C HAPTER 21: G ASTROINTESTINAL D ISORDERS
AND T HERAPEUTIC M ANAGEMENT
Urden: Priorities in Critical Care Nursing, 8th Edition
MULTIPLE CHOICE
1. A patient with acute pancreatitis is complaining of a pain in the left
upper quadrant. Using a 1 - to 10-point pain scale, the patient states the
current level is at an 8. What inter vention would the nurse include in the
patient’s plan of care to facilitate pain control?
a. Administer analgesics onl y as needed.
b. Administer analgesics around the clock.
c. Educate the patient and famil y on lifest yl e changes.
d. Teach relaxation and distraction t echniques.
ANS: B
Pain management is a major priorit y in acute pancreatitis.
Administration of around -the-clock analgesics to achieve pain relief is
essential. Morphine, fentanyl, and hydromorphone are the commonl y
used narcotics for pain control. Relaxa tion techniques and the knee -
chest position can also assist in pain control. However, the patient’s
pain needs to be addressed first.
PTS: 1 DIF: Cognitive Level: Anal yzing OBJ: Nursing
Process Step: Evaluation TOP: Gastrointestinal Disorders
and Therapeutic Management MSC: NC LEX:
Physiological Integrity: Physiological Adaptation
,2. A patient with a history of chronic alcoholism was admitted with acute
pancreatitis. The nurse is developing a patient education plan. Which
topic would the nurse include in the plan?
a. Diabetes management
b. Alcohol cessation
c. Occult blood testing
d. Anticoagulation management
ANS: B
As the patient moves toward discharge, teaching should focus on the
interventions necessary for preventing the recurrence of the
precipitating diso rder. If an alcohol abuser, the patient should be
encouraged to stop drinking and be referred to an alcohol cessation
program.
PTS: 1 DIF: Cognitive Level: Appl ying OBJ: Nursing
Process Step: Implementation TOP: Gastrointestinal
Disorders and Thera peutic Management MSC: NC LEX:
Health Promotion and Maintenance
3. A Salem sump nasogastric tube has two lumens. The first lumen is for
suction and drainage. What is the purpose of the second lumen?
a. Allows for administration of tube feeding.
b. Allows for testing of gastric secretions.
c. Prevents tube from adhering to the gastric wall.
d. Prevents the tube from advancing.
ANS: C
, The Salem sump has one lumen that is used for suction and drainage
and another that allows air to enter the patient’s stomach and preven ts
the tube from adhering to the gastric wall and damaging the mucosa.
PTS: 1 DIF: Cognitive Level: Understanding OBJ:
Nursing Process Step: Evaluation TOP: Gastrointestinal
Disorders and Therapeutic Management MSC: NC LEX:
Physiological Integrity: Reduction of Risk Potential
4. The nurse is caring for a patient with acute liver failure. The patient has
elevated ammonia levels. Which medication would the nurse expect the
practitioner to order for this patient?
a. Insulin
b. Vitamin K
c. Lactulose
d. Lorazepam
ANS: C
Lactulose, a synthetic Ketoanalogue of lactose split into lactic acid and
acetic acid in the intestine, is given orally through a nasogastric tube
or as a retention enema. The result is the creation of an acidic
environment that results in ammonia b eing drawn out of the portal
circulation. Lactulose has a laxative effect that promotes expulsion.
Vitamin K is used to help control bleeding. Insulin would be given to
control hypergl ycemia. Use of benzodiazepines and other sedatives is
discouraged in a p atient with ALF because pertinent neurologic
changes may be masked, and hepatic encephalopathy may be
exacerbated.
AND T HERAPEUTIC M ANAGEMENT
Urden: Priorities in Critical Care Nursing, 8th Edition
MULTIPLE CHOICE
1. A patient with acute pancreatitis is complaining of a pain in the left
upper quadrant. Using a 1 - to 10-point pain scale, the patient states the
current level is at an 8. What inter vention would the nurse include in the
patient’s plan of care to facilitate pain control?
a. Administer analgesics onl y as needed.
b. Administer analgesics around the clock.
c. Educate the patient and famil y on lifest yl e changes.
d. Teach relaxation and distraction t echniques.
ANS: B
Pain management is a major priorit y in acute pancreatitis.
Administration of around -the-clock analgesics to achieve pain relief is
essential. Morphine, fentanyl, and hydromorphone are the commonl y
used narcotics for pain control. Relaxa tion techniques and the knee -
chest position can also assist in pain control. However, the patient’s
pain needs to be addressed first.
PTS: 1 DIF: Cognitive Level: Anal yzing OBJ: Nursing
Process Step: Evaluation TOP: Gastrointestinal Disorders
and Therapeutic Management MSC: NC LEX:
Physiological Integrity: Physiological Adaptation
,2. A patient with a history of chronic alcoholism was admitted with acute
pancreatitis. The nurse is developing a patient education plan. Which
topic would the nurse include in the plan?
a. Diabetes management
b. Alcohol cessation
c. Occult blood testing
d. Anticoagulation management
ANS: B
As the patient moves toward discharge, teaching should focus on the
interventions necessary for preventing the recurrence of the
precipitating diso rder. If an alcohol abuser, the patient should be
encouraged to stop drinking and be referred to an alcohol cessation
program.
PTS: 1 DIF: Cognitive Level: Appl ying OBJ: Nursing
Process Step: Implementation TOP: Gastrointestinal
Disorders and Thera peutic Management MSC: NC LEX:
Health Promotion and Maintenance
3. A Salem sump nasogastric tube has two lumens. The first lumen is for
suction and drainage. What is the purpose of the second lumen?
a. Allows for administration of tube feeding.
b. Allows for testing of gastric secretions.
c. Prevents tube from adhering to the gastric wall.
d. Prevents the tube from advancing.
ANS: C
, The Salem sump has one lumen that is used for suction and drainage
and another that allows air to enter the patient’s stomach and preven ts
the tube from adhering to the gastric wall and damaging the mucosa.
PTS: 1 DIF: Cognitive Level: Understanding OBJ:
Nursing Process Step: Evaluation TOP: Gastrointestinal
Disorders and Therapeutic Management MSC: NC LEX:
Physiological Integrity: Reduction of Risk Potential
4. The nurse is caring for a patient with acute liver failure. The patient has
elevated ammonia levels. Which medication would the nurse expect the
practitioner to order for this patient?
a. Insulin
b. Vitamin K
c. Lactulose
d. Lorazepam
ANS: C
Lactulose, a synthetic Ketoanalogue of lactose split into lactic acid and
acetic acid in the intestine, is given orally through a nasogastric tube
or as a retention enema. The result is the creation of an acidic
environment that results in ammonia b eing drawn out of the portal
circulation. Lactulose has a laxative effect that promotes expulsion.
Vitamin K is used to help control bleeding. Insulin would be given to
control hypergl ycemia. Use of benzodiazepines and other sedatives is
discouraged in a p atient with ALF because pertinent neurologic
changes may be masked, and hepatic encephalopathy may be
exacerbated.
