Question 1

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 C

Question 2

The nurse will anticipate preparing a 71-year-old female patient who is vomiting "coffee-ground" emesis for

Accepted Answer

A)   endoscopy.
B)   angiography.
C)   barium studies.
D)   gastric analysis. A

Question 3

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." C

Question 4

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 5

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 6

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 7

A 68-year-old male patient with a stroke is unconscious and unresponsive to stimuli.After learning that the patient has a history of gastroesophageal reflux disease (GERD),the nurse will plan to do frequent assessments of the patient's

Accepted Answer

A)   apical pulse.
B)   bowel sounds.
C)   breath sounds.
D)   abdominal girth.

Question 8

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 9

A 38-year old woman receiving chemotherapy for breast cancer develops a Candida albicans oral infection.The nurse will anticipate the need for

Accepted Answer

A)   hydrogen peroxide rinses.
B)   the use of antiviral agents.
C)   administration of nystatin (Mycostatin)  tablets.
D)   referral to a dentist for professional tooth cleaning.

Question 10

After change-of-shift report,which patient should the nurse assess first?

Accepted Answer

A)   42-year-old who has acute gastritis and ongoing epigastric pain
B)   70-year-old with a hiatal hernia who experiences frequent heartburn
C)   53-year-old who has dumping syndrome after a recent partial gastrectomy
D)   60-year-old with nausea and vomiting who has dry oral mucosa and lethargy

Question 11

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 12

A 50-year-old patient who underwent a gastroduodenostomy (Billroth I)earlier today complains of increasing abdominal pain.The patient has no bowel sounds and 200 mL of bright red nasogastric (NG)drainage in the last hour.The highest priority action by the nurse is to

Accepted Answer

A)   contact the surgeon.
B)   irrigate the NG tube.
C)   monitor the NG drainage.
D)   administer the prescribed morphine.

Question 13

Which medications will the nurse teach the patient about whose peptic ulcer disease is associated with Helicobacter pylori?

Accepted Answer

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

Question 14

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 15

Which action should the nurse in the emergency department anticipate for a 23-year-old 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 about adverse effects of acetaminophen (Tylenol) .

Question 16

In which order will the nurse take the following actions when caring for a patient who develops watery diarrhea and a fever after prolonged omeprazole (Prilosec)therapy? (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 17

A 49-year-old man has been admitted with hypotension and dehydration after 3 days of nausea and vomiting.Which order from the health care provider 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 18

A 44-year-old man admitted with a peptic ulcer has a nasogastric (NG)tube in place.When the patient develops sudden,severe upper abdominal pain,diaphoresis,and a firm abdomen,which action should the nurse take?

Accepted Answer

A)   Irrigate the NG tube.
B)   Check the vital signs.
C)   Give the ordered antacid.
D)   Elevate the foot of the bed.

Question 19

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 complains of 7/10 (0 to 10 scale)  abdominal pain.
C)   The patient has absent breath sounds in the left anterior chest.
D)   The patient has hypoactive bowel sounds in all four quadrants.

Question 20

Which patient statement indicates that the nurse's teaching following a gastroduodenostomy has been effective?

Accepted Answer

A)   "Vitamin supplements may prevent anemia."
B)   "Persistent heartburn is common after surgery."
C)   "I will try to drink more liquids with my meals."
D)   "I will need to choose high carbohydrate foods."

Exam 38: Nursing Management: Upper Gastrointestinal Problems

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 will anticipate preparing a 71-year-old female patient who is vomiting "coffee-ground" emesis for

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?

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 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?

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

A 68-year-old male patient with a stroke is unconscious and unresponsive to stimuli.After learning that the patient has a history of gastroesophageal reflux disease (GERD) ,the nurse will plan to do frequent assessments of the patient's

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

A 38-year old woman receiving chemotherapy for breast cancer develops a Candida albicans oral infection.The nurse will anticipate the need for

After change-of-shift report,which patient should the nurse assess first?

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

A 50-year-old patient who underwent a gastroduodenostomy (Billroth I) earlier today complains of increasing abdominal pain.The patient has no bowel sounds and 200 mL of bright red nasogastric (NG) drainage in the last hour.The highest priority action by the nurse is to

Which medications will the nurse teach the patient about whose peptic ulcer disease is associated with Helicobacter pylori?

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?

Which action should the nurse in the emergency department anticipate for a 23-year-old patient who has had several episodes of bloody diarrhea?

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

A 49-year-old man has been admitted with hypotension and dehydration after 3 days of nausea and vomiting.Which order from the health care provider will the nurse implement first?

A 44-year-old man admitted with a peptic ulcer has a nasogastric (NG) tube in place.When the patient develops sudden,severe upper abdominal pain,diaphoresis,and a firm abdomen,which action should the nurse take?

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?

Which patient statement indicates that the nurse's teaching following a gastroduodenostomy has been effective?