Upper GI NCLEX question Flashcards EXAM 2024
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.
d. Give the ordered prochlorperazine (Compazine) before dressing changes. - ansC
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.
c. Give the ordered antacid.
d. Elevate the foot of the bed. - ansB
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."
d. "I quit smoking several years ago, but I still chew a lot of gum." - ansC
A 49-year-old man has been admitted with hypotension and dehydration after 3 days of
nausea and vomiting. Which order from the health care provider will the nurse
implement first?
a. Insert a nasogastric (NG) tube.
b. Infuse normal saline at 250 mL/hr.
c. Administer IV ondansetron (Zofran).
d. Provide oral care with moistened swabs. - ansB
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). - ansD
,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.
b. irrigate the NG tube.
c. monitor the NG drainage.
d. administer the prescribed morphine. - ansA
A 58-year-old patient has just been admitted to the emergency department with nausea
and vomiting. Which information requires the most rapid intervention by the nurse?
a. The patient has been vomiting for 4 days.
b. The patient takes antacids 8 to 10 times a day.
c. The patient is lethargic and difficult to arouse.
d. The patient has undergone a small intestinal resection. - ansC-Risk for aspiration
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.
d. abdominal girth. - ansC
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.
c. checks each stool for the presence of occult blood.
d. measures the volume of residual stomach contents. - ansB
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.
c. lower the risk for H. pylori infection.
d. prevent aspiration of gastric contents. - ansB
A patient returned from a laparoscopic Nissen fundoplication for hiatal hernia 4 hours
ago. Which assessment finding is most important for the nurse to address immediately?
a. The patient is experiencing intermittent waves of nausea.
b. The patient complains of 7/10 (0 to 10 scale) abdominal pain.
,c. The patient has absent breath sounds in the left anterior chest.
d. The patient has hypoactive bowel sounds in all four quadrants. - ansC
An 80-year-old who is hospitalized with peptic ulcer disease develops new-onset
auditory hallucinations. Which prescribed medication will the nurse discuss with the
health care provider before administration?
a. Sucralfate (Carafate)
b. Omeprazole (Prilosec)
c. Metoclopramide (Reglan)
d. Aluminum hydroxide (Amphojel) - ansC
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.
d. drink sugared fluids or eat candy after meals. - ansC
In which order will the nurse take the following actions when caring for a patient who
develops watery diarrhea and a fever after prolonged omeprazole (Prilosec) therapy?
(Put a comma and a space between each answer choice [A, B, C, D].)
a. Contact the health care provider.
b. Assess blood pressure and heart rate.
c. Give the PRN acetaminophen (Tylenol).
d. Place the patient on contact precautions. - ansD, B, A, C
The health care provider prescribes antacids and sucralfate (Carafate) for treatment of a
patient's peptic ulcer. The nurse will teach the patient to take
a. sucralfate at bedtime and antacids before each meal.
b. sucralfate and antacids together 30 minutes before meals.
c. antacids 30 minutes before each dose of sucralfate is taken.
d. antacids after meals and sucralfate 30 minutes before meals. - ansD
The nurse and a licensed practical/vocational nurse (LPN/LVN) are working together to
care for a patient who had an esophagectomy 2 days ago. Which action by the
LPN/LVN requires that the nurse intervene?
a. The LPN/LVN uses soft swabs to provide for oral care.
b. The LPN/LVN positions the head of the bed in the flat position.
c. The LPN/LVN encourages the patient to use pain medications before coughing.
d. The LPN/LVN includes the enteral feeding volume when calculating intake and
output. - ansB
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."
c. "These injections will increase the hydrochloric acid in my stomach."
d. "These injections will decrease my risk for developing stomach cancer." - ansB
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. -
ansD
The nurse is administering IV fluid boluses and nasogastric irrigation to a patient with
acute gastrointestinal (GI) bleeding. Which assessment finding is most important for the
nurse to communicate to the health care provider?
a. The bowel sounds are hyperactive in all four quadrants.
b. The patient's lungs have crackles audible to the midchest.
c. The nasogastric (NG) suction is returning coffee-ground material.
d. The patient's blood pressure (BP) has increased to 142/84 mm Hg. - ansB
The nurse is assessing a patient who had a total gastrectomy 8 hours ago. What
information is most important to report to the health care provider?
a. Absent bowel sounds
b. Complaints of incisional pain
c. Temperature 102.1° F (38.9° C)
d. Scant nasogastric (NG) tube drainage - ansC
The nurse will anticipate preparing a 71-year-old female patient who is vomiting "coffee-
ground" emesis for
a. endoscopy.
b. angiography.
c. barium studies.
d. gastric analysis. - ansA
Which assessment should the nurse perform first for a patient who just vomited bright
red blood?
a. Measuring the quantity of emesis
b. Palpating the abdomen for distention
c. Auscultating the chest for breath sounds
d. Taking the blood pressure (BP) and pulse - ansD-assess for shock
Which information about dietary management should the nurse include when teaching a
patient with peptic ulcer disease (PUD)?
a. "You will need to remain on a bland diet."
b. "Avoid foods that cause pain after you eat them."
c. "High-protein foods are least likely to cause you pain."
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.
d. Give the ordered prochlorperazine (Compazine) before dressing changes. - ansC
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.
c. Give the ordered antacid.
d. Elevate the foot of the bed. - ansB
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."
d. "I quit smoking several years ago, but I still chew a lot of gum." - ansC
A 49-year-old man has been admitted with hypotension and dehydration after 3 days of
nausea and vomiting. Which order from the health care provider will the nurse
implement first?
a. Insert a nasogastric (NG) tube.
b. Infuse normal saline at 250 mL/hr.
c. Administer IV ondansetron (Zofran).
d. Provide oral care with moistened swabs. - ansB
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). - ansD
,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.
b. irrigate the NG tube.
c. monitor the NG drainage.
d. administer the prescribed morphine. - ansA
A 58-year-old patient has just been admitted to the emergency department with nausea
and vomiting. Which information requires the most rapid intervention by the nurse?
a. The patient has been vomiting for 4 days.
b. The patient takes antacids 8 to 10 times a day.
c. The patient is lethargic and difficult to arouse.
d. The patient has undergone a small intestinal resection. - ansC-Risk for aspiration
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.
d. abdominal girth. - ansC
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.
c. checks each stool for the presence of occult blood.
d. measures the volume of residual stomach contents. - ansB
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.
c. lower the risk for H. pylori infection.
d. prevent aspiration of gastric contents. - ansB
A patient returned from a laparoscopic Nissen fundoplication for hiatal hernia 4 hours
ago. Which assessment finding is most important for the nurse to address immediately?
a. The patient is experiencing intermittent waves of nausea.
b. The patient complains of 7/10 (0 to 10 scale) abdominal pain.
,c. The patient has absent breath sounds in the left anterior chest.
d. The patient has hypoactive bowel sounds in all four quadrants. - ansC
An 80-year-old who is hospitalized with peptic ulcer disease develops new-onset
auditory hallucinations. Which prescribed medication will the nurse discuss with the
health care provider before administration?
a. Sucralfate (Carafate)
b. Omeprazole (Prilosec)
c. Metoclopramide (Reglan)
d. Aluminum hydroxide (Amphojel) - ansC
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.
d. drink sugared fluids or eat candy after meals. - ansC
In which order will the nurse take the following actions when caring for a patient who
develops watery diarrhea and a fever after prolonged omeprazole (Prilosec) therapy?
(Put a comma and a space between each answer choice [A, B, C, D].)
a. Contact the health care provider.
b. Assess blood pressure and heart rate.
c. Give the PRN acetaminophen (Tylenol).
d. Place the patient on contact precautions. - ansD, B, A, C
The health care provider prescribes antacids and sucralfate (Carafate) for treatment of a
patient's peptic ulcer. The nurse will teach the patient to take
a. sucralfate at bedtime and antacids before each meal.
b. sucralfate and antacids together 30 minutes before meals.
c. antacids 30 minutes before each dose of sucralfate is taken.
d. antacids after meals and sucralfate 30 minutes before meals. - ansD
The nurse and a licensed practical/vocational nurse (LPN/LVN) are working together to
care for a patient who had an esophagectomy 2 days ago. Which action by the
LPN/LVN requires that the nurse intervene?
a. The LPN/LVN uses soft swabs to provide for oral care.
b. The LPN/LVN positions the head of the bed in the flat position.
c. The LPN/LVN encourages the patient to use pain medications before coughing.
d. The LPN/LVN includes the enteral feeding volume when calculating intake and
output. - ansB
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."
c. "These injections will increase the hydrochloric acid in my stomach."
d. "These injections will decrease my risk for developing stomach cancer." - ansB
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. -
ansD
The nurse is administering IV fluid boluses and nasogastric irrigation to a patient with
acute gastrointestinal (GI) bleeding. Which assessment finding is most important for the
nurse to communicate to the health care provider?
a. The bowel sounds are hyperactive in all four quadrants.
b. The patient's lungs have crackles audible to the midchest.
c. The nasogastric (NG) suction is returning coffee-ground material.
d. The patient's blood pressure (BP) has increased to 142/84 mm Hg. - ansB
The nurse is assessing a patient who had a total gastrectomy 8 hours ago. What
information is most important to report to the health care provider?
a. Absent bowel sounds
b. Complaints of incisional pain
c. Temperature 102.1° F (38.9° C)
d. Scant nasogastric (NG) tube drainage - ansC
The nurse will anticipate preparing a 71-year-old female patient who is vomiting "coffee-
ground" emesis for
a. endoscopy.
b. angiography.
c. barium studies.
d. gastric analysis. - ansA
Which assessment should the nurse perform first for a patient who just vomited bright
red blood?
a. Measuring the quantity of emesis
b. Palpating the abdomen for distention
c. Auscultating the chest for breath sounds
d. Taking the blood pressure (BP) and pulse - ansD-assess for shock
Which information about dietary management should the nurse include when teaching a
patient with peptic ulcer disease (PUD)?
a. "You will need to remain on a bland diet."
b. "Avoid foods that cause pain after you eat them."
c. "High-protein foods are least likely to cause you pain."
