Nokea
A client is being taught about drug therapy for Helicobacter pylori infection. What assessment by the nurse is appropriate?
- A. Alcohol intake of 1 to 2 drinks per week
- B. Family history of H. pylori infection
- C. Former smoker still using nicotine patches
- D. Willingness to adhere to drug therapy
Correct Answer: D
Rationale: Treatment for this infection involves either triple or quadruple drug therapy, which may make it difficult for clients to remain adherent. The nurse should assess the client's willingness and ability to follow the regimen. The other assessment findings are not as critical.
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A client with peptic ulcer disease asks the nurse about taking slippery elm supplements. What response by the nurse is best?
- A. Ask your provider about it first.
- B. Slippery elm has no benefit for this problem.
- C. Slippery elm is often used for this disorder.
- D. There is no evidence that this will work.
Correct Answer: B
Rationale: Slippery elm is not recognized as an effective treatment for peptic ulcer disease. There is no evidence supporting its use for this condition, and it is not commonly recommended.
A nurse working with a client who has possible gastritis assesses the client's gastrointestinal system. Which findings indicate a chronic condition as opposed to acute gastritis? (Select all that apply.)
- A. Anorexia
- B. Dyspepsia
- C. Intolerance of fatty foods
- D. Pernicious anemia
- E. Nausea and vomiting
Correct Answer: C,D
Rationale: Intolerance of fatty or spicy foods and pernicious anemia are signs of chronic gastritis. Anorexia and nausea/vomiting can be seen in both conditions. Dyspepsia is seen in acute gastritis.
A client has dumping syndrome after a partial gastrectomy. Which action by the nurse would be most helpful?
- A. Arrange a dietary consult.
- B. Increase the client's fluid intake.
- C. Limit the client's foods.
- D. Make the client NPO.
Correct Answer: A
Rationale: The client with dumping syndrome after a gastrectomy has multiple dietary needs. A referral to a registered dietitian would be extremely helpful. Food and fluid intake is complicated and needs planning. The client should not be NPO.
The student nurse learns about risk factors for gastric cancer. Which factors does this include? (Select all that apply.)
- A. Achlorhydria
- B. Chronic atrophic gastritis
- C. Helicobacter pylori infection
- D. Iron deficiency anemia
- E. Pernicious anemia
Correct Answer: A,B,C,E
Rationale: Achlorhydria, chronic atrophic gastritis, H. pylori infection, and pernicious anemia are all risk factors for developing gastric cancer. Iron deficiency anemia is not a risk factor.
A client is scheduled for a total gastrectomy for gastric cancer. What preoperative laboratory result should be reported to the surgeon immediately?
- A. Albumin: 2.1 g/dL
- B. Hematocrit: 28%
- C. Hemoglobin: 8.1 g/dL
- D. International normalized ratio (INR): 4.2
Correct Answer: D
Rationale: An INR as high as 4.2 poses a serious risk of bleeding during the operation and should be reported. The albumin is low and is an expected finding. The hematocrit and hemoglobin are also low, but this is expected in gastric cancer.