Question 1

An older patient is experiencing significant weight loss and has poorly fitting dentures that cause severe oral sores. When preparing the plan of care, which intervention will be most beneficial to the patient?

Accepted Answer

The answer of An older patient is experiencing significant weight...

Question 2

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

Accepted Answer

Holding the antacids for at least 2 hours after oral medications are taken ensures that the oral medications are fully absorbed before being neutralized by the antacids. This is important for effective treatment of GERD.

Question 3

The physician has ordered metoclopramide (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 milliliters of the medication should the nurse administer?

Accepted Answer

The answer of The physician has ordered metoclopramide (Reglan) 2...

Question 4

A patient with gastrointestinal dysfunction says, "I was having chest pain so bad last week I thought I was having a heart attack!" What should the nurse suspect the patient was experiencing?

Accepted Answer

Chest pain is a common symptom of hiatal hernia, which occurs when the upper part of the stomach protrudes through the diaphragm into the chest cavity.

Question 5

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

Accepted Answer

Smoking cessation techniques can help reduce the symptoms of peptic ulcer disease.

Question 6

A patient with a long history of using chewing tobacco says, "I've been chewing for years. I'm not going to get cancer." How should the nurse respond?

Accepted Answer

The nurse should provide education on the link between smokeless tobacco and oral cancer to increase the patient's awareness and understanding of the risks associated with their tobacco use. Option B is dismissive and unhelpful, Option C does not provide any new information or address the patient's misconception, and Option D is not an appropriate response and does not encourage a dialogue about the patient's health.

Question 7

A patient who is recovering from surgery for stomach cancer a month ago continues to experience dumping syndrome. What should the nurse instruct this patient?

Accepted Answer

Dumping syndrome is a common complication after gastric surgery. The nurse should reassure the patient that it is usually self-limiting and will resolve within 6 to 12 months. Additionally, the nurse should encourage the patient to eat smaller, more frequent meals and avoid foods high in sugar or simple carbohydrates. A clear-liquid diet is not appropriate for long-term management of dumping syndrome.

Question 8

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

Accepted Answer

A barium swallow test would show a narrow esophageal lumen due to the presence of a tumor, which is indicative of esophageal cancer.

Question 9

A patient who had stomach cancer surgery 2 years ago comes to the clinic fearful that "the cancer must be back because I'm so tired all the time." The nurse realizes that this patient is likely experiencing which health problem?

Accepted Answer

The patient's complaint of fatigue is a common symptom of vitamin deficiency, which can occur after stomach cancer surgery due to difficulties with nutrient absorption. While it is important to rule out a cancer recurrence or metastasis, the nurse should first investigate potential causes of the fatigue, including vitamin deficiencies. Ineffective coping may be a factor as well, but it is not the most likely explanation for the patient's current symptoms.

Question 10

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

Accepted Answer

Peptic ulcer disease is characterized by stomach pains that often improve after eating, as food can buffer the stomach acid and relieve pain temporarily. This symptom is a classic sign of peptic ulcers.

Question 11

A patient is being evaluated for gastroesophageal reflux disease (GERD). Which diagnostic tests should the nurse expect to be prescribed for this patient?

Accepted Answer

The most common diagnostic tests for GERD are barium swallow and upper endoscopy. Barium swallow is a radiographic test where the patient drinks a barium solution, which then coats the esophagus and stomach. X-rays are taken to see if there is reflux of barium into the esophagus. Upper endoscopy is an invasive test where a flexible tube with a camera is inserted through the mouth to visualize the esophagus and stomach lining. CT scan and complete blood count are not usually used in the diagnosis of GERD, and colonoscopy is used to evaluate the colon and rectum, not the esophagus and stomach.

Question 12

A patient with nausea says, "I'm tired of taking this medication. It makes me nauseated." What can the nurse suggest to the patient?

Accepted Answer

Eating a dry cracker before taking the medication can help alleviate the nausea. It is not appropriate to tell the patient to stop taking the medication without consulting their healthcare provider, and doing nothing does not address the patient's concern. Taking the medication with a heavy meal may help with the nausea but it may also reduce the effectiveness of the medication.

Question 13

The nurse suspects that a patient receiving dronabinol (Marinol) to treat nausea and vomiting caused by chemotherapy is experiencing adverse effects of the medication. What did the nurse assess to come to this conclusion?

Accepted Answer

Dronabinol can cause hypotension and tachycardia as adverse effects, which are indicated by low blood pressure (B) and increased heart rate (D).

Question 14

The nurse is teaching a patient about the major risk factors for peptic ulcer disease (PUD). Which risk factors should the nurse discuss?

Accepted Answer

The major risk factors for PUD include chronic H. pylori infection and the use of aspirin and NSAIDs. While dietary intake and stress may exacerbate symptoms, they are not considered major risk factors for developing PUD. While alcohol may cause stomach irritation, it is not considered a major risk factor for PUD.

Question 15

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 health problem?

Accepted Answer

While lack of food may temporarily relieve the symptoms of PUD, the patient is at risk for insufficient nutritional intake and malnutrition if they continue to avoid eating.

Question 16

A patient who needs a radical neck dissection for oral cancer continues to delay the surgery. The nurse should consider that which issue may be influencing the patient's decision-making process?

Accepted Answer

A radical neck dissection for oral cancer can result in significant changes to the patient's appearance and body image. The patient may be struggling with the idea of losing a part of their anatomy and the potential for disfigurement. Nurses should be aware of this potential psychological issue and work with the patient to address their concerns and fears.

Question 17

A patient who has had gastric surgery for cancer is denying the diagnosis of cancer. What should the nurse do?

Accepted Answer

The nurse should respect the patient's right to deny the diagnosis and focus on providing emotional support. Arguing or reminding the patient of the diagnosis may cause distress and harm the therapeutic relationship. Referring the patient to a clinical psychologist or talking about the prognosis may also be appropriate, but only after building a rapport and developing trust with the patient.

Question 18

The nurse learns that an older patient with ill-fitting dentures has been using an over-the-counter (OTC) preparation for a gum sore over the last month. What should the nurse instruct this patient to do?

Accepted Answer

The nurse should instruct the patient to make an appointment to see the physician because prolonged use of OTC preparations may mask underlying issues that a dentist or physician needs to diagnose and treat. Additionally, ill-fitting dentures can cause oral sores that need professional attention.

Question 19

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:

Accepted Answer

The patient is using a complementary therapy (ginger tea) to manage their symptoms of chronic gastritis. It is important for the nurse to acknowledge and discuss the use of complementary therapies with the patient, while also ensuring that they are still receiving proper medical treatment for their condition.

Question 20

The nurse is preparing to instruct a patient newly diagnosed with gastroesophageal reflux disease (GERD) about dietary considerations. What should the nurse include in these instructions?

Accepted Answer

B) Meals should be small and more frequent to avoid overloading the stomach and triggering GERD symptoms.
A) Peppermint can relax the lower esophageal sphincter and aggravate GERD symptoms, so it should be avoided. 
C) Having a bedtime snack can worsen GERD symptoms because lying down can increase reflux. 
D) Citrus fruits are acidic and can worsen GERD symptoms. 
E) Alcohol should be avoided or strictly limited as it can relax the lower esophageal sphincter and increase acid reflux.

Quiz 23: Nursing Care of Patients With Upper Gastrointestinal Disorders