Chapter 55: Care of Patients with Stomach Disorders

Chapter 55: Care of Patients with Stomach Disorders

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE

1. The nurse is caring for a client with peptic ulcer disease who reports sudden onset of sharp abdominal pain. On palpation, the client’s abdomen is tense and rigid. What action takes priority?
   1. Administer the prescribed pain medication.
   2. Notify the health care provider immediately.
   3. Percuss all four abdominal quadrants.
   4. Take and document a set of vital signs.

ANS:   B

This client has manifestations of a perforated ulcer, which is an emergency. The priority is to get the client medical attention. The nurse can take a set of vital signs while someone else calls the provider. The nurse should not percuss the abdomen or give pain medication since the client may need to sign consent for surgery.

DIF:     Applying/Application                         REF: 1132                   KEY: Gastrointestinal disorders| nursing assessment| communication  MSC: Integrated Process: Communication and Documentation  NOT:   Client Needs Category: Safe and Effective Care Environment: Management of Care

2. A client has a pyloric obstruction and reports sudden muscle weakness. What action by the nurse takes priority?
   1. Document the findings in the chart.
   2. Request an electrocardiogram (ECG).
   3. Facilitate a serum potassium test.
   4. Place the client on bedrest.

ANS:   B

Pyloric stenosis can lead to hypokalemia, which is manifested by muscle weakness. The nurse first obtains an ECG because potassium imbalances can lead to cardiac dysrhythmias. A potassium level is also warranted, as is placing the client on bedrest for safety. Documentation should be thorough, but none of these actions takes priority over the ECG.

DIF:     Analyzing/Analysis                            REF: 1132                   KEY: Gastrointestinal disorders| electrolyte imbalances| cardiac system  MSC:                                  Integrated Process: Communication and Documentation  NOT: Client Needs Category: Safe and Effective Care Environment: Management of Care

3. A client with peptic ulcer disease is in the emergency department and reports the pain has gotten much worse over the last several days. The client’s blood pressure when lying down was 122/80 mm Hg and when standing was 98/52 mm Hg. What action by the nurse is most appropriate?
   1. Administer ibuprofen (Motrin).
   2. Call the Rapid Response Team.
   3. Start a large-bore IV with normal saline.
   4. Tell the client to remain lying down.

ANS:           C

This client has orthostatic changes to the blood pressure, indicating fluid volume loss. The nurse should start a large-bore IV with isotonic solution. Ibuprofen will exacerbate the ulcer. The Rapid Response Team is not needed at this point. The client should be put on safety precautions, which includes staying in bed, but this is not the priority.

DIF:            Applying/Application                         REF:    1136                 KEY: Gastrointestinal disorders| fluid imbalances| nursing assessment  MSC:        Integrated Process: Nursing Process: Implementation                      NOT:                                                 Client Needs Category: Physiological Integrity: Physiological Adaptation

4. A client with a bleeding gastric ulcer is having a nuclear medicine scan. What action by the nurse is most appropriate?
   1. Assess the client for iodine or shellfish allergies.
   2. Educate the client on the side effects of sedation.
   3. Inform the client a second scan may be needed.
   4. Teach the client about bowel preparation for the scan.

ANS:           C

A second scan may be performed in 1 to 2 days to see if interventions have worked. The nuclear medicine scan does not use iodine-containing contrast dye or sedation. There is no required bowel preparation.

DIF:     Understanding/Comprehension          REF:    1134     KEY: Gastrointestinal disorders| patient education| nuclear medicine    MSC: Integrated Process: Teaching/Learning                       NOT: Client Needs Category: Physiological Integrity: Reduction of Risk Potential