Understanding Medical Surgical Nursing 5th Edition by Linda S. Williams Paula D. Hopper
Understanding Medical Surgical Nursing 5th Edition by Linda S. Williams Paula D. Hopper
$2.99
Chapter 33. Nursing Care of Patients With Upper Gastrointestinal Disorders
Complete Chapter Questions With Answers
Sample Questions Are Posted Below
Multiple Choice
Identify the choice that best completes the statement or answers the question.
____ 1. The nurse is caring for a patient with a sliding hiatal hernia. In which position should the nurse expect the patient to report that the symptoms are more acute?
| a. | Sitting |
| b. | Standing |
| c. | Lying down |
| d. | Semi-Fowler’s |
____ 2. The nurse is reinforcing teaching provided to a patient with a hiatal hernia. Which patient statement indicates a correct understanding of lifestyle modification to reduce symptoms?
| a. | “Avoid high-stress situations.” |
| b. | “Perform daily aerobic exercise.” |
| c. | “Avoid nicotine and alcohol use.” |
| d. | “Carefully space activity periods with rest.” |
____ 3. The nurse teaching a patient with gastroesophageal reflux about the influence of body position on the disease process. Which patient statement indicates that teaching has been effective?
| a. | “I elevate the head of the bed 4 to 6 inches.” |
| b. | “I elevate the foot of the bed 12 to 16 inches.” |
| c. | “I sleep on my back without a pillow under my head.” |
| d. | “I sleep on my stomach with my head turned to the left.” |
____ 4. A patient with a duodenal peptic ulcer vomits old blood. What description should the nurse use to document the appearance of the vomitus?
| a. | Duodenal fecal matter |
| b. | Coffee-ground particles |
| c. | Undigested particles of food |
| d. | Chyme streaked with a black syrupy material |
____ 5. The nurse is caring for a patient on a gastrointestinal unit. Which patient statement should cause the nurse the most concern?
| a. | “My stool has been dark green and hard to pass lately.” |
| b. | “Lately, I’ve had two or three loose, sticky black stools every day.” |
| c. | “Usually I move my bowels every day and the stool is light brown.” |
| d. | “My stool is soft and dark brown; I usually move my bowels twice a day.” |
MULTIPLE CHOICE
In a sliding hiatal hernia, the stomach slides up into the thoracic cavity when a patient is supine and then goes back into the abdominal cavity when upright. Sliding hiatal hernia symptoms are worse when lying down. A. B. D. The symptoms of a hiatal hernia are not worse when sitting, standing, or in the semi-Fowler’s position.
PTS: 1 DIF: Moderate
KEY: Client Need: Physiological Integrity—Physiological Adaptation | Cognitive Level: Analysis
Lifestyle changes for symptomatic hiatal hernia include losing weight, antacids, eating small meals that pass easily through the esophagus, not reclining for 3-4 hours after eating, elevating the head of the bed 6 to 12 inches to prevent reflux, and avoiding bedtime snacks, spicy foods, alcohol, caffeine, and smoking. A. B. D. Stress, exercise, and rest periods are not recommendations for the patient with a hiatal hernia.
PTS: 1 DIF: Moderate
KEY: Client Need: Physiological Integrity—Physiological Adaptation | Cognitive Level: Analysis
Elevating the head of the bed 4 to 6 inches helps prevent reflux of gastric contents into the esophagus. B. The head of the bed does not need to be elevated 12 to 16 inches. C. D. Sleeping flat or on the stomach could exacerbate symptoms of gastroesophageal reflux.
PTS: 1 DIF: Moderate
KEY: Client Need: Physiological Integrity—Physiological Adaptation | Cognitive Level: Analysis
When blood mixes with hydrochloric acid and enzymes in the stomach, a dark, granular material resembling coffee grounds is produced. This indicates old bleeding, as fresh bleeding would be red in color. A.C. D. The nurse should not document the appearance of the patient’s emesis as being duodenal fecal matter, undigested food particles or a chyme mixture.
PTS: 1 DIF: Moderate
KEY: Client Need: Physiological Integrity—Physiological Adaptation | Cognitive Level: Application
The nurse should be most concerned if there were evidence of blood loss causing black tarry stools (melena). A. Stool that is dark green and hard to pass could indicate constipation caused by an iron preparation. C. D. More information is needed before becoming concerned about these descriptions.
PTS: 1 DIF: Moderate
KEY: Client Need: Physiological Integrity—Physiological Adaptation | Cognitive Level: Analysis
Original price was: $25.00.$15.00Current price is: $15.00.
Original price was: $60.00.$40.00Current price is: $40.00.
Original price was: $80.00.$60.00Current price is: $60.00.
Original price was: $30.00.$20.00Current price is: $20.00.
Original price was: $39.99.$19.99Current price is: $19.99.
Original price was: $40.00.$20.00Current price is: $20.00.