Nokea
The health care provider prescribes intravenous (IV) pantoprazole for a patient with gastrointestinal (GI) bleeding caused by peptic ulcer disease. When teaching the patient about the effect of the medication, which of the following information should the nurse include?
- A. Pantoprazole inhibits some of the stomach cells from pumping stomach acid.
- B. Pantoprazole neutralizes the acid in the stomach.
- C. Pantoprazole constricts the blood vessels in the stomach and decreases bleeding.
- D. Pantoprazole covers the ulcer with a protective material that promotes healing.
Correct Answer: A
Rationale: Pantoprazole is a proton pump inhibitor, which inhibits some of the stomach cells from pumping gastric acid. The response beginning, 'Pantoprazole constricts the blood vessels' describes the effect of vasopressin. The response beginning 'Pantoprazole neutralizes the acid' describes the effect of antacids. And the response beginning 'Pantoprazole covers the ulcer' describes the action of sucralfate.
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The nurse is counselling a patient with a family history of stomach cancer about risk factors. Which of the following is a risk factor for the development of stomach cancer?
- A. Type A blood
- B. Persistent abdominal distension
- C. Long-term use of H2 blocking medications
- D. Exposure to emotionally or physically stressful situations
Correct Answer: A
Rationale: Patients with Type A blood have an increased risk for stomach cancer. Use of H2 blockers, stressful situations, and abdominal distension are not associated with an increased incidence of stomach cancer.
Which of the following information should the nurse plan to teach to a patient with newly diagnosed achalasia?
- A. A liquid or blenderized diet will be necessary.
- B. Drinking fluids with meals should be avoided.
- C. Endoscopic procedures may be used for treatment.
- D. Lying down and resting after meals is recommended.
Correct Answer: C
Rationale: Endoscopic and laparoscopic procedures are the most effective therapy for improving symptoms caused by achalasia. Patients are advised to drink fluid with meals. Keeping the head elevated after eating will improve esophageal emptying. A semisolid diet is recommended to improve esophageal emptying.
The nurse is caring for a patient who is nauseated, vomiting up blood-streaked fluid and has acute gastritis. Which of the following assessments should the nurse ask the patient about to determine possible risk factors for gastritis?
- A. The amount of fat in the diet
- B. History of recent weight gain or loss
- C. Any family history of gastric problems
- D. Use of nonsteroidal anti-inflammatory drugs (NSAIDs)
Correct Answer: D
Rationale: Use of an NSAID is associated with damage to the gastric mucosa, which can result in acute gastritis. Family history, recent weight gain or loss, and fatty foods are not risk factors for acute gastritis.
The nurse is assessing a patient with gastroesophageal reflux disease (GERD) who is experiencing increasing mid-epigastric discomfort. Which of the following patient statements indicate that additional patient education about GERD is needed?
- A. I take antacids between meals and at bedtime each night.
- B. I sleep with the head of the bed elevated on 10-cm blocks.
- C. I quit smoking several years ago, but I still chew a lot of gum.
- D. I eat small meals throughout the day and have a bedtime snack.
Correct Answer: D
Rationale: GERD is exacerbated by eating late at night, and the nurse should plan to teach the patient to avoid eating at bedtime. The other patient actions are appropriate to control symptoms of GERD.
The nurse is admitting a patient with Escherichia coli O157:H7 food poisoning who has bloody diarrhea and dehydration. Which of the following prescriptions should the nurse question?
- A. Infuse lactated Ringer's solution at 250 ml/hour
- B. Monitor blood urea nitrogen and creatinine daily.
- C. High protein, high fat diet.
- D. Provide a clear liquid diet and progress diet as tolerated.
Correct Answer: C
Rationale: The patient would not have an intake of solid food at this time. Clear fluids would be ordered. The other orders are appropriate.