Question 1

A 62-year-old man patient who requires daily use of a nonsteroidal antiinflammatory drug (NSAID)for the management of severe rheumatoid arthritis has recently developed melena.The nurse will anticipate teaching the patient about

Accepted Answer

A)  substitution of acetaminophen (Tylenol) for the NSAID. 
B)  use of enteric-coated NSAIDs to reduce gastric irritation. 
C)  reasons for using corticosteroids to treat the rheumatoid arthritis. 
D)  misoprostol (Cytotec) to protect the gastrointestinal (GI) mucosa.

Question 2

When a 72-year-old 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 3

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 4

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 5

A family member of a 28-year-old patient who has suffered massive abdominal trauma in an automobile accident asks the nurse why the patient is 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.

Question 6

A 58-year-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 undergone a small intestinal resection.

Question 7

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 8

A 58-year-old woman who recently has been diagnosed with esophageal cancer tells the nurse,"I do not feel ready to die yet." Which response by the nurse is most appropriate?

Accepted Answer

A)  "You may have quite a few years still left to live." 
B)  "Thinking about dying will only make you feel worse." 
C)  "Having this new diagnosis must be very hard for you." 
D)  "It is important that you be realistic about your prognosis."

Question 9

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 H? blocking medications.

Question 10

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 11

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 12

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 13

Which finding in the mouth of a patient who uses smokeless tobacco is suggestive of oral cancer?

Accepted Answer

A)  Bleeding during tooth brushing 
B)  Painful blisters at the lip border 
C)  Red, velvety patches on the buccal mucosa 
D)  White, curdlike plaques on the posterior tongue

Question 14

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 15

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.

Question 16

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 17

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

Accepted Answer

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

Question 18

Vasopressin (Pitressin)0.2 units/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 (Pitressin)0.2 units/min infusion is prescribed for...

Question 19

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 20

Which assessment should the nurse perform first for a patient who just vomited bright red blood?

Accepted Answer

A)  Measuring the quantity of emesis 
B)  Palpating the abdomen for distention 
C)  Auscultating the chest for breath sounds 
D)  Taking the blood pressure (BP) and pulse

Exam 38: Nursing Management: Upper Gastrointestinal Problems

A 62-year-old man patient who requires daily use of a nonsteroidal antiinflammatory drug (NSAID) for the management of severe rheumatoid arthritis has recently developed melena.The nurse will anticipate teaching the patient about

When a 72-year-old patient is diagnosed with achalasia,the nurse will teach the patient that

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?

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

A family member of a 28-year-old patient who has suffered massive abdominal trauma in an automobile accident asks the nurse why the patient is receiving famotidine (Pepcid) .The nurse will explain that the medication will

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

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 58-year-old woman who recently has been diagnosed with esophageal cancer tells the nurse,"I do not feel ready to die yet." Which response by the nurse is most appropriate?

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

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