Chapter 47 Brunner & Suddarth’s Textbook of Medical-Surgical Nursing 13Th Edition

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Chapter 47  Brunner & Suddarth’s Textbook of Medical-Surgical Nursing 13Th Edition

 

 

Complete Chapter Questions And Answers
 

Sample Questions

 

1. A nurse is caring for a patient who just has been diagnosed with a peptic ulcer. When teaching the patient about his new diagnosis, how should the nurse best describe a peptic ulcer?

  1. A)  Inflammation of the lining of the stomach
  2. B)  Erosion of the lining of the stomach or intestine
  3. C)  Bleeding from the mucosa in the stomach
  4. D)  Viral invasion of the stomach wall

Ans: B

Feedback:

A peptic ulcer is erosion of the lining of the stomach or intestine. Peptic ulcers are often accompanied by bleeding and inflammation, but these are not the definitive characteristics.

2. A patient comes to the clinic complaining of pain in the epigastric region. What assessment question during the health interview would most help the nurse determine if the patient has a peptic ulcer?

  1. A)  “Does your pain resolve when you have something to eat?”
  2. B)  “Do over-the-counter pain medications help your pain?”
  3. C)  “Does your pain get worse if you get up and do some exercise?”
  4. D)  “Do you find that your pain is worse when you need to have a bowel movement?”

Ans: A

Feedback:

Pain relief after eating is associated with duodenal ulcers. The pain of peptic ulcers is generally unrelated to activity or bowel function and may or may not respond to analgesics.

3. A patient with a diagnosis of peptic ulcer disease has just been prescribed omeprazole (Prilosec). How should the nurse best describe this medication’s therapeutic action?

  1. A)  “This medication will reduce the amount of acid secreted in your stomach.”
  2. B)  “This medication will make the lining of your stomach more resistant to damage.”
  3. C)  “This medication will specifically address the pain that accompanies peptic ulcer

    disease.”

  4. D)  “This medication will help your stomach lining to repair itself.”

Ans: A

Feedback:

Proton pump inhibitors like Prilosec inhibit the synthesis of stomach acid. PPIs do not increase the durability of the stomach lining, relieve pain, or stimulate tissue repair.

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4. A nurse is admitting a patient diagnosed with late-stage gastric cancer. The patient’s family is distraught and angry that she was not diagnosed earlier in the course of her disease. What factor contributes to the fact that gastric cancer is often detected at a later stage?

  1. A)  Gastric cancer does not cause signs or symptoms until metastasis has occurred.
  2. B)  Adherence to screening recommendations for gastric cancer is exceptionally low.
  3. C)  Early symptoms of gastric cancer are usually attributed to constipation.
  4. D)  The early symptoms of gastric cancer are usually not alarming or highly unusual.

Ans: D

Feedback:

Symptoms of early gastric cancer, such as pain relieved by antacids, resemble those of benign ulcers and are seldom definitive. Symptoms are rarely a cause for alarm or for detailed diagnostic testing. Symptoms precede metastasis, however, and do not include constipation.

5. A nurse is preparing to discharge a patient after recovery from gastric surgery. What is an appropriate discharge outcome for this patient?

  1. A)  The patient’s bowel movements maintain a loose consistency.
  2. B)  The patient is able to tolerate three large meals a day.
  3. C)  The patient maintains or gains weight.
  4. D)  The patient consumes a diet high in calcium.

Ans: C

Feedback:

Expected outcomes for the patient following gastric surgery include ensuring that the patient is maintaining or gaining weight (patient should be weighed daily), experiencing no excessive diarrhea, and tolerating six small meals a day. Patients may require vitamin B12 supplementation by the intramuscular route and do not require a diet excessively rich in calcium.

6. A nurse caring for a patient who has had bariatric surgery is developing a teaching plan in anticipation of the patient’s discharge. Which of the following is essential to include?

  1. A)  Drink a minimum of 12 ounces of fluid with each meal.
  2. B)  Eat several small meals daily spaced at equal intervals.
  3. C)  Choose foods that are high in simple carbohydrates.
  4. D)  Sit upright when eating and for 30 minutes afterward.

Ans: B

Feedback:

Due to decreased stomach capacity, the patient must consume small meals at intervals to meet nutritional requirements while avoiding a feeling of fullness and complications such as dumping syndrome. The patient should not consume fluids with meals and low-Fowler’s positioning is recommended during and after meals. Carbohydrates should be limited.

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