Nokea
A patient who is being evaluated for episodes of hematemesis and dyspepsia tells the nurse that pain occurs when he eats, but pain does not waken him. The nurse recognizes a diagnostic sign of which condition?
- A. Duodenal ulcer
- B. Gastritis
- C. Achalasia
- D. Peptic ulcer
Correct Answer: D
Rationale: A significant subjective data assessment for a peptic ulcer is the patient report that pain is associated with eating. With duodenal ulcers the patient often complains of pain 1 to 2 hours after eating.
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Which activities should the home health nurse suggest to an older adult patient to avoid constipation?
- A. Schedule toileting after meals
- B. Taking bulk-forming laxatives
- C. Increasing fiber intake
- D. Drinking at least 1000 mL fluid
- E. Taking a daily stool softener
- F. Using tap water enemas for persons with altered mobility
Correct Answer: A,B,C,D
Rationale: Inactivity and changes in diet and fluid intake can contribute to constipation. A nutritional diet high in fiber and bulk-forming foods can promote normal elimination. Increasing fluids to 8 to 10 glasses per day will be beneficial in preventing constipation. A daily bowel routine will also benefit elimination. Use of daily stool softeners is no longer recommended for the older adult. Tap water enemas for persons with altered mobility are not routine.
The nurse explains that the chief enzyme of gastric juice, is activated by hydrochloric acid to begin digestion of protein.
- A. pepsin
Correct Answer: pepsin
Rationale: Pepsin is activated by the hydrochloric acid to break down protein for digestion.
What is the most lethal complication of a peptic ulcer?
- A. Bleeding
- B. Perforation
- C. Severe pain
- D. Gastric outlet obstruction
Correct Answer: B
Rationale: Perforation is considered the most lethal complication of peptic ulcer. Bleeding may occur when the ulcer erodes into a blood vessel; however, perforation occurs when the ulcer crater penetrates the entire thickness of the wall of the stomach or duodenum. Gastric outlet obstruction can occur at any time and can be relieved by NG aspiration of stomach contents.
In caring for a patient with gastric bleeding who has a nasogastric (NG) tube in place, the nurse expects to see which intervention for the nasogastric tube included in the plan of care?
- A. clamp for 10 minutes every hour.
- B. keep the patent with irrigation.
- C. frequently reposition to the opposite nostril.
- D. change every 72 hours.
Correct Answer: B
Rationale: Irrigating the NG tube as needed will keep the tube patent and ensure effective decompression.
The nurse clarifies that the end product of food is absorbed and put into the bloodstream by which anatomical feature?
- A. gastric lining of the stomach.
- B. villi of the small intestine.
- C. bile of the liver in the large intestine.
- D. excretion from the cecum.
Correct Answer: B
Rationale: The inner surface of the small intestine contains millions of tiny, fingerlike projections called villi, which contain small blood vessels. They are responsible for absorbing the products of digestion.