pain 2 to 3 hours after a meal. Explanation:The patient with a gastric ulcer often awakens between 1 to 2 with pain, and ingestion of food brings relief. Vomiting is uncommon in the patient with duodenal ulcer. Hemorrhage is less likely in the patient with duodenal ulcer than the patient with gastric ulcer. The patient with a duodenal ulcer may experience weight gain.
  • A nurse is caring for a client who underwent a subtotal gastrectomy 24 hours ago. The client has a nasogastric (NG) tube. The nurse should: apply suction to the NG tube every hour. clamp the NG tube if the client complains of nausea. irrigate the NG tube gently with normal saline solution if ordered. reposition the NG tube if pulled out.
  • The nurse recognizes that the patient diagnosed with a duodenal ulcer will likely experience vomiting. hemorrhage. pain 2 to 3 hours after a meal. weight loss.
  • Symptoms associated with pyloric obstruction include all of the following except: Anorexia Diarrhea Nausea and vomiting Epigastric fullness
  • Clients with Type O blood are at higher risk for which of the following GI disorders? Gastric cancer Duodenal ulcers Esophageal varices Diverticulitis
"I will have to take vitamin B12 shots up to 1 year after surgery." Explanation:After a total gastrectomy, a client will need to take vitamin B12 shots for life. Dietary B12 is absorbed in the stomach, and the inability to absorb it could lead to pernicious anemia. Visiting clergy for emotional support is normal after receiving a cancer diagnosis. This action should be encouraged by the nurse. It's appropriate for the client to call the physician if he experiences signs and symptoms of intestinal blockage or obstruction, such as abdominal pain. Because a client with a total gastrectomy will receive enteral feedings or parenteral feedings, he should weigh himself each day and keep a record of the weights.
  • A nurse is caring for a client with active upper GI bleeding. What is the appropriate diet for this client during the first 24 hours after admission? Regular diet Skim milk Nothing by mouth Clear liquids
  • The nurse is educating a patient with peptic ulcer disease about the disease process. What decreases the secretion of bicarbonate from the pancreas into the duodenum, resulting in increased acidity of the duodenum? Smoking Eating spicy foods Drinking carbonated beverages Taking antacids
  • A nurse is providing care for a client recovering from gastric bypass surgery. During assessment, the client exhibits pallor, perspiration, palpitations, headache, and feelings of warmth, dizziness, and drowsiness. The client reports eating 90 minutes ago. The nurse suspects: Vasomotor symptoms associated with dumping syndrome Dehiscence of the surgical wound Peritonitis A normal reaction to surgery
  • A nurse is performing discharge teaching with a client who had a total gastrectomy. Which statement indicates the need for further teaching? "I'm going to visit my pastor weekly for a while." "I will have to take vitamin B12 shots up to 1 year after surgery." "I will call my physician if I begin to have abdominal pain." "I will weight myself each day and record the weight."
Drinking carbonated beverages Explanation:The intent of dietary modification for patients with peptic ulcers is to avoid oversecretion of acid and hypermotility in the GI tract. These can be minimized by avoiding extremes of temperature in food and beverages and overstimulation from the consumption of alcohol, coffee (including decaffeinated coffee, which also stimulates acid secretion), and other caffeinated beverages.
  • A nurse is caring for a client with active upper GI bleeding. What is the appropriate diet for this client during the first 24 hours after admission? Regular diet Skim milk Nothing by mouth Clear liquids
  • The nurse is educating a patient with peptic ulcer disease about the disease process. What decreases the secretion of bicarbonate from the pancreas into the duodenum, resulting in increased acidity of the duodenum? Smoking Eating spicy foods Drinking carbonated beverages Taking antacids
  • A nurse is performing discharge teaching with a client who had a total gastrectomy. Which statement indicates the need for further teaching? "I'm going to visit my pastor weekly for a while." "I will have to take vitamin B12 shots up to 1 year after surgery." "I will call my physician if I begin to have abdominal pain." "I will weight myself each day and record the weight."
  • The nurse is assessing a client with a bleeding gastric ulcer. When examining the client's stool, which of the following characteristics would the nurse be most likely to find? Green color and texture Bright red blood in stool Black and tarry appearance Clay-like quality
Diarrhea Explanation:Pyloric obstruction, also called gastric outlet obstruction (GOO), occurs when the area distal to the pyloric sphincter becomes scarred and stenosed from spasm or edema or from scar tissue that forms when an ulcer alternately heals and breaks down. The client may have nausea and vomiting, constipation, epigastric fullness, anorexia, and, later, weight loss.
  • Symptoms associated with pyloric obstruction include all of the following except: Anorexia Diarrhea Nausea and vomiting Epigastric fullness
  • A client with severe peptic ulcer disease has undergone surgery and is several hours postoperative. During assessment, the nurse notes that the client has developed cool skin, tachycardia, and labored breathing; the client also appears to be confused. Which of the following complications has the client most likely developed? Hemorrhage Penetration Perforation Pyloric obstruction
  • The nurse recognizes that the patient diagnosed with a duodenal ulcer will likely experience vomiting. hemorrhage. pain 2 to 3 hours after a meal. weight loss.
  • Clients with Type O blood are at higher risk for which of the following GI disorders? Gastric cancer Duodenal ulcers Esophageal varices Diverticulitis
drink liquids only between meals. Explanation:A client who experiences dumping syndrome after a subtotal gastrectomy should be advised to ingest liquids between meals rather than with meals. Taking fluids between meals allows for adequate hydration, reduces the amount of bulk ingested with meals, and aids in the prevention of rapid gastric emptying. There is no need to restrict the amount of fluids, just the time when the client drinks fluids. Drinking liquids with meals increases the risk of dumping syndrome by increasing the amount of bulk and stimulating rapid gastric emptying. Small amounts of water are allowable before meals.
  • When caring for a client with an acute exacerbation of a peptic ulcer, the nurse finds the client doubled up in bed with severe pain to his right shoulder. The intial appropriate action by the nurse is to Notify the health care provider. Irrigate the client's NG tube. Place the client in the high-Fowler's position. Assess the client's abdomen and vital signs.
  • A nurse is caring for a client who underwent a subtotal gastrectomy. To manage dumping syndrome, the nurse should advise the client to: restrict fluid intake to 1 qt (1,000 ml)/day. drink liquids only with meals. don't drink liquids 2 hours before meals. drink liquids only between mea
  • 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. The nurse suspects the client has: dumping syndrome. dehiscence of the surgical wound. peritonitis. a normal reaction to surgery.
  • A nurse is caring for a client who underwent a subtotal gastrectomy 24 hours ago. The client has a nasogastric (NG) tube. The nurse should: apply suction to the NG tube every hour. clamp the NG tube if the client complains of nausea. irrigate the NG tube gently with normal saline solution if ordered. reposition the NG tube if pulled out.
Peptic ulcers Explanation:Chronic gastritis caused by Helicobacter pylori is implicated in the development of peptic ulcers. Chronic gastritis is sometimes associated with autoimmune disease, such as pernicious anemia, but not as a cause of the anemia. Chronic gastritis is not implicated in system infections and/or colostomies.
  • The nurse is creating a discharge plan of care for a patient with a peptic ulcer. The nurse tells the patient to avoid which of the following? Tylenol Decaffeinated coffee Skim milk Octreotide
  • The nursing student approaches his instructor to discuss the plan of care for his client diagnosed with peptic ulcer disease. The student asks what is the most common site for peptic ulcer formation? The instructor would state which one of the following? Duodenum Esophagus Pylorus Stomach
  • The nurse is conducting a community education class on gastritis. The nurse includes that chronic gastritis caused by Helicobacter pylori is implicated in which of the following diseases/conditions? Pernicious anemia Systemic infection Peptic ulcers Colostomy
  • A nurse is teaching a group of middle-aged men about peptic ulcers. When discussing risk factors for peptic ulcers, the nurse should mention: a sedentary lifestyle and smoking. a history of hemorrhoids and smoking. alcohol abuse and a history of acute renal failure. alcohol abuse and smoking.
"I need to drink 8 ounces of water before eating." Explanation:After a Roux-en-Y gastric bypass, the client should not drink fluids with meals, withholding fluids for 15 minutes before eating to 90 minutes after eating. Chewing foods slowly and thoroughly, keeping total serving sizes to less than 1 cup, and choosing foods such as breads, cereals, and grains that provide less than 2 g of fiber per serving.
  • The nurse is conducting a community education class on gastritis. The nurse includes that chronic gastritis caused by Helicobacter pylori is implicated in which of the following diseases/conditions? Pernicious anemia Systemic infection Peptic ulcers Colostomy
  • The nurse is creating a discharge plan of care for a patient with a peptic ulcer. The nurse tells the patient to avoid which of the following? Tylenol Decaffeinated coffee Skim milk Octreotide
  • The nursing student approaches his instructor to discuss the plan of care for his client diagnosed with peptic ulcer disease. The student asks what is the most common site for peptic ulcer formation? The instructor would state which one of the following? Duodenum Esophagus Pylorus Stomach
  • After teaching a client who has had a Roux-en-Y gastric bypass, which client statement indicates the need for additional teaching? "I need to chew my food slowly and thoroughly." "I need to drink 8 ounces of water before eating." "A total serving should amount to be less than one cup." "I should pick cereals with less than 2 g of fiber per serving."
Pepcid Explanation:Famotidine (Pepcid) is a histamine-2 receptor antagonist. Prevacid and Nexium are proton pump inhibitors (PPIs). Flagyl is an antibiotic
  • Which of the following are classified as a histamine-2 receptor antagonist? Pepcid Prevacid Flagyl Nexium
  • Which of the following surgical procedures for obesity utilizes a prosthetic device to restrict oral intake? Roux-en-Y gastric bypass Gastric banding Vertical-banded gastroplasty Biliopancreatic diversion with duodenal switch
  • Which of the following clients is at highest risk for peptic ulcer disease? Client with blood type A Client with blood type B Client with blood type AB Client with blood type O
  • Which of the following medications used for obesity improves cardiovascular disease risk factors in obese patients with metabolic syndrome? Rimonabant (Acomplia) Orlistat (Xenical) Alli Sibutramine (Meridia)
Rimonabant (Acomplia) Explanation:Acomplia is the newest medication used to treat obesity. It stimulates weight reduction and improves cardiovascular disease risk factors in obese patients with metabolic syndrome. Meridia was recently pulled from the market because of the increased risk of heart attack and stroke associated with this medication. Orlistat, available by prescription and over the counter as Alli, reduces caloric intake by binding to gastric and pancreatic lipase to prevent digestion of fats.
  • Which of the following clients is at highest risk for peptic ulcer disease? Client with blood type A Client with blood type B Client with blood type AB Client with blood type O
  • Which of the following medications used for obesity improves cardiovascular disease risk factors in obese patients with metabolic syndrome? Rimonabant (Acomplia) Orlistat (Xenical) Alli Sibutramine (Meridia)
  • Which of the following is an accurate statement regarding gastric cancer? The incidence of cancer of the stomach continues to decrease in the United States. Most gastric cancer deaths occur in people younger than 40 years. Females have a higher incidence of gastric cancers than males. A diet high in smoked foods and low in fruits and vegetables may decrease the risk of gastric cancer.
  • Which of the following surgical procedures for obesity utilizes a prosthetic device to restrict oral intake? Roux-en-Y gastric bypass Gastric banding Vertical-banded gastroplasty Biliopancreatic diversion with duodenal switch
Hemorrhage Explanation:Signs of hemorrhage following surgery include cool skin, confusion, increased heart rate, labored breathing, and blood in the stool. Signs of penetration and perforation are severe abdominal pain, rigid and tender abdomen, vomiting, elevated temperature, and increased heart rate. Indicators of pyloric obstruction are nausea, vomiting, distended abdomen, and abdominal pain.
  • A client with peptic ulcer disease must begin triple medication therapy. For how long will the client follow this regimen? 4 to 6 days 7 to 9 days 10 to 14 days 15 to 20 days
  • A client reports to the clinic, stating that she rapidly developed headache, abdominal pain, nausea, hiccuping, and fatigue about 2 hours ago. For dinner, she ate buffalo chicken wings and beer. Which of the following medical conditions is most consistent with the client's presenting problems? Acute gastritis Duodenal ulcer Gastric cancer Gastric ulcer
  • A client admitted for treatment of a gastric ulcer is being prepared for discharge on antacid therapy. Discharge teaching should include which instruction? "Continue to take antacids even if your symptoms subside." "You may take antacids with other medications." "Avoid taking antacids containing magnesium if you develop a heart problem." "Be sure to take antacids with meals."
  • A client with severe peptic ulcer disease has undergone surgery and is several hours postoperative. During assessment, the nurse notes that the client has developed cool skin, tachycardia, and labored breathing; the client also appears to be confused. Which of the following complications has the client most likely developed? Hemorrhage Penetration Perforation Pyloric obstruction
"The medications will kill the bacteria and stop the acid production." Explanation:Currently, the most commonly used therapy for peptic ulcers is a combination of antibiotics, proton-pump inhibitors, and bismuth salts that suppress or eradicate H. pylori. Recommended therapy for 10 to 14 days includes triple therapy with two antibiotics (eg, metronidazole [Flagyl] or amoxicillin [Amoxil] and clarithromycin [Biaxin]) plus a proton-pump inhibitor (eg, lansoprazole [Prevacid], omeprazole [Prilosec], or rabeprazole [Aciphex]), or quadruple therapy with two antibiotics (metronidazole and tetracycline) plus a proton-pump inhibitor and bismuth salts (Pepto-Bismol). Research is being conducted to develop a vaccine against H. pylori.
  • A client with a peptic ulcer is diagnosed with Heliobacter pylori infection. The nurse is teaching the client about the medications prescribed, including metronidazole (Flagyl), omeprazole (Prilosec), and clarithromycin (Biaxin). Which statement by the client indicates the best understanding of the medication regimen? "My ulcer will heal because these medications will kill the bacteria." "I should take these medications only when I have pain from my ulcer." "The medications will kill the bacteria and stop the acid production." "These medications will coat the ulcer and decrease the acid producation in my stomach."
  • A client reports to the clinic, stating that she rapidly developed headache, abdominal pain, nausea, hiccuping, and fatigue about 2 hours ago. For dinner, she ate buffalo chicken wings and beer. Which of the following medical conditions is most consistent with the client's presenting problems? Acute gastritis Duodenal ulcer Gastric cancer Gastric ulcer
  • A client with peptic ulcer disease must begin triple medication therapy. For how long will the client follow this regimen? 4 to 6 days 7 to 9 days 10 to 14 days 15 to 20 days
  • A client with severe peptic ulcer disease has undergone surgery and is several hours postoperative. During assessment, the nurse notes that the client has developed cool skin, tachycardia, and labored breathing; the client also appears to be confused. Which of the following complications has the client most likely developed? Hemorrhage Penetration Perforation Pyloric obstruction
The incidence of cancer of the stomach continues to decrease in the United States. Explanation:While the incidence continues to decrease, gastric cancer still accounts for 12,800 deaths annually. While gastric cancer deaths occasionally occur in younger people, most occur in people older than 40 years of age. Males have a higher incidence of gastric cancers than females. More accurately, a diet high in smoked foods and low in fruits and vegetables may increase the risk of gastric cancer.
  • Which of the following medications used for obesity improves cardiovascular disease risk factors in obese patients with metabolic syndrome? Rimonabant (Acomplia) Orlistat (Xenical) Alli Sibutramine (Meridia)
  • Which of the following surgical procedures for obesity utilizes a prosthetic device to restrict oral intake? Roux-en-Y gastric bypass Gastric banding Vertical-banded gastroplasty Biliopancreatic diversion with duodenal switch
  • When caring for a client with an acute exacerbation of a peptic ulcer, the nurse finds the client doubled up in bed with severe pain to his right shoulder. The intial appropriate action by the nurse is to Notify the health care provider. Irrigate the client's NG tube. Place the client in the high-Fowler's position. Assess the client's abdomen and vital signs.
  • Which of the following is an accurate statement regarding gastric cancer? The incidence of cancer of the stomach continues to decrease in the United States. Most gastric cancer deaths occur in people younger than 40 years. Females have a higher incidence of gastric cancers than males. A diet high in smoked foods and low in fruits and vegetables may decrease the risk of gastric cancer.
Assess the client's abdomen and vital signs. Explanation:Signs and symptoms of perforation includes sudden, severe upper abdominal pain (persisting and increasing in intensity); pain may be referred to the shoulders, especially the right shoulder, because of irritation of the phrenic nerve in the diaphragm. The nurse should assess the vital signs and abdomen prior to notifying the physician. Irrigation of the NG tube should not be performed because the additional fluid may be spilled into the peritoneal cavity, and the client should be placed in a position of comfort, usually on the side with the head slightly elevated.
  • Which of the following surgical procedures for obesity utilizes a prosthetic device to restrict oral intake? Roux-en-Y gastric bypass Gastric banding Vertical-banded gastroplasty Biliopancreatic diversion with duodenal switch
  • When caring for a client with an acute exacerbation of a peptic ulcer, the nurse finds the client doubled up in bed with severe pain to his right shoulder. The intial appropriate action by the nurse is to Notify the health care provider. Irrigate the client's NG tube. Place the client in the high-Fowler's position. Assess the client's abdomen and vital signs.
  • Which of the following is an accurate statement regarding gastric cancer? The incidence of cancer of the stomach continues to decrease in the United States. Most gastric cancer deaths occur in people younger than 40 years. Females have a higher incidence of gastric cancers than males. A diet high in smoked foods and low in fruits and vegetables may decrease the risk of gastric cancer.
  • A client reports to the clinic, stating that she rapidly developed headache, abdominal pain, nausea, hiccuping, and fatigue about 2 hours ago. For dinner, she ate buffalo chicken wings and beer. Which of the following medical conditions is most consistent with the client's presenting problems? Acute gastritis Duodenal ulcer Gastric cancer Gastric ulcer
Decaffeinated coffee Explanation:The nurse should include avoidance of decaffeinated coffee in the patient's discharge teaching plan. Decaffeinated coffee is avoided to keep from overstimulating acid secretion.
  • The nurse is creating a discharge plan of care for a patient with a peptic ulcer. The nurse tells the patient to avoid which of the following? Tylenol Decaffeinated coffee Skim milk Octreotide
  • The nursing student approaches his instructor to discuss the plan of care for his client diagnosed with peptic ulcer disease. The student asks what is the most common site for peptic ulcer formation? The instructor would state which one of the following? Duodenum Esophagus Pylorus Stomach
  • The nurse is conducting a community education class on gastritis. The nurse includes that chronic gastritis caused by Helicobacter pylori is implicated in which of the following diseases/conditions? Pernicious anemia Systemic infection Peptic ulcers Colostomy
  • After teaching a client who has had a Roux-en-Y gastric bypass, which client statement indicates the need for additional teaching? "I need to chew my food slowly and thoroughly." "I need to drink 8 ounces of water before eating." "A total serving should amount to be less than one cup." "I should pick cereals with less than 2 g of fiber per serving."
Gastric banding Explanation:In gastric banding, a prosthetic device is used to restrict oral intake by creating a small pouch of 10 to 15 milliliters that empties through the narrow outlet into the remainder of the stomach. Roux-en-Y gastric bypass uses a horizontal row of staples across the fundus of the stomach to create a pouch with a capacity of 20 to 30 mL. Vertical-banded gastroplasty involves placement of a vertical row of staples along the lesser curvature of the stomach, creating a new, small gastric pouch. Biliopancreatic diversion with duodenal switch combines gastric restriction with intestinal malabsorption.
  • Which of the following clients is at highest risk for peptic ulcer disease? Client with blood type A Client with blood type B Client with blood type AB Client with blood type O
  • Which of the following is an accurate statement regarding gastric cancer? The incidence of cancer of the stomach continues to decrease in the United States. Most gastric cancer deaths occur in people younger than 40 years. Females have a higher incidence of gastric cancers than males. A diet high in smoked foods and low in fruits and vegetables may decrease the risk of gastric cancer.
  • Which of the following medications used for obesity improves cardiovascular disease risk factors in obese patients with metabolic syndrome? Rimonabant (Acomplia) Orlistat (Xenical) Alli Sibutramine (Meridia)
  • Which of the following surgical procedures for obesity utilizes a prosthetic device to restrict oral intake? Roux-en-Y gastric bypass Gastric banding Vertical-banded gastroplasty Biliopancreatic diversion with duodenal switch
Black and tarry appearance Explanation:Black and tarry stools (melena) are a sign of bleeding in the upper gastrointestinal (GI) tract. As the blood moves through the GI system, digestive enzymes turn red blood to black. Bright red blood in the stool is a sign of lower GI bleeding. Green color and texture is a distractor for this question. Clay-like stools are a characteristic of biliary disorders.
  • A nurse practitioner prescribes drug therapy for a patient with peptic ulcer disease. Choose the drug that can be used for 4 weeks and has a 90% chance of healing the ulcer. Ranitidine (Zantac) Cimetidine (Tagamet) Famotidine (Pepcid) Omeprazole (Prilosec)
  • The nurse is educating a patient with peptic ulcer disease about the disease process. What decreases the secretion of bicarbonate from the pancreas into the duodenum, resulting in increased acidity of the duodenum? Smoking Eating spicy foods Drinking carbonated beverages Taking antacids
  • The nurse is assessing a client with a bleeding gastric ulcer. When examining the client's stool, which of the following characteristics would the nurse be most likely to find? Green color and texture Bright red blood in stool Black and tarry appearance Clay-like quality
  • A nurse is caring for a client with active upper GI bleeding. What is the appropriate diet for this client during the first 24 hours after admission? Regular diet Skim milk Nothing by mouth Clear liquids
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