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Upper Gastrointestinal Disorders and Cancer Practice Questions and Answers (Complete Guide to Success)

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What are the consequences of prolong nausea and vomiting? (Select all that apply) a. Hyperkalemia b. Fluid overload c. Hyponatremia d. Hypochloremia e. Circulatory collapse 2. Which of the follo... wing ABGs would be most commonly seen with prolonged vomiting? a. Low pH, normal pCO2, low HCO3 b. Elevated pH, low pCO2, normal HCO3 c. Low pH, elevated pCO2, normal HCO3 d. Elevated pH, normal pCO2, elevated HCO3 3. What combination of drugs may be used to treat nausea associated with chemotherapy? (Select all that apply) a. Lorazepam b. Dronabilol c. Cimetadine d. Odansetron e. Dexamethasone 4. Which of the following drugs is primarily used to treat patients with motion sickness? a. Aprepitant b. Dronabinol c. Scopolamine d. Promethazine 5. What is a common side effect of scopolamine patches? a. Oily skin b. Diarrhea c. Dry mouth d. Urinary frequency 6. For whom is scopolamine contraindicated? a. People with asthma b. People with glaucoma c. People with Crohn's disease d. People with hypercholesterolemia 7. Which patients should antihistamines such a meclizine be use cautiously or is contraindicated? (Select all that apply) a. Cancer b. Elderly (agitation, mental confusion, psychosis) c. Pediatric (paradoxical effect) d. Lactating (contraindicated) e. Menopausal Upper Gastrointestinal Disorders and Cancer Practice Questions 2 Bgw 04/07/2020 8. What instructions should the nurse give a patient who just received promethazine for nausea? a. Notify the nurse if itching or dyspnea occurs b. Report if they notice black tarry or bloody stools c. This drug can cause lower extremity paresthesia d. Use the call light for assistance getting out of bed 9. Which of the following orders should the nurse get clarification before administering? a. Hydroxyzine intravenous b. Promethazine suppository c. Prochlorperazine intramuscular d. Odansetron disintegrating tablets 10. Which of the following drugs can interact adventitiously with the neurokinin receptor antagonist, apprepitant? a. Insulins b. Antivirals c. Penicillins d. Anticoagulants 11. Which of the following assessment finding would indicate a severe side effect of long term use of metroclopramide in young adults? a. Chronic constipation and/or paralytic ileus b. Skin desquamation and secondary infections. c. Excessive upper body movement and lip smacking d. Elevated blood pressure and prolonged headaches 12. Which of the following antinausea drug can promote weight gain in patients with acquired immunodeficiency syndrome (AIDS) and patients with cancer? a. Dronabilol b. Odansetron c. Scopalamine d. Promethazine 13. Odansetron is prescribed to a patient who is to receive chemotherapy. When is the best time to administer this drug? a. At the end of the chemotherapy treatment b. At the start of the chemotherapy treatment c. When the patient reports nausea and requests treatment. d. 30-60 minutes prior to the start of the chemotherapy treatment 14. Prolonged administration or misuse of which antinausea drug can lead to psychiatric adverse reactions and addiction? a. Meclizine b. Dronabilol c. Odansetron d. Scopalamine Upper Gastrointestinal Disorders and Cancer Practice Questions 3 Bgw 04/07/2020 15. Which of the following types of emesis could indicated delayed gastric emptying? a. Coffee ground emesis one to two hours prior to a meal b. Forceful expulsion of stomach contents without nausea c. Recurring episodes of nausea & vomiting for several days d. Partially undigested food several hours after a eating a meal 16. A patient with prolonged vomiting, feces smelling emesis, and bile. The bowel sounds are absent. The patient had multiple episodes of small liquid stools but no solid bowel movements since admission 4 days ago. What is the best course of action for the nurse to take at this time? a. Speak to the healthcare provider to request an antiemetic b. Encourage the patient to eat foods high in fiber and low fat c. Collaborate with the physician to request a nasogastric tube d. Request a prescription for aluminum hydroxide from the HCP (Lilly page 803) 17. An unconscious patient begins to vomit. Which action should the nurse take first? a. Perform oral suctioning b. Administer an antiemetic c. Provide thorough oral care d. Turn the patient on their side 18. A patient who has been vomiting for three days is ready to start consuming fluids. Which fluid should the nurse offer first? a. Sports drink b. Hot coffee or tea c. Room temperature water d. Cold carbonated beverage 19. Which assessment finding could indicate a complication of rehydration treatment for vomiting in the elderly? a. Low grade fever b. Mental confusion c. Crackles in the lungs d. Elevated liver enzymes 20. Which of the following patients is at highest risk for gastrointestinal reflux disease (GERD)? a. A nonsmoking man with a BMI of 29 b. A man with a BMI of 55 who smokes c. A woman with a BMI of 20 who smokes d. A nonsmoking woman in early pregnancy 21. How can chest pain be distinguished between GERD and angina? a. The pain is relieved by rest b. The pain radiates to the jaw c. The pain is moderate in nature d. The pain is relieved by antacids Upper Gastrointestinal Disorders and Cancer Practice Questions 4 Bgw 04/07/2020 22. A patient with GERD complains of feeling like they have a lump in their throat. What do these symptoms describe? a. Dyspepsia b. Aspiration c. Regurgitation d. Globus sensation 23. What is the highest priority nursing diagnosis for patients who have chronic GERD? a. Impaired comfort b. Risk for aspiration c. Impaired sleep pattern d. Risk for impaired nutrition 24. Which of the following statement regarding Barrett’s esophagus (BE)? a. BE is unrelated to GERD symptoms b. It is definitive for esophageal cancer c. 80% of people with GERD develop BE d. It will be surveilled by diagnostic endoscopy 25. What dietary instructions should be given to a patient with GERD? (Select all that apply) a. Avoid consuming alcoholic beverages b. Eat three low carbohydrate meals a day c. Hot coffee will help the digestion of fats d. Avoid eating foods that are heavily spiced e. Stop eating 30 minutes before going to bed f. Do not lay supine for 2-3 hours after a meal 26. What are potential side effects of prolonged use of H2 receptor antagonists? a. Seizures activity and coma b. Menorrhagia and mastalgia c. Gynecomastia and impotence d. Venous thrombosis and ulcers 27. Which of the following drugs should not be given to patients who take anticonvulsants for a seizure disorder? a. Cimetidine b. Famotidine c. Misoprostol d. Simethicone 28. What complication can occur with prolonged use of proton pump inhibitors PPI) such as omeprazole? a. Alzheimer’s b. Fractured hip c. Paralytic ileus d. Hypermagnesemia Upper Gastrointestinal Disorders and Cancer Practice Questions 5 Bgw 04/07/2020 29. Which instruction is appropriate for a patient taking a PPI? a. Take at bedtime b. Take after a full meal c. Take with a glass of milk d. Take on and empty stomach 30. The nurse is caring for a hospitalized elderly patient who has taken esomeprazole for years. Which clinical manifestation would be of most concern in this patient regarding this drug? a. Diarrhea b. Joint pain c. Headache d. Confusion 31. Which of the following drugs is thought of as a “liquid bandage” to the gastric mucosal lining? a. Sucralfate b. Ranitidine c. Simethicone d. Pantoprazole 32. When is misoprostol absolutely contraindicated? a. Pregnancy b. Heart failure c. Renal failure d. Seizure disorders 33. Which of the following statements is true regarding the drug Simethicone? a. It has no listed adverse effects b. It should not be taken by diabetics c. It can cause worsening heart failure d. It can prolong the effects of anticoagulants 34. What should be included in the discharge instruction of a patient who underwent a LINX Reflux Management System? a. Eat full liquid fluids for the next twelve weeks b. Hematemesis is to be expected for three days c. Call the HCP immediately if swallowing is painful d. Do not have magnetic resonance imaging (MRI) 35. What instructions can the nurse give a patient to decrease reflux symptoms while they await a laparoscopic Nissan fundoplication for a hiatal hernia? a. Prop their feet on a pillow at night b. Raise the head of their bed on blocks c. Eat a light meal before going the bed d. Refrain from smoking 1 hour before bed Upper Gastrointestinal Disorders and Cancer Practice Questions 6 Bgw 04/07/2020 36. Match the following symptoms with the type of peptic ulcer. A. Pain relief with food. B. Most often in women C. Pain 2-5 hours after meals D. No increased risk of cancer E. Peak age 50-60 years of age F. Food aggravates the symptoms G. Burning, gaseous, epigastric pain H. Pain one to two hours after meals I. Peak age in third and fourth decades J. Occurs more often in men than women K. Associated with an increased cancer risk L. Cramping pain midepigastrium and upper abdomen Gastric Ulcer Duodenal ulcer B E F G H K A C D I J L 37. A patient with a PUD caused by the helicobacter pylori (H-pylori) bacteria asked the nurse who they may have “caught” if from. What is the best response by the nurse? a. “It is part of the normal bowel flora.” b. “You probably got it from your spouse” c. “You probably consumed some tainted food.” d. “Most people get exposed to it in childhood.” 38. Which of the following physiological changes does NOT describe how NSAIDS contribute to PUD? a. Increase gastric acid secretion b. Inhibits prostaglandin synthesis c. Causes genetic changes in mucosal cells d. Reduce the integrity of the mucosal barrier 39. Which of the following lifestyle factors contribute to the development of PUD? (Select all that apply) a. Stress b. Alcohol c. Smoking d. Depression e. Decaffeinated coffee f. Physical deconditioning 40. A 78 year old person takes naproxen sodium (NSAID) routinely for treatment of arthritic pain. What type of peptic ulcer is this person at highest risk? e. Silent f. Stress g. Gastric h. Duodenal Upper Gastrointestinal Disorders and Cancer Practice Questions 7 Bgw 04/07/2020 41. How long does it take for a peptic ulcer to completely heal with successful treatment? i. Six to ten days j. One to two months k. Approximately one year l. The ulcer never completely heals 42. A patient with a history of myocardial infarction and recent treatment for a bleeding PUD who needs to resume low dose aspirin therapy asks the nurse if enteric coated aspirin will prevent the recurrence of the ulcer. How should the nurse respond to this question? m. A better solution would be a full strength aspirin with a proton pump inhibitor. n. Low dose aspirin is absolutely contraindicated in patients with a history of PUD. o. Enteric coated aspirin may decreased localized irritation but not gastric bleeding. p. Enteric coated aspirin is a good solution to prevent PUD recurrence who had an MI 43. Which drugs are included in the treatment of H-pylori caused PUD? (Select all that apply) a. Sucralfate b. Bismuth c. Amoxicillin d. Famotidine e. Omeprazole f. Simethicone g. Metronidazole 44. A patient is prescribed omeprazole and sucralfate. How should these drugs be administered? a. Give both of the medications at the same drug pass. b. Give the sucralfate at least 1 hour before the omeprazole. c. Give the omeprazole at least 1 hour before the sucralfate. d. Give the sucralfate in the am and the omeprazole in the pm 45. A patient with PUD suddenly complains of severe upper abdominal pain that radiates to the back and shoulder. The nurse suspects perforation of the ulcer. Which of the following assessment findings would support this supposition? (Select all that apply) a. Projectile vomiting b. Abdominal guarding c. No relief with antacids d. Rapid shallow breathing e. Weak tachycardic pulses f. Rigid, board-like abdomen g. Hyperactive bowel sounds 46. A patient is showing acute symptoms of ulcer gastric perforation. What intervention should the nurse perform first? a. Give PRN intravenous opioid analgesia b. Administer prescribed IV PPI medication c. Call the health care provider immediately d. Stop all tube feedings and/or medications Upper Gastrointestinal Disorders and Cancer Practice Questions 8 Bgw 04/07/2020 47. A patient with chronic PUD complains of pain that worsens at the end of the day. The nurse suspect gastric outlet obstruction. Which of the following assessment findings would support this supposition? a. Belching b. Diarrhea c. Projectile vomiting d. Weak thready pulse e. Abdominal distention f. Rapid labored respirations 48. The NG tube of a patient with gastric outlet obstruction has been clamped over night for 12 hours. The morning gastric residual volume is 175ml. What changes to the plan of care should the nurse anticipate at this time? a. The patient will be able to start eating a regular diet. b. The suction on the nasogastric tube will be increased. c. The patient will be allowed to start drinking clear liquids. d. The patient will need to have surgery to correct the problem. 49. How do NSAIDS and corticosteroids cause gastroenteritis? a. Reduced prostaglandins (provides the protection for the gastric mucosa) b. Buffering of gastric acids c. Increased hydrochloric acid d. Chemical caustic corrosion 50. What is the consequence of autoimmune gastritis? a. Esophagitis b. Colon cancer c. Type 2 diabetes d. Pernicious anemia 51. What metabolic issue does a person who is an alcoholic and has chronic gastritis often have? a. Hypoparathyroidism b. Cobalamin deficiency c. Inadequate fat absorption d. Decreased corticosteroid levels 52. A patient who is awaiting biopsy results for possible breast cancer says to the nurse “I am scared that I am going to die before I get to see my children grow up” What is the best response by the nurse? a. “Why don’t we wait to discuss that when the results are back” b. “I understand, how can I help you while you await the results?” c. “Treatment for breast cancer usually results in a complete cure” d. “Don’t worry about that, most of these types of lumps are benign” Upper Gastrointestinal Disorders and Cancer Practice Questions 9 Bgw 04/07/2020 53. Which of these following types of biopsies is considered therapeutic as well as diagnostic? a. Excisional b. Large-core c. Fine-needle d. Percutaneous 54. Which of the following statements by an individual should the nurse recommend they see their primary care provider to evaluate for possible cancer symptoms? a. “I has a cold 3 weeks ago and I am still coughing.” b. “I always get diarrhea after I eat high fat, spicy foods.” c. “I have gone through menopause but I am having a period.” d. “My breast always get tender and lumpy before I start my period.” 55. An operating room nurse reports the results of the frozen biopsy to a surgeon while the patient is still on the operating table. Why did they not wait for the results after the surgery? a. The patient wanted to be given the information in the PACU. b. The result will determine that the patient is cured of the cancer. c. The surgeon prefers to give the results to the family after the surgery. d. The results determine it the excisional margins are negative or positive. 56. What are the warning signs of cancer? C: change in bowel or bladder habits A: A sore that does not heal U: Unusual bleeding or discharge from any body orifice T: Thickening or a lump in the breast or elsewhere I: Indigestion or difficulty swallowing O: Obvious change in wart or mole N: Nagging cough or horseness [Show More]

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