Deck 29: Care of Patients With Disorders of the Upper Gastrointestinal System

Question 1

The nurse explains that the laparoscopic adjustable gastric banding surgery is best described as:

A)restrictive.
B)malabsorptive.
C)restrictive/malabsorptive.
D)obstructive.

Answer 1

restrictive.

Question 2

A patient with a gastrostomy tube gets a bolus feeding of 200 mL every 4 hours.Before giving the bolus,the nurse aspirates a residual of 100 mL.After returning the residual to the patient,the nurse should:

A)give the 200 mL feeding.
B)record the residual and give 100 mL of the feeding.
C)document the residual and hold the feeding.
D)position the patient in high Fowler's and give the feeding.

Answer 2

document the residual and hold the feeding.

Question 3

The nurse will encourage the patient who has gastroesophageal reflux disease (GERD)to modify her diet by:

A)avoiding garlic.
B)drinking carbonated beverages with meals.
C)using a straw to drink all fluids.
D)eating three meals regularly spaced apart.

Answer 3

avoiding garlic.

Question 4

The nurse documenting the presence of pain in a patient with possible gastric ulcer would anticipate that the pain would occur:

A)in the morning.
B)erratically, without pattern.
C)at bedtime.
D)with meals.

Question 5

When the patient with a Salem sump tube for decompression complains of feeling full and has dyspnea and nausea,the initial intervention by the nurse should be to:

A)increase the amount of suction from low to high.
B)notify the charge nurse.
C)irrigate the tube with normal saline.
D)pull the tube out about 3 inches.

Question 6

For the patient who is taking daily doses of ibuprofen for arthritis,the amount of nonsteroidal anti-inflammatory drugs (NSAIDs)such as acetaminophen should be limited,in order to prevent a peptic ulcer,to a daily intake of _____ tablets of 500 mg.

A)2
B)3
C)4
D)5

Question 7

The patient who had an esophagoenterostomy 3 days ago becomes dyspneic and complains of substernal pain.The nurse suspects the patient has:

A)a suture line leak into the mediastinum.
B)an accumulation of gas in the stomach.
C)a myocardial infarct.
D)esophageal reflux.

Question 8

The nurse is aware that patients who have chronic gastritis from renal failure may present with the first sign of this disorder as:

A)an increase in the WBC count.
B)sudden massive hemorrhage.
C)asthma-like symptoms.
D)extreme dyspnea.

Question 9

The nurse preparing a teaching plan for lifestyle changes for the patient with GERD would include:

A)sleeping on the right side on a flat bed.
B)wearing tight belts to reduce reflux.
C)lying down after each meal for 20 minutes.
D)smoking cessation.

Question 10

The nurse is caring for a patient who is being treated for extensive burns.The nurse notes the presence of coffee-ground material in the Salem sump catheter.The nurse correctly recognizes that the probable cause is:

A)esophagitis.
B)perforated gastric ulcer.
C)gastric irritation from the Salem sump tube.
D)a physiologic stress ulcer.

Question 11

The nurse is caring for a patient who is being treated for a gunshot wound to the abdomen.The patient is receiving total parenteral nutrition (TPN).The physician has prescribed insulin coverage on a sliding scale.The patient reports he has never had diabetes before.What response by the nurse is indicated?

A)"It is likely you have developed diabetes as a result of your illness."
B)"Do you have a family history for diabetes?"
C)"The TPN you are receiving has high amounts of glucose."
D)"Insulin is needed to manage your stomach's inability to adequately metabolize food at this time."

Question 12

The nurse is assessing the efficiency of swallowing in a patient with dysphagia.During the assessment,the nurse will use what finding to evaluate the process?

A)An audible "gurgle"
B)Rising of the larynx
C)Tilting of the head backward
D)Nodding of the head forward

Question 13

The nurse evaluates a need for further instruction to the patient with Barrett's esophagus when the patient says:

A)"I gave up smoking for my health."
B)"I can still have a small glass of wine with dinner."
C)"I am using chewing tobacco instead of smoking."
D)"I eat slowly and do not lie down after a meal."

Question 14

For the patient with a hiatal hernia,the nurse recommends avoidance of fats because fats:

A)relax the sphincter, allowing reflux.
B)may cause nausea and vomiting.
C)cause hypermobility of the colon.
D)may initiate the strangulation of the hernia.

Question 15

The nurse is discussing bariatric surgery complications with a patient.Which statement by the patient indicates understanding of a common side effect of the procedure?

A)"I understand that gastric ulcers frequently occur in patients who have bariatric surgery."
B)"Gallstones are a common occurrence in patients who have bariatric surgery."
C)"I know an umbilical hernia might happen after I have bariatric surgery."
D)"Unfortunately I may experience gastritis after having bariatric surgery."

Question 16

The nurse is aware that the major cause of Barrett's esophagus is:

A)esophageal reflux.
B)eating hot, spicy foods.
C)frequent episodes of vomiting.
D)esophageal polyps.

Question 17

A patient who had gastric bypass surgery 5 weeks ago calls the office to report feelings of nausea,sweating,and diarrhea shortly after eating meals.What response by the nurse is most appropriate?

A)"This is common after the type of surgery you had."
B)"Try to eat your meals slower to promote absorption."
C)"Reduce the amount of refined sugars that you are eating."
D)"You may be experiencing a postoperative infection."

Question 18

The nurse calculates the body mass index (BMI)of a man who is 6 feet tall (1.8 meters)and weighs 150 pounds (68.1 kilograms)to be:

A)21.0.
B)34.8.
C)43.1.
D)66.3.

Question 19

The nurse explains that the diagnosis of morbidly obese is reserved for people who are ____% above their recommended weight.

A)50
B)70
C)90
D)100

Question 20

The nurse would question an order for esomeprazole (Nexium)for the patient who is:

A)taking digoxin.
B)noncompliant.
C)asthmatic.
D)on chemotherapy for cancer.

Question 21

The nurse is presenting a program discussing bulimia nervosa to a group of student nurses.After the program,the participants correctly identify the methods of treatment including: (Select all that apply.)

A)antianxiety mediations.
B)antidepressant medications.
C)psychotherapy.
D)behavior modification.
E)increased exercise.

Question 22

The nurse demonstrates that the person whose recommended weight is 150 pounds based on height,age,and body type would be considered obese if the person weighed a minimum of ______ pounds.

Question 23

The nurse cautions that increased morbidity from hypertension and cardiac disease,even in children,is related to the modifiable risk factor of __________.

Question 24

The nurse instructs the patient on the weight reduction drug sibutramine (Meridia)that side effects will include: (Select all that apply.)

A)dry mouth.
B)hypoglycemia.
C)constipation.
D)facial rash.
E)insomnia.

Question 25

The nurse is caring for a patient who is suspected of having oral cancer.When reviewing the patient's health history,which finding provides supportive data for the diagnosis?

A)Presence of leukoplakia
B)History of oral herpes simplex
C)History of an oral yeast infection
D)Reports of a dry oral cavity

Question 26

The nurse correctly recognizes that esophageal cancer is associated with: (Select all that apply.)

A)cigarette smoking.
B)diabetes.
C)hypertension.
D)heavy alcohol use.
E)smokeless tobacco.

Question 27

To assist the patient with dysphagia to eat a meal,the nurse can: (Select all that apply.)

A)encourage "practice swallowing" before the meal.
B)coach the patient to chew thoroughly.
C)assist the patient to sit upright with the head forward and chin tucked.
D)offer fluid during the meal.
E)give the patient thin liquids, such as water.

Question 28

The nurse caring for a 70-year-old patient with gastroenteritis following a camping trip to Mexico would anticipate which signs and symptoms? (Select all that apply.)

A)Positive stool culture for Giardia or Shigella
B)Abdominal cramping
C)Fat in the stool
D)Mucus in stool
E)Blood in stool

Question 29

The nurse explains that the medically supervised approach to weight reduction will include: (Select all that apply.)

A)medications to suppress the appetite.
B)an exercise program.
C)participation in a support group.
D)stress reduction.
E)change in concepts about food.