Gerd, Peptic Ulcer, Ulcerative Colitis, Crohn’s Disease

Name: _______________________ Section: ___________ Date: ___________

Multiple Choice.

1. The nurse explains to the patient with gastroesophageal reflux disease that
this disorder:
A. Results in acid erosion and ulceration of the esophagus caused by
frequent vomiting,
B. Will require surgical wrapping or repair of the pyloric sphincter to control
the symptoms,
C. Is the protrusion of a portion of the stomach into to esophagus through
an opening in the diaphragm,
D. Often involves relaxation of the lower esophageal sphincter, allowing
stomach contents to back up into the espophagus.

2. A patient is admitted with ulcerative colitis. In the physician's notes, it is

stated that the patient's barium enema results showed the patient has colitis
that starts in the rectum and extends into the sigmoid and descending colon.
As the nurse, you know that this is what type of ulcerative colitis?
A. Right-sided colitis
B. Proctosigmoiditis
C. Ulcerative procotitis
D. Left-sided colitis\

3. The client is experiencing bleeding related to peptic ulcer disease (PUD).

Which nursing intervention is the highest priority
A. Starting a large-bore intravenous (IV)
B. Administering intravenous (IV) pain medication
C. Preparing equipment for intubation
D. Monitoring the client's anxiety level

4. Wich of the following types of gastritis is associated with Helicobacter pylori

and duodenal ulcers?
A. Erosive (hemorrhagic) gastritis
B. Fundic gland gastritis (type A)
C. Antral gland gastritis (type B)
D. Aspiring-induced gastric ulcer
5. A patient diagnosed with pancolitis is experiencing extreme abdominal
distension, pain 10 on 1-10 scale in the abdomen, temperature of 103.6 'F,
HR 120, and profuse diarrhea. What complication due you suspect the pain is
experiencing?
A. Fistulae
B. Stricture
C. Bowel obstruction
D. Toxic megacolon

6. Gastroesophageal reflux disease (GERD) weakens the lower esophageal

sphincter, predisposing older persons to risk for impaired swallowing. In
managing the symptoms associated with GERD, the nurse should assign the
highest priority to which of the following interventions?
A. Decrease daily intake of vegetables and water, and ambulate frequently
B. Drink coffee diluted with milk at each meal, and remain in an upright
position for 30 minutes.
C. Eat small, frequent meals, and remain in an upright position for at least
30 minutes after eating
D. Avoid over-the-counter drugs that have antacids in them

7. A patient is newly diagnosed with mild ulcerative colitis. What type of anti-
inflammatory medication is typically prescribed as first-line treatment for this
condition?
A. 5-Aminosalicylates (Sulfasalazine)
B. Immunomodulators (Adalimumab)
C. Corticosteroids (Prednisone)
D. Immunosupressors (Azathioprine)

8. The nurse is reviewing the laboratory results of a client with Crohn's disease.
Which of the following would the nurse most likely find?
A. Decreased white blood cell count
B. Increased albumin levels
C. Stool cultures negative for microorganisms or parasite
D. Decrease erythrocyte sedimentation rate
9. The client with peptic ulcer disease (PUD) asks the nurse whether licorice and
slippery elm might be useful in managing the disease. What is the nurse's
best response?
A. "No, they probably won't be useful. You should use only prescription
medications in your treatment plan."
B. "These herbs could be helpful. However, you should talk with your
physician before adding them to your treatment regimen."
C. "Yes, these are known to be effective in managing this disease, but make
sure you research the herbs thoroughly before taking them."
D. "No, herbs are not useful for managing this disease. You can use any type
of over-the-counter drugs though. They have been shown to be safe."

10.A patient is receiving treatment for ulcerative colitis by taking Azathioprine.

Which physician's order would the nurse question if received?
A. Ambulate the patient twice day
B. Low-fiber and high-protein diet
C. Administer varicella vaccine intramuscularly
D. Administer calcium carbonate by mouth daily

11.Crohn's disease is a condition of malabsorption caused by which

pathophysiological process?
A. Inflammation of all layers of intestinal mucosa
B. Infectious disease
C. Disaccharidase deficiency
D. Gastric resection

12.The client with a hiatal hernia chronically experiences heartburn following

meals. The nurse plans to teach the client to avoid which action because it is
contraindicated with hiatal hernia?
A. Lying recumbent following meals
B. Taking in small, frequent, bland meals
C. Raising the head of the bed on 6-inch blocks
D. Taking H2-receptor antagonist medication

13.What response should a nurse offer to a client who asks why he's having a
vagotomy to treat his ulcer?
A. To repair a hole in the stomach
B. To reduce the ability of the stomach to produce acid
C. To prevent the stomach from sliding into the chest
D. To remove a potentially malignant lesion in the stomach
14.A nurse is completing discharge teaching with a client who has Crohn's
disease. Which of the following instructions should the nurse include in the
teaching?
A. Decrease intake of calorie-dense foods
B. Drink canned protein supplements
C. Increase intake of high fiber foods
D. Take a bulk-forming laxative daily

15.Which of the following factors is believed to cause ulcerative colitis?

A. Acidic diet
B. Altered immunity
C. Chronic constipation
D. Emotional stress

16.Fistulas are most common with which of the following bowel disorders?
A. Crohn's disease
B. Diverticulitis
C. Diverticulosis
D. Ulcerative colitis

17.Which assessment data support the client's diagnosis of gastric ulcer?

A. Presence of blood in the client's stool for the past month.
B. Complaints of a burning sensation that moves like a wave.
C. Sharp pain in the upper abdomen after eating a heavy meal.
D. Comparison of complaints of pain with ingestion of food and sleep

18.Which of the following associated disorders may a client with ulcerative colitis
exhibit?
A. Gallstones
B. Hydronephrosis
C. Nephrolithiasis
D. Toxic megacolon

19.The nurse is teaching the client with peptic ulcer disease (PUD) about the
prescribed drug regimen. Which statement made by the client indicates a
need for further teaching before discharge?
A. "Nizatidine (Axid) needs to be taken three times a day to be effective."
B. "Taking ranitidine (Zantac) at bedtime should decrease acid production at
night."
C. "Sucralfate (Carafate) should be taken 1 hour before and 2 hours after
meals."
D. "Omeprazole (Prilosec) should be swallowed whole and not crushed."
20.Which of the following symptoms is associated with ulcerative colitis?
A. Dumping syndrome
B. Rectal bleeding
C. Soft stools
D. Fistulas

21.The nurse is caring for an older adult male client who reports stomach pain
and heartburn. Which syndrome is most significant in determining whether
the client's ulceration is gastric or duodenal in origin?
A. Pain occurs 1 1/2 to 3 hours after a meal, usually at night.
B. Pain is worsened by the ingestion of food.
C. The client has a malnourished appearance.
D. The client is a man older than 50 years.

22.If a client had irritable bowel syndrome, which of the following diagnostic
tests would determine if the diagnosis is Crohn's disease or ulcerative colitis?
A. Abdominal computed tomography (CT) scan
B. Abdominal x-ray
C. Barium swallow
D. Colonoscopy with biopsy

23.In planning the care for the patient with Crohn's disease, the nurse
recognizes that a major difference between ulcerative colitis and Crohn's
disease is that Crohn's disease:
A. Frequently results in toxic megacolon
B. Causes fewer nutritional deficiencies than does ulcerative colitis.
C. Often recurs after surgery, whereas ulcerative colitis is curable with a
colectomy.
D. Is manifested by rectal bleeding and anemia more frequently than is
ulcerative colitis.

24.When assessing the client with the diagnosis of peptic ulcer disease, which
physical examination should the nurse implement first?
A. Auscultate the client's bowel sounds in all four quadrants.
B. Palpate the abdominal area for tenderness.
C. Percuss the abdominal borders to identify organs.
D. Assess the tender area progressing to nontender

25.The nurse is monitoring a client with a diagnosis of peptic ulcer. Which

assessment finding would most likely indicate perforation of the ulcer?
A. Bradycardia
B. Numbness in the legs
C. Nausea and vomiting
D. A rigid, board-like abdomen
26.The nurse is monitoring the client with gastric cancer for signs and symptoms
of upper GI bleeding. Which change in vital signs is most indicative of
bleeding related to cancer?
A. Respiratory rate from 24 to 20 breaths/min
B. Apical pulse from 80 to 72 beats/min
C. Temperature from 98.9° F to 97.9° F
D. Blood pressure from 140/90 to 110/70 mm Hg

27.Surgical management of ulcerative colitis may be performed to treat which of

the following complications?
A. Gastritis
B. Bowel herniation
C. Bowel outpouching
D. Bowel perforation

28.Which of the following nursing interventions should the nurse perform for a
female client receiving enteral feedings through a gastrostomy tube?
A. Change the tube feeding solutions and tubing at least every 24 hours
B. Maintain the head of the bed at a 15-degree elevation continuously.
C. Check the gastrostomy tube for position every 2 days.
D. Maintain the client on bed rest during the feedings

29.In planning care for the patient with Crohn's disease, the nurse recognizes
that a major difference between ulcerative colitis and Crohn's disease is that
Crohn's disease:
A. Frequently results in toxic megacolon,
B. Causes fewer nutritional deficiencies than does ulcerative colitis,
C. Often recurs after surgery, whereas ulcerative colitis is curable with a
colectomy,
D. Is manifested by rectal bleeding and anemia more frequently than is
ulcerative colitis.

30.Colon cancer is most closely associated with which of the following

conditions?
A. Appendicitis
B. Hemorrhoids
C. Hiatal hernia
D. Ulcerative colitis
31.The client is diagnosed with Crohn's disease, also known as regional enteritis.
Which statement by the client would support this diagnosis?
A. "My pain goes away when I have a bowel movement"
B. "I have bright red blood in my stool all the time"
C. "I have episodes of diarrhea and constipation"
D. "My abdomen is hard and rigid and I have a fever".

32.The nurse is teaching the patient a client with a peptic ulcer discharge
instructions. The client asks the nurse which type of analgesic he may take.
Which of the following responses by the nurse would be most accurate?
A. Aspirin
B. Acetaminophen
C. Naproxen
D. Ibuprofen

33.Which associated disorder might a client with Crohn's disease exhibit most
often?
A. Ankylosing spondylitis
B. Colon cancer
C. Malabsorption
D. Lactase deficiency

34.The nurse finds a client vomiting coffee ground-type material. On

assessment, the client has blood pressure of 100/74 mm Hg, is acutely
confused, and has a weak and thready pulse. Which intervention will be the
nurse's first priority?
A. Administering an H2 antagonist
B. Initiating enteral nutrition
C. Administering intravenous (IV) fluids
D. Administering antianxiety medication

35.Which of the following instructions should the nurse include in the teaching
plan for a client who is experiencing gastroesophageal reflux disease
(GERD)?
A. Limit caffeine intake to two cups of coffee per day
B. Do not lie down for 2 hours after eating
C. Follow a low-protein diet
D. Take medications with milk to decrease irritation
36.The nurse is caring for a client diagnosed with rule out peptic ulcer disease.
Which test confirms this diagnosis?
A. Esophagogastroduodenoscopy
B. Magnetic resonance imaging
C. Occult blood test
D. Gastric acid stimulation.

37.The client is scheduled to have an upper GI tract series of x-rays. Following

the x-rays, the nurse should instruct the client to:
A. Take a laxative
B. Follow a clear liquid diet
C. Administer an enema
D. Take an antiemetic

38.A client who has been diagnosed with GERD has heartburn. To decrease the
heartburn, the nurse should instruct the client to eliminate which of the
following items from the diet?
A. Lean beef
B. Air-popped popcorn
C. Hot chocolate
D. Raw vegetables

39.Which physical examination should the nurse implement first when assessing
the client diagnosed with peptic ulcer disease?
A. Auscultate the clients bowel sounds in all four quadrants
B. Palpate the abdominal area for tenderness
C. Percuss the abdominal borders to identify organs
D. Assess the tender area progressing to nontender

40.The client with GERD has a chronic cough. This symptom may be indicative
of which of the following?
A. Development of laryngeal cancer
B. Irritation of the esophagus
C. Esophageal scar tissue formation
D. Aspiration of gastric contents
41.In planning the care for the patient with Crohn's disease, the nurse
recognizes that a major difference between ulcerative colitis and Crohn's
disease is that Crohn's disease:
A. Frequently results in toxic megacolon.
B. Causes fewer nutritional deficiencies than does ulcerative colitis.
C. Often recurs after surgery, whereas ulcerative colitis is curable with a
colectomy.
D. Is manifested by rectal bleeding and anemia more frequently than is
ulcerative colitis.

42.The nurse has been assigned to care for a client diagnosed with peptic ulcer
disease. Which assessment data require further intervention?
A. Bowel sour s auscultated 15 times in 1 minute
B. Belching after eating a heavy and fatty meal late at night
C. A decrease in systolic BP of 20 mm Hg from lying to sitting
D. A decreased frequency of distress located in the epigastric region

43.Bethanechol (Urecholine) has been prescribed for a client with GERD. The
nurse should assess the client for which of the following adverse effects?
A. Constipation
B. Urinary urgency
C. Hypertension
D. Dry oral mucosa

44.The client attends two sessions with the dietitian to learn about diet
modifications to minimize GERD. The teaching would be considered
successful if the client decreases the intake of which of the following foods?
A. fats
B. high-sodium foods
C. Carbohydrates
D. high calcium foods

45.Which oral medication should the nurse question before administering to the
client with peptic ulcer disease?
A. E-mycin, an antibiotic
B. Prilosec, a proton pump inhibitor
C. Flagyl, an anti microbial agent
D. Tylenol, a nonnarcotic analgesic
46.The nurse is reviewing the record of a female client with Crohn's disease.
Which stool characteristics should the nurse expect to note documented in
the client's record
A. Diarrhea
B. Chronic constipation
C. Constipation alternating with diarrhea
D. Stools constantly oozing form the rectum

47.Nurse is caring for a patient with a diagnosis of ulcerative colitis. Which

finding, if noted on assessment of the client, would the nurse report to the
Dr?
A. Hypotension
B. Bloody diarrhea
C. Rebound tenderness
D. Hemoglobin of 12 mg/ dl

48.Which of the following dietary measures would be useful in preventing

Esophageal reflux?
A. Eating small, frequent meals
B. Increasing fluid intake
C. Avoiding air swallowing with meals
D. Adding a bedtime snack to the dietary plan

49.The client has a long-term history of Crohn's disease and has recently
developed acute gastritis. The client asks the nurse whether Crohn's disease
was a direct cause of the gastritis. What is the nurse's best response?
A. Yes, Crohn's disease is known to be a direct cause of the development of
chronic gastritis."
B. "We know that there can be an association between Crohn's disease and
chronic gastritis, but Crohn's does not directly cause acute gastritis to
develop."
C. "What has your doctor told you about how your gastritis developed?"
D. "Yes, a familial tendency to inherit Crohn's disease as well as gastritis has
been reported. Have your other family members been tested for Crohn's
disease?"

50.The client is diagnosed with an acute exacerbation of ulcerative colitis. Which

intervention should the nurse implement?
A. Provide a low-residue diet.
B. Monitor intravenous fluids.
C. Assess vital signs daily.
D. Administer antacids orally.
 Prepared by: Dr. Jhonnifer A. Abarao,
DHCM, MAN, USRN, RN, LPT, CHA,

“Not all angels have wings … some have scrubs.” —Unknown