Deck 31: Management of Clients with Digestive Disorders

Question 1

The nurse administers alternating doses of two antacids into the NG tube of a client with a duodenal ulcer. The finding that best indicates that this drug regimen has been successful is

A) absent NG tube drainage.
B) decreased abdominal rigidity.
C) increased gastric pH.mild diarrhea.
D) mild diarrhea.

Answer 1

increased gastric pH.mild diarrhea.

Question 2

The nurse planning to irrigate a nasogastric (NG) tube prepares to use

A) half-strength peroxide.
B) normal saline.
C) sterile water.
D) tap water.

Answer 2

normal saline.

Question 3

An older male client with chronic gastritis asks the nurse, "Do you think I'll get gastric cancer?" The most accurate response by the nurse is

A) "As long as the chronic gastritis is diagnosed early, there is little risk of gastric cancer."
B) "Chronic gastritis is not associated with the development of gastric cancer in men over 40."
C) "Individual predictions are not possible, but chronic gastritis is associated with the development of gastric cancer."
D) "Women with chronic gastritis are more likely to get gastric cancer than men who have chronic gastritis."

Answer 3

"Individual predictions are not possible, but chronic gastritis is associated with the development of gastric cancer."

Question 4

A nurse is instructing a client with a peptic ulcer on recommended dietary changes. A goal of teaching has been met when the client states that he/she will avoid which of the following beverages?

A) Apple juice
B) Lemonade
C) Milk
D) Water

Question 5

A client is taking cortisone. The nurse schedules the medication with food because cortisone can have which effect on gastric mucosa when given on an empty stomach? Cortisone will cause

A) dramatically increased gastric pH.
B) increased amount of GI secretions.
C) increased transit time of GI contents.
D) susceptibility of the mucosa to injury.

Question 6

A client with acute gastritis is admitted to the emergency department for GI bleeding. The nurse would anticipate the client's history will include

A) alcohol abuse.
B) anorexia.
C) high-carbohydrate, high-fat diet.
D) recent use of oral penicillin.

Question 7

The nurse is monitoring a client who has had gastric surgery for manifestations of dumping syndrome. The nurse should be particularly watchful for the early manifestation of

A) hypertension.
B) pain.
C) tenesmus.
D) vertigo.

Question 8

The client with chronic gastritis is experiencing abdominal pain. In order to provide the client the fastest relief, the nurse plans to administer

A) aluminum hydroxide with magnesium trisilicate (Gaviscon).
B) clarithromycin (Biaxin).
C) metronidazole (Flagyl).
D) omeprazole (Prilosec).

Question 9

The nurse is caring for a client with chronic atrophic gastritis. When taking an admission history, the nurse would anticipate a history of

A) cardiac disease.
B) emphysema.
C) intestinal parasites.
D) pernicious anemia.

Question 10

A client asks the nurse about the prescribed diet after gastric surgery. The nurse clarifies that a high-protein, high-fat, low-carbohydrate, dry diet is the best choice after gastric surgery because this diet

A) does not cause diarrhea.
B) does not dilate the stomach.
C) is quickly digested.
D) is slow to leave the stomach.

Question 11

A nurse is assessing a client with a history of a duodenal ulcer. Which finding is consistent with the nurse's knowledge about this condition?

A) Certain types of food increase gastric distress.
B) Eating nearly any food causes pain.
C) Pain may awaken the client in the middle of the night.
D) The client complains of spitting up blood.

Question 12

Priority nursing actions to achieve critical goals in the postoperative period for a client who has just returned from a Billroth II procedure should include

A) encouraging oral intake.
B) ensuring frequent coughing and deep breathing.
C) irrigating the client's NG tube every hour.
D) maintaining the client in the semi-Fowler position.

Question 13

Ranitidine (Zantac) is prescribed for a client with a gastric ulcer. The statement that best indicates to the nurse that the client understands the action of this drug is

A) "I will take this medication at bedtime to relieve pain."
B) "Ranitidine will activate protective mucous barriers."
C) "Stomach acids are neutralized by this medication."
D) "This drug reduces the acid in my stomach."

Question 14

A client needs insertion of a long tube for intestinal decompression. The tube that is inappropriate for intestinal decompression is the

A) Cantor tube.
B) Harris tube.
C) Miller-Abbott tube.
D) Salem sump tube.

Question 15

An important health promotion activity for nurses to teach clients with chronic gastritis is to

A) avoid any spicy or overly-hot food.
B) see the health care provider at regular intervals.
C) stick to a regular exercise plan.
D) take only nonsteroidal anti-inflammatory drugs for mild pain.

Question 16

Before tube insertion, the nurse performs the NEX measurement, which is the

A) distance from the tip of the nose to the ear lobe and to the xiphoid.
B) length of a tube from the hub to the tip converted to centimeters.
C) distance from the ear lobe to the umbilicus.
D) width of the lumen of the tube multiplied by the length.

Question 17

A nurse is caring for a client with severe burns. The client complains of abdominal pain and begins vomiting blood. The nurse anticipates diagnostic testing to determine if the client has developed

A) a Curling's ulcer.
B) chronic gastritis.
C) H. pylori infection.
D) pyloric stenosis.

Question 18

A client in the emergency department is hemorrhaging from a peptic ulcer and is being prepared quickly for emergency surgery. The nurse notes that the client is crying and reaches for the nurse frequently. The best response by the nurse to this client is to

A) continue working efficiently to get the client ready for the operating room.
B) make eye contact, touch the client, and say, "This must be very scary for you."
C) send someone to find the chaplain to discuss advance directives.
D) sit by the client and say, "I have some time that I can spend with you."

Question 19

The nurse has just finished inserting a nasogastric (NG) tube in a client who has difficulty swallowing. The best measure to test for placement of the tube is

A) asking the client to speak.
B) aspirating gastric contents.
C) inspecting the posterior pharynx for correct placement.
D) placing the end of the tube in a glass of water.

Question 20

A nurse is caring for a patient who had surgery and will be receiving chemotherapy and radiation treatment for stage III gastric cancer. The client is planning several extensive trips after the chemotherapy and radiation are finished. Which statement by the nurse is most appropriate at this time?

A) "Before you leave, be sure your will and other advance directives are up to date."
B) "What does your family think of your travel plans?"
C) "What has the physician told you about your disease and treatment?"
D) "Your trip sounds wonderful! Tell me more about it."

Question 21

A client with a duodenal ulcer complains of a sudden onset of severe pain. In which order should the nurse perform the following activities? (select all that apply)

A) Assess the patency of the patient's IV line.
B) Call the physician.
C) Have the nurses' aid obtain a set of vital signs.
D) Perform a complete abdominal examination.
E) Prepare to administer IV pain medication.

Question 22

A nurse is teaching health promotion measures to a support group for clients who are at high risk for gastric cancer. Important health promotion measures to advise the clients include (select all that apply)

A) avoiding alcohol.
B) eating a diet high in nitrites.
C) limiting salted fish and pickled foods.
D) quitting smoking.

Question 23

A nurse is inserting a nasogastric (NG) tube. Put the steps in the correct order.(select all that apply)

A) Advance the tube into the stomach.
B) Aspirate gastric contents and measure the pH.
C) Assist the client into a high-Fowler position.
D) Complete the NEX measurement and mark it on the tube.
E) Insert the tube gently into the nares and posterior nasal pharynx.
F) Instruct the client to swallow when the tube is in the oropharynx.
G) Lubricate the tip of the tube.
H) Secure the tube to the nose with a device to hold tubes or hypoallergenic tape.