Upper GI Disorders

Question 1

A nurse is preparing to place a patient’s ordered NG tube. How should the nurse best determine the correct length of the NG tube?

A. Place distal tip to nose, then ear tip and end of xiphoid process
B. Instruct patient to lie prone and measure tip of nose to umbilical area
C. Insert the tube into the patient’s nose until secretions can be aspirated
D. Obtain an order from the physician for the length of the tube to insert

Answer 1

A. Place distal tip to nose, then ear tip and end of xiphoid process

Question 2

A patient is concerned about leakage of gastric contents out of the gastric sump tube the nurse has just inserted. What would the nurse do to prevent reflux gastric contents from coming through the blue vent of a gastric sump tube?

A. Prime the tubing with 20 mL of NS
B. Keep the vent lumen above the patient’s waist
C. Maintain the patient in a high fowler’s position
D. Have the patient pin the tube to the thigh

Answer 2

B. Keep the vent lumen above the patient’s waist

Question 3

A patient receiving tube feedings is experiencing diarrhea. The nurse and the physician suspect that the patient is experiencing dumping syndrome. What intervention is most appropriate?

A. Stop the tube feed and aspirate stomach contents
B. Increase the hourly feed rate so it finishes earlier
C. Dilute the concentration of the feeding solution
D. Administer fluid replace via IV

Answer 3

C. Dilute the concentration of the feeding solution

Question 4

A nurse is admitting a patient to the post surgical unit following a gastrostomy. When planning assessments, the nurse should be aware of what potential postop complication of gastrostomy?

A. Premature removal of the G tube
B. Bowel perforation
C. Constipation
D. Development of peptic ulcer disease (PUD)

Answer 4

A. Premature removal of the G tube

Question 5

A nursing education is reviewing the care of patients with feeding tubes and endotracheal tubes (ET). The educator has emphasized the need to check for tube placement in the stomach as well as residual volume. What is the main purpose of this nursing action?

A. Prevent gastric ulcers
B. Prevent aspiration
C. Prevent abdominal distention
D. Prevent diarrhea

Answer 5

B. Prevent aspiration

Question 6

The nurse is administering total parenteral nutrition (TPN) to a client who underwent surgery for gastric cancer. Which of the nurse’s assessments most directly addresses a major complication of TPN?

A. Checking the patient’s capillary blood glucose levels regularly
B. Having the patient frequently rate his or her hunger on a 10-point scale
C. Measuring the patient’s heart rhythm at least every 6 hours
D. Monitoring the patient’s LOC each shift

Answer 6

A. Checking the patient’s capillary blood glucose levels regularly

Question 7

A critical care nurse is caring for a patient diagnosed with acute pancreatitis. The nurse knows that the indications for starting parenteral nutrition (PN) for this patient are what?

A. 5% deficit in body weight compared to pre-illness weight and increased caloric need
B. Calorie deficit and muscle wasting combined with low electrolyte levels
C. Inability to take in adequate oral food or fluids within 7 days
D. Significant risk of aspiration coupled with decreased LOC

Answer 7

C. Inability to take in adequate oral food or fluids within 7 days

Question 8

A nurse is preparing to administer a patient’s IV fat emulsion simultaneously with parenteral nutrition (PN). Which of the following principles should guide the nurse’s action?

A. IV fat emulsions may be infused simultaneously with PN through a y-connector close to the infusion site and should be filtered
B. The nurse should prepare for placement of another IV line, as IV fat emulsions may not be infused simultaneously through the line used for PN
C. IV fat emulsions may be infused simultaneously with PN through a Y-connector close to the infusion site after running the emulsion through a filter
D. The IV fat emulsions can be piggy-backed into any exiting IV solution

Answer 8

A. IV fat emulsions may be infused simultaneously with PN through a y-connector close to the infusion site and should be filtered

Question 9

A nurse is participating in a patient’s care conference and the team is deciding between parenteral nutrition (PN) and a total nutritional admixture (TNA). What advantages are associated with providing TNA rather than PN?

A. TNA can be mixed by a certified RN
B. TNA can be administered over 8 hours, while PN requires 24-hour administration
C. TNA is less costly than PN
D. TNA doesn’t require use of micron filter

Answer 9

C. TNA is less costly than PN

Question 10

A nurse is initiating parenteral nutrition (PN) to a postop patient who has developed complications. The nurse should initiate therapy by performing which of the following actions?

A. Starting its a rapid infusion rate to meet the patient’s nutritional needs as quickly as possible
B. Initiating the infusion slowly and monitoring the patient’s fluid and glucose tolerance
C. Changing the rate of administration every 2 hours based on serum electrolyte values
D. Increasing the rate of infusion at mealtimes to mimic the circadian rhythm of the body

Answer 10

B. Initiating the infusion slowly and monitoring the patient’s fluid and glucose tolerance

Question 11

A patient’s physician has determined that for the next 3 to 4 weeks the patient will require parenteral nutrition (PN). The nurse should anticipate the placement of what type of venous access device?

A. Peripheral catheter
B. Nontunneled central catheter
C. Implantable port
D. Tunneled central catheter

Answer 11

B. Nontunneled central catheter

Question 12

A nurse is caring for a patient who has an order to discontinue the administration of parenteral nutrition. What should the nurse do to prevent the occurrence of rebound hypoglycemia in the patient?

A. Administer an isotonic dextrose solution for 1 to 2 hours after discontinuing the PN
B. Administer a hypertonic dextrose solution for 1 to 2 hours after discontinuing the PN
C. Administer 3 ampules of dextrose 50% immediately prior to discontinuing the PN
D. Administer 3 ampules of dextrose 50% 1 hour after discontinuing the PN

Answer 12

A. Administer an isotonic dextrose solution for 1 to 2 hours after discontinuing the PN

Question 13

A nurse is caring for a patient with subclavian central line who is receiving parenteral nutrition (PN). In preparing a care plan for this patient, what nursing diagnosis should the nurse prioritize?

A. Risk for Activity Intolerance related to the presence of subclavian catheter
B. Risk for Infection related to the presence of a subclavian catheter
C. Risk for Functional Urinary Incontinence related to the presence of a subclavian catheter
D. Risk for Sleep Deprivation related to the presence of a subclavian catheter

Answer 13

B. Risk for Infection related to the presence of a subclavian catheter

Question 14

A patient’s health decline necessitates the use of total parenteral nutrition. The patient has questioned the need for insertion of a central venous catheter, expressing a preference for a normal IV. The nurse should know that peripheral administration of high-concentration PN formulas is contraindicated because of the risk for what complication?

A. Chemical phlebitis
B. Hyperglycemia
C. Dumping syndrome
D. Line sepsis

Answer 14

A. Chemical phlebitis

Question 15

A nurse is providing care for a patient with a diagnosis of late-stage Alzheimer’s disease. The patient has just returned it the medical unit to begin supplemental feedings through an NG tube. Which of the nurse’s assessments addressed this patient’s most significant potential complication of feeding?

A. Frequent assessment of the patient’s abdominal girth
B. Assessment for hemorrhage front he nasal insertion site
C. Frequent lung auscultation
D. Vigilant monitoring of the frequency and character of BMs

Answer 15

C. Frequent lung auscultation

Question 16

The management of the patient’s gastrostomy is an assessment priority for the home care nurse. What statement would indicate that the patient is managing the tube correctly?

A. I clean my stoma twice a day with alcohol
B. The only time I flush my tube is when I’m putting in medications
C. I flush my tube with water before and after each of my medications
D. I try to stay still most of the time to avoid dislodging my tube

Answer 16

C. I flush my tube with water before and after each of my medications

Question 17

A nurse is caring for a patient with a NG tube for feeding. During shift assessment, the nurse auscultates a new onset of bilateral lung crackles and notes a RR of 30 breaths per minute. The patient’s oxygen saturation is 89% by pulse ox. After ensuring the patient’s immediate safety, what is the nurse’s most appropriate action?

A. Perform CPT
B. Reduce the height of the patient’s bed and remove the NG tube
C. Liaise with the dietitian to obtain a feeding solution with lower osmolality
D. Report possible signs of aspiration PNA to the PCP

Answer 17

D. Report possible signs of aspiration PNA to the PCP

Question 18

A nurse is creating a care plan for a patient with a NG tube. How should the nurse direct other members of the care team to check correct placement of the tube?

A. Auscultation the patient’s abdomen after injecting air through the tube
B. Assess the color and pH of aspirate
C. Locate the marking made after the initial x-ray confirming placement
D. Use a combo of at least two accepted methods for confirming placement

Answer 18

D. Use a combo of at least two accepted methods for confirming placement

Question 19

The nurse is assessing placement of a NG tube that the patient has had in place for 2 days. The tube is draining green aspirate. What is the nurse’s most appropriate action?

A. Inform the physician that the tube may be in the patient’s pleural space
B. Withdraw the tube 2-4 cm
C. Leave the tube in its present position
D. Advance the tube up to 8 cm

Answer 19

C. Leave the tube in its present position

Question 20

A patient’s new onset of dysphagia has required insertion of an NG tube for feeding; the nurse has modified the patient’s care plan accordingly. What intervention should the nurse include in the patient’s plan of care?

A. Confirm placement of the tube prior to each medication administration
B. Have the patient sip cool water to stimulate saliva production
C. Keep the patient in low Fowler’s position when at rest
D. Connect the tube to continuous wall suction when not in use

Answer 20

A. Confirm placement of the tube priori to each medication administration

Question 21

A patient has been brought to the ED by EMS after telling a family member that he deliberately took an overdose of NSAIDs a few minutes earlier. If lovage is ordered, the nurse should prepare to assist with the insertion of what type of tube?

A. NG tube
B. Levin tube
C. Gastric sump
D. Orogastric tube

Answer 21

D. Orogastric tube

Question 22

A patient’s NG tube has become clogged after the nurse instilled a medication that was in sufficiently crushed. The nurse has attempted to aspirate with a large-bore syringe, with no success. What should the nurse do next?

A. Withdraw the NG tube 3-5 cm and re-attempt aspiration
B. Attach a syringe filled with warm water and attempt an in-and-out motion of instilling and aspirating
C. Withdraw the NG tube slightly and attempt to dislodge by flicking the tube with the fingers
D. Remove the NG tube promptly and obtain an order for reinsertion from the PCP

Answer 22

B. Attach a syringe filled with warm water and attempt an in-and-out motion of instilling and aspirating

Question 23

A nurse has obtained an order to remove a patient’s NG tube and has prepared the patient accordingly. After flushing the tube and removing the nasal tape, the nurse attempts removal but is met with resistance. Because the nurse is unable to overcome this resistance, what is the most appropriate action?

A. Gently twist the tube before pulling
B. Instill a digestive enzyme solution and rest tempt removal in 10-15 minutes
C. Flush the tube with hot tap water and re-attempt removal
D. Report this finding to the patient’s PCP

Answer 23

D. Report this finding to the patient’s PCP

Question 24

A nurse is writing a care plan for a patient with a NG tube in place for gastric decompression. What risk nursing diagnosis is the most appropriate component of the care plan?

A. Risk for Excess Fluid Volume related to enteral feedings
B. Risk for Impaired Skin Integrity related to presence of NG tube
C. Risk for Unstable Blood Glucose related to enteral feedings
D. Risk for Impaired Verbal Communication related to presence of NG tube

Answer 24

B. Risk for Impaired Skin Integrity related to presence of NG tube

Question 25

A patient’s enteral feedings have been determined to be too concentrated based on the patient’s development of dumping syndrome. What physiological phenomenon caused this patient’s complication of enteral feeding?

A. Increased gastric secretion of HCl and gastric because of high osmolality of feeds
B. Entry of large amounts of water into the small intestine because of osmotic pressure
C. Mucosal irritation of the stomach and small intestine by the high concentration of the feed
D. Acid-base imbalance resulting from the high volume of solutes in the feed

Answer 25

B. Entry of large amounts of water into the small intestine because of osmotic pressure

Question 26

A nurse is creating a care plan for a patient who is receiving parenteral nutrition. The patient’s care plan should include nursing actions relevant to what potential complications? SATA.

A. Dumping syndrome
B. Clotted or displaced catheter
C. Pneumothorax
D. Hyperglycemia
E. Line sepsis

Answer 26

B. Clotted or displaced catheter
C. Pneumothorax
D. Hyperglycemia
E. Line sepsis

Question 27

A nurse is caring for a patient who has a GI tube in place. Which of the following are indications for GI intubation? SATA.

A. To remove gas from the stomach
B. To administer clotting factors to treat a GI bleed
C. To remove toxins from the stomach
D. To open sphincters that are close
E. To diagnose GI motility disorders

Answer 27

A. To remove gas from the stomach
C. To remove toxins from the stomach
E. To diagnose GI motility disorders

Question 28

A patient with dysphagia is scheduled for PEG tube insertion and asks the nurse how the tube will stay in place. What is the nurse’s best response?

A. Adhesive holds a flange in place against the abdominal skin
B. A stitch holds the tube in place externally
C. The tube is stitched to the abdominal skin externally and the stomach wall internally
D. An internal retention disc secures the tube against the stomach wall

Answer 28

D. An internal retention disc secures the tube against the stomach wall

Question 29

A patient is postop day 1 following gastrostomy. The nurse is planning interventions to address the nursing diagnosis of Risk for Infection related to Presence of Wound and Tube. What intervention is most appropriate?

A. Administer antibiotics via the tube as ordered
B. Wash the area around the tube with soap and water daily
C. Cleanse the skin within 2 cm of the insertion site with hydrogen peroxide once per shift
D. Irritate the skin surrounding the insertion site with NS before each use

Answer 29

B. Wash the area around the tube with soap and water daily

Question 30

The nurse is preparing the insert a patient’s ordered NG tube. What factor should the nurse recognize as a risk for incorrect placement?

A. The patient is obese and has a short neck
B. The patient is agitated
C. The patient has a history of gastric esophageal reflux disease (GERD)
D. The patient is being treated for PNA

Answer 30

B. The patient is agitated

Question 31

Prior to a patient’s scheduled jejunostomy, the nurse is performing the preop assessment. What goal should the nurse prioritize during the preop assessment?

A. Determine the patient’s nutritional needs
B. Determining that the patient fully understands the postop care required
C. Determining the patient’s ability to understand and cooperate with the procedure
D. Determining the patient’s ability to cope with an altered body image

Answer 31

C. Determining the patient’s ability to understand and cooperate with the procedure

Question 32

You are caring for a patient who was admitted to have a low-profile gastrostomy device (LPGD) placed. How soon after the original gastrostomy tube placement can an LPGD be placed?

A. 2 weeks
B. 4-6 weeks
C. 2-3 months
D. 4-6 months

Answer 32

C. 2-3 months

Question 33

A nurse is caring for a patient who is receiving parenteral nutrition. When writing this patient’s plan of care, which of the following nursing diagnoses should be included?

A. Risk for Peripheral Neurovascular Dysfunction related to catheter placement
B. Ineffective Role Performance related to parenteral nutrition
C. Bowel Incontinence related to parenteral nutrition
D. Chronic Pain related to catheter placement

Answer 33

B. Ineffective Role Performance related to parenteral nutrition

Question 34

A nurse is aware of the high incidence of catheter-related bloodstream infections in patients receiving parenteral nutrition. What nursing action has the greatest potential to reduce catheter-related bloodstream infections?

A. Use clean technique and wear a mask during dressing changes
B. Change the dressing no more than weekly
C. Apply antibiotic ointment around the site with each dressing change
D. Irrigate the insertion site with sterile water during each dressing change

Answer 34

B. Change the dressing no more than weekly

Question 35

A patient who suffered a stroke had an NG tube inserted to facilitate feeding shortly after admission. The patient has since become comatose and the patient’s family asks the nurse why the physician is recommending the removal of the patient’s NG tube and the insertion of a gastrostomy tube. What is the nurse’s best response?

A. It eliminates the risk for infection
B. Feeds can be infused a faster rate
C. Regurgitation and aspiration are less likely
D. It allows caregivers to provide personal hygiene more easily

Answer 35

C. Regurgitation and aspiration are less likely

Question 36

A patient has been discharged home on parenteral nutrition (PN). Much of the nurse’s discharge education focused on coping. What must a patient on PN likely learn to cope with? SATA.

A. Changes in lifestyle
B. Loss of eating as a social behavior
C. Chronic bowel incontinence from GI changes
D. Sleep disturbances related to frequent urination during nighttime infusions
E. Stress of choosing the correct PN formulation

Answer 36

A. Changes in lifestyle
B. Loss of eating as a social behavior
D. Sleep disturbances related to frequent urination during nighttime infusions

Question 37

A patient has a gastrostomy tube that has been placed to drain stomach contents by low intermittent suction. What is the nurse’s priority during the aspect of the patient’s care?

A. Measure and record drainage
B. Monitor drainage for change in color
C. Titration the suction every hour
D. Feed the patient via the G tube as ordered

Answer 37

A. Measure and record drainage

Question 38

A nurse is preparing to discharge a patient home on parenteral nutrition. What should an effective home care teaching program address? SATA.

A. Preparing the patient to troubleshoot for problems
B. Teaching the patient and family strict aseptic technique
C. Teaching the patient and family how to set up the infusion
D. Teaching the patient to flush the line with sterile water
E. Teaching the patient when it is safe to leave the access site open to air

Answer 38

A. Preparing the patient to troubleshoot for problems
B. Teaching the patient and family strict aseptic technique
C. Teaching the patient and family how to set up the infusion

Question 39

The nurse is caring for a patient who is postop from having a gastrostomy tube placed. What should the nurse do on a daily basis to prevent skin breakdown?

A. Verify tube placement
B. Loop adhesive tape around the tube and connect it securely to the abdomen
C. Gently rotate the tube
D. Change the wet-to-dry dressing

Answer 39

C. Gently rotate the tube

Question 40

A nurse is preparing to administer a patient’s scheduled parenteral nutrition (PN). Upon inspecting the bag, the nurse notices that the presence of small amounts of white precipitate are present in the bag. What is the nurse’s best action?

A. Recognize this as an expected finding
B. Place the bag in a warm environment for 30 minutes
C. Shake the bag vigorously for 10-20 seconds
D. Contact the pharmacy to obtain a new bag of PN

Answer 40

D. Contact the pharmacy to obtain a new bag of PN

Question 41

The patient has been diagnosed with a peptic ulcer. The patient asks the nurse, “what is a peptic ulcer?” Which of the following best describes 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. Bacterial invasion of the stomach wall

Answer 41

B. Erosion of the lining of the stomach or intestine

Question 42

The nurse asks the patient with a peptic ulcer to describe his pain. A patient with a peptic ulcer usually describes the pain as:

A. Gnawing
B. Sharp stabbing
C. Overdistended feeling
D. Cramping or aching

Answer 42

A. Gnawing

Question 43

A patient has been prescribed ranitidine. Which of the following statements would indicate that the patient correctly understands the actions of this medication?

A. “The medication inhibits acid secretions”
B. “The medication is an antibiotic”
C. “The medication is an analgesic”
D. “The medication will repair my ulcer”

Answer 43

A. “The medication inhibits acid secretions”

Question 44

The nurse suspects that the patient’s pain is related to a peptic ulcer when the patient states the pain is relieved by:

A. Eating
B. Drinking milk
C. Suppressing emesis
D. Having a BM

Answer 44

A. Eating

Question 45

A patient admitted with a peptic ulcer complains of right shoulder pain and is hypotensive. The nurse anticipates that the causes for these symptoms are related to:

A. Improper positioning in the bed
B. Ulcer perforation
C. Angina
D. A pulmonary infection

Answer 45

B. Ulcer perforation

Question 46

The nurse is concerned that the patient is experiencing progressive gastric cancer when she assesses which symptom?

A. Stomach pain relieved with antacids
B. Bloating
C. Diarrhea
D. Anemia

Answer 46

D. Anemia

Question 47

The patient is being discharged after gastric surgery. What is an appropriate discharge outcome for this patient?

A. The patient’s BMs are loose
B. The patient eats three meals a day
C. The patient maintains a reasonable weight
D. The patient consumes a diet high in calcium

Answer 47

C. The patient maintains a reasonable weight

Question 48

The nurse is bringing the meal tray to a patient who is receiving tetracycline therapy for the eradication of Helicobacter pylori. Upon taking the cover off of the tray, the nurse recognizes that the patient will not be allowed to eat which of the following foods?

A. Red meat
B. Yogurt
C. Whole wheat bread
D. Nuts

Answer 48

B. Yogurt

Question 49

The nurse is receiving a report from the PACU about a patient who is returning to the unit after a Billroth II (gastrojejunostomy). The nurse will assess for which complication related to this procedure?

A. Feeling of hunger
B. Constipation
C. Feeling of fullness
D. Gastric reflux

Answer 49

C. Feeling of fullness

Question 50

The nurse is caring for a patient who underwent a subtotal gastrectomy. To manage dumping syndrome, the nurse should advise the patient to:

A. Restrict fluid intake to 1 qt (1000 mL) per day
B. Drink liquids only with meals
C. Maintain NPO status
D. Drink liquids only between meals

Answer 50

D. Drink liquids only between meals

Question 51

During a routine follow-up exam, the nurse updates the patient’s medication history. The patient currently receives prednisone therapy. Concomitant use of an agent from which of the following classes could increase the risk of peptic ulcer disease?

A. Anti diabetic agents administered orally
B. NSAIDs
C. Beta-adrenergic blockers
D. Contraceptive agents administered orally

Answer 51

B. NSAIDs

Question 52

A patient with peptic ulcer disease secondary to chronic NSAID use is prescribed misoprostol (Cytotec). The nurse would be most accurate in informing the patient that the drug:

A. Reduces the stomach’s volume of HCl
B. Increases speed of gastric emptying
C. Protects the stomach’s lining
D. Increases lower esophageal sphincter pressure

Answer 52

C. Protects the stomach’s lining

Question 53

The nurse is developing a teaching plan for a patient who has undergone bariatric surgery. Which information listed below is essential to include?

A. Drink a minimum of 90 cc of fluid with each meal
B. Eat 6 small meals daily spaced at equal intervals
C. Choose foods high in carbohydrates especially simple sugars
D. Limit calories to no more than 1800 daily

Answer 53

B. Eat 6 small meals daily spaced at equal intervals

Question 54

The nurse is assessing an obese patient who expresses an interest in bariatric surgery. The nurse knows that in addition to meeting the criterion of morbid obesity, a candidate for bariatric surgery must also demonstrate which of the following?

A. Knowledge of the causes of obesity and its associated risks
B. Emotional stability and understanding of required lifestyle changes
C. Positive body image and high self-esteem
D. Insight into why their past weight loss efforts failed

Answer 54

B. Emotional stability and understanding of required lifestyle changes

Question 55

The nurse is caring for a 34-year-old obese female patient who underwent gastric banding 3 days ago. Essential postop teaching for this patient should include instruction related to the importance of abstaining from which of the following for the next two years?

A. Multivitamin supplements
B. Pregnancy
C. Antidepressants
D. Control-top panty hose

Answer 55

B. Pregnancy

Question 56

A patient is admitted to the ED after a suicide attempt during which she ingested liquid drain cleaner. Her diagnosis is acute gastritis and esophagitis. Which of the following nursing actions is a priority when caring for this patient?

A. Induce vomiting to minimize risk of esophageal damage
B. Prepare the patient for an immediate endoscopy
C. Administer an acidic antidote such as diluted vinegar
D. Place the patient in high-Fowler’s position to eliminate reflux

Answer 56

C. Administer an acidic antidote such as diluted vinegar

Question 57

A middle-age patient presents at the community clinic with abdominal pains and heartburn, which he says have persisted for several days following a particularly spicy meal. Which of the following complications would the nurse be particularly likely to assess for?

A. Esophageal or pyloric obstruction related to scarring
B. Acute systemic infection related to peritonitis
C. Gastric hyperacidity related to excessive gastric secretion
D. Chronic referred pain in the right shoulder

Answer 57

A. Esophageal or pyloric obstruction related to scarring

Question 58

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?

A. Consumes one or more protein drinks daily
B. Takes OTC antacids frequently throughout the day
C. Smokes two packs of cigarettes daily
D. Reports a history of social drinking on a daily basis

Answer 58

C. Smokes two packs of cigarettes daily

Question 59

The nurse is assisting a patient with a peptic ulcer to select his dinner menu. Which beverage would be most appropriate?

A. Vanilla milkshake
B. Decaffeinated coffee
C. Unsweetened iced tea
D. Room temperature grape juice

Answer 59

D. Room temperature grape juice

Question 60

A patient presents with vomiting and burning in his midepigastrium. The nurse knows that to confirm peptic ulcer disease, the physician is likely to order a diagnostic test to detect the presence of:

A. Infection with Helicobacter pylori
B. Excessive stomach acid secretion
C. Gastric irritation caused by NSAIDs
D. Overconsumption of spicy foods

Answer 60

A. Infection with Helicobacter pylori

Question 61

A patient is admitted to the post anesthesia care unit following resection of a gastric tumor. In which position should the patient be placed to facilitate both patient comfort and gastric emptying?

A. Semi-fowler’s
B. Dorsal recumbent
C. Side-lying
D. Left Simm’s

Answer 61

A. Semi-fowler’s

Question 62

The nurse is caring for a patient who experienced a gastric hemorrhage. The bleeding has been controlled, and his condition is now stable. The nurse’s priority should be frequent assessment of the patient for which of the following?

A. Tachycardia, hypotension, and tachypnea
B. Tarry, foul smelling stools
C. “Coffee ground” material in the NG tube drainage
D. Irritation of the nares and nasal mucosa

Answer 62

A. Tachycardia, hypotension, and tachypnea

Question 63

The nurse is assessing a patient on antibiotic therapy who requests more information about the typical causes of H. pylori infection. It would be appropriate for the nurse to instruct the patient that:

A. Most affected patients acquired the infection during international travel
B. Infection typically occurs due to ingestion of contaminated food and water
C. A genetic factor predisposing individuals to H. pylori infection is having type A blood
D. Person-to-person transmission of the H. pylori organism does not occur

Answer 63

B. Infection typically occurs due to ingestion of contaminated food and water

Question 64

The nurse is preparing for a home visit to a patient discharged following a total gastrectomy for treatment of gastric cancer. The nurse anticipates that the plan of care is most likely to include which of the following nursing actions?

A. Encouraging the patient to eat small, high-fiber meals at frequent intervals
B. GI decompression by the NG tube
C. Periodic assessment for esophageal distension
D. Monthly administration of injections of vitamin B

Answer 64

D. Monthly administration of injections of vitamin B

Question 65

The distressing symptoms of dumping syndrome result from the occurrence of which of the following physiological events?

A. Irritation of the phrenic nerve due to diaphragmatic pressure
B. Chronic malabsorption of iron and vitamins A and C
C. Reflux of bile into the distal esophagus
D. Osmotic transport of extracellular fluid into the GI tract

Answer 65

D. Osmotic transport of extracellular fluid into the GI tract

Question 66

A nurse is working with a patient who has chronic constipation. What should be included in patient teaching to promote normal bowel function?

A. Use glycerin suppositories on a regular basis
B. Limit physical activity in order to promote bowel peristalsis
C. Consume high-residue, high-fiber foods
D. Resist the urge to defecate until the urge becomes intense

Answer 66

C. Consume high-residue, high-fiber foods

Question 67

A nurse is preparing to provide care for a patient whose exacerbation of ulcerative colitis has required hospital admission. During an exacerbation of this health problem, the nurse would anticipate that the patient’s stools will have what characteristics?

A. Watery with blood and mucus
B. Hard and black or tarry
C. Dry and streaked with blood
D. Loose with visible fatty streaks

Answer 67

A. Watery with blood and mucus

Question 68

A patient has had an ileostomy created for the treatment of IBS and the patient is now preparing for discharge. What should the patient be taught about changing this device in the home setting?

A. Apply antibiotic ointment as ordered after cleaning the stoma
B. Apply a skin barrier to the peristomal skin prior to applying the pouch
C. Dispose of the clamp with each bag change
D. Cleanse the area surrounding the stoma with alcohol or chlorhexidine

Answer 68

B. Apply a skin barrier to the peristomal skin prior to applying the pouch

Question 69

A patient admitted with acute diverticulitis has experienced a sudden increase in temperature and complains of a sudden onset of exquisite abdominal tenderness. The nurse’s rapid assessment reveals that the patient’s abdomen is uncharacteristically rigid on palpation. What is the nurse’s best response?

A. Administer a Fleet enema as ordered and remain with the patient
B. Contact the PCP promptly and report these signs of perforation
C. Position the patient supine and insert an NG tube
D. Page the PCP and report that the patient may be obstructed

Answer 69

B. Contact the PCP promptly and report these signs of perforation

Question 70

A 35-year-old male patient presents at the ED with symptoms of a small bowel obstruction. In collaboration with the PCP, what intervention should the nurse prioritize?

A. Insertion of a NG tube
B. Insertion of a central venous catheter
C. Administration of a mineral oil enema
D. Administration of a glycerin suppository and an oral laxative

Answer 70

A. Insertion of a NG tube

Question 71

A patient admitted with inflammatory bowel disease asks the nurse for help with menu selections. What menu selection is most likely the best choice for this patient?

A. Spinach
B. Tofu
C. Multigrain bagel
D. Blueberries

Answer 71

B. Tofu

Question 72

A patient is admitted to the medical unit with a diagnosis of intestinal obstruction. When planning this patient’s care, which of the following nursing diagnoses should the nurse prioritize?

A. Ineffective Tissue Perfusion related to bowel ischemia
B. Imbalanced Nutrition: Less Than Body Requirements related to impaired absorption
C. Anxiety related to bowel obstruction and subsequent hospitalization
D. Impaired Skin Integrity related to bowel obstruction

Answer 72

A. Ineffective Tissue Perfusion related to bowel ischemia

Question 73

A nurse is presenting an educational event to a local community group. When speaking about colorectal cancer, what risk factor should the nurse cite?

A. High levels of alcohol consumption
B. History of bowel obstruction
C. History of diverticulitis
D. Long-standing psychosocial stress

Answer 73

A. High levels of alcohol consumption

Question 74

A patient’s screening colonoscopy revealed the presence of numerous polyps in the large bowel. What principle should guide the subsequent treatment of this patient’s health problem?

A. Adherence to a high-fiber diet will help the polyps resolve
B. The patient should be assured that these are a normal, age-related physiologic change
C. The patient’s polyps constitute a risk factor for cancer
D. The presence of polyps is associated with an increased risk of bowel obstruction

Answer 74

C. The patient’s polyps constitute a risk factor for cancer

Question 75

A nursing instructor is discussing hemorrhoids with the nursing class. Which patients would the nursing instructor identify as most likely to develop hemorrhoids?

A. A 45-year-old teacher who stands for 6 hours per day
B. A pregnant woman at 28 weeks’ gestation
C. A 37-year-old construction worker who does heavy lifting
D. A 60-year-old professional who is under stress

Answer 75

B. A pregnant woman at 28 weeks’ gestation

Question 76

A nurse is planning discharge teaching for a 21-year-old patient with a new diagnosis of ulcerative colitis. When planning family assessment, the nurse should recognize that which of the following factors will likely have the greatest impact on the patient’s coping after discharge?

A. The family’s ability to take care of the patient’s special diet needs
B. The family’s ability to monitor the patient’s changing health status
C. The family’s ability to provide emotional support
D. The family’s ability to manage the patient’s medication regimen

Answer 76

C. The family’s ability to provide emotional support

Question 77

An older adult who resides in an assisted living faculty has sought care from the nurse because of recurrent episodes of constipation. Which of the following actions should the nurse first perform?

A. Encourage the patient to take stool softener daily
B. Assess the patient’s food and fluid intake
C. Assess the patient’s surgical history
D. Encourage the patient to take fiber supplements

Answer 77

B. Assess the patient’s food and fluid intake

Question 78

A 16-year-old presents at the ED complaining of right lower quadrant pain and is subsequently diagnosed with appendicitis. When planning this patient’s nursing care, the nurse should prioritize what nursing diagnosis?

A. Imbalanced Nutrition: Less Than Body Requirements related to decreased oral intake
B. Risk for Infection related to possible rupture of appendix
C. Constipation related to decreased bowel motility and decreased fluid intake
D. Chronic Pain related to appendicitis

Answer 78

B. Risk for Infection related to possible rupture of appendix

Question 79

A nurse is talking with a patient who is scheduled to have a hemicolectomy with the creation of a colostomy. The patient admits to being anxious, and has many questions concerning the surgery, the care of a stoma, and necessary lifestyle changes. Which of the following nursing actions is most appropriate?

A. Reassure the patient that the procedure is relatively low risk and that patients are usually successful in adjusting to an ostomy
B. Provide the patient with educational materials that match the patient’s learning style
C. Encourage the patient to write down these concerns and questions to bring forward to the surgeon
D. Maintain an open dialogue with the patient and facilitate a referral to the wound-ostomy-continence (WOC) nurse

Answer 79

D. Maintain an open dialogue with the patient and facilitate a referral to the wound-ostomy-continence (WOC) nurse

Question 80

A nurse is caring for a patient with constipation whose PCP has recommended senna (Senokot) for the management of this condition. The nurse should provide which of the following education points?

A. Limit your fluid intake temporarily so you don’t get diarrhea
B. Avoid taking the drug on a long-term basis
C. Make sure to take a multivitamin with each dose
D. Take this on an empty stomach to ensure maximum effect

Answer 80

B. Avoid taking the drug on a long-term basis

Question 81

The nurse is caring for a patient who is undergoing diagnostic testing for suspected malabsorption. When taking this patient’s health history and performing the physical assessment, the nurse should recognize what finding as most consistent with this diagnosis?

A. Recurrent constipation coupled with weight loss
B. Foul-smelling diarrhea that contains fat
C. Fever accompanied by a rigid, tender abdomen
D. Blood bowel movements accompanied by fecal incontinence

Answer 81

B. Foul-smelling diarrhea that contains fat

Question 82

A nurse is caring for a patient admitted with symptoms of an anorectal infection; cultures indicate that the patient has a viral infection. The nurse should anticipate the administration of what drug?

A. Acyclovir (Zovirax)
B. Doxycycline (Vibramycin)
C. Penicillin
D. Metronidazole (Flagyl)

Answer 82

A. Acyclovir (Zovirax)

Question 83

A nurse caring for a patient with colorectal cancer is preparing the patient for upcoming surgery. The nurse administers cephalexin (Keflex) to the patient and explains what rationale?

A. To treat any undiagnosed infections
B. To reduce intestinal bacteria levels
C. To reduce bowel motility
D. To reduce abdominal distention postoperatively

Answer 83

B. To reduce intestinal bacteria levels

Question 84

A nurse is teaching a group of adults about screening and prevention of colorectal cancer. The nurse should describe which of the following as the most common sign of possible colon cancer?

A. Development of new hemorrhoids
B. Abdominal bloating and flank pain
C. Unexplained weight gain
D. Change in bowel habits

Answer 84

D. Change in bowel habits

Question 85

A nurse caring for a patient with a newly created ileostomy assesses the patient and notes that the patient has had not ostomy output for the past 12 hours. The patient also complains of worsening nausea. What is the nurse’s priority action?

A. Facilitate a referral to the wound-ostomy-continence (WOC) nurse
B. Report signs and symptoms of obstruction to the physician
C. Encourage the patient to mobilize in order to enhance motility
D. Contact the physician and obtain a swab of the stoma for culture

Answer 85

B. Report signs and symptoms of obstruction to the physician

Question 86

A nurse is working with a patient who is learning to care for a continent ileostomy (Kock pouch). Following the initial period of healing, the nurse is teaching the patient how to independently empty the ileostomy. The nurse should teach the patient to do which of the following actions?

A. Aim to eventually empty the pouch every 90 minutes
B. Avoid emptying the pouch until it is visibly full
C. Insert the catheter approximately 5 cm into the pouch
D. Aspirate the contents of the pouch using a 60 mL piston syringe

Answer 86

C. Insert the catheter approximately 5 cm into the pouch

Question 87

A nurse is providing care for a patient who has a diagnosis of IBS. When planning this patient’s care, the nurse should collaborate with the patient and prioritize what goal?

A. Patient will accurately identify foods that trigger symptoms
B. Patient will demonstrate appropriate care of his ileostomy
C. Patient will demonstrate appropriate use of standard infection control precautions
D. Patient will adhere to recommended guidelines for mobility and activity

Answer 87

A. Patient will accurately identify foods that trigger symptoms

Question 88

A patient has been experiencing disconcerting GI symptoms that have been worsening in severity. Following medical assessment, the patient has been diagnosed with lactose intolerance. The nurse should recognize an increased need for what form of health promotion?

A. Annual screening colonoscopies
B. Adherence to recommended immunization schedules
C. Regular BP monitoring
D. Frequent screening for osteoporosis

Answer 88

D. Frequent screening for osteoporosis

Question 89

An older adult has a diagnosis of Alzheimer’s disease and has recently been experiencing fecal incontinence. However, the nurse has observed no recent change in the character of the patient’s stools. What is the nurse’s most appropriate intervention?

A. Keep a food diary to determine foods that exacerbate the patient’s symptoms
B. Provide the patient with a blank, low-residue diet
C. Toilet the patient on a frequent, scheduled basis
D. Liaise with the PCP to obtain an order for loperamide

Answer 89

C. Toilet the patient on a frequent, scheduled basis

Question 90

An adult patient has been diagnoses with diverticulas disease after ongoing challenges with constipation. The patient will be treated on a outpatient basis. What components of treatment should the nurse anticipate? SATA.

A. Anticholinergic medications
B. Increased fiber intake
C. Enemas on alternating days
D. Reduced fat intake
E. Fluid reduction

Answer 90

B. Increased fiber intake
D. Reduced fat intake

Question 91

A patient’s health history is suggestive of inflammatory bowel disease. Which of the following would suggest Crohn’s disease, rather that ulcerative colitis, as the cause of the patient’s signs and symptoms?

A. A pattern of distinct exacerbations and remissions
B. Severe diarrhea
C. An absence of blood in stool
D. Involvement of the rectal mucosa

Answer 91

C. An absence of blood in stool

Question 92

During a patient’s scheduled home visit, an older adult patient has stated to the community health nurse that she has been experiencing hemorrhoids of increasing severity in recent months. The nurse should recommend which of the following?

A. Regular application of an OTC antibiotic ointment
B. Increased fluid and fiber intake
C. Daily use of OTC glycerin suppositories
D. Use of an NSAID to reduce inflammation

Answer 92

B. Increased fluid and fiber intake

Question 93

A nurse is providing care for a patient whose recent colostomy has contributed to a nursing diagnosis of Disturbed Body Image related to colostomy. What intervention best addresses this diagnosis?

A. Encourage the patient to conduct online research into colostomies
B. Engage the patient in the care of the ostomy to the extent that the patient is willing
C. Emphasize the fact that the colostomy was needed to alleviate a much more serious health problem
D. Emphasize the fact that the colostomy is temporary measure and is not permanent

Answer 93

B. Engage the patient in the care of the ostomy to the extent that the patient is willing

Question 94

A nurse is caring for a patient who has been admitted to the hospital with diverticulitis. Which of the following would be appropriate nursing diagnoses for this patient? SATA.

A. Acute Pain related to increased peristalsis and GI inflammation
B. Activity Intolerance related to generalized weakness
C. Bowel incontinence related to increased intestinal peristalsis
D. Deficient Fluid Volume related to anorexia, nausea, and diarrhea
E. Impaired Urinary Elimination related to GI pressure on the bladder

Answer 94

A. Acute Pain related to increased peristalsis and GI inflammation
B. Activity Intolerance related to generalized weakness
D. Deficient Fluid Volume related to anorexia, nausea, and diarrhea

Question 95

The nurse is providing care for a patient whose inflammatory bowel disease has necessitated hospital treatment. Which of the following would most likely be included in the patient’s medication regimen?

A. Anticholinergic medications 30 minutes before a meal
B. Antiemetics on a PRN basis
C. Vitamin B12 injections to prevent pernicious anemia
D. Beta adrenergic blockers to reduce bowel motility

Answer 95

A. Anticholinergic medications 30 minutes before a meal

Question 96

Patient’s colorectal cancer has necessitated a hemicolectomy with the creation of a colostomy. In the 4 days since the surgery, the patient has been unwilling to look at the ostomy or participate in any aspects of ostomy care. What is the nurse’s most appropriate response to this observation?

A. Ensure that the patient knows that he or she will be responsible for care after discharge
B. Reassure the patient that many people are fearful after the creation of an ostomy
C. Acknowledge the patient’s reluctance and initiate discussion of the factors underlying it
D. Arrange for the patient to be seen by a social worker or spiritual advisor

Answer 96

C. Acknowledge the patient’s reluctance and initiate discussion of the factors underlying it

Question 97

A nurse is caring for an older adult who has been experiencing severe C. difficile related diarrhea. When reviewing the patient’s most recent laboratory tests, the nurse should prioritize which of the following?

A. White blood cell level
B. Creatinine level
C. Hemoglobin level
D. Potassium level

Answer 97

D. Potassium level

Question 98

A nurse is assessing a patient’s stoma on postop day 3. The nurse notes that the stoma has a shiny appearance and a bright red color. How should the nurse best respond to this assessment finding?

A. Irrigate the ostomy to clear a possible obstruction
B. Contact the PCP to report this finding
C. Document that the stoma appears healthy and well perfused
D. Document a nursing diagnosis of Impaired Skin Integrity

Answer 98

C. Document that the stoma appears healthy and well perfused

Question 99

A patient has been diagnosed with a small bowel obstruction and has been admitted to the medical unit. The nurse’s care should prioritize which of the following outcomes?

A. Preventing infection
B. Maintain skin and tissue integrity
C. Preventing nausea and vomiting
D. Maintain fluid and electrolyte balance

Answer 99

D. Maintain fluid and electrolyte balance

Question 100

A patient’s large bowel obstruction has failed to resolve spontaneously and the patient’s worsening condition has warranted admission to the medical unit. Which of the following aspects of nursing care is most appropriate for this patient?

A. Administering bowel stimulants as ordered
B. Administering bulk-forming laxatives as ordered
C. Performing deep palpation as ordered to promote peristalsis
D. Preparing the patient for surgical bowel resection

Answer 100

D. Preparing the patient for surgical bowel resection

Question 101

A patient has been experiencing occasional episodes of constipation and has been unable to achieve consistent relief by increasing physical activity and improving his diet. What pharmacologic intervention should th nurse recommend to the patient for ongoing use?

A. Mineral oil enemas
B. Bisacodyl (Dulcolax)
C. Senna (Senokot)
D. Psyllium hydrophilic mucilloid (Metamucil)

Answer 101

D. Psyllium hydrophilic mucilloid (Metamucil)

Question 102

A patient with a diagnosis of colon cancer is 2 days postop following bowel resection and anastomosis. The nurse has planned the patient’s care in the knowledge of potential complications. What assessment should the nurse prioritize?

A. Close monitoring of temperature
B. Frequent abdominal auscultation
C. Assessment of hemoglobin, hematocrit, and red blood cell levels
D. Palpation of peripheral pulses and leg girth

Answer 102

B. Frequent abdominal auscultation

Question 103

A teenage patient with a pilonidal cyst has been brought for care by her mother. The nurse who is contributing the patient’s care knows that treatment will be chosen based on what risk?

A. Risk for infection
B. Risk for bowel incontinence
C. Risk for constipation
D. Risk for impaired tissue perfusion

Answer 103

A. Risk for infection

Question 104

A nurse at an outpatient surgery center is caring for a patient who had a hemorrhoidectomy. What discharge education topics should the nurse address with this patient?

A. The appropriate use of antibiotics to prevent postop infection
B. The correct procedure for taking a sitz bath
C. The need to eat a low-residue, low-fat diet for the next 2 weeks
D. The correct technique for keeping the perianal region clean without the use of water

Answer 104

B. The correct procedure for taking a sitz bath

Question 105

Which of the following is the most plausible nursing diagnosis for a patient whose treatment for colon cancer has necessitated a colonostomy?

A. Risk for Unstable Blood Glucose due to changes in digestion and absorption
B. Unilateral Neglect related to decreased physical mobility
C. Risk for Excess Fluid Volume related to dietary changes and changes in absorption
D. Ineffective Sexuality Patterns related to changes in self-concept

Answer 105

D. Ineffective Sexuality Patterns related to changes in self-concept

Question 106

Amoxicillin

Answer 106

ABX

Bactericidal antibiotic that assists with eradicating H. Pylori Bactria in gastric mucosa

Nursing considerations: may cause abdominal pain, diarrhea; allergies to penicillin

Question 107

Clarithromycin

Answer 107

ABX

Exerts bactericidal effects to eradicate H. Pylori bacteria in the gastric mucosa

Nursing consideration: GI upset, HA, altered taste; interacts with grapefruit juice, colchicine, lovastatin, warfarin

Question 108

Metronidazole

Answer 108

ABX

Synthetic antibacterial and antiprotozoal agent that assists with eradicating H. Pylori bacteria in the gastric mucosa when given with other Abx and PPIs

Nursing consideration: take with food; can cause anorexia, metallic taste; avoid ETOH; increases blood thinning effects of warfarin

Question 109

Tetracycline

Answer 109

ABX

Exerts bacteriostatic effects to eradicate H. Pylori bacteria in the gastric mucosa

Nursing considerations: can cause photosensitivity reaction, use sunscreen; GI upset; caution with renal/hepatic impaired; milk, dairy products REDUCE effectiveness

Question 110

Bismuth subsalicylate

Answer 110

Antidiarrheal

Suppresses H. Pylori bacteria in the gastric mucosa and assists with healing of mucosal ulcers

Nursing considerations: given with Abx to eradicate H. Pylori; take on EMPTY stomach; can darken BMs

Question 111

Cimetidine

Answer 111

H2 receptor antagonist

Decreases amount of HCl produced by stomach by blocking action of histamine on histamine receptors of parietal cells in the stomach

Nursing considerations: least expensive; can cause confusion, agitation, coma in elderly or renal/hepatic insufficiency; long term use can cause diarrhea, dizziness, Gynecomastia; interacts with amiodarone, amitriptyline, benzos, metoprolol, nifedipine, phenytoin, warfarin

Question 112

Famotidine

Answer 112

H2 receptor antagonists

decreases amount of HCl produced by stomach by blocking action of histamine on histamine receptions of parietal cells in the stomach

Nursing considerations: least risk of drug-drug interactions; prolonged half-life in patients with renal insufficiency; short term relief for GERD

Question 113

Nizatidine

Answer 113

H2 receptor antagonist

decreases amount of HCl produced by stomach by blocking action of histamine on histamine receptions of parietal cells in the stomach

Nursing considerations: used to Tx ulcers, GERD; prolonged half-life in patients with renal insufficiency; can cause HA, dizziness, diarrhea, NV, GI upset, urticaria

Question 114

Esomeprazole

Answer 114

PPI

Decreases gastric acid secretion by slowing the H+, K+ -ATPase pump on the surface of the parietal cells of the stomach

Nursing considerations: treatment of duodenal ulcer disease, H. Pylori infection; take before meals (delayed release)

Question 115

Lansoprazole

Answer 115

PPI

Decreases gastric acid secretion by slowing the H+, K+ -ATPase pump on the surface of the parietal cells of the stomach

Nursing considerations: taken before meals (delayed releases)

Question 116

Omeprazole

Answer 116

PPI

Decreases gastric acid secretion by slowing the H+, K+ -ATPase pump on the surface of the parietal cells of the stomach

Nursing considerations: taken before meals (delayed release); can cause NV, constipation, abdominal pain, HA, dizziness

Question 117

Pantoprazole

Answer 117

PPI

Decreases gastric acid secretion by slowing the H+, K+ -ATPase pump on the surface of the parietal cells of the stomach

Nursing considerations: taken before meals (delayed release); can cause diarrhea, hyperglycemia, HA, abdominal pain, abnormal liver function tests

Question 118

Rabeprazole

Answer 118

PPI

Decreases gastric acid secretion by slowing the H+, K+ -ATPase pump on the surface of the parietal cells of the stomach

Nursing considerations: taken without regard to food; with duodenal ulcers, give after meals; with H. Pylori treatment, give with food; can cause nausea, abdominal pain, diarrhea, HA; drug-drug interaction with digoxin, iron, warfarin

Question 119

Misoprostol

Answer 119

Prostaglandin E1 Analogue

Synthetic prostaglandin; protects the gastric mucosa from agents that cause ulcers; also increases mucus production and bicarbonate levels

Nursing considerations: prevents ulceration with NSAID use; give with food; can cause diarrhea, cramping; used primarily for duodenal ulcers;
C/I: pregnant women

Question 120

Sucralfate

Answer 120

Prostaglandin E1 Analogue

Creates a viscous substance in the presence of gastric acid that forms a protective barrier, binding to the surface of the ulcer, and prevents digestion by pepsin

Nursing considerations: give without food, but with water 1-hour before meal; meds should be given 2-hours before or after this med; can cause nausea, constipation; drug-drug interaction with digoxin, phenytoin, warfarin

Question 121

Vagotomy

Answer 121

Severing of vagus nerve; decreases gastric acid by making parietal cells less response to gastrin

AE: problems with feeling of fullness, dumping syndrome, diarrhea, gastritis

Question 122

Truncal vagotomy

Answer 122

Severs the right and left vagus nerves to decrease acid secretions

AE: some patient experience problems with feeling of fullness, dumping syndrome, diarrhea, or constipation

Question 123

Selective vagotomy

Answer 123

Severs vagal innervation to the stomach, but maintains innervation to other abdominal organs

AE: fewer associate adverse effects than truncal

Question 124

Proximal (parietal cell) gastric vagotomy without drainage

Answer 124

Denervates acid-secreting parietal cells but preserves vagal innervation to the gastric antrum and pylorus

Question 125

Pyloroplasty

Answer 125

Longitudinal incision to enlarge outlet and relax the muscle; typically accompanies truncal and selective vagotomies

AE: patients can experience problems feeling of fullness, dumping syndrome, diarrhea, constipation; fewer associate adverse effects than with truncal

Question 126

Antrectomy Billroth I (gastroduodenostomy)

Answer 126

Removal of the lower portion of stomach & duodenum, and pylorus

AE: patients may have problems with feeling of fullness, dumping syndrome, and diarrhea

Question 127

Billroth II (gastrojejuostomy)

Answer 127

Removal of lower portion of stomach with anastomosis to jejunum; duodenal stump remains & is oversewn

AE: patients frequently have associate dumping syndrome, anemia, weight loss, and malabsorption