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NURS 1400 TEST BANK QUESTIONS WITH ANSWERS-UPPER GI PROBLEMS GRADED A+
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NURS 1400 TEST BANK QUESTIONS WITH ANSWERS-UPPER GIPROBLEMS GRADED A+
1. A 53-year-old male patient with deep partial-thickness burns from a chemical spill in the workplace experiences severe
pain followed by nausea during dressing changes. Which action will be most useful in decreasing the patient’s nausea?
a. Keep the patient NPO for 2 hours before and after dressing changes.
b. Avoid performing dressing changes close to the patient’s mealtimes.
c. Administer the prescribed morphine sulfate before dressing
changes.
i. Because the patient’s nausea is associated with severe pain, it is likely that it is precipitated by stress and
pain. The best treatment will be to provide adequate pain medication before dressing changes. The nurse
should avoid doing painful procedures close to mealtimes, but nausea/vomiting that occur at other times
also should be addressed. Keeping the patient NPO does not address the reason for the nausea and
vomiting and will have an adverse effect on the patient’s nutrition. Administration of antiemetics is not
the best choice for a patient with nausea caused by pain.
d. Give the ordered prochlorperazine (Compazine) before dressing changes.
2. Which item should the nurse offer to the patient who is to restart oral intake after being NPO due to nausea and vomiting?
a. Glass of orange juice
b. Dish of lemon
gelatin
i. Clear cool liquids are usually the first foods started after a patient has been nauseated. Acidic foods such
as orange juice, very hot foods, and coffee are poorly tolerated when patients have been nauseated
c. Cup of coffee with cream
d. Bowl of hot chicken broth
3. A 46-year-old female with gastroesophageal reflux disease (GERD) is experiencing increasing discomfort. Which
patient statement indicates that additional teaching about GERD is needed?
a. “I take antacids between meals and at bedtime each night.”
b. “I sleep with the head of the bed elevated on 4-inch blocks.”
c. “I eat small meals during the day and have a bedtime
snack.”
i. GERD is exacerbated by eating late at night, and the nurse should plan to teach the patient to avoid
eating at bedtime. The other patient actions are appropriate to control symptoms of GERD
d. “I quit smoking several years ago, but I still chew a lot of gum.”
4. A 68-year-old male patient with a stroke is unconscious and unresponsive to stimuli. After learning that the patient has a
history of gastroesophageal reflux disease (GERD), the nurse will plan to do frequent assessments of the patient’s
a. apical pulse.
b. bowel sounds.
c. breath sounds.
i. Because GERD may cause aspiration, the unconscious patient is at risk for developing aspiration
pneumonia. Bowel sounds, abdominal girth, and apical pulse will not be affected by the patient’s stroke
or GERD and do not require more frequent monitoring than the routine.
d. abdominal girth.
5. The nurse explaining esomeprazole (Nexium) to a patient with recurring heartburn describes that the medication
a. reduces gastroesophageal reflux by increasing the rate of gastric emptying.
b. neutralizes stomach acid and provides relief of symptoms in a few minutes.
c. coats and protects the lining of the stomach and esophagus from gastric acid.
d. treats gastroesophageal reflux disease by decreasing stomach acid
production.
i. The proton pump inhibitors decrease the rate of gastric acid secretion. Promotility drugs such as
metoclopramide (Reglan) increase the rate of gastric emptying. Cryoprotective medications such
as sucralfate (Carafate) protect the stomach. Antacids neutralize stomach acid and work rapidly
6. Which patient choice for a snack 2 hours before bedtime indicates that the nurse’s teaching about gastroesophageal
reflux disease (GERD) has been effective?
a. Chocolate pudding
b. Glass of low-fat milk
c. Cherry gelatin with fruit
NURS 1400 TEST BANK QUESTIONS WITH ANSWERS-UPPER GI
PROBLEMS GRADED A+
, NURS 1400 TEST BANK QUESTIONS WITH ANSWERS-UPPER GI
PROBLEMS GRADED A+
i. Gelatin and fruit are low fat and will not decrease lower esophageal sphincter (LES) pressure. Foods such
as chocolate are avoided because they lower LES pressure. Milk products increase gastric acid secretion.
High- fat foods such as peanut butter decrease both gastric emptying and LES pressure.
d. Peanut butter and jelly sandwich
7. The nurse will anticipate teaching a patient experiencing frequent heartburn about
a. a barium swallow.
b. radionuclide tests.
c. endoscopy procedures.
d. proton pump
inhibitors.
i. Because diagnostic testing for heartburn that is probably caused by gastroesophageal reflux disease
(GERD) is expensive and uncomfortable, proton pump inhibitors are frequently used for a short period as
the first step in the diagnosis of GERD. The other tests may be used but are not usually the first step in
diagnosis
8. Which information will the nurse include for a patient with newly diagnosed gastroesophageal reflux disease (GERD)?
a. “Peppermint tea may reduce your symptoms.”
b. “Keep the head of your bed elevated on
blocks.”
i. Elevating the head of the bed will reduce the incidence of reflux while the patient is sleeping. Peppermint
will decrease lower esophageal sphincter (LES) pressure and increase the chance for reflux. Small,
frequent meals are recommended to avoid abdominal distention. There is no need to make changes in
physical activities because of GERD.
c. “You should avoid eating between meals to reduce acid secretion.”
d. “Vigorous physical activities may increase the incidence of reflux.”
9. Which nursing action should be included in the postoperative plan of care for a patient after a laparoscopic esophagectomy?
a. Notify the doctor about bloody nasogastric (NG)
drainage. b. Elevate the head of the bed to at least 30
degrees.
i. Elevation of the head of the bed decreases the risk for reflux and aspiration of gastric secretions. The
NG tube should not be repositioned without consulting with the health care provider. Bloody NG
drainage is expected for the first 8 to 12 hours. A swallowing study is needed before oral fluids are
started.
c. Reposition the NG tube if drainage stops.
d. Start oral fluids when the patient has active bowel sounds.
10. A 50-year-old man vomiting blood-streaked fluid is admitted to the hospital with acute gastritis. To determine possible
risk factors for gastritis, the nurse will ask the patient about
a. the amount of saturated fat in the diet.
b. any family history of gastric or colon cancer.
c. a history of a large recent weight gain or loss.
d. use of nonsteroidal antiinflammatory drugs (NSAIDs).
i. Use of an NSAID is associated with damage to the gastric mucosa, which can result in acute gastritis.
Family history, recent weight gain or loss, and fatty foods are not risk factors for acute gastritis.
11. The nurse determines that teaching regarding cobalamin injections has been effective when the patient with chronic
atrophic gastritis states which of the following?
a. “The cobalamin injections will prevent gastric inflammation.”
b. “The cobalamin injections will prevent me from becoming anemic.”
i. Cobalamin supplementation prevents the development of pernicious anemia. Chronic gastritis may cause
achlorhydria, but cobalamin does not correct this. The loss of intrinsic factor secretion with chronic
gastritis is permanent, and the patient will need lifelong supplementation with cobalamin. The incidence
of stomach cancer is higher in patients with chronic gastritis, but cobalamin does not reduce the risk for
stomach cancer.
c. “These injections will increase the hydrochloric acid in my stomach.”
d. “These injections will decrease my risk for developing stomach cancer.”
12. Which medications will the nurse teach the patient about whose peptic ulcer disease is associated with Helicobacter pylori?
NURS 1400 TEST BANK QUESTIONS WITH ANSWERS-UPPER GI
PROBLEMS GRADED A+
, NURS 1400 TEST BANK QUESTIONS WITH ANSWERS-UPPER GI
PROBLEMS GRADED A+
a. Sucralfate (Carafate), nystatin (Mycostatin), and bismuth (Pepto-
Bismol) b. Amoxicillin (Amoxil), clarithromycin (Biaxin), and
omeprazole (Prilosec)
i. The drugs used in triple drug therapy include a proton pump inhibitor such as omeprazole and the
antibiotics amoxicillin and clarithromycin. The other combinations listed are not included in the
protocol for H. pylori infection.
c. Famotidine (Pepcid), magnesium hydroxide (Mylanta), and pantoprazole (Protonix)
d. Metoclopramide (Reglan), bethanechol (Urecholine), and promethazine (Phenergan)
13. Which action should the nurse in the emergency department anticipate for a 23-year-old patient who has had several
episodes of bloody diarrhea?
a. Obtain a stool specimen for culture.
i. Patients with bloody diarrhea should have a stool culture for E. coli O157:H7. Antidiarrheal medications
are usually avoided for possible infectious diarrhea to avoid prolonging the infection. Antibiotic therapy in
the treatment of infectious diarrhea is controversial because it may precipitate kidney complications.
Acetaminophen does not cause bloody diarrhea.
b. Administer antidiarrheal medication.
c. Provide teaching about antibiotic therapy.
d. Teach about adverse effects of acetaminophen (Tylenol).
14. The nurse will anticipate preparing a 71-year-old female patient who is vomiting “coffee-ground” emesis
for a. endoscopy.
i. Endoscopy is the primary tool for visualization and diagnosis of upper gastrointestinal (GI) bleeding.
Angiography is used only when endoscopy cannot be done because it is more invasive and has more
possible complications. Barium studies are helpful in determining the presence of gastric lesions, but not
whether the lesions are actively bleeding. Gastric analysis testing may help with determining the cause
of gastric irritation, but it is not used for acute GI bleeding.
b. angiography.
c. barium studies.
d. gastric analysis.
15. Which information will the nurse include when teaching a patient with peptic ulcer disease about the effect of
ranitidine (Zantac)?
a. “Ranitidine absorbs the gastric acid.”
b. “Ranitidine decreases gastric acid secretion.”
i. Ranitidine is a histamine-2 (H2) receptor blocker, which decreases the secretion of gastric acid. The
response beginning, “Ranitidine constricts the blood vessels” describes the effect of vasopressin. The
response “Ranitidine absorbs the gastric acid” describes the effect of antacids. The response
beginning “Ranitidine covers the ulcer” describes the action of sucralfate (Carafate).
c. “Ranitidine constricts the blood vessels near the ulcer.”
d. “Ranitidine covers the ulcer with a protective material.”
16. A family member of a 28-year-old patient who has suffered massive abdominal trauma in an automobile accident asks the
nurse why the patient is receiving famotidine (Pepcid). The nurse will explain that the medication will
a. decrease nausea and vomiting.
b. inhibit development of stress ulcers.
i. Famotidine is administered to prevent the development of physiologic stress ulcers, which are associated
with a major physiologic insult such as massive trauma. Famotidine does not decrease nausea or
vomiting, prevent aspiration, or prevent H. pylori infection.
c. lower the risk for H. pylori infection.
d. prevent aspiration of gastric contents.
17. A 68-year-old patient with a bleeding duodenal ulcer has a nasogastric (NG) tube in place, and the health care provider
orders 30 mL of aluminum hydroxide/magnesium hydroxide (Maalox) to be instilled through the tube every hour. To
evaluate the effectiveness of this treatment, the nurse
a. monitors arterial blood gas values daily.
b. periodically aspirates and tests gastric
pH.
i. The purpose for antacids is to increase gastric pH. Checking gastric pH is the most direct way of
NURS 1400 TEST BANK QUESTIONS WITH ANSWERS-UPPER GI
PROBLEMS GRADED A+
, NURS 1400 TEST BANK QUESTIONS WITH ANSWERS-UPPER GI
PROBLEMS GRADED A+
evaluating the effectiveness of the medication. Arterial blood gases may change slightly, but this does
not directly reflect the effect of antacids on gastric pH. Because the patient has upper gastrointestinal
(GI) bleeding, occult blood in the stools will appear even after the acute bleeding has stopped. The
amount of residual stomach contents is not a reflection of resolution of bleeding or of gastric pH.
c. checks each stool for the presence of occult blood.
d. measures the volume of residual stomach contents.
18. A 44-year-old man admitted with a peptic ulcer has a nasogastric (NG) tube in place. When the patient develops sudden,
severe upper abdominal pain, diaphoresis, and a firm abdomen, which action should the nurse take?
a. Irrigate the NG tube.
b. Check the vital
signs.
i. The patient’s symptoms suggest acute perforation, and the nurse should assess for signs of hypovolemic
shock. Irrigation of the NG tube, administration of antacids, or both would be contraindicated because
any material in the stomach will increase the spillage into the peritoneal cavity. Elevating the foot of the
bed may increase abdominal pressure and discomfort, as well as making it more difficult for the patient
to breathe.
c. Give the ordered antacid.
d. Elevate the foot of the bed.
19. A 50-year-old patient who underwent a gastroduodenostomy (Billroth I) earlier today complains of increasing abdominal
pain. The patient has no bowel sounds and 200 mL of bright red nasogastric (NG) drainage in the last hour. The highest
priority action by the nurse is to
a. contact the surgeon.
i. Increased pain and 200 mL of bright red NG drainage 12 hours after surgery indicate possible
postoperative hemorrhage, and immediate actions such as blood transfusion and/or return to surgery are
needed. Because the NG is draining, there is no indication that irrigation is needed. Continuing to monitor
the NG drainage is not an adequate response. The patient may need morphine, but this is not the highest
priority action.
b. irrigate the NG tube.
c. monitor the NG drainage.
d. administer the prescribed morphine.
20. Which patient statement indicates that the nurse’s teaching following a gastroduodenostomy has been
effective? a. “Vitamin supplements may prevent anemia.”
i. Cobalamin deficiency may occur after partial gastrectomy, and the patient may need to receive cobalamin
via injections or nasal spray. Although peptic ulcer disease may recur, persistent heartburn is not expected
after surgery and the patient should call the health care provider if this occurs. Ingestion of liquids with
meals is avoided to prevent dumping syndrome. Foods that have moderate fat and low carbohydrate
should be chosen to prevent dumping syndrome.
b. “Persistent heartburn is common after surgery.”
c. “I will try to drink more liquids with my meals.”
d. “I will need to choose high carbohydrate foods.”
21. At his first postoperative checkup appointment after a gastrojejunostomy (Billroth II), a patient reports that dizziness,
weakness, and palpitations occur about 20 minutes after each meal. The nurse will teach the patient to
a. increase the amount of fluid with meals.
b. eat foods that are higher in
carbohydrates. c. lie down for about 30
minutes after eating.
i. The patient is experiencing symptoms of dumping syndrome, which may be reduced by lying down
after eating. Increasing fluid intake and choosing high carbohydrate foods will increase the risk for
dumping syndrome. Having a sweet drink or hard candy will correct the hypoglycemia that is
associated with dumping syndrome but will not prevent dumping syndrome.
d. drink sugared fluids or eat candy after meals.
22. A 62-year-old man patient who requires daily use of a nonsteroidal antiinflammatory drug (NSAID) for the management
of severe rheumatoid arthritis has recently developed melena. The nurse will anticipate teaching the patient about
a. substitution of acetaminophen (Tylenol) for the NSAID.
NURS 1400 TEST BANK QUESTIONS WITH ANSWERS-UPPER GI
PROBLEMS GRADED A+
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