Nokea
The nurse caring for clients with gastrointestinal disorders should understand that which category best describes the mechanism of action of sucralfate (Carafate)?
- A. Gastric acid inhibitor
- B. Histamine receptor blocker
- C. Mucosal barrier fortifier
- D. Proton pump inhibitor
Correct Answer: C
Rationale: Sucralfate is a mucosal barrier fortifier (protector). It is not a gastric acid inhibitor, a histamine receptor blocker, or a proton pump inhibitor.
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A client has dumping syndrome after a partial gastrectomy. Which action by the nurse would be most helpful?
- A. Arrange a dietary consult.
- B. Increase the client's fluid intake.
- C. Limit the client's foods.
- D. Make the client NPO.
Correct Answer: A
Rationale: The client with dumping syndrome after a gastrectomy has multiple dietary needs. A referral to a registered dietitian would be extremely helpful. Food and fluid intake is complicated and needs planning. The client should not be NPO.
A client has dumping syndrome. What menu selections indicate the client understands the correct diet to manage this condition? (Select all that apply.)
- A. Canned unsweetened apricots
- B. Canned cake
- C. Milk and water
- D. Potato soup
- E. Steamed broccoli
Correct Answer: A,D
Rationale: Canned apricots and potato soup are appropriate selections as they are part of a high-protein, high-fat, low- to moderate-carbohydrate diet. Cake and other sweets must be avoided. Milk products and sweet drinks such as shakes must be avoided. Gas-forming foods such as broccoli must also be avoided.
A client has a recurrence of gastric cancer and is in the gastrointestinal clinic crying. What response by the nurse is most appropriate?
- A. Do you have family or friends for support?
- B. I'd like to know what you are feeling now.
- C. Well, we knew this would probably happen.
- D. Would you like me to refer you to hospice?
Correct Answer: B
Rationale: The nurse assesses the client's emotional state with open-ended questions and statements and shows a willingness to listen to the client's concerns. Asking about support people is very limited in nature, and yes-or-no questions are not therapeutic. Saying that this was expected dismisses the client's concerns. The client may or may not be ready to hear about hospice, and this is another limited, yes-or-no question.
A nurse working with a client who has possible gastritis assesses the client's gastrointestinal system. Which findings indicate a chronic condition as opposed to acute gastritis? (Select all that apply.)
- A. Anorexia
- B. Dyspepsia
- C. Intolerance of fatty foods
- D. Pernicious anemia
- E. Nausea and vomiting
Correct Answer: C,D
Rationale: Intolerance of fatty or spicy foods and pernicious anemia are signs of chronic gastritis. Anorexia and nausea/vomiting can be seen in both conditions. Dyspepsia is seen in acute gastritis.
A client has a gastrointestinal hemorrhage and is prescribed two units of packed red blood cells. What actions should the nurse perform prior to hanging the blood? (Select all that apply.)
- A. Ask a second nurse to double-check the blood.
- B. Prime the IV tubing with normal saline.
- C. Prime the IV tubing with dextrose in water.
- D. Take and record a set of vital signs.
- E. Teach the client about reaction manifestations.
Correct Answer: A,B,D,E
Rationale: Prior to starting a blood transfusion, the nurse asks another nurse to double-check the blood (and client identification), primes the IV tubing with normal saline, takes and records a set of vital signs, and teaches the client about manifestations to report. The IV tubing is not primed with dextrose in water.