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A nurse is caring for a patient who just has been diagnosed with a peptic ulcer. When teaching the patient about his new diagnosis, how should the nurse best describe a peptic ulcer?
- A. Inflammation of the lining of the stomach
- B. Erosion of the lining of the stomach or intestine
- C. Bleeding from the mucosa in the stomach
- D. Viral invasion of the stomach wall
Correct Answer: B
Rationale: A peptic ulcer is erosion of the lining of the stomach or intestine. Peptic ulcers are often accompanied by bleeding and inflammation, but these are not the definitive characteristics.
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A patient with a diagnosis of peptic ulcer disease has just been prescribed omeprazole (Prilosec). How should the nurse best describe this medications therapeutic action?
- A. This medication will reduce the amount of acid secreted in your stomach.
- B. This medication will make the lining of your stomach more resistant to damage.
- C. This medication will specifically address the pain that accompanies peptic ulcer disease.
- D. This medication will help your stomach lining to repair itself.
Correct Answer: A
Rationale: Proton pump inhibitors like Prilosec inhibit the synthesis of stomach acid. PPIs do not increase the durability of the stomach lining, relieve pain, or stimulate tissue repair.
A nurse is caring for a patient who has a diagnosis of GI bleed. During shift assessment, the nurse finds the patient to be tachycardic and hypotensive, and the patient has an episode of hematemesis while the nurse is in the room. In addition to monitoring the patients vital signs and level of consciousness, what would be a priority nursing action for this patient?
- A. Place the patient in a prone position.
- B. Provide the patient with ice water to slow any GI bleeding.
- C. Prepare for the insertion of an NG tube.
- D. Notify the physician.
Correct Answer: D
Rationale: The nurse must always be alert for any indicators of hemorrhagic gastritis, which include hematemesis (vomiting of blood), tachycardia, and hypotension. If these occur, the physician is notified and the patients vital signs are monitored as the patients condition warrants. Putting the patient in a prone position could lead to aspiration. Giving ice water is contraindicated as it would stimulate more vomiting.
A nurse caring for a patient who has had bariatric surgery is developing a teaching plan in anticipation of the patients discharge. Which of the following is essential to include?
- A. Drink a minimum of 12 ounces of fluid with each meal.
- B. Eat several small meals daily spaced at equal intervals.
- C. Choose foods that are high in simple carbohydrates.
- D. Sit upright when eating and for 30 minutes afterward.
Correct Answer: B
Rationale: Due to decreased stomach capacity, the patient must consume small meals at intervals to meet nutritional requirements while avoiding a feeling of fullness and complications such as dumping syndrome. The patient should not consume fluids with meals and low-Fowlers positioning is recommended during and after meals. Carbohydrates should be limited.
A patient who experienced an upper GI bleed due to gastritis has had the bleeding controlled and the patients condition is now stable. For the next several hours, the nurse caring for this patient should assess for what signs and symptoms of recurrence?
- A. Tachycardia, hypotension, and tachypnea
- B. Tarry, foul-smelling stools
- C. Diaphoresis and sudden onset of abdominal pain
- D. Sudden thirst, unrelieved by oral fluid administration
Correct Answer: A
Rationale: Tachycardia, hypotension, and tachypnea are signs of recurrent bleeding. Patients who have had one GI bleed are at risk for recurrence. Tarry stools are expected short-term findings after a hemorrhage. Hemorrhage is not normally associated with sudden thirst or diaphoresis.
A patient comes to the clinic complaining of pain in the epigastric region. What assessment question during the health interview would most help the nurse determine if the patient has a peptic ulcer?
- A. Does your pain resolve when you have something to eat?
- B. Do over-the-counter pain medications help your pain?
- C. Does your pain get worse if you get up and do some exercise?
- D. Do you find that your pain is worse when you need to have a bowel movement?
Correct Answer: A
Rationale: Pain relief after eating is associated with duodenal ulcers. The pain of peptic ulcers is generally unrelated to activity or bowel function and may or may not respond to analgesics.