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.

Accepted Answer

The nurse should instruct the person to eat smaller, more frequent meals and to drink liquids separately from solid foods to help address dumping syndrome. Options A and B are incorrect and not helpful for the person's recovery. Option D is not appropriate as a clear liquid diet may not provide enough nutrients for the person's recovery.

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?

Accepted Answer

Antacids should be held for at least two hours after other oral medications to prevent interference with their absorption. Therefore, it is appropriate to provide the other oral medications first and then follow with the antacids later on.

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.

Accepted Answer

A, B

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?

Accepted Answer

Use of smokeless tobacco, including chewing tobacco, has been linked to oral cancer. It is important to provide accurate information and education to the patient and encourage them to quit or seek assistance to quit. Simply stating that they are unlikely to get cancer or that they are lucky is not appropriate and does not address the potential risks associated with tobacco use. It is important to promote informed decision-making and support the patient in making positive health choices.

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?

Accepted Answer

The person's statement indicates that they have stopped eating, which puts them at risk for imbalanced nutrition: less than body requirements. This person may be experiencing relief from their symptoms of peptic ulcer disease due to decreased stimulation of stomach acid from not eating, but long-term avoidance of food can lead to malnutrition and other health complications.

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?

Accepted Answer

The person should not eat or drink for at least 30 minutes after using nystatin oral suspension to allow the medication to fully coat the inside of the mouth and work optimally.

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?

Accepted Answer

Eating a dry cracker can help settle the stomach and reduce nausea, making it a practical suggestion for someone experiencing nausea from medication.

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?

Accepted Answer

Ill-fitting dentures can cause gum irritation and sores, and using an over-the-counter preparation for an extended period of time may mask the underlying issue. It is necessary for the person to see a doctor to have the dentures adjusted or replaced as needed, and to determine the cause of the gum sore.

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?

Accepted Answer

Cigarette smoking can worsen gastric ulcers by increasing acid secretion and delaying ulcer healing. It is important for the person to avoid smoking to promote healing.

Answer: D
 Taking ranitidine with an antacid can help to reduce gastric pain by further reducing stomach acid. The person should be advised to take the antacid at a separate time from the ranitidine, however, to avoid interference with absorption.

Therefore, the best choices are C and D. A is incorrect because the medication should continue to be taken as prescribed even after pain and discomfort are relieved. B is incorrect because aspirin can actually worsen gastric ulcers by inhibiting the production of prostaglandins that help to protect the stomach lining.

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:

Accepted Answer

The person is using ginger tea as a complementary therapy for the symptoms of gastritis. While ginger may have some benefits for digestive issues, it is not a substitute for prescribed medication that targets the underlying condition of chronic gastritis. The nurse should educate the person on the importance of continuing prescribed medication while using complementary therapies in consultation with their doctor.

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?

Accepted Answer

Ondansetron is a serotonin receptor antagonist, which means that it blocks the effect of serotonin on vagal afferent nerves that stimulate the vomiting centre. This mechanism of action helps to prevent and treat nausea and vomiting associated with chemotherapy.

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?

Accepted Answer

The creamy white, curd-like patches on the back of the mouth and throat are characteristic of candidiasis, also known as oral thrush. This is a fungal infection caused by Candida albicans.

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?

Accepted Answer

A narrow oesophageal lumen is indicative of oesophageal cancer and can be seen on a barium swallow. Delayed swallowing, blood in the upper gastrointestinal tract, and malabsorption of barium are not specific to oesophageal cancer.

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?

Accepted Answer

The person may be delaying surgery due to concerns about how the surgery will affect their appearance, indicating a 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?

Accepted Answer

Sucralfate suspension should be shaken well before use to ensure the medication is properly mixed for effective treatment.

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?

Accepted Answer

Arguing or trying to convince the person may not be effective and may actually increase their resistance. Providing emotional support and respecting their denial is important to maintain a positive therapeutic relationship. Referring to a psychologist may also be helpful in addressing the person's emotional needs. Reminding the person of prognosis or how many people live with cancer may also not be effective as the person may have their own unique experiences and beliefs.

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?

Accepted Answer

The person's symptoms of stomach pain that are relieved by eating suggest peptic ulcer disease, which is characterized by the formation of open sores in the lining of the stomach or small intestine. These sores can cause pain or discomfort, especially when the stomach is empty. Dumping syndrome is a condition that occurs after eating, not during fasting, and is characterized by symptoms such as nausea, vomiting, and diarrhea. Cushing's ulcers are a type of stress ulcer that occurs as a result of severe medical conditions or trauma, and can cause bleeding in the digestive tract. Haematemesis refers to vomiting of blood, which is not indicated by the person's symptoms.

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?

Accepted Answer

Hiatal hernia can cause chest pain that mimics a heart attack. Lactose intolerance, Crohn's disease, and stomatitis do not typically cause chest pain.

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?

Accepted Answer

The person's persistent fatigue is most likely a symptom of anaemia resulting from a vitamin deficiency. This is a common problem after stomach cancer surgery, as the surgery can interfere with the body's ability to absorb nutrients. It is unlikely that the cancer has returned without any other symptoms or evidence. Muscle wasting and respiratory metastases would also be accompanied by other symptoms, such as weakness or difficulty breathing, respectively.

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?

Accepted Answer

The answer of The nurse learns that a person who...

Quiz 22: Nursing Care of People With Upper Gastrointestinal Disorders