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A nurse is assessing a patient who has peptic ulcer disease. The patient requests more information about the typical causes of Helicobacter pylori infection. What would it be appropriate for the nurse to instruct the patient?
- A. Most affected patients acquired the infection during international travel.
- B. Infection typically occurs due to ingestion of contaminated food and water.
- C. Many people possess genetic factors causing a predisposition to H. pylori infection.
- D. The H. pylori microorganism is endemic in warm, moist climates.
Correct Answer: B
Rationale: Most peptic ulcers result from infection with the gram-negative bacteria H. pylori, which may be acquired through ingestion of food and water. The organism is endemic to all areas of the United States. Genetic factors have not been identified.
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A patient presents to the walk-in clinic complaining of vomiting and burning in her mid-epigastria. The nurse knows that in the process of confirming peptic ulcer disease, the physician is likely to order a diagnostic test to detect the presence of what?
- A. Infection with Helicobacter pylori
- B. Excessive stomach acid secretion
- C. An incompetent pyloric sphincter
- D. A metabolic acid-base imbalance
Correct Answer: A
Rationale: H. pylori infection may be determined by endoscopy and histologic examination of a tissue specimen obtained by biopsy, or a rapid urease test of the biopsy specimen. Excessive stomach acid secretion leads to gastritis; however, peptic ulcers are caused by colonization of the stomach by H. pylori. Sphincter dysfunction and acid-base imbalances do not cause peptic ulcer disease.
A nurse is providing patient education for a patient with peptic ulcer disease secondary to chronic nonsteroidal anti-inflammatory drug (NSAID) use. The patient has recently been prescribed misoprostol (Cytotec). What would the nurse be most accurate in informing the patient about the drug?
- A. It reduces the stomachs volume of hydrochloric acid
- B. It increases the speed of gastric emptying
- C. It protects the stomachs lining
- D. It increases lower esophageal sphincter pressure
Correct Answer: C
Rationale: Misoprostol is a synthetic prostaglandin that, like prostaglandin, protects the gastric mucosa. NSAIDs decrease prostaglandin production and predispose the patient to peptic ulceration. Misoprostol does not reduce gastric acidity, improve emptying of the stomach, or increase lower esophageal sphincter pressure.
A patient with gastritis required hospital treatment for an exacerbation of symptoms and receives a subsequent diagnosis of pernicious anemia due to malabsorption. When planning the patients continuing care in the home setting, what assessment question is most relevant?
- A. Does anyone in your family have experience at giving injections?
- B. Are you going to be anywhere with strong sunlight in the next few months?
- C. Are you aware of your blood type?
- D. Do any of your family members have training in first aid?
Correct Answer: A
Rationale: Patients with malabsorption of vitamin B12 need information about lifelong vitamin B12 injections; the nurse may instruct a family member or caregiver how to administer the injections or make arrangements for the patient to receive the injections from a health care provider. Questions addressing sun exposure, blood type, and first aid are not directly relevant.
A nurse is completing a health history on a patient whose diagnosis is chronic gastritis. Which of the data should the nurse consider most significantly related to the etiology of the patients health problem?
- A. Consumes one or more protein drinks daily.
- B. Takes over-the-counter antacids frequently throughout the day.
- C. Smokes one pack of cigarettes daily.
- D. Reports a history of social drinking on a weekly basis.
Correct Answer: C
Rationale: Nicotine reduces secretion of pancreatic bicarbonate, which inhibits neutralization of gastric acid and can underlie gastritis. Protein drinks do not result in gastric inflammation. Antacid use is a response to experiencing symptoms of gastritis, not the etiology of gastritis. Alcohol ingestion can lead to gastritis; however, this generally occurs in patients with a history of consumption of alcohol on a daily basis.
A nurse in the postanesthesia care unit admits a patient following resection of a gastric tumor. Following immediate recovery, the patient should be placed in which position to facilitate patient comfort and gastric emptying?
- A. Fowlers
- B. Supine
- C. Left lateral
- D. Left Sims
Correct Answer: A
Rationale: Positioning the patient in a Fowlers position postoperatively promotes comfort and facilitates emptying of the stomach following gastric surgery. Any position that involves lying down delays stomach emptying and is not recommended for this type of patient. Supine positioning and the left lateral (left Sims) position do not achieve this goal.