NUR 417 Exam 2 | Nursing Practice Questions & Verified Answers
A patient vomiting blood-streaked fluid is admitted to the 3. Use of nonsteroidal antiinflammatory drugs
hospital with acute gastritis. What would the nurse ask the
patient about to determine possible risk factors for Use of an NSAID is associated with damage to the gastric mucosa, which can result
gastritis? in acute gastritis. Family history, recent weight gain or loss, and fatty foods are not
risk factors for acute 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
A patient has peptic ulcer disease associated with 3. Amoxicillin (Amoxil), clarithromycin, and omeprazole (Prilosec)
Helicobacter pylori. Which medications will the nurse plan
to teach the patient? The drugs used in triple drug therapy include a proton pump inhibitor such as
omeprazole and the antibiotics amoxicillin and clarithromycin. The other
1. Sucralfate (Carafate), nystatin, and bismuth (Pepto- combinations listed are not included in the protocol for H. pylori infection.
Bismol)
2. Metoclopramide (Reglan), bethanechol, and
promethazine
3. Amoxicillin (Amoxil), clarithromycin, and omeprazole
(Prilosec)
4. Famotidine (Pepcid), magnesium hydroxide (Mylanta),
and pantoprazole
Which diagnostic test would the nurse anticipate for an 1. Endoscopy
older patient who is vomiting "coffee-ground" emesis?
Endoscopy is the primary tool for visualization and diagnosis of upper
1. Endoscopy gastrointestinal (GI) bleeding. Angiography is used only when endoscopy cannot be
2. Angiography done because it is more invasive and has more possible complications. Barium
3. Barium studies studies are helpful in determining the presence of gastric lesions, but not whether
4. Gastric analysis 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 2. "Famotidine decreases gastric acid secretion."
patient with peptic ulcer disease about the effect of
famotidine (Pepcid)? 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
1. "Famotidine absorbs the excess gastric acid." acid, or cover the ulcer.
2. "Famotidine decreases gastric acid secretion."
3. "Famotidine constricts the blood vessels near the ulcer."
4. "Famotidine covers the ulcer with a protective material."
A young adult patient is hospitalized with massive 2. "It inhibits development of stress ulcers."
abdominal trauma from a motor vehicle crash. The patient
asks about the purpose of receiving famotidine (Pepcid). Famotidine is administered to prevent the development of physiologic stress ulcers,
Which information would the nurse explain about the which are associated with a major physiologic insult such as massive trauma.
action of the medication? Famotidine does not decrease nausea or vomiting, prevent aspiration, or prevent H.
pylori infection.
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."
A patient admitted with a peptic ulcer has a nasogastric 2. Check the vital signs.
(NG) tube in place. When the patient develops sudden,
severe upper abdominal pain, diaphoresis, and a firm The patient's symptoms suggest acute perforation, and the nurse should assess for
abdomen, which action would the nurse take? 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
1. Irrigate the NG tube. the spillage into the peritoneal cavity. Elevating the foot of the bed may increase
2. Check the vital signs. abdominal pressure and discomfort, as well as making it more difficult for the patient
3. Give the ordered antacid. to breathe.
4. Elevate the foot of the bed.
, NUR 417 Exam 2 | Nursing Practice Questions & Verified Answers
A patient who underwent a gastroduodenostomy (Billroth I) 2. Contact the surgeon.
12 hours ago reports increasing abdominal pain. The
patient has no bowel sounds and 200 mL of bright red Increased pain and 200 mL of bright red NG drainage 12 hours after surgery
nasogastric (NG) drainage in the past hour. Which nursing indicate possible postoperative hemorrhage, and immediate actions such as blood
action is the highest priority? 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
1. Monitor drainage. drainage is needed but not an adequate response to the findings. The patient may
2. Contact the surgeon. need morphine, but this is not the highest priority action.
3. Irrigate the NG tube.
4. Give prescribed morphine.
Which patient statement indicates that the nurse's 3. "Vitamin supplements may prevent anemia."
postoperative teaching after a gastroduodenostomy has
been effective? Cobalamin deficiency may occur after partial gastrectomy, and the patient may need
to receive cobalamin via injections or nasal spray. Although peptic ulcer disease
1. "I will drink more liquids with my meals." may recur, persistent heartburn is not expected after surgery, and the patient should
2. "I should choose high carbohydrate foods." call the health care provider if this occurs. Ingestion of liquids with meals is avoided
3. "Vitamin supplements may prevent anemia." to prevent dumping syndrome. Foods that have moderate fat and low carbohydrate
4. "Persistent heartburn is expected after surgery." should be chosen to prevent dumping syndrome.
At his first postoperative checkup appointment after a 3. Lie down for about 30 minutes after eating.
gastrojejunostomy (Billroth II), a patient reports that
dizziness, weakness, and palpitations occur about 20 The patient is experiencing symptoms of dumping syndrome, which may be
minutes after each meal. Which action would the nurse reduced by lying down for a short rest after eating. Increasing fluid intake and
teach the patient to take? 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
1. Increase the amount of fluid with meals. with dumping syndrome but will not prevent dumping syndrome.
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.
A patient who takes a nonsteroidal antiinflammatory drug 4. Misoprostol (Cytotec) to protect the gastrointestinal (GI) mucosa
(NSAID) daily for the management of severe rheumatoid
arthritis has recently developed melena. What would the Misoprostol, a prostaglandin analog, reduces acid secretion and the incidence of
nurse anticipate teaching the patient? upper GI bleeding associated with NSAID use. Enteric coating of NSAIDs does not
reduce the risk for GI bleeding. Corticosteroids increase the risk for ulcer
1. Substitution of acetaminophen (Tylenol) for the NSAID development and will not be substituted for NSAIDs for this patient. Acetaminophen
2. Use of enteric-coated NSAIDs to reduce gastric irritation will not be effective in treating rheumatoid arthritis.
3. Reasons for using corticosteroids to treat the
rheumatoid arthritis
4. Misoprostol (Cytotec) to protect the gastrointestinal (GI)
mucosa
The health care provider prescribes antacids and 4. Antacids after meals and sucralfate 30 minutes before meals
sucralfate (Carafate) for treatment of a patient's peptic
ulcer. Which medication schedule would the nurse teach Sucralfate is most effective when the pH is low and should not be given with or soon
the patient? after antacids. Antacids are most effective when taken after eating. Administration of
sucralfate 30 minutes before eating and antacids just after eating will ensure that
1. Sucralfate at bedtime and antacids before each meal both drugs can be most effective. The other regimens will decrease the
2. Sucralfate and antacids together 0 minutes before effectiveness of the medications.
meals
3. Antacids 30 minutes before each dose of sucralfate is
taken
4. Antacids after meals and sucralfate 30 minutes before
meals
Which information about dietary management would the 2. "Avoid foods that cause pain after you eat them."
nurse include when teaching a patient with peptic ulcer
disease (PUD)? The best information is that each person should choose foods that are not
associated with postprandial discomfort. Raw fruits and vegetables may irritate the
1. "You will need to remain on a bland diet." gastric mucosa but chewing well seems to decrease this problem and some
2. "Avoid foods that cause pain after you eat them." patients tolerate these healthy foods well. High-protein foods help neutralize acid,
3. "High-protein foods are least likely to cause pain." but they also stimulate hydrochloric (HCl) acid secretion and may increase
4. "You should avoid eating raw fruits and vegetables." discomfort for some patients. Bland diets may be recommended during an acute
exacerbation of PUD, but there is little evidence to support their ongoing use.
A patient vomiting blood-streaked fluid is admitted to the 3. Use of nonsteroidal antiinflammatory drugs
hospital with acute gastritis. What would the nurse ask the
patient about to determine possible risk factors for Use of an NSAID is associated with damage to the gastric mucosa, which can result
gastritis? in acute gastritis. Family history, recent weight gain or loss, and fatty foods are not
risk factors for acute 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
A patient has peptic ulcer disease associated with 3. Amoxicillin (Amoxil), clarithromycin, and omeprazole (Prilosec)
Helicobacter pylori. Which medications will the nurse plan
to teach the patient? The drugs used in triple drug therapy include a proton pump inhibitor such as
omeprazole and the antibiotics amoxicillin and clarithromycin. The other
1. Sucralfate (Carafate), nystatin, and bismuth (Pepto- combinations listed are not included in the protocol for H. pylori infection.
Bismol)
2. Metoclopramide (Reglan), bethanechol, and
promethazine
3. Amoxicillin (Amoxil), clarithromycin, and omeprazole
(Prilosec)
4. Famotidine (Pepcid), magnesium hydroxide (Mylanta),
and pantoprazole
Which diagnostic test would the nurse anticipate for an 1. Endoscopy
older patient who is vomiting "coffee-ground" emesis?
Endoscopy is the primary tool for visualization and diagnosis of upper
1. Endoscopy gastrointestinal (GI) bleeding. Angiography is used only when endoscopy cannot be
2. Angiography done because it is more invasive and has more possible complications. Barium
3. Barium studies studies are helpful in determining the presence of gastric lesions, but not whether
4. Gastric analysis 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 2. "Famotidine decreases gastric acid secretion."
patient with peptic ulcer disease about the effect of
famotidine (Pepcid)? 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
1. "Famotidine absorbs the excess gastric acid." acid, or cover the ulcer.
2. "Famotidine decreases gastric acid secretion."
3. "Famotidine constricts the blood vessels near the ulcer."
4. "Famotidine covers the ulcer with a protective material."
A young adult patient is hospitalized with massive 2. "It inhibits development of stress ulcers."
abdominal trauma from a motor vehicle crash. The patient
asks about the purpose of receiving famotidine (Pepcid). Famotidine is administered to prevent the development of physiologic stress ulcers,
Which information would the nurse explain about the which are associated with a major physiologic insult such as massive trauma.
action of the medication? Famotidine does not decrease nausea or vomiting, prevent aspiration, or prevent H.
pylori infection.
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."
A patient admitted with a peptic ulcer has a nasogastric 2. Check the vital signs.
(NG) tube in place. When the patient develops sudden,
severe upper abdominal pain, diaphoresis, and a firm The patient's symptoms suggest acute perforation, and the nurse should assess for
abdomen, which action would the nurse take? 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
1. Irrigate the NG tube. the spillage into the peritoneal cavity. Elevating the foot of the bed may increase
2. Check the vital signs. abdominal pressure and discomfort, as well as making it more difficult for the patient
3. Give the ordered antacid. to breathe.
4. Elevate the foot of the bed.
, NUR 417 Exam 2 | Nursing Practice Questions & Verified Answers
A patient who underwent a gastroduodenostomy (Billroth I) 2. Contact the surgeon.
12 hours ago reports increasing abdominal pain. The
patient has no bowel sounds and 200 mL of bright red Increased pain and 200 mL of bright red NG drainage 12 hours after surgery
nasogastric (NG) drainage in the past hour. Which nursing indicate possible postoperative hemorrhage, and immediate actions such as blood
action is the highest priority? 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
1. Monitor drainage. drainage is needed but not an adequate response to the findings. The patient may
2. Contact the surgeon. need morphine, but this is not the highest priority action.
3. Irrigate the NG tube.
4. Give prescribed morphine.
Which patient statement indicates that the nurse's 3. "Vitamin supplements may prevent anemia."
postoperative teaching after a gastroduodenostomy has
been effective? Cobalamin deficiency may occur after partial gastrectomy, and the patient may need
to receive cobalamin via injections or nasal spray. Although peptic ulcer disease
1. "I will drink more liquids with my meals." may recur, persistent heartburn is not expected after surgery, and the patient should
2. "I should choose high carbohydrate foods." call the health care provider if this occurs. Ingestion of liquids with meals is avoided
3. "Vitamin supplements may prevent anemia." to prevent dumping syndrome. Foods that have moderate fat and low carbohydrate
4. "Persistent heartburn is expected after surgery." should be chosen to prevent dumping syndrome.
At his first postoperative checkup appointment after a 3. Lie down for about 30 minutes after eating.
gastrojejunostomy (Billroth II), a patient reports that
dizziness, weakness, and palpitations occur about 20 The patient is experiencing symptoms of dumping syndrome, which may be
minutes after each meal. Which action would the nurse reduced by lying down for a short rest after eating. Increasing fluid intake and
teach the patient to take? 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
1. Increase the amount of fluid with meals. with dumping syndrome but will not prevent dumping syndrome.
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.
A patient who takes a nonsteroidal antiinflammatory drug 4. Misoprostol (Cytotec) to protect the gastrointestinal (GI) mucosa
(NSAID) daily for the management of severe rheumatoid
arthritis has recently developed melena. What would the Misoprostol, a prostaglandin analog, reduces acid secretion and the incidence of
nurse anticipate teaching the patient? upper GI bleeding associated with NSAID use. Enteric coating of NSAIDs does not
reduce the risk for GI bleeding. Corticosteroids increase the risk for ulcer
1. Substitution of acetaminophen (Tylenol) for the NSAID development and will not be substituted for NSAIDs for this patient. Acetaminophen
2. Use of enteric-coated NSAIDs to reduce gastric irritation will not be effective in treating rheumatoid arthritis.
3. Reasons for using corticosteroids to treat the
rheumatoid arthritis
4. Misoprostol (Cytotec) to protect the gastrointestinal (GI)
mucosa
The health care provider prescribes antacids and 4. Antacids after meals and sucralfate 30 minutes before meals
sucralfate (Carafate) for treatment of a patient's peptic
ulcer. Which medication schedule would the nurse teach Sucralfate is most effective when the pH is low and should not be given with or soon
the patient? after antacids. Antacids are most effective when taken after eating. Administration of
sucralfate 30 minutes before eating and antacids just after eating will ensure that
1. Sucralfate at bedtime and antacids before each meal both drugs can be most effective. The other regimens will decrease the
2. Sucralfate and antacids together 0 minutes before effectiveness of the medications.
meals
3. Antacids 30 minutes before each dose of sucralfate is
taken
4. Antacids after meals and sucralfate 30 minutes before
meals
Which information about dietary management would the 2. "Avoid foods that cause pain after you eat them."
nurse include when teaching a patient with peptic ulcer
disease (PUD)? The best information is that each person should choose foods that are not
associated with postprandial discomfort. Raw fruits and vegetables may irritate the
1. "You will need to remain on a bland diet." gastric mucosa but chewing well seems to decrease this problem and some
2. "Avoid foods that cause pain after you eat them." patients tolerate these healthy foods well. High-protein foods help neutralize acid,
3. "High-protein foods are least likely to cause pain." but they also stimulate hydrochloric (HCl) acid secretion and may increase
4. "You should avoid eating raw fruits and vegetables." discomfort for some patients. Bland diets may be recommended during an acute
exacerbation of PUD, but there is little evidence to support their ongoing use.
