Deck 23: Nursing Care of Patients with Upper Gastrointestinal Disorders

Question 1

There are several classifications of drugs that can be used to prevent or treat nausea and vomiting. One such classification is dopamine antagonists, which include which of the following drugs? Select all that apply.

A)Compazine
B)Torcan
C)Reglan
D)Zofran
E)Vistaril

Answer 1

Compazine
Torcan
Reglan

Question 2

The nurse is providing emotional support to the spouse of a patient recently diagnosed with terminal esophageal cancer. The spouse voices feelings of anger and confusion and questions why his partner did not seek help sooner. Which response by the nurse would be the most appropriate at this time?

A)"Unfortunately, the early symptoms are often vague, and often not recognized as something serious."
B)"Your spouse was probably afraid of getting bad news."
C)"You will never know."
D)"It is not important to know that right now."

Answer 2

"Unfortunately, the early symptoms are often vague, and often not recognized as something serious."

Question 3

The nurse is assessing a patient diagnosed with gastrointestinal bleeding. Which of the following findings would indicate that the patient's condition is deteriorating?

A)The patient reports feeling very tired.
B)Urinary output has increased 50 mL more than the previous hour.
C)Skin is warm and dry.
D)Capillary refill time is increased.

Answer 3

The patient reports feeling very tired.

Question 4

A patient who has been experiencing nausea voices an interest in aromatherapy to manage the condition. What response by the nurse will be most therapeutic?

A)"Ginger has been used with some success to manage nausea."
B)"Aromatherapy has shown very limited effectiveness with nausea."
C)"Aromatherapy helps to exert conscious control over physiologic processes."
D)"Why are you considering this method?"

Question 5

A patient has been diagnosed with type 1 herpes simplex lesions on the mouth and face. Which of the following statements indicates that the patient understands teaching provided by the nurse?

A)"I will have this condition for life."
B)"This has been caused by a bacterial infection."
C)"I have come into contact with some type of fungal infection."
D)"An antibiotic will help heal these sores in about three days."

Question 6

A patient with a history of gastric bypass surgery one year prior is experiencing mouth soreness. Upon assessment, the nurse notes the patient's tongue is beefy, red, and smooth. Which of the following diagnostic tests would be used to help diagnose this patient's health problem?

A)vitamin B₁₂ levels
B)iron levels
C)vitamin B₆ levels
D)potassium levels

Question 7

The nurse has identified the goals of "intact skin integrity" and "intact stoma integrity" for a patient with a colostomy. The evaluation parameters best suited for these goals would be which of the following? Select all that apply.

A)Stoma is pink and moist.
B)No excoriation is noted on skin surrounding stoma.
C)Patient shows understanding of importance of preventing fecal leakage.
D)Patient demonstrates ability to apply the collecting appliance properly.
E)Stomal area is free of pain.

Question 8

Which acid base and electrolyte complications are commonly associated with prolonged vomiting? Select all that apply.

A)hypokalemia
B)metabolic alkalosis
C)metabolic acidosis
D)hypocalemia
E)hyponatremia

Question 9

A patient prescribed an antacid is experiencing muscle cramps. Which of the following should the nurse do to assist this patient?

A)Notify the healthcare provider.
B)Review the patient's diet history.
C)Review the patient's elimination patterns.
D)Provide reassurance to the patient.

Question 10

A patient is experiencing heartburn, reflux, and belching. Which of the following diagnostic tests would the nurse anticipate being used to diagnose the patient's symptoms?

A)upper GI series
B)colonoscopy
C)barium enema
D)chest x-ray

Question 11

The nurse is developing the postoperative plan of care for a patient recovering from surgery for oral cancer. Which of the following nursing diagnoses has the highest priority?

A)Ineffective Airway Clearance
B)Impaired Verbal Communication
C)Ineffective Body Image, Disturbed
D)Risk for Imbalanced Nutrition: More than Body Requirements

Question 12

In a patient experiencing a GI hemorrhage, the focus of care is the effect of the bleeding on the cardiovascular status. Place in order the actions the nurse should take in assessing the patient. Click and drag the options below to move them up or down.

A)Identify possible contributing factors including medications.
B)Obtain vital signs and orthostatic vital signs.
C)Place the acutely ill patient on a cardiac monitor and obtain a rhythm strip.
D)Evaluate mental status.
E)Assess peripheral pulse strength, color, temperature, and cap refill of extremities.
F)Obtain oxygen saturation level.

Question 13

A patient is experiencing manifestations consistent with an oral fungal infection. The patient's health history is unremarkable. Which of the following does the nurse initially anticipate being ordered to manage this condition?

A)nystatin
B)fluconazole
C)ampicillin
D)Anbesol

Question 14

A patient, four weeks post gastric resection surgery, is experiencing cramping, nausea, and diarrhea within 10 minutes after eating. The nurse suspects that the patent is experiencing "dumpingsyndrome" and suggests that he do which of the following? Select all that apply.

A)Increase the protein in his diet.
B)Lie down for 30 minutes immediately after eating.
C)Eat frequent, small meals.
D)Reduce the amount of carbohydrates eaten daily.
E)Drink a glass of water prior to each meal.

Question 15

Complementary and alternative medications have been found to be effective for some patients with nausea and vomiting. Examples of complementary and alternative medications for use include which of the following? Select all that apply.

A)ginger
B)biofeedback
C)music therapy
D)acupuncture
E)St.John's Wort

Question 16

With which of the following should the nurse instruct a patient diagnosed with gastroesophageal reflux disease (GERD)? Select all that apply.

A)Limit last food intake to four hours before bedtime.
B)Eat largest meal of the day at midday.
C)Sleep in a bed with the head elevated six to eight inches.
D)Develop a daily exercise routine.
E)Include a caffeinated beverage with meals.

Question 17

Look at the figure below and identify what kind of gastrointestinal condition that the patient has a 11ea992e_0a4c_9dd6_9f38_f51b14b35c82

A)hiatal hernia
B)diaphragmatic hernia
C)esophageal ulcer
D)stomach ulcer

Question 18

Acyclovir (Zovirax) ointment has been prescribed for a patient with oral herpes lesions. Which of the following should the nurse include when providing information to the patient regarding this medication? Select all that apply.

A)Adverse effects include vomiting and diarrhea.
B)It can reduce the length of the herpes outbreak.
C)It is an antibiotic medication.
D)Repeated usage of the drug will likely put the patient into a permanent remission state.
E)It is most effective when administered intravenously.

Question 19

A patient diagnosed with peptic ulcer disease (PUD) asks if he will need surgery. With which of the following should the nurse respond to this patient?

A)"The administration of the appropriate medications makes surgery rarely necessary."
B)"Surgery is required in about 50% of the cases."
C)"Surgery has a higher success rate than medication therapy alone."
D)"If you take your medications and follow the prescribed diet, surgery isn't usually needed."

Question 20

A patient recovering from gastric surgery has red fluid in the nasogastric tube. The patient's vital signs are temperature 98° F; heart rate 104; respirations 23; blood pressure 105/69. Which action by the nurse is indicated?

A)Document the findings and notify the healthcare provider.
B)Document the findings and reassess the patient in four hours.
C)Review the patient's most recent laboratory results.
D)Document the findings and review the nasogastric suction settings.

Question 21

A patient 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 patient?

A)"It's usually self-limiting and will resolve within 6 to 12 months."
B)"It will be a problem for the rest of your life."
C)"There's no treatment."
D)"Only eat a clear-liquid diet."

Question 22

A patient 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 patient's delay?

A)Disturbed Body Image
B)Impaired Verbal Communication
C)Imbalanced Nutrition: Less than Body Requirements
D)Risk for Ineffective Airway Clearance

Question 23

The nurse is teaching a patient about the major risk factors for peptic ulcer disease (PUD). The two major risk factors for PUD are which of the following? Select all that apply.

A)chronic H.pylori infection
B)use of aspirin and NSAIDS
C)use of alcohol
D)dietary intake
E)stress

Question 24

A patient 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 patient is experiencing which of the following?

A)peptic ulcer disease
B)gastroesophageal reflux disease (GERD)
C)acute gastritis
D)chronic gastritis

Question 25

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

A)Try smoking cessation techniques.
B)Eat a bland diet.
C)Avoid eating breakfast.
D)Have the largest meal of the day at lunchtime.

Question 26

A patient with chronic gastritis says, "I've stopped taking the medication because I feel so much better now that I drink ginger tea." The nurse realizes that this patient

A)is using a complementary therapy for the symptoms.
B)is in denial of the disease.
C)cannot afford the medication.
D)needs to see the doctor immediately.

Question 27

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

A)vitamin deficiency
B)a return of the stomach cancer
C)metastasis
D)ineffective coping

Question 28

When teaching a patient with fungal stomatitis about performing oral care, the nurse would include which of the following topics? Select all that apply.

A)Avoid tobacco and alcohol.
B)Use saline or sodium bicarbonate rinse after every meal.
C)Consume 8 oz of yogurt or buttermilk daily.
D)Avoid cold beverages.
E)Use lemon glycerin swabs between meals.

Question 29

The nurse is preparing the morning medications for a patient with gastroesophageal reflux disease (GERD). Which of the following nursing interventions would be appropriate for this patient's medications?

A)Hold the antacids for at least two hours after oral medications are taken.
B)Provide all prescribed medications at 1000.
C)Provide the antacids first and then follow with the oral medications.
D)Provide the antacids only at the hour of sleep.

Question 30

Patient teaching in the management of dumping syndrome following a gastrectomy for cancer of the stomach includes which of the following topics? Select all that apply.

A)Consume small frequent meals.
B)Position in a semi-recumbent position 30-60 minutes after meals.
C)Administer anticholinergics and antispasmodics.
D)Increase carbohydrates and decrease fat in the diet.
E)Drink lots of fluids with each meal.

Question 31

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

A)a narrow esophageal lumen
B)a tumor
C)metastasis
D)blood

Question 32

The nurse learns that an elderly patient 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 patient to do?

A)Make an appointment to see the physician.
B)Continue to use the preparation.
C)Change the preparation.
D)Stop wearing the dentures.

Question 33

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

A)Suggest eating a dry cracker to help with the nausea.
B)Encourage the patient to stop taking the medication.
C)Nothing.
D)Suggest that the patient take the medication with a heavy meal.

Question 34

The nurse is preparing to instruct a patient who is newly diagnosed with gastroesophageal reflux disease (GERD) 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)"Avoid eating up to three hours before bedtime."
D)"Be sure to eat at least one citrus fruit per day."
E)"Alcohol should be limited to two drinks per day."

Question 35

The nurse is assessing a patient 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 patient was experiencing which of the following?

A)hiatal hernia
B)diverticulitis
C)constipation
D)bowel obstruction

Question 36

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

A)"Use of smokeless tobacco has been linked to oral cancer."
B)"You are probably one of the lucky ones."
C)"I guess you're right."
D)"It's not my body."

Question 37

The physician has ordered Reglan 2 mg/kg IVP to be given 30 minutes before the start of chemotherapy. The patient weighs 54 kg. The Reglan is dispensed in a 10 mg/10 mL vial. How many cc's of Reglan will the patient receive? ___________

Question 38

A patient with peptic ulcer disease (PUD) says, "I feel so much better now that I've stopped eating." The nurse realizes that this patient is at risk for which of the following?

A)Imbalanced Nutrition: Less than Body Requirements
B)Sleep Pattern Disturbance
C)Pain
D)Fluid Volume Overload

Question 39

All of the following are diagnostic procedures that may be used to diagnose gastroesophageal reflux disease (GERD). Which two are most frequently used? Select all that apply.

A)barium swallow
B)upper endoscopy
C)esophageal manometry
D)ambulatory pH monitoring
E)bernstein test

Question 40

A patient is being prepared for chemotherapy and the doctor has ordered Zofran 0.15 mg/kg IV to be given 30 minutes prior to starting the chemotherapy. The patient weighs 80 kg. How many mg of Zofran will the patient receive? ___________

Question 41

An elderly patient, experiencing a significant weight loss, has poorly fitting dentures causing severe oral sores. When preparing the plan of care, which of the following interventions will be most beneficial to the patient?

A)Provide analgesics as needed.
B)Determine the need for assistive devices.
C)Serve meals in an attractive environment.
D)Offer assistance to eat.

Question 42

A patient who is in the post-gastric surgery stage for cancer is denying the diagnosis of cancer. The nurse should do which of the following?

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