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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.
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A patient with a peptic ulcer disease has had metronidazole (Flagyl) added to his current medication regimen. What health education related to this medication should the nurse provide?
- A. Take the medication on an empty stomach.
- B. Take up to one extra dose per day if stomach pain persists.
- C. Take at bedtime to mitigate the effects of drowsiness.
- D. Avoid drinking alcohol while taking the drug.
Correct Answer: D
Rationale: Alcohol must be avoided when taking Flagyl and the medication should be taken with food. This drug does not cause drowsiness and the dose should not be adjusted by the patient.
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 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 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 patient has been diagnosed with peptic ulcer disease and the nurse is reviewing his prescribed medication regimen with him. What is currently the most commonly used drug regimen for peptic ulcers?
- A. Bismuth salts, antivirals, and histamine-2 (H2) antagonists
- B. H2 antagonists, antibiotics, and bicarbonate salts
- C. Bicarbonate salts, antibiotics, and ZES
- D. Antibiotics, proton pump inhibitors, and bismuth salts
Correct Answer: D
Rationale: Currently, the most commonly used therapy for peptic ulcers is a combination of antibiotics, proton pump inhibitors, and bismuth salts that suppress or eradicate H. pylori. H2 receptor antagonists are used to treat NSAID-induced ulcers and other ulcers not associated with H. pylori infection, but they are not the drug of choice. Bicarbonate salts are not used. ZES is the Zollinger-Ellison syndrome and not a drug.