HESI CASE STUDY : PEPTIC ULCER DISEASE
COMPLETE DETAILED CASE STUDY
n Which information is most significant when assessing a client suspected of having a peptic ulcer? -
Correct answer.Frequent use of aspirin or products containing aspirin.
R : Long-term use of anti inflammatory medications (NSAIDs) damages the stomach lining and causes
ulcers. NSAIDs inhibit the production of an enzyme (cyclooxygenase) that produces prostaglandins which
help protect the stomach lining from chemical and physical injury.
Which response by the client supports a peptic ulcer? (Select all that apply. One, some, or all options
may be correct.) - Correct answer.The pain sometimes wakes me up at night.
My pain seems to be worse several hours after I eat a meal.
The pain is so bad that I get nauseated and sometimes I vomit
The HCP suspects that the client has a peptic ulcer and schedules her for a Helicobacter pylori (H. pylori)
breath test. Which intervention should the nurse include? - Correct answer.Instruct the client not to take
any antibiotics for 4 weeks prior to the test.
R : Antibiotics and oral bismuth subsalicylate (Pepto-Bismol) should be withheld for 4 weeks so that they
do not interfere with the results of the H. pylori breath test.
The client asks the nurse what happens during this test. Which information should the nurse provide? -
Correct answer.A pleasant-tasting solution is ingested and you breathe into a balloon.
R : Exhaling into a balloon-like bag is performed first to obtain a baseline sample. Then a small amount of
a pleasant lemon-flavored solution is ingested, and 15 minutes later another balloon breath sample is
obtained. This sample is tested for an increase in carbon dioxide which indicates a positive H. pylori
breath test.
The client asks the nurse what happens if her pain is due to the H. pylori bacteria. What information
should the nurse tell the client? - Correct answer.Antibiotics and acid-suppressing medications are
prescribed.
R : H. pylori is eradicated with a 14-day treatment of antibiotics (tetracycline), a proton-pump inhibitor,
and Pepto-Bismol.
, Which priority intervention should the nurse implement when providing immediate post procedure care
for an EGD? - Correct answer.Confirm the return of the gag reflex.
R : During an EGD, a local anesthetic is used to suppress the gag reflex prior to insertion of the
endoscope down the esophagus. Food and liquids are not given until the gag reflex returns, so this is the
priority intervention.
Which action should the nurse include in the discharge preparation? - Correct answer.Discuss the need
to notify the HCP if fever or shoulder pain occurs.
R : The client should contact the HCP if difficulty swallowing or epigastric, substernal, or shoulder pain
occurs. Vomiting blood, black tarry stools, and fever are also signs of a complication following an EGD.
During the client's visit to the HCP an antiulcer agent, sucralfate, is prescribed for her. The client asks the
nurse how the medication cures her ulcer. How should the nurse respond to the client's question? -
Correct answer.The medication adheres to the lining of the stomach.
R : Sucralfate, a cytoprotective medication, reacts with gastric acid to form a thick paste that adheres to
damaged gastric mucosal tissue to protect the gastric mucosa and promote healing.
The healthcare professional has also prescribed the proton pump inhibitor omeprazole for the client.
Which instruction should the nurse discuss with the client? - Correct answer.Take the medication daily
even if pain is not present.
R : This medication is taken routinely whether or not pain is present because the medication decreases
the production of gastric acid.
The nurse and the client discuss diet modifications that may help prevent the pain caused by the peptic
ulcer. Which action should the nurse include in the teaching plan? - Correct answer.Avoid bedtime
snacks.
R : Bedtime snacks are avoided because they may stimulate gastric acid secretion.
The client listens attentively to the nurse during the teaching session. She tells the nurse that she always
thought there was a special diet for people with ulcers.Which information should the nurse provide? -
Correct answer.Foods that cause gastric pain should be avoided.
R : The intent of dietary modification is to avoid over-secretion of acid and hypermotility in the GI tract.
The diet is an individual matter in which the client avoids foods that cause pain
COMPLETE DETAILED CASE STUDY
n Which information is most significant when assessing a client suspected of having a peptic ulcer? -
Correct answer.Frequent use of aspirin or products containing aspirin.
R : Long-term use of anti inflammatory medications (NSAIDs) damages the stomach lining and causes
ulcers. NSAIDs inhibit the production of an enzyme (cyclooxygenase) that produces prostaglandins which
help protect the stomach lining from chemical and physical injury.
Which response by the client supports a peptic ulcer? (Select all that apply. One, some, or all options
may be correct.) - Correct answer.The pain sometimes wakes me up at night.
My pain seems to be worse several hours after I eat a meal.
The pain is so bad that I get nauseated and sometimes I vomit
The HCP suspects that the client has a peptic ulcer and schedules her for a Helicobacter pylori (H. pylori)
breath test. Which intervention should the nurse include? - Correct answer.Instruct the client not to take
any antibiotics for 4 weeks prior to the test.
R : Antibiotics and oral bismuth subsalicylate (Pepto-Bismol) should be withheld for 4 weeks so that they
do not interfere with the results of the H. pylori breath test.
The client asks the nurse what happens during this test. Which information should the nurse provide? -
Correct answer.A pleasant-tasting solution is ingested and you breathe into a balloon.
R : Exhaling into a balloon-like bag is performed first to obtain a baseline sample. Then a small amount of
a pleasant lemon-flavored solution is ingested, and 15 minutes later another balloon breath sample is
obtained. This sample is tested for an increase in carbon dioxide which indicates a positive H. pylori
breath test.
The client asks the nurse what happens if her pain is due to the H. pylori bacteria. What information
should the nurse tell the client? - Correct answer.Antibiotics and acid-suppressing medications are
prescribed.
R : H. pylori is eradicated with a 14-day treatment of antibiotics (tetracycline), a proton-pump inhibitor,
and Pepto-Bismol.
, Which priority intervention should the nurse implement when providing immediate post procedure care
for an EGD? - Correct answer.Confirm the return of the gag reflex.
R : During an EGD, a local anesthetic is used to suppress the gag reflex prior to insertion of the
endoscope down the esophagus. Food and liquids are not given until the gag reflex returns, so this is the
priority intervention.
Which action should the nurse include in the discharge preparation? - Correct answer.Discuss the need
to notify the HCP if fever or shoulder pain occurs.
R : The client should contact the HCP if difficulty swallowing or epigastric, substernal, or shoulder pain
occurs. Vomiting blood, black tarry stools, and fever are also signs of a complication following an EGD.
During the client's visit to the HCP an antiulcer agent, sucralfate, is prescribed for her. The client asks the
nurse how the medication cures her ulcer. How should the nurse respond to the client's question? -
Correct answer.The medication adheres to the lining of the stomach.
R : Sucralfate, a cytoprotective medication, reacts with gastric acid to form a thick paste that adheres to
damaged gastric mucosal tissue to protect the gastric mucosa and promote healing.
The healthcare professional has also prescribed the proton pump inhibitor omeprazole for the client.
Which instruction should the nurse discuss with the client? - Correct answer.Take the medication daily
even if pain is not present.
R : This medication is taken routinely whether or not pain is present because the medication decreases
the production of gastric acid.
The nurse and the client discuss diet modifications that may help prevent the pain caused by the peptic
ulcer. Which action should the nurse include in the teaching plan? - Correct answer.Avoid bedtime
snacks.
R : Bedtime snacks are avoided because they may stimulate gastric acid secretion.
The client listens attentively to the nurse during the teaching session. She tells the nurse that she always
thought there was a special diet for people with ulcers.Which information should the nurse provide? -
Correct answer.Foods that cause gastric pain should be avoided.
R : The intent of dietary modification is to avoid over-secretion of acid and hypermotility in the GI tract.
The diet is an individual matter in which the client avoids foods that cause pain
