What is the nursing priority in the management of a patient with -1

?an active upper G.I. bleed

.A. Obtain vital signs

.B. Apply oxygen by nasal cannula
.C. Type and crossmatch the patient for blood products
.D. Notify the physician

A 40-year-old male client has been hospitalized with peptic ulcer -2

disease. He is being treated with a histamine receptor antagonist
(cimetidine), antacids, and diet. The nurse doing discharge planning
:will teach him that the action of cimetidine is to

A- Reduce gastric acid output

B- Protect the ulcer surface

C- Inhibit the production of hydrochloric acid (HCl)

D- Inhibit vagus nerve stimulation

3-Risk factors for the development of hiatal hernias are those that
lead to increased abdominal pressure. Which of the following
complications can cause increased abdominal pressure?

A- Obesity

B- Volvulus

C- Constipation

D- Inhibit vagus nerve stimulation

4-Which of the following symptoms is common with a hiatal hernia?

A- Left arm pain

B- Lower back pain

C- Esophageal reflux

D- Abdominal cramping
5-A client with peptic ulcer disease tells the nurse that he has black
stools, which he has not reported to his physician. Based on this
information, which nursing diagnosis would be appropriate for this
client?

A- Ineffective coping related to fear of diagnosis of chronic illness

B- Deficient knowledge related to unfamiliarity with significant signs

and symptoms

C- Constipation related to decreased gastric motility

D- Imbalanced nutrition: Less than body requirements due to gastric

bleeding

6-A client is admitted to the hospital after vomiting bright red blood
and is diagnosed with a bleeding duodenal ulcer. The client develops
a sudden, sharp pain in the mid epigastric area along with a rigid,
board-like abdomen. These clinical manifestations most likely
indicate which of the following?

A- An intestinal obstruction has developed

B- Additional ulcers have developed

C- The esophagus has become inflamed

D- The ulcer has perforated

7-A client with a peptic ulcer reports epigastric pain that frequently
awakens her at night, a feeling of fullness in the abdomen, and a
feeling of anxiety about her health. Based on this information, which
nursing diagnosis would be most appropriate?

A- Imbalanced Nutrition: Less than Body Requirements related to

anorexia

B- Disturbed Sleep Pattern related to epigastric pain

C- Ineffective Coping related to exacerbation of duodenal ulcer

D- Activity Intolerance related to abdominal pain

8-Which of the following conditions can cause a hiatal hernia?

A- Increased intrathoracic pressure

B- Weakness of the esophageal muscle

C- Increased esophageal muscle pressure

D- Weakness of the diaphragmic muscle

9-Which of the following tests can be performed to diagnose a hiatal

hernia?

A- Colonoscopy

B- Lower GI series

C- Barium swallow

D- Abdominal x-rays

10-When a client has peptic ulcer disease, the nurse would expect a
priority intervention to be:

A- Assisting in inserting a Miller-Abbott tube

B- Assisting in inserting an arterial pressure line

C- Inserting a nasogastric tube

D- Inserting an I.V.

11-A client with a peptic ulcer is scheduled for a vagotomy. The client
asks the nurse about the purpose of this procedure. The nurse tells
the client that the procedure:

A- Decreases food absorption in the stomach

B- Heals the gastric mucosa

C- Halts stress reactions

D- Reduces the stimulus to acid secretions

12-Which of the following tests can be used to diagnose ulcers?

A- Abdominal x-ray

B- Barium swallow

C- Computed tomography (CT) scan

D- Esophagogastroduodenoscopy (EGD)

13-The most important pathophysiologic factor contributing to the

formation of esophageal varices is:

A- Decreased prothrombin formation

B- Decreased albumin formation by the liver

C- Portal hypertension

D- Increased central venous pressure

14-Which of the following measures should the nurse focus on for the
client with esophageal varices?

A- Recognizing hemorrhage

B- Controlling blood pressure

C- Encouraging nutritional intake

D- Teaching the client about varices

15-When obtaining a nursing history on a client with a suspected

gastric ulcer, which signs and symptoms would the nurse expect to
see? Select all that apply.

A- Epigastric pain at night

B- Relief of epigastric pain after eating

C- Vomiting

D- Weight loss
16-The pain of a duodenal ulcer can be distinguished from that of a
gastric ulcer by which of the following characteristics?

A- Early satiety

B- Pain on eating

C- Dull upper epigastric pain

D- Pain on empty stomach

17-The client with a duodenal ulcer may exhibit which of the

following findings on assessment?

A- Hematemesis

B- Malnourishment

C- Melena

D- Pain with eating

18-Which diagnostic test would be used first to evaluate a client with

upper GI bleeding?

A- Endoscopy

B- Upper GI series

C- Hemoglobin (Hb) levels and hematocrit (HCT)

D- Arteriography

19-The nurse caring for a client with small-bowel obstruction would

plan to implement which nursing intervention first?

A- Administering pain medication

B- Obtaining a blood sample for laboratory studies

C- Preparing to insert a nasogastric (NG) tube

D- Administering I.V. fluids

20-The nurse is caring for a female client with active upper GI

bleeding. What is the appropriate diet for this client during the first
24 hours after admission?

A- Regular diet

B- Skim milk

C- Nothing by mouth

D- Clear liquids

21-Which of the following conditions is most likely to directly cause

peritonitis?
A- Cholelithiasis

B- Gastritis

C- Perforated ulcer

D- Incarcerated hernia

22-Which of the following laboratory results would be expected in a

client with peritonitis?
A- Partial thromboplastin time above 100 seconds

B- Hemoglobin level below 10 mg/dL

C- Potassium level above 5.5 mEq/L

D- White blood cell count above 15.000

23-Which of the following therapies is not included in the medical

management of a client with peritonitis?
A- Broad-spectrum antibiotics

B- Electrolyte replacement
C- I.V. fluids

D- Regular diet

24-Which of the following aspects is the priority focus of nursing

management for a client with peritonitis?
A- Fluid and electrolyte balance

B- Gastric irrigation

C- Pain management

D- Psychosocial issues

25-Which of the following symptoms would a client in the early

stages of peritonitis exhibit?
A- Abdominal distention

B- Abdominal pain and rigidity

C- Hyperactive bowel sounds

D- Right upper quadrant pain

26- Which of the following would NOT lead to peritonitis?

A- Open abdominal wound

B- Lung disease

C- Ruptured appendix

D- Tear in the peritoneum

27-After surgery for peritonitis, a priority nursing intervention

should be what?
A- Provide light meals after surgery.

B- Give acetaminophen for pain.

C- Give IV antibiotics with electrolyte replacement.

D- Place in Trendelenburg position.

28-The peritoneum is the most extensive serous membrane in the

body) T or F

29- Peritonitis is localized or generalized inflammation in the

pancrease .T or F

30- Klebsiella and streptococcus.are common bacteria for peritonitis

T or F

This bariatric surgical procedure involves creating a stoma and -31

gastric pouch that is reversible, and no malabsorption occurs. What
?surgical procedure is this
a. Vertical gastric banding
b. Biliopancreatic diversion
c. Roux-en-Y gastric bypass
d. Adjustable gastric banding

A severely obese patient has undergone Roux-en-Y gastric bypass -32

surgery. In planning postoperative care, the nurse anticipates that
the patient
.a. may have severe diarrhea early in the postoperative period
.b. will not be allowed to ambulate for 1 to 2 days postoperatively
.c. will require nasogastric suction until the incision heals
d. may have only liquids orally, and in very limited amounts, during
.the postoperative period

33-Bariatric surgery is effective at encouraging weight loss because it

makes changes to this.

A- Your pancreas
B- Your liver
C- Your kidneys
D- Your mindset
E-Your digestive tract
34-Bariatric surgery could alter this first part of the small intestine
where much of the digestion of food takes place.
A- Pancreatic duct
B- Ileocecal valve
C- Duodenum
D- Jejunum
E- Ileum

35-A client asks the nurse about criteria for bariatric

weight loss
surgery. What information should the nurse provide?

A-"If you are over 45, you must have a BMI

of 35."

B-"Since you have no other illnesses, your

BMI must be over 40 to qualify for this
surgery."

C-"Women must have a BMI of 36 and men

must have a BMI of 40."
".D-"There is no standard criterion for bariatric surgery

Bariatric procedures often cause hormonal changes T or F -36

The adjustable gastric band is considered the ‘gold standard’ of -37

weight loss surgery T or F

Sleeve Gastrectomy has a higher early complication rate than the -38
Gastric Bypass T or F