Chapter 42: Nursing Management: Upper Gastrointestinal Problems

Chapter 42: Nursing Management: Upper Gastrointestinal Problems

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE
1. 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
patient’s nausea?
a. The patient NPO 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 prochlorperazine (Compazine) before dressing changes.
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/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.
DIF: Cognitive Level: Application REF: 963-964
TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity
2. A patient who has been NPO 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?
a. A glass of orange juice
b. A dish of lemon gelatin
c. A cup of coffee with cream
d. A bowl of hot chicken broth
ANS: B
Clear 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: Application REF: 965 | 966-967
TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity
3. A patient who is receiving chemotherapy develops a Candida albicans oral infection. The
nurse will anticipate the need for
a. hydrogen peroxide rinses.
b. the use of antiviral agents.
c. referral to a dentist for professional tooth cleaning.
Test Bank 42-2
d. administration of nystatin (Mycostatin) oral tablets.
ANS: D
Candida albicans is treated with an antifungal such as nystatin. 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: Application REF: 968 TOP: Nursing Process:
Planning
MSC: NCLEX: Physiological Integrity
4. When the nurse is assessing the mouth of a patient who uses smokeless tobacco for signs
of oral cancer, which finding will be of most concern?
a. Bleeding during tooth brushing
b. Painful blisters at the border of the lips
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 (greater than
50%) of progression to squamous cell carcinoma. The other lesions are suggestive of
acute processes (gingivitis, oral candidiasis, and herpes simplex).
DIF: Cognitive Level: Comprehension REF: 968-969
TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity