Deck 22: Nursing Care of People With Upper Gastrointestinal Disorders

Question 1

A person who is recovering from surgery for stomach cancer a month ago continues to experience dumping syndrome. Which of the following should the nurse instruct this person to help the person address this problem? Select all that apply.

A)'It is likely to be a problem for the rest of your life.'
B)'There's no effective treatment for this complication.'
C)'Eat smaller, more frequent meals.'
D)'Only eat a clear liquid diet until the problem resolves.
E)'Drink your liquids separately from your solid foods.;

Answer 1

'Eat smaller, more frequent meals.'
'Drink your liquids separately from your solid foods.;

Question 2

The nurse is preparing the morning medications for a person with gastro-oesophageal reflux disease (GORD). Which of the following nursing interventions would be appropriate for this person's medications?

A)Provide the antacids immediately upon awakening.
B)Provide the antacids first and then follow with the oral medications.
C)All the prescribed medications should be given together at 10:00 a.m.
D)Hold the antacids for at least two hours after oral medications are taken.

Answer 2

Hold the antacids for at least two hours after oral medications are taken.

Question 3

The nurse is preparing to instruct a person who is newly diagnosed with gastro-oesophageal reflux disease (GORD)about dietary considerations. Which of the following should the nurse include in these instructions? Select all that apply.

A)'Avoid peppermint.'
B)'Meals should be small and more frequent.'
C)'Alcohol should only be consumed in moderation.'
D)'Be sure to eat at least one citrus fruit per day.'

Answer 3

'Avoid peppermint.'
'Meals should be small and more frequent.'

Question 4

A person with a long history of chewing tobacco says, 'I've been chewing for years. I'm not going to get lung cancer.' Which of the following would be an appropriate nursing response?

A)'You are unlikely to get cancer from chewing tobacco.'
B)'You are probably one of the lucky ones.'
C)'Use of smokeless tobacco has been linked to oral cancer.'
D)'It is up to you whether to use chewing tobacco or not.'

Question 5

A person with peptic ulcer disease says, 'I feel so much better now that I've stopped eating.' The nurse realises that this person is at risk of developing which nursing diagnosis?

A)Fluid volume overload
B)Risk of aspiration
C)Imbalanced nutrition: less than body requirements
D)Diarrhoea

Question 6

A person is commencing therapy with nystatin (Nilstat), a topical antifungal medication to treat oral thrush. What would the nurse teach the person about using this medication?

A)Immediately expectorate the oral suspension.
B)Do not eat or drink for 30 minutes after the medication.
C)The medication is safe to use during pregnancy.
D)Take the medication with food or milk.

Question 7

A person with nausea says, 'I'm tired of taking this medication. All it does is make me feel nausea.' Which of the following could the nurse instruct this person to do?

A)Suggest that the person take the medication with a large meal.
B)Encourage the person to reduce the dosage of the medication to reduce the nausea.
C)Persist with the medication.
D)Suggest eating a dry cracker to help with the nausea.

Question 8

The nurse learns that an elderly person with ill-fitting dentures has been using an over-the-counter preparation for a gum sore over the last month. Which of the following should the nurse instruct this person?

A)Make an appointment to see the doctor.
B)Continue to use the preparation.
C)Choose a different over-the-counter preparation.
D)Get a new set of dentures.

Question 9

The nurse is teaching a person about the medication ranitidine (Zantac)prescribed to treat the person's gastric ulcers. What information should the nurse give to this person?

A)The medication can be ceased once pain and discomfort are relieved.
B)If needed, the person may take aspirin for additional pain relief.
C)Avoid cigarette smoking.
D)Take the medication with an antacid to reduce gastric pain.

Question 10

A person with chronic gastritis says, 'I've stopped taking the prescribed medication because I feel so much better now that I drink ginger tea.' The nurse realises that this person:

A)has not given the prescribed medication enough time to work.
B)is using a complementary therapy for the symptoms.
C)needs to see the doctor immediately.
D)is in denial of the disease.

Question 11

The nurse is reviewing the mechanisms of action for ondansetron (Zofran)being used to treat nausea for a person receiving chemotherapy for cancer. Which of the following accurately reflects the mechanism of action of ondansetron?

A)Ondansetron is a serotonin receptor antagonist which blocks the effect of serotonin on vagal afferent nerves that stimulate the vomiting centre.
B)Ondansetron blocks dopamine receptors in the chemoreceptor trigger zone to suppress nausea and vomiting.
C)Ondansetron acts by blocking histamine and acetylcholine receptors in the neural pathway from the inner ear to the vomiting centre.
D)Ondansetron antagonizes H1-receptors, competing for binding with free histamine, thus relieving nausea and vomiting.

Question 12

On examination, the nurse observes that a person has creamy white, curd-like patches on the back of her mouth and throat. What is the likely infectious agent causing these patches?

A)Diphtheria
B)Oral mucositis
C)Candidiasis (oral thrush)
D)Epidemic parotitis

Question 13

A person who is experiencing difficulty swallowing is diagnosed with oesophageal cancer after having a barium swallow. The nurse realises that the diagnostic test must have displayed which of the following?

A)Delayed swallowing
B)A narrow oesophageal lumen
C)Blood in the upper gastrointestinal tract
D)Malabsorption of the barium

Question 14

A person who is in need of a radical neck dissection for cancer continues to delay the surgery. Which of the following nursing diagnoses would best describe the reason for this person's delay?

A)Dysfunctional grieving
B)Unilateral neglect
C)Ineffective management of individual therapeutic regimen
D)Disturbed body image

Question 15

A person with gastritis is commencing therapy with the anti-ulcer agent sucralfate (Carafate). What would the nurse teach the person about using this medication?

A)The medication may be taken with antacids.
B)The medication is likely to cause nausea.
C)Shake the suspension well.
D)Take the medication with meals.

Question 16

A person who is in the post-gastric surgery stage for cancer is denying that he has cancer. What should the nurse do?

A)Ask a clinical psychologist to talk with the person.
B)Remind the person of the positive prognosis.
C)Do not argue with the person, but continue to provide emotional support as needed.
D)Explain how many people with cancer live long, productive lives.

Question 17

A person tells the nurse, 'I get these tremendous stomach pains in the middle of the night and they disappear after I eat something. No wonder I can't lose any weight!' The nurse suspects that this person is experiencing which of the following?

A)Peptic ulcer disease
B)Dumping syndrome
C)Cushing's ulcers
D)Haematemesis

Question 18

The nurse is assessing a person with gastrointestinal dysfunction who says, 'I was having chest pain so bad last week I thought I was having a heart attack!' The nurse suspects that the person was experiencing which of the following?

A)Lactose intolerance
B)Crohn's disease
C)Stomatitis
D)Hiatal hernia

Question 19

A person who had stomach cancer surgery 2 years ago comes into the clinic fearful that the 'cancer is back because I'm so tired all of the time.' The nurse realises that this person is likely experiencing which of the following?

A)Muscle wasting
B)Respiratory metastases
C)A return of the stomach cancer
D)Anaemia resulting from vitamin deficiency

Question 20

The nurse learns that a person who is being treated for peptic ulcer disease is still 'having problems'. Which of the following should the nurse instruct this person?

A)Smoking cessation techniques can help.
B)Make sure the person is keeping to their restrictive diet.
C)Avoid eating lunch.
D)Do not consume any alcohol.