Med Surg Exam Peptic Ulcer

Peptic Ulcer 1. In the stomach lining, the parietal cells release _________ and the chief cells release __________ which both play a role in peptic ulcer disease. a. pepsin, hydrochloric acid b. pepsinogen, pepsin c. pepsinogen, gastric acid d. hydrochloric acid, and pepsinogen 2. A patient has developed a duodenal ulcer. As the nurse, you know that which of the following plays a role in peptic ulcer formation. Select ALL that apply: a. Spicy foods b. Helicobacter pylori c. NSAIDs d. Milk e. Zollinger-Ellison Syndrome 3. A patient arrives to the clinic for evaluation of epigastric pain. The patient describes the pain to be relieved by food intake. In addition, the patient reports awaking in the middle of the night with a gnawing pain in the stomach. Based on the patient's description this appears to be what type of peptic ulcer? a. Duodenal b. Gastric c. Esophageal d. Refractory 4. A peptic ulcer may occur in all of these areas except which? a. Duodenum b. Stomach c. Esophagus d. Jejunum 5. A class of students has learned about contributing factors to duodenal ulcers. What statement indicates to the professor that the students need a review? e. Gastric emptying is slowed, causing greater exposure of the mucosa to acid. f. Bleeding from duodenal ulcers causes hematemesis or melena. g. The characteristic pain begins 30 min to 2 hours after eating h. Duodenal ulcers occur with greater frequency than other types of peptic ulcers. 6. A client with a peptic ulcer is about to begin a therapeutic regimen that includes a bland diet, antacids, and famotidine. Before the client is discharged, the nurse should provide which instruction? a. "Eat three balanced meals every day." b. "Stop taking the drugs when your symptoms subside." c. "Avoid aspirin and products that contain aspirin." d. "Increase your intake of fluids containing caffeine." 8. The nurse is caring for a client with chronic gastritis. The nurse monitors the client knowing that this client is at risk for which vitamin deficiency? a. b. c. d. 9. Vitamin A Vitamin B12 Vitamin C Vitamin E Which assessment data indicate to the nurse the clients gastric ulcer has perforated? a. b. c. d. Complaints of sudden, sharp, substernal pain Rigid, boardlike abdomen with rebound tenderness Frequent, clay-colored, liquid stool Complaints of vague abdominal pain in the right upper quadrant the information. 10. Which of the following medications is classified as a proton pump inhibitor (PPI)? a. Omeprazole b. Nizatidine c. Cimetidine d. Famotidine 11. 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? a. “Caffeine stimulates the central nervous system and thus gastric activity and secretions, which need to be minimized to promote recovery.” b. “Caffeine increases the fluid volume in your system, which irritates your digestive organs.” c. “Caffeine intake can cause tears in your esophagus and intestines, which can lead to hemorrhage.” d. “Caffeine can interfere with absorption of vitamin B12, which leads to anemia and further digestive problems.” 12. A client with a history of peptic ulcer disease has presented to the emergency department (ED) in distress. What assessment finding would lead the ED nurse to suspect that the client has a perforated ulcer? a. The client has abdominal bloating that developed rapidly. b. The client has a rigid, "board-like" abdomen that is tender. c. The client is experiencing intense lower right quadrant pain. d. The client is experiencing dizziness and confusion with no apparent hemodynamic changes. 13. A healthcare provider prescribes a combination of drugs to treat reoccurring peptic ulcer disease, and the client asks the nurse the reason for all the medications. What teaching should the nurse review with the client? a. The antibiotics, prostaglandin E1 analogs, and bismuth salts will work together to suppress or eradicate H. pylori. b. The proton pump inhibitors, prostaglandin E1 analogs, and bismuth salts will suppress or eradicate H. pylori. c. The bismuth salts, antibiotics, and proton pump inhibitors will work together to suppress or eradicate H. pylori. d. The prostaglandin E1 analogs, antibiotics, and proton pump inhibitors will work together to suppress or eradicate H. pylori. 14. The nurse practitioner suspects that a patient may have a gastric ulcer after completing a history and physical exam. Select an indicator that can be used to help establish the distinction between gastric and duodenal ulcers. a. Amount of hydrochloric acid (HCL) secretion in the stomach b. Sensitivity to the use of nonsteroidal anti-inflammatory drugs (NSAIDs) c. Presence of H. pylori d. Patient's age 15. You are providing discharge teaching to a patient taking Sucralfate (Carafate). Which statement by the patient demonstrates they understand how to take this medication? a. "I will take this medication at the same time I take Ranitidine." b. "I will always take this medication on an empty stomach." c. "It is best to take this medication with antacids." d. "I will take this medication once a week." 16. Which statement is INCORRECT about Histamine-receptor blockers? a. "H2 blockers block histamine which causes the chief cells to decrease the secretion of hydrochloric acid." b. "Ranitidine and Famotidine are two types of histamine-receptor blocker medications." c. "Antacids and H2 blockers should not be given together." d. All the statements are CORRECT. 17. The nurse advises the patient who has just been diagnosed with acute gastritis to: a. Take an emetic to rid the stomach of the irritating products. b. Refrain from food until the GI symptoms subside. c. Restrict food and fluids for 12 hours. d. Restrict all food for 72 hours to rest the stomach. 18. A nurse is monitoring a client with peptic ulcer disease. Which assessment findings would most likely indicate perforation of the ulcer? Select all that apply. a. Tachycardia b. Hypotension c. Mild epigastric pain d. A rigid, board-like abdomen e. Diarrhea 19. A nurse is providing follow-up teaching at a clinic visit for a client recovering from gastric resection. The client reports sweating, diarrhea, nausea, palpitations, and the desire to lie down 15 to 30 minutes after meals. Based on the client's assessment, what will the nurse suspect? a. Dumping syndrome b. Dehiscence of the surgical wound c. Peritonitis d. A normal reaction to surgery