Brunner and Suddarth's Textbook of Medical-surgical Nursing- Chapter 40 Questions
with Answers
Multiple Choice
Chapter 40: Management of Patients with Gastric and Duodenal Disorders
1. A nurse is caring for a client who just has been diagnosed with a peptic ulcer. When teaching the client
about his new diagnosis, how should the nurse best describe it?
A. Inflammation of the lining of the stomach
B. Erosion of the lining of the stomach or intestine
C. Bleeding from the mucosa in the stomach
D. Viral invasion of the stomach wall - correct answersB
Rationale: 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.
PTS: 1 REF: p. 1270
NAT: Client Needs: Physiological Integrity: Physiological Adaptation
TOP: Chapter 40: Management of Clients With Gastric and Duodenal Disorders
KEY: Integrated Process: Teaching/Learning BLM: Cognitive Level: Apply
Multiple Choice
2. A nurse is admitting a client diagnosed with late-stage gastric cancer. The client's family is distraught
and angry that the client was not diagnosed earlier in the course of her disease. What factor most likely
contributed to the client's late diagnosis?
A. Gastric cancer does not cause signs or symptoms until metastasis has occurred.
B. Adherence to screening recommendations for gastric cancer is exceptionally low.
C. Early symptoms of gastric cancer are usually attributed to constipation.
D. The early symptoms of gastric cancer are usually not alarming or highly unusual. - correct answersD
,Rationale: 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.
PTS: 1 REF: p. 1278
NAT: Client Needs: Physiological Integrity: Physiological Adaptation
TOP: Chapter 40: Management of Clients With Gastric and Duodenal Disorders
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Analyze
Multiple Choice
3. A nurse is preparing to discharge a client after recovery from gastric surgery. What is an appropriate
discharge outcome for this client?
A. Bowel movements maintain a loose consistency.
B. Three large meals per day are tolerated.
C. Weight is maintained or gained.
D. High calcium diet is consumed. - correct answersC
Rationale: Weight loss is common in the postoperative period, with early satiety, dysphagia, reflux and
regurgitation, and elimination issues contributing to this problem. The client should weigh oneself daily,
with a goal of maintaining or gaining weight. The client should not have bowel movements that maintain
a loose consistency, because this would indicate diarrhea and would warrant intervention as it is a
symptom of dumping syndrome. The client should be able to tolerate six small meals per day, rather
than three large meals. The client does not require a diet excessively rich in calcium but should consume
a diet high in calories, iron, vitamin A and vitamin C.
PTS: 1 REF: p. 1277
NAT: Client Needs: Physiological Integrity: Reduction of Risk Potential
TOP: Chapter 40: Management of Clients With Gastric and Duodenal Disorders
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply
Multiple Choice
, 4. A nurse is completing a health history on a client whose diagnosis is chronic gastritis. Which of the
data should the nurse consider most significantly related to the etiology of the client's health problem?
A. Consumes one or more protein drinks daily.
B. Takes over-the-counter antacids frequently throughout the day.
C. Smokes one pack of cigarettes daily.
D. Reports a history of social drinking on a weekly basis. - correct answersC
Rationale: Nicotine reduces secretion of pancreatic bicarbonate, which inhibits neutralization of gastric
acid and can underlie gastritis. Protein drinks do not result in gastric inflammation. Antacid use is a
response to experiencing symptoms of gastritis, not the etiology of gastritis. Alcohol ingestion can lead
to gastritis; however, this generally occurs in clients with a history of consumption of alcohol on a daily
basis.
PTS: 1 REF: p. 1273
NAT: Client Needs: Physiological Integrity: Reduction of Risk Potential
TOP: Chapter 40: Management of Clients With Gastric and Duodenal Disorders
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Analyze
Multiple Choice
5. A community health nurse is preparing for an initial home visit to a client discharged following a total
gastrectomy for treatment of gastric cancer. What would the nurse anticipate that the plan of care is
most likely to include?
A. Enteral feeding via gastrostomy tube (G tube)
B. Gastrointestinal decompression by nasogastric tube
C. Periodic assessment for esophageal distension
D. Administration of injections of vitamin B12 - correct answersD
Rationale: Since vitamin B12 is absorbed in the stomach, the client requires vitamin B12 replacement to
prevent pernicious anemia. A gastrectomy precludes the use of a G tube. Since the stomach is absent, a
nasogastric tube would not be indicated. As well, this is not possible in the home setting. Since there is
no stomach to act as a reservoir and fluids and nutrients are passing directly into the jejunum, distension
is unlikely.
with Answers
Multiple Choice
Chapter 40: Management of Patients with Gastric and Duodenal Disorders
1. A nurse is caring for a client who just has been diagnosed with a peptic ulcer. When teaching the client
about his new diagnosis, how should the nurse best describe it?
A. Inflammation of the lining of the stomach
B. Erosion of the lining of the stomach or intestine
C. Bleeding from the mucosa in the stomach
D. Viral invasion of the stomach wall - correct answersB
Rationale: 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.
PTS: 1 REF: p. 1270
NAT: Client Needs: Physiological Integrity: Physiological Adaptation
TOP: Chapter 40: Management of Clients With Gastric and Duodenal Disorders
KEY: Integrated Process: Teaching/Learning BLM: Cognitive Level: Apply
Multiple Choice
2. A nurse is admitting a client diagnosed with late-stage gastric cancer. The client's family is distraught
and angry that the client was not diagnosed earlier in the course of her disease. What factor most likely
contributed to the client's late diagnosis?
A. Gastric cancer does not cause signs or symptoms until metastasis has occurred.
B. Adherence to screening recommendations for gastric cancer is exceptionally low.
C. Early symptoms of gastric cancer are usually attributed to constipation.
D. The early symptoms of gastric cancer are usually not alarming or highly unusual. - correct answersD
,Rationale: 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.
PTS: 1 REF: p. 1278
NAT: Client Needs: Physiological Integrity: Physiological Adaptation
TOP: Chapter 40: Management of Clients With Gastric and Duodenal Disorders
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Analyze
Multiple Choice
3. A nurse is preparing to discharge a client after recovery from gastric surgery. What is an appropriate
discharge outcome for this client?
A. Bowel movements maintain a loose consistency.
B. Three large meals per day are tolerated.
C. Weight is maintained or gained.
D. High calcium diet is consumed. - correct answersC
Rationale: Weight loss is common in the postoperative period, with early satiety, dysphagia, reflux and
regurgitation, and elimination issues contributing to this problem. The client should weigh oneself daily,
with a goal of maintaining or gaining weight. The client should not have bowel movements that maintain
a loose consistency, because this would indicate diarrhea and would warrant intervention as it is a
symptom of dumping syndrome. The client should be able to tolerate six small meals per day, rather
than three large meals. The client does not require a diet excessively rich in calcium but should consume
a diet high in calories, iron, vitamin A and vitamin C.
PTS: 1 REF: p. 1277
NAT: Client Needs: Physiological Integrity: Reduction of Risk Potential
TOP: Chapter 40: Management of Clients With Gastric and Duodenal Disorders
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply
Multiple Choice
, 4. A nurse is completing a health history on a client whose diagnosis is chronic gastritis. Which of the
data should the nurse consider most significantly related to the etiology of the client's health problem?
A. Consumes one or more protein drinks daily.
B. Takes over-the-counter antacids frequently throughout the day.
C. Smokes one pack of cigarettes daily.
D. Reports a history of social drinking on a weekly basis. - correct answersC
Rationale: Nicotine reduces secretion of pancreatic bicarbonate, which inhibits neutralization of gastric
acid and can underlie gastritis. Protein drinks do not result in gastric inflammation. Antacid use is a
response to experiencing symptoms of gastritis, not the etiology of gastritis. Alcohol ingestion can lead
to gastritis; however, this generally occurs in clients with a history of consumption of alcohol on a daily
basis.
PTS: 1 REF: p. 1273
NAT: Client Needs: Physiological Integrity: Reduction of Risk Potential
TOP: Chapter 40: Management of Clients With Gastric and Duodenal Disorders
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Analyze
Multiple Choice
5. A community health nurse is preparing for an initial home visit to a client discharged following a total
gastrectomy for treatment of gastric cancer. What would the nurse anticipate that the plan of care is
most likely to include?
A. Enteral feeding via gastrostomy tube (G tube)
B. Gastrointestinal decompression by nasogastric tube
C. Periodic assessment for esophageal distension
D. Administration of injections of vitamin B12 - correct answersD
Rationale: Since vitamin B12 is absorbed in the stomach, the client requires vitamin B12 replacement to
prevent pernicious anemia. A gastrectomy precludes the use of a G tube. Since the stomach is absent, a
nasogastric tube would not be indicated. As well, this is not possible in the home setting. Since there is
no stomach to act as a reservoir and fluids and nutrients are passing directly into the jejunum, distension
is unlikely.
