressing changes close to the patient's mealtimes.

Question 10

Which nursing action should be included in the postoperative plan of care for a patient after a laparoscopic esophagectomy?

Accepted Answer

A) Reposition the NG tube if drainage stops. 
B) Elevate the head of the bed to at least 30 degrees. 
C) Start oral fluids when the patient has active bowel sounds. 
D) Notify the doctor for any bloody nasogastric (NG) drainage.

Question 11

A young adult 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 12

A patient returned from a laparoscopic Nissen fundoplication for hiatal hernia 4 hours ago. Which assessment finding is most important for the nurse to address immediately?

Accepted Answer

A) The patient is experiencing intermittent waves of nausea. 
B) The patient has no breath sounds in the left anterior chest. 
C) The patient complains of 7/10 (0 to 10 scale) abdominal pain. 
D) The patient has hypoactive bowel sounds in all four quadrants.

Question 13

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 14

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 15

The nurse is caring for a patient who develops watery diarrhea and a fever after prolonged omeprazole (Prilosec)therapy. In which order will the nurse take actions? (Put a comma and a space between each answer choice [A,B,C,D].)

Accepted Answer

A) Contact the health care provider. 
B) Assess blood pressure and heart rate. 
C) Give the PRN acetaminophen (Tylenol). 
D) Place the patient on contact precautions.

Question 16

Which action should the nurse in the emergency department anticipate for a young adult patient who has had several episodes of bloody diarrhea?

Accepted Answer

A) Obtain a stool specimen for culture. 
B) Administer antidiarrheal medication. 
C) Provide teaching about antibiotic therapy. 
D) Teach the adverse effects of acetaminophen (Tylenol).

Question 17

After the nurse has completed teaching a patient with newly diagnosed eosinophilic esophagitis about the management of the disease,which patient action indicates that the teaching has been effective?

Accepted Answer

A) Patient orders nonfat milk for each meal. 
B) Patient uses the prescribed corticosteroid inhaler. 
C) Patient schedules an appointment for allergy testing. 
D) Patient takes ibuprofen (Advil) to control throat pain.

Question 18

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 19

An older patient with a bleeding duodenal ulcer has a nasogastric (NG)tube in place. The health care provider prescribes 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 20

A young adult patient is hospitalized with massive abdominal trauma from a motor vehicle crash. The patient asks the nurse about the purpose of receiving famotidine (Pepcid). The nurse will explain that the medication will

Accepted Answer

A) decrease nausea and vomiting. 
B) inhibit development of stress ulcers. 
C) lower the risk for H.pylori infection. 
D) prevent aspiration of gastric contents.

Exam 41: Upper Gastrointestinal Problems