NCM31116 Care of clients

1. A male client with a peptic ulcer is scheduled for vagotomy and the client asks the nurse about
the purpose of this procedure. Which response by the nurse best describes the purpose of
vagotomy?
 Reduces the stimulus to acid secretions (quizlet)

2. After undergoing a subtotal thyroidectomy a female develops hypothyroidism. Dr. Cantas

prescribes levothyroxine (levothroid) 25 mcg P O daily. For which condition is levothyroxine the
preferred agent?
 Primary hypothyroidism (coursehero)

3. Early this morning, a female client had a subtotal thyroidectomy. During evening rounds, nurse
Tina assesses the client, who now has nausea, a temperature of 105° F (40.5° C), tachycardia,
and extreme restlessness. What is the most likely cause of these signs?
 Thyroid crisis quizlet

4. For the first 72 hours after thyroidectomy surgery, nurse Jamie would assess the female client
for Chvostek’s sign and Trousseau’s sign because they indicate which of the following?
 hypocalcemia

5. A physician prescribes a Proton-Pump Inhibitor to a patient with a gastric ulcer. Which

medication is considered a PPI?*
 Pantoprazole

6. When instructing the female client diagnosed with hyperparathyroidism about diet, nurse Gina
should stress the importance of which of the following?
 Forcing fluids

7. The nurse is planning to care to a client with peptic ulcer disease. To avoid the worsening
condition of the client, the nurse should carefully plan the diet of the client. Which of the
following will be included in the diet regime of the client?
 Eliminating intake of alcohol and coffee

8. Match the best answer.

a. Pain occurs after 2 to 4 hours after eating.
o Duodenal ulcer

b. Sudden inflammation of the lining of the stomach.

o Acute gastritis
c. Feeling discomfort in the epigastrium with a conscious desire to vomit.
o Nausea
NCM31116 Care of clients

d. Universal recipient of blood.

o Type AB-positive

e. Inhibit action of dopamine increase Gastric mobility and emptying

o Metoclopramide
f. Pain occurs 1 to 2 hours after eating.
o Gastric ulcer
g. The forceful ejection of partially digested food and secretions (emesis) from upper GI
tract
o Vomiting
h. Helicobacter pylori
o Causative agent of PUD
i. An inflammation of the lining of the stomach that occurs gradually and persist for a
prolonged time.
o Chronic gastritis
j. Removing vagal innervation to the fundus of the stomach.
o vagotomy
k. Block dopamine receptors that trigger nausea and vomiting
o promethazine

l. Omeprazole (Omeprone)
o Proton pump inhibitor
m. Ranitidine (Zantac)
o H2 receptor blocker

n. Universal blood donor

o Type O -

o. Involves transecting nerves that stimulate the acid secretion and opening the pylorus.
o pyloplasty
9. Select all the medications a physician may order to treat a H. Pylon infection that is causing a
peptic ulcer?
 Proton-Pump Inhibitors
 Antibiotics
 H2 Blockers
 Bismuth Subsalicylates

10. When caring for a female client who is being treated for Hyperthyroidism, it is important to:
 Monitor the client for signs of restlessness, sweating and excessive weight loss during
thyroid replacement therapy
NCM31116 Care of clients

11. A patient with a peptic ulcer is suddenly vomiting dark coffee ground emesis. On assessment of
the abdomen you find bloating and an epigastric mass in the abdomen. Which complication may
this patient be experiencing?
 Upper gastrointestinal bleeding

12. Wilfredo with a recent history of rectal bleeding is being prepared for a colonoscopy. How
should the nurse Patricia position the client for this test initially?
 Lying on the left side with knees bent
13. Polyethylene glycol-electrolyte solution (GOL.YTELY) is prescribed for the female client
scheduled for a colonoscopy, the client begins to experience diarrhea following the
administration of the solution. What action of the nurse id appropriate?
 Explain that diarrhea is expected

14. A patient is taking Bethanechol “Urecholine” for treatment of GERD. This is known of what type
of drug?
 Prokenitic

15. A client is scheduled to have an Inguina herniorraphy in the outpatient surgical department. The
nurse is providing health teaching about postsurgical care to the client. Which of the following
statements if made by the client would reflect the need for more teaching?
 I will be able to drive soon after surgery
16. Hemorrhoids are painful, swollen veins in the lower portion of the rectum or anus.
 true
17. A client is diagnosed with peptic ulcer, the nurse caring for the clients expects he physician to
order which diet?
 Small feedings of bland food

18. An incoherent female client with a history of hypothyroidism is brought to the emergency
department by the rescue squad. Physical and laboratory findings reveal hypothermia,
hypoventilation, respiratory acidosis, bradycardia, hypotension, and non-pitting edema of the
face and pretibial area. Knowing that these findings suggest severe hypothyroidism, nurse Libby
prepares to take emergency action to prevent the potential complication of:
 myxedema coma

19. A patient arrives to the clinic for evaluation of epigastric pain. The patient describes the pain to
be relieved by food intake. In addition, the patient reports awakening in the middle of the night
with a gnawing pain in the stomach. Based on the patient’s description this appears to be what
type of peptic ulcer?
 Duodenal
NCM31116 Care of clients

20. Sarah complains of a nursing sensation, cramping pain in the top part of her abdomen that
becomes worse in the afternoon and sometimes awakes her at night. She reports that when she
eats, it helps the go away but that pain is now becoming intense. Which of the following is the
best condition for the nurse to draw:
 These symptoms are consistent with an ulcer
21. A female client arrives at the emergency department with chest and stomach pain and a report
of black tarry school for several months. Which of the following order should the nurse Oliver
anticipate?
 Electrocardiogram, complete blood count, testing for occult blood, comprehensive serum
metabolic panel

22. Nurse Eve is caring for a client who has a thyroidectomy 12 hours ago for treatment of Grave’s
disease. The nurse would be more concerned if which of the following was observed?
 The client spontaneously flexes his wrist when the blood pressure is obtained
23. Hemorrhoids is being prevented by drinking plenty of water, at least six glasses per day.
 False

24. Mixed hemorrhoids occur just inside the anus, at the beginning of the rectum.
 False

25. A female adult client with a history of chronic hyperparathyroidism admits to being
noncompliant. Based on initial assessment findings, nurse Julia formulates the nursing diagnosis
of Risk for injury. To complete the nursing diagnosis statement for this client, which “related-to”
phrase should the nurse add?
 Related to bone demineralization resulting in pathologic fractures

26. Post operative intervention following hemorrhoidectomy is to provide warm sitz bath to reduce
local pain
 False

27. A female client with hypothyroidism (myxedema) is receiving levothyroxine (Synthroid), 25 mcg
P.O. daily. Which finding should nurse Hans recognize as an adverse drug effect?
 Tachycardia

28. You are providing discharge teaching to a patient taking Sucralfate (Carafate). Which statement
by the patient demonstrates they understand how to take this medication?
 "I will always take this medication on an empty stomach."

29. Your patient, who is presenting with signs and symptoms of GERD, is scheduled to have a test
that assesses the function of the esophagus’ ability to squeeze food down into the stomach and
NCM31116 Care of clients

the closer of the lower esophageal sphincter. The patient asks you, “What is the name of the
test I’m having later today?” You tell the patient the name of the test is:
 Esophageal manometry

30. A patient is recovering from discomfort from a peptic ulcer. The doctor has ordered to advance
the patient's diet to solid foods. The patient's lunch tray arrives. What food should the patient
avoid eating?
 Oranges

31. You're collecting a patient's medication history that has GERD. Which medication below is NOT
typically used to treat GERD?
 Colesevelam "Welchol"

32. A 25-year-old male client has been newly diagnosed with hypothyroidism and will take
levothyroxine (synthroid) 50 mcg/ day by mouth. As part of the teaching plan, the nurse
emphasizes that this medication:
 Should be taken in the morning

33. A female client being seen in a physician's office has just been scheduled for a barium swallow
the next day. The nurse writes down which instruction for the client to follow before the test?
 Fast for 8 hours before the test

34. The pernicious anemia that may accompany gastritis is due to which of the following?
 a lack of intrinsic factor normally produced by acid-secreting cells of the gastric mucusa.

35. Matilda, with hyperthyroidism is to receive Lugol's iodine solution before a subtotal
thyroidectomy is performed. The nurse is aware that this medication is given to:
 Decrease size and vascularity of thyroid gland
36. The nurse is caring for a male client with a diagnosis of chronic gastritis. The nurse monitors the
client knowing that this client is at risk for which vitamin deficiency?
 Vitamin B12
37. A patient with chronic peptic ulcer disease underwent a gastric resection 1 month ago and is
reporting nausea, bloating, and diarrhea 30 minutes after eating. What condition is this patient
most likely experiencing?*
 Dumping Syndrome
38. Side lying position would be ideal for the client in the early postoperative period after
hemorrhoidectomy.
 True
39. The physician orders a patient with a duodenal ulcer to take a UREA breath test. Which lab value
will the test measure to determine if h. pylori is present?
 Carbon dioxide
NCM31116 Care of clients

40. Nurse Ryan is assessing for correct placement of a nasogastric tube. The nurse aspirates the
stomach contents and check the contents for pH. The nurse verifies correct tube placement if
which pH value is noted?
 3.5

41. The nurse is reviewing the medication of a female client with acute gastritis. Which medication,
if noted at the client’s record, would the nurse question?
 Indomethacin (Indocin)
42. In the stomach lining, the parental cells release ________ and the chief cells release ________
which both play a role in peptic ulcer disease.
 HYDROCHLORIC ACID and PEPSINOGEN

43. You’re educating a group of patients at an outpatient clinic about peptic ulcer formation. Which
statement is correct about how peptic ulcers form?
 "Peptic ulcers can form when acid penetrates unprotected stomach mucosa. This causes
histamine to be released which signals to the parietal cells to release more hydrochloric acid
which erodes the stomach lining further."

44. Nurse Oliver should expect a client with hypothyroidism to report which health concerns?
 Puffiness of the face and hands

45. Nurse is performing colonoscopy irrigation on a male client. During the irrigation, the client
begins to complain of abdominal cramps. What is the appropriate nursing action?
 Stop the irrigation temporarily

46. A patient has developed a duodenal ulcer. As the nurse, you know that which of the following
plays a role in peptic ulcer formation. Select all that apply:
 Helicobacter pylori
 NSAIDs
 Zollinger-Ellison Syndrome

47. The nurse is instructing the male client who has an inguinal hernia repair how to reduce
postoperative swelling following the procedure. What should the nurse tell the client?
 Elevate the scrotum

48. Nurse Wayne is aware that the positive Chvostek’s sign indicate?
 Hypocalcemia

49. Which of the following factors would most likely contribute to the development of a client hiatal
hernia?
 Being 5 feet, 3 inches tall and weighing 190 lb
NCM31116 Care of clients

50. Trousseau’s sign is associated with which electrolyte imbalance?

 Hypocalcemia

51. Nurse Ruth is assessing a client after a thyroidectomy. The assessment reveals muscle twitching
and tingling, along with numbness in the fingers, toes, and mouth area. The nurse should
suspect which complication?
 Tetany

52. The nurse is monitoring a female client with a diagnosis of peptic ulcer. Which assessment
finding would most likely indicate perforation of the ulcer?
 A rigid, board-like abdomen
53. A 67-year-old male client has been complaining of sleeping more, increased urination, anorexia,
weakness, irritability, depression, and bone pain that interferes with her going outdoors. Based
on these assessment findings, nurse Richard would suspect which of the following disorders?
Hyperparathyroidism
54. During preoperative teaching for a female client who will undergo subtotal thyroidectomy, the
nurse should include which statement?
you must avoid hyperextending your neck after surgery
55. A patient reports frequent heartburn twice a week for the past 4 months. What other symptoms
reported by the patient may indicate the patient has GERD? SELECT-ALL-THAT-APPLY:*
Bitter taste in mouth
Difficulty swallowing
56. The nurse is instructing the male client who has an inguinal hernia repair how to reduce
postoperative swelling following the procedure. What should the nurse tell the client?
Elevate the scrotum
57. During a home health visit, you are helping a patient develop a list of foods they should avoid
due to GERD. Which items in the patient's pantry should be avoided? SELECT-ALL-THAT-APPLY:
Tomato Soup
Hot and Spicy Pork Rinds
Peppermint Patties
Chocolate Fondue
58. Your patient is diagnosed with peptic ulcer disease due to h. pylori. This bacterium has a unique
shape which allows it to penetrate the stomach mucosa. You know this bacterium is.
Spiral shaped
59. After providing education to a patient with GERD. You ask the patient to list 4 things they can do
to prevent or alleviate signs and symptoms of GERD. Which statement is incorrect?
"I will try to lie down after eating a meal to help decrease pressure on the lower esophageal
sphincter."
60. Which nursing diagnosis takes highest priority for a female client with hyperthyroidism?
Imbalanced nutrition: Less than body requirements related to thyroid hormone excess
NCM31116 Care of clients

61. Which statement is incorrect about histamine-receptor blockers

"H2 blockers block histamine which causes the chief cells to decrease the secretion of
hydrochloric acid."
62. Which of the following does not play a role in the development of GERD?
All the above play a role in GERD
63. Which of the following nursing interventions would most likely promote self-care behaviors in
the client with a hiatal hernia?
Ask the client to identify other situations in which he demonstrated responsibility for himself.
64. After dinner time, during hourly rounding, a patient awakes to report they feel like “food is
coming up” in the back of their throat and that there is a bitter taste in their mouth. What
nursing intervention will you perform next?
Assist the patient into the Semi-Fowler's position
65. The nurse is caring for a patient with a diagnosis of chronic gastritis. The nurse monitors the
client knowing that this patient is at risk for which vitamin deficiency?
Vitamin B12
66. A nurse is inserting a nasogastric tube in an adult male client. During the procedure, the client
begins to cough and has difficulty breathing. Which of the following is the appropriate nursing
action?
Pull back on the tube and wait until the respiratory distress subsides.