NUR 417 Exam 1 part 1
A patient vomiting blood-streaked fluid is admitted to the hospital with acute gastritis.
What would the nurse ask the patient about to determine possible risk factors for
gastritis?
1. The amount of saturated fat in the diet
2. A family history of gastric or colon cancer
3. Use of nonsteroidal antiinflammatory drugs
4. A history of a large recent weight gain or loss - CORRECT ANSWERS-3. Use of
nonsteroidal antiinflammatory drugs
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.
A patient has peptic ulcer disease associated with Helicobacter pylori. Which
medications will the nurse plan to teach the patient?
1. Sucralfate (Carafate), nystatin, and bismuth (Pepto-Bismol)
2. Metoclopramide (Reglan), bethanechol, and promethazine
3. Amoxicillin (Amoxil), clarithromycin, and omeprazole (Prilosec)
4. Famotidine (Pepcid), magnesium hydroxide (Mylanta), and pantoprazole - CORRECT
ANSWERS-3. Amoxicillin (Amoxil), clarithromycin, and omeprazole (Prilosec)
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.
Which diagnostic test would the nurse anticipate for an older patient who is vomiting
"coffee-ground" emesis?
1. Endoscopy
2. Angiography
3. Barium studies
4. Gastric analysis - CORRECT ANSWERS-1. Endoscopy
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.
,Which information will the nurse include when teaching a patient with peptic ulcer
disease about the effect of famotidine (Pepcid)?
1. "Famotidine absorbs the excess gastric acid."
2. "Famotidine decreases gastric acid secretion."
3. "Famotidine constricts the blood vessels near the ulcer."
4. "Famotidine covers the ulcer with a protective material." - CORRECT ANSWERS-2.
"Famotidine decreases gastric acid secretion."
Famotidine is a histamine-2 (H2) receptor blocker that decreases the secretion of
gastric acid. Famotidine does not constrict the blood vessels, absorb the gastric acid, or
cover the ulcer.
A young adult patient is hospitalized with massive abdominal trauma from a motor
vehicle crash. The patient asks about the purpose of receiving famotidine (Pepcid).
Which information would the nurse explain about the action of the medication?
1. "It decreases nausea and vomiting."
2. "It inhibits development of stress ulcers."
3. "It lowers the risk for H. pylori infection."
4. "It prevents aspiration of gastric contents." - CORRECT ANSWERS-2. "It inhibits
development of stress ulcers."
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.
A patient 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 would the nurse take?
1. Irrigate the NG tube.
2. Check the vital signs.
3. Give the ordered antacid.
4. Elevate the foot of the bed. - CORRECT ANSWERS-2. Check the vital signs.
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.
A patient who underwent a gastroduodenostomy (Billroth I) 12 hours ago reports
increasing abdominal pain. The patient has no bowel sounds and 200 mL of bright red
nasogastric (NG) drainage in the past hour. Which nursing action is the highest priority?
, 1. Monitor drainage.
2. Contact the surgeon.
3. Irrigate the NG tube.
4. Give prescribed morphine. - CORRECT ANSWERS-2. Contact the surgeon.
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 or
return to surgery are needed (or both). Because the NG is draining, there is no
indication that irrigation is needed. Continuing to monitor the NG drainage is needed but
not an adequate response to the findings. The patient may need morphine, but this is
not the highest priority action.
Which patient statement indicates that the nurse's postoperative teaching after a
gastroduodenostomy has been effective?
1. "I will drink more liquids with my meals."
2. "I should choose high carbohydrate foods."
3. "Vitamin supplements may prevent anemia."
4. "Persistent heartburn is expected after surgery." - CORRECT ANSWERS-3. "Vitamin
supplements may prevent anemia."
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.
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. Which action would the nurse teach the patient to take?
1. Increase the amount of fluid with meals.
2. Eat foods that are higher in carbohydrates.
3. Lie down for about 30 minutes after eating.
4. Drink sugared fluids or eat candy after meals. - CORRECT ANSWERS-3. Lie down
for about 30 minutes after eating.
The patient is experiencing symptoms of dumping syndrome, which may be reduced by
lying down for a short rest 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.
A patient vomiting blood-streaked fluid is admitted to the hospital with acute gastritis.
What would the nurse ask the patient about to determine possible risk factors for
gastritis?
1. The amount of saturated fat in the diet
2. A family history of gastric or colon cancer
3. Use of nonsteroidal antiinflammatory drugs
4. A history of a large recent weight gain or loss - CORRECT ANSWERS-3. Use of
nonsteroidal antiinflammatory drugs
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.
A patient has peptic ulcer disease associated with Helicobacter pylori. Which
medications will the nurse plan to teach the patient?
1. Sucralfate (Carafate), nystatin, and bismuth (Pepto-Bismol)
2. Metoclopramide (Reglan), bethanechol, and promethazine
3. Amoxicillin (Amoxil), clarithromycin, and omeprazole (Prilosec)
4. Famotidine (Pepcid), magnesium hydroxide (Mylanta), and pantoprazole - CORRECT
ANSWERS-3. Amoxicillin (Amoxil), clarithromycin, and omeprazole (Prilosec)
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.
Which diagnostic test would the nurse anticipate for an older patient who is vomiting
"coffee-ground" emesis?
1. Endoscopy
2. Angiography
3. Barium studies
4. Gastric analysis - CORRECT ANSWERS-1. Endoscopy
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.
,Which information will the nurse include when teaching a patient with peptic ulcer
disease about the effect of famotidine (Pepcid)?
1. "Famotidine absorbs the excess gastric acid."
2. "Famotidine decreases gastric acid secretion."
3. "Famotidine constricts the blood vessels near the ulcer."
4. "Famotidine covers the ulcer with a protective material." - CORRECT ANSWERS-2.
"Famotidine decreases gastric acid secretion."
Famotidine is a histamine-2 (H2) receptor blocker that decreases the secretion of
gastric acid. Famotidine does not constrict the blood vessels, absorb the gastric acid, or
cover the ulcer.
A young adult patient is hospitalized with massive abdominal trauma from a motor
vehicle crash. The patient asks about the purpose of receiving famotidine (Pepcid).
Which information would the nurse explain about the action of the medication?
1. "It decreases nausea and vomiting."
2. "It inhibits development of stress ulcers."
3. "It lowers the risk for H. pylori infection."
4. "It prevents aspiration of gastric contents." - CORRECT ANSWERS-2. "It inhibits
development of stress ulcers."
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.
A patient 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 would the nurse take?
1. Irrigate the NG tube.
2. Check the vital signs.
3. Give the ordered antacid.
4. Elevate the foot of the bed. - CORRECT ANSWERS-2. Check the vital signs.
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.
A patient who underwent a gastroduodenostomy (Billroth I) 12 hours ago reports
increasing abdominal pain. The patient has no bowel sounds and 200 mL of bright red
nasogastric (NG) drainage in the past hour. Which nursing action is the highest priority?
, 1. Monitor drainage.
2. Contact the surgeon.
3. Irrigate the NG tube.
4. Give prescribed morphine. - CORRECT ANSWERS-2. Contact the surgeon.
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 or
return to surgery are needed (or both). Because the NG is draining, there is no
indication that irrigation is needed. Continuing to monitor the NG drainage is needed but
not an adequate response to the findings. The patient may need morphine, but this is
not the highest priority action.
Which patient statement indicates that the nurse's postoperative teaching after a
gastroduodenostomy has been effective?
1. "I will drink more liquids with my meals."
2. "I should choose high carbohydrate foods."
3. "Vitamin supplements may prevent anemia."
4. "Persistent heartburn is expected after surgery." - CORRECT ANSWERS-3. "Vitamin
supplements may prevent anemia."
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.
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. Which action would the nurse teach the patient to take?
1. Increase the amount of fluid with meals.
2. Eat foods that are higher in carbohydrates.
3. Lie down for about 30 minutes after eating.
4. Drink sugared fluids or eat candy after meals. - CORRECT ANSWERS-3. Lie down
for about 30 minutes after eating.
The patient is experiencing symptoms of dumping syndrome, which may be reduced by
lying down for a short rest 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.
