Question 1

Which acid base and electrolyte complications are commonly associated with prolonged vomiting?. Select all that apply.

Accepted Answer

Prolonged vomiting leads to loss of gastric acid (HCl), causing metabolic alkalosis. It also results in loss of potassium, leading to hypokalemia.

Question 2

A 24-year-old patient is admitted for treatment of celiac disease. The nurse would anticipate managing which symptoms?. Select all that apply.

Accepted Answer

B,C,E

Question 3

A patient, 4 weeks post gastric resection surgery, is experiencing cramping, nausea, and diarrhea within 10 minutes after eating. The nurse suspects that the patent is experiencing "dumping syndrome" and suggests which intervention?. Select all that apply.

Accepted Answer

Dumping syndrome can be managed by increasing protein intake, lying down after meals to slow gastric emptying, eating small frequent meals, and reducing carbohydrate intake to prevent rapid gastric emptying. Drinking water before meals is not recommended as it can increase the speed of gastric emptying.

Question 4

Acyclovir (Zovirax) ointment has been prescribed for a patient with oral herpes lesions. What should the nurse include when instructing the patient regarding this medication?. Select all that apply.

Accepted Answer

The answer of Acyclovir (Zovirax) ointment has been prescribed for...

Question 5

The nurse is preparing to instruct a patient who is newly diagnosed with gastroesophageal reflux disease (GERD) about dietary considerations. What should the nurse include in these instructions?. Select all that apply.

Accepted Answer

Patients with GERD should avoid peppermint as it can relax the lower esophageal sphincter (LES) and worsen symptoms. Meals should be small and more frequent to prevent overeating and reduce pressure on the LES. Patients should avoid eating within 4 hours of bedtime to allow time for digestion and reduce the likelihood of reflux while lying down. Citrus fruits, which are acidic, can exacerbate symptoms and should be avoided. Alcohol should be avoided altogether, as it can relax the LES and increase acid production.

Question 6

Which instructions should the nurse provide for a patient diagnosed with gastroesophageal reflux disease (GERD)?. Select all that apply.

Accepted Answer

Patients with GERD should avoid eating close to bedtime, have their largest meal earlier in the day, elevate the head of the bed to prevent reflux, and maintain a healthy lifestyle including exercise. Caffeinated beverages should be avoided as they can worsen GERD symptoms.

Question 7

A patient prescribed an antacid is experiencing muscle cramps. What should the nurse do to assist this patient?

Accepted Answer

Muscle cramps can be a sign of electrolyte imbalances, which can be a potential side effect of some antacids. The nurse should notify the health care provider to assess the patient's electrolyte levels and consider alternative treatments. Reviewing the patient's diet history and elimination patterns may also be helpful in identifying possible contributing factors, but notifying the health care provider is the priority. Providing reassurance to the patient is important but does not address the potential underlying issue.

Question 8

A patient is experiencing manifestations consistent with an oral fungal infection. The patient's health history is unremarkable. Which medication does the nurse anticipate being ordered to manage this condition initially?

Accepted Answer

Nystatin is an antifungal medication commonly used to treat oral fungal infections such as thrush. Ciprofloxacin and ampicillin are antibiotics used to treat bacterial infections, and viscous lidocaine is a local anesthetic used to relieve pain. However, none of these medications would be effective in treating a fungal infection.

Question 9

The nurse is providing emotional support to the spouse of a patient recently diagnosed with terminal esophageal cancer. The spouse expresses anger and confusion and questions why the patient did not seek help sooner. Which response by the nurse would be the most appropriate at this time?

Accepted Answer

This response provides a factual explanation for why the patient may not have sought help sooner and offers reassurance that this is a common problem. It addresses the spouse's confusion and may help alleviate some of their anger or guilt. Responses B and C could come across as dismissive or insensitive, while response D does not address the spouse's concerns.

Question 10

The nurse is developing the postoperative plan of care for a patient recovering from surgery for oral cancer. Which nursing diagnosis has the highest priority?

Accepted Answer

Ineffective Airway Clearance is the most critical issue in the postoperative care of a patient recovering from oral cancer surgery. The patient may have difficulty breathing due to swelling, bleeding, or airway obstruction caused by the surgery. This could lead to life-threatening complications if not addressed immediately. Impaired Verbal Communication, Body Image Disturbance, and Risk for Imbalanced Nutrition should also be addressed, but they are not as life-threatening as Ineffective Airway Clearance.

Question 11

The physician has ordered metoclopramide (Reglan) 2 mg/kg IVP to be given 30 minutes before the start of chemotherapy. The patient weighs 54 kg. The metoclopramide (Reglan) is dispensed in a 10 mg/10 mL vial. The nurse will administer ________ mL of metoclopramide.

Accepted Answer

The answer of The physician has ordered metoclopramide (Reglan) 2...

Question 12

A patient with cancer of the rectum is scheduled for surgery and the placement of a permanent ostomy. Which type of ostomy is most likely to be performed on this patient?

Accepted Answer

A patient with cancer of the rectum would require a colostomy that is located in the descending or sigmoid colon. A sigmoid colostomy is the most appropriate choice in this case as the sigmoid colon is located near the rectum, making it an ideal site for a colostomy. An ileostomy involves the creation of an opening in the ileum, which is part of the small intestine, and is less likely to be performed in this case. A double-barrel colostomy involves the creation of two stomas, and a transverse loop colostomy is typically performed in emergency situations or as a temporary measure.

Question 13

A patient has been diagnosed with type 1 herpes simplex lesions on the mouth and face. Which statement indicates that the patient understands the information provided by the nurse?

Accepted Answer

Type 1 herpes simplex virus is a viral infection that remains in the body for life. Even though the symptoms may come and go, the virus remains dormant in the body and can be reactivated at any time.

Question 14

The nurse learns that an elderly patient with ill-fitting dentures has been using an over-the-counter preparation for a gum sore over the last month. What instruction should the nurse give this patient?

Accepted Answer

Over-the-counter preparations can sometimes exacerbate underlying issues and may require medical attention. Encouraging the patient to see a physician can help identify any potential problems and determine the best course of treatment.

Question 15

When teaching a patient with fungal stomatitis about performing oral care, the nurse would include which instructions?. Select all that apply.

Accepted Answer

Avoiding tobacco and alcohol helps prevent irritation and further infection. Saline or sodium bicarbonate rinses help maintain oral hygiene and reduce fungal growth. Using a soft toothbrush minimizes trauma to the oral mucosa.

Question 16

The nurse has identified the goals of "intact skin integrity" and "intact stoma integrity" for a patient with a colostomy. Which evaluation parameters are best suited for these goals?. Select all that apply.

Accepted Answer

The answer of The nurse has identified the goals of...

Question 17

A patient is suspected of having sprue. Which instruction should the nurse provide this patient about diet?

Accepted Answer

Sprue, also known as celiac disease, is an autoimmune disorder in which the person's body reacts to the protein gluten found in wheat, barley, and rye. Therefore, the patient must eliminate gluten products from their diet to prevent damage to their small intestine. Avoiding all milk products or whey products is not necessarily related to this condition. While a vegetarian diet may be beneficial for some, it is not specifically recommended for the treatment of sprue.

Question 18

The nurse is teaching a patient about the major risk factors for peptic ulcer disease (PUD). Which risk factors should the nurse discuss?. Select all that apply.

Accepted Answer

Chronic H. pylori infection, use of aspirin and NSAIDs, and cigarette smoking are all established risk factors for developing peptic ulcer disease. Dietary intake of dairy products and stress have not been proven to be significant risk factors for PUD.

Question 19

The nurse is preparing the morning medications for a patient with gastroesophageal reflux disease (GERD). Which nursing intervention would be appropriate regarding this patient's medications?
000.

Accepted Answer

It is appropriate to hold the antacids for at least 2 hours after oral medications are taken to avoid interference with absorption of the other medications. This allows the other medications to be absorbed appropriately before use of antacids.

Question 20

A patient diagnosed with peptic ulcer disease (PUD) asks if surgery will be necessary. How should the nurse respond?

Accepted Answer

Surgery for peptic ulcer disease is rarely necessary due to the effectiveness of medications such as proton pump inhibitors and antibiotics for H. pylori infection.

Quiz 37: Caring for the Patient With Gastrointestinal Disorders