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A patient is undergoing diagnostic testing for a tumor of the small intestine. What are the most likely symptoms that prompted the patient to first seek care?
- A. Hematemesis and persistent sensation of fullness
- B. Abdominal bloating and recurrent constipation
- C. Intermittent pain and bloody stool
- D. Unexplained bowel incontinence and fatty stools
Correct Answer: C
Rationale: When the patient is symptomatic from a tumor of the small intestine, benign tumors often present with intermittent pain. The next most common presentation is occult bleeding. The other listed signs and symptoms are not normally associated with the presentation of small intestinal tumors.
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A patient who is obese has been unable to lose weight successfully using lifestyle modifications and has mentioned the possibility of using weight-loss medications. What should the nurse teach the patient about pharmacologic interventions for the treatment of obesity?
- A. Weight loss drugs have many side effects, and most doctors think theyll all be off the market in a few years.
- B. There used to be a lot of hope that medications would help people lose weight, but its been shown to be mostly a placebo effect.
- C. Medications can be helpful, but few people achieve and maintain their desired weight loss with medications alone.
- D. Medications are rapidly become the preferred method of weight loss in people for whom diet and exercise have not worked.
Correct Answer: C
Rationale: Though antiobesity drugs help some patients lose weight, their use rarely results in loss of more than 10% of total body weight. Patients are consequently unlikely to attain their desired weight through medication alone. They are not predicted to disappear from the market and results are not attributed to a placebo effect.
A patient who is obese is exploring bariatric surgery options and presented to a bariatric clinic for preliminary investigation. The nurse interviews the patient, analyzing and documenting the data. Which of the following nursing diagnoses may be a contraindication for bariatric surgery?
- A. Disturbed Body Image Related to Obesity
- B. Deficient Knowledge Related to Risks and Expectations of Surgery
- C. Anxiety Related to Surgery
- D. Chronic Low Self-Esteem Related to Obesity
Correct Answer: B
Rationale: It is expected that patients seeking bariatric surgery may have challenges with body image and self-esteem related to their obesity. Anxiety is also expected when facing surgery. However, if the patients knowledge remains deficient regarding the risks and realistic expectations for surgery, this may show that the patient is not an appropriate surgical candidate.
A patient who underwent gastric banding 3 days ago is having her diet progressed on a daily basis. Following her latest meal, the patient complains of dizziness and palpitations. Inspection reveals that the patient is diaphoretic. What is the nurses best action?
- A. Insert a nasogastric tube promptly.
- B. Reposition the patient supine.
- C. Monitor the patient closely for further signs of dumping syndrome.
- D. Assess the patient for signs and symptoms of aspiration.
Correct Answer: C
Rationale: The patients symptoms are characteristic of dumping syndrome, which results in a sensation of fullness, weakness, faintness, dizziness, palpitations, diaphoresis, cramping pains, and diarrhea. Aspiration is a less likely cause for the patients symptoms. Supine positioning will likely exacerbate the symptoms and insertion of an NG tube is contraindicated due to the nature of the patients surgery.
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 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.