SOLVED

Chapter 21 Question 1 Which assessment finding would the nurse evaluate as most likely occurring due to a lower gastrointestinal bleed? 1. Hematochezia 2. Hematemesis 3. Dark brown guaiac positive stools 4. Melena Question 2 A patient admitted with fatigue, dyspnea, and a hemoglobin level of 8.6 mg/dL tells the nurse that he occasionally has dark, smelly stools but they “go away” in a few days. The nurse would conduct additional assessment for which most common cause of this history? 1. Inability to absorb protein 2. Lower gastrointestinal bleed 3. Chronic gastrointestinal bleed 4. Upper gastrointestinal bleed Question 3 A patient diagnosed with gastric ulcer is prescribed sucralfate (Carafate). Which patient teaching should the nurse provide? 1. “Watch for systemic effects such as hypotension.” 2. “Plan to take this medicine for the rest of your life.” 3. “Increase your water intake to 8 to 10 glasses per day.” 4. “Do not take this medication within 30 minutes of other drugs.” 5. “Rest quietly in an upright position for at least 30 minutes after taking this medication.” Question 4 A patient admitted with possible ulcer disease tells the nurse that he has frequent nausea and vomiting and “just can’t eat.” The nurse would suspect this patient’s ulcer to be in which area? 1. Colon 2. Gastric 3. Duodenal 4. Esophageal Question 5 A patient is hospitalized with recurrent gastric ulcers. Which education should the nurse provide? 1. “You may need to consider treating your chronic headaches with some therapy besides NSAIDs.” 2. “You should try to avoid eating spicy foods.” 3. “It is time for you to seriously consider smoking cessation.” 4. “You should contact a personal trainer to get your body in shape.” 5. “Take the prescribed antibiotic until you are pain free.” Question 6 A patient with a history of atrial fibrillation is experiencing a massive gastrointestinal bleed. The patient is prescribed vasopressin. The nurse would be most concerned about the development of which adverse effect? 1. Abdominal cramping 2. Nausea 3. Vertigo 4. Increase blood pressure Question 7 A patient taking NSAIDs for osteoarthritis is admitted with acute erosive gastritis caused by alcohol ingestion. Which nursing instruction is indicated? 1. “Limit your alcohol intake to one glass of wine with dinner.” 2. “Avoid alcohol use while you are taking NSAIDs.” 3. “It is important that we find a different method of controlling pain from your arthritis.” 4. “In some people, having a couple of drinks can reduce arthritis pain enough that NSAIDs are not necessary.” Question 8 A patient with a massive gastrointestinal bleed is diagnosed with a Mallory-Weiss tear. The nurse would anticipate which patient history? 1. Chronic alcohol ingestion 2. Ingestion of spicy foods 3. Aspirin use 4. 20 pack-year smoking history Question 9 A patient experiencing massive amounts of bloody diarrhea from the rectum is diagnosed with inflammation of the mucosa and submucosa after a colonoscopy and biopsy. The nurse prepares to provide care for a patient with which condition? 1. Ulcerative colitis 2. Crohn’s disease 3. Arteriovenous malformation 4. Polyps Question 10 A patient is recovering from a colonoscopy with removal of polyps. Which teaching should the nurse provide? 1. “Rectal bleeding can occur up to a year after the polyps are removed.” 2. “Rectal bleeding can occur up to 1 month after polyp removal.” 3. “Contact the surgeon if any rectal bleeding occurs.” 4. “Polyp removal weakens the intestinal wall, so bleeding may occur off and on indefinitely.”