Nokea
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.
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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 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.
A patient has come to the clinic complaining of pain just above her umbilicus. When assessing the patient, the nurse notes Sister Mary Josephs nodules. The nurse should refer the patient to the primary care provider to be assessed for what health problem?
- A. A GI malignancy
- B. Dumping syndrome
- C. Peptic ulcer disease
- D. Esophageal/gastric obstruction
Correct Answer: A
Rationale: Palpable nodules around the umbilicus, called Sister Mary Josephs nodules, are a sign of a GI malignancy, usually a gastric cancer. This would not be a sign of dumping syndrome, peptic ulcer disease, or esophageal/gastric obstruction.
A patient has just been diagnosed with acute gastritis after presenting in distress to the emergency department with abdominal symptoms. What would be the nursing care most needed by the patient at this time?
- A. Teaching the patient about necessary nutritional modification
- B. Helping the patient weigh treatment options
- C. Teaching the patient about the etiology of gastritis
- D. Providing the patient with physical and emotional support
Correct Answer: D
Rationale: For acute gastritis, the nurse provides physical and emotional support and helps the patient manage the symptoms, which may include nausea, vomiting, heartburn, and fatigue. The scenario describes a newly diagnosed patient; teaching about the etiology of the disease, lifestyle modifications, or various treatment options would be best provided at a later time.
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.