Chapter 41: Upper Gastrointestinal Problems

MULTIPLE CHOICE

1. Question: A 53-year-old male patient with deep partial-thickness burns from a chemical spill in the workplace experiences severe pain followed by nausea during dressing changes. Which action will be most useful in decreasing the patients nausea?
2. Question: Which item should the nurse offer to the patient who is to restart oral intake after being NPO due to nausea and vomiting?
3. Question: A 38-year old woman receiving chemotherapy for breast cancer develops a Candida albicans oral infection.  The nurse will anticipate the need for
4. Question: Which finding in the mouth of a patient who uses smokeless tobacco is suggestive of oral cancer?
5. Question: Which information will the nurse include when teaching adults to decrease the risk for cancers of the tongue and buccal mucosa?
6. Question: A 46-year-old female with gastroesophageal reflux disease (GERD) is experiencing increasing discomfort. Which patient statement indicates that additional teaching about GERD is needed?
7. Question: A 68-year-old male patient with a stroke is unconscious and unresponsive to stimuli. After learning that the patient has a history of gastroesophageal reflux disease (GERD), the nurse will plan to do frequent assessments of the patients
8. Question: The nurse explaining esomeprazole (Nexium) to a patient with recurring heartburn describes that the medication
9. Question: Which patient choice for a snack 2 hours before bedtime indicates that the nurses teaching about gastroesophageal reflux disease (GERD) has been effective?
10. Question: The nurse will anticipate teaching a patient experiencing frequent heartburn about
11. Question: A 58-year-old woman who recently has been diagnosed with esophageal cancer tells the nurse, I do not feel ready to die yet. Which response by the nurse is most appropriate?
12. Question: Which information will the nurse include for a patient with newly diagnosed gastroesophageal reflux disease (GERD)?
13. Question: Which nursing action should be included in the postoperative plan of care for a patient after a laparoscopic esophagectomy?
14. Question: When a 72-year-old patient is diagnosed with achalasia, the nurse will teach the patient that
15. Question: A 50-year-old man vomiting blood-streaked fluid is admitted to the hospital with acute gastritis. To determine possible risk factors for gastritis, the nurse will ask the patient about
16. Question: The nurse determines that teaching regarding cobalamin injections has been effective when the patient with chronic atrophic gastritis states which of the following?
17. Question: Which medications will the nurse teach the patient about whose peptic ulcer disease is associated with Helicobacter pylori?
18. Question: Which action should the nurse in the emergency department anticipate for a 23-year-old patient who has had several episodes of bloody diarrhea?
19. Question: The nurse will anticipate preparing a 71-year-old female patient who is vomiting coffee-ground emesis for
20. Question: A 57-year-old man with Escherichia coli O157:H7 food poisoning is admitted to the hospital with bloody diarrhea and dehydration. Which order will the nurse question?
21. Question: Which information will the nurse include when teaching a patient with peptic ulcer disease about the effect of ranitidine (Zantac)?
22. Question: A 68-year-old patient with a bleeding duodenal ulcer has a nasogastric (NG) tube in place, and the health care provider orders 30 mL of aluminum hydroxide/magnesium hydroxide (Maalox) to be instilled through the tube every hour. To evaluate the effectiveness of this treatment, the nurse
23. Question: A 44-year-old man admitted with a peptic ulcer has a nasogastric (NG) tube in place. When the patient develops sudden, severe upper abdominal pain, diaphoresis, and a firm abdomen, which action should the nurse take?
24. Question: A 50-year-old patient who underwent a gastroduodenostomy (Billroth I) earlier today complains of increasing abdominal pain. The patient has no bowel sounds and 200 mL of bright red nasogastric (NG) drainage in the last hour. The highest priority action by the nurse is to
25. Question: Which patient statement indicates that the nurses teaching following a gastroduodenostomy has been effective?
26. Question: At his first postoperative checkup appointment after a gastrojejunostomy (Billroth II), a patient reports that dizziness, weakness, and palpitations occur about 20 minutes after each meal. The nurse will teach the patient to
27. Question: A 62-year-old man patient who requires daily use of a nonsteroidal antiinflammatory drug (NSAID) for the management of severe rheumatoid arthritis has recently developed melena. The nurse will anticipate teaching the patient about
28. Question: The health care provider prescribes antacids and sucralfate (Carafate) for treatment of a patients peptic ulcer. The nurse will teach the patient to take
29. Question: The health care provider prescribes antacids and sucralfate (Carafate) for treatment of a patients peptic ulcer. The nurse will teach the patient to take
30. Question: Which information about dietary management should the nurse include when teaching a patient with peptic ulcer disease (PUD)?
31. Question: A 73-year-old patient is diagnosed with stomach cancer after an unintended 20-pound weight loss. Which nursing action will be included in the plan of care?
32. Question: A 26-year-old patient with a family history of stomach cancer asks the nurse about ways to decrease the risk for developing stomach cancer. The nurse will teach the patient to avoid
33. Question: The nurse is assessing a patient who had a total gastrectomy 8 hours ago. What information is most important to report to the health care provider?
34. Question: A 58-year-old patient has just been admitted to the emergency department with nausea and vomiting. Which information requires the most rapid intervention by the nurse?
35. Question: A 26-year-old woman has been admitted to the emergency department with nausea and vomiting. Which action could the RN delegate to unlicensed assistive personnel (UAP)?
36. Question: A 49-year-old man has been admitted with hypotension and dehydration after 3 days of nausea and vomiting. Which order from the health care provider will the nurse implement first?
37. Question: Which patient should the nurse assess first after receiving change-of-shift report?
38. Question: A patient returned from a laparoscopic Nissen fundoplication for hiatal hernia 4 hours ago. Which assessment finding is most important for the nurse to address immediately?
39. Question: Which assessment should the nurse perform first for a patient who just vomited bright red blood?
40. Question: Which order from the health care provider will the nurse implement first for a patient who has vomited 1200 mL of blood?
41. Question: The nurse is administering IV fluid boluses and nasogastric irrigation to a patient with acute gastrointestinal (GI) bleeding. Which assessment finding is most important for the nurse to communicate to the health care provider?
42. Question: After the nurse has completed teaching a patient with newly diagnosed eosinophilic esophagitis about the management of the disease, which patient action indicates that the teaching has been effective?
43. Question: An 80-year-old who is hospitalized with peptic ulcer disease develops new-onset auditory hallucinations. Which prescribed medication will the nurse discuss with the health care provider before administration?
44. Question: The nurse and a licensed practical/vocational nurse (LPN/LVN) are working together to care for a patient who had an esophagectomy 2 days ago. Which action by the LPN/LVN requires that the nurse intervene?
45. Question: After change-of-shift report, which patient should the nurse assess first?