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 Which 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

3 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

4 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

5 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

6 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 nonAfected

7 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?

1. Aspirin

2. Acetaminophen

3. Naproxen

4. Ibuprofen

8 The nurse is planning the care of a client diagnosed with lower esophageal sphincter dysfunction.
Which dietary modifications should be included in the plan of care?

A Allow any of the client's favorite foods as long as the amount is limited.

B. Have the client perform eructation exercises several times a day.

C Eat four (4) to six (6) small meals a day and limit fluids during mealtimes.

D. Encourage the client to consume a glass of red wine with one (1) meal a day

9 The nurse teaches the client about an anti-ulcer diet. Which of the following statements by the client
indicates to the nurse that dietary teaching was successful?

A. "I must eat bland foods to help my stomach heal."

B "I can eat most foods, as long as they don't bother my stomach."

C. "I cannot eat fruits and vegetables because they cause too much gas."

D. "I should eat a low-fiber diet to delay gastric emptying -

10 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

11 A patient with a history of peptic ulcer disease has presented to the emergency department with
complaints of severe abdominal pain and a rigid, boardlike abdomen, prompting the health care team to
suspect a perforated ulcer. Which of the following actions should the nurse anticipate?

A. Providing IV fluids and inserting a nasogastric tube

B. Administering oral bicarbonate and testing the patient's gastric pH level.

C. Performing a fecal occult blood test and administering IV calcium gluconate.

D. Starting parenteral nutrition and placing the patient in high-Fowler's position

12 The teaching plan for the patient being discharged following an acute episode of upper GI bleeding
will concern information concerning the importance of (select all that apply)

a. only taking aspirin with milk or bread products

b. avoiding taking aspirin and drugs containing aspirin

c. taking only drugs prescribed by the health care provider

d. taking all drugs 1 hour before mealtime to prevent further bleeding e. reading all OTC drug labels to
avoid those containing stearic acid and calcium

13 A patient has a vagotomy with antrectomy to treat a duodenal ulcer. Postoperatively, the patient
develops dumping syndrome. Which of the following statements, if made by the patient, should indicate
to the nurse that further dietary teaching is needeD

A I should eat bread with each meal

BI should eat smaller meals more frequently.

C. I should lie down after eating.

D I should avoid drinking fluids with my meals

14 The results of a patient's recent endoscopy indicate the presence of peptic ulcer disease (PUD).
Which of the following teaching points should the nurse provide to the patient in light of his new
diagnosis?

A) "You'll need to drink at least two to three glasses of milk daily."

B) "It would likely be beneficial for you to eliminate drinking alcohol."

C) "Many people find that a minced or pureed diet eases their symptoms of PUD."

D) "Your medications should allow you to maintain your present diet while minimizing symptoms

15 The client with hiatal hernia chronically experiences heartburn following meals. The nurses plans to
teach the client to avoid which action because it is contraindicated with a hiatal hernia?

A Lying recumbent following meals

B Taking in small, frequent, bland meals

C Raising the head of bed on 6-inch blocks

D Taking H2-receptor antagonist medication

16 "A patient with a history of peptic ulcer disease has presented to the emergency department with
complaints of severe abdominal pain and a rigid, boardlike abdomen, prompting the health care team to
suspect a perforated ulcer. Which of the following actions should the nurse anticipate?

A. Providing IV fluids and inserting a nasogastric tube

B. Administering oral bicarbonate and testing the patient's gastric pH level

C. Performing a fecal occult blood test and administering IV calcium gluconate

D. Starting parenteral nutrition and placing the patient in a high-Fowler's position

17 The nurse determines that a patient has experienced the beneficial effects

of medication therapy with famotidine (Pepcid) when which of the following

symptoms is relieved? "

A) Nausea

B) Belching

C) Epigastric pain

D) Difficulty swallowing
18 The nurse is reviewing the medication record of a female client with acute gastritis. Which
medication, if noted on the client's record, would the nurse question? "

a. Digoxin (Lanoxin)

b. Furosemide (Lasix)

c. Indomethacin (Indocin)

d. Propranolol hydrochloride (Inderal)

19 The pt with chronic gastritis is being put on a combination of medications to eradicate H. Pylori.
Which drugs dose the nurse know will probably be used for this pt?

A Antibiotic, antacid, and corticosteroid

B Antibiotic, aspirin, and antiulcer/protectant

C Antibiotic, proton pump inhibitor, and bismuth

D Antibiotic, and NSAIDs

20 The male client tells the nurse he has been experiencing "heartburn" at night that awakens him.
Which assessment question should the nurse ask?

A -"how much weight have you gained recently?"

B -"what have you done to alleviate the heartburn"

C -"Do you consume many milk and dairy products"

D -"Have you been around anyone with a stomach virus"

21 The nurse is performing an admission assessment on a client diagnosed with GERD. Which sign and
symptoms would indicate GERD?

A -Pyrosis, water brash, and flatulence

B -Weight loss, dysarthria, and diarrhea

C -Decreased abdominal fat, proteinuria, and constipation

D -Midepigastric pain, positive H pylori test, and melena

22 Which statement made by the client indicates to the nurse the client may be experiencing GERD?

A "My chest hurts when I walk up the stairs in my home."

B "I take antacid tablets with me wherever I go."

C My spouse tells me I snore very loudly at night."

D I drink six (6) to seven (7) soft drinks every day

23 As the patient prepares for discharge, the nurse provides education about behaviors that reduce
symptoms and aggravate peptic ulcers. Which teaching does the nurse provide? (Select all that apply.)

a. Sit upright 30 to 60 minutes after meals.

b. Spices should be added to food to enhance flavor.

c. A vagotomy will be needed in the future

d. Extreme vomiting should be reported to your physician.

e. H. pylori can be a concern in patients with peptic ulcers.

f. The goal of initial intervention is to control symptoms and prevent further complications.

.
24 The nurse is teaching a client how to prevent recurrent chronic gastritis symptoms before discharge.
Which statement by the client demonstrates a correct understanding of the nurse's instruction?

A. "It is okay to continue to drink coffee in the morning when I get to work."

B. "I will need to take vitamin B12 shots for the rest of my life."

C. "Ibuprophen should be taken"

D. "I should eat small meals about six times a day."

D. "I should eat small meals about six times a day."

25 The client is experiencing bleeding related to peptic ulcer disease (PUD). Which nursing intervention
is the highest priority?

A. Administering intravenous (IV) pain medication

B. Starting a large-bore intravenous (IV)

C. Monitoring the client's anxiety level

D. Preparing equipment for intubation

26 The client attends two sessions with the dietitian to learn about diet modifications to minimize
gastroesophageal reflux. The teaching would be considered successful if the client says that she will
decrease her intake of which of the following foods?

A Fats.

B. High-sodium foods.

C. Carbohydrates.

D. High-calcium foods.
27 The nurse instructs the client on health maintenance activities to help control symptoms from her
hiatal hernia. Which of the following statements would indicate that the client has understood the
instructions?

A "I'll avoid lying down after a meal."

B "I can still enjoy my potato chips and cola at bedtime."

C "I wish I didn't have to give up swimming."

D. "If I wear a girdle, I'll have more support for my stomach

28 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.

29 Which of the following dietary measures would be useful in preventing esophageal reflux?

1. Eating small, frequent meals.

2. Increasing fluid intake.

3. Avoiding air swallowing with meals.

4. Adding a bedtime snack to the dietary plan