Nokea
The nurse caring for a patient with a peptic ulcer who has had a nasogastric tube inserted notes bright blood in the tube, the patient complains of pain and has become hypotensive. Which condition should the nurse recognize these as signs of?
- A. Hiatal hernia
- B. Gastritis
- C. Perforation
- D. Bowel obstruction
Correct Answer: C
Rationale: Perforation of the gastric wall causes pain, hypotension, and hematemesis. Immediate reporting to the charge nurse/physician is essential as peritonitis, potentially lethal, is the result of a perforation.
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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.
A male patient reports that he will never adjust to his colostomy. Which is the best action for the nurse in this situation?
- A. Encourage him to express his concern.
- B. Suggest that he discuss his concerns with his physician.
- C. Counsel him that everything will be all right.
- D. Assure him that his concerns will diminish when he is able to care for his colostomy.
Correct Answer: A
Rationale: When a colostomy is performed, the patient or significant other should be able to verbalize concerns about the ostomy to the nurse.
The nurse points out which is an example of a nonmechanical bowel obstruction?
- A. A paralytic ileus
- B. Narrowed bowel lumen from an inflammatory process
- C. Tumor of the bowel
- D. Fecal impaction
Correct Answer: A
Rationale: A nonmechanical bowel obstruction can be caused by a paralytic ileus.
Flexible sigmoidoscopy should be performed every years.
- A. 5
Correct Answer: 5
Rationale: Flexible sigmoidoscopy should be performed every 5 years. Endoscopy of the lower GI tract allows visualization and, if indicated, access to obtain biopsy specimens of tumors, polyps, or ulcerations of the anus, rectum, and sigmoid colon. The lower GI tract is difficult to visualize radiographically, but sigmoidoscopy allows direct visualization.
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.