ANSWERS GRADED A+
◉ 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. Answer: 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. Answer: 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.". Answer:
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.". Answer: 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.. Answer: 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.. Answer: 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