Chapter 41: Upper Gastrointestinal Problems

Chapter 41: Upper Gastrointestinal Problems

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. A 53-yr-old male patient with deep partial-thickness burns from a chemical spill in the workplace experiences severe pain followed by nausea during dressing changes. Which action will be most useful in decreasing the patient’s nausea?

a.	Keep the patient NPO for 2 hours before dressing changes.
b.	Give the ordered prochlorperazine before dressing changes.
c.	Administer the prescribed morphine sulfate before dressing changes.
d.	Avoid performing dressing changes close to the patient’s mealtimes.

 

 

ANS:  C

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 or vomiting that occur at other times also should be addressed. Keeping the patient NPO does not address the reason for the nausea and vomiting and will have an adverse effect on the patient’s nutrition. Administration of antiemetics is not the best choice for a patient with nausea caused by pain. However, an antiemetic may be added later if the nausea persists despite pain management.

 

DIF:    Cognitive Level: Analyze (analysis)                                  REF:   894

TOP:   Nursing Process: Implementation     MSC:  NCLEX: Physiological Integrity

 

2. Which item should the nurse offer to the patient who is to restart oral intake after being NPO due to nausea and vomiting?

a.	Glass of orange juice	c.	Cup of coffee with cream
b.	Dish of lemon gelatin	d.	Bowl of hot chicken broth

 

 

ANS:  B

Clear cool liquids are usually the first foods started after a patient has been nauseated. Acidic foods such as orange juice, very hot foods, and coffee are poorly tolerated when patients have been nauseated.

 

DIF:    Cognitive Level: Apply (application)           REF:               894

TOP:   Nursing Process: Implementation     MSC:  NCLEX: Physiological Integrity

 

3. A 38-year old woman receiving chemotherapy for breast cancer develops a Candida albicans oral infection. The nurse will anticipate the need for

a.	hydrogen peroxide rinses.
b.	the use of antiviral agents.
c.	administration of nystatin tablets.
d.	referral to a dentist for professional tooth cleaning.

 

 

ANS:  C

Candida albicans infections are treated with an antifungal such as nystatin. Peroxide rinses would be painful. Oral saltwater rinses may be used but will not cure the infection. Antiviral agents are used for viral infections such as herpes simplex. Referral to a dentist is indicated for gingivitis but not for Candida infection.

 

DIF:    Cognitive Level: Apply (application)           REF:               897

TOP:   Nursing Process: Planning               MSC:  NCLEX: Physiological Integrity

 

4. Which finding in the mouth of a patient who uses smokeless tobacco is suggestive of oral cancer?

a.	Bleeding during tooth brushing
b.	Painful blisters at the lip border
c.	Red, velvety patches on the buccal mucosa
d.	White, curdlike plaques on the posterior tongue

 

 

ANS:  C

A red, velvety patch suggests erythroplasia, which has a high incidence (>50%) of progression to squamous cell carcinoma. The other lesions are suggestive of acute processes (e.g., gingivitis, oral candidiasis, herpes simplex).

 

DIF:    Cognitive Level: Understand (comprehension)                   REF:   898

TOP:   Nursing Process: Assessment           MSC:  NCLEX: Physiological Integrity

 

5. Which information will the nurse include when teaching adults to decrease the risk for cancers of the tongue and buccal mucosa?

a.	Avoid use of cigarettes and smokeless tobacco.
b.	Use sunscreen when outside even on cloudy days.
c.	Complete antibiotic courses used to treat throat infections.
d.	Use antivirals to treat herpes simplex virus (HSV) infections.

 

 

ANS:  A

Tobacco use greatly increases the risk for oral cancer. Acute throat infections do not increase the risk for oral cancer, although chronic irritation of the oral mucosa does increase risk. Sun exposure does not increase the risk for cancers of the buccal mucosa. Human papillomavirus (HPV) infection is associated with an increased risk, but HSV infection is not a risk factor for oral cancer.

 

DIF:    Cognitive Level: Apply (application)           REF:               898

TOP:   Nursing Process: Planning               MSC:  NCLEX: Health Promotion and Maintenance