Deck 33: Nursing Care of Patients With Upper Gastrointestinal Disorders

Question 1

The nurse is asking about the type of bariatric surgery the patient had. The patient states, "They folded my stomach inward and sutured the folds in place." Which surgery description does the nurse recognize?

A)Sleeve gastrectomy
B)Gastric plication
C)Roux-en-Y bypass
D)Gastric banding

Answer 1

Gastric plication

Question 2

The nurse is providing care for a patient who reports nausea following chemotherapy. Which nursing intervention is unlikely to effectively manage the patient's nausea?

A)Provide a quiet, odor-free, visually clean environment.
B)Give an antiemetic as needed and prescribed by the HCP.
C)Bring the patient a small, bland meal to ease any hunger.
D)Provide frequent mouth care to remove noxious tastes.

Answer 2

Bring the patient a small, bland meal to ease any hunger.

Question 3

The nurse is providing care to a patient 3 days after a Billroth I procedure. About which observation should the nurse be most concerned?

A)Pulse 58 beats per minute
B)Incisional pain score of 4 on a 1-to-10 scale
C)Patient tearful while viewing the incision
D)Reports of abdominal cramping shortly after eating

Answer 3

Reports of abdominal cramping shortly after eating

Question 4

The nurse is providing care for a patient who is receiving chemotherapy and radiation as treatment for esophageal cancer. Which factor in the care of this patient is the nurse's least concern?

A)Risk of choking
B)The ability to speak
C)Meeting nutritional needs
D)Effective pain management

Question 5

The nurse is reinforcing teaching provided to a patient with a peptic ulcer. Which patient statement indicates understanding of the medication ranitidine?

A)"It clings to the ulcer."
B)"It coats your stomach."
C)"It neutralizes stomach acid."
D)"It reduces production of gastric acid."

Question 6

The nurse is teaching a patient with gastroesophageal reflux related to a hiatal hernia about body position for management of the disease process. Which patient statement indicates that teaching has been effective?

A)"I elevate the head of the bed 4 to 6 inches on blocks."
B)"I elevate the foot of the bed 12 to 16 inches on blocks."
C)"I sleep on my back with several pillows under my head."
D)"I sleep in a recliner to elevate my head correctly."

Question 7

The nurse is providing care for a patient who is diagnosed with a Mallory-Weiss tear (MWT). Which treatment for the condition is the nurse expecting?

A)Immediate emergency surgery
B)Ice lavage to the damaged esophagus
C)Positioning in reverse Trendelenburg's
D)An injection of epinephrine

Question 8

A patient who had bariatric surgery presents at the HCP's office and is diagnosed with aphthous stomatitis. Given the patient's medical history, the nurse recognizes which cause of the condition is most likely?

A)Vitamin B₁₂ deficiency
B)Emotional stress
C)Recent dental work
D)Menstruation

Question 9

The nurse reviews the laboratory results for a patient during a routine office visit. The results indicate a low hemoglobin level. The client denies any obvious signs of illness. For which primary reason does the nurse suspect the HCP will order gastric studies?

A)The condition can be related to low intrinsic factor.
B)Gastric bleeding is the likely cause of the anemia.
C)Type A chronic gastritis is asymptomatic.
D)The laboratory results have been noted previously.

Question 10

The nurse is providing care for a client with multiple injuries from a serious car accident. The HCP prescribes a diet as tolerated and administration of sucralfate orally. Which condition and goal does the nurse associate with the HCP's prescriptions?

A)Prevention of peptic ulcer disease
B)Decreased healing from malnutrition
C)Management of causes of shock
D)Formation of stress ulcers

Question 11

The nurse is providing care for a client with a body mass index (BMI) of 44, type 2 diabetes mellitus, sleep apnea, and was recently hospitalized for congestive heart failure. The patient is short of breath and ambulates with difficulty. Which therapeutic management does the nurse suspect the HCP will initially recommend?

A)Psychiatric treatment for poor self-esteem
B)Enrollment in an exercise program for the obese
C)Attendance at a weight-loss support group
D)Initiation of the process for bariatric surgery

Question 12

The nurse is providing care for a client who had surgical repair of a paraesophageal hernia. The nurse observes that the patient exhibits signs of dysphagia during the first postoperative meal. Which action does the nurse take?

A)Offer the patient fluids.
B)Cut the food into small pieces.
C)Report observation to the health care provider (HCP).
D)Assure patient the problem is temporary.

Question 13

The nurse is collecting data for a patient who is taking lansoprazole for peptic ulcer disease. Which data collection finding requires immediate intervention?

A)A rash
B)Tarry stools
C)Constipation
D)Changes in mental status

Question 14

The nurse is reinforcing teaching with a patient who had a large portion of the stomach surgically removed. For which condition related to the surgery will the patient need to receive vitamin B₁₂ for life?

A)Sickle cell anemia
B)Pernicious anemia
C)Iron-deficiency anemia
D)Acquired hemolytic anemia

Question 15

The nurse is providing care for a patient who underwent a Billroth I surgery for stomach cancer. Which nursing care is most important during the postoperative period for this patient?

A)Medicating for pain to promote coughing and deep breathing
B)Assisting the patient out of bed to prevent clot formation
C)Observing the surgical dressing to recognize excessive bleeding
D)Monitoring the amount and type of drainage from the NG tube

Question 16

The nurse is collecting health information from a patient. Which patient statement will cause the nurse the most concern?

A)"My stool has been dark green and hard to pass lately."
B)"Lately, I've had two or three loose, sticky, black stools every day."
C)"Usually I move my bowels every day and the stool is light brown."
D)"My stool is soft and dark brown; I usually move my bowels twice a day."

Question 17

The nurse is caring for a patient who has developed esophagitis from gastroesophageal reflux disease (GERD). For which additional complication should the nurse anticipate providing care to this patient?

A)Laryngospasm
B)Bronchospasm
C)Barrett's esophagus
D)Aspiration pneumonia

Question 18

The nurse is providing care for a patient who is experiencing nausea and vomiting. Which pathological manifestation is unlikely to occur with prolonged vomiting?

A)Anemia
B)Dehydration
C)Metabolic alkalosis
D)Electrolyte imbalance

Question 19

The nurse works with cancer patients. Which factor does the nurse identify as a cause of gastric cancer?

A)The female gender
B)Oxidants in fruit and vegetables
C)High intake of smoked fish and meats
D)Medical history of iron deficiency anemia

Question 20

The nurse is preparing to provide care for a client diagnosed with peptic ulcer disease. Which pathophysiological characteristic will the nurse correctly associate with the patient's diagnosis?

A)Erosion is confined to the stomach and esophagus.
B)A common cause is an infection from Helicobacter pylori.
C)Surgery to increase mucus will heal the ulcerations.
D)Gastric ulcers occur more frequently than do peptic ulcers.

Question 21

The nurse instructs a patient prescribed omeprazole for peptic ulcer disease about the use of the medication. Which patient statements indicate understanding of the instructions? (Select all that apply.)

A)"I should not take antacids while I'm on this medication."
B)"If I wish, I can open the capsule and sprinkle it on food."
C)"I will take the capsule before eating a meal in the morning."
D)"I will need to take this drug for 3 weeks for my ulcer to heal."
E)"I will report any abdominal pain, diarrhea, or bleeding that occurs."

Question 22

The nurse is planning care for a patient admitted for gastric bleeding, which is presently controlled. If the patient experiences a recurrence of bleeding, which manifestation will indicate to the nurse that the patient is experiencing hypovolemic shock?

A)Tachycardia and tachypnea
B)Dry mucous membranes
C)Change in level of consciousness
D)Reports of fatigue and thirst

Question 23

A patient's ideal body weight is 150 lb. At which weight would the patient be considered obese? Enter the numeral only.

Question 24

A patient who had extensive gastric surgery for stomach cancer reports feeling sick and diaphoretic with abdominal cramping about 20 minutes after eating. The nurse is providing information about dumping syndrome. Which information is correct? (Select all that apply.)

A)The patient is experiencing one of the most common complications.
B)Food enters the jejunum without adequate amounts of digestive juices.
C)The condition is lifelong and may require treatment with insulin.
D)High concentrations of electrolytes and sugar draws fluid into the bowel.
E)The patient will need to eat some candy or drink juice containing sugar.

Question 25

The nurse is contributing to the care plan of a patient admitted after a massive gastric bleed. Which goals will the nurse consider during this process of planning care? (Select all that apply.)

A)Recognize and treat hypovolemic shock.
B)Reassess for pain and medicate as needed.
C)Monitor and report signs of stress-induced ulcers.
D)Reassess for indications of electrolyte imbalances.
E)Implement measures to prevent or treat dehydration.