Question 1

The nurse is caring for a patient who complains of nausea related to gastric cancer.Which supplement should the nurse suggest?

Accepted Answer

It has been believed that ginger can be an effective aid in relieving nausea in cancer patients receiving chemotherapy,pregnant patients,and postoperative patients.Research however did not find this to be so.Even so,patients might have some relief from using ginger for nausea.B.C.D.These supplements are not identified as helping with nausea.

Question 2

The nurse is evaluating care provided to a patient with bulimia nervosa.Which observation indicates that addition care is required?

Accepted Answer

If looking in the mirror makes the patient nauseated,the patient is not developing a positive self-image and would need additional interventions for this area.A.Talking with others after a meal indicates that the patient is not purging after eating.C.Stating the importance of continuing with therapy sessions indicates that the patient sees the value of meeting with someone to talk about feelings and behaviors.D.Planning meals and snacks indicates the patient is not binging.

Question 3

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?

Accepted Answer

Complications of GERD can result in esophagitis.Over time,this can lead to changes in the epithelium of the esophagus and lead to Barrett's esophagus,a precancerous lesion.A.B.D.Laryngospasm,bronchospasm,and aspiration pneumonia are not complications typically associated with gastroesophageal reflux disease.

Question 4

The nurse is caring for a patient who has a nursing diagnosis of acute postoperative pain after a gastrectomy.The patient has a nasogastric (NG)tube.What interventions should the nurse implement? (Select all that apply.)

Accepted Answer

Pain should be monitored and evaluated hourly while awake.Maintaining NG tube function prevents distention and pain due to pressure on the suture line.Giving pain medication as needed is essential.C.The nurse does not reposition the NG tube after gastric surgery,and it would not be repositioned once a shift.A.The patient should be up and ambulating as soon as ordered to prevent complications.E.After removal of the NG tube,clear fluids may be ordered with progression to full liquids,soft food,and then a regular diet as the patient tolerates.

Question 5

The nurse is caring for a patient with bulimia.Which complication should the nurse recognize that this patient is at risk for developing?

Accepted Answer

The loss of hydrochloric acid from the stomach due to vomiting can result in metabolic alkalosis.A.B.C.This patient is not at any particular risk for developing weight gain,fluid overload,or ischemic stroke.

Question 6

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

Accepted Answer

With Prevacid administration,the nurse should assess for epigastric or abdominal pain and for blood in stool (tarry stools),emesis,or gastric aspirate.Notify the physician if any evidence of bleeding has occurred.A.C.D.Rash,constipation,and mental status changes are not identified adverse effects of Prevacid.

Question 7

The nurse is contributing to a patient's teaching plan on how to avoid dumping syndrome after a gastrectomy.What should be included in the teaching?

Accepted Answer

To avoid dumping syndrome,avoid fluids 1 hour before,with,or for 2 hours after meals to prevent rapid gastric emptying.B.The patient should rest after eating.C.Carbohydrates should be limited.D.The patient should eat small frequent meals.

Question 8

A patient is considering surgery to treat obesity.Which factors meet established criteria for the use of surgery in the treatment of obesity? (Select all that apply.)

Accepted Answer

Patients who do not respond to medical methods of weight loss,who weigh 100 pounds over ideal body weight,or have a BMI over 40,or BMI over 35 with severe health effects as a result,might be candidates for surgical weight loss.Additional screening for psychiatric and social stability is required.B.E.Gallstones and percentage of body weight are not criteria for Bariatric surgery.

Question 9

The nurse is caring for a patient recovering from a bleeding gastric ulcer.Which patient statements indicate correct understanding of beverages to avoid after treatment of a bleeding gastric ulcer? (Select all that apply.)

Accepted Answer

Foods known to cause discomfort such as spicy foods,carbonated drinks,caffeinated products,and alcohol,should be avoided during the healing period.B.E.There is no reason for the patient to abstain from milk or lemonade.

Question 10

The nurse is visiting the home of a patient recovering from a sleeve gastrectomy.Which observation indicates that this surgery has been successful for the patient?

Accepted Answer

Laparoscopic sleeve gastrectomy removes about 75% of the stomach to leave a slim gastric "sleeve".This reduces the stomach's volume and limits food intake at one time.It also may decrease the hormone produced by the stomach that causes hunger.B.Dry skin and hair falling out indicates that the patient is not taking in an adequate amount of nutrients to support the skin and hair.C.Being constantly hungry indicates that the surgery was not successful since the hormone produced by the stomach that causes hunger should be reduced from this surgery.D.There is no saline solution injected into a pouch with this surgery.

Question 11

The nurse is providing care to a patient anticipating radiation therapy for head and neck cancer.What should the nurse include in pre-therapy education? (Select all that apply.)

Accepted Answer

The importance of daily and ongoing oral care should be considered for all patients.Prior to any radiation therapy of the head or neck area,a thorough oral examination and any needed restorative dental procedures should be completed.An artificial saliva substitute should be considered for patients with xerostomia (dry mouth).C.Xerostomia can lead to rampant tooth decay in older adults,putting their dentition at risk.A.Water does not contain the necessary compounds such as lubricants to protect the teeth.E.Teeth do not need to be pulled prior to radiation therapy.

Question 12

A patient with a nasogastric tube connected to suction is NPO (nothing by mouth)and reports a dry mouth and gagging feeling.What action should the nurse take?

Accepted Answer

Frequent oral care is needed for comfort for patients who are NPO with NG tubes as dry mouth is a continual concern.B.The nurse should not reposition the patient's nasogastric tube.C.The patient is NPO so ice chips would be contraindicated.D.There is no reason to provide lidocaine for the patient's mouth.

Question 13

The nurse is participating in planning care for a patient who is experiencing nausea.Which interventions should be included in this patient's plan of care? (Select all that apply.)

Accepted Answer

To provide comfort for the patient with nausea the nurse should provide antiemetics as prescribed to relieve nausea,ensure the environment is odor-free to avoid triggering stimuli,provide oral care to remove taste of emesis and enhance patient comfort,and instruct to avoid odors or foods that precipitate nausea.C.Monitoring intake,output,and vital signs would be appropriate if the patient were at risk for fluid volume deficit.

Question 14

A patient who is unconscious begins to vomit blood.What action should the nurse take first?

Accepted Answer

If vomiting occurs,turn the patient onto his or her side to protect the airway and prevent aspiration.B.The patient is unconscious so water should not be placed into the patient's mouth.C.Oral care can be done after the airway has been protected.D.Antiemetic medication requires a physician's order which may or may not be available at this time.

Question 15

The nurse is preparing to calculate a patient's body mass index.What measurements does the nurse need to make this calculation?

Accepted Answer

Height and weight are used to calculate body mass index.B.Waist and hip measurements are used to calculate waist-to-hip ratio.C.D.There are no calculations that use weight and waist measurement or waist measurement and height.

Question 16

The nurse is caring for a patient who has aphthous stomatitis.What care should the nurse provide? (Select all that apply.)

Accepted Answer

Aphthous stomatitis appears as small,white,painful ulcers on the inner cheeks,lips,tongue,gums,palate,or pharynx and typically lasts for several days to 2 weeks.Self-induced trauma such as biting the lips and cheeks can cause these ulcers to develop,as well as stress or exposure to irritating foods.Application of topical tetracycline several times a day usually shortens the healing time.A topical anesthetic such as benzocaine or lidocaine provides pain relief and makes it possible to eat with minimal pain.A.The patient does not need to be NPO.B.A fluid restriction is not necessary.

Question 17

The nurse is reinforcing teaching provided to a patient being tested for type B gastritis.
Which patient statement indicates a correct understanding of the test that is used to diagnose this condition?

Accepted Answer

Type B gastritis can also be diagnosed by endoscopy,upper gastrointestinal x-ray examination,and gastric aspirate analysis.A.B.C.Colonoscopy,barium enema,and abdominal x-ray are not used to diagnose type B gastritis.

Question 18

After collecting data the nurse suspects that an adolescent patient is at risk for developing anorexia nervosa.What data did the nurse use to come to this conclusion? (Select all that apply.)

Accepted Answer

Anorexia nervosa is an eating disorder recognized by the American Psychiatric Association.This disease most commonly occurs in females between ages 12 and 18 who are from the middle and upper classes of Western culture.Young women with low self-esteem seem to be at highest risk.Anorexia nervosa is thought to be psychological in origin.Patients may have a phobia about weight gain,be afraid of a loss of control,and be mistrusting.E.Texting with friends does not suggest that the patient is at risk for developing anorexia nervosa.

Question 19

The nurse has instructed a patient prescribed omeprazole (Prilosec)for peptic ulcer disease on use of the medication.What patient statements indicate understanding of the instructions? (Select all that apply.)

Accepted Answer

The patient should be instructed to take before meal in morning and notify the physician if bleeding,diarrhea,headache,or abdominal pain develops.The patient will need to have complete blood counts and liver enzymes routinely assessed when taking this medication.A.This medication may be taken with antacids.B.The capsule should be swallowed whole.D.This medication must be taken 4 to 8 weeks for ulcer healing.

Question 20

The nursing assistant is delivering patient meals.Which meal should the nurse expect to be delivered to a patient who had gastric bypass surgery the day before?

Accepted Answer

Patients are started on a clear liquid diet because of the small stomach pouch that has been created.A.B.The patient will progress to these diets over the next days.D.This patient will not be provided with a general diet for quite a while.

Quiz 33: Nursing Care of Patients With Upper Gastrointestinal Disorders