Deck 28: Care of Patients with Disorders of the Upper Gastrointestinal System

Question 1

The nurse explains that the diagnosis of morbidly obese is reserved for people who exceed which percentage of their recommended weight?

A) 50%
B) 70%
C) 90%
D) 100%

Answer 1

100%

Question 2

The nurse explains that the laparoscopic adjustable gastric banding surgery is best described as which type of bariatric surgery?

A) Restrictive
B) Malabsorptive
C) Restrictive/malabsorptive
D) Obstructive

Answer 2

Restrictive

Question 3

The nurse is caring for a patient who is being treated for extensive burns.The nurse notes the presence of coffee-ground material in the Salem sump catheter.The nurse correctly recognizes which factor as the likely cause?

A) Esophagitis
B) Perforated gastric ulcer
C) Gastric irritation from the Salem sump tube
D) A physiologic stress ulcer

Answer 3

A physiologic stress ulcer

Question 4

The nurse is caring for a patient who is being treated for a gunshot wound to the abdomen.The patient is receiving total parenteral nutrition (TPN),and the physician has prescribed insulin coverage on a sliding scale.The patient reports he has never had diabetes before.What response is best for the nurse to make?

A) "It is likely you have developed diabetes as a result of your illness."
B) "Do you have a family history for diabetes?"
C) "The TPN you are receiving has high amounts of glucose."
D) "Insulin is needed to manage your stomach's inability to adequately metabolize food at this time."

Question 5

The nurse is educating a patient with Barrett esophagus.Which statement indicates that the patient requires a need for further instruction?

A) "I should eat smaller meals and avoid foods that cause reflux."
B) "I can still have a small glass of wine with dinner."
C) "I should consider switching to smokeless tobacco."
D) "I should stay upright after eating."

Question 6

The nurse is discussing bariatric surgery complications with a patient.Which statement indicates that the patient accurately understands the nurse's teaching about common procedural side effects?

A) "I understand that gastric ulcers frequently occur in patients who have bariatric surgery."
B) "Gallstones are a common occurrence in patients who have bariatric surgery."
C) "I know an umbilical hernia might happen after I have bariatric surgery."
D) "Unfortunately, I may experience gastritis after having bariatric surgery."

Question 7

The nurse is caring for a patient with a Salem sump tube for decompression.The patient displays dyspnea and reports feeling full and nauseated.What action should the nurse take first?

A) Increase suction from low to high.
B) Notify the charge nurse.
C) Irrigate the tube with normal saline.
D) Withdraw the tube about three inches.

Question 8

The nurse is caring for a patient with a peptic ulcer.The patient also has a history of chronic bronchitis,diabetes,and arthritis.Which component of the patient's history is the most likely contributing factor to the patient's ulcer?

A) The patient requires insulin to manage his diabetes.
B) The patient uses a daily inhaler to decrease incidence of asthma attacks.
C) The patient takes ibuprofen daily for arthritis pain.
D) The patient takes a multivitamin daily.

Question 9

The nurse is preparing a teaching plan for a patient with gastroesophageal reflux disease (GERD)who has been prescribed multi-drug therapy for treatment.Which information is most important for the nurse to obtain?

A) "Can you identify triggers for your reflux?"
B) "Can you commit to changing your diet?"
C) "Do you understand how each type of medication works?"
D) "Do you think you can afford these prescriptions?"

Question 10

The nurse documenting the presence of pain in a patient with possible gastric ulcer would anticipate that the pain would occur at which time?

A) In the morning
B) Erratically, without pattern
C) At bedtime
D) With meals

Question 11

The nurse is caring for a patient who is postoperative after esophageal resection.Shortly after the nurse starts a feeding,the patient suddenly becomes dyspneic and complains of substernal pain.What should the nurse do first?

A) Stop the feeding.
B) Ambulate the patient.
C) Notify the charge nurse.
D) Reassure the patient.

Question 12

The nurse is educating a patient with a hiatal hernia.Which statement indicates that the patient understands the nurse's teaching?

A) "I should avoid tea and chocolate."
B) "I should wear an abdominal binder for added support.
C) "I should sleep flat on a single pillow."
D) "I should not eat within an hour of going to bed."

Question 13

A patient who had gastric bypass surgery 5 weeks ago calls the office to report feelings of nausea,sweating,and diarrhea shortly after eating meals.What response by the nurse is most appropriate?

A) "This is common after the type of surgery you had."
B) "How much, if any, alcohol do you consume each day?"
C) "Avoid large meals, limit sweets, and drink small amounts of liquids between meals."
D) "You may be experiencing a postoperative infection."

Question 14

The nurse calculates the body mass index (BMI)of a man who is 6 feet tall and weighs 150 pounds.Which value is correct?

A) 21.0
B) 25.0
C) 43.1
D) 66.3

Question 15

The nurse is aware that patients who have chronic gastritis from renal failure may present with which first sign of this disorder?

A) An increase in the white blood cell count
B) Sudden massive hemorrhage
C) Asthma-like symptoms
D) Extreme dyspnea

Question 16

A patient with a gastrostomy tube gets a bolus feeding of 200 mL every 4 hours.Before giving the bolus,the nurse aspirates a residual of 100 mL.Which action is most appropriate?

A) Give the 200 mL feeding.
B) Record the residual and give 100 mL of the feeding.
C) Document the residual and hold the feeding.
D) Position the patient in high Fowler position and give the feeding.

Question 17

The nurse is educating a patient who has gastroesophageal reflux disease (GERD)about dietary modification.Which information is most important for the nurse to include in the teaching plan?

A) Avoid highly seasoned or spiced foods.
B) Drink ginger ale or lemon lime soda rather than cola.
C) Use a straw to drink all fluids.
D) Eating three meals spaced evenly apart.

Question 18

The nurse is caring for a patient with suspected dysphagia.Which action is most appropriate for the nurse to take?

A) Encourage incentive spirometry use.
B) Instruct the patient to take practice swallows before the meal.
C) Encourage patient attempts to communicate, and pay attention to nonverbal cues.
D) Encourage the patient to keep a food diary.

Question 19

For which patient should the nurse question an order for esomeprazole (Nexium)?

A) A 55-year-old female who takes digoxin
B) A 52-year-old male who is noncompliant
C) A 38-year-old female who has asthma
D) A 56-year-old male who has epistaxsis

Question 20

Which causative agent is the primary cause of Barrett esophagus?

A) Gastroesophageal reflux disease (GERD)
B) Eating hot, spicy foods
C) Anorexia nervosa
D) Esophageal polyps

Question 21

The nurse is caring for a patient who is suspected of having oral cancer.When reviewing the patient's health history,which finding provides supportive data for the diagnosis?

A) Presence of leukoplakia
B) History of oral herpes simplex
C) History of an oral yeast infection
D) Reports of a dry oral cavity

Question 22

The nurse explains to an obese patient that initial medically supervised weight reduction includes which components(s)?

A) General health assessment
B) Specialized exercise program
C) Participation in a support group
D) Stress reduction
E) Surgery

Question 23

The nurse instructs the patient on the weight reduction drug Orlistat (Xenical,Alli)that he may experience which side effect(s)?

A) Diarrhea
B) Hypoglycemia
C) Abdominal cramping
D) Constipation
E) Nausea

Question 24

The nurse cautions that increased morbidity from hypertension and cardiac disease,even in children,is related to the modifiable risk factor of __________.

Question 25

To best assist a patient with dysphagia,the nurse should implement which action(s)?

A) Encourage "practice swallowing" before the meal.
B) Coach the patient to chew thoroughly.
C) Assist the patient to sit upright with the head forward and chin tucked.
D) Offer fluid during the meal.
E) Give the patient thin liquids, such as water.

Question 26

The nurse demonstrates that the person whose recommended weight is 150 pounds based on height,age,and body type would be considered obese if the person weighed a minimum of ______ pounds.

Question 27

The nurse correctly recognizes that esophageal cancer is associated with which risk factor(s)?

A) Cigarette smoking
B) Diabetes
C) Hypertension
D) Heavy alcohol use
E) Smokeless tobacco

Question 28

The nurse is presenting a program about bulimia nervosa to a group of student nurses.After the program,the participants correctly identify which method(s)of treatment?

A) Appetite suppressants
B) Antidepressant medications
C) Psychotherapy
D) Behavior modification
E) Increased exercise

Question 29

The nurse is caring for a 70-year-old patient who was diagnosed with gastroenteritis after returning from a camping trip to Mexico.Which manifestation(s)is/are consistent with this diagnosis?

A) Positive stool culture for Giardia or Shigella
B) Abdominal cramping
C) Fat in the stool
D) Mucus in stool
E) Blood in stool