BRUNNER AND SUDDARTH'S TEXTBOOK OF
MEDICAL-SURGICAL NURSING- CHAPTER 40
QUESTIONS AND ANSWERS WITH VERIFIED
SOLUTIONS 100% LATEST UPDATE
Multiple Choice
3. A nurse is preparing to discharge a client after recovery from gastric surgery. What is
an appropriate discharge outcome for this client?
A. Bowel movements maintain a loose consistency.
B. Three large meals per day are tolerated.
C. Weight is maintained or gained.
D. High calcium diet is consumed. - CORRECT ANSWES -- C
Rationale: Weight loss is common in the postoperative period, with early satiety,
dysphagia, reflux and regurgitation, and elimination issues contributing to this problem.
The client should weigh oneself daily, with a goal of maintaining or gaining weight. The
client should not have bowel movements that maintain a loose consistency, because
this would indicate diarrhea and would warrant intervention as it is a symptom of
dumping syndrome. The client should be able to tolerate six small meals per day, rather
than three large meals. The client does not require a diet excessively rich in calcium but
should consume a diet high in calories, iron, vitamin A and vitamin C.
PTS: 1 REF: p. 1277
NAT: Client Needs: Physiological Integrity: Reduction of Risk Potential
TOP: Chapter 40: Management of Clients With Gastric and Duodenal Disorders
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply
Multiple Choice
Chapter 40: Management of Patients with Gastric and Duodenal Disorders
1. A nurse is caring for a client who just has been diagnosed with a peptic ulcer. When
teaching the client about his new diagnosis, how should the nurse best describe it?
A. Inflammation of the lining of the stomach
B. Erosion of the lining of the stomach or intestine
C. Bleeding from the mucosa in the stomach
D. Viral invasion of the stomach wall - CORRECT ANSWES -- B
,Rationale: A peptic ulcer is erosion of the lining of the stomach or intestine. Peptic
ulcers are often accompanied by bleeding and inflammation, but these are not the
definitive characteristics.
PTS: 1 REF: p. 1270
NAT: Client Needs: Physiological Integrity: Physiological Adaptation
TOP: Chapter 40: Management of Clients With Gastric and Duodenal Disorders
KEY: Integrated Process: Teaching/Learning BLM: Cognitive Level: Apply
Multiple Choice
2. A nurse is admitting a client diagnosed with late-stage gastric cancer. The client's
family is distraught and angry that the client was not diagnosed earlier in the course of
her disease. What factor most likely contributed to the client's late diagnosis?
A. Gastric cancer does not cause signs or symptoms until metastasis has occurred.
B. Adherence to screening recommendations for gastric cancer is exceptionally low.
C. Early symptoms of gastric cancer are usually attributed to constipation.
D. The early symptoms of gastric cancer are usually not alarming or highly unusual. -
CORRECT ANSWES -- D
Rationale: Symptoms of early gastric cancer, such as pain relieved by antacids,
resemble those of benign ulcers and are seldom definitive. Symptoms are rarely a
cause for alarm or for detailed diagnostic testing. Symptoms precede metastasis,
however, and do not include constipation.
PTS: 1 REF: p. 1278
NAT: Client Needs: Physiological Integrity: Physiological Adaptation
TOP: Chapter 40: Management of Clients With Gastric and Duodenal Disorders
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Analyze
Multiple Choice
4. A nurse is completing a health history on a client whose diagnosis is chronic gastritis.
Which of the data should the nurse consider most significantly related to the etiology of
the client's health problem?
A. Consumes one or more protein drinks daily.
B. Takes over-the-counter antacids frequently throughout the day.
C. Smokes one pack of cigarettes daily.
D. Reports a history of social drinking on a weekly basis. - CORRECT ANSWES -- C
Rationale: Nicotine reduces secretion of pancreatic bicarbonate, which inhibits
neutralization of gastric acid and can underlie gastritis. Protein drinks do not result in
gastric inflammation. Antacid use is a response to experiencing symptoms of gastritis,
not the etiology of gastritis. Alcohol ingestion can lead to gastritis; however, this
generally occurs in clients with a history of consumption of alcohol on a daily basis.
PTS: 1 REF: p. 1273
NAT: Client Needs: Physiological Integrity: Reduction of Risk Potential
, TOP: Chapter 40: Management of Clients With Gastric and Duodenal Disorders
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Analyze
Multiple Choice
5. A community health nurse is preparing for an initial home visit to a client discharged
following a total gastrectomy for treatment of gastric cancer. What would the nurse
anticipate that the plan of care is most likely to include?
A. Enteral feeding via gastrostomy tube (G tube)
B. Gastrointestinal decompression by nasogastric tube
C. Periodic assessment for esophageal distension
D. Administration of injections of vitamin B12 - CORRECT ANSWES -- D
Rationale: Since vitamin B12 is absorbed in the stomach, the client requires vitamin B12
replacement to prevent pernicious anemia. A gastrectomy precludes the use of a G
tube. Since the stomach is absent, a nasogastric tube would not be indicated. As well,
this is not possible in the home setting. Since there is no stomach to act as a reservoir
and fluids and nutrients are passing directly into the jejunum, distension is unlikely.
PTS: 1 REF: p. 1270 NAT: Client Needs: Health Promotion and Maintenance
TOP: Chapter 40: Management of Clients With Gastric and Duodenal Disorders
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Analyze
Multiple Choice
6. A nurse is assessing a client who has peptic ulcer disease. The client requests more
information about the typical causes of Helicobacter pylori infection. What would it be
appropriate for the nurse to instruct the client?
A. Most affected clients acquired the infection during international travel.
B. Infection typically occurs due to ingestion of contaminated food and water.
C. Many people possess genetic factors causing a predisposition to H. pylori infection.
D. The H. pylori microorganism is endemic in warm, moist climates. - CORRECT
ANSWES -- B
7. A client who experienced a large upper gastrointestinal (GI) bleed due to gastritis has
had the bleeding controlled and is now stable. For the next several hours, the nurse
caring for this client should assess for what signs and symptoms of recurrence?
A. Tachycardia, hypotension, and tachypnea
B. Tarry, foul-smelling stools
C. Diaphoresis and sudden onset of abdominal pain
D. Sudden thirst, unrelieved by oral fluid administration - CORRECT ANSWES -- A
Rationale: Tachycardia, hypotension, and tachypnea are signs of recurrent bleeding.
Clients who have had one GI bleed are at risk for recurrence. Tarry stools are expected
short-term findings after a hemorrhage. Hemorrhage is not normally associated with
sudden thirst or diaphoresis.
MEDICAL-SURGICAL NURSING- CHAPTER 40
QUESTIONS AND ANSWERS WITH VERIFIED
SOLUTIONS 100% LATEST UPDATE
Multiple Choice
3. A nurse is preparing to discharge a client after recovery from gastric surgery. What is
an appropriate discharge outcome for this client?
A. Bowel movements maintain a loose consistency.
B. Three large meals per day are tolerated.
C. Weight is maintained or gained.
D. High calcium diet is consumed. - CORRECT ANSWES -- C
Rationale: Weight loss is common in the postoperative period, with early satiety,
dysphagia, reflux and regurgitation, and elimination issues contributing to this problem.
The client should weigh oneself daily, with a goal of maintaining or gaining weight. The
client should not have bowel movements that maintain a loose consistency, because
this would indicate diarrhea and would warrant intervention as it is a symptom of
dumping syndrome. The client should be able to tolerate six small meals per day, rather
than three large meals. The client does not require a diet excessively rich in calcium but
should consume a diet high in calories, iron, vitamin A and vitamin C.
PTS: 1 REF: p. 1277
NAT: Client Needs: Physiological Integrity: Reduction of Risk Potential
TOP: Chapter 40: Management of Clients With Gastric and Duodenal Disorders
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply
Multiple Choice
Chapter 40: Management of Patients with Gastric and Duodenal Disorders
1. A nurse is caring for a client who just has been diagnosed with a peptic ulcer. When
teaching the client about his new diagnosis, how should the nurse best describe it?
A. Inflammation of the lining of the stomach
B. Erosion of the lining of the stomach or intestine
C. Bleeding from the mucosa in the stomach
D. Viral invasion of the stomach wall - CORRECT ANSWES -- B
,Rationale: A peptic ulcer is erosion of the lining of the stomach or intestine. Peptic
ulcers are often accompanied by bleeding and inflammation, but these are not the
definitive characteristics.
PTS: 1 REF: p. 1270
NAT: Client Needs: Physiological Integrity: Physiological Adaptation
TOP: Chapter 40: Management of Clients With Gastric and Duodenal Disorders
KEY: Integrated Process: Teaching/Learning BLM: Cognitive Level: Apply
Multiple Choice
2. A nurse is admitting a client diagnosed with late-stage gastric cancer. The client's
family is distraught and angry that the client was not diagnosed earlier in the course of
her disease. What factor most likely contributed to the client's late diagnosis?
A. Gastric cancer does not cause signs or symptoms until metastasis has occurred.
B. Adherence to screening recommendations for gastric cancer is exceptionally low.
C. Early symptoms of gastric cancer are usually attributed to constipation.
D. The early symptoms of gastric cancer are usually not alarming or highly unusual. -
CORRECT ANSWES -- D
Rationale: Symptoms of early gastric cancer, such as pain relieved by antacids,
resemble those of benign ulcers and are seldom definitive. Symptoms are rarely a
cause for alarm or for detailed diagnostic testing. Symptoms precede metastasis,
however, and do not include constipation.
PTS: 1 REF: p. 1278
NAT: Client Needs: Physiological Integrity: Physiological Adaptation
TOP: Chapter 40: Management of Clients With Gastric and Duodenal Disorders
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Analyze
Multiple Choice
4. A nurse is completing a health history on a client whose diagnosis is chronic gastritis.
Which of the data should the nurse consider most significantly related to the etiology of
the client's health problem?
A. Consumes one or more protein drinks daily.
B. Takes over-the-counter antacids frequently throughout the day.
C. Smokes one pack of cigarettes daily.
D. Reports a history of social drinking on a weekly basis. - CORRECT ANSWES -- C
Rationale: Nicotine reduces secretion of pancreatic bicarbonate, which inhibits
neutralization of gastric acid and can underlie gastritis. Protein drinks do not result in
gastric inflammation. Antacid use is a response to experiencing symptoms of gastritis,
not the etiology of gastritis. Alcohol ingestion can lead to gastritis; however, this
generally occurs in clients with a history of consumption of alcohol on a daily basis.
PTS: 1 REF: p. 1273
NAT: Client Needs: Physiological Integrity: Reduction of Risk Potential
, TOP: Chapter 40: Management of Clients With Gastric and Duodenal Disorders
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Analyze
Multiple Choice
5. A community health nurse is preparing for an initial home visit to a client discharged
following a total gastrectomy for treatment of gastric cancer. What would the nurse
anticipate that the plan of care is most likely to include?
A. Enteral feeding via gastrostomy tube (G tube)
B. Gastrointestinal decompression by nasogastric tube
C. Periodic assessment for esophageal distension
D. Administration of injections of vitamin B12 - CORRECT ANSWES -- D
Rationale: Since vitamin B12 is absorbed in the stomach, the client requires vitamin B12
replacement to prevent pernicious anemia. A gastrectomy precludes the use of a G
tube. Since the stomach is absent, a nasogastric tube would not be indicated. As well,
this is not possible in the home setting. Since there is no stomach to act as a reservoir
and fluids and nutrients are passing directly into the jejunum, distension is unlikely.
PTS: 1 REF: p. 1270 NAT: Client Needs: Health Promotion and Maintenance
TOP: Chapter 40: Management of Clients With Gastric and Duodenal Disorders
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Analyze
Multiple Choice
6. A nurse is assessing a client who has peptic ulcer disease. The client requests more
information about the typical causes of Helicobacter pylori infection. What would it be
appropriate for the nurse to instruct the client?
A. Most affected clients acquired the infection during international travel.
B. Infection typically occurs due to ingestion of contaminated food and water.
C. Many people possess genetic factors causing a predisposition to H. pylori infection.
D. The H. pylori microorganism is endemic in warm, moist climates. - CORRECT
ANSWES -- B
7. A client who experienced a large upper gastrointestinal (GI) bleed due to gastritis has
had the bleeding controlled and is now stable. For the next several hours, the nurse
caring for this client should assess for what signs and symptoms of recurrence?
A. Tachycardia, hypotension, and tachypnea
B. Tarry, foul-smelling stools
C. Diaphoresis and sudden onset of abdominal pain
D. Sudden thirst, unrelieved by oral fluid administration - CORRECT ANSWES -- A
Rationale: Tachycardia, hypotension, and tachypnea are signs of recurrent bleeding.
Clients who have had one GI bleed are at risk for recurrence. Tarry stools are expected
short-term findings after a hemorrhage. Hemorrhage is not normally associated with
sudden thirst or diaphoresis.
