Lower GI Disorders Flashcards
A nurse is caring for a patient who just has been diagnosed with a peptic ulcer. When teaching the patient about his new diagnosis, how should the nurse best describe a peptic ulcer?
A. Inflammation of the lining of the stomach
B. Erosion of the lining of the stomach or intestine
C. Bleeding from the mucosa in the stomach
D. Viral invasion of the stomach wall
B. Erosion of the lining of the stomach or intestine
A patient comes to the clinic complaining of pain in the epigastric region. What assessment question during the health interview would most help the nurse determine if the patient has a peptic ulcer?
A. Does your pain resolve when you have something to eat?
B. Do OTC pain medications help your pain?
C. Does your pain get worse if you get up and do some exercise?
D. Do you find that your pain is worse when you need to have a BM?
A. Does your pain resolve when you have something to eat?
A patient with a diagnosis of peptic ulcer disease has just been prescribed omeprazole (Prilosec). How should the nurse best describe this medication’s therapeutic action?
A. This medication will reduce the amount of acid secreted in your stomach
B. This medication will make the lining of your stomach more resistant to damage
C. This medication will specifically address the pain that accompanies peptic ulcer disease
D. This medication will help your stomach lining to repair itself
A. This medication will reduce the amount of acid secreted in your stomach
A nurse is admitting a patient diagnosed with late-stage gastric cancer. The patient’s family is distraught and angry that she was not diagnosed earlier in the course of her disease. What factor contributes to the fact that gastric cancer is often detected at a later stage?
A. Gastric cancer doesn’t cause signs or symptoms until metastasis has occurred
B. Adherence to screening recommendations for gastric cancer is exceptionally low
C. Early symptoms of gastric cancer are usually attributed to constipation
D. The early symptoms of gastric cancer are usually not alarming or highly unusual
D. The early symptoms of gastric cancer are usually not alarming or highly unusual
A nurse is preparing to discharge a patient after recovery from gastric surgery. What is an appropriate discharge outcome for this patient?
A. The patient’s bowel movements maintain a loose consistency
B. The patient is able to tolerate three large meals a day
C. The patient maintains or gains weight
D. The patient consumes a diet high in calcium
C. The patient maintains or gains weight
A nurse caring for a patient who has had bariatric surgery is developing a teaching plan in anticipation of the patient’s discharge. Which of the following is essential to include?
A. Drink a minimum of 12 oz of fluid with each meal
B. Eat several small meals daily spaced at equal intervals
C. Choose foods that are high in simple carbohydrates
D. Sit upright when eating and for 30 minutes afterward
B. Eat several small meals daily spaced at equal intervals
A nurse is completing a health history on a patient whose diagnosis is chronic gastritis. Which of the data should the nurse consider most significantly related to the etiology of the patient’s health problem?
A. Consumes one or more protein drinks daily
B. Takes OTC antacids frequently throughout the day
C. Smokes one pack of cigarettes daily
D. Reports a history of social drinking on a weekly basis
C. Smokes one pack of cigarettes daily
A nurse in the post anesthesia care unit admits a patient following resection of a gastric tumor. Following immediate recovery, the patient should be placed in which position to facilitate patient comfort and gastric emptying?
A. Fowler’s
B. Supine
C. Left lateral
D. Left Sim’s
A. Fowler’s
A community health nurse is preparing for an initial home visit to a patient discharged following a total gastrectomy for treatment of gastric cancer. What would the nurse anticipate that the plan of care is most likely to include?
A. Enteral feeding via G tube
B. GI decompression by NG tube
C. Periodic assessment for esophageal distension
D. Monthly administration of injection of vitamin B12
D. Monthly administration of injection of vitamin B12
A nurse is assessing a patient who has peptic ulcer disease. The patient requests more information about the typical causes of Helicobacter pylori infection. What would it be appropriate for the nurse to instruct the patient?
A. Most affected patients acquired the infection during international travel
B. Infection typically occurs due to ingestion of contaminated food and water
C. Many people possess genetic factors causing a predisposition to H. Pylori infection
D. The H. Pylori microorganism is endemic in warm, moist climates
B. Infection typically occurs due to ingestion of contaminated food and water
A patient who experienced an upper GI bleed due to gastritis has had the bleeding controlled the patient’s condition is now stable. For the next several hours, the nurse caring for this patient should assess for what signs and symptoms of recurrence?
A. Tachycardia, hypotension, and tachypnea
B. Tarry, foul-smelling stools
C. Diaphoresis and sudden onset of abdominal pain
D. Sudden thirst, unrelieved by oral fluid administration
A. Tachycardia, hypotension, and tachypnea
A patient presents to the walk-in clinic complaining of vomiting and burning in her mid-epigastria. The nurse knows that in the process of confirming peptic ulcer disease, the physician is likely to order a diagnostic test to detect the presence of what?
A. Infection with Helicobacter pylori
B. Excessive stomach acid secretion
C. An incompetent pyloric sphincter
D. A metabolic acid-base imbalance
A. Infection with Helicobacter pylori
A patient with a peptic ulcer disease has had metronidazole (flagyl) added to his current medication regiment. What health education related to this medication should the nurse provide?
A. Take the medication on an empty stomach
B. Take up to one extra dose per day if stomach pain persists
C. Take at bedtime to mitigate the effects of drowsiness
D. Avoid drinking alcohol while taking the drug
D. Avoid drinking alcohol while taking the drug
A patient was treated in the emergency department and critical care unit after ingesting bleach. What possible complication of the resulting gastritis should the nurse recognize?
A. Esophageal or pyloric obstruction related to scarring
B. Uncontrolled proliferation of H. Pylori
C. Gastric hyperacidity related to excessive gastric secretion
D. Chronic referred pain in the lower abdomen
A. Esophageal or pyloric obstruction related to scarring
A patient who underwent gastric banding 3 days ago is having her diet progressed on a daily basis. Following her last eat meal, the patient complains of dizziness and palpitations. Inspection reveals that the patient is diaphoretic. What is the nurse’s best action?
A. Insert a NG tube promptly
B. Reposition the patient supine
C. Monitor the patient closely for further signs of dumping syndrome
D. Assess the patient for signs and symptoms of aspiration
C. Monitor the patient closely for further signs of dumping syndrome
A patient is one month postop following restrictive bariatric surgery. The patient tells the clinic nurse that he has been having trouble swallowing for the past few days. What recommendation should the nurse make?
A. Eating more slowly and chewing food more thoroughly
B. Taking an OTC antacid or drinking a glass of milk prior to each meal
C. Chewing gum to cause relaxation of the lower esophageal sphincter
D. Drinking at least 12 oz of liquid with each meal
A. Eating more slowly and chewing food more thoroughly
A patient is receiving education about his upcoming Billroth I procedure (gastroduodenostomy). This patient should be informed that he may experience which of the following adverse effects associate with this procedure?
A. Persistent feelings of hunger and thirst
B. Constipation or bowel incontinence
C. Diarrhea and feelings of fullness
D. Gastric reflux and belching
C. Diarrhea and feelings of fullness
A patient has experienced symptoms of dumping syndrome following bariatric surgery. To what physiologic phenomenon does the nurse attribute this syndrome?
A. Irritation of the phrenic nerve due to diaphragmatic pressure
B. Chronic malabsorption of iron and vitamins A & C
C. Reflux of bile into the distal esophagus
D. A sudden release of peptides
D. A sudden release of peptides
A patient comes to the bariatric clinic to obtain information about bariatric surgery. The nurse assesses the obese patient bowing that in addition to meeting the criterion of morbid obesity, a candidate for bariatric surgery must also demonstrate what?
A. Knowledge of the causes of obesity and its associated risks
B. Adequate understanding of required lifestyle changes
C. Positive body image and high self-esteem
D. Insight into why past weight loss efforts failed
B. Adequate understanding of required lifestyle changes
A nurse is providing patient education for a patient with peptic ulcer disease secondary to chronic NSAID use. The patient has recently been prescribed misoprostol (Cytotec). What would the nurse be most accurate in informing the patient about the drug?
A. It reduces the stomach’s volume of Hcl
B. It increases the speed of gastric emptying
C. It protects the stomach’s lining
D. It increases lower esophageal sphincter pressure
C. It protects the stomach’s lining
A nurse is providing anticipatory guidance to a patient who is preparing for bariatric surgery. The nurse learns that the patient is anxious about numerous aspects of the surgery. What intervention is most appropriate to alleviate the patient’s anxiety?
A. Emphasize the fact that bariatric surgery has a low risk of complications
B. Encourage the patient to focus on the benefits of the surgery
C. Facilitate the patient’s contact with a support group
D. Obtain an order for a PRN benzodiazepine
C. Facilitate the patient’s contact with a support group
A patient has just been diagnosed with acute gastritis after presenting in distress to the ED with a ordinal symptoms. What would be the nursing care most needed by the patient at this time?
A. Teaching the patient about necessary nutritional modification
B. Helping the patient weigh treatment options
C. Teaching the patient about the etiology of gastritis
D. Providing the patient with physical and emotional support
D. Providing the patient with physical and emotional support
A nurse is providing care for a patient who is postop day 2 following gastric surgery. The nurse’s assessment should be planned in light of the possibility of what potential complications? SATA.
A. Malignant hyperthermia
B. Atelectasis
C. Pneumonia
D. Metabolic imbalances
E. Chronic gastritis
B. Atelectasis
C. Pneumonia
D. Metabolic imbalances
A patient is undergoing diagnostic testing for a tumor of the small intestine. What are the most likely symptoms that prompted the patient to first seek care?
A. Hematemesis and persistent sensation of fullness
B. Abdominal bloating and recurrent constipation
C. Intermittent pain and blood stool
D. Unexplained bowel incontinence and fatty stools
C. Intermittent pain and blood stool
A patient is recovering in the hospital following gastrectomy. The nurse notes that the patient has become increasingly difficult to engage and has had several angry outbursts at various staff members in recent days. The nurse’s attempts at therapeutic dialogue have been rebuffed. What is the nurse’s most appropriate action?
A. Ask the patient’s PCP to liaise between the nurse and the patient
B. Delegate care of the patient to a colleague
C. Limit contact with the patient in order to provide privacy
D. Make appropriate referrals to services that provide psychosocial support
D. Make appropriate referrals to services that provide psychosocial support
A patient has been admitted to the hospital after diagnostic imaging revealed the presence of a gastric outlet obstruction (GOO). What is the nurse’s priority intervention?
A. Administration of antiemetics
B. Insertion of an NG tube for decompression
C. Infusion of hypotonic IV solution
D. Administration of proton pump inhibitors as ordered
B. Insertion of an NG tube for decompression
A patient with a history of peptic ulcer disease has presented to the ED in distress. What assessment finding would lead the ED nurse to suspect that the patient has a perforated ulcer?
A. The patient has abdominal bloating that developed rapidly
B. The patient has a rigid, boardlike abdomen that is tender
C. The patient is experiencing intense lower right quadrant pain
D. The patient is experiencing dizziness and confusion with no apparent hemodynamic changes
B. The patient has a rigid, boardlike abdomen that is tender
Diagnostic imaging and physical assessment have revealed that a patient with peptic ulcer disease has suffered a perforated ulcer. The nurse recognizes that emergency interventions must be performed as soon as possible in order prevent the development of what complication?
A. Peritonitis
B. Gastritis
C. Gastroesophageal reflux
D. Acute pancreatitis
A. Peritonitis
A nurse is performing the admission assessment of a patient whose high BMI corresponds to class II obesity. In order to ensure empathic and patient-centered care, the nurse should do which of the following?
A. Examine one’s own attitudes towards obesity in general and the patient in particular
B. Dialogue with the patient about the lifestyle and psychosocial factors that resulted in obesity
C. Describe one’s own struggles with weight gain and weight loss to the patient
D. Elicit the patient’s short-term and long-term goals for weight loss
A. Examine one’s own attitudes towards obesity in general and the patient in particular
A patient has been prescribed orlistat (Xenical) for the treatment of obesity. When providing relevant health education for this patient, the nurse should ensure the patient is aware of what potential adverse effect of treatment?
A. Bowel incontinence
B. Flatus with oily discharge
C. Abdominal pain
D. Heat intolerance
B. Flatus with oily discharge
A patient who is obese has been unable to lose weight successfully using lifestyle modification and has mentioned the possibility of using weight-loss medications. What should the nurse teach the patient about pharmacologic interventions for the treatment of obesity?
A. Weight loss drugs have many side effects, and most doctors think they’ll all be off the market in a few years
B. There used to be a lot of hope that medications would help people lose weight, but it’s been shown to be mostly a placebo effect
C. Medications can be helpful, but few people achieve and maintain their desired weight loss with medications alone
D. Medications are rapidly become the preferred method of weight loss in people for whom diet and exercise have not worked
C. Medications can be helpful, but few people achieve and maintain their desired weight loss with medications alone
A patient has been diagnosed with peptic ulcer disease and the nurse is reviewing his prescribed medication regimen with him. What is currently the most commonly used drug regimen for peptic ulcers?
A. Bismuth salts, antivirals, and histamine-2 (H2) antagonists
B. H2 antagonists, antibiotics, and bicarbonate salts
C. Bicarbonate salts, antibiotics, and ZES
D. Antibiotics, proton pump inhibitors, and bismuth salts
D. Antibiotics, proton pump inhibitors, and bismuth salts
