Exam Prep Chapter.23 GI Disorders Nursing Care - Medical Surgical Nursing 7e | Test Bank by LeMone, Burke, Bauldoff by LeMone, Burke, Gerene Bauldoff. DOCX document preview.
LeMone & Burke's Medical-Surgical Nursing, 7e (Bauldoff/Gubrud/Carno)
Chapter 23 Nursing Care of Patients with Upper Gastrointestinal Disorders
1) A patient has been diagnosed with type 1 herpes simplex lesions on the mouth and face. Which statement indicates that the patient understands teaching provided by the nurse?
1. "I will have this condition for life."
2. "This was caused by a bacterial infection."
3. "This is a type of fungal infection."
4. "An antibiotic will help heal these sores in about 3 days."
Page Ref: 698
Cognitive Level: Analyzing
Client Need & Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.9. Monitor client outcomes to evaluate the effectiveness of psychobiological interventions | NLN Competencies: Context and Environment; Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Evaluation/Teaching/Learning
Learning Outcome: 23.2 Describe the pathophysiology and manifestations of disorders of the mouth, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 1. Examine the pathophysiology, incidence, risk factors, and clinical manifestations for patients with upper gastrointestinal disorders.
2) Acyclovir (Zovirax) ointment has been prescribed for a patient with oral herpes lesions. What should the nurse include when providing information to the patient regarding this medication? Select all that apply.
1. Take the medication with food.
2. It can reduce the length of the herpes outbreak.
3. It is an antibiotic medication.
4. Repeated usage of the drug usually leads to permanent remission.
5. It is most effective when administered intravenously.
Page Ref: 699
Cognitive Level: Analyzing
Client Need & Sub: Physiological Integrity: Pharmacological and Parenteral Therapies
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Evaluation/Teaching/Learning
Learning Outcome: 23.2 Describe the pathophysiology and manifestations of disorders of the mouth, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 4. Determine appropriate nursing interventions for patients with upper gastrointestinal disorders.
3) A patient is diagnosed with an oral fungal infection. What should the nurse anticipate being prescribed to manage this health problem initially?
1. Nystatin
2. Fluconazole
3. Ampicillin
4. Anbesol
Page Ref: 698
Cognitive Level: Analyzing
Client Need & Sub: Physiological Integrity: Pharmacological and Parenteral Therapies
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.3. Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management, and nursing management across the health-illness continuum, across lifespan, and in all healthcare settings | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 23.2 Describe the pathophysiology and manifestations of disorders of the mouth, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 2. Consider intraprofessional care for patients with upper gastrointestinal disorders.
4) The nurse is developing the postoperative plan of care for a patient recovering from surgery for oral cancer. Which potential problem should the nurse identify as the priority for this patient?
1. Airway maintenance
2. Communication
3. Body image change
4. Insufficient oral intake
Page Ref: 702
Cognitive Level: Analyzing
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.3. Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management, and nursing management across the health-illness continuum, across lifespan, and in all healthcare settings | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 23.2 Describe the pathophysiology and manifestations of disorders of the mouth, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 4. Determine appropriate nursing interventions for patients with upper gastrointestinal disorders.
5) The nurse is caring for a patient with gastroesophageal reflux disease (GERD). What should the nurse include when teaching the patient about this health problem? Select all that apply.
1. Limit last food intake to 3 hours before bedtime.
2. Eat the largest meal of the day at midday.
3. Sleep in a bed with the head elevated 6 to 8 inches.
4. Follow a daily exercise routine.
5. Drink coffee with meals.
Page Ref: 709
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Implementation/Teaching/Learning
Learning Outcome: 23.3 Describe the pathophysiology and manifestations of disorders of the esophagus, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 4. Determine appropriate nursing interventions for patients with upper gastrointestinal disorders.
6) A patient receiving an antacid is experiencing muscle cramps. What should the nurse do to assist this patient?
1. Notify the healthcare provider.
2. Review the patient's diet history.
3. Review the patient's elimination patterns.
4. Provide reassurance to the patient.
Page Ref: 707
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.3. Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management, and nursing management across the health-illness continuum, across lifespan, and in all healthcare settings | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 23.3 Describe the pathophysiology and manifestations of disorders of the esophagus, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 3. Analyze assessment data to determine a plan of care for patients with upper gastrointestinal disorders.
7) A patient who has been experiencing nausea expresses an interest in aromatherapy to manage the condition. What response by the nurse would be most therapeutic?
1. "Ginger has been used with some success to manage nausea."
2. "Aromatherapy has shown very limited effectiveness with nausea."
3. "Aromatherapy helps to exert conscious control over physiologic processes."
4. "Why are you considering this method?"
Page Ref: 695
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.4. Communicate effectively with all members of the healthcare team, including the patient and the patient's support network | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 23.1 Describe the pathophysiology and manifestations of nausea and vomiting, and outline the interprofessional care and nursing care of patients with nausea and vomiting.
MNL Learning Outcome: 4. Determine appropriate nursing interventions for patients with upper gastrointestinal disorders.
8) The nurse is assessing a patient diagnosed with gastrointestinal bleeding. Which finding should alert the nurse that the patient's condition is deteriorating?
1. The patient reports feeling very tired.
2. Urinary output has increased over the previous hour to 50 mL.
3. The patient's skin is warm and dry.
4. Capillary refill time has increased.
Page Ref: 714
Cognitive Level: Analyzing
Client Need & Sub: Physiological Integrity: Physiological Adaptation
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 23.4 Describe the pathophysiology and manifestations of disorders of the stomach and duodenum, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 3. Analyze assessment data to determine a plan of care for patients with upper gastrointestinal disorders.
9) Four weeks post gastric resection surgery, a patient is experiencing cramping, nausea, and diarrhea within 10 minutes after eating. Suspecting that the patient may have dumping syndrome, what should the nurse suggest? Select all that apply.
1. Increase protein in the diet.
2. Lie down for 30 minutes immediately after eating.
3. Eat frequent, small meals.
4. Reduce the amount of carbohydrates eaten daily.
5. Drink a glass of water prior to each meal.
Page Ref: 728
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Physiological Adaptation
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.3. Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management, and nursing management across the health-illness continuum, across lifespan, and in all healthcare settings | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 23.4 Describe the pathophysiology and manifestations of disorders of the stomach and duodenum, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 4. Determine appropriate nursing interventions for patients with upper gastrointestinal disorders.
10) A patient diagnosed with peptic ulcer disease (PUD) asks if surgery will be necessary. How should the nurse respond?
1. "Taking the appropriate medications makes surgery rarely necessary."
2. "Surgery is required in about 50% of cases."
3. "Surgery has a higher success rate than medication therapy alone."
4. "If you take your medications and follow the prescribed diet, you will likely not need surgery."
Page Ref: 720
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Physiological Adaptation
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.3. Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management, and nursing management across the health-illness continuum, across lifespan, and in all healthcare settings | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 23.4 Describe the pathophysiology and manifestations of disorders of the stomach and duodenum, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 2. Consider intraprofessional care for patients with upper gastrointestinal disorders.
11) The spouse of a patient recently diagnosed with terminal esophageal cancer is angry because the patient did not seek help sooner. Which response by the nurse would be the most appropriate at this time?
1. "Unfortunately, the early symptoms are often vague and often not recognized as something serious."
2. "Your spouse was probably afraid of getting bad news."
3. "You will never know."
4. "It is not important to know that right now."
Page Ref: 710
Cognitive Level: Applying
Client Need & Sub: Psychosocial Integrity: Grief and Loss
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.3. Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management, and nursing management across the health-illness continuum, across lifespan, and in all healthcare settings | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 23.3 Describe the pathophysiology and manifestations of disorders of the esophagus, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 1. Examine the pathophysiology, incidence, risk factors, and clinical manifestations for patients with upper gastrointestinal disorders.
12) A patient complains of heartburn, reflux, and belching. Which diagnostic test should the nurse anticipate being prescribed for this patient?
1. Barium swallow
2. Colonoscopy
3. Barium enema
4. Chest x-ray
Page Ref: 709
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.3. Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management, and nursing management across the health-illness continuum, across lifespan, and in all healthcare settings | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 23.3 Describe the pathophysiology and manifestations of disorders of the esophagus, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 2. Consider intraprofessional care for patients with upper gastrointestinal disorders.
13) A patient recovering from gastric surgery has red fluid in the nasogastric tube. Vital signs are temperature 98°F; heart rate 104 beats per minute; respirations 23 breaths per minute; blood pressure 105/69 mmHg. Which action by the nurse is indicated?
1. Document the findings and notify the healthcare provider.
2. Document the findings and reassess the patient in 4 hours.
3. Review the patient's most recent laboratory results.
4. Document the findings and review the nasogastric suction settings.
Page Ref: 722
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.4. Communicate effectively with all members of the healthcare team, including the patient and the patient's support network | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Implementation/Communication and Documentation
Learning Outcome: 23.4 Describe the pathophysiology and manifestations of disorders of the stomach and duodenum, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 2. Consider intraprofessional care for patients with upper gastrointestinal disorders.
14) The nurse is caring for a patient who has been vomiting for 3 days. On which potential acid-base and electrolyte complications should the nurse focus when caring for this patient? Select all that apply.
1. Hypokalemia
2. Metabolic alkalosis
3. Metabolic acidosis
4. Hypocalcemia
5. Hyponatremia
Page Ref: 693
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Physiological Adaptation
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.3. Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management, and nursing management across the health-illness continuum, across lifespan, and in all healthcare settings | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 23.1 Describe the pathophysiology and manifestations of nausea and vomiting, and outline the interprofessional care and nursing care of patients with nausea and vomiting.
MNL Learning Outcome: 4. Determine appropriate nursing interventions for patients with upper gastrointestinal disorders.
15) The nurse is identifying interventions to assist a patient experiencing nausea and vomiting. Which complementary and alternative approach should the nurse consider to help this patient? Select all that apply.
1. Adding ginger to the diet
2. Biofeedback
3. Music therapy
4. Acupuncture
5. Taking St. John's wort
Page Ref: 695
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Basic Care and Comfort
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.17. Develop a beginning understanding of complementary and alternative modalities and their role in healthcare | NLN Competencies: Context and Environment; Practice-Know-How; Apply evidence to support decision making in situations characterized by ambiguity and uncertainty | Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 23.1 Describe the pathophysiology and manifestations of nausea and vomiting, and outline the interprofessional care and nursing care of patients with nausea and vomiting.
MNL Learning Outcome: 4. Determine appropriate nursing interventions for patients with upper gastrointestinal disorders.
16) The nurse is caring for a patient who is experiencing a new onset of gastrointestinal bleeding. In which order should the nurse assess this patient? Place in order the steps of the process.
Choice 1. Identify possible contributing factors, including medications.
Choice 2. Obtain vital signs, including orthostatic changes.
Choice 3. Place the acutely ill patient on a cardiac monitor and obtain a rhythm strip.
Choice 4. Evaluate mental status.
Choice 5. Assess peripheral pulse strength, color, temperature, and cap refill of extremities.
Choice 6. Obtain oxygen saturation level.
Page Ref: 714
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.3. Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management, and nursing management across the health-illness continuum, across lifespan, and in all healthcare settings | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 23.4 Describe the pathophysiology and manifestations of disorders of the stomach and duodenum, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 3. Analyze assessment data to determine a plan of care for patients with upper gastrointestinal disorders.
17) The nurse expects that a dopamine antagonist will be prescribed for a patient who is experiencing nausea and vomiting. Which medication should the nurse anticipate being prescribed for this patient? Select all that apply.
1. Prochlorperazine (Compazine)
2. Thiethylperazine (Torecan)
3. Metoclopramide (Reglan)
4. Ondansetron (Zofran)
5. Hydroxyzine (Vistaril)
Page Ref: 694
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Pharmacological and Parenteral Therapies
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.3. Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management, and nursing management across the health-illness continuum, across lifespan, and in all healthcare settings | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 23.1 Describe the pathophysiology and manifestations of nausea and vomiting, and outline the interprofessional care and nursing care of patients with nausea and vomiting.
MNL Learning Outcome: 2. Consider intraprofessional care for patients with upper gastrointestinal disorders.
18) A patient is being prepared for chemotherapy, and the doctor has ordered Zofran 0.15 mg/kg IV to be given 30 minutes prior to starting the chemotherapy. The patient weighs 80 kg. How many milligrams of Zofran will the patient receive? Record your answer rounding to the nearest whole number.
Page Ref: 694
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Pharmacological and Parenteral Therapies
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.3. Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management, and nursing management across the health-illness continuum, across lifespan, and in all healthcare settings | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 23.1 Describe the pathophysiology and manifestations of nausea and vomiting, and outline the interprofessional care and nursing care of patients with nausea and vomiting.
MNL Learning Outcome: 2. Consider intraprofessional care for patients with upper gastrointestinal disorders.
19) The nurse is teaching a patient with stomatitis about mouth care. What should the nurse include in this teaching? Select all that apply.
1. Avoid tobacco and alcohol.
2. Use a saline or sodium bicarbonate rinse after every meal.
3. Consume 8 oz of yogurt or buttermilk daily.
4. Avoid cold beverages.
5. Use lemon-glycerin swabs between meals.
Page Ref: 700
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Basic Care and Comfort
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Implementation/Teaching/Learning
Learning Outcome: 23.2 Describe the pathophysiology and manifestations of disorders of the mouth, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 4. Determine appropriate nursing interventions for patients with upper gastrointestinal disorders.
20) A patient is being evaluated for gastroesophageal reflux disease (GERD). Which diagnostic test should the nurse expect to be prescribed for this patient? Select all that apply.
1. Barium swallow
2. Upper endoscopy
3. CT scan
4. Complete blood count
5. Colonoscopy
Page Ref: 706
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.3. Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management, and nursing management across the health-illness continuum, across lifespan, and in all healthcare settings | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 23.3 Describe the pathophysiology and manifestations of disorders of the esophagus, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 2. Consider intraprofessional care for patients with upper gastrointestinal disorders.
21) The nurse is teaching a patient about the major risk factors for peptic ulcer disease (PUD). Which risk factors should the nurse discuss? Select all that apply.
1. Chronic H. pylori infection
2. Use of aspirin and NSAIDs
3. Use of alcohol
4. Dietary intake
5. Stress
Page Ref: 716
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Implementation/Teaching/Learning
Learning Outcome: 23.4 Describe the pathophysiology and manifestations of disorders of the stomach and duodenum, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 1. Examine the pathophysiology, incidence, risk factors, and clinical manifestations for patients with upper gastrointestinal disorders.
22) The healthcare provider has prescribed metoclopramide (Reglan) 2 mg/kg IVP to be given 30 minutes before the start of chemotherapy. The patient weighs 54 kg. The Reglan is dispensed in a 10 mg/10 mL vial. How many milliliters of the medication should the nurse administer? Record your answer rounding to the nearest whole number.
Page Ref: 708
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Pharmacological and Parenteral Therapies
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.3. Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management, and nursing management across the health-illness continuum, across lifespan, and in all healthcare settings | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 23.3 Describe the pathophysiology and manifestations of disorders of the esophagus, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 2. Consider intraprofessional care for patients with upper gastrointestinal disorders.
23) The nurse learns that an older patient with ill-fitting dentures has been using an over-the-counter (OTC) preparation for a gum sore over the last month. What should the nurse instruct this patient to do?
1. Make an appointment to see the physician.
2. Continue to use the preparation.
3. Change the preparation.
4. Stop wearing the dentures.
Page Ref: 700
Cognitive Level: Applying
Client Need & Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Implementation/Teaching/Learning
Learning Outcome: 23.2 Describe the pathophysiology and manifestations of disorders of the mouth, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 4. Determine appropriate nursing interventions for patients with upper gastrointestinal disorders.
24) A patient with a long history of using chewing tobacco says, "I've been chewing for years. I'm not going to get cancer." How should the nurse respond?
1. "The use of smokeless tobacco has been linked to oral cancer."
2. "You are probably one of the lucky ones."
3. "I guess you're right."
4. "It's not my body."
Page Ref: 701
Cognitive Level: Applying
Client Need & Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.4. Communicate effectively with all members of the healthcare team, including the patient and the patient's support network | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 23.2 Describe the pathophysiology and manifestations of disorders of the mouth, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 1. Examine the pathophysiology, incidence, risk factors, and clinical manifestations for patients with upper gastrointestinal disorders.
25) A patient who needs a radical neck dissection for oral cancer continues to delay the surgery. Which issue may be influencing the patient's decision-making process?
1. Potential for change in body image
2. Future problem with communication
3. Fear about not being able to eat
4. Fear about not being able to breathe
Page Ref: 703
Cognitive Level: Analyzing
Client Need & Sub: Psychosocial Integrity: Coping Mechanisms
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.3. Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management, and nursing management across the health-illness continuum, across lifespan, and in all healthcare settings | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 23.2 Describe the pathophysiology and manifestations of disorders of the mouth, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 3. Analyze assessment data to determine a plan of care for patients with upper gastrointestinal disorders.
26) The nurse is preparing to instruct a patient newly diagnosed with gastroesophageal reflux disease (GERD) about dietary considerations. What should the nurse include in these instructions? Select all that apply.
1. "Avoid peppermint."
2. "Meals should be small and more frequent."
3. "Have a bedtime snack."
4. "Be sure to eat at least one citrus fruit per day."
5. "Alcohol should be limited to two drinks per day."
Page Ref: 709
Cognitive Level: Applying
Client Need & Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Implementation/Teaching/Learning
Learning Outcome: 23.3 Describe the pathophysiology and manifestations of disorders of the esophagus, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 4. Determine appropriate nursing interventions for patients with upper gastrointestinal disorders.
27) The nurse is preparing the morning medications for a patient with gastroesophageal reflux disease (GERD). Which nursing intervention would be appropriate for this patient's medications?
1. Hold the antacids for at least 2 hours after oral medications are taken.
2. Provide all prescribed medications at 1000.
3. Provide the antacids first, then follow with the oral medications.
4. Provide the antacids only at the hour of sleep.
Page Ref: 707
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Pharmacological and Parenteral Therapies
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.3. Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management, and nursing management across the health-illness continuum, across lifespan, and in all healthcare settings | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 23.3 Describe the pathophysiology and manifestations of disorders of the esophagus, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 4. Determine appropriate nursing interventions for patients with upper gastrointestinal disorders.
28) A patient with gastrointestinal dysfunction says, "I was having chest pain so bad last week I thought I was having a heart attack!" What should the nurse suspect the patient was experiencing?
1. Hiatal hernia
2. Diverticulitis
3. Constipation
4. Bowel obstruction
Page Ref: 709
Cognitive Level: Analyzing
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 23.3 Describe the pathophysiology and manifestations of disorders of the esophagus, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 3. Analyze assessment data to determine a plan of care for patients with upper gastrointestinal disorders.
29) A patient who is experiencing difficulty swallowing is diagnosed with esophageal cancer after having a barium swallow. Which finding is consistent with this patient's health problem?
1. Narrow esophageal lumen
2. Tumor
3. Metastasis
4. Blood
Page Ref: 711
Cognitive Level: Analyzing
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 23.3 Describe the pathophysiology and manifestations of disorders of the esophagus, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 3. Analyze assessment data to determine a plan of care for patients with upper gastrointestinal disorders.
30) A patient with nausea refuses to take a medication because it makes the nausea worse. What can the nurse suggest to the patient?
1. Eat a dry cracker to help with the nausea.
2. Stop taking the medication.
3. Nothing.
4. Take the medication with a heavy meal.
Page Ref: 693
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.3. Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management, and nursing management across the health-illness continuum, across lifespan, and in all healthcare settings | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 23.1 Describe the pathophysiology and manifestations of nausea and vomiting, and outline the interprofessional care and nursing care of patients with nausea and vomiting.
MNL Learning Outcome: 4. Determine appropriate nursing interventions for patients with upper gastrointestinal disorders.
31) A patient with chronic gastritis stops taking prescribed medication and uses ginger tea instead. What should the nurse realize is occurring with this patient?
1. Using a complementary therapy for the symptoms.
2. In denial of the disease
3. Cannot afford the medication
4. Needs to see the healthcare provider immediately
Page Ref: 726
Cognitive Level: Analyzing
Client Need & Sub: Physiological Integrity: Pharmacological and Parenteral Therapies
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.17. Develop a beginning understanding of complementary and alternative modalities and their role in healthcare | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 23.4 Describe the pathophysiology and manifestations of disorders of the stomach and duodenum, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 3. Analyze assessment data to determine a plan of care for patients with upper gastrointestinal disorders.
32) A patient reports having stomach pains during the night that disappear after eating. Which health problem should the nurse suspect this patient is experiencing?
1. Peptic ulcer disease
2. Gastroesophageal reflux disease (GERD)
3. Acute gastritis
4. Chronic gastritis
Page Ref: 719
Cognitive Level: Analyzing
Client Need & Sub: Physiological Integrity: Physiological Adaptation
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 23.4 Describe the pathophysiology and manifestations of disorders of the stomach and duodenum, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 1. Examine the pathophysiology, incidence, risk factors, and clinical manifestations for patients with upper gastrointestinal disorders.
33) The nurse learns that a patient who is being treated for peptic ulcer disease is "still having problems." What should the nurse instruct this patient to do?
1. Try smoking cessation techniques.
2. Eat a bland diet.
3. Avoid eating breakfast.
4. Have the largest meal of the day at lunchtime.
Page Ref: 727
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Physiological Adaptation
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Implementation/Teaching/Learning
Learning Outcome: 23.4 Describe the pathophysiology and manifestations of disorders of the stomach and duodenum, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 4. Determine appropriate nursing interventions for patients with upper gastrointestinal disorders.
34) A patient with peptic ulcer disease (PUD) reports feeling better since not eating. Which health problem is this patient at risk for developing?
1. Insufficient nutritional intake
2. Insomnia
3. Ongoing pain
4. Overhydration
Page Ref: 722
Cognitive Level: Analyzing
Client Need & Sub: Physiological Integrity: Physiological Adaptation
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 23.4 Describe the pathophysiology and manifestations of disorders of the stomach and duodenum, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 3. Analyze assessment data to determine a plan of care for patients with upper gastrointestinal disorders.
35) A patient who is recovering from surgery for stomach cancer a month ago continues to experience dumping syndrome. What should the nurse instruct this patient?
1. "It's usually self-limiting and will resolve within 6 to 12 months."
2. "It will be a problem for the rest of your life."
3. "There's no treatment."
4. "Eat only a clear-liquid diet."
Page Ref: 728
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Physiological Adaptation
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Implementation/Teaching/Learning
Learning Outcome: 23.4 Describe the pathophysiology and manifestations of disorders of the stomach and duodenum, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 4. Determine appropriate nursing interventions for patients with upper gastrointestinal disorders.
36) A patient who had stomach cancer surgery 2 years ago is concerned about it recurring because of being fatigued. Which health problem should the nurse realize this patient is experiencing?
1. Vitamin deficiency
2. A return of the stomach cancer
3. Metastasis
4. Ineffective coping
Page Ref: 728
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Physiological Adaptation
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 23.4 Describe the pathophysiology and manifestations of disorders of the stomach and duodenum, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 3. Analyze assessment data to determine a plan of care for patients with upper gastrointestinal disorders.
37) A patient who has had gastric surgery for cancer is denying the diagnosis of cancer. What should the nurse do?
1. The nurse should not argue with the patient but continue to provide emotional support as needed.
2. The nurse should remind the patient of the diagnosis.
3. The nurse should ask a clinical psychologist to talk with the patient.
4. The nurse should explain how many people with cancer live long, productive lives.
Page Ref: 729
Cognitive Level: Applying
Client Need & Sub: Psychosocial Integrity: Coping Mechanisms
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.3. Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management, and nursing management across the health-illness continuum, across lifespan, and in all healthcare settings | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 23.4 Describe the pathophysiology and manifestations of disorders of the stomach and duodenum, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 4. Determine appropriate nursing interventions for patients with upper gastrointestinal disorders.
38) An older patient is experiencing significant weight loss and has poorly fitting dentures that cause severe oral sores. When preparing the plan of care, which intervention will be most beneficial to the patient?
1. Providing analgesics as needed
2. Evaluating the need for assistive devices
3. Serving meals in an attractive environment
4. Offering assistance to eat
Page Ref: 700
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Basic Care and Comfort
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.3. Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management, and nursing management across the health-illness continuum, across lifespan, and in all healthcare settings | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 23.2 Describe the pathophysiology and manifestations of disorders of the mouth, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 4. Determine appropriate nursing interventions for patients with upper gastrointestinal disorders.
39) The nurse suspects that a patient receiving dronabinol (Marinol) to treat nausea and vomiting caused by chemotherapy is experiencing adverse effects of the medication. What did the nurse assess to come to this conclusion? Select all that apply.
1. Urine output 50 mL/hr
2. Blood pressure 88/62 mmHg
3. Complaints of extreme hunger
4. Heart rate 112 beats per minute
5. Oxygen saturation 96% on room air
Page Ref: 695
Cognitive Level: Analyzing
Client Need & Sub: Physiological Integrity: Pharmacological and Parenteral Therapies
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 23.1 Describe the pathophysiology and manifestations of nausea and vomiting, and outline the interprofessional care and nursing care of patients with nausea and vomiting.
MNL Learning Outcome: 3. Analyze assessment data to determine a plan of care for patients with upper gastrointestinal disorders.
40) A 32-year-old patient receiving chemotherapy for breast cancer is prescribed aprepitant (Emend). What should the nurse emphasize when teaching the patient about this medication? Select all that apply.
1. Take this medication for 10 days.
2. Take the medication either with food or on an empty stomach.
3. Use a barrier contraceptive while taking this medication.
4. A skin rash is an expected effect of this medication.
5. Contact the healthcare provider about any onset of confusion.
Page Ref: 694
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Pharmacological and Parenteral Therapies
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Implementation/Teaching/Learning
Learning Outcome: 23.1 Describe the pathophysiology and manifestations of nausea and vomiting, and outline the interprofessional care and nursing care of patients with nausea and vomiting.
MNL Learning Outcome: 4. Determine appropriate nursing interventions for patients with upper gastrointestinal disorders.
41) A patient with severe esophageal spasms is diagnosed with achalasia. For which surgical procedure should the nurse prepare teaching for this patient? Select all that apply.
1. Esophagectomy
2. Gastric resection
3. Laparoscopic myotomy
4. Balloon dilation of the lower esophageal sphincter
5. Endoscopically guided injection of botulinum toxin
Page Ref: 710
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Planning/Teaching/Learning
Learning Outcome: 23.3 Describe the pathophysiology and manifestations of disorders of the esophagus, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 4. Determine appropriate nursing interventions for patients with upper gastrointestinal disorders.
42) The nurse suspects that a patient is exhibiting manifestations of Zollinger-Ellison syndrome. What did the nurse assess to make this clinical judgment? Select all that apply.
1. Nausea
2. Diarrhea
3. Belching
4. Steatorrhea
5. Abdominal pain
Page Ref: 719
Cognitive Level: Analyzing
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 23.4 Describe the pathophysiology and manifestations of disorders of the stomach and duodenum, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 3. Analyze assessment data to determine a plan of care for patients with upper gastrointestinal disorders.
Document Information
Connected Book
Medical Surgical Nursing 7e | Test Bank by LeMone, Burke, Bauldoff
By LeMone, Burke, Gerene Bauldoff
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Chapter 21 Assessing The Gastrointestinal System
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Chapter 22 Nursing Care Of Patients With Nutritional Disorders
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Chapter 23 GI Disorders – Nursing Care
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Chapter 24 Nursing Care Of Patients With Bowel Disorders
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