Chapter 44 Upper Gastro Problems

Question 1

1. The daughter of a client calls to tell the nurse that her 85-year-old mother has been nauseated all day and has vomited twice. Before the nurse hangs up and telephones the health care provider to communicate the assessment data, what does the nurse instruct the client’s daughter to do?
   a. Administer antispasmodic drugs and observe skin turgor.
   b. Give her mother sips of water and elevate the head of her bed to prevent aspiration.
   c. Offer her mother a high-protein liquid supplement to drink to maintain her nutritional needs.
   d. Offer her mother large quantities of Gatorade to drink because older adults are at risk for sodium depletion.

Answer 1

B

Question 2

2. The nurse explains to a patient with Vincent’s infection that treatment will include which of the following?
   a. Smallpox vaccinations
   b. Viscous lidocaine rinses
   c. Amphotericin B suspension
   d. Topical application of antibiotics

Answer 2

D

Question 3

3. The nurse is involved in health promotion related to oral cancer. Which behaviours are included in the teaching of adolescents with regard to behaviours that put them at risk for oral cancer? (Select all that apply)
   a. Avoiding use of perfumed lip gloss
   b. Discouraging use of chewing gum
   c. Avoiding use of smokeless tobacco
   d. Discouraging drinking of carbonated beverages
   e. Avoiding excessive alcohol consumption

Answer 3

C E

Question 4

4. What information is included when the nurse is explaining gastro-esophageal reflux disease (GERD) to a client with GERD?
   a. Results in acid erosion and ulceration of the esophagus caused by frequent vomiting
   b. Will require surgical wrapping or repair of the pyloric sphincter to control the symptoms
   c. Is the protrusion of a portion of the stomach into the esophagus through an opening in the diaphragm
   d. Often involves relaxation of the lower esophageal sphincter, allowing stomach contents to back up into the esophagus

Answer 4

D

Question 5

5. A client who has undergone an esophagectomy for esophageal cancer develops increasing pain, fever, and dyspnea when a full liquid diet is started postoperatively. What are these symptoms most indicative of?
   a. An intolerance to the feedings
   b. Extension of the tumour into the aorta
   c. Leakage of fluid or foods into the mediastinum
   d. Esophageal perforation with fistula formation into the lung

Answer 5

C

Question 6

6. The pernicious anemia that may accompany gastritis is caused by which of the following?
   a. Chronic autoimmune destruction of cobalamin stores in the body
   b. Progressive gastric atrophy from chronic breakage in the mucosal barrier and blood loss
   c. A lack of intrinsic factor normally produced by acid-secreting cells of the gastric mucosa
   d. Hyperchlorhydria resulting from an increase in acid-secreting parietal cells and degradation of red blood cells

Answer 6

C

Question 7

7. For the client being discharged after an acute episode of gastrointestinal (GI) bleeding, what information would the nurse’s teaching plan include?
   a. Taking only drugs prescribed by the health care provider
   b. Avoiding taking ASA (Aspirin) with acidic beverages such as orange juice
   c. Taking all drugs 1 hour before mealtime to prevent further bleeding
   d. Reading all over-the-counter (OTC) drug labels to avoid those containing stearic acid and calcium

Answer 7

A

Question 8

8. The nurse is teaching the client and her family about possible causes of peptic ulcers. How does the nurse explain ulcer formation?
   a. Caused by a stressful lifestyle and other acid-producing factors such as Helicobacter pylori
   b. Inherited within families and reinforced by bacterial spread of Staphylococcus aureus in childhood
   c. Promoted by factors that tend to cause over secretion of acid, such as excess dietary fats, smoking, and H. pylori
   d. Promoted by a combination of possible factors that may result in erosion of the gastric mucosa, including certain drugs and alcohol

Answer 8

D

Question 9

9. What information should be included in an optimal teaching plan for an outpatient with gastric cancer who is receiving radiation therapy?
   a. Cancer support groups, alopecia, and stomatitis
   b. Avitaminosis, ostomy care, and community resources
   c. Prosthetic devices, skin conductance, and grief counselling
   d. Wound and skin care, nutrition, drugs, and community resources

Answer 9

D

Question 10

10. Several clients are seen at an urgent care centre with symptoms of nausea, vomiting, and diarrhea that began 2 hours ago while they were attending a large family reunion potluck dinner. What kinds of foods that were ingested should the nurse question the patients specifically about? (Select all that apply)
    a. Beef
    b. Meat and milk
    c. Poultry and eggs
    d. Home-preserved vegetables
    e. Potato salad

Answer 10

B E