SAS 40

1. D

Following gastrectomy, drainage from the nasogastric tube is normally bloody for 24 hours
postoperatively, changes to brown-tinged, and is then to yellow or clear. Because bloody drainage is
expected in the immediate postoperative period, the nurse should continue to monitor the drainage.
The nurse does not need to notify the physician at this time. Measuring abdominal girth is performed to
detect the development of distention. Following gastrectomy, a nasogastric tube should not be irrigated
unless there are specific physician orders to do so.

2. B

The major difference between benign and malignant tumors is that malignant tumors invade adjacent
tissues and spread to distant tissues and benign tumors never metastasize. Both types of tumors may
cause damage to adjacent tissues. The cells differ from normal in both benign and malignant tumors.
Benign tumors usually do not recur.

3. B

A high-fat diet plays a role in the development of cancer of the pancreas. Options A, C, and D are risk
factorsrelated to gastric cancer.

4. D

Following gastrectomy, drainage from the nasogastric tube is normally bloody for 24 hours
postoperatively, changes to brown-tinged, and is then to yellow or clear. Because bloody drainage is
expected in the immediate postoperative period, the nurse should continue to monitor the drainage.
The nurse does not need to notify the physician at this time. Measuring abdominal girth is performed to
detect the development of distention. Following gastrectomy, a nasogastric tube should not be irrigated
unless there are specific physician orders to do so.

5. C

Radiation therapy may cause fatigue, skin toxicities, and anorexia regardless of the treatment site. Hair
loss, stomatitis, and vomiting are site-specific, not generalized, adverse effects of radiation therapy.

6. D

Continue to monitor the drainage Following gastrectomy, drainage from the nasogastric tube is normally
bloody for 24 hours postoperatively, changes to brown-tinged, and is then to yellow or clear. Because
bloody drainage is expected in the immediate post-operative period, the nurse should continue to
monitor the drainage. The nurse does not need to notify the physician at this time. Measuring
abdominal girth is performed to detect the development of distention. Following gastrectomy, a
nasogastric tube should not be irrigated unless there are specific physician perscriptions to do so.
7. D

Wound and skin care, nutrition, drugs, and community resources "Radiation therapy is used as an
adjuvant to surgery or for palliation in stomach cancer treatment. The nurse's role is to provide detailed
instructions, to reassure the patient, and to ensure completion of the designated number of treatments.
The nurse should start by assessing the patient's knowledge of radiation therapy. The nurse should
teach the patient about the skin care, the need for nutrition and fluid intake during therapy, and the
appropriate use of antiemetic drugs.

8. D

Chemotherapy is contraindicated in cases of infection (chemotherapeutic agents are

immunosuppressive), recent surgery (chemotherapeutic agent may retard the healing process),
impaired renal and hepatic function (drugs are nephrotoxic and hepatotoxic), recent radiation therapy
(immunosuppressive treatment), pregnancy (drugs can cause congenital defects) and bone marrow
depression (chemo. Agents may aggravate the condition).

9. D

An appropriate expected outcome is for the client to maintain nutrition either through oral or total
parenteral feedings. Oral and total parenteral nutrition may also be used concurrently. It is not realistic
to expect the client to regain weight loss within 4 weeks of surgery. After surgery, it is recommended
that the client eat six small meals a day rather than three full meals to decrease symptoms of dumping
syndrome. Enteral feedings are not part of the expected outcome for gastric surgery. NURSING PROCESS
STEP: Evaluation CLIENT NEEDS CATEGORY: Physiological integrity CLIENT NEEDS SUBCATEGORY: Basic
care and comfort

10. B

The Valsalva's maneuver facilitates the expulsion of feces by closing the

glottis and increasing the intra-abdominal pressure. Crede's maneuver is used to
manually expel urine from the bladder, Heimlich's maneuver is used to dislodge
food from the esophagus, and Epley's maneuver is used for vertigo.