Medical, Surgical Nursing II - Practice Questions

The nurse is cautiously assessing a client admitted with peptic ulcer disease because the most common complication that occurs in 10% to 20% of clients is:  Hemorrhage Which medication classification represents a proton (gastric acid) pump inhibitor?  Omeprazole Peptic ulcer disease occurs more frequently in people with which blood type? You Selected:  O A critical care nurse is closely monitoring a patient who has recently undergone surgical repair of a bleeding peptic ulcer. The nurse should prioritize assessments of which of the following signs and symptoms of a recurrence of hemorrhage? You Selected:  Hypotension and tachycardia An obese male patient has sought advice from the nurse about the possible efficacy of medications in his efforts to lose weight. What should the nurse teach the patient about pharmacologic interventions for the treatment of obesity?  “Medications may be of some use, but they don't tend to resolve obesity on their own.” 10s Report this Question A client is prescribed a histamine (H2)-receptor antagonist. The nurse understands that this might include which medication(s)? Select all that apply.    Nizatidine Famotidine Cimetidine  A nursing student is caring for a client with gastritis. Which of the following would the student recognize as a common cause of gastritis? Choose all that apply.    Ingestion of strong acids Irritating foods Overuse of aspirin Which is a true statement regarding gastric cancer?  Most clients are asymptomatic during the early stage of the disease. A client with severe peptic ulcer disease has undergone surgery and is several hours postoperative. During assessment, the nurse notes that the client has developed cool skin, tachycardia, labored breathing, and appears to be confused. Which complication has the client most likely developed? You Selected:  Hemorrhage Endoscopy of a 60-year-old woman has revealed the presence of an esophageal peptic ulcer. The nurse who is providing this woman's care is assessing for risk factors that may have contributed to the development of this disease. What question most directly addresses these risk factors?  “Have you ever been diagnosed with reflux?” The nurse recognizes that the client diagnosed with a duodenal ulcer will likely experience You Selected:  pain 2 to 3 hours after a meal. A 30-year-old obese female patient who underwent gastric banding 3 days ago is getting ready to go home. Essential postoperative teaching for this patient should include instruction related to the importance of abstaining from what for the next 2 years? You Selected:  Pregnancy Review the following four examples of ideal body weight (IBW), actual weight, and body mass index (BMI). Using three criteria for each example, select the body weight that indicates morbid obesity. You Selected:  IBW = 145 lbs; weight = 290 lbs; BMI = 31 kg/m2 client being treated for a peptic ulcer seeks medical attention for vomiting blood. Which statement indicates to the nurse the reason for the client developing hematemesis?  “The pain stopped so I stopped taking the medications.” When caring for a client with an acute exacerbation of a peptic ulcer, the nurse finds the client doubled up in bed with severe pain in the right shoulder. What is the initial appropriate action by the nurse? You Selected:  Assess the client's abdomen and vital signs. The nurse instructs a client with acute gastritis on lifestyle modifications. Which client statement indicates that additional teaching is required? You Selected:  “I will reduce the amount of smoking.” A nurse is caring for a client who is suspected to have developed a peptic ulcer hemorrhage. Which action would the nurse perform first?  Place the client in a recumbent position with the legs elevated. A patient presents to the walk-in clinic complaining of vomiting and burning in his mid-epigastria. The nurse knows that to confirm peptic ulcer disease, the health care provider is likely to order a diagnostic test to detect the presence of what? You Selected:  Infection with Helicobacter pylori A nurse is providing care for a client recovering from gastric bypass surgery. During assessment, the client exhibits pallor, perspiration, palpitations, headache, and feelings of warmth, dizziness, and drowsiness. The client reports eating 90 minutes ago. What will the nurse suspect? You Selected:  Vasomotor symptoms associated with dumping syndrome A client is admitted to the hospital with an exacerbation of chronic gastritis. When assessing the client's nutritional status, the nurse should expect to find what type of deficiency? You Selected:  vitamin B12 A patient comes to the bariatric clinic to obtain information about bariatric surgery. The nurse assesses the obese patient knowing that, in addition to meeting the criterion of morbid obesity, a candidate for bariatric surgery must also demonstrate what?  Emotional stability and understanding of required lifestyle changes. The nurse determines that teaching for the client with peptic ulcer disease has been effective when the client makes which statement?  "I have learned some relaxation strategies that decrease my stress." A nurse is teaching a client with gastritis about the need to avoid the intake of caffeinated beverages. The client asks why this is so important. Which explanation from the nurse would be most accurate?  “Caffeine stimulates the central nervous system and thus gastric activity and secretions, which need to be minimized to promote recovery.” A client is admitted to the health care facility with a diagnosis of a bleeding gastric ulcer. The nurse expects the client's stools to have which description?  Black and tarry The nurse is conducting a community education class on gastritis. The nurse includes that chronic gastritis caused by Helicobacter pylori is implicated in which disease/condition? You Selected:  Peptic ulcers Which of the following clients is at highest risk for peptic ulcer disease? You Selected:  Client with blood type O A client with peptic ulcer disease has a blood pressure of 88/40 mm Hg, dizziness, and nausea. Which complication will the nurse suspect is occurring with this client? You Selected:  Bleeding from the ulcer When caring for a client with an acute exacerbation of a peptic ulcer, the nurse finds the client doubled up in bed with severe pain in the right shoulder. What is the initial appropriate action by the nurse?  Assess the client's abdomen and vital signs. A client is preparing for discharge to home following a partial gastrectomy and vagotomy. Which is the best rationale for the client being taught to lie down for 30 minutes after each meal?  Slows gastric emptying The nurse is providing care to a client who has had a percutaneous liver biopsy. The nurse would monitor the client for which of the following? You Selected:  Signs and symptoms of bleeding The nurse is assessing a client with an ulcer for signs and symptoms of hemorrhage. The nurse interprets which condition as a sign/symptom of possible hemorrhage?  Hematemesis The nurse is conducting a community education class on gastritis. The nurse includes that chronic gastritis caused by Helicobacter pylori is implicated in which disease/condition?  Peptic ulcers A client who had a Roux-en-Y bypass procedure for morbid obesity ate a chocolate chip cookie after a meal. After ingestion of the cookie, the client reported cramping pains, dizziness, and palpitation. After having a bowel movement, the symptoms resolved. What should the nurse educate the client about regarding this event?  Dumping syndrome A client weighing 165 lb. (75 kg) is being treated for acute gastritis. Which amount of urine output for 4 hours would indicate an adequate fluid balance if the output should be 1 mL/kg/hour?  300 The nurse is completing a health history on a patient whose diagnosis is chronic gastritis. Which of the data below should the nurse consider most significantly related to the etiology of the patient's health problem?  Smokes two packs of cigarettes daily The nurse is performing detailed patient education with a 40-year-old woman who will be soon discharged following a Roux-en-Y gastric bypass. The nurse and other members of the interdisciplinary team have been emphasizing the need for eating small amounts of food at a sitting and eating food slowly. What is the rationale for the nurse's advice?  Nausea and esophageal distention can result from eating too fast. The nurse is providing care to a client who has had a percutaneous liver biopsy. The nurse would monitor the client for which of the following?  Signs and symptoms of bleeding A patient is scheduled for a Billroth I procedure for ulcer management. What does the nurse understand will occur when this procedure is performed?  A partial gastrectomy is performed with anastomosis of the stomach segment to the duodenum. A client with gastric ulcers caused by H. pylori is prescribed metronidazole. Which client statement indicates to the nurse that teaching about this medication was effective?  “It might cause a metallic taste in my mouth.” The nurse visits the home of a client recovering from acute gastritis. Which observation indicates that teaching about the disorder was effective?  Medications placed in a pillbox Which of the following appears to be a significant factor in the development of gastric cancer?  Diet Which term refers to the first portion of the small intestine?  Duodenum A nurse practitioner prescribes drug therapy for a patient with peptic ulcer disease. Choose the drug that can be used for 4 weeks and has a 90% chance of healing the ulcer.  Omeprazole A client is recovering from gastric surgery. Toward what goal should the nurse progress the client’s enteral intake?  Six small meals daily with 120 mL fluid between meals 70-year-old woman with a complex medical history made an appointment with her primary care provider because she has recently been experiencing heartburn, abdominal pain, and nausea. The clinician has identified that the woman's symptoms are characteristic of acute gastritis. Which of the woman's following statements is suggestive of the etiology of her problem? You Selected:  “I've changed from taking Tylenol for my arthritis pain to taking aspirin.” The nurse reviews dietary guidelines with a client who had a gastric banding. Which teaching points are included? Select all that apply. Do not eat and drink at the same time. Drink plenty of water, from 90 minutes after each meal to 15 minutes before each meal. Avoid fruit drinks and soda. Clients with Type O blood are at higher risk for which of the following GI disorders? You Selected:  Duodenal ulcers Which medication classification represents a proton (gastric acid) pump inhibitor? You Selected:  Omeprazole The nurse in the ED admits a client with suspected gastric outlet obstruction. The client’s symptoms include nausea and vomiting. The nurse anticipates that the physician will issue which order?  Nasogastric tube insertion During a home visit the nurse notes that a client recovering from peptic ulcer disease is experiencing cool clammy skin and has a heart rate of 96 beats a minute. Which action will the nurse take?  Notify the primary health care provider. A health care provider suspects that a client has peptic ulcer disease. With which diagnostic procedure would the nurse most likely prepare to assist?  Endoscopy The nurse is performing detailed patient education with a 40-year-old woman who will be soon discharged following a Roux-en-Y gastric bypass. The nurse and other members of the interdisciplinary team have been emphasizing the need for eating small amounts of food at a sitting and eating food slowly. What is the rationale for the nurse's advice? You Selected:  Nausea and esophageal distention can result from eating too fast. Correct response:  Nausea and esophageal distention can result from eating too fast. Explanation: Reference:  Honan, L., Focus on Adult Health: Medical-Surgical Nursing, 2nd ed., Philadelphia, Wolters Kluwer, 2019, Chapter 23: Nursing Management: Patients With Gastric and Duodenal Disorders, Nursing Management, p. 703. Chapter 23: Nursing Management: Patients With Gastric and Duodenal Disorders - Page 703 Question 2 18s A client with an H. pylori infection asks why bismuth subsalicylate is prescribed. Which response will the nurse make? You Selected:  “It aids in the healing of the stomach lining.” Correct response:  “It aids in the healing of the stomach lining.” Explanation: Reference:  Honan, L., Focus on Adult Health: Medical-Surgical Nursing, 2nd ed., Philadelphia, Wolters Kluwer, 2019, Chapter 23: Nursing Management: Patients With Gastric and Duodenal Disorders. Question 3 14s See full question Rebleeding may occur from a peptic ulcer and often warrants surgical interventions. Signs of bleeding include which of the following? You Selected:  Bradycardia Correct response:  Mental confusion Explanation: Reference:  Honan, L., Focus on Adult Health: Medical-Surgical Nursing, 2nd ed., Philadelphia, Wolters Kluwer, 2019, Chapter 23: Nursing Management: Patients With Gastric and Duodenal Disorders, p. 700. Chapter 23: Nursing Management: Patients With Gastric and Duodenal Disorders - Page 700 Question 4 See full question 4s Which medication is classified as a histamine-2 receptor antagonist? You Selected:  Famotidine Correct response:  Famotidine Explanation: Reference:  Honan, L., Focus on Adult Health: Medical-Surgical Nursing, 2nd ed., Philadelphia, Wolters Kluwer, 2019, Chapter 23: Nursing Management: Patients With Gastric and Duodenal Disorders, pp. 693-694. Chapter 23: Nursing Management: Patients With Gastric and Duodenal Disorders - Page 693-694