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Most clients with chronic gastritis are managed at home and need to see their health care provider on a regular basis to detect complications. A client with H. Pylori and atrophic gastritis is at high risk for gastric cancer, which must be caught early for a positive outcome. 3. The nurse has just finished inserting a instigators (ENG) tube in a client who has difficulty swallowing. The best measure to test for placement of the tube is a. Asking the client to speak. B.

Aspirating gastric contents. C. Inspecting the posterior pharynx for correct placement. D. Placing the end of the tube in a glass of water.MANS: B To verify tube placement, the nurse can aspirate gastric contents for short tubes, like a instigators tube. Other reliable methods for determining placement include measuring the pH of the gastric contents and checking placement with an Cray if the tube has radiographic markings.

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4 The nurse planning to irrigate a instigators (ENG) tube prepares to use a. Haltering peroxide. B. Normal saline. C. Sterile water. D.

Tap water. Normal saline is the preferred irrigating solution because water, a hypotonic solution, increases electrolyte loss through osmotic action if the tube is irrigated frequently..

S.A client with acute gastritis is admitted to the emergency department for GIG bleeding. The nurse would anticipate the client’s history will include a.

Alcohol abuse. B. Anorexia. C. Historiographer, highest diet. D. Recent use of oral penicillin. MANS: A Gastritis usually stems from the ingestion of a corrosive, erosive, or infection substance.

Aspirin and other nonessential nondiscriminatory drugs (Unsaid), digitalis, chemotherapeutic drugs, steroids, acute alcoholism, and food poisoning (typically caused by Staphylococcus organisms) are common causes. 6. The client with chronic gastritis is experiencing abdominal pain.In order to provide the client the fastest relief, the nurse plans to administer a. Aluminum hydroxide with magnesium triplicate (Sauvignon). B. Clarification (Biaxial). C.

Modernization (Flag). D. Maypole (Proposes). Aluminum hydroxide with magnesium triplicate (Sauvignon), which produces soothing foam, is the best antacid for gastritis. Biaxial and Modernization are antibiotics.

Maypole can be used for gastritis and for the shorter management of peptic ulcer disease but it will not relieve pain as quickly as the coating effect of aluminum hydroxide. 7. The nurse is caring for a client with chronic atrophic gastritis.When taking an admission history, the nurse would anticipate a history of a. Cardiac disease. B.

Emphysema. C. Intestinal parasites. D. Pernicious anemia. Atrophic gastritis, which occurs in all layers of the stomach, often develops IR association with gastric ulcer and gastric cancer and is invariably associated with pernicious anemia because of the lack of intrinsic factor.

8. A client is taking cortisone. The nurse schedules the medication with food because cortisone can have which effect on gastric mucosa when given on at empty stomach? Cortisone will cause a. Dramatically increased gastric PH. . Increased amount of GIG secretions.

. Increased transit time of GIG contents. D. Susceptibility of the mucosa to injury. Nondiscriminatory agents may stimulate acid production, cause local mucosa damage, and suppress mucus secretion.

9. A nurse is instructing a client with a peptic ulcer on recommended dietary changes. A goal of teaching has been met when the client states that he/she will avoid which of the following beverages? A. Apple juice b. Lemonade c. Milk d. Water MANS: C Foods known to increase gastric acidity or cause discomfort should be avoided, such as coffee, alcohol, and milk. Patients should slimiest any other foods that cause them distress.

0. A nurse is caring for a client with severe burns. The client complains of abdominal pain and begins vomiting blood.

The nurse anticipates diagnostic testing to determine if the client has developed a. A Curling’s ulcer. B. Chronic gastritis. C.

H. Pylori infection. D. Pyloric Stetsons. Besides peptic and gastric ulcers, acute gastric erosion (frequently called stress ulcers or stress erosive gastritis) can occur after an acute medical crisis. Major assaults that lead to gastronomical ulcerations include (a) severe aroma or major illness, (b) severe burns, (c) head injury or interracial disease, (d) drug ingestion (e. . , aspirin, Nasals, alcohol) that acts on the gastric mucosa, (e) shock, and (f) sepsis.

11. A nurse is assessing a client with a history of a duodenal ulcer. Which finding is consistent with the nurse’s knowledge about this condition? A. Certain types of food increase gastric distress. B. Eating nearly any food causes pain. C. Pain may awaken the client in the middle of the night.

D. The client complains of spitting up blood. Clients with duodenal ulcers have pain on an empty stomach or in the middle f the night, and discomfort may be relieved by the ingestion of food or antacids. 12.The nurse administers alternating doses of two antacids into the ENG tube of a client with a duodenal ulcer. The finding that best indicates that this drug regimen has been successful is a.

Absent ENG tube drainage. B. Decreased abdominal rigidity. C. Increased gastric pH.

Midi diarrhea. D. Mild diarrhea. Antacids increase gastric pH to reduce pepsin activity. Antacids would not affect ENG tube drainage.

Abdominal rigidity is not a sign of duodenal ulcers. Mild diarrhea might occur as a side effect of antacid administration. 13. Rendition (Contact) is prescribed for a client with a gastric ulcer.The statement that best indicates to the nurse that the client understands the action of this drug is a. “l will take this medication at bedtime to relieve pain.

” b. “Rendition will activate protective mucous barriers. ” c. “Stomach acids are neutralized by this medication. ” d. “This drug reduces the acid in my stomach. ” Horoscopes antagonists inhibit gastric acid secretions by blocking H2O receptors on parietal cells. 14.

The nurse is monitoring a client who has had gastric surgery for manifestations of dumping syndrome. The nurse should be particularly tactful for the early manifestation of a. Hypertension. B. Pain. C. Tenseness.

D. Retire. ANSI D Early manifestations of dumping syndrome, which occur 5 30th minutes after eating, involve the vasomotor disturbances of vertigo, tachycardia, syncope, sweating, pallor, palpitation, diarrhea, and nausea, with the urge to lie down. None of the other three choices are early man affectations of dumping syndrome.

A client asks the nurse about the prescribed diet after gastric surgery. The nurse clarifies that a highpoint, highest, Carbohydrate, dry diet is the best choice after gastric surgery because this diet? .. Does not cause diarrhea b. Does not dilate the stomach. C. Is quickly digested. D.

Is slow to leave the stomach.The diet is slowly digested and is slow to leave the stomach because of its density and the reduction of fluid with the meal. This reduces the possibility of dumping syndrome. 16.

An older male client with chronic gastritis asks the nurse, “Do you think I’ll get gastric cancel The most accurate response by the nurse is a. “As long as the chronic gastritis is diagnosed early, there is little risk of gastric cancer. ” b. “Chronic gastritis is not associated with the development of gastric cancer n men over 40. ” C.

“Individual predictions are not possible, but chronic gastritis is associated with the development of gastric cancer. D. “Women with chronic gastritis are more likely to get gastric cancer than men who have chronic gastritis. ” Chronic gastritis usually heals without scarring but can cause hemorrhage and ulcer formation. The atrophic changes eventually result in minimal amounts of acid being secreted into the stomach (chlorinated), which is a major risk factor for development of gastric cancer.

17. Priority nursing actions to achieve critical goals in the postoperative erred for a client who has just returned from a Billionth II procedure should include a. Encouraging oral intake.

B. Ensuring frequent coughing and deep breathing. . Irrigating the client’s ENG tube every hour. D. Maintaining the client in the semivowels position. Nurses should thoroughly demonstrate and discuss the importance of depreciating exercises or use of an incentive speedometer for any surgical client.

Clients should be warned that the high abdominal incision with a Billionth II procedure makes deep breathing very uncomfortable and therefore increases the risk of respiratory complications. This client will be NP for non and will not be allowed oral intake. Irrigation of a surrealistically ENG tube hourly is not a standard order.In the immediate postoperative period, the client will likely be supine or in a lowlife position. 18. A nurse is caring for a patient who had surgery and will be receiving chemotherapy and radiation treatment for stage Ill gastric cancer. The client is planning several extensive trips after the chemotherapy and radiation are finished.

Which statement by the nurse is most appropriate at this time? A. “Before you leave, be sure your will and other advance directives are up to date. B. “What does your family think of your travel plans? ” c.

“What has the physician told you about your disease and treatment? . “Your trip sounds wonderful! Tell me more about it. ” ANSI C The Shear survival rate for stage Ill gastric cancer is less than 10%. Chemotherapy and radiation may be palliative measures for this client.

The nurse needs to gently find out what the client understands about this condition and the prognosis before being able to guide the client in making appropriate plans. 19. A client in the emergency department is hemorrhaging from a peptic ulcer and is being prepared quickly for emergency surgery. The nurse notes that the client is crying and reaches for the nurse frequently.The best response by the nurse to this client is to a.

Continue working efficiently to get the client ready for the operating room. B. Make eye contact, touch the client, and say, “This must be very scary for you. ” c.

Send someone to find the chaplain to discuss advance directives. D. Sit by the client and say, “l have some time that I can spend with you.

” MANS: B This is an emergency situation, so the nurse must continue to prepare the client for a lifesaving operation. However, in this setting, clients may be afraid ND the nurse needs to respond in a caring fashion to the nonverbal behavior the client exhibits. 20.Before tube insertion, the nurse performs the NEXT measurement, which is the a. Distance from the tip of the nose to the ear lobe and to the siphon.

B. Length of a tube from the hub to the tip converted to centimeters. C. Distance from the ear lobe to the umbilicus. D. Width of the lumen of the tube multiplied by the length.

The NEXT is the measurement from the tip of the nose to the ear lobe and to the siphon process used to determine the amount of tube needed for entry into the stomach. MULTIPLE RESPONSE 1 . A nurse is teaching health promotion measures to a support group for clients who are at high risk for gastric cancer.

Important health promotion measures to advise the clients include (select all that apply) a. Avoiding alcohol. B. Eating a diet high in nitrites. C.

Limiting salted fish and pickled foods. D. Quitting smoking. MANS: A, C, D Risk factors for gastric cancer include eating carcinogens such as smoked fish or meats, pickled foods, slated, fish, and nitrates.

Metal crafts workers, coal miners, and bakers have occupational risks for gastric cancer. 2. A client with a duodenal ulcer complains of a sudden onset of severe pain. In which order should the nurse perform the following activities? Select all that apply) a. Assess the potency of the patient’s IV line.

B. Call the physician. C. Have the nurses’ aid obtain a set of vital signs. D. Perform a complete abdominal examination.

E. Prepare to administer IV pain medication. MANS: A, B, C, D, E This patient may have experienced a perforation of the duodenal ulcer, which is a surgical emergency.

The first step in the nursing process is assessment, so the nurse should perform a complete abdominal (and pain) assessment. Before calling the physician, the nurse will need this information and a set of ITIL signs.Since this patient is possibly going to the operating room, the nurse should next assess the IV line. Preparing to give pain medications is last because the physician may want to examine the client before the client receives any more pain medications. The client may also need to sign a permit form before receiving any pain medication. 3.

A nurse is inserting a instigators (ENG) tube. Put the steps in the correct order. (select all that apply) a.

Advance the tube into the stomach. B. Aspirate gastric contents and measure the PH. C. Assist the client into a highlighter position.

D. Complete the NEXT measurement and mark it on the tube. . Insert the tube gently into the mares and posterior nasal pharynx. F. Instruct the client to swallow when the tube is in the orphans.

G. Lubricate the tip of the tube. H. Secure the tube to the nose with a device to hold tubes or hypoallergenic tape. MANS: A, B, C, D, E, F, G, H Lewis: Medical-Surgical Nursing, 8th Edition Chapter 42: Nursing Management: upper Gastrointestinal Problems Test Bank A patient with deep partial-thickness burns experiences severe pain associated with nausea during dressing changes. Which action will be most useful in decreasing the patients nausea?The patient NP 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 personalization (Companion) before dressing changes.

Because the patient’s nausea is associated with severe pain, it is likely that it is precipitated by stress and pain. The best treatment will be to provide adequate pain medication before dressing changes. The nurse should avoid doing painful procedures close to mealtimes, but nausea/vomiting that occur at other times also should be addressed.Keeping the patient NP does not address the reason for the nausea and vomiting and will have an adverse effect on the patient’s nutrition. Administration Of mathematics is not the best choice for a patient with nausea caused by pain. A patient who has been NP during treatment for nausea and vomiting caused by gastric irritation is to start oral intake. Which of these should the nurse offer to the patient? 2.

A glass of orange juice b. A dish of lemon gelatin A cup of coffee with cream d. A bowl Of hot chicken broth MANS: 8 Clear liquids are usually the first foods started after a patient has been seated.Acidic foods such as orange juice, very hot foods, and coffee are poorly tolerated when patients have been nauseated. The nurse is assessing a patient with gastrointestinal reflux disease (GERI) who is experiencing increasing discomfort. Which patient statement indicates that additional patient education about GERI is needed? 6. “L take antacids between meals and at bedtime each night. ” b.

“l sleep with the head of the bed elevated on 4-inch blocks. ” c. “l quit smoking several years ago, but I still chew a lot of gum. ” d. “l eat small meals throughout the day and have a bedtime snack.MANS: D GERI is exacerbated by eating late at night, and the nurse should plan to teach the patient to avoid eating at bedtime. The other patient actions are appropriate to control symptoms of GERI. When admitting a patient with a stroke who is unconscious and unresponsive to stimuli, the nurse learns from the patients family that the patient has a history of gastrointestinal reflux disease (GERI).

The nurse will plan to do frequent assessments of the patient’s 7. Apical pulse. Bowel sounds. Breath sounds.

Abdominal girth. Because GERI may cause aspiration, the unconscious patient is at risk for evolving aspiration pneumonia.Bowel sounds, abdominal girth, and apical pulse will not be affected by the patient’s stroke or GERI and do not require more frequent monitoring than the routine. A patient with recurring heartburn receives a new prescription for comparable (Maximum).

In teaching the patient about this medication, the nurse explains that this drug 8. Neutralizes stomach acid and provides relief of symptoms in a few minutes. Reduces the reflux of gastric acid by increasing the rate of gastric emptying. C. Coats and protects the lining of the stomach and esophagi from gastric acid.

Eats gastrointestinal reflux disease by decreasing stomach acid prod action. The proton pump inhibitors decrease the rate of gastric acid secretion. Promotional drugs such as meteorological (Raglan) increase the rate of gastric emptying. Correctively medications such as correlate (Accurate) protect the stomach. Antacids neutralize stomach acid and work rapidly. After the nurse teaches a patient with gastrointestinal reflux disease (GERI) about recommended dietary modifications, which diet choice for a snack 2 hours before bedtime indicates that the teaching has been effective?

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